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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Niu K, Liu Q. Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995. Occup Environ Med 2023; 80:687-693. [PMID: 37918914 DOI: 10.1136/oemed-2023-108875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers. METHODS This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose. RESULTS 1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers. CONCLUSIONS These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.
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Affiliation(s)
- Yeqing Gu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Jinhan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Chang Xu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Liqing Du
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Qin Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaihua Ji
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Ningning He
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Manman Zhang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Huijuan Song
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaijun Niu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
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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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Fenske N, Deffner V, Schnelzer M, Sobotzki C, Kreuzer M. Mortality from cancer (other than lung) and radon exposure in German uranium miners, 1946–2013. BIO WEB OF CONFERENCES 2019. [DOI: 10.1051/bioconf/20191404005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Qu SG, Gao J, Tang B, Yu B, Shen YP, Tu Y. Low-dose ionizing radiation increases the mortality risk of solid cancers in nuclear industry workers: A meta-analysis. Mol Clin Oncol 2018; 8:703-711. [PMID: 29725540 DOI: 10.3892/mco.2018.1590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/28/2018] [Indexed: 11/05/2022] Open
Abstract
Low-dose ionizing radiation (LDIR) may increase the mortality of solid cancers in nuclear industry workers, but only few individual cohort studies exist, and the available reports have low statistical power. The aim of the present study was to focus on solid cancer mortality risk from LDIR in the nuclear industry using standard mortality ratios (SMRs) and 95% confidence intervals. A systematic literature search through the PubMed and Embase databases identified 27 studies relevant to this meta-analysis. There was statistical significance for total, solid and lung cancers, with meta-SMR values of 0.88, 0.80, and 0.89, respectively. There was evidence of stochastic effects by IR, but more definitive conclusions require additional analyses using standardized protocols to determine whether LDIR increases the risk of solid cancer-related mortality.
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Affiliation(s)
- Shu-Gen Qu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Jin Gao
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Bo Tang
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Bo Yu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Yue-Ping Shen
- Department of Health Statistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Yu Tu
- Department of Radiation Health, Research Center of Radiation Protection and Nuclear Safety, School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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Walsh L, Grosche B, Schnelzer M, Tschense A, Sogl M, Kreuzer M. A review of the results from the German Wismut uranium miners cohort. RADIATION PROTECTION DOSIMETRY 2015; 164:147-53. [PMID: 25267854 DOI: 10.1093/rpd/ncu281] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/09/2014] [Indexed: 05/27/2023]
Abstract
The Wismut cohort is currently the largest single study on the health risks associated with occupational exposures to ionising radiation and dust accrued during activities related to uranium mining. The cohort has ∼59 000 male workers, first employed between 1946 and 1989, at the Wismut Company in Germany. The main effect is a statistically significant increase in mortality from lung cancer with both increasing cumulative radon exposure and silica dust exposure. Risks for cancers of the extrathoracic airways, all extra-pulmonary cancers and cardiovascular diseases associated with radiation exposures have been evaluated. Cohort mortality rates for some other cancer sites, stomach and liver, are statistically significantly increased in relation to the general population, but not statistically significantly related to occupational exposures. No associations between leukaemia mortality and occupational doses of ionising radiation were found.
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Affiliation(s)
- L Walsh
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - B Grosche
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - M Schnelzer
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - A Tschense
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - M Sogl
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
| | - M Kreuzer
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, Neuherberg 85764, Germany
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Mortality analyses in the updated French cohort of uranium miners (1946-2007). Int Arch Occup Environ Health 2014; 88:717-30. [PMID: 25410273 DOI: 10.1007/s00420-014-0998-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/10/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE The objectives are to analyze mortality risks in the extended follow-up of the French uranium miners' cohort and to examine their potential relation to occupational exposure to ionizing radiation (IR). METHODS The total cohort includes 5,086 uranium miners employed in the CEA-COGEMA group and followed up from 1946 to 2007. Vital status, causes of death, and cumulative radon exposures were recorded. The post-55 subcohort includes 3,377 miners first employed after 1955, for whom long-lived radionuclides (LLR) and external gamma-ray exposure were also recorded. External mortality analyses were performed by computing standardized mortality ratios (SMR). Excess relative risks (ERRs) due to IR exposures were estimated from Poisson regression models. RESULTS The miners included in the total cohort were followed up for 35.4 years and exposed to 36.6 working level months (WLM) on average. There was no evidence of a difference in overall mortality between miners and the general French male population. Miners had a statistically significant excess mortality rate from lung cancer (SMR = 1.34 [95% CI 1.16-1.53]) and from kidney cancer (SMR = 1.60 [1.03-2.39]). Cumulative radon exposure was significantly associated with lung cancer risk (ERR/100 WLM = 0.71 [0.31-1.30]) and cerebrovascular risk (ERR/100 WLM = 0.41 [0.04-1.03]). In the post-55 subcohort, this excess mortality from lung cancer remained associated with exposure to radon, and also with exposure to LLR and external gamma rays. CONCLUSIONS The analyses in the extended follow-up strengthen the results previously observed among French uranium miners about their excess risk of mortality and its association with their occupational IR exposure.
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