Millirem to Millisievert

ALARA stands for "As Low As Reasonably Achievable" — the idea that radiation doses should be minimized beyond what regulations require, using a cost-benefit analysis. In practice, a hospital might install additional lead shielding in a catheterisation lab wall (reducing staff dose from 300 mrem/year to 50 mrem/year) because the shielding cost is modest compared to the dose reduction. But spending $1 million to reduce a dose from 5 mrem to 4 mrem would not be "reasonable." ALARA is a philosophy, not a number — it forces every radiation facility to continuously ask "can we do better without being absurd?"

Almost everything. A nuclear power plant delivers roughly 0.1–1 mrem/year to its nearest neighbors. Eating one banana: 0.01 mrem. Sleeping next to another person for a year (their K-40): about 0.5 mrem. A cross-country flight: 2–5 mrem. Moving from a wood-frame house to a brick one: ~10 mrem/year from terrestrial gamma. A single chest X-ray: 2 mrem. Living in Denver instead of Miami adds ~50 mrem/year from cosmic rays. Even the potassium in your own body irradiates you at ~17 mrem/year. The nuclear plant next door is the least significant radiation source in most people's lives.

About 620 mrem (6.2 mSv). The breakdown is roughly: radon inhalation 200 mrem, medical imaging 300 mrem (CT scans are the big driver), cosmic radiation 33 mrem, terrestrial gamma 21 mrem, internal radionuclides 29 mrem, and consumer products (smoke detectors, certain ceramics) about 10 mrem. The medical imaging component has nearly doubled since the 1980s due to the explosion of CT and nuclear medicine scans. A single abdominal CT at 1,000–2,000 mrem can exceed a year's worth of natural background in one sitting.

Before the 1920s, radiologists routinely tested X-ray machines by placing their own hands in the beam to check image quality. Cumulative doses to their fingers reached tens of sieverts over years — enough to cause chronic radiation dermatitis, ulceration, and eventually squamous cell carcinoma. Dozens of pioneering radiologists had fingers amputated; some died of metastatic cancer. The "Martyrs of Radiology" memorial in Hamburg lists over 350 names. Their suffering directly led to the first dose limits (the 1928 ICRP recommendations) and the fundamental principle that no one should use their own body as a radiation detection instrument.

A quarterly dosimeter report lists: deep dose equivalent (whole-body penetrating radiation, in mrem), lens of eye dose, shallow dose (skin dose from beta or low-energy photons), and sometimes extremity dose (from ring dosimeters worn in labs). Most workers see "M" for minimal — below the reporting threshold of 10 mrem. A nuclear medicine technologist might report 100–300 mrem/quarter; an interventional cardiologist might see 500+. If any reading exceeds an administrative action level (often 500 mrem/quarter), the radiation safety officer investigates whether something went wrong or if the work simply required it.

The UNSCEAR figure of 2.4 mSv/year is a population-weighted average across all countries. But the real range is enormous: 1–1.5 mSv in flat coastal cities with low radon, up to 50+ mSv in places like Ramsar, Iran, where naturally occurring radium hot springs push radon levels through the roof. The 2.4 figure is useful as a benchmark — when a doctor says "this CT scan is equivalent to 3 years of background," they mean 3 × 2.4 = 7.2 mSv — but it should not be mistaken for what any specific individual actually receives.

A head CT delivers about 2 mSv; a chest CT about 7 mSv; an abdomen/pelvis CT about 10–20 mSv. For context, the increased cancer risk from a 10 mSv CT is estimated at roughly 1 in 2,000 — compared to the baseline lifetime cancer risk of about 1 in 3. If the scan detects a tumor, blood clot, or appendicitis, the diagnostic benefit massively outweighs that tiny added risk. The concern is not one scan but cumulative dose from repeated scans, particularly in children, who are more radiosensitive and have more years ahead for a potential cancer to develop.

The ICRP recommends 20 mSv/year averaged over 5 years, with no single year exceeding 50 mSv. This limit was derived from epidemiological data on atomic bomb survivors, radium dial painters, and early radiologists — groups whose cancer rates could be correlated with estimated doses. The 20 mSv figure is set so that a worker exposed at the limit for an entire 40-year career (total: ~800 mSv) faces an additional cancer risk of about 3–4% — roughly the same as working in a slightly more hazardous industry. Most workers actually receive well under 5 mSv/year.

Radon-222, a decay product of uranium in soil, seeps into buildings and is inhaled continuously. Its short-lived decay products (Po-218 and Po-214) lodge in lung tissue and blast it with alpha particles. Alpha radiation deposits 20 times more biological damage per unit of energy than gamma rays, which is why the sievert weighting factor for alpha is 20. The global average radon contribution is about 1.26 mSv/year — more than cosmic radiation, terrestrial gamma, and internal radionuclides combined. In areas with granite bedrock or uranium-rich soils, radon can dominate the dose budget even further.

Studies on airline crew consistently show a small but statistically detectable increase in certain cancers (melanoma, breast cancer in female crew), though it is difficult to separate radiation effects from other occupational factors like jet lag, irregular sleep, and UV exposure during layovers. A long-haul pilot accumulates about 2–5 mSv/year from cosmic radiation — comparable to a couple of CT scans. EU regulations classify aircrew as radiation workers if they exceed 1 mSv/year, requiring dose monitoring and schedule management to keep exposure ALARA. The US has no equivalent requirement.