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Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
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Milder CM, Howard SC, Ellis ED, Deppen SA. Deep Breaths: A Systematic Review of the Potential Effects of Employment in the Nuclear Industry on Mortality from Non-Malignant Respiratory Disease. Radiat Res 2022; 198:396-429. [PMID: 35943867 PMCID: PMC9704034 DOI: 10.1667/rade-21-00014.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/05/2022] [Indexed: 11/03/2022]
Abstract
Ionizing radiation is an established carcinogen, but its effects on non-malignant respiratory disease (NMRD) are less clear. Cohorts exposed to multiple risk factors including radiation and toxic dusts conflate these relationships, and there is a need for clarity in previous findings. This systematic review was conducted to survey the body of existing evidence for radiation effects on NMRD in global nuclear worker cohorts. A PubMed search was conducted for studies with terms relating to radiation or uranium and noncancer respiratory outcomes. Papers were limited to the most recent report within a single cohort published between January 2000 and December 2020. Publication quality was assessed based upon UNSCEAR 2017 criteria. In total, 31 papers were reviewed. Studies included 29 retrospective cohorts, one prospective cohort, and one longitudinal cohort primarily comprising White men from the U.S., Canada and Western Europe. Ten studies contained subpopulations of uranium miners or millers. Papers reported standardized mortality ratio (SMR) analyses, regression analyses, or both. Neither SMR nor regression analyses consistently showed a relationship between radiation exposure and NMRD. A meta-analysis of excess relative risks (ERRs) for NMRD did not present evidence for a dose-response (overall ERR/Sv: 0.07; 95% CI: -0.07, 0.21), and results for more specific outcomes were inconsistent. Significantly elevated SMRs for NMRD overall were observed in two studies among the subpopulation of uranium miners and millers (combined n = 4229; SMR 1.42-1.43), indicating this association may be limited to mining and milling populations and may not extend to other nuclear workers. A quality review showed limited capacity of 17 out of 31 studies conducted to provide evidence for a causal relationship between radiation and NMRD; the higher-quality studies showed no consistent relationship. All elevated NMRD SMRs were among mining and milling cohorts, indicating different exposure profiles between mining and non-mining cohorts; future pooled cohorts should adjust for mining exposures or address mining cohorts separately.
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Affiliation(s)
- Cato M. Milder
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sara C. Howard
- Health Studies Program, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Elizabeth D. Ellis
- Health Studies Program, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Stephen A. Deppen
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Zhang L, Chu J, Xia B, Xiong Z, Zhang S, Tang W. Health Effects of Particulate Uranium Exposure. TOXICS 2022; 10:575. [PMID: 36287855 PMCID: PMC9610560 DOI: 10.3390/toxics10100575] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Uranium contamination has become a nonnegligible global health problem. Inhalation of particulate uranium is one of the predominant routes of occupational and environmental exposure. Uranium particle is a complex two-phase flow of matter that is both particulate and flowable. This particular physicochemical property may alter its biological activity. Epidemiological studies from occupationally exposed populations in the uranium industry have concluded that there is a possible association between lung cancer risk and uranium exposure, while the evidence for the risk of other tumors is not sufficient. The toxicological effects of particulate uranium exposure to animals have been shown in laboratory tests to focus on respiratory and central nervous system damage. Fibrosis and tumors can occur in the lung tissue of the respiratory tract. Uranium particles can also induce a concentration-dependent increase in cytotoxicity, targeting mitochondria. The understanding of the health risks and potential toxicological mechanisms of particulate uranium contamination is still at a preliminary stage. The diversity of particle parameters has limited the in-depth exploration. This review summarizes the current evidence on the toxicology of particulate uranium and highlights the knowledge gaps and research prospects.
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Golden AP, Milder CM, Ellis ED, Anderson JL, Boice JD, Bertke SJ, Zablotska LB. Cohort profile: four early uranium processing facilities in the US and Canada. Int J Radiat Biol 2021; 97:833-847. [PMID: 33970767 PMCID: PMC10201456 DOI: 10.1080/09553002.2021.1917786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Pooling of individual-level data for workers involved in uranium refining and processing (excluding enrichment) may provide valuable insights into risks from occupational uranium and external ionizing radiation exposures. METHODS Data were pooled for workers from four uranium processing facilities (Fernald, Mallinckrodt and Middlesex from the U.S.; and Port Hope, Canada). Employment began as early as the 1930s and follow-up was as late as 2017. Workers were exposed to high concentrations of uranium, radium, and their decay products, as well as gamma radiation and ambient radon decay products. Exposure and outcome data were harmonized using similar definitions and dose reconstruction methods. Standardized mortality ratios (SMR) were estimated. RESULTS In total, 560 deaths from lung cancer, 503 non-malignant respiratory diseases, 67 renal diseases, 1,596 ischemic heart diseases, and 101 dementia and Alzheimer's disease (AD) were detected in the pooled cohort of over 12,400 workers (∼1,300 females). Mean cumulative doses were 45 millisievert for whole-body external ionizing radiation exposure and 172 milligray for lung dose from radon decay products. Only SMR for dementia and AD among males was statistically significant (SMR=1.29; 95% confidence interval: 1.04, 1.54). CONCLUSIONS This is the largest study to date to examine long-term health risks of uranium processing workers.
