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SC 4-4: Risks of Ionizing Radiation to the Developing Embryo, Fetus and Nursing Infant  

NCRP is preparing a report on radiation risks to the embryo, fetus and nursing infant that will significantly update and extend information contained in two previous NCRP publications: Report No. 54 on Medical Radiation Exposure of Pregnant and Potentially Pregnant Women, published in 1977, and Commentary No. 9 on Considerations Regarding the Unintended Radiation Exposure of the Embryo, Fetus or Nursing Child, published in 1994. Subsequent advances have been made in determining the potentially adverse effects of both pre- and postconception maternal irradiation, and of irradiation at various stages of pregnancy. In addition, there have been significant increases in recent years in the use of diagnostic radiological procedures to which pregnant or potentially pregnant women can be exposed, including the rapidly increasing use of computed tomography (CT), positron emission tomography (PET), and single photon emission computed tomography (SPECT), and as well as multi-modality imaging procedures (e.g., PET/CT and SPECT/CT).

This report will provide a comprehensive discussion of the following topics:

• Birth defects and developmental abnormalities that can result from irradiation of an embryo, fetus, or nursing infant based on information gained from studies on in utero and postnatal exposures of atomic-bomb survivors and inadvertent medical or occupational exposures of pregnant and nursing women.
• Quantitative estimation of doses to embryos, fetuses, and nursing infant from external radiation sources or radionuclides administered to the mother.
• Potential risks of birth defects or developmental abnormalities in an embryo/fetus from maternal exposures to diagnostic imaging procedures that involve nonionizing radiation, especially ultrasound and magnetic resonance imaging.
• Effective methods of communicating the risks of radiation exposure to pregnant women, and conveying to them the scientific basis for decisions on whether and when diagnostic or therapeutic radiological procedures should be performed with minimal risk to the developing embryo or fetus.

The Committee that will prepare the report has been established, and drafting of the report will begin in 2008.

The Committee held its first meeting October 29-31, 2008 at NCRP Headquarters. At this meeting, the title, scope and general structure of the report were discussed and agreed upon. The most significant point of discussion was to what extent nonionizing radiation effects should be included. Writing assignments were distributed among the members with the deadline for drafts to be submitted to the technical consultant by February 20, 2009. He will then combine them in time for the next meeting of the Committee scheduled for March 12-13, 2009, at which time the first draft will be discussed. In addition, other expert(s) in nonionizing radiation effects on the embryo/fetus may be invited to the meeting. 

The technical consultant took the outline agreed upon at the first meeting and put it into NCRP report format. The text that several SC 4-4 members had drafted in accordance with their writing assignments was incorporated into Revision 1 of the document and distributed prior to the Committee’s second meeting on March 12-13, 2009 at NCRP Headquarters. This revision was discussed in conceptual terms at the meeting, along with other material that had come in too late to be incorporated. A telephone discussion was held with two additional consultants regarding the incorporation of nonionizing radiation effects in the report. As a result of these discussions, the structure of the document was revised and feedback was provided to the authors for their consideration during the next revision. Additional writing assignments were made and proposed dates for the next meeting in July were discussed. After the meeting the NCRP Staff Consultant distributed notes of the meeting, a listing of individual responsibilities, and a revised table of contents for the report.

The third meeting of the Committee was held at NCRP on July 20-21, 2009. It was decided that the title of the report should be changed to “Adverse Effects of Radiation on the Gonads, Embryo and Fetus.” Proposals were also made for significant rearrangement of topics and text. Feedback was given to the authors of the various sections, so that the next revision could be more consistent in style, depth and content. It was agreed that missing text material would be drafted by August 31, with revisions to existing material being submitted to the Technical Staff Consultant by October 19, 2009. The intent was that a significantly improved and more complete text would be available for the next scheduled meeting on November 12-13, 2009. The Technical Consultant issued the fourth major revision, incorporating Committee member comments and consolidated references, at the end of the third quarter of 2009.

The fourth meeting of the Committee was held November 12-13, 2009. Revision five of the draft was reviewed at this time with the focus on the entire document, rather than specific editorial issues. Final writing and editorial assignments were made. It was agreed that January 15, 2010 would be the deadline for the last revision of text to be submitted to the technical consultant, with a February 15, 2010 deadline for the completion of his edits. The Committee would then have until March 15, 2010 to make comments and further edits with a view to having a final in-person meeting on April 22-23, 2010. At this meeting detailed edits will be made before submitting the draft report for PAC review.

During the second day of the November meeting, the Committee went through a brainstorming session developing some conclusions and recommendations. After the meeting, it was found that one of the consultants was going to be unable to complete his writing assignment on schedule and a new consultant, Joseph J. Morissey, was appointed to draft a chapter on radiofrequency effects.

SC 4-1  Management of Persons Contaminated with Radionuclides >

SC 4-2 Population Monitoring and Decontamination Following
a Nuclear or Radiological Incident >

SC 4-3 Diagnostic Reference Levels in Medical Imaging:
Recommendations for Application in the United States >

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