Medical Radiology and Radiation Safety. 2025. Vol. 70. № 5
DOI:10.33266/1024-6177-2025-70-5-63-69
T.V. Azizova1, E.S. Grigoryeva1, N. Hamada2
Influence of Dose Rate on Mortality from Coronary Heart Disease in the Mayak Employee Cohort
1 Southern Urals Federal Medical Biophysics Research Centre, Ozyorsk, Russia
2 Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
Contact person: T.V. Azizova , e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: The study aimed to evaluate the impact of radiation dose rate on the mortality from ischemic heart disease (IHD) in a cohort of workers chronically exposed to ionizing radiation.
Material and methods: The study considered the subcohort of the Mayak Production Association (PA) workers (WSC) who were hired between 1948 and 1982 and were living in the city of Ozyorsk (residents). The WSC included 13,156 individuals who were followed up until December 31, 2018 (13,156 individuals). To assess the impact of dose rate on the mortality from IHD, the dose window method was applied. In the first phase of the study, we analyzed the dose-response relationship using the excess relative risk (ERR) per unit dose of external radiation exposure (in Gy) based on the conventional linear model. Subsequently, we performed the analysis considering the radiation dose rate by utilizing annual doses recorded with individual film badge dosimeters. We defined the dose rate cut-off points from 5 to 50 mGy/year, with intervals of 5 mGy. To compare the conventional model with the dose-rate models, the maximum likelihood technique was used. All the calculations were carried out using the AMFIT module of the EPICURE software.
Results: We found the significantly increased IHD mortality risk in workers exposed at dose rates >0.015 Gy/year, >0.020 Gy/year, >0.025 Gy/year, >0.030 Gy/year, >0.035 Gy/year, >0.040 Gy/year, >0.045 Gy/year, >0.050 Gy/year compared to dose rates below these cut-off points. The uninterrupted radiation exposure at dose rate above a cut-off point during 5 consecutive years considerably increased the IHD mortality risk. Exclusion of the adjustment for alpha dose from the model resulted in the decrease of the ERR/Gy at higher dose rate and to the loss of the statistical significance for certain cut-off points (0.045 and 0.050 Gy). On the contrary, the exclusion of this adjustment resulted in the increase in risk estimates at lower dose rates for all cut-off points without any changes in the statistical significance of the estimates.
Conclusions: The study results indicate that the excess relative risks of the IHD mortality per unit dose of external radiation exposure in nuclear workers chronically exposed to ionizing radiation depended on the dose rate and the duration of the uninterrupted exposure at higher dose rates.
Keywords: mortality, ischemic heart disease, ocupational radiation exposure, ionizing radiation dose rate
For citation: Azizova TV, Grigoryeva ES, Hamada N. Influence of Dose Rate on Mortality from Coronary Heart Disease in the Mayak Employee Cohort. Medical Radiology and Radiation Safety. 2025;70(5):63–69. (In Russian). DOI:10.33266/1024-6177-2025-70-5-63-69
References
1. Brenner A.V., et al. Comparison of All Solid Cancer Mortality and Incidence Dose-Response in the Life Span Study of Atomic Bomb Survivors, 1958-2009. Radiat Res. 2022 May; 1;197:491-508. doi: 10.1667/RADE-21-00059.1.
2. Metz-Flamant C., Samson E., Caër-Lorho S., Acker A., Laurier D. Leukemia Risk Associated with Chronic External Exposure to Ionizing Radiation in a French Cohort of Nuclear Workers. Radiat Res. 2012;178;5:489-98. doi: 10.1667/RR2822.1.
3. Sasaki M., Kudo S., Furuta H. Effect of Radiation Dose Rate on Cancer Mortality among Nuclear Workers: Reanalysis of Hanford Data. Health Phys. 2019;117;1:13-19. doi: 10.1097/HP.0000000000001039.
4. Sasaki M., Kudo S., Furuta H. Effect of Radiation Dose Rate on Circulatory Disease Mortality among Nuclear Workers: Reanalysis of Hanford Data. Health Phys. 2020;119;3:280-288. doi: 10.1097/HP.0000000000001230.
5. Clement C., et al. Keeping the ICRP Recommendations Fit for Purpose. J Radiol Prot. 2021;41:4. doi:10.1088/1361-6498/ac1611.
6. Laurier D., Rühm W., Paquet F., Applegate K., Cool D., Clement C. International Commission on Radiological Protection (ICRP). Areas of Research to Support the System of Radiological Protection. Radiat Environ Biophys. 2021;60;4:519-530. doi: 10.1007/s00411-021-00947-1.
7. Kruglov A. The History of the Soviet Atomic Industry. London, Taylor and Francis, 2002. 273 p.
8. ICD-9 Guidelines for Coding Diseases, Injuries and Causes of Death/Revision 1975. Geneva, Switzerland, WHO, 1980.
9. Azizova T.V., et al. 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.
10. Napier B.A. The Mayak Worker Dosimetry System (MWDS-2013): an Introduction to the Documentation. Radiat. Prot. Dosim. 2017;176;1-2:6-9. doi: 10.1093/rpd/ncx020.
11. Azizova T.V., Bannikova M.V., Grigoryeva E.S., Briks K.V., Hamada N. Mortality from Various Diseases of the Circulatory System in the Russian Mayak Nuclear Worker Cohort: 1948-2018. J Radiol Prot. 2022;42:2. doi: 10.1088/1361-6498/ac4ae3.
12. Preston D., Lubin J., Pierce D., McConney M. Epicure Users Guide. Seattle, Hirosoft, 1993.
13. Mitchel R.E., et al. Low-Dose Radiation Exposure and Protection against Atherosclerosis in ApoE(-/-)Mice: the Influence of P53 Heterozygosity. Radiat Res. 2013;179;2:190-9. doi: 10.1667/RR3140.1.
14. Mancuso M., et al. Acceleration of Atherogenesis in ApoE-/-Mice Exposed to Acute or Low-Dose-Rate Ionizing Radiation. Oncotarget. 2015;6;31:31263-71. doi: 10.18632/oncotarget.5075.
15. Andreassi M.G., et al. Subclinical Carotid Atherosclerosis and Early Vascular Aging from Long-Term Low-Dose Ionizing Radiation Exposure: a Genetic, Telomere, and Vascular Ultrasound Study in Cardiac Catheterization Laboratory Staff. JACC Cardiovasc Interv. 2015;8;4:616-27. doi: 10.1016/j.jcin.2014.12.233.
16. Kloosterman A., et al. How Radiation Influences Atherosclerotic Plaque Development: a Biophysical Approach in ApoE-/-Mice. Radiat Environ Biophys. 2017;56;4:423-431. doi: 10.1007/s00411-017-0709-2.
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: 20.05.2025. Accepted for publication: 25.06.2025.




