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Environmental Medicine (week 9): RADIATION

HOMEWORK ATSDR CSEM
Taking an Environmental Health History
atsdr.cdc.gov/csem/csem.asp?csem=17&po=o (or pdf on moodle
complete post-test questions 1-8 by next class

class on week 11 is when we get the take-home final
due friday week 12
homeworks will be reviewed over Thanksgiving
and notice given to students who haven't complete them
no homeworks will be graded late

ACAM & AAEM conference in PDX this week
Marianne Marchese is speaking, 2002 NCNM grad
her book: 8 Wks to Wmns Wellness


RADIATION
spectrum from non-ionizing to ionizing
ELFs<-->(power lines) nonthermal (radio)<-->(radio) thermal (microwaves)<-->(infrared) optical (UV)<-->broken bonds (UV, X-ray, gamma ray)

high speed = more penetrating potential
alpha largest, beta midsized, gamma smallest/not material and penetrate most

IONIZING RADIATION
cellular damage (free radicals) ie sunburn, skin cancer
organelle and molecular damage, DNA damage
instant cell death

X-RAYS
falling down of eletraons to more stable state
release high energy EM wave
high frequency short wavelength
penetrates less dense matter with ease

ALPHA PARTICLES
2 proton & 2 neutron (helium nucleus)
positive charge
high mass, high energy
dangerous but low penetration because they are large
superficial burns

BETA PARTICLES
basically an eletron
negative charge
decay of an atomic neutron, low energy
medium penetration (3-4mm)
can reach subcu

GAMMA PARTICLES
not a particle but a wave
no charge, high energy, high frequency
high penetration, no mass, short wavelength
damages all matter, causes "radiation poisoning"
10^-12m, smaller than atoms
used in: radio-oncology (gamma knife), sterilization (irradiation), DI (nuclear medicine)
used in: astronomy (telescopes, Hubble), military operations, superhero creation (Hulk)

ACUTE RADIATION SYNDROME (ARS)
aka radiation poisoning
high mortality rate
sx: dose dependent, mb recurrent or relapse
sx: some delayed effects, can result in tumors, anemia dt BM destrx
sx: N/V/D mb blood, dermal burns, hair loss, fatigue, dizziness, headache
synergistic effect with endocrine disruption-->cancer

2005 report on effects of ionizing radiation
www.nap.edu/openbook.php?isbn=030909156X

PCBS and melanoma
http://www.biomedcentral.com/1753-6561/4/S2/O4

WOMEN MORE AT RISK
for radiation induced cancers than men for equal dose
30-60% greater risk for overall cancer
2-5x risk of thyroid ca for women relative to men

DECAY RATES
half lives vary widely
allows for carbon dating
measured in Becquerels, 1 Bq = 1 decay/second
he won 2 Nobel prizes for his work
1 Curie (Ci) = 37 billion Bq
1Bq/m3 = 0.027Ci/m3

MEASUREMENTS OF IONIZING RADIATION
Rads = 0.01J/
1 Gray = 1Jkg = 100 rad
measure emited/absorbed dose ie w/ x-ray maching
1 Sievert (Sv) = 1J/kg = 100 rem
measures effective dose
determined by radiation type and tissue type

** print adverse health effects of various radiation doses (from notes)
** print medical radiation exposure doses

MEDICAL EXPOSURES
from low to high
DEXA, dental, chest, mammogram, pelvis x-ray, head CT, abd/pelvic CT

SOURCES OF EXPOSURE
#1 source by far is radon (more than half)
medical is next
then terrestrial, natural, cosmic, consumer products, cosmogenic

RADON
is alpha particles
2nd mc cause of lung cancer
10-20,000 deaths/year
#1 cause of lung cancer in non smokers
no threat of other damage (dermal/somatic)
radium-->radon-->polonium (radium B)-->lead (radium B)
-->bismuth (radium C)-->polonium (radium C)
radon testing:
charcoal absorption test, 2-7 days, $10-25 bucks
alpha track, 3mo-1yr, $15-30
continuous monitoring, constant instant level reports, used professionally, pricey

granite countertops may leak radon

RADON EXPOSURE PREVENTION
seal cracks in concrete floors
vapor barries
subslab depressurization
EPA's "Consumer's guide to Radon Reduction"
www.epa.gov/radon/

