The Effect of Protracted Exposure to Radiation on Liver Injury: A Cohort Study of Industrial Radiographers in Xinjiang, China

Background: At present, a large number of studies indicate that high dose ionizing radiation exposure is an important risk factor for liver damage. Whether protracted exposure to low external doses of ionizing radiation could induce liver injury is unclear. The aim of this study was to assess the risk of liver injury following protracted exposure to occupational radiation compared to a group of unexposed workers. Methods: A three-year cohort study was initiated in Xinjiang, China in 2010 and included 508 industrial radiographers and 2156 unexposed workers. The incidence of liver injury was assessed clinically based on the evaluation of alanine aminotransferase (ALT) and aspartate transaminase (AST) levels. Logistic regression was used to examine whether radiation is a risk factor for liver injury. Results: Compared with the unexposed group, protracted radiation exposure was found to be a risk factor for liver injury. Sex, age at baseline and alcohol consumption were not associated with liver injury. However, hypertension was a risk factor for liver injury. The association between cumulative recorded radiation dose and liver injury was not found in this study. Conclusions: These findings indicate that protracted exposure to radiation is a risk factor for liver injury.