Risk of Lung Cancer Mortality in Nuclear Workers from Internal Exposure to Alpha Particle-emitting Radionuclides

作者：James Grellier, W. D. Atkinson, Philippe Berard, Derek Bingham, Alan Birchall, E. Blanchardon, R.K. Bull, Irina Guseva Canu, C. Challeton-de Vathaire, Rupert Cockerill, Minh T. Do, Hilde Engels, Jordi Figuerola, A. D. Foster, Luc Holmstock, Christian Hurtgen, Dominique Laurier, Matthew R. B. Puncher, Anthony E. Riddell, Éric Samson, Isabelle Thierry-Chef, Margot Tirmarche, Martine Vrijheid, Elisabeth Cardis · 发表于：Epidemiology · 年份：2017 · DOI：10.1097/ede.0000000000000684 · 被引用次数：49 · 研究领域：Radioactivity and Radon Measurements、Radioactive contamination and transfer、Radiation Dose and Imaging

BACKGROUND: Carcinogenic risks of internal exposures to alpha-emitters (except radon) are poorly understood. Since exposure to alpha particles-particularly through inhalation-occurs in a range of settings, understanding consequent risks is a public health priority. We aimed to quantify dose-response relationships between lung dose from alpha-emitters and lung cancer in nuclear workers. METHODS: We conducted a case-control study, nested within Belgian, French, and UK cohorts of uranium and plutonium workers. Cases were workers who died from lung cancer; one to three controls were matched to each. Lung doses from alpha-emitters were assessed using bioassay data. We estimated excess odds ratio (OR) of lung cancer per gray (Gy) of lung dose. RESULTS: The study comprised 553 cases and 1,333 controls. Median positive total alpha lung dose was 2.42 mGy (mean: 8.13 mGy; maximum: 316 mGy); for plutonium the median was 1.27 mGy and for uranium 2.17 mGy. Excess OR/Gy (90% confidence interval)-adjusted for external radiation, socioeconomic status, and smoking-was 11 (2.6, 24) for total alpha dose, 50 (17, 106) for plutonium, and 5.3 (-1.9, 18) for uranium. CONCLUSIONS: We found strong evidence for associations between low doses from alpha-emitters and lung cancer risk. The excess OR/Gy was greater for plutonium than uranium, though confidence intervals overlap. Risk estimates were similar to those estimated previously in plutonium workers, and in uranium miners exposed to radon and its p...