Cerebrovascular Diseases in Workers at Mayak PA: The Difference in Radiation Risk between Incidence and Mortality

PLoS One. 2015 May 1;10(5):e0125904. doi: 10.1371/journal.pone.0125904. eCollection 2015.

Abstract

A detailed analysis of cerebrovascular diseases (CeVD) for the cohort of workers at Mayak Production Association (PA) is presented. This cohort is especially suitable for the analysis of radiation induced circulatory diseases, due to the detailed medical surveillance and information on several risk factors. The risk after external, typically protracted, gamma exposure is analysed, accounting for potential additional internal alpha exposure. Three different endpoints have been investigated: incidence and mortality from all cerebrovascular diseases and incidence of stroke. Particular emphasis was given to the form of the dose-response relationship and the time dependence of the radiation induced risk. Young attained age was observed to be an important, aggravating modifier of radiation risk for incidence of CeVD and stroke. For incidence of CeVD, our analysis supports a dose response sub-linear for low doses. Finally, the excess relative risk per dose was confirmed to be significantly higher for incidence of CeVD compared to CeVD mortality and incidence of stroke. Arguments are presented for this difference to be based on a true biological effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Radiation-Induced / epidemiology*
  • Abnormalities, Radiation-Induced / physiopathology
  • Aged
  • Aged, 80 and over
  • Cerebrovascular Disorders / epidemiology*
  • Cerebrovascular Disorders / etiology
  • Cerebrovascular Disorders / physiopathology
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology*
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / physiopathology
  • Nuclear Weapons
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / etiology
  • Occupational Diseases / physiopathology
  • Occupational Exposure
  • Plutonium / adverse effects
  • Risk Factors

Substances

  • Plutonium

Grants and funding

This work was supported by a project of the German Federal Office for Radiation Protection (contract 3611S30022) and by the EU project ProCardio (contract number 295823). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.