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.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
The journal is included in the List of Russian Reviewed Scientific Journals of the Higher Attestation Commission. Since 2008 the journal has been available on the Internet and indexed in the RISC database which is placed on Web of Science. Since February 2nd, 2018, the journal "Medical Radiology and Radiation Safety" has been indexed in the SCOPUS abstract and citation database.
Brief electronic versions of the Journal have been publicly available since 2005 on the website of the Medical Radiology and Radiation Safety Journal: http://www.medradiol.ru. Since 2011, all issues of the journal as a whole are publicly available, and since 2016 - full-text versions of scientific articles. Since 2005, subscribers can purchase full versions of other articles of any issue only through the National Electronic Library. The editor of the Medical Radiology and Radiation Safety Journal in accordance with the National Electronic Library agreement has been providing the Library with all its production since 2005 until now.
The main working language of the journal is Russian, an additional language is English, which is used to write titles of articles, information about authors, annotations, key words, a list of literature.
Since 2017 the journal Medical Radiology and Radiation Safety has switched to digital identification of publications, assigning to each article the identifier of the digital object (DOI), which greatly accelerated the search for the location of the article on the Internet. In future it is planned to publish the English-language version of the journal Medical Radiology and Radiation Safety for its development. In order to obtain information about the publication activity of the journal in March 2015, a counter of readers' references to the materials posted on the site from 2005 to the present which is placed on the journal's website. During 2015 - 2016 years on average there were no more than 100-170 handlings per day. Publication of a number of articles, as well as electronic versions of profile monographs and collections in the public domain, dramatically increased the number of handlings to the journal's website to 500 - 800 per day, and the total number of visits to the site at the end of 2017 was more than 230.000.
The two-year impact factor of RISC, according to data for 2017, was 0.439, taking into account citation from all sources - 0.570, and the five-year impact factor of RISC - 0.352.
Issues journals
Medical Radiology and Radiation Safety. 2023. Vol. 68. № 4
DOI: 10.33266/1024-6177-2023-68-4-43-50
A.N. Koterov, L.N. Ushenkova, M.V. Kalinina, A.P. Biryukov
The ‘Healthy Worker Effect’ on Indexes of Total Mortality
and Malignant Neoplasms Mortality for Nuclear and Chemical Workers: Meta-Analysis
A.I. Burnazyan Federal Medical Biophysical 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
A meta-analysis of studies of the ‘Standardized mortality ratio’ (SMR, in % compared with the general population) indexes of overall mortality and mortality from all malignant neoplasms for nuclear workers (NW) from 15 countries (for 2007), as well as for workers dealing with the most toxic heavy metals (Hg, Cd, Pb, Cu) and beta-naphthylamine (a carcinogenic antioxidant previously used in the manufacture of paints) was carried out. For NW, a ‘Healthy worker effect’ (HWE) was found for both indexes (SMR = 62 (95 % CI: 56; 69) and 74 (95 % CI: 69; 78), respectively). The obtained SMR values for NW were compared with data for other professional groups (the results of meta-analyses and individual studies with maximum and minimum SMR values: from cosmonauts/astronauts, pilots and athletes, to work with chemical compounds in general or with their individual types (solvents, heavy metals, beta-naphthylamine), as well as with asbestos. It was found that the level of HWE for NW is comparable to that for one group of athletes and is significantly (1.30–1.45 times) higher than for chemical production personnel, although the combined data for NW is not final.
For workers in the chemical industry as a whole, according to published meta-analyses, HWE was also found in SMR, but weak: the value for total mortality was 90 (95 % CI: 87; 92). At the same time, mortality from all malignant neoplasms compared with the population did not reveal a clear HWE, but was not increased either. The most harmful types of employment are, on the rise, work with heavy metals, in coal mines, with beta-naphthylamine and with asbestos.
The data obtained eliminates the prevailing stereotypes and can improve the image of employment in the nuclear and chemical industries in general.
Keywords: standardized mortality ratio, healthy worker effect, nuclear industry, chemical industry, heavy metals, beta-naphthylamine, meta-analysis
For citation: Koterov AN, Ushenkova LN, Kalinina MV, Biryukov AP. The ‘Healthy Worker Effect’ on Indexes of Total Mortality and Malignant Neoplasms Mortality for Nuclear and Chemical Workers: Meta-Analysis. Medical Radiology and Radiation Safety. 2023;68(4):43–50. (In Russian). DOI:10.33266/1024-6177-2023-68-4-43-50
References
1. Monson R.R. Observations on the Healthy Worker Effect. J. Occup. Med. 1986;28;6:425–433. https://doi.org/10.1097/00043764-198606000-00009.
2. Ogle W. Letter to the Registrar-General on the Mortality in the Registration Districts of England and Wales During the Ten Years 1871–80. Supplement to the 45th Annual Report of the Registrar-General of Births, Deaths, and Marriages, in England. London, 1885. P. 23.
3. 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.
4. Trubetskov A.D., Zhirov K.S. ‘The Effect of Healthy Worker’ in Various Areas of Occupational Medicine: the Publications Review. Problemy Sotsialnoy Gigiyeny, Zdravookhraneniya i Istorii Meditsiny = Problems of Social Hygiene, Public Health and History of Medicine. 2021;29;2:254–259. https://doi.org/10.32687/0869-866X-2021-29-2-254-259 (In Russ.).
5. Demographic and Social Statistics T.5. Entsiklopediya statisticheskikh terminov. V 8-mi t. = Encyclopedia of Statistical Terms. In 8 Volumes. Moscow Publ., 2011. 482 p. (In Russ.).
6. Samorodskaya I.V., Semenov V.Yu. Malignant Neoplasms Mortality Rates in Moscow and Saint Petersburg in 2015 and 2018. Sovremennaya Onkologiya = Journal of Modern Oncology. 2020;22;3:79–84. https://doi.org/10.26442/18151434.2020.3.200192 (In Russ.).
7. Drapkina O.M., Samorodskaya I.V., Bolotova E.V., Dudnikova A.V. Analysis of the Dynamics of Mortality from Respiratory Diseases in the Russian Federation for 2019–2020. Terapevticheskiy Arkhiv = Therapeutic Archive. 2022;94;3:401–408. https://doi.org/10.26442/00403660.2022.03.201403 (In Russ.).
8. Tikhonova G.I., Piktushanskaya T.E., Gorchakova T.Yu., Churanova A.N., Bryleva M.S. Influence of Duration and Intensity of Exposure to Occupational Hazards on Mortality Levels of Coal Miners. Meditsina Truda i Promyshlennaya Ekologiya = Russian Journal of Occupational Health and Industrial Ecology. 2018;7:16–21. https://doi.org/10.31089/1026-9428-2021-61-9-580-587
(In Russ.).
9. Mastrangelo G., Marzia V., Marcer G. Reduced Lung Cancer Mortality in Dairy Farmers: is Endotoxin Exposure the Key Factor? Am. J. Ind. Med. 1996;30;5:601–609. https://doi.org/110.1002/(SICI)1097-0274(199611)30:5<601::AID-AJIM8>
3.0.CO;2-V.
10. A Dictionary of Epidemiology. Ed. Last J.M. Oxford, Oxford University Press, 2001.
11. Vlasov V.V. Epidemiologiya = Epidemiology. Textbook. Moscow, GEOTAR-Media Publ., 2006. 464 p. (In Russ.).
12. Guidelines for the Development of Regional Demographic Development Programs. Moscow Publ., 2012. 50 p. (In Russ.).
13. Fox A.J., Collier P.F. Low Mortality Rates in Industrial Cohort Studies Due to Selection for Work and Survival in the Industry. Br. J. Prev. Soc. Med. 1976;30;4:225–230. https://doi.org/10.1136/jech.30.4.225.
