JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2026. Vol. 71. № 3
DOI:10.33266/1024-6177-2026-71-3-66-79
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 2. Meta-Analyses and Pooled-Analyses
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
This synthetic study, presented in two reports, is intended to, firstly, serve as an image-building tool for employment in the nuclear industry (assessing the psychological state of nuclear workers (NW), including comparisons with other professions). Secondly, it aims to identify the consequences of occupational stress, such as suicide, the frequency of which is an index of professional psychological well-being/ill-being. This is relevant for the psychological and psychophysiological support of contingents under the jurisdiction of the Federal Medical-Biological Agency of the Russian Federation.
At the initial stage of the study, the results of which were presented in the form of a systematic review in Report 1, full samples of studies on the standardized mortality ratio (SMR; compared to the general population) for suicides in foreign NW for male and female (15 nuclear installations from five countries) were compiled and characterized. The presented Report 2 is devoted to the implementation of a meta-analysis and a pooled analysis for the aforementioned samples. Firstly, a good agreement between the results of both synthetic approaches is demonstrated (which is of particular theoretical interest) and, secondly, a sharply different situation for male and female is discovered. While a statistically significant ‘Healthy Worker Effect’ was revealed for NW male, albeit not very high in magnitude (according to both the meta-analysis and pooled analysis, SMR = 0.85), such an effect was completely absent for NW female, although the index level was not higher than that of the population (SMR = 0.97–1.04). For the two gender samples, the SMR for suicides according to the Mann-Whitney U test showed a statistically significant difference (p = 0.019), as did the corresponding comparison of the mean values for the five installations for which the indexes for NW male and female were simultaneously studied (p = 0.021). Similar trends were also identified for the PO ‘Mayak’ NW, although these data were only qualitative due to the lack of suitable suicide risk indexes for analysis.
The magnitude of the inverse ‘gender paradox’ for suicides in NW, which distinguishes certain occupations from the general population (where the rate of fatal suicides is higher in female than in male), was the highest among all occupations for which similar data were found, including physicians, who were previously known to be most susceptible to this phenomenon.
The study was subject to a number of statistical and epidemiological limitations, but none of them could completely invalidate the aforementioned patterns or the reliability of the data obtained, with the exception of the hypothesis that gender-related initial selection for psychological characteristics may influence for NW male and female.
It was concluded that the occupational stress and psychological well-being index for female NW, regardless of the underlying cause, differ significantly from those for male NW, and this difference is likely more pronounced than that of any other profession. This requires a differentiated gender approach to psychological and psychophysiological support for NW. It would also be advisable to reduce the number of female NW directly involved in production in the nuclear industry.
Keywords: nuclear workers; fatal suicides, gender differences, meta-analysis, pooled analysis
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 2. Meta-Analyses And Pooled-Analyses. Medical Radiology and Radiation Safety. 2026;71(3):66–79. DOI:10.33266/1024-6177-2026-71-3-66-79
References
1.Котеров А.Н., Ушенкова Л.Н., Вайнсон А.А., Тихонова О.А., Кретов А.С., Паринов О.В., Лебедев А.О., Бушманов А.Ю. Риск суицидов у работников ядерной индустрии — отличия для мужчин и женщин обратны популяционным (синтетическое исследование). Сообщение 1. Постановка проблемы, поиск источников и характеристика выборки исследований // Медицинская радиология и радиационная безопасность. 2026. Т.71. №2. С. 53-65 [Koterov A.N., Ushenkova L.N., Vaynson A.A., Tikhonova O.A., Kretov A.S., Parinov O.V., Lebedev A.O., Bushmanov A.Yu. Suicide Risk among Nuclear Industry Workers: Differences for Men and Women are Inverse to Population Ones (synthetic study). Report 1. Statement of the Problem, Search for Sources and Characteristics of the Study Sample. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2026;71:2:53-65 (Preprint). (In Russ.)]. Doi: 10.33266/1024-6177-2026-71-2-53-65.
2.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.
3.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: Article e1000097. 6 p. Doi: 10.1371/journal.pmed.1000097. URL: https://legacyfileshare.elsevier.com/promis_misc/PRISMA-2009-Checklist1.pdf; https://legacyfileshare.elsevier.com/promis_misc/prisma-2009-flow-diagram.pdf (Date of Access 17.12.2025).
4.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.)].
5.Schernhammer E.S., Colditz G.A. Suicide Rates among Physicians: a Quantitative and Gender Assessment (Meta-Analysis). Am. J. Psychiatry. 2004;161;12:2295–2302. Doi: 10.1176/appi.ajp.161.12.2295.
