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It is increasingly recognised that stakeholder views can be essential for ascertaining the credibility of those entrusted with protection of the public and workers against radiation risks, the robustness of the approaches to protection and the relevance of research underpinning radiation protection (RP). The CONCERT European Joint Programme of RP research included consideration of stakeholder views. These were evaluated by means of a publicly available survey, translated into 15 languages, to encourage responses from a wide range of European countries. The survey ran in 2017 and received some 1961 responses from many countries, although response rates varied widely between countries. The survey respondents were largely highly educated, with many having a professional connection to RP or the use of radiation in medicine or industry. Survey results indicated a high level of scientific/technical knowledge relevant to RP and indicated a general trust of most actors involved in the RP field, perhaps unsurprisingly given the nature of the sampled population. Most expressed a reasonable level of satisfaction with the information available to them on radiation risk, but there is clearly room for improvement. Additionally, the survey identified potential training needs amongst the groups who responded. It is concluded that, while the survey results are limited by the non-representativeness of the respondents by comparison with the population of the European Union as a whole, it has been successful in gaining insights into areas where communication could be improved, where professional training gaps are present and where research could help to build wider trust in RP., (© 2021 Society for Radiological Protection. Published on behalf of SRP by IOP Publishing Limited. All rights reserved.)

This special issue of JRP includes a selection of research papers and review articles presented at the 15th Congress of the International Radiation Protection Association (IRPA15) as chosen by the scientific committee. All invited journal contributions are suitably expanded beyond the initial conference presentations to meet the criteria for a full journal article and include (a) presentation within a comprehensive radiological protection context and (b) additional data/interpretation. Published contributions address a wide spectrum of scientific topics and concepts to further develop the radiation protection (RP) system. They are based on scientific evidence and available experience in a wide spectrum of applications of the protection system. The IRPA is the international voice of the RP profession. It promotes excellence in RP by providing benchmarks of good practice, enhancing professional competence, and encourages the application of the highest standards of professional conduct, skills and knowledge for the benefit of individuals and society. Within the overarching theme of the conference 'Bridging RP Culture and Science-Widening Public Empathy' IRPA15 provided an invaluable opportunity to discuss and strengthen the relations between RP culture and science, and share developing scientific knowledge and related experience in RP among members of the scientific community, between representatives of key international organizations, including ICRP, IAEA, WHO, and NEA but also with the public. Some discussions focused on the rationale of available RP programmes and priorities, with an opportunity to identify and further develop key scientific issues of the current RP system as well as key processes for the interaction between members of the scientific community and society. The scientific programme of IRPA15 included eight topics and four thematic areas. The topical areas were: Underpinning Science; Dosimetry and Measurement; the System of Protection; Standards and Regulation; Practical Implementation-Medical Sector, as well as Industry and Research; Emergency Preparedness and Response; Existing Exposures and Non-ionizing Radiation. The thematic areas addressed were: Ethics; Communication and Public Understanding; RP Culture; Human Capital and Competency., (Creative Commons Attribution license.)

During the last decade there has been remarkable integration of radiation protection research in Europe, driven by six research platforms. The platforms are associations of research centres, university research groups and funding bodies in Member States that are dedicated to specialised areas of research in radiation protection, such as health risks (MELODI), radioecology (ALLIANCE), radiological emergencies (NERIS), dosimetry (EURADOS), medical use of radiation (EURAMED) and societal aspects (SHARE). Recently these platforms established an umbrella organisation MEENAS, to endorse further integration and joint activities in research, education and training, and infrastructures. A milestone in this process of integration and priority setting was achieved in 2020 when the first edition of the joint roadmap for radiation protection research was finalised. In this paper we describe the various roles for research and development in the radiation protection context, ranging from basic scientific knowledge underpinning the system of protection to research supporting the development and application of international standards and research and development activities needed to ensure safety in radiation practices and in potential exposure scenarios. We describe the process of how the joint roadmap has been developed and how it could be implemented. Finally, we address the need to anticipate potential future exposure scenarios and to systematically consider the impact of emerging technologies and global challenges in the context of radiation protection. The joint roadmap is a living document that needs to be regularly updated to cover both current and potential exposures of humans and the environment., (Creative Commons Attribution license.)

