Nezahat Hunter

Cardiovascular Diseases in the Cohort of Workers First Employed at Mayak PA in 1948–1958

Abstract Incidence of and mortality from cardiovascular diseases have been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948–1958 and followed up to 31 December 2000. Information on external γ-ray doses is available for virtually all of these workers (99.9%); the mean total γ-ray dose (±SD) was 0.91 ± 0.95 Gy (99% percentile 3.9 Gy) for men and 0.65 ± 0.75 Gy (99% percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured for only 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium alpha exposure (± SD) was 0.40 ± 1.15 Gy (99% percentile 5.88 Gy) for men and 0.81 ± 4.60 Gy (99% percentile 15.95 Gy) for women. A total of 3751 cases of ischemic heart disease (IHD), including 683 cases of acute myocardial infarction (AMI), and 1495 IHD deaths, including 338 AMI deaths, were identified in the study cohort during the follow-up period. Having adjusted for non-radiation factors, there were statistically significant increasing trends with both total external γ-ray dose and internal liver dose in IHD incidence. The trend with internal dose was weaker and was not statistically significant after adjusting for external dose, whereas the external dose trend was little changed after adjusting for internal dose. The trend with external dose in IHD mortality was not statistically significantly greater than zero but was consistent with the corresponding trend in IHD incidence. The estimated trend in IHD mortality with internal dose was lower and was not statistically significant once adjustment was made for external dose. There was a statistically significantly increasing trend in AMI incidence but not AMI incidence with external dose. The risk estimates for IHD in relation to external radiation are generally compatible with those from other large occupational studies and the Japanese A-bomb survivors.

Radon, smoking and lung cancer risk: results of a joint analysis of three European case-control studies among uranium miners.

A combined analysis of three case-control studies nested in three European uranium miner cohorts was performed to study the joint effects of radon exposure and smoking on lung cancer death risk. Occupational history and exposure data were available from the cohorts. Smoking information was reconstructed using self-administered questionnaires and occupational medical archives. Linear excess relative risk models adjusted for smoking were used to estimate the lung cancer risk associated with radon exposure. The study includes 1046 lung cancer cases and 2492 controls with detailed radon exposure data and smoking status. The ERR/WLM adjusted for smoking is equal to 0.008 (95% CI: 0.004–0.014). Time since exposure is shown to be a major modifier of the relationship between radon exposure and lung cancer risk. Fitting geometric mixture models yielded arguments in favor of a sub-multiplicative interaction between radon and smoking. This combined study is the largest case-control study to investigate the joint effects of radon and smoking on lung cancer risk among miners. The results confirm that the lung carcinogenic effect of radon persists even when smoking is adjusted for, with arguments in favor of a sub-multiplicative interaction between radon and smoking.

Uncertainties in radon related to house-specific factors and proximity to geological boundaries in England

Data collected as a part of a survey on radon concentrations from about 40 000 dwellings in England for six contrasting geological units were analysed to evaluate the impact of house-specific factors (building characteristics and construction dates) and of proximity to geological boundaries. After adjusting for temperature and outdoor radon, geological unit, house type, double glazing and date of building were found to have a statistically significant influence on indoor radon concentrations and explained about 29 % of the total variation between dwellings in logarithmically transformed radon values. In addition, there were statistically significant differences in radon concentrations according to proximity to geological boundaries categories for most of the geological units, but no consistent pattern could be detected.

Seasonal variation of radon concentrations in UK homes

The patterns of seasonal variation of radon concentrations were measured in 91 homes in five regions of the UK over a period of two years. The results showed that there was no significant difference between the regions in the pattern or magnitude of seasonal variation in radon concentrations. The arithmetic mean variation was found to be close to that found previously in the UK national survey. Differences in the pattern between the two years of the study were not significant. Two-thirds of homes in the study followed the expected pattern of high radon in the winter and low radon in the summer. Most of the rest showed little seasonal variation, and a few showed a reversed seasonal pattern. The study does not provide any clear evidence for the recorded house characteristics having an effect on the seasonal variation in radon concentrations in UK homes, though the statistical power for determining such effects is limited in this study. The magnitude of the seasonal variation varied widely between homes. Analysis of the individual results from the homes showed that because of the wide variation in the amount of seasonal variation, applying seasonal correction factors to the results of three-month measurements can yield only relatively small improvements in the accuracy of estimates of annual mean concentrations.

