Radiation Risk of Cardiovascular Diseases in the Cohort of Russian Emergency Workers of the Chernobyl Accident.

This paper continues a series of publications that analyze the impact of radiation on incidence of circulatory system diseases in the cohort of Russian recovery operation workers (liquidators) and presents the results of the analysis of cardiovascular disease (CVD) incidence. The studied cohort consists of 53,772 liquidators who arrived in the Chernobyl accident zone within the first year after the accident (26 April 1986 to 26 April 1987). The individual doses varied from 0.0001 Gy to 1.42 Gy, and the mean external whole body dose in the cohort was 0.161 Gy. A total of 27,456 cases of CVD were diagnosed during the follow-up period 1986-2012 as a result of annual health examinations. A Poisson regression model was applied to estimate radiation risks and other risk factors associated with CVD. The following factors were identified as risk factors for CVD: the dose, duration of the liquidators' work in the Chernobyl zone, and concomitant diseases (diabetes mellitus, hypertension, overweight, and alcohol dependence). The baseline incidence of CVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR Gy = 0.47, 95% CI = 0.31, 0.63, p < 0.001. Radiation risks of CVD statistically significantly (p = 0.01) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.80, 95% CI = 0.53; 1.08, p < 0.001.

Radiation-epidemiological studies of thyroid cancer incidence in Russia after the Chernobyl accident (estimation of radiation risks, 1991-2008 follow-up period).

This study presents an analysis of the thyroid cancer incidence in the population of the most contaminated territories of Bryansk, Kaluga, Oryol and Tula oblasts affected by the Chernobyl accident. The follow-up period is 1991-2008, and the cohort size is 309 130 people. For that period 978 thyroid cancer cases were detected. The excess relative risk per 1 Gy (ERR/Gy) is found to be statistically significant for children and adolescents (0-17 y of age) at the time of the Chernobyl accident (ERR/Gy=3.22; 95 % confidence interval (1.56; 5.81). In boys, the ERR/Gy was higher than in girls -6.54 and 2.24, respectively. A statistically significant decrease in ERR/Gy with time since exposure, by a factor of 0.37 per 10 y, was observed for the whole cohort and for boys separately, but not for girls. No radiation risks of a thyroid cancer among people of 18 y of age at exposure and older were found.

Radiation-epidemiological studies of thyroid cancer incidence among children and adolescents in the Bryansk oblast of Russia after the Chernobyl accident (1991-2001 follow-up period).

In this study, thyroid cancer incidence (follow-up period: 1991-2001) has been analyzed, including persons who were exposed as children at an age between 0 and 17 years and who are living in the Bryansk oblast, the worst contaminated area of Russia after the Chernobyl accident. According to the census of 1989, the population of this oblast comprises 375 thousand people. Thyroid doses from incorporated radioiodine isotopes -- both for the thyroid cancer cases and the study population -- were determined based on the official methodology approved by the Russian Scientific Commission on Radiation Protection. Between 1991 and 2001, a total of 199 thyroid cancer cases were diagnosed at cancer centers (the so-called oncological dispensaries) of the investigated regions. The performed analysis relies on medical and dosimetric information available from the Russian National Medical and Dosimetric Registry which was established after the Chernobyl accident. Diagnoses were confirmed histologically for 95% of the cases. The analysis described revealed statistically significant radiation risk only for those exposed as children at an age of 0-9 years. In this group, the standardized incidence ratio (the national incidence rate was used as a reference) in the considered time period is estimated to be 6.7 (5.1, 8.6 95%CI) and 14.6 (10.3, 20.2 95%CI) for girls and boys, respectively. The risk dependence on age at exposure has also been studied. It has been shown that the smaller the age the higher the risk. For girls whose age at exposure was 0-4 years, the excess relative risk per 1 Gy for the period 1991-2001 was 45.3 (5.2, 9,953 95%CI; with internal control) and 28.8 (4.3, 2,238 95%CI; with external control), respectively. For boys whose age at exposure was 0-9 years the corresponding excess relative risk per 1 Gy was 68.6 (10.0, 4,520 95%CI) and 177.4 (-276, 10(6) 95%CI), respectively. Dependence of radiation risk on time was studied, with the focus on two follow-up periods 1991-1996 and 1997-2001, respectively. In 1997-2001 the radiation risk is shown to decrease among girls, and increase among boys.

Thyroid cancer incidence among adolescents and adults in the Bryansk region of Russia following the Chernobyl accident.

Thyroid cancer incidence in the Bryansk region, the most contaminated area of Russia after the Chernobyl accident, is analyzed for the residents aged 15-69 y at the time of the accident (about 1 million persons according to the 1989 census) for the period from 1986 to 1998. Sex and age standardized incidence rates are presented and compared to the whole Russian population rates (SIR analysis). Also, a geographical correlation analysis is performed for incidence rates and mean thyroid doses at the district level, which provides a basis for preliminary estimation of radiation associated risks for the period 1991-1998 (to allow for a potential five year latent period). Thyroid doses were estimated based on the State official document "Methodology for reconstruction of dose from iodine radioisotopes in residents of the Russian Federation exposed to radioactive contamination as a result of the Chernobyl accident in 1986" (2000). Altogether, 1,051 thyroid cancer cases were detected in the Bryansk oncological dispensary from 1986 to 1998 and 769 from 1991 to 1998. Histological confirmation was available for 87% and 95% of these cases, respectively. Standardized incidence ratios (SIR) were 1.27 (95% CI = 0.92, 1.73) for the period 1986-1990 and 1.45 (95% CI = 1.20, 1.73) for the period 1991-1998 for males and 1.94 (95% CI = 1.70, 2.20) and 1.96 (95% CI = 1.82, 2.1) for females. The excess relative risk per 1 Gy (using external control) estimate for the period 1991-1998 was -0.4 (95% CI = -3.5, 2.7), -1.3 (95% CI = -2.8, 0.1) for males and females, respectively, and -0.6 (95% CI = -2.1, 0.8) for both sexes. Using internal controls, the excess relative risk (ERR(1Gy)) per unit dose of 1 Gy was found to be 0.7 with 95% CI (-2.3, 5.2) for males, -0.9 with 95% CI (-2.4, 0.8) for females and 0.0 with 95% CI (-1.4, 1.7) for males and females together. These results are discussed in the light of the quality of information available on thyroid cancer cases and screening campaigns carried out after the Chernobyl accident.