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Taj T, Chen J, Rodopoulou S, Strak M, de Hoogh K, Poulsen AH, Andersen ZJ, Bellander T, Brandt J, Zitt E, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Jørgensen JT, Katsouyanni K, Ketzel M, Lager A, Leander K, Liu S, Ljungman P, Severi G, Besson C, Magnusson PKE, Nagel G, Pershagen G, Peters A, Rizzuto D, Samoli E, Sørensen M, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-term exposure to ambient air pollution and risk of leukemia and lymphoma in a pooled European cohort. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123097. [PMID: 38065336 DOI: 10.1016/j.envpol.2023.123097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/08/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
Leukemia and lymphoma are the two most common forms of hematologic malignancy, and their etiology is largely unknown. Pathophysiological mechanisms suggest a possible association with air pollution, but little empirical evidence is available. We aimed to investigate the association between long-term residential exposure to outdoor air pollution and risk of leukemia and lymphoma. We pooled data from four cohorts from three European countries as part of the "Effects of Low-level Air Pollution: a Study in Europe" (ELAPSE) collaboration. We used Europe-wide land use regression models to assess annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) at residences. We also estimated concentrations of PM2.5 elemental components: copper (Cu), iron (Fe), zinc (Zn); sulfur (S); nickel (Ni), vanadium (V), silicon (Si) and potassium (K). We applied Cox proportional hazards models to investigate the associations. Among the study population of 247,436 individuals, 760 leukemia and 1122 lymphoma cases were diagnosed during 4,656,140 person-years of follow-up. The results showed a leukemia hazard ratio (HR) of 1.13 (95% confidence intervals [CI]: 1.01-1.26) per 10 μg/m3 NO2, which was robust in two-pollutant models and consistent across the four cohorts and according to smoking status. Sex-specific analyses suggested that this association was confined to the male population. Further, the results showed increased lymphoma HRs for PM2.5 (HR = 1.16; 95% CI: 1.02-1.34) and potassium content of PM2.5, which were consistent in two-pollutant models and according to sex. Our results suggest that air pollution at the residence may be associated with adult leukemia and lymphoma.
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Affiliation(s)
- Tahir Taj
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | | | - Zorana J Andersen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria.
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, United Kingdom.
| | - John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom.
| | - Ole Hertel
- Department of Ecoscience, Aarhus University, Roskilde, Denmark.
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
| | | | - Jeanette T Jørgensen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Shuo Liu
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
| | - Gianluca Severi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, 94805, Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti" (DISIA), University of Florence, Italy.
| | - Caroline Besson
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, 94805, Villejuif, France.
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Mette Sørensen
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy.
| | - Anne Tjønneland
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Ole Raaschou-Nielsen
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
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2
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Schaaf GW, Justice JN, Quillen EE, Cline JM. Resilience, aging, and response to radiation exposure (RARRE) in nonhuman primates: a resource review. GeroScience 2023; 45:3371-3379. [PMID: 37188889 PMCID: PMC10643677 DOI: 10.1007/s11357-023-00812-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/17/2023] Open
Abstract
The Wake Forest nonhuman primate (NHP) Radiation Late Effects Cohort (RLEC) is a unique and irreplaceable population of aging NHP radiation survivors which serves the nation's need to understand the late effects of radiation exposure. Over the past 16 years, Wake Forest has evaluated > 250 previously irradiated rhesus macaques (Macaca mulatta) that were exposed to single total body irradiation (IR) doses of 1.14-8.5 Gy or to partial body exposures of up to 10 Gy (5% bone marrow sparing) or 10.75 Gy (whole thorax). Though primarily used to examine IR effects on disease-specific processes or to develop radiation countermeasures, this resource provides insights on resilience across physiologic systems and its relationship with biological aging. Exposure to IR has well documented deleterious effects on health, but the late effects of IR are highly variable. Some animals exhibit multimorbidity and accumulated health deficits, whereas others remain relatively resilient years after exposure to total body IR. This provides an opportunity to evaluate biological aging at the nexus of resilient/vulnerable responses to a stressor. Consideration of inter-individual differences in response to this stressor can inform individualized strategies to manage late effects of radiation exposure, and provide insight into mechanisms underlying systemic resilience and aging. The utility of this cohort for age-related research questions was summarized at the 2022 Trans-NIH Geroscience Interest Group's Workshop on Animal Models for Geroscience. We present a brief review of radiation injury and its relationship to aging and resilience in NHPs with a focus on the RLEC.
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Affiliation(s)
- George W Schaaf
- Department of Pathology, Section On Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Jamie N Justice
- Department of Internal Medicine, Section On Gerontology and Geriatric Medicine, and Stich Center for Health Aging and Alzheimer's Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ellen E Quillen
- Department of Internal Medicine, Section On Molecular Medicine, and Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - J Mark Cline
- Department of Pathology, Section On Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Little MP, Wakeford R, Zablotska LB, Borrego D, Griffin KT, Allodji RS, de Vathaire F, Lee C, Brenner AV, Miller JS, Campbell D, Pearce MS, Sadetzki S, Doody MM, Holmberg E, Lundell M, French B, Adams MJ, Berrington de González A, Linet MS. Radiation exposure and leukaemia risk among cohorts of persons exposed to low and moderate doses of external ionising radiation in childhood. Br J Cancer 2023; 129:1152-1165. [PMID: 37596407 PMCID: PMC10539334 DOI: 10.1038/s41416-023-02387-8] [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: 12/21/2022] [Revised: 07/12/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Many high-dose groups demonstrate increased leukaemia risks, with risk greatest following childhood exposure; risks at low/moderate doses are less clear. METHODS We conducted a pooled analysis of the major radiation-associated leukaemias (acute myeloid leukaemia (AML) with/without the inclusion of myelodysplastic syndrome (MDS), chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL)) in ten childhood-exposed groups, including Japanese atomic bomb survivors, four therapeutically irradiated and five diagnostically exposed cohorts, a mixture of incidence and mortality data. Relative/absolute risk Poisson regression models were fitted. RESULTS Of 365 cases/deaths of leukaemias excluding chronic lymphocytic leukaemia, there were 272 AML/CML/ALL among 310,905 persons (7,641,362 person-years), with mean active bone marrow (ABM) dose of 0.11 Gy (range 0-5.95). We estimated significant (P < 0.005) linear excess relative risks/Gy (ERR/Gy) for: AML (n = 140) = 1.48 (95% CI 0.59-2.85), CML (n = 61) = 1.77 (95% CI 0.38-4.50), and ALL (n = 71) = 6.65 (95% CI 2.79-14.83). There is upward curvature in the dose response for ALL and AML over the full dose range, although at lower doses (<0.5 Gy) curvature for ALL is downwards. DISCUSSION We found increased ERR/Gy for all major types of radiation-associated leukaemia after childhood exposure to ABM doses that were predominantly (for 99%) <1 Gy, and consistent with our prior analysis focusing on <100 mGy.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA.
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B Zablotska
- Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, 2nd floor, San Francisco, CA, 94143, USA
| | - David Borrego
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Keith T Griffin
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Rodrigue S Allodji
- Equipe d'Epidémiologie des radiations, Unité 1018 INSERM, Bâtiment B2M, Institut Gustave Roussy, Villejuif, Cedex, 94805, France
| | - Florent de Vathaire
- Equipe d'Epidémiologie des radiations, Unité 1018 INSERM, Bâtiment B2M, Institut Gustave Roussy, Villejuif, Cedex, 94805, France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Alina V Brenner
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Jeremy S Miller
- Information Management Services, Silver Spring, MD, 20904, USA
| | - David Campbell
- Information Management Services, Silver Spring, MD, 20904, USA
| | - Mark S Pearce
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
- NIHR Health Protection Research Unit in chemical and radiation threats and hazards, Newcastle University, Newcastle upon Tyne, UK
| | - Siegal Sadetzki
- Israel Ministry of Health, Jerusalem, Israel
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Michele M Doody
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Erik Holmberg
- Department of Oncology, Sahlgrenska University Hospital, S-413-45, Göteborg, Sweden
| | - Marie Lundell
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, S-17176, Stockholm, Sweden
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael Jacob Adams
- University of Rochester School of Medicine and Dentistry, 265 Crittenden Boulevard, CU 420644, Rochester, NY, 14642-0644, USA
| | - Amy Berrington de González
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Martha S Linet
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
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Jeong SK, Oh SJ, Kang YR, Kim H, Kye YU, Lee SH, Lee CG, Park MT, Baek JH, Kim JS, Jeong MH, Jo WS. Biological dosimetry dose-response curves for residents living near nuclear power plants in South Korea. Sci Prog 2023; 106:368504231198935. [PMID: 37769294 PMCID: PMC10540589 DOI: 10.1177/00368504231198935] [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] [Indexed: 09/30/2023]
Abstract
The purpose of this study was to establish the dose-response curves for biological dosimetry of the Dong Nam Institute of Radiological and Medical Sciences to monitor radiation exposure of local residents in the vicinity of the nuclear power plant. The blood samples of five healthy volunteers were irradiated with gamma ray, and each sample was divided equally for analysis of chromosomal aberrations by Giemsa staining and three-color fluorescence in situ hybridization painting of the triplet (chromosomes #1, #2, and #4). The results of chromosomal aberrations followed the Poisson distribution in all individual and averaged data which include inter-individual variation in radiation susceptibility. Cytogenetics Dose Estimate Software version 5.2 was used to fit the dose-response curve and to determine the coefficients of linear-quadratic equations. The goodness of fit of the curves and statistical significance of fitted α and β-coefficients were confirmed in both Giemsa-based dicentric analysis and FISH-based translocation analysis. The coefficients calculated from the five-donor average data were almost identical in both of the analyses. We also present the results that the dose-response curve for dicentric chromosomes plus fragments could be more effective for dose estimation following low-dose radiation accidents.
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Affiliation(s)
- Soo Kyung Jeong
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
- Department of Microbiology, Dong-A University College of Medicine, Seo-gu, Busan, Republic of Korea
| | - Su Jung Oh
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Yeong-Rok Kang
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - HyoJin Kim
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Yong Uk Kye
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Seong Hun Lee
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Chang Geun Lee
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Moon-Taek Park
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Jeong-Hwa Baek
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
| | - Joong Sun Kim
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, Republic of Korea
| | - Min Ho Jeong
- Department of Microbiology, Dong-A University College of Medicine, Seo-gu, Busan, Republic of Korea
| | - Wol Soon Jo
- Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Gijang-gun, Busan, Republic of Korea
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5
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Radiation and leukaemia: Which leukaemias and what doses? Blood Rev 2023; 58:101017. [PMID: 36220737 DOI: 10.1016/j.blre.2022.101017] [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: 08/11/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022]
Abstract
The cause(s) of most cases of leukaemia is unknown. Save for several rare inherited disorders the most convincingly-identified causes of leukaemia are exposures to ionizing radiations, to some chemicals and to some anti-cancer drugs. Data implicating ionizing radiations as a cause of leukaemias come from several sources including persons exposed to the atomic bomb explosions in Japan, persons receiving radiation therapy for cancer and other disorders, persons occupationally exposed to radiation such as radiologists and nuclear facility workers, cigarette smokers, and others. Although ionizing radiations can be a cause of almost all types of leukaemias, some are especially sensitive to induction such as acute and chronic myeloid leukaemias (AML and CML) and acute lymphoblastic leukaemia (ALL). Whether chronic lymphocytic leukaemia can be caused by radiation exposure is controversial. The mechanism(s) by which ionizing radiations cause leukaemia differs for different leukaemia types. I discuss these issues and close with a hypothesis which might explain why haematopoietic stem cells are localized to the bone marrow.
