Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003.
Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950-2003.
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DOI：
10.1136/bmj.b5349
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发表时间：
2010-01-14
期刊：
影响因子：
--
通讯作者：
Shore RE
中科院分区：
文献类型：
--
作者：
Shimizu Y;Kodama K;Nishi N;Kasagi F;Suyama A;Soda M;Grant EJ;Sugiyama H;Sakata R;Moriwaki H;Hayashi M;Konda M;Shore RE
目的探讨电离辐射在多大程度上增加心脏病和中风的死亡率。设计前瞻性队列研究，随访50年以上。将原子弹幸存者安置在日本广岛和长崎。参与者86名 611寿命研究队列成员的个人估计辐射剂量在0到3GY之间(86%接受了0.2GY)。主要结果衡量中风或心脏病的死亡率是死亡的根本原因，以及与原子弹辐射的剂量-反应关系。结果1950-2003年间，约有9600人死于中风，8400人死于心脏病。对于中风，根据线性剂量-反应模型，每灰色估计的超额相对风险为9%(95%可信区间为1%至17%，P=0.02)，但可能向上弯曲的迹象表明，低剂量时风险相对较小。对于心脏病，每灰色估计的超额相对风险为14%(6%至23%，P<；0.001)；线性模型提供了最好的拟合，表明即使在较低剂量下也有超额风险。但在限制剂量范围内，剂量-反应效应不明显。关于吸烟、饮酒、教育、职业、肥胖和糖尿病的前瞻性数据对中风或心脏病的辐射风险估计几乎没有影响，将癌症误诊为循环系统疾病不能解释所看到的关联。结论0.5Gy以上的剂量与中风和心脏病的风险增加有关，但较低剂量的风险程度尚不清楚。中风和心脏病加在一起，与辐射相关的过量死亡人数大约是原子弹幸存者中癌症死亡人数的三分之一。
Objective To investigate the degree to which ionising radiation confers risk of mortality from heart disease and stroke. Design Prospective cohort study with more than 50 years of follow-up. Setting Atomic bomb survivors in Hiroshima and Nagasaki, Japan. Participants 86 611 Life Span Study cohort members with individually estimated radiation doses from 0 to >3 Gy (86% received <0.2 Gy). Main outcome measures Mortality from stroke or heart disease as the underlying cause of death and dose-response relations with atomic bomb radiation. Results About 9600 participants died of stroke and 8400 died of heart disease between 1950 and 2003. For stroke, the estimated excess relative risk per gray was 9% (95% confidence interval 1% to 17%, P=0.02) on the basis of a linear dose-response model, but an indication of possible upward curvature suggested relatively little risk at low doses. For heart disease, the estimated excess relative risk per gray was 14% (6% to 23%, P<0.001); a linear model provided the best fit, suggesting excess risk even at lower doses. However, the dose-response effect over the restricted dose range of 0 to 0.5 Gy was not significant. Prospective data on smoking, alcohol intake, education, occupation, obesity, and diabetes had almost no impact on the radiation risk estimates for either stroke or heart disease, and misdiagnosis of cancers as circulatory diseases could not account for the associations seen. Conclusion Doses above 0.5 Gy are associated with an elevated risk of both stroke and heart disease, but the degree of risk at lower doses is unclear. Stroke and heart disease together account for about one third as many radiation associated excess deaths as do cancers among atomic bomb survivors.
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