Page 67 - GTM-4-1

Global Translational Medicine Low-dose radiation

In particular, the uncertain and biased data are unsuitable effect modifiers.” Mild and borderline conditions must
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for the computations of the DDREF. Earlier Russian be more often diagnosed in people with higher doses
publications stressed the higher biological efficiency due to the more thorough examinations and patients’
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of acute exposures to chronic and fractionated ones ; attention to their health. “The markedly elevated mortality
later, the same scientists reiterated that the International and morbidity rates of circulatory disease in the Russian
Commission on Radiological Protection underestimates population compared with other developed countries”
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cancer risks from chronic exposures and recommended has been explained by unsubstantiated conclusions in
the use of DDREF = 1.0, meaning acute and chronic unclear cases, both post- and ante-mortem. At least in
exposures are equally efficient. This recommendation the former SU, the lower the diagnostic quality, the higher
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is obviously unreasonable for dose rates compatible with the fraction of cardiovascular diseases among all causes
those from the natural radiation background. DDREF has of death. The same is also true for deceased patients not
been discussed in more detail previously. 1,38 undergoing autopsy, where cardiovascular diseases are
often recorded as causes of death in questionable cases. 46
4. Cardiovascular and cerebrovascular
A recent study based on the MPA cohort analyzed
conditions 9469 CeVD cases including 2078 strokes. The following
In earlier reports, an incidence increase in cardiovascular statements appear contradictory: “CeVD incidence was
diseases and CeVD, if found in MPA, Techa River, and found to be significantly associated with cumulative
EURT populations, was not accompanied by a mortality radiation dose” and “No significant associations of either
increase. 28,31,39 This can be reasonably explained by the stroke or its types with cumulative gamma-ray dose
greater diagnostic effectiveness in people with higher of external exposure or alpha-particle dose of internal
doses, with the registration of mild and questionable exposure were found.” Expectedly, with more arterial
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cases. However, a recent paper utilizing the MPA cohort occlusions and stenoses, there would be more strokes.
reported an increase in the excess relative risk (ERR/Gy) An apparent explanation for the discrepancy is the dose-
of mortality due to ischemic heart disease for the dose dependent diagnostic quality and a larger screening effect
range of 5 – 50 mGy/year. Our preceding comments, in patients with higher doses. At that time, mild and
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although not cited, might have been taken into account by borderline conditions would be recorded more frequently.
the authors. Moreover, the recent review by Koterov et al. On the contrary, strokes are usually diagnosed based on
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was influenced by our comments cited by Koterov and distinct morphological and/or clinical criteria, with false
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commented. However, trying to shift responsibility for positivity being less probable. Moreover, “The estimates of
biased information onto foreign experts can be illustrated the CeVD incidence risk significantly decreased with the
by the following quote from the English abstract: “In most increasing duration of employment for the entire cohort
sources, 2005 – 2021 (publications by M.P. Little with (p < 0.001).” “In addition, a significant decrease in CeVD
co-workers, and others) reveals an ideological bias toward diseases incidence risk with increasing attained age was
the effects of low doses of radiation… In selected M.P. Little observed in both males and females.” The incidence
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and co-authors sources for reviews and meta-analyses of CeVD increases with age; therefore, the above quotes
observed both absurd ERR values per 1 Gy and incorrect are compatible with a protective effect of radiation, that
recalculations of the risk estimated in the originals at is, hormesis. Azizova et al. did not mention radiation
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0.1 Gy.” Relevant papers co-authored by Professor Little 43,44 hormesis nor other above-cited papers. In our opinion, the
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used the data provided by coworkers from the former SU. authors should have discussed harmful CeVD (strokes)
In this connection, the author agreed that “Russian national and concluded the lack of increase in strokes following
mortality data are likely to be particularly unreliable, with the low-dose, low-rate exposures. In fact, this is common
major variations in disease coding practices across the knowledge. By including relatively harmless and less
country [references], and should therefore probably not reliably diagnosed conditions, they were able to conclude
be used for epidemiologic analysis, in particular for the that low-dose radiation increases the frequency of CeVD.
Russian worker studies considered here [references].” The greater CeVD risk at higher doses in women than
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Koterov used mistranslations of quotes with a change of in men agrees with the known tendency that women
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meaning in his Russian-language writings, as commented in Russia care more than men about their health and are
previously. 42 generally given more attention by medical personnel.
The recent review noted the “diagnosis (by a physician Hence, in the world’s highest sex gaps in life expectancy,
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knowing the patient’s history) could vary with dose” and countries of the former SU lead the list. Accordingly, the
the “inter-study variation in unmeasured confounders or diagnostics in women must be, on average, more efficient

Volume 4 Issue 1 (2025) 59 doi: 10.36922/gtm.7229