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Table 1 Estimated excess relative risks of circulatory disease in various studies of moderate- and low-dose radiation exposure. (Adapted from Little et al. [11, 12]). All data are in relation to underlying cause of death, unless otherwise indicated

From: Low dose radiation and circulatory diseases: a brief narrative review

Cohort/Study Reference Mean (range) [SD] heart/brain dose, Sv Cohort, n (person years of follow-up) Endpoint (mortality unless otherwise indicated) Excess relative risk Sv−1 (95 % CI)
Japanese atomic bomb survivors
Japanese atomic bomb survivors Shimizu et al. [19] 0.1 (0–4)a 86,611 (n.a.) Ischemic heart disease (ICD9 410–414) 0.02 (−0.10, 0.15)
     Myocardial infarction (ICD9 410) 0.00 (−0.15, 0.18)
     Hypertensive heart disease (ICD9 402, 404) 0.37 (0.08, 0.72)
     Rheumatic heart disease (ICD9 393–398) 0.86 (0.25, 1.72)
     Heart failure (ICD9 428) 0.22 (0.07, 0.39)
     Other heart disease (ICD9 390–392, 415–427, 429) −0.01 (−0.21, 0.24)
     Hypertensive disease without heart disease (ICD9 401, 403, 405) 0.07 (−0.22, 0.55)
     Heart disease total (ICD9 393–429 excluding 401, 403, 405) 0.18 (0.11, 0.25)b
     Cerebral infarction (ICD9 433,434) 0.04 (−0.10, 0.20)
     Cerebral hemorrhage (ICD9 431) 0.05 (−0.06, 0.17)
     Subarachnoid hemorrhage (ICD9 430) 0.30 (−0.04, 0.76)
     Other or unspecified cerebrovascular disease 0.16 (0.01, 0.34)
     Cerebrovascular disease total (ICD9 430–438) 0.12 (0.05, 0.19)b
     Circulatory disease apart from heart disease and stroke (ICD9 390–392, 401, 403, 405, 439–459) 0.58 (0.45, 0.72)b
     Other circulatory disease (ICD9 399–400, 406–409, 439–459) −0.01 (<−0.01, 0.34)
     All circulatory disease (ICD9 390–459) 0.15 (0.10, 0.20)b
Japanese atomic bomb survivors Yamada et al. [20] 0.1 (0–4)b 10,339 (n.a.) Hypertension incidence, 1958–1998 (ICD9 401) 0.05 (−0.01, 0.10)c
     Hypertensive heart disease incidence, 1958–1998 (ICD9 402, 404) −0.01 (−0.09, 0.09)c
     Ischemic heart disease incidence, 1958–1998 (ICD9 410–414) 0.05 (−0.05, 0.16)c
     Myocardial infarction incidence, 1964–1998 (ICD9 410) 0.12 (−0.16, 0.60)c
     Occlusion incidence, 1958–1998 (ICD9 433, 434) 0.06 (−0.11, 0.30)c
     Aortic aneurysm incidence, 1958–1998 (ICD9 441, 442) 0.02 (−0.22, 0.41)c
     Stroke incidence, 1958–1998 (ICD9 430, 431, 433, 434, 436) 0.07 (−0.08, 0.24)c
Japanese atomic bomb survivors Tatsukawa et al. [21] 0.001 (0–1.79) 506 (9265) Morbidity in utero: hypertension 0.20 (−0.39, 1.38)
     Morbidity in utero: nonfatal stroke or myocardial infarction −0.91 (−1.00, 79.3)
Japanese atomic bomb survivors Tatsukawa et al. [21] 0.13 (0–3.53) 1053 (20,216) Morbidity: hypertension 0.15 (−0.01, 0.34)
     Morbidity: stroke or myocardial infarction 0.72 (0.24, 1.40)
Occupational studies
Mayak workers Moseeva et al. [24] 0.62 ± 0.80 (males)d 18,856 (356,880) Ischemic heart disease morbidity (ICD9 410–414) 0.160 (0.089, 0.230)d, e
  Azizova et al. [23] 0.51 ± 0.68 (females)d 22,377 (425,735) Cerebrovascular disease morbidity (ICD9 430–438) 0.49 (0.39, 0.60)d, e
Chernobyl emergency workers Ivanov et al. [22] 0.109 (0 - >0.5) 61,017 (n.a.) Hypertension (ICD10 I10-I15) morbidity 0.26 (−0.04, 0.56)
     Essential hypertension (ICD10 I10) morbidity 0.36 (0.005, 0.71)
     Hypertensive heart disease (ICD10 I11) morbidity 0.04 (−0.36, 0.44)
     Ischemic heart disease (ICD10 I20-I25) morbidity 0.41 (0.05, 0.78)
     Acute myocardial infarction (ICD10 I21) morbidity 0.19 (−0.99, 1.37)
     Other acute ischemic heart disease (ICD10 I24) morbidity 0.82 (−0.62, 2.26)
     Angina pectoris (ICD10 I20) morbidity 0.26 (−0.19, 0.71)
     Chronic ischemic heart disease (ICD10 I25) morbidity 0.20 (−0.23, 0.63)
     Other heart disease (ICD10 I30-I52) morbidity −0.26 (−0.81, 0.28)
     Cerebrovascular disease (ICD10 I60-I69) morbidity 0.45 (0.11, 0.80)
     Morbidity from diseases of arteries, arterioles and capillaries (ICD10 I70-I79) 0.47 (−0.15, 1.09)
     Morbidity from diseases of veins, lymphatic vessels and lymph nodes (ICD10 I80-I89) −0.26 (−0.70, 0.18)
     All circulatory disease (ICD10 I00-I99) morbidity 0.18 (−0.03, 0.39)