6.Dutheil F., Aubert C., Pereira B., Dambrun M., Moustafa F., Mermillod M., et al. Suicide among Physicians and Health-Care Workers: a Systematic Review and Meta-Analysis. PLoS One. 2019;14;12:Article e0226361. 28 p. Doi: 10.1371/journal.pone.0226361.
7.Duarte D., El-Hagrassy M.M., Couto T.C.E., Gurgel W., Fregni F., Correa H. Male and Female Physician Suicidality: a Systematic Review and Meta-Analysis. JAMA Psychiatry. 2020;77;6:587–597. Doi: 10.1001/jamapsychiatry.2020.0011.
8.Zimmermann C., Strohmaier S., Herkner H., Niederkrotenthaler T., Schernhammer E. Suicide Rates among Physicians Compared with the General Population in Studies from 20 Countries: Gender Stratified Systematic Review and Meta-Analysis. Brit. Med. J. 2024;386:Article e078964. 11 p. Doi: 10.1136/bmj-2023-078964.
9.Cochrane Handbook for Systematic Reviews of Interventions. Ed. by: J.P.T. Higgins, T. James, J. Chandler, et al. Cochrane, Willey Blackwell, 2019. 694 p. Doi: 10.1002/9781119536604.
10.Checkoway H. Data Pooling in Occupational Studies. J. Occup. Med. 1991;33;12:1257–1260.
11.Friedenreich C.M. Methods for Pooled Analyses of Epidemiologic Studies. Epidemiology. 1993;4;4:295–302. Doi: 10.1097/00001648-199307000-00004.
12.Stewart L.A., Parmar M.K. Meta-Analysis of the Literature or of Individual Patient Data: is there a Difference? Lancet. 1993;341;8842:418–422. Doi: 10.1016/0140-6736(93)93004-k.
13.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.
14.Olsen J. Meta-Analyses or Collaborative Studies. J. Occup. Environ. Med. 1995;37;8:897–902. Doi: 10.1097/00043764-199508000-00002.
15.Gordon I., Boffetta P., Demers P.A. A Case Study Comparing a Meta-Analysis and a Pooled Analysis of Studies of Sinonasal Cancer among Wood Workers. Epidemiology. 1998;9;5:518–524. Doi: 10.1097/00001648-199809000-00006.
16.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.
17.Bravata D.M., Olkin I. Simple Pooling Versus Combining in Meta-Analysis. Eval. Health Prof. 2001;24;2:218–230. Doi: 10.1177/01632780122034885.
18.Altman D.G., Deeks J.J. Meta-Analysis, Simpson’s Paradox, and the Number Needed to Treat. BMC Med. Res. Methodol. 2002;2:Article 3. 5 p. Doi: 10.1186/1471-2288-2-3.
19.Lievre M., Cucherat M., Leizorovicz A. Pooling, Meta-Analysis, and the Evaluation of drug Safety. Curr. Control Trials Cardiovasc. Med. 2002;3;1:Article 6. 4 p. Doi: 10.1186/1468-6708-3-6.
20.Taioli E., Bonassi S. Methodological Issues in Pooled Analysis of Biomarker Studies. Mutat. Res. 2002;512;1:85–92. Doi: 10.1016/s1383-5742(02)00027-3.
21.Reade M.C., Delaney A., Bailey M.J., Angus D.C. Bench-to-Bedside Review: Avoiding Pitfalls in Critical Care Meta-Analysis-Funnel Plots, Risk Estimates, Types of Heterogeneity, Baseline Risk and the Ecologic Fallacy. Crit Care. 2008;12;4:Article 220. 8 p. Doi: 10.1186/cc694.
22.Daniels R.D., Bertke S., Waters K.M., Schubauer-Berigan M.K. Risk of Leukaemia Mortality from Exposure to Ionising Radiation in US Nuclear Workers: a Pooled Case-Control Study. Occup. Environ. Med. 2013;70;1:41–48. Doi: 10.1136/oemed-2012-100906.
23.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’. August 25–28 2019, Utrecht, the Netherlands. Environmental Epidemiology 2019. V.3;1:389. Doi: 10.1097/01.EE9.0000610336.09715.b9.
24.Rojanaworarit C. Misleading Epidemiological and Statistical Evidence in the Presence of Simpson’s Paradox: an Illustrative Study Using Simulated Scenarios of Observational Study Designs. J. Med. Life. 2020;13;1:37–44. Doi: 10.25122/jml-2019-0120.
