UNICEF - Radiation and Children´s Health

Executive summary Radiation (the emission of energy as electromagnetic waves or particles) can disrupt molecular structures, directly damaging people's DNA and increasing their risk of cancer and other health conditions. Children are more sensitive to radiation than adults due to several physiological, anatomical, developmental, and behavioural factors. First, children’s bodies are undergoing rapid growth, which involves a higher rate of cell division. Because their cells replicate more frequently, children are more vulnerable than adults to DNA damage from ionizing radiation. If this damage overwhelms the body’s natural repair mechanisms, it can lead to permanent changes in the DNA sequence, which raises the risk of developing cancer later in life. Moreover , children’s smaller body size means they absorb a higher dose of radiation per unit of body mass compared to adults. Certain organs, such as the thyroid, are particularly sensitive. Additionally, children have a longer life expectancy, which increases the time for radiation-induced conditions, such as cancer , to develop. Finally, children tend to spend more time outdoors (increasing UV exposure) and may have higher exposure to digital devices emitting non-ionizing radiation. Prenatal exposure to ionizing radiation can lead to lower IQ scores and neurodevelopmental delays. The developing fetal brain is highly sensitive to radiation, particularly during the first trimester of pregnancy. Exposure to doses as low as 0.1 gray can result in cognitive impairments. Exposure to ionizing radiation, especially from early medical imaging or fallout from nuclear incidents, increases the risk of bone marrow suppression and childhood leukaemia. Despite children’s unique vulnerability to the harmful effects of ionizing radiation, many health care facilities continue to use adult-sized CT scan settings for paediatric patients, leading to unnecessarily high radiation doses. The World Health Organization (WHO) offers global guidance protocols for medical imaging, emphasizing the need to tailor these recommendations for children's heightened vulnerability. The ALARA (As

adult-sized CT scan settings for paediatric patients, leading to unnecessarily high radiation doses. The World Health Organization (WHO) offers global guidance protocols for medical imaging, emphasizing the need to tailor these recommendations for children's heightened vulnerability. The ALARA (As Low As Reasonably Achievable) principle is critical in minimizing unnecessary medical radiation, particularly in diagnostic imaging. WHO also recommends remediation for buildings with radon levels annually on average exceeding 2.7 picocuries per litre. There are a variety of actions to reduce radiation exposure. Communities can promote home radon testing and remediation programmes, especially in regions known for elevated radon levels, to reduce indoor ionizing radiation exposure. Parents can encourage sun-safe behaviours such as wearing protective clothing, applying broad-spectrum sunscreen, protecting the eyes, and limiting outdoor activities during peak UV hours. Families can encourage prudent use of digital devices, emphasizing limited screen time and maintaining physical distance from EMF sources, particularly for young children. To reduce health care-based exposures, paediatricspecific imaging standards can be mandated across all medical facilities, ensuring consistent application of child-appropriate techniques and safety practices. The ALARA principle should be enforced in all diagnostic imaging involving children, minimizing unnecessary exposure while maintaining diagnostic quality. Nonionizing alternatives, such as ultrasound and MRI, should be prioritized whenever clinically appropriate, particularly in scenarios where repeated imaging may be required. Paediatric-specific emergency protocols should be established for evacuation, sheltering, and post-exposure screening after a radiation emergency. This ensures that children receive appropriate care in an emergency and are monitored for immediate and long-term health effects. Such interventions can protect children’s health from the adverse effects of exposure to radiation.

RADIATION AND

CHILDREN'S HEALTHIntroduction Radiation refers to the emission of energy as electromagnetic waves or particles and can be broadly categorized into ionizing and non-ionizing forms.

protect children’s health from the adverse effects of exposure to radiation.

