The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: Estimates of Radiation-Related Cancer Risks

• DOI: 10.1667/rr0553.1
• Publication Date: 2007-03-27T18:01:57Z
• Authors: E. Cardis; M. Vrijheid; M. Blettner; E. Gilbert; M. Hakama; C. Hill; G. Howe; J. Kaldor; C. R. Muirhead; M. Schubauer-Berigan; T. Yoshimura; F. Bermann; G. Cowper; J. Fix; C. Hacker; B. Heinmiller; M. Marshall; I. Thierry-Chef; D. Utterback; Y-O. Ahn; E. Amoros; P. Ashmore; A. Auvinen; J-M. Bae; J. Bernar; A. Biau; E. Combalot; P. Deboodt; A. Diez Sacristan; M. Eklöf; H. Engels; G. Engholm; G. Gulis; R. R. Habib; K. Holan; H. Hyvonen; A. Kerekes; J. Kurtinaitis; H. Malker; M. Martuzzi; A. Mastauskas; A. Monnet; M. Moser; M. S. Pearce; D. B. Richardson; F. Rodriguez-Arta...; A. Rogel; H. Tardy; M. Telle-Lamberton; I. Turai; M. Usel; K. Veress
• Keywords: Male; Neoplasms, Radiation-Induced; [SDV]Life Sciences [q-bio]; International Cooperation; radiation exposure; nuclear industry; cancer risk; Whole-Body Counting; Cohort Studies; cause of death; 0302 clinical medicine; Nuclear Reactors; Risk Factors; Neoplasms; cancer mortality; industry; adult; international cooperation; article; leukemia; risk assessment; methodology; cohort analysis; 3. Good health; multiple myeloma; Occupational Diseases; Survival Rate; female; priority journal; risk factor; statistics; employment; Female; ionizing radiation; radiation dose; radiation injury; survival rate; Adult; Employment; 610; Radiation Dosage; survival; Risk Assessment; 03 medical and health sciences; socioeconomics; male; Occupational Exposure; follow up; Humans; Industry; human; industrial worker; Nicotiana tabacum; occupational exposure; mortality; Survival Analysis; lung cancer; whole body counting; confidence interval; Radiation-Induced; occupational disease; nuclear reactor

A 15-Country collaborative cohort study was conducted to provide direct estimates of cancer risk following protracted low doses of ionizing radiation. Analyses included 407,391 nuclear industry workers monitored individually for external radiation and 5.2 million person-years of follow-up. A significant association was seen between radiation dose and all-cause mortality [excess relative risk (ERR) 0.42 per Sv, 90% CI 0.07, 0.79; 18,993 deaths]. This was mainly attributable to a dose-related increase in all cancer mortality (ERR/Sv 0.97, 90% CI 0.28, 1.77; 5233 deaths). Among 31 specific types of malignancies studied, a significant association was found for lung cancer (ERR/Sv 1.86, 90% CI 0.49, 3.63; 1457 deaths) and a borderline significant (P = 0.06) association for multiple myeloma (ERR/Sv 6.15, 90% CI <0, 20.6; 83 deaths) and ill-defined and secondary cancers (ERR/Sv 1.96, 90% CI -0.26, 5.90; 328 deaths). Stratification on duration of employment had a large effect on the ERR/Sv, reflecting a strong healthy worker survivor effect in these cohorts. This is the largest analytical epidemiological study of the effects of low-dose protracted exposures to ionizing radiation to date. Further studies will be important to better assess the role of tobacco and other occupational exposures in our risk estimates.