Environmental Analysis Health and Toxicology

The Korean Society of Environmental Health and Toxicology (환경독성보건학회)
권호 표지
DOI QR코드

DOI QR Code

Genetic radiation risks: a neglected topic in the low dose debate

  • Received : 2015.10.17
  • Accepted : 2016.01.20
  • Published : 2016.01.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (A-bomb) survivors. Methods To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down's syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. Results Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. Conclusions We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.

Keywords

References

  1. Muller HJ. Radiation damage to the genetic material. Am Sci 1950;38(1):33-59.
  2. International Commission on Radiological Protection. The 2007 recommendations of the International Commission on Radiological Protection; 2007 [cited 2016 Jan 28]. Available from: http://www.icrp.org/publication.asp?id=ICRP%20Publication%20103.
  3. International Commission on Radiological Protection. 1990 Recommendations of the International Commission on Radiological Protection; 1991 [cited 2016 Jan 28]. Available from: http://www.icrp.org/publication.asp?id=icrp%20publication%2060.
  4. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). UNSCEAR 2001 report: hereditary effects of radiation [cited 2016 Jan 28]. Available from: http://www.unscear.org/unscear/en/publications/2001.html.
  5. Doll R. Hazards of the first nine months: an epidemiologist's nightmare. J Ir Med Assoc 1973;66(5):117-126.
  6. Busby C. Aspects of DNA damage from internal radionuclides; 2013 [cited 2016 Jan 28]. Available from: http://www.intechopen.com/books/new-research-directions-in-dna-repair/aspects-of-dna-damage-from-internal-radionuclides.
  7. Platt JR. Strong inference: certain systematic methods of scientific thinking may produce much more rapid progress than others. Science 1964;146(3642):347-353. https://doi.org/10.1126/science.146.3642.347
  8. Feyerabend P. Against method. 4th ed. London: Verso; 2010, p. 13-48.
  9. De Bellefeuille P. Genetic hazards of radiation to man. I. Acta Radiol 1961;56:65-80. https://doi.org/10.3109/00016926109172572
  10. Busby C. Uranium epidemiology. Jacobs J Epidemiol Prev Med 2015;1(2):009.
  11. Huxley HE, Zubay G. Preferential staining of nucleic acid-containing structures for electron microscopy. J Biophys Biochem Cytol 1961;11:273-296. https://doi.org/10.1083/jcb.11.2.273
  12. Constantinescu DG, Hatieganu E. Metachromasia through uranyl ions: a procedure for identifying the nucleic acids and the nucleotides. Anal Biochem 1974;62(2):584-587. https://doi.org/10.1016/0003-2697(74)90191-2
  13. Nielsen PE, Hiort C, Sonnichsen SH, Buchardt O, Dahl O, Norden B. DNA binding and photocleavage by uranyl(VI)(UO22+) salts. J Am Chem Soc 1992;114(13):4967-4975. https://doi.org/10.1021/ja00039a003
  14. Luning KG, Frolen H, Nelson A, Ronnback C. Genetic effects of strontium-90 injected into male mice. Nature 1963;197:304-305. https://doi.org/10.1038/197304a0
  15. Ehrenberg L, Eriksson G. The dose dependence of mutation rates in the rad range, in the light of experiments with higher plants. Acta Radiol Diagn (Stockh) 1966:Suppl 254:73-78.
  16. Stokke T, Oftedal P, Pappas A. Effects of small doses of radioactive strontium on the rat bone marrow. Acta Radiol Ther Phys Biol 1968;7(5):321-329. https://doi.org/10.3109/02841866809133205
  17. Smirnova EI, Lyaginskaya AM. Heart development of Sr-90 injured rats. In: Moskalev YI, Idz Y, editors. Radioactive isotopes and the body. Moscow: Izdatel'stvo Meditsina;1969, p. 348 (Russian).
  18. Busby C, Lengfelder E, Pflugbeil S, Schmitz-Feuerhake I. The evidence of radiation effects in embryos and fetuses exposed to Chernobyl fallout and the question of dose response. Med Confl Surviv 2009;25(1):20-40. https://doi.org/10.1080/13623690802568954
  19. Dolk H, Nichols R. Evaluation of the impact of Chernobyl on the prevalence of congenital anomalies in 16 regions of Europe. EUROCAT Working Group. Int J Epidemiol 1999;28(5):941-948. https://doi.org/10.1093/ije/28.5.941
  20. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2006 report vol. I: effects of ionizing radiation [cited 2016 Jan 28]. Available from: http://www.unscear.org/unscear/en/publications/2006_1.html.
  21. Hoffmann W. Fallout from the Chernobyl nuclear disaster and congenital malformations in Europe. Arch Environ Health 2001;56(6):478-484. https://doi.org/10.1080/00039890109602895