25.Lin L., Sherman P.D. Cleaning Data the Chauvenet Way. The Proceedings of the SouthEast SAS Users Group, Sesug Proceedings, Paper SA11, 2007. P. 1–11. URL: https://www.nbi.dk/~petersen/Teaching/Stat2017/Notes/StatNote_RejectingData.pdf.
26.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) // Медицинская радиология и радиационная безопасность. 2024. Т.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.
27.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 / Под ред. С.И. Сычика и др. Гомель: Редакция газеты 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). Zdorov’ye i Okruzhayushchaya Sreda = Health and Environment. Ed. S.I. Sychik., et al. Gomel, Redaktsiya Gazety Gomel’skaya Prauda Publ., 2024. P. 59–69 (In Russ.)].
28.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 // Медицинская радиология и радиационная 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.
29.Wisenburn B., Mahoney K. A Meta-Analysis of Word-Finding Treatments for Aphasia. Aphasiology. 2009;23;11:1338–1352. Doi: 10.1080/02687030902732745.
30.Voutilainen A., Pitkaaho T., Vehvilainen-Julkunen K., Sherwood P.R. Meta-Analysis: Methodological Confounders in Measuring Patient Satisfaction. Journal of Research in Nursing. 2015;20;8:698–714. Doi: 10.1177/1744987115619209.
31.Arce R., Arias E., Novo M., Farina F. Are Interventions with Batterers Effective? A Meta-Analytical Review. Psychosocial Intervention. 2020;29;3:153–164. Doi: 10.5093/pi2020a11.
32.Gancedo Y., Farina F., Seijoa D., Vilarinoa M., Arcea R. Reality Monitoring: a Meta-Analytical Review for Forensic Practice. The European Journal of Psychology Applied to Legal Context. 2021;13;2:99–110. Doi: 10.5093/ejpalc2021a10.
33.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:Article 13852. 9 p. Doi: 10.3390/ijerph192113852.
34.Quevedo-Blasco R., Perez M.J., Guillen-Riquelme A., Hess T. Civil Liability for Clinical Misdiagnosis of Suicidal Intention: Procedure and Guidelines to Minimize Fatal Diagnostic Error. The European Journal of Psychology Applied to Legal Context. 2023;15;2:73–81. Doi: 10.5093/ejpalc2023a8.
35.Суворов А.Ю., Латушкина И.В., Гуляева К.А., Буланов Н.М., Надинская М.Ю., Заикин А.А. Базовые аспекты мета-анализа. Часть 1 // Сеченовский вестник. 2023. Т.14. №1. С. 4–14 [Suvorov A.Yu., Latushkina I.V., Gulyayeva K.A., Bulanov N.M., Nadinskaya M.Yu., Zaikin A.A. Basic Aspects of Meta-Analysis. Part 1. Sechenovskiy Vestnik = Sechenov Medical Journal. 2023;14;1:4-14 (In Russ.)]. Doi: 10.47093/2218-7332.2023.14.1.4-14.
36.Daniels R.D., Schubauer-Berigan M.K. A Meta-Analysis of Leukaemia Risk from Protracted Exposure to Low-Dose Gamma Radiation. Occup. Environ. Med. 2011;68;6:457–464. Doi: 10.1136/oem.2009.054684.
37.Lin R.-T., Boonhat H., Leen Y.-Y., Klebe S., Takahashi K. Health Effects of Occupational and Environmental Exposures to Nuclear Power Plants: a Meta-Analysis and Meta-Regression. Curr. Environ. Health Rep. 2024;11;3:329–339. Doi: 10.1007/s40572-024-00453-8.
38.Chen D.-G. (Din), Peace K.E. Applied Meta-Analysis with R. New York, Chapman & Hall CRC. 2013. 336 p.
39.Dr John D. Boice Jr. Curriculum Vitae. Site ICRP. URL: https://www.icrp.org/cv/%7B2A6A529B-0533-401A-B64B 61055E23BF80%7D/Boice_CV.pdf (Date of Access 26.12.2025).
40.Lensen S. When to Pool Data in a Meta-Analysis (and when not to)? Fertil. Steril. 2023;119;6:902–903. Doi: 10.1016/j.fertnstert.2023.03.015.
41.Egger M., Davey Smith G., Schneider M., Minder C. Bias in Meta-Analysis Detected by a Simple, Graphical Test. Brit. Med. J. 1997;315;7109:629–634. Doi: 10.1136/bmj.315.7109.629.
