Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure

BMC Cancer

Volumn 12, Issue , 2012, Pages

  Picano, Eugenio ^a   Vano, Eliseo ^b   Domenici, Luciano ^c   Bottai, Matteo ^d   Thierry Chef, Isabelle ^e  

^a CNR   (Italy)

^b HOSPITAL CLÍNICO SAN CARLOS   (Spain)

^c UNIVERSITY OF L'AQUILA   (Italy)

^d KAROLINSKA INSTITUTE   (Sweden)

^e INTERNATIONAL AGENCY FOR RESEARCH ON CANCER   (France)

Author keywords

Brain cancer; Cognitive effects; Interventional cardiologist; Radiation exposure; Risk

Indexed keywords

ATHEROSCLEROSIS; BRAIN CANCER; BRAIN DISEASE; BYSTANDER EFFECT; CARDIOLOGIST; CATARACT; CATHETERIZATION; CELL DIFFERENTIATION; CELL FUNCTION; CELL PROLIFERATION; DENTATE GYRUS; GLIOMA; HIPPOCAMPUS; HUMAN; IONIZING RADIATION; LEARNING; LYMPHOCYTE; MACROPHAGE; MEMORY; MICROCIRCULATION; MORBIDITY; MORPHOLOGY; NERVE CELL; NERVOUS SYSTEM DEVELOPMENT; OLFACTORY BULB; PROCESS OPTIMIZATION; RADIATION DOSE; RADIATION EXPOSURE; RADIATION PROTECTION; RADIATION SHIELD; RADIOBIOLOGY; RADIOFREQUENCY ABLATION; REVIEW; RISK ASSESSMENT; TISSUE DISTRIBUTION; VASCULAR DISEASE;

BRAIN; BRAIN NEOPLASMS; CARDIOLOGY; COGNITION; DOSE-RESPONSE RELATIONSHIP, RADIATION; EYE; EYE NEOPLASMS; HEALTH PERSONNEL; HUMANS; NEOPLASMS, RADIATION-INDUCED; OCCUPATIONAL DISEASES; OCCUPATIONAL EXPOSURE; RADIATION INJURIES;

EID: 84862224767     PISSN: None     EISSN: 14712407     Source Type: Journal    
DOI: 10.1186/1471-2407-12-157     Document Type: Review

References (103)

