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Leuraud K, Laurier D, Gillies M, Haylock R, Kelly-Reif K, Bertke S, Daniels RD, Thierry-Chef I, Moissonnier M, Kesminiene A, Schubauer-Berigan MK, Richardson DB. Leukaemia, lymphoma, and multiple myeloma mortality after low-level exposure to ionising radiation in nuclear workers (INWORKS): updated findings from an international cohort study. Lancet Haematol 2024:S2352-3026(24)00240-0. [PMID: 39222647 DOI: 10.1016/s2352-3026(24)00240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND A major update to the International Nuclear Workers Study (INWORKS) was undertaken to strengthen understanding of associations between low-dose exposure to penetrating forms of ionising radiation and mortality. Here, we report on associations between radiation dose and mortality due to haematological malignancies. METHODS We assembled a cohort of 309 932 radiation-monitored workers (269 487 [87%] males and 40 445 [13%] females) employed for at least 1 year by a nuclear facility in France (60 697 workers), the UK (147 872 workers), and the USA (101 363 workers). Workers were individually monitored for external radiation exposure and followed-up from Jan 1, 1944, to Dec 31, 2016, accruing 10·72 million person-years of follow-up. Radiation-mortality associations were quantified in terms of the excess relative rate (ERR) per Gy of radiation dose to red bone marrow for leukaemia excluding chronic lymphocytic leukaemia (CLL), as well as subtypes of leukaemia, myelodysplastic syndromes, non-Hodgkin and Hodgkin lymphomas, and multiple myeloma. Estimates of association were obtained using Poisson regression methods. FINDINGS The association between cumulative dose to red bone marrow, lagged 2 years, and leukaemia (excluding CLL) mortality was well described by a linear model (ERR per Gy 2·68, 90% CI 1·13 to 4·55, n=771) and was not modified by neutron exposure, internal contamination monitoring status, or period of hire. Positive associations were also observed for chronic myeloid leukaemia (9·57, 4·00 to 17·91, n=122) and myelodysplastic syndromes alone (3·19, 0·35 to 7·33, n=163) or combined with acute myeloid leukaemia (1·55, 0·05 to 3·42, n=598). No significant association was observed for acute lymphoblastic leukaemia (4·25, -4·19 to 19·32, n=49) or CLL (0·20, -1·81 to 2·21, n=242). A positive association was observed between radiation dose and multiple myeloma (1·62, 0·06 to 3·64, n=527) whereas minimal evidence of association was observed between radiation dose and non-Hodgkin lymphoma (0·27, -0·61 to 1·39, n=1146) or Hodgkin lymphoma (0·60, -3·64 to 4·83, n=122) mortality. INTERPRETATION This study reports a positive association between protracted low dose exposure to ionising radiation and mortality due to some haematological malignancies. Given the relatively low doses typically accrued by workers in this study (16 mGy average cumulative red bone marrow dose) the radiation attributable absolute risk of leukaemia mortality in this population is low (one excess death in 10 000 workers over a 35-year period). These results can inform radiation protection standards and will provide input for discussions on the radiation protection system. FUNDING National Cancer Institute, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Institut de Radioprotection et de Sûreté Nucléaire, Orano, Electricité de France, UK Health Security Agency. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire, PSE-SANTE, Fontenay-aux-Roses, France.
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire, PSE-SANTE, Fontenay-aux-Roses, France
| | | | | | - Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Stephen Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | | | | | | | - David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
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Chen J. A Study on Geographic Correlation between Indoor Radon Exposure and Leukemia Incidence in Canada. HEALTH PHYSICS 2024; 126:315-321. [PMID: 38526250 DOI: 10.1097/hp.0000000000001813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT In Canada, leukemia is diagnosed at a rate of 15 cases per 100,000 persons and accounts for about 3% of all new primary cancers. In this study, geographical correlation between residential radon exposure and leukemia incidence was investigated at a provincial level with more accurate long-term radon measurement data in 21,330 homes and 10-y (2000-2009) age standardized incidence rates per 100,000 population for various subtypes of leukemia. The analyses showed that the incidence rate of non-Hodgkin lymphoma is statistically significantly correlated with average indoor radon (222Rn) concentration for Canadian females (p = 0.01210) but not for males. At a provincial level, the association between average indoor radon level and chronic lymphocytic leukemia incidence rate is statistically significant (p = 0.0167), and the correlation is somewhat stronger for females (p = 0.0043). No correlation was found between indoor radon exposure and any other subtypes of leukemia evaluated in this study.
