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OPERRA – Open Project for the European Radiation Research Area

Open Project for the European Radiation Research Area – the research, called EURALOC, is financed within OPERRA project. It focuses on low dose radiation effects on the formation of lens opacities in the eye. Although, it has already been proved in previous studies that there is an increased risk of lens opacities within the cohort of interventional cardiologists still several issues regarding the relationship between radiation dose, lens opacities and cataract development remain unclear due to their poor statistical power.

EURALOC combines epidemiological, ophthalmological and dosimetric research expertise to address effects of radiation on the lens of the eye and to determine the dose – response relationship at low dose. The epidemiological study will be performed on a European cohort of interventional cardiologists from 12 countries (Belgium, Finland, France, Germany, Greece, Italy, Luxemburg, The Netherlands, Norway, Poland, Portugal, Serbia).

A clarification of the dose – response relationship for radiation – induced lens opacities will not only provide a scientific basis for the determination of the low-dose threshold for lens opacities, but will also have an impact on the improvement of radiation protection and dose reduction procedures for medical staff in the clinical environment. The common methodology is going to be used by each participant to guarantee harmonised data collection as well as evaluation of cumulative eye lens doses. All recruited cardiologists will have also a slit lamp eye examination, performed by an ophthalmologist. These images are digitised and evaluated by 2 experienced study ophthalmologists within the EURALOC team. This approach will reduce the inter-observer variability for LOCS III lens classification. In order to reduce also variability in the performance of the slit lamp examinations, a manual is prepared on how these examinations should be performed by the ophthalmologists in the participating countries.

The latest epidemiological evidence suggest that the dose threshold for radiation induced lens opacities could be lower than previously considered or even there is not threshold at all. For this reason ICRP (International Commission on Radiation Protection) considers the threshold dose to be 0.5 Gy and has recommended the equivalent dose limit for the lens of the eye of 20 mSv/year for individuals  occupationally exposed to ionising radiation. This fact will seriously impact radiation protection at the workplace and particularly healthcare provision. The project results will deliver the information about the prevalence of lens opacities among physicians occupationally exposed to ionizing radiation and related risk based on European cohort. Also the more general issue will be addressed in the project which is the question about the deterministic and/or stochastic nature of the eye lens opacities and the level of dose threshold. This is manifested by a final expected outcome of this project which is an attempt to determine the dose – response relationship. From more practical point of view the project will also have great impact on optimization of radiation protection in workplaces and will provide the basis for improvements to regulatory regimes. The recent European directive 2013/59/EURATOM follows the ICRP guidance and member states should undertake the necessary steps to comply with Directive by 6 February 2018.

Project manager: Joanna Domienik, PhD: Joanna.Domienik@imp.lodz.pl

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