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Achilles S, Olson JD, Dugan GO, Cline JM. Assessment of Blood Pressure in Irradiated Rhesus Macaques (Macaca mulatta). Radiat Res 2023; 200:13-20. [PMID: 37083731 PMCID: PMC10481370 DOI: 10.1667/rade-22-00117.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/08/2023] [Indexed: 04/22/2023]
Abstract
There is increasing evidence that circulatory disease incidence and mortality is associated with radiation exposure. Wake Forest School of Medicine is home to a unique cohort of total-body irradiated macaques, some with evidence of vascular end-organ disease in the brain, kidney and heart. Because there is a link between high blood pressure and vascular disease in all these sites, we undertook a retrospective study to evaluate blood pressure and radiation in this cohort of animals. In this work, we utilized a cohort of nonhuman primates (rhesus macaques, Macaca mulatta) long-term survivors of high-dose total-body irradiation (1.1-8.5 Gy, N = 129) and controls (N = 37) to evaluate the effects of radiation on blood pressure and obesity. Subjects were between 3 and 22 years of age (median 9 years). Blood pressure (BP) was measured 1-14 years postirradiation (median 4 years). Subjects were sedated with a combination of ketamine HCl (15 mg/kg body weight, IM) and midazolam (0.1 mg/kg body weight, IM) and systolic, diastolic, and mean arterial pressures were measured using a high definition oscillometer. Obesity was defined by dual energy X-ray absorptiometry as a body fat percentage >35%. Statistical analysis of the collected data indicated significant increases in blood pressure with increasing age and obesity. However, radiation did not significantly alter blood pressure in irradiated animals relative to controls, radiation dose, or age of irradiation.
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Affiliation(s)
- Stephanie Achilles
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Animal Resources Program, Winston-Salem, North Carolina
| | - John D. Olson
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Animal Resources Program, Winston-Salem, North Carolina
| | - Gregory O. Dugan
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Animal Resources Program, Winston-Salem, North Carolina
| | - J. Mark Cline
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Animal Resources Program, Winston-Salem, North Carolina
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2
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Chinybayeva AA, Karazhanova LK, Mansurova JA, Zhunuspekova AS. Features of the Course of Various types of Stroke in Patients Exposed to Low-dose Radiation. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND: There is limited number of studies about peculiarities of cardiovascular diseases in population of different region by the zone of radiation exposure risk.
AIM: The aim of the study was to study the effect of radiation factor on the pathogenesis of stroke.
MATERIALS AND METHODS: To study the in influence of radiation factor on pathogenesis of stroke, 358 stroke patients were distributed based on the place of their residence into corresponding zones of radiation risk: 53 patients lived in zone of extremely high radiation level (488–100 cSV, zone I): 75 - from the zone of maximal radiation exposure (35–100 cSV, zone II), 158 - from zone with high radiation exposure (35–7 cSV, zone III), and 72 patients were the residents of minimal radiation risk (1–7 cSV, zone IV).
RESULTS: The study of coagulation hemostasis had revealed the significant increase of fibrinogen level in patients from zone I: 4.7 ± 0.14% versus 3.2 ± 0.11%, in patients living in minimal radiation risk zone (p < 0.01). The patients from extremely high radiation risk had significant decrease in fibrinolysis time in comparison to patients from zone IV (p < 0.05). The primary APS was diagnosed in 24 (6.7%) patients in total group of stroke patients (11 males and 13 females), from which 21 patients with ischemic stroke and 3 with hemorrhagic stroke. Leiden Va defect was found significantly more often in patients lived in high radiation risk zone (9.4%), in 13.5% stroke patients from zone II, in 13.2% patients lived in zone I, in comparison to 6.9% patients lived in zone IV. The patients from zone I had significantly higher level of plasma homocysteine in comparison to patients from other zones, (p < 0.01). Furthermore, the significantly higher levels of plasma homocysteine were found in the group with maximal and high radiation exposure, in comparison to the group of patients from minimal risk zone (p < 0.05).
CONCLUSIONS: We can see the presence of indirect evidences of modifying influence of radiation factor on pathogenic mechanisms of stroke.
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3
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Haruta D, Landes RD, Hida A, Imaizumi M, Ohishi W, Akahoshi M, Maemura K. Relationship Between Radiation Exposure and Incident Atrial Fibrillation Among Atomic Bomb Survivors. Circ Rep 2021; 3:381-387. [PMID: 34250279 PMCID: PMC8258179 DOI: 10.1253/circrep.cr-21-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Atrial fibrillation (AF) is a common arrhythmia. Although radiation exposure is associated with an elevated risk of cardiovascular disease, the effects of radiation on arrhythmia, especially AF, are unclear. We evaluated the relationship between radiation and AF in a cohort of atomic bomb survivors. Methods and Results: From a baseline enrollment period (1967-1969) to 2009, 7,379 Hiroshima and Nagasaki atomic bomb survivors (mean baseline age 50.6 years, 65.8% women, 72.9% from Hiroshima) without AF and who had been exposed to estimated radiation doses between 0 and 3.614 Gy were followed-up once every 2 years. AF was identified by 12-lead electrocardiograms and medical records. Treating age as the time scale, AF incidence was modeled with Cox proportional hazards models adjusting for demographics, AF risk factors, and radiation. We modeled radiation as both a continuous variable and categorized according to radiation dose (Control [<0.005 Gy] and 5 equal-sized groups based on radiation dose quintiles in the cohort). Over 4 decades of follow-up, we identified 276 AF cases in 176,687 person-years, for an incidence rate of 1.56 per 1,000 person-years. After adjusting for sex and city, neither categorized, linear, nor linear-quadratic models showed substantive evidence of radiation effects. Similar results were obtained after adjusting for AF risk factors. Conclusions: There were no clear positive associations between radiation dose and AF risk, rather null or non-significant inverse associations.
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Affiliation(s)
- Daisuke Haruta
- Department of Clinical Studies, Radiation Effects Research Foundation Nagasaki and Hiroshima Japan.,Saikakai Shibata Chokodo Hospital Shimabara Japan
| | - Reid D Landes
- Department of Statistics, Radiation Effects Research Foundation Hiroshima Japan.,Department of Biostatistics, University of Arkansas for Medical Sciences Little Rock, AR USA
| | - Ayumi Hida
- Department of Clinical Studies, Radiation Effects Research Foundation Nagasaki and Hiroshima Japan
| | - Misa Imaizumi
- Department of Clinical Studies, Radiation Effects Research Foundation Nagasaki and Hiroshima Japan
| | - Waka Ohishi
- Department of Clinical Studies, Radiation Effects Research Foundation Nagasaki and Hiroshima Japan
| | - Masazumi Akahoshi
- Department of Clinical Studies, Radiation Effects Research Foundation Nagasaki and Hiroshima Japan.,Wakokai Keiju Hospital Isahaya Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
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4
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Rackova L, Mach M, Brnoliakova Z. An update in toxicology of ageing. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 84:103611. [PMID: 33581363 DOI: 10.1016/j.etap.2021.103611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
The field of ageing research has been rapidly advancing in recent decades and it had provided insight into the complexity of ageing phenomenon. However, as the organism-environment interaction appears to significantly affect the organismal pace of ageing, the systematic approach for gerontogenic risk assessment of environmental factors has yet to be established. This puts demand on development of effective biomarker of ageing, as a relevant tool to quantify effects of gerontogenic exposures, contingent on multidisciplinary research approach. Here we review the current knowledge regarding the main endogenous gerontogenic pathways involved in acceleration of ageing through environmental exposures. These include inflammatory and oxidative stress-triggered processes, dysregulation of maintenance of cellular anabolism and catabolism and loss of protein homeostasis. The most effective biomarkers showing specificity and relevancy to ageing phenotypes are summarized, as well. The crucial part of this review was dedicated to the comprehensive overview of environmental gerontogens including various types of radiation, certain types of pesticides, heavy metals, drugs and addictive substances, unhealthy dietary patterns, and sedentary life as well as psychosocial stress. The reported effects in vitro and in vivo of both recognized and potential gerontogens are described with respect to the up-to-date knowledge in geroscience. Finally, hormetic and ageing decelerating effects of environmental factors are briefly discussed, as well.
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Affiliation(s)
- Lucia Rackova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia.
| | - Mojmir Mach
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
| | - Zuzana Brnoliakova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
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5
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Sun L, Inaba Y, Sogo Y, Ito A, Bekal M, Chida K, Moritake T. Total body irradiation causes a chronic decrease in antioxidant levels. Sci Rep 2021; 11:6716. [PMID: 33762608 PMCID: PMC7990969 DOI: 10.1038/s41598-021-86187-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/11/2021] [Indexed: 01/06/2023] Open
Abstract
Ionizing radiation exposure may not only cause acute radiation syndrome, but also an increased risk of late effects. It has been hypothesized that induction of chronic oxidative stress mediates the late effects of ionizing radiation. However, only a few reports have analyzed changes in long-term antioxidant capacity after irradiation in vivo. Our previous study demonstrated changes in whole-blood antioxidant capacity and red blood cell (RBC) glutathione levels within 50 days after total body irradiation (TBI). In this study, seven-week-old, male, C57BL/6J mice exposed to total body irradiation by X-ray and changes in whole-blood antioxidant capacity and RBC glutathione levels at ≥ 100 days after TBI were investigated. Whole-blood antioxidant capacity was chronically decreased in the 5-Gy group. The RBC reduced glutathione (GSH) level and the GSH/oxidative glutathione (GSSG) ratio were chronically decreased after ≥ 1 Gy of TBI. Interestingly, the complete blood counts (CBC) changed less with 1-Gy exposure, suggesting that GSH and the GSH/GSSG ratio were more sensitive radiation exposure markers than whole-blood antioxidant capacity and CBC counts. It has been reported that GSH depletion is one of the triggers leading to cataracts, hypertension, and atherosclerosis, and these diseases are also known as radiation-induced late effects. The present findings further suggest that chronic antioxidant reduction may contribute to the pathogenesis of late radiation effects.
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Affiliation(s)
- Lue Sun
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki, 305-8566, Japan.