  22. Lazjuk GI, Nikolaev DL, Novikova IV. Changes in registered congenital anomalies in the Republic of Belarus after the Chernobyl accident. Stem Cells 1997;15 Suppl 2:255-260. https://doi.org/10.1002/stem.5530150833
  23. Feshchenko SP, Schroder HC, Muller WE, Lazjuk GI. Congenital malformations among newborns and developmental abnormalities among human embryos in Belarus after Chernobyl accident. Cell Mol Biol (Noisy-le-grand) 2002;48(4):423-426.
  24. Bogdanovich IP. Comparative analysis of the death rate of children, aged 0-5, in 1994 in radiocontaminated and conventionally clean areas of Belarus. In: Medicobiological effects and the ways of overcoming the Chernobyl accident consequence. Minsk-Vitebsk: Ministry of Emergency and Chernobyl Problems of Belarus and Academy of Sciences of Belarus; 1997, p. 4 (Russian).
  25. Savchenko VK. The ecology of the Chernobyl catastrophe: scientific outlines of an International Programme of Collaborative Research. Paris: United Nations Educational Scientific and Organisation; 1995, p. 83.
  26. Kulakov VI, Sokur TN, Volobuev AI, Tzibulskaya IS, Malisheva VA, Zikin BI, et al. Female reproductive function in areas affected by radiation after the Chernobyl power station accident. Environ Health Perspect 1993;101 Suppl 2:117-123. https://doi.org/10.1289/ehp.93101s3117
  27. Petrova A, Gnedko T, Maistrova I, Zafranskaya M, Dainiak N. Morbidity in a large cohort study of children born to mothers exposed to radiation from Chernobyl. Stem Cells 1997;15 Suppl 2:141-150. https://doi.org/10.1002/stem.5530150818
  28. Shidlovskii PR. General morbidity of the population in districts of the Brest region. Zdravoohranenie Belorussii (Minsk) 1992;1:8-11 (Russian).
  29. Wertelecki W. Malformations in a Chernobyl-impacted region. Pediatrics 2010;125(4):e836-e843. https://doi.org/10.1542/peds.2009-2219
  30. Wertelecki W, Yevtushok L, Zymak-Zakutnia N, Wang B, Sosyniuk Z, Lapchenko S, et al. Blastopathies and microcephaly in a Chernobyl-impacted region of Ukraine. Congenit Anom (Kyoto) 2014;54(3):125-149. https://doi.org/10.1111/cga.12051
  31. Godlevsky I, Nasvit O. Dynamics of health status of residents in the Lugyny district after the accident of the ChNPS. In: Imanaka T, editor. Research activities about the radiological consequences of the Chernobyl NPS accident and social activities to assist the sufferers by the accident. Osaka: Kyoto University Research Reactor Institute; 1998, p. 149-156.
  32. Akar N, Ata Y, Aytekin AF. Neural tube defects and Chernobyl? Paediatr Perinat Epidemiol 1989;3(1):102-103. https://doi.org/10.1111/j.1365-3016.1989.tb00373.x
  33. Caglayan S, Kayhan B, Mentesoglu S, Aksit S. Changing incidence of neural tube defects in Aegean Turkey. Paediatr Perinat Epidemiol 1989;3(1):62-65. https://doi.org/10.1111/j.1365-3016.1989.tb00370.x
  34. Guvenc H, Uslu MA, Guvenc M, Ozekici U, Kocabay K, Bektas S. Changing trend of neural tube defects in eastern Turkey. J Epidemiol Community Health 1993;47(1):40-41. https://doi.org/10.1136/jech.47.1.40
  35. Mocan H, Bozkaya H, Mocan MZ, Furtun EM. Changing incidence of anencephaly in the eastern Black Sea region of Turkey and Chernobyl. Paediatr Perinat Epidemiol 1990;4(3):264-268. https://doi.org/10.1111/j.1365-3016.1990.tb00649.x
  36. Moumdjiev N, Nedkova V, Christova V, Kostova S. Influence of the Chernobyl reactor accident on the child health in the region of Pleven, Bulgaria. In: International Pediatric Association. Excerpts from the 20th International Congress of Pediatrics; 1992 Sep 5-10; Rio de Janeiro, Brazil. Vevey: Nestle Nutrition Services; 1992, p. 57.
  37. Kruslin B, Jukic S, Kos M, Simic G, Cviko A. Congenital anomalies of the central nervous system at autopsy in Croatia in the period before and after the Chernobyl accident. Acta Med Croatica 1998;52(2):103-107.
  38. Zieglowski V, Hemprich A. Facial cleft birth rate in former East Germany before and after the reactor accident in Chernobyl. Mund Kiefer Gesichtschir 1999;3(4):195-199 (German). https://doi.org/10.1007/s100060050129
  39. Scherb H, Weigelt E. Cleft lip and cleft palate birth rate in Bavaria before and after the Chernobyl nuclear power plant accident. Mund Kiefer Gesichtschir 2004;8(2):106-110 (German). https://doi.org/10.1007/s10006-004-0524-1
  40. Korblein A. Abnormalities in Bavaria after Chernobyl. Strahlentelex 2004;416-417:4-6 (German).
  41. Government of Berlin West, Section of Health and Social Affairs. Annual health report. Berlin: Government of Berlin West; 1987 (German).
