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Incidence risks for subtypes of heart diseases in a Russian cohort of Mayak Production Association nuclear workers

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Abstract

Heart diseases are one of the main causes of death. The incidence risks were assessed for various types of heart diseases (HDs) in a cohort of Russian nuclear workers of the Mayak Production Association (PA) who had been chronically occupationally exposed to external gamma and/ or internal alpha radiation. The study cohort included all workers (22,377 individuals) who had been hired at the Mayak PA during 1948–1982 and followed up until 31 December 2018. The mean gamma-absorbed dose to the liver (standard deviation) was 0.43 (0.63) Gy, and the mean alpha-absorbed dose to the liver was 0.25 (1.19) Gy. Excess relative risk (ERR) per unit liver-absorbed dose (Gy) was calculated based on maximum likelihood. At the end of the follow-up, 559 chronic rheumatic heart disease (CRHD), 7722 ischemic heart disease (IHD) [including 2185 acute myocardial infarction (AMI) and 3976 angina pectoris (AP)], 4939 heart failure (HF), and 3689 cardiac arrhythmia and conduction disorder (CACD) cases were verified in the study cohort. Linear model fits of the gamma dose response for HDs were best once adjustments for non-radiation factors (sex, attained age, calendar period, smoking status and alcohol consumption) and alpha dose were included. ERR/Gy in males and females was 0.17 (95% confidence intervals: 0.10, 0.26) and 0.23 (0.09, 0.38) for IHD; 0.18 (0.09, 0.29) and 0.26 (0.08, 0.49) for AP; − 0.01 (n/a, 0.1) and − 0.01 (n/a, 0.27) for AMI; 0.27 (0.16, 0.40) and 0.27 (0.10, 0.49) for HF; 0.32 (0.19, 0.46) and 0.05 (− 0.09, 0.22) for CACD; 0.73 (− 0.02, 2.40) and − 0.12 (− 0.50, 0.69) for CRHD, respectively. Sensitivity analyses demonstrated the persistence of a significant dose–response regardless of exclusion/inclusion of adjustments for known potential non-radiation confounders (smoking, alcohol consumption, body mass index, hypertension, diabetes mellitus), and it was only the magnitude of the risk estimate that varied. The risks of HD incidence were not modified with sex (except for the CACD risk). This study provides evidence for a significant association of certain types of HDs with cumulative dose of occupational chronic external exposure to gamma radiation.

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Availability of data and material

The dataset is the intellectual property of the Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, 456780, Russia. For privacy reasons, it is not publicly available. These restrictions on data availability are imposed by Federal Act No. 323 of 21 November 2011 on the basics of health care for Russian citizens, and by Federal Act No. 152 of 27 July 2014 on personal data. Any access to the Mayak Worker Cohort must be approved by the institutional Ethics Review Board of the Southern Urals Biophysics Institute. To request the data used in the presented analyses, please, contact Dr. Tamara Azizova, the head of the clinical department of the Southern Urals Biophysics Institute (clinic@subi.su, + 73513029395), and/or Dr. Valentina Rybkina, MD, leading researcher of the Southern Urals Biophysics Institute and member of the institutional Ethics Review Board (rybkina@subi.su; +73513029953).

Abbreviations

DCS:

Diseases of the circulatory system

HD:

Heart disease

IHD:

Ischemic heart disease

CRHD:

Chronic rheumatic heart disease

AP:

Angina pectoris

AMI:

Acute myocardial infarction

HF:

Heart failure

CACD:

Cardiac arrhythmia and conduction disorder

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Authors and Affiliations

  1. Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk Region, Russia

    Tamara V. Azizova, Maria V. Bannikova, Ksenia V. Briks & Evgeniya S. Grigoryeva

  2. Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan

    Nobuyuki Hamada

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  1. Tamara V. Azizova
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by TVA and KVB. Data compilation, choice of statistical analysis methods, and analysis were performed by MVB and ESG. The first draft of the manuscript was written by TVA. Interpretation of the results was provided by TVA, MVB, ESG, and NH. Consultations on the study design and methodology were provided by NH. All authors commented on the original and all succeeding versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tamara V. Azizova.

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This was a retrospective epidemiological study that did not involve human participants and was based on depersonalized data stored in the database maintained by the Southern Urals Biophysics Institute (SUBI). An approval for the study was granted by the Ethics Review Board of SUBI. The study was performed in line with the principles of the Declaration of Helsinki.

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Azizova, T.V., Bannikova, M.V., Briks, K.V. et al. Incidence risks for subtypes of heart diseases in a Russian cohort of Mayak Production Association nuclear workers. Radiat Environ Biophys 62, 51–71 (2023). https://doi.org/10.1007/s00411-022-01005-0

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