Non-cancer morbidity among Estonian Chernobyl cleanup workers: a register-based cohort study
Rahu, Kaja; Bromet, Evelyn J; Hakulinen, Timo; Auvinen, Anssi; Uusküla, Anneli; Rahu, Mati (2014)
Rahu, Kaja
Bromet, Evelyn J
Hakulinen, Timo
Auvinen, Anssi
Uusküla, Anneli
Rahu, Mati
2014
BMJ Open 4 5
e004516
Terveystieteiden yksikkö - School of Health Sciences
CC BY-NC 3.0
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:uta-201606302054
https://urn.fi/URN:NBN:fi:uta-201606302054
Tiivistelmä
Objective: To examine non-cancer morbidity in the
Estonian Chernobyl cleanup workers cohort compared
with the population sample with special attention to
radiation-related diseases and mental health disorders.
Design: Register-based cohort study.
Setting: Estonia.
Participants: An exposed cohort of 3680 men (cleanup
workers) and an unexposed cohort of 7631 men
(population sample) were followed from 2004 to 2012
through the Population Registry and Health Insurance
Fund database.
Methods: Morbidity in the exposed cohort compared
with the unexposed controls was estimated in terms of
rate ratio (RR) with 95% CIs using Poisson regression
models.
Results: Elevated morbidity in the exposed cohort was
found for diseases of the nervous system, digestive
system, musculoskeletal system, ischaemic heart disease
and for external causes. The most salient excess risk was
observed for thyroid diseases (RR=1.69; 95% CI 1.38 to
2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to
2.09) and selected alcohol-related diagnoses (RR=1.25;
95% CI 1.12 to 1.39). No increase in morbidity for stress
reactions, depression, headaches or sleep disorders was
detected.
Conclusions: No obvious excess morbidity consistent
with biological effects of radiation was seen in the
exposed cohort, with the possible exception of benign
thyroid diseases. Increased alcohol-induced morbidity
may reflect alcohol abuse, and could underlie some of
the higher morbidity rates. Mental disorders in the
exposed cohort were probably under-reported.
The future challenge will be to study mental and
physical comorbidities in the Chernobyl cleanup workers
cohort.
Estonian Chernobyl cleanup workers cohort compared
with the population sample with special attention to
radiation-related diseases and mental health disorders.
Design: Register-based cohort study.
Setting: Estonia.
Participants: An exposed cohort of 3680 men (cleanup
workers) and an unexposed cohort of 7631 men
(population sample) were followed from 2004 to 2012
through the Population Registry and Health Insurance
Fund database.
Methods: Morbidity in the exposed cohort compared
with the unexposed controls was estimated in terms of
rate ratio (RR) with 95% CIs using Poisson regression
models.
Results: Elevated morbidity in the exposed cohort was
found for diseases of the nervous system, digestive
system, musculoskeletal system, ischaemic heart disease
and for external causes. The most salient excess risk was
observed for thyroid diseases (RR=1.69; 95% CI 1.38 to
2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to
2.09) and selected alcohol-related diagnoses (RR=1.25;
95% CI 1.12 to 1.39). No increase in morbidity for stress
reactions, depression, headaches or sleep disorders was
detected.
Conclusions: No obvious excess morbidity consistent
with biological effects of radiation was seen in the
exposed cohort, with the possible exception of benign
thyroid diseases. Increased alcohol-induced morbidity
may reflect alcohol abuse, and could underlie some of
the higher morbidity rates. Mental disorders in the
exposed cohort were probably under-reported.
The future challenge will be to study mental and
physical comorbidities in the Chernobyl cleanup workers
cohort.
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