Medical Radiology and Radiation Safety, 2016, Vol. 61. No. 5. P. 13-26

RADIATION EPIDEMIOLOGY

V. Azizova¹, E.S. Grigoryeva¹, R. Haylock², M.V. Bannikova¹, M.B. Moseeva¹

Risk of Incidence and Mortality from Ischemic Heart Disease in the Cohort of Workers with Chronic Occupational Exposure

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. Public Health England, Chilton, UK

ABSTRACT

Purpose: Assessment of incidence and mortality risk from ischemic heart disease (IHD) in relation to radiation (external gamma- and internal alpha-exposure) and non-radiation factors (gender, age, smoking, alcohol consumption, hypertension, increased body mass index).

Material and methods: IHD risk was studied in the cohort of workers of the nuclear enterprise (22377 workers, 25 % - females) with chronic occupational exposure. Relative risks and excess relative risks per unit dose (1 Gray) were calculated based on maximum likelihood using AMFIT module of the EPICURE software. Dose estimates used in analyses were provided by an updated ‘Mayak Worker Dosimetry System-2008’.

Results: A significant linear association of IHD incidence risk with total dose from external gamma-rays was observed after having adjusted for non-radiation factors and dose from internal radiation (ERR/Gy = 0.10; 95 % CI: 0.04, 0.17). No significant association of IHD mortality risk was revealed after having adjusted for non-radiation factors and dose from internal alpha-radiation (ERR/Gy = 0.06; 95 % CI: < 0, 0.15). No association of IHD incidence risk with total absorbed dose from internal alpha-radiation to the liver after having adjusted for non-radiation factors and external gamma-dose (ERR/Gy = 0.02; 95 % CI: n/a, 0,10). Statistically significant linear association of IHD mortality risk with total absorbed dose from internal alpha-radiation to the liver was revealed after having adjusted for non-radiation factors and external gamma-dose (ERR/Gy = 0.21; 95 % CI: 0.01, 0.58).

Conclusion: This study provides strong evidence of the association of the ischemic heart disease incidence risk with external gamma-ray exposure and some evidence of the association of the mortality risk for ischemic heart disease with internal alpha-radiation exposure.

Key words: risk, mortality, incidence, ischemic heart disease, Mayak PA, gamma-ray, alpha-radiation, occupational exposure