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Burtt JJ, Akiba S, Bazyka D, Coleman CN, Hatch M, Bernstein JL. Radiation disasters - long term consequences: reflections and summary of a recent symposium. Int J Radiat Biol 2022; 99:561-568. [PMID: 36154906 DOI: 10.1080/09553002.2022.2110315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Julie J Burtt
- Canadian Nuclear Safety Commission, Ottawa, ON, Canada
| | - Suminori Akiba
- Hirosaki University Center for Radiation Support and Safety, Hirosaki, Japan
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine of the Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - C Norman Coleman
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA.,Office of the Assistant Secretary for Preparedness and Response (ASPR), Department of Health and Human Services, Washington, DC, USA
| | - Maureen Hatch
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Drozdovitch V, Chizhov K, Chumak V, Bakhanova E, Trotsyuk N, Bondarenko P, Golovanov I, Kryuchkov V. Reliability of Questionnaire-Based Dose Reconstruction: Human factor uncertainties in the Radiation Dosimetry of Chernobyl Cleanup Workers. Radiat Res 2022; 198:172-180. [PMID: 35604875 PMCID: PMC9384793 DOI: 10.1667/rade-21-00207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 05/10/2022] [Indexed: 11/03/2022]
Abstract
This original study aims to quantify the human factor uncertainties in radiation doses for Chernobyl cleanup workers that are associated with errors in direct or proxy personal interviews due to poor memory recall a long time after exposure. Two types of doses due to external irradiation during cleanup mission were calculated independently. First, a "reference" dose, that was calculated using the historical description of cleanup activities reported by 47 cleanup workers shortly after the completion of the cleanup mission. Second, a "current" dose that was calculated using information reported by 47 cleanup workers and respective 24 proxies (colleagues) nominated by cleanup workers during a personal interview conducted more recently, as part of this study, i.e., 25-30 years after their cleanup missions. The Jaccard similarity coefficient for reference and current doses was moderate: the arithmetic mean ± standard deviation was 0.29 ± 0.18 (median = 0.31) and 0.23 ± 0.18 (median = 0.22) for the cleanup worker's and proxy's interviews, respectively. The agreement between two doses was better if the cleanup worker was interviewed rather than his proxy: the median ratio of current to reference dose was 1.0 and 0.56 for cleanup workers and proxies, respectively. The present study has shown that human factor uncertainties lead to underestimation or overestimation of the "true" reference dose for most cleanup workers up to 3 times. In turn, the potential impact of these errors on radiation-related risk estimates should be assessed.
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Affiliation(s)
- Vladimir Drozdovitch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Konstantin Chizhov
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Kyiv, Ukraine
| | - Elena Bakhanova
- National Research Centre for Radiation Medicine, Kyiv, Ukraine
| | | | | | - Ivan Golovanov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
| | - Victor Kryuchkov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
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8
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Jargin SV. Chernobyl consequences are coming. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:014501. [PMID: 35043785 DOI: 10.1088/1361-6498/ac3e08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Sergei V Jargin
- Peoples' Friendship University of Russia, Clementovski per 6-82, 115184 Moscow, Russia
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9
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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Sun X, Wang J, Kitahara CM, de Gonzalez AB, Niu K, Liu Q. Low-dose ionizing radiation exposure and risk of leukemia: results from 1950-1995 Chinese medical X-ray workers cohort study and meta-analysis. JOURNAL OF THE NATIONAL CANCER CENTER 2022. [DOI: 10.1016/j.jncc.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Boice JD, Cohen SS, Mumma MT, Hagemeyer DA, Chen H, Golden AP, Yoder RC, Dauer LT. Mortality from Leukemia, Cancer and Heart Disease among U.S. Nuclear Power Plant Workers, 1957-2011. Int J Radiat Biol 2021; 98:657-678. [PMID: 34669562 DOI: 10.1080/09553002.2021.1967507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of the Million Person Study (MPS) of Low Dose Health Effects is to examine the level of radiation risk for chronic exposures received gradually over time and not acutely as was the case for the Japanese atomic bomb survivors. Nuclear power plant (NPP) workers comprise nearly 15 percent of the MPS. Leukemia, selected cancers, Parkinson's disease, ischemic heart disease (IHD) and other causes of death are evaluated. METHODS AND MATERIAL The U.S. Nuclear Regulatory Commission's Radiation Exposure Information and Reporting System (REIRS) and the Landauer, Inc. dosimetry databases identified 135,193 NPP workers first monitored 1957-1984. Annual personal dose equivalents [Hp(10)] were available for each worker. Radiation records from all places of employment were sought. Vital status was determined through 2011. Mean absorbed doses to red bone marrow (RBM), esophagus, lung, colon, brain and heart were estimated by adjusting the recorded Hp(10) for each worker by scaling factors, accounting for exposure geometry and energy of the incident gamma radiation. Standardized mortality ratios (SMR) were calculated. Radiation risks were estimated using Cox proportional hazards models. RESULTS Nearly 50% of workers were employed for more than 20 years. The mean duration of follow-up was 30.2 y. Overall, 29,076 total deaths occurred, 296 from leukemia other than chronic lymphocytic leukemia (CLL), 3,382 from lung cancer, 140 from Parkinson's disease and 5,410 from IHD. The mean dose to RBM was 37.9 mGy (maximum 1.0 Gy; percent >100 mGy was 9.2%), 43.2 mGy to lung, 43.7 mGy to colon, 33.2 mGy to brain, and 43.9 mGy to heart. The SMRs (95% CI) were 1.06 (0.94;1.19) for leukemia other than CLL, 1.10 (1.07;1.14) for lung cancer, 0.90 (0.76;1.06) for Parkinson's disease, and 0.80 (0.78; 0.82) for IHD. The excess relative risk (ERR) per 100 mGy for leukemia other than CLL was 0.15 (90% CI 0.001; 0.31). For all solid cancers the ERR per 100 mGy (95% CI) was 0.01 (-0.03; 0.05), for lung cancer -0.04 (-0.11; 0.02), for Parkinson's disease 0.24 (-0.02; 0.50), and for IHD -0.01 (-0.06; 0.04). CONCLUSION Prolonged exposure to radiation increased the risk of leukemia other than CLL among NPP workers. There was little evidence for a radiation-association for all solid cancers, lung cancer or ischemic heart disease. Increased precision will be forthcoming as the different cohorts within the MPS are combined, such as industrial radiographers and medical radiation workers who were assembled and evaluated in like manner.
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Affiliation(s)
- John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | | | - Michael T Mumma
- International Epidemiology Institute, Rockville, MD, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Heidi Chen
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Lawrence T Dauer
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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11
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Little MP, Wakeford R, Zablotska LB, Borrego D, Griffin KT, Allodji RS, de Vathaire F, Lee C, Brenner AV, Miller JS, Campbell D, Sadetzki S, Doody MM, Holmberg E, Lundell M, Adams MJ, French B, Linet MS, Berrington de Gonzalez A. Lymphoma and multiple myeloma in cohorts of persons exposed to ionising radiation at a young age. Leukemia 2021; 35:2906-2916. [PMID: 34050261 PMCID: PMC8484030 DOI: 10.1038/s41375-021-01284-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023]
Abstract
There is limited evidence that non-leukaemic lymphoid malignancies are radiogenic. As radiation-related cancer risks are generally higher after childhood exposure, we analysed pooled lymphoid neoplasm data in nine cohorts first exposed to external radiation aged <21 years using active bone marrow (ABM) and, where available, lymphoid system doses, and harmonised outcome classification. Relative and absolute risk models were fitted. Years of entry spanned 1916-1981. At the end of follow-up (mean 42.1 years) there were 593 lymphoma (422 non-Hodgkin (NHL), 107 Hodgkin (HL), 64 uncertain subtype), 66 chronic lymphocytic leukaemia (CLL) and 122 multiple myeloma (MM) deaths and incident cases among 143,136 persons, with mean ABM dose 0.14 Gy (range 0-5.95 Gy) and mean age at first exposure 6.93 years. Excess relative risk (ERR) was not significantly increased for lymphoma (ERR/Gy = -0.001; 95% CI: -0.255, 0.279), HL (ERR/Gy = -0.113; 95% CI: -0.669, 0.709), NHL + CLL (ERR/Gy = 0.099; 95% CI: -0.149, 0.433), NHL (ERR/Gy = 0.068; 95% CI: -0.253, 0.421), CLL (ERR/Gy = 0.320; 95% CI: -0.678, 1.712), or MM (ERR/Gy = 0.149; 95% CI: -0.513, 1.063) (all p-trend > 0.4). In six cohorts with estimates of lymphatic tissue dose, borderline significant increased risks (p-trend = 0.02-0.07) were observed for NHL + CLL, NHL, and CLL. Further pooled epidemiological studies are needed with longer follow-up, central outcome review by expert hematopathologists, and assessment of radiation doses to lymphoid tissues.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA.
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Institute of Population Health, The University of Manchester, Manchester, UK
| | - Lydia B Zablotska
- Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
| | - David Borrego
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Keith T Griffin
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Rodrigue S Allodji
- Equipe d'Epidémiologie des radiations, Unité 1018 INSERM, Bâtiment B2M, Institut Gustave Roussy, Villejuif Cedex, France
| | - Florent de Vathaire
- Equipe d'Epidémiologie des radiations, Unité 1018 INSERM, Bâtiment B2M, Institut Gustave Roussy, Villejuif Cedex, France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Alina V Brenner
- Radiation Effects Research Foundation, Hiroshima City, Japan
| | | | | | - Siegal Sadetzki
- Israel Ministry of Health, Jerusalem, Israel
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Michele M Doody
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Erik Holmberg
- Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Marie Lundell
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Jacob Adams
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Martha S Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
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12
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Smailyte G, Kaceniene A, Steponaviciene R, Kesminiene A. Lithuanian cohort of Chernobyl cleanup workers: Cancer incidence follow-up 1986-2012. Cancer Epidemiol 2021; 74:102015. [PMID: 34455236 DOI: 10.1016/j.canep.2021.102015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/24/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cancer risks following radiation exposure in adulthood after Chernobyl are less studied compared to those after exposure in childhood. We aimed to evaluate cancer risk in the Lithuanian cohort of Chernobyl cleanup workers 26 years after their exposure in Chernobyl. METHODS Study population (6707 men) was followed for cancer incidence upon return from Chernobyl till the end of 2012 by linkage procedure with the Lithuanian Cancer Registry and for migration and death - with Central Population Registry. The site-specific cancer risk in the cohort was estimated by calculating the standardised incidence ratio (SIR) with 95 % confidence interval (CI). RESULTS A total of 596 cancer cases was observed in the cohort, against 584 expected (SIR 1.02; 95 % CI 0.94, 1.11). Only incidence of mouth and pharynx cancers was increased compared to the expected (SIR 1.41; 95 % CI 1.07, 1.86). Nevertheless, an increased risk of thyroid cancer was observed among cleanup workers who were younger than 30 years when entering the Chernobyl zone (SIR 2.90; 95 % CI 1.09, 7.72), whose radiation dose was above 100 milisievert (mSv) (SIR 3.13; 95 % CI 1.30, 7.52) and who had shorter duration of stay (SIR 2.30; 95 % CI 1.03, 5.13). CONCLUSIONS Our findings are consistent with those observed in other cohorts of workers, namely, the increased risk of cancer sites related to behavioural factors. The increased risk of thyroid cancer among cleanup workers who were younger than 30 years when entering Chernobyl and whose radiation dose was above 100 mSv cannot exclude the association with the radiation exposure in Chernobyl.
