核工人白内障晶状体疾病的相对风险:系统回顾和荟萃分析

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

摘要

晶状体细胞是体内对辐射最敏感的细胞,在关键参数上甚至超过了淋巴细胞。在相对较低的剂量下可以观察到晶状体中的辐射损伤,许多作者认为这些影响不是确定性的,而是随机性的。尽管白内障的后果并不总是影响视力,晶状体也会成功地进行手术矫正,但在照射包括核工业工人在内的各种专业群体时,这些后果在恶性肿瘤和循环系统疾病之后立即被认为是重要的。所提交的研究表明,关于核工作者晶状体疾病的出版物很少——仅确定了20个来源(1967年至2022年),并且没有发现关于低剂量(低LET辐射为0.1 Gy)影响的数据。在对核工作者晶状体中1 Gy/Sv的ERR辐射损伤进行荟萃分析时,有三个队列被证明是相关的:美国超铀元素加工研究中的一个小组,Mayak人员和ROSATOM工作人员——切尔诺贝利事故的清算人。样本是同质的,不太可能出现发表偏倚,根据荟萃分析(固定效应模型)的结果,每1 Gy/Sv的ERR为0.30(95%置信区间:0.25;0.35)。根据早期的工作(Koterov a.N.等人,2022),核工作人员作为一个世界专业类别的外部暴露平均累积剂量为31.1 mSv,计算表明,当ERR=0.3/1Gy/Sv时,一组“普通”工人的白内障过度患病率为0.0093。这对应于潜在放射源性白内障的患病率在10.3%的背景水平上增加了0.096%(最后一个值取自Hashemi H.等人的荟萃分析,2020)。这样的增长不大可能具有实际意义。尽管对于一些队列(Sellafield,PO‘Mayak’),可能存在累积剂量显著的群体,因此风险增加。放射工作人员晶状体中致白内障疾病风险的重要性可能是由于专业适用性的降低,因为人工晶状体通常适应能力较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Excess Relative Risk of Cataractogenic Lense Disordes in Nuclear Workers: Systematic Review and Meta-analysis
The lens cells are the most radiosensitive cells in the body, surpassing even lymphocytes in key parameters. Radiation damages in the lens can be observed at relatively low doses, in connection with which a number of authors attribute to these effects not a deterministic, but a stochastic nature. Although cataractogenic consequences do not always affect visual acuity, and lens undergo successful surgical correction, when irradiating various professional groups, including workers in the nuclear industry, these consequences are regarded in importance immediately after malignant neoplasms and diseases of the circulatory system. The presented study showed that there are very few publications on the lens disorders in nuclear workers – only 20 sources were identified (1967–2022), and no data were found on the effects of low doses (0.1 Gy for low LET radiation). When conducting a meta-analysis for ERR at 1 Gy/Sv for radiation damage in the lens of nuclear workers, three cohorts turned out to be relevant: a small group in the American study of transuranium elements processing, Mayak personnel and ROSATOM workers – liquidators of the Chernobyl accident. The sample was homogeneous, publication bias was unlikely, and, according to the results of a meta-analysis (Fixed effect model), ERR per 1 Gy/Sv was 0.30 (95 % confidence intervals: 0.25; 0.35). Based on the earlier work (Koterov A.N. et al, 2022) of the mean cumulative dose of external exposure for nuclear workers as a world professional category, which amounted to 31.1 mSv, the calculation showed that with ERR = 0.3 per 1 Gy/Sv excess prevalence of cataracts for a group of ‘average’ workers is 0.0093. This corresponds to an increase in prevalence of 0.096 % over a background level of 10.3 % for potentially radiogenic cataracts (last value taken from a meta analysis by Hashemi H. et al., 2020). Such an increase is unlikely to have practical significance. Although for some cohorts (Sellafield, PO ‘Mayak’) there may be groups with significant cumulative doses and, therefore, with increased risks. The importance of the risks of cataractogenic disorders in the lens in radiation workers may be due to a decrease in professional suitability, since the artificial lens, as a rule, is poorly capable of accommodation.
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来源期刊
Medical Radiology and Radiation Safety
Medical Radiology and Radiation Safety Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.40
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