Occupational radiation exposure and risk of cataract incidence in a cohort of US radiologic technologists

Little, Mark P.; Kitahara, Cari M.; Cahoon, Elizabeth K.; Bernier, Marie Odile; Velazquez‐Kronen, Raquel; Doody, Michele M.; Borrego, David; Miller, Jeremy S.; Alexander, Bruce H.; Simon, Steven L.; Preston, Dale L.; Hamada, Nobuyuki; Linet, Martha S.; Meyer, Craig S.

doi:10.1007/s10654-018-0435-3

Cited by 59 publications

(54 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, there appeared to be a positive relationship of cataract risk with occupational radiation exposure 16. An increased risk of cataract was also reported in a subset of 12 964 technologists followed between 2003–2005 and 2012–2013 who reported ever working with nuclear medicine procedures 17.…”

Section: Introductionmentioning

confidence: 86%

Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study

et al. 2019

Self Cite

View full text Add to dashboard Cite

ObjectivesTo assess radiation exposure-related work history and risk of cataract and cataract surgery among radiologic technologists assisting with fluoroscopically guided interventional procedures (FGIP).MethodsThis retrospective study included 35 751 radiologic technologists who reported being cataract-free at baseline (1994–1998) and completed a follow-up questionnaire (2013–2014). Frequencies of assisting with 21 types of FGIP and use of radiation protection equipment during five time periods (before 1970, 1970–1979, 1980–1989, 1990–1999, 2000–2009) were derived from an additional self-administered questionnaire in 2013–2014. Multivariable-adjusted relative risks (RRs) for self-reported cataract diagnosis and cataract surgery were estimated according to FGIP work history.ResultsDuring follow-up, 9372 technologists reported incident physician-diagnosed cataract; 4278 of incident cases reported undergoing cataract surgery. Technologists who ever assisted with FGIP had increased risk for cataract compared with those who never assisted with FGIP (RR: 1.18, 95% CI 1.11 to 1.25). Risk increased with increasing cumulative number of FGIP; the RR for technologists who assisted with >5000 FGIP compared with those who never assisted was 1.38 (95% CI 1.24 to 1.53; p trend <0.001). These associations were more pronounced for FGIP when technologists were located ≤3 feet (≤0.9 m) from the patient compared with >3 feet (>0.9 m) (RRs for >5000 at ≤3 feet vs never FGIP were 1.48, 95% CI 1.27 to 1.74 and 1.15, 95% CI 0.98 to 1.35, respectively; pdifference=0.04). Similar risks, although not statistically significant, were observed for cataract surgery.ConclusionTechnologists who reported assisting with FGIP, particularly high-volume FGIP within 3 feet of the patient, had increased risk of incident cataract. Additional investigation should evaluate estimated dose response and medically validated cataract type.

show abstract

Section: Introductionmentioning

confidence: 86%

Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…The USRT study has been previously described 13. Four questionnaires (administered during 1983–2014) collected information on health outcomes, work history and other variables 13.…”

Section: Methodsmentioning

confidence: 99%

“…The USRT study has been previously described 13. Four questionnaires (administered during 1983–2014) collected information on health outcomes, work history and other variables 13. Since data on cataract were only elicited in the second through fourth questionnaires, we only included responders to the second or third questionnaire and at least one subsequent questionnaire for follow-up of these ocular endpoints.…”

Section: Methodsmentioning

confidence: 99%

“…High radiation doses of 1 Gy or more can induce cataract,2 and accumulating evidence from follow-up studies of the Japanese atomic bomb survivors3–5 and worker populations6–12 suggests that cataracts may be induced by cumulative lower doses, of the order of 100–250 mGy. A recent study of cataract in the US radiologic technologists (USRT) demonstrated cataract risk associated with cumulative ionising radiation exposure below 100 mGy 13. The use of diagnostic CT in the USA is substantial with about 18% of visits to the emergency room associated with use of CT 14.…”

