Reducing Uncertainties in Low Dose/Low Dose Rate Health Risks Requires International Networking in Research Implementation and Its Communication to Stakeholders

The robustness of the international system of radiological protection relies on regularly updating its scientific underpinnings while providing a clear understanding of the assumptions needed to cope with the remaining uncertainties associated to radiation-induced health risks at low dose/low dose rate (i.e. below 100 mSv or below 0.1 mSv/minute). Recent reviews of biological and epidemiological data tend to provide additional support to the assumption that, for low dose, low dose rate exposures, stochastic effects (e.g. cancer risk) follow a dose response with no threshold. However, the adoption of this Linear-Non-Threshold (LNT) model remains controversial because of the large uncertainties persisting about health risks associated with low dose/low dose rate radiation exposures. Current knowledge in low dose or low dose rate radiobiology shows that the mechanisms involved in carcinogenesis are extremely complex. The integration of biological evidence on radiation-induced cancers with epidemiological results offers a promising mechanism-based approach for a less uncertain inference from high doses/dose rates to low doses/dose rates. This approach also applies to non-cancer effects (e.g. circulatory diseases, cognitive effects, lens opacities), where interpretation of epidemiological and animal studies could be reconciled through the development of Adverse Outcome Pathways (AOP), adopting the strategy used for chemical toxicity and its regulation. Given the importance placed on such research by public funding bodies and the broad amount of research being conducted and continued in this area across the globe, while noting national and regional ongoing efforts to effectively collaborate and co-ordinate research, ongoing and planned work merits consideration under an international meta-coordination. One way to reduce uncertainties in low dose/low dose rate health risks is to advance related research strategically, ensuring better use of key results in policy making and improving the way research findings and policies are communicated to stakeholders. To address these issues, the High-Level Group on Low-Dose Research (HLG-LDR) operating under the auspices of the Nuclear Energy Agencies (NEA���s) Committee on Radiological Protection and Public Health (CRPPH), aims to facilitate global networking of low dose research funding organisations and research implementing organisations. This initiative will also integrate a policy-oriented communication strategy on risk uncertainties. Finally, the HLG-LDR activities will enhance the impact of research and have implications for radiological protection policy, regulation and implementation, which will contribute to the revision of the International Commission on Radiological Protection system and beyond.
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