An analysis was carried out of multiaberrant ("rogue") cells in lymphocytes of persons living in unpolluted areas (controls), and in areas chemically or radioactively (Chernobyl fall-out) polluted. The total number of analysed cells was 102,391, among these 10 cells with three and more aberrations were found. These multiaberrant cells occur in persons of both sexes and various ages living in regions with a moderate degree of mutagenic exposure. The main types of aberrations in multiaberrant cells were chromosome exchanges, accompanied by double fragments.
One group that has the potential to be exposed to radiation is workers in the nuclear industry. Results of a systematic medical follow-up and dosimetric monitoring of these workers can form the basis for a study of the relationship between cancer incidence and radiation dose. As part of such efforts in Russia, a major institution of the nuclear industry with an established medical care unit, archiving capabilities, and dosimetry department was selected: the Institute of Physics and Power Engineering (IPPE) in Obninsk. In the study, a comparative analysis of cancer incidence rates for the IPPE workers and for the general population of Russia in 1991-1997 was carried out. The subjects were the IPPE workers hired before 1981. This restriction was imposed to reduce the uncertainty associated with the possible latent period in the development of solid cancers. Thus the possibility of including persons who already had the disease at the time when they were hired was minimized. The analysis is based on information about 158 cancer cases, including 24 cancers in persons under individual dosimetric monitoring. A statistically significant excess in cancer incidence was found among the IPPE workers compared with a comparison population (the general population of Russia) for some types of cancers. The SIR values for all cancers (ICD-9: 140-208) is 0.93 (95% CI 0.76, 1.12) for males and 1.42 (95% CI 1.06, 1.87) for females. A statistically significant excess for all cancers was also observed for residents of Obninsk compared to the control comparison population. The corresponding SIR value was 1.20 (95% CI 1.12, 1.28) for males and 1.58 (95% CI 1.49, 1.69) for females. An important reason for the observed excess in cancer incidence compared to the control population may be the higher level of health care in the so-called nuclear cities of Russia which may have resulted in increased diagnosis and registration of cancers. A statistically significant dependence of the cancer incidence on the dose of ionizing radiation was not established. The excess relative risk per gray for all types of cancer was 0.91 (95% CI -2.75, 4.61) for males and 0.40 (95% CI -6.94, 7.83) for females. These estimates should be considered to be preliminary, as the number of cases considered in the analysis of the dose response is small (17 males and 7 females).
122 persons who had participated in the Chernobyl nuclear power station disaster control were passed through ECG examinations, as a result of which susceptibility to bradycardia was revealed. To exclude a marked vagal influence on the myocardium, orthostatic, atropine and ephedrine tests were performed. Weakened reactions to atropine and ephedrine indicated a secondary vagotomy caused by the lowered sensitivity of beta-adrenoreceptors.
Incidence of and mortality from cardiovascular diseases have been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948-1958 and followed up to 31 December 2000. Information on external gamma-ray doses is available for virtually all of these workers (99.9%); the mean total gamma-ray dose (+/-SD) was 0.91 +/- 0.95 Gy (99% percentile 3.9 Gy) for men and 0.65 +/- 0.75 Gy (99% percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured for only 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium alpha exposure (+/- SD) was 0.40 +/- 1.15 Gy (99% percentile 5.88 Gy) for men and 0.81 +/- 4.60 Gy (99% percentile 15.95 Gy) for women. A total of 3751 cases of ischemic heart disease (IHD), including 683 cases of acute myocardial infarction (AMI), and 1495 IHD deaths, including 338 AMI deaths, were identified in the study cohort during the follow-up period. Having adjusted for non-radiation factors, there were statistically significant increasing trends with both total external gamma-ray dose and internal liver dose in IHD incidence. The trend with internal dose was weaker and was not statistically significant after adjusting for external dose, whereas the external dose trend was little changed after adjusting for internal dose. The trend with external dose in IHD mortality was not statistically significantly greater than zero but was consistent with the corresponding trend in IHD incidence. The estimated trend in IHD mortality with internal dose was lower and was not statistically significant once adjustment was made for external dose. There was a statistically significantly increasing trend in AMI incidence but not AMI incidence with external dose. The risk estimates for IHD in relation to external radiation are generally compatible with those from other large occupational studies and the Japanese A-bomb survivors.
