Average Annual Dose Research Articles

Proposed Method For Studying Radon Exhalation

Objective: The main objective was to test the closed radon exhalation methodology, with AlphaGuard radon detector, for different grain sizes of a granite rock sampled from central area of Belo Horizonte and propose experimental methods for its determination. Theoretical Framework: Natural radioactivity accounts for about 80% of the average annual radiation dose humans receive, primarily due to primordial radionuclides in the Earth’s crust. The World Health Organization (WHO) recommends national radon (Rn) exposure mapping programs based on geological studies due to the significant contribution of Rn gas to annual radiation doses. Studies indicate that granitic and metamorphic rocks, black shales, phosphate rocks, and some carbonate rocks are common radon sources. Rn is generated in soil and migrates through soil pores, entering buildings through cracks and openings. Rn transport is influenced by factors like local geology, humidity, and temperature. Method: The study tested radon exhalation from granite samples in center of Belo Horizonte using a proposed method with AlphaGuard in an exhalation circuit. Results and Discussion The studied method proved to be effective with particle sizes up to 16#. For very fine particle sizes, the air flow is hampered and therefore reduces the effectiveness of transporting the radon-filled gas. Research Implications: The implications of this research are discussed, providing insights into radon exhalation method in a closed circuit and its challenges. This study contributes to literature by studing exhalation rate is vital for estimating radiation risk from many kinds of materials and the indoor radon.

CT surveillance for type 1 autoimmune pancreatitis: cumulative radiation dose and diagnostic performance for disease relapse.

Long-term follow-up is essential for type 1 autoimmune pancreatitis (AIP) patients due to high relapse rates. The cumulative radiation dose from repeated CT scans during follow-up should not be ignored. We aim to investigate the cumulative radiation dose in AIP patients undergoing CT surveillance and the diagnostic performance of CT in detecting disease relapse. The diagnostic performance of MRI from a secondary cohort during the same period was also investigated. This retrospective single-institutional study included 247 type 1 AIP patients with one or more follow-up CT scans, and 120 patients with MR follow-ups. Four metrics were utilized to report the radiation dose, including the volume computed tomography dose index, the dose length product, size-specific dose estimate and effective dose. The diagnostic performance for AIP relapse was assessed, taking the final clinical diagnosis in retrospect as the reference standard. With a median 2.3-year follow-up period, AIP patients followed up with CT exhibited a median cumulative radiation dose of 37.5 mSv. 11.3% of patients have accumulated doses exceeding 100 mSv. For the 169 patients followed over a year, 30.8% sustained an average annual radiation dose surpassing 20 mSv. The sensitivity/specificity/accuracy of CT for detecting abdominal organ relapse was 64.1%/99.6%/97.0%. For AIP patients followed up with MRI, the sensitivity for detecting disease relapse was 90.5%. Considering the accumulation of radiation dose in AIP patients and the insufficient sensitivity in detecting disease relapse with CT, safer and more sensitive imaging follow-up strategies should be explored. Question CT, as the primary imaging modality for autoimmune pancreatitis (AIP) follow-up, raises concerns regarding radiation exposure and lacks reported diagnostic performance in detecting AIP relapse. Findings CT in AIP follow-up causes significant cumulative radiation exposure and exhibits insufficient sensitivity in relapse detection. Clinical relevance Type 1 AIP necessitates long-term imaging follow-up, yet current guidelines lack consensus regarding the prioritization of CT or MRI for such follow-up. CT is widely used but has radiation concerns and limited sensitivity, calling for safer, efficient strategies.