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Affiliation(s)
- Jing Chen
- Radiation Protection Bureau, Health Canada, 775 Brookfield Road, Ottawa K1A 1C1, Ontario, Canada
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3
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Radiation and leukaemia: Which leukaemias and what doses? Blood Rev 2023; 58:101017. [PMID: 36220737 DOI: 10.1016/j.blre.2022.101017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022]
Abstract
The cause(s) of most cases of leukaemia is unknown. Save for several rare inherited disorders the most convincingly-identified causes of leukaemia are exposures to ionizing radiations, to some chemicals and to some anti-cancer drugs. Data implicating ionizing radiations as a cause of leukaemias come from several sources including persons exposed to the atomic bomb explosions in Japan, persons receiving radiation therapy for cancer and other disorders, persons occupationally exposed to radiation such as radiologists and nuclear facility workers, cigarette smokers, and others. Although ionizing radiations can be a cause of almost all types of leukaemias, some are especially sensitive to induction such as acute and chronic myeloid leukaemias (AML and CML) and acute lymphoblastic leukaemia (ALL). Whether chronic lymphocytic leukaemia can be caused by radiation exposure is controversial. The mechanism(s) by which ionizing radiations cause leukaemia differs for different leukaemia types. I discuss these issues and close with a hypothesis which might explain why haematopoietic stem cells are localized to the bone marrow.
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Updated Standardized Mortality Ratio Evaluation of Disease Risks of Shipyard Workers Exposed to Low Dose Ionizing Radiation. J Occup Environ Med 2022; 64:e224-e230. [DOI: 10.1097/jom.0000000000002491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mozzoni P, Pinelli S, Corradi M, Ranzieri S, Cavallo D, Poli D. Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10466. [PMID: 34639764 PMCID: PMC8508162 DOI: 10.3390/ijerph181910466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022]
Abstract
Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.
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Affiliation(s)
- Paola Mozzoni
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvana Pinelli
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Delia Cavallo
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
| | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
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Hartel C, Nasonova E, Ritter S, Friedrich T. Alpha-Particle Exposure Induces Mainly Unstable Complex Chromosome Aberrations which do not Contribute to Radiation-Associated Cytogenetic Risk. Radiat Res 2021; 196:561-573. [PMID: 34411274 DOI: 10.1667/rade-21-00116.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/06/2021] [Indexed: 11/03/2022]
Abstract
The mechanism underlying the carcinogenic potential of α radiation is not fully understood, considering that cell inactivation (e.g., mitotic cell death) as a main consequence of exposure efficiently counteracts the spreading of heritable DNA damage. The aim of this study is to improve our understanding of the effectiveness of α particles in inducing different types of chromosomal aberrations, to determine the respective values of the relative biological effectiveness (RBE) and to interpret the results with respect to exposure risk. Human peripheral blood lymphocytes (PBLs) from a single donor were exposed ex vivo to doses of 0-6 Gy X rays or 0-2 Gy α particles. Cells were harvested at two different times after irradiation to account for the mitotic delay of heavily damaged cells, which is known to occur after exposure to high-LET radiation (including α particles). Analysis of the kinetics of cells reaching first or second (and higher) mitosis after irradiation and aberration data obtained by the multiplex fluorescence in situ hybridization (mFISH) technique are used to determine of the cytogenetic risk, i.e., the probability for transmissible aberrations in surviving lymphocytes. The analysis shows that the cytogenetic risk after α exposure is lower than after X rays. This indicates that the actually observed higher carcinogenic effect of α radiation is likely to stem from small scale mutations that are induced effectively by high-LET radiation but cannot be resolved by mFISH analysis.
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Affiliation(s)
- C Hartel
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - E Nasonova
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany.,Joint Institute for Nuclear Research, Laboratory of Radiation Biology, Dubna, Russia
| | - S Ritter
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - T Friedrich
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
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Harbron RW, Pasqual E. Ionising radiation as a risk factor for lymphoma: a review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R151-R185. [PMID: 33017815 DOI: 10.1088/1361-6498/abbe37] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.
