The Mortality Risk from Main Pathologies Due to Passive Smoking is not Achieved by the Overwhelming Majority of Nuclear Workers in All Periods of Employment
Authors:   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Koterov A.N. , Ushenkova L.N. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Wainson A.A. ,   N.N. Blokhin Russian Cancer Research Center, Moscow, Dibirgadzhiev I.G. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Kalinina M.V. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Bushmanov A.Yu. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia
Published: June 2024

To date, there are about 100 meta-analyses for lung cancer and circulatory (cardiovascular) diseases (CVD) as the effects of second hand smoking (SHS). The obtained risk values (Relative Risk – RR, odds ratio – OR, etc.) are in the range of 1.2–1.3, but there are no definitively accepted estimates yet, and many estimates were not made in recent years. Both SHS and work at nuclear industry enterprises have become stereotypes in everyday and scientific everyday consciousness, meaning something harmful in everyday and professional terms. The present study compared the mortality risks from all cancers, lung cancer, and CVD for SHS and nuclear workers (NW). At the first stage, an umbrella review (review of reviews; overview) and meta-analyses of meta-analyses (meta-meta-analyses) on the risks of mortality from these pathologies as effects of SHS were performed. Umbrella review and meta-meta-analysis are regarded as the highest level of evidence and, thus, the identified risks can be conditionally considered as ‘standard’. There were insufficient data available for all cancer mortality rates after SHS; Therefore, the results from the meta-analysis by Kim A.S. et al, 2018 were used., and meta-meta-analyses were performed for lung cancer and CVD mortality. The risk values were in the range of 1.22–1.24, which replicates previous findings. At the second stage, the risks identified for SHS were compared with the risks of mortality from the named pathologies for NW. The sample of publications for NW, extracted from the database maintained by the authors, included the most representative cohorts in relation to nuclear installations: with maximum doses, as well as combined cohorts (14–15 countries and INWORK – 3 countries). Based on published ERRs per 1 Gy for a given NW population, the radiation doses that NW would have to accumulate to approach the mortality risks from SHS were calculated. To achieve SHS risks for all three disease types, NWs were found to need to receive radiation doses ranging from 129–183 mSv to 1.07–6.0 Sv. There have been no cases in which the risk from SHS was equivalent to exposure to low-dose radiation (up to 100 mGy); more often, doses were localized in the range of about 300–800 mSv, up to 6 Sv. Analysis of published data on dose distributions for NW has demonstrated that such doses are received either by a relatively small or vanishingly small proportion of NW. Risks for 80–96 % of NWs from various countries, including activities since the 1940s, did not reach the harms of chronic exposure to SHS. It is concluded that the decades-long study of risks for NW, in particular ‘low doses’, does not seem adequate without taking into account the magnitude of even weak, but poorly controlled risks of everyday life, and the data obtained once again improves the image of employment in the field of nuclear energy.