标题：Systematic Review and Meta-analysis of Circulatory Disease from Exposure to Low-Level Ionizing Radiation and Estimates of Potential Population Mortality Risks
摘要：a c k g r o u n d: Although high doses of ionizing ra dia tion have long been linked to circula tory disease, evidence for an associa tion at lower exposures remains controversial. However, recent analy-ses suggest excess relative risks at occupa tional exposure levels.oB j e c t i v e s: We performed a systematic review and meta-analy sis to summarize informa tion on circula tory disease risks associated with moderate- and low-level whole-body ionizing radia tion exposures.Me t h o d s: We conducted PubMed/ISI Thomson searches of peer-reviewed papers published since 1990 using the terms "radia tion" AND "heart" AND "disease," OR "radia tion" AND "stroke," OR "radia tion" AND "circula tory" AND "disease." Radia tion exposures had to be whole-body, with a cumulative mean dose of < 0.5 Sv, or at a low dose rate (< 10 mSv/day). We estimated popula tion risks of circula tory disease from low-level radia tion exposure using excess relative risk estimates from this meta-analysis and current mortality rates for nine major developed countries.re s u l t s: Estimated excess popula tion risks for all circula tory diseases combined ranged from 2.5%/Sv [95% confidence interval (CI): 0.8, 4.2] for France to 8.5%/Sv (95% CI: 4.0, 13.0) for Russia.co n c l u s i o n s: Our review supports an associa tion between circula tory disease mortality and low and moderate doses of ionizing radia tion. Our analy sis was limited by heterogeneity among studies (particularly for noncardiac end points), the possibility of uncontrolled confounding in some occupa-tional groups by lifestyle factors, and higher dose groups (> 0.5 Sv) generally driving the observed trends. If confirmed, our findings suggest that overall radia tion-related mortality is about twice that currently estimated based on estimates for cancer end points alone (which range from 4.2% to 5.6%/Sv for these popula tions).
关键词：cancer; circula ;tory disease; heart disease; radia ;tion; stroke