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Affiliation(s)
- Richard W Harbron
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, United Kingdom
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisa Pasqual
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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9
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Semenova Y, Pivina L, Zhunussov Y, Zhanaspayev M, Chirumbolo S, Muzdubayeva Z, Bjørklund G. Radiation-related health hazards to uranium miners. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:34808-34822. [PMID: 32638305 DOI: 10.1007/s11356-020-09590-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
Concerns on health effects from uranium (U) mining still represent a major issue of debate. Any typology of active job in U mines is associated with exposure to U and its decay products, such as radon (Rn), thorium (Th), and radium (Ra) and its decay products with alpha-emission and gamma radiation. Health effects in U miners have been investigated in several cohort studies in the USA, Canada, Germany, the Czech Republic, and France. While public opinion is particularly addressed to pay attention to the safety of nuclear facilities, health hazard associated with mining is poorly debated. According to the many findings from cohort studies, the most significant positive dose-response relationship was found between occupational U exposure and lung cancer. Other types of tumors associated with occupational U exposure are leukemia and lymphoid cancers. Furthermore, it was found increased but not statistically significant death risk in U miners due to cancers in the liver, stomach, and kidneys. So far, there has not been found a significant association between U exposure and increased cardiovascular mortality in U miners. This review tries to address the current state of the art of these studies.
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Affiliation(s)
- Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | | | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- CONEM Scientific, Verona, Italy
| | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
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Satta G, Loi M, Becker N, Benavente Y, De Sanjose S, Foretova L, Staines A, Maynadie M, Nieters A, Meloni F, Pilia I, Campagna M, Pau M, Zablotska LB, Cocco P. Occupational exposure to ionizing radiation and risk of lymphoma subtypes: results of the Epilymph European case-control study. Environ Health 2020; 19:43. [PMID: 32334593 PMCID: PMC7183712 DOI: 10.1186/s12940-020-00596-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 04/07/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels. METHODS We investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education. RESULTS We did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation. CONCLUSIONS Further investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation.
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Affiliation(s)
- Giannina Satta
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Matteo Loi
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | | | | | | | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | | | | | | | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Marco Pau
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Pierluigi Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, SS554, km 4.500, 09042, Monserrato (Cagliari), Italy.
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Fast and direct determination of catechol-3, 6-bis(methyleiminodiacetic acid) prototype in beagle dog plasma using liquid chromatography tandem mass spectrometry: A simplified and high throughput in-vivo method for the metal chelator. J Chromatogr A 2019; 1596:84-95. [PMID: 30890257 DOI: 10.1016/j.chroma.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/26/2019] [Accepted: 03/03/2019] [Indexed: 11/21/2022]
Abstract
It is usually somewhat difficult to analyze the metal chelators, especially in complex biological matrix, because of the interference of metal ions in both the matrix and analyzing system. In this study, an innovative and simple bioanalytical method was established and validated for the quantification of a newly developed uranium chelator catechol-3, 6-bis (methyleiminodiacetic acid) (CBMIDA) in beagle dog plasma. Different analytical columns and mobile phase were tested for effective chromatography resolution and sensitive and reproducible response of CBMIDA and the internal standard. An Agilent Zorbax SB AQ column was chosen. Excessive peak tailing, peak asymmetry, low recovery, and poor reproducibility, which are generally observed in chromatographic analysis of metal chelators, were overcome by the use of a pulse gradient method and addition of ethylene diamine tetraacetic acid (EDTA) to the mobile phase at 8 μg mL-1, enabling good peak shape, low matrix interference, high precision and good linearity for CBMIDA quantification in beagle dog plasma. Plasma sample pretreatment was performed by a simple, high throughput protein precipitation step with 2.5 mM EDTA methanol solution in a 96-well protein precipitation plate without complexing with the metal ions, and the sample was directly analyzed by electrospray ionization mass spectrometry. By shifting the analysis target from the metal complex to metal chelator itself, the method has an advantage over the existing method for determination of EDTA and diethylenetriaminepentaacetic acid owing to increased sample throughput and apparent simplicity. The assay was validated in accordance with the United States Food and Drug Administration guidelines and successfully applied to the pharmacokinetic study of CBMIDA in beagles after intramuscular injection of CBMIDA at different doses. The method was sensitive enough for the detection of CBMIDA concentration at 4 elimination half-times. The experimental strategies presented herein may be helpful for the measurement of other radionuclide chelators in biological matrices.
