Medical Radiology and Radiation Safety. 2026. Vol. 71. № 2

DOI:10.33266/1024-6177-2026-71-2-40-47

K.V. Briks, T.V. Azizova, E.S. Grigoryeva, M.V. Bannikova

Risk of Angina Pectoris in a Cohort of Nuclear Workers

Southern Urals Federal Research and Clinical Center for Medical Biophysics, 456783, Ozyorsk, Russia

Contact person: K.V. Briks, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To assess the incidence risk of angina pectoris (ICD-10 code: I20) in a cohort of workers who had chronic occupational exposure taking into account non-radiation factors: sex, age, smoking status, alcohol consumption, body mass index (BMI), arterial hypertension (AH), diabetes mellitus (DM).

Material and methods: The study cohort included 22,377 workers of the nuclear energy enterprise ‒ the Mayak Production Association (PA) ‒ who had been hired during 1948‒1982 and followed up until the end of 2018. The vital status at the end of the follow-up period is known for 95 % of the cohort members, of whom 67.2 % died, .and 32 % are alive. The presented study utilizes the MWDS-2013 (Mayak Worker Dosimetry System-2013) individual dose estimates of external and internal exposure. Mean cumulative liver absorbed dose of external gamma-exposure was 0.45 (0.65) Gy ‒ in males (mean(standard deviation)) and 0.37 (0.56) Gy ‒ in females. Mean cumulative dose of internal alpha-exposure to the liver made up 0.18 (0.65) Gy and 0.40 (1.92) Gy, respectively. The analysis included the calculation of relative risks (RR) and excess relative risk per unit dose (ERR/Gy) with the Poisson regression using the AMFIT module of the EPICURE statistical software package. Excess relative risk (ERR), i.e. the relative risk minus one, was described with the help of the linear dependence on the external dose adjusted for non-radiation factors (via stratification) and internal dose, as well as on the internal dose adjusted for the non-radiation factors and external dose. 95 % confidence intervals (CI) and statistical significance (p-values) were calculated with maximum likelihood methods. All the criteria of statistical significance were two-sided. The differences were considered statistically significant at
p < 0.05.

Results: A statistically significant linear dependence of the angina pectoris incidence on the cumulative liver absorbed dose of external gamma-exposure once adjusted for non-radiation factors (sex, attained age, calendar period, smoking status, alcohol consumption) and internal alpha-exposure dose has been established both for males and females.

Conclusion: This is the first study of the angina pectoris incidence risk in the cohort of workers who had chronic occupational exposure that brings forward evidence of the relationship with the ionizing radiation. 

Keywords: chronic occupational radiation exposure, Mayak PA, angina pertoris, external exposure to gamma radiation, internal exposure to alpha particles, risk, incidence

For citation: Briks KV, Azizova TV, Grigoryeva ES, Bannikova MV. Risk of Angina Pectoris in a Cohort of Nuclear Workers. Medical Radiology and Radiation Safety. 2026;71(2):40–47. (In Russian). DOI:10.33266/1024-6177-2026-71-2-40-47

