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

Azizova, Tamara V.; Haylock, Richard; Moseeva, M. B.; Банникова, М. В.; Grigoryeva, E. S.

doi:10.1667/rr13680.1

Cited by 71 publications

(99 citation statements)

References 26 publications

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“…It may also be possible that internal exposures influence the pattern of risks we are observing; recent findings in the Mayak cohort suggest a possible link between IHD, cerebrovascular disease and plutonium exposure (34)(35)(36). However, internal exposures in the Mayak cohort are considerably larger than those in other cohorts.…”

Section: Discussionmentioning

confidence: 83%

“…In published studies of the Russian Federation Mayak nuclear workers, associations between external radiation exposure and circulatory disease have also been reported (34), with significant effects noted for IHD mortality and morbidity (35) and cerebrovascular disease morbidity (36)(37). Mayak relative risk per unit dose estimates were similar to our estimates for circulatory disease mortality and IHD mortality; however, there was little evidence of increased risks of cerebrovascular disease mortality associated with external dose in the Mayak cohort, a significant association only being noted for morbidity.…”

Section: Discussionmentioning

confidence: 90%

“…However, by their very nature, surrogate measurements for these risk factors are not as good as actual measurements and some residual confounding is likely. Nevertheless, in a recent review on circulatory disease and radiation effects (16), in those studies that had additional information on some of these risk factors (9,(34)(35)(36), ERR/Sv estimates were virtually unchanged when additional adjustment for these factors was made.…”

Section: Discussionmentioning

confidence: 99%

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“…Many studies lack this information on lifestyle factors. Of the studies considered in Table 7 only those of the Japanese atomic-bomb survivors [7,48], Mayak workers [49,50], and Canadian fluoroscopy patients [15] had such information. Some lifestyle factors were included in the Nordic breast cancer case-control study [4], and specific medical factors (surgery, thoracoplasty, pneumolobectomy), alcohol consumption, and cigarette smoking were included in the cohort considered here.…”

Section: Discussionmentioning

confidence: 99%

“…However, the importance of these findings is unclear, and they may best be interpreted as the effects of chance. In all other radiation-exposed groups with such information there is no evidence that lifestyle factors interacted with radiation risk [4,7,[48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study

et al. 2015

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High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy -0.023; 95 % CI -0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95 % CI -0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart dis-ease (n = 1950; excess relative risk/Gy -0.077; 95 % CI -0.130, -0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95 % CI -0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95 % CI, -0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation-associated risk (excess relative risk/Gy 0.252; 95 % CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data.

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Risk of lower extremity arterial disease in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period

Азизова

Банникова

Grigorieva

et al. 2016

Radiat Environ Biophys

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In this study the incidence risk of lower extremity arterial disease (LEAD; international classification of diseases version 9 code 440.2) was assessed in a cohort of workers occupationally exposed to radiation over a prolonged period. The study cohort includes 22,377 workers of the Mayak Production Association (25% of whom are females) first employed at one of the main facilities in 1948-1982 and followed up to the end of 2008. Dose estimates used in the study are provided by Mayak Worker Dosimetry System 2008. The mean total dose from external gamma-rays is 0.54 Gy for males and 0.44 Gy for females. The mean absorbed liver dose from internal alpha-radiation due to incorporated plutonium is 0.23 Gy in males and 0.44 Gy in females. Relative risks and excess relative risks per unit dose (ERR/Gy) are calculated based on maximum likelihood. A total of 943 cases of LEAD are registered in the study cohort during the follow-up of 512,801 person-years. A significant association of LEAD incidence with total dose from external gamma-rays (based on a linear model) was revealed, and the ERR/Gy is 0.27 (95% confidence interval (CI) 0.11; 0.48). It turned out that a linear-exponential model provides a better fit of the data (∆AIC = 9.957). Inclusion of an adjustment for internal alpha-radiation dose resulted in the reduction of the ERR/Gy to 0.19 (95% CI 0.05; 0.39), but the risk remains significant. No association of LEAD incidence with dose from internal alpha-radiation was found in the study worker cohort. It is concluded that this study provides evidence for an association of LEAD incidence with dose from external gamma-rays taking non-radiation factors into account.

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

Cited by 71 publications

References 26 publications

Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study

Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study

Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study

Risk of lower extremity arterial disease in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period

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