RADIATION AND

CHILDREN'S HEALTHIntroduction Radiation refers to the emission of energy as electromagnetic waves or particles and can be broadly categorized into ionizing and non-ionizing forms. Ionizing radiation (e.g., used in medical applications, present in radon gas, or produced in nuclear fallout) possesses enough energy to remove tightly bound electrons from atoms, creating charged ions. This disruption to molecular structures can directly damage people's DNA and increase their risk of disease malignancies and other health conditions (United Nations Scientific Committee on the Effects of Atomic Radiation [UNSCEAR], 2017). Non-ionizing radiation, which includes electromagnetic fields (EMFs) from wireless technologies, ultraviolet (UV) radiation from the sun, and visible light, does not carry enough energy to ionize atoms but can still alter biological function, particularly with chronic or high-intensity exposure (United Nations Environment Programme [UNEP], 2016). Both forms of radiation are pervasive in modern environments and often are insufficiently regulated. Children are especially vulnerable to the effects of radiation due to their developing organ systems, longer expected lifetime for disease manifestation, and unique behaviours that may increase their risk of exposure. Prenatal exposures may disrupt fetal development, while radiation exposure in germ cells can carry transgenerational risks. Importantly, global disparities exist in the regulation, monitoring, and mitigation of radiation hazards. Conflict zones, and areas near nuclear facilities are often disproportionately burdened, further compounding risks for already vulnerable populations (International Atomic Energy Agency [IAEA], n.d.). This document details the general health impacts on children exposed to the most common forms of radiation. It outlines three distinct settings in which exposure occurs – in the household/community, and in health careand emergency-related settings – and suggests strategies for interventions at the individual and

details the general health impacts on children exposed to the most common forms of radiation. It outlines three distinct settings in which exposure occurs – in the household/community, and in health careand emergency-related settings – and suggests strategies for interventions at the individual and policy levels to protect children’s health. 2Children worldwide are increasingly exposed to a wide array of radiation sources, both medical and environmental. The use of ionizing radiation such as medical imaging in paediatric care has risen significantly over recent decades, driven by technological advancements and improved diagnostic capabilities. While many of these procedures are essential, studies show a growing reliance on modalities such as computed tomography (CT) scans and imaging-guided interventional procedures, which contribute disproportionately to cumulative ionizing radiation doses in children. Beyond clinical settings, environmental exposures also are widespread. Naturally occurring sources of ionizing radiation like radon, a radioactive gas found in some poorly ventilated homes and non-ionizing UV radiation from the sun are nearly universal and remain underrecognized contributors to the paediatric radiation burden. Other non-ionizing exposures – particularly from EMFs associated with digital devices, Wi-Fi, and cell towers – are becoming more pervasive with wireless connectivity and increased screen time, even among young children. See Table 1 for types and sources of radiation exposure and Figure 1 for the worldwide distribution of radiation exposure. Sources of exposure Global exposure, however , is not evenly distributed. Geographic hotspots include conflict zones, where children may be exposed to ionizing radiation from depleted uranium or radioactive remnants of warfare. Other hotspots include regions in which nuclear disasters have occurred (e.g., Chernobyl, Ukraine, in 1986; and Fukushima, Japan, in 2011); certain geographic areas in which radon enters into homes and buildings and is trapped there; and communities served by under-resourced health systems, where overuse of radiation in medical applications or the

in 1986; and Fukushima, Japan, in 2011); certain geographic areas in which radon enters into homes and buildings and is trapped there; and communities served by under-resourced health systems, where overuse of radiation in medical applications or the lack of imaging safety protocols can compound risk. Additionally, the intensity of non-ionizing solar UV radiation increases closer to the equator and at altitude, as thinner air absorbs less radiation. Reduced atmospheric ozone due to climate change enables greater penetration of UV radiation reaching the Earth’s surface (World Health Organization [WHO], 2022) where children can be exposed. These disparities highlight the urgent need for expanded global surveillance, stronger implementation of standardized paediatric imaging guidelines, and policies that prioritize radiation protection, particularly in vulnerable populations. Ionizing radiation has enough energy to remove tightly bound electrons from atoms, creating ions Non-ionizing radiation does not have enough energy to make changes to atoms or molecules Natural sources Radon gas: Naturally occurring radioactive gas that can accumulate in buildings Cosmic radiation: Radiation from space that reaches the Earth's surface Terrestrial radiation: Radiation from naturally occurring radioactive materials in the Earth Sunlight: Inclusive of UV, visible, and infrared radiation Earth’s magnetic field: Generates extremely low frequency radiation [<300 hertz (Hz)] Human-made sources Medical devices (X-rays, CT scans, nuclear medicine, and radiotherapy) Industrial applications (nuclear power plants) Consumer products (smoke detectors, certain types of luminous watches) Emergencies/disasters: Radiological incidents that disproportionately affect children due to vulnerability and displacement Electrical appliances: Microwave ovens, power lines, and common household electronics that give off low levels of electromagnetic energy, including very low-frequency waves (from 3 Hz to 300 Hz) and radio waves (from 100,000 Hz to 300 billion Hz)

