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

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

“…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.…”

“…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.…”

“…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.…”

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].…”