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Relationship: 1981


The title of the KER should clearly define the two KEs being considered and the sequential relationship between them (i.e., which is upstream and which is downstream). Consequently all KER titles take the form “upstream KE leads to downstream KE”.  More help

Energy Deposition leads to Increase, Mutations

Upstream event
Upstream event in the Key Event Relationship. On the KER page, clicking on the Event name under Upstream Relationship will bring the user to that individual KE page. More help
Downstream event
Downstream event in the Key Event Relationship. On the KER page, clicking on the Event name under Upstream Relationship will bring the user to that individual KE page. More help

Key Event Relationship Overview

The utility of AOPs for regulatory application is defined, to a large extent, by the confidence and precision with which they facilitate extrapolation of data measured at low levels of biological organisation to predicted outcomes at higher levels of organisation and the extent to which they can link biological effect measurements to their specific causes. Within the AOP framework, the predictive relationships that facilitate extrapolation are represented by the KERs. Consequently, the overall WoE for an AOP is a reflection in part, of the level of confidence in the underlying series of KERs it encompasses. Therefore, describing the KERs in an AOP involves assembling and organising the types of information and evidence that defines the scientific basis for inferring the probable change in, or state of, a downstream KE from the known or measured state of an upstream KE. More help

AOPs Referencing Relationship

This table is automatically generated upon addition of a KER to an AOP. All of the AOPs that are linked to this KER will automatically be listed in this subsection. Clicking on the name of the AOP in the table will bring you to the individual page for that AOP. More help
AOP Name Adjacency Weight of Evidence Quantitative Understanding Point of Contact Author Status OECD Status
Deposition of energy leading to lung cancer non-adjacent High High Brendan Ferreri-Hanberry (send email) Under development: Not open for comment. Do not cite EAGMST Approved

Taxonomic Applicability

Select one or more structured terms that help to define the biological applicability domain of the KER. In general, this will be dictated by the more restrictive of the two KEs being linked together by the KER. Authors can indicate the relevant taxa for this KER in this subsection. The process is similar to what is described for KEs (see pages 30-31 and 37-38 of User Handbook) More help
Term Scientific Term Evidence Link
human Homo sapiens High NCBI
rat Rattus norvegicus High NCBI
mouse Mus musculus High NCBI

Sex Applicability

Authors can indicate the relevant sex for this KER in this subsection. The process is similar to what is described for KEs (see pages 31-32 of the User Handbook). More help
Sex Evidence
Unspecific High

Life Stage Applicability

Authors can indicate the relevant life stage for this KER in this subsection. The process is similar to what is described for KEs (see pages 31-32 of User Handbook). More help
Term Evidence
All life stages High

Key Event Relationship Description

Provide a brief, descriptive summation of the KER. While the title itself is fairly descriptive, this section can provide details that aren’t inherent in the description of the KEs themselves (see page 39 of the User Handbook). This description section can be viewed as providing the increased specificity in the nature of upstream perturbation (KEupstream) that leads to a particular downstream perturbation (KEdownstream), while allowing the KE descriptions to remain generalised so they can be linked to different AOPs. The description is also intended to provide a concise overview for readers who may want a brief summation, without needing to read through the detailed support for the relationship (covered below). Careful attention should be taken to avoid reference to other KEs that are not part of this KER, other KERs or other AOPs. This will ensure that the KER is modular and can be used by other AOPs. More help

Energy can be deposited on biomolecules from various forms of radiation. Radiation with high linear energy transfer (LET) tends to produce more complex, dense structural damage than low LET radiation; both, however, can lead to detrimental damage within a cell (Hada & Georgakilas, 2008; Okayasu, 2012; Lorat et al., 2015; Nikitaki et al., 2016). The DNA is particularly susceptible to damage which can be in the form of mutations. Mutations may occur in germ cells or somatic cells; mutations in germ stem and progenitor cells are often of the greatest concern, as they may persist and be propagated to offspring. Regardless of the cell type, there are several different categories of mutations including: missense, nonsense, insertion, deletion, duplication, and frame-shift mutations.  These mutations can present with different downstream effects which are not predictable but can potentially initiate a path to carcinogenesis.

