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月球、火星与心智:在低剂量效应百万人研究中评估美国辐射工人和退伍军人的帕金森病死亡率。

Moon, Mars and Minds: Evaluating Parkinson's disease mortality among U.S. radiation workers and veterans in the million person study of low-dose effects.

机构信息

Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Department of Physics, University of Zürich, Zürich, Switzerland.

出版信息

Z Med Phys. 2024 Feb;34(1):100-110. doi: 10.1016/j.zemedi.2023.07.002. Epub 2023 Aug 1.

Abstract

BACKGROUND

Radiation is one of the most important stressors related to missions in space beyond Earth's orbit. Epidemiologic studies of exposed workers have reported elevated rates of Parkinson's disease. The importance of cognitive dysfunction related to low-dose rate radiation in humans is not defined. A meta-analysis was conducted of six cohorts in the Million Person Study (MPS) of low-dose health effects to learn whether there is consistent evidence that Parkinson's disease is associated with radiation dose to brain.

MATERIALS AND METHODS

The MPS evaluates all causes of death among U.S. radiation workers and veterans, including Parkinson's disease. Systematic and consistent methods are applied to study all categories of workers including medical radiation workers, industrial radiographers, nuclear power plant workers, atomic veterans, and Manhattan Projects workers at the Los Alamos National Laboratory and at Rocky Flats. Consistent methods for all cohorts are used to estimate organ-specific doses and to obtain vital status and cause of death.

RESULTS

The meta-analysis include 6 cohorts within the MPS, consisting of 517,608 workers and 17,219,001 person-years of observation. The mean dose to brain ranged from 6.9 to 47.6 mGy and the maximum dose from 0.76 to 2.7 Gy. Five of the 6 cohorts revealed positive associations with Parkinson's disease. The overall summary estimate from the meta-analysis was statistically significant based on 1573 deaths due to Parkinson's disease. The summary excess relative risk at 100 mGy was 0.17 (95% CI: 0.05; 0.29).

CONCLUSIONS

Parkinson's disease was positively associated with radiation in the MPS cohorts indicating the need for careful evaluation as to causality in other studies, delineation of possible mechanisms, and assessing possible implications for space travel as well as radiation protection guidance for terrestrial workers.

摘要

背景

辐射是与地球轨道以外的太空任务相关的最重要应激源之一。暴露于辐射的工人的流行病学研究报告称帕金森病的发病率升高。低剂量率辐射引起认知功能障碍的重要性尚未确定。对 Million Person Study(MPS)中与低剂量健康影响相关的六个队列进行了荟萃分析,以了解帕金森病是否与大脑的辐射剂量有关。

材料和方法

MPS 评估了美国辐射工人和退伍军人的所有死因,包括帕金森病。系统和一致的方法应用于研究所有类别的工人,包括医疗辐射工作者、工业放射技师、核电站工人、原子老兵以及洛斯阿拉莫斯国家实验室和洛基弗拉茨的曼哈顿计划工作者。使用一致的方法对所有队列进行剂量估算,以获得生命状态和死因。

结果

荟萃分析包括 MPS 中的 6 个队列,由 517608 名工人和 17219001 人年的观察组成。大脑的平均剂量范围从 6.9 到 47.6 mGy,最大剂量从 0.76 到 2.7 Gy。6 个队列中的 5 个显示出与帕金森病的阳性关联。荟萃分析的总体汇总估计基于 1573 例帕金森病死亡病例,具有统计学意义。100 mGy 时的汇总超额相对风险为 0.17(95%CI:0.05;0.29)。

结论

MPS 队列中的帕金森病与辐射呈正相关,表明需要在其他研究中仔细评估因果关系,确定可能的机制,并评估对太空旅行的潜在影响以及陆地工人的辐射防护指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b880/10919963/18c209a17cce/gr1.jpg

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