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Aramaki Aza-Aoba 468-1, Aoba-ku, Sendai, 980-0845, Japan
| | - Yu Sogo
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki, 305-8566, Japan
| | - Atsuo Ito
- Health and Medical Research Institute, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki, 305-8566, Japan
| | - Mahesh Bekal
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Aramaki Aza-Aoba 468-1, Aoba-ku, Sendai, 980-0845, Japan
| | - Takashi Moritake
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
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6
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Nakamizo T, Cologne J, Cordova K, Yamada M, Takahashi T, Misumi M, Fujiwara S, Matsumoto M, Kihara Y, Hida A, Ohishi W. Radiation effects on atherosclerosis in atomic bomb survivors: a cross-sectional study using structural equation modeling. Eur J Epidemiol 2021; 36:401-414. [PMID: 33742296 PMCID: PMC8076141 DOI: 10.1007/s10654-021-00731-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
Past reports indicated that total-body irradiation at low to moderate doses could be responsible for cardiovascular disease risks, but the mechanism remains unclear. The purpose of this study was to investigate the association between radiation exposure and atherosclerosis, an underlying pathology of cardiovascular diseases, in the Japanese atomic bomb survivors. We performed a cross-sectional study measuring 14 clinical-physiological atherosclerosis indicators during clinical exams from 2010 to 2014 in 3274 participants of the Adult Health Study cohort. Multivariable analyses were performed by using a structural equation model with latent factors representing underlying atherosclerotic pathologies: (1) arterial stiffness, (2) calcification, and (3) plaque as measured with indicators chosen a priori on the basis of clinical-physiological knowledge. Radiation was linearly associated with calcification (standardized coefficient per Gy 0.15, 95 % confidence interval: CI [0.070, 0.23]) and plaque (0.11, 95 % CI [0.029, 0.20]), small associations that were comparable to about 2 years of aging per Gy of radiation exposure, but not with arterial stiffness (0.036, 95 % CI [− 0.025, 0.095]). The model fitted better and had narrower confidence intervals than separate ordinary regression models explaining individual indicators independently. The associations were less evident when the dose range was restricted to a maximum of 2 or 1 Gy. By combining individual clinical-physiological indicators that are correlated because of common, underlying atherosclerotic pathologies, we found a small, but significant association of radiation with atherosclerosis.
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Affiliation(s)
- Tomoki Nakamizo
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan.
| | - John Cologne
- Department of Statistics, RERF, Hiroshima, Japan
| | | | | | - Tetsuya Takahashi
- Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan
| | | | - Saeko Fujiwara
- Department of Clinical Studies, RERF, Hiroshima, Japan.,Faculty of Pharmacy, Yasuda Women's University, Hiroshima, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.,Department of Neurology, Sakai City Medical Center, Osaka, Japan
| | - Yasuki Kihara
- Department of Clinical Studies, RERF, Hiroshima, Japan.,Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan.,Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Ayumi Hida
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan
| | - Waka Ohishi
- Department of Clinical Studies, RERF, Hiroshima, Japan
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7
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Takahashi N, Misumi M, Niwa Y, Murakami H, Ohishi W, Inaba T, Nagamachi A, Tanaka S, Braga Tanaka I, Suzuki G. Effects of Radiation on Blood Pressure and Body Weight in the Spontaneously Hypertensive Rat Model. Are Radiation Effects on Blood Pressure Affected by Genetic Background? Radiat Res 2020; 193:552-559. [PMID: 32150496 DOI: 10.1667/rr15536.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/28/2020] [Indexed: 11/03/2022]
Abstract
In this work, we utilized spontaneously hypertensive rats (SHR) and Wister Kyoto rats (WKY), from which the SHR was established, to evaluate the effects of whole-body acute radiation on the cardiovascular system at doses from 0 to 4 Gy. In the irradiated SHR, the systolic blood pressure (SBP) increased with increasing dose, while body weight gain decreased with increasing radiation dose. Furthermore, pathological observations of SHR demonstrated that the number of rats with cystic degeneration in the liver increased with increasing dose. The effects observed among SHR, such as increased SBP and retardation of body weight gain, appear very similar to those observed in Japanese atomic bomb survivors. In contrast, the SBP among WKY did not change relative to dose; the body weight, however, did change, as in the SHR. Therefore, the association between radiation exposure and SBP, but not between radiation exposure and retardation of body weight gain, may be affected by genetic background, as evident from strain difference. These results suggest that the SHR and WKY animal models may be useful for studying radiation effects on non-cancer diseases including circulatory diseases, chronic liver disease and developmental retardation.
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Affiliation(s)
- Norio Takahashi
- Consultant, Radiation Effects Research Foundation (RERF), Hiroshima, 732-0815, Japan
| | - Munechika Misumi
- Department of Statistics, Radiation Effects Research Foundation (RERF), Hiroshima, 732-0815, Japan
| | - Yasuharu Niwa
- Department of Molecular Biosciences, Radiation Effects Research Foundation (RERF), Hiroshima, 732-0815, Japan
| | - Hideko Murakami
- Department of Molecular Biosciences, Radiation Effects Research Foundation (RERF), Hiroshima, 732-0815, Japan
| | - Waka Ohishi
- Department of Clinical Studies (Hiroshima), Radiation Effects Research Foundation (RERF), Hiroshima, 732-0815, Japan
| | - Toshiya Inaba
- Department of Molecular Oncology and Leukemia Program Project, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Akiko Nagamachi
- Department of Molecular Oncology and Leukemia Program Project, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Satoshi Tanaka
- Department of Radiobiology, Institute for Environmental Sciences, Aomori, 039-3212, Japan
| | - Ignacia Braga Tanaka
- Department of Radiobiology, Institute for Environmental Sciences, Aomori, 039-3212, Japan
| | - Gen Suzuki
- International University of Health and Welfare Clinic, Tochigi, 324-8501, Japan
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8
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Takahashi N, Misumi M, Murakami H, Niwa Y, Ohishi W, Inaba T, Nagamachi A, Suzuki G. Association between low doses of ionizing radiation, administered acutely or chronically, and time to onset of stroke in a rat model. JOURNAL OF RADIATION RESEARCH 2020; 61:666-673. [PMID: 32748938 PMCID: PMC7482173 DOI: 10.1093/jrr/rraa050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/10/2020] [Indexed: 06/10/2023]
Abstract
Exposure to high-doses of ionizing radiation has been reported to be associated with the risk of stroke. However, risks associated with lower dose exposures remain unclear, and there is little information available for the risk modification according to the dose-rate. There are few studies using animal models which might be able to provide complementary information on this association. In this study, the male stroke-prone spontaneously hypertensive rat (SHRSP) was used as a model animal. The rats were acutely irradiated with doses between 0 and 1.0 Gy or chronically irradiated with a cumulative dose of 0.5 or 1.0 Gy (at a dose rate of 0.05 or 0.1 Gy/day, respectively). The onset time of stroke related symptoms in SHRSP was used as an endpoint for evaluating the effects of low dose and the low dose-rate gamma-ray exposures. With respect to acute exposure, the time to the onset of stroke in the irradiated rats suggested the presence of a threshold around 0.1 Gy. For the low dose-rate chronically exposed, no significant increase in stroke symptom was observed. These findings are novel and demonstrate that the SHRSP system can be used to determine the association between the risk of stroke and radiation exposure with high sensitivity. Moreover, these studies provide important information regarding the association between the low dose and low dose-rate radiation exposure and circulatory diseases, especially stroke.
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Affiliation(s)
| | - Munechika Misumi
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Hideko Murakami
- Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Yasuharu Niwa
- Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Waka Ohishi
- Clinical Studies (Hiroshima), Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - Toshiya Inaba
- Department of Molecular Oncology and Leukemia Program Project, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Akiko Nagamachi
- Department of Molecular Oncology and Leukemia Program Project, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Gen Suzuki
- International University of Health and Welfare Clinic, Otawara, Tochigi, Japan
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9
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Ozasa K, Cullings HM, Ohishi W, Hida A, Grant EJ. Epidemiological studies of atomic bomb radiation at the Radiation Effects Research Foundation. Int J Radiat Biol 2019; 95:879-891. [PMID: 30676179 DOI: 10.1080/09553002.2019.1569778] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Epidemiological studies of people who were exposed to atomic bomb radiation and their children who were conceived after parental exposure to radiation (F1) have investigated late health effects of atomic bomb radiation and its transgenerational effects. Those studies were initiated by the Atomic Bomb Casualty Commission (ABCC) in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF) in 1975, which continued the work of the ABCC. Follow-up of vital status and cause of death is performed for all RERF cohorts, including the atomic bomb survivors (the Life Span Study: LSS), in utero survivors, and the children of the survivors (F1). Cancer incidence is investigated for accessible subpopulations of the cohorts. Health examinations for subcohorts of the LSS and in utero survivors are conducted as the Adult Health Study (AHS); a program of health examinations for a subcohort of the F1 study is called the F1 Offspring Clinical Study (FOCS). Participants of all clinical programs are asked to donate their blood and urine for storage and future biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors including those exposed in utero, and possible risks for some noncancer diseases. No increased risks due to parental exposure to radiation have been observed for malignancies or other diseases in F1, but continuing investigations are required.
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Affiliation(s)
- Kotaro Ozasa
- a Department of Epidemiology , Radiation Effects Research Foundation , Hiroshima , Japan
| | - Harry M Cullings
- b Department of Statistics , Radiation Effects Research Foundation , Hiroshima , Japan
| | - Waka Ohishi
- c Department of Clinical Studies , Radiation Effects Research Foundation , Hiroshima , Japan
| | - Ayumi Hida
- d Department of Clinical Studies , Radiation Effects Research Foundation , Nagasaki , Japan
| | - Eric J Grant
- e Associate Chief of Research, Radiation Effects Research Foundation , Hiroshima , Japan
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10
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Takai D, Abe A, Komura JI. Chronic exposure to gamma irradiation at low-dose rates accelerates blood pressure decline associated with aging in female B6C3F 1 mice. Int J Radiat Biol 2018; 95:347-353. [PMID: 30513245 DOI: 10.1080/09553002.2019.1552808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Many studies are focusing on the biological effects of gamma irradiation at low-dose rates. Studies have shown that chronic exposure to gamma irradiation at low-dose rates shortened the lifespan of mice due to neoplasm formation. The aim of this study was to clarify the physiological effects of long-term exposure to gamma irradiation at low-dose rates in mice, measured with noninvasive parameters such as blood pressure. MATERIALS AND METHODS Specific-pathogen-free female B6C3F1 mice were irradiated with gamma rays at a low dose of 20 mGy/day - a dose rate shown to shorten the life span in previous studies. The blood pressure parameters (systolic, diastolic, and mean blood pressure), heart rate, tail blood volume, and blood flow of the mice were measured every 7 weeks. Age-matched, non-irradiated mice were used as controls. RESULTS AND CONCLUSION The blood pressure levels of the irradiated mice decreased at an earlier age compared to the non-irradiated control mice. The expression levels of the marker genes of aging that are also associated with regulation of blood pressure showed significant differences between non-irradiated and irradiated mice. These results indicated that long-term exposure to gamma irradiation at low-dose rates induce the expression levels of Rap1a and reduces Panx1 and Sirt3, which may have contributed to the accelerated blood pressure decline in female mice.