Evidence Supporting this KER

Assembly and description of the scientific evidence supporting KERs in an AOP is an important step in the AOP development process that sets the stage for overall assessment of the AOP (see pages 49-56 of the User Handbook). To do this, biological plausibility, empirical support, and the current quantitative understanding of the KER are evaluated with regard to the predictive relationships/associations between defined pairs of KEs as a basis for considering WoE (page 55 of User Handbook). In addition, uncertainties and inconsistencies are considered. More help
Biological Plausibility
Define, in free text, the biological rationale for a connection between KEupstream and KEdownstream. What are the structural or functional relationships between the KEs? For example, there is a functional relationship between an enzyme’s activity and the product of a reaction it catalyses. Supporting references should be included. However, it is recognised that there may be cases where the biological relationship between two KEs is very well established, to the extent that it is widely accepted and consistently supported by so much literature that it is unnecessary and impractical to cite the relevant primary literature. Citation of review articles or other secondary sources, like text books, may be reasonable in such cases. The primary intent is to provide scientifically credible support for the structural and/or functional relationship between the pair of KEs if one is known. The description of biological plausibility can also incorporate additional mechanistic details that help inform the relationship between KEs, this is useful when it is not practical/pragmatic to represent these details as separate KEs due to the difficulty or relative infrequency with which it is likely to be measured (see page 40 of the User Handbook for further information).   More help

The biological rationale for linking direct deposition of energy by ionizing radiation to mutation induction is strong. The structural and functional relationships in this KER contribute sufficiently to the overall biological plausibility.

There are numerous studies that demonstrate, using various model systems, an increase in mutation frequency in response to radiation exposure (Russell et al., 1957; Winegar et al., 1994; Gossen et al., 1995; Suzuki & Hei 1996; Albertini et al., 1997; Dubrova et al., 1998; Kraemer et al., 2000; Dubrova, Plumb, et al., 2000; Canova et al., 2002; Dubrova et al., 2002; Dubrova & Plumb, 2002; Masumura et al., 2002; Somers et al., 2004; Burr et al., 2007; Ali et al., 2012; Bolsunovsky et al., 2016; Mcmahon et al., 2016; Matuo et al., 2018; Nagashima et al., 2018; Wu et al., 1999; Hei et al., 1997; Nagasawa and Little, 1999; Barnhart and Cox, 1979; Thacker at al., 1982; Zhu et al., 1982; Metting et al., 1992; Schwartz et al., 1991; Chen et al., 1984; Albertini et al., 1997). The process of mutation induction by radiation is initiated when cells are exposed to ionizing radiation. These high-energy waves or particles interact with the genetic material in the nucleus, damaging the DNA and triggering a cascade of signalling events and activities aimed at repairing the damage. This process, however, may result in not only the repair of the DNA, but also the formation of mutations (Sankaranarayanan & Nikjoo, 2015). Of note, radiation is not likely to impact only one gene; more often than not, the random nature of energy deposition by radiation results in mutations to many genes and genomic sites clustered in the same area (Sankaranarayanan & Nikjoo, 2015; Adewoye et al., 2015). Many of the radiation-induced mutations have been documented as deletions (Gossen et al., 1995; Behjati et al., 2016), often of differing sizes in a number of different genes (Sankaranarayanan & Nikjoo, 2015). The mechanism for radiation-induced mutations is thought to be similar to the process for spontaneously-occurring mutations, as the structure of radiation-induced mutations examined at expanded simple tandem repeat (ESTR) loci was not found to differ from the structure of spontaneous mutations (Dubrova, 2005). Moreover, exposure to radiation may produce specific mutational signatures. Two ionizing radiation-specific mutational signatures were found when 12 radiation-induced secondary tumours across 4 different tumour types underwent whole-genome sequencing and bioinformatics processing. In particular, these radiation-exposed tumours were significantly enriched in small deletions and balanced inversions. These results were validated when the same mutational signatures were observed in radiation-exposed but not radiation-naïve prostate tumours from a previously-published dataset (Behjati et al., 2016). Similarly, another study examining mutations present in radiation-induced tumours of Nf1 heterozygous and wild-type mice revealed three distinctive mutational signatures. Interestingly, these signatures were found in all of the tumours regardless of its histology or of the animal’s genotype. Moreover, these signatures were still present after removal of the 33 most mutated samples from the analysis, after analysis of only the non-synonymous substitutions, and after analysis of only the synonymous substitutions (though the third mutational signature could not be extracted in this last analysis group) (Sherborne et al. 2015). There were also common cellular pathways that were found to be frequently mutated in the tumours of these mice. In sarcomas from mice of both genetic backgrounds (Nf1 heterozygous and wild-type), the top two pathways harbouring mutations were those influencing cellular assembly and organization, and those involved in cellular function and maintenance. Additionally, Ras pathways were commonly mutated in tumours from both genetic backgrounds. Specific to wild-type sarcomas, mutations were also found in cell cycle and cell signalling pathways (Sherborne et al., 2015). Supporting the finding that different genetic backgrounds in mice do not affect mutational signatures in tumours (Sherborne et al., 2015), there also does not appear to be strain-specific differences in ESTR mutational frequencies in response to radiation. One study examined five different strains of male mice that were irradiated and mated to unirradiated females at least 4 weeks post-irradiation. Although there was a difference in doubling doses between strains, the ESTR mutations themselves were not significantly different. Furthermore, there were no significant differences found between strains in terms of germline mutation induction (Dubrova, 2005).

