Table 1.
Estimated excess relative risks of circulatory disease in various studies of moderate- and low-dose radiation exposure. (Adapted from Little et al. [11, 12]). All data are in relation to underlying cause of death, unless otherwise indicated
| Cohort/Study | Reference | Mean (range) [SD] heart/brain dose, Sv | Cohort, n (person years of follow-up) | Endpoint (mortality unless otherwise indicated) | Excess relative risk Sv−1 (95 % CI) |
|---|---|---|---|---|---|
| Japanese atomic bomb survivors | |||||
| Japanese atomic bomb survivors | Shimizu et al. [19] | 0.1 (0–4)a | 86,611 (n.a.) | Ischemic heart disease (ICD9 410–414) | 0.02 (−0.10, 0.15) |
| Myocardial infarction (ICD9 410) | 0.00 (−0.15, 0.18) | ||||
| Hypertensive heart disease (ICD9 402, 404) | 0.37 (0.08, 0.72) | ||||
| Rheumatic heart disease (ICD9 393–398) | 0.86 (0.25, 1.72) | ||||
| Heart failure (ICD9 428) | 0.22 (0.07, 0.39) | ||||
| Other heart disease (ICD9 390–392, 415–427, 429) | −0.01 (−0.21, 0.24) | ||||
| Hypertensive disease without heart disease (ICD9 401, 403, 405) | 0.07 (−0.22, 0.55) | ||||
| Heart disease total (ICD9 393–429 excluding 401, 403, 405) | 0.18 (0.11, 0.25)b | ||||
| Cerebral infarction (ICD9 433,434) | 0.04 (−0.10, 0.20) | ||||
| Cerebral hemorrhage (ICD9 431) | 0.05 (−0.06, 0.17) | ||||
| Subarachnoid hemorrhage (ICD9 430) | 0.30 (−0.04, 0.76) | ||||
| Other or unspecified cerebrovascular disease | 0.16 (0.01, 0.34) | ||||
| Cerebrovascular disease total (ICD9 430–438) | 0.12 (0.05, 0.19)b | ||||
| Circulatory disease apart from heart disease and stroke (ICD9 390–392, 401, 403, 405, 439–459) | 0.58 (0.45, 0.72)b | ||||
| Other circulatory disease (ICD9 399–400, 406–409, 439–459) | −0.01 (<−0.01, 0.34) | ||||
| All circulatory disease (ICD9 390–459) | 0.15 (0.10, 0.20)b | ||||
| Japanese atomic bomb survivors | Yamada et al. [20] | 0.1 (0–4)b | 10,339 (n.a.) | 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 | ||||
| Ischemic 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 | ||||
| Occlusion incidence, 1958–1998 (ICD9 433, 434) | 0.06 (−0.11, 0.30)c | ||||
| Aortic aneurysm incidence, 1958–1998 (ICD9 441, 442) | 0.02 (−0.22, 0.41)c | ||||
| Stroke incidence, 1958–1998 (ICD9 430, 431, 433, 434, 436) | 0.07 (−0.08, 0.24)c | ||||
| Japanese atomic bomb survivors | Tatsukawa et al. [21] | 0.001 (0–1.79) | 506 (9265) | Morbidity in utero: hypertension | 0.20 (−0.39, 1.38) |
| Morbidity in utero: nonfatal stroke or myocardial infarction | −0.91 (−1.00, 79.3) | ||||
| Japanese atomic bomb survivors | Tatsukawa et al. [21] | 0.13 (0–3.53) | 1053 (20,216) | Morbidity: hypertension | 0.15 (−0.01, 0.34) |
| Morbidity: stroke or myocardial infarction | 0.72 (0.24, 1.40) | ||||
| Occupational studies | |||||
| Mayak workers | Moseeva et al. [24] | 0.62 ± 0.80 (males)d | 18,856 (356,880) | Ischemic heart disease morbidity (ICD9 410–414) | 0.160 (0.089, 0.230)d, e |
| Azizova et al. [23] | 0.51 ± 0.68 (females)d | 22,377 (425,735) | Cerebrovascular disease morbidity (ICD9 430–438) | 0.49 (0.39, 0.60)d, e | |
| Chernobyl emergency workers | Ivanov et al. [22] | 0.109 (0 - >0.5) | 61,017 (n.a.) | Hypertension (ICD10 I10-I15) morbidity | 0.26 (−0.04, 0.56) |
| Essential hypertension (ICD10 I10) morbidity | 0.36 (0.005, 0.71) | ||||
| Hypertensive heart disease (ICD10 I11) morbidity | 0.04 (−0.36, 0.44) | ||||
| Ischemic heart disease (ICD10 I20-I25) morbidity | 0.41 (0.05, 0.78) | ||||
| Acute myocardial infarction (ICD10 I21) morbidity | 0.19 (−0.99, 1.37) | ||||
| Other acute ischemic heart disease (ICD10 I24) morbidity | 0.82 (−0.62, 2.26) | ||||
| Angina pectoris (ICD10 I20) morbidity | 0.26 (−0.19, 0.71) | ||||
| Chronic ischemic heart disease (ICD10 I25) morbidity | 0.20 (−0.23, 0.63) | ||||
| Other heart disease (ICD10 I30-I52) morbidity | −0.26 (−0.81, 0.28) | ||||
| Cerebrovascular disease (ICD10 I60-I69) morbidity | 0.45 (0.11, 0.80) | ||||
| Morbidity from diseases of arteries, arterioles and capillaries (ICD10 I70-I79) | 0.47 (−0.15, 1.09) | ||||
