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Abstract
Supplemental Digital Content is available in the text. This paper describes an ecological study investigating whether there is an excess incidence of acute leukaemia among children aged 0–14 years living in the vicinity of the nuclear sites in Belgium. Poisson regression modelling was carried out for proximity areas of varying sizes. In addition, the hypothesis of a gradient in leukaemia incidence with increasing levels of surrogate exposures was explored by means of focused hypothesis tests and generalized additive models. For the surrogate exposures, three proxies were used, that is, residential proximity to the nuclear site, prevailing winds and simulated radioactive discharges, on the basis of mathematical dispersion modelling. No excess incidence of acute leukaemia was observed around the nuclear power plants of Doel or Tihange nor around the nuclear site of Fleurus, which is a major manufacturer of radioactive isotopes in Europe. Around the site of Mol-Dessel, however, two- to three-fold increased leukaemia incidence rates were found in children aged 0–14 years living in the 0–5, 0–10 and the 0–15 km proximity areas. For this site, there was evidence for a gradient in leukaemia incidence with increased proximity, prevailing winds and simulated radioactive discharges, suggesting a potential link with the site that needs further investigation. An increased incidence of acute leukaemia in children aged 0–14 years was observed around one nuclear site that hosted reprocessing activities in the past and where nuclear research activities and radioactive waste treatment are ongoing.
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Kendall GM, Bithell JF, Bunch KJ, Draper GJ, Kroll ME, Murphy MFG, Stiller CA, Vincent TJ. Childhood cancer research in oxford III: The work of CCRG on ionising radiation. Br J Cancer 2018; 119:771-778. [PMID: 30131551 PMCID: PMC6173777 DOI: 10.1038/s41416-018-0182-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/26/2018] [Accepted: 06/20/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND High doses of ionising radiation are a known cause of childhood cancer and great public and professional interest attaches to possible links between childhood cancer and lower doses, particularly of man-made radiation. This paper describes work done by the Childhood Cancer Research Group (CCRG) on this topic METHODS: Most UK investigations have made use of the National Registry of Childhood Tumours and associated controls. Epidemiological investigations have included national incidence and mortality analyses, geographical investigations, record linkage and case-control studies. Dosimetric studies use biokinetic and dosimetric modelling. RESULTS This paper reviews the work of the CCRG on the association between exposure to ionising radiation and childhood cancer, 1975-2014. CONCLUSION The work of CCRG has been influential in developing understanding of the causes of 'clusters' of childhood cancer and the risks arising from exposure to ionising radiation both natural and man-made. Some clusters around nuclear installations have certainly been observed, but ionising radiation does not seem to be a plausible cause. The group's work has also been instrumental in discounting the hypothesis that paternal preconception irradiation was a cause of childhood cancers and has demonstrated an increased leukaemia risk for children exposed to higher levels of natural gamma-ray radiation.
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Affiliation(s)
- Gerald M Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - John F Bithell
- Department of Statistics, University of Oxford, 24-29 St Giles', Oxford, OX1 3LB, UK
| | - Kathryn J Bunch
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Gerald J Draper
- Department of Statistics, University of Oxford, 24-29 St Giles', Oxford, OX1 3LB, UK
| | - Mary E Kroll
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michael F G Murphy
- Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Chancellor Court, Oxford Business Park South, Oxford, OX4 2GX, UK
| | - Tim J Vincent
- Formerly of Childhood Cancer Research Group, University of Oxford, Oxford, UK
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Desbiolles A, Roudier C, Goria S, Stempfelet M, Kairo C, Quintin C, Bidondo M, Monnereau A, Vacquier B. Cancer incidence in adults living in the vicinity of nuclear power plants in France, based on data from the French Network of Cancer Registries. Int J Cancer 2017; 142:899-909. [DOI: 10.1002/ijc.31116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Alice Desbiolles
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Candice Roudier
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Sarah Goria
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Morgane Stempfelet
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Cécile Kairo
