title: Risk of mortality from circulatory diseases in Mayak workers cohort following occupational radiation exposure.
abstract: Mortality from circulatory diseases (CD) (ICD-9 codes 390-459) was studied in an extended Mayak worker cohort, which included 22,377 workers first employed at the Mayak Production Association in 1948-1982 and followed up to the end of 2008. The enlarged cohort and extended follow-up as compared to the previous analyses provided an increased number of deaths from CD and improved statistical power of this mortality study. The analyses were based on dose estimates provided by a new Mayak Worker Dosimetry System 2008 (MWDS-2008). For the first time in the study of non-cancer effects in this cohort quantitative smoking data (smoking index) were taken into account. A significant increasing trend for CD mortality with increasing dose from external gamma-rays was found after having adjusted for non-radiation factors; the excess relative risk per unit dose (ERR/Gy) was 0.05 (95% confidence interval (CI):  >0, 0.11). Inclusion of an additional adjustment for dose from internal alpha-radiation to the liver resulted in a two-fold increase of ERR/Gy = 0.10 (95% CI: 0.02, 0.21). A significant increasing trend in CD mortality with increasing dose from internal alpha-radiation to the liver was observed (ERR/Gy = 0.27, 95% CI: 0.12, 0.48). However the ERR/Gy decreased and lost its significance after adjusting for dose from external gamma-rays. Results of the current study are in good agreement with risk estimates obtained for the Japanese LSS cohort as well as other studies of cohorts of nuclear workers.
authors.affiliation: Southern Urals Biophysics Institute, 19 Ozyorskoe shosse, Ozyorsk, 456780, Chelyabinsk Region, Russia.
authors.forename: T V
authors.initials: TV
authors.lastname: Azizova
authors.forename: E S
authors.initials: ES
authors.lastname: Grigorieva
authors.forename: N
authors.initials: N
authors.lastname: Hunter
authors.forename: M V
authors.initials: MV
authors.lastname: Pikulina
authors.forename: M B
authors.initials: MB
authors.lastname: Moseeva
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D005720:Gamma Rays; D006801:Humans; D008297:Male; D008875:Middle Aged; D009688:Nuclear Reactors; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D011005:Plutonium; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects*; D011834:Radiation Monitoring; D012306:Risk; D012426:Russia / Q000453:epidemiology
chemical_list: D011005:Plutonium