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Affiliation(s)
- Giedre Smailyte
- Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio 3B, LT-08406, Vilnius, Lithuania; Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio. 21, LT-03101, Vilnius, Lithuania
| | - Auguste Kaceniene
- Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio 3B, LT-08406, Vilnius, Lithuania
| | - Rita Steponaviciene
- External Beam Radiotherapy Department, National Cancer Institute, Santariskių 1, LT-08660, Vilnius, Lithuania
| | - Ausrele Kesminiene
- Environmental and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France.
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13
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Taj T, Poulsen AH, Ketzel M, Geels C, Brandt J, Christensen JH, Puett R, Hvidtfeldt UA, Sørensen M, Raaschou-Nielsen O. Exposure to PM 2.5 constituents and risk of adult leukemia in Denmark: A population-based case-control study. ENVIRONMENTAL RESEARCH 2021; 196:110418. [PMID: 33157111 DOI: 10.1016/j.envres.2020.110418] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Leukemia is one of the most common forms of hematologic malignancy, which can affect people of all ages. We previously showed an association between exposure to ambient particulate matter 2.5 μg (PM2.5) and risk for leukemia in adults. The aim of this study was to investigate which PM2.5 constituents were responsible for our previous observation. METHODS This is a nationwide register-based case-control study. We identified 14,983 persons diagnosed with leukemia at age 20 or above, 1989-2014, in the Danish Cancer Registry. We selected up to four sex and age-matched controls per case at random from the entire Danish population (n = 51,613). We modelled concentrations of ambient PM2.5 and its constituents at the addresses of cases and controls for the 10-year period before index date with a state-of-the-art multiscale air pollution modeling system. We used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. RESULT The results showed higher risk for overall leukemia in association with interquartile range exposure to PM2.5 (OR = 1.09; 95% CI: 1.02, 1.17), black carbon (BC) (OR = 1.02; 95% CI: 1.00, 1.03), secondary inorganic aerosols (SIA) (OR = 1.15; 95% CI: 1.03, 1.29) and its components ammonium (NH4) (OR = 1.08; 95% CI: 1.00, 1.17) and nitrate (NO3) (OR = 1.08; 95% CI: 1.02, 1.14). In leukemia subtype analysis, statistically significant associations were found for AML with PM2.5 (OR = 1.14; 95% CI: 1.00, 1.29), BC (OR = 1.03; 95% CI: 1.00, 1.07), SIA (OR = 1.23; 95% CI: 1.01, 1.51), NH4 (OR = 1.16; 95% CI: 1.01, 1.34) and NO3 (OR = 1.12; 95% CI: 1.01, 1.24). The association between PM2.5 and leukemia persisted in two pollutants models including sum of primary emitted black and organic carbon (BC + OC), secondary organic aerosols (SOA), or sea-salt. The association between black carbon (BC) and leukemia persisted in two pollutants models including organic carbon (OC). The three pollutant model with sulfate (SO4), NH4 and NO3 showed an association with NO3 but not with SO4 or NH4. CONCLUSION Ambient concentrations of the PM2.5 components BC, NH4 and NO3 at the residence showed associations with risk of incident leukemia in adults.
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Affiliation(s)
- Tahir Taj
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Aslak Harbo Poulsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford GU2 7XH, UK
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Jesper Heile Christensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Robin Puett
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
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14
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Dyagil IS, Dmytrenko IV, Sholoiko VV, Fedorenko VG, Shlyakhtichenko TY, Petrusha OO, Martina ZV, Tovstogan AO, Silayev YO, Stupakova ZV, Minchenko ZM. CHRONIC MYELOID LEUKEMIA COURSE IN PERSONS EXPOSED TO IONIZING RADIATION AS A RESULT OF THE CHORNOBYL ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:443-455. [PMID: 33361853 DOI: 10.33145/2304-8336-2020-25-443-455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Describe and characterize the peculiarities of the chronic myeloid leukemia (CML) course and responseto treatment in patients irradiated as a result of the Chornobyl nuclear power plant (ChNPP) accident based on theassessment of clinical-laboratory and clinical parameters. MATERIALS AND METHODS The CML patients (n = 33) exposed to ionizing radiation as a result of the ChNPP accidentwere enrolled. The comparison group consisted of CML patients (n = 725) with no history of radiation exposure. Allpatients were in the chronic phase of the disease. Clinical, hematological and molecular genetic research methodswere applied. RESULTS Patients exposed to ionizing radiation as a result of the ChNPP accident had no differences in CML manifestation, as well as in classical genetic markers at the onset of the disease compared with patients with no historyof radiation exposure. Reduction of tumor clone on imatinib therapy was significantly less effective in the patientsexposed to ionizing radiation than in cases of no history of radiation exposure. Cases of primary resistance were statistically significantly prevalent in the ChNPP accident consequences clean-up workers while in the residents ofradiologically contaminated areas a statistically significant increase in probability of loss of complete cytogeneticresponse (development of secondary resistance) to imatinib therapy was found. An association was found betweenthe radiation exposure and probability of loss of complete cytogenetic response to imatinib therapy in this group ofpatients. CONCLUSION The radiation exposure in the history even many years before the onset of CML is an unfavorable exogenous factor responsible for the development of resistance to imatinib therapy.
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Affiliation(s)
- I S Dyagil
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - I V Dmytrenko
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - V V Sholoiko
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - V G Fedorenko
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - T Yu Shlyakhtichenko
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - O O Petrusha
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - Z V Martina
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - A O Tovstogan
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - Yu O Silayev
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - Z V Stupakova
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
| | - Z M Minchenko
- State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine
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15
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Bilous NI, Abramenko IV, Chumak AA, Diagil IS, Martina ZV. EXPRESSION OF LIPOPROTEIN LIPASE AND c-MYC ONCOGENE IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA AFFECTED BY THE CHORNOBYL ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:421-429. [PMID: 33361851 DOI: 10.33145/2304-8336-2020-25-421-429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE to determine the association between the expression of lipoprotein lipase (LPL) and c-MYC genes inperipheral blood cells of chronic lymphocytic leukemia (CLL) patients affected by the Chornobyl catastrophedepending on the mutational status of IGHV genes. METHODS Analysis was performed in the group of 69 CLL patients irradiated due to the Chornobyl NPP accident (58clean-up workers of 1986 year, 6 inhabitants of radionuclide contaminated areas, and 5 evacuees). The IGHV genemutational status was studied by polymerase chain reaction (PCR) followed by direct sequencing. LPL and c-MYCexpression was evaluated by Quantitative Real-time PCR. Data were analyzed with the SPSS software package, version 20.0. RESULTS Relative LPL expression levels in CLL samples ranged from 0 to 1663.5 (mean 138.47 ± 30.69, median 26.1).A strong correlation between individual LPL expression levels and IGHV mutational status was found (r = 0.684;p < 0.0001). The average relative c-MYC expression level was 5.7 ± 0.87 (median 2.86; range 0-48.5). No association between c-MYC expression and IGHV mutational status was found. Among unmutated IGHV cases, a correlationbetween LPL and c-MYC gene expression levels was identified: r = 0.351; p = 0.013. CONCLUSIONS Our data confirm the dominant concept that unmutated IGHV CLL cases are more sensitive to the actionof proliferative stimuli compared to mutated IGHV CLL cases. This is manifested by an increase in the expression ofa functionally significant LPL gene, is one for the strongest negative prognostic markers in CLL.
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Affiliation(s)
- N I Bilous
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
| | - I V Abramenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
| | - A A Chumak
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
| | - I S Diagil
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
| | - Z V Martina
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
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16
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Bazyka D, Hatch M, Gudzenko N, Cahoon EK, Drozdovitch V, Little MP, Chumak V, Bakhanova E, Belyi D, Kryuchkov V, Golovanov I, Mabuchi K, Illienko I, Belayev Y, Bodelon C, Machiela MJ, Hutchinson A, Yeager M, Berrington de González A, Chanock SJ. Field Study of the Possible Effect of Parental Irradiation on the Germline of Children Born to Cleanup Workers and Evacuees of the Chornobyl Nuclear Accident. Am J Epidemiol 2020; 189:1451-1460. [PMID: 32613232 DOI: 10.1093/aje/kwaa095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/01/2023] Open
Abstract
Although transgenerational effects of exposure to ionizing radiation have long been a concern, human research to date has been confined to studies of disease phenotypes in groups exposed to high doses and high dose rates, such as the Japanese atomic bomb survivors. Transgenerational effects of parental irradiation can be addressed using powerful new genomic technologies. In collaboration with the Ukrainian National Research Center for Radiation Medicine, the US National Cancer Institute, in 2014-2018, initiated a genomic alterations study among children born in selected regions of Ukraine to cleanup workers and/or evacuees exposed to low-dose-rate radiation after the 1986 Chornobyl (Chernobyl) nuclear accident. To investigate whether parental radiation exposure is associated with germline mutations and genomic alterations in the offspring, we are collecting biospecimens from father-mother-offspring constellations to study de novo mutations, minisatellite mutations, copy-number changes, structural variants, genomic insertions and deletions, methylation profiles, and telomere length. Genomic alterations are being examined in relation to parental gonadal dose, reconstructed using questionnaire and measurement data. Subjects are being recruited in exposure categories that will allow examination of parental origin, duration, and timing of exposure in relation to conception. Here we describe the study methodology and recruitment results and provide descriptive information on the first 150 families (mother-father-child(ren)) enrolled.
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17
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Harbron RW, Pasqual E. Ionising radiation as a risk factor for lymphoma: a review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R151-R185. [PMID: 33017815 DOI: 10.1088/1361-6498/abbe37] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.
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Affiliation(s)
- Richard W Harbron
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, United Kingdom
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisa Pasqual
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Ulanowski A, Shemiakina E, Güthlin D, Becker J, Preston D, Apostoaei AI, Hoffman FO, Jacob P, Kaiser JC, Eidemüller M. ProZES: the methodology and software tool for assessment of assigned share of radiation in probability of cancer occurrence. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:601-629. [PMID: 32851496 PMCID: PMC7544726 DOI: 10.1007/s00411-020-00866-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/10/2020] [Indexed: 05/20/2023]
Abstract
ProZES is a software tool for estimating the probability that a given cancer was caused by preceding exposure to ionising radiation. ProZES calculates this probability, the assigned share, for solid cancers and hematopoietic malignant diseases, in cases of exposures to low-LET radiation, and for lung cancer in cases of exposure to radon. User-specified inputs include birth year, sex, type of diagnosed cancer, age at diagnosis, radiation exposure history and characteristics, and smoking behaviour for lung cancer. Cancer risk models are an essential part of ProZES. Linking disease and exposure to radiation involves several methodological aspects, and assessment of uncertainties received particular attention. ProZES systematically uses the principle of multi-model inference. Models of radiation risk were either newly developed or critically re-evaluated for ProZES, including dedicated models for frequent types of cancer and, for less common diseases, models for groups of functionally similar cancer sites. The low-LET models originate mostly from the study of atomic bomb survivors in Hiroshima and Nagasaki. Risks predicted by these models are adjusted to be applicable to the population of Germany and to different time periods. Adjustment factors for low dose rates and for a reduced risk during the minimum latency time between exposure and cancer are also applied. The development of the methodology and software was initiated and supported by the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) taking up advice by the German Commission on Radiological Protection (SSK, Strahlenschutzkommission). These provide the scientific basis to support decision making on compensation claims regarding malignancies following occupational exposure to radiation in Germany.