1. UNSCEAR Sources and effects of ionizing radiation. United Nations Scientific Committee on the Effects of Atomic Radiation 2008, UNSCEAR.
2. BEIR VII Phase 2 Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, National Research Council of the National Academies. Health Risks From Exposure to Low Levels of Ionizing Radiation 2006, Washington: The National Academies Press, BEIR VII Phase 2.
3. Annals of the ICRP Early and late effects of radiation in normal tissues and organs: threshold doses for tissue reactions and other non-cancer effects of radiation in a radiation protection context 2012, public draft, published at ICRP website:, Annals of the ICRP., http://www.icrp.org
4. Vañó E, González L, Guibelalde E, Fernández JM, Ten JI. Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 1998, 71:954-960.
5. Lie T, Paulsen GU, Wøhni T. Assessment of effective dose and dose to the lens of the eye for the interventional cardiologist. Radiat Prot Dosimetry 2008, 132:313-318. 10.1093/rpd/ncn296, 19056809.
6. Kuon E. Radiation exposure in invasive cardiology. Heart 2008, 94:667-674. 10.1136/hrt.2007.125021, 18411362.
7. ICRP's Recommendations on Radiological Protection Issue n. 136 2007, ICRP's., http://www.icrp.org
8. Darby SC, Cutter DJ, Boerma M, Constine LS, Fajardo LF, Kodama K, Mabuchi K, Marks LB, Mettler FA, Pierce LJ, Trott KR, Yeh ET, Shore RE. Radiation-related heart disease: current knowledge and future prospects. Int J Radiat Oncol Biol Phys 2010, 76:656-665. 10.1016/j.ijrobp.2009.09.064, 20159360.
9. ICRP Statement on Tissue Reactions Approved by the Commission on April 21, 2011 2011, ICRP Statement on Tissue Reactions., http://www.icrp.org/docs/ICRP%20Statement%20on%20Tissue%20Reactions
10. Picano E. Sustainability of medical imaging. Education and debate. BMJ 2004, 328:578-580. 10.1136/bmj.328.7439.578, 381057, 15001510.
11. Mettler FA, Bhargavan M, Faulkner K, Gilley DB, Gray JE, Ibbott GS, Lipoti JA, Mahesh M, McCrohan JL, Stabin MG, Thomadsen BR, Yoshizumi TT. Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources--1950-2007. Radiology 2009, 253:520-531. 10.1148/radiol.2532082010, 19789227.
12. Gerber TC, Carr JJ, Arai AE, Dixon RL, Ferrari VA, Gomes AS, Heller GV, McCollough CH, McNitt-Gray MF, Mettler FA, Mieres JH, Morin RL, Yester MV. Ionizing radiation in cardiac imaging: a science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation 2009, 119:1056-1065. 10.1161/CIRCULATIONAHA.108.191650, 19188512.
13. Vano E. Radiation exposure to cardiologists: how it could be reduced. Heart 2003, 89:1123-1124. 10.1136/heart.89.10.1123, 1767905, 12975391.
14. Kim KP, Miller DL, Balter S, Kleinerman RA, Linet MS, Kwon D, Simon SL. Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys 2008, 94:211-227. 10.1097/01.HP.0000290614.76386.35, 18301095.
15. Sauren LD, van Garsse L, van Ommen V, Kemerink GJ. Occupational radiation dose during transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2011, 8:770-776.
16. Panuccio G, Greenberg RK, Wunderle K, Mastracci TM, Eagleton MG, Davros W. Comparison of indirect radiation dose estimates with directly measured radiation dose for patients and operators during complex endovascular procedures. J Vasc Surg 2011, 53:885-894. 10.1016/j.jvs.2010.10.106, 21292431.
17. Venneri L, Rossi F, Botto N, Andreassi MG, Salcone N, Emad A, Lazzeri M, Gori C, Vano E, Picano E. Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: insights from the National Research Council's Biological Effects of Ionizing Radiation VII Report. Am Heart J 2009, 157:118-124. 10.1016/j.ahj.2008.08.009, 19081407.
