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Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study.
Richardson, David B; Leuraud, Klervi; Laurier, Dominique; Gillies, Michael; Haylock, Richard; Kelly-Reif, Kaitlin; Bertke, Stephen; Daniels, Robert D; Thierry-Chef, Isabelle; Moissonnier, Monika; Kesminiene, Ausrele; Schubauer-Berigan, Mary K.
Afiliação
  • Richardson DB; Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA david.richardson@uci.edu.
  • Leuraud K; Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France.
  • Laurier D; Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France.
  • Gillies M; UK Health Security Agency, Chilton, Didcot, Oxfordshire, UK.
  • Haylock R; UK Health Security Agency, Chilton, Didcot, Oxfordshire, UK.
  • Kelly-Reif K; National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
  • Bertke S; National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
  • Daniels RD; National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
  • Thierry-Chef I; Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.
  • Moissonnier M; International Agency for Research on Cancer. Lyon, France.
  • Kesminiene A; International Agency for Research on Cancer. Lyon, France.
  • Schubauer-Berigan MK; International Agency for Research on Cancer. Lyon, France.
BMJ ; 382: e074520, 2023 08 16.
Article em En | MEDLINE | ID: mdl-37586731
OBJECTIVE: To evaluate the effect of protracted low dose, low dose rate exposure to ionising radiation on the risk of cancer. DESIGN: Multinational cohort study. SETTING: Cohorts of workers in the nuclear industry in France, the UK, and the US included in a major update to the International Nuclear Workers Study (INWORKS). PARTICIPANTS: 309 932 workers with individual monitoring data for external exposure to ionising radiation and a total follow-up of 10.7 million person years. MAIN OUTCOME MEASURES: Estimates of excess relative rate per gray (Gy) of radiation dose for mortality from cancer. RESULTS: The study included 103 553 deaths, of which 28 089 were due to solid cancers. The estimated rate of mortality due to solid cancer increased with cumulative dose by 52% (90% confidence interval 27% to 77%) per Gy, lagged by 10 years. Restricting the analysis to the low cumulative dose range (0-100 mGy) approximately doubled the estimate of association (and increased the width of its confidence interval), as did restricting the analysis to workers hired in the more recent years of operations when estimates of occupational external penetrating radiation dose were recorded more accurately. Exclusion of deaths from lung cancer and pleural cancer had a modest effect on the estimated magnitude of association, providing indirect evidence that the association was not substantially confounded by smoking or occupational exposure to asbestos. CONCLUSIONS: This major update to INWORKS provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality based on some of the world's most informative cohorts of radiation workers. The summary estimate of excess relative rate solid cancer mortality per Gy is larger than estimates currently informing radiation protection, and some evidence suggests a steeper slope for the dose-response association in the low dose range than over the full dose range. These results can help to strengthen radiation protection, especially for low dose exposures that are of primary interest in contemporary medical, occupational, and environmental settings.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 12_ODS3_hazardous_contamination Base de dados: MEDLINE Assunto principal: Exposição Ocupacional / Exposição à Radiação / Neoplasias Induzidas por Radiação / Doenças Profissionais Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte / Europa Idioma: En Revista: BMJ Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 12_ODS3_hazardous_contamination Base de dados: MEDLINE Assunto principal: Exposição Ocupacional / Exposição à Radiação / Neoplasias Induzidas por Radiação / Doenças Profissionais Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte / Europa Idioma: En Revista: BMJ Ano de publicação: 2023 Tipo de documento: Article