REFERENCES

1. Doklad ekspertov VOZ. Zheneva: VOZ. 2008. 76 p. (In Russ.).
2. Oganov R.G. Demograficheskie tendentsii v Rossiiskoi Federatsii: vklad boleznei sistemy krovoobrashcheniya. Kardiovaskulyarnaya terapiya i profilaktika. 2012. No. 1. P. 5-10. (In Russ.).
3. Oganov R.G., Maslennikova G.Ya. Epidemiyu serdechno-sosudistykh zabolevanii mozhno ostanovit' usileniem profilaktiki. Profilakticheskaya meditsina. 2009, Vol. 12. No. 6. P. 3-7. (In Russ.).
4. Yusuf S., Hawken S., Ounpuu S. et al. INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case-control study. Lancet. Vol. 364. No. 9438. P. 937-952.
5. Azizova T.V., Muirhead C.R., Druzhinina M.B. et al. Cardiovascular Diseases in the Cohort of Workers First Employed at Mayak PA in 1948-1958. Radiat. 2010. No. 174. P. 155-168.
6. Azizova T.V., Muirhead C.R., Moseeva M.B. et al. Ischemic heart disease in nuclear workers first employed at the Mayak PA in 1948-1972. Health Phys. 2012. 103. No. 1. P. 3-14.
7. Simonetto C., Azizova T.V., Grigoryeva E.S. et al. Ischemic heart disease in workers at Mayak PA: Latency of incidence risk after radiation exposure. PLoS ONE. 2014. 9. No. 5. P. e96309.
8. Moseeva M.B., Azizova T.V., Grigorieva E.S. et al. Risk of circulatory diseases among Mayak PA workers with radiation doses estimated using the improved Mayak Workers Dosimetry System 2008. Radiat. Biophys. 2014. Vol. 53. No. 2. P. 469-477.
9. Azizova T.V., Day R.D., Wald N. et al. The “Clinic” medical-dosimetric database of Mayak production association workers: structure, characteristics and prospects of utilization. Health Phys. 2008. 94. P. 449-458.
10. Rossiiskaya Federatsiya. Zakony. Federal'nyi zakon o personal'nykh dannykh: ot 27 iyulya 2006 g. № 152-FZ. Rossiiskaya gazeta. Federal'nyi vypusk 4131 ot 29.07.06. (In Russ.).
11. Koshurnikova N.A., Shilnikova N.S., Okatenko P.V. Characteristics of the cohort of workers at the Mayak nuclear complex. Radiat. Res. 1999. Vol. 152. No. 4. P. 352-363
12. Mezhdunarodnaya statisticheskaya klassifikatsiya boleznei i problem, svyazannykh so zdorov'em. Desyatyi peresmotr. V 3 t. Vol 1. Moscow: Meditsina. 1995. 698 p. (In Russ.).
13. Vasilenko E.K., Scherpelz R.I., Gorelov M.V. et al. External Dosimetry Reconstruction for Mayak Workers. AAHP Special Session Health Physics Society Annual Meeting. Available from: http://www.hps1.org/aahp/public/AAHP_Special_Sessions/2010_Salt_Lake_City/pm-1.pdf. 2010 (10.12.2010).
14. Khokhryakov V.V., Khokhryakov V.F., Suslova K.G. et al. Mayak Worker Dosimetry System 2008 (MWDS-2008): Assessment of internal alpha-dose from measurement results of plutonium activity in urine. Health Phys. 2013. 104. No. 4. P. 366-378.
15. Preston D., Lubin J., Pierce D., McConney M. EPCURE Users Guide. Seattle, WA: Hirosoft. 1993. 330 p.
16. Nemtsov A.V., Terekhin A.T. Serdechno-sosudistaya smertnost' i potreblenie alkogolya v Rossii. Profilakticheskaya meditsina. 2008. No. P. 25-30. (In Russ.).
17. Preston D.L., Shimizu Y., Pierce D.A. et al. Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997. Radiat. Res. 2012. No. 178. AV146-AV172.
18. Shimizu Y., Kodama K., Nishi N. et al. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003. BMJ. 2010.Vol. 340. b5349
19. McGeoghegan D., Binks K., Gillies M. et al. The non-cancer mortality experience of male workers at British Nuclear Fuels plc, 1946-2005. Int. J. Epidemiol. Vol. 37. P. 506-518.
20. Vrijheid M., Cardis E., Ashmore P. et al. Mortality from diseases other than cancer following low doses of ionizing radiation: results from the 15-country study of nuclear industry workers. Int. J. Epidemiol. Vol. 36. P. 1126-1135.
21. Muirhead C.R., O’Hagan J.A., Haylock R.G.E. et al. Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers. Brt. J. Cancer. Vol. 100. P. 206-212.
22. Metz-Flamant C., Laurent O., Samson E. et al. Mortality associated with chronic external radiation exposure in the French combined cohort of nuclear workers. Occup. Med. 2013. Vol. 70. P. 630-638.
23. Zablotska L.B., Little M.P., Cornett R.J. Potential increased risk of ischemic heart disease mortality with significant dose fractionation in the Canadian Fluoroscopy cohort study. Amer. J. Epidemiol. Vol. 179. No. 1. P. 120-131.
24. Yamada M., Wong F.L., Fujiwara S. et al. Non-cancer disease incidence in atomic bomb survivors, 1958-1998. Radiat. 2004. Vol. 161. P. 622-632.
25. Ivanov V., Maksioutov M.A., Chekin S.Y. et al. The risk of radiation-induced cerebrovascular disease in Chernobyl emergency workers. Health Phys. 2006. Vol. 90. P. 199-207.
26. Little M.P., Tawn E.J., Tzoulaki I. et al. Review and meta-analysis of epidemiological associations between low/moderate doses of ionizing radiation and circulatory disease risks and their possible mechanisms. Radiat. Biophys. 2010. Vol. 49. No. 2. P. 139-153.
27. Little M.P. A review of non-cancer effects, especially circulatory and ocular diseases. Radiat. Biophys. 2013. Vol. 52. No. 4. P. 435-449.
28. Borghini A., Gianicolo E.A.L., Picano E., Andreassi M.G. Ionizing radiation and atherosclerosis: Current knowledge and future challenges. Elsevier. No. 230. P. 40-47.
29. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Effects of Ionizing Radiation. UNSCEAR 2006 Report to the General Assembly, with scientific annexes. United Nations: New York. 2008.

For citation: Azizova TV, Grigoryeva ES, Haylock R, Bannikova MV, Moseeva MB. The Risk of Incidence and Mortality from Ischemic Heart Disease in the Cohort of Workers with Chronic Occupational Exposure. Medical Radiology and Radiation Safety. 2016;61(5):13-26. Russian.

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