sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20220402sibmed-836Research ArticleДИСКУССИИDISCUSSIONПереоценка медицинских последствий воздействия малых доз ионизирующего излученияOverestimation of medical consequences of low-dose exposures to ionizing radiationhttps://orcid.org/0000-0003-4731-1853ЯргинС. В.JarginS. V.

Сергей Вадимович Яргин, к.м.н.

117198, г. Москва, ул. Миклухо-Маклая, 6

Sergei V. Jargin, candidate of medical sciences

117198, Moscow, Miklukho-Maklay str., 6

sjargin@mail.ruРоссийский университет дружбы народовРоссияPeoples’ Friendship University of RussiaRussian Federation2022270820224241532Copyright © Яргин С.В., 20222022Яргин С.В.Jargin S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/836

Преувеличение медицинских последствий ионизирующего облучения в малых дозах препятствует развитию атомной энергетики. В этом обзоре преувеличение обсуждается на примерах аварии на Чернобыльской АЭС, Восточно-Уральского радиоактивного следа и Семипалатинского ядерного полигона. Результаты исследований злокачественных новообразований, связанных с Чернобылем, требуют переоценки с учетом того, что некоторые случаи, классифицированные как агрессивные радиогенные раки, на самом деле представляли собой опухоли на поздних стадиях. Ассоциации различных маркеров с опухолевой прогрессией могут стать темой дальнейших исследований и новой интерпретации данных, ранее полученных в исследованиях со сравнением злокачественных новообразований из различных регионов. Найденные зависимости между малыми дозами облучения и частотой неопухолевых заболеваний ставят под сомнение причинно-следственный характер таких ассоциаций для рака. Причинами корреляций могли стать нерадиационные факторы, в особенности, дозозависимый отбор и самоотбор. Лица с высокими оценочными значениями доз в среднем более мотивированы для прохождения медицинских осмотров, где им уделяется больше внимания. Таким образом, эффективность диагностики иногда зависит от дозы. Перспективным подходом к исследованию зависимостей «доза–эффект» могут стать эксперименты на животных с оценкой средней продолжительности жизни.

Overestimation of medical consequences of low-dose exposures to ionizing radiation contributes to the strangulation of nuclear energy production. Several examples of the overestimation are discussed here: the Chernobyl accident, East Urals Radioactive Trace and Semipalatinsk Nuclear Test Site. Results of certain studies of Chernobyl-related malignancies should be reassessed taking into account that some cases, classified as aggressive radiogenic cancers, were in fact late-stage malignancies. Associations of various markers with the tumor progression can become a field for future research and re-interpretation of data obtained in studies comparing malignancies from different regions. Reported correlations between low-dose exposures and non-malignant diseases call in question the cause-effect character of such correlations for cancer reported by the same and other researchers. The correlations may have been caused or influenced by bias, in particular, the dose-dependent selection and self-selection: individuals with higher dose estimates would be on average more motivated to undergo medical checkups and given more attention. Therefore, diagnostics tend to be more efficient in people with higher doses. Lifelong animal experiments are a promising approach to the research of dose-response relationships.

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The authors declare that there are no conflicts of interest present.