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The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium (2019)

Chapter: Appendix C: List of Questions Submitted to Speakers and Panelists

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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
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Appendix C

List of Questions Submitted to Speakers and Panelists
1

  1. How do we add dose rate to radiation risk assessment?
  2. Is anyone considering psychological effects of low dose radiation with no physiological basis and how this may direct or be affected by biophysical research?
  3. There are still high dose experts being developed through Rad Onc departments (this is limited). How much do high dose experts help with low dose issues?
  4. Of the 22,000 estimated deaths per year from radon in BEIR VII, has anyone calculated the true number realized? If so, how does it compare?
  5. Are there incentives that might be offered to governmental agencies to participate in low dose radiation research efforts?
  6. Can someone talk about the work that the OSTP is doing for low dose radiation?
  7. To John Neumann: How was a decision made for OSTP to focus on radiation biology (as opposed to radiation biology and epidemiology)?
  8. What research is being done or needs to be done on health effects of combined radiation/chemical exposure at DOE cleanup sites?
  9. While we wait for this research, how do you currently answer the question “how much radiation is safe”?
  10. When involving private sector participants as funders, how are conflicts of interest mitigated?

___________________

1 This list of questions is unedited other than for spelling mistakes and for consistency.

Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. To Ted Lazo: How did NEA come to the conclusion that coordination of low dose research nationally and internationally is efficient?
  2. Ted: Great points about opportunities to increase data networks/sharing. One area we could leverage is radiation oncology patient registries. Comments?
  3. What is the relationship of the NEA to the IAEA? Might the IAEA be a better synchronizer for international coordination of research and research funding?
  4. What about the uncertainty of choosing adults, primarily males to look at dose-response versus LIFECYCLE which every species has? And have cumulative impacts?
  5. I didn’t see a lot of U.S. survey respondents and was wondering if the different NIH Institutes that fund radiation research were invited to participate?
  6. How does ICRP fit in the OECD/NEA?
  7. Has anyone considered how to bring industry into the conversation? Maybe through radiation protection?
  8. Consider knowledge on risk communication in medicine, Image Gently/ Wisely, and for example in the Bonn Call for Action (WHO/IAEA).
  9. Smoking is not just a confounder of radon exposure, but also is a source of low dose radiation exposure.
  10. Every adult was in utero. Ignoring exposures pre-birth/childhood, prior to adulthood is UNCERTAINTY for outcomes of adult exposure. Do we have model 4 this?
  11. Has the NEA LDR resulted in changes in radiation protection policies or programs?
  12. Tony: How do you translate systems biology based risks from model systems to genetically diverse humans, given the strong impact of genetic background on risk?
  13. Dr. Brooks: What were the top 2 or 3 contributions of the DOE low dose radiation research program to radiation protection policies or regulations?
  14. Has there been any work within MELODI on in utero effects?
  15. Are there any longitudinal studies of cancer, fertility, and birth defects in St. George, Utah?
  16. How has MELODI avoided conflicts of interest? For example, a small group of scientists creating a research agenda that they will pursue and be awarded?
  17. Michaela: How rapidly do individual labs cycle in and out of MELODI as priorities are adjusted?
  18. What is total investment in LDR in Americas, Europe, and Asia?
  19. Tony: Based on DOE research what in your opinion should be the shape of the low dose curve?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. How does MELODI track translation of research results into medical practice, trading, and policy?
  2. Michaela: I am encouraged by the response of students. Are there any goals for gender balance in participation or leadership? USA so far behind on these matters.
  3. Any cataract data from the animal research in Japan by age?
  4. What was the justification used for financial support for the great facilities at IES?
  5. What is the cause of death of mice that undergo premature death in low dose exposures?
  6. How does MELODI translate results into best practice and policy?
  7. How do reports that help set radiation protection standards (BEIR, UNSCEAR, ICRP, NCRP, other) also help inform your program’s research priorities?
  8. How well do animal models represent human health outcomes? Do we know enough about this to plan research?
  9. Dmitri: Is the Canadian low dose exposure faculty available for fee for service research?
  10. Tony: Do you think the European model of collaborative prioritization and funding of research could work in the U.S.? Comment on challenges (e.g., funding)?
  11. Michaela: Can you tell us more about the move to include humanities within the European low dose radiation research collaborative framework?
  12. What is your definition of low dose in quantitative terms? What is your definition of low dose rate?
