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Prenatal Radiation Exposure: Background Material for Counseling Pregnant Patients Following Exposure to Radiation

Published online by Cambridge University Press:  08 April 2013

Elizabeth H. Donnelly ,
James M. Smith ,
Eduardo B. Farfán  and
Ibrahim Ozcan
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Abstract

Fetal sensitivity to radiation-induced health effects is related to gestational age, and it is highly dependent on fetal dose. Typical fetal doses from diagnostic radiology are usually below any level of concern. Although rare, significant fetal radiation doses can result from interventional medical exposures (fluoroscopically guided techniques), radiation therapy, or radiological or nuclear incidents, including terrorism. The potential health effects from these large radiation doses (possibly large enough to result in acute radiation syndrome in the expectant mother) include growth retardation, malformations, impaired brain function, and neoplasia. If exposure occurs during blastogenesis (and the embryo survives), there is a low risk for congenital abnormalities. (In all stages of gestation, radiation-induced noncancer health effects have not been reported for fetal doses below about 0.05 Gy [5 rad].) The additional risk for childhood cancer from prenatal radiation exposure is about 12% per Gy (0.12%/rad) above the background incidence.

(Disaster Med Public Health Preparedness. 2011;5:62-68)

Keywords

radiation effectsfetusfetal developmentprenatal exposure delayed effectsgestational agecongenital abnormalitiesneoplasmscarcinogenicitypregnancyradionuclidesradiotherapypatient safetyprenatal radiation exposureradiation health effectsradiological emergenciesfetal radiation dosetutorial
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 5 , Issue 1 , March 2011 , pp. 62 - 68
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2011

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References

REFERENCES

1.Castronovo, FP JrTeratogen update: radiation and Chernobyl. Teratology. 1999;60 (2):100–106.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
2.National Council on Radiation Protection and Measurements. Ionizing Radiation Exposure of the Population of the United States. NCRP Report No. 93. Bethesda, MD: NCRP; 1988.Google Scholar
3.International Commission on Radiological Protection. Annals of the ICRP, Publication 84: Pregnancy and Medical Radiation. Tarrytown, NY: Pergamon, Elsevier Science; 2000.Google Scholar
4.US Nuclear Regulatory Commission. Standards For Protection Against Radiation 10 CFR Part 20.1201-1208. http://www.nrc.gov/reading-rm/doc-collections/cfr/part020/full-text.html. Accessed October 26, 2006.Google Scholar
5.International Commission on Radiological Protection. Annals of the ICRP, Publication 85: Avoidance of Radiation Injury from Medical Interventional Procedures. Tarrytown, NY: Pergamon, Elsevier Science; 2001.Google Scholar
6.Donnelly, EH, Farfan, EB, Parker, DD.Potential nuclear and radiological incidents: a summary for clinicians. Health Phys. 2007;93 2(Suppl)S134–S138.CrossRefGoogle ScholarPubMed
7.Mettler, FA, Upton, AC.Medical Effects of Ionizing Radiation. 3rd ed. Philadelphia: Saunders Elsevier; 2008.Google Scholar
8.National Council on Radiation Protection and Measurements. NCRP Report No. 128: Radionuclide Exposure of the Embryo/fetus. Bethesda, MD: NCRP; 1998.Google Scholar
9.Gusev, IA, Guskova, AK, Mettler, FA JrMedical Management of Radiation Accidents. 2nd ed. Boca Raton, FL: CRC Press; 2001.Google Scholar
10.National Council on Radiation Protection and Measurements. NCRP Report No. 138: Management of Terrorist Events Involving Radioactive Material. Bethesda, MD: NCRP; 2001.Google Scholar
11.Otake, M, Schull, WJ, Lee, S.Threshold for radiation-related severe mental retardation in prenatally exposed A-bomb survivors: a re-analysis. Int J Radiat Biol. 1996;70 (6):755–763.CrossRefGoogle ScholarPubMed
12.International Commission on Radiological Protection. Annals of the ICRP, Publication 90: Biological Effects After Prenatal Irradiation (Embryo and Fetus). Tarrytown, NY: Pergamon, Elsevier Science; 2003.Google Scholar
13.Schull, WJ.Effects of Atomic Radiation, A Half-Century of Studies from Hiroshima and Nagasaki. New York: Wiley-Liss; 1995.Google Scholar
14.Hiroshima International Council for Medical Care of the Radiation-Exposed. Effects of A-Bomb Radiation on the Human Body. Chur, Switzerland: Harwood Academic; 1995.Google Scholar
15.Sasaski, S, Kasuga, T, Sato, F.Late effects of fetal mice X-irradiated at middle or late interuterine stage. Gann. 1978;69:451–452.Google Scholar
16.National Radiological Protection Board. Documents of the NRPB 4(4): Diagnostic medical exposures: Exposure to ionizing radiation of pregnant women. Chilton, UK: NRBP; 1993:5-14.Google Scholar
17.Agency for Toxic Substances and Disease Registry. Toxicological Profile for Cesium. Atlanta: US Department of Health and Human Services, Public Health Service; 2004.Google Scholar
18.Harrison, J, Leggett, R, Lloyd, D, Phipps, A, Scott, B.Polonium-210 as a poison. J Radiol Prot. 2007;27 (1):17–40.CrossRefGoogle ScholarPubMed
19.Scott, BR.Health risk evaluations for ingestion exposure of humans to polonium-210. Dose Response. 2007;5 (2):94–122.CrossRefGoogle ScholarPubMed
20.Brosh-Nissimov, T, Havkin, O, Davidovitch, N, Poles, L, Shapira, C.Suspected radioactive contamination: evaluation of 45 Israeli citizens potentially exposed to polonium-210 in London. Isr Med Assoc J. 2008;10 (2):99–103.Google Scholar
21.Agency for Toxic Substances and Disease Registry. Toxicological Profile for Uranium. Atlanta: US Department of Health and Human Services, Public Health Service; 1999.Google Scholar
22.Sikov, MR, Hui, TE.Contribution of Maternal Radionuclide Burdens to Prenatal Radiation Doses. NUREG/CR-5631 (PNL-7442), Rev 2. Washington, DC: NRC Publications; 1996:82.Google Scholar
23.Russell, JR, Stabin, MG, Sparks, RB, Watson, E.Radiation absorbed dose to the embryo/fetus from radiopharmaceuticals. Health Phys. 1997;73 (5):756–769.CrossRefGoogle Scholar
24.Agency for Toxic Substances and Disease Registry. Toxicological Profile for Iodine. Atlanta: US Department of Health and Human Services, Public Health Service; 2004.Google Scholar
25.Brent, RL.Utilization of developmental basic science principles in the evaluation of reproductive risks from pre- and postconception environmental radiation exposures. Teratology. 1999;59:102–204.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
26.National Research Council of the National Academies. Health Risks from Exposure to Low Levels of Ionizing Radiation. Washington, DC: National Academies Press; 2006.Google Scholar
27.Ries, LAG, Harkins, D, Krapcho, MSEER Cancer Statistics Review, 1975-2003, National Cancer Institute. http://seer.cancer.gov/csr/1975_2003. Accessed October 25, 2006.Google Scholar
28.United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation, United Nations Scientific Committee on the Effects of Atomic Radiation 2000 Report to the General Assembly with Scientific Annexes. New York: United Nations Publications; 2000:428.Google Scholar
29.Preston, DL, Cullings, H, Suyama, A.Solid cancer incidence in atomic bomb survivors exposed in utero or as young children. J Natl Cancer Inst. 2008;100 (6):428–436.CrossRefGoogle ScholarPubMed