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Affiliation(s)
- Daisaku Takai
- a Department of Radiobiology , Institute for Environmental Sciences , Takahoko , Rokkasho , Aomori , Japan
| | - Akiko Abe
- b JAC Co. ltd , Meguro , Tokyo , Japan
| | - Jun-Ichiro Komura
- a Department of Radiobiology , Institute for Environmental Sciences , Takahoko , Rokkasho , Aomori , Japan
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11
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Takahashi I, Cologne J, Haruta D, Yamada M, Takahashi T, Misumi M, Fujiwara S, Matsumoto M, Kihara Y, Hida A, Ohishi W. Association Between Prevalence of Peripheral Artery Disease and Radiation Exposure in the Atomic Bomb Survivors. J Am Heart Assoc 2018; 7:e008921. [PMID: 30486720 PMCID: PMC6405541 DOI: 10.1161/jaha.118.008921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022]
Abstract
Background Past reports suggested that total-body irradiation at 0.5 to 1.0 Gy could be responsible for atherosclerosis. Peripheral artery disease ( PAD ) is a manifestation of systematic atherosclerosis. Whether the consequences of a low-to-moderate dose of radiation include increased risk of PAD remains to be determined. The purpose of this study was to examine the association between radiation exposure and prevalence of PAD among Japanese atomic bomb survivors. Methods and Results Radiation exposure from the atomic bombing was assessed in 3476 participants (41.1% men, mean age 74.8 years with SD 6.4 years) with a cross-sectional survey in 2010 to 2014. Left- and right-side ankle-brachial indexes and upstroke time ( UT ) were obtained using oscillometric VP -2000. PAD was defined as an ankle-brachial index of 1.0 or less or a prior history related to revascularization. UT was considered a sensitive marker of early-stage PAD . Association between radiation exposure and PAD or UT was assessed using multivariable regression analyses with adjustment for potential confounding factors. Of 3476 participants, 79 (2.3%) were identified as having prevalent PAD . Multivariate logistic regression analysis indicated that radiation dose was unrelated to PAD prevalence (odds ratio, 0.83; 95% confidence interval [0.57-1.21]). UT appeared to increase with radiation dose, but the increase was not statistically significant (1.09 ms/Gy; 95% confidence interval [-0.17 to 2.36]). Conclusions We found no clear association of radiation dose with PAD , but it remains to be determined whether UT is associated with radiation dose.
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Affiliation(s)
- Ikuno Takahashi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - John Cologne
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Daisuke Haruta
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Michiko Yamada
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
| | - Munechika Misumi
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Saeko Fujiwara
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
- Hiroshima Atomic‐bomb Casualty CouncilHiroshimaJapan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
- Japan Community Health care OrganizationHoshigaoka Medical CenterOsakaJapan
| | - Yasuki Kihara
- Department of Cardiovascular MedicineHiroshima UniversityHiroshimaJapan
| | - Ayumi Hida
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Waka Ohishi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
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Markabayeva A, Bauer S, Pivina L, Bjørklund G, Chirumbolo S, Kerimkulova A, Semenova Y, Belikhina T. Increased prevalence of essential hypertension in areas previously exposed to fallout due to nuclear weapons testing at the Semipalatinsk Test Site, Kazakhstan. ENVIRONMENTAL RESEARCH 2018; 167:129-135. [PMID: 30014894 DOI: 10.1016/j.envres.2018.07.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/06/2018] [Accepted: 07/07/2018] [Indexed: 06/08/2023]
Abstract
This study examines the association between environmental radiation exposure and essential hypertension in a series of investigated geographical districts adjacent to the Semipalatinsk nuclear test site in Kazakhstan. The sample consists of 2000 volunteers participants in screening examinations in three administrative districts close to the nuclear test site, which was carried out as part of the Government Programs on Environmental Health Hazard. The cross-sectional study compares prevalence ratios in a population sample with long-term exposure in the low and intermediate dose range. Age-adjusted odds ratios for hypertension were found significantly increased with higher exposure groups. After accounting for main cardiovascular risk factors into the model and stratifying by gender, the prevalence odds ratios for radiation remained significantly increased, with a significant dose-response effect observed for some but not all subgroups. The results support existing evidence of cardiovascular health effects of radiation exposure and of persisting environmental health issues that require attention in both epidemiological surveys and healthcare provision.
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Affiliation(s)
| | | | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway.
| | - Salvatore Chirumbolo
- Department of Neuroscience, Biomedicine and Movement Sciences-University of Verona, Verona, Italy
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Boaventura P, Durães C, Mendes A, Costa NR, Chora I, Ferreira S, Araújo E, Lopes P, Rosa G, Marques P, Tavares S, Chaves V, Bettencourt P, Oliveira I, Costa F, Ramos I, Teles MJ, Guimarães JT, Sobrinho-Simões M, Soares P. Is Low-Dose Radiation Exposure a Risk Factor for Atherosclerotic Disease? Radiat Res 2018; 189:418-424. [PMID: 29461943 DOI: 10.1667/rr14942.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Nontargeted late effects of radiation include an increased risk of cardiovascular disease, although this is still debatable in the context of low-dose radiation. Tinea capitis patients treated in childhood with X rays to induce scalp epilation received a low dose of radiation to their carotids. To better clarify this issue, we evaluated carotid atherosclerosis in a cohort of such patients treated in 1950-1963 in Portugal. A group of 454 individuals randomly chosen from previously observed Portuguese tinea capitis patients and a control group mainly composed of their spouses (n = 280) were enrolled. Cardiovascular risk factors such as waist circumference, body mass index, blood pressure and tobacco consumption, as well as biochemical measurements were obtained. Ultrasound imaging of carotid arteries for intima media thickness and stenosis evaluation were performed according to a standardized protocol. In comparison to the control group, the irradiated cohort members were significantly older, more frequently never smokers, hypertensive, and presented higher glycated hemoglobin and alkaline phosphatase levels. In addition, the irradiated cohort showed a higher frequency of carotid stenosis ≥30% than the nonirradiated group (13.9% vs. 10.7%), although this was not significant ( P = 0.20). Stenosis was ≥50% in 2.9% of the irradiated group and 0.4% of the nonirradiated group ( P = 0.02). Likewise, the frequency of intima media thickness ≥1 mm was significantly higher in the irradiated group (16.8% vs. 10.7%; P = 0.02). Multivariate analysis, including other cardiovascular risk factors, showed that exposure to low-dose radiation increased the risk of carotid stenosis by ≥50% [odds ratio (OR) = 8.85; P = 0.04] and intima media thickness by ≥1 mm (OR = 1.82; P = 0.02). These findings confirm that low-dose exposure is a risk factor of carotid atherosclerotic disease.
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Affiliation(s)
- Paula Boaventura
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S)
| | - Cecília Durães
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S)
| | - Adélia Mendes
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S)
| | - Natália Rios Costa
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S)
| | | | | | | | | | | | | | | | | | - Paulo Bettencourt
- c S. João Hospital, Porto.,d Department of Pathology, Faculty of Medicine of the University of Porto
| | | | | | - Isabel Ramos
- c S. João Hospital, Porto.,e Faculty of Medicine of the University of Porto
| | - Maria José Teles
- c S. João Hospital, Porto.,e Faculty of Medicine of the University of Porto
| | | | - Manuel Sobrinho-Simões
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S).,c S. João Hospital, Porto.,d Department of Pathology, Faculty of Medicine of the University of Porto.,e Faculty of Medicine of the University of Porto
| | - Paula Soares
- a Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP).,b Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S).,c S. João Hospital, Porto.,e Faculty of Medicine of the University of Porto
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Zhivin S, Guseva Canu I, Davesne E, Blanchardon E, Garsi JP, Samson E, Niogret C, Zablotska LB, Laurier D. Circulatory disease in French nuclear fuel cycle workers chronically exposed to uranium: a nested case–control study. Occup Environ Med 2017; 75:270-276. [DOI: 10.1136/oemed-2017-104575] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/28/2017] [Accepted: 10/18/2017] [Indexed: 01/25/2023]
Abstract
ObjectivesThere is growing evidence of an association between low-dose external γ-radiation and circulatory system diseases (CSDs), yet sparse data exist about an association with chronic internal uranium exposure and the role of non-radiation risk factors. We conducted a nested case–control study of French AREVA NC Pierrelatte nuclear workers employed between 1960 and 2005 to estimate CSD risks adjusting for major CSD risk factors (smoking, blood pressure, body mass index, total cholesterol and glycaemia) and external γ-radiation dose.MethodsThe study included 102 cases of death from CSD and 416 controls individually matched on age, gender, birth cohort and socio-professional status. Information on CSD risk factors was collected from occupational medical records. Organ-specific absorbed doses were estimated using biomonitoring data, taking into account exposure regime and uranium physicochemical properties. External γ-radiation was measured by individual dosimeter badges. Analysis was conducted with conditional logistic regression.ResultsWorkers were exposed to very low radiation doses (mean γ-radiation dose 2 and lung uranium dose 1 mGy). A positive but imprecise association was observed (excess OR per mGy 0.2, 95% CI 0.004 to 0.5). Results obtained after adjustment suggest that uranium exposure might be an independent CSD risk factor.ConclusionsOur results suggest that a positive association might exist between internal uranium exposure and CSD mortality, not confounded by CSD risk factors. Future work should focus on numerous uncertainties associated with internal uranium dose estimation and on understanding biological pathway of CSD after protracted low-dose internal radiation exposure.