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Al Rashida VJM, Wang X, Myers OB, Boyce TW, Kocher E, Moreno M, Karr R, Ass'ad N, Cook LS, Sood A. Greater Odds for Angina in Uranium Miners Than Nonuranium Miners in New Mexico. J Occup Environ Med 2019; 61:1-7. [PMID: 30601436 PMCID: PMC6541557 DOI: 10.1097/jom.0000000000001482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that uranium miners in New Mexico (NM) have a greater prevalence of cardiovascular disease than miners who extracted the nonuranium ore. METHODS NM-based current and former uranium miners were compared with nonuranium miners by using cross-sectional standardized questionnaire data from the Mining Dust in the United States (MiDUS) study from 1989 to 2016. RESULTS Of the 7215 eligible miners, most were men (96.3%). Uranium miners (n = 3151, 43.7%) were older and diabetic, but less likely to currently smoke or use snuff (P ≤ 0.001 for all). After adjustment for covariates, uranium miners were more likely to report angina (odds ratio 1.51, 95% confidence interval 1.23 to 1.85) than nonuranium miners. CONCLUSION Our data suggest that along with screening for pulmonary diseases, uranium industry workers should be screened for cardiovascular diseases.
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Affiliation(s)
- Vanessa J M Al Rashida
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico (Drs al Rashida, Wang, Myers, Boyce, Kocher, Assad, Cook, Sood); Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr al Rashida); and Black Lung Program, Miners' Colfax Medical Center, Raton, New Mexico (Moreno, Karr, Dr Sood)
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Ferri GM, Specchia G, Mazza P, Ingravallo G, Intranuovo G, Guastadisegno CM, Congedo ML, Lagioia G, Loparco MC, Giordano A, Perrone T, Gaudio F, Spinosa C, Minoia C, D'Onghia L, Strusi M, Corrado V, Cavone D, Vimercati L, Schiavulli N, Cocco P. Risk of lymphoma subtypes by occupational exposure in Southern Italy. J Occup Med Toxicol 2017; 12:31. [PMID: 29201133 PMCID: PMC5701427 DOI: 10.1186/s12995-017-0177-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/24/2017] [Indexed: 12/22/2022] Open
Abstract
Background Occupational exposure is known to play a role in the aetiology of lymphomas. The aim of the present work was to explore the occupational risk of the major B-cell lymphoma subtypes using a case–control study design. Methods From 2009 to 2014, we recruited 158 lymphoma cases and 76 controls in the provinces of Bari and Taranto (Apulia, Southern Italy). A retrospective assessment of occupational exposure based on complete work histories and the Carcinogen Exposure (CAREX) job-exposure matrix was performed. Results After adjusting for major confounding factors, farmers showed an increased risk of diffuse large B-cell lymphoma (DLBCL) [odds ratio (OR) = 10.9 (2.3–51.6)] and multiple myeloma (MM) [OR = 16.5 (1.4–195.7)]; exposure to the fungicide Captafol was significantly associated with risk of non-Hodgkin lymphoma (NHL) [OR = 2.6 (1.1–8.2)], particularly with the risk of DLBCL [OR = 5.3 (1.6–17.3)]. Conclusions Agricultural activity seems to be a risk factor for developing lymphoma subtypes, particularly DLBCL, in the provinces of Bari and Taranto (Apulia Region, Southern Italy). Exposure to the pesticides Captafol, Paraquat and Radon might be implicated. Trial registration Protocol number UNIBA 2207WEJLZB_004 registered 22/09/2008.
