Основные результаты радиационно-эпидемиологического анализа данных РГМДР (к 20-летию Чернобыля)

«Радиация и риск». 2005. Спецвыпуск, с.6-11

Сведения об авторах

Иванов В.К., Цыб А.Ф., Максютов М.А., Горский А.И., Марченко Т.А.¹, Кайдалов О.В., Корело А.М., Чекин С.Ю., Петров А.В., Бирюков А.П., Кочергина Е.В., Круглова З.Г., Зеленская Н.С., Власов О.К., Щукина Н.В., Кащеева П.В., Туманов К.А., Михальский А.И.²
ГУ - Медицинский радиологический научный центр РАМН, Обнинск.
¹Департамент развития инфраструктуры, МЧС России, Москва.
²Институт проблем управления РАН, Москва.

Аннотация

В работе представлены основные результаты радиационно-эпидемиологического анализа данных РГМДР (к 20-летию Чернобыля). Проведен анализ динамики показателей заболеваемости раком щитовидной железы на загрязненных радионуклидами территориях, оценка текущих рисков и прогноз. Оценены заболеваемость раком щитовидной железы среди детей и подростков, жителей Брянской области, после аварии на ЧАЭС, радиационные риски заболеваемости лейкозами, неонкологическими заболеваниями среди ликвидаторов и населения загрязненных радионуклидами территорий, солидными раками среди ликвидаторов. Рассмотрен контроль качества медицинской информации при проведении радиационно-эпидемиологического анализа. В статье дан анализ дозовой зависимости смертности ликвидаторов последствий аварии на Чернобыльской АЭС, проведена оценка радиационных рисков онкологической заболеваемости при учёте гетерогенности фоновых повозрастных показателей.

Ключевые слова
Динамика показателей заболеваемости, рак щитовидной железы, загрязненные радионуклидами территории, авария на ЧАЭС, ликвидаторы, солидные раки, неонкологические заболевания, дозовая зависимость смертности, радиационные риски, онкологические заболевания.

Список цитируемой литературы

1. Likhtarev I.A., Sobolev B.G., Kairo I.A., Tronko N.D., Bogdanova T.I., Oleinic V.A., Epshtein E.V., Beral V. Thyroid cancer in the Ukraine //Nature. - 1995. - V. 375. - P. 365.

2. Jacob P., Goulko G., Heidenreich W.F., Likhtarev I.A., Kairo I.A., Tronko N.D., Bogdanova T.I., Kenigsberg J., Buglova E., Drozdovitch V., Beral V. Thyroid cancer risk to children calculated //Nature. - 1998. - V. 392. - P. 31-32.

3. Radiation and Thyroid Cancer. Proceedings of an International Seminar on Radiation and Thyroid Cancer /Eds. Thomas G., Karaoglou A., Willliams E.D. - Brussels-Luxembourg: World Scientific Pub-lishing, 1999.

4. Ivanov V.K., Gorsky A.I., Tsyb A.F., Maksyoutov M.A., Rastopchin E.M. Dynamics of thyroid cancer in-cidence in Russia following the Chernobyl accident //J. Radiol. Prot. - 1999. - V. 19, N 4. - P. 305-318.

5. Ivanov V.K., Gorski A.I., Pitkevitch V.A., Tsyb A.F., Cardis E., Storm H. Risk of radiogenic thyroid cancer in Russia following the Chernobyl accident /Eds. Thomas G., Karaoglou A., Willliams E.D. Proceedings of an International Seminar on Radiation and Thyroid Cancer. - Brussels-Luxembourg: World Scientific Publishing, 1999. - P. 89-96.

6. Heidenreich W.F., Kenigsberg Y., Jacob P., Buglova E., Gulko G., Paretzke H.G., Demidchik E.P., Golovneva A. Time trends of thyroid cancer incidence in Belarus after Chernobyl accident //Radiation Res. - 1999. - V. 151. - P. 617-625.

7. Jacob P., Kenigsberg Y., Zvonova I., Gulko G., Buglova E., Heidenreich W.F., Golovneva A., Bratilova A.A., Drozdovitch V., Kruk J., Pochtennaja G.T., Balonov M., Demidchik E.P., Paretzke H.G. Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia //British J. of Cancer. - 1999. - V. 80, N 9. - P. 1461-1469.

8. Likhtarev I.A., Kairo I.A., Shpak V.M. et al. Radiation-induced and background thyroid cancer of Ukranichildren (dosimetric approach) //Int. J. Radiat. Med. - 1999. - V. 3-4. - P. 51-66.