Germline mutations have been further interrogated in studies examining the effects of radiation exposure on germ cells. There is evidence from mouse studies suggesting that the germ cells of radiation-exposed males have elevated ESTR mutations and that the offspring of these irradiated males inherit more ESTR mutations as a result of the germline mutations (Dubrova et al., 1998; Dubrova, Bersimbaev, et al., 2000; Dubrova & Plumb, 2002; Somers et al., 2004; Barber et al., 2009; Ali et al., 2012; T.E. Wilson et al., 2015). This was reviewed by Somers et al. (2006). Interestingly, in utero irradiation of embryos at day 12 resulted in increased ESTR mutations across several tissue types in males and females; however, only the offspring of the irradiated males showed an elevated ESTR mutation rate (Barber et al., 2009). On a genome-wide scale, the offspring of irradiated males were found to have significantly more clustered single nucleotide variants (SNVs) and insertion/deletion events compared to offspring from unirradiated fathers (Adewoye et al., 2015).

Human studies have also shown correlations in radiation exposure and increased germline mutations. This relationship was assessed in families exposed accidently to high doses of ionizing radiation after the Chernobyl accident in Ukraine, and in families living in close proximity to the Semipalatinsk nuclear test site in Kazakhstan. In both cases, germline mutations were evaluated using eight hypervariable minisatellite probes. In the Chernobyl study, the paternal mutation rate in the exposed group was significantly increased by 1.6-fold relative to an unexposed control group; there was, however, no significant difference in the maternal germline mutation rates between the exposed group and the unexposed control group (Dubrova et al., 2002C). In the Semipalatinsk study, analysis of families living in the affected region over three generations found that germline mutations in the first and second generation were significantly increased relative to unexposed families living in a low-radiation area. Overall, the germline mutation rate in the families exposed to radiation from this test site was doubled (Dubrova, Bersimbaev, et al., 2000).

Uncertainties and Inconsistencies
In addition to outlining the evidence supporting a particular linkage, it is also important to identify inconsistencies or uncertainties in the relationship. Additionally, while there are expected patterns of concordance that support a causal linkage between the KEs in the pair, it is also helpful to identify experimental details that may explain apparent deviations from the expected patterns of concordance. Identification of uncertainties and inconsistencies contribute to evaluation of the overall WoE supporting the AOPs that contain a given KER and to the identification of research gaps that warrant investigation (seep pages 41-42 of the User Handbook).Given that AOPs are intended to support regulatory applications, AOP developers should focus on those inconsistencies or gaps that would have a direct bearing or impact on the confidence in the KER and its use as a basis for inference or extrapolation in a regulatory setting. Uncertainties that may be of academic interest but would have little impact on regulatory application don’t need to be described. In general, this section details evidence that may raise questions regarding the overall validity and predictive utility of the KER (including consideration of both biological plausibility and empirical support). It also contributes along with several other elements to the overall evaluation of the WoE for the KER (see Section 4 of the User Handbook).  More help

Uncertainties and inconsistencies in this KER are as follows:

  1. In a review paper describing the role ionizing radiation plays in elevating mutation frequency in the germline and therefore genetic risk, Sankaranarayanan & Nikjoo (2015) stated that most radiation-induced mutations tended to be deletions. In contrast, an examination of ESTR loci mutations in offspring and their irradiated fathers found that the ESTR mutations tended to be gains more often than losses (Dubrova ,2005). This may, however, highlight a characteristic specific to ESTR mutations rather than mutations in general.
  2. In a study examining the long-term of effects of in utero radiation exposure, males irradiated at embryonic day 12 showed significant increases in both somatic and germline ESTR mutations as adults, and produced offspring with significantly elevated ESTR mutations in their sperm (Barber et al., 2009). In contrast, male mice exposed to radiation during their neonatal days (6 - 8 days old) or pubertal stage (18 - 25 days) did not have increased mutations in adult spermatozoa, as mutant frequencies that were present in spermatogenesis stages immediately after radiation returned to normal levels later in the spermatogenesis process (Xu et al., 2008).
  3. Factors such as dose, dose-rate, tissue type and radiation quality can influence mutation rate induction (Hooker et al., 2004; Rydberg et al., 2005; Day et al., 2007; Okudaira et al., 2010; Brooks et al., 2016). 
Response-response Relationship
This subsection should be used to define sources of data that define the response-response relationships between the KEs. In particular, information regarding the general form of the relationship (e.g., linear, exponential, sigmoidal, threshold, etc.) should be captured if possible. If there are specific mathematical functions or computational models relevant to the KER in question that have been defined, those should also be cited and/or described where possible, along with information concerning the approximate range of certainty with which the state of the KEdownstream can be predicted based on the measured state of the KEupstream (i.e., can it be predicted within a factor of two, or within three orders of magnitude?). For example, a regression equation may reasonably describe the response-response relationship between the two KERs, but that relationship may have only been validated/tested in a single species under steady state exposure conditions. Those types of details would be useful to capture.  More help

There is evidence of a positive response-response relationship between the radiation dose and the frequency of mutations (Russell et al., 1957; Suzuki & Hei, 1996; Albertini et al., 1997; Kraemer et al., 2000; Canova et al., 2002; Dubrova & Plumb, 2002; J.W. Wilson et al., 2015; Bolsunovsky et al., 2016; Mcmahon et al., 2016; Nagashima et al., 2018) . Most studies found that the response-response relationship was linear (Russell et al., 1957; Albertini et al., 1997; Canova et al., 2002; Dubrova et al., 2002; Nagashima et al., 2018). There were however, two exceptions. In a study using normal human bronchial epithelial cells irradiated with 1 - 6 Gy of gamma-rays, the relationship between the number of induced HPRT mutants and the radiation dose was described as non-linear (Suzuki & Hei, 1996) Similarly, in a study examining HPRT mutations in isolated peripheral blood T-lymphocytes irradiated with low LET gamma-rays, the slope of the line from 0 - 2 Gy differed from the slope at the 2 - 4 Gy interval; thus this was described as two different linear relationships or an overall linear-quadratic relationship (Albertini et al., 1997). In a study with V79 Chinese hamster cells, a curvilinear response was also seen as a result of x-ray response while a linear response was seen for Am-241 alpha-particle exposure (Schmidt and Keifer, 1998).

This sub-section should be used to provide information regarding the approximate time-scale of the changes in KEdownstream relative to changes in KEupstream (i.e., do effects on KEdownstream lag those on KEupstream by seconds, minutes, hours, or days?). This can be useful information both in terms of modelling the KER, as well as for analyzing the critical or dominant paths through an AOP network (e.g., identification of an AO that could kill an organism in a matter of hours will generally be of higher priority than other potential AOs that take weeks or months to develop). Identification of time-scale can also aid the assessment of temporal concordance. For example, for a KER that operates on a time-scale of days, measurement of both KEs after just hours of exposure in a short-term experiment could lead to incorrect conclusions regarding dose-response or temporal concordance if the time-scale of the upstream to downstream transition was not considered. More help

The time scale relationship between radiation exposure and the frequency of mutations is not well defined. Most studies look for manifestation of mutations days or weeks after irradiation, making it particularly difficult to pinpoint exactly when the mutations first occur. Analysis of various organs from mice after in vivo radiation found that mutations were present at 2 days (Winegar et al., 1994; Masumura et al., 2002) and 3 days (Gossen et al., 1995)(Gossen, 1995) post-exposure. Mutations were still present at 7 days and 14 days (Winegar et al., 1994), and 10 days and 21 days (Gossen, 1995) following irradiation. One study documented a doubling in the number of mutations from 7 to 14 days (Winegar et al., 1994) while the other reported a two-fold decrease from 3 to 21 days  (Gossen et al., 1995).


