Association between occupational ionizing radiation exposure duration and the increased risk of dyslipidemia: Evidence from a large group of radiation workers

Meimei Zhong^1,2Xiaowen Wang³Qifeng Li²Zhijia Wu^2,4Xiangyuan Huang^1,2Xinyue Li^2,5Yiqing Lian²Yingyi Peng²Zhiqiang Li^2,5Zhifang Liu²Qia Wang²Yajun Gong^2,4Peixia Hu^1,2Xiaoyong Liu²Shuming Zhu⁵Shaomin Wu⁵Fangfang Zeng⁵Yiru Qin²Qiying Nong²Jinhan Wang⁶Yeqing Gu⁶Yongshun Huang²Wangjian Zhang^5*Na Zhao^2*

• ¹Shanxi Medical University School of Public Health, Taiyuan, China
• ²Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
• ³Peking University School of Public Health, Beijing, China
• ⁴Southern Medical University School of Public Health, Guangzhou, China
• ⁵Sun Yat-Sen University School of Public Health, Guangzhou, China
• ⁶Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Radiation Medicine, Tianjin, China

Although radiation workers' exposure levels consistently remained below established safety thresholds, accumulating evidence demonstrates that chronic low-dose ionizing radiation exposure may still pose significant health risks to humans. We aimed to explore the relationship between the years of low-dose radiation work and dyslipidemia. We collected occupational and physical examination data of 10338 radiation workers from 1200 workplaces during 2019-2020 in Guangdong Province, China. After controlling for social demographic and health behavior confounders, we used a mixed-effects model to assess the association of ionizing radiation exposure duration with blood lipid biomarkers as well as the prevalence of dyslipidemia. We further comprehensively evaluated the modifying effects of various demographic characteristics, health behavior factors, and air pollutant concentrations. We found that participants with prolonged ionizing radiation exposure tended to have 8%-40% higher levels of total cholesterol (TC) compared to those with < 10 years of exposure. The estimates were 9%-23% for triglycerides (TG) and 5%-26% for low-density lipoprotein cholesterol (LDL-C). Similar disparities were observed for the prevalence of overall dyslipidemia, abnormal TC or TG, hypercholesterolemia, hypertriglyceridemia, and high β-lipoproteinemia, with odds being 1.51-2.45 times higher in the group with > 30 years of ionizing radiation exposure compared to others. Our estimates further indicated greater effect estimates for prolonged ionizing radiation exposure and the prevalence of lipid abnormalities (P < 0.05) among the females, unmarried ones, and the workers with normal BMI. These findings suggest a deleterious effect of prolonged ionizing radiation exposure on lipid metabolism, with certain groups of workers being particularly vulnerable.