Abstract

Purpose

There are well-known correlations between high and moderate doses (>0.5 Gy) of ionizing radiation exposure and circulatory system damage, also between radiation and posterior subcapsular cataract. At lower dose correlations with circulatory disease are emerging in the Japanese atomic bomb survivors and in some occupationally exposed groups, and are still to some extent controversial. Heterogeneity in excess relative risks per unit dose in epidemiological studies at low (<0.1 Gy) and at low-moderate (>0.1 Gy, <0.5 Gy) doses may result from confounding and other types of bias, and effect modification by established risk factors. There is also accumulating evidence of excess cataract risks at lower dose and low dose rate in various cohorts. Other ocular endpoints, specifically glaucoma and macular degeneration have been little studied. In this paper, we review recent epidemiological findings, and also discuss some of the underlying radiobiology of these conditions. We briefly review some other types of mainly neurological nonmalignant disease in relation to radiation exposure.

Conclusions

We document statistically significant excess risk of the major types of circulatory disease, specifically ischemic heart disease and stroke, in moderate- or low-dose exposed groups, with some not altogether consistent evidence suggesting dose-response non-linearity, particularly for stroke. However, the patterns of risk reported are not straightforward. We also document evidence of excess risks at lower doses/dose-rates of posterior subcapsular and cortical cataract in the Chernobyl liquidators, US Radiologic Technologists and Russian Mayak nuclear workers, with fundamentally linear dose-response. Nuclear cataracts are less radiogenic. For other ocular endpoints, specifically glaucoma and macular degeneration there is very little evidence of effects at low doses; radiation-associated glaucoma has been documented only for doses >5 Gy, and so has the characteristics of a tissue reaction. There is some evidence of neurological detriment following low-moderate dose (∼0.1–0.2 Gy) radiation exposure in utero or in early childhood.

中文翻译：

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低剂量和中剂量电离辐射对直接暴露个体的非癌症影响，特别是循环系统和眼部疾病：流行病学回顾

摘要

目的

众所周知，高剂量和中等剂量（>0.5 Gy）的电离辐射暴露与循环系统损伤之间存在相关性，辐射与后囊下白内障之间也存在相关性。在日本原子弹幸存者和一些职业暴露群体中，较低剂量的剂量与循环系统疾病的相关性正在显现，并且在某种程度上仍然存在争议。流行病学研究中低（<0.1 Gy）和中低（>0.1 Gy，<0.5 Gy）剂量的每单位剂量的过度相对风险的异质性可能是由混杂和其他类型的偏倚以及已确定的风险因素的效应修正造成的。越来越多的证据表明，在不同人群中，较低剂量和低剂量率会增加白内障风险。其他眼部终点，特别是青光眼和黄斑变性的研究很少。在本文中，我们回顾了最近的流行病学发现，并讨论了这些疾病的一些基础放射生物学。我们简要回顾了与辐射暴露相关的一些其他类型的主要神经系统非恶性疾病。

结论

我们记录了中度或低剂量暴露组中主要类型循环系统疾病（特别是缺血性心脏病和中风）的统计显着超额风险，一些不完全一致的证据表明剂量反应非线性，特别是中风。然而，报告的风险模式并不简单。我们还记录了切尔诺贝利清理人员、美国放射技术专家和俄罗斯玛雅克核工作人员在较低剂量/剂量率下发生后囊下和皮质白内障的过度风险的证据，并且基本上呈线性剂量反应。核性白内障的放射性较小。对于其他眼部终点，特别是青光眼和黄斑变性，几乎没有证据表明低剂量有影响；与辐射相关的青光眼仅在剂量 >5 Gy 时被记录，因此具有组织反应的特征。有一些证据表明，在子宫内或幼儿期接受低中等剂量（∼0.1-0.2 Gy）辐射会造成神经系统损害。