The prevailing belief in radiation
protection fraternity has been that human radiation-related cataract occurs
only after relatively high doses and the ICRP guidelines on minimal doses for
cataract induction in humans are given in the table for single exposure and
protracted exposure scenarios.
Table: ICRP Guidelines on Minimal Lens
Doses for Cataract Induction
End
point
|
Brief
exposure
(Sv)
|
Protracted
exposure (Sv)
|
Annual
dose
(Sv)
|
Detectable
opacities
|
0.5 to 2
|
5
|
>0.1
|
Visual
impairment
|
5
|
>8
|
>0.15
|
Epidemiological studies among
Chernobyl clean-up workers, Atom - bomb survivors in Japan, astronauts,
residents of contaminated buildings, radiological technicians and recent
surveys of staff in interventional rooms indicate that there is an increased
incidence of lens opacities at doses below 1 Gy.
The IAEA studies on radiation induced
cataract among cardiologists and support staff in cardiac catheterization
laboratories, published in “Radiation Research” received wider attention since
it pointed towards possibility of opacities in the lens of the eyes below the
currently specified threshold by International Commission of Radiological
Protection (ICRP). However, there are issues such as difficulty in accurate
dose estimation in eyes of medical staff as hardly any data is available that
can be used to correlate with lens opacities. Only rough estimations based on
work load and typical factors used in the procedures performed by staff could
be made. In contrast, there is much better dosimetry in A-Bomb survivors and
much longer follow up period.
Based on the overwhelming data, the
ICRP released a statement in 2011 recommending a change in the threshold dose
for the eye lens and dose limits for eye for occupationally exposed persons.
According to this statement, the threshold in
absorbed dose for the lens of the eye is now considered to be 0.5 Gy. Further,
for occupational exposure in planned exposure situations the Commission now
recommends an equivalent dose limit for the lens of the eye of 20 mSv in a
year, averaged over defined periods of 5 years, with no single year exceeding
50 mSv.
The Commission continues to recommend that
optimisation of protection be applied in all exposure situations and for all
categories of exposure. With the recent evidence, the Commission further
emphasises that protection should be optimised not only for whole body exposures,
but also for exposures to specific tissues, particularly the lens of the eye,
and to the heart and the cerebrovascular system.
The implementation of the limit amongst the
occupational workers in nuclear and radiological facilities is operationally
difficult in view of the fact that there is hardly any reliable and recorded dosimetric
data available. To begin with, however, some rough assessment of the exposure
to eyes can still be made using whole-body exposure data.
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