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Ozasa K, Takahashi I, Grant EJ, Kodama K. Cardiovascular disease among atomic bomb survivors. Int J Radiat Biol 2017; 93:1145-1150. [DOI: 10.1080/09553002.2017.1290849] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Minami-ku, Hiroshima, Japan
| | - Ikuno Takahashi
- Department of Epidemiology, Radiation Effects Research Foundation, Minami-ku, Hiroshima, Japan
| | - Eric J. Grant
- Radiation Effects Research Foundation, Minami-ku, Hiroshima, Japan
| | - Kazunori Kodama
- Radiation Effects Research Foundation, Minami-ku, Hiroshima, Japan
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Takahashi I, Shimizu Y, Grant EJ, Cologne J, Ozasa K, Kodama K. Heart Disease Mortality in the Life Span Study, 1950-2008. Radiat Res 2017; 187:319-332. [PMID: 28170314 DOI: 10.1667/rr14347.1] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Based on the findings from the Radiation Effects Research Foundation's studies of the cohort of Japanese atomic bomb survivors, it has been reported that total-body irradiation at 0.5-1.0 Gy could be responsible for increased rates of mortality from broad-based categories of cardiovascular disease (CVD), i.e., stroke and heart disease. However, CVD consists of various subtypes that have potentially different radiation dose responses, as well as subtype-specific risks that have not been fully evaluated. Potential problems with changes in the coding rules for the International Classification of Diseases (ICD) and the underlying causes and trends in CVD mortality in Japan also need to be considered. The goal of this study was to clarify the radiation risk of subtype-specific heart disease over different time periods. Radiation dose response was examined for mortality from several heart disease subtypes in 86,600 members of the Life Span Study (LSS) cohort during 1950-2008. These subtypes included ischemic heart disease (IHD), valvular heart disease (VHD), hypertensive organ damage (HOD) and heart failure (HF). Individual radiation doses ranged between 0 and 4 Gy. In addition to analyses for the total period, we examined specific periods, 1950-1968, 1969-1980, 1981-1994 and 1995-2008, corresponding to major developments in medical technologies and ICD code revisions. We observed significant positive associations between radiation dose and mortality from heart disease overall in 1950-2008 [excess relative risk or ERR/Gy (95% CI) = 0.14 (0.06, 0.22)]. Subtype-specific ERRs also positively increased with dose: 0.45 (0.13, 0.85) for VHD, 0.36 (0.10, 0.68) for HOD and 0.21 (0.07, 0.37) for HF, respectively. No significant departure from linearity was shown for the dose-response model. Although there was no evidence for a threshold in a model function, the lowest dose ranges with a statistically significant dose response were 0-0.7 Gy for heart disease overall and VHD, 0-1.5 Gy for HOD and 0-0.4 Gy for HF. No significant association between radiation exposure and IHD was observed in any model, although a quadratic model fit the best. The risk of HOD and rheumatic VHD increased significantly in the earliest periods [ERR/Gy = 0.59 (0.07, 1.32) and 1.34 (0.24, 3.16), respectively]. The risk of nonrheumatic VHD increased with calendar time and was significant in the latest period [ERR/Gy = 0.75 (0.02, 1.92)]. The risk of IHD, especially for myocardial infarction, tended to be elevated in the most recent period after 2001, where cautious interpretation is needed due to the uncertain validity of death diagnosis. Radiation risks of heart disease mortality in the LSS appeared to vary substantially among subtypes, indicating possible differences in radiation-induced pathogenesis. Trends in CVD rates in Japan during the long observation period may also impact risk analyses.
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Affiliation(s)
- Ikuno Takahashi
- a Department of Clinical Studies, Radiation Effects Research Foundation (RERF) Hiroshima, Japan.,b Department of Epidemiology, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
| | - Yukiko Shimizu
- b Department of Epidemiology, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
| | - Eric J Grant
- b Department of Epidemiology, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
| | - John Cologne
- c Department of Statistics, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
| | - Kotaro Ozasa
- b Department of Epidemiology, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
| | - Kazunori Kodama
- a Department of Clinical Studies, Radiation Effects Research Foundation (RERF) Hiroshima, Japan.,d Chief Scientist, Radiation Effects Research Foundation (RERF) Hiroshima, Japan
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Andreassi MG, Piccaluga E, Guagliumi G, Del Greco M, Gaita F, Picano E. Occupational Health Risks in Cardiac Catheterization Laboratory Workers. Circ Cardiovasc Interv 2016; 9:e003273. [PMID: 27072525 DOI: 10.1161/circinterventions.115.003273] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/24/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Orthopedic strain and radiation exposure are recognized risk factors in personnel staff performing fluoroscopically guided cardiovascular procedures. However, the potential occupational health effects are still unclear. The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure. METHODS AND RESULTS We used a self-administered questionnaire to collect demographic information, work-related information, lifestyle-confounding factors, all current medications, and health status. A total number of 746 questionnaires were properly filled comprising 466 exposed staff (281 males; 44±9 years) and 280 unexposed subjects (179 males; 43±7years). Exposed personnel included 218 interventional cardiologists and electrophysiologists (168 males; 46±9 years); 191 nurses (76 males; 42±7 years), and 57 technicians (37 males; 40±12 years) working for a median of 10 years (quartiles: 5-24 years). Skin lesions (P=0.002), orthopedic illness (P<0.001), cataract (P=0.003), hypertension (P=0.02), and hypercholesterolemia (P<0.001) were all significantly higher in exposed versus nonexposed group, with a clear gradient unfavorable for physicians over technicians and nurses and for longer history of work (>16 years). In highly exposed physicians, adjusted odds ratio ranged from 1.7 for hypertension (95% confidence interval: 1-3; P=0.05), 2.9 for hypercholesterolemia (95% confidence interval: 1-5; P=0.004), 4.5 for cancer (95% confidence interval: 0.9-25; P=0.06), to 9 for cataract (95% confidence interval: 2-41; P=0.004). CONCLUSIONS Health problems are more frequently observed in workers performing fluoroscopically guided cardiovascular procedures than in unexposed controls, raising the need to spread the culture of safety in the cath laboratory.
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Affiliation(s)
- Maria Grazia Andreassi
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
| | - Emanuela Piccaluga
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.)
| | - Giulio Guagliumi
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.)
| | - Maurizio Del Greco
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.)
| | - Fiorenzo Gaita
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.)
| | - Eugenio Picano
- From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.)
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Koivurova M, Leppänen AP. Derivation and validation of a novel Semi Empirical Deposition Estimation Model (SEDEM). JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2016; 165:206-218. [PMID: 27770699 DOI: 10.1016/j.jenvrad.2016.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/29/2016] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
Predictive models are necessary in order to minimize potential damages in the event of a nuclear or radiological release. For this reason, a novel model for the calculation of both wet and dry deposition from airborne radioactivity is proposed. Full derivation of the model and the estimation of uncertainty are presented, and the validity of the model is evaluated by calculating deposition based on several measured airborne activities in different countries. The results are compared with the corresponding measured deposition activities and the predictive power of the model is found to be good, i.e. calculated depositions being within the limits of measurement uncertainty. Additionally, limitations of the model and possible sources of error in the calculations are discussed.
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Affiliation(s)
- Matias Koivurova
- University of Eastern Finland, Department of Physics and Mathematics, P.O. Box 111, FI-80101, Joensuu, Finland.
| | - Ari-Pekka Leppänen
- Radiation and Nuclear Safety Authority - STUK, Environmental Surveillance and Measurement, Lähteentie 2, FIN-96400, Rovaniemi, Finland
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19
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Environmental carcinogens and mutational pathways in atherosclerosis. Int J Hyg Environ Health 2015; 218:293-312. [DOI: 10.1016/j.ijheh.2015.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 02/07/2023]
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20
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Kreuzer M, Auvinen A, Cardis E, Hall J, Jourdain JR, Laurier D, Little MP, Peters A, Raj K, Russell NS, Tapio S, Zhang W, Gomolka M. Low-dose ionising radiation and cardiovascular diseases – Strategies for molecular epidemiological studies in Europe. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2015; 764:90-100. [DOI: 10.1016/j.mrrev.2015.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 12/31/2022]
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Drubay D, Caër-Lorho S, Laroche P, Laurier D, Rage E. Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study. Radiat Res 2015; 183:550-62. [PMID: 25807316 DOI: 10.1667/rr13834.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A significant association has been observed between radon exposure and cerebrovascular disease (CeVD) mortality among French uranium miners, but risk factors for circulatory system diseases (CSD) have not been previously considered. We conducted new analyses in the recently updated (through 2007) French cohort of uranium miners (n = 5,086), which included 442 deaths from CSD, 167 of them from ischemic heart disease (IHD) and 105 from CeVD. A nested case-control study was then set up to collect and investigate the influence of these risk factors on the relationships between mortality from CSD and occupational external gamma ray and internal ionizing radiation exposure (radon and long-lived radionuclides) in this updated cohort. The nested case-control study included miners first employed after 1955, still employed in 1976 and followed up through 2007. Individual information about CSD risk factors was collected from medical files for the 76 deaths from CSD (including 26 from IHD and 16 from CeVD) and 237 miners who had not died of CSD by the end of follow-up. The exposure-risk relationships were assessed with a Cox proportional hazard model weighted by the inverse sampling probability. A significant increase in all CSD and CeVD mortality risks associated with radon exposure was observed in the total cohort [hazard ratios: HRCSD/100 working level months (WLM) = 1.11, 95% confidence interval (1.01; 1.22) and HRCeVD/100 WLM = 1.25 (1.09; 1.43), respectively]. A nonsignificant exposure-risk relationship was observed for every type of cumulative ionizing radiation exposure and every end point [e.g., HRCSD/100WLM = 1.43 (0.71; 2.87)]. The adjustment for each CSD risk factor did not substantially change the exposure-risk relationships. When the model was adjusted for overweight, hypertension, diabetes, hypercholesterolemia and smoking status, the HR/100WLM for CSD, for example, was equal to 1.21 (0.54; 2.75); and when it was adjusted for risk factors selected with the Akaike information criterion, it was equal to 1.44 (0.66; 3.14). To our knowledge, this is the first study to use a uranium miner cohort to consider the major standard CSD risk factors in assessing the relationships between ionizing radiation exposure and the risk of death from these diseases. These results suggest that the significant relationship between CeVD risk and radon exposure observed in the total French cohort is probably not affected by the CSD risk factors. Extending the collection of information about CSD risk factors to a larger subsample would be useful to confirm this result.