14. Wen C.P., Tsai S.P., Gibson R.L. Anatomy of the Healthy Worker Effect: a Critical Review. J. Occup. Med. 1983;25;4:283–289.
15. Sheikh K. A Review of the Healthy Worker Effect in Occupational Epidemiology. Occup. Med. (Lond). 2000;50;2:146. https://doi.org/10.1093/occmed/50.2.146.
16. Roessler M. Can We Trust the Standardized Mortality Ratio? A Formal Analysis and Evaluation Based on Axiomatic Requirements. PLoS One. 2021;16;9:e0257003. https://doi.org/10.1371/journal.pone.0257003.
17. Gaffey W.R. A Critique of the Standardized Mortality Ratio. J. Occup. Med. 1976;18;3:157–160. https://doi.org/10.1097/00043764-197603000-00007.
18. Monson R.R. Observations on the Healthy Worker Effect. J. Occup. Med. 1986;28;6:425–433. https://doi.org/10.1097/00043764-198606000-00009.
19. Guidotti T.L. The Handbook of Occupational and Environmental Medicine: Principles, Practice, and Problem-Solving. In 2 Volumes. Praeger-ABC-CLIO, LLC. 2020. 1212 p.
20. Metz-Flamant C., Rogel A., Caer S., Samson E., Laurier D., Acker A., Tirmarche M. Mortality among Workers Monitored for Radiation Exposure at the French Nuclear Fuel Company. Arch. Environ Occup. Health. 2009;64;4:242–250. https://doi.org/10.1080/19338240903348246.
21. Bond G.G., Bodner K.M., Olsen G.W., Cook R.R. Mortality among Workers Engaged in the Development or Manufacture of Styrene-Based Products: an Update. Scand J. Work Environ Health. 1992;18;3:145–154. https://doi.org/10.5271/sjweh.1594.
22. Beckman I.N. Yadernaya Industriya = Nuclear Industry. Lecture Course. Moscow Publ., 2005. 867 p. (In Russ.).
23. Kirkeleit J., Riise T., Bjorge T., Christiani D.C. The Healthy Worker Effect in Cancer Incidence Studies. Am. J. Epidemiol. 2013;177;11:1218–1224. https://doi.org/10.1093/aje/kws373.
24. Breslow N.E., Day N.E. Statistical Methods in Cancer Research. V.II. The Design and Analysis of Cohort Studies. Lyon, World Health Organization, 1987. P. 17–20.
25. Carpenter L.M. Some Observations on the Healthy Worker Effect. Br. J. Ind. Med. 1987;44;5:289–291. https://doi.org/10.1136/oem.44.5.289.
26. Li C.Y., Sung F.C. A Review of the Healthy Worker Effect in Occupational Epidemiology. Occup. Med. (Lond). 1999;49;4:225–229. https://doi.org/10.1093/occmed/49.4.225.
27. Koshurnikova N.A., Buldakov L.A., Bysogolov G.D., Bolotnikova M.G., Komleva N.S., Peternikova V.S. Mortality from Malignancies of the Hematopoietic and Lymphatic Tissues among Personnel of the First Nuclear Plant in the USSR. Sci. Total. Environ. 1994;142;1–2:19–23. https://doi.org/10.1016/0048-9697(94)90068-x.
28. Koshurnikova N.A., Bolotnikova M.G., Gruzdeva E.A., Kabirova N.R., Kreslov V.V., Okatenko P.V., et al. Late Effects of Occupational Radiation Exposure (Mortality in Personnel of ‘Mayak’ Complex for 45 Years of Follow-Up). Radiatsiya i Risk = Radiation and Risk. 1995;5:137–44 (In Russ.).
29. Koshurnikova N.A., Bysogolov G.D., Bolotnikova M.G., Khokhryakov V.F., Kreslov V.V., Okatenko P.V. et al. Mortality among Personnel who Worked at the Mayak Complex in the First Years of Its Operation. Health Phys. 1996;71;1:90–93. https://doi.org/10.1097/00004032-199607000-00015.
30. Koshurnikova N.A., Okatenko P.V., Sokolnikov M.E., Vasilenko E.K., Khokhryakov V.V. Medical Consequences of the Professional Exposure: Carcinogenic Risk in the Cohort of ‘Mayak’ PA Workers. Medits. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2008;53;3:23–33 (In Russ.).
31. Azizova T.V., Batistatou E., Grigorieva E.S., et al. An Assessment of Radiation-Associated Risks of Mortality from Circulatory Disease in the Cohorts of Mayak and Sellafield Nuclear Workers. Radiat. Res. 2018;189;4:371–388. https://doi.org/10.1667/RR14468.1.
32. Greenberg R.S., Mandel J.S., Pastides H., Britton N.L., Rudenko L., Starr T.B. A Meta-Analysis of Cohort Studies Describing Mortality and Cancer Incidence among Chemical Workers in the United States and Western Europe. Epidemiology. 2001;12;6:727–740. https://doi.org/10.1097/00001648-200111000-00023.
33. Chen R., Seaton A. A Meta-Analysis of Mortality among Workers Exposed to Organic Solvents. Occup. Med. 1996;46:337–344. https://doi.org/10.1093/occmed/46.5.337.
34. Rothman K.J. Cancer Occurrence among Workers Exposed to Acrylonitrile. Scand. J. Work Environ Health. 1994;20;5:313–321. doi: 10.5271/sjweh.1391.
35. Alder N., Fenty J., Warren F., et al. Meta-Analysis of Mortality and Cancer Incidence among Workers in the Synthetic Rubber-Producing Industry. Am. J. Epidemiol. 2006;164;5:405–420. https://doi.org/10.1093/aje/kwj252.
36. Morfeld P., Mundt K.A., Dell L.D., Sorahan T., McCunney R.J. Meta-Analysis of Cardiac Mortality in Three Cohorts of Carbon Black Production Workers. Int. J. Environ Res. Public. Health. 2016;13;3:302. doi: 10.3390/ijerph13030302.
37. Vrijheid M., Cardis E., Blettner M., Gilbert E., Hakama M., Hill C., et al. The 15-Country Collaborative Study of Cancer Risk Among Radiation Workers in the Nuclear Industry: Design, Epidemiological Methods and Descriptive Results. Radiat. Res. 2007;167;4:361–379. https://doi.org/10.1667/RR0554.1.
38. Cassidy L.D., Youk A.O., Marsh G.M. The Drake Health Registry Study: Cause-Specific Mortality Experience of Workers Potentially Exposed to Beta-Naphthylamine. Am. J. Ind. Med. 2003;44;3:282–290. https://doi.org/10.1002/ajim.10268.
39. Higgins J.P., Thompson S.G., Deeks J.J., Altman D.G. Measuring Inconsistency in Meta-Analyses. Brit. Med. J. 2003;327;7414:557–560. https://doi.org/10.1136/bmj.327.7414.557.
40. 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. https://doi.org/10.1093/ije/28.1.1.
41. Sterne J.A., Egger M., Smith G.D. Systematic Reviews in Health Care: Investigating and Dealing with Publication and Other Biases in Meta-Analysis. Br. Med. J. 2001;323;7304:101–105. https://doi.org/10.1136/bmj.323.7304.101.