Telecommunications: Mobile phones, Wi-Fi

lines, and common household electronics that give off low levels of electromagnetic energy, including very low-frequency waves (from 3 Hz to 300 Hz) and radio waves (from 100,000 Hz to 300 billion Hz) Telecommunications: Mobile phones, Wi-Fi routers, and broadcasting antennas that emit radio frequency radiation Medical devices: LASERs and certain diagnostic equipment that emit UV, visible, and infrared radiation Table 1. General sources of radiation exposure 3Children may encounter radiation through multiple environmental pathways, and each of these pathways contributes to children's overall exposure burden in a unique way. This document describes in detail three broad exposure settings: the household/community, health care-related, and emergency-related settings. A comprehensive (but not exhaustive) list of exposure sources by radiation type (ionizing vs. non-ionizing) is below. • Inhalation is a common route of exposure, particularly when children breathe in radon, a naturally occurring ionizing-radiation gas that can accumulate in some poorly ventilated homes, or when children inhale airborne radioactive particles released during nuclear accidents or industrial activities. • Dermal penetration is typically less significant for ionizing radiation, yet it is an important route for non-ionizing UV radiation, especially in children who spend greater time in outdoor activity and have more sun exposure. Direct exposure may arise from frequent use of personal electronic devices emitting EMFs, or in residences near nuclear facilities, cell towers, or other high-intensity, EMF-emitting infrastructure. • Ingestion of radiation is a less common exposure pathway, but the health impacts are equally severe. It occurs when radioactive materials enter the body through eating, drinking, or swallowing contaminated substances (i.e., breast milk) or in emergency contexts involving radioactive fallout. Documented pathways of ingestion exposure include people's drinking of groundwater contaminated with radioactive substances (He et al., 2022) and consumption of

swallowing contaminated substances (i.e., breast milk) or in emergency contexts involving radioactive fallout. Documented pathways of ingestion exposure include people's drinking of groundwater contaminated with radioactive substances (He et al., 2022) and consumption of fish and seafood exposed to radioactive isotopes like caesium-137 after nuclear disasters (IAEA and Food and Agriculture Organization of the United Nations [FAO], n.d.). Once inside the body, these materials can continue to emit harmful radiation, damaging cells. Exposure pathways Figure 1. Worldwide distribution of radiation exposure Adapted from Radiation: Effects and sources, 2016, by UNEP , p. 27. (https://www.unep.org/resources/report/radiation-effects-and-sources) Cosmic 13% Soil 16% Medical 20% Radon 42% Food 9% l doses Interna 4Children are more radiosensitive than adults due to several physiological, anatomical, developmental, and behavioural factors. First, children’s bodies are undergoing rapid growth, which involves a higher rate of cell division. Because their cells replicate more frequently, children are more vulnerable than adults to DNA damage from ionizing radiation. If this damage overwhelms the body’s natural repair mechanisms, it can lead to permanent changes in the DNA sequence, which raises the risk of developing cancer later in life. Moreover , children’s smaller body size means they absorb a higher dose of radiation per unit of body mass compared to adults. Certain organs, such as the thyroid, are particularly sensitive; for instance, children’s thyroids absorb more radioactive iodine, increasing their risk of developing thyroid cancer (WHO, 2023). Children also have different bodily proportions compared to adults. For example, an infant is shorter and broader at the trunk compared to an adult frame (Alzen & BenzBohm, 2011), therefore a greater surface area may be exposed during chest CT scans or abdominal X-rays, two

