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1986 - 1987年切尔诺贝利清理工作人员因主要非肿瘤性疾病导致的死亡水平及相对风险(观察期为1988 - 2021年)

LEVELS AND RELATIVE RISKS OF MORTALITY OF CHORNOBYL CLEAN-UP WORKERS IN 1986-1987 YEARS FROM MAIN NON-NEOPLASTIC DISEASES (OBSERVATION PERIOD 1988-2021).

作者信息

Fedirko P A, Babenko T F, Kapustinska O A, Belyaev Y M, Tereshchenko S O, Dorichevska R Y

机构信息

State Institution «National Scientific Center for Radiation Medicine, Hematology and Oncology of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.

State Institution «Ukrainian Center of Information Technologies and National Register of the Ministry of Health of Ukraine», 119/121 Beresteyskyi Ave., Kyiv, 03115, Ukraine.

出版信息

Probl Radiac Med Radiobiol. 2024 Dec(29):182-198. doi: 10.33145/2304-8336-2024-29-182-198.

Abstract

UNLABELLED

The emergency destruction of the 4th reactor of the Chornobyl nuclear power plant necessitated large-scale emergency work, which involved large contingents of specialists. Analysis the mortality of Chornobyl clean-up workers isan important and relevant basis for planning medical protection measures in conditions of a potential threat ofemergency and other radiation situations.The objective of this work is to determine the levels and relative risks of mortality of Chornobyl clean-up workers in1986-1987 years from major non-tumor diseases depending on the received dose of radiation exposure, taking intoaccount age and time after the accident (period of epidemiological studies 1988-2021).

MATERIALS AND METHODS

The cohort of Chornobyl clean-up workers in 1986-1987 years with a known dose of external γ-irradiation of the whole body, totaling 64,490 male, was divided by age at the date of the accident at theChornobyl nuclear power plant and dose of external γ-irradiation of the whole body. Epidemiological analysis of mortality from non-tumor diseases was conducted for the entire post-accident period and in dynamics over five-yearmonitoring periods.

RESULTS

The highest mortality rate, regardless of age, on the date of the Chornobyl disaster, were from diseases of thecirculatory system, of the digestive and respiratory systems. For Chornobyl clean-up workers 18-39 years on the dateof the accident, relative risks of mortality from non-tumor diseases over the entire observation period were significantly higher in all dose subgroups (from 0.05 Gy to 0.7 Gy) compared to the dose subgroup < 0.05 Gy. In the period1993-1997 (6-10 years after the Chornobyl accident), significantly higher relative risks of mortality from diseases ofthe circulatory system (pulmonary heart and pulmonary circulatory disorders, cardiomyopathy, myocardial infarction)were found; in 26-30 years - from cerebrovascular diseases, including cerebral infarction. The indicated reliabledose-dependent relative risks are characteristic of all dose subgroups relative to the subgroup with a dose < 0.05 Gy.

CONCLUSIONS

The overall mortality of Chornobyl clean-up workers from non-tumor diseases tends to increase. Theresults of the risk analysis of dose dependent mortality in the Chornobyl clean-up workers cohort showed a highersensitivity to ionizing radiation of persons of the younger age group (18-39 years old at the date of the accident).The most dangerous period of relative dose-dependent risk of death of Chornobyl clean-up workers due to non-tumordiseases was established - 6-10 years after radiation exposure for all dose subgroups (from 0.05 Gy to 0.7 Gy) relative to the subgroup with a radiation dose < 0.05 Gy.

摘要

未标注

切尔诺贝利核电站4号反应堆的紧急销毁需要开展大规模应急工作,这涉及大量专业人员。分析切尔诺贝利清理人员的死亡率是在潜在紧急威胁和其他辐射情况下规划医疗防护措施的重要且相关的依据。这项工作的目的是确定1986 - 1987年切尔诺贝利清理人员因主要非肿瘤疾病导致的死亡率水平及相对风险,该风险取决于所接受的辐射剂量,并考虑年龄和事故发生后的时间(流行病学研究时间段为1988 - 2021年)。

材料与方法

1986 - 1987年已知全身外部γ辐射剂量的切尔诺贝利清理人员队列,共计64490名男性,按照切尔诺贝利核电站事故发生时的年龄和全身外部γ辐射剂量进行划分。对事故后的整个时期以及五年监测期内非肿瘤疾病死亡率进行了流行病学分析。

结果

无论年龄大小,在切尔诺贝利灾难发生当日,死亡率最高的是循环系统疾病、消化系统和呼吸系统疾病。对于事故发生当日年龄在18 - 39岁的切尔诺贝利清理人员,在整个观察期内,所有剂量亚组(从0.05 Gy到0.7 Gy)非肿瘤疾病的相对死亡风险相较于剂量亚组< 0.05 Gy均显著更高。在1993 - 1997年期间(切尔诺贝利事故发生后的6 - 10年),发现循环系统疾病(肺心病和肺循环障碍、心肌病、心肌梗死)的相对死亡风险显著更高;在事故发生后的26 - 30年,脑血管疾病(包括脑梗死)的相对死亡风险显著更高。相对于剂量< 0.05 Gy的亚组,所有剂量亚组均呈现出上述可靠的剂量依赖性相对风险特征。

结论

切尔诺贝利清理人员因非肿瘤疾病导致的总体死亡率呈上升趋势。切尔诺贝利清理人员队列中剂量依赖性死亡率的风险分析结果表明,年龄较小的人群(事故发生当日年龄在18 - 39岁)对电离辐射更为敏感。确定了切尔诺贝利清理人员因非肿瘤疾病导致的相对剂量依赖性死亡风险最危险时期——相对于辐射剂量< 0.05 Gy的亚组,所有剂量亚组(从0.05 Gy到0.7 Gy)在辐射暴露后的6 - 10年。

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