MEDIRAD | DoReMi | OPERRA | EUROHEIS 2 | ORAMED
DoReMi – Low Dose Research towards Multidisciplinary Integration
The grant has been obtained in the framework of the 3rd call for an additional partner in the DoReMi ('Low Dose Research towards Multidisciplinary Integration') project. DoReMi project aims at promoting the integration of European research on the health risks (present in the environment, in the workplace or received in the course of medical procedures) from low doses of ionizing radiation in order to more effectively resolve the key policy questions concerning the shape/s of dose response relationship/s, variation in risk between individuals, tissue sensitivity for cancer, radiation quality, risks from internal exposures and non-cancer effects. In particular, the Work Package 7 (WP7) is dedicated to non-cancer effects of ionizing radiation such as, among others, development of lens opacities and cataract.
The latest European and worldwide epidemiological studies on occupational cataract among interventional cardiologists and radiologists provided a clear evidence for the induction of lens opacities due to exposure of low dose radiation. Previous national epidemiological studies in the USA, Malaysia, Finland and France all reported excess risks of lens opacities,however, they were not able to confirm any dose-response relationship due to weak statistics. Pooling the cohorts of these previous studies for a joined analysis is not possible based on inconsistent methods regarding lens opacity classification, assessment of known risk factors of cataract and none or a poor dose assessment.It appeared that a well-designed large – scale epidemiological study is needed (as has been stressed by DoReMi Transitional Research Agenda (TRA Statement)) to create a large European cohort which would allow to answer fundamental questions about the deterministic and/or stochastic character of lens opacities.
Therefore, in the frame of the DoReMi project much effort has already been made to harmonise the establishment of a European cohort of interventional cardiologists for a possible future large-scale epidemiology study on dose-response relationship for radiation-induced lens opacities. For example, in the ealier tasks of the project DoReMi (ELDO initiative, Task 7.4) the methodology has been developed, including the creation of questionnaires to collect occupational and medical history, as well as a detailed protocol related to the inclusion and exclusions criteria, the performance of ophthalmological examinations, the classification of lens opacities and last but not least the retrospective assessment of cumulative eye lens dose. It would be of great value if the developed methodology would be tested and validated in practice.
Therefore, the next goal of the project DoReMi, carried out by the Institute of Occupational Medicine in Lodz in the Task 7.11, is to perform a pilot epidemiological study among interventional cardiologists in Poland based on the developed in Task 7.4 protocols in order to test them in practice on national level. Moreover, a thorough dose measurement program will be set up in routine practice with these cardiologists in order to validate the developed approaches for retrospective eye dose assessment. The latter is a crucial issue for precise establishment of a dose-response relationship.
The main objective of the study is to create a sound basis for better planning of a future European epidemiological research aiming to establish dose-response relationship for radiation-induced lens opacities. The better knowledge of the uncertainties related to the estimation of cumulative eye lens doses is crucial for determination of the dose-response curve and confirmation of the dose threshold.
Project manager: Joanna Domienik, PhD: Joanna.Domienik@imp.lodz.pl
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