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Affiliation(s)
- Alexander Ulanowski
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- IAEA Environment Laboratories, International Atomic Energy Agency, 2444, Seibersdorf, Austria
| | - Elena Shemiakina
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Denise Güthlin
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, 85764, Oberschleissheim, Germany
| | - Janine Becker
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | | | | | - F Owen Hoffman
- Oak Ridge Center for Risk Analysis, Inc, Oak Ridge, TN, USA
| | - Peter Jacob
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Jan Christian Kaiser
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Markus Eidemüller
- Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
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Pasqual E, Turner MC, Gracia-Lavedan E, Casabonne D, Benavente Y, Chef IT, Maynadié M, Cocco P, Staines A, Foretova L, Nieters A, Boffetta P, Brennan P, Cardis E, de Sanjose S. Association of ionizing radiation dose from common medical diagnostic procedures and lymphoma risk in the Epilymph case-control study. PLoS One 2020; 15:e0235658. [PMID: 32649712 PMCID: PMC7351167 DOI: 10.1371/journal.pone.0235658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/21/2020] [Indexed: 11/19/2022] Open
Abstract
Medical diagnostic X-rays are an important source of ionizing radiation (IR) exposure in the general population; however, it is unclear if the resulting low patient doses increase lymphoma risk. We examined the association between lifetime medical diagnostic X-ray dose and lymphoma risk, taking into account potential confounding factors, including medical history. The international Epilymph study (conducted in the Czech-Republic, France, Germany, Ireland, Italy, and Spain) collected self-reported information on common diagnostic X-ray procedures from 2,362 lymphoma cases and 2,465 frequency-matched (age, sex, country) controls. Individual lifetime cumulative bone marrow (BM) dose was estimated using time period-based dose estimates for different procedures and body parts. The association between categories of BM dose and lymphoma risk was examined using unconditional logistic regression models adjusting for matching factors, socioeconomic variables, and the presence of underlying medical conditions (atopic, autoimmune, infectious diseases, osteoarthritis, having had a sick childhood, and family history of lymphoma) as potential confounders of the association. Cumulative BM dose was low (median 2.25 mGy) and was not positively associated with lymphoma risk. Odds ratios (ORs) were consistently less than 1.0 in all dose categories compared to the reference category (less than 1 mGy). Results were similar after adjustment for potential confounding factors, when using different exposure scenarios, and in analyses by lymphoma subtype and by type of control (hospital-, population-based). Overall no increased risk of lymphoma was observed. The reduced ORs may be related to unmeasured confounding or other sources of systematic bias.We found little evidence that chronic medical conditions confound lymphoma risk and medical radiation associations.
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Affiliation(s)
- Elisa Pasqual
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Michelle C. Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Esther Gracia-Lavedan
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Delphine Casabonne
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Yolanda Benavente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Isabelle Thierry Chef
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marc Maynadié
- Registre des Hémopathies Malignes de Côte d’Or INSERM U 1231, Université de Bourgogne Franche-Comté et CHU Dijon-Bourgogne, Dijon, France
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | - Anthony Staines
- School of Nursing and Human Science, Dublin City University, Glasnevin, Dublin, Ireland
| | - Lenka Foretova
- Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | - Alexandra Nieters
- Centre of Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Paolo Boffetta
- Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul Brennan
- IARC, International Agency for Research on Cancer, Lyon, France
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Silvia de Sanjose
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
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20
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Hauptmann M, Daniels RD, Cardis E, Cullings HM, Kendall G, Laurier D, Linet MS, Little MP, Lubin JH, Preston DL, Richardson DB, Stram DO, Thierry-Chef I, Schubauer-Berigan MK, Gilbert ES, Berrington de Gonzalez A. Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Summary Bias Assessment and Meta-Analysis. J Natl Cancer Inst Monogr 2020; 2020:188-200. [PMID: 32657347 PMCID: PMC8454205 DOI: 10.1093/jncimonographs/lgaa010] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/26/2020] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Ionizing radiation is an established carcinogen, but risks from low-dose exposures are controversial. Since the Biological Effects of Ionizing Radiation VII review of the epidemiological data in 2006, many subsequent publications have reported excess cancer risks from low-dose exposures. Our aim was to systematically review these studies to assess the magnitude of the risk and whether the positive findings could be explained by biases. METHODS Eligible studies had mean cumulative doses of less than 100 mGy, individualized dose estimates, risk estimates, and confidence intervals (CI) for the dose-response and were published in 2006-2017. We summarized the evidence for bias (dose error, confounding, outcome ascertainment) and its likely direction for each study. We tested whether the median excess relative risk (ERR) per unit dose equals zero and assessed the impact of excluding positive studies with potential bias away from the null. We performed a meta-analysis to quantify the ERR and assess consistency across studies for all solid cancers and leukemia. RESULTS Of the 26 eligible studies, 8 concerned environmental, 4 medical, and 14 occupational exposure. For solid cancers, 16 of 22 studies reported positive ERRs per unit dose, and we rejected the hypothesis that the median ERR equals zero (P = .03). After exclusion of 4 positive studies with potential positive bias, 12 of 18 studies reported positive ERRs per unit dose (P = .12). For leukemia, 17 of 20 studies were positive, and we rejected the hypothesis that the median ERR per unit dose equals zero (P = .001), also after exclusion of 5 positive studies with potential positive bias (P = .02). For adulthood exposure, the meta-ERR at 100 mGy was 0.029 (95% CI = 0.011 to 0.047) for solid cancers and 0.16 (95% CI = 0.07 to 0.25) for leukemia. For childhood exposure, the meta-ERR at 100 mGy for leukemia was 2.84 (95% CI = 0.37 to 5.32); there were only two eligible studies of all solid cancers. CONCLUSIONS Our systematic assessments in this monograph showed that these new epidemiological studies are characterized by several limitations, but only a few positive studies were potentially biased away from the null. After exclusion of these studies, the majority of studies still reported positive risk estimates. We therefore conclude that these new epidemiological studies directly support excess cancer risks from low-dose ionizing radiation. Furthermore, the magnitude of the cancer risks from these low-dose radiation exposures was statistically compatible with the radiation dose-related cancer risks of the atomic bomb survivors.
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Affiliation(s)
- Michael Hauptmann
- Correspondence to: Michael Hauptmann, Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane. Fehrbelliner Straße 38, 16816 Neuruppin, Germany (e-mail: )
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21
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Linet MS, Schubauer-Berigan MK, Berrington de González A. Outcome Assessment in Epidemiological Studies of Low-Dose Radiation Exposure and Cancer Risks: Sources, Level of Ascertainment, and Misclassification. J Natl Cancer Inst Monogr 2020; 2020:154-175. [PMID: 32657350 PMCID: PMC8454197 DOI: 10.1093/jncimonographs/lgaa007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/18/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Outcome assessment problems and errors that could lead to biased risk estimates in low-dose radiation epidemiological studies of cancer risks have not been systematically evaluated. METHODS Incidence or mortality risks for all cancers or all solid cancers combined and for leukemia were examined in 26 studies published in 2006-2017 involving low-dose (mean dose ≤100 mGy) radiation from environmental, medical, or occupational sources. We evaluated the impact of loss to follow-up, under- or overascertainment, outcome misclassification, and changing classifications occurring similarly or differentially across radiation dose levels. RESULTS Loss to follow-up was not reported in 62% of studies, but when reported it was generally small. Only one study critically evaluated the completeness of the sources of vital status. Underascertainment of cancers ("false negatives") was a potential shortcoming for cohorts that could not be linked with high-quality population-based registries, particularly during early years of exposure in five studies, in two lacking complete residential history, and in one with substantial emigration. False positives may have occurred as a result of cancer ascertainment from self- or next-of-kin report in three studies or from enhanced medical surveillance of exposed patients that could lead to detection bias (eg, reporting precancer lesions as physician-diagnosed cancer) in one study. Most pediatric but few adult leukemia studies used expert hematopathology review or current classifications. Only a few studies recoded solid cancers to the latest International Classification of Diseases or International Classification of Diseases for Oncology codes. These outcome assessment shortcomings were generally nondifferential in relation to radiation exposure level except possibly in four studies. CONCLUSION The majority of studies lacked information to enable comprehensive evaluation of all major sources of outcome assessment errors, although reported data suggested that the outcome assessment limitations generally had little effect on risk or biased estimates towards the null except possibly in four studies.
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Affiliation(s)
- Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Mary K Schubauer-Berigan
- Monographs Programme, Evidence Synthesis and Classification Section, International Agency for Research on Cancer, Lyon, France
| | - Amy Berrington de González
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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22
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Schubauer-Berigan MK, Berrington de Gonzalez A, Cardis E, Laurier D, Lubin JH, Hauptmann M, Richardson DB. Evaluation of Confounding and Selection Bias in Epidemiological Studies of Populations Exposed to Low-Dose, High-Energy Photon Radiation. J Natl Cancer Inst Monogr 2020; 2020:133-153. [PMID: 32657349 PMCID: PMC7355263 DOI: 10.1093/jncimonographs/lgaa008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Low-dose, penetrating photon radiation exposure is ubiquitous, yet our understanding of cancer risk at low doses and dose rates derives mainly from high-dose studies. Although a large number of low-dose cancer studies have been recently published, concern exists about the potential for confounding to distort findings. The aim of this study was to describe and assess the likely impact of confounding and selection bias within the context of a systematic review. METHODS We summarized confounding control methods for 26 studies published from 2006 to 2017 by exposure setting (environmental, medical, or occupational) and identified confounders of potential concern. We used information from these and related studies to assess evidence for confounding and selection bias. For factors in which direct or indirect evidence of confounding was lacking for certain studies, we used a theoretical adjustment to determine whether uncontrolled confounding was likely to have affected the results. RESULTS For medical studies of childhood cancers, confounding by indication (CBI) was the main concern. Lifestyle-related factors were of primary concern for environmental and medical studies of adult cancers and for occupational studies. For occupational studies, other workplace exposures and healthy worker survivor bias were additionally of interest. For most of these factors, however, review of the direct and indirect evidence suggested that confounding was minimal. One study showed evidence of selection bias, and three occupational studies did not adjust for lifestyle or healthy worker survivor bias correlates. Theoretical adjustment for three factors (smoking and asbestos in occupational studies and CBI in childhood cancer studies) demonstrated that these were unlikely to explain positive study findings due to the rarity of exposure (eg, CBI) or the relatively weak association with the outcome (eg, smoking or asbestos and all cancers). CONCLUSION Confounding and selection bias are unlikely to explain the findings from most low-dose radiation epidemiology studies.
