Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study
Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study
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DOI：
10.1016/s2352-3026(15)00094-0
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发表时间：
2015-07-01
影响因子：
24.7
通讯作者：
Kesminiene, Ausrele
中科院分区：
文献类型：
--
作者：
Leuraud, Klervi;Richardson, David B.;Kesminiene, Ausrele
背景：在典型的职业、环境和诊断性医疗环境中反复或长期低剂量辐射暴露后，白血病和淋巴瘤的风险有很多不确定性。在法国、英国和美国接受辐射监测的成年人中，我们量化了长期低剂量辐射暴露与白血病、淋巴瘤和多发性骨髓瘤死亡率之间的关系。方法：我们收集了308 297名受辐射监测的工作人员，这些工作人员受雇于原子能委员会、阿海珐核循环公司或法国国家电力公司、美国能源和国防部以及英国国家辐射工作人员登记处的核工业雇主至少1年。该队列共随访8例。2200万人年。我们确定了由白血病、淋巴瘤和多发性骨髓瘤引起的死亡。我们使用泊松回归来量化估计的红骨髓吸收剂量与白血病和淋巴瘤死亡率之间的关系。剂量累积率非常低（平均1.1 mGy /年，标准差2.6）。白血病死亡率的超额相对危险度（不包括慢性淋巴细胞白血病）为2.96 / Gy （90% CI 1.17-5.21；滞后2年），最显著的原因是辐射剂量与慢性髓性白血病死亡率之间存在关联（超额相对危险度/ Gy 10.45, 90% CI 4.48-19.65）。本研究提供了长期低剂量辐射暴露与白血病正相关的有力证据。
Background There is much uncertainty about the risks of leukaemia and lymphoma after repeated or protracted low-dose radiation exposure typical of occupational, environmental, and diagnostic medical settings. We quantified associations between protracted low-dose radiation exposures and leukaemia, lymphoma, and multiple myeloma mortality among radiation-monitored adults employed in France, the UK, and the USA.Methods We assembled a cohort of 308 297 radiation-monitored workers employed for at least 1 year by the Atomic Energy Commission, AREVA Nuclear Cycle, or the National Electricity Company in France, the Departments of Energy and Defence in the USA, and nuclear industry employers included in the National Registry for Radiation Workers in the UK. The cohort was followed up for a total of 8 . 22 million person-years. We ascertained deaths caused by leukaemia, lymphoma, and multiple myeloma. We used Poisson regression to quantify associations between estimated red bone marrow absorbed dose and leukaemia and lymphoma mortality.Findings Doses were accrued at very low rates (mean 1.1 mGy per year, SD 2.6). The excess relative risk of leukaemia mortality (excluding chronic lymphocytic leukaemia) was 2.96 per Gy (90% CI 1.17-5.21; lagged 2 years), most notably because of an association between radiation dose and mortality from chronic myeloid leukaemia (excess relative risk per Gy 10.45, 90% CI 4.48-19.65).Interpretation This study provides strong evidence of positive associations between protracted low-dose radiation exposure and leukaemia.