LUNG-CANCER IN RADON-EXPOSED MINERS AND ESTIMATION OF RISK FROM INDOOR EXPOSURE
LUNG-CANCER IN RADON-EXPOSED MINERS AND ESTIMATION OF RISK FROM INDOOR EXPOSURE
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DOI：
10.1093/jnci/87.11.817
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发表时间：
1995-06-07
期刊：
影响因子：
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通讯作者：
PIERCE, DA
中科院分区：
文献类型：
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作者：
LUBIN, JH;BOICE, JD;PIERCE, DA
背景资料：放射性氡是一种惰性气体，可以从土壤和岩石中迁移，并积累在封闭的区域，如房屋和地下矿井。对矿工的研究表明，接触氡衰变产物会导致肺癌。因此，它是公共卫生利益的准确估计的后果，每天低水平暴露在家庭中的这种已知的致癌物质。住宅氡暴露的流行病学研究负担的无法准确估计暴露，低总暴露，以及随后的小过量风险。因此，迄今为止，这些研究尚未得出结论。对住宅氡造成的危害的估计是基于对矿工数据的分析，最近的估计是基于对矿工的四项职业队列研究的汇总，其中包括360例肺癌死亡。目的：为了更全面地描述氡暴露矿工的肺癌风险，我们汇集了来自11项氡暴露地下矿工研究的原始数据，进行了全面的分析，并开发了估计氡相关肺癌风险的模型。研究方法：我们汇总了来自11项氡暴露地下矿工队列研究的原始数据，包括65000名男性和2700多名肺癌死亡，并拟合了各种相对危险度（RR）回归模型。结果如下：累积氡子体暴露的RR关系在矿工暴露的范围内始终是线性的，这表明在较低水平的暴露，如在家中，会带来一定的风险。从不吸烟者的风险响应趋势是吸烟者趋势的三倍，表明从不吸烟者暴露的RR更高。自暴露发生以来，暴露的RR随时间推移而降低。在总接触量相等的情况下，长时间接触（低剂量）比短时间接触（高剂量）的危害更大。结论：在矿工中，约40%的肺癌死亡可能是由于氡子体暴露，70%的肺癌死亡是由于从不吸烟者，39%的肺癌死亡是由于吸烟者。在美国，10%的肺癌死亡可能是由于室内氡暴露，11%的吸烟者肺癌死亡，30%的从不吸烟者肺癌死亡。这个风险模型估计，减少所有家庭的氡超过美国。S.环境保护署的建议行动水平可能会减少肺癌死亡约2%-4%。这些估计数应谨慎解释，因为矿工同时暴露于砷或柴油机废气等物质可能会改变氡的影响，当考虑到家庭和矿井之间的其他差异时，可能会降低矿工调查结果的普遍性。
Background: Radioactive radon is an inert gas that can migrate from soils and rocks and accumulate in enclosed areas, such as homes and underground mines. Studies of miners show that exposure to radon decay products causes lung cancer. Consequently, it is of public health interest to estimate accurately the consequences of daily, low-level exposure in homes to this known carcinogen. Epidemiologic studies of residential radon exposure are burdened by an inability to estimate exposure accurately, low total exposure, and subsequent small excess risks. As a result, the studies have been inconclusive to date. Estimates of the hazard posed by residential radon have been based on analyses of data on miners, with recent estimates based on a pooling of four occupational cohort studies of miners, including 360 lung cancer deaths. Purpose: To more fully describe the lung cancer risk in radon-exposed miners, we pooled original data from 11 studies of radon-exposed underground miners, conducted a comprehensive analysis, and developed models for estimating radon-associated lung cancer risk. Methods: We pooled original data from 11 cohort studies of radon-exposed underground miners, including 65 000 men and more than 2700 lung cancer deaths, and fit various relative risk (RR) regression models. Results: The RR relationship for cumulative radon progeny exposure was consistently linear in the range of miner exposures, suggesting that exposures at lower levels, such as in homes, would carry some risk. The exposure-response trend for never-smokers was threefold the trend for smokers, indicating a greater RR for exposure in never-smokers. The RR from exposure diminished with time since the exposure occurred. For equal total exposure, exposures of long duration (and low rate) were more harmful than exposures of short duration (and high rate). Conclusions: In the miners, about 40% of all lung cancer deaths may be due to radon progeny exposure, 70% of lung cancer deaths in never-smokers, and 39% of lung cancer deaths in smokers. In the United States, 10% of all lung cancer deaths might be due to indoor radon exposure, 11% of lung cancer deaths in smokers, and 30% of lung cancer deaths in never-smokers. This risk model estimates that reducing radon in all homes exceeding the U. S. Environmental Protection Agency's recommended action level may reduce lung cancer deaths about 2%-4%. These estimates should be interpreted with caution, because concomitant exposures of miners to agents such as arsenic or diesel exhaust may modify the radon effect and, when considered together with other differences between homes and mines, might reduce the generalizability of findings in miners.