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Cécile Quintin
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Marie‐Laure Bidondo
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Alain Monnereau
- French Network of Cancer Registries (FRANCIM) and INSERM U1219 EPICENE Team, Bordeaux France
| | - Blandine Vacquier
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
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Kheifets L, Swanson J, Yuan Y, Kusters C, Vergara X. Comparative analyses of studies of childhood leukemia and magnetic fields, radon and gamma radiation. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:459-491. [PMID: 28586320 DOI: 10.1088/1361-6498/aa5fc7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this paper we compare the findings of epidemiologic studies of childhood leukemia that examined at least two of ELF magnetic fields and/or distance to power lines, and exposure to radon and gamma radiation or distance to nuclear plants. Many of the methodologic aspects are common to studies of non-ionising (i.e. ELF-MF) and ionising radiation. A systematic search and review of studies with more than one exposure under study identified 33 key and 35 supplementary papers from ten countries that have been included in this review. Examining studies that have looked at several radiation exposures, and comparing similarities and differences for the different types of radiation, through the use of directed acyclic graphs, we evaluate to what extent bias, confounding and other methodological issues might be operating in these studies. We found some indication of bias, although results are not clear cut. There is little evidence that confounding has had a substantial influence on results. Influence of the residential mobility on the study conduct and interpretation is complex and can manifest as a selection bias, confounding, increased measurement error or could also be a potential risk factor. Other factors associated with distance to power lines and to nuclear power plants should be investigated. A more complete and consistent reporting of results in the future studies will allow for a more informative comparison across studies and integration of results.
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Affiliation(s)
- Leeka Kheifets
- University of California Los Angeles, United States of America
| | - John Swanson
- National Grid, 1-3 Strand, London, United Kingdom
| | - Yingzhe Yuan
- University of California Los Angeles, United States of America
| | - Cynthia Kusters
- University of California Los Angeles, United States of America
| | - Ximena Vergara
- University of California Los Angeles, United States of America
- Electric Power Research Institute, Palo Alto, CA, United States of America
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Spix C, Grosche B, Bleher M, Kaatsch P, Scholz-Kreisel P, Blettner M. Background gamma radiation and childhood cancer in Germany: an ecological study. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2017; 56:127-138. [PMID: 28337585 DOI: 10.1007/s00411-017-0689-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 03/11/2017] [Indexed: 06/06/2023]
Abstract
The relationship of low-dose background gamma radiation and childhood leukaemia was investigated in a number of studies. Results from these studies are inconclusive. Therefore, in the present study 25 years of German childhood cancer data were analyzed using interpolated background annual gamma dose rate per community in an ecological study. The main question was leukaemia; as exploratory questions we investigate central nervous system (CNS) tumours, thyroid carcinomas and diagnoses less likely to be related to radiation. A Poisson regression model was applied and a fractional polynomial model building procedure. As the main sensitivity analysis a community deprivation index was included as a potential confounder. It was found that outdoor background gamma annual dose rates in Germany range roughly from 0.5-1.5 mSv/a with an average of 0.817 mSv/a. No association of annual ambient gamma dose rates with leukaemia incidence was found. Amongst the exploratory analyses, a strong association was found with CNS tumour incidence [rate ratio for 1.5 vs 0.5 mSv/a: 1.35; 95% confidence interval (1.17, 1.57)]. The community level deprivation index was not a confounder. It is concluded that the present study did not confirm an association of annual outdoor ambient gamma dose rate and childhood leukaemia, corresponding to some studies and contrasting others. An association with CNS incidence was found in the exploratory analyses. As this is an ecological study no causal interpretation is possible.
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Affiliation(s)
- Claudia Spix
- German Childhood Cancer Registry at the Institute for Medical Biometry, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany.
