Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study

Mark P. Little, Lydia B. Zablotska, Alina V. Brenner, Steven E Lipshultz

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

High-dose ionizing radiation is associated with circulatory disease. Risks from lower-dose fractionated exposures, such as from diagnostic radiation procedures, remain unclear. In this study we aimed to ascertain the relationship between fractionated low-to-medium dose radiation exposure and circulatory disease mortality in a cohort of 13,568 tuberculosis patients in Massachusetts, some with fluoroscopy screenings, between 1916 and 1961 and follow-up until the end of 2002. Analysis of mortality was in relation to cumulative thyroid (cerebrovascular) or lung (all other circulatory disease) radiation dose via Poisson regression. Over the full dose range, there was no overall radiation-related excess risk of death from circulatory disease (n = 3221; excess relative risk/Gy −0.023; 95 % CI −0.067, 0.028; p = 0.3574). Risk was somewhat elevated in hypertensive heart disease (n = 89; excess relative risk/Gy 0.357; 95 % CI −0.043, 1.030, p = 0.0907) and slightly decreased in ischemic heart disease (n = 1950; excess relative risk/Gy −0.077; 95 % CI −0.130, −0.012; p = 0.0211). However, under 0.5 Gy, there was a borderline significant increasing trend for all circulatory disease (excess relative risk/Gy 0.345; 95 % CI −0.032, 0.764; p = 0.0743) and for ischemic heart disease (excess relative risk/Gy 0.465; 95 % CI, −0.032, 1.034, p = 0.0682). Pneumolobectomy increased radiation–associated risk (excess relative risk/Gy 0.252; 95 % CI 0.024, 0.579). Fractionation of dose did not modify excess risk. In summary, we found no evidence of radiation-associated excess circulatory death risk overall, but there are indications of excess circulatory death risk at lower doses (<0.5 Gy). Although consistent with other radiation-exposed groups, the indications of higher risk at lower doses are unusual and should be confirmed against other data.

Original languageEnglish (US)
JournalEuropean Journal of Epidemiology
DOIs
StateAccepted/In press - Aug 9 2015
Externally publishedYes

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Fluoroscopy
Tuberculosis
Cohort Studies
Mortality
Radiation
Myocardial Ischemia
Dose Fractionation
Ionizing Radiation
Heart Diseases
Thyroid Gland

Keywords

  • Circulatory disease
  • Fluoroscopy
  • Hypertension
  • Ionizing radiation
  • Tuberculosis

ASJC Scopus subject areas

  • Epidemiology

Cite this

Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study. / Little, Mark P.; Zablotska, Lydia B.; Brenner, Alina V.; Lipshultz, Steven E.

In: European Journal of Epidemiology, 09.08.2015.

Research output: Contribution to journalArticle

Little, Mark P. ; Zablotska, Lydia B. ; Brenner, Alina V. ; Lipshultz, Steven E. / Circulatory disease mortality in the Massachusetts tuberculosis fluoroscopy cohort study. In: European Journal of Epidemiology. 2015.
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