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Affiliation(s)
- Ashley P. Golden
- Oak Ridge Associated Universities, Health Studies Program, Oak Ridge, Tennessee
| | - Cato M. Milder
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
| | - Elizabeth D. Ellis
- Oak Ridge Associated Universities, Health Studies Program, Oak Ridge, Tennessee
| | - Jeri L. Anderson
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, Ohio
| | - John D. Boice
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
- National Council on Radiation Protection and Measurements (NCRP), Bethesda, Maryland
| | - Stephen J. Bertke
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, Ohio
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, U.S.A
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Karpov AB, Takhauov RM, Zerenkov AG, Semenova YV, Bogdanov IM, Kazantceva SB, Blinov AP, Kalinkin DE, Gorina GV, Litvinova OV, Ermolaev YD, Mironova EB, Plaksin MB, Takhauov AR, Zablotska LB. Descriptive characteristics of occupational exposures and medical follow-up in the cohort of workers of the Siberian Group of Chemical Enterprises in Seversk, Russia. Int J Radiat Biol 2021; 97:848-860. [PMID: 33979238 DOI: 10.1080/09553002.2021.1917787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To date, only a few studies have examined long-term health risks of exposures in the uranium processing industry and reported contradictory results, necessitating further research in this area. This is the first description of a cohort of ∼65,000 uranium processing workers (20.6% women) of the Siberian Group of Chemical Enterprises (SGCE) in Seversk, Russia, first employed during 1950-2010. METHODS SGCE is one of the largest and oldest uranium processing complexes in the world. SGCE workers at the Radiochemical, Plutonium, Sublimate and Enrichment plants were exposed to a combination of internal and external radiation, while workers at the Support Facility were primarily exposed to non-radiation factors. RESULTS Mean cumulative gamma-ray dose based on individual external dosimetry was 28.3 millisievert. About 4,000 workers have individual biophysical survey data that could be used for estimation of organ doses from uranium. SGCE workers were followed up for mortality and cancer incidence during 1950-2013 (vital status known for 80.8% of workers). The SGCE computerized database contains information on the results of regular medical examinations, and on smoking, alcohol and other individual characteristics. CONCLUSIONS The SGCE cohort is uniquely suited to examine long-term health risks of exposures to gamma-radiation and long-lived radionuclides in uranium processing workers.
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Affiliation(s)
- Andrey B Karpov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Ravil M Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Andrey G Zerenkov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yulia V Semenova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Igor M Bogdanov
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Svetlana B Kazantceva
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Aleksey P Blinov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Dmitriy E Kalinkin
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Galina V Gorina
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Olesya V Litvinova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yuriy D Ermolaev
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Elena B Mironova
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Mikhail B Plaksin
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Anas R Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
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Zander A, Paunesku T, Woloschak G. Radiation databases and archives - examples and comparisons. Int J Radiat Biol 2019; 95:1378-1389. [PMID: 30676164 DOI: 10.1080/09553002.2019.1572249] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Studies of ionizing radiation effects through the archiving of data began with standardizing medical treatments in the early 1900s shortly after the discovery of X-rays. Once the breadth of the delayed effects of ionizing radiation was recognized, the need for long-term follow up became apparent. There are now many human archives of data from nuclear disasters and accidents, occupational exposures, and medical procedures. Planned animal irradiation experiments began around the time of the Cold War and included a variety of doses, fractions, dose rates, and types of ionizing radiation. The goal of most of these studies was to supplement information coming from human data through carefully planned experimental conditions and immediate and uninterrupted data collection. This review aims to highlight major archives and databases that have shaped the field of radiation biology and provide a broad range of the types of datasets currently available. By preserving all of these data and tissue sets, radiation biologists can combine databases and conduct large-scale analyses of detailed existing data and perform new assays with cutting edge scientific approaches.
