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Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [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: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
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Milder CM, Howard SC, Ellis ED, Golden AP, Cohen SS, Mumma MT, Leggett RW, French B, Zablotska LB, Boice JD. Third mortality follow-up of the Mallinckrodt uranium processing workers, 1942-2019. Int J Radiat Biol 2024; 100:161-175. [PMID: 37819879 PMCID: PMC10843089 DOI: 10.1080/09553002.2023.2267640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Mallinckrodt Chemical Works was a uranium processing facility during the Manhattan Project from 1942 to 1966. Thousands of workers were exposed to low-dose-rates of ionizing radiation from external and internal sources. This third follow-up of 2514 White male employees updates cancer and noncancer mortality potentially associated with radiation and silica dust. MATERIALS AND METHODS Individual, annualized organ doses were estimated from film badge records (n monitored = 2514), occupational chest x-rays (n = 2514), uranium urinalysis (n = 1868), radium intake through radon breath measurements (n = 487), and radon ambient measurements (n = 1356). Silica dust exposure from pitchblende processing was estimated (n = 1317). Vital status and cause of death determination through 2019 relied upon the National Death Index and Social Security Administration Epidemiological Vital Status Service. The analysis included standardized mortality ratios (SMRs), Cox proportional hazards, and Poisson regression models. RESULTS Vital status was confirmed for 99.4% of workers (84.0% deceased). For a dose weighting factor of 1 for intakes of uranium, radium, and radon decay products, the mean and median lung doses were 65.6 and 29.9 mGy, respectively. SMRs indicated a difference in health outcomes between salaried and hourly workers, and more brain cancer deaths than expected [SMR: 1.79; 95% confidence interval (CI): 1.14, 2.70]. No association was seen between radiation and lung cancer [hazard ratio (HR) at 100 mGy: 0.93; 95%CI: 0.78, 1.11]. The relationship between radiation and kidney cancer observed in the previous follow-up was maintained (HR at 100 mGy: 2.07; 95%CI: 1.12, 3.79). Cardiovascular disease (CVD) also increased significantly with heart dose (HR at 100 mGy: 1.11; 95%CI: 1.02, 1.21). Exposures to dust ≥23.6 mg/m3-year were associated with nonmalignant kidney disease (NMKD) (HR: 3.02; 95%CI: 1.12, 8.16) and kidney cancer combined with NMKD (HR: 2.46; 95%CI: 1.04, 5.81), though without evidence of a dose-response per 100 mg/m3-year. CONCLUSIONS This third follow-up of Mallinckrodt uranium processors reinforced the results of the previous studies. There was an excess of brain cancers compared with the US population, although no radiation dose-response was detected. The association between radiation and kidney cancer remained, though potentially due to few cases at higher doses. The association between levels of silica dust ≥23.6 mg/m3-year and NMKD also remained. No association was observed between radiation and lung cancer. A positive dose-response was observed between radiation and CVD; however, this association may be confounded by smoking, which was unmeasured. Future work will pool these data with other uranium processing worker cohorts within the Million Person Study.
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Affiliation(s)
- Cato M. Milder
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute
| | | | | | | | - Sarah S. Cohen
- EpidStrategies, a Division of ToxStrategies, Inc., Katy, TX
| | | | | | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
| | - John D. Boice
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
- National Council on Radiation Protection and Measurements (NCRP), Bethesda, MD, USA
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Manenti G, Coppeta L, Kirev IV, Verno G, Garaci F, Magrini A, Floris R. Low-Dose Occupational Exposure to Ionizing Radiation and Cardiovascular Effects: A Narrative Review. Healthcare (Basel) 2024; 12:238. [PMID: 38255124 PMCID: PMC10815868 DOI: 10.3390/healthcare12020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Historically, non-cancer diseases have not been considered a health risk following low-dose exposure to ionizing radiation. However, it is now well known that high-dose ionizing radiation causes cardiovascular disease, and emerging epidemiological evidence suggests an excess risk of non-cancer diseases even following exposure to lower doses of ionizing radiation than previously thought. In fact, the evidence is strongest for cardiovascular disease (CVD). The aim of this review was to report the most representative studies and data on the risk of CVD from low-dose radiation in people with occupational exposure. We reported the results of 27 articles selected from a database search of 1151 studies. The results show a complex evidence landscape on the relationship between radiation exposure and cardiovascular disease. In general, published papers show a positive association between ionizing radiation exposure and dermal microcirculation damage, ischemic heart disease, and cerebrovascular disease. Overall, they highlight the need for comprehensive and detailed research to clarify this relationship. Due to limited statistical power, the dose-risk relationship below 0.5 Gy is inconclusive, but if this relationship is found to have no threshold, it could have a significant impact on current estimates of health risks at low doses.
