Abstract
Incidence risks for cerebrovascular diseases (CeVD) and some types of stroke in a cohort of 22,377 Russian Mayak nuclear workers chronically exposed to ionising radiation and followed up until the end of 2018 are reported. Among total 9469 cases of CeVD, 2078 cases were strokes that included 262 hemorrhagic strokes (HS) and 1611 ischemic strokes (IS). Data evaluation was performed with categorical and dose–response analyses estimating the relative risk (RR) and excess relative risk (ERR) per unit cumulative liver absorbed dose of external gamma-ray or internal alpha-particle exposure based on a linear model utilizing the AMFIT module of the EPICURE software. CeVD incidence was found to be significantly associated with cumulative radiation dose: ERR/Gy was 0.37 (95% confidence interval (CI) 0.27, 0.47) in males and 0.47 (95% CI 0.31, 0.66) in females for external exposure, and 0.31 (95% CI 0.11, 0.59) in males and 0.32 (95% CI 0.11, 0.61) in females for internal exposure. When the model for the analysis of external radiation effect did not include an adjustment for alpha radiation dose (and vice versa), the radiogenic risk estimate increased notably both for males and for females. In contrast, exclusion from or inclusion in the model of additional adjustments for non-radiation factors did not notably change the risk estimates. ERR/Gy of external gamma dose for CeVD incidence significantly decreased with increasing attained age (males and females) and duration of employment (females). No significant associations of either stroke or its types with cumulative gamma-ray dose of external exposure or alpha-particle dose of internal exposure were found.
Similar content being viewed by others
Data availability
Protection of all personal data stored at SUBI are guaranteed by SUBI via the Institutional Review Board. SUBI is responsible for use of this data in compliance with the personal data protection national regulations and laws. Any access to the SUBI-protected individual/depersonalized data should be requested and granted upon approval by the Institutional Review Board (subi@subi.su).
Code availability
Not applicable.
References
AGIR (2010) Circulatory disease risk. Report of the independent Advisory Group on Ionising Radiation. Chilton:Doc HPA, RCE-16, p 116
Akaike H (1974) A new look at statistical model identification. IEEE Trans Autom Control 19:716223
Azizova TV, Day RD, Wald N, Muirhead CR, O’Hagan JA, Sumina MV, Belyaeva ZD, Druzhinina MB, Teplyakov II, Semenikhina NG, Stetsenko LA, Grigoryeva ES, Krupenina LN, Vlasenko EV (2008) The “Clinic” medical-dosimetric database of Mayak production association workers: structure, characteristics and prospects of utilization. Health Phys 94(5):449–458. https://doi.org/10.1097/01.HP.0000300757.00912.a2
Azizova TV, Muirhead CR, Druzhinina MB, Grigoryeva ES, Vlasenko EV, Sumina MV, O’Hagan JA, Zhang W, Haylock RGE, Hunter N (2010) Cerebrovascular diseases in the cohort of workers first employed at Mayak PA in 1948–1958. Radiat Res 174(6):851–864. https://doi.org/10.1667/RR1928.1
Azizova TV, Haylock RGE, Moseeva MB, Bannikova MV, Grigoryeva ES (2014) Cerebrovascular diseases incidence and mortality in an extended Mayak worker cohort 1948–1982. Radiat Res 182(5):529–544. https://doi.org/10.1667/RR13680.1
Borghini A, Gianicolo EAL, Picano E, Andreassi MG (2013) Ionizing radiation and atherosclerosis: current knowledge and future challenges. Atherosclerosis 230(1):40–47. https://doi.org/10.1016/j.atherosclerosis.2013.06.010
Cha ES, Zablotska LB, Bang YJ, Lee WJ (2020) Occupational radiation exposure and morbidity of circulatory disease among diagnostic medical radiation workers in South Korea. Occup Environ Med 77(11):752–760. https://doi.org/10.1136/oemed-2019-106326
Clement C, Rühm W, Harrison J, Applegate K, Cool D, Larsson C-M, Cousins C, Lochard J, Bouffler S, Cho K, Kai M, Laurier D, Liu S, Romanov S (2021) Keeping the ICRP recommendations fit for purpose. J Radiol Prot. https://doi.org/10.1088/1361-6498/ac1611
Gillies M, Richardson DB, Cardis E, Daniels RD, O’Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonier M, Schubauer-Berigan MK, Thierry-Chef I, Kesminiene A (2017) Mortality from circulatory diseases and other non-cancer outcomes among nuclear workers in France, the United Kingdom and the United States (INWORKS). Radiat Res 188(3):276–290. https://doi.org/10.1667/RR14608.1
