Prevention of work-related injuries and diseases: lessons from experience with ionizing radiation

Almost immediately after the discovery of the Roentgen ray, in 1895, radiation injuries of various kinds began to be encountered in early X-ray workers, radium handlers, radiologists, and exposed patients. The injuries, which were predominantly acute reactions resulting from the killing of cells in affected tissues, were found to be preventable merely by keeping exposures below relevant threshold levels. By the middle of the twentieth century, however, it was realized that thresholds might not exist for certain effects of ionizing radiation, such as mutagenic, carcinogenic, and teratogenic effects. The risks of such effects in workers and other populations exposed to low-level radiation have thus been of increasing concern in recent years. The scientific basis for assessing such risks and the principles that have evolved for their control have important implications for occupational and environmental health in general.