Joint analysis of three European nested case-control studies of lung cancer among radon exposed miners: exposure restricted to below 300 WLM.

AbstractAnalyses of lung cancer risk were carried out using restrictions to nested case-control data on uranium miners in the Czech Republic, France, and Germany. With the data restricted to cumulative exposures below 300 working-level-months (WLM) and adjustment for smoking status, the excess relative risk (ERR) per WLM was 0.0174 (95% CI: 0.009–0.035), compared to the estimate of 0.008 (95% CI: 0.004–0.014) using the unrestricted data. Analysis of both the restricted and unrestricted data showed that time since exposure windows had a major effect; the ERR/WLM was six times higher for more recent exposures (5–24 y) than for more distant exposures (25 y or more). Based on a linear model fitted to data on exposures <300 WLM, the ERR WLM−1 of lung cancer at 30 y after exposure was estimated to be 0.021 (95% CI: 0.011–0.040), and the risks decreased by 47% per decade increase in time since exposure. The results from analyzing the joint effects of radon and smoking were consistent with a sub-multiplicative interaction; the ERR WLM−1 was greater for non-smokers compared with current or ex-smokers, although there was no statistically significant variation in the ERR WLM−1 by smoking status. The patterns of risk with radon exposure from the combined European nested case-control miner analysis were generally consistent with those based on the BEIR VI Exposure-Age-Concentration model. Based on conversions from WLM to time weighted averaged radon concentration (expressed per 100 Bq m−3), the results from this analysis of miner data were in agreement with those from the joint analysis of the European residential radon studies.

Chronic Bronchitis in the Cohort of Mayak Workers First Employed 1948–1958

Incidence of chronic bronchitis has been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948–1958 and followed up to 31 December 2005. Information on external gamma doses is available for virtually all of these workers; in contrast, plutonium body burden was measured only for 30% of workers. During the follow-up period in the study cohort 1,175 incident cases of chronic bronchitis were verified. The analyses of nonradiation factors revealed that the underlying risk of chronic bronchitis incidence increased with increasing attained age and was higher among smokers compared with never-smokers as would be expected. The most interesting finding in relationship to nonradiation factors was a sharp increase in the baseline chronic bronchitis risk before 1960. The cause of this is not clear but a number of factors may play a role. Based on the follow-up data after 1960, the analysis showed a statistically significant linear dose response relationship with cumulative external gamma-ray dose (ERR/Gy = 0.14, 95% CI 0.01, 0.32). Based on the same subset but with an additional restriction to members with cumulative internal lung dose below 1 Gy, a statistically significant linear dose response relationship with internal alpha-radiation lung dose from incorporated plutonium was found (ERR/Gy = 2.70, 95% CI 1.20, 4.87). In both cases, adjustment was made for nonradiation factors, including smoking and either internal or external dose as appropriate. At present there are no similar incidence studies with which to compare results. However, the most recent data from the atomic bomb survivor cohort (the Life Span Study) showed statistically significant excess mortality risk for respiratory diseases of 22% per Gy and this value is within the confidence bounds of the point estimate of the risk from this study in relation to external dose.

Age-at-exposure effects on risk estimates for non-cancer mortality in the Japanese atomic bomb survivors.

Statistically significant increases in non-cancer disease mortality with radiation dose have been observed among survivors of the atomic bombings of Hiroshima and Nagasaki. The increasing trends arise particularly for diseases of the circulatory, digestive, and respiratory systems. Rates for survivors exposed to a dose of 1 Sv are elevated by about 10%, a smaller relative increase than that for cancer. The aetiology of this increased risk is not yet understood. Neither animal nor human studies have found clear evidence for excess non-cancer mortality at the lower range of doses received by A-bomb survivors. In this paper, we examine the age and time patterns of excess risks in the A-bomb survivors. The results suggest that the excess relative risk of non-cancer disease mortality might be highest for exposure at ages 30-49 years, and that those exposed at ages 0-29 years might have a very low excess relative risk compared with those exposed at older ages. The differences in excess relative risk for different age-at-exposure groups imply that the dose response relationships for non-cancer disease mortality need to be modelled with adjustment for age-at-exposure.