9. Ivanov V.K., Gorski A.I., Tsyb A.F., Maksioutov M.A., Vlasov O.K., Godko A.M. Risk of radiogenic thyroid cancer in the population of the Bryansk and Oryol regions of Russia after the Chernobyl accident (1991-1998). - Chernobyl: Message for the 21st Century: Proceedings of the Sixth Chernobyl Sasakawa Medical Cooperation Symposium, Moscow, Russia, 30-31 May 2001 (International Congress Series No 1234) /Editors Shunichi Yamashita, Yoshisada Shibata, Masaharu Hoshi, Kingo Fujimura. - Amsterdam-London-New York-Oxford-Paris-Shannon-Singapore-Tokyo: ELSEVIER, 2002. - P. 85-93.

10. Ivanov V.K., Gorski A.I., Maksioutov M.A., Vlasov O.K., Godko A.M., Tsyb A.F., Tirmarche M., Valenty M., Verger P. Thyroid cancer incidence among adolescents and adults in the Bryansk region of Russia following the Chernobyl accident //Health Phys. - 2003. - V. 84, N 1. - P. 46-60.

11. Winkelmann R.A., Okeanov A., Gulak L., Remennik L., Rahu M., Storm H.H. Cancer registration tech-niques in the New Independent States of the former Soviet Union. IARC Technical Report N. 35. - Lyon: IARC, 1998. - P. 22-43.

12. Reference book of mean thyroid doses in persons of different age resident in the population points of the Bryansk, Tula, Oryol and Kaluga oblasts contaminated after the Chernobyl accident in 1986 /Edited by M.I.Balonov and I.A. Zvonova //Bulletin of the National Radiation Epidemiology Registry, special issue, 2002 (in Russian).

13. Methodology for reconstruction of thyroid doses from iodine radioisotopes in residents of the Russian Federation exposed to radioactive contamination as a result of the Chernobyl accident in 1986. Guide-lines MU-2.6.1-00b, 2000 (in Russian).

14. Preston D.L., Lubin J.H., Pierce D.A. and McConney M.E. EPICURE. - Seatle, USA: Hirosoft International Corporation, 1993.

15. Thompson D.E., Mabuchi K., Ron E., Soda M., Tokunaga M., Oshikubo S., Sugomoto S., Ikeda T., Terasaki M., Izumi S., Preston D.L. Cancer incidence in atomic bomb survivors. Part II: Solid tumors, 1958-1987 //Radiation Res. - 1994. - V. 137. - P. S17-S67.

16. Shore R.E. Issues and epidemiological evidence regarding radiation-induced thyroid cancer //Radiation Res. - 1992. - V. 131. - P. 98-117.

17. Ron E., Lubin J.Y., Shore R.E., Mabuchi K., Modan B., Pottern L.M., Shneider A., Tucker M., Boice J.D. Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies //Radiation Res. - 1995. - V. 141. - P. 259-277.

18. Preston D., Kusumi S., Tomonaga M., Izumi S., Ron E., Kuramato A., Kamada N., Dohy H., Matsui T., Nonaka H., Thompson D., Soda M., Mabuchi K. Cancer Incidence in Atomic Bomb Survivors. Part III: Leukemia and Multiple Myeloma, 1950-1987 //Radiation Research. - 1994. - V. 137. - P. S94.

19. Ivanov V.K., Tsyb A.F., Gorsky A.I., Maksyutov M.A., Rastopchin E.M., Konogorov A.P., Korelo A.M., Biryukov A.P., Matiash V.A. Leukaemia and thyroid cancer in emergency workers of the Chernobyl acci-dent: estimation of radiation risks (1986-1995) //Radiat. Environ. Biophys. - 1997. - V. 36. - P. 9-16.

20. Cardis E., Gilbert E.S., Carpenter L. et al. Effects of low doses and low dose rates of external ionizing radiation: cancer mortality among nuclear workers in three countries //Radiation Research. - 1995. - V. 143. - P. 117-132.

21. Preston D.L., Lubin J.H., Pierce D.A. EPICURE User's Guide. - Seattle: Hirosoft International Corp., 1992.

22. Накопленные эффективные средние дозы //Бюллетень Национального радиационно-эпидемиологического регистра, специальный выпуск, 1999.

23. Gilbert E.S., Cragle D.L., Wiggs L.D. Updated analysis of combined mortality data for workers at the Hanford Site, Oak Ridge National Laboratory and Rocky Flats Nuclear Weapons Plant //Radiat Res. - 1993. - V. 136. - P. 408-421.

