Combined analysis of mortality among nuclear workers

摘要 在20世纪60年代，美国原子能委员会发起了一项关于健康和死亡率的研究计划， 美国核工人从一开始，就注意到特定设施的队列研究不太可能包括 足够数量的工作人员提供统计上精确的流行病学调查结果;然而， 可以让研究人员研究大量核工作人员之间的关联。我们 建议对5个主要工厂的员工的美国工人数据进行汇总分析， 队列规模、人口统计学和就业史信息的可用性以及辐射的完整性 监测数据：橡树岭国家实验室、萨凡纳河站点、汉福德站点、爱达荷州国家 实验室和朴茨茅斯海军造船厂。更新了每个队列的生命状态随访， 最近进行的，使拟议的分析可行。拟议中的美国工人联合研究将 使我们能够解决有关辐射风险随暴露后时间变化的未决问题， 受辐射的年龄，以及癌症类型的辐射风险差异。我们建议雇用国家- 最大限度地减少由于混杂引起的偏倚的最新方法，评估暴露影响的敏感性分析 错误分类和创新回归模型，以评估效果指标修改和队列间 辐射风险的异质性。此外，流行病学研究结果的因果解释是 通过可重复性和一致性的证据来加强。因此，我们建议以经验评估 来自美国核工人数据的结果与来自英国和法国核工人数据的结果的一致性 两个同样发展了大型核项目的国家。一种新的分层回归方法 方法将用于评估美国，英国和法国工人之间的联合调查结果的一致性 对每个队列采用可比分析方法的分析。如果将这3个国家的数据汇总， 在适当的情况下，将进行国际联合分析，以得出最精确的辐射 迄今为止报告的核工作人员的风险估计。拟议的国际综合分析将包括： 这是以往任何关于核工作人员癌症流行病学研究的统计能力的两倍多。的 该研究项目的结果预计将对有关职业的讨论产生重大影响。 辐射风险和辐射防护。

Abstract In the 1960s, the US Atomic Energy Commission initiated a research program on the health and mortality of US nuclear workers. From the outset, it was noted that facility-specific cohort studies were unlikely to include sufficient numbers of workers to provide statistically precise epidemiological findings; however, combining data across facilities could allow an investigator to study associations in a large population of nuclear workers. We propose to conduct a pooled analysis of US worker data for employees of 5 major facilities selected based on cohort size, availability of demographic and employment history information, and completeness of radiation monitoring data: Oak Ridge National Laboratory, Savannah River Site, Hanford site, Idaho National Laboratory, and Portsmouth Naval Shipyard. An update of vital status follow-up of each cohort has been conducted recently, making the proposed analysis feasible. The proposed combined study of US workers will permit us to address outstanding questions regarding variation in radiation risks with time-since-exposure and age-at-exposure, as well as variation in radiation risks by type of cancer. We propose to employ state-of-the- art methods to minimize bias due to confounding, sensitivity analyses to assess the impact of exposure misclassification, and innovative regression models to assess effect measure modification and between-cohort heterogeneity in radiation risks. Moreover, a causal interpretation of epidemiological study findings is strengthened by evidence of reproducibility and consistency. Therefore, we propose to empirically assess the consistency of results derived from US nuclear worker data with results derived from UK and French nuclear worker cohorts, two nations that also developed large nuclear programs. A novel hierarchical regression approach will be used to assess the consistency of findings between US, UK, and French workers in a joint analysis that employs comparable analytical methods for each cohort. If pooling data from these 3 countries is appropriate, an international combined analysis will be conducted in order to derive the most precise radiation risk estimates for nuclear workers reported to-date. The proposed international combined analysis will have more than twice the statistical power of any prior epidemiological study of cancer among nuclear workers. The findings of this research project are expected to have substantial impact on discussions regarding occupational radiation risks and radiation protection.