Assessment of radiological risk to workers and members of the public from the operation of a groundwater treatment plant in Jordan

ABSTRACT The study aimed to evaluate the radiation doses received by workers at a pilot water treatment plant (WTP) in Jordan. It also examined the concentrations of gross alpha, gross beta, and radium activities in both groundwater and treated water, along with a radiological risk assessment for the waste generated by the treatment process. The radioactivity levels of gross alpha and gross beta in the groundwater were found to exceed the established drinking water limits. In the pilot WTP, two methods were applied for water treatment, namely, ceramic ultra-filtration (CUF) and reverse osmosis (RO), both of which produced treated water that met drinking water quality standards. The annual effective dose from external radiation exposure to the WTP workers was found to be less than 0.007 mSv y−1 (during the filters backwash operation). However, the average annual dose from internal radiation due to inhalation of radon released from groundwater reached 3.2 mSv y−1, exceeding the 1 mSv y−1 limit. Therefore, monitoring radon levels in workplaces is recommended. Radioisotope concentrations in the waste (sludge) stockpiles exceeded clearance levels, requiring them to be treated as radioactive waste. Overall, the WTP successfully produced drinking water that met quality standards, and the methods used could be replicated in other locations.

Analysis of personal dose monitoring results of occupational external exposure for radiation workers in a hospital

Objective: To analyze and understand the level of occupational external radiation personal dose of radiation workers in a hospital, and provide a reference for radiation protection. Methods: In May 2023, the personal dose monitoring data of all radiation workers in the hospital from 2018 to 2022 were collected, and their occupational external radiation exposure levels were analyzed and evaluated. All radiation workers were divided into radiation diagnosis, radiotherapy, interventional radiology, and nuclear medicine according to their occupational categories. Results: A total of 1626 person-times were monitored from 2018 to 2022, and the average annual effective dose per person (0.13-0.36 mSV) was lower than the national limit of 20 mSv. The average annual dose of nuclear medicine was the highest (0.36 mSv), and interventional radiology was lower (0.13 mSv). The average annual dose of individuals was the highest in 2020 (0.24 mSv) . Conclusion: The average annual effective dose per person of radiation workers in this hospital is lower than the national standard, and it is still necessary to strengthen the inspection of the wearing of personal dosimeters and the using of protective equipment for radiation workers.

Analysis of the results of personal monitoring to ionizing radiation at workplaces

The paper presents the results of dosimetric measurements routinely performed by the Radiation Protection Department of the Nofer Institute of Occupational Medicine (NIOM) in Łódź in 2022 for people occupationally exposed to X and γ radiation. The evaluation of the effective dose as part of individual dosimetry was provided using the film or thermoluminescent dosimetry (TLD). Additionally, based exclusively on the TLD method, measurements of the ambient dose equivalent H*(10) and personal dose equivalents Hp(0.07) and Hp(3) were performed. In 2022, the dosimetric service of the Radiological Protection Department of the NIOM covered >30 000 workers employed in >4500 laboratories (mainly health care departments). All measurements were performed in accordance with accredited research procedures (number AB 327). In 2022, the average annual dose of Hp(10) was equal to 0.26 mSv, whereas Hp(0.07) measured using ring and wrist dosimetry was equal to 0.63 mSv and 0.78 mSv, respectively. In turn, the average Hp(3) value was 0.21 mSv. In 2022, there was not a single case of exceeding the annual dose limit among people measured by the NIOM. The data collected in the "Dosimetry" database of the NIOM and a detailed analysis of annual doses received by people occupationally exposed to ionizing radiation indicate a well-functioning radiological protection system in Poland. Med Pr Work Health Saf. 2024;75(5):415-423.

Occupational eye lens dose among nuclear medicine workers in a tertiary hospital in Saudi Arabia

Background: Exposure to ionizing radiation remains a major concern in nuclear medicine, especially given the possible health risks posed to medical personnel. Additionally, since the occupational eye dose limit was lowered in 2011 to an equivalent dose of 20 mSv/yr, new implications have extended to roles within nuclear medicine units. The goal of this investigation was to determine the current occupational radiation eye doses for nuclear medicine employees. Methods: A 5 yr retrospective assessment was performed on staff members involved in all nuclear medicine imaging from different categories. Optically Stimulated Luminescence (OSL) badges were used to measure occupational dose. The H-lens values were calculated for each staff member during this period. Results: Significant differences were observed between individual staff members in terms of H-lens values. They were significantly higher among hot lab technicians than among NIC (p < 0.001) and NM (p < 0.0001) technicians. Conclusions: Although none of the participants exceeded the eye dose limit for ionizing radiation exposure, there was significant variation in exposure across various roles and expertise. The annual average eye dose ranged from 0.2 mSv to 2.9 mSv, which is within the advised dose limit.