Children also have different bodily proportions compared to adults. For example, an infant is shorter and broader at the trunk compared to an adult frame (Alzen & BenzBohm, 2011), therefore a greater surface area may be exposed during chest CT scans or abdominal X-rays, two common sources of ionizing radiation exposures related to health care imaging. Children with certain genetic conditions, such as retinoblastoma, neurofibromatosis type 1, and Li-Fraumeni syndrome, are at an even greater risk of developing radiation-induced cancers (Kleinerman, 2009). Additionally, children have a longer life expectancy, which increases the window of time for radiation-induced conditions, such as cancer , to develop. For example, following acute exposure to 1 sievert (Sv) of radiation, it is estimated that a child (age 5 years) will have twice the excess relative risk of developing a solid cancer compared to an adult (Figure 2). Finally, children's behavioural patterns may magnify their exposure to risk. They tend to spend more time outdoors (increasing UV exposure), often play closer to the ground where floor-level pollutants accumulate, and may have higher exposure to digital devices emitting non-ionizing radiation. On the basis of results from various epidemiological studies, including the Life Span Study (LSS), the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) concluded that children are generally more sensitive than adults to radiation for 25 per cent of cancer types, including leukaemia and cancers of the thyroid, skin, breast, and brain (UNSCEAR, 2013). Children’s unique vulnerability Figure 2. Excess relative risk of solid cancer incidence after acute radiation exposure (1 Sv)

at 5, 15, and 25 years of age Adapted from "Ionizing radiation" by E. J. Grant and D. G. Hoel, 2024, in Textbook of children’s environmental health (2nd ed.), edited by

R. A. Etzel and P . J. Landrigan, Oxford University Press. (https://doi.org/10.1093/oso/9780197662526.003.0045)

2.2 2.0 1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 10 20 30 40 50 60 70 80 Attained age Age 5 years Age 15 years Age 25 years 5UNSCEAR evaluates scientific evidence on the health and environmental effects of radiation exposure (UNSCEAR, 2013). The impact of exposure depends on several factors, including the type of radiation (e.g., ionizing vs. non-ionizing), the duration of exposure (which may involve radioactive substances with specific half-lives), and the amount of energy deposited in body tissues. Radiation exposure is often measured using two units: the gray (Gy), which measures the amount of radiation energy absorbed by the body, and the sievert (Sv), which reflects the potential health effect of that exposure (Table 2 and Figure 3). Biomonitoring and reference values Dose band Dose range Examples High dose More than ~1 Gy Radiotherapy and severe radiation accidents (e.g., firemen's exposure at the Chernobyl accident) Moderate dose ~100 mGy to ~1 Gy Recovery operation workers after the Chernobyl accident Low dose ~10 mGy to ~100 mGy Multiple computer tomography (CT) scans Very low dose Less than ~10 mGy Conventional radiography (i.e., without CT) Table 2. Examples of radiation exposure, by dose band and range Figure 3. Everyday examples of radiation exposure and their effective doses

Low dose ~10 mGy to ~100 mGy Multiple computer tomography (CT) scans Very low dose Less than ~10 mGy Conventional radiography (i.e., without CT) Table 2. Examples of radiation exposure, by dose band and range Figure 3. Everyday examples of radiation exposure and their effective doses Note: 1,000 mSv is equivalent to 1 Sv. From Radiation: Effects and sources, 2016, by UNEP , front cover . (https://www.unep.org/resources/report/radiation-effects-and-sources) Note: 1,000 mGy is equivalent to 1 Gy. Adapted from Radiation: Effects and sources, 2016, by UNEP , p. 12. (https://www.unep.org/ resources/report/radiation-effects-and-sources) > 1,000 mSv Dose used in radiotherapy Astronaut dose (4 months) CT scan of the abdomen Worker dose in nuclear industry (1 year) Chest X-ray or flight (20 hours) Dental X-ray Brazil nuts (30 g) 100 mSv 10 mSv 1 mSv 0.1 mSv 0.01 mSv 0.001 mSv 6The health effects of radiation exposure in children have been observed in multiple organ systems (Figure 4). The principal biological mechanism Monitoring radiation exposure in children presents unique challenges. Unlike persistent chemicals, many forms of radiation (particularly those from radionuclides) have short biological half-lives, making it difficult to capture exposures unless measurement occurs promptly after the event (UNSCEAR, 2017). Additionally, biomonitoring infrastructure specifically tailored for paediatric populations is limited, leading to gaps in exposure surveillance. In emergency settings, personal dosimeters can help track individual exposure levels, while post-exposure thyroid scans are commonly used to assess uptake of radioactive iodine (IAEA, n.d.). Urinary biomarkers can also be employed to detect

