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Radiat Environ Biophys. 2020 Mar;59(1):63-78. doi: 10.1007/s00411-019-00819-9. Epub 2019 Nov 28.

Radio-biologically motivated modeling of radiation risks of mortality from ischemic heart diseases in the Canadian fluoroscopy cohort study.

Author information

1
Department of Radiation Sciences, Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany. hschoellnberger@bfs.de.
2
Division UR-Environmental Radioactivity, Federal Office for Radiation Protection, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany. hschoellnberger@bfs.de.
3
Department of Radiation Sciences, Institute of Radiation Medicine, Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany.
4
Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.

Abstract

Recent analyses of the Canadian fluoroscopy cohort study reported significantly increased radiation risks of mortality from ischemic heart diseases (IHD) with a linear dose-response adjusted for dose fractionation. This cohort includes 63,707 tuberculosis patients from Canada who were exposed to low-to-moderate dose fractionated X-rays in 1930s-1950s and were followed-up for death from non-cancer causes during 1950-1987. In the current analysis, we scrutinized the assumption of linearity by analyzing a series of radio-biologically motivated nonlinear dose-response models to get a better understanding of the impact of radiation damage on IHD. The models were weighted according to their quality of fit and were then mathematically superposed applying the multi-model inference (MMI) technique. Our results indicated an essentially linear dose-response relationship for IHD mortality at low and medium doses and a supra-linear relationship at higher doses (> 1.5 Gy). At 5 Gy, the estimated radiation risks were fivefold higher compared to the linear no-threshold (LNT) model. This is the largest study of patients exposed to fractionated low-to-moderate doses of radiation. Our analyses confirm previously reported significantly increased radiation risks of IHD from doses similar to those from diagnostic radiation procedures.

KEYWORDS:

Ionizing radiation; Ischemic heart diseases; LNT model; Multi-model inference; Nonlinear dose–response

PMID:
31781840
DOI:
10.1007/s00411-019-00819-9

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