RADON EXPOSURE AND CANCERS OTHER THAN LUNG-CANCER AMONG URANIUM MINERS IN WEST-BOHEMIA
RADON EXPOSURE AND CANCERS OTHER THAN LUNG-CANCER AMONG URANIUM MINERS IN WEST-BOHEMIA
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DOI：
10.1016/0140-6736(93)91212-5
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发表时间：
1993-04-10
期刊：
影响因子：
168.9
通讯作者：
KUNZ, E
中科院分区：
文献类型：
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作者：
TOMASEK, L;DARBY, SC;KUNZ, E
最近的观察表明，环境空气中的氡气可能会导致肺部以外部位的癌症，但证据是间接的。我们研究了西波西米亚 4320 名铀矿工人的特定地点癌症死亡率，这些矿工平均随访了 25 年，其中与氡气相关的肺癌发病率已经确定为四倍。对于除肺癌之外的所有癌症，观察到的死亡人数略高于国家死亡率的预期，但增加的统计意义并不显着（观察到的死亡人数与预期死亡人数的比率 [O/E]=1.11，95% 置信区间） [CI]=0.98-1.24）并且死亡率不会随着在地下工作的时间或累积接触氡的时间而增加。 25 岁以下开始采矿工作的男性非肺癌死亡率显着升高，但这种升高与累积氡暴露无关。当对 28 个单独部位和类型的癌症进行检查时，发现肝癌 (O/E=1.67)、胆囊癌和肝外胆管癌 (O/E=2.26) 的风险显着增加。对于肝癌，死亡率并不随着在地下工作的时间或氡气暴露的累积而增加。对于胆囊癌和肝外胆管癌，死亡率并不随着工作时间的延长而增加，而是随着氡暴露的累积而增加。多发性骨髓瘤的死亡率虽然总体上没有显着增加（O/E=1.08），但随着氡暴露的累积而增加。白血病死亡率总体上没有增加（O/E=0.91），并且与累积氡暴露无关，但随着在矿山工作时间的增加而增加。在这些矿工身上，没有证据表明富含氡气的大气会增加患肺癌以外的任何癌症的风险。可能的例外是胆囊癌、肝外胆管癌和多发性骨髓瘤，但需要进一步研究才能得出所发现的关联是因果关系的结论。
Recent observations have suggested that radon in the ambient air may cause cancers at sites other than the lung, but the evidence is indirect. We have studied site-specific cancer mortality in 4320 uranium miners in West Bohemia who have been followed-up for an average of 25 years, and in whom a four-fold radon-related excess of lung cancer has already been established.For all cancers other than lung cancer the number of deaths observed was slightly greater than that expected from national rates, but the increase was not significant statistically (ratio of observed to expected deaths [O/E]=1.11, 95% confidence interval [CI]=0.98-1.24) and mortality did not increase with duration of employment underground or with cumulative exposure to radon. Non-lung cancer mortality was significantly raised among men who started mining work aged under 25 but the increase was not related to cumulative radon exposure. When twenty-eight individual sites and types of cancer were examined, significantly increased risks were found for cancers of the liver (O/E=1.67) and gallbladder and extrahepatic bileducts (O/E=2.26). For liver cancer, mortality did not increase with duration of employment underground or with cumulative radon exposure. For cancer of the gallbladder and extrahepatic bileducts, mortality did not increase with duration of employment, but increased with cumulative exposure to radon. Mortality from multiple myeloma, although not significantly increased overall (O/E=1.08), increased with cumulative exposure to radon. Mortality from leukaemia was not increased overall (O/E=0.91) and was not related to cumulative radon exposure, but did increase with increasing duration of employment in the mines. There is no evidence in these miners that a radon-rich atmosphere increases the risk of any cancer other than lung cancer. Possible exceptions are cancer of the gallbladder and extrahepatic bileducts and multiple myeloma but further study is needed before it can be concluded that the associations found are causal.