References

1. Барбараш О.Л., Карпов Ю.А., Панов А.В. и др. Стабильная ишемическая болезнь сердца. Клинические рекомендации 2024 // Российский кардиологический журнал. 2024. Т.29. №9. С. 6110 [Barbarash O.L., Karpov Yu.A., Panov A.V., et al. Stable Ischemic Heart Disease. Clinical Guidelines 2024. Rossiyskiy Kardiologicheskiy Zhurnal = Russian Journal of Cardiology. 2024;29;9:6110 (In Russ.)].   Doi: 10.15829/1560-4071-2024-6110.
2. Gaidai O., Cao Y., Loginov S. Global Cardiovascular Diseases Death Rate Prediction. Current Problems in Cardiology. 2023;48;5:1016–1022. Doi: 10.1016/J.Cpcardiol.2023.101622.
3. Min Choon Tan, Yong Hao Yeo, Boon Jian San, Addi Suleiman, Justin Z. Lee, Arka Chatterjee, Kristen A. Sell‐Dottin, John P. Sweeney, F. David Fortuin, and Kwan S. Lee. Trends and Disparities in Valvular Heart Disease Mortality in the United States from 1999 to 2020. Journal of the American Heart Association. 2024;13;8:e030895. Doi: 10.1161/JAHA.123.030895. Epub 2024 Apr 8.10.1161/JAHA.123.03089.
4. Hammond-Haley M., Hartley A., Essa M., DeLago A.J., Marshall D.C., Salciccioli J.D., Shalhoub J. Trends in Ischemic Heart Disease and Cerebrovascular Disease Mortality in Europe: an Observational Study 1990–2017. Journal of the American College of Cardiology. 2021;77;13:1697–1698. Doi: 10.1016/j.jacc.2021.02.013.
5. Бойцов С.А., Шальнова С.А., Деев А.Д. Смертность от сердечно-сосудистых заболеваний в Российской Федерации и возможные механизмы ее изменения // Журнал неврологии и психиатрии им. C.C.Корсакова. 2018. Т.118. №8. С. 98–103 [Boytsov S.A., Shal’nova S.A., Deyev A.D. Mortality from Cardiovascular Diseases in the Russian Federation and Possible Mechanisms of its Change. Zhurnal Nevrologii i Psikhiatrii im. C.C.Korsakova = S.S.Korsakov Journal of Neurology and Psychiatry. 2018;118;8:98–103 (In Russ.)]. Doi: 10.17116/jnevro201811808198.
6. Effects of Ionizing Radiation. UNSCEAR 2006 Report to the General Assembly, with Scientific Annexes. V.I. New York, United Nations, 2008. 392 p.
7. Moseeva M.B., Azizova T.V., Grigoryeva E.S., Haylock R.G. Risks of Circulatory Diseases among Mayak PA Workers with Radiation Doses Estimated Using the Improved Mayak Worker Dosimetry System 2008. Radiat. Environ. Biophys. 2014;53;2:469–477. Doi: 10.1007/s00411-014-0517-x.
8. Azizova T.V., Haylock R.G.E., Moseeva M.B., Bannikova M.V., Grigoryeva E.S. Cerebrovascular Diseases Incidence and Mortality in an Extended Mayak Worker Cohort 1948–1982. Radiat. Res.2014;182;5:529–544. Doi: 10.1667/RR13680.1.
9. Azizova T.V., Grigoryeva E.S., Haylock R.G.E., Pikulina M.V., Moseeva M.B. Ischeamic Heart Disease Incidence and Mortality in an Extended Cohort of Mayak Workers First Employed in 1948– 1982. Br. J. Radiol. 2015;88;1054:20150–20169. Doi: 10.1259/bjr.20150169.
10. Takahashi I., Shimizu Y., Grant E.J., Cologne J., Ozasa K., Kodama K. Heart Disease Mortality in the Life Span Study, 1950–2008. Radiat. Res. 2017;187;3:319–332.  Doi: 10.1667/RR14347.1.
11. Gillies M., Richardson D.B., Cardis E., Daniels R.D., O’Hagan J.A., Haylock R., Laurier D., Leuraud K., Moissonnier M., Schubauer-Berigan M.K., Thierry-Chefh I., Kesminieneh A. Mortality from Circulatory Diseases and other Non-Cancer Outcomes among Nuclear Workers in France, the United Kingdom and the United States (INWORKS). Radiat. Res. 2017;188;3:276–290. Doi: 10.1667/RR14608.1.
12. Little M.P. Radiation and Circulatory Disease. Mutat. Res. 2016;770:299–318. Doi: 10.1016/j.mrrev.2016.07.008.
13. Ivanov V.K., Maksioutov M.A., Chekin S.Yu., Petrov A.V., Biryukov A.P., Kruglova Z.G., Matyash V.A., Tsyb A.F., Manton K.G., Kravchenko J.S. The Risk of Radiation-Induced Cerebrovascular Disease in Chernobyl Emergency Workers. Health Phys. 2006;90;3:199–207. Doi: 10.1097/01.HP.0000175835.31663.ea.
14. Azizova T.V., Grigorieva E.S.,  Hunter N.,  Pikulina M.V.,  Moseeva M.B. Risk of Mortality from Circulatory Diseases in Mayak Workers Cohort Following Occupational Radiation Exposure. J Radiol Prot. 2015;35;3:517–538. Doi: 10.1088/0952-4746/35/3/517.
15. Azizova T.V., Briks K.V., Bannikova M.V., Grigoryeva E.S. Hypertension Incidence Risk in a Cohort of Russian Workers Exposed to Radiation at the Mayak Production Association Over Prolonged Periods. Hypertension. 2019;73;6:1174–1184. Doi: 10.1161/HYPERTENSIONAHA.118.11719.
16. Azizova T.V., Day R.D., Wald N., Muirhead C.R., O’Hagan J.A., Sumina M.V., Belyaeva Z.D., Druzhinina M.B., Teplyakov I.I., Semenikhina N.G., Stetsenko L.A., Grigoryeva E.S., Krupenina L.N., Vlasenko E.V. The “Clinic” Medical-Dosimetric Database of Mayak Production Association Workers: Structure, Characteristics and Prospects of Utilization. Health Phys. 2008;94;5:449–458. Doi: 10.1097/01.HP.0000300757.00912.a2.
17. Fountos B.N. The Department of Energy’s Russian Health Studies Program. Radiat Protect Dosim. 2017;176;1–2:3–5. Doi: 10.1093/rpd/ncw110.
18. Napier B.A. The Mayak Worker Dosimetry System (MWDS-2013): an Introduction to the Documentation. Radiat Prot Dosimetry. 2017;176;1–2:6–9. Doi: 10.1093/rpd/ncx020.
19. Preston D., Lubin J., Pierce D., McConney M. Epicure users Guide. Seattle, Hirosoft, 1993. 186 p.
20. Akaike H. A New Look at Statistical Model Identification. IEEE Trans Automat Control, 1974. P. 716–723.

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.01.2026. Accepted for publication: 25.02.2026.

Medical Radiology and Radiation Safety. 2026. Vol. 71. № 2

DOI:10.33266/1024-6177-2026-71-2-53-65

A.N. Koterov¹, L.N. Ushenkova¹, A.A. Wainson², O.A. Tikhonova¹,
A.S. Kretov¹, O.V. Parinov¹, A.O. Lebedev¹, A.Yu. Bushmanov¹

Suicide Risk Among Nuclear Workers: Differences for Male and Female are Inverse to Population-Based Results (Synthetic Study). Report 1. Problem Statement, Search for Sources, and Characteristic of the Sample

¹ A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

² N.N. Blokhin Russian Cancer Research Center, Moscow, Russia

Contact person: Alexey N. Koterov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Suicide rate is considered an index of social and professional well-being/ill-being. Therefore, studying this index among nuclear workers (NW), a group subordinate to the Federal Medical-Biological Agency of the Russian Federation, is relevant both for image-building purposes and for optimizing psychological support for this category of workers. This two-report cycle (a synthetic study) presents a systematic review, followed by a meta-analysis and pooled analysis, for suicide risk among NW in different countries and gender patterns of this risk (Standardized Mortality Ratio (SMR) compared to the general population).

