Table 1.
Excess relative risks (per Sv) of circulatory disease in published low/moderate dose (<5 Sv) epidemiological datasets with estimated average radiation dose to the heart/brain and for which quantitative risk assessment is possible (reproduced in part from Little et al. 2008, 2009a)
| Data | References | Average heart/brain dose (range) (Sv) |
Numbers in cohort (person years follow-up) |
Endpoint (mortality unless otherwise indicated) | Excess relative risk Sv−1 (and 95% CI) |
|---|---|---|---|---|---|
| Japanese atomic bomb survivors | |||||
| Mortality | Preston et al. (2003) | 0.1 (0–4)a | 86,572 (1,697,861) | Heart disease, 1968–1997 (ICD9 390–429) | 0.17 (0.08, 0.26)a,b |
| Stroke, 1968–1997 (ICD9 430–438) | 0.12 (0.02, 0.22)a,b | ||||
| Morbidity | Yamada et al. (2004) | 0.1 (0–4)c | 10,339 (NA) | Hypertension incidence, 1958–1998 (ICD9 401) | 0.05 (−0.01, 0.10)c |
| Hypertensive heart disease incidence, 1958–1998 (ICD9 402, 404) | −0.01 (−0.09, 0.09)c | ||||
| Ischaemic heart disease incidence, 1958–1998 (ICD9 410–414) | 0.05 (−0.05, 0.16)c | ||||
| Myocardial infarction incidence, 1964–1998 (ICD9 410) | 0.12 (−0.16, 0.60)c | ||||
| Stroke incidence, 1958–1998 (ICD9 430, 431, 433, 434, 436) | 0.07 (−0.08, 0.24)c | ||||
| Low-dose radiotherapy and medical diagnostic studies | |||||
| Peptic ulcer study | Carr et al. (2005) | 1.3 (0.0–7.6) | 3,719 (92,979) | Coronary heart disease (ICD8 410–414)d | 0.10 (−0.12, 0.33) |
| Other heart disease (ICD8 400–404, 420–429)d | −0.16 (−0.49, 0.17) | ||||
| Ankylosing spondylitis | Darby et al. (1987) | 0.14 (0.0–4.80)e | 14,106 (183,749) | Stroke (ICD7 430–434) | −2.43 (−4.29, 0.71)e |
| 2.49 (0.0–17.28)f | Other circulatory disease (ICD7 400–429, 435–468) | −0.01 (−0.12, 0.13)f | |||
| TB fluoroscopy | Davis et al. (1989) | 0.84g (NA) | 13,385 (331,006) | All circulatory disease (ICD8 390–458) | −0.11 (−0.20, −0.01)g |
| Occupational studies | |||||
| Canadian nuclear and other workers | Ashmore et al. (1998) | 0.063 (0.0 to >0.4) | 206,620 (NA) | Circulatory disease (males) (ICD9 390–459) | 2.3 (0.9, 3.7)b |
| Circulatory disease (females) (ICD9 390–459) | 12.1 (−0.4, 24.6)b | ||||
| Mayak workers | Azizova and Muirhead (2009) | 0.83 (0–5.92)i | 12,210 (205,249) | Ischaemic heart disease morbidity (ICD9 410–414) | 0.109 (0.049, 0.168)i |
| 0.52 (0–127.82)j | 12,210 (443,350) | Ischaemic heart disease mortality (ICD9 410–414) | 0.275 (0.05, 0.501)j | ||
| 0.83 (0–5.92)i | 12,210 (197,344) | Cerebrovascular disease morbidity (ICD9 430–438) | 0.464 (0.360, 0.567)i | ||
| 0.52 (0–127.82)j | 12,210 (197,344) | Cerebrovascular disease morbidity (ICD9 430–438) | 0.155 (0.075, 0.235)j | ||
| Chernobyl emergency worker morbidity | Ivanov et al. (2006) | 0.109 (0 to >0.5) | 61,017 (NA) | Hypertension (ICD10 I10–I15) | 0.26 (−0.04, 0.56) |