  42. Lotz B, Haerting J, Schulze E. Changes in fetal and childhood autopsies in the region of Jena after the Chernobyl accident; 1996 [cited 2016 Jan 28]. Available from: http://www.meb.uni-bonn.de/gmds/abstracts/0095e.html (German).
  43. Eckerman KF, Ryman JC. Federal guidance report 12: external exposure to radionuclides in air, water and soil; 1993 [cited 2016 Feb 20]. Available from: https://crpk.ornl.gov/documents/fgr12.pdf.
  44. Busby C, Cato MS. Increases in leukemia in infants in Wales and Scotland following Chernobyl: evidence for errors in statutory risk estimates. Energy Environ 2000;11(2):127-139. https://doi.org/10.1260/0958305001499962
  45. Yablokov AV, Nesterenko VB, Nesterenko AV, editors. Chernobyl-consequences of the Catastrophe for people and the environment; 2009 [cited 2016 Feb 20]. Available from: http://www.strahlentelex.de/Yablokov_Chernobyl_book.pdf.
  46. Lomat L, Galburt G, Quastel MR, Polyakov S, Okeanov A, Rozin S. Incidence of childhood disease in Belarus associated with the Chernobyl accident. Environ Health Perspect 1997;105 Suppl 6:1529-1532. https://doi.org/10.1289/ehp.97105s61529
  47. Scherb H, Sperling K. Today's lessons from the Chernobyl accident. Naturwiss Rundsch 2011;64(5):229-239 (German).
  48. Sperling K, Neitzel H, Scherb H. Evidence for an increase in trisomy 21 (Down syndrome) in Europe after the Chernobyl reactor accident. Genet Epidemiol 2012;36(1):48-55. https://doi.org/10.1002/gepi.20662
  49. Zatsepin IO, Verger P, Gagniere B, Khmel RD; Belarus Institute for Hereditary Diseases. Cluster of Down's syndrome cases registered in January 1987 in Republic of Belarus as a possible effect of the Chernobyl accident. Int J Radiat Med 2004;6(1-4):57-71.
  50. Akar N. Further notes on neural tube defects and Chernobyl. Pediatr Perinatal Epidemiol 1994;8:456-457.
  51. Sviatova GS, Abil'dinova GZh, Berezina GM. Frequency, dynamics, and structure of congenital malformations in populations under long-term exposure to ionizing radiation. Genetika 2001;37(12):1696-1704 (Russian).
  52. Wiesel A, Spix C, Mergenthaler A, Queisser-Luft A. Maternal occupational exposure to ionizing radiation and birth defects. Radiat Environ Biophys 2011;50(2):325-328 https://doi.org/10.1007/s00411-010-0350-9
  53. Cox DW. An investigation of possible genetic damage in the offspring of women receiving multiple diagnostic pelvic X rays. Am J Hum Genet 1964;16:214-230.
  54. Macht SH, Lawrence PS. National survey of congenital malformations resulting from exposure to roentgen radiation. Am J Roentgenol Radium Ther Nucl Med 1955;73(3):442-466.
  55. Sever LE, Gilbert ES, Hessol NA, McIntyre JM. A case-control study of congenital malformations and occupational exposure to low-level ionizing radiation. Am J Epidemiol 1988;127(2):226-242. https://doi.org/10.1093/oxfordjournals.aje.a114799
  56. Parker L, Pearce MS, Dickinson HO, Aitkin M, Craft AW. Still-births among offspring of male radiation workers at Sellafield nuclear reprocessing plant. Lancet 1999;354(9188):1407-1414. https://doi.org/10.1016/S0140-6736(99)04138-0
  57. Shakhatreh FM. Reproductive health of male radiographers. Saudi Med J 2001;22(2):150-152.
  58. Tsyb AF, Souchkevitch GN, Lyasko LI, Artamonova YZ, Navolokin VV, Raykina LG. General characterization of health in first-generation offspring born to liquidators of the Chernobyl NPP accident consequences. Int J Radiat Med 2004;6(1-4):116-121.
  59. Matveenko EG, Borovykova MP, Davydow GA. Physical characteristics and primary morbidity in liquidator's children. In: Yablokov AV, Busby C, editors. Chernobyl 20 years after. Aberystwyth: Green Audit Books; 2006, p. 176-179.
  60. Liaginskaia AM, Tukov AR, Osipov VA, Ermalitskii AP, Prokhorova ON. Congenital malformations among offspring of the liquidators of the consequences from Chernobyl accident. Radiats Biol Radioecol 2009;49(6):694-702 (Russian).
  61. Urquhart J. Radiation exposure and subsequent health history of veterans and their children. In: New Evaluation of Radiation Risk, International Conference of the Society for Radiation Protection. Bremen: Gesellschaft fur Strahlenschutz; 1992, p. 209-216 (German).
  62. Roff SR. Mortality and morbidity of members of the British Nuclear Tests Veterans Association and the New Zealand Nuclear Tests Veterans Association and their families. Med Confl Surviv 1999;15 Suppl 1:i-ix, 1-51.
  63. Busby C, de Messieres ME. Miscarriages and congenital conditions in offspring of veterans of the British Nuclear Atmospheric Test Programme. Epidemiology (Sunnyvale) 2014;4:172.