This Report 1 presents, first, a search methodology for sources in a supported bibliographic database for NW in different countries, including PubMed, Embase, Google Scholar, eLibrary, and the reference lists of identified publications. The primary sample, generated based on the search results for all the specified types, totaled 556 sources (many duplicates), allowing for visual analysis of all of them during subsequent selection.

Second, the stages of processing the resulting sample in preparation for meta- and pooled analyses are described (selection of studies with only SMR indexes, only the most recent chronological publications for the studied cohorts, elimination of outliers in the samples, and assessment of the epidemiological quality of the remaining studies).

None of the four identified USSR/Russian studies (all for the PO ‘Mayak’) were included in the systematic review due to the lack of the necessary risk index. Nevertheless, some qualitative conclusions were reached, according to which, with overexposure to NW from the PO ‘Mayak’ (up to more than 1 and 4 Gy in two studies), an increased risk of suicide was observed; in the absence of high exposure levels, the unweighted risk index was not increased compared to the general population for male. A reverse ‘gender paradox’ was also observed, with the fatal suicide rate among female NW at the PO ‘Mayak’ being higher than among males, while a direct ‘gender paradox’ (a multiple higher suicide rate for males and a multiple higher rate of suicide attempts for females) has been described for the populations of almost all countries since the 19th century.

For foreign NWs, two study samples were created, corresponding to 15 nuclear installations (from five countries; 62% from the USA) for both male NW and female NW (coincidence). Further meta-analyses and pooled analyses of SMR for suicides in foreign NW, as well as a comparison of their risk for male and female cohorts to test for the reverse ‘gender paradox’, will be presented in Report 2.

Keywords: nuclear workers, fatal suicides, systematic review

For citation: Koterov AN, Ushenkova LN, Wainson AA, Tikhonova OA, Kretov AS, Parinov OV, Lebedev AO, Bushmanov AYu. Suicide Risk Among Nuclear Workers: Differences for Male and Female are Inverse to Population-Based Results (Synthetic Study). Report 1. Problem Statement, Search for Sources, and Characteristic of the Sample. Medical Radiology and Radiation Safety. 2026;71(2):53–65. DOI:10.33266/1024-6177-2026-71-2-53-65

