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Mortality from Circulatory Diseases and other Non-Cancer Outcomes among Nuclear Workers in France, the United Kingdom and the United States (INWORKS).
Gillies, Michael; Richardson, David B; Cardis, Elisabeth; Daniels, Robert D; O'Hagan, Jacqueline A; Haylock, Richard; Laurier, Dominique; Leuraud, Klervi; Moissonnier, Monika; Schubauer-Berigan, Mary K; Thierry-Chef, Isabelle; Kesminiene, Ausrele.
Afiliação
  • Gillies M; a Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom.
  • Richardson DB; b Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
  • Cardis E; c ISGlobal, Center for Research in Environmental Epidemiology (ISGlobal), Barcelona, Spain.
  • Daniels RD; d Universitat Pompeu Fabra (UPF), Barcelona, Spain.
  • O'Hagan JA; e CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
  • Haylock R; f National Institute for Occupational Safety and Health, Cincinnati, Ohio.
  • Laurier D; a Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom.
  • Leuraud K; a Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom.
  • Moissonnier M; g Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, 92262 Fontenay-aux-Roses, France.
  • Schubauer-Berigan MK; g Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, 92262 Fontenay-aux-Roses, France.
  • Thierry-Chef I; h International Agency for Research on Cancer, Lyon, France.
  • Kesminiene A; f National Institute for Occupational Safety and Health, Cincinnati, Ohio.
Radiat Res ; 188(3): 276-290, 2017 09.
Article em En | MEDLINE | ID: mdl-28692406
Positive associations between external radiation dose and non-cancer mortality have been found in a number of published studies, primarily of populations exposed to high-dose, high-dose-rate ionizing radiation. The goal of this study was to determine whether external radiation dose was associated with non-cancer mortality in a large pooled cohort of nuclear workers exposed to low-dose radiation accumulated at low dose rates. The cohort comprised 308,297 workers from France, United Kingdom and United States. The average cumulative equivalent dose at a tissue depth of 10 mm [Hp(10)] was 25.2 mSv. In total, 22% of the cohort were deceased by the end of follow-up, with 46,029 deaths attributed to non-cancer outcomes, including 27,848 deaths attributed to circulatory diseases. Poisson regression was used to investigate the relationship between cumulative radiation dose and non-cancer mortality rates. A statistically significant association between radiation dose and all non-cancer causes of death was observed [excess relative risk per sievert (ERR/Sv) = 0.19; 90% CI: 0.07, 0.30]. This was largely driven by the association between radiation dose and mortality due to circulatory diseases (ERR/Sv = 0.22; 90% CI: 0.08, 0.37), with slightly smaller positive, but nonsignificant, point estimates for mortality due to nonmalignant respiratory disease (ERR/Sv = 0.13; 90% CI: -0.17, 0.47) and digestive disease (ERR/Sv = 0.11; 90% CI: -0.36, 0.69). The point estimate for the association between radiation dose and deaths due to external causes of death was nonsignificantly negative (ERR = -0.12; 90% CI: <-0.60, 0.45). Within circulatory disease subtypes, associations with dose were observed for mortality due to cerebrovascular disease (ERR/Sv = 0.50; 90% CI: 0.12, 0.94) and mortality due to ischemic heart disease (ERR/Sv = 0.18; 90% CI: 0.004, 0.36). The estimates of associations between radiation dose and non-cancer mortality are generally consistent with those observed in atomic bomb survivor studies. The findings of this study could be interpreted as providing further evidence that non-cancer disease risks may be increased by external radiation exposure, particularly for ischemic heart disease and cerebrovascular disease. However, heterogeneity in the estimated ERR/Sv was observed, which warrants further investigation. Further follow-up of these cohorts, with the inclusion of internal exposure information and other potential confounders associated with lifestyle factors, may prove informative, as will further work on elucidating the biological mechanisms that might cause these non-cancer effects at low doses.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 12_ODS3_hazardous_contamination / 3_ND / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Transtornos Respiratórios / Doenças Cardiovasculares / Exposição Ocupacional / Exposição à Radiação / Centrais Nucleares Tipo de estudo: Etiology_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Revista: Radiat Res Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 12_ODS3_hazardous_contamination / 3_ND / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Transtornos Respiratórios / Doenças Cardiovasculares / Exposição Ocupacional / Exposição à Radiação / Centrais Nucleares Tipo de estudo: Etiology_studies / Prevalence_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Revista: Radiat Res Ano de publicação: 2017 Tipo de documento: Article