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Affiliation(s)
- Guglielmo Manenti
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Ivan Valentinov Kirev
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Greta Verno
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Francesco Garaci
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Roberto Floris
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
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Rathod AM, Verpaele S, Kelvin M, Sullivan KV, Leybourne MI. Uranium: an overview of physicochemical properties, exposure assessment methodologies, and health effects of environmental and occupational exposure. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:1183-1200. [PMID: 35711076 DOI: 10.1007/s10653-022-01293-x] [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: 10/20/2021] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
Uranium is chemo- and radiotoxic element which can cause multifactorial health hazards. Natural and anthropogenic uranium contamination raises concerns about potential public health problems. Natural contamination plays a significant role with regard to uranium exposure in the general population, whereas anthropogenic contamination leads to occupational uranium exposure, particularly in nuclear industry workers. In this review, we present a state-of-the-art status concerning uranium-induced health risks with a focus on epidemiological findings of uranium processing and enrichment plant workers. We provide a general overview of physicochemical properties of uranium and analytical methods for measuring or monitoring uranium, describe environmental and occupational exposure scenarios, and discuss the challenges for objectively investigating risks from uranium exposure.
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Affiliation(s)
- Abhisha M Rathod
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, 64 Bader Lane, Kingston, ON, K7L 3N6, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, T6G 2S2, Canada
| | - Steven Verpaele
- Nickel Institute, Health and Environment Public Policy, Brussels, Belgium
| | - Michelle Kelvin
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
| | - Kaj V Sullivan
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
| | - Matthew I Leybourne
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada.
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, 64 Bader Lane, Kingston, ON, K7L 3N6, Canada.
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Jiao X, Dong Z, Baccolo G, Li F, Wei T, Li J, Qin X. Insights on the distribution and environmental implications of the radio-isotope 235U in surface soils and glaciers of the Tibetan Plateau. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120824. [PMID: 36493938 DOI: 10.1016/j.envpol.2022.120824] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/14/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
Atom ratio between 235U and 238U is often used as an indicator of U contamination as the isotopic signature of products generated by the nuclear and military industry significantly vary from the natural isotopic ratio of U. In this study, surface soils and glaciers samples were collected in the Tibetan Plateau (TP) and its surrounding areas and analyzed for U isotopic composition. Results show that the 235U/238U atom ratios in the surface soils of the TP ranges from 0.007122 to 0.007615, with an average value of 0.007378 ± 0.00011; while in the snow/ice dust from high-altitude glaciers it ranges from 0.007254 to 0.007687, with an average value of 0.007345 ± 0.000128. These ratios are slightly higher than the typical crustal value, indicating that the TP was affected by an anthropogenic input of 235U, especially in its northeast and southwest sectors. The variability of our results suggests that the spatial distribution of this contamination is not uniform, pointing to differences in the potential sources and transmission paths of radioactive particles. Combining the knowledge of past tests and activities conducted in the geographic areas around the TP with the knowledge of prevailing winds, we hypothesize that the observed 235U contamination in the TP surface soils and glaciers may have originated mainly from the previous nuclear related activities in surrounding areas (e.g., north Gobi Desert and South Asia). In addition, the horizontal and vertical wind field around the Tibetan Plateau, as well as the atmospheric aerosol optical thickness data also demonstrated the possible transport paths of the radionuclides, that is, originated from in northern Gobi desert and South Asia and reached the TP crossing the Himalayas.
