The influence of dose uncertainty on the assessment of radiation risks of non-cancer mortality among Russian participants in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant

S. Chekin, M. Maksioutov, V. Kashcheev, S. Karpenko, K. Tumanov, A. M. Korelo, E. Kochergina, N. S. Zelenskaya, O. E. Lashkova, N. V. Shchukina, V. Ivanov
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Abstract

Currently, the system of standards and rules of radiation protection considers the need to con-straint the absorbed radiation doses in order to prevent the development of deterministic effects of ionizing radiation on humans. Deterministic effects in terms of mortality include bone marrow syndrome with a dose threshold of 1 Gy, gastrointestinal syndrome and pneumonitis with dose thresholds of 6 Gy. For inclusion in international radiation safety standards, a threshold of 0.5 Gy for cardiovascular and cerebrovascular diseases is being discussed. The wide experience of ra-diation-epidemiological studies shows that the deterministic effects of mortality are not limited to those effects that are currently considered in the system of standards and rules of radiation pro-tection. This paper presents estimates of radiation risks of mortality from diseases of the circula-tory system (CSD) and the digestive system, as well as dose thresholds corresponding to these effects, in the Russian cohort of liquidators of the Chernobyl accident registered in the National Radiation and Epidemiological Register (NRER), who have registered doses from external whole-body exposure to gamma radiation within 1 Gy. The risks were estimated over the follow-up peri-od 1986-2020. The stability of estimated radiation risks of mortality from CSD and from the di-gestive system diseases in relation to the uncertainty of personal doses received by liquidators has been studied. The absorbed doses received by 11% of the liquidators were estimated from the data of personal dosimeters, the maximum error was about 50%. For the remaining 89% of liquidators, group and route doses were registered, and the maximum uncertainty of individual doses was about 500%. For CSD mortality, the excess relative rates per 1 Gy (ERR/Gy) were 0.361 and 0.349, excluding and considering dose uncertainties, respectively. For mortality from diseases of the digestive system, ERR/Gy=0,791 excluding dose uncertainty and ERR/Gy=0,726 with considering dose uncertainty. Uncertainties in individual dose estimates result in 5% and 8% reductions in ERR/Gy estimates (for CSD mortality and digestive disease, respectively). This re-duction in risk estimates is not related to a bias in the dose estimates. It is caused by the statistical properties of radiation risk models in conventional radiation epidemiology. If the excessive mor-tality from the studied causes is attributed to deterministic effects, then the estimates of the corre-sponding dose thresholds, considering the uncertainty of individual doses, also increase quite slightly: for CSD – from 0,028 Gy to 0,029 Gy, and for diseases of the digestive system – from 0,013 Gy to 0,014 Gy. The obtained results confirm the high stability and validity of radiation risk assessments of non-oncological diseases obtained earlier from the doses of Russian partici-pants in the liquidation of the consequences of the Chernobyl accident registered in the unified federal database of the NRER.
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剂量不确定性对评估清理切尔诺贝利核电站事故后果的俄罗斯参与者非癌症死亡率的辐射风险的影响
目前,辐射防护标准和规则体系考虑到有必要限制吸收的辐射剂量,以防止电离辐射对人类产生决定性影响。死亡率方面的决定性影响包括剂量阈值为1戈瑞的骨髓综合征、剂量阈值为6戈瑞的胃肠综合征和肺炎。目前正在讨论将0.5 Gy的心脑血管疾病阈值纳入国际辐射安全标准。辐射流行病学研究的广泛经验表明,死亡率的决定性影响并不局限于辐射防护标准和规则系统目前所考虑的那些影响。本文介绍了在国家辐射和流行病学登记册(NRER)中登记的俄罗斯切尔诺贝利事故清理者队列中因循环系统(CSD)和消化系统疾病而死亡的辐射风险的估计,以及与这些影响相对应的剂量阈值,这些人已登记了1 Gy以内的外部γ辐射照射剂量。这些风险是在1986-2020年随访期间估计的。已经研究了CSD和消化系统疾病死亡的估计辐射风险的稳定性与清算者个人接受剂量的不确定性之间的关系。11%的清理者接受的吸收剂量是根据个人剂量计数据估算的,最大误差约为50%。对于其余89%的清除者,登记了组剂量和路线剂量,个体剂量的最大不确定性约为500%。对于CSD死亡率,排除并考虑剂量不确定性后,每1 Gy的过量相对死亡率(ERR/Gy)分别为0.361和0.349。对于消化系统疾病的死亡率,不考虑剂量不确定性的ERR/Gy= 0.791,考虑剂量不确定性的ERR/Gy= 0.726。个体剂量估计值的不确定性导致ERR/Gy估计值降低5%和8%(分别针对CSD死亡率和消化系统疾病)。这种风险估计值的降低与剂量估计值的偏差无关。这是由于传统辐射流行病学中辐射风险模型的统计特性造成的。如果所研究原因造成的过高死亡率归因于确定性效应,那么考虑到个体剂量的不确定性,相应剂量阈值的估计值也会略有增加:对于CSD,从0.028戈瑞增至0.029戈瑞,对于消化系统疾病,从0.013戈瑞增至0.014戈瑞。所取得的结果证实,先前从登记在国家核研究委员会统一联邦数据库中的清理切尔诺贝利事故后果的俄罗斯参与者的剂量中获得的非肿瘤疾病辐射风险评估具有高度的稳定性和有效性。
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