At Branch No. 1 of the Russian State Research Center "Biophysics Institute", a registry has been created of workers at the "Mayak" Production Association, the first nuclear complex in Russia. This registry includes 18,830 persons hired at Mayak's nuclear reactors and radiochemical and plutonium production plant between 1948 and 1972. Twenty-five percent of these workers are women. As of December 31, 1994, the vital status is known for approximately 90% of the cohort members. A total of 5,118 persons have died. The cause for 97% of total deaths has been ascertained. The cohort members were exposed to both external gamma radiation and internal radiation from incorporated plutonium. The plutonium body burden has been measured in 30% of the cohort members with potential for plutonium exposure. External gamma-ray doses were in the range from tenths of milligrays to about 10 Gy, and plutonium body burdens were up to about 260 kBq. In view of the nature of the Mayak worker cohort, it has the potential to provide reasonably precise, quantitative estimates of the long-term health effects associated with chronic low-dose-rate exposure to external gamma radiation as well as internal radiation from plutonium. However, a number of issues must be addressed before credible risk estimates can be obtained from this cohort. These issues include the development of an appropriate internal comparison group and/or external rates and separating of the effects of internal and external exposures on risk estimates.
To study early (deterministic) and long-term effects of radiation exposure, the "Clinic" medical-dosimetric database for the Mayak Production Association worker cohort has been established at the Southern Urals Biophysics Institute (SUBI). This paper describes the principles of organization, structure and prospects of future utilization of this database.
Long-lived, sensitive, and specific biomarkers of particular mutagenic agents are much sought after and potentially have broad applications in the fields of cancer biology, epidemiology, and prevention. Many clastogens induce a spectrum of chromosome aberrations, and some of them can be exploited as biomarkers of exposure. Densely ionizing radiation, for example, alpha particle radiation (from radon or plutonium) and neutron radiation, preferentially induces complex chromosome aberrations, which can be detected by the 24-color multifluor fluorescence in situ hybridization (mFISH) technique. We report the detection and quantification of stable complex chromosome aberrations in lymphocytes of healthy former nuclear-weapons workers, who were exposed many years ago to plutonium, gamma rays, or both, at the Mayak weapons complex in Russia. We analyzed peripheral-blood lymphocytes from these individuals for the presence of persistent complex chromosome aberrations. A significantly elevated frequency of complex chromosome translocations was detected in the highly exposed plutonium workers but not in the group exposed only to high doses of gamma radiation. No such differences were found for simple chromosomal aberrations. The results suggest that stable complex chromosomal translocations represent a long-lived, quantitative, low-background biomarker of densely ionizing radiation for human populations exposed many years ago.
OBJECTIVE: To clarify the effects of ionizing radiation and to dispel fear associated with the use of radioactivity in medical diagnosis and therapy. DESIGN: Studies of populations in geographic areas of increased cosmic radiation and high natural background radiation, radiation-exposed workers, patients with medical exposure to radioactivity, and accidental exposure are reviewed. RESULTS: No reproducible evidence shows harmful effects associated with increases in background radiation of 3 to 10 times the usual levels. American military personnel who participated in nuclear testing had no increase in leukemia or other cancers. Among 22,000 patients with hyperthyroidism treated with 131I (mean dose, 10 rem), no increased incidence of leukemia was found in comparison with 14,000 similar patients who received other treatment. A 20-year follow-up of 35,000 patients who underwent 131I uptake tests for evaluation of thyroid function revealed that those studied for other than a suspected tumor had only 60% of the thyroid cancers expected in a control group. Although early studies showed that high exposures to miners to radon and its daughters resulted in a substantial increase in lung cancer, no evidence exists for an increase in lung cancer among nonsmokers exposed to increased radon levels in the home. CONCLUSION: Perhaps the association of radiation with the atomic bomb has created a climate of fear about the possible dangers of radiation at any level; however, no evidence indicates that current radiation exposures associated with medical usage are harmful.
In this article we discuss examples of challenging problems in retrospective dosimetry and describe some promising solutions. The ability to make measurements by accelerator mass spectrometry and luminescence techniques promises to provide improved dosimetry for regions of Belarus, Ukraine and Russian Federation contaminated by radionuclides from the Chernobyl accident. In addition, it may soon be possible to resolve the large neutron discrepancy in the dosimetry system for Hiroshima through novel measurement techniques that can be used to reconstruct the fast-neutron fluence emitted by the bomb some 51 years ago. Important advances in molecular cytogenetics and electron paramagnetic resonance measurements have produced biodosimeters that show potential in retrospective dosimetry. The most promising of these are the frequency of reciprocal translocations measured in chromosomes of blood lymphocytes using fluorescence in situ hybridization and the electron paramagnetic resonance signal in tooth enamel.