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Affiliation(s)
- Xiaoyu Jiao
- State Key Laboratory of Cryosphere Sciences, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhiwen Dong
- State Key Laboratory of Cryosphere Sciences, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Giovanni Baccolo
- Laboratory of Environmental Chemistry, Paul Scherrer Institut, Villigen, Switzerland
| | - Fangzhou Li
- College of Environmental Science and Engineering, Peking University, Beijing, China
| | - Ting Wei
- State Key Laboratory of Cryosphere Sciences, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - Jing Li
- State Key Laboratory of Cryosphere Sciences, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - Xiang Qin
- State Key Laboratory of Cryosphere Sciences, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, China; Qilian Mountain Glacier and Ecological Environment Research Station, Chinese Academy of Sciences, Lanzhou, 730000, China
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Laurent O, Samson E, Caër-Lorho S, Fournier L, Laurier D, Leuraud K. Updated Mortality Analysis of SELTINE, the French Cohort of Nuclear Workers, 1968-2014. Cancers (Basel) 2022; 15:cancers15010079. [PMID: 36612076 PMCID: PMC9817793 DOI: 10.3390/cancers15010079] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
Cohorts of nuclear workers are particularly relevant to study the health effects of protracted exposures to low doses at low dose-rates of ionizing radiation (IR). In France, a cohort of nuclear workers badge-monitored for external IR exposure has been followed-up for several decades. Its size and follow-up period have recently been extended. The present paper focuses on mortality from both cancer and non-cancer diseases in this cohort. The SELTINE cohort of nuclear workers employed by CEA, Orano, and EDF companies was followed-up for mortality from 1968 to 2014. Mortality in the cohort was compared to that in the French general population. Poisson regression methods were used to estimate excess relative rates of mortality per unit of cumulative dose of IR, adjusted for calendar year, age, company, duration of employment, and socioeconomic status. The cohort included 80,348 workers. At the end of the follow-up, the mean attained age was 63 years, and 15,695 deaths were observed. A strong healthy worker effect was observed overall. A significant excess of pleural cancer mortality was observed but not associated with IR dose. Death from solid cancers was positively but non-significantly associated with radiation. Death from leukaemia (excluding chronic lymphocytic leukaemia), dementia, and Alzheimer's disease were positively and significantly associated with IR dose. Estimated dose-risk relationships were consistent with those from other nuclear worker studies for all solid cancers and leukaemia but remained associated with large uncertainty. The association between IR dose and dementia mortality risk should be interpreted with caution and requires further investigation by other studies.
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Tirmarche M, Apostoaei I, Blanchardon E, Ellis ED, Gilbert E, Harrison JD, Laurier D, Marsh JW, Sokolnikov M, Wakeford R, Zhivin S. ICRP Publication 150: Cancer Risks from Plutonium and Uranium Exposure. Ann ICRP 2021; 50:1-143. [PMID: 34877884 DOI: 10.1177/01466453211028020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Golden AP, Milder CM, Ellis ED, Anderson JL, Boice JD, Bertke SJ, Zablotska LB. Cohort profile: four early uranium processing facilities in the US and Canada. Int J Radiat Biol 2021; 97:833-847. [PMID: 33970767 PMCID: PMC10201456 DOI: 10.1080/09553002.2021.1917786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Pooling of individual-level data for workers involved in uranium refining and processing (excluding enrichment) may provide valuable insights into risks from occupational uranium and external ionizing radiation exposures. METHODS Data were pooled for workers from four uranium processing facilities (Fernald, Mallinckrodt and Middlesex from the U.S.; and Port Hope, Canada). Employment began as early as the 1930s and follow-up was as late as 2017. Workers were exposed to high concentrations of uranium, radium, and their decay products, as well as gamma radiation and ambient radon decay products. Exposure and outcome data were harmonized using similar definitions and dose reconstruction methods. Standardized mortality ratios (SMR) were estimated. RESULTS In total, 560 deaths from lung cancer, 503 non-malignant respiratory diseases, 67 renal diseases, 1,596 ischemic heart diseases, and 101 dementia and Alzheimer's disease (AD) were detected in the pooled cohort of over 12,400 workers (∼1,300 females). Mean cumulative doses were 45 millisievert for whole-body external ionizing radiation exposure and 172 milligray for lung dose from radon decay products. Only SMR for dementia and AD among males was statistically significant (SMR=1.29; 95% confidence interval: 1.04, 1.54). CONCLUSIONS This is the largest study to date to examine long-term health risks of uranium processing workers.