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Affiliation(s)
- Damien Drubay
- a Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM, SRBE, LEPID, Fontenay-aux-Roses, France
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Cullings HM. Impact on the Japanese atomic bomb survivors of radiation received from the bombs. HEALTH PHYSICS 2014; 106:281-293. [PMID: 24378504 DOI: 10.1097/hp.0000000000000009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Radiation Effects Research Foundation (RERF) studies various cohorts of Japanese atomic bomb survivors, the largest being the Life Span Study (LSS), which includes 93,741 persons who were in Hiroshima or Nagasaki at the times of the bombings; there are also cohorts of persons who were exposed in utero and survivors' children. This presentation attempts to summarize the total impact of the radiation from the bombs on the survivors from both an individual perspective (both age-specific and integrated lifetime risk, along with a measure of life expectancy that describes how the risk affects the individual given age at exposure) and a group perspective (estimated numbers of excess occurrences in the cohort), including both early and late effects. As survivors' doses ranged well into the acutely lethal range at closer distances, some of them experienced acute signs and symptoms of radiation exposure in addition to being at risk of late effects. Although cancer has always been a primary concern among late effects, estimated numbers of excess cancers and hematopoietic malignancies in the LSS are a small fraction of the total due to the highly skewed dose distribution, with most survivors receiving small doses. For example, in the latest report on cancer incidence, 853 of 17,448 incident solid cancers were estimated to be attributable to radiation from the bombs. RERF research indicates that risk of radiation-associated cancer varies among sites and that some benign tumors such as uterine myoma are also associated with radiation. Noncancer late effects appear to be in excess in proportion to radiation dose but with an excess relative risk about one-third that of solid cancer and a correspondingly small overall fraction of cases attributable to radiation. Specific risks were found for some subcategories, particularly circulatory disease, including stroke and precedent conditions such as hypertension. Radiation-related cataract in the atomic bomb survivors is well known, with evidence in recent years of risk at lower dose levels than previously appreciated. In addition to somatic effects, survivors experienced psychosocial effects such as uncertainty, social stigma, or rejection, and other social pressures. Developmental deficits associated with in utero exposure, notably cognitive impairment, have also been described. Interaction of radiation with other risk factors has been demonstrated in relation to both cancer and noncancer diseases. Current research interests include whether radiation increases risk of diabetes or conditions of the eye apart from cataract, and there continues to be keen interest as to whether there are heritable effects in survivors' children, despite negative findings to date. Introduction of Impact on the Japanese Atomic- Bomb Survivors (Video 1:52, http://links.lww.com/HP/A29).
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Affiliation(s)
- Harry M Cullings
- *Department of Statistics, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
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Takahashi I, Ohishi W, Mettler FA, Ozasa K, Jacob P, Ban N, Lipshultz SE, Stewart FA, Nabika T, Niwa Y, Takahashi N, Akahoshi M, Kodama K, Shore R. A report from the 2013 international workshop: radiation and cardiovascular disease, Hiroshima, Japan. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2013; 33:869-880. [PMID: 24190873 DOI: 10.1088/0952-4746/33/4/869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Two longitudinal cohort studies of Japanese atomic bomb survivors-the life span study (LSS) and the adult health study (AHS)-from the Radiation Effects Research Foundation (RERF) indicate that total body irradiation doses less than 1 Gy are associated with an increased risk of cardiovascular disease (CVD), but several questions about this association remain.In particular, the diversity of heart disease subtypes and the high prevalence of other risk factors complicate the estimates of radiation effects. Subtype-specific analyses with more reliable diagnostic criteria and measurement techniques are needed. The radiation effects on CVD risk are probably tissue-reaction (deterministic) effects, so the dose-response relationships for various subtypes of CVD may be nonlinear and therefore should be explored with several types of statistical models.Subpopulations at high risk need to be identified because effects at lower radiation doses may occur primarily in these susceptible subpopulations. Whether other CVD risk factors modify radiation effects also needs to be determined. Finally, background rates for various subtypes of CVD have historically differed substantially between Japanese and Western populations, so the generalisability to other populations needs to be examined.Cardiovascular disease mechanisms and manifestations may differ between high-dose local irradiation and low-dose total body irradiation (TBI)-microvascular damage and altered metabolism from low-dose TBI, but coronary artery atherosclerosis and thrombotic myocardial infarcts at high localised doses. For TBI, doses to organs other than the heart may be important in pathogenesis of CVD, so data on renal and liver disorders, plaque instability, microvascular damage, metabolic disorders, hypertension and various CVD biomarkers and risk factors are needed. Epidemiological, clinical and experimental studies at doses of less than 1 Gy are necessary to clarify the effects of radiation on CVD risk.
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Affiliation(s)
- Ikuno Takahashi
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
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Borghini A, Luca Gianicolo EA, Picano E, Andreassi MG. Ionizing radiation and atherosclerosis: Current knowledge and future challenges. Atherosclerosis 2013; 230:40-7. [DOI: 10.1016/j.atherosclerosis.2013.06.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/13/2013] [Accepted: 06/12/2013] [Indexed: 11/16/2022]
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Radiation-induced noncancer risks in interventional cardiology: optimisation of procedures and staff and patient dose reduction. BIOMED RESEARCH INTERNATIONAL 2013; 2013:976962. [PMID: 24027768 PMCID: PMC3762166 DOI: 10.1155/2013/976962] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 06/28/2013] [Accepted: 07/18/2013] [Indexed: 12/18/2022]
Abstract
Concerns about ionizing radiation during interventional cardiology have been increased in recent years as a result of rapid growth in interventional procedure volumes and the high radiation doses associated with some procedures. Noncancer radiation risks to cardiologists and medical staff in terms of radiation-induced cataracts and skin injuries for patients appear clear potential consequences of interventional cardiology procedures, while radiation-induced potential risk of developing cardiovascular effects remains less clear. This paper provides an overview of the evidence-based reviews of concerns about noncancer risks of radiation exposure in interventional cardiology. Strategies commonly undertaken to reduce radiation doses to both medical staff and patients during interventional cardiology procedures are discussed; optimisation of interventional cardiology procedures is highlighted.
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Stewart FA, Seemann I, Hoving S, Russell NS. Understanding radiation-induced cardiovascular damage and strategies for intervention. Clin Oncol (R Coll Radiol) 2013; 25:617-24. [PMID: 23876528 DOI: 10.1016/j.clon.2013.06.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/26/2013] [Accepted: 06/30/2013] [Indexed: 12/22/2022]
Abstract
There is a clear association between therapeutic doses of thoracic irradiation and an increased risk of cardiovascular disease (CVD) in cancer survivors, although these effects may take decades to become symptomatic. Long-term survivors of Hodgkin's lymphoma and childhood cancers have two-fold to more than seven-fold increased risks for late cardiac deaths after total tumour doses of 30-40 Gy, given in 2 Gy fractions, where large volumes of heart were included in the field. Increased cardiac mortality is also seen in women irradiated for breast cancer. Breast doses are generally 40-50 Gy in 2 Gy fractions, but only a small part of the heart is included in the treatment fields and mean heart doses rarely exceeded 10-15 Gy, even with older techniques. The relative risks of cardiac mortality (1.1-1.4) are consequently lower than for Hodgkin's lymphoma survivors. Some epidemiological studies show increased risks of cardiac death after accidental or environmental total body exposures to much lower radiation doses. The mechanisms whereby these cardiac effects occur are not fully understood and different mechanisms are probably involved after high therapeutic doses to the heart, or part of the heart, than after low total body exposures. These various mechanisms probably result in different cardiac pathologies, e.g. coronary artery atherosclerosis leading to myocardial infarct, versus microvascular damage and fibrosis leading to congestive heart failure. Experimental studies can help to unravel some of these mechanisms and may identify suitable strategies for managing or inhibiting CVD. In this overview, the main epidemiological and clinical evidence for radiation-induced CVD is summarised. Experimental data shedding light on some of the underlying pathologies and possible targets for intervention are also discussed.
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Affiliation(s)
- F A Stewart
- Division of Biological Stress Response, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Sera N, Hida A, Imaizumi M, Nakashima E, Akahoshi M. The association between chronic kidney disease and cardiovascular disease risk factors in atomic bomb survivors. Radiat Res 2012; 179:46-52. [PMID: 23148507 DOI: 10.1667/rr2863.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Atomic bomb (A-bomb) radiation is associated with cardiovascular disease (CVD) and metabolic CVD risk factors. Chronic kidney disease (CKD) is also known to be a risk factor for CVD and little is known whether CKD is associated with A-bomb radiation. To examine whether CKD is associated with CVD risk factors or with A-bomb radiation in A-bomb survivors, we classified renal dysfunction in 1,040 A-bomb survivors who were examined in 2004-2007 as normal [n = 121; estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m(2)]; mild (n = 686; eGFR 60-89 ml/min/1.73 m(2)); moderate (n = 217; eGFR 30-59 ml/min/1.73 m(2)); or severe (n = 16; eGFR <30 ml/min/1.73 m(2)). Also, we diagnosed subjects in the moderate and severe renal dysfunction groups as having CKD (n = 233; eGFR <59 ml/min/1.73 m(2)). After adjusting for age, gender, and smoking and drinking habits, we looked for an association between renal dysfunction and hypertension, diabetes mellitus (DM), hyperlipidemia, and metabolic syndrome (MetS), and between renal dysfunction and A-bomb radiation. Hypertension [odds ratio (OR), 1.57; 95% confidence interval (CI), 1.12-2.20, P = 0.009]; DM (OR, 1.79; 95% CI, 1.23-2.61, P = 0.002); hyperlipidemia (OR, 1.55; 95% CI, 1.12-2.14, P = 0.008); and MetS (OR, 1.86; 95% CI, 1.32-2.63, P < 0.001) were associated with CKD (moderate/severe renal dysfunction), and hyperlipidemia and MetS were also associated with mild renal dysfunction. CKD (OR/Gy, 1.29; 95% CI, 1.01-1.63, P = 0.038) and severe renal dysfunction (OR/Gy, 3.19; 95% CI, 1.63-6.25, P < 0.001) were significantly associated with radiation dose. CKD associated with radiation may have played a role in the development of CVD among A-bomb survivors.
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Affiliation(s)
- Nobuko Sera
- Department of a Nagasaki Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan.
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Karpov AB, Semenova YV, Takhauov RM, Litvinenko TM, Kalinkin DE. The risk of acute myocardial infarction and arterial hypertension in a cohort of male employees of a Siberian Group of Chemical Enterprises exposed to long-term irradiation. HEALTH PHYSICS 2012; 103:15-23. [PMID: 22647907 DOI: 10.1097/hp.0b013e318249fa59] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
During the period from 1998 to 2007, a prospective cohort study of acute myocardial infarction morbidity cases as well as a "case-control" study of arterial hypertension was carried out. The risk of acute myocardial infarction was assessed as well as arterial hypertension; the dose-response relationship and the role of radiation in the mechanism of acute myocardial infarction as well as arterial hypertension development were studied. As a result of this study, a statistically significant increased risk of acute myocardial infarction among the male staff at the Siberian Group of Chemical Enterprises [standardized relative risk = 1.16 (1.04; 1.29)] exposed to external irradiation in comparison with employees unexposed to ionizing radiation was observed. A significant increase in the risk of acute myocardial infarction was observed at external radiation dose accumulation of more than 300 mSv [standardized relative risk = 1.46 (1.09; 1.91)]. The increase in arterial hypertension risk has been established among the analyzed group of employees exposed to long-term irradiation in the absence of the linear dependence of risk, based on cumulative dose of external γ-irradiation [risk due to external radiation dose in the range of 7.3-21.3 mSv = 1.6 (0.96; 2.51) and in the range of external radiation dose 21.4-68.5 mSv = 1.7 (1.04; 2.67) for 68.6-864 mSv = 1.6 (1.01; 2.57)]. This led to the conclusion that radiation can act also as a factor that might potentiate the negative effects of the "traditional" risk factors in the pathogenesis of acute myocardial infarction and hypertension.
