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Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)

Study question Is protracted exposure to low doses of ionising radiation associated with an increased risk of solid cancer? Methods In this cohort study, 308 297 workers in the nuclear industry from France, the United Kingdom, and the United States with detailed monitoring data for external exposure...

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Autores principales: Richardson, David B, Cardis, Elisabeth, Daniels, Robert D, Gillies, Michael, O’Hagan, Jacqueline A, Hamra, Ghassan B, Haylock, Richard, Laurier, Dominique, Leuraud, Klervi, Moissonnier, Monika, Schubauer-Berigan, Mary K, Thierry-Chef, Isabelle, Kesminiene, Ausrele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4612459/
https://www.ncbi.nlm.nih.gov/pubmed/26487649
http://dx.doi.org/10.1136/bmj.h5359
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author Richardson, David B
Cardis, Elisabeth
Daniels, Robert D
Gillies, Michael
O’Hagan, Jacqueline A
Hamra, Ghassan B
Haylock, Richard
Laurier, Dominique
Leuraud, Klervi
Moissonnier, Monika
Schubauer-Berigan, Mary K
Thierry-Chef, Isabelle
Kesminiene, Ausrele
author_facet Richardson, David B
Cardis, Elisabeth
Daniels, Robert D
Gillies, Michael
O’Hagan, Jacqueline A
Hamra, Ghassan B
Haylock, Richard
Laurier, Dominique
Leuraud, Klervi
Moissonnier, Monika
Schubauer-Berigan, Mary K
Thierry-Chef, Isabelle
Kesminiene, Ausrele
author_sort Richardson, David B
collection PubMed
description Study question Is protracted exposure to low doses of ionising radiation associated with an increased risk of solid cancer? Methods In this cohort study, 308 297 workers in the nuclear industry from France, the United Kingdom, and the United States with detailed monitoring data for external exposure to ionising radiation were linked to death registries. Excess relative rate per Gy of radiation dose for mortality from cancer was estimated. Follow-up encompassed 8.2 million person years. Of 66 632 known deaths by the end of follow-up, 17 957 were due to solid cancers. Study answer and limitations Results suggest a linear increase in the rate of cancer with increasing radiation exposure. The average cumulative colon dose estimated among exposed workers was 20.9 mGy (median 4.1 mGy). The estimated rate of mortality from all cancers excluding leukaemia increased with cumulative dose by 48% per Gy (90% confidence interval 20% to 79%), lagged by 10 years. Similar associations were seen for mortality from all solid cancers (47% (18% to 79%)), and within each country. The estimated association over the dose range of 0-100 mGy was similar in magnitude to that obtained over the entire dose range but less precise. Smoking and occupational asbestos exposure are potential confounders; however, exclusion of deaths from lung cancer and pleural cancer did not affect the estimated association. Despite substantial efforts to characterise the performance of the radiation dosimeters used, the possibility of measurement error remains. What this study adds The study provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality. Although high dose rate exposures are thought to be more dangerous than low dose rate exposures, the risk per unit of radiation dose for cancer among radiation workers was similar to estimates derived from studies of Japanese atomic bomb survivors. Quantifying the cancer risks associated with protracted radiation exposures can help strengthen the foundation for radiation protection standards. Funding, competing interests, data sharing Support from the US Centers for Disease Control and Prevention; Ministry of Health, Labour and Welfare of Japan; Institut de Radioprotection et de Sûreté Nucléaire; AREVA; Electricité de France; US National Institute for Occupational Safety and Health; US Department of Energy; and Public Health England. Data are maintained and kept at the International Agency for Research on Cancer.
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spelling pubmed-46124592015-10-22 Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS) Richardson, David B Cardis, Elisabeth Daniels, Robert D Gillies, Michael O’Hagan, Jacqueline A Hamra, Ghassan B Haylock, Richard Laurier, Dominique Leuraud, Klervi Moissonnier, Monika Schubauer-Berigan, Mary K Thierry-Chef, Isabelle Kesminiene, Ausrele BMJ Research Study question Is protracted exposure to low doses of ionising radiation associated with an increased risk of solid cancer? Methods In this cohort study, 308 297 workers in the nuclear industry from France, the United Kingdom, and the United States with detailed monitoring data for external exposure to ionising radiation were linked to death registries. Excess relative rate per Gy of radiation dose for mortality from cancer was estimated. Follow-up encompassed 8.2 million person years. Of 66 632 known deaths by the end of follow-up, 17 957 were due to solid cancers. Study answer and limitations Results suggest a linear increase in the rate of cancer with increasing radiation exposure. The average cumulative colon dose estimated among exposed workers was 20.9 mGy (median 4.1 mGy). The estimated rate of mortality from all cancers excluding leukaemia increased with cumulative dose by 48% per Gy (90% confidence interval 20% to 79%), lagged by 10 years. Similar associations were seen for mortality from all solid cancers (47% (18% to 79%)), and within each country. The estimated association over the dose range of 0-100 mGy was similar in magnitude to that obtained over the entire dose range but less precise. Smoking and occupational asbestos exposure are potential confounders; however, exclusion of deaths from lung cancer and pleural cancer did not affect the estimated association. Despite substantial efforts to characterise the performance of the radiation dosimeters used, the possibility of measurement error remains. What this study adds The study provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality. Although high dose rate exposures are thought to be more dangerous than low dose rate exposures, the risk per unit of radiation dose for cancer among radiation workers was similar to estimates derived from studies of Japanese atomic bomb survivors. Quantifying the cancer risks associated with protracted radiation exposures can help strengthen the foundation for radiation protection standards. Funding, competing interests, data sharing Support from the US Centers for Disease Control and Prevention; Ministry of Health, Labour and Welfare of Japan; Institut de Radioprotection et de Sûreté Nucléaire; AREVA; Electricité de France; US National Institute for Occupational Safety and Health; US Department of Energy; and Public Health England. Data are maintained and kept at the International Agency for Research on Cancer. BMJ Publishing Group Ltd. 2015-10-20 /pmc/articles/PMC4612459/ /pubmed/26487649 http://dx.doi.org/10.1136/bmj.h5359 Text en © Richardson et al 2015 http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Research
Richardson, David B
Cardis, Elisabeth
Daniels, Robert D
Gillies, Michael
O’Hagan, Jacqueline A
Hamra, Ghassan B
Haylock, Richard
Laurier, Dominique
Leuraud, Klervi
Moissonnier, Monika
Schubauer-Berigan, Mary K
Thierry-Chef, Isabelle
Kesminiene, Ausrele
Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title_full Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title_fullStr Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title_full_unstemmed Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title_short Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
title_sort risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in france, the united kingdom, and the united states (inworks)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4612459/
https://www.ncbi.nlm.nih.gov/pubmed/26487649
http://dx.doi.org/10.1136/bmj.h5359
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