References

1. Fukui T., Rahman M., Sekimoto M., Hira K., Maeda K., Morimoto T., et al. Study Design, Statistical Method, and Level of Evidence in Japanese and American Clinical Journals. J. Epidemiol. 2002;12;3:266–270. Doi: 10.2188/Jea.12.266.
2. Власов В.В. Эпидемиология: Учебное пособие. 2-е изд. М.: ГЭОТАР-Медиа, 2006. 464 с. [Vlasov V.V. Epidemiologiya = Epidemiology. Textbook. 2nd ed. Moscow, GEOTAR-Media Publ., 2006. 464 p. (In Russ.)].
3. UNSCEAR 2017. Report to the General Assembly, with Scientific Annexes. Annex A. Principles and Criteria for Ensuring the Quality of the Committee’s Reviews of Epidemiological Studies of Radiation Exposure.  United Nations. New York, 2018. P. 17–64.
4. Jadad A.R., Enkin M.W. Randomized Controlled Trials. Questions, Answers, and Musings. 2nd edition.  Malden, Oxford, Carlton, BMJ Books, 2007.  136 p.
5. Blettner M., Sauerbrei W., Schlehofer B., Scheuchenpflug T., Friedenreich C. Traditional Reviews, Meta-Analyses and Pooled Analyses in Epidemiology. Int. J. Epidemiol. 1999;28;1:1–9. Doi: 10.1093/Ije/28.1.1.
6. Friedenreich C.M. Methods for Pooled Analyses of Epidemiologic Studies. Epidemiology. 1993;4;4:295–302. Doi: 10.1097/00001648-199307000-00004.
7. Bravata D.M., Olkin I. Simple Pooling Versus Combining in Meta-Analysis. Eval. Health Prof. 2001;24;2:218–230. Doi: 10.1177/01632780122034885.
8. Котеров А.Н., Ушенкова Л.Н., Калинина М.В., Бирюков А.П. Сравнение риска смертности от солидных раков после радиационных инцидентов и профессионального облучения // Медицина труда и промышленная экология. 2021. Т.61. №9. С. 580–587 [Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Comparison of the Risk of Mortality from Solid Cancers after Radiation Incidents and Occupational Exposure. Meditsina Truda i Promyshlennaya Ekologiya = Russian Journal of Occupational Health and Industrial Ecology. 2021;61;9:580–587 (In Russ.)]. Doi: 10.31089/1026-9428-2021-61-9-580-587.
9. Sturmberg J.P. Evidence-Based Medicine — not a Panacea for the Problems of a Complex Adaptive World. J. Eval. Clin. Pract. 2019;25;5:706–716. Doi: 10.1111/Jep.13122.
10. Umbrella Reviews: Evidence Synthesis with Overviews of Reviews and Meta-Epidemiologic Studies. Ed. by G. Biondi-Zoccai. 1st Edition.  Springer International Publishing, Switzerland, 2016.  526 p.
11. Trinquart L., Dechartres A., Ravaud P. Commentary: Meta-Epidemiology, Meta-Meta-Epidemiology or Network Meta-Epidemiology? Int. J. Epidemiol. 2013;42;4:1131–1133. Doi: 10.1093/Ije/Dyt137.
12. Котеров А.Н., Ушенкова Л.Н., Буланова Т.М., Богданенко Н.А. Отраслевые библиографические базы данных: перспективы использования в ФМБА России для научной экспертизы при принятии решений. Сообщение 1. Общие вопросы и база данных по медико-биологическим и иным эффектам у работников ядерной индустрии // Медицинская радиология и радиационная безопасность. 2025. Т.70. №2. С. 88–106 [Koterov A.N., Ushenkova L.N., Bulanova T.M., Bogdanenko N.A. Industry Bibliographic Databases: Prospects for Use in the Federal Medical and Biological Agency of Russia for Scientific Expertise in Decision-Making. Report 1. General Issues and a Database on Medical, Biological and other Effects in Workers in the Nuclear Industry. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2025;70;2:88–106 (In Russ.)]. Doi: 10.33266/1024-6177-2025-70-2-88-106.
13. Котеров А.Н., Ушенкова Л.Н., Буланова Т.М., Богданенко Н.А. Отраслевые библиографические базы данных: перспективы использования в ФМБА России для научной экспертизы при принятии решений. Сообщение 2. База данных по медико-биологическим и иным эффектам у шахтеров урановых рудников // Мед. радиология и радиац. безопасность. 2025. Т.70. № 4. С. 66–76 [Koterov A.N., Ushenkova L.N., Bulanova T.M., Bogdanenko N.A. Industry Bibliographic Databases: Prospects for Use in the Federal Medical and Biological Agency of Russia for Scientific Expertise in Decision-Making. Report 2. Database on Medical, Biological and other Effects in Uranium Miners. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2025;70;4;66-76 (In Russ.)]. Doi: 10.33266/1024-6177-2025-70-4-66-77.
14. Grint K., Nixon D. The Sociology of Work. 4th Edition.  John Wiley & Sons, 2025.  472 p.
15. Котеров А.Н., Ушенкова Л.Н., Дибиргаджиев И.Г., Буланова Т.М. Сравнение риска общей смертности для работников ядерной индустрии, шахтеров урановых рудников и других профессий с риском пассивного курения (мета-анализы) // Мед. радиология и радиац. безопасность. 2024. V.69. №5. С. 75–86 [Koterov A.N., Ushenkova L.N., Dibirgadzhiyev I.G., Bulanova T.M. Comparison of the Risk of Overall Mortality for Workers in the Nuclear Industry, Uranium Miners and other Professions with the Risk of Passive Smoking (Meta-Analyses). Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2024;69;5:75–86 (In Russ.)]. Doi: 10.33266/1024-6177-2024-69-5-75-86.
16. Котеров А.Н., Ушенкова Л.Н., Дибиргаджиев И.Г., Калинина М.В. Смертность от всех причин и от всех раков для работников ядерной индустрии и шахтеров урановых рудников сравнительно с наиболее вредными/опасными профессиями (синтетическое исследование) // Здоровье и окружающая среда: Сб. научн. тр. / Под ред. С.И.Сычика и др.  Гомель: Гомельская прауда, 2024. С. 59–69 [Koterov A.N., Ushenkova L.N., Dibirgadzhiyev I.G., Kalinina M.V. Mortality from all Causes and from all Cancers for Workers in the Nuclear Industry and Uranium Miners Compared with the Most Harmful/Dangerous Professions (Synthetic Study). Collection of Scientific Papers Zdorov’ye i Okruzhayushchaya Sreda = Health and the Environment. Ed. S.I.Sychik, et al. Gomel, Gomel’skaya Prauda Publ., 2024. P. 59–69 (In Russ.)].
17. Котеров А.Н., Ушенкова Л.Н., Вайнсон А.А., Дибиргаджиев И.Г., Калинина М.В., Бушманов А.Ю. Риск смертности от основных патологий вследствие пассивного курения не достигается подавляющим большинством работников ядерной индустрии всех периодов занятости // Мед. радиология и радиац.безопасность. 2024. Т.69. №3. С. 57–67 [Koterov A.N., Ushenkova L.N., Vaynson A.A., Dibirgadzhiyev I.G., Kalinina M.V., Bushmanov A.Yu. The Risk of Mortality from Major Pathologies Due to Passive Smoking is not Achieved by the Overwhelming Majority of Workers in the Nuclear Industry of All Periods of Employment. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2024;69;3:57–67 (In Russ.)]. Doi: 10.33266/1024-6177-2024-69-3-57-67.