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Affiliation(s)
- Mary K Schubauer-Berigan
- Evidence Synthesis and Classification Section, International Agency for Research on Cancer, Lyon, France
| | | | - Elisabeth Cardis
- Radiation Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Jay H Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Michael Hauptmann
- Division of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, The Netherlands (MH); Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | - David B Richardson
- Department of Epidemiology, University of North Carolina, School of Public Health, Chapel Hill, NC, USA
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23
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Daniels RD, Kendall GM, Thierry-Chef I, Linet MS, Cullings HM. Strengths and Weaknesses of Dosimetry Used in Studies of Low-Dose Radiation Exposure and Cancer. J Natl Cancer Inst Monogr 2020; 2020:114-132. [PMID: 32657346 PMCID: PMC7667397 DOI: 10.1093/jncimonographs/lgaa001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/07/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND A monograph systematically evaluating recent evidence on the dose-response relationship between low-dose ionizing radiation exposure and cancer risk required a critical appraisal of dosimetry methods in 26 potentially informative studies. METHODS The relevant literature included studies published in 2006-2017. Studies comprised case-control and cohort designs examining populations predominantly exposed to sparsely ionizing radiation, mostly from external sources, resulting in average doses of no more than 100 mGy. At least two dosimetrists reviewed each study and appraised the strengths and weaknesses of the dosimetry systems used, including assessment of sources and effects of dose estimation error. An overarching concern was whether dose error might cause the spurious appearance of a dose-response where none was present. RESULTS The review included 8 environmental, 4 medical, and 14 occupational studies that varied in properties relative to evaluation criteria. Treatment of dose estimation error also varied among studies, although few conducted a comprehensive evaluation. Six studies appeared to have known or suspected biases in dose estimates. The potential for these biases to cause a spurious dose-response association was constrained to three case-control studies that relied extensively on information gathered in interviews conducted after case ascertainment. CONCLUSIONS The potential for spurious dose-response associations from dose information appeared limited to case-control studies vulnerable to recall errors that may be differential by case status. Otherwise, risk estimates appeared reasonably free of a substantial bias from dose estimation error. Future studies would benefit from a comprehensive evaluation of dose estimation errors, including methods accounting for their potential effects on dose-response associations.
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Affiliation(s)
- Robert D Daniels
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, OH
| | - Gerald M Kendall
- Cancer Epidemiology Unit, NDPH, University of Oxford, Oxford, UK
| | - Isabelle Thierry-Chef
- Barcelona Institute for Global Health, Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Harry M Cullings
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan
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24
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Gilbert ES, Little MP, Preston DL, Stram DO. Issues in Interpreting Epidemiologic Studies of Populations Exposed to Low-Dose, High-Energy Photon Radiation. J Natl Cancer Inst Monogr 2020; 2020:176-187. [PMID: 32657345 PMCID: PMC7355296 DOI: 10.1093/jncimonographs/lgaa004] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/02/2020] [Indexed: 01/19/2023] Open
Abstract
This article addresses issues relevant to interpreting findings from 26 epidemiologic studies of persons exposed to low-dose radiation. We review the extensive data from both epidemiologic studies of persons exposed at moderate or high doses and from radiobiology that together have firmly established radiation as carcinogenic. We then discuss the use of the linear relative risk model that has been used to describe data from both low- and moderate- or high-dose studies. We consider the effects of dose measurement errors; these can reduce statistical power and lead to underestimation of risks but are very unlikely to bring about a spurious dose response. We estimate statistical power for the low-dose studies under the assumption that true risks of radiation-related cancers are those expected from studies of Japanese atomic bomb survivors. Finally, we discuss the interpretation of confidence intervals and statistical tests and the applicability of the Bradford Hill principles for a causal relationship.
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Affiliation(s)
- Ethel S Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Daniel O Stram
- Department of Preventive Medicine, School of Medicine, University of Southern California, Los Angeles, CA, USA
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25
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Berrington de Gonzalez A, Daniels RD, Cardis E, Cullings HM, Gilbert E, Hauptmann M, Kendall G, Laurier D, Linet MS, Little MP, Lubin JH, Preston DL, Richardson DB, Stram D, Thierry-Chef I, Schubauer-Berigan MK. Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Rationale and Framework for the Monograph and Overview of Eligible Studies. J Natl Cancer Inst Monogr 2020; 2020:97-113. [PMID: 32657348 PMCID: PMC7610154 DOI: 10.1093/jncimonographs/lgaa009] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Whether low-dose ionizing radiation can cause cancer is a critical and long-debated question in radiation protection. Since the Biological Effects of Ionizing Radiation report by the National Academies in 2006, new publications from large, well-powered epidemiological studies of low doses have reported positive dose-response relationships. It has been suggested, however, that biases could explain these findings. We conducted a systematic review of epidemiological studies with mean doses less than 100 mGy published 2006-2017. We required individualized doses and dose-response estimates with confidence intervals. We identified 26 eligible studies (eight environmental, four medical, and 14 occupational), including 91 000 solid cancers and 13 000 leukemias. Mean doses ranged from 0.1 to 82 mGy. The excess relative risk at 100 mGy was positive for 16 of 22 solid cancer studies and 17 of 20 leukemia studies. The aim of this monograph was to systematically review the potential biases in these studies (including dose uncertainty, confounding, and outcome misclassification) and to assess whether the subset of minimally biased studies provides evidence for cancer risks from low-dose radiation. Here, we describe the framework for the systematic bias review and provide an overview of the eligible studies.
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Affiliation(s)
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Ethel Gilbert
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Michael Hauptmann
- Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Brandenburg Medical School Theodor Fontane, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | | | | | - Martha S Linet
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Jay H Lubin
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | | | | | - Daniel Stram
- University of Southern California, Los Angeles, CA
| | - Isabelle Thierry-Chef
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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26
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Hematological malignancies in Ukraine in post-Chernobyl era: sources of data and their preliminary analysis. Ann Hematol 2020; 99:1543-1550. [PMID: 32430702 DOI: 10.1007/s00277-020-04076-5] [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: 07/14/2019] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
The major sources of the data on the hematological malignancies in the post-Chernobyl period in the regions of Ukraine differing by the levels of the residual contamination with radionuclides have been analyzed. According to the data collected from the primary hematological facilities in Ukraine in 2010-2017, the incidence of lymphoid neoplasms from mature B cells, acute myeloid leukemia, and multiple myeloma in the most contaminated regions was higher than in the less contaminated ones. For the first time, the relative contribution of the several specific types of leukemia in the total diagnosed hematological malignancies has been analyzed throughout 1997-2017 based on the in-house database compiled by the Reference Laboratory of RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, the National Academy of Sciences of Ukraine. In 2011-2017, the Reference Laboratory provided the diagnostic studies in about 26% of all Ukrainian patients with tumors of hematopoietic and lymphoid tissues (34% of patients with different forms of acute and chronic leukemia). The increased proportion of acute myeloid leukemia and chronic lymphocytic leukemia in the total diagnosed cases of overall leukemia in the patients from contaminated regions has been demonstrated following Chernobyl accident.
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27
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Satta G, Loi M, Becker N, Benavente Y, De Sanjose S, Foretova L, Staines A, Maynadie M, Nieters A, Meloni F, Pilia I, Campagna M, Pau M, Zablotska LB, Cocco P. Occupational exposure to ionizing radiation and risk of lymphoma subtypes: results of the Epilymph European case-control study. Environ Health 2020; 19:43. [PMID: 32334593 PMCID: PMC7183712 DOI: 10.1186/s12940-020-00596-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 04/07/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels. METHODS We investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education. RESULTS We did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation. CONCLUSIONS Further investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation.
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Affiliation(s)
- Giannina Satta
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Matteo Loi
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | | | | | | | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | | | | | | | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Marco Pau
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Pierluigi Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy.
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Cancers after Chornobyl: From Epidemiology to Molecular Quantification. Cancers (Basel) 2019; 11:cancers11091291. [PMID: 31480731 PMCID: PMC6770927 DOI: 10.3390/cancers11091291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/18/2019] [Accepted: 08/03/2019] [Indexed: 11/17/2022] Open
Abstract
An overview and new data are presented from cancer studies of the most exposed groups of the population after the Chornobyl accident, performed at the National Research Center for Radiation Medicine (NRCRM). Incidence rates of solid cancers were analyzed for the 1990-2016 period in cleanup workers, evacuees, and the general population from the contaminated areas. In male cleanup workers, the significant increase in rates was demonstrated for cancers in total, leukemia, lymphoma, and thyroid cancer, as well as breast cancer rates were increased in females. Significantly elevated thyroid cancer incidence was identified in the male cleanup workers cohort (150,813) in 1986-2012 with an overall standardized incidence ratio (SIR) of 3.35 (95% CI: 2.91-3.80). A slight decrease in incidence rates was registered starting at 25 years after exposure. In total, 32 of 57 deaths in a group of cleanup workers with confirmed acute radiation syndrome (ARS) or not confirmed ARS (ARS NC) were due to blood malignancies or cancer. Molecular studies in cohort members included gene expression and polymorphism, FISH, relative telomere length, immunophenotype, micronuclei test, histone H2AX, and TORCH infections. Analysis of chronic lymphocytic leukemia (CLL) cases from the cohort showed more frequent mutations in telomere maintenance pathway genes as compared with unexposed CLL patients.
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Gamma Radiation-Induced Disruption of Cellular Junctions in HUVECs Is Mediated through Affecting MAPK/NF- κB Inflammatory Pathways. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1486232. [PMID: 31467629 PMCID: PMC6701340 DOI: 10.1155/2019/1486232] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/08/2019] [Accepted: 07/02/2019] [Indexed: 12/15/2022]
Abstract
Ionizing radiation-induced cardiovascular diseases (CVDs) have been well documented. However, the mechanisms of CVD genesis are still not fully understood. In this study, human umbilical vein endothelial cells (HUVECs) were exposed to gamma irradiation at different doses ranging from 0.2 Gy to 5 Gy. Cell viability, migration ability, permeability, oxidative and nitrosative stresses, inflammation, and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) pathway activation were evaluated postirradiation. It was found that gamma irradiation at doses ranging from 0.5 Gy to 5 Gy inhibited the migration ability of HUVECs without any significant effects on cell viability at 6 h and 24 h postirradiation. The decreased transendothelial electrical resistance (TEER), increased permeability, and disruption of cellular junctions were observed in HUVECs after gamma irradiation accompanied by the lower levels of junction-related proteins such as ZO-1, occludin, vascular endothelial- (VE-) cadherin, and connexin 40. The enhanced oxidative and nitrosative stresses, e.g., ROS and NO2 - levels and inflammatory cytokines IL-6 and TNF-α were demonstrated in HUVECs after gamma irradiation. Western blot results showed that protein levels of mitogen-activated protein kinase (MAPK) pathway molecules p38, p53, p21, and p27 increased after gamma irradiation, which further induced the activation of the NF-κB pathway. BAY 11-7085, an inhibitor of NF-κB activation, was demonstrated to partially block the effects of gamma radiation in HUVECs examined by TEER and FITC-dextran permeability assay. We therefore concluded that the gamma irradiation-induced disruption of cellular junctions in HUVECs was through the inflammatory MAPK/NF-κB signaling pathway.