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Affiliation(s)
- Alia Zander
- Feinberg School of Medicine, Radiation Oncology, Northwestern University , Chicago , IL , USA
| | - Tatjana Paunesku
- Feinberg School of Medicine, Radiation Oncology, Northwestern University , Chicago , IL , USA
| | - Gayle Woloschak
- Feinberg School of Medicine, Radiation Oncology, Northwestern University , Chicago , IL , USA
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Golden AP, Ellis ED, Cohen SS, Mumma MT, Leggett RW, Wallace PW, Girardi D, Watkins JP, Shore RE, Boice JD. Updated mortality analysis of the Mallinckrodt uranium processing workers, 1942–2012. Int J Radiat Biol 2019; 98:701-721. [DOI: 10.1080/09553002.2019.1569773] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | | | | | | | | | | | - David Girardi
- Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | | | - Roy E. Shore
- Epidemiology Division, New York University School of Medicine, NewYork, NY, USA
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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Golden AP, Cohen SS, Chen H, Ellis ED, Boice JD. Evaluation of statistical modeling approaches for epidemiologic studies of low-dose radiation health effects. Int J Radiat Biol 2019; 98:572-579. [DOI: 10.1080/09553002.2018.1554924] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
| | | | - Heidi Chen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | | | - John D. Boice
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA
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Qu SG, Gao J, Tang B, Yu B, Shen YP, Tu Y. Low-dose ionizing radiation increases the mortality risk of solid cancers in nuclear industry workers: A meta-analysis. Mol Clin Oncol 2018; 8:703-711. [PMID: 29725540 DOI: 10.3892/mco.2018.1590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/28/2018] [Indexed: 11/05/2022] Open
Abstract
Low-dose ionizing radiation (LDIR) may increase the mortality of solid cancers in nuclear industry workers, but only few individual cohort studies exist, and the available reports have low statistical power. The aim of the present study was to focus on solid cancer mortality risk from LDIR in the nuclear industry using standard mortality ratios (SMRs) and 95% confidence intervals. A systematic literature search through the PubMed and Embase databases identified 27 studies relevant to this meta-analysis. There was statistical significance for total, solid and lung cancers, with meta-SMR values of 0.88, 0.80, and 0.89, respectively. There was evidence of stochastic effects by IR, but more definitive conclusions require additional analyses using standardized protocols to determine whether LDIR increases the risk of solid cancer-related mortality.
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Affiliation(s)
- Shu-Gen Qu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Jin Gao
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Bo Tang
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Bo Yu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Yue-Ping Shen
- Department of Health Statistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Yu Tu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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Zablotska LB, Fenske N, Schnelzer M, Zhivin S, Laurier D, Kreuzer M. Analysis of mortality in a pooled cohort of Canadian and German uranium processing workers with no mining experience. Int Arch Occup Environ Health 2018; 91:91-103. [PMID: 28940040 PMCID: PMC5752750 DOI: 10.1007/s00420-017-1260-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/11/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE Long-term health risks of occupational exposures to uranium processing were examined to better understand potential differences with uranium underground miners and nuclear reactor workers. METHODS A cohort study of mortality of workers from Port Hope, Canada (1950-1999) and Wismut, Germany (1946-2008) employed in uranium milling, refining, and processing was conducted. Poisson regression was used to evaluate the association between cumulative exposures to radon decay products (RDP) and gamma-rays and causes of death potentially related to uranium processing. RESULTS The pooled cohort included 7431 workers (270,201 person-years of follow-up). Mean RDP exposures were lower than in miners while gamma-ray doses were higher than in reactor workers. Both exposures were highly correlated (weighted rho = 0.81). Radiation risks of lung cancer and cardiovascular diseases (CVD) in males were increased but not statistically significant and compatible with risks estimated for miners and reactor workers, respectively. Higher RDP-associated CVD risks were observed for exposures 5-14 years prior to diagnosis compared to later exposures and among those employed <5 years. Radiation risks of solid cancers excluding lung cancer were increased, but not statistically significant, both for males and females, while all other causes of death were not associated with exposures. CONCLUSIONS In the largest study of uranium processing workers to systematically examine radiation risks of multiple outcomes from RDP exposures and gamma-rays, estimated radiation risks were compatible with risks reported for uranium miners and nuclear reactor workers. Continued follow-up and pooling with other cohorts of uranium processing workers are necessary for future comparisons with other workers of the nuclear fuel cycle.