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Affiliation(s)
- Giovanni Maria Ferri
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy.,Interdisciplinary Department of Medicine (DIM), University Hospital. Policlinico-Giovanni XXIII, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Giorgina Specchia
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Patrizio Mazza
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Giuseppe Ingravallo
- Department of Emergency and Transplantation (DETO), Regional University Hospital "Policlinico - Giovanni XXIII° ", Unit of Pathology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Graziana Intranuovo
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Chiara Monica Guastadisegno
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Maria Luisa Congedo
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Gianfranco Lagioia
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Maria Cristina Loparco
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Annamaria Giordano
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Tommasina Perrone
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Francesco Gaudio
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Caterina Spinosa
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Carla Minoia
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Lucia D'Onghia
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Michela Strusi
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Vincenzo Corrado
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Nunzia Schiavulli
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Pierluigi Cocco
- Department of Public Health, Clinical & Molecular Medicine, Occupational Health Section, University of Cagliari, 09100 Cagliari, Italy
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14
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Finch SC, Dyagil I, Reiss RF, Gudzenko N, Babkina N, Lyubarets T, Bebeshko V, Romanenko A, Chumak VV, Bouville A, Hatch M, Little MP, Bazyka D, Zablotska LB. Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers. Hematol Oncol 2017; 35:215-224. [PMID: 26806761 PMCID: PMC5531054 DOI: 10.1002/hon.2278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 11/23/2015] [Accepted: 12/04/2015] [Indexed: 11/06/2022]
Abstract
The recently demonstrated radiation-induction of chronic lymphocytic leukemia (CLL) raises the question as to whether the amount of radiation exposure influences any of the clinical characteristics of the disease. We evaluated the relationship between bone marrow radiation doses and clinical characteristics and survival of 79 CLL cases diagnosed during 1986-2006 in a cohort of 110 645 male workers who participated in the cleanup work of the Chornobyl nuclear accident in Ukraine in 1986. All diagnoses were confirmed by an independent International Hematology Panel. Patients were followed up to the date of death or end of follow-up on 31 October 2010. The median age at diagnosis was 57 years. Median bone marrow dose was 22.6 milligray (mGy) and was not associated with time between exposure and clinical diagnosis of CLL (latent period), age, peripheral blood lymphocyte count or clinical stage of disease in univariate and multivariate analyses. Latent period was significantly shorter among those older at first exposure, smokers and those with higher frequency of visits to the doctor prior to diagnosis. A significant increase in the risk of death with increasing radiation dose was observed (p = 0.03, hazard ratio = 2.38, 95% confidence interval: 1.11,5.08 comparing those with doses ≥22 mGy to doses <22 mGy). After adjustment for radiation dose, survival of CLL cases was significantly shorter among those with younger age at first exposure, higher peripheral blood lymphocyte count, more advanced clinical stage of disease and older age at diagnosis (all p < 0.05). This is the first study to examine association between bone marrow radiation doses from the Chornobyl accident and clinical manifestations of the CLL in Chornobyl cleanup workers. The current study provides new evidence on the association of radiation dose and younger age at first radiation exposure at Chornobyl with shorter survival after diagnosis. Future studies are necessary with more cases in order to improve the statistical power of these analyses and to determine their significance. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Stuart C. Finch
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Irina Dyagil
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Robert F. Reiss
- Department of Pathology and Cell Biology, and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | | | | | | | | | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Andre Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Maureen Hatch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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15
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Geographical Correlations between Indoor Radon Concentration and Risks of Lung Cancer, Non-Hodgkin's Lymphoma, and Leukemia during 1999-2008 in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040344. [PMID: 28338643 PMCID: PMC5409545 DOI: 10.3390/ijerph14040344] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 12/11/2022]
Abstract
Indoor radon is the second most important risk factor for lung cancer and may also be a risk factor for hematopoietic cancers, particularly in children and adolescents. The present study measured indoor radon concentration nationwide at 5553 points during 1989–2009 and spatially interpolated using lognormal kriging. The incidences of lung cancer, non-Hodgkin’s lymphoma (NHL), and leukemia, stratified by sex and five-year age groups in each of the 234 administrative regions in the country during 1999–2008, were obtained from the National Cancer Registry and used to calculate the standardized incidence ratios. After considering regional deprivation index values and smoking rates by sex in each region as confounding variables, the cancer risks were estimated based on Bayesian hierarchical modeling. We found that a 10 Bq/m3 increase in indoor radon concentration was associated with a 1% increase in the incidence of lung cancer in male and a 7% increase in NHL in female children and adolescents in Korea aged less than 20 years. Leukemia was not associated with indoor radon concentration. The increase in NHL risk among young women requires confirmation in future studies, and the radon control program should consider children and adolescents.