  13. For Dmitri: In Canada, what conflict of interest protections are in place when accepting funding from industry?
  14. Dmitri: Do the CANDU funders have a role in setting priorities and/or have influence on results reporting?
  15. Are there any efforts to develop an international consortium of low dose work that would allow for interface of Canada, Europe, Japan, U.S., Korea, etc.?
  16. How well do endpoint driven animal studies capture cumulative or progressive effects? What types of studies are needed to interrogate these phenomena?
  17. Isaf: How is DOE coordinating with other federal agencies in the low dose arena? Could that be enhanced?
  18. Dr. Al-Nabulsi: Can you provide examples of the methods your organization is using to integrate low dose radiobiology and epidemiology?
  19. There are so many agencies and groups that handle radiation issues in the U.S. Is there ever a forum where everyone gets together to discuss issues?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. Can Dr. Al-Nabulsi please comment on the current/future status of the DOE Low Dose Radiation Research Program in OBER, given Congress seems willing to fund?
  2. Armin: Is risk communication research too delusional to the main issues of radiobiology and risk estimation?
  3. Given the general need for better information on low dose risk, is there a mechanism where all agencies contribute to a coordinated research effort?
  4. How much does the atomic veteran program cost DoD?
  5. For Gilsted: Have we not made significant strides in cancer treatment, cures, screening, and prevention?
  6. How will artificial intelligence affect LDRR?
  7. Al-Nabuisi: The DOE had a Memorandum of Understanding with CDC to support public health research. Does the DOE view that as a model of future collaboration?
  8. What are some immediate, low-cost steps agencies could take to better communicate radiation risk on issues of current public interest?
  9. I love basic science, but how much of this impacts public health? We can agree that risks are very low at low dose and uncertainty will likely always be high.
  10. Steve: Are there NASA programs in place to obtain biosamples from astronauts before and during exposure for response assessment?
  11. For Terry Brock: Has the NRC’s Advisory Committee on Medical Uses of Isotopes (ACMUI) ever taken up the issue of low dose research and radiation protection?
  12. Terry Brock: How much do you think public perception of radiation affects the decisions that are made by NRC in regulating radiation exposures?
  13. If you could define the data quality objective for low dose research, what would it be?
  14. What information do you hope to receive by the end of this symposium as far as the future of the low dose program is concerned?
  15. How do your agencies differentiate risks of low dose external penetrating ionizing radiation and internal radionuclide exposures?
  16. How much of low dose research drivers are actually science vs. acceptable legal culpability?
  17. Should a low dose research be independent rad bio, epidem., dosimetry, risk comm. vs. a consortium research model w/all integrated into larger joint projects?
  18. Will there be a messaging strategy or plan to address public concerns that will be heightened from watching the popular miniseries Chernobyl?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. Suggestion, not question: make it easier for webcast participants to submit questions. Add link to agenda, webpage, etc.
  2. Why isn’t there more emphasis on analyzing malignant human tissue for radionuclides, to assess causal linkage between nuclear sites and nearby disease incidence.
  3. Donald: Is EPRI coordinating with the NIH on any research themes?
  4. All: As leaders of organizations that promote radiation research, what do you see as the barriers to the development of an integrated low dose research program?
  5. Note to all: Detecting effect requires knowledge of normal. The NIH Human Biomolecular Atlas Program will provide much of what is needed for many tissues.
  6. Do any of your organizations coordinate efforts with funding agencies such as DOE or NIH?
  7. NCRP and ICRP: How is independence of your recommendations for regulators and researchers ensured? Reflected in forming committees, selecting report topics?
  8. Alan, you cited several non-radiogenic effects of nuclear disasters. What responsibility does the nuclear industry take for the social impacts of its disasters?
  9. How do you see your organization contributing to a potential low dose program in the U.S.?
  10. What is the status of the million radiation worker study?
  11. Much of the science is inaccessible to the public (e.g., NCRP/ICRP docs) due to cost. Are we impeding public understanding because they are inaccessible?
  12. Kimberly, given your example of the industry outreach, why are there so many concerns about radiation?
  13. Larry Dauer didn’t answer the question. He spoke of modeling. The question was about tissue analysis.
  14. Is the RERF biased by many young health men being away in active duty?
  15. Dr. Ullrich, with the updates to the LSS have the slopes of cancer incidence vs. dose changed (increased or decreased) significantly from earlier LSS studies?
  16. Bob: What is the status of “use consent” for the RERF biospecimens?
  17. RERF: Please comment on present or future efforts to generate and analyze Next Generation Sequencing data (DNA-seq and RNA-seq) from the Survivor Cohort?
