Medical Radiology and Radiation Safety. 2015. Vol. 60. No. 4. P. 43-61

RADIATION SAFETY

T.V. Azizova¹, R. Haylock², M.B. Moseeva¹, M.V. Pikulina¹, E.S. Grigorieva¹

Cerebrovascular Diseases Incidence and Mortality in an Extended Mayak Worker Cohort: 1948-1982

1. Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk region, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. UK Health Ministry, Chilton, UK

ABSTRACT

Purpose: To analyze risks of incidence and mortality from cerebrovascular diseases (CeVD) (430-438 ICD-9 codes) in a cohort of workers first employed at the Mayak Production Association (Mayak PA) in 1948-1982 and followed up to the end of 2008 (22,377 individuals).

Material and methods: Workers of the study cohort were exposed occupationally to prolonged external gamma and internal alpha radiation. The mean (± standard deviation) total dose from external gamma-radiation was 0.54 ± 0.76 Gy for males and 0.44 ± 0.65 Gy for females. 8,717 CeVD incidences during 425,735 person-years of the follow-up and 1,578 deaths from CeVD during 836,078 person-years of the follow-up have been registered by its end.

Results: The analysis revealed the association of incidence and mortality from CeVD in the cohort of Mayak PA workers with such non-radiation factors as gender, attained age, smoking, alcohol consumption, hypertension, obesity, etc. Significant upward trends with total absorbed dose from external gamma radiation and with total absorbed dose from internal alpha radiation were found for CeVD incidence after adjustment for non-radiation factors (gender, age, calendar period, period of first employment, facility type, smoking and alcohol consumption); excess relative risks per unit dose (ERR/Gy) based on linear model were 0.46 (95 % confidence intervals CI 0.37-0.57) and 0.28 (95 % CI 0.16-0.42), respectively. Additional adjustments (for hypertension, body mass index, duration of employment, smoking index and total absorbed dose from internal alpha radiation while analyzing the association with external dose and vice versa) had a marginal effect on the obtained results. It is the first time when a significant onward trend with dose from internal radiation was found for CeVD mortality among a sub-cohort of workers exposed to alpha radiation at total absorbed liver dose below 1.0 Gy adjusted for non-radiation factors with ERR/Gy 0.84 (95 % CI 0.09-1.92).

Conclusions: The study established the statistically significant association of CeVD incidence risk with external gamma and internal alpha radiation.

Key words: cerebrovascular disease, incidence, mortality, gammaradiation, alpha-radiation, Mayak PA, occupational exposure