Потужність поглиненої дози зовнішнього опромінення представників іхтіофауни озер у Чорнобильській зоні відчуження

The limits of the average value of the average annual external radiation dose rate of fishes from four lakes (with different degrees of radionuclide pollution of ichthyofauna representatives) of the Chornobyl Exclusion Zone as of 2021 are given, namely: Azbuchyn Lake (4 - 33 μGy/h), Vershyna Lake (3 - 26 μGy/h), Glyboke Lake (2 - 15 μGy/h) and Plyutovyshche Lake (0.02 - 0.16 μGy/h). Bottom-dwelling fish species such as tench and Prussian carp receive the highest external radiation dose, and rudd and surface fish species receive the lowest. It has been proven that the radionuclide 137Cs forms from 62.8 to 98.7 % of the absorbed dose of external irradiation of fishes from the studied water bodies. It is clearly shown that the current levels of the average annual absorbed external dose rate for many of the studied fishes of the lakes exceed the screening dose of 2 μGy/h and in 6 cases out of 22 exceed the safe level of 10 μGy/h recommended by the European Commission project “PROTECT”.

Natural radioactivity in food crops and soil and estimation of the concomitant dose from tin mining areas in Nigeria

Mining of mineral ore is considered one of the anthropogenic sources of elevating the activity concentrations of the natural radionuclides in the environment, which in turn causes an increased risk of human exposure via the food chain. In an attempt to evaluate the radiological burdens resulting from tin mining activities in Nigeria, farm soil and sixty-two samples of different food crops grown around tin mining areas were evaluated for the activity concentrations of 226Ra, 232Th, and 40K using a high-purity germanium detector. The mean activity concentrations of 226Ra, 232Th and 40K in soil were 64.6 ± 29.5, 72.03 ± 28.73 and 680.6 ± 324.3 Bq/kg, respectively. These values were found to be higher than their corresponding world average values. However, the mean activity concentrations of the measured radionuclides in plants were below their respective world average values, as reported by UNSCEAR. The overall average annual ingestion dose due to the consumption of the analysed plants was 151 µSv/y, which is below the reported world average value of 290 µSv/y. The results obtained show that the hazard indices were low enough to cause any immediate radiological health complications due to the ingestion of the crops grown in the studied areas.

Peculiarities of the exposure dose formation on the population in the most affected regions of Russia after the Chernobyl NPP accident

The paper presents an analysis of the current radiation situation in the settlements of the Russian Federation located on the most radioactively contaminated territory after the Chernobyl accident. The assessment of 137Cs content in local agricultural (milk, beef, pork, potatoes), natural (mushrooms) foodstuffs, doses of external, and internal irradiation of residents was carried out. 37 years after the Chernobyl NPP accident, 72 settlements with a total number of residents of 63869 remain in the zone of radioactive contamination whose average effective radiation doses exceed 1 mSv/year. All these settlements are located in five southwestern districts of the Bryansk region and are rural except for Novozybkov. In the private sector of settlements, potatoes and pork fully comply with radiological standards for the content of 137Cs. In milk, the content of the radionuclide can exceed the standards up to 3, in beef up to 5, in mushrooms up to 8–17 times. Over the past 30 years, the number of settlements exceeding the legally established standard for the total exposure dose to the population (1 mSv/year) has decreased by 7.5 times. Due to the decrease in the levels of 137Cs contamination of local foodstuffs and the volume of their consumption, the role of internal exposure dose has been decreasing in recent years. It was noted that in addition to a comprehensive assessment of the radiation situation in settlements, agricultural and natural ecosystems, when planning the rehabilitation of settlements with average annual radiation doses of residents above 1 mSv, it is important to take into account the current diets of residents and the real demographic situation in the territories affected by the Chernobyl accident.

