INTRODUCTION TO

IONIZING RADIATION
AND RADIATION
HAZARD
Dr. Gurmit Kaur
Diagnostic Imaging
Department

OUTLINE
Introduction
Radiation exposure: sources
Radiation effects
How to explain to patient
Radiation risk estimation
Radiation exposure during
pregnancy

DEFINITION
RADIATION
- energy that is radiated or
transmitted in the form of rays or
waves or particles.
- Some forms of this energy with
the ability to ionise, are called ionising radiation

RADIATION
IONISING
PARTICULATE-energy and mass.
Alpha, beta, etc.

ELECTROMAGNETIC-only energy, no
mass.
X-ray, gamma ray, etc.

NON-IONISING
Radio waves, Light, etc.

GAMMA RAYS
Electro Magnetic energy emitted
after a decay reaction-result of
nuclear interaction.
No mass; No charge.
High energy.
Technitium-99m and caesium137.
Plenty of medical use.

Wilhelm Conrad Roentgen, 1895

The discoverer of X-RAYS

I have discovered something interesting but I do not know

whether or not my observations are correct.

WHAT ARE X-RAYS?

Electromagnetic radiation of
VERY SHORT WAVELENGTH and
VERY HIGH ENERGY.
It has the
ability to ionise.

Produced in an x-ray tube-outside the

nucleus.

IS EVERYONE EXPOSED TO
IONISING RADIATION ?

YES. Everyone is exposed to

some amount of background
radiation, but it varies from
place to place.

Annual natural
background
exposure ~ 3 mSv,
mostly from
radioactive radon
gas or gamma
radiation.

Ref: X-rays. How safe are they?

NRPB May 2001

RADIATION EXPOSURE
Dose from:
Medical practice~14%
Natural sources~ 85%
Industrial activity & weapons~ 1%

radiations in the environment that

come from sunlight, power-lines,
electrical equipment and mobile
phone systems do not have enough
energy to produce ionizations nonionizing radiations.

EFFECTS OF RADIATION
Ions might react
with the DNA
causing it to
break damage.
DNA controls the
way in which each
individual cell
behaves.

EFFECTS OF RADIATIONCellular Damage

EFFECTS OF RADIATION
General Classification
SOMATIC
In this lifetime
Stochastic (Probabilistic)
Deterministic (Non Stochastic)
GENETIC
In future generations

Deterministic Effects
different types of radiation damage
resulting from the loss of organ function.
characterized by having a threshold dose
(below which there is no observable
effect) followed by a response where the
severity of the effect increases with
increasing radiation dose.
Cataract, burns, sterility, depression of
hematopoiesis

Deterministic Effect Graph

Cataract

RADIATION INJURY-BURNS

Acute effects to specific organs

Dose
(mSv)

Organ

Effect

3 500

Testes

Permanent sterility

3 500

Eye

3 000

Ovaries

2 500+

Skin

500

Bone marrow

150+

Testes

Temporary sterility

60

Foetus

Probable minimum dose

causing effect (possible
malformation)

Later cataract formation

Sterility
Skin reddening (erythema)
and possible permanent hair
loss
Reduced blood cell formation

Stochastic Effect
No threshold dose.
Governed by the laws of chance.
The probability of occurrence increases
with the dose, but the severity of the
disease (if any), is not dependent on
dose.
e.g. degree of malignancy does not
related to dose.
Carcinogenesis and mutagenesis.

Stochastic Effect Graph

Stochastic Effect
CANCER
The most worrying of all.
Latent period of 7 20 years.
1:4 chance of the general population
developing cancer, in their lifetime.
Exposure of the population to all sources
of ionizing radiation (natural plus manmade) responsible for an additional risk of
fatal cancer of about 1%.
Whilst caution is prescribed, it should not
prevent us from using radiation, when
justified.

EFFECTS - Summary
Deterministic effects
will occur above a threshold dose
Severity of effect increases with the dose.

Stochastic effects
has no threshold dose.
severity of illness is not related to the
dose.
probability of occurrence increases with
dose

Compare the Graphs

Deterministic

Stochastic

HOW TO EXPLAIN RADIATION

RISK TO PATIENTS

Medical radiation too low to produce

immediate harmful effects, e.g. burns
and radiation sickness.
The only effect on the patient that is
known to be possible at these low doses
is a very slight increase in the chance of
cancer occurring many years or even
decades after the exposure.
Benefits from making correct diagnosis
outweigh the small risk involved.

