绝大多数核电工人在所有工作时期都无法降低被动吸烟导致的主要病症的死亡率风险

Q4 Medicine
A. N. Koterov, L. Ushenkova, A. Wainson, I. G. Dibirgadzhiev, M. Kalinina, A.Yu. Bushmanov
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引用次数: 0

摘要

迄今为止,约有 100 项关于二手烟(SHS)影响肺癌和循环系统(心血管)疾病(CVD)的荟萃分析。得出的风险值(相对风险 - RR、几率比例 - OR 等)在 1.2-1.3 之间,但还没有明确公认的估算值,许多估算值也不是近几年得出的。在日常生活和科学意识中,SHS 和在核工业企业工作都已成为定型观念,在日常和专业用语中意味着有害。本研究比较了 SHS 和核工业工人(NW)所有癌症、肺癌和心血管疾病的死亡风险。在第一阶段,对这些病症的死亡风险进行了总综述(综述的综述;概述)和荟萃分析(荟萃分析)。总综述和元分析被视为最高级别的证据,因此,已确定的风险可有条件地被视为 "标准"。由于没有足够的数据可用于说明可吸入有害气体后的所有癌症死亡率;因此,采用了 Kim A.S. 等人 2018 年的元分析结果,并对肺癌和心血管疾病死亡率进行了元分析。风险值在 1.22-1.24 之间,这与之前的研究结果相同。在第二阶段,将确定的 SHS 风险与指定病症的 NW 死亡率风险进行了比较。从作者维护的数据库中提取的核武器出版物样本包括与核设施有关的最具代表性的队列:最大剂量以及合并队列(14-15 个国家和 INWORK - 3 个国家)。根据已公布的特定核武器人口每 1 Gy 的ERR,计算出核武器必须累积的辐射剂量才能接近SHS的死亡风险。结果发现,要达到所有三种疾病的 SHS 风险,NW 需要接受的辐射剂量从 129-183 mSv 到 1.07-6.0 Sv 不等。没有任何案例表明,SHS 的风险等同于低剂量辐射(低至 100 mGy);更常见的情况是,剂量在大约 300-800 mSv 之间,最高达 6 Sv。对已公布的核武器剂量分布数据的分析表明,接受此类剂量的核武器比例相对较小或微乎其微。来自不同国家的 80-96% 的裸体主义者所面临的风险,包括自 20 世纪 40 年代以来的活动,都没有达到长期暴露于 SHS 的危害程度。结论是,如果不考虑日常生活中即使微弱、但控制不力的风险的严重程度,长达数十年的对核武器风险,特别是 "低剂量 "风险的研究似乎是不够的,所获得的数据再次改善了核能领域的就业形象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Mortality Risk from Main Pathologies Due to Passive Smoking is not Achieved by the Overwhelming Majority of Nuclear Workers in All Periods of Employment
To date, there are about 100 meta-analyses for lung cancer and circulatory (cardiovascular) diseases (CVD) as the effects of second hand smoking (SHS). The obtained risk values (Relative Risk – RR, odds ratio – OR, etc.) are in the range of 1.2–1.3, but there are no definitively accepted estimates yet, and many estimates were not made in recent years. Both SHS and work at nuclear industry enterprises have become stereotypes in everyday and scientific everyday consciousness, meaning something harmful in everyday and professional terms. The present study compared the mortality risks from all cancers, lung cancer, and CVD for SHS and nuclear workers (NW). At the first stage, an umbrella review (review of reviews; overview) and meta-analyses of meta-analyses (meta-meta-analyses) on the risks of mortality from these pathologies as effects of SHS were performed. Umbrella review and meta-meta-analysis are regarded as the highest level of evidence and, thus, the identified risks can be conditionally considered as ‘standard’. There were insufficient data available for all cancer mortality rates after SHS; Therefore, the results from the meta-analysis by Kim A.S. et al, 2018 were used., and meta-meta-analyses were performed for lung cancer and CVD mortality. The risk values were in the range of 1.22–1.24, which replicates previous findings. At the second stage, the risks identified for SHS were compared with the risks of mortality from the named pathologies for NW. The sample of publications for NW, extracted from the database maintained by the authors, included the most representative cohorts in relation to nuclear installations: with maximum doses, as well as combined cohorts (14–15 countries and INWORK – 3 countries). Based on published ERRs per 1 Gy for a given NW population, the radiation doses that NW would have to accumulate to approach the mortality risks from SHS were calculated. To achieve SHS risks for all three disease types, NWs were found to need to receive radiation doses ranging from 129–183 mSv to 1.07–6.0 Sv. There have been no cases in which the risk from SHS was equivalent to exposure to low-dose radiation (up to 100 mGy); more often, doses were localized in the range of about 300–800 mSv, up to 6 Sv. Analysis of published data on dose distributions for NW has demonstrated that such doses are received either by a relatively small or vanishingly small proportion of NW. Risks for 80–96 % of NWs from various countries, including activities since the 1940s, did not reach the harms of chronic exposure to SHS. It is concluded that the decades-long study of risks for NW, in particular ‘low doses’, does not seem adequate without taking into account the magnitude of even weak, but poorly controlled risks of everyday life, and the data obtained once again improves the image of employment in the field of nuclear energy.
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来源期刊
Medical Radiology and Radiation Safety
Medical Radiology and Radiation Safety Medicine-Radiology, Nuclear Medicine and Imaging
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