42.Sterne J.A.C., Egger M. Funnel Plots for Detecting Bias in Meta-Analysis: Guidelines on Choice of Axis. J. Clin. Epidemiol. 2001;54;10:1046–1155. Doi: 10.1016/s0895-4356(01)00377-8.
43.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 // Медицинская радиология и радиационная 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.
44.Bo Q., Qingfang L., Jianfeng W., Ge G. Cohort Studies on Cancer Mortality among Nuclear Workers Exposed to Low-Dose Ionizing Radiation: a Meta-Analysis. Radiation Protection (Taiyuan). 2008;28;3:161–169.
45.Park E.S., Moon K., Kim H.N., Lee W.J., Jin Y.W. Radiation Exposure and Cancer Mortality among Nuclear Power Plant Workers: a Meta-Analysis. J. Prev. Med. Public Health. 2010;43;2:185–192. Doi: 10.33266/10.3961/jpmph.2010.43.2.185.
46.Qu S.G., Gao J., Tang B., Yu B., Shen Y.P., Tu Y. Low-Dose Ionizing Radiation Increases the Mortality Risk of Solid Cancers in Nuclear Industry Workers: a Meta-Analysis. Mol. Clin. Oncol. 2018;8;5:703–711. Doi: 10.3892/mco.2018.1590.
47.Hogstedt C., Andersson K. A Cohort Study on Mortality among Dynamite Workers. J. Occup. Med. 1979;21;8:553–556.
48.Boice J.D., Jr. Ionizing Radiation. Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. Ed. by D. Schottenfeld, J.F. Fraumeni. New York, Oxford University Press. 2006. P. 259–293.
49.McMichael A.J., Spirtas R., Kupper L.L. An Epidemiologic Study of Mortality within a Cohort of Rubber Workers, 1964–72. J. Occup. Med. 1974;16;7:458–464.
50.Engel L.S., Taioli E., Pfeiffer R., Garcia-Closas M., Marcus P.M., Lan Q., et al. Pooled Analysis and Meta-Analysis of Glutathione S-Transferase M1 and Bladder Cancer: a HuGE Review. Am. J. Epidemiol. 2002;156;2:95–109. Doi: 10.1093/aje/kwf018.
51.Simpson E.H. The Interpretation of Interaction in Contingency Tables. J. R. Stat. Soc. 1951;13;2:238–241.
52.Baillargeon J. Characteristics of the Healthy Worker Effect. Occup. Med. 2001;16;2:359–366. Doi: 10.1097/00043764-199804000-00012.
53.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.
54.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.
55.Котеров А.Н., Ушенкова Л.Н., Дибиргаджиев И.Г. База данных по стандартизованному отношению смертности (SMR All Causes и SMR All Cancer) для различных профессий (706 когорт / групп): максимальный «эффект здорового работника» - у космонавтов и врачей // Медицина труда и промышленная экология. 2023. Т.63. №3. С. 179–192 [Koterov A.N., Ushenkova L.N., Dibirgadzhiyev I.G. Database of Standardized Mortality Ratios (SMR All Causes and SMR All Cancer) for Various Professions (706 Cohorts/Groups): Maximum Healthy Worker Effect in Cosmonauts and Doctors. Meditsina Truda i Promyshlennaya Ekologiya = Russian Journal of Occupational Health and Industrial Ecology. 2023;63;3:179–192 (In Russ.)]. Doi: 10.31089/1026-9428-2023-63-3-179-192.
56.Котеров А.Н., Ушенкова Л.Н., Калинина М.В., Дибиргаджиев И.Г. Профессии, наиболее отражающиеся на здоровье: ядерная индустрия на последних местах по вредности (синтетическое исследование) // Здоровье и окружающая среда: Сборник материалов международной научно-практической конференции / Под ред. С.И. Сычик. Минск, 23–24 ноября 2023 г. Минск: Белорусский государственный университет. 2023. С. 96–100 [Koterov A.N., Ushenkova L.N., Kalinina M.V., Dibirgadzhiyev I.G. Professions that have the Greatest Impact on Health: the Nuclear Industry Ranks Last in Terms of Harmfulness (Synthetic Study). Zdorov’ye i Okruzhayushchaya Sreda = Health and the Environment. Proceedings from the International Scientific and Practical Conference. Ed. S.I. Sychik. Minsk, November 23–24, 2023. Minsk, Belorusskiy Gosudarstvennyy Universitet Publ., 2023. P. 96–100 (In Russ)].
57.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.
58.Umbrella Reviews: Evidence Synthesis with Overviews of Reviews and Meta-Epidemiologic Studies. Ed. G. Biondi-Zoccai. Switzerland, Springer International Publishing, 2016. 526 p.
