100 years of observation on British radiologists: mortality from cancer and other causes 1897-1997
100 years of observation on British radiologists: mortality from cancer and other causes 1897-1997
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DOI：
10.1259/bjr.74.882.740507
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发表时间：
2001-06-01
影响因子：
2.6
通讯作者：
Doll, R
中科院分区：
文献类型：
--
作者：
Berrington, A;Darby, SC;Doll, R
放射科医生和放射治疗师是最早接触到电离辐射的职业群体之一。它们的死亡率模式提供了关于分次外辐射照射的长期影响的资料。在1897年至1979年期间在放射学会注册的英国放射科医生现在已被跟踪到1997年1月1日，并对1920年之后在学会注册的人的死亡率进行了调查，1920年是第一个放射防护建议发表的时候。在1920年以后登记的患者中观察到的癌症死亡人数与所有医疗从业人员的死亡率总和相似（SMR=1.04; 95% CI 0.89-1.21）。然而，有证据表明，自首次在放射学会注册以来，随着时间的推移，癌症死亡风险呈增加趋势（p=0.002），因此，在注册超过40年的患者中，癌症死亡风险增加了41% （SMR=1.41; 95% CI 1.03-1.90）。这可能是1921-1935年和1936-1954年期间首次登记的人受到辐射照射的长期影响。没有证据表明1954年以后首次注册的放射科医生的癌症死亡率增加，他们的辐射暴露可能更低。对非癌症死亡原因的研究也比以前报道的更为详细。即使是最早的放射科医生，也没有证据表明辐射对癌症以外的疾病有影响，尽管他们所接受的剂量大小与日本原子弹爆炸幸存者的死亡率增加了一倍以上有关。
Radiologists and radiotherapists were one of the earliest occupational groups to be exposed to ionizing radiation. Their patterns of mortality provide information on the long-term effects of fractionated external radiation exposure. British radiologists who registered with a radiological society between 1897 and 1979 have now been followed-up until 1 January 1997, and the mortality experience examined among those who registered with a society after 1920, when the first radiological protection recommendations were published. The observed number of cancer deaths in those who registered after 1920 was similar to that expected from death rates for all medical practitioners combined (SMR=1.04; 95% CI 0.89-1.21). However, there was evidence of an increasing trend in risk of cancer mortality with time since first registration with a radiological society (p=0.002), such that in those registered for more than 40 years there was a 41% excess risk of cancer mortality (SMR=1.41; 95% CI 1.03-1.90). This is probably a long-term effect of radiation exposure in those who first registered during 1921-1935 and 1936-1954. There was no evidence of an increase in cancer mortality among radiologists who first registered after 1954, in whom radiation exposures are likely to have been lower. Non-cancer causes of death were also examined in more detail than has been reported previously. There was no evidence of an effect of radiation on diseases other than cancer even in the earliest radiologists, despite the fact that doses of the size received by them have been associated with more than a doubling in the death rate among the survivors of the Japanese atomic bombings.