| | - Bernd Grosche
- Federal Office for Radiation Protection, 85764, Oberschleissheim, Germany
| | - Martin Bleher
- Federal Office for Radiation Protection, 85764, Oberschleissheim, Germany
| | - Peter Kaatsch
- German Childhood Cancer Registry at the Institute for Medical Biometry, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany
| | - Peter Scholz-Kreisel
- Institute for Medical Biometry, Epidemiology and Informatics, University Medical center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany
| | - Maria Blettner
- Institute for Medical Biometry, Epidemiology and Informatics, University Medical center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany
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Fornalski KW, Cohen M, Cuttler JM, Dobrzyński L, Doss M, Esposito VJ, Feinendegen LE, Fellman A, Miller ML, Orient J, Pennington CW, Rithidech KN, Sacks B, Sanders CL, Scott BR, Siegel JA, Socol Y, Welsh J. French nuclear power plants and childhood leukemia. Dose Response 2015; 12:518-21. [PMID: 25552953 DOI: 10.2203/dose-response.14-048.fornalski] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jane Orient
- President of Doctors for Disaster Preparedness, USA
| | | | | | - Bill Sacks
- FDA's Center for Devices and Radiological Health (retired), USA
| | | | - Bobby R Scott
- Lovelace Respiratory Research Institute (retired), USA
| | | | | | - James Welsh
- Loyola University Chicago - Stritch School of Medicine, USA
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Thyroid cancer incidence around the Belgian nuclear sites: surrogate exposure modelling. Cancer Epidemiol 2014; 39:48-54. [PMID: 25475063 DOI: 10.1016/j.canep.2014.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/02/2014] [Accepted: 10/28/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND In a recent ecological study among residents living around Belgian nuclear sites (the NUCABEL study), significant increased incidences of thyroid cancer were observed around the two nuclear facilities with industrial and research activities (Mol-Dessel and Fleurus), prompting further research. METHODS The data from the NUCABEL study were reanalysed to test the hypothesis of a gradient in cancer incidence with increasing levels of exposure from these sites using three measures of surrogate exposure, being (i) residential proximity, (ii) prevailing wind directions and (iii) simulated dispersion of radioactive discharges. Single-site focussed hypothesis tests were complemented with Generalized Additive Models to estimate the exposure-response relationships. RESULTS For Mol-Dessel, the results of the focussed hypothesis tests were far from significant. For Fleurus, the p-values were much closer to significance with p=0.05 for Bithell's Linear Risk Score using radioactive discharge estimates as surrogate. CONCLUSIONS The re-analyses refute an association with the nuclear facilities for the site of Mol-Dessel. For the site of Fleurus, one of Europe's major production sites of radio-iodines, the results were less conclusive and further research suggests itself.
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Fairlie I. A hypothesis to explain childhood cancers near nuclear power plants. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2014; 133:10-17. [PMID: 24054083 DOI: 10.1016/j.jenvrad.2013.07.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 06/05/2013] [Accepted: 07/29/2013] [Indexed: 06/02/2023]
Abstract
Over 60 epidemiological studies world-wide have examined cancer incidences in children near nuclear power plants (NPPs): most of them indicate leukemia increases. These include the 2008 KiKK study commissioned by the German Government which found relative risks (RR) of 1.6 in total cancers and 2.2 in leukemias among infants living within 5 km of all German NPPs. The KiKK study has retriggered the debate as to the cause(s) of these increased cancers. A suggested hypothesis is that the increased cancers arise from radiation exposures to pregnant women near NPPs. However any theory has to account for the >10,000 fold discrepancy between official dose estimates from NPP emissions and observed increased risks. An explanation may be that doses from spikes in NPP radionuclide emissions are significantly larger than those estimated by official models which are diluted through the use of annual averages. In addition, risks to embryos/fetuses are greater than those to adults and haematopoietic tissues appear more radiosensitive in embryos/fetuses than in newborn babies. The product of possible increased doses and possible increased risks per dose may provide an explanation.
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Affiliation(s)
- Ian Fairlie
- 115 Riversdale Road, London N5 2SU, United Kingdom.
