Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk region, Russia.
Radiat Res. 2010 Dec;174(6):851-64. doi: 10.1667/RR1928.1. Epub 2010 Sep 15.
The incidence of and mortality from cerebrovascular diseases (CVD) 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 γ-ray doses is available for virtually all of these workers (99.9%); the mean total γ-ray dose (± SD) was 0.91 ± 0.95 Gy (99th percentile 3.9 Gy) for men and 0.65 ± 0.75 Gy (99th percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured only for 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium α-particle exposure (± SD) was 0.40 ± 1.15 Gy (99th percentile 5.88 Gy) for men and 0.81 ± 4.60 Gy (99th percentile 15.95 Gy) for women. A total of 4418 cases of CVD, including 665 cases of stroke, and 753 deaths from CVD, including 404 deaths from stroke, were identified in the study cohort. Having adjusted for non-radiation factors, there were statistically significant increasing trends in CVD incidence but not mortality with both total external γ-ray dose and internal liver dose. Much of the evidence for increased incidence in relation to external dose arose for workers with cumulative doses above 1 Gy. Although the dose response is consistent with linearity, the statistical power to detect non-linearity at external doses below 1 Gy was low. CVD incidence was statistically significantly higher among workers with a plutonium liver dose above 0.1 Gy. There was a statistically significant increasing trend in incidence with increasing internal dose, even after adjusting for external dose, although the trend estimates differed between workers at different plants. The risk estimates for external radiation are generally compatible with those from other large occupational studies, although the incidence data point to higher risk estimates compared to those from the Japanese A-bomb survivors.
对 1948 年至 1958 年期间在马雅克核设施主要工厂之一首次就业的 12210 名工人进行了队列研究，以研究脑血管疾病（CVD）的发病率和死亡率。几乎所有这些工人（99.9%）的外部γ射线剂量信息都可用；男性的总γ射线剂量（±SD）平均值为 0.91 ± 0.95Gy（99%的 3.9Gy），女性为 0.65 ± 0.75Gy（99%的 2.99Gy）。相比之下，钚体负荷仅测量了 30.0%的工人；在监测的工人中，钚α粒子暴露的累积肝剂量（±SD）平均值为男性 0.40 ± 1.15Gy（99%的 5.88Gy），女性 0.81 ± 4.60Gy（99%的 15.95Gy）。在研究队列中，共确定了 4418 例 CVD 病例，包括 665 例中风病例，以及 753 例 CVD 死亡病例，包括 404 例中风死亡病例。在调整了非辐射因素后，总外部γ射线剂量和内部肝脏剂量均与 CVD 发病率呈统计学上显著的上升趋势，但死亡率没有变化。与外部剂量相关的发病率增加的大部分证据来自累积剂量超过 1Gy 的工人。虽然剂量反应呈线性，但在低于 1Gy 的外部剂量下检测非线性的统计能力较低。在累积钚肝剂量超过 0.1Gy 的工人中，CVD 的发病率明显更高。即使在调整了外部剂量后，内部剂量的增加也与发病率呈统计学上显著的上升趋势，但不同工厂的工人的趋势估计值不同。外部辐射的风险估计值通常与其他大型职业研究的结果一致，尽管发病率数据表明与日本原子弹幸存者的结果相比，风险估计值更高。