There is widespread recognition of the challenge of an ageing profession and the need to recruit, train and retain the next generation of radiation protection professionals. This challenge was the topic of a special session at the International Radiation Protection Association IRPA15 International Congress. It is necessary to address three key aspects: capturing the future professional: gaining RP knowledge and skills: addressing retention, development and career progression. We must support the flow of students into science-based topics and attractively promote our profession. The availability of university and other training courses, together with research opportunities, must be supported. Mentoring of young professionals is key, supported by empathetic seniors in the profession. The overall challenge necessitates cooperation across a wide range of organisations at both international and national level., (© 2021 Society for Radiological Protection. Published on behalf of SRP by IOP Publishing Limited. All rights reserved.)

Purpose: To summarize existing knowledge and to understand individual response to radiation exposure, the MELODI Association together with CONCERT European Joint Programme has organized a workshop in March 2018 on radiation sensitivity and susceptibility. Methods: The workshop reviewed the current evidence on this matter, to inform the MELODI Strategic Research Agenda (SRA), to determine social and scientific needs and to come up with recommendations for suitable and feasible future research initiatives to be taken for the benefit of an improved medical diagnosis and treatment as well as for radiation protection. Results: The present paper gives an overview of the current evidence in this field, including potential effect modifiers such as age, gender, genetic profile, and health status of the exposed population, based on clinical and epidemiological observations. Conclusion: The authors conclude with the following recommendations for the way forward in radiation research: (a) there is need for large (prospective) cohort studies; (b) build upon existing radiation research cohorts; (c) use data from well-defined cohorts with good exposure assessment and biological material already collected; (d) focus on study quality with standardized data collection and reporting; (e) improve statistical analysis; (f) cooperation between radiobiology and epidemiology; and (g) take consequences of radiosensitivity and radiosusceptibility into account.

Purpose: The workshop on 'Individual Radiosensitivity and Radiosusceptibility' organized by MELODI and CONCERT on Malta in 2018, evaluated the current state of assays to identify sensitive and susceptible subgroups. The authors provide an overview on potential screening assays detecting individuals showing moderate to severe early and late radiation reactions or are at increased risk to develop cancer upon radiation exposure. Conclusion: It is necessary to separate clearly between tissue reactions and stochastic effects such as cancer when comparing the existing literature to validate various test systems. Requirements for the assays are set up. The literature is reviewed for assays that are reliable and robust. Sensitivity and specificity of the assays are regarded and scrutinized for modifying factors. Accuracy of an assay system is required to be more than 90% to balance risks of adverse reactions against risk to fail to cure the cancer. No assay/biomarker is in routine use. Assays that have shown predictive potential for radiosensitivity include SNPs, the RILA assay, and the pATM assay. A tree of risk guideline for radiologists is provided to assist medical treatment decisions. Recommendations for effective research include the setup of common retrospective and prospective cohorts/biobanks to validate current and future tests.

Reflecting a change in funding strategies for European research projects, and a commitment to the idea of responsible research and innovation in radiological protection (RP), a collective of research institutes and universities have developed a prospective Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiological protection. This is the first time such a research agenda has been proposed. This paper identifies six research lines of interest and concern: (1) Effects of social, psychological and economic aspects on RP behaviour; (2) Holistic approaches to the governance of radiological risks; (3) Responsible research and innovation in RP; (4) Stakeholder engagement and participatory processes in RP research, development, policy and practice; (5) Risk communication; and (6) RP cultures. These topics were developed through broad stakeholder consultation, in conjunction with activities carried out in the framework of various projects and initiatives (EU H2020 CONCERT programme, the EU FP7 projects OPERRA, PREPARE and EAGLE, the 2015-2018 RICOMET series of conferences, and the 2014 and 2016 International Symposia on Ethics of Environmental Health); as well as through dialogues with members of the European radiation protection research communities. The six research lines open opportunities to integrate a range of key social and ethical considerations into RP, thereby expanding research opportunities and programmes and fostering collaborative approaches to research and innovation.