RADIUM
atomic number 88
symbol: Ra
pure white metal, faint blue blow (luminescence)
radioactive decay product of uranium
decaysinto radon
has half life of 1600 years
uses: glowing watch dial, luminescent paint, airplane instruments, signs
uses: historical medical treatments, cancer, arthritis, diabetes, ulcers
uses: mineral baths (Montana, Germany)
uses: health products, radithor, patent elixir, "perpetual sunshine", revigator is water cistern with ceramics infused with radium, tooth pastes
book: 1915 "Benefits of Radium"
case study: the Radium Girls
women that painted WWI instruments in NJ sued for labor abuse and eventually won

RADIUM
absorbed by ingestion or dermal contact
calcium analogue (absorbed by bones)
effects: bone cancer, anemia, leukemia, multiple myeloma

THE BOMB
*watch this!!
http://www.youtube.com/watch?v=LLCF7vPanrY
A time lapse video of all nuclear detonations

Hiroshima and Nagasaki
other detonations "peaceful"
testing since 1945

1963 Partial Test Ban Treaty
retricts: atmospheric, underwater and outer space testing
underground testing still permitted

Nuclear death
direct explosive force kills 40-50%
thermal effects 30-40
ionizing radiation 5%
residual radiation 5-10%
electromagnetic pulse disrupts electrical devices (pace makers)
other effects
nuclear fallout

NUCLEAR MATERIAL AND CANCER
thyroid cancer rates higher downwind from testing sites
higher in midwest, central Idaho
Hanford release of Iodine 131 affected 2 million people
most exposure through milk after cows graze on affected

COAL BURNING
releases more radioactivity that nuclear reactors
(under normal operating conditions)

TOHOKU EARTHQUAKE March 11, 2011
Richter 9.0
caused Tsunami that hit Japan
130ft waves, 6 miles inliand, floods nuclear reactors
6 reactor failures
no reported radiation deaths or illness
projected 1000 additional deaths dt cancer mortality
Fukushima-Daiichi
27.1PBq released into ocean
20 mile radius of contaminated land, up to 20 years before people can move back there
Cesium 137 and Damaged farmland BBC article
http://www.bbc.co.uk/news/science-environment-15691571
elements detected: iodine 131, cesium 134/137, plutonium 239/240, strontium 90, telurium 129m
half life of iodine about 8 days
cesium half life is 2, 30 years
plutonnium is greatest long-term concern
strontium subs for Ca in bone, half life 27 is years
telurium not bioactive

NUCLEAR EVENTS
iNTERNATIONAL Nuclear event scale
http://en.wikipedia.org/wiki/International_Nuclear_Event_Scale
Chernnobyl, Ukraine worse in hx
6 million exposed
4K-600K affected
others: Chalk River, ontario 1952, Mayak russia 1957, Three Mile Island 1979

EFFECTS
erosion of epithelium
hyperparathyroidism
immune and hematologic dz dt bone marrow effects
MM, leuk, aplastic anemia, Lupus, MS
genetic and birth defects: miscarriage, neural tube defects
psych

PROPHYLAXIS AFTER AN EXPOSURE
before, during and after an exposure

IODINE
to fill up binding sites in thyroid, worked great after Chernobyl, 100%
SSKI is 750mg/ml, dose 100mg/day (2 gtts)
Lugols: 16 gtts qd
Povidone-iodine topical ONLY: 8ml qd x8 days, dermal absorption is effective
only effective for 131I exposure, not other radiation effects

CESIUM
theoretical use
Cesium chloride is non-radioactive
used in medicine: oncology, cardiology (vasoconstrictor), DI (telemetry)
dose: 3g powder/day

FDA.gov/drugs/emergencypreparedness/bioterrorismanddrugpreparedness
CDC emergency/.cdc.gov/radiation
look here for handouts

that's all??