42. Axelson O. Negative and Non-Positive Epidemiological Studies. Int. J. Occup. Med. Environ. Health. 2004;17;1:115–121.
43. Gerosa A., Ietri E., Belli S., Grignoli M., Comba P. High Risk of Pleural Mesothelioma among the State Railroad Carriage Repair Workers. Epidemiol. Prev. 2000;24;3:117–119 (In Italian.).
44. Miller B.G., MacCalman L. Cause-Specific Mortality in British Coal Workers and Exposure to Respirable Dust and Quartz. Occup. Environ. Med. 2010;67;4:270–276. https://doi.org/10.1136/oem.2009.046151.
45. Nakashima E., Neriishi K., Minamoto A. A Reanalysis of Atomic-Bomb Cataract Data, 2000–2002: a Threshold Analysis. Health Phys. 2006;90;2:154–160. https://doi.org/10.1097/01.hp.0000175442.03596.63.
46. Neriishi K., Nakashima E., Minamoto A., Fujiwara S., Akahoshi M., Mishima H.K., et al. Postoperative Cataract Cases among Atomic Bomb Survivors: Radiation Dose Response and Threshold. Radiat. Res. 2007;168;4:404–408. https://doi.org/10.1667/RR0928.1.
47. Juel K. High Mortality in the Thule Cohort: an Unhealthy Worker Effect. Int. J. Epidemiol. 1994;23;6:1174–1178. https://doi.org/10.1093/ije/23.6.1174.
48. Ushakov I.B., Voronkov Y.I., Bukhtiyarov I.V. Tikhonova G.I., Gorchakova T.Yu., Bryleva M.S. A Cohort Mortality Study among Soviet and Russian Cosmonauts, 1961–2014. Aerosp. Med. Hum. Perform. 2017;88;12:1060–1065. https://doi.org/10.3357/AMHP.4701.2017.
49. Reynolds R.J., Day S.M. Mortality of US Astronauts: Comparisons with Professional Athletes. Occup. Environ. Med. 2019;76;2:114–117. https://doi.org/10.1136/oemed-2018-105304.
50. Gajewski A.K., Poznanska A. Mortality of Top Athletes, Actors and Clergy in Poland: 1924-2000 Follow-Up Study of the Long Term Effect of Physical Activity. Eur. J. Epidemiol. 2008;23;5:335–340. https://doi.org/10.1007/s10654-008-9237-3.
51. Hammer G.P., Auvinen A., De Stavola B.L., Grajewski B., Gundestrup M., Haldorsen T., et al. Mortality from Cancer and Other Causes in Commercial Airline Crews: a Joint Analysis of Cohorts from 10 Countries. Occup. Environ. Med. 2014;71;5:313–322. https://doi.org/10.1136/oemed-2013-101395.
52. McLaughlin R., Nielsen L., Waller M. An Evaluation of the Effect of Military Service on Mortality: Quantifying the Healthy Soldier Effect. Ann. Epidemiol. 2008;18;12:928–936. https://doi.org/10.1016/j.annepidem.2008.09.002.
53. Alif S.M., Sim M.R., Ho C., Glass D.C. Cancer and Mortality in Coal Mine Workers: a Systematic Review and Meta-Analysis. Occup. Environ. Med. 2022;79;5:347–357. https://doi.org/10.1136/oemed-2021-107498.
54. Luberto F., Ferrante D., Silvestri S., Angelini A., Cuccaro F., Nannavecchia A.M., et al. Cumulative Asbestos Exposure and Mortality from Asbestos Related Diseases in a Pooled Analysis of 21 Asbestos Cement Cohorts in Italy. Environ Health. 2019;18;1:71. https://doi.org/10.1186/s12940-019-0510-6.
55. Piolatto G., Negri E., La Vecchia C., Pira E., Decarli A., Peto J. An Update of Cancer Mortality among Chrysotile Asbestos Miners in Balangero, Northern Italy. Br. J. Ind. Med. 1990;47;12:810–814. https://doi.org/10.1136/oem.47.12.810.
56. Dement J.M., Harris R.L.Jr., Symons M.J., Shy C.M. Exposures and Mortality among Chrysotile Asbestos Workers. Part II: Mortality. Am. J. Ind. Med. 1983;4;3:421–433. https://doi.org/10.1002/ajim.4700040304.
57. Duffus J.H. ‘Heavy Metals’— a Meaningless Term? Pure and Applied Chemistry. 2002:74;5:793–807. http://dx.doi.org/10.1351/pac200274050793.
58. Srivastava N.K., Majumder C.B. Novel Biofiltration Methods for the Treatment of Heavy Metals from Industrial Wastewater. J. Hazard Mater. 2008;151;1:1–8. https://doi.org/10.1016/j.jhazmat.2007.09.101.
59. Koterov A.N., Ushenkova L.N., Kalinina M.V., Biryukov A.P. Brief Review of World Researches of Radiation and Non-Radiation Effects in Nuclear Industry Workers. Mediko-Biologicheskiye Problemy Zhiznedeyatelnosti = Medical and Biological Problems of Life Activity. 2020;1:17–31 (In Russ.).
60. Skriver M.V., Vaeth M., Stovring H. Loss of Life Expectancy Derived from a Standardized Mortality Ratio in Denmark, Finland, Norway and Sweden. Scand. J. Public Health. 2018;46;7:767–773. https://doi.org/10.1177/1403494817749050.
61. Tsai S.P., Hardy R.J., Wen C.P. The Standardized Mortality Ratio and Life Expectancy. Am. J. Epidemiol. 1992;135;7:824–831. https://doi.org/10.1093/oxfordjournals.aje.a116369.
62. Lai D., Guo F., Hardy R.J. Standardized Mortality Ratio and Life Expectancy: a Comparative Study of Chinese Mortality. Int. J. Epidemiol. 2000;29;5:852–855. https://doi.org/10.1093/ije/29.5.852.
63. DeVivo M.J, Savic G., Frankel H.L., Jamous M.A., Soni B.M., Charlifue S., et al. Comparison of Statistical Methods for Calculating Life Expectancy after Spinal Cord Injury. Spinal Cord. 2018;56;7:666–673. https://doi.org/10.1038/s41393-018-0067-1.
64. Lutz W., Striessnig E., Dimitrova A., Ghislandi S., Lijadi A., Reiter C., et al. Years of Good Life Is a Well-Being Indicator Designed to Serve Research on Sustainability. Proc. Natl. Acad. Sci. USA. 2021;118;12:e1907351118. https://doi.org/10.1073/pnas.1907351118.
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: 20.02.2022. Accepted for publication: 27.03.2023.
Medical Radiology and Radiation Safety. 2023. Vol. 68. № 4
DOI: 10.33266/1024-6177-2023-68-4-51-57
A.N. Menyajlo, S.Yu. Chekin, M.A. Maksioutov, E.V. Kochergina, O.K. Vlasov,
N.V. Shchukina, P.V. Kascheeva
Forecast of Radiation Risks of Thyroid Cancer among the Population of Areas of the Bryansk Region Contaminated as a Result of the Accident at the Chernobyl Nuclear Power Plant, allowing for Uncertainties in Risk Model Estimates
A.F. Tsyb Medical Radiological Research Centre ‒ branch of the National Medical Research Radiological Centre, Obninsk, Russia
Contact person: A.N. Menyajlo, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: Forecasting the lifetime attributable radiation risk of incidence with malignant neoplasm (MN) of the thyroid gland and identifying groups of increased radiation risk (HR) for the population of the Bryansk region currently (at the beginning of 2023) living in six areas most contaminated with radionuclides after the accident at Chernobyl NPP, based on a conservative approach, taking into account dose uncertainty factors and parameters of mathematical risk models.
