Medical Radiology and Radiation Safety. 2023. Vol. 68. № 3
DOI: 10.33266/1024-6177-2023-68-3-21-32
A.N. Koterov1, L.N. Ushenkova1, I.G. Dibirgadzhiev1 A.A. Wainson2, M.V. Kalinina1, A.P. Biryukov1
Excess Relative Risk of Cataractogenic Lense Disordes in Nuclear Workers: Systematic Review and Meta-analysis
1A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia
2N.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
The lens cells are the most radiosensitive cells in the body, surpassing even lymphocytes in key parameters. Radiation damages in the lens can be observed at relatively low doses, in connection with which a number of authors attribute to these effects not a deterministic, but a stochastic nature.
Although cataractogenic consequences do not always affect visual acuity, and lens undergo successful surgical correction, when irradiating various professional groups, including workers in the nuclear industry, these consequences are regarded in importance immediately after malignant neoplasms and diseases of the circulatory system. The presented study showed that there are very few publications on the lens disorders in nuclear workers – only 20 sources were identified (1967–2022), and no data were found on the effects of low doses (0.1 Gy for low LET radiation).
When conducting a meta-analysis for ERR at 1 Gy/Sv for radiation damage in the lens of nuclear workers, three cohorts turned out to be relevant: a small group in the American study of transuranium elements processing, Mayak personnel and ROSATOM workers – liquidators of the Chernobyl accident. The sample was homogeneous, publication bias was unlikely, and, according to the results of a meta-analysis (Fixed effect model), ERR per 1 Gy/Sv was 0.30 (95 % confidence intervals: 0.25; 0.35).
Based on the earlier work (Koterov A.N. et al, 2022) of the mean cumulative dose of external exposure for nuclear workers as a world professional category, which amounted to 31.1 mSv, the calculation showed that with ERR = 0.3 per 1 Gy/Sv excess prevalence of cataracts for a group of ‘average’ workers is 0.0093. This corresponds to an increase in prevalence of 0.096 % over a background level of 10.3 % for potentially radiogenic cataracts (last value taken from a meta analysis by Hashemi H. et al., 2020). Such an increase is unlikely to have practical significance. Although for some cohorts (Sellafield, PO ‘Mayak’) there may be groups with significant cumulative doses and, therefore, with increased risks.
The importance of the risks of cataractogenic disorders in the lens in radiation workers may be due to a decrease in professional suitability, since the artificial lens, as a rule, is poorly capable of accommodation.
Keywords: nuclear workers, lens disorders, cataracts, systematic review, meta-analysis
For citation: Koterov AN, Ushenkova LN, Dibirgadzhiev IG, Wainson AA, Kalinina MV, Biryukov AP. Excess Relative Risk of Cataractogenic Lense Disorders in Nuclear Workers: Systematic Review and Meta-analysis. Medical Radiology and Radiation Safety. 2023;68(3):21–32. (In Russian). DOI: 10.33266/1024-6177-2023-68-3-21-32
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Conflict of interest. The authors declare no conflict of interest.
Financing. The work was carried out on the budget topic of the research of the FMBA of Russia and was not supported by any other sources of funding.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.01.2022. Accepted for publication: 25.02.2023.