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Picano E, Vano E, Domenici L, Bottai M, Thierry-Chef I. Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure. BMC Cancer 2012; 12:157. [PMID: 22540409 PMCID: PMC3495891 DOI: 10.1186/1471-2407-12-157] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/27/2012] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND According to a fundamental law of radiobiology ("Law of Bergonié and Tribondeau", 1906), the brain is a paradigm of a highly differentiated organ with low mitotic activity, and is thus radio-resistant. This assumption has been challenged by recent evidence discussed in the present review. RESULTS Ionizing radiation is an established environmental cause of brain cancer. Although direct evidence is lacking in contemporary fluoroscopy due to obvious sample size limitation, limited follow-up time and lack of focused research, anecdotal reports of clusters have appeared in the literature, raising the suspicion that brain cancer may be a professional disease of interventional cardiologists. In addition, although terminally differentiated neurons have reduced or mild proliferative capacity, and are therefore not regarded as critical radiation targets, adult neurogenesis occurs in the dentate gyrus of the hippocampus and the olfactory bulb, and is important for mood, learning/memory and normal olfactory function, whose impairment is a recognized early biomarker of neurodegenerative diseases. The head doses involved in radiotherapy are high, usually above 2 Sv, whereas the low-dose range of professional exposure typically involves lifetime cumulative whole-body exposure in the low-dose range of < 200 mSv, but with head exposure which may (in absence of protection) arrive at a head equivalent dose of 1 to 3 Sv after a professional lifetime (corresponding to a brain equivalent dose around 500 mSv). CONCLUSIONS At this point, a systematic assessment of brain (cancer and non-cancer) effects of chronic low-dose radiation exposure in interventional cardiologists and staff is needed.
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Affiliation(s)
- Eugenio Picano
- Institute Clinical Physiology of the National Research Council CNR, 56124, Pisa, Italy
| | - Eliseo Vano
- San Carlos University Hospital, Complutense University, Medical Physics Service, Madrid, Spain
| | - Luciano Domenici
- Neuroscience Institute of the National Research Council, CNR, Pisa, and Scienze e Tecnologie Biomediche Department, L'Aquila University, Pisa, Italy
| | - Matteo Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Karolinska, Sweden
| | - Isabelle Thierry-Chef
- Environment and Radiation, International Agency for Research on Cancer, Lyon, France
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Sakata R, Grant EJ, Ozasa K. Long-term follow-up of atomic bomb survivors. Maturitas 2012; 72:99-103. [PMID: 22440534 DOI: 10.1016/j.maturitas.2012.02.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 02/20/2012] [Indexed: 11/29/2022]
Abstract
The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1 Gy), cancer incidence (47% at 1 Gy), death due to leukemia (310% at 1 Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public.
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Affiliation(s)
- Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan.
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Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, Aleman BM, Edgar AB, Mabuchi K, Muirhead CR, Shore RE, Wallace WH. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context. Ann ICRP 2012; 41:1-322. [PMID: 22925378 DOI: 10.1016/j.icrp.2012.02.001] [Citation(s) in RCA: 798] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.
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Takahashi I, Abbott RD, Ohshita T, Takahashi T, Ozasa K, Akahoshi M, Fujiwara S, Kodama K, Matsumoto M. A prospective follow-up study of the association of radiation exposure with fatal and non-fatal stroke among atomic bomb survivors in Hiroshima and Nagasaki (1980-2003). BMJ Open 2012; 2:e000654. [PMID: 22307102 PMCID: PMC3274709 DOI: 10.1136/bmjopen-2011-000654] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Use of medical radiotherapy has increased markedly in recent decades. Whether the consequence includes an increased risk of cardiovascular disease remains to be determined. The purpose of this study was to examine the association between radiation exposure and the incidence of stroke among Japanese atomic bomb survivors. DESIGN A prospective follow-up study. SETTING AND PARTICIPANTS Radiation exposure from the atomic bombing was assessed in 9515 subjects (34.8% men) with 24-year follow-up from 1980. Subjects were free of prevalent stroke when follow-up began. OUTCOME MEASURES Stroke events and the underlying cause of death were reviewed to confirm the first-ever stroke. Subtypes (ischaemic and haemorrhagic events) were categorised based on established criteria according to the definitions of typical/atypical stroke symptoms. RESULTS Overall mean radiation dose (±SD) in units of gray (Gy) was 0.38±0.58 (range: 0-3.5). During the study period, 235 haemorrhagic and 607 ischaemic events were identified. For men, after adjusting for age and concomitant risk factors, the risk of haemorrhagic stroke rose consistently from 11.6 to 29.1 per 10 000 person-years as doses increased from <0.05 to ≥2 Gy (p=0.009). Incidence also rose within the dose range <1 Gy (p=0.004) with no dose threshold. In women, the risk of haemorrhagic stroke rose with increasing radiation exposure but not until doses reached a threshold of 1.3 Gy (95% CI 0.5 to 2.3). Among women, for doses <1.3 Gy, differences in stroke risk were modest (13.5 per 10 000 person-years), while it increased to 20.3 per 10 000 person-years for doses that ranged from 1.3 to <2.2 Gy and to 48.6 per 10 000 person-years for doses that were higher (p=0.002). In both sexes, dose was unrelated to ischaemic stroke. CONCLUSION While the risk of haemorrhagic stroke increases with rising radiation exposure for both sexes, effects in women are less apparent until doses exceed a threshold at 1.3 Gy.
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Affiliation(s)
- Ikuno Takahashi
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Robert D Abbott
- Department of Statistics, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - Tomohiko Ohshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - Masazumi Akahoshi
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan
| | - Saeko Fujiwara
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - Kazunori Kodama
- Chief Scientist, Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
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Adams MJ, Grant EJ, Kodama K, Shimizu Y, Kasagi F, Suyama A, Sakata R, Akahoshi M. Radiation dose associated with renal failure mortality: a potential pathway to partially explain increased cardiovascular disease mortality observed after whole-body irradiation. Radiat Res 2011; 177:220-8. [PMID: 22149958 DOI: 10.1667/rr2746.1] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Whole-body and thoracic ionizing radiation exposure are associated with increased cardiovascular disease (CVD) risk. In atomic bomb survivors, radiation dose is also associated with increased hypertension incidence, suggesting that radiation dose may be associated with chronic renal failure (CRF), thus explaining part of the mechanism for increased CVD. Multivariate Poisson regression was used to evaluate the association of radiation dose with various definitions of chronic kidney disease (CKD) mortality in the Life Span Study (LSS) of atomic bomb survivors. A secondary analysis was performed using a subsample for whom self-reported information on hypertension and diabetes, the two biggest risk factors for CRF, had been collected. We found a significant association between radiation dose and only our broadest definition of CRF among the full cohort. A quadratic dose excess relative risk model [ERR/Gy(2) = 0.091 (95% CI: 0.05, 0.198)] fit minimally better than a linear model. Within the subsample, association was also observed only with the broadest CRF definition [ERR/Gy(2) = 0.15 (95% CI: 0.02, 0.32)]. Adjustment for hypertension and diabetes improved model fit but did not substantially change the ERR/Gy(2) estimate, which was 0.17 (95% CI: 0.04, 0.35). We found a significant quadratic dose relationship between radiation dose and possible chronic renal disease mortality that is similar in shape to that observed between radiation and incidence of hypertension in this population. Our results suggest that renal dysfunction could be part of the mechanism causing increased CVD risk after whole-body irradiation, a hypothesis that deserves further study.
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Affiliation(s)
- Michael Jacob Adams
- Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY14642-0644, USA.
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Grosche B, Lackland DT, Land CE, Simon SL, Apsalikov KN, Pivina LM, Bauer S, Gusev BI. Mortality from cardiovascular diseases in the Semipalatinsk historical cohort, 1960-1999, and its relationship to radiation exposure. Radiat Res 2011; 176:660-9. [PMID: 21787182 PMCID: PMC3866702 DOI: 10.1667/rr2211.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The data on risk of mortality from cardiovascular disease due to radiation exposure at low or medium doses are inconsistent. This paper reports an analysis of the Semipalatinsk historical cohort exposed to radioactive fallout from nuclear testing in the vicinity of the Semipalatinsk Nuclear Test Site, Kazakhstan. The cohort study, which includes 19,545 persons of exposed and comparison villages in the Semipalatinsk region, had been set up in the 1960s and comprises 582,656 person-years of follow-up between 1960 and 1999. A dosimetric approach developed by the U.S. National Cancer Institute (NCI) has been used. Radiation dose estimates in this cohort range from 0 to 630 mGy (whole-body external). Overall, the exposed population showed a high mortality from cardiovascular disease. Rates of mortality from cardiovascular disease in the exposed group substantially exceeded those of the comparison group. Dose-response analyses were conducted for both the entire cohort and the exposed group only. A dose-response relationship that was found when analyzing the entire cohort could be explained completely by differences between the baseline rates in exposed and unexposed groups. When taking this difference into account, no statistically significant dose-response relationship for all cardiovascular disease, for heart disease, or for stroke was found. Our results suggest that within this population and at the level of doses estimated, there is no detectable risk of radiation-related mortality from cardiovascular disease.
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Affiliation(s)
- Bernd Grosche
- Federal Office for Radiation Protection, Department of Radiation Protection and Health, Oberschleissheim, Germany.
