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LETTERS: Michael Swift and Yun Su Link between breast cancer and ATM gene is strong BMJ 1999; 318: 400 [Full text]

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Radiation protection norms and A-T

Christophe De Brouwer   (1 September 2000)

Radiation protection norms and A-T 1 September 2000
Christophe De Brouwer, Directeur du laboratoire de Santé au Travail et de Toxicologie du Milieu. School of Public Health. Université Libre de Bruxelles Send response to journal: Re: Radiation protection norms and A-T	The problem caused by AT heterozygotes in the increase in cancers is controversed. The radiation protection limitation recommandations are primarily based on the estimation of excess risk of whole populations. Currently the ICRP (Publication 79, 1998, page 138) does not recommend the take into consideration of these particular populations: "insufficient to form the basis of special precautions". With regard to the AT heterozygotes for norm recommendations, ICRP estimates that the controversy brought eg by Fitzgerald et al.(1), currently do not allow the taking into account of the heterozygous AT . This position does not hold any account of the precautionary principle (2). However this precautionary principle should obviously apply in this case, taking into account many studies (3) which show a risk clearly increased in this population. If one were to hold account of the results obtained in particular by Athma et al.(4), it is probable that the limits of doses recommended for the workers (ICRP, Publication 60, 1990) would be still lowered. In the field of protection against radiation, one can notice that the taking into account of the occupational hazard is rarely based on early indicative results, but mainly on late obviousnesses. (1) FitzGerald MG, Bean JM, Hedge SR, Unsal H, MacDonald DJ, Harkin DP, Finkelstein DM, Isselbacher KJ, Haber DA. Heterozygous ATM mutations do not contribute to early onset of breast cancer. Nat Genet. 1997; 15: 307-310. (2) Communication from the Commission on the precautionary principle. COM (2000) 1 (01). 2-2-2000. (3) Janin N, Andrieu N, Ossian K, Lauge A, Croquette MF, Griscelli C, Debre M, Bressac de Paillerets B, Aurias A, Stoppa-Lyonnet D. Breast cancer risk in ataxia telangiectasia (AT) heterozygotes: haplotype study in French AT families. Br J Cancer. 1999; 80: 1042-1045. (4)Athma P, Rappaport R, Swift M. Molecular genotyping shows that ataxia- telangiectasia heterozygotes are predisposed to breast cancer. Cancer Genet Cytogenet. 1996; 92: 130-134.