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Affiliation(s)
- Lydia B Zablotska
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
| | - Nora Fenske
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
| | - Maria Schnelzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
| | - Sergey Zhivin
- French National Institute of Health and Medical Research, INSERM, Paris, France
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, IRSN, Fontenay-Aux-Roses, France
| | - Michaela Kreuzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
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Havránková R, Freitinger Skalická Z, Havránek J, Novotná D, Zölzer F. Effective Doses of Employees at the Former Uranium Processing Plant MAPE Mydlovary, Czechoslovakia. RADIATION PROTECTION DOSIMETRY 2017; 175:171-177. [PMID: 27765893 DOI: 10.1093/rpd/ncw282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/10/2016] [Indexed: 06/06/2023]
Abstract
Results are presented of a survey of almost 1000 dosimetric records of employees at the former uranium processing plant MAPE Mydlovary. Located ~20 km to the north-west of České Budějovice in South Bohemia, it was the place where most of the uranium ore mined in Czechoslovakia in the years from 1962 to 1991 was processed. The records refer to incorporation of short-lived radon progeny and long-lived radionuclides as well as external gamma exposure. The average annual doses calculated from the recorded data were 2.7 ± 1.4, 5.0 ± 3.1 and 1.7 ± 0.9 mSv from these three sources, respectively. Thus, the relative contributions of these components to the effective dose were 29 ± 6, 53 ± 14 and 18 ± 13% , respectively. This is different from the findings in an earlier study for the exposure of uranium miners, where the overall doses were similar, but over 50% was contributed by short-lived radon progeny. No legal limits applicable at the time were exceeded, as the inclusion of long-lived radionuclides in the dose calculations was not yet obligatory.
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Affiliation(s)
- Renata Havránková
- Institute of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia in Ceské Budejovice, Božena Nemcová 54, 37001 Ceské Budejovice, Czech Republic
| | - Zuzana Freitinger Skalická
- Institute of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia in Ceské Budejovice, Božena Nemcová 54, 37001 Ceské Budejovice, Czech Republic
| | - Jirí Havránek
- Institute of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia in Ceské Budejovice, Božena Nemcová 54, 37001 Ceské Budejovice, Czech Republic
| | - Dana Novotná
- Institute of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia in Ceské Budejovice, Božena Nemcová 54, 37001 Ceské Budejovice, Czech Republic
| | - Friedo Zölzer
- Institute of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia in Ceské Budejovice, Božena Nemcová 54, 37001 Ceské Budejovice, Czech Republic
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Stammler L, Uhl A, Mayer B, Keller F. Renal Effects and Carcinogenicity of Occupational Exposure to Uranium: A Meta-Analysis. NEPHRON EXTRA 2016; 6:1-11. [PMID: 27275162 PMCID: PMC4886082 DOI: 10.1159/000442827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE Uranium is a heavy metal with alpha radioactivity. We state the hypothesis that uranium exposure is harmful to human kidneys and carcinogenic to body tissues. Therefore, we review epidemiological studies from people with known long-lasting uranium exposure. MATERIALS AND METHODS Three meta-analyses are performed using clinical studies published in the PubMed database and applying RevMan 5.3 from the Cochrane Collaboration to calculate the outcome. The first two meta-analyses examine the standardized mortality ratio (SMR) and the standardized incidence ratio for any cancers of uranium workers who were operating in areas ranging from uranium processing to the assembly of final uranium products. The third meta-analysis evaluates the nephrotoxic risk in uranium workers as well as soldiers and of individuals with exposure to drinking water containing uranium. RESULTS Overall and contrasting to our hypothesis, the tumor risk is significantly lower for uranium workers than for control groups (SMR = 0.90 with a 95% confidence interval of 0.84 to 0.96). In addition and also contrasting to our hypothesis, the risk of nephrotoxicity is not increased either. This holds for both the incidence and the mortality due to renal cell carcinoma or due to acute kidney injury or chronic kidney disease. In contrast, a significantly better creatinine clearance is found for the uranium cohort as compared to the control groups (mean difference = 7.66 with a 95% confidence interval of 0.12 to 15.2). CONCLUSION Our hypothesis that a chronic uranium exposure is associated with an increased risk of cancer mortality or of kidney failure is refuted by clinical data. The decreased risk may result from better medical surveillance of uranium workers.