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Douple EB, Mabuchi K, Cullings HM, Preston DL, Kodama K, Shimizu Y, Fujiwara S, Shore RE. Long-term radiation-related health effects in a unique human population: lessons learned from the atomic bomb survivors of Hiroshima and Nagasaki. Disaster Med Public Health Prep 2011; 5 Suppl 1:S122-33. [PMID: 21402804 PMCID: PMC3907953 DOI: 10.1001/dmp.2011.21] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
For 63 years scientists in the Atomic Bomb Casualty Commission and its successor, the Radiation Effects Research Foundation, have been assessing the long-term health effects in the survivors of the atomic bombings of Hiroshima and Nagasaki and in their children. The identification and follow-up of a large population (approximately a total of 200,000, of whom more than 40% are alive today) that includes a broad range of ages and radiation exposure doses, and healthy representatives of both sexes; establishment of well-defined cohorts whose members have been studied longitudinally, including some with biennial health examinations and a high survivor-participation rate; and careful reconstructions of individual radiation doses have resulted in reliable excess relative risk estimates for radiation-related health effects, including cancer and noncancer effects in humans, for the benefit of the survivors and for all humankind. This article reviews those risk estimates and summarizes what has been learned from this historic and unique study.
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Affiliation(s)
- Evan B Douple
- Radiation Effects Research Foundation, Hiroshima, Japan.
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36
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Shimizu Y, Kodama K, Nishi N, Kasagi F, Suyama A, Soda M, Grant EJ, Sugiyama H, Sakata R, Moriwaki H, Hayashi M, Konda M, Shore RE. Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003. BMJ 2010; 340:b5349. [PMID: 20075151 PMCID: PMC2806940 DOI: 10.1136/bmj.b5349] [Citation(s) in RCA: 328] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the degree to which ionising radiation confers risk of mortality from heart disease and stroke. DESIGN Prospective cohort study with more than 50 years of follow-up. SETTING Atomic bomb survivors in Hiroshima and Nagasaki, Japan. PARTICIPANTS 86 611 Life Span Study cohort members with individually estimated radiation doses from 0 to >3 Gy (86% received <0.2 Gy). MAIN OUTCOME MEASURES Mortality from stroke or heart disease as the underlying cause of death and dose-response relations with atomic bomb radiation. RESULTS About 9600 participants died of stroke and 8400 died of heart disease between 1950 and 2003. For stroke, the estimated excess relative risk per gray was 9% (95% confidence interval 1% to 17%, P=0.02) on the basis of a linear dose-response model, but an indication of possible upward curvature suggested relatively little risk at low doses. For heart disease, the estimated excess relative risk per gray was 14% (6% to 23%, P<0.001); a linear model provided the best fit, suggesting excess risk even at lower doses. However, the dose-response effect over the restricted dose range of 0 to 0.5 Gy was not significant. Prospective data on smoking, alcohol intake, education, occupation, obesity, and diabetes had almost no impact on the radiation risk estimates for either stroke or heart disease, and misdiagnosis of cancers as circulatory diseases could not account for the associations seen. CONCLUSION Doses above 0.5 Gy are associated with an elevated risk of both stroke and heart disease, but the degree of risk at lower doses is unclear. Stroke and heart disease together account for about one third as many radiation associated excess deaths as do cancers among atomic bomb survivors.
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Affiliation(s)
- Yukiko Shimizu
- Department of Epidemiology, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan.
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Richardson RB. Ionizing radiation and aging: rejuvenating an old idea. Aging (Albany NY) 2009; 1:887-902. [PMID: 20157573 PMCID: PMC2815743 DOI: 10.18632/aging.100081] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 11/16/2009] [Indexed: 12/27/2022]
Abstract
This paper reviews the contemporary evidence that radiation can accelerate aging, degenerative health effects and mortality. Around the 1960s, the idea that ionizing radiation caused premature aging was dismissed as the radiation-induced health effects appeared to be virtually confined to neoplasms. More recently, radiation has become associated with a much wider spectrum of age-related diseases, including cardiovascular disease; although some diseases of old age, such as diabetes, are notably absent as a radiation risk. On the basis of recent research, is there a stronger case today to be made linking radiation and aging? Comparison is made between the now-known biological mechanisms of aging and those of radiation, including oxidative stress, chromosomal damage, apoptosis, stem cell exhaustion and inflammation. The association between radiation effects and the free-radical theory of aging as the causative hypothesis seems to be more compelling than that between radiation and the nutrient-sensing TOR pathway. Premature aging has been assessed by biomarkers in calorie restriction studies; yet, biomarkers such as telomere erosion and p16(INK4a) are ambiguous for radiation-induced aging. Some animal studies suggest low dose radiation may even demonstrate hormesis health benefits. Regardless, there is virtually no support for a life span extending hypothesis for A-bomb survivors and other exposed subjects.
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Affiliation(s)
- Richard B Richardson
- Radiation Protection Research and Instrumentation Branch, Atomic Energy of Canada Limited, Chalk River Laboratories, Chalk River, ON K0J 1J0, Canada.
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38
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Irradiations à faibles doses et risque de pathologie cardiovasculaire : revue des études épidémiologiques. Rev Epidemiol Sante Publique 2009; 57:347-59. [DOI: 10.1016/j.respe.2009.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 02/17/2009] [Accepted: 04/15/2009] [Indexed: 12/20/2022] Open
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Loganovsky K. Do Low Doses of Ionizing Radiation Affect the Human Brain? DATA SCIENCE JOURNAL 2009. [DOI: 10.2481/dsj.br-04] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Jhun HJ, Kim BG, Park JT, Kim SY, Koo BM, Kim JK. Biological profiles of Korean atomic bomb survivors in residence at Daegu and Kyungbuk, Republic of Korea. J Korean Med Sci 2008; 23:1090-3. [PMID: 19119455 PMCID: PMC2610645 DOI: 10.3346/jkms.2008.23.6.1090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 03/17/2008] [Indexed: 11/20/2022] Open
Abstract
In 1945, many Koreans, in addition to Japanese, were killed or injured by the atomic bombs dropped on Hiroshima and Nagasaki, Japan. This study compared the biological profiles of Korean atomic bomb survivors in residence at Daegu and Kyungbuk, Republic of Korea with those of a representative sample of Koreans obtained during a similar period. We evaluated anthropometric measurements, blood pressure, blood cell counts, blood chemistry, and urinalysis of survivors (n=414) and age- and sex-matched controls (n=414) recruited from the third Korea National Health and Nutrition Examination Survey conducted in 2005. Univariate analyses revealed significantly higher systolic blood pressure, white blood cell count, and serum total cholesterol, triglycerides, high-density lipoprotein-cholesterol, and aspartate aminotransferase levels (p<0.01) in the survivors. Conversely, hemoglobin concentration, hematocrit, red blood cell count, and the proportion of positive urine occult blood (p<0.01) were lower in the survivors. Our findings suggest that biological profiles of Korean atomic bomb survivors were adversely affected by radiation exposure.
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Affiliation(s)
- Hyung-Joon Jhun
- Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Ansan, Korea
| | - Byoung-Gwon Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Ansan, Korea
| | - Jong-Tae Park
- Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Ansan, Korea
| | - Su-Young Kim
- Department of Preventive Medicine, College of Medicine, Cheju National University, Jeju, Korea
| | - Bon-Min Koo
- Department of Family Medicine, Daegu Red Cross Hospital, Daegu, Korea
| | - Jin-Kook Kim
- Department of Neurology, Daegu Red Cross Hospital, Daegu, Korea
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Tatsukawa Y, Nakashima E, Yamada M, Funamoto S, Hida A, Akahoshi M, Sakata R, Ross NP, Kasagi F, Fujiwara S, Shore RE. Cardiovascular disease risk among atomic bomb survivors exposed in utero, 1978-2003. Radiat Res 2008; 170:269-74. [PMID: 18763869 DOI: 10.1667/rr1434.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Accepted: 06/03/2008] [Indexed: 11/03/2022]
Abstract
Given the well-documented association of in utero radiation exposure with childhood cancer and developmental impairments, the possibility of effects on adult onset diseases is an important issue. The objectives of the present study were to examine the effects of atomic bomb radiation dose on the incidence of hypertension, hypercholesterolemia and cardiovascular disease (myocardial infarction and stroke) among survivors exposed in utero and to compare their risk estimates with those of survivors exposed in childhood (<10 years old) at the time of the bombing. A total of 506 participants exposed in utero and 1,053 participants exposed in childhood were followed during 1978-2003 with biennial clinical examinations. There were no significant radiation dose effects for any diseases in the entire in utero-exposed cohort or in trimester-of-exposure subgroups, though there was a suggestion of an increased risk when fatal and nonfatal cardiovascular disease cases were combined. Positive radiation dose effects were found for hypertension and cardiovascular disease in the childhood-exposure cohort, but there were no statistically significant differences in the relative risks when we compared the two cohorts. Since the in utero cohort was under age 60 at the latest examination, continued follow-up is needed to document cardiovascular disease risk more fully.
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Affiliation(s)
- Yoshimi Tatsukawa
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
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Little MP, Tawn EJ, Tzoulaki I, Wakeford R, Hildebrandt G, Paris F, Tapio S, Elliott P. A systematic review of epidemiological associations between low and moderate doses of ionizing radiation and late cardiovascular effects, and their possible mechanisms. Radiat Res 2008; 169:99-109. [PMID: 18159955 DOI: 10.1667/rr1070.1] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 08/29/2007] [Indexed: 11/03/2022]
Abstract
Little, M. P., Tawn, E. J., Tzoulaki, I., Wakeford, R., Hildebrandt, G., Paris, F., Tapio, S. and Elliott, P. A Systematic Review of Epidemiological Associations Between Low and Moderate Doses of Ionizing Radiation and Late Cardiovascular Effects, and Their Possible Mechanisms. Radiat. Res. 169, 99-109 (2008). The link between high doses of ionizing radiation and damage to the heart and coronary arteries is established. In this paper, we systematically review the epidemiological evidence for associations between low and moderate doses (<5 Gy) of ionizing radiation and late-occurring cardiovascular disease. Risks per unit dose in epidemiological studies vary over at least two orders of magnitude, possibly a result of confounding factors. An examination of possible biological mechanisms indicates that the most likely causative effect of radiation exposure is damage to endothelial cells and subsequent induction of an inflammatory response, although it seems unlikely that this would extend to low-dose and low-dose-rate exposure. However, a role for somatic mutation has been proposed that would indicate a stochastic effect. In the absence of a convincing mechanistic explanation of epidemiological evidence that is less than persuasive at present, a cause-and-effect interpretation of the reported statistical associations cannot be reliably inferred, although neither can it be reliably excluded. Further epidemiological and biological evidence will allow a firmer conclusion to be drawn.
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Affiliation(s)
- M P Little
- Department of Epidemiology and Public Health, Imperial College Faculty of Medicine, London W2 1PG, United Kingdom.
