Risk of Leukemia Associated with Protracted Low-Dose Radiation Exposure: Updated Results from the National Registry for Radiation Workers Study
Risk of Leukemia Associated with Protracted Low-Dose Radiation Exposure: Updated Results from the National Registry for Radiation Workers Study
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DOI：
10.1667/rr15358.1
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发表时间：
2019-11-01
影响因子：
3.4
通讯作者：
Zhang, Wei
中科院分区：
文献类型：
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作者：
Gillies, Michael;Haylock, Richard;Zhang, Wei
虽然白血病风险与急性辐射照射之间的联系对于急性接受的大剂量而言已得到充分确立，但将这些风险估计数转化为职业照射情景仍然存在不确定性，因为职业照射情景中的剂量很低，并随着时间的推移而积累，可能持续多年。我们目前的白血病发病率和死亡率的辐射风险估计来自国家登记处的辐射工作人员，这是一个大型队列的职业暴露的工人从英国（UK）。该队列包括来自英国的173，081名工人，他们接受了职业辐射暴露监测。该队列共随访530万人年，确定了白血病的发病率和死亡率，直至2011年随访结束。Poisson回归采用超额相对危险度（ERR）和超额加性危险度（ERI）模型研究累积辐射剂量与白血病死亡率和发病率之间的关系。这项工作的结果表明，该队列累积的集体剂量为4，414人希沃特，平均累积剂量为25.5 mSv。在男性工作者中，ERR模型和ESTA模型均显示与累积剂量增加相关的白血病风险增加（不包括慢性淋巴细胞白血病）的证据。当使用线性模型时，ERR为1.38/Sv（90% CI：0.04; 3.24），RR为1.33/10，000人-年-Sv（90% CI：0.04; 2.89）。这些额外风险是由慢性髓性白血病风险增加驱动的[ERR/Sv = 6.77（90% CI：2.14; 15.44）]。总之，这项研究提供了进一步的证据表明，低剂量和长期的外部辐射暴露可能会增加白血病的风险。这些风险与原子弹爆炸幸存者研究中观察到的风险以及国际辐射安全标准所依据的风险系数基本一致，包括用于控制照射的剂量限制和约束。(C)2019辐射研究学会
While the link between risk of leukemia and acute radiation exposure is well established for large doses received acutely, uncertainty remains around the translation of these risk estimates to occupational exposure scenarios where the doses are low and accumulated over time, possibly over many years. We present leukemia incidence and mortality radiation risk estimates derived from the National Registry for Radiation Workers, which is a large cohort of occupationally exposed workers from the United Kingdom (UK). The cohort comprised 173,081 workers from the UK who were monitored for occupational exposure to radiation. The cohort was followed for a total of 5.3 million person-years and the incidence and mortality due to leukemia was identified through to the end of follow-up in 2011. Poisson regression was used to investigate the relationship between cumulative radiation dose and leukemia mortality and incidence rates using excess relative risk (ERR) and excess additive risk (EAR) models. The results of this work showed a collective dose of 4,414 person-Sv accumulated by the cohort with an average cumulative dose of 25.5 mSv. Among male workers both the ERR and EAR models showed evidence of increased leukemia risk (excluding chronic lymphatic leukemia) associated with increasing cumulative dose. The ERR was 1.38 per Sv (90% CI: 0.04; 3.24) and EAR was 1.33 per 10,000 person-year-Sv (90% CI: 0.04; 2.89) when a linear model was used. These excess risks were driven by increased risks for chronic myeloid leukemia [ERR/Sv = 6.77 (90% CI: 2.14; 15.44)]. In conclusion, this study provides further evidence that leukemia risks may be increased by low-dose and protracted external radiation exposure. The risks are generally consistent with those observed in the atomic bomb survivor studies, as well as with risk coefficients on which international radiation safety standards, including the dose limits and constraints used to control exposures, are based. (C) 2019 by Radiation Research Society