Postoperative cataract cases among atomic bomb survivors: radiation dose response and threshold.
Recent evidence argues against a high threshold dose for vision-impairing radiation-induced cataractogenesis. We conducted logistic regression analysis to estimate the dose response and used a likelihood profile procedure to determine the best-fitting threshold model among 3761 A-bomb survivors who underwent medical examinations during 2000-2002 for whom radiation dose estimates were available, including 479 postoperative cataract cases. The analyses indicated a statistically significant dose-response increase in the prevalence of postoperative cataracts [odds ratio (OR), 1.39; 95% confidence interval (CI), 1.24-1.55] at 1 Gy, with no indication of upward curvature in the dose response. The dose response was suggestive when the restricted dose range of 0 to 1 Gy was examined. A nonsignificant dose threshold of 0.1 Gy (95% CI, <0-0.8) was found. The prevalence of postoperative cataracts in A-bomb survivors increased significantly with A-bomb radiation dose. The estimate (0.1 Gy) and upper bound (0.8 Gy) of the dose threshold for operative cataract prevalence was much lower than the threshold of 2-5 Gy usually assumed by the radiation protection community and was statistically compatible with no threshold at all.
Neriishi
Kazuo
K
Department of Clinical Studies (Hiroshima), Radiation Effects Research Foundation, Japan. Neriishi@rerf.or.jp
Nakashima
Eiji
E
Minamoto
Atsushi
A
Fujiwara
Saeko
S
Akahoshi
Masazumi
M
Mishima
Hiromu K
HK
Kitaoka
Takashi
T
Shore
Roy E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009689:Nuclear Warfare; D011183:Postoperative Complications / Q000209:etiology*; D012044:Regression Analysis; D017741:Survivors