Material and methods: The mathematical model of the radiation risk of thyroid cancer is the model recommended by the International Commission on Radiological Protection (ICRP). The uncertainty assessment of radiation risks was carried out by simulation modeling, i.e. by multiple calculation of random realizations of the risk using the normal or log-normal distribution of all parameters involved in the calculation of this risk. Based on a set of random realizations, 95 % confidence limits of risks were estimated. The Unified Federal Database of the National Radiation and Epidemiological Register (NRER) containing reconstructed absorbed doses in the thyroid gland in the population was used as the initial data for the calculation.
Results: At the beginning of 2023, the group of 37–40-year-old women is characterized by the maximum radiation risks of thyroid cancer. According to conservative estimates (according to the upper 95 % confidence limits of radiation risk assessments), up to 19.9 % of people from this group may experience the development of radiation-induced thyroid cancer in the future, and for 37-year-old women this proportion can be up to 30.0 %. The greatest risk is predicted for people living in the Krasnogorsk district of the Bryansk region. Radiation-induced thyroid cancer can develop in 40.1 % of individuals from this group. Radiation risks of thyroid cancer in men are up to 10 times lower than in women. For 74.5 % of the population of the entire studied cohort, it is predicted that the maximum individual risk of 5.0×10-5, established by NRB-99/2009 for the population under normal operation of ionizing radiation sources, will be exceeded.
Conclusions: At present (since 2023 and for life), the population of the most polluted districts of the Bryansk region continues to be at a high risk of developing radiation-induced thyroid cancers. Women at the age of 0–3 years at the time of exposure (in 1986) should be allocated to the maximum risk group. The results of this work can be used in the preparation of recommendations by health authorities to improve medical monitoring of exposed citizens.
Keywords: lifetime attributable risk, Chernobyl accident, malignant neoplasm, thyroid gland, population of contaminated territories, radiation risk models, absorbed dose
For citation: Menyajlo AN, Chekin SYu, Maksioutov MA, Kochergina EV, Vlasov OK, Shchukina NV, Kascheeva PV. Forecast of Radiation Risks of Thyroid Cancer among the Population of Areas of the Bryansk Region Contaminated as a Result of the Accident at the Chernobyl Nuclear Power Plant, allowing for Uncertainties in Risk Model Estimates. Medical Radiology and Radiation Safety. 2023;68(4):51–57. (In Russian). DOI:10.33266/1024-6177-2023-68-4-51-57
References
1. International Atomic Energy Agency. The International Nuclear and Radiological Event Scale. User’s Manual 2008 Edition. Vienna, IAEA, 2013. 218 p.
2. Health Risk Assessment from the Nuclear Accident after the 2011 Great East Japan Earthquake and Tsunami Based on a Preliminary Dose Estimation. World Health Organization, 2013. 172 p.
3. ICRP Publication 103. Eds. Kiselev M.F., Shandala N.K. Moscow Publ., 2009. 312 p. URL: http://www.icrp.org/docs/P103_Russian.pdf. (Accessed 06.12.2022) (In Russ.).
4. Meditsinskiye Radiologicheskiye Posledstviya Chernobylya: Prognoz i Fakticheskiye Dannyye Spustya 30 Let = Medical Radiological Consequences of Chernobyl: Forecast and Actual Data after 30 Years. Ed. Ivanov V.K., Kaprin A.D. Moscow, GEOS Publ., 2015. 450 p. (In Russ.).
5. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) 2012 Report to the General Assembly with Scientific Annexes. Scientific Annex B. Uncertainties in Risk Estimates for Radiation-Induced Cancer. New York, United Nation, 2014. 219 p.
6. Sasaki M., Ogino H., Hattori T. Quantitative Evaluation of Conservatism in the Concept of Committed Dose from Internal Exposure for Radiation Workers. J. Radiol. Prot. 2021;41;4:1328–1343. DOI: 10.1088/1361-6498/ac057f.
7. Ramzayev P.V., Balonov M.I., Zvonova I.A., Bratilova A.A., TSyb A.F., Pitkevich V.A., Stepanenko V.F., SHishkanov N.G., Ilin L.A., Gavrilin YU.I. Rekonstruktsiya Dozy Izlucheniya Radioizotopov Yoda v Shchitovidnoy Zheleze Zhiteley Naselennykh Punktov Rossiyskoy Federatsii, Podvergshikhsya Radioaktivnomu Zagryazneniyu Vsledstviye Avarii na Chernobylskoy AES v 1986 Godu = Reconstruction of the Radiation Dose of Iodine Radioisotopes in the Thyroid Gland of Residents of Settlements of the Russian Federation Exposed to Radioactive Contamination as a Result of the Accident at the Chernobyl Nuclear Power Plant in 1986. Guidelines MU2.6.1.1000-00. Moscow Publ., 2001 (In Russ.).
8. Balonov M.I., Zvonova I.F., Bratilova A.A., Zhesko T.B., Vlasov O.K., Shishkanov N.G., Shchukina N.V. Average Exposure Doses of the Thyroid Gland of Residents of Different Ages who Lived in 1986 in the Settlements of the Bryansk, Tula, Oryol and Kaluga Regions Contaminated with Radionuclides Due to the Accident at the Chernobyl Nuclear Power Plant. Radiatsiya i Risk = Radiation and Risk. 2002;Special issue:1–96 (In Russ.).
9. Zlokachestvennyye Novoobrazovaniya v Rossii v 2019 Godu (Zabolevayemost i Smertnost) = Malignant Tumors in Russia in 2019 (Morbidity and Mortality). Ed. Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. Moscow Publ., 2020. 252 p. (In Russ.).
10. Preston D.L., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M., Mabuchi K., Kodama K. Solid Cancer Incidence in Atomic Bomb Survivors: 1958-1998. Radiat. Res. 2007;168;1:1–64. DOI: 10.1667/RR0763.1.
11. Radiation Safety Standards (NRB-99/2009). Sanitary Rules and regulations. SanPin 2.6.1.2523-09. Moscow Publ., 2009. 100 p. (In Russ.).
12. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Sources and effects of ionizing radiation. UNSCEAR 2006 Report Vol. I, Annex A: Epidemiological Studies of Radiation and Cancer. New York, United Nation, 2008.
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: 20.02.2022. Accepted for publication: 27.03.2023.
Medical Radiology and Radiation Safety. 2023. Vol. 68. № 4
DOI: 10.33266/1024-6177-2023-68-4-69-74
M.V. Lukin, A.Yu. Efimtsev, A.A. Borshevetskaya, L.E. Galyautdinova,
V.P. Ivanov, S.V. Trusheleva, E.O. Sereda, A.M. Shchetinina, A.V. Kim
Radiation Diagnostics of Ischemic Stroke
in Pediatric Practice: an Approach in the SARS-CoV2 Pandemic
V.A. Almazov National Medical Research Centre, Saint Petersburg, Russia
Contact person: M.V. Lukin, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Stroke is a condition of acute cerebrovascular accident (ACV), with neurological symptoms corresponding that last more than 24 hours. This condition can lead to severe disability, persistent disorders motor and cognitive functions, and even death of the child. The most common causes of strokes in children: aneurysms, vascular malformations, neuroinfections, rheumatological and oncological diseases. As the epidemic COVID-19 spreads, its pathogenetic mechanisms have been identified that contribute to the development of ACV, including in children. These mechanisms may also play a role in the development of ACV in the course of other acute respiratory viral infections. Technological development and increasing availability of magnetic resonance imaging (MRI) and computed tomography (CT) allows to detect strokes at the earliest stages. A comprehensive examination, including clinical, laboratory, instrumental examination data, neuroimaging techniques, is necessary for the verification and pathogenetic treatment of ACV in children and adults.