Kashcheev VV, Chekin SYu, Maksioutov MA, Tumanov KA, Menyalo AN, Kochergina EV, Kashcheeva PV, Gorsky AI, Shchukina NV, Karpenko SV, Ivanov VK (2016) Radiation-epidemiological study of cerebrovascular diseases in the cohort of Russian recovery operation workers of the Chernobyl accident. Health Phys 111(2):192–197. https://doi.org/10.1097/HP.0000000000000523
Laurier D, Rühm W, Paquet F, Applegate K, Cool D, Clement C (2021) Areas of research to support the system of radiological protection. Radiat Environ Biophys 60:519–530. https://doi.org/10.1007/s00411-021-00947-1
Little MP (2016) Radiation and circulatory disease. Mutat Res 770(Pt B):299–318. https://doi.org/10.1016/j.mrrev.2016.07.008
Moseeva MB, Azizova TV, Grigoryeva ES, Haylock R (2014) Risk of circulatory diseases among Mayak PA workers with radiation doses estimated using the improved Mayak Worker Dosimetry System 2008. Radiat Environ Biophys 53(2):469–477. https://doi.org/10.1007/s00411-014-0517-x
Napier BA (2017) The Mayak worker dosimetry system (MWDS-2013): an introduction to the documentation. Radiat Prot Dosim 176(1–2):6–9. https://doi.org/10.1093/rpd/ncx020
Preston D, Lubin J, Pierce D, McConney M (1993) Epicure users guide. Hirosoft, Seattle, WA
Simonetto C, Schöllnberger H, Azizova TV, Grigoryeva ES, Pikulina MV, Eidemüller M (2015) Cerebrovascular diseases in workers at Mayak PA: the difference in radiation risk between incidence and mortality. PLoS One 10(5):e0125904. https://doi.org/10.1371/journal.pone.0125904
Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleinman NJ, MacVittie TJ, Aleman BM, Adgar AB, Mabuchi K, Muirhead CR, Shore RE, Wallace WH (2012) ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs – threshold doses for tissue reactions in a radiation protection context. Ann ICRP 41(12):1–322. https://doi.org/10.1016/j.icrp.2012.02.001
Takahashi I, Abbott RD, Ohshita T, Takahashi T, Ozasa K, Akahoshi M, Fujiwara S, Kodama K, Matsumo M (2012) A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980–2003). BMJ Open 2(1):e000654. https://doi.org/10.1136/bmjopen-2011-000654
Tapio S (2016) Pathology and biology of radiation-induced cardiac disease. J Radiat Res 57(5):439–448. https://doi.org/10.1093/jrr/rrw064
Tapio S, Little MP, Kaiser JC, Impens N, Hamada N, Georgakilas AG, Simar D, Salomaa S (2021) Ionizing radiation-induced circulatory and metabolic diseases. Environ Int 146:106235. https://doi.org/10.1016/j.envint.2020.106235
UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) Sources and Effects of Ionizing Radiation (2010) UNSCEAR 2008 report to the general assembly with scientific annexes. Volume I. Annex B: Exposures of the Public and Workers from Various Sources of Radiation. New York: United Nations; p 202
Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Lean J, Luendo-Fernandez R, Burns R, Rayner M, Townsend N (2017) European cardiovascular disease statistics, 2017th edn. European Heart Network, Brussels, p 192
Yamada M, Wong FL, Fujiwara S, Akahoshi M, Suzuki G (2004) Non-cancer disease incidence in atomic bomb survivors, 1958–1998. Radiat Res 161(6):622–632. https://doi.org/10.1667/rr3183
Funding
The study was financially supported by the Federal Medical Biological Agency of Russia.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation and data collection were performed by TVA and MBM. Data compilation, choice of statistical analysis methods and analysis were performed by ESG. The first draft of the manuscript was written by TVA and MBM. Interpretation of the results was provided by TVA, MBM, NH, ESG. All authors commented on the original and all succeeding versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interests.
Ethical approval
No direct contact of researchers with cohort members was required in this record-based epidemiological study. This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Review Board of the Southern Urals Biophysics Institute.
Consent to participate/consent for publication
Every individual included in a cohort for a study performed by SUBI provided a written informed consent stating that an individual agrees with SUBI storing and protecting his/her individual data and using depersonalized data for research purposes and that results of these studies may be published in the scientific literature.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Azizova, T.V., Moseeva, M.B., Grigoryeva, E.S. et al. Incidence risks for cerebrovascular diseases and types of stroke in a cohort of Mayak PA workers. Radiat Environ Biophys 61, 5–16 (2022). https://doi.org/10.1007/s00411-022-00966-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00411-022-00966-6