18. Tsai S.P., Hardy R.J., Wen C.P. The Standardized Mortality Ratio and Life Expectancy. Am. J. Epidemiol. 1992;135;7:824–831. Doi: 10.1093/Oxfordjournals.Aje.A116369.
19. Котеров А.Н., Ушенкова Л.Н., Калинина М.В., Бирюков А.П. «Эффект здорового работника» по показателям общей смертности и смертности от злокачественных новообразований у персонала предприятий ядерной и химической индустрии: мета-анализы // Мед. радиология и радиац. безопасность. 2023. Т.68. № 4. С. 43–50 [Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. The Healthy Worker Effect in Terms of Overall Mortality and Mortality from Malignant Neoplasms among Personnel of Nuclear and Chemical Industry Enterprises: Meta-Analyses. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2023;68;4:43–50 (In Russ.)] Doi: 10.33266/1024-6177-2023-68-4-43-50.
20. Cousteaux A.-S., Pan Ke Shon J.-L. Is Ill-Being Gendered? Suicide, Risk for Suicide, Depression and Alcohol Dependence. R. Fanc. Sociol. 2010;51;5:3–40. Doi: 10.3917/Rfs.515.0003.
21. Гилинский Я.И. Самоубийство как социальный феномен // Социологический журнал. 2011. №2. С. 39–48 [Gilinskiy Ya.I. Suicide as a Social Phenomenon. Sotsiologicheskiy Zhurnal = Sociological Journal. 2011;2:39–48  (In Russ.)].
22. Landy F., Quick J.C., Kasl S. Work, Stress, and Well-Being. International Journal of Stress Management. 1994;1;1:33–73. Doi: 10.1007/Bf01857282.
23. Brodsky C.M. Suicide Attributed to Work. Suicide Life Threat Behav. 1977;7;4:216–229. Doi: 10.1111/j.1943-278X.1977.tb00893.x.
24. Bedeian A.G. Suicide and Occupation: a Review. Journal of Vocational Behavior. 1982;21;2:206–223. Doi: 10.1016/0001-8791(82)90030-6.
25. Boxer P.A., Burnett C., Swanson N. Suicide and Occupation: a Review of the Literature. J. Occup. Environ. Med. 1995;37;4:442–452. Doi: 10.1097/00043764-199504000-00016.
26. Samuels S.W. A Moral History of the Evolution of a Caste of Workers. Environ. Health Perspect. 1996;104;5:991–998. Doi: 10.1289/Ehp.96104s5991.
27. Roberts S.E., Jaremin B., Lloyd K. High-Risk Occupations for Suicide. Psychol. Med. 2013;43;6:1231–1240. Doi: 10.1017/S0033291712002024.
28. Baumert J., Schneider B., Lukaschek K., Emeny R.T., Meisinger C., Erazo N., et al. Adverse Conditions at the Workplace are Associated with Increased Suicide Risk. J. Psychiatr. Res. 2014;57:90–95. Doi: 10.1016/J.Jpsychires.2014.06.007.
29. Loerbroks A., Cho S.I., Dollard M.F., Zou J., Fischer J.E., Jiang Y., et al. Associations between Work Stress and Suicidal Ideation: Individual-Participant Data from Six Cross-Sectional Studies. J. Psychosom. Res. 2016;90:62–69. Doi: 10.1016/J.Jpsychores.2016.09.008.
30. Milner A., Witt K., LaMontagne A.D., Niedhammer I. Psychosocial Job Stressors and Suicidality: a Meta-Analysis and Systematic Review. Occup. Environ. Med. 2018;75;4:245–253. Doi: 10.1136/oemed-2017-104531.
31. Guseva-Canu I., Bovio N., Mediouni Z., Bochud M., Wild P. Swiss National Cohort (SNC). Suicide Mortality Follow-Up of the Swiss National Cohort (1990–2014): Sex-Specific Risk Estimates by Occupational Socio-Economic Group in Working-Age Population. Soc. Psychiatry Psychiatr. Epidemiol. 2019;54;12:1483–1495. Doi: 10.1007/S00127-019-01728-4.
32. Kim S.Y., Shin Y.C., Oh K.S., Shin D.W., Lim W.J., Cho S.J., Jeon S.W. Association between Work Stress and Risk of Suicidal Ideation: a Cohort Study among Korean Employees Examining Gender and Age Differences. Scand. J. Work Environ. Health. 2020;46;2:198–208. Doi: 10.5271/Sjweh.3852.
33. Aberg M., Staats E., Robertson J., Schioler L., Toren K., LaMontagne A.D., et al. Psychosocial Job Stressors and Risk of Suicidal Behavior ‒ an Observational Study among Swedish Men. Scand. J. Work Environ. Health. 2022;48;6:435–445. Doi: 10.5271/sjweh.4039.
34. Stare J., Boulch D.M. Odds Ratio, Hazard Ratio and Relative Risk. Metodoloski Zvezki. 2016;13;1:59–67. Doi: 10.51936/Uwah2960.
35. About WONUC [World Council of Nuclear Workers]. Proceedings 1st Internat. Symp. The Effects of Low and Very Low Doses of Ionizing Radiation on Human Health. France, Saint Quentin en Yvelines, 17–18 June 1999. Ed. by WONUC’.  Elsevier Science B.V., 2000.
36. Shrader-Frechette K. Trading Jobs for Health: Ionizing Radiation, Occupational Ethics, and the Welfare Argument. Sci. Eng. Ethics. 2002;8;2:139–154. Doi: 10.1007/S11948-002-0015-4.
37. Laurier D., Marsh J.W., Rage E., Tomasek L. Miner Studies and Radiological Protection Against Radon. Ann. ICRP. 2020;49;1:57–67. Doi: 10.1177/0146645320931984.
38. Varnik P. Suicide in the World. Int. J. Environ. Res. Public Health. 2012;9:760–771. Doi: 10.3390/Ijerph9030760.
39. Yip P.S., Callanan C., Yuen H.P. Urban/Rural and Gender Differentials in Suicide Rates: East and West. J Affect Disord. 2000;57;1–3:99–106. Doi: 10.1016/S0165-0327(99)00058-0.
40. Demir M. Gender Differences in Suicide Rates. Forensic Science & Addiction Research. 2018;2;4:161–165. Doi: 10.31031/Fsar.2018.02.000550.
41. Bommersbach T.J., Rosenheck R.A., Petrakis I.L., Rhee T.G. Why are Women more Likely to Attempt Suicide than Men? Analysis of Lifetime Suicide Attempts among US Adults in a Nationally Representative Sample. J. Affect Disord. 2022;311:157–164. Doi: 10.1016/J.Jad.2022.05.096.
42. Berardelli I., Rogante E., Sarubbi S., Erbuto D., Cifrodelli M., Concolato C., et al. Is Lethality Different between Males and Females? Clinical and Gender Differences in Inpatient Suicide Attempters.Int. J. Environ. Res. Public Health. 2022;19;20;13309. 8 p. Doi: 10.3390/Ijerph192013309.
43. Cochrane Handbook for Systematic Reviews of Interventions. 2nd Edition. Ed. by J.P.T. Higgins, T. James, J. Chandler, et al. Cochrane, Willey Blackwell, 2019. 694 p. Doi: 10.1002/9781119536604.
44. Wilkinson G.S., Trieff N., Graham R., Priore R.L. Study of Mortality among Female Nuclear Weapons Workers. Final Report. Grant Numbers: 1R01 OHO3274, R01/CCR214546, R01/CCR61 2934-01. 2000. 447 p. URL: https://stacks.cdc.gov/view/cdc/217970 (Date of Access 15.12.2025).