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Affiliation(s)
- Leonhard Stammler
- Nephrology, Department of Internal Medicine 1, Ulm University, Ulm, Germany
| | | | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Frieder Keller
- Nephrology, Department of Internal Medicine 1, Ulm University, Ulm, Germany
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Peterson LE, Kovyrshina T. Adjustment of lifetime risks of space radiation-induced cancer by the healthy worker effect and cancer misclassification. Heliyon 2015; 1:e00048. [PMID: 27441231 PMCID: PMC4945756 DOI: 10.1016/j.heliyon.2015.e00048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/13/2015] [Accepted: 11/10/2015] [Indexed: 01/12/2023] Open
Abstract
Background. The healthy worker effect (HWE) is a source of bias in occupational studies of mortality among workers caused by use of comparative disease rates based on public data, which include mortality of unhealthy members of the public who are screened out of the workplace. For the US astronaut corp, the HWE is assumed to be strong due to the rigorous medical selection and surveillance. This investigation focused on the effect of correcting for HWE on projected lifetime risk estimates for radiation-induced cancer mortality and incidence. Methods. We performed radiation-induced cancer risk assessment using Poisson regression of cancer mortality and incidence rates among Hiroshima and Nagasaki atomic bomb survivors. Regression coefficients were used for generating risk coefficients for the excess absolute, transfer, and excess relative models. Excess lifetime risks (ELR) for radiation exposure and baseline lifetime risks (BLR) were adjusted for the HWE using standardized mortality ratios (SMR) for aviators and nuclear workers who were occupationally exposed to ionizing radiation. We also adjusted lifetime risks by cancer mortality misclassification among atomic bomb survivors. Results. For all cancers combined (“Nonleukemia”), the effect of adjusting the all-cause hazard rate by the simulated quantiles of the all-cause SMR resulted in a mean difference (not percent difference) in ELR of 0.65% and mean difference of 4% for mortality BLR, and mean change of 6.2% in BLR for incidence. The effect of adjusting the excess (radiation-induced) cancer rate or baseline cancer hazard rate by simulated quantiles of cancer-specific SMRs resulted in a mean difference of −1.2% in the all-cancer mortality ELR and mean difference of −6.4% in the mortality BLR. Whereas for incidence, the effect of adjusting by cancer-specific SMRs resulted in a mean change of −14.4% for the all-cancer BLR. Only cancer mortality risks were adjusted by simulated quantiles for misclassification, and results indicate a mean change of 1.1% for all-cancer mortality ELR, while the mean change in the all-cancer PC was approximately 4% for males and 6% for females. Conclusions. The typical life table approach for projecting lifetime risk of radiation-induced cancer mortality and incidence for astronauts and radiation workers can be improved by adjusting for HWE while simulating the uncertainty of input rates, input excess risk coefficients, and bias correction factors during multiple Monte Carlo realizations of the life table.
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Affiliation(s)
- Leif E Peterson
- Center for Biostatistics, Houston Methodist Research Institute, 6565 Fannin Street, Suite MGJ6-031, Houston, TX 77030, United States
| | - Tatiana Kovyrshina
- Center for Biostatistics, Houston Methodist Research Institute, 6565 Fannin Street, Suite MGJ6-031, Houston, TX 77030, United States
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14
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Zhivin S, Laurier D, Guseva Canu I. Health effects of occupational exposure to uranium: do physicochemical properties matter? Int J Radiat Biol 2015; 90:1104-13. [PMID: 25014993 DOI: 10.3109/09553002.2014.943849] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Physicochemical properties of uranium, including isotopic composition and solubility, are determinants of its toxicity. We reviewed epidemiological studies in civilian and military workers known to be exposed to uranium with different physicochemical properties to investigate its long-term effects, such as cancerous and circulatory diseases. MATERIALS AND METHODS We systematically searched the Pubmed and the Scopus databases to identify studies of uranium- processing workers (published between 1980 and 2013) and veterans of the wars in the Persian Gulf and the Balkans (published between 1991 and 2013) in which defined outcomes, such as lung, lymphohematopoietic, kidney cancers, and circulatory diseases were examined. RESULTS from these studies in terms of risk of each health outcome (mortality or incidence) and analyses of dose-response relationship were examined to present the impact of uranium physicochemical properties on the observed results. RESULTS Twenty-seven articles were reviewed. There is some evidence for increased lung cancer risk among uranium-processing workers. The evidence is less strong for lymphohematopoietic cancer. We found that most of the studies insufficiently assessed the physicochemical properties of uranium and some of them used proxies for the exposure assessment and risk estimation analyses. Studies of veterans of the wars in the Persian Gulf and the Balkans are uninformative in respect to internal uranium exposure. CONCLUSIONS Existing epidemiological data on the physicochemical properties of uranium and associated health outcomes are inconclusive. Further studies among certain groups of uranium-processing workers (uranium-enrichment and fuel-fabrication workers) could contribute to our knowledge of the health effects of uranium with respect to its physicochemical properties.