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Dagher RLE, Thompson JBPA. Radiation Exposure and Cancer Incidence (1990 to 2008) around Nuclear Power Plants in Ontario, Canada. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jep.2013.49104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Recent epidemiological studies of the association between lung cancer and exposure to radon and its decay products are reviewed. Particular emphasis is given to pooled case-control studies of residential exposures, and to cohorts of underground miners exposed to relatively low levels of radon. The residential and miner epidemiological studies provide consistent estimates of the risk of lung cancer, with significant associations observed at average annual concentrations of approximately 200 Bq/m³ and cumulative occupational levels of approximately 50 working level months (WLM), respectively. Based on recent results from combined analyses of epidemiological studies of miners, a lifetime excess absolute risk of 5 × 10⁻⁴ per WLM [14 × 10⁻⁵ per (mJh/m³)] should now be used as the nominal probability coefficient for radon- and radon-progeny-induced lung cancer, replacing the previous Publication 65 (ICRP, 1993) value of 2.8 × 10⁻⁴ per WLM [8 × 10⁻⁵ per (mJh/m³)]. Current knowledge of radon-associated risks for organs other than the lungs does not justify the selection of a detriment coefficient different from the fatality coefficient for radon-induced lung cancer. Publication 65 (ICRP, 2003) recommended that doses from radon and its progeny should be calculated using a dose conversion convention based on epidemiological data. It is now concluded that radon and its progeny should be treated in the same way as other radionuclides within the ICRP system of protection; that is, doses from radon and its progeny should be calculated using ICRP biokinetic and dosimetric models. ICRP will provide dose coefficients per unit exposure to radon and its progeny for different reference conditions of domestic and occupational exposure, with specified equilibrium factors and aerosol characteristics.
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Sermage-Faure C, Laurier D, Goujon-Bellec S, Chartier M, Guyot-Goubin A, Rudant J, Hémon D, Clavel J. Childhood leukemia around French nuclear power plants-The geocap study, 2002-2007. Int J Cancer 2012; 131:E769-80. [DOI: 10.1002/ijc.27425] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 12/20/2011] [Indexed: 11/09/2022]
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Spycher BD, Feller M, Zwahlen M, Röösli M, von der Weid NX, Hengartner H, Egger M, Kuehni CE. Childhood cancer and nuclear power plants in Switzerland: a census-based cohort study. Int J Epidemiol 2011; 40:1247-60. [PMID: 21750009 PMCID: PMC3204210 DOI: 10.1093/ije/dyr115] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2011] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies on childhood cancer and nuclear power plants (NPPs) produced conflicting results. We used a cohort approach to examine whether residence near NPPs was associated with leukaemia or any childhood cancer in Switzerland. METHODS We computed person-years at risk for children aged 0-15 years born in Switzerland from 1985 to 2009, based on the Swiss censuses 1990 and 2000 and identified cancer cases from the Swiss Childhood Cancer Registry. We geo-coded place of residence at birth and calculated incidence rate ratios (IRRs) with 95% confidence intervals (CIs) comparing the risk of cancer in children born <5 km, 5-10 km and 10-15 km from the nearest NPP with children born >15 km away, using Poisson regression models. RESULTS We included 2925 children diagnosed with cancer during 21 117 524 person-years of follow-up; 953 (32.6%) had leukaemia. Eight and 12 children diagnosed with leukaemia at ages 0-4 and 0-15 years, and 18 and 31 children diagnosed with any cancer were born <5 km from a NPP. Compared with children born >15 km away, the IRRs (95% CI) for leukaemia in 0-4 and 0-15 year olds were 1.20 (0.60-2.41) and 1.05 (0.60-1.86), respectively. For any cancer, corresponding IRRs were 0.97 (0.61-1.54) and 0.89 (0.63-1.27). There was no evidence of a dose-response relationship with distance (P > 0.30). Results were similar for residence at diagnosis and at birth, and when adjusted for potential confounders. Results from sensitivity analyses were consistent with main results. CONCLUSIONS This nationwide cohort study found little evidence of an association between residence near NPPs and the risk of leukaemia or any childhood cancer.
