THE FUTURE OF
LOW DOSE RADIATION
RESEARCH IN THE
UNITED STATES

PROCEEDINGS OF A SYMPOSIUM

Ourania Kosti, Rapporteur

Nuclear and Radiation Studies Board

Division on Earth and Life Studies

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts from the American College of Radiology (unnumbered contract), the American Society for Radiation Oncology (unnumbered contract), the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (Award #75D30119P04238), the Environmental Protection Agency (Award #EPA EP-C-14-005/668HERC19F0033), the Gordon and Betty Moore Foundation (unnumbered contract), the National Institute of Allergy and Infectious Diseases (unnumbered contract), the Radiological Society of North America (unnumbered contract), the Uniformed Services University of the Health Sciences (Award #HU00011910005), and the U.S. Nuclear Regulatory Commission (Award #31310018M0056). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-49771-8
International Standard Book Number-10: 0-309-49771-X
Digital Object Identifier: https://doi.org/10.17226/25578

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2019 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. https://doi.org/10.17226/25578.

SYMPOSIUM PLANNING COMMITTEE¹

JOE W. GRAY (Chair), Oregon Health & Science University, Portland, Oregon

RALPH ANDERSEN, Nuclear Energy Institute (retired), Washington, DC

JAMES A. BRINK, Massachusetts General Hospital, Boston, Massachusetts

MICHAELA KREUZER, Federal Office for Radiation Protection, Neuherberg, Germany

DAVID B. RICHARDSON, University of North Carolina, Chapel Hill, North Carolina

GAYLE WOLOSCHAK, Northwestern University, Chicago, Illinois

Staff

OURANIA KOSTI, Study Director

TONI GREENLEAF, Financial Business Partner

DARLENE GROS, Senior Program Assistant

JORGE MENDOZA-TORRES, Senior Research Librarian

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s symposium planning committees are solely responsible for organizing the symposium, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Symposium rests with the rapporteur and the institution.

NUCLEAR AND RADIATION STUDIES BOARD

GEORGE APOSTOLAKIS (Chair), Massachusetts Institute of Technology (emeritus), Los Angeles, California

JAMES A. BRINK (Vice Chair), Massachusetts General Hospital, Boston, Massachusetts

SALLY A. AMUNDSON, Columbia University, New York, New York

STEVEN M. BECKER, Old Dominion University, Norfolk, Virginia

AMY BERRINGTON DE GONZÁLEZ, National Cancer Institute, Bethesda, Maryland

PAUL T. DICKMAN, Argonne National Laboratory, Washington, DC

TISSA H. ILLANGASEKARE, Colorado School of Mines, Golden, Colorado

BONNIE D. JENKINS, Women of Color Advancing Peace, Security, and Conflict Transformation, Washington, DC

ALLISON M. MACFARLANE, The George Washington University, Washington, DC

NANCY JO NICHOLAS, Los Alamos National Laboratory, New Mexico

R. JULIAN PRESTON, Environmental Protection Agency, Raleigh, North Carolina

HENRY D. ROYAL, Washington University School of Medicine, St. Louis, Missouri

WILLIAM H. TOBEY, Harvard University, Cambridge, Massachusetts

SERGEY V. YUDINTSEV, Russian Academy of Sciences, Moscow, Russia

Staff

CHARLES D. FERGUSON, Director

JENNIFER HEIMBERG, Senior Program Officer

OURANIA KOSTI, Senior Program Officer

LAURA D. LLANOS, Financial Business Partner

TONI GREENLEAF, Administrative Associate

DARLENE GROS, Senior Program Assistant

Reviewers

This Proceedings of a Symposium was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by JAMES CLEAVER, University of California, San Francisco (emeritus). He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