This article describes the problems of early diagnosis of childhood stroke and the features of choosing a radiological method of research. Below is a clinical case of an 11-year-old patient with a genetically determined tendency to thrombosis, who had previously suffered an acute respiratory disease, with consequences in the form of an ischemic stroke in the basin of the left middle cerebral artery - in the area of blood supply to the anterior choroidal artery.
Keywords: stroke in children, MRI, CT, COVID-19, acute respiratory disease
For citation: Lukin MV, Efimtsev AYu, Borshevetskaya AA, Galyautdinova LE, Ivanov VP, Trusheleva SV, Sereda EO, Shchetinina AM, Kim AV. Radiation Diagnostics of Ischemic Stroke in Pediatric Practice: an Approach in the SARS-CoV2 Pandemic. Medical Radiology and Radiation Safety. 2023;68(4):69–74. (In Russian). DOI:10.33266/1024-6177-2023-68-4-69-74
References
1. World Health Statistics 2021: Monitoring Health for the SDGs, Sustainable Development Goals. ISBN 978-92-4-002705-3 (Online), ISBN 978-92-4-002706-0 (Print).
2. Zmeyeva E.V., Zmeyev S.A., Lyutaya E.D. Algorithm for the Emergency Beam Diagnostics of a Stroke Under Conditions of a Modern Hospital. Vestnik VolGMU = Journal of VolgSMU. DOI 10.19163/1994-9480-2020-3(75)-112-116 (In Russ.).
3. Turney C., Wang W., Seiber E., Lo W. Acute Pediatric Stroke: Contributors to Institutional Cost. Stroke. 2011;42:11:3219-3225.
4. Fullerton H.J., Wu Y.W., Zhao S., Johnston S.C. Risk of Stroke in Children: Ethnic and Gender Disparities. Neurology. 2003;61;2:189–194. doi: 10.1212/01.wnl.0000078894.79866.95.
5. Zahuranec D.B., Brown D.L., Lisabeth L.D., Morgenstern L.B. Is It Time for a Large, Collaborative Study of Pediatric Stroke? Stroke. 2005;36;9:1825–1829.
6. Mackay M.T., Wiznitzer M., Benedict S.L., Lee K.J., Deveber G.A., Ganesan V., International Pediatric Stroke Study Group. Arterial Ischemic Stroke Risk Factors: the International Pediatric Stroke Study. Ann. Neurol. 2011;69;1:130-140. doi: 10.1002/ana.22224.
7. Liang W., Liang H., Ou L., et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern. Med. 2020;180;8:1081-1089. https://doi.org/10.1001/jamainternmed.2020.2033.
8. Putilina M.V., Vechorko V.I., Grishin D.V., Sidelnikova L.V. Acute Cerebrovascular Accidents Associated with Sars-Cov-2 Coronavirus Infection (Covid-19). Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = The Korsakov’s Journal of Neurology and Psychiatry. 2020;120;12:109–117. DOI: 10.17116/jnevro2020120121109 (In Russ.).
9. Lindan C.E., Mankad K., Ram D., Kociolek L.K., Silvera V.M., Boddaert N., Stivaros S.M., Palasis S., ASPNR PECOBIG Collaborator Group. Neuroimaging Manifestations in Children with SARS-CoV-2 Infection: a Multinational, Multicentre Collaborative Study. Lancet Child. Adolesc. Health. 2021;5;3:167–177. doi: 10.1016/S2352-4642(20)30362-X.
10. Rukhsar Shabir Osman, et al. SARS-CoV-2 Precipitating a Stroke in a Child? A Case Report from Tanzania. Pan African Medical Journal. 2022;42;33. Doi: 10.11604/pamj.2022.42.33.33018.
11. Tiwari L., Shekhar S., Bansal A., Kumar S. COVID-19 Associated Arterial Ischaemic Stroke and Multisystem Inflammatory Syndrome in Children: a Case Report. Lancet Child. Adolesc. Health. 2021;5;1:88-90. doi: 10.1016/S2352-4642(20)30314-X.
12. Zhang S., Zhang J., Wang C., Chen X., Zhao X., Jing H., Liu H., Li Z., Wang L., Shi J. COVID-19 and Ischemic Stroke: Mechanisms of Hypercoagulability (Review). Int. J. Mol. Med. 2021;47;3:21. doi: 10.3892/ijmm.2021.4854.
13. Khaytovich A.B., Ermachkova P.A. Pathogenesis of COVID-19. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2020;23;4:113-132. DOI: 10.37279/2070-8092-2020-23-4-113-132 (In Russ.).
14. Powers W.J., Rabinstein A.A., Ackerson T., Adeoye O.M., Bambakidis N.C., Becker K., Biller J., Brown M., Demaerschalk B.M., Hoh B., Jauch E.C., Kidwell C.S., Leslie-Mazwi T.M., Ovbiagele B., Scott P.A., Sheth K.N., Southerland A.M., Summers D.V., Tirschwell D.L. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019;50;12:e344-e418. doi: 10.1161/STR.0000000000000211.
15. Muir K.W., Buchan A., von Kummer R., Rother J. Imaging of Acute Stroke. Lancet Neurol. 2006;5;9:755-768. doi: 10.1016/S1474-4422(06)70545-2.
16. Wintermark M., Rowley H.A., Lev M.H. Acute Stroke Triage to Intravenous Thrombolysis and Other Therapies with Advanced CT or MR Imaging: Pro CT. Radiology. 2009;251;3:619–626. doi: 10.1148/radiol.2513081073.
17. Köhrmann M., Schellinger P.D. Acute Stroke Triage to Intravenous Thrombolysis and Other Therapies with Advanced CT or MR Imaging: Pro MR Imaging. Radiology. 2009;251;3:627–633. doi: 10.1148/radiol.2513081074.
18. Sergeyev D.V., Lavrentyeva A.N., Krotenkova M.V. CT-Perfusion in Acute Ischemic Stroke. Annaly Klinicheskoy i Eksperimentalnoy Nevrologii = Annals of Clinical and Experimental Neurology. 2008;2;3. DOI: https://doi.org/10.17816/psaic397 (In Russ.).
19. Vilela P., Rowley H.A. Brain Ischemia: CT and MRI Techniques in Acute Ischemic Stroke. Eur. J. Radiol. 2017;96:162-172. doi: 10.1016/j.ejrad.2017.08.014.
20. Сhen J., Licht D.J., Smith S.E., Agner S.C., Mason S., Wang S., Silvestre D.W., Detre J.A., Zimmerman R.A., Ichord R.N., Wang J. Arterial Spin Labeling Perfusion MRI in Pediatric Arterial Ischemic Stroke: Initial Experiences. J. Magn. Reson. Imaging. 2009;29;2:282-290. doi: 10.1002/jmri.21641.
21. Lanni G., Catalucci A., Conti L., Di Sibio A., Paonessa A., Gallucci M. Pediatric Stroke: Clinical Findings and Radiological Approach. Stroke Res. Treat. 2011;2011:172168. doi: 10.4061/2011/172168.
