Belyi D, Nastina O, Sydorenko G, Kursina N, Bazyka O, Gabulavichene Z, Kovaliov O
State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2019 Dec;24:350-366. doi: 10.33145/2304-8336-2019-24-350-366.
The objective of this investigation is to determine features of hypertensive heart disease (HHD) and coronary heart disease (CHD) development in emergency workers (EW) of Chornobyl Nuclear Power Plant (ChNPP) in dependence on gender, occupation, duration of stay under radiation and the nature of performed job.
During the period from 2012 to 2018, 483 male EW (EW-m) and 134 female EW (EW-f), who worked in the accident zone over 1986-1987, were examined. All EW of both gender at the time of emergency works had no signs of cardiac pathology. The diagnosis of cardiovascular disease was established in accordance with the diagnostic standards adopted in Ukraine [2964], on the basis of clinical and laboratory examination.
EW could be divided into the following categories according to their occupational membership and nature of performed job: (1) ChNPP staff, (2) persons engaged in construction works (builders), (3) drivers, (4) engineers and technicians, (5) Soviet Army (SA) personnel, policemen and firemen served in Ministry of Internal Affairs (MIA), officers of Interior Troops (IT), (6) low skilled laborers (LSL), (7) medical staff (doctors, nurses, paramedics) and (8) service staff. Among all examined men and women who took part in emergency work, the overwhelming majority stood in the accident area from the end of April to the end of December 1986: 440 men and 111 women. Others were involved to work during 1987. Most men and women worked on liquidation of the accident from April 26, 1986 to the end of May (349 and 71 persons respectively), with the proportion of men was significantly higher. In the rest months of 1986 and the beginning of 1987, on the contrary, the relative number of women involved in the accident exceeded the proportion of men.The EW-m of all occupations were in the risk zone of the cardiovascular diseases, and the HHD development truly correlated with service in MIA, SA and IT, CHD development with profession of engi- neer and technician, and builder as well, and MI development with driver job. The risk of HHD development during the first 10 years after the accident was 4.6 times higher among officers of MIA, SA and IT who had non-shift work in Prypiat and/or at the ChNPP comparing with persons of other occupations and working conditions. The risk of CHD development during the first 15 years was 8.2 times higher in the engineers and technicians who worked in the 30-km zone, compared with other EW and risk of MI throughout the observation period was 6.4 times higher in the drivers, who had shift work in a 30-km zone. In EW-f the risk of HHD developing during the first 10 years after the accident was 2.1 times lower than those who worked in the service sector (kitchen, trade, economists and account- ants, communications, etc.) compared with the representatives of any other profession, and the risk of CHD devel- oping during the first 15 years after the accident was higher in medical staff and EW of other occupational cate- gories that had shift work. Women who worked with shifts had a 4.8-fold higher risk of MI developing than those who had limited terms of work with the subsequent withdrawal from the accident area.
For more accurately assess the radiation effects on the cardiovascular system of persons who took part in the emergency works at the ChNPP, it should not be limited by comparing the effects of unexposed populations, but to take into account the EW professional affiliation, the terms of stay in the accident area and the nature of performed work.
本研究的目的是确定切尔诺贝利核电站(ChNPP)应急工作人员(EW)中高血压性心脏病(HHD)和冠心病(CHD)的发展特征,这些特征取决于性别、职业、辐射暴露时间以及所从事工作的性质。
在2012年至2018年期间,对1986 - 1987年在事故区域工作的483名男性应急工作人员(EW - m)和134名女性应急工作人员(EW - f)进行了检查。所有参与应急工作的男女EW在应急工作时均无心脏病理迹象。心血管疾病的诊断依据乌克兰采用的诊断标准[2964],基于临床和实验室检查确定。
根据职业归属和所从事工作的性质,EW可分为以下几类:(1)ChNPP工作人员,(2)从事建筑工作的人员(建筑工人),(3)司机,(4)工程师和技术人员,(5)苏联军队(SA)人员、在内务部(MIA)服役的警察和消防员、内务部队(IT)军官,(6)低技能劳动者(LSL),(7)医务人员(医生、护士、护理人员)和(8)服务人员。在所有参与应急工作的男性和女性中,绝大多数人在1986年4月底至12月底期间身处事故区域:440名男性和111名女性。其他人在1987年参与工作。大多数男性和女性在1986年4月26日至5月底参与事故清理工作(分别为349人和71人),男性比例显著更高。相反,在1986年其余月份和1987年初,参与事故的女性相对数量超过男性比例。所有职业的EW - m都处于心血管疾病的风险区域,HHD的发展与在MIA、SA和IT部门工作确实相关,CHD的发展与工程师和技术人员以及建筑工人的职业相关,心肌梗死(MI)的发展与司机工作相关。与其他职业和工作条件的人员相比,在普里皮亚季和/或ChNPP进行非轮班工作的MIA、SA和IT军官在事故发生后的前10年中患HHD的风险高出4.6倍。在30公里区域工作的工程师和技术人员在事故发生后的前15年中患CHD的风险比其他EW高出8.2倍,在整个观察期内,在30公里区域进行轮班工作的司机患MI的风险比其他EW高出6.4倍。在EW - f中,与任何其他职业的代表相比,事故发生后的前10年中患HHD的风险比在服务部门(厨房、贸易、经济学家和会计、通信等)工作的人员低2.1倍,事故发生后的前15年中,医务人员和其他职业类别且进行轮班工作的EW患CHD的风险更高。进行轮班工作的女性患MI的风险比工作期限有限随后撤离事故区域的女性高4.8倍。
为了更准确地评估辐射对参与ChNPP应急工作的人员心血管系统的影响,不应局限于比较未暴露人群的影响,而应考虑EW的职业归属、在事故区域的停留时间以及所从事工作的性质。