A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries in order to assess the effect of low-to-medium dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked in 1986–87 around the Chernobyl plant. 117 cases (69 leukemia, 34 non-Hodgkin Lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue) and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The Excess Relative Risk (ERR) per 100 mGy was 0.60 (90% confidence interval (CI): −0.02, 2.35). The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90%CI −0.38, 5.7). It is slightly higher than, but statistically compatible with, those estimated from a-bomb survivors and recent low dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over or underestimation of the risk in this study.
After the Chernobyl accident in 1986, the "liquidators" or clean-up workers were among those who received the highest radiation doses to the thyroid from external radiation. Some were also exposed to radioiodines through inhalation or ingestion. A collaborative case-control study nested within cohorts of Belarusian, Russian and Baltic liquidators was conducted to evaluate the radiation-induced risk of thyroid cancer. The study included 107 cases and 423 controls. Individual doses to the thyroid from external radiation and from iodine-131 ((131)I) were estimated for each subject. Most subjects received low doses (median 69 mGy). A statistically significant dose-response relationship was found with total thyroid dose. The Excess Relative Risk (ERR) per 100 mGy was 0.38 [95% confidence interval (CI): 0.10, 1.09]. The risk estimates were similar when doses from (131)I and external radiation were considered separately, although for external radiation the ERR was not statistically significantly elevated. The ERR was similar for micro carcinomas and larger size tumors, and for tumors with and without lymph node involvement. Although recall bias and uncertainties in doses could have affected the magnitude of the risk estimates, the findings of this study contribute to a better characterization the risk of thyroid cancer after radiation exposure in adulthood.
This paper discusses the results of the analysis of the relationship between dose and solid cancer incidence among nuclear workers (males) who worked as liquidators after the Chernobyl accident. Information on this cohort of individuals is available at the regional center of Russian National Medical and Dosimetric Registry operating at the RF State Research Centre-Institute of Biophysics. Medical and dosimetric information on 8,654 persons 18-60 years of age with documented external radiation doses is used for the analysis. These data were gathered in the period from 1996 to 2001 and cover a total of 45,166.5 follow-up person-years. In the cohort under study, 179 solid cancers occurred during this period. The average age of liquidators at the time of exposure was 35.8 years, and the average dose as a result of the Chernobyl exposure was about 0.05 Sv. For an analysis of the dose-effect relationship (induction of radiation-induced malignant neoplasms) the statistical software EPICURE was used. The results of the analysis show that the cancer incidence in this cohort does not exceed cancer incidence in relevant age groups of the Russian population. The mean value of SIR for all cancer diseases was 0.88 (0.76, 1.02, 95% CI) for the whole period of follow-up. Risks for the induction of radiation-related cancer diseases were not statistically meaningful. Excess relative risk per 1 Sv was 0.95 (-1.52, 4.49, 95% CI).
Purpose: A comparative analysis of the health of the liquidators of the consequences of the Chernobyl accident, employees of enterprises and enterprises of the nuclear industry, and residents of the Moscow region. Material and methods: The information bases of the Industrial Register of Persons Exposed to Radiation from the Chernobyl Accident and the Register of the Liquidators of the Consequences of the Chernobyl NPP Residents of the Moscow Region were used in the work. The development of the material was carried out according to the total morbidity and mortality rates of men + women in 2017 by disease classes (ICD-10). Statistical processing of the material was carried out in the Excel system; morbidity, mortality, their error, indicator structure (%), ratio indicator and reliability of the difference in indicators were calculated (p = 0.05 %). Results: The results of the study showed that the incidence of some diseases is higher among the liquidators of the consequences of the Chernobyl accident – residents of the Moscow region: incidence of diseases of the skin and subcutaneous tissue (ratio 2.0), urogenital system (ratio 1.7). There was a higher mortality from diseases of the digestive system among the liquidators of the consequences of the Chernobyl accident – residents of the Moscow region (ratio 1.8). Conclusion: The difference in the health indicators of the studied cohorts can be explained by the difference in their age structure and the difference in dispensary observation. The need for further observation of this cohort of individuals to increase the power of the study is shown.
Introduction. Occupational neurosensory hearing loss is one of the most common occupational diseases. So far, there have been no studies in the scientific literature devoted to a retrospective analysis of professional conditions and conditions of medical care organization in case this pathology is detected in workers served by the system of health care institutions of FMBA of Russia.Materials and methods The study used data from the "Industry register of persons with occupational diseases", accounting documents and regulations that allow an analysis of working conditions and medical care.Results The rate of neurosensory hearing loss was 31.3 % in the structure of occupational diseases among employees of enterprises and organizations served by FMBA health care institutions of Russia in 2010-2020. The frequency of continuous use of anti-noise personal protective equipment decreased from 77.8 % (2010–2015) to 75.4 % (2016–2020). Occupational neurosensory hearing loss was diagnosed in 79.4 % of workers based on periodic medical examinations and in 20.6 % of workers based on self-referrals. The decision to refer an employee for determination of the degree of disability was made in 16.5 % of cases.Discussion On the basis of the scientific literature and the results of our study, a proposal to take into account not only physical, but also chemical occupational hazards that aggravate the impact of industrial noise on employee health, as well as the anamnesis of tobacco smoking, cardiovascular disease, diabetes mellitus and atherosclerosis.Conclusion The risk group for occupational neurosensory hearing loss is men over 50 years of age. The duration of formation of this pathology is 34,1 ± 1,1 years at the PS level of 90,6 ± 1,0 dB. The importance of optimal organization of periodic medical examinations and the need to control the use of anti-noise personal protective equipment in the workplace is noted.
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