Risk of lung cancer associated with residential radon exposure in south-west England: a case-control study
Risk of lung cancer associated with residential radon exposure in south-west England: a case-control study
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DOI：
10.1038/bjc.1998.506
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发表时间：
1998-08-01
影响因子：
8.8
通讯作者：
Doll, R
中科院分区：
文献类型：
--
作者：
Darby, S;Whitley, E;Doll, R
对职业性接触氡的地下矿工进行的研究一致表明，吸烟者和非吸烟者患肺癌的风险增加。氡暴露也发生在其他地方，特别是在房屋中，基于矿工调查结果的估计表明，住宅氡是英国约二十分之一肺癌的原因，大多数是与吸烟结合引起的。然而，这些计算取决于若干假设，需要关于风险程度的更直接证据。为了获得这样的证据，在英格兰西南部进行了一项病例对照研究，其中采访了982名肺癌患者和3185名对照者。此外，氡浓度进行了测量，在受试者居住在30年的时间内结束5年前采访的地址。肺癌的风险进行了检查，考虑到受试者在每个地址居住的时间长度，并调整年龄，性别，吸烟状况，居住县和社会阶层后，住宅氡浓度。观察到的时间加权住宅氡浓度每增加100 Bq m（-3），肺癌的相对危险性增加0.08（95%CI-0.03，0.20）。当分析仅限于484名肺癌受试者和1637名对照受试者时，在整个30年的研究期间，氡测量值可用，相应的增加略高，为0.14/100 Bq m（-3）（95% CI 0.01，0.29），尽管该组与其余受试者之间的差异没有统计学意义。当考虑到氡暴露评估中的不确定性而重复分析时，每100 Bq m（-3）的相对风险估计增加较大，为0.12（95% CI-0.05，0.33），当所有受试者均入选时，0.24（95%CI-0.01，0.56），仅限于所有30年的氡测量结果可用的受试者。这些结果与在其他国家进行的住宅氡研究中收集的个人数据一致。综合证据表明，与住宅氡暴露相关的肺癌风险与根据对氡暴露矿工的研究所假设的风险大小大致相同。
Studies of underground miners occupationally exposed to radon have consistently demonstrated an increased risk of lung cancer in both smokers and non-smokers. Radon exposure also occurs elsewhere, especially in houses, and estimates based on the findings for miners suggest that residential radon is responsible for about one in 20 lung cancers in the UK, most being caused in combination with smoking. These calculations depend, however, on several assumptions and more direct evidence on the magnitude of the risk is needed. To obtain such evidence, a case-control study was carried out in south-west England in which 982 subjects with lung cancer and 3185 control subjects were interviewed. In addition, radon concentrations were measured at the addresses at which subjects had lived during the 30-year period ending 5 years before the interview. Lung cancer risk was examined in relation to residential radon concentration after taking into account the length of time that subjects had lived at each address and adjusting for age, sex, smoking status, county of residence and social class. The relative risk of lung cancer increased by 0.08 (95% CI -0.03, 0.20) per 100 Bq m(-3) increase in the observed time-weighted residential radon concentration. When the analysis was restricted to the 484 subjects with lung cancer and the 1637 control subjects with radon measurements available for the entire 30-year period of interest, the corresponding increase was somewhat higher at 0.14 per 100 Bq m(-3) (95% CI 0.01, 0.29), although the difference between this group and the remaining subjects was not statistically significant. When the analysis was repeated taking into account uncertainties in the assessment of radon exposure, the estimated increases in relative risk per 100 Bq m(-3) were larger, at 0.12 (95% CI -0.05, 0.33) when all subjects were included and 0.24 (95% CI -0.01, 0.56) when limited to subjects with radon measurements available for all 30 years. These results are consistent with those from studies of residential radon carried out in other countries in which data on individual subjects have been collected. The combined evidence suggests that the risk of lung cancer associated with residential radon exposure is about the size that has been postulated on the basis of the studies of miners exposed to radon.