22. Oppenheim C., Naggara O., Arquizan C., Brami-Zylberberg F., Mas J.L., Meder J.F., Frédy D. [MRI of Acute Ischemic Stroke]. J. Radiol. 2005;86;9 Pt 2:1069-1078 (In French.). doi: 10.1016/s0221-0363(05)81495-7.
23. Bohmer M., Niederstadt T., Heindel W., et al. Impact of Childhood Arterial Ischemic Stroke Standardized Classification and Diagnostic Evaluation Classification on Further Course of Arteriopathy and Recurrence of Childhood Stroke. Stroke. 2019;50;1:83–87. DOI: 10.1161/STROKEAHA.118.023060.
24. Beslow L.A., Linds A.B., Fox C.K., et al. International Pediatric Stroke Study Group. Pediatric Ischemic Stroke: An Infrequent Complication of SARS-CoV-2. Ann. Neurol. 2021;89;4:657–665. DOI: 10.1002/ana.25991.
25. Appavu B., Deng D., Dowling M.M., et al. Arteritis and Large Vessel Occlusive Strokes in Children after COVID-19 Infection. Pediatrics. 2021;147;3:e2020023440. DOI: 10.1542/peds.2020-023440.
26. Shchetinina A.M., Ivanov V.P., Kim A.V., Ivanova G.G., Malko V.A., Alekseyeva T.M. Ischemic Stroke in a Pediatric Patient: Complication of the Course of COVID-19 (Clinical Case and Literature Review). Russkiy Zhurnal Detskoy Nevrologii = Russian Journal of Child Neurology. 2022;17;2:47-54. https://doi.org/10.17650/2073-8803-2022-17-2-47-54 (In Russ.).
27. Kalashnikova L.A., Dobrynina L.A., Legenko M.S. Primary Central Nervous System Vasculitis. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = The Korsakov’s Journal of Neurology and Psychiatry. 2019;119;8:113-123. https://doi.org/10.17116/jnevro2019119081113 (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: 20.02.2022. Accepted for publication: 27.03.2023.
Medical Radiology and Radiation Safety. 2023. Vol. 68. № 4
DOI: 10.33266/1024-6177-2023-68-4-58-68
S.Yu. Chekin, A.I. Gorski, M.A. Maksioutov, S.V. Karpenko,
N.V. Shchukina, E.V. Kochergina, O.E. Lashkova, N.S. Zelenskaya
Assessment of Radiation Risks of Cataract Morbidity Among Liquidators of the Consequences of the Accident at the Chernobyl Nuclear Power Plant, Allowing for Impact of Concomitant Diseases
A.F. Tsyb Medical Radiological Research Centre ‒ branch of the National Medical Research Radiological Centre, Obninsk, Russia
Contact person: S.Yu. Chekin, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: To assess the radiation risk of cataracts among the Chernobyl clean-up workers (liquidators), considering the impact of concomitant diseases on this risk and to determine the dose threshold for the development of cataracts.
Material and methods: Radiation risks of cataract incidence were studied in the cohort of liquidators of the consequences of the accident at the Chernobyl nuclear power plant, observed in the system of the National Radiation and Epidemiological Register (NRER) from 1986 to 2021. Among the 62,828 male liquidators, 9,461 new cases of cataracts were detected. The average age of the liquidators at the beginning of exposure was 34 years, the average absorbed dose of external gamma exposure of the whole body was 0.132 Gy, the maximum dose was 1.5 Gy, and the average duration of exposure was 2.5 months. To analyze the relationships of cataract incidence with other diseases and with the dose, a statistical method of link analysis, free from the type of distribution, as well as logistic regression models, were used.
Results: The radiation risk of cataracts in the cohort of liquidators who did not have diagnoses of diabetes mellitus, hypoparathyroidism, malnutrition and myotonic disorders depends on the presence of concomitant diseases in the patient: glaucoma (ICD-10 H40–H42), hyperopia (H52.0), myopia (H52.1) or presbyopia (H52.4). For liquidators with comorbidities, radiation risk is statistically significant only 15 years after exposure, with an excess relative risk of ERR/Gy=0.46 with 90 % CI (0.06; 0.90). For liquidators without comorbidities, ERR/Gy decrease over time: from 4.42 with 90 % CI (0.72; 13.41) in the first 5 years, to zero risk 15 years after exposure. Nonparametric estimates of the relative risk (RR) of cataracts for the dose groups of liquidators are consistent with the estimates of ERR/Gy in the linear non-threshold (LNT) model. The determination of the dose threshold for cataracts according to the LNT model, in accordance with the recommendations of the ICRP, leads to estimates from 1.2 Gy to 13.3 Gy, depending on the presence or absence of cataract concomitant diseases in the liquidators.
Conclusions: At present, there are no epidemiological evidence for reducing the equivalent dose limit for the lens of the eye for occupational exposure in planned exposure situations at the level of 150 mSv per year, previously established by the recommendations of the ICRP in 2007 and the current Russian radiation safety standards NRB-99/2009.
Keywords: cataract, radiation risk, Chernobyl liquidators, National Radiation and Epidemiological Register, dose-effect relationship, linear non-threshold model, excess relative risk, excess absolute risk, dose threshold
For citation: Chekin SYu, Gorski AI, Maksioutov MA, Karpenko SV, Shchukina NV, Kochergina EV, Lashkova OE, Zelenskaya NS. Assessment of Radiation Risks of Cataract Morbidity Among Liquidators of the Consequences of the Accident at the Chernobyl Nuclear Power Plant, Allowing for Impact of Concomitant Diseases. Medical Radiology and Radiation Safety. 2023;68(4):58–68. (In Russian). DOI:10.33266/1024-6177-2023-68-4-58-68
References
1. ICRP. Statement on Tissue Reactions. ICRP ref 4825-3093-1464. Approved by the Commission on April 21, 2011. URL: https://www.icrp.org/docs/2011%20Seoul.pdf (Accessed 19.04.2023).
2. ICRP Publication 103. Ed. Kiselev M.F., Shandala N.K. Moscow, Alana Publ., 2009. 312 p. URL: http://www.icrp.org/docs/P103_Russian.pdf. (Accessed 19.04.2023) (In Russ.).
3. ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context. ICRP Publication 118. Ed. Akleyev A.V., Kiselev M.F.. Chelyabinsk, Kniga Publ., 2012. 384 p. URL: https://www.icrp.org/docs/P118_Russian.pdf. (Accessed 19.04.2023) (In Russ.).
4. Minamoto A., Taniguchi H., Yoshitani N., Mukai S., Yokoyama T., Kumagami T., Tsuda Y., Mishima H.K., Amemiya T., Nakashima E., Neriishi K., Hida A., Fujiwara S., Suzuki G., Akahoshi M. Cataract in Atomic Bomb Survivors. Int. J. Radiat. Biol. 2004;80;5:339–345. DOI: 10.1080/09553000410001680332.
5. Neriishi K., Nakashima E., Minamoto A., Fujiwara S., Akahoshi M., Mishima H.K., Kitaoka T., Shore R.E. Postoperative Cataract Cases among Atomic Bomb Survivors: Radiation Dose Response and Threshold. Radiat. Res. 2007;168;4:404–408. DOI: 10.1667/RR0928.1.
6. Azizova T.V., Bragin E.V., Hamada N., Bannikova M.V. Risk of Cataract Incidence in a Cohort of Mayak PA Workers Following Chronic Occupational Radiation Exposure. PLoS One. 2016;11;10:e0164357. DOI: 10.1371/journal.pone.0164357.