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Affiliation(s)
- Ashley P. Golden
- Oak Ridge Associated Universities, Health Studies Program, Oak Ridge, Tennessee
| | - Cato M. Milder
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
| | - Elizabeth D. Ellis
- Oak Ridge Associated Universities, Health Studies Program, Oak Ridge, Tennessee
| | - Jeri L. Anderson
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, Ohio
| | - John D. Boice
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
- National Council on Radiation Protection and Measurements (NCRP), Bethesda, Maryland
| | - Stephen J. Bertke
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, Ohio
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, U.S.A
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Karpov AB, Takhauov RM, Zerenkov AG, Semenova YV, Bogdanov IM, Kazantceva SB, Blinov AP, Kalinkin DE, Gorina GV, Litvinova OV, Ermolaev YD, Mironova EB, Plaksin MB, Takhauov AR, Zablotska LB. Descriptive characteristics of occupational exposures and medical follow-up in the cohort of workers of the Siberian Group of Chemical Enterprises in Seversk, Russia. Int J Radiat Biol 2021; 97:848-860. [PMID: 33979238 DOI: 10.1080/09553002.2021.1917787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To date, only a few studies have examined long-term health risks of exposures in the uranium processing industry and reported contradictory results, necessitating further research in this area. This is the first description of a cohort of ∼65,000 uranium processing workers (20.6% women) of the Siberian Group of Chemical Enterprises (SGCE) in Seversk, Russia, first employed during 1950-2010. METHODS SGCE is one of the largest and oldest uranium processing complexes in the world. SGCE workers at the Radiochemical, Plutonium, Sublimate and Enrichment plants were exposed to a combination of internal and external radiation, while workers at the Support Facility were primarily exposed to non-radiation factors. RESULTS Mean cumulative gamma-ray dose based on individual external dosimetry was 28.3 millisievert. About 4,000 workers have individual biophysical survey data that could be used for estimation of organ doses from uranium. SGCE workers were followed up for mortality and cancer incidence during 1950-2013 (vital status known for 80.8% of workers). The SGCE computerized database contains information on the results of regular medical examinations, and on smoking, alcohol and other individual characteristics. CONCLUSIONS The SGCE cohort is uniquely suited to examine long-term health risks of exposures to gamma-radiation and long-lived radionuclides in uranium processing workers.