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Affiliation(s)
- Sergey Zhivin
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PRP-HOM/SRBE/LEPID , BP 17, 92262 Fontenay-aux-Roses , France
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15
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Guseva Canu I, Zhivin S, Garsi JP, Caër-Lorho S, Samson E, Collomb P, Acker A, Laurier D. Effets de la contamination chronique à l’uranium sur la mortalité : bilan d’une étude-pilote chez les travailleurs de l’industrie nucléaire en France. Rev Epidemiol Sante Publique 2014; 62:339-50. [DOI: 10.1016/j.respe.2014.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/02/2014] [Accepted: 09/19/2014] [Indexed: 12/31/2022] Open
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Kreuzer M, Dufey F, Laurier D, Nowak D, Marsh JW, Schnelzer M, Sogl M, Walsh L. Mortality from internal and external radiation exposure in a cohort of male German uranium millers, 1946–2008. Int Arch Occup Environ Health 2014; 88:431-41. [DOI: 10.1007/s00420-014-0973-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/11/2014] [Indexed: 11/30/2022]
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17
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Zhivin S, Laurier D, Caër-Lorho S, Acker A, Guseva Canu I. Impact of chemical exposure on cancer mortality in a French cohort of uranium processing workers. Am J Ind Med 2013; 56:1262-71. [PMID: 24009194 DOI: 10.1002/ajim.22231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Nuclear workers may be exposed to a variety of chemical hazards, in addition to radiation. We examined the effect of chemical exposures on cancer mortality among French uranium processing workers at the AREVA NC Pierrelatte facility. METHODS A cohort of 2,897 uranium processing workers employed for at least 6 months was followed from 1968 through 2006. Exposure to uranium and potentially carcinogenic chemicals was assessed with a plant-specific job-exposure matrix. Mortality hazard ratios (HRs) for cancers of the lung, lymphohematopoietic system, kidney and bladder, brain and central nervous system (BCNS), and prostate were estimated for each specific chemical exposure, with Cox regression models stratified for sex and calendar period and adjusted for socioeconomic status. Additional adjustments enabled us to examine the effect of co-exposure to uranium and other chemicals. RESULTS Exposure to aromatic solvents was associated with increased risk of BCNS malignancies after adjustment for other chemicals (HR=6.53, 95% CI=1.14-37.41; n=6) and for other chemicals and uranium (HR=7.26, 95% CI=0.90-58.19) in the annual exposure status model. Selected groups of lymphohematopoietic cancers were found associated with solvent exposure. Inconclusive results were found regarding chromium (VI) exposure, since only 2 workers died from lung cancer among 109 exposed. CONCLUSION Based on our pilot study, it seemed important to take into account chemical exposures in the analyses of cancer mortality among French uranium processing workers.
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Affiliation(s)
- Sergey Zhivin
- Laboratoire d'Epidémioloeie; Institut de Radioprotection et de Sûreté Nucléaire (IRSN); Fontenay-aux-Roses; France
| | - Dominique Laurier
- Laboratoire d'Epidémioloeie; Institut de Radioprotection et de Sûreté Nucléaire (IRSN); Fontenay-aux-Roses; France
| | - Sylvaine Caër-Lorho
- Laboratoire d'Epidémioloeie; Institut de Radioprotection et de Sûreté Nucléaire (IRSN); Fontenay-aux-Roses; France
| | - Alain Acker
- AREVA Group; Medical Coordination Section; Paris; France
| | - Irina Guseva Canu
- Laboratoire d'Epidémioloeie; Institut de Radioprotection et de Sûreté Nucléaire (IRSN); Fontenay-aux-Roses; France
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18
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Guseva Canu I, Faust S, Knieczak E, Carles M, Samson E, Laurier D. Estimating historic exposures at the European Gaseous Diffusion plants. Int J Hyg Environ Health 2013; 216:499-507. [DOI: 10.1016/j.ijheh.2012.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/05/2012] [Accepted: 07/17/2012] [Indexed: 10/27/2022]
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Metz-Flamant C, Laurent O, Samson E, Caër-Lorho S, Acker A, Hubert D, Richardson DB, Laurier D. Mortality associated with chronic external radiation exposure in the French combined cohort of nuclear workers. Occup Environ Med 2013; 70:630-8. [PMID: 23716722 DOI: 10.1136/oemed-2012-101149] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The long-term effects of protracted low level ionising radiation exposure are investigated in a combined analysis of French nuclear workers employed by the Commissariat à l'Energie Atomique (CEA), AREVA Nuclear Cycle (AREVA NC) and Electricité de France (EDF). Associations between cumulative external radiation dose and mortality due to solid cancers, leukaemia and circulatory disease were examined. METHODS All workers hired by CEA, AREVA NC and EDF between 1950 and 1994 who were employed for at least 1 year, badge-monitored for radiation exposure and alive on 1 January 1968 were included. Individual data of annual exposure to penetrating photons (X-rays and gamma rays) were reconstructed for each worker. Estimates of radiation dose-mortality associations were obtained using a linear excess relative risk (ERR) Poisson regression model. RESULTS Among the 59 021 nuclear workers, 2312 died of solid cancer, 78 of leukaemia and 1468 of circulatory diseases during the 1968-2004 period. Approximately 72% of the cohort had a non-zero cumulative radiation dose estimate, with a mean cumulative dose of 22.5 mSv. Positive but non-significant ERR/Sv were observed for all solid cancers, leukaemia excluding chronic lymphocytic leukaemia (CLL), ischaemic heart diseases and cerebrovascular diseases. A significant ERR/Sv was found for myeloid leukaemia. CONCLUSIONS This is the first combined analysis of major French cohorts of nuclear workers. Results were consistent with risks estimated in other nuclear worker cohorts and illustrate the potential of a further joint international study to yield direct risk estimates in support to radiation protection standards.
