Highlights

Exposures at low doses of radiation, generally taken to mean doses below 100 millisieverts, are of primary interest for setting standards for protecting individuals against the adverse effects of ionizing radiation. However, there are considerable uncertainties associated with current best estimates of risks and gaps in knowledge on critical scientific issues that relate to low dose radiation. Nevertheless, in the United States there is no program that is dedicated to advancing knowledge on low dose radiation exposures. Starting in 1999, the Department of Energy’s (DOE’s) Low Dose Radiation Research Program funded experimental research on cellular and molecular responses to low dose radiation but was terminated in 2016 after ramping down funding over several years. Since then, Congress attempted to re-establish a low dose radiation research program in the United States but negotiations within the government have not yet resulted in its establishment.

The Nuclear and Radiation Studies Board of the National Academies hosted the symposium on The Future of Low Dose Radiation Research in the United States on May 8 and 9, 2019. The goal of the symposium was to provide an open forum for a national discussion on the need for a long-term strategy to guide a low dose radiation research program in the United States. The symposium featured presentations on low dose radiation programs around the world (see Chapter 2), panel discussions with representatives from governmental and nongovernmental organizations about the need for a low dose radiation research program (see Chapter 3), reviews of low dose radiation research in epidemiology and radiation

biology including new directions (see Chapter 4), and lessons to be learned from setting up large research programs in non-radiation research fields (see Chapter 5).

Almost all of the symposium participants who represented the national and international radiation research and radiation protection communities expressed support for a low dose radiation research program. This support came equally from those who are concerned about the risks at low doses of radiation and those who argue that the risks are overestimated and that this overestimation leads to tighter-than-necessary regulations. Participants discussed the following eight elements that could facilitate establishing and maintaining a low dose radiation program (see Chapter 6):

1. Leadership team. Many symposium participants noted that a leader (or a leading team) could become the knowledgeable and trusted communicator of the arguments for a low dose radiation program to Congress and the potential sponsors. Some noted that such a leader does not currently exist.
2. Appropriate model for organizing the research. A future low dose radiation research program in the United States has been almost exclusively thought to follow the same model as the previous DOE-managed low dose radiation research program. However, a number of alternative models were described at the symposium, such as a multi-agency-managed program, a government-managed program overseen by an independent scientific organization, a government–private sector partnership, and an internationally coordinated program.
3. Strategic planning. An effective strategic plan sets the direction and priorities of a program and is adjustable based on new circumstances to improve both the relevance and the timeliness of the program’s research activities. One expert highlighted the value of involving a trusted and reputable independent organization in the strategic planning of the program, and in monitoring its implementation and research progress.
4. Goal-oriented research. Symposium participants recognized that the opportunities for research in low dose radiation are numerous. However, because funding for a low dose radiation program is likely to be limited, focusing research on issues of highest priority and relevance to radiation-related policy decisions would be most efficient.
5. Multidisciplinary research. A number of symposium participants recognized that bringing together scientists from a variety of disciplines, including epidemiologists, radiation biologists, dosimetrists, and other investigators, to work on a common scientific question

6. can lead to creative and high-impact research. Many also argued in favor of involving social scientists and specifically risk communicators in the research program.

7. Independent review. It is generally thought that those who manage a program may not be the most objective judges of the projects that program funds and that independent review can both improve the technical quality of the projects and increase confidence in the decision-making process.
8. Infrastructure. Professional, facility, and information technology infrastructures were discussed at the symposium as crucial for building and maintaining a low dose radiation research program. A participant suggested that a pilot study might be needed to test that the program’s infrastructure is appropriate to meet its needs and if not, to make necessary adjustments.
9. Sustainable funding. Many symposium participants recognized that long-term financial commitment is an important element for the success of a low dose radiation research program. Some noted that the ability to show to the sponsoring agencies that the program’s goals are met and that the program has mechanisms in place (e.g., strategic plan, oversight, and independent reviews) to regularly assess its performance could help with achieving sustainable funding.

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