Date of review by ARPANSA

November 2024

Article publication date

October 2024

Summary

This systematic review and meta-analysis assessed the association between artificial light-at-night (ALAN) exposure and cancer incidence in human populations. A total of 28 studies (15 cohort, 13 case-control) were included in the review and meta-analysis. The strength of the association was reported in risk ratio (RR) with a 95% confidence interval (CI). RR of cancer (breast, prostrate, and others - colorectal, pancreatic, non-Hodgkin lymphoma and thyroid cancer) were assessed. The studies had indoor ALAN exposure data assessed through self-reported questionnaires, whereas outdoor ALAN exposure data were collected from satellite data. Risk of bias and quality of the included studies were evaluated using the tool recommended by the Joanna Briggs Institute (Munn et al. 2015). The meta-analyses showed no statistically significant association for indoor ALAN exposure and breast cancer, and outdoor ALAN exposure and prostate cancer. Higher levels of outdoor ALAN exposure were associated with increased breast cancer risk (RR =1.12, 95 % CI 1.03–1.23). The qualitative synthesis of evidence indicated positive associations between ALAN exposure and risk of non-Hodgkin lymphoma, colorectal, pancreatic and thyroid cancer. Overall, the included studies had high quality scores. 

Published in

Science of the Total Environment

Link to study

Indoor and outdoor artificial light-at-night (ALAN) and cancer risk: A systematic review and meta-analysis of multiple cancer sites and with a critical appraisal of exposure assessment

ARPANSA's commentary

The review indicates an association between outdoor ALAN exposure and increased breast cancer. Importantly, this review contributes to the body of knowledge on the potential risk of cancer incidence associated with ALAN exposures. The risk estimates provided by this meta-analysis are comparable to those provided by other reviews (Urbano et al., 2021; Luo et al., 2023). Strengths of this review are that it included prostate cancer in the meta-analysis and other cancers in the qualitative review, and it critically appraised exposure assessment. Accordingly, it highlighted some methodological limitations of the included studies, such as self-reported assessment of indoor ALAN exposure that results in recall bias, exposure measurement error and exposure misclassification potentially biasing the risk estimates. Similarly, the satellite data used in estimating outdoor ALAN exposure in the included studies had poor spatial resolution and had no colour (e.g., blue light) data. Therefore, as highlighted in the review, future epidemiological research using robust GIS-based ALAN exposure data and methods, controlling for potential confounders (such as noise, pollution, green space) are needed to improve the risk estimates of cancer incidence. 

The International Commission on Non-ionizing Radiation Protection (ICNIRP) has published a statement on short wavelength light (SWL) exposure from indoor artificial source and human health. The ICNIRP acknowledges that there is no scientific consensus on whether ALAN exposure from SWL light causes health effects. It is important to note that the studies informing an association between ALAN exposure and cancer risk have limitations. Therefore, well-designed epidemiological studies with improved exposure assessment tools are required to better inform on whether long-term ALAN exposure is a human health risk. There are also other publications which provide some recommendations for visible light exposure and potential health effects (e.g. SSLC, 2024; Brown et al., 2022). 

10 December 2024

The Australian Government’s nuclear regulator, the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) Chief Executive Officer, has approved the first stage of decommissioning of Australia’s original nuclear research reactor. 

The High Flux Australian Reactor (HIFAR) was a 10 Megawatt research reactor that commenced operation in 1958. It was permanently shutdown on 30 January 2007 and the spent fuel and heavy water was removed. The CEO of ARPANSA issued a license to ANSTO to possess and control HIFAR in September 2008.

In 2023, the Australian Nuclear Science and Technology Organisation (ANSTO) submitted a licence application to commence early stages of decommissioning of HIFAR. Following thorough review, public consultation and assessment, ARPANSA has determined that ANSTO has demonstrated it can safely commence limited decommissioning.

‘The CEO has issued a license for the commencement of initial decommissioning work at HIFAR,’ said Mr Jim Scott, Chief Regulatory Officer at ARPANSA. 

‘As the independent regulator of Commonwealth entities that use or produce radiation, we have assessed ANSTO’s license application and found that the proposed decommissioning activities can be conducted without harming workers, the Australian people or the environment.’ 

The license application is for limited decommissioning only, allowing ANSTO to use and retain the knowledge of the personnel who were involved in pre-decommissioning works and planning at the facility. 