  64. Gardner MJ, Snee MP, Hall AJ, Powell CA, Downes S, Terrell JD. Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria. BMJ 1990;300(6722):423-429. https://doi.org/10.1136/bmj.300.6722.423
  65. Nomura T. Parental exposure to x rays and chemicals induces heritable tumours and anomalies in mice. Nature 1982;296(5857):575-577. https://doi.org/10.1038/296575a0
  66. Hicks N, Zack M, Caldwell GG, Fernbach DJ, Falletta JM. Childhood cancer and occupational radiation exposure in parents. Cancer 1984;53(8):1637-1643. https://doi.org/10.1002/1097-0142(19840415)53:8<1637::AID-CNCR2820530802>3.0.CO;2-Y
  67. McKinney PA, Alexander FE, Cartwright RA, Parker L. Parental occupations of children with leukaemia in west Cumbria, north Humberside, and Gateshead. BMJ 1991;302(6778):681-687. https://doi.org/10.1136/bmj.302.6778.681
  68. Graham S, Levin ML, Lilienfeld AM, Schuman LM, Gibson R, Dowd JE, et al. Preconception, intrauterine, and postnatal irradiation as related to leukemia. Natl Cancer Inst Monogr 1966;19:347-371.
  69. Shu XO, Gao YT, Brinton LA, Linet MS, Tu JT, Zheng W, et al. A population-based case-control study of childhood leukemia in Shanghai. Cancer 1988;62(3):635-644. https://doi.org/10.1002/1097-0142(19880801)62:3<635::AID-CNCR2820620332>3.0.CO;2-3
  70. Shu XO, Reaman GH, Lampkin B, Sather HN, Pendergrass TW, Robison LL. Association of paternal diagnostic X-ray exposure with risk of infant leukemia. Investigators of the Childrens Cancer Group. Cancer Epidemiol Biomarkers Prev 1994;3(8):645-653.
  71. Stewart A, Webb J, Hewitt D. A survey of childhood malignancies. Br Med J 1958;1(5086):1495-1508. https://doi.org/10.1136/bmj.1.5086.1495
  72. Natarajan N, Bross ID. Preconception radiation and leukemia. J Med 1973;4(5):276-281.
  73. Shiono PH, Chung CS, Myrianthopoulos NC. Preconception radiation, intrauterine diagnostic radiation, and childhood neoplasia. J Natl Cancer Inst 1980;65(4):681-686. https://doi.org/10.1093/jnci/65.4.681
  74. Vogel, F, Rohrborn G, Schleiermeyer E. Radiation genetics in mammals. Stuttgart: Verlag; 1969 (German).
  75. Dickinson HO, Parker L, Binks K, Wakeford R, Smith J. The sex ratio of children in relation to paternal preconceptional radiation dose: a study in Cumbria, northern England. J Epidemiol Community Health 1996;50(6):645-652. https://doi.org/10.1136/jech.50.6.645
  76. Choi JW, Mehrotra P, Macdonald LA, Klein LW, Linsky NM, Smith AM, et al. Sex proportion of offspring and exposure to radiation in male invasive cardiologists. Proc (Bayl Univ Med Cent) 2007;20(3):231-234. https://doi.org/10.1080/08998280.2007.11928292
  77. Scherb H, Voigt K. Trends in the human sex odds at birth in Europe and the Chernobyl Nuclear Power Plant accident. Reprod Toxicol 2007;23(4):593-599. https://doi.org/10.1016/j.reprotox.2007.03.008
  78. Scherb H, Voigt K. The human sex odds at birth after the atmospheric atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities. Environ Sci Pollut Res Int 2011;18(5):697-707. https://doi.org/10.1007/s11356-011-0462-z
  79. Padmanabhan VT. Sex ratio in A-bomb survivors. Evidence of radiation induced X-linked lethal mutations. In: Busby C, Busby J, Rietuma D, de Messieres M, editors. Fukushima and health: what to expect. Proceedings of the 3rd International Conference for the European Committee on Radiation Risk; 2009 May 5-6; Lesvos, Greece. Aberystwyth: Green Audit; 2012, p. 273-304.
  80. Sternglass, EJ. Environmental radiation and human health. In: Le Cam LM, Neyman J, Scott EL, editors. Proceedings of the Sixth Berkeley Symposium on Mathematical Statistics and Probability; 1971 Jul 19-22; Berkeley, CA, USA. Berkeley: University of Calififornia Press; 1971, p. 145-221.
  81. Whyte RK. First day neonatal mortality since 1935: re-examination of the Cross hypothesis. BMJ 1992;304(6823):343-346. https://doi.org/10.1136/bmj.304.6823.343
  82. le Vann LJ. Congenital abnormalities in children born in Alberta during 1961: a survey and a hypothesis. Can Med Assoc J 1963;89(3):120-126.
  83. Baverstock K, Belyakov OV. Some important questions connected with non-targeted effects. Mutat Res 2010;687(1-2):84-88. https://doi.org/10.1016/j.mrfmmm.2010.01.002
  84. Busby CC. Very low dose fetal exposure to Chernobyl contamination resulted in increases in infant leukemia in Europe and raises questions about current radiation risk models. Int J Environ Res Public Health 2009;6(12):3105-3114. https://doi.org/10.3390/ijerph6123105