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Xu J, Liu D, Xiao S, Meng X, Zhao D, Jiang X, Jiang X, Cai L, Jiang H. Low-Dose Radiation Prevents Chemotherapy-Induced Cardiotoxicity. CURRENT STEM CELL REPORTS 2019. [DOI: 10.1007/s40778-019-00158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shore RE, Beck HL, Boice JD, Caffrey EA, Davis S, Grogan HA, Mettler FA, Preston RJ, Till JE, Wakeford R, Walsh L, Dauer LT. Recent Epidemiologic Studies and the Linear No-Threshold Model For Radiation Protection-Considerations Regarding NCRP Commentary 27. HEALTH PHYSICS 2019; 116:235-246. [PMID: 30585971 DOI: 10.1097/hp.0000000000001015] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
National Council on Radiation Protection and Measurements Commentary 27 examines recent epidemiologic data primarily from low-dose or low dose-rate studies of low linear-energy-transfer radiation and cancer to assess whether they support the linear no-threshold model as used in radiation protection. The commentary provides a critical review of low-dose or low dose-rate studies, most published within the last 10 y, that are applicable to current occupational, environmental, and medical radiation exposures. The strengths and weaknesses of the epidemiologic methods, dosimetry assessments, and statistical modeling of 29 epidemiologic studies of total solid cancer, leukemia, breast cancer, and thyroid cancer, as well as heritable effects and a few nonmalignant conditions, were evaluated. An appraisal of the degree to which the low-dose or low dose-rate studies supported a linear no-threshold model for radiation protection or on the contrary, demonstrated sufficient evidence that the linear no-threshold model is inappropriate for the purposes of radiation protection was also included. The review found that many, though not all, studies of solid cancer supported the continued use of the linear no-threshold model in radiation protection. Evaluations of the principal studies of leukemia and low-dose or low dose-rate radiation exposure also lent support for the linear no-threshold model as used in protection. Ischemic heart disease, a major type of cardiovascular disease, was examined briefly, but the results of recent studies were considered too weak or inconsistent to allow firm conclusions regarding support of the linear no-threshold model. It is acknowledged that the possible risks from very low doses of low linear-energy-transfer radiation are small and uncertain and that it may never be possible to prove or disprove the validity of the linear no-threshold assumption by epidemiologic means. Nonetheless, the preponderance of recent epidemiologic data on solid cancer is supportive of the continued use of the linear no-threshold model for the purposes of radiation protection. This conclusion is in accord with judgments by other national and international scientific committees, based on somewhat older data. Currently, no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes than the linear no-threshold model.
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Affiliation(s)
- Roy E Shore
- New York University School of Medicine, New York, NY, and Radiation Effects Research Foundation, Hiroshima, Japan (retired)
| | | | - John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, and Vanderbilt University, Nashville, TN
| | | | - Scott Davis
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Bilous NI, Abramenko IV, Chumak AA, Dyagil IS, Martina ZV, Saenko V, Bazyka DA. THE SPECTRUM OF TP53, SF3B1, AND NOTCH1 MUTATIONS IN CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS EXPOSED TO IONIZING RADIATION DUE TO THE CHORNOBYL NPP ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2018; 23:283-301. [PMID: 30582853 DOI: 10.33145/2304-8336-2018-23-283-301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE to analyze TP53, NOTCH1 and SF3B1 mutations in chronic lymphocytic leukemia (CLL) patients, sufferersof Chornobyl NPP accident to clarify the possible relationship between ionizing radiation (IR) and CLL. METHODS Mutations of TP53, NOTCH1, and SF3B1 genes were studied by direct sequencing in the main group of 106 CLLpatients exposed to IR due to Chornobyl NPP accident and in the control group of 130 IR non-exposed CLL patients. RESULTS We found TP53 and SF3B1 mutations with similar incidence in both groups - 11.3 % and 10.0 % in the maingroup, and 12.7 % and 11.5 % in the control group, respectively. In contrast, the frequency of NOTCH1 mutationswas lower in IR-exposed patients (6.7 % vs 17.7 %; p = 0.012). TP53 mutations were seen with equal frequency amongmutated (11.1 %) and unmutated (11.8 %) immunoglobulin heavy-chain variable gene (IGHV) cases in IR-exposedCLL patients, while the tendency to prevalence of TP53 mutations in unmutated compared with mutated IGHV caseswas found in the control group (14.1 % and 5.6 %, correspondingly; p = 0.178). In IR-exposed group SF3B1 muta-tions were combined with mutations in TP53 almost in half of detected cases. In opposite, in the control group therewas mutual exclusivity between SF3B1 and TP53 lesions (p = 0.001). Among IR-exposed CLL patients we found two dif-ferent cases with identical rare mutation of TP53 gene - c.665C>T substitution (Pro222Leu). This substitution is verylikely to represent inherited TP53 mutation, which may influence CLL development under IR exposure. CONCLUSION Our preliminary data suggest that TP53 abnormalities are involved in CLL development in subjectsexposed at the Chornobyl accident and also a possible connection between inherited sensitivity to ionizing radia-tion caused by mutation in TP53, radiation and CLL development.
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Affiliation(s)
- N I Bilous
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - I V Abramenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - A A Chumak
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - I S Dyagil
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - Z V Martina
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - V Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - D A Bazyka
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
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Kitamura H, Okubo T, Kodama K. EPIDEMIOLOGICAL STUDY OF HEALTH EFFECTS IN FUKUSHIMA NUCLEAR EMERGENCY WORKERS-STUDY DESIGN AND PROGRESS REPORT. RADIATION PROTECTION DOSIMETRY 2018; 182:40-48. [PMID: 30137628 DOI: 10.1093/rpd/ncy136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Between 14 March and 16 December 2011, the radiation dose limit for emergency work was tentatively raised from an effective dose of 100-250 mSv by the Japanese Government after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. The objective of this study is to clarify the long-term health effects of radiation on the emergency workers involved during that period, based on a detailed evaluation of the radiation exposures and long-term monitoring. The potential subjects of the study are the approximately 20 000 workers who were engaged in emergency operations at FDNPP during the period described above. During the first phase of this project, the first 5 years from 2014, we plan to set up a research scheme and establish a cohort. To date, the establishment of the scheme for general health examinations is nearly complete. As of 31 January 2017, 5419 emergency workers (27.4% of the subjects) have agreed to participate in the study. We will continue our efforts to recruit additional potential subjects during the first phase to maximize the size of the cohort.
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Affiliation(s)
- Hiroko Kitamura
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
| | - Toshiteru Okubo
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
| | - Kazunori Kodama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
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Cucinotta FA, Smirnova OA. Dependence of the human leukemia risk on the dose and dose rate of continuous irradiation: Modeling study. LIFE SCIENCES IN SPACE RESEARCH 2018; 19:17-23. [PMID: 30482277 DOI: 10.1016/j.lssr.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/24/2018] [Accepted: 08/14/2018] [Indexed: 06/09/2023]
Abstract
A biologically motivated dynamical model of the radiogenic leukemia risk assessment (Smirnova, 2015, 2017; Smirnova and Cucinotta, 2018) is applied to the study of the effects of dose rate N and dose D on the excess relative risk ERR for non-CLL leukemia among continuously irradiated humans. In the study, the dose rate N of continuous irradiation is varied from 3×10-6 to 0.576 Sv/day and the dose D is varied from zero to 2.2 Sv. In the considered range of doses D, the developed model reproduces the linear dependence of ERR on D for the low dose rates N. For higher N, the dependence of ERR on D remains linear for low doses D and becomes nonlinear for higher D, that agrees with empirical observations. In turn, for the considered values of D, the developed model reproduces the practical independence of the ratio ERR/D on N at low N, the inverse dependence of the ratio ERR/D on N at higher N, and the direct dependence of the ratio ERR/D on N at more high N, that also conforms to empirical observations. Additionally, the modeling values of ERR obtained for the scenarios of continuous irradiation corresponding to those for the nuclear industry workers, Chernobyl cleanup workers, and patients treated with radiotherapy, practically, coincide with the respective empirical data. All these modeling findings, along with those obtained in our previous works, demonstrate the predictive power of the developed model and its capability of estimating, on quantitative level, the excess relative risk for non-CLL leukemia among humans exposed to continuous irradiation in wide ranges of doses and dose rates.
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Affiliation(s)
- Francis A Cucinotta
- Department of Health Physics and Diagnostic Sciences, University of Nevada, Las Vegas, NV, USA.
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Jargin SV. Studies of radiation risk at low doses and low dose rates: a new approach needed. Int J Radiat Biol 2018; 94:1073-1074. [PMID: 30273088 DOI: 10.1080/09553002.2019.1524991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sergei V Jargin
- a Peoples' Friendship University of Russia , Moscow , Russian Federation
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Karabulutoglu M, Finnon R, Imaoka T, Friedl AA, Badie C. Influence of diet and metabolism on hematopoietic stem cells and leukemia development following ionizing radiation exposure. Int J Radiat Biol 2018; 95:452-479. [PMID: 29932783 DOI: 10.1080/09553002.2018.1490042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The review aims to discuss the prominence of dietary and metabolic regulators in maintaining hematopoietic stem cell (HSC) function, long-term self-renewal, and differentiation. RESULTS Most adult stem cells are preserved in a quiescent, nonmotile state in vivo which acts as a "protective state" for stem cells to reduce endogenous stress provoked by DNA replication and cellular respiration as well as exogenous environmental stress. The dynamic balance between quiescence, self-renewal and differentiation is critical for supporting a functional blood system throughout life of an organism. Stress-conditions, for example ionizing radiation exposure can trigger the blood forming HSCs to proliferate and migrate through extramedullary tissues to expand the number of HSCs and increase hematopoiesis. In addition, a wealth of investigation validated that deregulation of this balance plays a critical pathogenic role in various different hematopoietic diseases including the leukemia development. CONCLUSION The review summarizes the current knowledge on how alterations in dietary and metabolic factors could alter the risk of leukemia development following ionizing radiation exposure by inhibiting or even reversing the leukemic progression. Understanding the influence of diet, metabolism, and epigenetics on radiation-induced leukemogenesis may lead to the development of practical interventions to reduce the risk in exposed populations.
