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Original research
Occupational radiation exposure and morbidity of circulatory disease among diagnostic medical radiation workers in South Korea
  1. Eun Shil Cha1,
  2. Lydia B Zablotska2,
  3. Ye Jin Bang1,
  4. Won Jin Lee1
  1. 1 Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
  2. 2 Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, California, USA
  1. Correspondence to Dr Won Jin Lee, Department of Preventive Medicine, Korea University College of Medicine, Seongbuk-gu, Seoul 02841, South Korea; leewj{at}


Objectives We investigated the association between low-dose external occupational radiation exposure and circulatory disease morbidity among diagnostic medical radiation workers.

Methods A cohort of 11 500 diagnostic medical radiation workers was linked with the National Dosimetry Registry data and the National Health Insurance Service data. Relative risks (RRs) were calculated to explore the association between occupational factors and circulatory disease morbidity, and excess relative risks per 100 milligray (ERR/100 mGy) were estimated to quantify the radiation dose-response relationship.

Results Overall, there were 2270 cases of circulatory diseases during 93 696 person-years of observation (average follow-up=8.1 years). RRs for hypertension were significantly increased for individuals who started working before 2000 compared with those who started in 2005 and later. ERR/100 mGy for all circulatory diseases was 0.14 (95% CI −0.57 to 0.99). Radiation risks of cerebrovascular diseases and ischaemic heart disease were non-significantly increased with estimates of individual cumulative doses to the heart (ERR/100 mGy=3.10 (−0.75 to 11.59) and 1.22 (−0.71 to 4.73), respectively). However, ERR estimates were generally more strongly positive for female versus male workers and for younger workers versus more than 50-year-old workers.

Conclusions This study provides little evidence in support of a positive association between occupational radiation exposure and the overall risk of circulatory disease over a short follow-up period among medical radiation workers in South Korea. However, significantly increased RR with earlier year first worked, elevated ERR in female workers and young workers should be further followed up.

  • radiation
  • epidemiology

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  • Contributors WJL and ESC conceptualised the research. ESC performed the data analyses and wrote the first draft of the manuscript. LBZ, YJB and WJL provided advice on analysis of data and critically revised the manuscript. All authors contributed to the draft revision and approved the final manuscript.

  • Funding This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2020R1A2C1008891).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.