Solid cancer incidence among Chinese medical diagnostic x-ray workers, 1950-1995: Estimation of radiation-related risks.
Solid cancer incidence among Chinese medical diagnostic x-ray workers, 1950-1995: Estimation of radiation-related risks.
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1950-1995年中国医学诊断X射线工作者的实体癌症发病率：辐射相关风险的估计
DOI：
10.1002/ijc.30036
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发表时间：
2016-06-15
影响因子：
6.4
通讯作者：
Fan S
中科院分区：
文献类型：
--
作者：
Sun Z;Inskip PD;Wang J;Kwon D;Zhao Y;Zhang L;Wang Q;Fan S
本研究的目的是估计由于长期、分次职业暴露于低剂量电离辐射而导致的实体癌症风险。根据 1950-1995 年间 27,011 名中国医疗诊断 X 射线工作人员的癌症发病率和 25,782 名在工作中不使用 X 射线设备的中国医生的对照队列，我们使用泊松回归来拟合所有实体癌合并发病率的超额相对风险 (ERR) 和超额绝对风险 (EAR) 剂量反应模型。辐射剂量重建基于之前发布的方法，该方法依赖于对多台 X 射线机、工作场所和工作条件的模拟测量、有关防护措施的信息（包括铅围裙的使用）以及工作历史。所得模型用于估计日历年特定的徽章剂量，并校准为个人剂量当量 (Sv)。为了获得历年特定的结肠剂量 (Gy)，我们应用了标准器官换算系数。在 145 万人年的随访中，发现了 1643 例实体癌病例。在 ERR 和 EAR 模型中，实体癌作为一个群体观察到统计上显着的辐射剂量反应关系。对男女进行平均，并使用结肠剂量作为剂量指标，估计的 ERR/Gy 为 0.87（95% CI：0.48, 1.45），50 岁时 EAR 为每 104PY-Gy 22（95% CI：14, 32）。我们获得了每单位剂量实体癌的 ERR 和 EAR 估计值，这些估计值与来自长期暴露的其他人群的估计值一致低剂量率职业或环境辐射。
The objective of this study was to estimate solid cancer risk attributable to long-term, fractionated occupational exposure to low-doses of ionizing radiation. Based on cancer incidence for the period 1950–1995 in a cohort of 27,011 Chinese medical diagnostic X-ray workers and a comparison cohort of 25,782 Chinese physicians who did not use X-ray equipment in their work, we used Poisson regression to fit excess relative risk (ERR) and excess absolute risk (EAR) dose-response models for incidence of all solid cancers combined. Radiation dose reconstruction was based on a previously published method that relied on simulating measurements for multiple X-ray machines, workplaces and working conditions, information about protective measures, including use of lead aprons, and work histories. The resulting model was used to estimate calendar year-specific badge dose calibrated as personal dose equivalent (Sv). To obtain calendar year-specific colon doses (Gy), we applied a standard organ conversion factor. 1643 cases of solid cancer were identified in 1.45 million person-years of follow-up. In both ERR and EAR models, a statistically significant radiation dose-response relationship was observed for solid cancers as a group. Averaged over both sexes, and using colon dose as the dose metric, the estimated ERR/Gy was 0.87 (95% CI: 0.48, 1.45), and the EAR was 22 per 104PY-Gy (95% CI: 14, 32) at age 50. We obtained estimates of the ERR and EAR of solid cancers per unit dose that are compatible with those derived from other populations chronically exposed to low dose-rate occupational or environmental radiation.