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Affiliation(s)
- Ben D Spycher
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Martin Feller
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Marcel Zwahlen
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Martin Röösli
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Nicolas X von der Weid
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Heinz Hengartner
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Matthias Egger
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
| | - Claudia E Kuehni
- Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland, School of Social and Community Medicine, University of Bristol, Bristol, UK, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Switzerland, Paediatric Haematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois, Service de Pédiatrie, Lausanne-CHUV, Switzerland and Ostschweizer Kinderspital, St Gallen, Switzerland
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Ghirga G. Cancer in children residing near nuclear power plants: an open question. Ital J Pediatr 2010; 36:60. [PMID: 20831815 PMCID: PMC2944154 DOI: 10.1186/1824-7288-36-60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Accepted: 09/10/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global warming and the established responsibility of the anthropogenic emissions of greenhouse gases represent a strong push towards the construction of new nuclear power plants (NPPs) to cope with the growing energy needs. The toxicity of nuclear waste associated with the extreme difficulty of their disposal and increase in cancer mortality and incidence following occupational radiation exposure are considered the only health problems. METHODS A search of scientific articles and government documents published since January 1, 1980 to July 1, 2010 was performed to evaluate cancer rate and mortality in residents, particularly children, in the vicinity of NPPs. RESULTS A recent well conducted state-of-the-art case-control study of childhood cancers in the areas around German NPPs (KiKK study) showed a statistically significant cancers (2.2-fold increase in leukemia and a 1.6-fold increase in solid tumor) among children under five years of age living in the inner 5 km circle around NPPs when compared to residence outside this area. These findings have been confirmed by two meta-analyses. Nevertheless, other UK, France, Spain and Finland studies did not find cancer incidence and/or death increase near NPPs. CONCLUSIONS Increased cancer risk near NPPs remains in fact an open question. The stronger evidence from the KiKK study suggests there may well be such increases at least in children regardless of the country in which nuclear reactors are located. In fact, few months ago the U.S. Nuclear Regulatory Commission has asked the National Academy of Sciences (NAS) to perform a state-of-the-art study on cancer risk for populations surrounding NPPs.
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Affiliation(s)
- Giovanni Ghirga
- International Society of Doctors for Environment Alto Lazio, Italy.
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Fairlie I. Childhood cancers near German nuclear power stations: hypothesis to explain the cancer increases. Med Confl Surviv 2010; 25:206-20. [PMID: 19813417 DOI: 10.1080/13623690902943396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In early 2008, the very large Kinderkrebs in der Umgebung von Kernkraftwerken [Childhood Cancer near Nuclear Power Plants] (KiKK) study in Germany reported increases in leukaemias and solid cancers among children living near all German nuclear power plants (NPPs). This study, previously described in Medicine, Conflict and Survival, has triggered debates in many countries as to the cause or causes of these increased cancers. An accompanying article reports on the recent developments on the KiKK study including the responses by German radiation agencies, and the results of recent epidemiological studies near United Kingdom and French nuclear installations. This article outlines a possible explanation for the increased cancers. In essence, doses from environmental NPP emissions to embryos/foetuses in pregnant women near NPPs may be larger than suspected, and haematopoietic tissues may be considerably more radiosensitive in embryos/foetuses than in newborn babies. The article concludes with recommendations for further research.
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Dauer LT, Brooks AL, Hoel DG, Morgan WF, Stram D, Tran P. Review and evaluation of updated research on the health effects associated with low-dose ionising radiation. RADIATION PROTECTION DOSIMETRY 2010; 140:103-136. [PMID: 20413418 DOI: 10.1093/rpd/ncq141] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
While radiation health risks at low doses have traditionally been estimated from high-dose studies, we have reviewed recent literature and concluded that the mechanisms of action for many biological endpoints may be different at low doses from those observed at high doses; that acute doses <100 mSv may be too small to allow epidemiological detection of excess cancers given the background of naturally occurring cancers; that low-dose radiation research should use holistic approaches such as systems-based methods to develop models that define the shape of the dose-response relationship; and that these results should be combined with the latest epidemiology to produce a comprehensive understanding of radiation effects that addresses both damage, likely with a linear effect, and response, possibly with non-linear consequences. Continued research is needed to understand how radiobiology and epidemiology advances should be used to effectively model radiation worker risks.