Geographical distribution of radon and associated health risks in drinking water samples collected from the Mulazai area of Peshawar, Pakistan

Geospatial methods, such as GIS and remote sensing, map radon levels, pinpoint high-risk areas and connect geological traits to radon presence. These findings direct health planning, focusing tests, mitigation, and policies where radon levels are high. Overall, geospatial analyses offer vital insights, shaping interventions and policies to reduce health risks from radon exposure. There is a formidable threat to human well-being posed by the naturally occurring carcinogenic radon (222Rn) gas due to high solubility in water. Under the current scenario, it is crucial to assess the extent of 222Rn pollution in our drinking water sources across various regions and thoroughly investigate the potential health hazards it poses. In this regard, the present study was conducted to investigate the concentration of 222Rn in groundwater samples collected from handpumps and wells and to estimate health risks associated with the consumption of 222Rn-contaminated water. For this purpose, groundwater samples (n = 30) were collected from handpumps, and wells located in the Mulazai area, District Peshawar. The RAD7 radon detector was used as per international standards to assess the concentration of 222Rn in the collected water samples. The results unveiled that the levels of 222Rn in the collected samples exceeded the acceptable thresholds set by the US Environmental Protection Agency (US-EPA) of 11.1 Bq L−1. Nevertheless, it was determined that the average annual dose was below the recommended limit of 0.1 mSv per year, as advised by both the European Union Council and the World Health Organization. In order to avoid the harmful effects of such excessive 222Rn concentrations on human health, proper ventilation and storage of water in storage reservoirs for a long time before use is recommended to lower the 222Rn concentration.

Rn-222 Activity Concentration and Age-Dependent Annual Effective Dose Analysis of Drinking Water Sources in Southern Benue State, Nigeria.

Radon is one of the carcinogenic radioactive gases causing radiological risk to the public via ingestion and inhalation. The 222Rn activity concentrations were estimated in potable water of Benue South (Otukpo and Ado Local Government Areas) using the Tri-Carb 1000 Liquid Scintillation Counter (LSC). 222Rn activity for Ado and Otukpo LGAS ranged from 2.281±1.861 to 27.525±1.861 Bq/L with a mean value of 10.031±1.861 Bq/L and 2.115±0.689 to 11.367±0.689 Bq/L with an arithmetic mean of 7.574±0.689 Bq/L respectively. The radon levels are within the reference level of 100 Bql−1 proposed by the WHO and EU Commission. Nearly 33% of the potable water had radon activity levels exceeding the maximum contamination level of 11.1 Bql−1 proposed by USEPA. The annual average ingestion dose values are lower than the action level of 100 µSvy−1 as proposed by the WHO and EU Commission. The values of dose variations of Annual effective dose (AED) to individuals were found to increase with age and water consumption rates. The estimated mean radio sensitivity for the different age groups followed a decreasing trend of Adults>Children>Infants in both Ado and Otukpo LGAs. The radiation dose for inhalation received by individual lungs from consumption of radon in water samples from Ado and Otukpo LGAs was significantly higher than the corresponding radiations received by the walls of the stomach. In conclusion, there is a possible occurrence of cancerous bronchial epithelium than stomach cancer over time in the study areas due to the consumption of water.

Measurement of radium and radon gas in bottled mineral waters.

In this study, the radon gas and radium concentration in the bottled mineral water samples was measured. A total of sixty samples were collected from bottled mineral water sold in the markets in Kahramanmaraş. DURRIDGE Rad7 electronic radon detector was used for measurements. Radon and radium activity amounts range from 33.50 ± 1.30mBq/L to 51.70 ± 2.20mBq/L, and 2.92 ± 0.15mBq/L to 4.51 ± 0.26mBq/L, respectively. Average radon and radium active amounts are 41.67 ± 1.54mBq/L and 3.63 ± 0.18mBq/L, respectively. Total annual effective dose values were calculated for these mineral waters according to three different scenarios. In the first of these, it was assumed that natural mineral water was consumed annually instead of 730 L of drinking water (S1). In the second case, 150 L which was the annual average amount of natural mineral water consumed in European Union member countries was used for the annual average amount of natural mineral water consumed by adults (S2). Finally, the annual average amount of natural mineral water consumed in Turkey, 14 L, was used for adults (S3). For scenarios (S1, S2, S3), the total (ingestion + inhalation) annual average dose values ranged from 6.83E-04mSv/y to 1.05E-03mSv/y, 1.40E-04mSv/y to 2.17E-04, and 1.32E-05mSv/y to 2.03E-05mSv/y, their average values were 8.49E-04mSv/y, 1.75E-04mSv/y, and 1.64E-05mSv/y, respectively. The total effective dose values calculated within the scope of the current study were below the limit value announced by WHO.