Cited by

  1. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  2. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  3. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  4. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  5. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  6. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  7. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  8. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  9. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  10. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  11. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  12. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  13. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  14. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  15. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  16. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  17. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  18. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  19. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  20. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  21. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  22. There’s a World Going on Underground—Infant Mortality and Fracking in Pennsylvania vol.8, pp.4, 2016, https://doi.org/10.4236/jep.2017.84028
  23. γH2AX, 53BP1 and Rad51 protein foci changes in mesenchymal stem cells during prolonged X-ray irradiation vol.8, pp.38, 2016, https://doi.org/10.18632/oncotarget.19203
  24. A Risk Coefficient for Radiation-Induced Dementia vol.7, pp.2, 2016, https://doi.org/10.4236/aad.2018.72002
  25. Comparison of bilateral versus unilateral decompression incision of minimally invasive transforaminal lumbar interbody fusion in two-level degenerative lumbar diseases vol.42, pp.12, 2016, https://doi.org/10.1007/s00264-018-3974-z
  26. Sex Difference of Radiation Response in Occupational and Accidental Exposure vol.10, pp.None, 2016, https://doi.org/10.3389/fgene.2019.00260
  27. High Cancer Risk in US Naval Personnel Serving in Nuclear Powered Ships vol.38, pp.3, 2016, https://doi.org/10.1080/07357907.2020.1731526
  28. Radiotherapy for COVID-19: Primum non nocere vol.149, pp.None, 2016, https://doi.org/10.1016/j.radonc.2020.05.046
  29. Ionizing Radiation Protein Biomarkers in Normal Tissue and Their Correlation to Radiosensitivity: A Systematic Review vol.11, pp.2, 2016, https://doi.org/10.3390/jpm11020140