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Affiliation(s)
- Lawrence T Dauer
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Wakeford R, Darby SC, Murphy MFG. Temporal trends in childhood leukaemia incidence following exposure to radioactive fallout from atmospheric nuclear weapons testing. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2010; 49:213-227. [PMID: 20309707 DOI: 10.1007/s00411-010-0266-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 01/21/2010] [Indexed: 05/29/2023]
Abstract
Notably raised rates of childhood leukaemia incidence have been found near some nuclear installations, in particular Sellafield and Dounreay in the United Kingdom, but risk assessments have concluded that the radiation doses estimated to have been received by children or in utero as a result of operations at these installations are much too small to account for the reported increases in incidence. This has led to speculation that the risk of childhood leukaemia arising from internal exposure to radiation following the intake of radioactive material released from nuclear facilities has been substantially underestimated. The radionuclides discharged from many nuclear installations are similar to those released into the global environment by atmospheric nuclear weapons testing, which was at its height in the late-1950s and early-1960s. Measurements of anthropogenic radionuclides in members of the general public resident in the vicinity of Sellafield and Dounreay have found levels that do not differ greatly from those in persons living remote from nuclear installations that are due to ubiquitous exposure to the radioactive debris of nuclear weapons testing. Therefore, if the leukaemia risk to children resulting from deposition within the body of radioactive material discharged from nuclear facilities has been grossly underestimated, then a pronounced excess of childhood leukaemia would have been expected as a consequence of the short period of intense atmospheric weapons testing. We have examined childhood leukaemia incidence in 11 large-scale cancer registries in three continents for which data were available at least as early as 1962. We found no evidence of a wave of excess cases corresponding to the peak of radioactive fallout from atmospheric weapons testing. The absence of a discernible increase in the incidence of childhood leukaemia following the period of maximum exposure to the radioactive debris of this testing weighs heavily against the suggestion that conventional methods are seriously in error when assessing the risk of childhood leukaemia from exposure to man-made radionuclides released from nuclear installations.
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Affiliation(s)
- Richard Wakeford
- Dalton Nuclear Institute, The University of Manchester, Pariser Building, G Floor, Sackville Street, PO Box 88, Manchester, M60 1QD, UK.
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Fairlie I. Childhood cancer near German nuclear power stations. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2010; 28:1-21. [PMID: 20390965 DOI: 10.1080/10590500903585366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In 2008, the Kinderkrebs in der Umgebung von Kernkraftwerken (KiKK) study in Germany reported a 60% increase in solid cancers and a 120% increase in leukemias among children living within 5 km of all German nuclear power stations. The study has triggered debates as to the cause(s) of these increased cancers. This article reports on the findings of the KiKK study; discusses past and more recent epidemiological studies of leukemias near nuclear installations around the world, and outlines a possible biological mechanism to explain the increased cancers. This suggests that the observed high rates of infant leukemias may be a teratogenic effect from radionuclides incorporated by pregnant women living near nuclear reactors. Doses and risks from environmental emissions to embryos and fetuses may be larger than suspected. Hematopoietic tissues appear to be considerably more radiosensitive in embryos/fetuses than in newborn babies. Recommendations for advice to local residents and for further research are made.
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Cancer incidence in the vicinity of Finnish nuclear power plants: an emphasis on childhood leukemia. Cancer Causes Control 2009; 21:587-95. [PMID: 20037792 PMCID: PMC2839478 DOI: 10.1007/s10552-009-9488-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 12/05/2009] [Indexed: 11/05/2022]
Abstract
The objective of this paper was to study cancer incidence, especially leukemia in children (<15 years), in the vicinity of Finnish nuclear power plants (NPPs). We used three different approaches: ecological analysis at municipality level, residential cohorts defined from census data, and case–control analysis with individual residential histories. The standardized incidence ratio of childhood leukemia for the seven municipalities in the vicinity of NPPs was 1.0 (95% CI 0.6, 1.6) compared to the rest of Finland. The two cohorts defined by censuses of 1980 and 1990 gave rate ratios of 1.0 (95% CI 0.3, 2.6) and 0.9 (95% CI 0.2, 2.7), respectively, for childhood leukemia in the population residing within 15 km from the NPPs compared to the 15–50 km zone. The case–control analysis with 16 cases of childhood leukemia and 64 matched population-based controls gave an odds ratio for average distance between residence and NPP in the closest 5–9.9 km zone of 0.7 (95% CI 0.1, 10.4) compared to ≥30 km zone. Our results do not indicate an increase in childhood leukemia and other cancers in the vicinity of Finnish NPPs though the small sample size limits the strength of conclusions. The conclusion was the same for adults.