| Morbidity from diseases of veins, lymphatic vessels and lymph nodes (ICD10 I80-I89) | −0.26 (−0.70, 0.18) | ||||
| All circulatory disease (ICD10 I00-I99) morbidity | 0.18 (−0.03, 0.39) | ||||
| German uranium miner study | Kreuzer et al. [31] | 0.041 (0–0.909)d | 58,982 (2,180,639) | All circulatory disease (ICD10 I00-I99) | −0.13 (−0.38, 0.12)d |
| Ischemic heart disease (ICD10 I20-I25) | −0.03 (−0.38, 0.32)d | ||||
| Cerebrovascular disease (ICD10 I60-I69) | 0.44 (−0.16, 1.04)d | ||||
| Électricité de France workers | Laurent et al. [33] | 0.0215 (0–0.6) | 22,393 (440,984) | Ischemic heart disease | 4.1 (−2.9, 13.7)f |
| Cerebrovascular disease | 17.4 (0.2, 43.9)f | ||||
| All circulatory disease | 2.7 (−2.3, 9.1)f | ||||
| Eldorado uranium miners and processing (male) workers | Lane et al. [32] | 0.0522 (<0.0234– > 0.1215) | 16,236 (508,673) | Ischemic heart disease | 0.15 (−0.14, 0.58) |
| Stroke | −0.29 (<−0.29, 0.27) | ||||
| All other circulatory disease | 0.07 (<−0.33, 0.77) | ||||
| British Nuclear Fuels plc. workers | McGeoghegan et al. [34] | 0.0569 (0– > 0.729) | 38,779 (1,081,570) | Ischemic heart disease (ICD9 410–414) | 0.70 (0.37, 1.07)b, f |
| Cerebrovascular disease (ICD9 430–438) | 0.66 (0.17, 1.27)b, f | ||||
| Other circulatory diseases (ICD9 390–398, 415–429, 440–459) | 0.83 (−0.10, 1.12)f | ||||
| Circulatory diseases apart from cerebrovascular (ICD9 390–429, 439–459) | 0.72 (0.39, 1.10)f | ||||
| All circulatory disease (ICD9 390–459) | 0.54 (0.30, 0.82)b, f | ||||
| 3rd Analysis of UK National Registry for Radiation Workers | Muirhead et al. [29] | 0.0249 (<0.01– > 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) | ||||
| Aortic aneurysm (ICD9 441) | −0.132 (−1.29, 1.92) | ||||
| Ischemic heart disease (ICD9 410–414) | 0.259 (−0.05, 0.61) | ||||
| Cerebrovascular disease (ICD9 430–438) | 0.161 (−0.42, 0.91) | ||||
| US Oak Ridge workers | Richardson and Wing [63] | n.a. (0– > 0.1) | 14,095 (425,486) | Ischemic heart disease (ICD8 410–414) | −2.86 (−6.90, 1.18) |
| International Agency for Research on Cancer15-country nuclear worker study | Vrijheid et al. [27] | 0.0207 (0.0– > 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) |
| Ischemic 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, I80, I82, O88.2) | −0.95 (−1.00, 9.09)g | ||||
| Cerebrovascular disease (ICD10 I60-I69) | 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. [64] | 0.0001 (0– > 0.00016) | 32,135 (561,063) | Heart disease (white males) | −274 (−874, 438) |
| Heart disease (white females) | −951 (−1433, −390) | ||||
| Techa River study | Krestinina et al. [35] | 0.035 (0–0.51)h | 29,735 (901,563) | All circulatory disease mortality (ICD9 390–459) (10 year lag) | 0.24 (−0.08, 0.59) |
| All circulatory disease mortality (ICD9 390–459) (15 year lag) | 0.36 (0.02, 0.75) | ||||
| Ischemic heart disease mortality (ICD9 410–414) (10 year lag) | 0.40 (−0.11, 0.99) | ||||
| Ischemic heart disease mortality (ICD9 410–414) (15 year lag) | 0.56 (0.01, 1.19) | ||||
| Semipalatinsk nuclear test study | Grosche et al. [36] | 0.09 (0–0.63)d | 19,545 (582,656) | Heart disease (ICD9 410–429): all settlements | 3.22 (2.33, 4.10)d |
| Heart disease (ICD9 410–429): exposed settlements | 0.06 (−0.39, 0.52)d | ||||
| Stroke (ICD9 430–438): all settlements | 2.96 (1.77, 4.14)d | ||||
| Stroke (ICD9 430–438): exposed settlements | −0.06 (−0.65, 0.54)d | ||||
| Cardiovascular disease (ICD9 390–459): all settlements | 3.15 (2.48, 3.81)d | ||||
| Cardiovascular disease (ICD9 390–459): exposed settlements | 0.02 (−0.32, 0.37)d | ||||
CI Confidence Interval, ICD International Classification of Diseases
aAnalysis based on colon dose
bAnalysis using underlying or contributing cause of death
c Analysis based on stomach dose, derived from Table 4 of Yamada et al. [20] with smoking and drinking in the stratification
dRisk estimates in relation to cumulative whole body external gamma dose; doses given here are from Moseeva et al. [24]
eAssuming a lag period of 10 years
f90 % CI
gEstimate derived from log-linear model, evaluated at 1 Sv
hAnalysis based on dose to muscle