Combined analysis of lung cancer among uranium miners

 描述(申请人提供)：美国公共卫生服务在20世纪50年代发起了一项关于科罗拉多高原受雇的美国铀矿工健康的研究计划。矿山作业最初几年的职业暴露导致呼吸系统疾病造成大量死亡，这些疾病很容易被传统的流行病学方法发现。这些发现对了解美国和国外氡暴露的致癌效应具有很大的影响。今天，尽管职业暴露大幅减少，但氡仍然是肺癌的主要原因，在各种环境中，包括地下金属和非金属采矿、地铁和公用隧道、磷肥厂、天然气和石油管道设施、炼油厂和作为氡补救工作人员，氡仍然有可能导致较高的职业暴露。 工人和水处理工人。其他工作场所，包括学校、医院和监狱，也可能有高氡水平的地区。为了加强保护当代工人免受氡致癌影响的基础，并改善对过去暴露的工人的补偿决定，我们建议对最近更新的美国地下矿工队列进行汇总分析。将使用最先进的统计方法进行纵向数据分析，以评估自暴露以来的时间、暴露时的年龄和达到的年龄的影响。此外，我们将研究氡和吸烟在这些队列中的联合影响，利用这些队列的最新更新提供的关于非吸烟者肺癌信息的实质性进展。最后，由于流行病学结果的因果解释因证据的重复性和一致性而得到加强，我们将通过结合来自加拿大、捷克共和国、德国、法国和中国的主要矿工队列的数据进行汇集分析，评估美国地下矿工队列分析得出的结果与其他国际队列观察到的关联的一致性。这一研究项目的结果将产生迄今为止报告的最准确的氡风险估计，预计将对了解职业和环境氡暴露的影响产生重大影响。

 DESCRIPTION (provided by applicant): The US Public Health Service initiated a research program in the 1950s on the health of US uranium miners employed in the Colorado Plateau. Occupational exposures in the early years of mine operation resulted in large excesses of mortality due to respiratory diseases that were readily-detected by classical epidemiological methods. These findings were highly influential for informing understanding of the carcinogenic effect of radon exposures in the US and abroad. Today, despite important reductions in occupational exposures, radon remains a leading cause of lung cancer, with potential for relatively high occupational exposures among workers in a wide range of settings including underground metal and non-metal mining, subway and utility tunnels, phosphate fertilizer plants, natural gas and oil piping facilities, oil refineries, and for people employed as radon remediation workers and water treatment workers. Other workplaces including schools, hospitals, and prisons also may have areas with high radon levels. To strengthen the basis for protection of contemporary workers from the carcinogenic effects of radon, and to improve compensation decisions for workers exposed in the past, we propose a pooled analysis of recently-updated cohorts of US underground miners. State-of-the-art statistical methods for longitudinal data analysis will be used to assess the effects of time-since- exposure, age-at-exposure, and attained age. In addition, we will examine the joint effects of radon and smoking in these cohorts, leveraging substantial gains in information on lung cancer among non-smokers provided by recent updates of these cohorts. Finally, because a causal interpretation of epidemiological findings is strengthened by evidence of reproducibility and consistency, we will assess the consistency of results derived from analysis of US underground miner cohorts with associations observed in other international cohorts by conducting a pooled analysis incorporating data from major cohorts of miners from Canada, the Czech Republic, Germany, France, and China. The findings of this research project, which will yield the most precise radon risk estimates reported to-date, are expected to have substantial impact on understanding of the effects occupational and environmental radon exposures.