REFERENCES

1. Azizova T.V., Muirhead C.R., Druzhinina M.B. et al. Cerebrovascular diseases in the cohort of workers first employed at Mayak PA in 1948-1958. Radiat. Res. 2010a. Vol. 174. P. 851-864.
2. Azizova T.V., Muirhead C.R., Druzhinina M.B. et al. Cardiovascular Diseases in the Cohort of Workers First Employed at Mayak PA in 1948-1958. Radiat. Res. 2010b. Vol. 174. P. 155-168.
3. Azizova T.V., Muirhead C.R., Moseeva M.B. et al. Cerebrovascular diseases in nuclear workers first employed at the Mayak PA in 1948-1972. Rad. Environ. Biophys. 2011. Vol. 50. No. 4. P. 539-552.
4. Azizova T.V., Muirhead C.R., Moseeva M.B. et al. Ischemic heart disease in nuclear workers first employed at the Mayak PA in 1948-1972. Health Phys. 2012. Vol. 103. No. 1. P. 3-14.
5. Azizova T.V., Zhuntova G.V., Haylock R.G.E. et al. Chronic bronchitis in the cohort of Mayak workers first employed 1948-1958. Radiat. Res. 2013. Vol. 180. No. 6. P. 610-621.
6. Moseeva M.B., Azizova T.V., Grigorieva E.S., Haylock R. Risk of circulatory diseases among Mayak PA workers with radiation doses estimated using the improved Mayak Workers Dosimetry System 2008. Rad. Environ. Biophys. 2014. Vol. 53. No. 2. P. 469-477.
7. Simonetto C., Azizova T.V., Grigoryeva E.S. et al. Ischemic heart disease in workers at Mayak PA: Latency of incidence risk after radiation exposure. PLoS ONE. 2014. Vol. 9. No. 5. P. e96309. DOI: 10.1371/journal. phone.0096309.
8. Khokhryakov V.V., Khokhryakov V.F., Suslova K.G. et al. Mayak Worker Dosimetry System 2008 (MWDS-2008): Assessment of internal alpha-dose from measurement results of plutonium activity in urine. Health Phys. 2013. Vol. 104. No. 4. P. 366-378.
9. Vasilenko E.K., Scherpelz R.I., Gorelov M.V. et al. External dosimetry reconstruction for Mayak workers. AAHP special session health physics society annual meeting. Available from: http://www.hps1.org/aahp/public/AAHP_Special_Sessions/2010_Salt_Lake_City/pm-1.pdf (accessed: 2010).
10. ICD-9 Guidelines for Coding Diseases, Injures and Causes of Death. Revision 1975. Geneva, WHO, 1980, 752 p.
11. Azizova T.V., Day R.D., Wald N. et al. The “Clinic” medical-dosimetric database of Mayak production association workers: structure, characteristics and prospects of utilization. Health Phys. 2008. Vol. 94. P. 449-458.
12. Koshurnikova N.A., Shilnikova N.S., Okatenko P.V. Characteristics of the cohort of workers at the Mayak nuclear complex. Radiat. Res. 1999. Vol. 152. No. 4. P. 352-363.
13. Preston D., Lubin J., Pierce D., McConney M. Epicure users guide. Hirosoft, Seattle, WA. 1993.
14. Lipovetskii B.M. Infarkt, insul't, vnezapnaya smert'. Saint Petersburg: «Spetsial'naya literatura». 1997.
15. United Nations Scientific Committee on the Effects of Atomic Radiation. Effects of ionizing radiation. UNSCEAR 2006 Report. 1. 2008. P. 325-383.
16. Ozasa K., Shimizu Y., Suyama A. et al. Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: An Overview of Cancer and Noncancer Diseases. Radiat. Res. 2012. Vol. 177. P. 229-243.
17. Shimizu Y., Kodama K., Nishi N. et al. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003. BMJ. 2010. Vol. 340. P. b5349. DOI: 10.1136/bmj.b5349.
18. Yamada M., Wong F.L., Fujiwara S. et al. Non-cancer disease incidence in atomic bomb survivors, 1958-1998. Radiat. Res. 2004. Vol. 161. P. 622-632.
19. Vrijheid M., Cardis E., Ashmore P. et al. Mortality from diseases other than cancer following low doses of ionizing radiation: results from the 15-country study of nuclear industry workers. Int. J. Epidemiol. 2007. Vol. 36. P. 1126-1135.
20. McGeoghegan D., Binks K., Gillies M. et al. The noncancer mortality experience of male workers at British Nuclear Fuels plc, 1946-2005. Int. J. Epidemiol. 2008. Vol. 37. P. 506-518.
21. Muirhead C.R., O’Hagan J.A., Haylock R.G.E. et al. Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers. Brit. J. Cancer, 2009. Vol. 100. P. 206-212.
22. Kreuzer M., Dufey F., Sogl M. et al. External gamma radiation and mortality from cardiovascular diseases in the German WISMUT uranium miners cohort study, 1946-2008. Radiat. Biophys. 2012. Vol. 52. No. 1. P. 37-46. DOI: 10.1007/s00411-012-0446-5.
23. Ivanov V., Maksioutov M.A., Chekin S.Y. et al. The risk of radiation-induced cerebrovascular disease in Chernobyl emergency workers. Health Phys. 2006. Vol. 90. P. 199-207.
24. Krestinina L.Y., Epifanova S., Silkin S. et al. Chronic low-dose exposure in the Techa River Cohort: risk of mortality from circulatory diseases. Rad. Environ. Biophys. 2013. Vol. 52. No. 1. P. 47-57. DOI: 10.1007/s00411-012-0438-5.
25. Grosche B., Lackland D.T., Land C.E. et al. Mortality from cardiovascular diseases in the Semipalatinsk historical cohort, 1960-1999, and its relationship to radiation exposure. Radiat. Res. 2011. Vol. 176. P. 660-669.
26. Little M.P., Azizova T.V., Bazyka D. et al. Systematic review and meta-analysis of circulatory disease from exposure to low-level ionizing radiation and estimates of potential population mortality risks. Environ. Health Perspect. 2012. Vol. 120. P. 1503-1511. DOI: 10.1289/ehp.1204982.
27. Akiba S. Circulatory disease risk after low-level ionizing radiation exposure. Radiat. Emerg. Med. 2013. Vol. 2. No. 2. P. 13-22.
28. ICRP-2012. ICRP Statement on Tissue Reactions. Early and late effects of radiation in normal tissues and organs — threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann. ICRP. Vol. 41. No. 1/2.
29. Little M.P., Tawn E.J., Tzoulaki I. et al. Review and meta-analysis of epidemiological associations between low/moderate doses of ionizing radiation and circulatory disease risks and their possible mechanisms. Radiat. Environ Biophys. 2010. DOI: 10.1007/s00411-009-0250-z.
30. Little M.P. A review of non-cancer effects, especially circulatory and ocular diseases. Radiat. Environ Biophys. 2013. DOI: 10.1007/s00411-013-0484-7.
31. Borghini A., Gianicolo E.A.L., Picano E., Andreassi M.G. Ionizing radiation and atherosclerosis: Current knowledge and future challenges. Elsevier 2013. Vol. 230. P. 40-47.
32. Lowe D., Raj K. Premature aging induced by radiation exhibits pro-atherosclerotic effects mediated by epigenetic activation of CD44 expression. Aging Cell. 2014. P. 1-11. DOI: 10.1111/acel.12253.

For citation: Azizova TV, Haylock R, Moseeva MB, Pikulina MV, Grigorieva E.S. Cerebrovascular Diseases Incidence and Mortality in an Extended Mayak Worker Cohort: 1948-1982. Medical Radiology and Radiation Safety. 2015;60(4):43-61. Russian.

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