  18. Bob: Can you talk about the lung cancer differences for men and women that have been discussed with the A bomb cohort?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. For Bob Ullrich: Have you seen any perturbations in estrogen signaling in your cohort? We have seen some stimulation of estrogen pathway signaling in mice.
  2. Does the thyroid cancer data in atomic bomb survivors show a longer latency due to the iodine-sufficient diet in the Japanese population as claimed recently?
  3. David: Are combined cohort data being organized so they are conveniently available to the general scientific community?
  4. Is LNT likely to be replaced with another curve, or with an algorithm with many inputs?
  5. David or Bob: Please describe current efforts/results on occupational studies of Fukushima cleanup workers.
  6. David: Are you aware of the development any consortia similar to MELODI in North America? If not, how do you suggest interested researchers start?
  7. Dale: Please elaborate why we should over sample the higher dose groups if we are interested in the dose response shape at lower doses.
  8. Amy, was dose given to pediatric patients randomized?
  9. Which EPI studies from those discussed by the panel, if any, were supported by DOE’s past low dose program?
  10. Is there any genetically based confounding in the childhood medical exposure cohorts? Could this population be more genetically susceptible?
  11. Any: Are their plans to continue to follow the participants in the million children study and if so for how long.
  12. Any: Are the radiation data and associated metadata in the EMRs now standardized across the U.S.?
  13. Amy: What are the sex and age distributions for the childhood medical exposure studies you discussed?
  14. Why are all solid tumors being considered? Doesn’t a person typically have one specific type of tumor instead of multiple site tumors in the same person?
  15. Comment on Slido poll re: potential epidemiology/radiobiology research contributions to understanding risks @ low doses. What happened to the role of dosimetry?
  16. Ted Lazo: If sums of multiple small exposures cause statistically significant risks, do many “very small” doses also cause statistically significant risks?
  17. How are you integrating low dose radiobiological data into your epic studies?
  18. What types of biological studies help increase the power of the EPI studies at low doses? Where will the best samples come from?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. Gayle: Is the exposure and biological metadata associated with the archived FFPE samples organized and available?
  2. Gayle: How heavily are the animal archive tissues being used and is the resulting data being added to the dB as it is acquired?
  3. Gayle, do you know if the old Oak Ridge mega-mouse data were preserved and are they represented in your summary?
  4. Do you see value in cooperation with chemical toxicology studies and the AOP approach?
  5. How will the change to poly energetic X-ray beams complicate dosimetry and interpretation of systemic radiobiological effect?
  6. Al: What is the mechanism proposed to explain the long term maintenance of lesions that attract repair complexes like gh2ax?
  7. Dr. Fornace: You listed DOE as a stakeholder. Would you please elaborate on what your research means for DOE? You did not include NRC, was that intentional?
  8. Randy: Did the level of radiation induced methylation differ by cell type?
  9. For Randy Jirtle: Could you please comment on how the Agouti methylation data would translate to other murine strains?
  10. Randy, did you follow the mice for any other effects from radiation?
  11. Are epigenetic changes maintained or diluted down generations?
  12. Dr. Jirtle: Does your research represent a significant shot across the bow of LNT?
  13. Can stress from radiological emergency affect your epigenetic state and therefore susceptibility to radiation damage?
  14. Randy: There are some differences in epigenetic effects from mice to humans. Can mice be used to predict human responses?
  15. Randy, what do your results suggest regarding what we really know about redox imbalance or “dysfunction” mediated by radiation exposure?
  16. What efforts have been taken by the radiobiology community to address the concerns about reproducibility and replicability in science?
  17. A previous poll showed that EPI and radiobiology combined can help better understand risks at low doses. How do you think EPI can support your work?
  18. How does the agouti transposon result translate to post gestational effects on the epigenome?
  19. Randy: If hormesis was the right model for radiation dose-response and cancer in humans, what would the public health/radiation protection implications be?
  20. Can you provide examples of collaboration/coordination with epidemiologists to answer low dose questions?
  21. What effect does low dose exposure have on adult agouti mice?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. Given the methylation effects could be positive or negative, is a j-shaped curve a better, less charged way to refer to the obs. in Agouti mice?
  2. Would it be correct to say that in vitro work (such as Dr. Fornace’s) is “blind” to epigenetic effects?
  3. For Michaela: Could AOP “Key Events” be considered as relevant in the context of identifying biomarkers?
  4. Given the lack of unity among the organizations involved in low dose research and lack of funding, how can the task of biomarker be undertaken?