7. Mukesh B.N., Le A., Dimitrov P.N., Ahmed S., Taylor H.R., McCarty C.A. Development of Cataract and Associated Risk Factors: the Visual Impairment Project. Arch. Ophthalmol. 2006;124;1:79–85. DOI:10.1001/archopht.124.1.79.
8. Fernández J., Rodríguez-Vallejo M., Martínez J., Tauste A., Piñero D.P. From Presbyopia to Cataracts: a Critical Review on Dysfunctional Lens Syndrome. J. Ophthalmol. 2018;2018:4318405. DOI: 10.1155/2018/4318405.
9. Kiuchi Y., Yanagi M., Itakura K., Takahashi I., Hida A., Ohishi W., Furukawa R. Association between Radiation, Glaucoma Subtype, and Retinal Vessel Diameter in Atomic Bomb Survivors. Sci. Rep. 2019;9:8642. DOI: 10.1038/s41598-019-45049-7.
10. Hamada N., Azizova T.V., Little M.P. An Update on Effects of Ionizing Radiation Exposure on the Eye. Br. J. Radiol. 2020;93;1115:20190829. DOI:10.1259/bjr.20190829.
11. Katarakta Starcheskaya = Senile Cataract. Clinical Guidelines. Moscow Publ., 2020. 51 p. URL: https://cr.minzdrav.gov.ru/recomend/284_1. (Accessed 19.04.2023) (In Russ.).
12. Ivanov V.K., Maksyutov M.A., Tumanov K.A., Kochergina E.V., Vlasov O.K., Chekin S.Yu., Gorskiy A.I., Korelo A.M., Shchukina N.V., Zelenskaya N.S., Lashkova O. E., Ivanov S.A., Kaprin A.D. 35-Year Experience in the Functioning of the National Radiation and Epidemiological Registry as a State Information System for Monitoring the Radiological Consequences of the Chernobyl Accident. Radiatsiya i Risk = Radiation and Risk. 2021;30;1:7–39 (In Russ.).
13. International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). V.1 (Part 1). Geneva, WHO, 1995. 698 p. (In Russ.).
14. Package of Statistical Programs Statistics. URL: http://www.statsoft.ru. (Accessed 19.04.2023) (In Russ.).
15. Gorskiy A.I., Maksyutov M.A., Tumanov K.A., Vlasov O.K., Kochergina E.V., Zelenskaya N.S., Chekin S.Yu., Ivanov S.A., Kaprin A.D., Ivanov V.K. Analysis of Statistical Correlation between Radiation Dose and Cancer Mortality among the Population Residing in Areas Contaminated with Radionuclides after the Chernobyl Nuclear Power Station. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2019;64;6:5–11 (In Russ.).
16. Gorskiy A.I., Chekin S.Yu., Maksyutov M.A., Shchukina N.V., Kochergina E.V., Zelenskaya N.S., Lashkova O.E. Method for Assessing the Radiation Risks of the Solid Cancer Incidence Accounting for Possible Diagnostic Errors. Radiatsiya i Risk = Radiation and Risk. 2022;31;4:53–63 (In Russ.).
17. Breslow N.E., Day N.E. Statistical Methods in Cancer Research. V. II. The Design and Analysis of Cohort Studies. IARC Scientific Publication No 82. IARC, Lyon, 1987. 406 p.
18. Gorskiy A.I., Chekin S.Yu., Maksyutov M.A., Karpenko S.V., Tumanov K.A., Zelenskaya N.S., Lashkova O.E. Statistical Relationship between Radiation Dose and Radiation Risks Estimates for Non-Cancer Endocrine Diseases in Liquidators of the Chernobyl Accident with Account of Possible Wrong Diagnoses Established and Registered. Radiatsiya i Risk = Radiation and Risk. 2023;31;1:21–35 (In Russ.).
19. Nakashima E., Neriishi K., Minamoto A. A Reanalysis of Atomic-Bomb Cataract Data, 2000-2002: a Threshold Analysis. Health Phys. 2006;90;2:154–160. DOI: 10.1097/01.hp.0000175442.03596.63.
20. Worgul B.V., Kundiyev Y.I., Sergiyenko N.M., Chumak V.V., Vitte P.M., Medvedovsky C., Bakhanova E.V., Junk A.K., Kyrychenko O.Y., Musijachenko N.V., Shylo S.A., Vitte O.P., Xu S., Xue X., Shore R.E. Cataracts among Chernobyl Clean-Up Workers: Implications Regarding Permissible Eye Exposures. Radiat. Res. 2007;167;2:233–243. DOI: 10.1667/rr0298.1
21. Tukov A.R., Shafranskiy I.L., Prokhorova O.N., Ziyatdinov M.N. The Incidence of Cataracts and the Radiation Risk of Their Occurrence in Liquidators of the Chernobyl Accident, Workers in the Nuclear Industry. Radiatsiya i Risk = Radiation and Risk. 2019;28;1:37–46
(In Russ.).
22. Chodick G., Bekiroglu N., Hauptmann M., Alexander B.H., Freedman D.M., Doody M.M., Cheung L.C., Simon S.L., Weinstock R.M., Bouville A., Sigurdson AJ. Risk of Cataract after Exposure to Low Doses of Ionizing Radiation: a 20-Year Prospective Cohort Study among US Radiologic Technologists. Am. J. Epidemiol. 2008;168;6:620–631. DOI: 10.1093/aje/kwn171.
23. Bushmanov A.Yu., Biryukov A.P., Korovkina E.P., KretovA.S. The Analysis of Documentary Regulatory Base and Results Of Activity of Interdepartmental Advisory Councils on Establishment of the Causal Relationship of Diseases, Disability and Death of the Citizens of Russia Affected by Radiation Factors Owing to the Chernobyl Accident. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2016;61;3:103–108 (In Russ.).
24. Radiation Safety Standards (NRB-99/2009). Sanitary Rules and Regulations. SanPin 2.6.1.2523-09 Moscow Publ., 2009. 100 p. (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: 20.02.2022. Accepted for publication: 27.03.2023.
Medical Radiology and Radiation Safety. 2023. Vol. 68. № 4
DOI: 10.33266/1024-6177-2023-68-4-75-80
V.I. Kobylyansky1, T.V. Kudasheva2, M.G. Berezina2, T.M. Magomedov3
Studying the Aerodynamic Characteristics of the Macrotech
and Evaluation of the Possibilities of Its Use for Dynamic Aerosol Scintigraphy
1 Research Institute of Pulmonology, Moscow, Russia
2 Federal Scientific and Clinical Center, Moscow, Russia
3 Russian Research Institute of Physical, Technical and Radio Engineering Measurements, Zelenograd, Moscow region, Russia
Contact person: V.I. Kobylyansky, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Introduction: The leading protective mechanism of the lungs is the processes of deposition of inhaled substances and mucociliary clearance (MCC), the optimal method for studying which is dynamic radioaerosol scintigraphy. are not available on the market. The applicant in this regard for a number of characteristics is the radiopharmaceutical from albumin, produced in the Russian Federation under the brand name Macrotech (M). It is used for perfusion scintigraphy to verify primarily pulmonary embolism and its ability to study deposition of inhalants and MCC has not been studied.
Purpose: To study the aerodynamic properties of M dispersion and to determine the possibilities of its use for dynamic radioaerosol scintigraphy of the lungs in order to assess the processes of deposition of inhaled substances and MCC.
