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

Literature review date

September 2024

Article publication date

July 2024

Summary

This systematic review and meta-analysis examined the effect of radiofrequency electromagnetic energy (RF EME) on cognitive performance in human experimental studies. The review included 50 studies in the meta-analysis (2,433 participants) from 15 countries that were conducted between 2001 and 2021. It assessed cognitive performance of five (of the 7) cognitive domains (Orientation and attention, Perception, Memory, Construction and motor performance, and Concept formation and reasoning), including 19 (of 35) cognitive domain subclasses as defined by Lezak et al (2004). Each subclass was assessed based on the speed and accuracy of the participant performing tasks associated with that particular subclass (attentional capacity, concentration, etc). Most of the included studies used 2G-era mobile phone RF EME as the exposure source. Certainty of evidence and risk of bias were also evaluated according to OHAT-GRADE approach. 

The authors reported no statistically significant results, indicating that RF-EME exposure has not impact on cognitive performance on human in experimental studies for all of the 19 subclasses tested. However, the certainty in these results ranged from high to low. Three of the 19 subclasses were not able to be tested for both speed and accuracy. Of 35 meta-analyses performed on the subclasses, a majority (20) of them provided high certainty of evidence that RF EME exposure results in little to no difference in cognitive outcome. The evidence on the effect of RF EME on the remaining 16 subclasses of the cognitive domains was uncertain. This uncertainty was due to limitations in the study quality, inconsistency in the results or imprecision of the combined effect size estimate. Overall, the review reported no evidence that RF EME exposure impacts cognitive performance. 

Link to

The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: Systematic review and meta-analyses

Published in

Environment International 

ARPANSA commentary

The overall conclusion of the review was that RF EME exposure does not impact cognitive performance in human experimental studies. This systematic review is the most comprehensive that has been published on this topic as it considered all cognitive domains and people of all ages. Other recent reviews and meta-analyses have had similar outcomes (Valentini et al, 2010; Barth et al ,2011; Zubko et al, 2017) reporting no impact of mobile phone frequencies on short term cognitive performance. However, these studies only examined a few cognitive domains including, attention, processing speed and working memory. Further, these reviews did not assess the quality or risk of bias of their included studies in the same manner as this systematic review. For example, Barth et al (2011) performed no quality assessment; Valentini et al (2010) used a simple assessment that assessed the blinding, participant selection, exposure assessment and statistics used. Zubko et al (2017) did use the risk of bias tool developed by OHAT, however, it did not assess the certainty of the evidence according to the GRADE approach. 

This review is part of the World Health Organization’s (WHO) ongoing project assessing the health effects of RF-EMF. ARPANSA is supporting this WHO review process. One of the WHO systematic reviews has examined the long-term impacts on cognition of RF EME exposure (Benke et al 2024). This review was conducted in Australia and was co-led by ARPANSA scientists. This systematic review also reported that RF EME had no consistent impact on cognition.

Overall, the results from this systematic review are consistent with previous research and ARPANSA’s scientific understanding that exposure to RF EME below the limits in the ARPANSA RF safety standard do not cause health impacts, including cognitive outcomes.

2 September 2024

4 September 2024