Updated Mortality Analysis of SELTINE, the French Cohort of Nuclear Workers, 1968–2014

SIMPLE SUMMARY: Cohort studies of nuclear workers are key to study the health effects of protracted exposures to low doses of ionizing radiation (IR), which is necessary to verify the adequacy of radiation protection standards. In this cohort of nuclear workers monitored for exposure to IR and followed-up for mortality, a strong healthy worker effect was observed. Exposure to IR was significantly associated with death from leukaemia and dementia. This second finding is novel and should be interpreted with caution at this stage. It should motivate the research community to evaluate its replicability by studying dementia in other cohorts exposed to low-dose IR. Findings for solid cancers were not statistically significant, but estimates were still imprecise and compatible with those from other studies. Continued follow-up of the cohort and its participation in pooled analyses with similar cohorts will help to further improve the statistical precision of risk estimates in the future. ABSTRACT: Cohorts of nuclear workers are particularly relevant to study the health effects of protracted exposures to low doses at low dose-rates of ionizing radiation (IR). In France, a cohort of nuclear workers badge-monitored for external IR exposure has been followed-up for several decades. Its size and follow-up period have recently been extended. The present paper focuses on mortality from both cancer and non-cancer diseases in this cohort. The SELTINE cohort of nuclear workers employed by CEA, Orano, and EDF companies was followed-up for mortality from 1968 to 2014. Mortality in the cohort was compared to that in the French general population. Poisson regression methods were used to estimate excess relative rates of mortality per unit of cumulative dose of IR, adjusted for calendar year, age, company, duration of employment, and socioeconomic status. The cohort included 80,348 workers. At the end of the follow-up, the mean attained age was 63 years, and 15,695 deaths were observed. A strong healthy worker effect was observed overall. A significant excess of pleural cancer mortality was observed but not associated with IR dose. Death from solid cancers was positively but non-significantly associated with radiation. Death from leukaemia (excluding chronic lymphocytic leukaemia), dementia, and Alzheimer’s disease were positively and significantly associated with IR dose. Estimated dose–risk relationships were consistent with those from other nuclear worker studies for all solid cancers and leukaemia but remained associated with large uncertainty. The association between IR dose and dementia mortality risk should be interpreted with caution and requires further investigation by other studies.