Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, Russia, 456780.
Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan.
Eur J Epidemiol. 2018 Dec;33(12):1193-1204. doi: 10.1007/s10654-018-0450-4. Epub 2018 Oct 10.
This study is the first to report cataract type specific risks in a cohort of Russian Mayak Production Association workers following chronic occupational exposure to ionizing radiation. In this retrospective cohort study, 22,377 workers (females 25.4%) first employed in 1948-1982 were followed up till the end of 2008. All cataract subtypes were significantly dependent on sex, attained age, diabetes mellitus, myopia and glaucoma. For each of posterior subcapsular (PSC), cortical and nuclear cataracts, the risk of cataract incidence significantly linearly increased with increasing radiation dose. Excess relative risk per unit effective dose (ERR/Sv) from external γ-rays based on the linear model was 0.91 [95% confidence intervals (CIs) 0.67, 1.20] for PSC, 0.63 (95% CIs 0.49, 0.76) for cortical, and 0.47 (95% CIs 0.35, 0.60) for nuclear cataracts. For all three types of cataracts, exclusion of an adjustment for neutron dose as well as inclusion of additional adjustments for body mass index and smoking index decreased ERR/Sv of external γ-rays. Inclusion of an additional adjustment for glaucoma, however, modestly increased incidence risks for cortical and nuclear cataracts, but not PSC cataracts. Inclusion of an adjustment for diabetes mellitus decreased ERR/Sv of external γ-rays only for PSC incidence. Both males and females had increased risks for all three types of cataracts, but ERR/Sv was significantly higher in females than in males (p < 0.001), particularly for PSC cataracts. The results suggest that chronic occupational radiation exposure significantly increases risks of PSC, cortical and nuclear cataracts, and that such risks are higher in females than in males.
本研究首次报告了俄罗斯马雅克生产协会工作人员在慢性职业性电离辐射暴露后白内障类型特异性风险。在这项回顾性队列研究中,对 1948 年至 1982 年首次就业的 22377 名工人(女性占 25.4%)进行了随访,直至 2008 年底。所有白内障亚型均与性别、获得年龄、糖尿病、近视和青光眼显著相关。对于后囊下(PSC)、皮质和核白内障,白内障发病率的风险与辐射剂量呈显著线性增加。基于线性模型,外照射γ射线的单位有效剂量超额相对风险(ERR/Sv)分别为 PSC 0.91(95%置信区间[CI]为 0.67,1.20),皮质 0.63(95%CI 为 0.49,0.76),核 0.47(95%CI 为 0.35,0.60)。对于所有三种类型的白内障,排除对中子剂量的调整以及增加对体重指数和吸烟指数的调整,均降低了外照射γ射线的 ERR/Sv。然而,对青光眼进行额外调整会适度增加皮质和核白内障的发病风险,但不会增加 PSC 白内障的发病风险。对糖尿病进行调整仅降低了 PSC 发生率的外照射γ射线 ERR/Sv。男性和女性患所有三种类型白内障的风险均增加,但女性的 ERR/Sv 明显高于男性(p<0.001),尤其是 PSC 白内障。结果表明,慢性职业性辐射暴露显著增加了 PSC、皮质和核白内障的风险,且女性的风险高于男性。