Ischaemic heart disease incidence and mortality in an extended cohort of Mayak workers first employed in 1948-1982 - PubMed (original) (raw)

Ischaemic heart disease incidence and mortality in an extended cohort of Mayak workers first employed in 1948-1982

Tamara V Azizova et al. Br J Radiol. 2015 Oct.

Abstract

Objective: Incidence and mortality from ischaemic heart disease (IHD) was studied in an extended cohort of 22,377 workers first employed at the Mayak Production Association during 1948-82 and followed up to the end of 2008.

Methods: Relative risks and excess relative risks per unit dose (ERR/Gy) were calculated based on the maximum likelihood using Epicure software (Hirosoft International Corporation, Seattle, WA). Dose estimates used in analyses were provided by an updated "Mayak Worker Dosimetry System-2008".

Results: A significant increasing linear trend in IHD incidence with total dose from external γ-rays was observed after having adjusted for non-radiation factors and dose from internal radiation {ERR/Gy = 0.10 [95% confidence interval (CI): 0.04 to 0.17]}. The pure quadratic model provided a better fit of the data than did the linear one. No significant association of IHD mortality with total dose from external γ-rays after having adjusted for non-radiation factors and dose from internal alpha radiation was observed in the study cohort [ERR/Gy = 0.06 (95% CI: <0 to 0.15)]. A significant increasing linear trend was observed in IHD mortality with total absorbed dose from internal alpha radiation to the liver after having adjusted for non-radiation factors and dose from external γ-rays in both the whole cohort [ERR/Gy = 0.21 (95% CI: 0.01 to 0.58)] and the subcohort of workers exposed at alpha dose <1.00 Gy [ERR/Gy = 1.08 (95% CI: 0.34 to 2.15)]. No association of IHD incidence with total dose from internal alpha radiation to the liver was found in the whole cohort after having adjusted for non-radiation factors and external gamma dose [ERR/Gy = 0.02 (95% CI: not available to 0.10)]. Statistically significant dose effect was revealed in the subcohort of workers exposed to internal alpha radiation at dose to the liver <1.00 Gy [ERR/Gy = 0.44 (95% CI: 0.09 to 0.85)].

Conclusion: This study provides strong evidence of IHD incidence and mortality association with external γ-ray exposure and some evidence of IHD incidence and mortality association with internal alpha-radiation exposure.

Advances in knowledge: It is the first time the validity of internal radiation dose estimates has been shown to affect the risk of IHD incidence.

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Figures

Figure 1.

Figure 1.

Average annual dose from external γ-rays based on Mayak Worker Dosimetry System—2008.

Figure 2.

Figure 2.

Average annual absorbed liver dose from internal alpha-particle radiation.

Figure 3.

Figure 3.

Ischaemic heart disease incidence in relation to total external gamma dose (a) for the full data set with 0 lag period (b) for the dose-restricted data set (external dose <4.00 Gy) with 0 lag period. CI, confidence interval; ERR/Gy, excess relative risk per unit dose.

Figure 4.

Figure 4.

Ischaemic heart disease mortality and incidence in relation to total external gamma dose (a) for the full data set with 0 lag period (b) for the dose-restricted data set (external dose <4.00 Gy) with 0 lag period. CI, confidence interval; ERR/Gy, excess relative risk per unit dose.

Figure 5.

Figure 5.

Ischaemic heart disease (IHD) incidence for males in relation to total absorbed alpha dose in the liver in workers exposed to internal alpha radiation at doses <1.00 Gy without taking into account (a) and taking into account (b) the validity of internal dose estimates. CI, confidence interval; ERR/Gy, excess relative risk per unit dose.

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