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Affiliation(s)
- Melis Karabulutoglu
- a Cancer Mechanisms and Biomarkers group, Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards , Public Health England , Didcot , UK.,b CRUK & MRC Oxford Institute for Radiation Oncology, Department of Oncology , University of Oxford , Oxford , UK
| | - Rosemary Finnon
- a Cancer Mechanisms and Biomarkers group, Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards , Public Health England , Didcot , UK
| | - Tatsuhiko Imaoka
- c Department of Radiation Effects Research, National Institute of Radiological Sciences , National Institutes for Quantum and Radiological Science and Technology , Chiba , Japan
| | - Anna A Friedl
- d Department of Radiation Oncology , University Hospital, LMU Munich , Munich , Germany
| | - Christophe Badie
- a Cancer Mechanisms and Biomarkers group, Biological Effects Department, Centre for Radiation, Chemical and Environmental Hazards , Public Health England , Didcot , UK
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Little MP, Wakeford R, Borrego D, French B, Zablotska LB, Adams MJ, Allodji R, de Vathaire F, Lee C, Brenner AV, Miller JS, Campbell D, Pearce MS, Doody MM, Holmberg E, Lundell M, Sadetzki S, Linet MS, Berrington de González A. Leukaemia and myeloid malignancy among people exposed to low doses (<100 mSv) of ionising radiation during childhood: a pooled analysis of nine historical cohort studies. LANCET HAEMATOLOGY 2018; 5:e346-e358. [PMID: 30026010 DOI: 10.1016/s2352-3026(18)30092-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Substantial evidence links exposure to moderate or high doses of ionising radiation, particularly in childhood, with increased risk of leukaemia. The association of leukaemia with exposure to low-dose (<100 mSv) radiation is less certain, although this is the dose range most relevant to the general population. We aimed to estimate the risk of leukaemia associated with low-dose radiation exposure in childhood (age <21 years). METHODS In this analysis of historical cohort studies, we pooled eligible cohorts reported up to June 30, 2014. We evaluated leukaemia and myeloid malignancy outcomes in these cohorts with the relevant International Classification of Diseases and International Classification of Diseases for Oncology definitions. The cohorts included had not been treated for malignant disease, had reported at least five cases of the relevant haematopoietic neoplasms, and estimated individual active bone marrow (ABM) doses. We restricted analysis to individuals who were younger than 21 years at first irradiation who had mean cumulative ABM doses of less than 100 mSv. Dose-response models were fitted by use of Poisson regression. The data were received in fully anonymised form by the statistical analyst. FINDINGS We identified nine eligible cohorts from Canada, France, Japan, Sweden, the UK, and the USA, including 262 573 people who had been exposed to less than 100 mSv enrolled between June 4, 1915, and Dec 31, 2004. Mean follow-up was 19·63 years (SD 17·75) and mean cumulative ABM dose was 19·6 mSv (SD 22·7). 154 myeloid malignancies were identified (which included 79 acute myeloid leukaemias, eight myelodysplastic syndromes, and 36 chronic myeloid leukaemias, in addition to other unspecified myeloid malignancies) and 40 acute lymphoblastic leukaemias, with 221 leukaemias (including otherwise unclassified leukaemias but excluding chronic lymphocytic leukaemia) identified overall. The fitted relative risks at 100 mSv were 3·09 (95% CI 1·41-5·92; ptrend=0·008) for acute myeloid leukaemia and myelodysplastic syndromes combined, 2·56 (1·09-5·06; ptrend=0·033) for acute myeloid leukaemia, and 5·66 (1·35-19·71; ptrend=0·023) for acute lymphoblastic leukaemia. There was no clear dose-response for chronic myeloid leukaemia, which had a relative risk at 100 mSv of 0·36 (0·00-2·36; ptrend=0·394). There were few indications of between-cohort heterogeneity or departure from linearity. For acute myeloid leukaemia and myelodysplastic syndromes combined and for acute lymphoblastic leukaemia, the dose-responses remained significant for doses of less than 50 mSv. Excess absolute risks at 100 mSv were in the range of 0·1-0·4 cases or deaths per 10 000 person-years. INTERPRETATION The risks of acute myeloid leukaemia and acute lymphoblastic leukaemia were significantly increased after cumulative doses of ionising radiation of less than 100 mSv in childhood or adolescence, with an excess risk also apparent for cumulative radiation doses of less than 50 mSv for some endpoints. These findings support an increased risk of leukaemia associated with low-dose exposure to radiation and imply that the current system of radiological protection is prudent and not overly protective. FUNDING National Cancer Institute Intramural Research Program, National Cancer Institute, and US National Institutes for Health.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA.
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Institute of Population Health, The University of Manchester, Manchester, UK
| | - David Borrego
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | | | - Lydia B Zablotska
- Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - M Jacob Adams
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Rodrigue Allodji
- Centre for Research in Epidemiology and Population Health, INSERM Unit 1018, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Florent de Vathaire
- Centre for Research in Epidemiology and Population Health, INSERM Unit 1018, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Alina V Brenner
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | | | | | - Mark S Pearce
- Institute of Health and Society, and National Institute for Health Research Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle-upon-Tyne, UK
| | - Michele M Doody
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Erik Holmberg
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Lundell
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Siegal Sadetzki
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Gertner Institute, Tel Hashomer, Israel
| | - Martha S Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
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Bazyka D, Prysyazhnyuk A, Gudzenko N, Dyagil I, Belyi D, Chumak V, Buzunov V. Epidemiology of Late Health Effects in Ukrainian Chornobyl Cleanup Workers. HEALTH PHYSICS 2018; 115:161-169. [PMID: 29787442 DOI: 10.1097/hp.0000000000000868] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article summarizes the results of 30 y of follow-up of cancer and noncancer effects in Ukrainian cleanup workers after the Chornobyl accident. The number of power plant employees and first responders with acute radiation syndrome under follow-up by the National Research Center for Radiation Medicine decreased from 179 in 1986-1991 to 105 in 2011-2015. Cancers and leukemia (19) and cardiovascular diseases (21) were the main causes of deaths among acute radiation syndrome survivors (54) during the postaccident period. Increased radiation risks of leukemia in the Ukrainian cohort of 110,645 cleanup workers exposed to low doses are comparable to those among survivors of the atomic bomb explosions in Japan in 1945. Additionally, an excess of chronic lymphocytic leukemia was demonstrated in the cleanup workers cohort for 26 y after the exposure. A significant excess of multiple myeloma incidence [standardized incidence rate (SIR) 1.61 %, 95% confidence interval (CI) 1.01-2.21], thyroid cancer (SIR 4.18, 95% CI 3.76-4.59), female breast cancer (SIR 1.57 CI 1.40-1.73), and all cancers combined (SIR 1.07; 95% CI 1.05-1.09) was registered. High prevalence was demonstrated for cardio- and cerebrovascular diseases and mental health changes. However, the reasons for the increases require further investigation. To monitor other possible late effects of radiation exposure in Chornobyl cleanup workers, analytical cohort and case-control studies need to include cardiovascular pathology, specifically types of potentially radiogenic cancers using a molecular epidemiology approach. Possible effects for further study include increased rates of thyroid, breast, and lung cancers and multiple myeloma; reduction of radiation risks of leukemia to population levels; and increased morbidity and mortality of cleanup workers from cardio- and cerebrovascular pathology.
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Affiliation(s)
- Dimitry Bazyka
- 1National Research Center for Radiation Medicine, 53 Melnikov Str., Kyiv 04050 Ukraine
| | | | | | | | | | | | - Volodymyr Buzunov
- National Research Center for Radiation Medicine, 53 Melnikov Str., Kyiv 04050 Ukraine
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Ojha J, Dyagil I, Finch SC, Reiss RF, de Smith AJ, Gonseth S, Zhou M, Hansen HM, Sherborne AL, Nakamura J, Bracci PM, Gudzenko N, Hatch M, Babkina N, Little MP, Chumak VV, Walsh KM, Bazyka D, Wiemels JL, Zablotska LB. Genomic characterization of chronic lymphocytic leukemia (CLL) in radiation-exposed Chornobyl cleanup workers. Environ Health 2018; 17:43. [PMID: 29720177 PMCID: PMC5930419 DOI: 10.1186/s12940-018-0387-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/20/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) was the predominant leukemia in a recent study of Chornobyl cleanup workers from Ukraine exposed to radiation (UR-CLL). Radiation risks of CLL significantly increased with increasing bone marrow radiation doses. Current analysis aimed to clarify whether the increased risks were due to radiation or to genetic mutations in the Ukrainian population. METHODS A detailed characterization of the genomic landscape was performed in a unique sample of 16 UR-CLL patients and age- and sex-matched unexposed general population Ukrainian-CLL (UN-CLL) and Western-CLL (W-CLL) patients (n = 28 and 100, respectively). RESULTS Mutations in telomere-maintenance pathway genes POT1 and ATM were more frequent in UR-CLL compared to UN-CLL and W-CLL (both p < 0.05). No significant enrichment in copy-number abnormalities at del13q14, del11q, del17p or trisomy12 was identified in UR-CLL compared to other groups. Type of work performed in the Chornobyl zone, age at exposure and at diagnosis, calendar time, and Rai stage were significant predictors of total genetic lesions (all p < 0.05). Tumor telomere length was significantly longer in UR-CLL than in UN-CLL (p = 0.009) and was associated with the POT1 mutation and survival. CONCLUSIONS No significant enrichment in copy-number abnormalities at CLL-associated genes was identified in UR-CLL compared to other groups. The novel associations between radiation exposure, telomere maintenance and CLL prognosis identified in this unique case series provide suggestive, though limited data and merit further investigation.
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Affiliation(s)
- Juhi Ojha
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Iryna Dyagil
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Stuart C. Finch
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Robert F. Reiss
- Department of Pathology and Cell Biology, and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Adam J. de Smith
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Semira Gonseth
- School of Public Health, University of California, Berkeley, Berkeley, CA USA
| | - Mi Zhou
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Helen M. Hansen
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Amy L. Sherborne
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Jean Nakamura
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Paige M. Bracci
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | | | - Maureen Hatch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
| | | | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD USA
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Kyle M. Walsh
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Joseph L. Wiemels
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Lydia B. Zablotska
- School of Medicine, University of California, San Francisco, San Francisco, CA USA
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40
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Chumak VV, Klymenko SV, Zitzelsberger H, Wilke C, Rybchenko LA, Bakhanova EV. Doses of Ukrainian female clean-up workers with diagnosed breast cancer. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2018; 57:163-168. [PMID: 29550923 DOI: 10.1007/s00411-018-0738-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/26/2018] [Indexed: 06/08/2023]
Abstract
The Chernobyl reactor accident in 1986 has caused significant exposure to ionizing radiation of the Ukrainian population, in particular clean-up workers and evacuees from the exclusion zones. A study aiming at the discovery of radiation markers of the breast cancer was conducted from 2008 to 2015 within a collaborative project by HZM, LMU, and NRCRM. In this study, post-Chernobyl breast cancer cases both in radiation-exposed female patients diagnosed at age less than 60 from 1992 to 2014 and in non-exposed controls matched for residency, tumor type, age at diagnosis, TNM classification as well as tumor grading were investigated for molecular changes with special emphasis to copy number alterations and miRNA profiles. Cancer registry and clinical archive data were used to identify 435 breast cancer patients among female clean-up workers and 14 among evacuees from highly contaminated territories as candidates for the study. Of these, 129 breast cancer patients fit study inclusion criteria and were traced for individual reconstruction of the target organ (breast) doses. The doses were estimated for 71 exposed cases (clean-up workers and evacuees from which biomaterial was available for molecular studies and who agreed to participate in a dosimetric interview) by the use of the well-established RADRUE method, which was adjusted specifically for the assessment of breast doses. The results of 58 female clean-up workers showed a large inter-individual variability of doses in a range of about five orders of magnitude: from 0.03 to 929 mGy, with median of 5.8 mGy. The study provides the first quantitative estimate of exposures received by female clean-up workers, which represent a limited but very important group of population affected by the Chernobyl accident. The doses of 13 women evacuated after the accident who did not take part in the clean-up activities (from 4 to 45 mGy with median of 19 mGy) are in line with the previous estimates for the evacuees from Pripyat and the 30-km zone.