24. Kendall G.M., Muirhead C.R., MacGibbon B.H. et al. Mortality and occupational exposure to radiation: first analysis of the National Registry for radiation workers //Br. Med. J. - 1992. - V. 304. - P. 220-225.

25. Muirhead C.R., Goodill A.A., Haylock R.G. et al. Occupational radiation exposure and mortality: second analysis of the National Registry for radiation workers //J. Radiol. Prot. - 1999. - V. 19. - P. 3-26.

26. Asmore J.P., Krewsky D., Zielinsky J.M. et al. First analyses of mortality and occupational radiation exposure based on National Dose Registry of Canada //Am. J. Epidemiol. - 1998. - V. 148. - P. 564-574.

27. Carpenter L., Higgins C., Douglas A., Fraser P., Beral V., Smith P. Combined analysis of mortality in the three United Kingdom Nuclear industry workforces, 1946-1988 //Radiat. Res. - 1994. - V. 138. - P. 224-238.

28. Gribbin M.A., Weeks J.L., Howe G.R. Cancer mortality (1956-1985) among male employees of atomic energy of Canada limited with respect to occupational exposure to external low-linear-energy-transfer ionizing radiation //Radiat. Res. - 1993. - V. 133. - P. 375-380.

29. Ron E., Muirhead C. The carcinogenic effects of ionizing radiation: epidemiological evidence. In: Low doses of ionizing radiation: biological effects and regulatory control. Invited papers and discussion. Proceedings of an International conference, Seville, Spain, 17-21 November 1997. - Vienna: International Atomic Energy Agency, 1998. - P. 165-180.

30. Koshurnikova N.A., Bysogolov G.D., Bolotnikova M.G. et al. Mortality among personnel who worked at the Mayak complex in the first years of its operation //Health Phys. - 1996. - V. 71. - P. 90-93.

31. Ivanov V.K., Gorski A.I., Maksioutov M.A., Tsyb A.F., Souchkevitch G.N. Mortality among the Chernobyl emergency workers: estimation of radiation risks (preliminary analysis) //Health Phys. - 2001. - V. 81, N 5. - P. 514-521.

32. Ivanov V.K., Tsyb A.F., Rastopchin E.M., Gorsky A.I., Maksyoutov M.A., Vayser V.I., Suspitsin Y.V., Fedorov Y.V. Cancer incidence among nuclear workers in Russia based on data from the Institute of Physics and Power Engineering: a preliminary analysis //Radiat. Res. - 2001. - V. 155. - P. 801-808.

33. Ivanov V.K., Tsyb A.F., Petrov A.V., Maksioutov M.A., Shilyaeva T.P., Kochergina E.V. Thyroid cancer incidence among liquidators of the Chernobyl accident: absence of dependence of radiation risks on ex-ternal radiation dose //Radiation and Environmental Biophysics. - 2002. - V. 41, N 3 (Sep). - P. 195-198.

34. Ivanov V.K., Rastopchin E.M., Gorsky A.I., Ryvkin V.B. Cancer incidence among liquidators of the Chernobyl accident: solid tumors, 1986-1995 //Health Physics. - 1998. - V. 74(3). - P. 309-315.

35. Sources and Effects of Ionizing Radiation. UNSCEAR 2000 Report. Vol. II. Effects. - New York: United Nations, 2000. - P. 470-471.

36. International Classification of Diseases, 10th Revision. - Geneva: WHO, 1977.

37. Pitkevich V.A., Ivanov V.K., Tsyb A.F. Dosimetric data of the All-Russian Medical and Dosimetric State Registry for emergency workers //Special Issue of Bulletin of the All-Russian Medical and Dosimetric State Registry. - Moscow, 1995.

38. Pierce A., Preston D.L. Commentary on: No evidence for increased tumor rates below 200 mSv in the atomic bomb survivors’ data //Radiat. Environ. Biophys. - 1997. - V. 36, N 3. - P. 209-210.

39. Griem M.L., Kleinerman R.A., Boice J.D.Jr. et al. Cancer following radiotherapy for peptic ulcer //J. Natl. Cancer Inst. - 1994. - V. 86. - P. 842-849.

40. Darby S.C., Doll R., Gill S.K. et al. Long term mortality after a single treatment course with X-rays in people treated for ankylosing spondylitis //Br. J. Cancer. - 1987. - V. 55. - P. 179-190.

41. Lewis C.A., Smith P.G., Stratton I.M. et al. Estimated radiation doses to different organs among patients treated for ankylosing spondylitis with a single course of X-rays //Br. J. Radiol. - 1988. - V. 61. - P. 212-220.