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Affiliation(s)
- Andrey B Karpov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Ravil M Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Andrey G Zerenkov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yulia V Semenova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Igor M Bogdanov
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Svetlana B Kazantceva
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Aleksey P Blinov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Dmitriy E Kalinkin
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Galina V Gorina
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Olesya V Litvinova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yuriy D Ermolaev
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Elena B Mironova
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Mikhail B Plaksin
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Anas R Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
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10
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Little MP, Azizova TV, Hamada N. Low- and moderate-dose non-cancer effects of ionizing radiation in directly exposed individuals, especially circulatory and ocular diseases: a review of the epidemiology. Int J Radiat Biol 2021; 97:782-803. [PMID: 33471563 PMCID: PMC10656152 DOI: 10.1080/09553002.2021.1876955] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/24/2020] [Accepted: 01/09/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE There are well-known correlations between high and moderate doses (>0.5 Gy) of ionizing radiation exposure and circulatory system damage, also between radiation and posterior subcapsular cataract. At lower dose correlations with circulatory disease are emerging in the Japanese atomic bomb survivors and in some occupationally exposed groups, and are still to some extent controversial. Heterogeneity in excess relative risks per unit dose in epidemiological studies at low (<0.1 Gy) and at low-moderate (>0.1 Gy, <0.5 Gy) doses may result from confounding and other types of bias, and effect modification by established risk factors. There is also accumulating evidence of excess cataract risks at lower dose and low dose rate in various cohorts. Other ocular endpoints, specifically glaucoma and macular degeneration have been little studied. In this paper, we review recent epidemiological findings, and also discuss some of the underlying radiobiology of these conditions. We briefly review some other types of mainly neurological nonmalignant disease in relation to radiation exposure. CONCLUSIONS We document statistically significant excess risk of the major types of circulatory disease, specifically ischemic heart disease and stroke, in moderate- or low-dose exposed groups, with some not altogether consistent evidence suggesting dose-response non-linearity, particularly for stroke. However, the patterns of risk reported are not straightforward. We also document evidence of excess risks at lower doses/dose-rates of posterior subcapsular and cortical cataract in the Chernobyl liquidators, US Radiologic Technologists and Russian Mayak nuclear workers, with fundamentally linear dose-response. Nuclear cataracts are less radiogenic. For other ocular endpoints, specifically glaucoma and macular degeneration there is very little evidence of effects at low doses; radiation-associated glaucoma has been documented only for doses >5 Gy, and so has the characteristics of a tissue reaction. There is some evidence of neurological detriment following low-moderate dose (∼0.1-0.2 Gy) radiation exposure in utero or in early childhood.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Ozyorsk Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Komae, Tokyo, Japan
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Ma M, Wang R, Xu L, Xu M, Liu S. Emerging health risks and underlying toxicological mechanisms of uranium contamination: Lessons from the past two decades. ENVIRONMENT INTERNATIONAL 2020; 145:106107. [PMID: 32932066 DOI: 10.1016/j.envint.2020.106107] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 06/11/2023]
Abstract
Uranium contamination is a global health concern. Regarding natural or anthropogenic uranium contamination, the major sources of concern are groundwater, mining, phosphate fertilizers, nuclear facilities, and military activities. Many epidemiological and laboratory studies have demonstrated that environmental and occupational uranium exposure can induce multifarious health problems. Uranium exposure may cause health risks because of its chemotoxicity and radiotoxicity in natural or anthropogenic scenarios: the former is generally thought to play a more significant role with regard to the natural uranium exposure, and the latter is more relevant to enriched uranium exposure. The understanding of the health risks and underlying toxicological mechanisms of uranium remains at a preliminary stage, and many controversial findings require further research. In order to present state-of-the-art status in this field, this review will primarily focus on the chemotoxicity of uranium, rather than its radiotoxicity, as well as the involved toxicological mechanisms. First, the natural or anthropogenic uranium contamination scenarios will be briefly summarized. Second, the health risks upon natural uranium exposure, for example, nephrotoxicity, bone toxicity, reproductive toxicity, hepatotoxicity, neurotoxicity, and pulmonary toxicity, will be discussed based on the reported epidemiological cases and laboratory studies. Third, the recent advances regarding the toxicological mechanisms of uranium-induced chemotoxicity will be highlighted, including oxidative stress, genetic damage, protein impairment, inflammation, and metabolic disorder. Finally, the gaps and challenges in the knowledge of uranium-induced chemotoxicity and underlying mechanisms will be discussed.
