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Incidence risks for cerebrovascular diseases and types of stroke in a cohort of Mayak PA workers

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Abstract

Incidence risks for cerebrovascular diseases (CeVD) and some types of stroke in a cohort of 22,377 Russian Mayak nuclear workers chronically exposed to ionising radiation and followed up until the end of 2018 are reported. Among total 9469 cases of CeVD, 2078 cases were strokes that included 262 hemorrhagic strokes (HS) and 1611 ischemic strokes (IS). Data evaluation was performed with categorical and dose–response analyses estimating the relative risk (RR) and excess relative risk (ERR) per unit cumulative liver absorbed dose of external gamma-ray or internal alpha-particle exposure based on a linear model utilizing the AMFIT module of the EPICURE software. CeVD incidence was found to be significantly associated with cumulative radiation dose: ERR/Gy was 0.37 (95% confidence interval (CI) 0.27, 0.47) in males and 0.47 (95% CI 0.31, 0.66) in females for external exposure, and 0.31 (95% CI 0.11, 0.59) in males and 0.32 (95% CI 0.11, 0.61) in females for internal exposure. When the model for the analysis of external radiation effect did not include an adjustment for alpha radiation dose (and vice versa), the radiogenic risk estimate increased notably both for males and for females. In contrast, exclusion from or inclusion in the model of additional adjustments for non-radiation factors did not notably change the risk estimates. ERR/Gy of external gamma dose for CeVD incidence significantly decreased with increasing attained age (males and females) and duration of employment (females). No significant associations of either stroke or its types with cumulative gamma-ray dose of external exposure or alpha-particle dose of internal exposure were found.

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Protection of all personal data stored at SUBI are guaranteed by SUBI via the Institutional Review Board. SUBI is responsible for use of this data in compliance with the personal data protection national regulations and laws. Any access to the SUBI-protected individual/depersonalized data should be requested and granted upon approval by the Institutional Review Board (subi@subi.su).

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Funding

The study was financially supported by the Federal Medical Biological Agency of Russia.

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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by TVA and MBM. Data compilation, choice of statistical analysis methods and analysis were performed by ESG. The first draft of the manuscript was written by TVA and MBM. Interpretation of the results was provided by TVA, MBM, NH, ESG. All authors commented on the original and all succeeding versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tamara V. Azizova.

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The authors declare no conflict of interests.

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No direct contact of researchers with cohort members was required in this record-based epidemiological study. This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Review Board of the Southern Urals Biophysics Institute.

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Every individual included in a cohort for a study performed by SUBI provided a written informed consent stating that an individual agrees with SUBI storing and protecting his/her individual data and using depersonalized data for research purposes and that results of these studies may be published in the scientific literature.

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Azizova, T.V., Moseeva, M.B., Grigoryeva, E.S. et al. Incidence risks for cerebrovascular diseases and types of stroke in a cohort of Mayak PA workers. Radiat Environ Biophys 61, 5–16 (2022). https://doi.org/10.1007/s00411-022-00966-6

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  • DOI: https://doi.org/10.1007/s00411-022-00966-6

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