Cardiovascular Diseases in the Cohort of Workers First Employed at Mayak PA in 1948–1958

Abstract

Incidence of and mortality from cardiovascular diseases have been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948-1958 and followed up to 31 December 2000. Information on external gamma-ray doses is available for virtually all of these workers (99.9%); the mean total gamma-ray dose (+/-SD) was 0.91 +/- 0.95 Gy (99% percentile 3.9 Gy) for men and 0.65 +/- 0.75 Gy (99% percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured for only 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium alpha exposure (+/- SD) was 0.40 +/- 1.15 Gy (99% percentile 5.88 Gy) for men and 0.81 +/- 4.60 Gy (99% percentile 15.95 Gy) for women. A total of 3751 cases of ischemic heart disease (IHD), including 683 cases of acute myocardial infarction (AMI), and 1495 IHD deaths, including 338 AMI deaths, were identified in the study cohort during the follow-up period. Having adjusted for non-radiation factors, there were statistically significant increasing trends with both total external gamma-ray dose and internal liver dose in IHD incidence. The trend with internal dose was weaker and was not statistically significant after adjusting for external dose, whereas the external dose trend was little changed after adjusting for internal dose. The trend with external dose in IHD mortality was not statistically significantly greater than zero but was consistent with the corresponding trend in IHD incidence. The estimated trend in IHD mortality with internal dose was lower and was not statistically significant once adjustment was made for external dose. There was a statistically significantly increasing trend in AMI incidence but not AMI incidence with external dose. The risk estimates for IHD in relation to external radiation are generally compatible with those from other large occupational studies and the Japanese A-bomb survivors.

Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study

“…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.…”

“…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].…”

Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer

“…4 Nevertheless, in most women, the heart still receives doses of 1 to 5 Gy. [5][6][7][8][9][10][11] Several studies have suggested that exposures at this level can cause is che mic heart disease, [12][13][14] but the magnitude of the risk after any given dose to the heart is uncertain, as are the time to the development of any radiation-related disease and the influence of other cardiac risk factors. We therefore conducted a study relating the risk of is chemic heart disease after radiotherapy to each woman's radiation dose to the heart and to any cardiac risk factors she had at the time of radiotherapy.…”

Biological Effectiveness of Ionizing Radiation: Acute vs. Protracted Exposures

“…and digestive systems, was reported in [22], which can be seen as circumstantial evidence in favor of dose-related differences in medical surveillance and self-reporting, a phenomenon noticed also by other researchers in populations exposed to radiation [28], discussed in [29]. In the author's opinion, the dose-effect relationships with non-neoplastic diseases [30][31][32][33][34] call in question such relationships with cancer, reported e.g. in the studies [23,24,[35][36][37][38][39][40][41][42][43] including those cited in [2,25] in support of the DDREF lowering.…”