| Ischaemic heart disease (ICD10 I20–I25) | 0.41 (0.05, 0.78) | ||||
| Other heart disease (ICD10 I30–I52) | −0.26 (−0.81, 0.28) | ||||
| Cerebrovascular disease (ICD10 I60–I69) | 0.45 (0.11, 0.80) | ||||
| All circulatory disease (ICD10 I00–I99) | 0.18 (−0.03, 0.39) | ||||
| German uranium miner study | Kreuzer et al. (2006) | 0.041 (0 to >0.3) | 59,001 (1,801,626) | All circulatory disease (ICD10 I00–I99) | −0.26 (−0.6, 0.05)k |
| Heart disease (ICD10 I00–I52) | −0.35 (−0.7, 0.009)k | ||||
| Cerebrovascular disease (ICD10 I60–I69) | 0.09 (−0.6, 0.8)k | ||||
| BNFL workers | McGeoghegan et al. (2008) | 0.0569 (0 to >0.729) | 38,779 (1,081,570) | Ischaemic heart disease (ICD9 410–414) | 0.70 (0.37, 1.07)b |
| Cerebrovascular disease (ICD9 430–438) | 0.66 (0.17, 1.27)b | ||||
| All circulatory disease (ICD9 390–459) | 0.54 (0.30, 0.82)b | ||||
| 3rd Analysis of UK National Registry for Radiation Workers | Muirhead et al. (2009) | 0.0249 (<0.01 to >0.4) | 174,541 (3.9 × 106) | All circulatory disease (ICD9 390–459) | 0.251 (−0.01, 0.54) |
| Circulatory disease not strongly related to smoking (ICD9 390–409, 415–440, 442–459) | 0.280 (−0.19, 0.85) | ||||
| Cerebrovascular disease (ICD9 430–438) | 0.161 (−0.42, 0.91) | ||||
| US Oak Ridge workers | Richardson and Wing (1999) | NA (0 to >0.1) | 14,095 (425,486) | Ischaemic heart disease (ICD8 410–414) | −2.86 (−6.90, 1.18) |
| IARC 15-country nuclear worker study | Vrijheid et al. (2007) | 0.0207 (0.0 to >0.5) | 275,312 (4,067,861) | Circulatory disease (ICD10 I00–I99, J60–J69, O88.2, R00–R02, R57) | 0.09 (−0.43, 0.70) |
| Ischaemic heart disease (ICD10 I20–I25) | −0.01 (−0.59, 0.69) | ||||
| Heart failure (ICD10 I50) | −0.03 (<0, 4.91) | ||||
| Deep vein thrombosis and pulmonary embolism (ICD10 I26, I60–I69, I80, I82) | −0.95 (−1.00, 9.09)h | ||||
| Cerebrovascular disease (ICD10 O88.2) | 0.88 (−0.67, 3.16) | ||||
| All other circulatory disease (ICD10 R00–R02, R57, I00–I99 excluding I20–26, I50, I60–69, I80, I82) | 0.29 (<0, 2.40) | ||||
| Environmental studies | |||||
| Three Mile Island study | Talbott et al. (2003) | 0.0001 (0 to >0.00016) | 32,135 (561,063) | Heart disease (white males) | −274 (−874, 438) |
| Heart disease (white females) | −951 (−1433, −390) |
a
Analysis based on colon dose
b
90% CI
c
Analysis based on stomach dose, derived from Table 2 of Yamada et al. (2004)) with smoking and drinking in the stratification
d
Analysis excluding highest dose group (3.1–7.6 Gy)
e
Based on brain dose
f
Based on heart dose
g
Based on lung dose
h
Estimate derived from log-linear model, evaluated at 1 Sv
i
External γ dose (Gy)
j
Internal α-particle dose (Sv), applying a relative biological effectiveness (RBE) of 1
k
Risk estimates in relation to cumulative whole body external γ dose