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Affiliation(s)
- C Metz-Flamant
- PRP-HOM/SRBE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
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20
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Chen J, Moir D, Lane R, Thompson P. An ecological study of cancer incidence in Port Hope, Ontario from 1992 to 2007. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2013; 33:227-242. [PMID: 23324463 DOI: 10.1088/0952-4746/33/1/227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A plant processing radium and uranium ores has been operating in the town of Port Hope since 1932. Given the nuclear industry located in the community and ongoing public health concerns, cancer incidence rates in Port Hope were studied for a recent 16 year period (1992-2007) for continued periodic cancer incidence surveillance of the community. The cancer incidence in the local community for all cancers combined was similar to the Ontario population, health regions with similar socio-economic characteristics in Ontario and in Canada, and the Canadian population. No statistically significant differences in childhood cancer, leukaemia or other radiosensitive cancer incidence were observed, with the exception of statistically significant elevated lung cancer incidence among women. However, the statistical significance was reduced or disappeared when the comparison was made to populations with similar socio-economic characteristics. These findings are consistent with previous ecological, case-control and cohort studies conducted in Port Hope, environmental assessments, and epidemiological studies conducted elsewhere on populations living around similar facilities or exposed to similar environmental contaminants. Although the current study covered an extended period of time, the power to detect risk at the sub-regional level of analysis was limited since the Port Hope population is small (16,500). The study nevertheless indicated that large differences in cancer incidence are not occurring in Port Hope compared to other similar communities and the general population.
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Affiliation(s)
- Jing Chen
- Radiation Protection Bureau, Health Canada, 2720 Riverside Drive, Ottawa, K1A 0K9, Canada.
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21
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Zablotska LB, Lane RSD, Frost SE. Mortality (1950-1999) and cancer incidence (1969-1999) of workers in the Port Hope cohort study exposed to a unique combination of radium, uranium and γ-ray doses. BMJ Open 2013; 3:e002159. [PMID: 23449746 PMCID: PMC3586082 DOI: 10.1136/bmjopen-2012-002159] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 01/17/2013] [Accepted: 01/21/2013] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Uranium processing workers are exposed to uranium and radium compounds from the ore dust and to γ-ray radiation, but less to radon decay products (RDP), typical of the uranium miners. We examined the risks of these exposures in a cohort of workers from Port Hope radium and uranium refinery and processing plant. DESIGN A retrospective cohort study with carefully documented exposures, which allowed separation of those with primary exposures to radium and uranium. SETTINGS Port Hope, Ontario, Canada, uranium processors with no mining experience. PARTICIPANTS 3000 male and female workers first employed (1932-1980) and followed for mortality (1950-1999) and cancer incidence (1969-1999). OUTCOME MEASURES Cohort mortality and incidence were compared with the general Canadian population. Poisson regression was used to evaluate the association between cumulative RDP exposures and γ-ray doses and causes of death and cancers potentially related to radium and uranium processing. RESULTS Overall, workers had lower mortality and cancer incidence compared with the general Canadian population. In analyses restricted to men (n=2645), the person-year weighted mean cumulative RDP exposure was 15.9 working level months (WLM) and the mean cumulative whole-body γ-ray dose was 134.4 millisieverts. We observed small, non-statistically significant increases in radiation risks of mortality and incidence of lung cancer due to RDP exposures (excess relative risks/100 WLM=0.21, 95% CI <-0.45 to 1.59 and 0.77, 95% CI <-0.19 to 3.39, respectively), with similar risks for those exposed to radium and uranium. All other causes of death and cancer incidence were not significantly associated with RDP exposures or γ-ray doses or a combination of both. CONCLUSIONS In one of the largest cohort studies of workers exposed to radium, uranium and γ-ray doses, no significant radiation-associated risks were observed for any cancer site or cause of death. Continued follow-up and pooling with other cohorts of workers exposed to by-products of radium and uranium processing could provide valuable insight into occupational risks and suspected differences in risk with uranium miners.
