Assessment of Radiation Risks of Digestive System Diseases among Chernobyl Liquidators, Considering the Influence of Other Diseases Identified in Them During the Follow-up Period
- Authors: Chekin S.Y.1, Gorski A.I.1, Maksioutov M.A.1, Karpenko S.V.1, Tumanov K.A.1, Shchukina N.V.1, Kochergina E.V.1
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Affiliations:
- A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
- Issue: Vol 70, No 4 (2025)
- Pages: 55-65
- Section: Radiation Epidemiology
- URL: https://bakhtiniada.ru/1024-6177/article/view/360393
- DOI: https://doi.org/10.33266/1024-6177-2025-70-4-55-65
- ID: 360393
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Full Text
Abstract
Purpose: To assess the radiation risks of digestive system diseases (DSD) in the low and medium dose range (up to 1.5 Gy), considering the influence of other diseases identified in the exposed cohort.
Material and methods: Radiation risks of DSD were studied in the Russian cohort of Chernobyl disaster clean-up workers (liquidators), followed-up in the system of the National Radiation Epidemiological Registry (NRER) from 1986 to 2023. The studied cases of DSD are included in three-digit headings K00–K93 of the International Statistical Classification of Diseases 10th revision (ICD-10). Radiation risks of incidence were assessed in a cohort of 86,623 male liquidators, in which 62,864 diagnoses of DSD were identified. For the assessment of radiation risks of mortality from DSD, the cohort size was 89,567, with 2,793 deaths. The average absorbed dose of whole-body external gamma radiation accumulated by the liquidators during their work was 0.133 Gy, with a maximum dose of 1.5 Gy. Radiation risks were investigated in the framework of linear no-threshold (LNT) model of excess relative risk (ERR), as well as in the form of nonparametric estimates of relative risk (RR) in dose groups.
Results: For incidence, the estimate of the excess relative risk per dose unit is ERR/Gy=0.33, for mortality the estimate is ERR/Gy=0.81. These DSD radiation risk estimates are comparable to ERR/Gy=0.63 and ERR/Gy=0.74 for incidence and mortality from solid malignant neoplasms (MN) in the same cohort. Among liquidators with diagnoses of MN, the radiation risk of DSD incidence is statistically significantly (p=0.03) increased almost twofold, to ERR/Gy=0.64. The practical dose threshold for late mortality from DSD, estimated by the LNT model, is in the range of 0.160–0.860 Gy, with a mean value of 0.280 Gy. This is 20 times lower than the 6 Gy dose threshold adopted by the ICRP for early DSD mortality (up to 10 days after exposure). Similar estimates of dose thresholds for DSD incidence are in the range of 0.006–0.042 Gy. Nonparametric estimates of relative radiation risks (RR) confirm the correctness of LNT models of DSD radiation risk.
Conclusions: In the range of low and medium doses (up to 1.5 Gy) radiation-induced DSDs have significant properties of stochastic effects and fit into the LNT risk model. Further accumulation of data in the NRER system will make it possible to investigate the characteristics of DSD that are inherent in late tissue reactions (progression over time, increase in their severity with increasing dose and dependence on the health of the organism as a whole).
About the authors
S. Yu. Chekin
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
A. I. Gorski
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
M. A. Maksioutov
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
S. V. Karpenko
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
K. A. Tumanov
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
N. V. Shchukina
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
E. V. Kochergina
A.F. Tsyb Medical Radiological Research Centre - branch of the National Medical Research Radiological Centre
Email: chekin@nrer.ru
Obninsk, Russia
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