An attempt to better define this time scale relationship was made in a study using Salmonella typhimurium bacteria. This study was designed to determine how mutation frequency was affected by constant cesium-137 gamma-ray radiation exposure at defined dose rates of 67.8 uGy/hour, 3.2 uGy/hour, and 0.6 uGy/hour; these mutation frequencies were compared to a control group exposed to background radiation levels (0.09 uGy/hour). Mutation frequencies were evaluated after 24, 48, 72 and 96 hours of constant exposure. At 24 hours, the 67.8 uGy/hour, 3.2 uGy/hour and 0.6 uGy/hour mutant frequencies were significantly higher than background exposure controls. Interestingly, however, these levels were decreased at 48 hours and continued to decline gradually towards control frequencies over time. This decline was proposed to be due to an elimination of the highly mutated cells, leaving behind an increasing number of cells that had adapted to the radiation and were thus more equipped for survival (Bolsunovsky et al., 2016). Other studies are required to build a more complete understanding of this timeline.

Known modulating factors
This sub-section presents information regarding modulating factors/variables known to alter the shape of the response-response function that describes the quantitative relationship between the two KEs (for example, an iodine deficient diet causes a significant increase in the slope of the relationship; a particular genotype doubles the sensitivity of KEdownstream to changes in KEupstream). Information on these known modulating factors should be listed in this subsection, along with relevant information regarding the manner in which the modulating factor can be expected to alter the relationship (if known). Note, this section should focus on those modulating factors for which solid evidence supported by relevant data and literature is available. It should NOT list all possible/plausible modulating factors. In this regard, it is useful to bear in mind that many risk assessments conducted through conventional apical guideline testing-based approaches generally consider few if any modulating factors. More help

There are several factors that have been documented to affect the relationship between direct deposition of energy and increased mutation frequency. The sex, age, and use of adaptive dosing have been demonstrated to affect the radiation-induced mutations present in offspring. In contrast to male mice, female mice that were irradiated in utero (Barber et al., 2009) or as adults (Ali et al., 2012)(Ali, 2012) did not produce offspring with increased ESTR mutations. This suggests that radiation-induced mutations are only heritable through the paternal line. As such, the age of the father may affect the mutant frequency in the offspring, as increased mutations were present in spermatogenic cells of older male mice relative to younger males both at baseline levels and post-irradiation (Xu et al., 2012). Lastly, the use of ‘adaptive’ radiation dosing, or giving a very small dose 24 hours prior to the full radiation dose, may also affect offspring’s mutational frequency. In male mice who received adaptive dosing relative to males who received only the full radiation dose, there were significant decreases in germline mutation frequencies and in the rate of paternal mutations in their offspring (Somers et al., 2004)


The radiation-mutation relationship may also be impacted by the genetics of the organism, as the genotype appears to play an important role in determining how the biological system responds to radiation. In yeast with inactivated rad50 or rad52, the radiation-induced mutation frequency was significantly increased relative to wild-type yeast (Matuo et al., 2018). Msh2 knock-out mice (Burr et al., 2007) and medaka fish (Otozai et al., 2014) both had significantly increased baseline mutation frequencies relative to wild-type animals. Irradiation, however, did not change this mutation rate from baseline for these Msh2 knock-out animals (Burr et al., 2007; Otozai et al., 2014). Similarly, BRCA2 knock-out embryos had significantly elevated baseline mutation rates relative to wild-type littermates; however, in utero radiation was found to increase the mutation rate of all genotypes. Thus irradiated BRCA2 knock-out embryos also had a significantly increased mutation frequency relative to wild-type embryos by approximately three-fold (Tutt et al., 2002). Finally, baseline mutation levels in p53 knock-out medaka fish did not differ from wild-types; however, p53 knock-out fish exposed to radiation were found to have a 24-fold increase in mutation frequency relative to unirradiated p53 knock-out fish (Otozai et al., 2014). Construction of a dose response curve found the following mutation rates for wild-type, Msh2 knock-out, p53 knockout, and Msh2/p53 double knock-out medaka fish, respectively: 1.1x10-4 mutations/allele/Gy, 1.1x10-4 mutations/allele/Gy, 4.3x10-4 mutations/allele/Gy, and 5.6x10-4 mutations/allele/Gy (Otozai et al., 2014).


