title: Lack of association between acute exposure to ionizing radiation and liver cirrhosis.
abstract: OBJECTIVE
  Although previous studies have shown significantly increased risks of liver cirrhosis and chronic liver disease for acute radiation exposure among survivors of the atomic bombings of Hiroshima and Nagasaki, Japan, these studies have not taken into account hepatitis B virus (HBV) infections. Because HBV is associated with both A-bomb radiation and liver cirrhosis, our goal was to investigate the relationship of acute ionizing radiation to liver cirrhosis adjusting for HBV, co-occurring primary liver cancer (PLC), and other potential confounders.
  
  
  METHODS
  Using a cross-sectional design and pathology review of a cohort of Japanese atomic-bomb survivors, we found that 213 of 335 (63.6%) subjects with PLC and 55 of 776 (7.1%) subjects without PLC had cirrhosis.
  
  
  RESULTS
  We found no association between acute exposure to A-bomb radiation and liver cirrhosis. The adjusted odds ratio of cirrhosis per Sv liver irradiation was 0.59 (95% confidence interval: 0.27 - 1.27). Cirrhosis risks for the highest tertile of radiation exposure (mean exposure 0.7 Sv) were also not elevated (0.8, 0.26 - 2.12 and 0.2, 0.03 - 0.98 among subjects with and without PLC.
  
  
  CONCLUSIONS
  Acute exposure to liver irradiation does not increase risks of liver cirrhosis, regardless of PLC status.
authors.affiliation: Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan. gsharp@niaid.nih.gov
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Sharp
authors.forename: Terumi
authors.initials: T
authors.lastname: Mizuno
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Shoji
authors.initials: S
authors.lastname: Tokuoka
mesh_terms: D001822:Body Burden; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006509:Hepatitis B / Q000401:mortality; D006526:Hepatitis C / Q000401:mortality; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000401:mortality*; D008297:Male; D009689:Nuclear Warfare / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000401:mortality*; D011839:Radiation, Ionizing; D012062:Relative Biological Effectiveness; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013223:Statistics as Topic; D017741:Survivors / Q000706:statistics & numerical data*