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16
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Kreuzer M, Sobotzki C, Fenske N, Marsh JW, Schnelzer M. Leukaemia mortality and low-dose ionising radiation in the WISMUT uranium miner cohort (1946–2013). Occup Environ Med 2016; 74:252-258. [DOI: 10.1136/oemed-2016-103795] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/08/2016] [Accepted: 10/08/2016] [Indexed: 12/30/2022]
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17
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Navaranjan G, Berriault C, Do M, Villeneuve PJ, Demers PA. Cancer incidence and mortality from exposure to radon progeny among Ontario uranium miners. Occup Environ Med 2016; 73:838-845. [PMID: 27651479 DOI: 10.1136/oemed-2016-103836] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/16/2016] [Accepted: 08/31/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study objectives were to extend the follow-up of the Ontario uranium miners cohort, one of the largest cohorts of uranium miners with low cumulative exposures, to examine the relationship between radon exposure and lung cancer mortality and, for the first time incidence, and address gaps in the literature, including dose-response relationship between radon exposure and other cancer sites, and non-cancer mortality. METHODS The cohort of mine and mill workers was created using data from Canada's National Dose Registry and the Ontario Mining Master File. The follow-up for the cohort was recently extended for mortality (1954-2007) and for the first time includes cancer incidence (1969-2005). The Poisson regression was used to estimate relative risks (RR) and excess relative risks (ERR) and their 95% CIs with levels of cumulative radon exposure. RESULTS The cohort consisted of 28 546 male miners with a mean cumulative radon exposure of 21.0 working level months (WLM). An increased risk of lung cancer and a dose-response relationship was observed with cumulative radon exposure. Miners exposed to >100 WLM demonstrated a twofold increase in the risk of lung cancer incidence (RR=1.89, CI 1.43 to 2.50) compared with the non-exposed group, and a linear ERR of 0.64/100 WLM (CI 0.43 to 0.85), with similar results observed for mortality. No association was observed for other cancer sites (stomach, leukaemia, kidney and extrathoracic airways) or non-cancer sites (cardiovascular diseases) with increasing cumulative exposure to radon. CONCLUSIONS These findings suggest no increased risk of cancer sites other than lung or non-cancer mortality from relatively low cumulative exposure to radon.
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Affiliation(s)
- Garthika Navaranjan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Minh Do
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul J Villeneuve
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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18
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Teras LR, Diver WR, Turner MC, Krewski D, Sahar L, Ward E, Gapstur SM. Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort. ENVIRONMENTAL RESEARCH 2016; 148:46-54. [PMID: 27015563 DOI: 10.1016/j.envres.2016.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148Bq/m(3)) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74Bq/m(3)) radon levels (HR=1.63, 95% CI:1.23-2.18), and there was evidence of a dose-response relationship (HRcontinuous=1.38, 95% CI:1.15-1.65 per 100Bq/m(3); p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings.
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Affiliation(s)
- Lauren R Teras
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.
| | - W Ryan Diver
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Michelle C Turner
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada; School of Epidemiology, Public Health and Disease Prevention, University of Ottawa, Ottawa, Ontario, Canada
| | - Liora Sahar
- Statistics and Evaluation Center, American Cancer Society, Atlanta, GA, USA
| | - Elizabeth Ward
- Intramural Research, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
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19
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Ionizing radiation exposures in treatments of solid neoplasms are not associated with subsequent increased risks of chronic lymphocytic leukemia. Leuk Res 2016; 43:9-12. [DOI: 10.1016/j.leukres.2016.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/14/2016] [Accepted: 02/17/2016] [Indexed: 01/30/2023]
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20
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Peckham EC, Scheurer ME, Danysh HE, Lubega J, Langlois PH, Lupo PJ. Residential Radon Exposure and Incidence of Childhood Lymphoma in Texas, 1995-2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12110-26. [PMID: 26404336 PMCID: PMC4626958 DOI: 10.3390/ijerph121012110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/23/2022]
Abstract
There is warranted interest in assessing the association between residential radon exposure and the risk of childhood cancer. We sought to evaluate the association between residential radon exposure and the incidence of childhood lymphoma in Texas. The Texas Cancer Registry (n = 2147) provided case information for the period 1995–2011. Denominator data were obtained from the United States Census. Regional arithmetic mean radon concentrations were obtained from the Texas Indoor Radon Survey and linked to residence at diagnosis. Exposure was assessed categorically: ≤25th percentile (reference), >25th to ≤50th percentile, >50th to ≤75th percentile, and >75th percentile. Negative binomial regression generated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI). We evaluated lymphoma overall and by subtype: Hodgkin (HL; n = 1248), Non-Hodgkin excluding Burkitt (non-BL NHL; n = 658), Burkitt (BL; n = 241), and Diffuse Large B-cell (DLBCL; n = 315). There was no evidence that residential radon exposure was positively associated with lymphoma overall, HL, or BL. Areas with radon concentrations >75th percentile had a marginal increase in DLBCL incidence (aIRR = 1.73, 95% CI: 1.03–2.91). In one of the largest studies of residential radon exposure and the incidence of childhood lymphoma, we found little evidence to suggest a positive or negative association; an observation consistent with previous studies.
