Complications of radiation
MJ Day in his presidential address of 1982 took as his theme benefit and detriment in the medical use of radiation (Day BJR 1984; 57(683): 977-988). He saw benefit and detriment in the medical use of radiation as being close to the primary concerns of the BIR. Protection against the harmful effects of radiation is of a particular concern to the medical physicist and it was the need for quantitative dosimetry in radiotherapy that led to the definition of the unit of dose and to the first appointments of hospital physicists.
Radiation protection remains central to our work. Some of the terms used can be confusing and EV Hulse and RH Mole from the MRC Radiobiology Unit in Harwell usefully discussed the terms stochastic and non-stochastic in May 1982 (Hulse and Mole BJR1982; 55(653): 321-324).
The use of radiotherapy and chemotherapy has resulted in an increasing number of young people being cured and wishing to have a normal life after recovery. P Ash from Harwell wrote in April 1980 on the important topic of the influence of such radiation on subsequent fertility (Ash BJR1980; 53(628): 271-278). Radiation effects on DNA were reviewed by G Scholes from Newcastle upon Tyne in his Silvanus Thompson Memorial Lecture in 1982 (Scholes BJR 1982; 56(664): 221-231).
Image source: Scholes BJR 1982; 56(664): 221-231
J Smith and others from New York described the development of radiation sarcoma following irradiation for Hodgkin’s disease (Smith BJR 1980; 53(628): 314-321). CJ Edmonds and T Smith from Harrow and London reviewed the long-term effects of radioiodine treatment for thyroid cancer in January 1986 (Edmonds and Smith BJR 1986; 59(697): 45-51) and concluded that it was reassuring to see that their present observations show the relatively low risk of high activity 131I therapy.
Of interest is the long-term follow-up of patients treated for ankylosing spondylitis between 1935 and 1954 In March 1988 CA Lewis and others including Sir Richard Doll reviewed 1400 patients and showed a substantial excess risk for developing cancer (Lewis, Smith, Stratton, Darby and Doll BJR 1988; 61(723): 212-220).
Experimental studies included a paper by HF Moustafa and JW Hopewell from the Churchill Hospital in Oxford in January 1980 on late functional changes in the vasculature of rat brain after local irradiation (Moustafa and Hopewell BJR 1980; 53(625): 21-25).
Image source: Moustafa and Hopewell BJR 1980; 53(625): 21-25
The Silvanus Thompson Memorial Lecture was given by Sir R Doll (Doll BJR 1981; 54(639): 179-186) describing 25 years of collaborative research in radiation hazards. The paper should be required reading for all who work with ionizing radiation. The following paper in the BJR in March 1981 was by PG Smith and Sir R Doll and looked at mortality from cancer and all causes among British radiologists (Smith and Doll BJR 1981; 54(639): 187-194) and again should be read by all radiologists.
KF Baverstock and PND Ash wrote an interesting review of radiation accidents involving whole body exposure for the November 1983 BJR (Baverstock and Ash BJR 1983; 56(671): 837-849). Constant care is needed when working with radioactivity. Radiation is hazardous and RH Mole from the MRC Radiobiology Unit at Harwell wrote a fascinating study of the LD50 for uniform low LET irradiation of humans (Mole BJR 1984; 57(677): 355-369). Mole analysed data from the atomic bombs, radiation accidents, radiotherapy and animal studies. There is remarkably little human experience from which to derive a value for the LD50 for humans. Sadly irradiation in utero affects the fetus and Masanori Otake and William Schull from Hiroshima (Otake and Schull BJR 1984; 57(677): 409-414) reviewed mental retardation in children exposed in utero to A-bomb radiation exposure. Radiation may result in chromosomal damage and in June 1989 these were reviewed in a thoughtful paper by John Savage (Savage BJR 1989; 62(738): 507-520) building on the earlier work of Douglas Lea.
Image source: Savage BJR 1989; 62(738): 507-520