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


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

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

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


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

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

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

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

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


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

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