Section: Introductionmentioning

confidence: 99%

“…All previous studies including our studies have assessed radiogenic relative risk of cataract, and in particular in the only two studies that have examined potential modification of effect by known and suspected non-radiation risk factors (eg, the Japanese atomic bomb survivors and the USRT) have done so in relation to measures of excess relative risk (ERR) 4 13. To the best of our knowledge, radiogenic excess additive risk (EAR) (ie, the number of cases per person-year and per unit of dose) has not previously been assessed for cataract, although additive risks have been assessed for radiation and cancer risks 16.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists

et al. 2019

Self Cite

View full text Add to dashboard Cite

ObjectivesPrevious analyses of cataract in radiation-exposed populations have assessed relative risk; radiogenic excess additive risk (EAR), arguably of more public health importance, has not been estimated. Previous analysis of a large prospective cohort of US radiologic technologists (USRT) quantified excess relative risk of cataract in relation to occupational radiation dose. We aim to assess EARs of cataract.MethodsWe estimated EARs of cataract/cataract surgery in the USRT cohort using generalised additive models in relation to occupational radiation exposure, and assessed risk modification by a priori-selected cataract risk factors (diabetes, body mass index, smoking, race, sex, birth-year, ultraviolet B (UVB) radiation exposure).ResultsThere were 11 345 cataract diagnoses and 5440 of cataract surgery during 832 462 and 888 402 person-years of follow-up, respectively. Cumulative occupational radiation exposure was associated with self-reported cataract, but not with cataract surgery, with EAR/104 person-year Gy=94 (95% CI: 47 to 143, p<0.001) and EAR/104 person-year Gy=13 (95% CI: <0 to 57, p=0.551), respectively. There was marked (p<0.001) variation of EAR by age and by diabetes status, with risk higher among persons ≥75 years and diabetics. There were indications of elevated risk among those with higher UVB radiation (p=0.045), whites (p=0.056) and among those with higher levels of cigarette smoking (p=0.062). Elevated additive risk was observed for estimated occupational radiation eye-lens doses <100 mGy (p=0.004) with no dose–response curvature (p=0.903).ConclusionsThe elevated additive risks associated with low-dose radiation, if confirmed elsewhere, have important public health and clinical implications for radiation workers as well as regulatory measures.

show abstract

AOP report: Development of an adverse outcome pathway for deposition of energy leading to cataracts

Carrothers,

Appleby,

Lai

et al. 2024

Environ and Mol Mutagen

View full text Add to dashboard Cite

Cataracts are one of the leading causes of blindness, with an estimated 95 million people affected worldwide. A hallmark of cataract development is lens opacification, typically associated not only with aging but also radiation exposure as encountered by interventional radiologists and astronauts during the long‐term space mission. To better understand radiation‐induced cataracts, the adverse outcome pathway (AOP) framework was used to structure and evaluate knowledge across biological levels of organization (e.g., macromolecular, cell, tissue, organ, organism and population). AOPs identify a sequence of key events (KEs) causally connected by key event relationships (KERs) beginning with a molecular initiating event to an adverse outcome (AO) of relevance to regulatory decision‐making. To construct the cataract AO and retrieve evidence to support it, a scoping review methodology was used to filter, screen, and review studies based on the modified Bradford Hill criteria. Eight KEs were identified that were moderately supported by empirical evidence (e.g., dose‐, time‐, incidence‐concordance) across the adjacent (directly linked) relationships using well‐established endpoints. Over half of the evidence to justify the KER linkages was derived from the evidence stream of biological plausibility. Early KEs of oxidative stress and protein modifications had strong linkages to downstream KEs and could be the focus of countermeasure development. Several identified knowledge gaps and inconsistencies related to the quantitative understanding of KERs which could be the basis of future research, most notably directed to experiments in the range of low or moderate doses and dose‐rates, relevant to radiation workers and other occupational exposures.

show abstract

Occupational radiation exposure and risk of cataract incidence in a cohort of US radiologic technologists

Cited by 59 publications

References 38 publications

Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study

Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study

Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists

AOP report: Development of an adverse outcome pathway for deposition of energy leading to cataracts

Contact Info

Product

Resources

About