Abstract
BACKGROUND: Radiation exposure may increase the risk of metabolic syndrome (MetS). However, evidence regarding low-dose exposure remains scarce. This study investigated the link between occupational radiation exposure and MetS incidence among Korean radiation workers. METHODS: We analyzed a national cohort of 129,802 Korean radiation workers enrolled in the National Dose Registry between 1984 and 2017, with follow-up based on a linked National Health Information Database. MetS was defined according to the criteria of the American Heart Association, as adapted by the Korean Society for the Study of Obesity. Standardized incidence ratios were calculated to compare the incidence of MetS between radiation workers and the general population. Poisson regression models were used to estimate relative risks and excess relative risks by radiation dose, after adjusting for sociodemographic and lifestyle factors. RESULTS: Of the 129,802 workers, 40,369 (31.1%) developed MetS. The standardized incidence ratio was 0.85 [95% confidence interval: 0.84, 0.86], indicating a lower incidence than that in the general population; however, non-destructive testing workers with poor lifestyle factors had a relatively higher risk of MetS than those in other occupations. Across the cohort, an increased risk of MetS associated with radiation doses was not observed with adjustment for sociodemographic and lifestyle factors, while it varied depending on sex, lag periods, and duration of employment. CONCLUSIONS: Overall, low MetS risk was observed among radiation workers. However, outdoor field workers frequently exposed to elevated levels of radiation should minimize high-risk behaviors-such as smoking and alcohol consumption, known risk factors for MetS or other occupational diseases. Further study is needed to investigate a more sophisticated dose-response association with the incidence of Mets through long-term follow-up, considering relevant organ dose and a latent period as well as pre-existing components of MetS before radiation exposure.