COMBINED ANALYSIS OF MORTALITY IN 3 UNITED-KINGDOM NUCLEAR INDUSTRY WORKFORCES, 1946-1988
COMBINED ANALYSIS OF MORTALITY IN 3 UNITED-KINGDOM NUCLEAR INDUSTRY WORKFORCES, 1946-1988
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DOI：
10.2307/3578592
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发表时间：
1994-05-01
影响因子：
3.4
通讯作者：
SMITH, P
中科院分区：
文献类型：
--
作者：
CARPENTER, L;HIGGINS, C;SMITH, P
对1946年至1988年期间英国原子能管理局、原子武器机构和英国塞拉菲尔德核燃料厂的75,006名雇员的死亡率进行了分析。接受外辐射暴露监测的工人全因死亡率比全国低19%，未接受外辐射监测的工人全因死亡率比全国低18%。癌症死亡率也低于全国水平，两组工人的死亡率相似[比率比(RR) = 0.96]。在检查的29个特定癌症部位中，只有胸膜癌和子宫癌在监测工人中相对于未监测工人的死亡率有统计学意义的增加[RR = 7.08，双侧P (2P) = 0.008, RR = 3.02, 2P = 0.003]。累积外辐射与暴露后10年或更长时间内所有癌症死亡风险之间几乎没有关联[趋势z = +0.11，单侧P (1P) = 0.5]。在白血病中观察到正相关（假设外照射与死亡风险增加之间有2年的滞后）（1P = 0.009），但在先前的分析中，与外照射相关的其他癌症（肺癌、子宫癌、前列腺癌和多发性骨髓瘤，所有1P均大于或等于0.1）没有观察到正相关。在黑色素瘤和其他皮肤癌（1P = 0.03）以及不明确的继发性癌症（1P = 0.04）中也观察到正相关（1P小于或等于0.05），但这些结果很难解释，并且考虑到所检查的关联数量，可能是偶然发现。除白血病外，所有癌症每西弗的超额相对危险度估计为-0.02 (95% CI = -0.5-+0.6)，白血病为+4.18 （95% CI = +0.4-+13.4）。白血病的阳性估计值与美国工人的阴性估计值形成对比，尽管两项研究中获得的置信区间重叠。虽然我们对风险的估计与从原子弹幸存者的研究中得出的结果是一致的，但与之相关的统计不确定性使得这些数据与白血病以外的癌症的风险范围一致，从没有额外的风险到两倍的风险，对于白血病，原子弹幸存者的风险从五分之一到三倍。
Mortality during 1946-1988 has been analyzed in 75,006 employees of the United Kingdom Atomic Energy Authority, the Atomic Weapons Establishment and the Sellafield plant of British Nuclear Fuels. All-cause mortality was 19% lower than national rates among workers monitored for external radiation exposure and 18% lower among nonmonitored workers. Cancer mortality was also lower than national rates and was similar in the two groups of workers [rate ratio (RR) = 0.96]. Of 29 specific cancer sites examined, only for cancers of the pleura and uterus were there statistically significant excesses of mortality in monitored workers relative to nonmonitored workers [RR = 7.08, two-sided P (2P) = 0.008 and RR = 3.02, 2P = 0.003, respectively]. There was little association between cumulative external radiation and risk of death from all cancers combined 10 or more years after exposure [z for trend = +0.11, one-sided P (1P) = 0.5]. A positive association was observed for leukemia (assuming a 2-year lag between external radiation and increasing risk of death) (1P = 0.009) but not for other cancers associated with external radiation in previous analyses (lung, uterus, prostate and multiple myeloma, all 1P greater than or equal to 0.1). Positive associations (1P less than or equal to 0.05) were also observed for melanoma and other skin cancers (1P = 0.03) and ill-defined and secondary cancers (1P = 0.04), but these results are difficult to interpret and, given the number of associations examined, may be chance findings. Estimates of excess relative risk per sievert were -0.02 (95% CI = -0.5-+0.6) for all cancers except leukemia and +4.18 for leukemia (95% CI = +0.4-+13.4). The positive estimates for leukemia contrast with negative values found for workers in the United States, although the confidence intervals obtained in the two studies overlap. While our estimates of risk are compatible with those derived from studies of A-bomb survivors, the statistical uncertainty associated with them is such that the data are consistent with risks ranging from no additional risk to twice the risk for cancers other than leukemia and, for leukemia, from one-fifth to three times the risk in A-bomb survivors.