Finally, factors such as dose, dose-rate, tissue type and radiation quality can influence mutation rate induction (Suzuki & Hei ,1996; Hooker et al., 2004; Rydberg et al., 2005; Day et al., 2007; Okudaira et al., 2010; Brooks et al., 2016)

Known Feedforward/Feedback loops influencing this KER
This subsection should define whether there are known positive or negative feedback mechanisms involved and what is understood about their time-course and homeostatic limits? In some cases where feedback processes are measurable and causally linked to the outcome, they should be represented as KEs. However, in most cases these features are expected to predominantly influence the shape of the response-response, time-course, behaviours between selected KEs. For example, if a feedback loop acts as compensatory mechanism that aims to restore homeostasis following initial perturbation of a KE, the feedback loop will directly shape the response-response relationship between the KERs. Given interest in formally identifying these positive or negative feedback, it is recommended that a graphical annotation (page 44) indicating a positive or negative feedback loop is involved in a particular upstream to downstream KE transition (KER) be added to the graphical representation, and that details be provided in this subsection of the KER description (see pages 44-45 of the User Handbook).  More help

Not identified.

Domain of Applicability

As for the KEs, there is also a free-text section of the KER description that the developer can use to explain his/her rationale for the structured terms selected with regard to taxonomic, life stage, or sex applicability, or provide a more generalizable or nuanced description of the applicability domain than may be feasible using standardized terms. More help

The domain of applicability applies to single-celled organisms such as bacteria and yeast, eukaryotic cells, and multi-cellular organisms such as fish, mice and humans.


List of the literature that was cited for this KER description using the appropriate format. Ideally, the list of references should conform, to the extent possible, with the OECD Style Guide (OECD, 2015). More help

Adewoye, A.B. et al. (2015),  "Mutation induction in the mammalian germline.", Nature Comm. 6:(6684), doi:10.1038/ncomms7684.

Albertini, R.J. et al. (1997), "Radiation Quality Affects the Efficiency of Induction and the Molecular Spectrum of HPRT Mutations in Human T Cells", Radiat Res. 148(5 Suppl):S76-86

Ali, A.H.E., R.C. Barber & Y.E. Dubrova (2012), "The effects of maternal irradiation during adulthood on mutation induction and transgenerational instability in mice.", Mutat Res. 732:21–25. doi:10.1016/j.mrfmmm.2012.01.003.

Barber, R.C. et al. (2009), "The effects of in utero irradiation on mutation induction and transgenerational instability in mice.", Mutat Res. 664:6–12. doi:10.1016/j.mrfmmm.2009.01.011.

Barnhart BJ and SH Cox. 1979. Mutagenicity and Cytotoxicity of 4.4-MeV alpha-particles Emitted by Plutonium-238. Radiat Res. 80:542-548.

Behjati, S. et al. (2016), "Mutational signatures of ionzing radiation in second malignancies". 7:12605, doi:10.1038/ncomms12605.

Bolsunovsky, A. et al. (2016), "Low doses of gamma-radiation induce SOS response and increase mutation frequency in Escherichia coli and Salmonella typhimurium cells.", Ecotoxicol Environ Saf. 134:233–238. doi:10.1016/j.ecoenv.2016.09.009.

Brooks, A.L., D.G. Hoel & R.J. Preston (2016), "The role of dose rate in radiation cancer risk: evaluating the effect of dose rate at the molecular, cellular and tissue levels using key events in critical pathways following exposure to low LET radiation.", Int. J. Radiat. Biol. 92(8):405–426. doi:10.1080/09553002.2016.1186301.

Burr, K.L. et al. (2007), "The effects of MSH2 deficiency on spontaneous and radiation-induced mutation rates in the mouse germline.", 617(1-2):147–151. doi:10.1016/j.mrfmmm.2007.01.010.

Canova, S. et al. (2002), "Minisatellite and HPRT Mutations in V79 And Human Cells Irradiated with Gamma Rays.", Radiat Prot. Dosimetry, 99:207–209. doi: 10.1093/oxfordjournals.rpd.a006763

Chen DJ, Striniste GF, Tokita N. 1984. The Genotoxicity of Alpha Particles in Human Embryonic Skin Fibroblasts. Radiat Res. 100:321-327.

Day, T.K. et al. (2007), "Adaptive Response for Chromosomal Inversions in pKZ1 Mouse Prostate Induced by Low Doses of X Radiation Delivered after a High Dose.", Radiat Res. 167(6):682–692. doi:10.1667/rr0764.1.

