A dosage response curve for the one rad range: adult risks from diagnostic radiation

Most exposure to low-level ionizing radiation, both diagnostic x-rays and nuclear radiation, occur in the range between 100 milirads and 10 rads--the "one rad range". In the past, the estimates of hazards in this range have been obtained by linear extrapolation from data on persons who were exposed to much higher dosages, generally in the centirad range used in radiotherapy of non-malignant disease. This article presents the first dosage response curve for the one rad range ever to be developed directly from data on men exposed to ordinary diagnostic radiation. The findings are based on approximately 220 men with non-lymphatic leukemia and more than 270 random-sample controls from the Tri-State Survey. The new findings suggest that the estimates previously obtained by extrapolation from high dosage levels to low dose levels underestimate the actual hazards by an order of magnitude. The new dosage response curves indicate that linear extrapolation fails because it disregards the subgroups in the general population that are particularly vulnerable to x-ray. There are immediate implications concerning the use of medical x-rays in screening or for routine purposes. The past risk-benefit calculations are based on extrapolative estimates and require drastic revision. Uses of x-ray which were previously marginal are now clearly counterindicated.