Annual gamma-ray background dose rates in dwellings of rural Tumkur.

The exposure to high levels of ionising radiation can cause severe health risks including cancer. The monitoring of background radiation is a primary task of nuclear scientists and researchers in the present day. The aim of the present work is to measure effective annual dose rate due to gamma-ray background radiation in dwellings of selected villages around Tumkur. It is very important to monitor background radiation in dwellings to safeguard from the harmful effects of gamma-ray background radiation. The dose rates in dwellings were measured using a German-made portable gamma dosemeter, Gamma-Scout. The measured annual dose rates were in the range of 1.103-2.824mSv/y. From this survey, it was observed that the average annual dose rate for dwellings under study area with concrete ceiling and tiles floor are comparatively higher than the dwellings with griddle ceiling and stone floor.

Annual radiation dose monitoring for catheterization laboratory operators

Monitoring the occupational radiation exposure to the operators is important from the viewpoint of radiation protection and safety. The main purpose of this study is to measure and analyze the annual radiation occupational dose to the operators in a unit of mSv in the Catheterization Laboratory (CL) at King Abdul-Aziz University Hospital (KAUH). This study measured and determined the annual effective dose to the CL operators for Twenty-Three operators at KAUH. Based on the responsibilities and position, the monitored operators were classified into different categories: Staff/Doctors, Nurses, and Technicians. The annual occupational doses were measured using Thermoluminescence dosimetry (TLD-100 (LiF: Mg, Ti)) placed at the Thyroid protective collar from the body to measure the individual dose. The calibration procedures and measurements in this study were carried out at the King Abdul-Aziz University Training and Prevention Center of the University of Radiation. The average annual dose to the CL was found to be 0.74, 1.10, 1.13, 0.65, 0.18, and 1.0 mSv for Consultants, Technicians, Nurses, Doctors, Registrar Cardiology, and Trainees respectively. More than 91% of the operators in the CL received radiation doses of less than 2 mSv. High awareness and skills are the reasons for obtaining a very low annual occupational dose in the department of CL at KAUH. The maximum value for the effective dose delivered to the operator is 2.29 mSv, which is much lower than the international dose limit (20 mSv/y) given by the International Commission of Radiological Protection (ICRP).

Uranium isotopes content in the certain types of foodstuffs. Optimization of the analytical method

An article contents the results of investigation of natural uranium isotopes content in the certain types of foodstuffs sampled in the kitchen gardens located in Leningrad region and bought in the trade network of Saint-Petersburg. More suitable and simple for realization than existing method is given for uranium isotopes (238U, 234U, 235U) content investigation in the foodstuffs from a sample with not more than 1,0 kg weight with minimal detectable activity not more than 0,02 Bq. Radiochemical investigations were carried out in 2018-2020. Estimation of potential average annual population internal exposure dose (Eint) have been carried out due to 238U and 234U content in the bread foodstuffs, black leaf tea, spicy herbs and salad greenery consumed by the local population. It is demonstrated that population internal exposure dose from uranium isotopes in the investigated types of foodstuffs could be about 0,0000022 mSv/ year. Estimated dose value is only small part of population internal exposure dose from uranium and even more so from total composition of natural radionuclides in the foodstuffs. At the same time toxic effect from soluble uranium as a chemical element prevails over its radiation effect.