18. Dragusin O, Weerasooriya R, Jaïs P, Hocini M, Ector J, Takahashi Y, Haïssaguerre M, Bosmans H, Heidbüchel H. Evaluation of a radiation protection cabin for invasive electrophysiological procedures. Eur Heart J 2007, 28:183-189.
19. Renaud L. A 5-y follow-up of the radiation exposure to in-room personnel during cardiac catheterization. Health Phys 1992, 62:10-15. 10.1097/00004032-199201000-00002, 1727405.
20. Vaño E, Gonzalez L, Fernandez JM, Alfonso F, Macaya C. Occupational radiation doses in interventional cardiology: a 15-year follow-up. Br J Radiol 2006, 79:383-388. 10.1259/bjr/26829723, 16632618.
21. Vano E, Kleiman NJ, Duran A, Rehani MM, Echeverri D, Cabrera M. Radiation cataract risk in interventional cardiology personnel. Radiat Res 2010, 174:490-495. 10.1667/RR2207.1, 20726724.
22. Kim C, Vasaiwala S, Haque F, Pratap K, Vidovich MI. Radiation safety among cardiology fellows. Am J Cardiol 2010, 106:125-128. 10.1016/j.amjcard.2010.02.026, 20609659.
23. Watson RM. Radiation exposure: clueless in the cath lab, or sayonara ALARA. Cathet Cardiovasc Diagn 1997, 42:126-127. 10.1002/(SICI)1097-0304(199710)42:2<126::AID-CCD5>3.0.CO;2-F, 9328691.
24. Correia MJ, Hellies A, Andreassi MG, Ghelarducci B, Picano E. Lack of radiological awareness among physicians working in a tertiary-care cardiological centre. Int J Cardiol 2005, 103:307-311. 10.1016/j.ijcard.2004.08.070, 16098394.
25. Mancuso M, Pasquali E, Leonardi S, Tanori M, Rebessi S, Di Majo V, Pazzaglia S, Toni MP, Pimpinella M, Covelli V, Saran A. Oncogenic bystander radiation effects in Patched heterozygous mouse cerebellum. Proc Natl Acad Sci U S A 2008, 105:12445-12450. 10.1073/pnas.0804186105, 2517601, 18711141.
26. Annual Report of the International Commission on Radiological Protection 1997, http://www.icrp.org.
27. Pflugbeil S, Pflugbeil C, Schitz-Fenerhake I. Risk estimates for meningiomas and other late effects after diagnostic X-ray exposure of the skull. Rad Prot Dosimetry 2011, 147:305-309.
28. Preston DL, Ron E, Yonehara S, Kobuke T, Fujii H, Kishikawa M, Tokunaga M, Tokuoka S, Mabuchi K. Tumors of the nervous system and pituitary gland associated with atomic bomb radiation exposure. J Natl Cancer Inst 2002, 94:1555-1563. 10.1093/jnci/94.20.1555, 12381708.
29. Alexander V, DiMarco JH. Reappraisal of brain tumor risk among U.S. nuclear workers: a 10-year review. Occup Med 2001, 16:289-315.
30. Center for Environmental health studies Cancer and workers exposed to ionizing radiation. A review of the research literature 2003, http://www.jsi.com (accessed November 10th, 2011), Center for Environmental health studies.
31. Zeeb H, Hammer GP, Langner I, Schafft T, Bennack S, Blettner M. Cancer mortality among German aircrew: second follow-up. Radiat Environ Biophys 2010, 49:187-194. 10.1007/s00411-009-0248-6, 19841929.
32. Matanoski GM, Seltser R, Sartwell PE, Diamond EL, Elliott EA. The current mortality rates of radiologists and other physician specialists: specific causes of death. Am J Epidemiol 1975, 101:199-210.
33. Wang JX, Inskip PD, Boice JD, Li BX, Zhang JY, Fraumeni JF. Cancer incidence among medical diagnostic X-ray workers in China, 1950 to 1985. Int J Cancer 1990, 45:889-895. 10.1002/ijc.2910450519, 2335392.
34. Andersson M, Engholm G, Ennow K, Jessen KA, Storm HH. Cancer risk among staff at two radiotherapy departments in Denmark. Br J Radiol 1991, 64:455-460. 10.1259/0007-1285-64-761-455, 2036572.
35. Carozza SE, Wrensch M, Miike R, et al. Occupation and adult gliomas. Am J Epidemiol 2000, 152:838-846. 10.1093/aje/152.9.838, 11085395.
36. Andersen A, Barlow L, Engeland A, Kjærheim K, Lynge E, Pukkala E. Work-related cancer in the Nordic countries. Scand J Work Environ Health 1999, 25:1-116. 10.5271/sjweh.376, 10507118.
