Abstract
Exposure to high doses of ionizing radiation is associated with damage to the heart and coronary arteries. However, only recently have studies with high-quality individual dosimetry data allowed this risk to be estimated while adjusting for concomitant chemotherapy. An association between lower dose exposures and late-occurring circulatory disease has only recently been suspected in the Japanese atomic bomb survivors and in various occupationally exposed cohorts and is still controversial. Excess relative risks per unit dose in moderate- and low-dose epidemiological studies are variable, possibly resulting from confounding and effect-modification by well known (but unobserved) risk factors. Here, we summarize the evidence for a causal association between moderate- and low-level radiation exposure (whether at high or low dose rates) and circulatory disease.
Highlights
Circulatory disease is the leading cause of death in the developed world [1]
Findings in the Japanese atomic bomb survivors Excess radiation-associated mortality from heart disease and stroke has been observed in the Life Span Study (LSS) cohort (Table 1) [19]
Analysis within the Adult Health Study (AHS) of those exposed in early childhood showed a significantly increased incidence of non-fatal stroke or myocardial infarction, there was no excess risk among those exposed in utero for whom the average exposures were much lower [21] (Table 1)
Summary
There are many types of circulatory disease [2]. Identified independent risk factors include cigarette smoking, diabetes, high blood pressure, obesity, and increased total and low-density-lipoprotein cholesterol [3]. The health risks of low-level exposure to ionizing radiation are usually thought to be related primarily to cancer in the directly-exposed population [6, 7]. Most cancer types have been associated with radiation exposure, whether in the Japanese atomic bomb survivors [8, 9] or in other groups [6]. Several recent reviews have suggested an excess radiation-induced risk at occupational and environmental dose levels (
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