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Affiliation(s)
- Vadim V Chumak
- National Research Center for Radiation Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
| | - Sergiy V Klymenko
- National Research Center for Radiation Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Horst Zitzelsberger
- Research Unit Radiation Cytogenetics, Deutsches Forschungszentrum fuer Gesundheit und Umwelt, Helmholtz Zentrum Muenchen, Neuherberg, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Christina Wilke
- Research Unit Radiation Cytogenetics, Deutsches Forschungszentrum fuer Gesundheit und Umwelt, Helmholtz Zentrum Muenchen, Neuherberg, Germany
| | - Lyudmila A Rybchenko
- National Research Center for Radiation Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Elena V Bakhanova
- National Research Center for Radiation Medicine, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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41
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Abstract
Hormesis can be explained by evolutionary adaptation to the current level of a factor present in the natural environment or to some average from the past. This pertains also to ionizing radiation as the natural background has been decreasing during the time of the life existence. DNA damage and repair are normally in a dynamic balance. The conservative nature of the DNA repair suggests that cells may have retained some capability to repair damage from higher radiation levels than that existing today. According to this concept, the harm caused by radioactive contamination would tend to zero with a dose rate tending to a wide range level of the natural radiation background. Existing evidence in favor of hormesis is substantial, experimental data being partly at variance with results of epidemiological studies. Potential bias, systematic errors, and motives to exaggerate risks from low-dose low-rate ionizing radiation are discussed here. In conclusion, current radiation safety norms are exceedingly restrictive and should be revised on the basis of scientific evidence. Elevation of the limits must be accompanied by measures guaranteeing their observance.
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Affiliation(s)
- S V Jargin
- Peoples' Friendship University of Russia, Moscow, Russian Federation
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42
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Scott BR. A Critique of Recent Epidemiologic Studies of Cancer Mortality Among Nuclear Workers. Dose Response 2018; 16:1559325818778702. [PMID: 29872372 PMCID: PMC5974569 DOI: 10.1177/1559325818778702] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/25/2018] [Accepted: 05/01/2018] [Indexed: 11/17/2022] Open
Abstract
Current justification by linear no-threshold (LNT) cancer risk model advocates for its use in low-dose radiation risk assessment is now mainly based on results from flawed and unreliable epidemiologic studies that manufacture small risk increases (ie, phantom risks). Four such studies of nuclear workers, essentially carried out by the same group of epidemiologists, are critiqued in this article. Three of the studies that forcibly applied the LNT model (inappropriate null hypothesis) to cancer mortality data and implicated increased mortality risk from any radiation exposure, no matter how small the dose, are demonstrated to manufacture risk increases for doses up to 100 mSv (or 100 mGy). In a study where risk reduction (hormetic effect/adaptive response) was implicated for nuclear workers, it was assumed by the researchers to relate to a "strong healthy worker effect" with no consideration of the possibility that low radiation doses may help prevent cancer mortality (which is consistent with findings from basic radiobiological research). It was found with basic research that while large radiation doses suppress our multiple natural defenses (barriers) against cancer, these barriers are enhanced by low radiation doses, thereby decreasing cancer risk, essentially rendering the LNT model to be inconsistent with the data.
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Affiliation(s)
- Bobby R. Scott
- Lovelace Respiratory Research Institute, Albuquerque, NM, USA
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43
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Kempin S, Finger PT, Gale RP, Rescigno J, Rubin J, Choi W, Fisher R, Aizman A, Genis I, Malamud SC, Moslehi R. A cluster of vitreoretinal lymphoma in New York with possible link to the Chernobyl nuclear disaster. Leuk Lymphoma 2017; 59:1998-2001. [PMID: 29164983 DOI: 10.1080/10428194.2017.1403025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sanford Kempin
- a Mount Sinai/Beth Israel Comprehensive Cancer Center , New York , NY , USA
| | - Paul T Finger
- b New York Eye and Ear Infirmary of Mount Sinai , New York , NY , USA
| | - Robert Peter Gale
- c Division of Experimental Medicine, Department of Medicine , Haematology Research Centre, Imperial College London , London , UK
| | - John Rescigno
- a Mount Sinai/Beth Israel Comprehensive Cancer Center , New York , NY , USA
| | - Jeffrey Rubin
- b New York Eye and Ear Infirmary of Mount Sinai , New York , NY , USA
| | - Walter Choi
- a Mount Sinai/Beth Israel Comprehensive Cancer Center , New York , NY , USA
| | - Rebecca Fisher
- d Department of Neurology , Mount Sinai/St. Luke's Roosevelt Hospital , New York , NY , USA
| | - Alexander Aizman
- b New York Eye and Ear Infirmary of Mount Sinai , New York , NY , USA
| | - Ilona Genis
- e Maimonides Medical Center , Brooklyn , NY , USA
| | - Stephen C Malamud
- a Mount Sinai/Beth Israel Comprehensive Cancer Center , New York , NY , USA
| | - Roxana Moslehi
- f School of Public Health, Cancer Research Center, University at Albany, State University of New York (SUNY) , Albany , NY , USA
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44
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Samet JM, Berrington de González A, Dauer LT, Hatch M, Kosti O, Mettler FA, Satyamitra MM. Gilbert W. Beebe Symposium on 30 Years after the Chernobyl Accident: Current and Future Studies on Radiation Health Effects. Radiat Res 2017; 189:5-18. [PMID: 29136393 DOI: 10.1667/rr14791.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This commentary summarizes the presentations and discussions from the 2016 Gilbert W. Beebe symposium "30 years after the Chernobyl accident: Current and future studies on radiation health effects." The symposium was hosted by the National Academies of Sciences, Engineering, and Medicine (the National Academies). The symposium focused on the health consequences of the Chernobyl accident, looking retrospectively at what has been learned and prospectively at potential future discoveries using emerging 21st Century research methodologies.
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Affiliation(s)
- Jonathan M Samet
- a Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | | | - Ourania Kosti
- d National Academies of Sciences, Engineering, and Medicine, Washington, DC
| | - Fred A Mettler
- e University of New Mexico School of Medicine, Albuquerque, New Mexico
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45
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Hatch M, Cardis E. Somatic health effects of Chernobyl: 30 years on. Eur J Epidemiol 2017; 32:1047-1054. [PMID: 28929329 DOI: 10.1007/s10654-017-0303-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/23/2017] [Indexed: 01/01/2023]
Abstract
2016 marked the 30th anniversary of the Chernobyl Nuclear Power Plant accident. We and others wrote reviews for the 25th anniversary. Since then, additional papers have appeared and it seems timely to highlight lessons learned. To present, not a systematic review, but a commentary drawing attention to notable findings. We include not only recent reports and updates on previous results, but key findings from prior Chernobyl studies. The dose-dependent increase in Papillary Thyroid Cancer (PTC) following childhood I-131 exposure in Ukraine and Belarus has now been shown to persist for decades. Studies of post-Chernobyl PTCs have produced novel information on chromosomal rearrangements and gene fusions, critical to understanding molecular mechanisms. Studies of clean-up workers/liquidators suggest dose-related increases of thyroid cancer and hematological malignancies in adults. They also report increases in cardiovascular and cerebrovascular disease. If confirmed, these would have significant public health and radiation protection implications. The lens opacities following low to moderate doses found earlier are also a concern, particularly among interventional radiologists who may receive substantial lens doses. Finally, there is some, inconsistent, evidence for genetic effects among offspring of exposed persons. Further efforts, including improved dosimetry, collection of information on other risk factors, and continued follow-up/monitoring of established cohorts, could contribute importantly to further understand effects of low doses and dose-rates of radiation, particularly in young people, and ensure that appropriate public health and radiation protection systems are in place. This will require multinational collaborations and long-term funding.
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Affiliation(s)
- Maureen Hatch
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| | - Elisabeth Cardis
- Radiation Programme, Barcelona Institute for Global Health (ISGlobal), Campus Mar, Barcelona Biomedical Research Park (PRBB), Dr Aiguader 88, 08003, Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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46
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Oancea SC, Rundquist BC, Simon I, Swartz S, Zheng Y, Zhou X, Sens MA, Schwartz GG. County level incidence rates of chronic lymphocytic leukemia are associated with residential radon levels. Future Oncol 2017; 13:1873-1881. [PMID: 28835109 PMCID: PMC5618932 DOI: 10.2217/fon-2017-0165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: We previously reported that incidence rates for chronic lymphocytic leukemia (CLL) among US states are significantly correlated with levels of residential radon (RR). Because these correlations could be influenced by confounding and/or misclassification among large geographic units, we reinvestigated them using smaller geographic units that better reflect exposure and disease at the individual level. Methods: We examined the relationships between CLL and RR per county in 478 counties with publicly-available data. Results: After adjustment for ultraviolet radiation, a possible risk factor for CLL, county rates for CLL and RR were significantly correlated among males and females both together and separately (p < 0.0001). Conclusion: CLL is significantly associated with RR at the county level.
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Affiliation(s)
- S Cristina Oancea
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
| | - Bradley C Rundquist
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Isaac Simon
- Department of Earth System Science & Policy, University of North Dakota, John D. Odegard School of Aerospace Sciences, Grand Forks, ND, 58202, USA
| | - Sami Swartz
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Yun Zheng
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Xudong Zhou
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Mary Ann Sens
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Gary G Schwartz
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
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47
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Till JE, Beck HL, Grogan HA, Caffrey EA. A review of dosimetry used in epidemiological studies considered to evaluate the linear no-threshold (LNT) dose-response model for radiation protection. Int J Radiat Biol 2017; 93:1128-1144. [DOI: 10.1080/09553002.2017.1337280] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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48
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Talibov M, Auvinen A, Weiderpass E, Hansen J, Martinsen JI, Kjaerheim K, Tryggvadottir L, Pukkala E. Occupational solvent exposure and adult chronic lymphocytic leukemia: No risk in a population-based case-control study in four Nordic countries. Int J Cancer 2017; 141:1140-1147. [PMID: 28571111 DOI: 10.1002/ijc.30814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/15/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022]
Abstract
The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.
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Affiliation(s)
- Madar Talibov
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Johnni Hansen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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49
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Boice JD. The linear nonthreshold (LNT) model as used in radiation protection: an NCRP update. Int J Radiat Biol 2017; 93:1079-1092. [DOI: 10.1080/09553002.2017.1328750] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA
- Department of Medicine, Division of Epidemiology, Vanderbilt University, Nashville, TN, USA
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50
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Fast determination of indoor radon ( 222Rn) concentration using liquid scintillation counting. J Radioanal Nucl Chem 2017; 312:337-342. [PMID: 28458411 PMCID: PMC5387011 DOI: 10.1007/s10967-017-5226-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Indexed: 11/24/2022]
Abstract
The indoor 222Rn radionuclide was directly absorbed in typical 20 ml glass scintillation vials by passing −3 dm3 of ambient air through 16 ml of water-immiscible non-volataile scintillation cocktail Ultima-Gold F for 10 min. The activity of radon and its two α-emitting daughters: 218Po and 214Po, was determined with the BetaScout low-background liquid scintillation counter. The limit of 222Rn detection is 9 Bq/m3, and the quantification limit with 20% relative accuracy is 28 Bq/m3. The results of the indoor Rn measurement in different houses showed good consistency with results obtained from a Sarad EQF 3220 device.
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