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Contents

ACRONYMS AND ABBREVIATIONS

HIGHLIGHTS

1 INTRODUCTION AND CONTEXT

1.1 Low Dose Radiation Exposures and Risks

1.2 Implications of Low Dose Radiation Risk Uncertainties

1.3 Current Low Dose Radiation Research in the United States

1.4 Efforts to Revive the Low Dose Radiation Research Program

2 LOW DOSE RADIATION RESEARCH PROGRAMS

2.1 Department of Energy’s (DOE’s) Past Low Dose Radiation Program, United States

2.2 Multidisciplinary European Low Dose Initiative (MELODI), Europe

2.3 Institute for Environmental Sciences (IES), Japan

2.4 Canadian Nuclear Laboratories (CNL)

2.5 Effort for Global Coordination, Organisation for Economic Co-operation and Development/Nuclear Energy Agency (OECD/NEA)

3 PERSPECTIVES ON THE NEED FOR A LOW DOSE RADIATION PROGRAM IN THE UNITED STATES

3.1 Government Perspectives

3.1.1 Department of Energy (DOE)

3.1.2 Environmental Protection Agency (EPA)

3.1.3 Centers for Disease Control and Prevention (CDC)

3.1.4 Department of Defense (DoD)

3.1.5 Food and Drug Administration (FDA)

3.1.6 National Institute for Occupational Safety and Health (NIOSH)

3.1.7 National Aeronautics and Space Administration (NASA)

3.1.8 U.S. Nuclear Regulatory Commission (USNRC)

3.1.9 Department of Homeland Security (DHS)

3.1.10 Conference of Radiation Control Program Directors (CRCPD)

3.2 Other Perspectives

3.2.1 National Council on Radiation Protection and Measurements (NCRP)

3.2.2 Health Physics Society (HPS)

3.2.3 American Nuclear Society (ANS)

3.2.4 Electric Power Research Institute (EPRI)

3.2.5 International Commission on Radiological Protection (ICRP)

3.2.6 American Society for Radiation Oncology (ASTRO)

3.2.7 American Association of Physicists in Medicine (AAPM)

3.2.8 Powerful Patient Inc.

4 CURRENT AND FUTURE DIRECTIONS OF LOW DOSE RADIATION RESEARCH

4.1 Radiation Epidemiology

4.1.1 Research Activities at the Radiation Effects Research Foundation (RERF)

4.1.2 Occupational Studies

4.1.3 Environmental Exposure Studies

4.1.4 Medically Exposed Populations

4.2 Radiation Biology

4.2.1 Low Dose and Low Dose Rate Responses in Animals

4.2.2 Molecular Injury Responses

4.2.3 Epigenetic Alterations from Low Dose Radiation

4.3 New Directions

4.3.1 Biomarkers for Molecular Epidemiological Studies

4.3.2 Technological Advancements

4.3.3 Single-Cell Genomics

4.3.4 Immune Responses

4.3.5 Systems Biology

4.3.6 Microbiome

5 LESSONS LEARNED FROM COORDINATED RESEARCH IN OTHER FIELDS

5.1 Research on Health Effects of Air Pollution

5.1.1 Research on Airborne Particulate Matter

5.1.2 The Health Effects Institute

5.2 Large-Scale Biology Initiatives

5.2.1 The Cancer Genome Atlas (TCGA)

5.2.2 The I-SPY 2 Trial

6 SYMPOSIUM PARTICIPANTS’ CONSIDERATIONS FOR A FUTURE LOW DOSE RADIATION RESEARCH PROGRAM

6.1 Possible Elements of a Low Dose Radiation Research Program

6.1.1 Leadership Team

6.1.2 Appropriate Model for Organizing the Research

6.1.3 Strategic Planning

6.1.4 Goal-Oriented Research

6.1.5 Multidisciplinary Research

6.1.6 Independent Review

6.1.7 Infrastructure

6.1.8 Sustainable Funding

6.2 Some Possible Next Steps Suggested at the Symposium

REFERENCES

APPENDIXES

A AGENDA

B BIOGRAPHIES

C LIST OF QUESTIONS SUBMITTED TO SPEAKERS AND PANELISTS

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Acronyms and Abbreviations

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