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Affiliation(s)
- Erin C Peckham
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Heather E Danysh
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Joseph Lubega
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, MC 1964, P.O. Box 149347, Austin, TX 78714-9347, USA.
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
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Šömen Joksić A, Katz SA. Chelation therapy for treatment of systemic intoxication with uranium: A review. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2015; 50:1479-1488. [PMID: 26305139 DOI: 10.1080/10934529.2015.1071154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Elevated levels of naturally occurring uranium have been found in small geographic areas throughout the world. Exposure of the general public to uranium is most often by the ingestion of food and water containing natural uranium from the hydrogeological environment, but this likelihood is remote. However, the risk is increased in regions where uranium is mined, milled, processed and/or fabricated as well as in the vicinity of former battlefields where depleted uranium munitions were deployed. Exposure in such cases is by the inhalation route. Internalized uranium is a long-term hazard the toxicity of which depends upon the dose and the dose rate as well as other parameters such as the chemical form and site of deposition of the uranium and the physiology of the host. The radiological toxicity and the chemical toxicity of uranium and its compounds are responsible for kidney damage and lung cancer. The vulnerable groups are the very young and the very old, individuals predisposed to hypertension or osteoporosis and individuals with chronic kidney disease. Those subject to long-term exposure from internalized uranium are a greater risk for the long-term implications. The accumulation of uranium may be mitigated by decreasing its absorption, distribution and deposition and increasing its elimination with chelating agents. The formation of soluble chelates may enhance the mobilization of uranium deposited in tissue and expedite its transport to and elimination from the renal system. The focus of this review is on the use of chelating agents to enhance decorporation of uranium thereby reducing the risk of intoxication.
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Affiliation(s)
- Agnes Šömen Joksić
- a National Institute of Public Health, RU Koper , Koper , Republic of Slovenia
- b University of Primorska, Faculty of Health Sciences , Izola , Republic of Slovenia
| | - Sidney A Katz
- c Department of Chemistry , Rutgers University , Camden , New Jersey , USA
- d University of Nova Gorica, School for Environmental Sciences , Nova Gorica , Republic of Slovenia
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The mystery of chronic lymphocytic leukemia (CLL): Why is it absent in Asians and what does this tell us about etiology, pathogenesis and biology? Blood Rev 2014; 29:205-13. [PMID: 25541495 DOI: 10.1016/j.blre.2014.12.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/01/2014] [Accepted: 12/09/2014] [Indexed: 11/23/2022]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma is common in persons of predominately European descent but rare in Asians. Why is unknown but is likely genetically-determined. Environmental factors may also operate but are likely to be less important. When CLL occurs in Asians it has different features than CLL in persons of predominately European descent. The reason(s) for this is also not understood. We reviewed data on CLL in Asians (mostly Han Chinese but also other ethnic groups) and compared these data with those from persons of predominately European descent with CLL. CLL incidence was about 5-10-fold less in Asians. Asians with CLL are younger, have atypical morphologic and immunologic features, an increased proportion of IGHV mutations and rearrangements and briefer freedom-from-progression than persons of predominately European descent with CLL. These observations provide clues to the etiology and biology of CLL. But the mystery continues; more research is needed.
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