A methodology for establishing radiation causality of pathologies in chronic exposure to low-LET radiation in significant doses (0.4–1.0 Gy and higher) is proposed. It is relevant for accidents and extreme incidents of unintentional and intentional (nuclear and radiological terrorism). The use of risk assessments for nuclear workers (NW), for whom individual dosimetry is available, for modeling such effects seems to be the most correct approach. Based on the maintained and registered database on effects in NW, a complete sample of studies was formed that would have mortality risk assessments (Standardized Mortality Ratio; Relative Risk) from various pathologies for NW irradiated at doses from 0.4 Gy to 1.0 Gy and higher (systematic review). Mortality risks were assessed binary — “yes” (i.e. 1.0) or “not” (up to 1.0 inclusive). The percentage of risk detection was calculated for the samples for various pathologies. When a positive risk was found in 50% of studies, the causality of the pathology was considered to be attributable to radiation, similar to the Daubert Ruling in US courts. Using this method, attribution gradations of non-cancerous diseases and various types of cancer were established. It was found that these gradations, except for those identified for the most radiation-induced pathologies (leukemia and circulatory diseases), do not coincide with the table data for the Japanese cohort of victims of the atomic bombings (the LSS cohort). The proposed gradation for the consequences of chronic exposure on the population, professional and special contingents in the case of emergency, extreme or terrorist irradiation is more adequate due to a number of factors (chronic, not acute exposure, as in LSS, a more homogeneous contingent, the presence of individual dosimetry, etc.). The calculated standard “probabilities of radiation-induced diseases”, obtained on the model of NW effects, can serve as additional benchmarks for Interdepartmental Expert Councils to establish a causal relationship between developed pathologies and the radiation factor in the personnel of enterprises subordinate to the Federal Medical and Biological Agency of Russia and other departments. The absence of radiation attribution for a number of cancers and non-cancerous pathologies, even in relation to such irradiated groups of NW, will allow making a similar conclusion, but with even greater confidence, for significantly less irradiated professional groups within the Federal Medical and Biological Agency of Russia and the Rosatom system. And in the case of accidents and terrorist attacks, the developed methodology will provide reference information for subsequent assessment of the radiation-induced effects in victims.
Koterov et al. (Wed,) studied this question.