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切尔诺贝利事故俄罗斯应急工作人员队列中心血管疾病的辐射风险

Radiation Risk of Cardiovascular Diseases in the Cohort of Russian Emergency Workers of the Chernobyl Accident.

作者信息

Kashcheev V V, Chekin S Yu, Karpenko S V, Maksioutov M A, Menyaylo A N, Tumanov K A, Kochergina E V, Kashcheeva P V, Gorsky A I, Shchukina N V, Lovachev S S, Vlasov O K, Ivanov V K

机构信息

*Medical Radiological Research Centre of Russian Academy of Medical Sciences, 4 Korolev Street, Obninsk 249036, Russia.

出版信息

Health Phys. 2017 Jul;113(1):23-29. doi: 10.1097/HP.0000000000000670.

Abstract

This paper continues a series of publications that analyze the impact of radiation on incidence of circulatory system diseases in the cohort of Russian recovery operation workers (liquidators) and presents the results of the analysis of cardiovascular disease (CVD) incidence. The studied cohort consists of 53,772 liquidators who arrived in the Chernobyl accident zone within the first year after the accident (26 April 1986 to 26 April 1987). The individual doses varied from 0.0001 Gy to 1.42 Gy, and the mean external whole body dose in the cohort was 0.161 Gy. A total of 27,456 cases of CVD were diagnosed during the follow-up period 1986-2012 as a result of annual health examinations. A Poisson regression model was applied to estimate radiation risks and other risk factors associated with CVD. The following factors were identified as risk factors for CVD: the dose, duration of the liquidators' work in the Chernobyl zone, and concomitant diseases (diabetes mellitus, hypertension, overweight, and alcohol dependence). The baseline incidence of CVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR Gy = 0.47, 95% CI = 0.31, 0.63, p < 0.001. Radiation risks of CVD statistically significantly (p = 0.01) 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 = 0.80, 95% CI = 0.53; 1.08, p < 0.001.

摘要

本文延续了一系列分析辐射对俄罗斯恢复行动工作人员(清理者)队列中循环系统疾病发病率影响的出版物,并展示了心血管疾病(CVD)发病率的分析结果。所研究的队列由53772名清理者组成,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。个体剂量从0.0001戈瑞到1.42戈瑞不等,该队列的平均全身外照射剂量为0.161戈瑞。在1986 - 2012年的随访期间,通过年度健康检查共诊断出27456例心血管疾病病例。应用泊松回归模型来估计与心血管疾病相关的辐射风险和其他风险因素。以下因素被确定为心血管疾病的风险因素:剂量、清理者在切尔诺贝利区域的工作时长以及伴随疾病(糖尿病、高血压、超重和酒精依赖)。心血管疾病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)。心血管疾病的发病率显示出统计学上显著的剂量反应,无潜伏期,平均每戈瑞超额相对危险度(ERR)= 0.47,95%置信区间(CI)= 0.31,0.63,p < 0.001。心血管疾病的辐射风险在统计学上有显著差异(p = 0.01),随清理者在切尔诺贝利区域停留时间的不同而变化;对于那些在切尔诺贝利区域停留少于6周的人,ERR/戈瑞 = 0.80,95% CI = 0.53;1.08,p < 0.001。

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