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Affiliation(s)
- Minghao Ma
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ruixia Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lining Xu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ming Xu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Sijin Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing 100049, China
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Anderson JL, Bertke SJ, Yiin J, Kelly-Reif K, Daniels RD. Ischaemic heart and cerebrovascular disease mortality in uranium enrichment workers. Occup Environ Med 2020; 78:105-111. [PMID: 32883719 DOI: 10.1136/oemed-2020-106423] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/19/2020] [Accepted: 08/02/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Linear and non-linear dose-response relationships between radiation absorbed dose to the lung from internally deposited uranium and external sources and circulatory system disease (CSD) mortality were examined in a cohort of 23 731 male and 5552 female US uranium enrichment workers. METHODS Rate ratios (RRs) for categories of lung dose and linear excess relative rates (ERRs) per unit lung dose were estimated to evaluate the associations between lung absorbed dose and death from ischaemic heart disease (IHD) and cerebrovascular disease. RESULTS There was a suggestion of modestly increased IHD risk in workers with internal uranium lung dose above 1 milligray (mGy) (RR=1.4, 95% CI 0.76 to 2.3) and a statistically significantly increased IHD risk with external dose exceeding 150 mGy (RR=1.3, 95% CI 1.1 to 1.6) compared with the lowest exposed groups. ERRs per milligray were positive for IHD and uranium internal dose and for both outcomes per gray external dose, although the CIs generally included the null. CONCLUSIONS Non-linear dose-response models using restricted cubic splines revealed sublinear responses at lower internal doses, suggesting that linear models that are common in radioepidemiological cancer studies may poorly describe the association between uranium internal dose and CSD mortality.
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Affiliation(s)
- Jeri L Anderson
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Stephen J Bertke
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - James Yiin
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Robert Douglas Daniels
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
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Guseva Canu I, Fraize-Frontier S, Michel C, Charles S. Weight of epidemiological evidence for titanium dioxide risk assessment: current state and further needs. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:430-435. [PMID: 31420585 DOI: 10.1038/s41370-019-0161-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/29/2019] [Accepted: 06/11/2019] [Indexed: 06/10/2023]
Abstract
We address here the importance of epidemiological evidence in risk assessment and decision-making in Europe. To illustrate this, titanium dioxide (TiO2) was used as a model compound. TiO2 is widely used as an odorless white pigment and opacifying agent. A recent systematic review assessing the weight of evidence on the relationship between exposure to TiO2 (all forms) and cancer in humans questions the assumptions that TiO2 is an inert material of low toxicity. Based on this new data, France submitted a proposal to classify TiO2 as a possible human carcinogen under the European regulation. The European Chemicals Agency Risk assessment committee concluded that TiO2 (all forms) warrants a classification as a suspected human carcinogen via inhalation (Category-2) under the CLP regulation (for Classification, Labeling and Packaging of chemicals). No considerations was given to TiO2 particle size, which may affect human health effects. Consequently, further epidemiological studies are needed to assess possible associations between different physical-chemical characteristics of TiO2 exposures and their impact on human health. This would allow strengthening the evidence on which to build the most appropriate regulation and to guaranty safe use given any exposure route of any TiO2 particle shape or size.
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Affiliation(s)
- Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Sandrine Fraize-Frontier
- Department of Risk Assessment, Methodology and Studies Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Cécile Michel
- Department of Risk Assessment, Chemical Evaluation Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Sandrine Charles
- Department of Risk Assessment, Chemical Evaluation Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
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High Sorption Capacity of U(VI) by COF-Based Material Doping Hydroxyapatite Microspheres: Kinetic, Equilibrium and Mechanism Investigation. J Inorg Organomet Polym Mater 2019. [DOI: 10.1007/s10904-019-01420-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Davesne E, Laurent O, Samson E, Jovanovic I, Bouet S, Challeton-de Vathaire C, Blanchardon E. Internal dose assessment for the French cohort of uranium workers. BIO WEB OF CONFERENCES 2019. [DOI: 10.1051/bioconf/20191403007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Analysis of the association between ionizing radiation and mortality in uranium workers from five plants involved in the nuclear fuel production cycle in France. Int Arch Occup Environ Health 2018; 92:249-262. [DOI: 10.1007/s00420-018-1375-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022]
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Davesne E, Laurent O, Lopez MA. How to assess internal doses for epidemiological studies and for emergency response? An overview of differences with routine operational radiation protection approach. RADIAT MEAS 2018. [DOI: 10.1016/j.radmeas.2018.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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