45. Boice J.D. Jr, Cohen S.S., Mumma M.T., Chadda B., Blot W.J. A Cohort Study of Uranium Millers and Miners of Grants, New Mexico, 1979–2005. J. Radiol. Prot. 2008;28;3:303–325. Doi: 10.1088/0952-4746/28/3/002.
46. OCRC-2015. The Occupational Cancer Research Centre, Cancer Care Ontario. Ontario Uranium Miners Cohort Study Report. Prepared for: The Canadian Nuclear Safety Commission. 2015.  137 p. URL: https://www.occupationalcancer.ca/wp-content/uploads/2023/01/RSP-0308.pdf (Date of Access 15.12.2025).
47. Kreuzer M., Schnelzer M., Tschense A., Walsh L., Grosche B. Cohort Profile: the German Uranium Miners Cohort Study (WISMUT cohort), 1946–2003. Int. J. Epidemiol. 2010;39;4:980–987. Doi: 10.1093/Ije/Dyp216.
48. Figgs L.W., Holsinger H., Freitas S.J., Brion G.M., Hornung R.W., Rice C.H., Tollerud D. Increased Suicide Risk among Workers Following Toxic Metal Exposure at the Paducah Gaseous Diffusion Plant from 1952 to 2003: a Cohort Study. Int. J. Occup. Environ. Med. 2011;2;4:199–214. URL: https://stacks.cdc.gov/view/cdc/193290 (Date of Access 15.12.2025).
49. Flanders W.D. Approximate Variance Formulas for Standardized Rate Ratios. J. Chronic Dis. 1984;37;6:449–453. Doi: 10.1016/0021-9681(84)90028-6.
50. Смертность от внешних причин в России с середины XX века / Под ред. А.Г.Вишневского. М.: Высшая школа экономики, 2017.  448 с. [Smertnost’ ot Vneshnikh Prichin v Rossii s Serediny XX Veka = Mortality from External Causes in Russia Since the Mid-20th Century. Ed. A.G.Vishnevskiy. Moscow, Vysshaya Shkola Ekonomiki Publ., 2017. 448 (In Russ.)]. Doi: 10.17323/978-5-7598-1397-2.
51. Котеров А.Н. От очень малых до очень больших доз радиации: новые данные по установлению диапазонов и их экспериментально-эпидемиологические обоснования // Медицинская радиология и радиационная безопасность. 2013. Т.58. №2. С. 5–21. [Koterov A.N. From Very Small to Very Large Doses of Radiation: New Data on Establishing Ranges and their Experimental and Epidemiological Justifications. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2013;58;2:5–21 (In Russ.)].
52. Amano M.A., French B., Sakata R., Dekker M., Brenner A.V. Lifetime Risk of Suicide among Survivors of the Atomic Bombings of Japan. Epidemiol. Psychiatr. Sci. 2021;30:e43. 9 p. Doi: 10.1017/S204579602100024x.
53. Moher D., Liberati A., Tetzlaff J., Altman D.G., PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. PLoS Med. 2009;6;7:e1000097. 6 p. Doi: 10.1371/Journal.Pmed.1000097; URL: https://legacyfileshare.elsevier.com/promis_misc/PRISMA-2009-Checklist1.pdf.
54. Rem. Unit of Measurement. Encyclopaedia Britannica. URL: https://www.britannica.com/science/rem-unit-of-measurement (Date of Access 17.12.2025).
55. Wilkinson G.S., Trieff N, Graham R, Priore RL. Study of Mortality among Female Nuclear Weapons Workers. Final Report. Grant Numbers: 1R01 OHO3274, R01/CCR214546, R01/CCR61 2934-01. 2000.  447 p. URL: http://www.pantex.com/RRoom/rrdocs/safetyhealth/wilkinsonfinalreport.pdf.
56. Кокунин В.А. Статистическая обработка данных при малом числе опытов // Украинский биохимический журнал. 1975. Т.47. №6. С. 776–790. [Kokunin V.A. Statistical Processing of Data with a Small Number of Experiments. Ukrainskiy Biokhimicheskiy Zhurnal = Ukrainian Biochemical Journal. 1975;47;6:776–790 (In Russ.)].
57. Gul M., Kotak Y., Muneer T., Ivanova S. Enhancement of Albedo for Solar Energy Gain with Particular Emphasis on Overcast Skies. Energies. 2018;11:2881. 17 p. URL: http://dx.doi.org/10.3390/en11112881.
58. Wisenburn B., Mahoney K. A Meta-Analysis of Word-Finding Treatments for Aphasia. Aphasiology. 2009;23;11:1338–1352. Doi: 10.1080/02687030902732745.
59. Montes A., Sanmarco J., Novo M., Cea B., Arce R. Estimating the Psychological Harm Consequence of Bullying Victimization: a Meta-Analytic Review for Forensic Evaluation. Int. J. Environ. Res. Public Health. 2022;19;13852. 9 p. Doi: 10.3390/Ijerph192113852.
60. Park R.M., Bailer A.J., Stayner L.T., Halperin W., Gilbert S.J. An Alternate Characterization of Hazard in Occupational Epidemiology: Years of Life Lost per Years Worked. Am. J. Ind. Med. 2002;42;1:1–10. Doi: 10.1002/Ajim.10082.
61. Waldron H.A. Did the Mad Hatter have Mercury Poisoning? Br. Med. J. (Clin. Res. Ed.). 1983;287;6409:1961. Doi: 10.1136/Bmj.287.6409.1961.
62. Омельяновский В.В., Авксентьева М.В., Сура М.В., Хачатрян Г.Р., Федяева В.К. Методические рекомендации по проведению мета-анализа.  М.: Центр экспертизы и контроля качества медицинской помощи Минздрава России, 2017.  28 с. [Omel’yanovskiy V.V., Avksent’yeva M.V., Sura M.V., Khachatryan G.R., Fedyayeva V.K. Metodicheskiye Rekomendatsii po Provedeniyu Meta-Analiza = Methodological Recommendations for Conducting Meta-Analysis. Moscow, Tsentr Ekspertizy i Kontrolya Kachestva Meditsinskoy Pomoshchi Minzdrava Rossii Publ., 2017. 28 p. (In Russ.)].
63. Boice J.D., Jr. Lauriston S. Taylor Lecture: Radiation Epidemiology — the Golden Age and Future Challenges. Health Phys. 2011;100;1:59–76. Doi: 10.1097/Hp.0b013e3181f9797d.
64. Kudo S., Ishida J., Yoshimoto K., Mizuno S., Ohshima S., Furuta H., Kasagi F. Direct Adjustment for Confounding by Smoking Reduces Radiation-Related Cancer Risk Estimates of Mortality among Male Nuclear Workers in Japan, 1999–2010. J. Radiol. Prot. 2018;38;1:357–371. Doi: 10.1088/1361-6498/Aaa65c.
65. Douglas A.J., Omar R.Z., Smith P.G. Cancer Mortality and Morbidity among Workers at the Sellafield Plant of British Nuclear Fuels. Br. J. Cancer. 1994;70;6:1232–1243. Doi: 10.1038/Bjc.1994.479.
66. Smith S.J., Steinberg K.K., Thacker S.B. Methods for Pooled Analyses of Epidemiologic Studies. Epidemiology. 1994;5;3:381–383. Doi: 10.1097/00001648-199405000-00024.
67. Szpiro A., Hazlehurst M., Karr C., Kaufman J., LeWinn K., Loftus C., et al. Meta-Analysis vs Pooling: Tradeoffs in Precision, Confounder Control, Mixtures, and Nonlinear Dose-Response. Abstracts of the 2019 Annual Conference of the International Society for Environmental Epidemiology. Utrecht, the Netherlands, August 25–28 2019. Environmental Epidemiology 2019;3;1:389. Doi : 10.1097/01.Ee9.0000610336.09715.B9. 