RADIOACTIVE WASTE
billions of pounds generated
low, med and high level
low = medical usually, bagged and buried
intermed = mining and nuclear by products
high = nuclear reactor core fuel, gets buried
Yucca Mtn

"Pooptonium"
rachel maddow 10/19/09 on msnbc

IAEA
promotes peaceful use of nuke tech for energy prod
reduction/elim of military nukes

NUKE POWERS
Confirmed: US, Soviets, France,UK, China, India, Pakistan, N Korea
Suspected: Israel, S Africa, Libya
Concerns: N Korea, Inida, Pakistan,Israel, Iran, Syria
N Korea withdrew from NPT in 2003

BACKGROUND RADIATION EQUIVALENT TIME (BRET)
cosmic rays, radon, etc
typical daily background dose = 6.6uSv (0.66mrem)
annual dose 3.6 mSv (at sea level) (in Denver loser to 5mSv)

http://www.scientificamerican.com/article.cfm?id=graphic-science-radiation-exposure

RADIATION THERAPY
focused ionizing radiation to tx pathology
ablative tx

PRENATAL EXPOSURE
weeks 2-15 mb most damaging
2-3 abdominal CTs-->incr risk by 2%
birth defects, brain damage, childhood cancer

AIRPORT SCANNERS
very low risk
0.00002MsV
same as flying at 30,000 ft for 30 sec
<3minBRET
low cancer potential

SPACE OR AIRPLANE FLIGHTS
exposure depends on altitude and latitude
time of day (less exposure farther from sun)
typical cross country flight gives 0.03mSv
(3-20mSv acceptable normal annual range for a person in a year)
30 years of 1000hr/year flying-->incr cancer risk by 1% (pilot or flight attendant)
pregnant women limit it to 200 hours flight time annually, 0.5mSv total/year
(10 transatlantic or 40 domestic)

**MORE TREATMENTS
Cordyceps pubmed 17149981
Eleutherococcus pubmed 7304498
Panax 20591513

EMF POLLUTION
EMFs 50-60Hx
Dirty Electricity (HFVTs') spikes on electrical wires
Ground current
Radio frequency MHz, GHz (cell phones, wifi)

DIRTY ELECTRICITY
HFVT's need better research
effects claimed: blood gluc/IR, MS sx, insomnia, asthma, fatigue, confusion
pubmed 17178585
all studies flawed pubmed 20336048

MICROWAVE OVENS
no reliable studies
probably reasonable to assume that there are effects
precautonary principle: don't use, don't stand right by it
effects on food itself are well demonstrated

CELL PHONES POPPING POPCORN
not true, was viral ad campaign by bluetooth manufacturer
http://www.metacafe.com/watch/1490878/cell_phone_popcorn_secret_revealed/

CELL PHONE
800-1800 Hz non ionizing
270 million in US 2008
more use elsewhere, easier than land line infrastructure
radiowave exposure proportional to distance to transmitting base station
farther from base-->more power needed
also affected by amount of traffic on network,
quality of transmission, distance of antenna from body

weakens BBB
dielectric heating
electro magnetic hypersensitivity
sterility dt disruption of meiosis (cell phone on belt or in pocket)

SAR specific absorption rate
amount of RF radiation abosrbed by body
max us limit is 1.6 watts/kg
low SAR models considered safes
ewg get a safer phone

CELL PHONE WORRIES
concerns: brain tumors, gliomas, acoustic neuromas, meningiomas, salivary gland tumors
most studies snow no effect
21862503 pubmed meta analysis doesn't show substantial evidence

200 WHO statement: unlikely to induce or promote cancer
2011 WHO possible carcinogen
BMJ 2011 Oct: no cancer risk

ELF EMF
disputed evidence for powerlines causing leukemia in children
other claims: alzheimer's, ALS, miscarriage (RR 4.0), melatonin reduction, depression
nothing conclusive
lots more asthma in kids in these areas
counfounders: poor areas have more overhead powerlines, old inner cities

ELECTRIC BLANKETS
incr risk of breast and endometrial cancer
36% incr endomet ca after 20 years use pubmed 17415095
study not well done

MOTORCYCLE CANCER
more testicular cancer in guys who ride bikes?
just a theory

ELECTROMAGNETIC HYPERSENSITIVY
range of psycho-somatic sx
assoc c prox to EM emissions
some dx: leuk, MS, fibro, migraine, dep
case study pubmed 21793784
two systematic reviews show no supportive evidence pubmed 21769898, 15784787
prob more pscych than physiol

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