37. Hardell L, Mild KH, Påhlson A, Hallquist A. Ionizing radiation, cellular telephones and the risk for brain tumours. Eur J Cancer Prev 2001, 10:523-529. 10.1097/00008469-200112000-00007, 11916351.
38. Blettner M, Schlehofer B, Samkange-Zeeb F, Berg G, Schlaefer K, Schüz J. Medical exposure to ionising radiation and the risk of brain tumours: Interphone study group, Germany. Eur J Cancer 2007, 43:1990-1998. 10.1016/j.ejca.2007.06.020, 17689954.
39. Finkelstein MM. Is brain cancer an occupational disease of cardiologists?. Can J Cardiol 1998, 14:1385-1388.
40. Roguin A, Goldstein J, Bar O. Brain tumors among Interventional Cardiologists - a call for alarm?. Eurointerv 2012, 7:1081-1086.
41. Wenzl TB. Increased brain cancer risk in physicians with high radiation exposure. Radiology 2005, 235:709-710.
42. Yoshinaga S, Mabuchi K, Sigurdson AJ, Doody MM, Ron E. Reply to Wenzl TB. Cancer risks among radiologists and radiologic technologists: review of epidemiologic studies. Radiology 2004, 233:313-321. 10.1148/radiol.2332031119, 15375227.
43. Plummer C, Henderson RD, O'Sullivan JD, Read SJ. Ischemic Stroke and Transient Ischemic Attack After Head and Neck Radiotherapy: A Review. Stroke 2011, 42:2410-2418. 10.1161/STROKEAHA.111.615203, 21817150.
44. McGale P, Darby SC. Commentary: a dose-response relationship for radiation-induced heart disease-current issues and future prospects. Int J Epidemiol 2008, 37:518-523. 10.1093/ije/dyn067, 18450809.
45. Little MP. Cancer and non-cancer effects in Japanese atomic bomb survivors. J Radiol Prot 2009, 29:A43-A59. 10.1088/0952-4746/29/2A/S04, 19454804.
46. Metz-Flamant C, Bonaventure A, Milliat F, Tirmarche M, Laurier D, Bernier MO. Low doses of ionizing radiation and risk of cardiovascular disease: A review of epidemiological studies. Rev Epidemiol Sante Publique 2009, 57:347-359. 10.1016/j.respe.2009.04.009, 19664891.
47. Little MP, Kleinerman RA, Stovall M, Smith SA, Mabuchi K. Analysis of dose response for circulatory disease after radiotherapy for benign disease. Int J Radiat Oncol Biol Phys 2012 Apr 10,
48. Schultz-Hector S, Trott KR. Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data?. Int J Radiat Oncol Biol Phys 2007, 67:10-18. 10.1016/j.ijrobp.2006.08.071, 17189062.
49. Yamada M, Naito K, Kasagi F, Masunari N, Suzuki G. Prevalence of atherosclerosis in relation to atomic bomb radiation exposure: an RERF Adult Health Study. Int J Radiat Biol 2005, 81:821-826. 10.1080/09553000600555504, 16484151.
50. Sasaki H, Wong FL, Yamada M, Kodama K. The effects of aging and radiation exposure on blood pressure levels of atomic bomb survivors. J Clin Epidemiol 2002, 55:974-981. 10.1016/S0895-4356(02)00439-0, 12464373.
51. Wong FL, Yamada M, Sasaki H, Kodama K, Hosoda Y. Effects of radiation on the longitudinal trends of total serum cholesterol levels in the atomic bomb survivors. Radiat Res 1999, 151:736-746. 10.2307/3580213, 10360794.
52. Neriishi K, Nakashima E, Delongchamp RR. Persistent subclinical inflammation among A-bomb survivors. Int J Radiat Biol 2001, 77:475-482. 10.1080/09553000010024911, 11304439.
53. Hayashi T, Kusunoki Y, Hakoda M, Morishita Y, Kubo Y, Maki M, Kasagi F, Kodama K, Macphee DG, Kyoizumi S. Radiation dose-dependent increases in inflammatory response markers in A-bomb survivors. Int J Radiat Biol 2003, 79:129-136.
54. Stewart FA, Hoving S, Russell NS. Vascular damage as an underlying mechanism of cardiac and cerebral toxicity in irradiated cancer patients. Radiat Res 2010, 174:865-869. 10.1667/RR1862.1, 21128810.
55. Dogan I, Sezen O, Sonmez B, Zengin AY, Yenilmez E, Yulug E, Abidin I, Bahat Z. Myocardial perfusion alterations observed months after radiotherapy are related to the cellular damage. Nuklearmedizin 2010, 49:209-215. 10.3413/nukmed-0315-10-05, 20949225.
56. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C, Launer LJ, Laurent S, Lopez OL, Nyenhuis D, Petersen RC, Schneider JA, Tzourio C, Arnett DK, Bennett DA, Chui HC, Higashida RT, Lindquist R, Nilsson PM, Roman GC, Sellke FW, Seshadri S, . on behalf of the American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011, 42:2672-2713. 10.1161/STR.0b013e3182299496, 21778438, on behalf of the American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia.
57. Scuteri A, Nilsson PM, Tzourio C, Redon J, Laurent S. Microvascular brain damage with aging and hypertension: pathophysiological consideration and clinical implications. J Hypertens 2011, 29:1469-1477. 10.1097/HJH.0b013e328347cc17, 21577138.
58. Tomei F, Papaleo B, Fantini S, Iavicoli S, Baccolo TP, Rosati MV. Vascular effects of occupational exposure to low-dose ionizing radiation. Am J Ind Med 1996, 30:72-77. 10.1002/(SICI)1097-0274(199607)30:1<72::AID-AJIM12>3.0.CO;2-5, 8837686.
59. Fike JR, Cann CE, Turowski K, Higgins RJ, Chan AS, Phillips TL, Davis RL. Radiation dose response of normal brain. Int J Radiat Oncol Biol Phys 1988, 14:63-70. 10.1016/0360-3016(88)90052-1, 3335464.
60. Douw L, Klein M, Fagel SS, van den Heuvel J, Taphoorn MJ, Aaronson NK, Postma TJ, Vandertop WP, Mooij JJ, Boerman RH, Beute GN, Sluimer JD, Slotman BJ, Reijneveld JC, Heimans JJ. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 2009, 8:810-818. 10.1016/S1474-4422(09)70204-2, 19665931.
61. Lyubimova N, Hopewell JW. Experimental evidence to support the hypothesis that damage to vascular endothelium plays the primary role in the development of late radiation-induced CNS injury. Br J Radiol 2004, 77:488-492. 10.1259/bjr/15169876, 15151969.
62. Panagiotakos G, Alshamy G, Chan B, Abrams R, Greenberg E, Saxena A, Bradbury M, Edgar M, Gutin P, Tabar V. Long-term impact of radiation on the stem cell and oligodendrocyte precursors in the brain. PLoS One 2007, 2:e588. 10.1371/journal.pone.0000588, 1913551, 17622341.
63. Gilmore SA, Phillips N, Liu KM, Houlé JD. Radiation-induced modulation of the microglial population in the normal and injured mature spinal cord. Exp Neurol 2003, 182:169-179. 10.1016/S0014-4886(03)00118-3, 12821387.
64. Mizumatsu S, Monje ML, Morhardt DR, Rola R, Palmer TD, Fike JR. Extreme sensitivity of adult neurogenesis to low doses of X-irradiation. Cancer Res 2003, 63:4021-4027.
65. Ma DK, Bonaguidi MA, Ming GL, Song H. Adult neural stem cells in the mammalian central nervous system. Cell Res 2009, 19:672-682. 10.1038/cr.2009.56, 2738865, 19436263.
66. Doty RL. The olfactory system and its disorders. Semin Neurol 2009, 29:74-81. 10.1055/s-0028-1124025, 19214935.
67. Peissner W, Kocher M, Treuer H, Gillardon F. Ionizing radiation-induced apoptosis of proliferating stem cells in the dentate gyrus of the adult rat hippocampus. Brain Res Mol Brain Res 1999, 71:61-68.
68. Kanzawa T, Iwado E, Aoki H, Iwamaru A, Hollingsworth EF, Sawaya R, Kondo S, Kondo Y. Ionizing radiation induces apoptosis and inhibits neuronal differentiation in rat neural stem cells via the c-Jun NH2-terminal kinase (JNK) pathway. Oncogene 2006, 25:3638-3648. 10.1038/sj.onc.1209414, 16491125.
69. Verheyde J, Benotmanea MA. Unraveling the fundamental molecular mechanisms of morphological and cognitive defects in the irradiated brain. Brain Res Rev 2007, 53:312-320. 10.1016/j.brainresrev.2006.09.004, 17188364.
70. Silasi G, Diaz-Heijtz R, Besplug J, Rodriguez-Juarez R, Titov V, Kolb B, Kovalchuk R. Selective brain responses to acute and chronic low-dose X-ray irradiation in males and females. Biochem Biophys Res Commun 2004, 325:1223-1235. 10.1016/j.bbrc.2004.10.166, 15555557.
