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Home | Current Program | PAC 4 | SC 4-4SC 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:
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 the NCRP office. At this meeting, the title, scope, and general structure of the report were discussed and agreed upon. The title chosen for the report was “Reproductive and Developmental Effects of Radiation to the Gonads, Embryo and Fetus.” A significant point of discussion was to what extent nonionizing radiation effects should be included. Writing assignments were distributed among the Committee with the deadline for drafts to be submitted to the technical consultant by February 20, 2009. He then combined them in time for the second meeting of the Committee on March 12-13, 2009, at which time the first draft was discussed. In addition, other expert(s) in nonionizing radiation effects on the embryo/fetus were invited to the meeting. The Staff 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. 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 2009 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 that 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. The fifth meeting of the Committee was held April 22-23, 2010. The report and future plans were discussed. It was agreed that authors will have revised text for Sections 2, 3, 4 and 5 by the end of May. With one exception this was done, and these and other edits were incorporated into Revision 7 which was posted for comment by Committee members by the middle of July. A major revision to the cancer risk section of Section 5 is due at that time also. All other sections are in a good condition, including the conclusions and recommendations. On September 1, 2010 the draft report was distributed for PAC review with a deadline for comments of October 1, 2010. The comment period was somewhat extended and comments were received through October 14, 2010. As of December 31, 2010, a revised draft report has been generated that reflects all comments received during PAC review, the Chairman’s initial thoughts on the comments, initial general editing, and a complete review of references. Active consultation on the section discussing oncogenic effects for ionizing radiation exposure of the embryo and fetus (Section 5.2.5) has occurred among the Chairman, the Committee, key PAC reviewers, and the current NCRP Staff Consultant. A revised version of Section 5.2.5 that will present the status of scientific information and accommodates the various viewpoints expressed during review is in process. In January 2011, most work on SC 4-4 was put on hold pending receipt of funding for this NCRP project. A two-day meeting of the Chairman and NCRP Staff Consultant occurred on January 18-19, 2011 at the NCRP offices and progress continued on preparation of the next draft and follow-up assignments to other SC 4-4 members on sections they had previously prepared. On April 22, 2011, the NCRP Staff Consultant met at the NCRP offices to consult with the author of Section 5.2.5 (oncogenic effects). In late June 2011, inquiries were made on the status of some pending follow-up assignments. As of June 30, 2011, most work on SC 4-4 is still on hold pending receipt of funding. As of September 30, 2011 funding for SC 4-4 is now available and further revision of the draft report is underway, in order to prepare and submit the draft report for Council review in 2012.
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