Kashcheev V V, Chekin S Yu, Maksioutov M A, Tumanov K A, Menyaylo A N, Kochergina E V, Kashcheeva P V, Gorsky A I, Shchukina N V, Karpenko S V, Ivanov V K
*A. Tsyb Medical Radiological Research Centre-Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4 Korolyov Street, 249036, Obninsk, Kaluga Region, Russia.
Health Phys. 2016 Aug;111(2):192-7. doi: 10.1097/HP.0000000000000523.
The paper presents an analysis of the incidence of cerebrovascular diseases (CeVD) in the cohort of Russian workers involved in recovery tasks after the Chernobyl accident. The studied cohort consists of 53,772 recovery operation workers (liquidators) who arrived in the zone of the Chernobyl accident within the first year after this accident (26 April 1986-26 April 1987). The mean external whole body dose in the cohort was 0.161 Gy, while individual doses varied from 0.0001 Gy to 1.42 Gy. During the follow-up period 1986-2012, a total of 23,264 cases of CeVD were diagnosed as a result of annual health examinations. A Poisson regression model was applied for estimation of radiation risks and for an assessment of other risk factors of CeVD. The following factors were considered as risk factors for CeVD: the dose, duration of the liquidators' work in the Chernobyl zone, and the concomitant diseases (hypertension, ischemic heart disease, atherosclerosis, and diabetes). The baseline incidence of CeVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CeVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR/Gy = 0.45, 95% CI: (0.28, 0.62), p < 0.001. Radiation risks of CeVD statistically significantly (p = 0.03) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.64, 95% CI = (0.38; 0.93), p < 0.001. Among studied concomitant diseases, diabetes mellitus statistically significantly (p = 0.002) increases the radiation risk of CeVD: for liquidators with diagnosed diabetes, ERR/Gy = 1.29.
本文对参与切尔诺贝利事故后恢复工作的俄罗斯工人队列中的脑血管疾病(CeVD)发病率进行了分析。所研究的队列由53772名恢复行动工人(清理人员)组成,他们在事故发生后的第一年(1986年4月26日至1987年4月26日)抵达切尔诺贝利事故区域。该队列的平均全身外照射剂量为0.161 Gy,而个体剂量从0.0001 Gy到1.42 Gy不等。在1986 - 2012年的随访期间,通过年度健康检查共诊断出23264例CeVD病例。应用泊松回归模型来估计辐射风险并评估CeVD的其他风险因素。以下因素被视为CeVD的风险因素:剂量、清理人员在切尔诺贝利区域的工作时长以及伴随疾病(高血压、缺血性心脏病、动脉粥样硬化和糖尿病)。CeVD的基线发病率与所有研究的伴随疾病在统计学上具有显著相关性(p < 0.001)。CeVD的发病率显示出统计学上显著的剂量反应,不存在潜伏期,平均每Gy的超额相对危险度(ERR/Gy)= 0.45,95%置信区间:(0.28,0.62),p < 0.001。CeVD的辐射风险在统计学上显著(p = 0.03)随清理人员在切尔诺贝利区域停留的时长而变化;对于那些在切尔诺贝利区域停留少于6周的人,ERR/Gy = 0.64,95%置信区间 =(0.38;0.93),p < 0.001。在所研究的伴随疾病中,糖尿病在统计学上显著(p = 0.002)增加了CeVD的辐射风险:对于诊断患有糖尿病的清理人员,ERR/Gy = 1.29。