gaps in exposure surveillance. In emergency settings, personal dosimeters can help track individual exposure levels, while post-exposure thyroid scans are commonly used to assess uptake of radioactive iodine (IAEA, n.d.). Urinary biomarkers can also be employed to detect specific radionuclides such as uranium or caesium (Agency for Toxic Substances and Disease Registry, 2014). To guide and standardize protective efforts, several benchmarks and principles are in place. The ALARA (As Low As Reasonably Achievable) principle is critical in minimizing unnecessary medical radiation, particularly in diagnostic imaging (Image Gently Alliance, n.d.). is damage to DNA (Frush, 2013), disrupting the fundamental instructions that guide how cells grow, function, and divide. Brain Thyroid Breast Bone marrow Skin Reference values for radiation are used to evaluate the risks of radiation exposure to people and the environment. These values have been produced for dose limits, drinking water , and air (radon gas) concentration. The International Commission on Radiological Protection (ICRP) recommends for the public a dose limit of 1 mSv per year when the exposure sources are man-made (International Commission on Radiological Protection [ICRP], 2007). The World Health Organization (WHO) has established a guideline of 0.1 mSv per year for radiation exposure from drinking water to minimize health risks (WHO, 2017a). WHO recommends remediation for buildings with radon levels equal to or exceeding 100 becquerels per cubic metre (≥100 Bq/m3) or 2.7 picocuries per litre (2.7 pCi/L) annually on average (WHO, 2000). Finally, WHO offers global guidance on safe limits for UV exposure and protocols for medical imaging, further emphasizing the need to tailor these recommendations for children's heightened vulnerability (WHO, 2024; WHO et al., 2002). Health impacts by organ system

WHO offers global guidance on safe limits for UV exposure and protocols for medical imaging, further emphasizing the need to tailor these recommendations for children's heightened vulnerability (WHO, 2024; WHO et al., 2002). Health impacts by organ system Adapted from Radiation: Effects and sources, 2016, by UNEP , p. 19. (https://www.unep.org/resources/report/radiation-effects-and-sources) Figure 4. Particularly radiosensitive organs in children 7Radiation can cause single-strand breaks in DNA; cells usually can repair such breaks with minimal lasting effects. However , double-strand breaks, particularly those occurring close together on the DNA helix, are more difficult to repair and can lead to mutations, cell death, or malfunctioning cells. In some cases, incorrect repairs may result in stable genetic abnormalities that initiate the multistep process of cancer development (carcinogenesis). Fetal outcomes/teratogenesis: Evidence-based investigations of large-scale radiation disasters, studies on the effects of radiation in animals, and analysis of outcomes in pregnant women exposed to medical treatment have established thresholds for the deterministic impacts of radiation exposure on children (Sutton et al., 2023) (Table 3).

Neurological: Prenatal exposure to ionizing radiation can lead to lower IQ scores and neurodevelopmental delays. The developing fetal brain is highly sensitive to radiation, particularly during the first trimester of pregnancy. Exposure doses as low as 0.1 Gy can result in cognitive impairments, with an estimated loss of 25

IQ points per 1,000 mGy at 10–17 weeks of gestation (Saada et al., 2023). In a retrospective study of children who were in utero during the Chernobyl accident, IQ loss was significant in the group of children whose mothers were most highly exposed. IQ loss was most pronounced when exposure occurred in the earlier

(Saada et al., 2023). In a retrospective study of children who were in utero during the Chernobyl accident, IQ loss was significant in the group of children whose mothers were most highly exposed. IQ loss was most pronounced when exposure occurred in the earlier weeks of gestation (Liutsko et al., 2024). Effects Potential outcome Estimated threshold dose at which outcome may occur Gestational period Before implantation (0–2 weeks after fertilization) Death of embryo or no consequence 50–100 mGy Organogenesis (2–8 weeks after fertilization) Congenital anomalies (skeleton, eyes, and genitals) 200 mGy Growth restriction 200–250 mGy Fetal period 8–15 weeks Severe intellectual deficit (loss of 25 IQ points) 1,000 mGy Microcephaly 200 mGy 16–25 weeks Severe intellectual disability (low risk) 250–280 mGy Table 3. Estimated threshold doses and their corresponding outcomes, by exposure timing Note: Fetal radiation doses associated with common radiological examinations have been estimated by the American College of Obstetricians and Gynecologists. However , the authors of the estimates note that these exposure values may vary among different health care facilities and may be further influenced by individual susceptibility. The table is adapted from "Guidelines for diagnostic imaging during pregnancy and lactation," Committee Opinion No. 723, by American College of Obstetricians and Gynecologists (2017). Obstetrics & Gynecology, 130(4), e210–216. (https://journals.lww.com/ greenjournal/fulltext/2017/10000/committee_opinion_no__723_summary__guidelines_for .55.aspx) Carcinogenicity: Ionizing radiation in children's body systems increases the risk of childhood leukaemia, especially from early medical imaging or fallout from nuclear incidents. The haematopoietic system is highly sensitive to radiation, leading to potential bone marrow suppression and increased leukaemia incidence

