Project 1: Cardiovascular disease incidence following low-dose occupational radiation exposure
Project Lead: Richard Haylock (UKHSA)
Project Team: Catherine Hinksman (UKHSA), Rosie Hillier (UKHSA), Marta Blangiardo (Imperial), Amy Berrington (ICR)
The National Registry for Radiation Workers (NRRW) is a long-term (50-year) follow-up study of 270,000 industrial radiation workers employed from the 1950s that provides direct evidence about the health risks of low-dose and low-dose-rate radiation exposure. Originally, it focused on estimating risks of cancer based on mortality and cancer registration data. However, in the last 10 years, it has provided the first good evidence of excess risk of circulatory disease mortality, in particular cardiovascular disease (CVD), at low exposure levels.
As for cancers, improving treatments for CVD over the past several decades have meant that the survival time for serious cardiovascular diseases has increased markedly to the extent that many people may die of other causes. As a result, analysis of just CVD mortality data misses the growing number of non-fatal cases. However, unlike for cancers, the UK has no equivalent registration scheme for CVD, which could be used to address this issue.
However, for many CVDs, such as a heart attack, a person is likely to attend hospital for treatment (either inpatient or outpatient) and as a result, hospital episode statistics (HES) data are generated. which can provide information about the illness and the treatment which could be used in place of formal registration data in statistical analyses. It may also provide information about smoking an important factor in estimating a person’s baseline rate of CVD.
This project aims to collect HES data for the NRRW retrospectively from the 1990’s to the present day and prospectively into the future. These data will be used to identify instances of CVD which will be analysed to provide the first estimates of CVD incidence risk in the NRRW cohort.
Year 1 aims:
- Obtain the information governance approvals to enable the collection of HES data.
- Once (1) has been achieved, begin the application process to seek HES data for England and Wales from NHS England (or whatever body takes over from it when it is abolished) and separately to undertake the same process in Scotland.
Year 2 aims:
- Revise the NRRW database structure and systems to enable the processing of HES data.
- Receive and process HES data into the NRRW database system.