42. Shimizu Y., Pierce D.A., Preston D.L., Mabuchi K. Studies of the mortality of atomic bomb survivors. Report 12, Part II. Noncancer mortality: 1950-1990 //Radiat. Res. - 1999. - V. 152, N 4. - P. 374-389.

43. Kodama K., Fujiwara S., Yamada M. et al. Profiles of non-cancer diseases in atomic bomb survivors //World Health Stat. Q. - 1996. - V. 49. - P. 7-16.

44. Ivanov V.K., Tsyb A.F., Maksyutov M.A., Pitkevich V.A., Gorsky A.I., Rastopchin Eu.M., Korelo A.M., Chekin S. Yu., Konogorov A.P., Nilova E.V. Radiation epidemiological analysis of the data of the National Chernobyl Registry of Russia: prognostication and facts nine years after the accident //Radiat. Prot. Dosimetry. - 1994. - V. 64. - P. 121-128.

45. Ivanov V.K., Maksioutov M.A., Chekin S.Yu., Kruglova Z.G., Petrov A.V., Tsyb A.F. Radiation-epidemiological analysis of incidence of non-cancer diseases among the Chernobyl liquidators //Health Phys. - 2000. - V. 78, N 5. - P. 495-501.

46. Pitkevitch V.A., Ivanov V.K., Tsyb A.F., Maksyoutov M.A., Matiash V.A., Shchukina N.V. Exposure levels for persons involved in recovery operations after the Chernobyl accident. Statistical analysis based on the data of the Russian National Medical and Dosimetric Registry (RNMDR) //Radiat. Environ. Biophys. - 1997. - V. 36, N 3. - P. 149-160.

47. Breslow N.E., Day N.E. Statistical Methods in Cancer Research. Vol. I. - The Analysis of Case-Control Studies. IARC Scientific Publication No. 32. - Lyon: IARC, 1980.

48. Pierce D.A., Shimizu Y., Preston D.L., Vaeth M., Mabuchi K. Studies of the mortality of atomic bomb survivors. Report 12, Part I. Cancer: 1950-1990 //Radiation Research. - 1996. - V.146. - P. 1-27.

49. Pierce D.A., Mendelsohn M.L. A model for radiation-related cancer suggested by atomic bomb survivor data //Radiat. Res. - 1999. - V. 52, N 6. - P. 642-654.

50. Михальский А.И., Петровский А.М., Яшин А.И. Теория оценивания неоднородных популяций. - М.: Наука, 1989.

51. Михальский А.И. Методы анализа гетерогенных структур и популяций. - М.: Институт проблем управления им. В.А.Трапезникова РАН, 2002.

52. Cardis E., Vrijheid M., Blettner M., Gilbert E., Hakama M., Hill C., Howe G., Kaldor J., Muirhead C.R., Schubauer-Berigan M., Yoshimura T., Bermann F., Cowper G., Fix J., Hacker C., Heinmiller B., Marshall M., Thierry-Chef I., Utterback D., Ahn Y.-O., Amoros E., Ashmore P., Auvinen A., Bae J.-M., Bernar Solano J., Biau A., Combalot E., Deboodt P., Diez Sacristan A., Eklof M., Engels H., Engholm G., Gulis G., Habib R., Holan K., Hyvonen H., Kerekes A., Kurtinaitis J., Malker H., Martuzzi M., Mastauskas A., Monnet A., Moser M., Pearce M.S., Richardson D.B., Rodriguez-Artalejo F., Rogel A., Tardy H., Telle-Lamberton M., Turai I., Usel M., Veress K. Risk of cancer after low doses of ionising radiation - retrospective cohort study in 15 countries //BMJ. - 2005. - V. 89. - P. 1-7.

53. Wakeford R. Cancer risk among nuclear workers //J. Radiol. Prot. - 2005. - V. 25. - P. 225-228.

54. Иванов В.К., Цыб А.Ф., Агапов А.М., Панфилов А.П., Кайдалов О.В., Горский А.И., Максютов М.А., Чекин С.Ю., Годько А.М., Суспицин Ю.В., Вайзер В.И., Козлов Е.П., Епихин А.И. Концепция оптимизации системы радиационной защиты в атомной отрасли: управление индивидуальными канцерогенными рисками и оказание адресной медицинской помощи //Радиация и риск, специальный выпуск, 2004.

55. Cox D.R. Partial likelihood //Biometrika. - 1975. - V. 62. - P. 269-276.

Полная версия статьи