71. Raber J, Rola R, LeFevour A, Morhardt D, Curley J, Mizumatsu S, VandenBerg SR, Fike JR. Radiation-induced cognitive impairments are associated with changes in indicators of hippocampal neurogenesis. Radiat Res 2004, 162:39-47. 10.1667/RR3206, 15222778.
72. Drew MR, Denny CA, Hen R. Arrest of adult hippocampal neurogenesis in mice impairs single- but not multiple-trial contextual fear conditioning. Behav Neurosci 2010, 124:446-454. 2925248, 20695644.
73. Díaz D, Recio JS, Baltanás FC, Gómez C, Weruaga E, Alonso JR. Long-lasting changes in the anatomy of the olfactory bulb after ionizing irradiation and bone marrow transplantation. Neuroscience 2011, 173:190-205.
74. Lazarini F, Mouthon MA, Gheusi G, de Chaumont F, Olivo-Marin JC, Lamarque S, Abrous DN, Boussin FD, Lledo PM. Cellular and behavioral effects of cranial irradiation of the subventricular zone in adult mice. PLoS One 2009, 4:e7017. 10.1371/journal.pone.0007017, 2737283, 19753118.
75. Sadetzki S, Chetrit A, Mandelzweig L, Nahon D, Freedman L, Susser E, Gross R. Childhood Exposure to Ionizing Radiation to the Head and Risk of Schizophrenia. Radiat Res 2011, 176:670-677. 10.1667/RR2596.1, 22026716.
76. Loganovsky KN, Volovik SV, Manton KG, Bazyka DA, Flor-Henry P. Whether ionizing radiation is a risk factor for schizophrenia spectrum disorders?. World J Biol Psychiatry 2005, 6:212-230. 10.1080/15622970510029876, 16272077.
77. Iwata Y, Suzuki K, Wakuda T, Seki N, Thanseem I, Matsuzaki H, Mamiya T, Ueki T, Mikawa S, Sasaki T, Suda S, Yamamoto S, Tsuchiya KJ, Sugihara G, Nakamura K, Sato K, Takei N, Hashimoto K, Mori N. Irradiation in adulthood as a new model of schizophrenia. PLoS One 2008, 3:e2283. 10.1371/journal.pone.0002283, 2386242, 18509473.
78. Rodgers CC. Dental X-ray exposure and Alzheimer's disease: a hypothetical etiological association. Med Hypotheses 2011, 77:29-34. 10.1016/j.mehy.2011.03.016, 21458164.
79. Acharya MM, Lan ML, Kan VH, Patel NH, Giedzinski E, Tseng BP, Limoli CL. Consequences of ionizing radiation-induced damage in human neural stem cells. Free Radic Biol Med 2010, 49:1846-1855. 10.1016/j.freeradbiomed.2010.08.021, 20826207.
80. Andreassi MG, Cioppa A, Botto N, Joksic G, Manfredi S, Federici C, Ostojic M, Rubino P, Picano E. Somatic DNA damage in interventional cardiologists: a case-control study. FASEB J 2005, 19:998-999.
81. Russo GL, Tedesco I, Russo M, Cioppa A, Andreassi MG, Picano E. Cellular adaptive response to chronic radiation exposure in interventional cardiologists. Eur Heart J 2012, 33:408-414. 10.1093/eurheartj/ehr263, 21862464.
82. Pellmar TC, Schauer DA, Zeman GH. Time- and dose-dependent changes in neuronal activity produced by X radiation in brain slices. Radiat Res 1990, 122:209-214. 10.2307/3577608, 2336467.
83. Roman DD, Sperduto PW. Neuropsychological effects of cranial radiation: current knowledge and future directions. Int J Radiat Oncol Biol Phys 1995, 31:983-998. 10.1016/0360-3016(94)00550-8, 7860415.
84. Yamada M, Kasagi F, Mimori Y, Miyachi T, Ohshita T, Sasaki H. Incidence of dementia among atomic-bomb survivors-Radiation Effects Research Foundation Adult Health Study. J Neurol Sci 2009, 281:11-14. 10.1016/j.jns.2009.03.003, 19327783.
85. Sibley RF, Moscato BS, Wilkinson GS, Natarajan N. Nested case-control study of external ionizing radiation dose and mortality from dementia within a pooled cohort of female nuclear weapons workers. Am J Ind Med 2003, 44:351-358. 10.1002/ajim.10288, 14502762.