Assessment of Radium Equivalent Activity and Total Annual Effective Dose in Cassava cultivated around Ewekoro Cement Factory

In this study, cassava tubers cultivated in the Ewekoro cement area were investigated with the aid of Hyper Pure Germanium (HPGe) detector in order to assess the radionuclide content. Twenty-seven (27) samples of both arable soil and cassava tubers were studied at different sites to the epicenter of the mining activity. The results revealed the highest activity concentrations of K-40, Ra-226, and Th-232 to be 194.10, 63.92, and 76.90 Bq/kg, respectively, in soil to be at site 1, which was 50 m away from the cement mining site. Similarly, cassava reported the highest activity concentrations of 228.15 and 81.50 Bq/kg for K-40 and Ra-226, respectively, at sites 2, which was 150 m away from the mining site. However, the highest value of Th-232 in cassava was noted in site 1. Also, the highest values of Raeq for arable soil and cassava tubers were estimated to be 188.84 Bq/kg and 199.89 Bq/kg at site 1 and site 2, respectively. All the above results were higher than the recommended safe limits by a factor of 2. Moreover, the Total Annual Effective Dose of exposure by oral ingestion of cassava tubers for different age groups revealed children to have the highest level of exposure with the highest mean value of 7.98 mSv. This is followed by adults and infants, which reported 5.66 and 5.38 mSv, respectively, all at site 2. This result is far greater than the recommended safe limits of 1 mSv. Therefore, the results of the total averages of annual effective doses due to consumption of the three natural radionuclides in cassava tubers and other products from it by adults, children, and infants were found to be above the average annual ingestion radiation dose due to natural sources. Further statistical analysis of the results showed significant differences between sites 1 and 2 and between sites 1 and 3, where there was no statistically significant difference between sites 2 and 3.

Gamma-ray Spectrometry and X-ray Fluorescence Analysis for Natural Radioactivity Evaluation Associated with Radiation Hazard in Construction Materials

Abstract: This paper had threefold objectives: 1) to evaluate the natural radioactivity using the gamma spectrometry technique, 2) to correct the gamma self-absorption using the transmission method, and 3) to perform mineralogical analysis using the X-ray fluorescence (XRF) analyzer in seven different types of construction materials. The transmission method was used to measure the linear attenuation coefficient µ(E) of the samples as well as their standards at different energetic points. Next, the µ(E) coefficients were used to calculate the self-absorption correction factors (Cauto), and then they were introduced in a simplified formula to correct the fraction of the attenuated gamma radiation inside the traveled medium. Moreover, the quantitative assessment of natural radioactive elements (238U, 232Th, and 40K) was done in different geological matrices. The results have shown that the mean absorbed dose and the annual average dose received by these materials are 40.65 nGy.h-1and 0.2 mSv.y-1, respectively. According to the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the obtained values in no way pose a risk to human health. For compositional analysis, the X-ray fluorescence (XRF) analyzer was used to determine the concentrations of the major oxides (SiO2, CaO, CO2, and Al2O3) along with other oxides in all collected samples. The compositional results show that the self-absorption correction factors varied depending on the density and chemical composition of a sample. The XRF data shows that the mineralogical compositions are within their recommended limit. Thus, from a health safety perspective, the composition of the minerals does not pose any significant risks. Keywords: Gamma Spectrometry, Natural Radioactivity, Construction Materials, Radiological Hazard, Self-Absorption. PACS NaI(Tl): Sodium iodide (NaI) detector activated by thallium (Tl), XRF: X-Ray Fluorescence.