Purpose: This paper provides an update and summary on the organization of European research in the field of low dose risk and radiation protection. To address declining resources and competence in radiation protection and related research across European countries, a High Level and Expert Group (HLEG) was established in 2007. The HLEG identified key policy and scientific questions to be addressed through a strategic research agenda for low dose radiation risk. This initiated the establishment of a European Research Platform, called MELODI (Multidisciplinary European Low Dose Research Initiative). Dr Bill Morgan closely followed the European low dose programme and chaired the international Advisory Boards of DoReMi Network of Excellence and the MELODI platform., Conclusion: The MELODI research platform is dedicated to low dose ionizing radiation risk. In 2010, MELODI was founded as a registered association with 15 members. As of September 2016, the association´s membership increased to 46. A major activity of MELODI is the establishment and updating of a long-term Strategic Research Agenda (SRA) for research on low dose risk in Europe. The SRA is intended to guide the priorities for national and European research programmes and the preparation of competitive calls at the European level. A key priority for radiation protection research is to improve health risk estimates for exposures corresponding to the dose limits for occupational exposures and to reference levels for the exposure of the population in emergency situations.

The importance of low-dose risk research for radiation protection is now widely recognised. The European Commission (EC) and five European Union (EU) Member States involved in the Euratom Programme set up in 2008 a 'High Level and Expert Group on European Low Dose Risk Research' (HLEG) aimed at identifying research needs and proposing a better integration of European efforts in the field. The HLEG revised the research challenges and proposed a European research strategy based on a 'Multidisciplinary European LOw Dose Initiative' (MELODI). In April 2009, five national organisations, with the support of the EC, created the initial core of MELODI (http://www.melodi-online.eu) with a view to integrate the EU institutions with significant programmes in the field, while being open to other scientific organisations and stakeholders, and to develop an agreed strategic research agenda (SRA) and roadmap. Since then, open workshops have been organised yearly, exploring ideas for SRA implementation. As of October 2014, 31 institutions have been included as members of MELODI. HLEG recommendations and MELODI SRA have become important reference points in the radiation protection part of the Euratom Research Programme. MELODI has established close interactions through Memorandum of Understanding with other European platforms involved in radiation protection (Alliance, NERIS and EURADOS) and, together with EURADOS, with the relevant medical European Associations. The role of Joint Programming in priority setting, foreseen in the forthcoming EU Horizon 2020, calls for keeping MELODI an open, inclusive and transparent initiative, able to avoid redundancies and possible conflicts of interest, while promoting common initiatives in radiation protection research. An important issue is the establishment of a proper methodology for managing these initiatives, and this includes the set-up of an independent MELODI Scientific Committee recently extended to Alliance, NERIS and EURADOS, with the aim of identifying research priorities to suggest for the forthcoming Euratom research calls., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

In 2009, the European High Level and Expert Group identified key policy and scientific questions to be addressed through a strategic research agenda for low-dose radiation risk. This initiated the establishment of a European Research Platform, called MELODI (Multidisciplinary European Low Dose Research Initiative). In 2010, the DoReMi Network of Excellence was launched in the Euratom 7th Framework Programme. DoReMi has acted as an operational tool for the sustained development of the MELODI platform during its early years. A long-term Strategic Research Agenda for European low-dose radiation risk research has been developed by MELODI. Strategic planning of DoReMi research activities is carried out in close collaboration with MELODI. The research priorities for DoReMi are designed to focus on objectives that are achievable within the 6-y lifetime of the project and that are in areas where stimulus and support can help progress towards the longer-term strategic objectives., (© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The fourth workshop of the Multidisciplinary European Low Dose Initiative (MELODI) was organised by STUK-Radiation and Nuclear Safety Authority of Finland. It took place from 12 to 14 September 2012 in Helsinki, Finland. The meeting was attended by 179 scientists and professionals engaged in radiation research and radiation protection. We summarise the major scientific findings of the workshop and the recommendations for updating the MELODI Strategic Research Agenda and Road Map for future low dose research activities.