  5. Is there a study that shows RET/PTC1 and RET/PTC3 rearrangements are not radiation specific?
  6. Have the technologies presented by the OHSU experts been tested/ applied in samples collected by longitudinal studies (radiation/non-radiation related)?
  7. Chuck: How much heterogeneity do you see when scRMAseq or scDNA seq are applied to cells from patients treated with DNA damaging drugs?
  8. Chuck: What are the prospects for seeing a Radiation specific genomic signature at the single cell level?
  9. Why don’t many radiobiologists report confidence intervals for their low dose risk models?
  10. Joe: For each of the microscopy techniques you discussed, how long does it take to generate the data? What is the resolution of each?
  11. Single cell DNA assays detect radiogenic outcomes, e.g., deletions and inversions?
  12. Frank: Please comment on the relative merits of diffeq vs agent based models to predict the behavior of complex systems.
  13. Eleanor: How do you think the individual variation of the microbiome affects individual radiosensitivity?
  14. Ellie: Do we understand the mechanisms by which changes in the microbiome alter radiation response?
  15. Ellie: How do you interpret mouse microbiome data in light of humans since the microbiomes of different species are so different?
  16. Would ASTRO/ESTRO and the Children’s Oncology Group (COG) be a collaborator in testing radiation biomarkers in humans?
  17. Ellie: How much of the change in microbiome is caused by stress?
  18. In the event of a radiological event, at what dose level would you consider evacuating your family?
  19. What are your suggestions for integrating research in these new directions in a potential low dose program?
  20. How do go from exposure to disease outcome for single cell omics studies?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
  1. Dan: How was the initial $50m funding level decided?
  2. What metrics does HEI use to judge success of its research model?
  3. Dan and Joe: What do you think about the idea of creating a Low Dose Radiation Health Effects Institute using HEI as an example?
  4. I did not see social sciences experts on the research committee for HEI. Can you please comment on that?
  5. Dan: Can you provide examples of how HEI work resulted in concrete changes to federal regulations/policy?
  6. What is HEI’s primary funding source?
  7. Dan: Is HEIs strategic plan publicly available?
  8. For Anna Baker: Newer technology we are discussing in radiology and dosimetry is AI/Machine Learning. Please comment for low dose radiation research program.
  9. To Dr. Barker: You mentioned a number of times that you communicated about TCGA. Who did you communicate to and who did the communication?
  10. At what level of informed consent were you required to go to use data?
  11. Anna Barker: Were individual science/discovery studies, beyond sequencing and publishing the sequences, also fully funded by the TCGA project?
  12. For Ann: For TCGA the infrastructure support could be provided by NCI. Is it possible to do a large-scale project without agency structural support?
  13. The panel: Is TCGA your legacy?
  14. Dan, did your field also face disagreement between epidemiology and biology results?
  15. Could a new low dose research program be leveraged by pairing it’s objectives with better funded cancer research, e.g., in looking for biomarkers?
  16. Does HEI have a view on nuclear power as it relates to the topic of air pollution?
  17. Why isn’t there a mandate to the NCI to fund radiation research to a greater extent given that ~50% of all cancer patients are treated with radiation?
Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×

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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Suggested Citation:"Appendix C: List of Questions Submitted to Speakers and Panelists." National Academies of Sciences, Engineering, and Medicine. 2019. The Future of Low Dose Radiation Research in the United States: Proceedings of a Symposium. Washington, DC: The National Academies Press. doi: 10.17226/25578.
×
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Exposures at low doses of radiation, generally taken to mean doses below 100 millisieverts, are of primary interest for setting standards for protecting individuals against the adverse effects of ionizing radiation. However, there are considerable uncertainties associated with current best estimates of risks and gaps in knowledge on critical scientific issues that relate to low dose radiation.

The Nuclear and Radiation Studies Board of the National Academies hosted the symposium on The Future of Low Dose Radiation Research in the United States on May 8 and 9, 2019. The goal of the symposium was to provide an open forum for a national discussion on the need for a long-term strategy to guide a low dose radiation research program in the United States. The symposium featured presentations on low dose radiation programs around the world, panel discussions with representatives from governmental and nongovernmental organizations about the need for a low dose radiation research program, reviews of low dose radiation research in epidemiology and radiation biology including new directions, and lessons to be learned from setting up large research programs in non-radiation research fields. This publication summarizes the presentation and discussion of the symposium.

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