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Title: RADIATION RISKS OF THYROID CANCER IN CHORNOBYL CLEAN-UP WORKERS USING THE ALTERNATIVE ESTIMATES OF DOSES OF EXTERNAL EXPOSURE.
Author: Prysyazhnyuk AY, Trotsyuk NK, Gudzenko NA, Chumak VV, Bakhanova OV, Fuzik MM, Belyaev YM, Fedorenko ZP, Gorokh YL, Romanenko AY, Bazyka DA, Khukhryanska OM.
Journal: Probl Radiac Med Radiobiol; 2018 Dec; 23():200-215. PubMed ID: 30582846.
Abstract:
OBJECTIVE: The objective of this study was to estimate the thyroid cancer radiation risks - excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) in the cohort of 150,813 Ukrainian male clean-up workers during the 1986-2012 period (more than 25 years after the Chornobyl accident). MATERIALS AND METHODS: The cohort under study of 150,813 Ukrainian men who participated emergency and clean-up work in 1986-1990 was formed based on the data of the Ukrainian State Register of persons affected due toChornobyl accident (SRU). The identification of thyroid cancer cases (216) was carried out by linking the SRU data-base with the National Cancer Registry of Ukraine (NCRU) data. Standardised incidence ratios (SIR) were estimatedcomparing thyroid cancer incidence in the cohort with the corresponding national indices. Excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) were calculated accounting for the alterna-tive dose estimates. The following sources of the average dose values for Ukrainian liquidators were used: officialtotal external dose records according to UNSCEAR 2008 report and results of external red bone marrow dose recon-struction by the RADRUE method for the cohort sample. For the radiation risk evaluation, these estimates were con-versed to the average external thyroid dose. RESULTS: Results of the long term study (1986-2012) of thyroid cancer risks in a cohort of 150813 Chornobyl clean-up workers («liquidators») from Ukraine are presented. Two options for the average thyroid dose estimates were usedfor radiation risks evaluation. According to the SRU and NCRU 216 incident thyroid cancers were diagnosed in 1986-2012 within the studied cohort with an overall SIR of 3.35 (95 % confidence interval (CI) 2.51-3.80). The SIR esti-mates were elevated throughout the entire follow-up period. Investigation of a contribution of the external expo-sure (according to the alternative values) showed the elevated dose associated thyroid cancer rates in the studiedcohort. Alternatively estimated EAR/104 PY Gy were of 1.86 (95 % CI 0.47-3.24) and 2.07 (95 % CI 0.53-3.62);ERR/Gy - 2.38 (95 % CI 0.60-4.15) and 2.66 (95 % CI 0.68-4.64) and AR % (Gy) 70.4 % and 72.7 % Gy. CONCLUSIONS: Obtained results prove the dose dependent increase of thyroid cancer incidence among UkrainianChornobyl clean-up workers. These conclusions are consistent with those received for combined cohort of Belarus,Russia and Baltic States liquidators. Meta: otsinyty radiatsiĭni ryzyky raku shchytopodibnoï zalozy (ShchZ) vprodovzh periodu 1986–2012 rr. (za bil'sh nizh25 rokiv pislia avariï na Chornobyl's'kiĭ AES): nadlyshkovyĭ absoliutnyĭ (EAR), nadlyshkovyĭ vidnosnyĭ (ERR)ta atrybutyvnyĭ (AR) ryzyky v ukraïns'kiĭ kogorti 150813 likvidatoriv cholovichoï stati z Ukraïny.Materialy ta metody. Doslidzhuvana kogorta chysel'nistiu 150 813 osib gromadian Ukraïny, cholovichoï stati, iaki vperiod 1986-1990 rr. braly uchast' u likvidatsiï naslidkiv avariï na Chornobyl's'kiĭ AES (ULNA na ChAES, «likvida-toriv»), sformovana na bazi danykh Derzhavnogo reiestru Ukraïny osib, iaki postrazhdaly vnaslidok Chornobyl's'-koï katastrofy (DRU). Identyfikatsiia vypadkiv zakhvoriuvannia na rak ShchZ (216 vypadkiv) zdiĭsniuvalas' shliakhomzistavlennia (linkidzhu) baz danykh DRU ta Natsional'nogo kantser-reiestru Ukraïny. Na osnovi porivniannia pokaz-nykiv zakhvoriuvanosti na rak ShchZ v doslidzhuvaniĭ kogorti z natsional'nymy pokaznykamy chastoty tsiieï patologiïbulo rozrakhovano standartyzovani rivni zakhvoriuvanosti. Pokaznyky nadlyshkovogo absoliutnogo ryzyku na 104liudyno-rokiv-Greĭ (EAR/104 PY Gy), nadlyshkovogo vidnosnogo ryzyku na 1 Greĭ oprominennia (ERR/Gy) ta atry-butyvnoï chastky ryzyku na 1 Greĭ oprominennia (AR/ Gy) buly vyznacheni z urakhuvanniam ĭmovirnoï dozy op-rominennia na ShchZ. Za osnovu vziati ofitsiĭni otsinky doz zovnishn'ogo oprominennia ULNA na ChAES, opublikovani vdopovidi UNSCEAR 2008, ta rezul'taty rekonstruktsiï dozy na chervonyĭ kistkovyĭ mozok dlia kogortnoï vybirkymetodom RADRUE. Dlia rozrakhunku radiatsiĭnykh ryzykiv tsi znachennia doz zvedeni do ĭmovirnoï dozy zovnishn'ogooprominennia ShchZ.Rezul'taty. Predstavleni rezul'taty dovgostrokovogo etapu doslidzhennia (1986–2012 rr.) chastoty taradiatsiĭnykh ryzykiv raku ShchZ v doslidzhuvaniĭ kogorti (150 813) likvidatoriv cholovichoï stati. V kogorti zadoslidzhuvanyĭ period 1986–2012 rr. bulo identyfikovano 216 vypadkiv raku ShchZ iz zagal'nym pokaznykom zakh-voriuvanosti – SIR 3,35 (95 % dovirchyĭ interval (CI): 2,51–3,80). Uprodovzh usikh rokiv sposterezhennia udoslidzhuvaniĭ kogorti maly mistse suttievo pidvyshcheni pokaznyky zakhvoriuvanosti v porivnianni z natsional'nymy.Doslidzhennia vnesku zovnishn'ogo oprominennia pokazaly pidvyshcheni pokaznyky ryzyku raku ShchZ v tsiĭ chyslenniĭgrupi naselennia dlia obokh dozovykh otsinok – EAR/104 PY Gy 1,86 (95 % CI 0,47–3,24) ta 2,07 (95 % CI 0,53–3,62),(ERR/Gy) 2,38 (95 % CI 0,60–4,15) ta 2,66 (95 % CI 0,68–4,64); ta (AR/ Gy) 70,4 % ta 72,7 %.Vysnovky. Rezul'taty doslidzhen' svidchat' pro zrostannia chastoty raku ShchZ sered uchasnykiv likvidatsiï naslidkivavariï na Chornobyl'skiĭ AES z Ukraïny u zv’iazku z otrymanoiu dozoiu oprominennia. Tsi vysnovky uzgodzhuiut'sia zvysnovkamy, otrymanymy dlia ob’iednanoï kogorty likvidatoriv z Bilorusi, Rosiĭs'koï Federatsiï ta kraïn Baltiï.

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