Risk of hematological malignancies among Chernobyl liquidators.
Risk of hematological malignancies among Chernobyl liquidators.
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DOI：
10.1667/rr1231.1
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发表时间：
2008-12
影响因子：
3.4
通讯作者：
Cardis E
中科院分区：
文献类型：
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作者：
Kesminiene A;Evrard AS;Ivanov VK;Malakhova IV;Kurtinaitis J;Stengrevics A;Tekkel M;Anspaugh LR;Bouville A;Chekin S;Chumak VV;Drozdovitch V;Gapanovich V;Golovanov I;Hubert P;Illichev SV;Khait SE;Kryuchkov VP;Maceika E;Maksyoutov M;Mirkhaidarov AK;Polyakov S;Shchukina N;Tenet V;Tserakhovich TI;Tsykalo A;Tukov AR;Cardis E
在来自白俄罗斯、俄罗斯和波罗的海国家的切尔诺贝利清理人员（事故恢复工作者）中进行了一项血液病病例对照研究，以评估低至中剂量长期辐射照射对这些疾病相对风险的影响。这项研究是在1986年至1987年在切尔诺贝利核电站周围工作的清理人员中进行的。117例（白血病69例，非霍奇金淋巴瘤34例，其他淋巴和造血组织恶性肿瘤14例）和481例匹配对照纳入研究。对每个受试者的骨髓剂量和不确定度进行了估计。主要分析限于70例（40例白血病，20例非hl和10例其他）和287例与切尔诺贝利地区工作可靠信息相匹配的对照。大多数受试者接受的剂量非常低（中位数为13毫戈瑞）。对于所有诊断，在200毫戈瑞及以上的剂量下，OR显著升高。每100 mGy的超额相对危险度（ERR）为0.60（90%置信区间（CI）： - 0.02, 2.35）。不包括慢性淋巴细胞白血病（CLL）的相应估计为0.50 （90%CI - 0.38, 5.7）。这个数字略高于原子弹幸存者和最近的低剂量率研究估计的数字，但在统计上与之相符。虽然敏感性分析显示了大致相似的结果，但我们不能排除偏倚和不确定性可能导致本研究中对风险的高估或低估。
A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries in order to assess the effect of low-to-medium dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked in 1986–87 around the Chernobyl plant. 117 cases (69 leukemia, 34 non-Hodgkin Lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue) and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The Excess Relative Risk (ERR) per 100 mGy was 0.60 (90% confidence interval (CI): −0.02, 2.35). The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90%CI −0.38, 5.7). It is slightly higher than, but statistically compatible with, those estimated from a-bomb survivors and recent low dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over or underestimation of the risk in this study.