Worgul, B. V., Kundiyev, Y. I., Sergiyenko, N. M., Chumak, V. V., Vitte, P. M., Medvedovsky, C., Bakhanova, E. V., Junk, A. K., Kyrychenko, O. Y., Musijachenko, N. V., Shylo, S. A., Vitte, O. P., Xu, S., Xue, X. and Shore, R. E. Cataracts among Chernobyl Clean-up Workers: Implications Regarding Permissible Eye Exposures. Radiat. Res. 167, 233–243 (2007).
The eyes of a prospective cohort of 8,607 Chernobyl clean-up workers (liquidators) were assessed for cataract at 12 and 14 years after exposure. The prevalence of strictly age-related cataracts was low, as expected (only 3.9% had nuclear cataracts at either examination), since 90% of the cohort was younger than 55 years of age at first examination. However, posterior subcapsular or cortical cataracts characteristic of radiation exposure were present in 25% of the subjects. The data for Stage 1 cataracts, and specifically for posterior subcapsular cataracts, revealed a significant dose response. When various cataract end points were analyzed for dose thresholds, the confidence intervals all excluded values greater than 700 mGy. Linear-quadratic dose–response models yielded mostly linear associations, with weak evidence of upward curvature. The findings do not support the ICRP 60 risk guideline assumption of a 5-Gy threshold for “detectable opacities” from protracted exposures but rather point to a dose–effect threshold of under 1 Gy. Thus, given that cataract is the dose-limiting ocular pathology in current eye risk guidelines, revision of the allowable exposure of the human visual system to ionizing radiation should be considered.