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Nakashima E, Akahoshi M, Neriishi K, Fujiwara S. Systolic Blood Pressure and Systolic Hypertension in Adolescence of Atomic Bomb Survivors ExposedIn Utero. Radiat Res 2007; 168:593-9. [DOI: 10.1667/rr1060.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 06/26/2007] [Indexed: 11/03/2022]
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Kreuzer M, Kreisheimer M, Kandel M, Schnelzer M, Tschense A, Grosche B. Mortality from cardiovascular diseases in the German uranium miners cohort study, 1946-1998. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2006; 45:159-66. [PMID: 16897062 DOI: 10.1007/s00411-006-0056-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Accepted: 07/08/2006] [Indexed: 05/11/2023]
Abstract
An increased risk of cardiovascular diseases after exposure to low doses of ionizing radiation has been suggested among the atomic bomb survivors. Few and inconclusive results on this issue are available from miner studies. A positive correlation between coronary heart disease mortality and radon exposure has been reported in the Newfoundland fluorspar miners study, yet low statistical power due to small sample size was of concern. To get further insight into this controversial issue, data from the German uranium miners cohort study were used, which is by far the largest miner study up to date. The cohort includes 59,001 male subjects who were employed for at least six months between 1946 and 1989 at the former Wismut uranium company in Eastern Germany. Exposure to radon, long-lived radionuclides and external gamma radiation was estimated by using a detailed job-exposure matrix. About 16,598 cohort members were deceased until 31 December 1998, including 5,417 deaths from cardiovascular diseases. Linear Poisson regression models were used to estimate the excess relative risk (ERR) per unit of cumulative radiation exposure after adjusting for attained age and calendar period. No trend in risk of circulatory diseases with increasing cumulative exposure to either radon [ERR per 100 working level month: 0.0006; 95% confidence limit (CI): -0.004 to 0.006], external gamma radiation (ERR per Sv: -0.26, 95% CI: -0.6 to 0.05) or long-lived radionuclides (ERR per 100 kBqh/m3: -0.2, 95% CI: -0.5 to 0.06), respectively, was observed. This was also true for the sub-group heart disease and stroke. Our findings do not support an association between cardiovascular disease mortality and exposure to radiation among miners, yet low doses and uncontrolled confounding hamper interpretation.
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Affiliation(s)
- M Kreuzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany.
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Ju YS, Jhun HJ, Kim JB, Kim JK. Non-cancer diseases of Korean atomic bomb survivors in residence at Hapcheon, Republic of Korea. J Korean Med Sci 2006; 21:385-90. [PMID: 16778377 PMCID: PMC2729939 DOI: 10.3346/jkms.2006.21.3.385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Many Koreans, in addition to Japanese, were killed or injured by the atomic bombs detonated over Hiroshima and Nagasaki, Japan, in 1945. Our study examined noncancer diseases of Korean A-bomb survivors in residence at Hapcheon, Republic of Korea and evaluated whether they had significantly higher prevalence of noncancer diseases than non-exposed people. We evaluated a number of tests, including anthropometric measurements, blood pressure, blood chemistry, hepatitis B surface antigen, and urinalysis, of survivors (n=223) and controls (n=372). Univariate analysis revealed significantly lower fasting glucose and creatinine, and higher diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase, and blood urea nitrogen levels in the survivors than in the controls. The calculation of crude prevalence ratios (PRs) revealed that A-bomb survivors had a significantly higher prevalence of hypertension (PR, 1.16; 95% CI, 1.00-1.35) and chronic liver disease (2.20; 1.59-3.06) than controls. After adjusting for covariates (age, sex, body mass index, marital status, education, alcohol consumption, and smoking), A-bomb survivors had a significantly higher prevalence of hypertension (1.24; 1.06-1.44), chronic liver disease (2.07; 1.51-2.84), and hypercholesterolemia (1.79; 1.11-2.90) than controls. This study suggests that A-bomb exposure is associated with a higher prevalence of non-cancer diseases in Korean survivors.
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Affiliation(s)
- Young-Su Ju
- Department of Occupational and Environmental Medicine, Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - Hyung-Joon Jhun
- Department of Occupational and Environmental Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea
| | - Jung-Bum Kim
- Association of Physicians for Humanism, Seoul, Korea
| | - Jin-Kook Kim
- Department of Neurology, Daegu Red Cross Hospital, Daegu, Korea
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Yamada M, Naito K, Kasagi F, Masunari N, Suzuki G. Prevalence of atherosclerosis in relation to atomic bomb radiation exposure: an RERF Adult Health Study. Int J Radiat Biol 2006; 81:821-6. [PMID: 16484151 DOI: 10.1080/09553000600555504] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine whether exposure to atomic bomb radiation altered the prevalence of asymptomatic atherosclerosis. MATERIAL AND METHODS In a cross-sectional analysis, we examined aortic arch calcification by plain chest radiography and common carotid artery intima-media thickness (IMT) by ultrasonography among 1804 survivors of the atomic bombing in Hiroshima. We evaluated the association between atherosclerotic changes and radiation exposure, while adjusting for potentially confounding factors. RESULTS Multivariate logistic regression analysis showed that aortic arch calcification was significantly associated with radiation exposure (p < 0.05). The odds ratio at 1 Gy was 1.30 (95% confidence interval [CI]: 1.05 - 1.53) for men and 1.31 (95% CI: 1.13 - 1.51) for women. Carotid artery IMT did not vary significantly with radiation dose (p = 0.18). CONCLUSION Radiation dose contributed to the prevalence of aortic atherosclerosis but not carotid artery atherosclerosis in atomic bomb survivors.
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Affiliation(s)
- Michiko Yamada
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
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Jhun HJ, Ju YS, Kim JB, Kim JK. Present status and self-reported diseases of the Korean atomic bomb survivors: a mail questionnaire survey. Med Confl Surviv 2005; 21:230-6. [PMID: 16180735 DOI: 10.1080/13623690500166085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Many Koreans were forced to move to Japan while Korea was occupied by Japan. Consequently, when the atomic bombs were dropped on Hiroshima and Nagasaki an estimated 40,000 Koreans died and 30,000 survived. In 2004, 2,235 Koreans were registered as A-bomb survivors in South Korea. A mail questionnaire survey to evaluate the present status and self-reported diseases of the Korean survivors was conducted. In total, 1,256 questionnaires were returned and analysed. The most frequent chronic diseases reported by Korean survivors were hypertension (40.1 per cent), peptic ulcer disease (25.7 per cent), anaemia (23.3 per cent) and cataracts (23.1 per cent). The most frequent malignant diseases were stomach cancer (1.9 per cent), colon cancer (0.5 per cent) and leukaemia/multiple myeloma (0.4 per cent). This study suggests that further investigations are needed into the health concerns of the survivors and into health protection measures.
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Affiliation(s)
- Hyung-Joon Jhun
- Dept. of Occupational and Environmental Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea.
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Yamada M, Wong FL, Fujiwara S, Akahoshi M, Suzuki G. Noncancer Disease Incidence in Atomic Bomb Survivors, 1958–1998. Radiat Res 2004; 161:622-32. [PMID: 15161358 DOI: 10.1667/rr3183] [Citation(s) in RCA: 238] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We examined the relationships between the incidence of noncancer diseases and atomic bomb radiation dose using the longitudinal data for about 10,000 Adult Health Study (AHS) participants during 1958-1998. The current report updates the analysis we presented in 1993 with 12 additional years of follow-up. In addition to the statistically significant positive linear dose-response relationships detected previously for the incidence of thyroid disease (P < 0.0001), chronic liver disease and cirrhosis (P = 0.001), and uterine myoma (P < 0.00001), we also found a significant positive dose response for cataract (P = 0.026), a negative linear dose-response relationship for glaucoma (P = 0.025), and significant quadratic dose-response relationships for hypertension (P = 0.028) and for myocardial infarction among survivors exposed at less than 40 years of age (P = 0.049). Significant radiation effects for calculus of the kidney and ureter were evident for men but not for women (test of heterogeneity by sex: P = 0.007). Accounting for smoking and drinking did not alter the results. Radiation effects for cataract, glaucoma, hypertension, and calculus of the kidney and ureter in men are new findings. These results attest to the need for continued follow-up of the aging A-bomb survivors to fully elucidate the effects of radiation exposure on the occurrence of noncancer diseases.
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Affiliation(s)
- Michiko Yamada
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
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Preston DL, Shimizu Y, Pierce DA, Suyama A, Mabuchi K. Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997. Radiat Res 2003; 160:381-407. [PMID: 12968934 DOI: 10.1667/rr3049] [Citation(s) in RCA: 753] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This continues the series of general reports on mortality in the cohort of atomic bomb survivors followed up by the Radiation Effects Research Foundation. This cohort includes 86,572 people with individual dose estimates, 60% of whom have doses of at least 5 mSv. We consider mortality for solid cancer and for noncancer diseases with 7 additional years of follow-up. There have been 9,335 deaths from solid cancer and 31,881 deaths from noncancer diseases during the 47-year follow-up. Of these, 19% of the solid cancer and 15% of the noncancer deaths occurred during the latest 7 years. We estimate that about 440 (5%) of the solid cancer deaths and 250 (0.8%) of the noncancer deaths were associated with the radiation exposure. The excess solid cancer risks appear to be linear in dose even for doses in the 0 to 150-mSv range. While excess rates for radiation-related cancers increase throughout the study period, a new finding is that relative risks decline with increasing attained age, as well as being highest for those exposed as children as noted previously. A useful representative value is that for those exposed at age 30 the solid cancer risk is elevated by 47% per sievert at age 70. There is no significant city difference in either the relative or absolute excess solid cancer risk. Site-specific analyses highlight the difficulties, and need for caution, in distinguishing between site-specific relative risks. These analyses also provide insight into the difficulties in interpretation and generalization of LSS estimates of age-at-exposure effects. The evidence for radiation effects on noncancer mortality remains strong, with risks elevated by about 14% per sievert during the last 30 years of follow-up. Statistically significant increases are seen for heart disease, stroke, digestive diseases, and respiratory diseases. The noncancer data are consistent with some non-linearity in the dose response owing to the substantial uncertainties in the data. There is no direct evidence of radiation effects for doses less than about 0.5 Sv. While there are no statistically significant variations in noncancer relative risks with age, age at exposure, or sex, the estimated effects are comparable to those seen for cancer. Lifetime risk summaries are used to examine uncertainties of the LSS noncancer disease findings.
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Affiliation(s)
- Dale L Preston
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan.
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