The reactor core will be decommissioned later and will require separate approval from ARPANSA’s CEO. 

It is expected that initial limited decommissioning work will commence in 2026. 

More information

• Statement of reasons

Article review date

26 October 2024

Article publication date

18 November 2024

Summary

This systematic review and narrative synthesis examined the evidence of genotoxic effects of radiofrequency electromagnetic fields (RF-EMF) on mammalian cells in vitro. The authors identified 159 articles eligible for inclusion in the review. Results from the included studies were grouped by genotoxicity endpoint and summary statistics that describe the results qualitatively were produced. Risk of bias and certainty of evidence evaluations were conducted according to OHAT-GRADE, although certainty of evidence assessments only considered studies that showed a statistically significant effect. 

The reviewers found that, in 80% of all experiments, RF-EMF exposure did not induce statistically significant effects on the analysed endpoint. Spindle disturbances (90%), chromatin condensation (63%) and 8-OH-dG adducts (57%) were the only endpoints where the majority of experiments reported significant effects, however, the total number of experiments for these endpoints was small. The restricted certainty of evidence assessments found that there was low to very low confidence in the articles that did report a statistically significant effect. The review concludes that RF exposure probably does not increase the occurrence of genotoxic effects in vitro.

The risk of bias ratings were also used to identify an inverse relationship between study quality and the proportion of experiments reporting an effect, where low quality studies reported more statistically significant effects. Similarly, the experiments with the lowest exposure levels and durations reported the most amount of statistically significant outcomes, contrary to what is expected for an ordinary dose-response relationship.

Published in

Environment International

Link to study

Systematic review on the effects of RF-EMF on genotoxicity in mammalian cells

ARPANSA commentary

The conclusions of the review are in alignment with those of past reviews (Karipidis et al., 2021) however, these conclusions are based on a qualitative synthesis only as limitations in the body of evidence unfortunately precluded a more informative meta-analysis. The primary reason for this was that the majority of studies presented data in an unextractable graphical format only. A lack of dedicated guidelines for systematic reviews on mechanistic types of evidence, in vitro studies in this case, also hindered the review process. Due to the shortcomings of narrative synthesis, the reviewers are restricted in the level of detail they can include in their conclusions about health endpoints. The most important outcomes from this review are therefore the evaluations of the relationship between studies reporting significant effects and study quality.   

GRADE certainty of evidence evaluations are typically used to evaluate evidence for health endpoints that are studied by the review. In this review’s implementation they restricted this analysis to studies that showed a statistically significant effect and assessed four of the eight categories defined in the GRADE methodology. The result is that the evidence assessments are an evaluation of the quality of studies that show a statistically significant effect, instead of an evaluation of certainty in the body of evidence for the health outcome. The finding that there is low to very low confidence in the studies showing a statistically significant effect in conjunction with the observed relationship between risk of bias and significant effects lends credibility to the overarching conclusion of the review that RF-EMF exposure probably does not increase the occurrence of genotoxic effects in vitro.

An ARPANSA review (Wood et al., 2021) has previously identified a similar negative correlation between effect size and study quality as well as between effect size and RF exposure level. This was also identified in a recent systematic review (Meyer et al., 2024) on the effects on RF-EMF on biomarkers of oxidative stress that ARPANSA has previously reviewed.

Article review date

Oct 2024

Summary

This systematic review examined the awareness and use of the ultraviolet radiation (UV) index according to the World Health Organisation definition. The authors identified 40 publications with an outcome related to either awareness of the UV index (UVI), sun exposure or protective behaviours in association with UVI, and the impact of UVI interventions. The review also assessed the risk of bias within the included studies using the working group guidelines of Joanna Briggs Institute (Munn et al. 2015).  The review identified variation in public awareness of the UV index between countries.  The highest level of awareness was noted in Australia with over 90% of study participants reporting to have UV index awareness. Notably, the awareness in other countries was reported to be much lower (Europeans 50%, New Zealanders 43%, North Americans 34%). Despite being the high awareness of the UV index in Australia, only less than 10% of Australians use the UV index to inform their sun protection behaviour. There was a high risk of bias for all the outcomes that examined the use of the UV index for sun protective behaviours in Australia. The review recommended that further information needs to be disseminated on the advantages on using the UV index to better inform sun protection behaviours globally. 