German uranium miner study Kreuzer et al. [31] 0.041 (0–0.909)d 58,982 (2,180,639) All circulatory disease (ICD10 I00-I99) −0.13 (−0.38, 0.12)d
     Ischemic heart disease (ICD10 I20-I25) −0.03 (−0.38, 0.32)d
     Cerebrovascular disease (ICD10 I60-I69) 0.44 (−0.16, 1.04)d
Électricité de France workers Laurent et al. [33] 0.0215 (0–0.6) 22,393 (440,984) Ischemic heart disease 4.1 (−2.9, 13.7)f
     Cerebrovascular disease 17.4 (0.2, 43.9)f
     All circulatory disease 2.7 (−2.3, 9.1)f
Eldorado uranium miners and processing (male) workers Lane et al. [32] 0.0522 (<0.0234– > 0.1215) 16,236 (508,673) Ischemic heart disease 0.15 (−0.14, 0.58)
     Stroke −0.29 (<−0.29, 0.27)
     All other circulatory disease 0.07 (<−0.33, 0.77)
British Nuclear Fuels plc. workers McGeoghegan et al. [34] 0.0569 (0– > 0.729) 38,779 (1,081,570) Ischemic heart disease (ICD9 410–414) 0.70 (0.37, 1.07)b, f
     Cerebrovascular disease (ICD9 430–438) 0.66 (0.17, 1.27)b, f
     Other circulatory diseases (ICD9 390–398, 415–429, 440–459) 0.83 (−0.10, 1.12)f
     Circulatory diseases apart from cerebrovascular (ICD9 390–429, 439–459) 0.72 (0.39, 1.10)f
     All circulatory disease (ICD9 390–459) 0.54 (0.30, 0.82)b, f
3rd Analysis of UK National Registry for Radiation Workers Muirhead et al. [29] 0.0249 (<0.01– > 0.4) 174,541 (3.9 × 106) All circulatory disease (ICD9 390–459) 0.251 (−0.01, 0.54)
     Circulatory disease not strongly related to smoking (ICD9 390–409, 415–440, 442–459) 0.280 (−0.19, 0.85)
     Aortic aneurysm (ICD9 441) −0.132 (−1.29, 1.92)
     Ischemic heart disease (ICD9 410–414) 0.259 (−0.05, 0.61)
     Cerebrovascular disease (ICD9 430–438) 0.161 (−0.42, 0.91)
US Oak Ridge workers Richardson and Wing [63] n.a. (0– > 0.1) 14,095 (425,486) Ischemic heart disease (ICD8 410–414) −2.86 (−6.90, 1.18)
International Agency for Research on Cancer15-country nuclear worker study Vrijheid et al. [27] 0.0207 (0.0– > 0.5) 275,312 (4,067,861) Circulatory disease (ICD10 I00-I99, J60-J69, O88.2, R00-R02, R57) 0.09 (−0.43, 0.70)
     Ischemic heart disease (ICD10 I20-I25) −0.01 (−0.59, 0.69)
     Heart failure (ICD10 I50) −0.03 (<0, 4.91)
     Deep vein thrombosis and pulmonary embolism (ICD10 I26, I80, I82, O88.2) −0.95 (−1.00, 9.09)g
     Cerebrovascular disease (ICD10 I60-I69) 0.88 (−0.67, 3.16)
     All other circulatory disease (ICD10 R00-R02, R57, I00-I99 excluding I20-26, I50, I60-69, I80, I82) 0.29 (<0, 2.40)
Environmental studies
Three Mile Island study Talbott et al. [64] 0.0001 (0– > 0.00016) 32,135 (561,063) Heart disease (white males) −274 (−874, 438)
     Heart disease (white females) −951 (−1433, −390)
Techa River study Krestinina et al. [35] 0.035 (0–0.51)h 29,735 (901,563) All circulatory disease mortality (ICD9 390–459) (10 year lag) 0.24 (−0.08, 0.59)
     All circulatory disease mortality (ICD9 390–459) (15 year lag) 0.36 (0.02, 0.75)
     Ischemic heart disease mortality (ICD9 410–414) (10 year lag) 0.40 (−0.11, 0.99)
     Ischemic heart disease mortality (ICD9 410–414) (15 year lag) 0.56 (0.01, 1.19)
Semipalatinsk nuclear test study Grosche et al. [36] 0.09 (0–0.63)d 19,545 (582,656) Heart disease (ICD9 410–429): all settlements 3.22 (2.33, 4.10)d
     Heart disease (ICD9 410–429): exposed settlements 0.06 (−0.39, 0.52)d
     Stroke (ICD9 430–438): all settlements 2.96 (1.77, 4.14)d
     Stroke (ICD9 430–438): exposed settlements −0.06 (−0.65, 0.54)d
     Cardiovascular disease (ICD9 390–459): all settlements 3.15 (2.48, 3.81)d
     Cardiovascular disease (ICD9 390–459): exposed settlements 0.02 (−0.32, 0.37)d
  1. CI Confidence Interval, ICD International Classification of Diseases
  2. aAnalysis based on colon dose
  3. bAnalysis using underlying or contributing cause of death
  4. c Analysis based on stomach dose, derived from Table 4 of Yamada et al. [20] with smoking and drinking in the stratification
  5. dRisk estimates in relation to cumulative whole body external gamma dose; doses given here are from Moseeva et al. [24]
  6. eAssuming a lag period of 10 years
  7. f90 % CI
  8. gEstimate derived from log-linear model, evaluated at 1 Sv
  9. hAnalysis based on dose to muscle