People are exposed to low-dose radiation in many ways: having a CT scan, working as a medical technician or in a nuclear power plant, or living in an area contaminated by radiation. The health effects of these low-dose exposures are not well understood — but a revitalized research program could change that.
Decades of research have revealed a number of adverse health effects that have occurred in individuals exposed to high doses of radiation, with most of this work focused on cancer. Much less is understood about the effects of low doses experienced by millions of Americans, although there is increasing evidence of its links to cardiovascular disease, neurological disorders, immune dysfunction, and cataracts, as well as cancer. These possible connections raise questions as to whether the public and workers are adequately protected by current radiation standards and regulations.
We and a group of colleagues working in radiation biology, dosimetry, epidemiology, biotechnology, economics, biostatistics, environmental health, and other disciplines released a report in early June detailing the limitations in what’s known about the health effects of exposure to low-dose radiation. This group, assembled by the National Academies of Science, Engineering, and Medicine at the request of Congress, presented a plan to revitalize low-dose radiation research in the U.S., which has stalled in recent years, including how this research could be coordinated, its essential elements, and high-priority areas needed to fill in some of the knowledge gaps.
The first step we recommend is to ensure adequate funding for this important work. The $5 million appropriated for the U.S. Department of Energy’s (DOE) low-dose radiation program in 2021 and 2022 is not sufficient even to get a research program off the ground, let alone fund the research itself. But with adequate funding, we estimate the DOE could implement a revitalized, strategic research program within just two years.
Significant investments over a sustained period spanning more than a decade will be required, with an estimated cost of about $100 million a year for the next 15 years. This funding would help establish a structure for research, fund competitive proposals in epidemiological and biological research, support engagement with affected communities, and train and retain a new generation of radiation scientists across a range of disciplines.
One critical finding of the report is that a revitalized low-dose research program would be able to leverage recent development in other fields, such as increased understanding of the cellular and molecular processes that enable development of human adverse health effects; new epidemiological methods and databases; and powerful new biological, measurement, and computational tools that previous researchers did not have at their disposal.
Epidemiological research can take advantage of increasingly accessible electronic databases and information on disease presence and severity from the internet of medical things, as well as more precise molecular classification of human diseases, and improved estimates of radiation doses, among other advances. These approaches could also aid in identifying factors such as inherited genetic variants or lifestyles that can modify the risks of low-dose radiation exposure.
Biological research can exploit new abilities to manipulate cells, tissues, and animals to understand how biological responses change with the level of exposure; to directly measure cellular and molecular changes resulting from exposure to low dose radiation; and to establish causal links to radiation exposure. The use of advanced measurement tools could help reveal the mechanisms that control biological responses to low-dose radiation.
We believe this research requires a long-term federal commitment, because the effects of low-dose radiation may take years or decades to manifest themselves. It will also take time to build and sustain a community of radiation effects experts who will be available to assist in the management and mitigation of the health effects of radiation exposures.
To be successful, any federal office leading the program will need to be dedicated to scientific independence, transparency, and stakeholder participation. This is especially important as science seeks to provide answers to concerned individuals and to communities that have been involuntarily exposed to radiation: indigenous communities, veterans exposed to radiation during military operations, nuclear workers, and others affected by the legacy of U.S. nuclear weapons testing and production. These communities had a strong voice in our report, and we learned how essential trust and meaningful involvement in research is to them.
Our committee also acknowledged concerns from communities affected by low-dose radiation regarding the Department of Energy’s leadership of low-dose radiation research, such as its conflicts of interest due to its work with the nuclear weapons program and promoting nuclear energy. While our committee was specifically asked to develop a research program led by DOE, our report notes that both it and the National Institutes of Health (NIH) have historically supported radiation research. While the DOE’s Office of Science has de-prioritized this research in recent years, the NIH’s health research capabilities are well established, and the NIH is widely trusted by the scientific community and has no perceived conflicts of interest regarding radiation research from the public.
Our report is clear: If a revitalized low-dose research program moves forward under DOE leadership, its performance should be independently evaluated. If the agency’s management of the program falls short, other agencies, including the NIH, should be considered to lead the program instead.
An opportunity exists to greatly expand the understanding of how low-dose radiation exposure affects health. A federally-coordinated program will provide valuable information, and reveal whether current regulations and protections are adequate to keep Americans safe from the effects of low-dose radiation. Now is the time to revitalize this research.
Joe Gray is a professor emeritus at the Oregon Health and Science University and University of California, San Francisco, and chair of the National Academies of Sciences, Engineering, and Medicine’s Committee on Developing a Long-Term Strategy for the Low-Dose Radiation Research in the United States. Lindsay Morton is a senior investigator and deputy chief of the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics at the National Cancer Institute, and a member of the committee. Gayle Woloschak is a professor of radiation oncology at Northwestern University in Chicago, adjunct professor of religion and science at Lutheran School of Theology Chicago and at Pittsburgh Theological Seminary, and a member of the committee.