86. Park RM, Schulte PA, Bowman JD, Walker JT, Bondy SC, Yost MG, Touchstone JA, Dosemeci M. Potential occupational risks for neurodegenerative diseases. Am J Ind Med 2005, 48:63-77. 10.1002/ajim.20178, 15940722.
87. Pinkerton LE, Waters MA, Hein MJ, Zivkovich Z, Schubauer-Berigan MK, Grajewski B. Cause-specific mortality among a cohort of U.S. flight attendants. Am J Ind Med 2011, 82:1049-1054.
88. Loganovsky KN, Loganovskaja TK. Schizophrenia spectrum disorders in persons exposed to ionizing radiation as a result of the Chernobyl accident. Schizophr Bull 2000, 26:751-773. 10.1093/oxfordjournals.schbul.a033492, 11087010.
89. Nyagu AI, Loganovsky KN, Loganovskaja TK. Psychophysiologic aftereffects of prenatal irradiation. Int J Psychophysiol 1998, 30:303-311. 10.1016/S0167-8760(98)00022-1, 9834886.
90. Chernobyl Forum: 2003e2005 Chernobyl's legacy: health, environmental and socio-economic impacts 2006, Vienna: International Atomic Energy Agency, Chernobyl Forum: 2003e2005.
91. Bromet EJ, Havenaar JM, Guey LT. A 25 year retrospective review of the psychological consequences of the Chernobyl accident. Clin Oncol (R Coll Radiol 2011, 23:297-305.
92. Marazziti D, Baroni S, Catena-Dell'osso M, Schiavi E, Ceresoli D, Dell'osso L, Conversano C, Picano E. Cognitive, Psychological and Psychiatric Effects of Ionizing Radiation Exposure. Curr Med Chem 2012, in press.
93. Ciraj-Bjelac O, Rehani MM, Sim KH, Liew HB, Vano E, Kleiman NJ. Risk for radiation-induced cataract for staff in interventional cardiology: is there reason for concern?. Catheter Cardiovasc Interv 2010, 76:826-834. 10.1002/ccd.22670, 20549683.
94. Balter S. Caution: Not seeing may be believing. Catheter Cardiovasc Interv 2010, 76:835. 10.1002/ccd.22848, 21104773.
95. Klein LW, Miller DL, Balter S, Laskey W, Haines D, Norbash A, Mauro MA, Goldstein JA. on behalf of the members of the Joint Inter-Society Task Force on Occupational Hazards in the Interventional Laboratory Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment. J Vasc Interv Radiol 2009, 20:S278-S283. 10.1016/j.jvir.2009.04.027, 19560009.
96. Kuon E, Birkel J, Schmitt M, Dahm JB. Radiation exposure benefit of a lead cap in invasive cardiology. Heart 2003, 89:1205-1210. 10.1136/heart.89.10.1205, 1767881, 12975420.
97. President's Cancer Panel 2010 Environmentally caused cancers are " grossly underestimated" and " needlessly devastate American lives 2010, http://www.environmentalhealthnews.org/ehs/news/presidents-cancer-panel, 3388474, 22759509, President's Cancer Panel 2010.
98. Linet MS, Kim KP, Miller DL, Kleinerman RA, Simon SL, Berrington de Gonzalez A. Historical review of occupational exposures and cancer risks in medical radiation workers. Radiat Res 2010, 174:793-808. 10.1667/RR2014.1, 21128805.
99. Vasan RS. Biomarkers of cardiovascular disease: molecular basis and practical considerations. Circulation 2006, 113:2335-2362. 10.1161/CIRCULATIONAHA.104.482570, 16702488.
100. Haehner A, Hummel T, Reichmann H. Olfactory loss in Parkinson's disease. Parkinsons Dis 2011, 2011:450939. 3109349, 21687752.
101. Zuccato C, Cattaneo E. Brain-derived neurotrophic factor in neurodegenerative diseases. Nat Rev Neurol 2009, 5:311-322. 10.1038/nrneurol.2009.54, 19498435.
102. Picano E, Vano E. The radiation issue in cardiology. The time for action is now. Cardiov Ultrasound 2011, 9:35.
103. Hirshfeld JW, Balter S, Brinker JA, Kern MJ, Klein LW, Lindsay BD, Tommaso CL, Tracy CM, Wagner LK. ACCF/AHA/HRS/SCAI Clinical Competence Statement on Physician Knowledge to Optimize Patient Safety and Image Quality in Fluoroscopically Guided Invasive Cardiovascular Procedures: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Circulation 2005, 111:511-532. 10.1161/01.CIR.0000157946.29224.5D, 15687141.