Occupational and environmental health: recognizing and preventing disease and injury, 5th edition. Levy BS, Wegman DH, Baron SL, Sokas RK, eds. Philadelphia PA: Lippincott Williams & Wilkins, 2005 Nov; :345-364
The impact to the psychological, social, and economic sectors of society from these radiation events leaves little doubt that radiation could be an effective terrorist weapon. However, since September 11, 2001, the United States has placed a priority on preventing biological, chemical, and radiological attacks and, in doing so, created a new category of workers that not only defend against such attacks but are also exposed to radiation in the course of their work (Fig. 14D-1). These workers are categorized as "security-based" workers that use radiation technology to prevent terrorist attacks. They use computed tomography (CT) technology to scan checked baggage at U.S. airports for explosive materials, operate gamma-emitting equipment to detect illegal contraband, and use special backscatter and transmission technologies to view through clothing and body cavities. (1) These workers join the ever-increasing workforce that uses radiation or radioactive materials in their jobs (Table 14D-1). In 1989, the National Council on Radiation Protection and Measurements (NCRP) published summary statistics on the average radiation exposures to various occupations in the United States. (2) Occupations that received the largest annual doses included underground uranium miners, commercial nuclear power plant workers, fuel fabricators, physicians, flight crews, industrial radiographers, and well loggers. Although these data are more than 15 years old, the general trends of an ever-increasing number of workers combined with a reduction of the average individual exposure likely continues today. Two exceptions to this statement exist for occupations in the commercial nuclear power plant industry and medical industry. The commercial nuclear power plant industry has had limited growth because no new plants have been built since the 1970s. Workers in health care may be exposed to higher radiation exposures due to a tremendous growth and use of new imaging technology, especially digital imaging. The risk that all these occupations assume remains controversial among the radiation-control community because most of the recorded doses are well below regulatory limits, where the risks are not well characterized. The controversies were further enhanced when the United States enacted legislation to compensate workers in the nuclear weapons industry whose average doses were among the lowest when compared to other industries with radiation exposure. (3) According to a report recently published by the National Academies, the smallest doses are presumed to pose a potential risk of cancer, (3a) so it remains a priority of those in occupational and environmental health to anticipate, recognize, evaluate, and control exposures to prevent radiation injuries and illnesses.