Medical Radiology and Radiation Safety. 2023. Vol. 68. № 6

DOI:10.33266/1024-6177-2023-68-6-60-66

A.R. Tukov, I.L. Shafransky, O.N. Prokhorova, A.M. Mikhailenko, M.N. Ziyatdinov

Diabetes Mellitus Incidence and the Risk of its Occurrence in Liquidators of the Chnpp Accident Consequences including Nuclear Industry Workers

A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: A.R. Tukov, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Abstract

Summary: Investigation purposes Diabetes mellitus (DM) occupies the largest share in the structure of endocrine system diseases, nutritional disorders and metabolic disorders, which is currently one of the important priorities of national health systems. Research on certain groups of the population with their own harmful occupational risk factors is relevant. Analysis of the incidence of diabetes mellitus of the second type - T2DM (ICD 10: E11-E11.9) of liquidators of the consequences of the Chernobyl accident ‒ workers of nuclear industry enterprises for 30 years of observation and assessment of the radiation risk of its occurrence.

Material and methods: The study includes data from the Industry register of persons exposed to radiation as a result of the Chernobyl accident over a thirty-year period, having a verified dose of external radiation received during work in the 30 km zone of the Chernobyl nuclear power plant, men – 12663 people, 1327, of whom have data on the dose of occupational irradiation. The Poisson process with an intensity parameter was chosen as a statistical model of morbidity.

Results: The incidence of T2DM in liquidators of the consequences of the Chernobyl accident was estimated by age and sex groups. On the basis of the obtained file of individual unstratified data, an analytical likelihood function for the Poisson process was constructed and the value of the excess relative risk (ERR) of T2DM incidence was calculated and the nature of the dose dependence of RR was investigated.
A cohort epidemiological study of a group of liquidators in 1986–1990 was carried out. over a thirty-year period, depending on the dose, both received during the liquidation of the consequences of the Chernobyl accident, and during professional work with radioactive substances (RS) and sources of ionizing radiation (IRS). Direct estimates of the radiogenic risk of diabetes mellitus are given. Different values ​​of risk were noted when using doses from different types of radiation. There was no significant increase in the risk of disease per dose unit (ERR / Sv).

Conclusion: With the aging of the cohort of liquidators, an increase in the incidence of T2DM was noted in both men and women. The results obtained on the assessment of the radiation risk of T2DM at this stage are taken as preliminary, since the use of radiation risk in the development of radiation safety regulations requires a total dose from all types of exposure (professional, emergency, medical, natural).

Keywords: diabetes, incidence, radiation, relative risk, overweight, Chernobyl accident, employees of the nuclear industry, sectoral register

For citation: Tukov AR, Shafransky IL, Prokhorova ON, Mikhailenko AM, Ziyatdinov MN. Diabetes Mellitus Incidence and the Risk of its Occurrence in Liquidators of the Chnpp Accident Consequences including Nuclear Industry Workers. Medical Radiology and Radiation Safety. 2023;68(6):60–66. (In Russian). DOI:10.33266/1024-6177-2023-68-6-60-66

References

1. Dedov I.I. Diabetes Mellitus – the Most Dangerous Challenge to the World Community. Vestnik Rossiiskoy Akademii Meditsinskikh Nauk = Annals of the Russian Academy of Medical Sciences. 2012;1:7-13 (In Russ.).

2. Dedov I.I., Shestakova M.V., Suntsov Yu.I., et al. Federal Targeted Programme ‘Prevention and Management of Socially Significant Diseases (2007-2012)’: Results of the ‘Diabetes Mellitus’ Sub-Programme. Sakharnyy Diabet = Diabetes Mellitus. 2013;16;2S:2-48 (In Russ.).

3. IDF Diabetes Atlas. Brussels, Belgium, International Diabetes Federation, 2015. URL: http://www.diabetesatlas.org/.

4. Maslova OV., Suntsov Yu.I. Epidemiology of Diabetes Mellitus and Microvascular Complications. Sakharnyy Diabet = Diabetes Mellitus. 2011;3:6-12 (In Russ.).

5. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. 2013;36;4:1033–1046.

6. Dedov I.I. Algorithms of Specialized Medical Care Patients with Diabetes. Ed. Dedov I.I., Shestakova M.V. Moscow Publ., 2015. P. 7-112 (In Russ.).

7. Vologodskaya I.A., Fomin E.A., Kovin A.I. Improving the Medical Monitoring System for Employees of the Nuclear Industry Enterprises. Meditsina: Tselevyye Proyekty. 2014;19:35-37 (In Russ.).

8. Vologodskaya I.A., Kurbatov A.V., Grigor’eva E.S. Predisposition to Multifactorial Pathology in Residents of the City in the Zone Around the “Maiak” Atomic Industry Enterprise. Radiats. Biol. Radioecol. 2002;42;6:690-692.

9. Pishhugina A.V., Ivanov A.G., Belyakova N.A. Features of the Incidence of Nuclear Energy Operating at the Enterprise. Problemy Sotsialnoy Gigiyeny, Zdravookhraneniya i Istorii Meditsiny = Problems of Social Hygiene, Public Health and History of Medicine. 2013;1:18-21 (In Russ.).

10. Florent de Vathaire, Chiraz El-Fayech, Faten Fedhila Ben Ayed, et. al. Radiation Dose to the Pancreas and Risk of Diabetes Mellitus in Childhood Cancer Survivors: a Retrospective Cohort Study. Lancet Oncol. 2012;13;10:1002-1010. doi: 10.1016/S1470-2045(12)70323-6. 

11. A van Nimwegen F., Schaapveld M., Janus C.P.M., et. al. Risk of Diabetes Mellitus in Long-Term Survivors of Hodgkin Lymphoma. J. Clin. Oncol. 2014;32;29б:3257-3263. doi: 10.1200/JCO.2013.54.4379. 

12. Meacham L.R., Sklar C.A., Li S., et. al. Diabetes Mellitus in long-term Survivors of Childhood Cancer. Increased Risk Associated with Radiation Therapy: a Report for the Childhood Cancer Survivor Study. Arch. Intern. Med. 2009;169;15:1381-1388. doi: 10.1001/archinternmed. 2009. 209.

13. Breslow N.E., Day N.E. Statistical Methods in Cancer Research. V. I. The Analysis of Case-Control Studies. IARC Scientific Publication No. 32. Lyon, IARC, 1980.

14. Preston D.L., Lubin D.B., Pierce D.A., McConney M.E. Epicure Users Guide. Seattle, WA, Hirosoft Inter-National Corporation, 1993. 330 p.

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The work was carried out as part of the implementation of the State Order.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.07.2023. Accepted for publication: 27.08.2023.