Mortality from Circulatory Diseases and Other Non-Cancer Outcomes Among Nuclear Workers in France, the United Kingdom and the United States (INWORKS)

Details

• Personal Author:
  Cardis E ; Daniels, Robert D. ; Gillies M ; Haylock R ; Kesminiene A ; Laurier D ; Leuraud K ; Moissonnier M ; O'Hagan JA ; Richardson DB ; Schubauer-Berigan, Mary K. ; Thierry-Chef I
• Description:
  Positive associations between external radiation dose and non-cancer mortality have been found in a number of published studies, primarily of populations exposed to highdose, 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 noncancer causes of death was observed [excess relative risk per sievert (ERR/Sv)¼0.19; 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 noncancer 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 noncancer 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. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Environmental Exposure Morbidity Mortality Neoplasms Occupational Health Radiation Risk Assessment Risk Factors Safety Workplace

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• Keywords:
  Cancer Cerebrovascular System Circulatory System Diseases Exposure Levels Fatalities Heart Disease Ionizing Radiation Morbidity Rates Mortality Data Nuclear Hazards Risk Factors Statistical Analysis Work Environment Workers

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• ISSN:
  0033-7587
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  North Carolina ; Ohio ; OSHA Region 4 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  EID - Education and Information Division ; DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  276-290
• Volume:
  188
• Issue:
  3
• NIOSHTIC Number:
  nn:20050380
• Citation:
  Radiat Resn 2017 Sep; 188(3):276-290
• Contact Point Address:
  Michael Gillies, Department of Radiation Effects, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Oxfordshire, OX11 0RQ
• Email:
  michael.gillies@phe.gov.uk
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of North Carolina, Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20110901
• Source Full Name:
  Radiation Research
• End Date:
  20140630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9db927a0e4233fac1b7c9ce827f776c1cca962d30e5584004811014a62089f236e34e585f5b2db80fa83a375beba8d6f0dd097f72ba7d2883f533aae8676185c
• Download URL:
  https://stacks.cdc.gov/view/cdc/210750/cdc_210750_DS1.pdf
• File Type:
  [PDF - 296.07 KB ]