Indoor radon survey in Whitehorse, Canada, and dose assessment

Radon-222 (222Rn) and its decay products are the primary sources of a population’s exposure to background ionizing radiation. Radon decay products are the leading cause of lung cancer for non-smokers and the second leading cause of lung cancer after smoking for smokers. A community-driven long-term radon survey was completed in 232 residential homes in different subdivisions of Whitehorse, the capital of the Yukon, during the heating season from November to April in 2016–2017 and in 2017–2018. Radon concentrations were measured in living rooms and bedrooms on ground floors. The arithmetic and geometric means of indoor radon activity concentrations in different subdivisions of Whitehorse ranged from 52 ± 0.6 Bq m−3 and 37 ± 2.3 Bq m−3 in the Downtown area of Whitehorse to 993.0 ± 55.0 Bq m−3 and 726.2 ± 2.4 Bq m−3 in Wolf Creek. Underlying geology and glacial surfaces may partly explain these variations of indoor radon concentrations in subdivisions of Whitehorse. A total of 78 homes (34.0%) had radon concentrations higher than 100 Bq m−3, 47 homes (20.5%) had concentrations higher than 200 Bq m−3 and 33 homes (14.4%) had concentrations higher than 300 Bq m−3. The indoor radon contribution to the annual effective inhalation dose to residents ranged from 3.0 mSv in the Downtown area to 51.0 mSv in Wolf Creek. The estimated annual average dose to adults in Whitehorse, Yukon, is higher than the world’s average annual effective dose of 1.3 mSv due to the inhalation of indoor radon. The annual radon inhalation effective dose was assessed using radon measurements taken during winter; hence the assessed dose may be overestimated. Cost-efficient mitigation methods are available to reduce radon in existing buildings and to prevent radon entry into new buildings.

Immune globulin usage trends in commercially insured and Medicare populations, 2009-2019.

Longitudinal patterns of immune globulins (IG) use have not been described in large populations. Understanding IG usage is important given potential supply limitations impacting individuals for whom IG is the sole life-saving/health-preserving therapy. The study describes US IG utilization patterns from 2009 to 2019. Using IBM MarketScan commercial and Medicare claims data, we examined four metrics overall and by condition-specific categories during 2009-2019: (1) IG administrations per 100,000 person-years, (2) IG recipients per 100,000 enrollees, (3) average annual administrations per recipient, and (4) average annual dose per recipient. In the commercial and Medicare populations respectively: IG administrations per 100,000 person-years increased by 120% (213-470) and 144% (692-1693); IG recipients per 100,000 enrollees grew by 71% (24-42) and 102% (89-179); average annual administrations per recipient rose by 28% (8-10) and 19% (8-9); and average annual dose (grams) per recipient increased by 29% (384-497) and 34% (317-426). IG administrations associated with immunodeficiency (per 100,000 person-years) increased by 154% (from 127 to 321) and 176% (from 365 to 1007). Autoimmune and neurologic conditions were associated with higher annual average administrations and dose than other conditions. IG use increased, coinciding with a growth in the IG recipient population in the United States. Several conditions contributed to the trend, with the largest increase observed among immunodeficient individuals. Future investigations should assess changes in the demand for IVIG by disease state or indication and consider treatment effectiveness.

The Use of San-Huang-Xie-Xin-Tang Reduces the Mortality Rate among Breast Cancer Patients

Globally, breast cancer is the most common cause of cancer deaths. In Taiwan, it is the most prevalent cancer among females. Since San-Huang-Xie-Xin-Tang (SHXXT) exerts not only an anti-inflammatory but an immunomodulatory effect, it may act as a potent anti-tumor agent. Herein, the study aimed to explore the influence of SHXXT and its constituents on the mortality rate among breast cancer patients in Taiwan regarding the component effect and the dose-relationship effect. By using the Taiwan National Health Insurance (NHI) Research Database (NHIRD), the study analyzed 5387 breast cancer patients taking Chinese herbal medicine (CHM) and 5387 breast cancer patients not using CHM. CHM means SHXXT and its constituents in the study. The Kaplan-Meier method was utilized to determine the mortality probabilities among patients. Whether the CHM influences the mortality rate among patients was estimated by Cox proportional hazard regression analysis. The use of CHM could lower the cancer mortality rate by 59% in breast cancer patients. The protective effect was parallel to the cumulative days of CHM use and the annual average CHM dose. In addition, the mortality rate was lower in patients who used SHXXT compared to those who only used one of its constituents. SHXXT and its constituents were all promising therapeutic weapons against breast cancer.