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.01.2026. Accepted for publication: 25.02.2026.

Medical Radiology and Radiation Safety. 2026. Vol. 71. № 2

DOI:10.33266/1024-6177-2026-71-2-48-52

S.S. Sokolnikova, N.R. Kabirova, P.V. Okatenko

The Offspring of the Liquidators of the Consequences
of Mayak PA Accident in 1957: the Cohort Composition

Southern Urals Federal Research and Clinical Center of Medical Biophysics, Ozyorsk, Russia

Contact person: S.S. Sokolnikova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To compose and to give characteristics of the cohort of the 1^st generation offspring of men who took part in liquidation of the consequences of the 1957 accident at Mayak PA.

Material and methods: The Registry of individuals who took part in liquidation of the consequences of Mayak PA accident in 1957 and the Registry of Ozyorsk residents exposed to anthropogenic radiation in childhood due to operation of the first nuclear facility in Russia were the sources of information. 

Results: A cohort of the 1^st generation offspring of male liquidators of 1957 accident was composed and described. The number of children born in 1958‒1992 is 4753 individuals. The life status is determined for 98.9 %. It was stated that 25.6 % of the children were born in the years of the accident liquidation, when maximum dose loads for the liquidators were observed. For the epidemiological study the groups were composed according to preconception doses of radiation exposure of men; at that, the mothers weren’t in contact with ionizing radiation sources. It was stated that the fathers of 13.0 % of the children had received doses over 500.0 mGy. The study cohort allows to perform epidemiological analyses of the effects of accidental exposure of the fathers. 

Keywords: liquidators of the consequences of an accident 1957, Mayak PA, the 1^st generation offspring, cohort, medical-dosimetry registry, preconception exposure

For citation: Sokolnikova SS, Kabirova NR, Okatenko PV. The Offspring of the Liquidators of the Consequences of Mayak PA Accident in 1957: the Cohort Composition. Medical Radiology and Radiation Safety. 2026;71(2):48–52. DOI:10.33266/1024-6177-2026-71-2-48-52