Carcinogenicity: Ionizing radiation in children's body systems increases the risk of childhood leukaemia, especially from early medical imaging or fallout from nuclear incidents. The haematopoietic system is highly sensitive to radiation, leading to potential bone marrow suppression and increased leukaemia incidence

(Wakeford, 2013). Children and young people exposed to radiation at ages below 20 years are about twice as likely to develop brain cancer as older adults exposed to the same dose. A similar association was noticed for breast cancer when girls and young women were exposed at ages below 20 years (UNSCEAR, 2013). Thyroid cancer risk is elevated after head and neck radiation exposure, which can lead to both benign and malignant lesions (Ronckers et al., 2004). 8Category Quantity Definition Physical quantity Activity The number of nuclear transformations of energy per unit of time. It is measured as decays per second and expressed in becquerels (Bq). Absorbed dose The amount of energy deposited by radiation in a unit mass of material, such as a tissue or organ. It is expressed in grays (Gy), which correspond to joules per kilogram. Calculated quantity Equivalent dose The absorbed dose multiplied by a radiation weighting factor (wR) that accounts for how different types of radiation cause biological harm. Expressed in sieverts (Sv) or joules per kilogram. Effective dose The equivalent dose multiplied by organ factors (wT) that account for susceptibility to radiation harm in different tissues. Expressed in sieverts (Sv) or joules per kilogram. Collective effective dose Sum of all effective doses for a population or group exposed to radiation. Expressed in man-sieverts (man-Sv). Table 4. Unit distinction From Radiation: Effects and sources, 2016, by UNEP , p. 8. (https://www.unep.org/resources/report/radiation-effects-and-sources) Note on units Radiation exposure is measured using different units depending on the context (Table 4). The

From Radiation: Effects and sources, 2016, by UNEP , p. 8. (https://www.unep.org/resources/report/radiation-effects-and-sources) Note on units Radiation exposure is measured using different units depending on the context (Table 4). The milligray (mGy) quantifies the absorbed dose, i.e., the amount of radiation energy deposited in a person’s tissue. In contrast, the millisievert (mSv) measures the biological effect of that radiation, accounting for the type of radiation and its impact on human health.

To convert mGy to mSv, the absorbed dose is multiplied by a radiation weighting factor (wR), which varies by radiation type. For instance, 10 mGy of X-rays (wR = 1) equals 10 mSv, whereas 10 mGy of alpha radiation (wR = 20) equates to 200 mSv, indicating a significantly higher biological risk.

Reproductive: Gonadal exposure to ionizing radiation can lead to long-term fertility issues. Exposure can alter sex cells, thus the health effects can be intergenerational. In adolescent males, radiation can impair spermatogenesis, leading to reduced sperm count and less motility. In females, ovarian exposure can result in premature ovarian failure and early menopause (Chougule & Joan, 2025).

Integumentary: Because skin cells are constantly proliferating, they are highly susceptible to damage from radiation exposure. Several radiation-induced skin complications have been reported in the scientific literature, including radiation dermatitis, radiation recall dermatitis, and radiation-induced skin malignancies (Bennardo et al., 2021). Most notably, UV exposure increases melanoma and non-melanoma skin cancers later in life. Childhood cancer survivors

(often treated with radiation therapy) have more than a two-fold standardized incidence ratio of melanoma compared with the general population (Rotz et al.,

UV exposure increases melanoma and non-melanoma skin cancers later in life. Childhood cancer survivors (often treated with radiation therapy) have more than a two-fold standardized incidence ratio of melanoma compared with the general population (Rotz et al., 2025). In this cohort, the development of melanoma was driven by exposures to certain drugs used to treat cancer (bleomycin and high cumulative alkylators), but not other chemotherapies.

Respiratory: Radiation exposure can significantly impact the lungs, with effects varying by age and dose. In both children and adults, high doses of ionizing radiation – such as from cancer therapy or environmental exposure – can