RADIATION DOSE COMPARISON

Equivalent Natural Background

Radiation (ENBR)
Exam

Typical ED ENBR
(mSv)

CXR

0.02

3 days

AXR
Lumbar
spine
CT brain
CT
abd+pelvis

0.7
1.3

4 months
7 months

Risk of
fatal
cancer
1 in a
million
1 in 30,000
1 in 15,000

2
10

1 year
4.5 years

1 in 10,000
1 in 2,000

RISK ESTIMATES
Effective dose of full body CT ~ 12
mSv.
Japanese atomic bombs survivors: 5100 mSv.
Single full-body CT in 45 y.o: Cancer
mortality risk ~0.08% (1 in 1250),
mainly from lung cancer.
(~0.06% for 65 y.o.), less time for
delayed radiation-induced cancer to
develop.
Ref: Brenner DJ. Estimated Radiation Risks Potentially associated with
Full-body CT Screening. Radiology 2004; 232: 735-738.

RISK ESTIMATES
Annual full-body CT in 45 y.o until
age of 75: Cancer mortality risk
1.9%.
Children with most of their life still
ahead of them, may be at twice the
risk of middle-aged people from the
same X-ray examination.

Estimated lifetime attributable cancer mortality risk as a function of age

at examination for a single typical CT examination of head and abdomen.
Ref: Brenner DJ. Estimated Risks of Radiation-induced Fatal Cancer
from Pediatric CT. AJR 2001;176: 289-296.

RISK ESTIMATES
New ICRP Recommendations 2006
Overall risk estimates
=0.00005/mSv.
or 1 in 20,000 per mSv.

RISK COMPARISON
Risk of fatal cancer from 1 CXR (0.02
mSv)= 1 in 1,000,000.
Relative risk of 1 in 1,000,000 chance
of dying from activities:
Airline flight crash
Driving 30 miles in car (accident)
Smoking 9 cigarettes.

Radiation Exposure During

Pregnancy: Deterministic effect
Induction of death or gross
malformation
Threshold dose lie well above the
mean dose of most procedures.
Fetal doses are unlikely to cause
deterministic effects in an
individual pregnancy.
Ref: Advice on Exposure to Ionizing Radiation during Pregnancy. NRPB
1998.

Radiation Exposure During

Pregnancy: Stochastic effects
Cancer induction: leukemia & solid
tumors.
Baseline risk of cancer in the first 15
years
of life is about 1 in 650 (1 in 1,300 for
fatal cancer).

Ref: Advice on Exposure to Ionizing Radiation during Pregnancy. NRPB

1998.

Risk of Cancer Following Fetal

Diagnostic Medical Exposure to
Radiation
Procedures

Mean Fetal
Dose (mGy)

AXR

1.4

Risk of Fatal
Cancer to age
15 years
1 in 24,000

Ba Enema

6.8

1 in 5,000

CT Abdomen

8.0

1 in 4,000

CT Pelvis

25

1 in 1,300

Radiation Exposure During

Pregnancy
For the majority of diagnostic
procedures, giving fetal doses up
to a few mGy, the associated
risks in childhood are judged to
be acceptable when compared
with the natural risk.

Radiation Exposure During

Pregnancy
Consequently, exposure of the
fetus in these circumstances is
not considered to justify the
greater risks of invasive fetal
diagnostic procedures to both the
fetus and mother nor to justify
the risks of a termination of the
pregnancy to the mother.

SUMMARY
All source of ionizing radiation
(natural & man-made) responsible
for an additional risk of fatal cancer
of about 1%
Risk is small compared with:
a life-time risk of cancer of about 20
25% from all causes.
other known cancer risk factors in the
population such as cigarette smoking,
excessive exposure to sunlight and
poor diet.

REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.

MF. McNitt-Gray. Radiation issues in CT

screening. RCNA 42 (2004) 711-723.
Brenner DJ. Estimated Radiation Risks
Potentially associated with Full-body CT
Screening. Radiology 2004; 232: 735-738.
Radiological Protection Bulletin. No. 231
September 2001. NRPB.
X-rays. How safe are they? NRPB May 2001.
Radiation and Risks. Radiation Information
Networks. Idaho State University.
1990 Recommendations of ICRP. Publication 60.
U.S. Nuclear Regulatory Commission Regulatory
Guide 8.29. Revision 1, 1996.
Advice on Exposure to Ionizing Radiation during
Pregnancy. NRPB 1998.