References

1. Ekologicheskiye i Meditsinskiye Posledstviya Radiatsionnoy Avarii 1957 Goda na PO Mayak = Ecological and medical consequences of the 1957 radiation accident at the Mayak Production Association. Ed. A.V. Akleyev, M.F. Kiselev. Moscow, Medbioekstrem Publ., 2001. 294 p. (In Russ.)
2. Krupnyye Radiatsionnyye Avarii: Posledstviya i Zashchitnyye Mery = Major Radiation Accidents: Consequences and Protective Measures. Ed L.A. Il’in, V.A. Gubanov. Moscow, IzdAT Publ., 2001. 752 p. (In Russ.).
3. Vorobtsova I.Ye. Genetic and Somatic Effects of Ionizing Radiation in Humans and Animals (Comparative Aspect). Radiatsionnaya Biologiya. Radioekologiya = Radiation Biology. Radioecology. 2002;42;6:639-643 (In Russ.).
4. Nakamura N. Genetic Effects of Radiation in Atomic-bomb Survivors and Their Children: Past, Present and Future. Radiation Resersh. 2006;47;B:67-73.
5. Dubrova Yu.E., Nesterov V.N., Krouchinsky N.G., et al. Human Minisatellite Mutation Rate after the Chernobil Accident. Nature. 1996;380:683–686.
6. Bolotnikova M.G., Koshurnikova N.A., Okatenko P.V., Gruzdeva Ye.A. Some Medical Consequences of the 1957 Radiation Accident at the Mayak Production Association. Ed. S.I. Rovnyy. Regional’naya Nauchno-Prakticheskaya Konferentsiya VURS-45 = Regional Scientific and Practical Conference VRU-45. Proceedings. Ozersk, September 26-27, 2002. Ozersk, Redaktsionno-Izdatel’skiy Tsentr VRB Publ., 2002. P. 294-299 (In Russ.).
7. Sokol’nikov M.E., Kabirova N.R., Okatenko P.V., Koshurnikova N.A., Tsareva Yu.V., Martinenko I.A., Gruzdeva Ye.A. Experience of Creating a Register of the Population of the Closed Administrative-Territorial Entity of the City of Ozersk, Exposed in Childhood to Technogenic Impacts due to the Activities of the First Nuclear Enterprise of Russia, PO Mayak. Voprosy Radiatsionnoy Bezopasnosti = Radiation Safety Problems. 2024;2;114:57-74 (In Russ.).
8. Petrushkina N.P. On the Influence of Professional Irradiation of Parents on the Health of their Children. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 1997;6:37-42 (In Russ.).

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.01.2026. Accepted for publication: 25.02.2026.

Medical Radiology and Radiation Safety. 2026. Vol. 71. № 2

DOI:10.33266/1024-6177-2026-71-2-66-68

I.O. Tomashevskiy, M.O. Shatalova

The Necessity of Employing SPECT/CT with ^99mTc-Pertechnetate
for Diagnosing Autonomous Thyroid Adenoma in a Specific Patient

Central clinical hospital RZD-Medicine, Moscow, Russia

Contact person: I.O. Tomashevskiy, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: Demonstrate a clinical observation where eight diagnostic techniques were required to establish the diagnosis of compensated autonomous thyroid adenoma.

Material and methods: Eight diagnostic methods were utilized to establish the diagnosis: ultrasound examination (US), measurement of blood concentrations of pituitary thyroid-stimulating hormone (TSH), free T₄ and T₃, antibodies to thyroperoxidase (TPOAb), antibodies to thyroglobulin (TgAb), planar scintigraphy (PS) with ^99mTc-pertechnetate, and single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT).

Results: The application of eight diagnostic techniques highlighted two main methods: US and SPECT/CT, which enable the visualization of nodules, determination of their autonomy, and assessment of functional autonomy compensation or decompensation. Planar scintigraphy failed to detect nodules due to its lower resolution compared to SPECT/CT.

Conclusion: It has been shown that in diagnosing compensated autonomous thyroid adenoma using US, PS, SPECT/CT, and measurements of TSH, T₃, T₄, TPOAb, and TgAb levels, the key technologies are US and SPECT/CT. These methods allow for the visualization of nodules and the assessment of their autonomy and functional state. Planar scintigraphy was insufficient for nodule detection due to its limited resolution compared to SPECT/CT.

Keywords: thyroid adenoma, SPECT/CT, scintigraphy, in vitro diagnostics

For citation: Tomashevskiy IO, Shatalova MO. The Necessity of Employing SPECT/CT with ^99mTc-Pertechnetate for Diagnosing Autonomous Thyroid Adenoma in a Specific Patient. Medical Radiology and Radiation Safety. 2026;71(2):66–68. DOI:10.33266/1024-6177-2026-71-2-66-68

References

1. Imanishi Y, Ehara N, Mori J, et al. Measurement of Thyroid Iodine by CT. J Comput Assist Tomogr. 1991;15;2:287-290. Doi: 10.1097/00004728-199103000-00019.
2. Shao W., Liu J., Liu D. Evaluation of Energy Spectrum CT for the Measurement of Thyroid Iodine Content. BMC Med Imaging. 2016;16;1:47. Doi: 10.1186/s12880-016-0151-y.
3. Tomashevskiy I.O., Shatalova M.O. The Importance of Scintigraphy, Single-Photon Emission Tomography, and X-Ray Computed Tomography in the Diagnosis of Autonomously Functioning Thyroid Nodes. XIX Vserossiyskiy Natsional’niy Kongress Luchevykh Diagnostov i Terapevtov Radiologiya-2025 = Proceedings of the XIX All-Russian National Congress of Radiation Diagnosticians and Therapists “Radiology-2025”, Moscow, May 27-29, 2025. Moscow Publ., 2025. P. 13-14 (In Russ.). ISBN 978-5-906484-82-6.
4. Shatalova M.O., Tomashevskiy I.O. X-ray Computed Tomography in the Comprehensive Diagnostics of Thyroid Diseases. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2025;70;2:107–112 (In Russ.). Doi: 10.33266/1024-6177-2025-70-2-107-112.

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.01.2026. Accepted for publication: 25.02.2026.