RadoNorm aims to manage risks from exposures to radon and naturally occurring radioactive material (NORM) to promote effective radiation protection based on improved scientific evidence and social considerations. It supports the European Member States and the EU Commission (EC) in implementing the Basic Safety Standards for protection against ionising radiation hazards at the legislative, executive, and operational levels (Directive 2013/59/EURATOM). The project is grounded on (1) implementation of multidisciplinary and innovative research and technologies, (2) integration of education and training, and (3) dissemination of project results targeting a broad stakeholder community including the public, regulators, and policymakers. The objectives are achieved through scientific research-related topics (exposure, dosimetry, biology, epidemiology, societal aspects), cross-cutting topics (education and training, dissemination, ethics) and project management. The project will yield guidelines at legal, executive and operational levels. It will enable consolidated and harmonised decision-making in the field of radiation protection, considering societal aspects and sustainable knowledge transfer. The project contributes to EC activities to strengthen radiation protection in a consistent and joint manner, as has already been done through the establishment of radiation protection platforms, the promotion of projects (e.g., DoReMi, OPERRA) and the partnership CONCERT-EJP. The outcomes may also impact future recommendations. [ABSTRACT FROM AUTHOR]

Since early April 2020, there has been intense debate over proposed clinical use of ionizing radiation to treat life-threatening pneumonia in Coronavirus Disease 2019 (COVID-19) patients. At least twelve relevant papers appeared by 20 May 2020. The radiation dose proposed for clinical trials are a single dose (0.1–1 Gy) or two doses (a few mGy followed by 0.1–0.25 Gy involving a putative adaptive response, or 1–1.5 Gy in two fractions 2–3 days apart). The scientific rationale for such proposed so-called low dose radiotherapy (LDRT) is twofold (note that only doses below 0.1 Gy are considered as low doses in the field of radiation protection, but here we follow the term as conventionally used in the field of radiation oncology). Firstly, the potentially positive observations in human case series and biological studies in rodent models on viral or bacterial pneumonia that were conducted in the pre-antibiotic era. Secondly, the potential anti-inflammatory properties of LDRT, which have been seen when LDRT is applied locally to subacute degenerative joint diseases, mainly in Germany. However, the human and animal studies cited as supportive evidence have significant limitations, and whether LDRT produces anti-inflammatory effects in the inflamed lung or exacerbates ongoing COVID-19 damage remains unclear. Therefore, we conclude that the available scientific evidence does not justify clinical trials of LDRT for COVID-19 pneumonia, with unknown benefit and known mortality risks from radiogenic cancer and circulatory disease. Despite the significant uncertainties in these proposals, some clinical trials are ongoing and planned. This paper gives an overview of current situations surrounding LDRT for COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

• Ionizing radiation causes adverse circulatory and metabolic effects at high doses. • Low-dose radiation is causally associated with circulatory disease. • Impact of low-dose radiation is modulated by inflammatory, stress, and immune responses. Risks to health are the prime consideration in all human situations of ionizing radiation exposure and therefore of relevance to radiation protection in all occupational, medical, and public exposure situations. Over the past few decades, advances in therapeutic strategies have led to significant improvements in cancer survival rates. However, a wide range of long-term complications have been reported in cancer survivors, in particular circulatory diseases and their major risk factors, metabolic diseases. However, at lower levels of exposure, the evidence is less clear. Under real-life exposure scenarios, including radiotherapy, radiation effects in the whole organism will be determined mainly by the response of normal tissues receiving relatively low doses, and will be mediated and moderated by systemic effects. Therefore, there is an urgent need for further research on the impact of low-dose radiation. In this article, we review radiation-associated risks of circulatory and metabolic diseases in clinical, occupational or environmental exposure situations, addressing epidemiological, biological, risk modelling, and systems biology aspects, highlight the gaps in knowledge and discuss future directions to address these gaps. [ABSTRACT FROM AUTHOR]