59.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.
60.Boice J.D. Jr, Cohen S.S., Mumma M.T., Howard S.C., Yoder R.C., Dauer L.T. Mortality among Medical Radiation Workers in the United States, 1965–2016. Int. J. Radiat. Biol. 2023;99;2:183–207. Doi: 10.1080/09553002.2021.1967508.
61.Lee W.J., Cha E.S., Bang Y.J., Hsu C.Y., Chang S.S. Suicide Deaths among Diagnostic Medical Radiation Workers in South Korea, 1996–2017. Occup. Environ. Med. 2020;77;10:675–680. Doi: 10.1136/oemed-2020-106446.
62.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:Article 13309. 8 p. Doi: 10.3390/ijerph192013309.
63.Komleva N.S., Koshurnikova N.A., Nifatov A.P., Bolotnikova M.G., Okatenko P.V. Mortality from External Causes among the Personnel of Mayak’s Radiochemical Plant. Sci. Total. Environ. 1994;142;1–2:33–35. Doi: 10.1016/0048-9697(94)90071-X.
64.Shilnikova N.S., Preston D.L., Ron E., Gilbert E.S., Vassilenko E.K., Romanov S.A., et al. Cancer Mortality Risk among Workers at the Mayak Nuclear Complex. Radiat. Res. 2003;159;6:787–798. Doi: 10.1667/0033-7587(2003)159[0787:cmrawa]2.0.co;2.
65.Azizova T.V., Grigoryeva E.S., Hamada N. Dose Rate Effect on Mortality from Ischemic Heart Disease in the Cohort of Russian Mayak Production Association Workers. Sci. Rep. 2023;13;1:Article 1926. 15 p. Doi: 10.1038/s41598-023-28954-w.
66.Котеров А.Н., Туков А.Р., Ушенкова Л.Н., Калинина М.В., Бирюков А.П. Средняя накопленная доза облучения для работников мировой ядерной индустрии: малые дозы, малые эффекты. Сравнение с дозами для медицинских радиологов // Радиационная биология. Радиоэкология. 2022. Т.62. №3. С. 227–239 [Koterov A.N., Tukov A.R., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Average Cumulative Radiation Dose for Workers in the Global Nuclear Industry: Low Doses, Low Effects. Comparison with Doses for Medical Radiologists. Radiatsionnaya Biologiya. Radioekologiya = Radiation Biology. Radioecology. 2022;62;3:227–239 (In Russ.)]. Doi: 10.31857/S0869803122030043.
67.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.
68.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).
69.Sivadon P., Fernandez A. L’etude des Attitudes Psychologiques des Travailleurs Nucleaires Vis-a-Vis du Risque Radioactif. [Study of Psychological Attitudes of Nuclear Workers Towards Radioactivity Risk.] Report Number(s): EUR-2113.f 1964. Rapport Final. EUR-4198.f. Centre de Recherches Psychopathologiques. Paris, France, 1968. 166 p. URL: https://www.osti.gov/biblio/4653569 (Date of Access 02.01.2026).
70.Сумина М.В., Азизова Т.В. Структура нервно-психических заболеваний у работников, подвергавшихся профессиональному облучению // Вопросы радиационной безопасности. 2002. №2. С. 51–58 [Sumina M.V., Azizova T.V. Structure of Neuropsychiatric Diseases in Workers Exposed to Occupational Radiation. Voprosy Radiatsionnoy Bezopasnosti = Radiation Safety Problems. 2002;2:51–58 (In Russ.)].
71.Quella A.K. Retrospective Mortality and Cancer Incidence Study of Former U.S. Atomic Energy Commission Workers at the Iowa Army Ammunitions Plant in Burlington, Iowa. Doctor’s Thesis (PHd). Iowa, University of Iowa, 2010. 155 p. Doi: 10.17077/etd.u2kgqofz.
72.Бушманов А.Ю., Касымова О.А., Кретов А.С., Солорева М.А., Денисова Е.А. Результаты психофизиологических обследований персонала объектов использования атомной энергии // Медицинская радиология и радиационная безопасность. 2022. Т.67. №6. С. 19–23 [Bushmanov A.Yu., Kasymova O.A., Kretov A.S., Soloreva M.A., Denisova Ye.A. Results of Psychophysiological Examinations of Personnel at Nuclear Facilities. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2022;67;6:19–23 (In Russ.)]. Doi: 10.33266/1024-6177-2022-67-6-19-23.
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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: 20.02.2026. Accepted for publication: 25.03.2026.