Fallout from Chernobyl and incidence of childhood leukaemia in Finland, 1976-92
Fallout from Chernobyl and incidence of childhood leukaemia in Finland, 1976-92
复制标题
切尔诺贝利事故的后果和芬兰儿童白血病的发病率，1976-92 年
作者：
A. Auvinen;M. Hakama;H. Arvela;T. Hakulinen;T. Rahola;M. Suomela;B. Soderman;T. Rytomaa
摘要目的：评估切尔诺贝利核事故沉降物对芬兰儿童白血病发病率的影响。设计：全国性队列研究。使用仪器在芬兰全国行驶19 000公里，测量了455个芬兰城市的外部照射。由于房屋和A弹试验的沉降物，修正了市政当局的具体数值。通过对81名儿童的随机抽样进行全身测量来估计体内暴露量。根据这些测量值计算事件发生后两年的平均有效剂量。关于儿童白血病的数据来自芬兰癌症登记处，并经治疗儿童癌症的医院核实。背景：芬兰，受切尔诺贝利事故污染最严重的国家之一;人口按暴露程度分为五分之一。对象：1976- 1992年0-14岁儿童。主要观察指标：儿童白血病的标准化发病率和每毫希儿童白血病的相对超额风险。根据芬兰癌症登记处1976-85年的发病率数据，计算了三个时期（1976-85年、1986-8年和1989-92年）每个城市特定于性别和年龄组（0-4岁、5-9岁和10-14岁）的预期数字，并将其合并为暴露五分之一。剂量反应估计为每个阶段五分之一平均剂量的标准化发生率比的回归斜率。结果如下：事故发生后头两年，全国人口加权平均有效剂量为410 µSv，剂量最高的五分之一人口为970 µSv。在整个芬兰儿童白血病的发病率并没有增加1976年至1992年。1989- 1992年的相对超额风险与零没有显著差异（7%/mSv; 95%置信区间-27%至41%）。结论：可以排除儿童白血病的重要增加。任何影响都小于芬兰每年每百万儿童增加8例病例。结果与预期的影响程度一致。
Abstract Objective: To assess effects of fallout from Chernobyl on incidence of childhood leukaemia in Finland. Design : Nationwide cohort study. External exposure measured for 455 Finnish municipalities with instruments driven 19 000 km throughout the country. Values specific to municipalities corrected for shielding due to houses and fallout from A bomb testing. Internal exposure estimated from whole body measurements on a random sample of 81 children. Mean effective dose for two years after incident calculated from these measurements. Data on childhood leukaemia obtained from Finnish cancer registry and verified through hospitals treating childhood cancers. Setting : Finland, one of the countries most heavily contaminated by the Chernobyl accident; the population was divided into fifths by exposure. Subjects : Children aged 0-14 years in 1976-92. Main outcome measures: Standardised incidence ratio of childhood leukaemia and relative excess risk of childhood leukaemia per mSv. From incidence data of Finnish cancer registry for 1976-85, expected numbers specific to sex and age group (0-4, 5-9, and 10-14 years) were calculated for each municipality for three periods (1976-85, 1986-8, and 1989-92) and pooled as exposure fifths. Dose response was estimated as regression slope of standardised incidence ratios on mean doses for fifths for each period. Results : Population weighted mean effective doses for first two years after the accident were 410 µSv for the whole country and 970 µSv for the population fifth with the highest dose. In all Finland the incidence of childhood leukaemia did not increase 1976-92. The relative excess risk 1989-92 was not significantly different from zero (7% per mSv; 95% confidence interval −27% to 41%). Conclusions: An important increase in childhood leukaemia can be excluded. Any effect is smaller than eight extra cases per million children per year in Finland. The results are consistent with the magnitude of effect expected.