Material and methods: To study the aerodynamic properties of M, on which the assessment of the deposition of inhaled substances and MCC significantly depends, we studied the dispersion of its particles in different states, and studied them in shape and morphology. An ultrasonic inhaler TuR USI-50 (Germany) generated an aerosol from a suspension of M in distilled water. To study the dispersion in air, laser spectrometry was used using the Spraytec Malvern Instruments system (Great Britain). The protein content in the initial suspension and dispersible aerosol, collected in the form of a condensate, was determined using an Immulite 2000 XPi immunochemical analyzer (Siemens, USA).The shape and morphology of the particles were studied using scanning electron microscopy using.
Results: The study of the aerodynamic properties of the dispersion of M indicated that its particles are involved in the dynamics of the movement of the airflow and the flight of water particles generated by the inhaler. The dispersity of the aerosol generated from the suspension M averaged about 5 μm and did not significantly depend on the concentration of the radiopharmaceutical and did not depend on the studied dispersion intensity and airflow rate set using an inhaler. The morphology of M particles was characterized by a complex shape and roughness.
Conclusion: The aerodynamic characteristics of M are not optimal for studying the processes of deposition and MCC. However, a final verdict requires a direct assessment of the deposition of the inhaled radioaerosol generated from this preparation.
Keywords: dynamic aerosol scintigraphy, albumin macroaggregates, macrotech, dispersion aerosol, shape and morphology of particles, inhalant deposition, mucociliary clearance
For citation: Kobylyansky VI, Kudasheva TV, Berezina MG, Magomedov TM. Studying the Aerodynamic Characteristics of the Macrotech and Evaluation of the Possibilities of Its Use for Dynamic Aerosol Scintigraphy. Medical Radiology and Radiation Safety. 2023;68(4):75–80. (In Russian). DOI:10.33266/1024-6177-2023-68-4-75-80
References
1. Krivonogov N.G., Zavadovskiy K.V. Radionuclide Diagnostics in Pulmonology. Natsionalnoye Rukovodstvo po Radionuklidnoy Diagnostike = National Guide on Radionuclide Diagnostics. V.2 v. Ed. Lishmanov Yu.B., Chernov V.I. Tomsk Publ., 2010. P. 163-190 (In Russ.).
2. Chokkappan K., Kannivelu A., Srinivasan S., Babut S.B. Review of Diagnostic Uses of Shunt Fraction Quantification with Technetium-99m Macroaggregated Albumin Perfusion Scan as Illustrated by a Case of Osler-Weber-Rendu Syndrome. Ann. Thorac. Med. 2016;11;2:155-160. doi: 10.4103/1817-1737.180020.
3. Kobylyanskiy V.I. Mukotsiliarnaya Sistema. Fundamentalnyyei Prikladnyye Aspekty = Mucociliary System. Fundamental and Applied Aspects. Moscow Binom Publ., 2008. 416 p. (In Russ.).
4. Kobylyanskiy V.I. Methods for Studying the Mucociliary System: Possibilities and Prospects. Terapevticheskiy Arkhiv = Therapeutic Archive. 2001;73;3:73-76 (In Russ.).
5. Grosser O.S., Ruf J., Kupitzm D., Pethe A., Ulrich G., Genseke P., et al. Pharmacokinetics of 99mTc-MAA- and 99mTc-HAS Microspheres Used in Pre-Radioembolization Dosimetry: Influence on the Liver–Lung Shunt. Journal of Nuclear Medicine. 2016;57;6:925-927. doi:10.2967/jnumed.115.169987.
6. Scheuch G., Bennett W., Borgström L., Clark A., Dalby R., Dolovich M., et al. Deposition, Imaging, and Clearance: What Remains to be Done? Journal of Aerosol Medicine and Pulmonary Drug. Delivery. 2010;23;Suppl 2:S39-S57. http://doi.org/10.1089/jamp.2010.0839.
7. Ball D.R., McGuiro B.E., Chapter 6. Benumof and Hagbergs Airway Management. 2013. P. 159-183. https://doi.org/10.1016/B978-1-4377-2764-7.00006-3.
8. Canziani L., Marenco M., Cavenaghi G., Manfrinato G., Taglietti A., Girella A., et al. Chemical and Physical Characterization of Macroaggregated Human Serum Albumin: Strength and Specificity of Bonds with 99mTc and 68Ga. Molecules. 2022;27:404. doi.org/ 10.3390/molecules27020404.
9. Ament S., Buchholz H.G., Bausbacher N., Brochhausen C., Graf F., Miederer M., et al. PET Lung Ventilation/Perfusion Imaging Using 68Ga Aerosol (Galligas) and 68Ga-Labeled Macroaggregated Albumin. V.194. Theranostics, Gallium-68, and Other Radionuclides. Recent Results in Cancer Research. Ed. Baum R., Rösch F. Springer, Berlin, Heidelberg, 2013. https://doi.org/10.1007/978-3-642-27994-2_22.
10. Gandhi S.J., Babu S., Subramanyam P., Shanmuga Sundaram P. Tc-99m Macro Aggregated Albumin Scintigraphy - Indications Other than Pulmonary Embolism: A Pictorial Essay. Indian J. Nucl. Med. 2013;28;3:152-62. doi: 10.4103/0972-3919.119546.
11. Fazio F. Clinical Radioaerosol Imaging. Bull. Eur. Phisiol. Resp. 1980;16:134-136.
12. Chambarlain M.J. Factor Influencing оn the Regionдk Deposition of Particles in Man. Clin. Sci. 1983;64:641-547.
13. Morgan W.K.C., Ahmad D., Chambarlain M.Y. The Effect of Exercise on an Inhaled Aerosol. Respir. Physiol. 1984;56:327-338.
14. Kobylyanskiy V.I., Artyushkin A.V. Sposob Opredeleniya Ekskretornoy Funktsii Legkikh = A Method for Determining the Excretory Function of the Lungs. A.s. No. 138982. 1986 (In Russ.).
15. Kobylyanskiy V.I. Sposob Opredeleniya Funktsii Mukotsiliarnogo Apparata Legkikh = A Method for Determining the Function of the Mucociliary Apparatus of the Lungs. A.s. No. 1602469. 1988 (In Russ.).
16. Persico M.G., Marenco M., De Matteis G., Manfrinato G., Cavenaghi G., Sgarella A., et al. 99mTc-68Ga-ICG-Labelled Macroaggregates and Nanocolloids of Human Serum Albumin: Synthesis Procedures of a Trimodal Imaging Agent Using Commercial Kits. Contrast Media Mol. Imaging. 2020;22;2020:3629705. doi: 10.1155/2020/3629705.
17. Hung J.C., Redfern M.G., Mahoney D.W., Thorson L.M., Wiseman G.A. Evaluation of Macroaggregated Albumin Particle Sizes for Use in Pulmonary Shunt Patient Studies. J. Am. Pharm. Assoc. (Wash). 2000;40;1:46-51. doi: 10.1016/s1086-5802(16)31035-x.
18. Pempuev V.M., Cmιnchcnhoɞ V.N., TSɔic G. Xaιupoɞ. Physical and Some Radiochemical Properties of Albumin Microspheres Used in Radionuclide Diagnostics. Isotopenpraxis Isotopes in Environmental and Health Studies. 1979;15;1:22-25. DOI: 10.1080/10256017908544275 (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: 20.02.2022. Accepted for publication: 27.03.2023.