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Ninth Annual Warren K. Sinclair Keynote Address: Effects of Childhood Radiation Exposure: An Issue From Computed Tomography Scans to Fukushima

Mettler, Fred A. Jr.*; Constine, Louis S.; Nosske, Dietmar; Shore, Roy E.§

doi: 10.1097/HP.0b013e31829c3548
Warren K. Sinclair Keynote Address

Abstract: The acute and chronic effects of radiation on children have been and will continue to be of great social, public health, scientific, and clinical importance. The focus of interest on ionizing radiation and children has been clear for over half a century and ranges from the effects of fallout from nuclear weapons testing to exposures from accidents, natural radiation, and medical procedures. There is a loosely stated notion that “children are three to five times more sensitive to radiation than adults.” Is this really true? In fact, children are at greater risk for some health effects, but not all. For a few sequelae, children may be more resistant than adults. Which are those effects? How and why do they occur? While there are clear instances of increased risk of some radiation-induced tumors in children compared to adults, there are other tumor types in which there appears to be little or no difference in risk by age at exposure and some in which published models that assume the same relative increase in risks for child compared to adult exposures apply to nearly all tumor types are not supported by the scientific data. The United Nations Scientific Committee on Effects of Atomic Radiation (UNSCEAR) has a task group producing a comprehensive report on the subject. The factors to be considered include relevant radiation sources; developmental anatomy and physiology; dosimetry; and stochastic, deterministic, and hereditary effects.

*Radiology and Nuclear Medicine Service, New Mexico Veterans Affairs Health Care System, 1501 San Pedro Blvd. SE, Albuquerque, NM,87108; †Radiation Oncology and Pediatrics, Department of RadiationOncology, Clinical Director, Philip Rubin Survivorship Division, James P. Wilmot Cancer Center, P.O. Box 647, University of Rochester Medical Center, Rochester, New York; ‡Fachbereich Strahlenschutz und Gesundheit, Bundesamt fur Strahlenschutz, Ingolstadter Landstrasse 1, 85764 Oberschleissheim, Neuherberg, Germany; §Radiation Effects Research Foundation, Hiroshima, Japan.

The authors declare no conflicts of interest.

For correspondence contact: Fred A. Mettler Jr., Radiology and Nuclear Medicine Service, New Mexico Veterans Affairs Health Care System, 1501 San Pedro Blvd. SE, Albuquerque, NM, 87108, or email at

(Manuscript accepted 16 May 2013)

© 2013 by the Health Physics Society