Dubrova, Y.E. (2005), "Radiation-Induced Mutation at Tandem Repeat DNA Loci in the Mouse Germline: Spectra and Doubling Doses", Radiat Res., 163(2):200-207 doi: 10.1667/RR3296.

Dubrova, Y.E. et al. (2002), "Nuclear Weapons Tests and Human Germline Mutation Rate.", Science, 295(5557):1037, doi:10.1126/science.1068102.

Dubrova, Y.E. et al. (2002), "Elevated Minisatellite Mutation Rate in the Post-Chernobyl Families from Ukraine.", Am. J. Hum. Genet. 74(4):801-809, doi: 10.1086/342729.

Dubrova, Y.E. et al. (2000), "Induction of minisatellite mutations in the mouse germline by low-dose chronic exposure to Y -radiation and fission neutrons.", Mutat Res. 453(1):17–24. doi: 10.1016/s0027-5107(00)00068-3.

Dubrova. Y.E. et al. (1998), "Stage specificity, dose response, and doubling dose for mouse minisatellite germ-line mutation induced by acute radiation.", Proc. natl. Acad. Sci. 95(11):6251–6255. doi: 10.1073/pnas.95.11.6251.

Dubrova, Y.E. & M.A. Plumb (2002), "Ionising radiation and mutation induction at mouse minisatellite loci The story of the two generations.", Mutat Res., 499(2):143–150. doi: 10.1016/s0027-5107(01)00284-6.

Gossen, J.A. et al. (1995), "Spontaneous and X-ray-induced deletion mutations in a LacZ plasmid-based transgenic mouse model.", Mutat Res., 331(1):89–97.

Hada, M. & A.G. Georgakilas (2008), "Formation of Clustered DNA Damage after High-LET Irradiation: A Review.", J. Radiat. Res., 49(3):203–210. doi:10.1269/jrr.07123.

Hei TK, Wu LJ, Liu SX, Vannais D, Waldren CA, Randers-Pehrson G. 1997. Mutagenic effects of a single and an exact number of alpha particles in mammalian cells. Proc Natl Acad Sci USA. 94:1765-3770.

Hooker, A.M. et al. (2004), "Cancer-associated genes can affect somatic intrachromosomal recombination early in carcinogenesis.", Mutat Res. - Fundam Mol Mech Mutagen. 550(1–2):1–10. doi:10.1016/j.mrfmmm.2004.01.003.

Valentin J. (2005), "Low-dose Extrapolation of Radiation-related Cancer Risk.", Ann. ICRP, 35(4):1-140

Jostes, R.F. (1996), "Genetic, cytogenetic, and carcinogenic effects of radon: a review.", Mutat. Res. / Rev. in Genet. Toxicol. 340(2-3):125–139. doi: 10.1016/s0165-1110(96)90044-5.

Kraemer, S.M. et al., (2000), Measuring the Spectrum of Mutation Induced by Nitrogen Ions and Protons in the Human-Hamster Hybrid Cell Line ALC., Rad Res., 153:743-751. doi: 10.1667/0033-7587(2000)153[0743:mtsomi];2.

Lorat. Y. et al. (2015), "Nanoscale analysis of clustered DNA damage after high-LET irradiation by quantitative electron microscopy – The heavy burden to repair.", DNA Repair (Amst). 28:93–106. doi:10.1016/j.dnarep.2015.01.007.

Masumura, K. et al. (2002), "Heavy-Ion-Induced Mutations in the gpt Delta Transgenic Mouse : Comparison of Mutation Spectra Induced by Heavy-Ion , X-Ray , and - Y-Ray Radiation.", Envrion. Mol. Mutagen, 40(3):207–215. doi:10.1002/em.10108.

Matuo, Y. et al. (2018), "Biological effects of carbon ion beams with various LETs on budding yeast Saccharomyces cerevisiae.", Mutat Res Fund Mol Mech Mutagen. 810(November 2017):45–51. doi:10.1016/j.mrfmmm.2017.10.003.

McMahon, S.J. et al. (2016), "Mechanistic Modelling of DNA Repair and Cellular Survival Following Radiation-Induced DNA Damage.", Nat. Publ. Gr.(April):1–14. doi:10.1038/srep33290.

Metting NF, Palayoor ST, Macklis RM, Atcher RW, Liber HL, Little JB. 1992. Induction of Mutations by Bismuth-212 Alpha Particles at Two Genetic Loci in Human B-Lymphoblasts. Radiat Res. 132:339-345.

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