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Radio-biologically Motivated Modeling of Radiation Risks of Mortality From Ischemic Heart Diseases in the Canadian Fluoroscopy Cohort Study

Schöllnberger, Helmut; Kaiser, Jan Christian; Eidemüller, Markus; Zablotska, Lydia B

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<oai_dc:dc xmlns:dc="" xmlns:oai_dc="" xmlns:xsi="" xsi:schemaLocation="">
  <dc:creator>Schöllnberger, Helmut</dc:creator>
  <dc:creator>Kaiser, Jan Christian</dc:creator>
  <dc:creator>Eidemüller, Markus</dc:creator>
  <dc:creator>Zablotska,  Lydia B</dc:creator>
  <dc:description>Recent analyses of the Canadian fluoroscopy cohort study reported significantly increased radiation risks of mortality from ischemic heart diseases (IHD) with a linear dose-response adjusted for dose fractionation. This cohort includes 63,707 tuberculosis patients from Canada who were exposed to low-to-moderate dose fractionated X-rays in 1930s-1950s and were followed-up for death from non-cancer causes during 1950-1987. In the current analysis, we scrutinized the assumption of linearity by analyzing a series of radio-biologically motivated nonlinear dose-response models to get a better understanding of the impact of radiation damage on IHD. The models were weighted according to their quality of fit and were then mathematically superposed applying the multi-model inference (MMI) technique. Our results indicated an essentially linear dose-response relationship for IHD mortality at low and medium doses and a supra-linear relationship at higher doses (&gt; 1.5 Gy). At 5 Gy, the estimated radiation risks were fivefold higher compared to the linear no-threshold (LNT) model. This is the largest study of patients exposed to fractionated low-to-moderate doses of radiation. Our analyses confirm previously reported significantly increased radiation risks of IHD from doses similar to those from diagnostic radiation procedures.</dc:description>
  <dc:description>This work was supported by a project from the Federal Office for Radiation Protection (BfS) (contract no. 3615S42221). The project has also received funding from the Euratom research and training program 2014-2018 under grant agreement No 755523 (MEDIRAD). Dr. Zablotska's work was supported by the National Cancer Institute of the National Institutes of Health (award numbers R03CA188614 and R01CA197422).

This is a post-peer-review, pre-copyedit version of an article published in Radiation and Environmental Biophysics. The final authenticated version is available online at:</dc:description>
  <dc:source>Radiation and Environmental Biophysics 59 63–78</dc:source>
  <dc:subject>Ionizing radiation</dc:subject>
  <dc:subject>Ischemic heart disease</dc:subject>
  <dc:subject>LNT model</dc:subject>
  <dc:subject>Multi-model inference</dc:subject>
  <dc:subject>Nonlinear dose-response</dc:subject>
  <dc:title>Radio-biologically Motivated Modeling of Radiation Risks of Mortality From Ischemic Heart Diseases in the Canadian Fluoroscopy Cohort Study</dc:title>
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