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Nussbaum RH. Childhood leukemia and cancers near German nuclear reactors: significance, context, and ramifications of recent studies. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2009; 15:318-23. [PMID: 19650588 DOI: 10.1179/oeh.2009.15.3.318] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A government-sponsored study of childhood cancer in the proximity of German nuclear power plants (German acronym KiKK) found that children < 5 years living < 5 km from plant exhaust stacks had twice the risk for contracting leukemia as those residing > 5 km. The researchers concluded that since "this result was not to be expected under current radiation-epidemiological knowledge" and confounders could not be identified, the observed association of leukemia incidence with residential proximity to nuclear plants "remains unexplained." This unjustified conclusion illustrates the dissonance between evidence and assumptions. There exist serious flaws and gaps in the knowledge on which accepted models for population exposure and radiation risk are based. Studies with results contradictory to those of KiKK lack statistical power to invalidate its findings. The KiKK study's ramifications add to the urgency for a public policy debate regarding the health impact of nuclear power generation.
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Affiliation(s)
- Rudi H Nussbaum
- Department of Physics and Environmental Sciences, Portland State University, Portland, OR, USA.
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Fairlie I. Commentary: childhood cancer near nuclear power stations. Environ Health 2009; 8:43. [PMID: 19775438 PMCID: PMC2757021 DOI: 10.1186/1476-069x-8-43] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 09/23/2009] [Indexed: 05/28/2023]
Abstract
In 2008, the KiKK study in Germany reported a 1.6-fold increase in solid cancers and a 2.2-fold increase in leukemias among children living within 5 km of all German nuclear power stations. The study has triggered debates as to the cause(s) of these increased cancers. This article reports on the findings of the KiKK study; discusses past and more recent epidemiological studies of leukemias near nuclear installations around the world, and outlines a possible biological mechanism to explain the increased cancers. This suggests that the observed high rates of infant leukemias may be a teratogenic effect from incorporated radionuclides. Doses from environmental emissions from nuclear reactors to embryos and fetuses in pregnant women near nuclear power stations may be larger than suspected. Hematopoietic tissues appear to be considerably more radiosensitive in embryos/fetuses than in newborn babies. Recommendations for advice to local residents and for further research are made.
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Tubiana M, Feinendegen LE, Yang C, Kaminski JM. The linear no-threshold relationship is inconsistent with radiation biologic and experimental data. Radiology 2009; 251:13-22. [PMID: 19332842 PMCID: PMC2663584 DOI: 10.1148/radiol.2511080671] [Citation(s) in RCA: 331] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Maurice Tubiana
- Department of Medicine, Centre Antoine Beclere, Paris, France
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Kaatsch P, Spix C, Schulze-Rath R, Schmiedel S, Blettner M. Leukaemia in young children living in the vicinity of German nuclear power plants. Int J Cancer 2008; 122:721-6. [DOI: 10.1002/ijc.23330] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Case–control study on childhood cancer in the vicinity of nuclear power plants in Germany 1980–2003. Eur J Cancer 2008; 44:275-84. [DOI: 10.1016/j.ejca.2007.10.024] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 10/11/2007] [Accepted: 10/29/2007] [Indexed: 11/19/2022]
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Laurier D, Jacob S, Bernier MO, Leuraud K, Metz C, Samson E, Laloi P. Epidemiological studies of leukaemia in children and young adults around nuclear facilities: a critical review. RADIATION PROTECTION DOSIMETRY 2008; 132:182-90. [PMID: 18922823 DOI: 10.1093/rpd/ncn262] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The existence of an increased risk of childhood leukaemia near nuclear installations is a recurrent issue. A review of the related epidemiological literature is presented here. Results for 198 nuclear sites throughout 10 countries were included in the review. In addition to local studies, 25 multi-site studies have been published for eight countries. A large variability was noticed in the quality of the data as well as in the definition of the study population and in the methods of analysis. Many studies present important limits that make the results difficult to interpret. The review confirms that some clusters of childhood leukaemia cases exist locally. However, results based on multi-site studies around nuclear installations do not indicate an increased risk globally. Many studies were launched to investigate possible origins of the observed clusters around specific sites, but up to now, none of the proposed hypotheses have explained them.
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Affiliation(s)
- D Laurier
- Institute for Radiological Protection and Nuclear Safety, IRSN, DRPH/SRBE, BP17, F-92262 Fontenay-aux-Roses Cedex, France.
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Little J, McLaughlin J, Miller A. Leukaemia in young children living in the vicinity of nuclear power plants. Int J Cancer 2007; 122:x-xi. [DOI: 10.1002/ijc.23347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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