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Affiliation(s)
- Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA
| | - Rachel S D Lane
- Radiation and Health Sciences Division, Directorate of Environmental and Radiation Protection and Assessment, Canadian Nuclear Safety Commission, Ottawa, Ontario, Canada
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Uranium carcinogenicity in humans might depend on the physical and chemical nature of uranium and its isotopic composition: results from pilot epidemiological study of French nuclear workers. Cancer Causes Control 2011; 22:1563-73. [DOI: 10.1007/s10552-011-9833-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 08/13/2011] [Indexed: 10/17/2022]
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Metz-Flamant C, Samson E, Caër-Lorho S, Acker A, Laurier D. Solid cancer mortality associated with chronic external radiation exposure at the French atomic energy commission and nuclear fuel company. Radiat Res 2011; 176:115-27. [PMID: 21476856 DOI: 10.1667/rr2528.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Studies of nuclear workers make it possible to directly quantify the risks associated with ionizing radiation exposure at low doses and low dose rates. Studies of the CEA (Commissariat à l'Energie Atomique) and AREVA Nuclear Cycle (AREVA NC) cohort, currently the most informative such group in France, describe the long-term risk to nuclear workers associated with external exposure. Our aim is to assess the risk of mortality from solid cancers among CEA and AREVA NC nuclear workers and its association with external radiation exposure. Standardized mortality ratios (SMRs) were calculated and internal Poisson regressions were conducted, controlling for the main confounding factors [sex, attained age, calendar period, company and socioeconomic status (SES)]. During the period 1968-2004, there were 2,035 solid cancers among the 36,769 CEA-AREVA NC workers. Cumulative external radiation exposure was assessed for the period 1950-2004, and the mean cumulative dose was 12.1 mSv. Mortality rates for all causes and all solid cancers were both significantly lower in this cohort than in the general population. A significant excess of deaths from pleural cancer, not associated with cumulative external dose, was observed, probably due to past asbestos exposure. We observed a significant excess of melanoma, also unassociated with dose. Although cumulative external dose was not associated with mortality from all solid cancers, the central estimated excess relative risk (ERR) per Sv of 0.46 for solid cancer mortality was higher than the 0.26 calculated for male Hiroshima and Nagasaki A-bomb survivors 50 years or older and exposed at the age of 30 years or older. The modification of our results after stratification for SES demonstrates the importance of this characteristic in occupational studies, because it makes it possible to take class-based lifestyle differences into account, at least partly. These results show the great potential of a further joint international study of nuclear workers, which should improve knowledge about the risks associated with chronic low doses and provide useful risk estimates for radiation protection.
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Affiliation(s)
- C Metz-Flamant
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), DRPH,SRBE,LEPID, Fontenay-aux-Roses, France.
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Metz-Flamant C, Guseva Canu I, Laurier D. Malignant pleural mesothelioma risk among nuclear workers: a review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2011; 31:9-23. [PMID: 21346295 DOI: 10.1088/0952-4746/31/1/r01] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Exposure to ionising radiation has been suggested as a causal risk factor for malignant pleural mesothelioma (MPM). Studies of patients treated by radiotherapy for primary cancers have suggested that radiation contributes to the development of secondary MPM. Here we examined the risk to nuclear workers of MPM related to exposure to low doses of occupational radiation at low dose rates. All results concerning MPM risk in published studies of nuclear workers were examined for their association with radiation exposure and potential confounders. We found 19 relevant studies. Elevated risks of pleural cancer were reported in most (15/17) of these studies. Eight reported risks higher for radiation monitored workers than for other workers. However, of 12 studies that looked at associations with ionising radiation, only one reported a significant dose-risk association. Asbestos was an important confounder in most studies. We conclude that studies of nuclear workers have not detected an association between ionising radiation exposure and MPM. Further investigations should improve the consideration of asbestos exposure at the same time as they address the risk of MPM related to occupational exposure of nuclear workers to low doses of ionising radiation at low dose rates.
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Affiliation(s)
- C Metz-Flamant
- Laboratory of Epidemiology, Institute of Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France.
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Canu IG, Jacob S, Cardis E, Wild P, Caër-Lorho S, Auriol B, Laurier D, Tirmarche M. Reprocessed uranium exposure and lung cancer risk. HEALTH PHYSICS 2010; 99:308-313. [PMID: 20699691 DOI: 10.1097/hp.0b013e3181c2f4f6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study investigated the risk of lung cancer in regards to protracted occupational exposure to reprocessed uranium compounds. Two thousand seven hundred and nine male workers employed at the AREVA NC uranium processing plant between 1960 and 2005 in France were included in the cohort. Historical exposure to reprocessed uranium compounds classified by their solubility type was assessed on the basis of the plant's specific job-exposure matrix. Cox proportional hazard models adjusted for attained age, calendar period, and socioeconomic status were used to estimate relative risks in regards of each type of uranium compound. The relative risk of lung cancer tended to increase with decreasing solubility of reprocessed uranium compounds. The highest-though not statistically significant-relative risk was observed among workers exposed to slowly soluble reprocessed uranium dioxide. This study is the first suggesting an increasing risk of lung cancer associated with exposure to reprocessed uranium. Our results are consistent with data from experimental studies of biokinetics and the action mechanism of slowly soluble uranium compounds, but need to be confirmed in larger studies with more detailed dose-response analyses.
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Affiliation(s)
- Irina Guseva Canu
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Service de Radiobiologie et d'Epidémiologie, Fontenay aux Roses, France.
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