Published in:

Kaiser et al. Photochemistry and Photobiology, 2024

 Link to study

A systematic review has examined the awareness of UV index and how it is used to inform sun protection messaging globally, and in Australia 

ARPANSA commentary

The study shows that awareness of UV index considerably varied globally with Australians having the highest awareness of the UV index. This finding demonstrates the success of the Australian sun protection messaging to spread awareness of the UV index. However, the UV index has not always been considered by the Australian public while considering how to protect themselves from UV exposure. In Australia, there are policies and recommendations in place to protect people from harmful UV exposure. For example, in Victoria, 97% of early childhood services and 90% of primary schools have policies to use the UV index to inform sun protection (SunSmart 2024) in their settings. Similar data for other Australian state and territory are lacking. The use of media and app to enhance the dissemination awareness of the UV index has been highlighted in the study. One of the limitations of the review is that it is difficult to draw qualitative evidence on how UV index is used to inform sun protection behaviours. Therefore, more research is needed to understand how Australians use the UV index. 

Despite the high awareness of the UV index in Australia and the Slip, Slop, Slap, Seek and Slide messaging, Australia has some of the highest rates of melanoma and skin cancer in the world and two-thirds of Australians will receive a skin cancer diagnosis of some type in their lifetime. As such, skin cancers, including melanoma, continue to constitute a large public health burden. This indicates that further work is needed to improve Australians’ sun protection behaviours and improve awareness on how to use the UV index to inform those behaviours. The UV index helps Australians know when UV exposure is high, and they should avoid sun exposure or practice other sun protection measures. More information on UV protection can be found on the ARPANSA Sun Protection factsheet. The UV index must be disseminated with greater efficacy via the media and apps. Currently, a free SunSmart Global UV app is available to know live UV index of global cities in view of boosting public awareness of the UV index globally. 

26 November 2024

ARPANSA’s Australian Clinical Dosimetry Service (ACDS) was highlighted as a case study in the 2023-2024 Australian Public Service Commission State of the Service Report, which was tabled in parliament on 26 November 2024.  

ARPANSA’s Chief Medical Radiation Scientist, Dr Ivan Williams, says inclusion of the ACDS profile by the Australian Public Service Commission reflects the value of this service to the wider Australian community.  

‘ACDS is the only radiotherapy audit program in Australia that is recognised by national and international oncology groups,’ Dr Williams said.  

‘Around 90,000 Australians will receive radiotherapy this year. These patients and their families rely on us to make sure their treatment is safe.

‘Our audits have identified issues and resulted in significant changes to clinical practice that have reduced actual or potential clinical hazards.

This is the second year in a row that ARPANSA’s work to protect the people and the environment from the harmful effects of radiation has been showcased in this report.  

‘ARPANSA’s work provides an important contribution to patient safety and trust in quality care,’ Dr Williams said.  

The recent Trust in Australian public services: 2024 annual report found that levels of trust remained stable, with 58% of respondents indicating that they trust public services. Trust in specific services, like ACDS, remained stable at 71%.  

Australian Government entities, including ARPANSA, work extensively with non-government organisations, industry and research institutions to identify and respond to community needs. ARPANSA’s ACDS provides an important services to protect workers, patients and carers from the harmful effects of radiation.  

In the last financial year, the ACDS delivered a program of 99 dosimetry audits, including 46 remote audits and 53 onsite audits covering the full range of radiotherapy treatment units and techniques.

Further information:

• The 2023-2024 State of the Service Report  
• ACDS audit program 

Article review date

November 2024

Article publication date

September 2024

Summary

This systematic review and meta-analysis assessed the association between radon exposure and health effects other than lung cancer in human populations. A total of 129 studies, published during 1990-2023, were included in the review and 40 studies were used in the meta-analysis. Risk estimates such as risk ratio (RR) per 100 units (Bq/m³ or Working level Month) of increased radon exposure level were calculated with a 95% confidence interval (CI). A range of health outcomes, including cancers (except lung cancer) and non-cancerous diseases were considered in the evaluation. The quality of the included studies were jointly evaluated using the New-castle Ottawa Scale (NOS) and the UNSCEAR’s approach of assessing quality of studies (including ecological studies) (UNSCEAR, 2017, p 48, table 3).The meta-analyses generally showed no statistically significant positive association for any health outcomes. Some of the estimated risk ratios were positive with the significance level near the threshold  for statistical significance including lympho-hematological cancer incidence in children (RR = 1.01; 95% CI: 1.00-1.03; p = 0.08); malignant melanoma mortality in adults in the general population (RR = 1.10; 95% CI: 0.99-1.21; p = 0.07); liver cancer mortality (RR = 1.04; 95% CI: 1.00-1.10; p = 0.06), and intestine and rectal cancer mortality combined among mine workers (RR = 1.02; 95% CI: 1.00-1.04; p = 0.06). The included studies had moderate to high quality scores. In conclusion, this review showed an absence of statistically significant associations between radon exposure and potential health outcomes other than lung cancer however, these effects cannot be ruled out. 

Published in

Frontiers in Public Health

Link to study

A recent review assessed evidence on links between radon exposure and health outcomes apart from lung cancer

ARPANSA commentary:

The overall conclusion of the review indicates no significant association between radon exposure and a range of health outcomes other than lung cancer in children and adult populations. Importantly, this review contributes to the body of knowledge on the potential health effects (both malignant and non-malignant diseases) of radon exposure in occupational and residential settings. Comparison of the findings of this review with other studies was not possible due to a lack of similar published reviews. Of the epidemiological studies included (except those on miners related to occupational radon) in this review, a majority of them related to children and adults were ecological studies, which may lead to ecological fallacy. There were several methodological limitations of the included studies, such as assessment of radon exposure and health outcomes as well as accounting for potential confounders which may alter the risk estimation. Therefore, further well-designed epidemiological research using robust radon exposure assessment tools and methods are needed to evaluate the potential risk of radon exposure for a range of population health outcomes. Some limitations of the study were: the inclusion of few studies in the meta-analysis of the exposure-risk relationships may have resulted in a lack of statistical power, significant heterogeneity was estimated in studies on occupational exposure to radon which limits the interpretation of the risk estimates and meta-regressions/in-depth sensitivity analyses was not done to evaluate the sources of heterogeneity due to the limited number of included studies. The review also did not conduct a certainty in evidence assessment which is another limitation.

According to the Australian Radiation Protection and Nuclear Safety Agency’s (ARPANSA) nationwide survey of Australian homes, the average radon exposure level in Australian homes is much lower than the global average. Consequently, residential radon exposure is not expected to be a significant contributor to any health risk other than lung cancer in Australia. ARPANSA has a fact sheet on ionising radiation exposure doses, including natural sources such as radon, and health. The International Commission on Radiological Protection has published guidance on radiological protection against radon exposure.

11 November 2024

25 October 2024

The 2023-24 Annual Report of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has been tabled in Parliament and is now available to read on our website and the Federal Government's Transparency Portal.

The report covers the activities of ARPANSA and its supporting committees, as well as the agency’s performance against key activities and financial objectives. 

ARPANSA’s Chief Executive Officer Dr Gillian Hirth AO reflected that the past year has been one of significant change, driven by ARPANSA’s continued engagement and support of Australia's nuclear-powered submarine capability stewardship arrangements.

‘I am proud that staff have risen to meet the challenge of substantial new programs of work, all the while maintaining our ongoing commitment to delivering regulatory excellence, radiological protection and community engagement,’ said Dr Hirth.

This last year also saw an expansion in ARPANSA’s remit, as the agency faced a higher than usual volume of complex regulatory assessments due to planned works at the Australian Nuclear Science and Technology Organisation (ANSTO) Lucas Heights facilities. ARPANSA also received a licence application from the Australian Submarine Agency to prepare a site for a controlled industrial facility. Public consultations and regulatory approvals were key components of ARPANSA's oversight during this period. 

This was delivered alongside the agency’s unwavering commitment to our business-as-usual activities, which ensure we are protecting the Australian public and environment from the harmful effects of radiation. Some highlights included:

• ARPANSA’s engagement in international nuclear security, research and health advice, and engagement with Pacific nations
• ongoing work in the provision of risk management and mitigation relating to a radiological or nuclear incident
• enhancement of our regulatory systems and alignment with international best practice 
• a deep dive into ARPANSA’s approach to fostering innovation in the workplace.

Read the full ARPANSA Annual Report 2023-24 on the Transparency Portal.
 

7 October 2024

23 September 2023