Lopes Julie, Leuraud Klervi, Klokov Dmitry, Durand Christelle, Bernier Marie-Odile, Baudin Clémence
Laboratory of Epidemiology (LEPID), Institute for Radiobiological Protection and Nuclear Safety (IRSN), 92262 Fontenay-aux-Roses, France.
Experimental Radiotoxicology and Radiobiology Laboratory (LRTOX), Institute for Radiobiological Protection and Nuclear Safety (IRSN), 92262 Fontenay-aux-Roses, France.
Brain Sci. 2022 Jul 26;12(8):984. doi: 10.3390/brainsci12080984.
Background: High-dose ionizing radiation (IR) (>0.5 Gy) is an established risk factor for cognitive impairments, but this cannot be concluded for low-to-moderate IR exposure (<0.5 Gy) in adulthood as study results are inconsistent. The objectives are to summarize relevant epidemiological studies of low-to-moderate IR exposure in adulthood and to assess the risk of non-cancerous CNS diseases. Methods: A systematic literature search of four electronic databases was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled standardized mortality ratios, relative risks, and excess relative risks (ERR) were estimated with a random effect model. Results: Forty-five publications were included in the systematic review, including thirty-three in the quantitative meta-analysis. The following sources of IR-exposure were considered: atomic bomb, occupational, environmental, and medical exposure. Increased dose-risk relationships were found for cerebrovascular diseases incidence and mortality (ERRpooled per 100 mGy = 0.04; 95% CI: 0.03−0.05; ERRpooled at 100 mGy = 0.01; 95% CI: −0.00−0.02, respectively) and for Parkinson’s disease (ERRpooled at 100 mGy = 0.11; 95% CI: 0.06−0.16); Conclusions: Our findings suggest that adult low-to-moderate IR exposure may have effects on non-cancerous CNS diseases. Further research addressing inherent variation issues is encouraged.
高剂量电离辐射（IR）（>0.5 Gy）是认知障碍的既定风险因素，但对于成年期低至中度IR暴露（<0.5 Gy）而言，由于研究结果不一致，无法得出此结论。目的是总结成年期低至中度IR暴露的相关流行病学研究，并评估非癌性中枢神经系统疾病的风险。方法：对四个电子数据库进行系统的文献检索，以检索2000年至2022年发表的相关流行病学研究。采用随机效应模型估计合并标准化死亡率、相对风险和超额相对风险（ERR）。结果：系统评价纳入45篇文献，其中33篇纳入定量荟萃分析。考虑了以下IR暴露源：原子弹、职业、环境和医疗暴露。发现脑血管疾病发病率和死亡率的剂量-风险关系增加（每100 mGy的合并ERR = 0.04；95% CI：0.03−0.05；100 mGy时的合并ERR = 0.01；95% CI：−0.00−0.02）以及帕金森病（100 mGy时的合并ERR = 0.11；95% CI：0.06−0.16）；结论：我们的研究结果表明，成年期低至中度IR暴露可能对非癌性中枢神经系统疾病有影响。鼓励针对固有变异问题进行进一步研究。
