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Published, Version of Record (VoR)CC BY-NC V4.0, Open
Journal article
Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
BMJ (Online), v 351, h5359
20 Oct 2015
PMID: 26487649
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
STUDY QUESTION
Is protracted exposure to low doses of ionising radiation associated with an increased risk of solid cancer?
METHODS
In this cohort study, 308 297 workers in the nuclear industry from France, the United Kingdom, and the United States with detailed monitoring data for external exposure to ionising radiation were linked to death registries. Excess relative rate per Gy of radiation dose for mortality from cancer was estimated. Follow-up encompassed 8.2 million person years. Of 66 632 known deaths by the end of follow-up, 17 957 were due to solid cancers.
STUDY ANSWER AND LIMITATIONS
Results suggest a linear increase in the rate of cancer with increasing radiation exposure. The average cumulative colon dose estimated among exposed workers was 20.9 mGy (median 4.1 mGy). The estimated rate of mortality from all cancers excluding leukaemia increased with cumulative dose by 48% per Gy (90% confidence interval 20% to 79%), lagged by 10 years. Similar associations were seen for mortality from all solid cancers (47% (18% to 79%)), and within each country. The estimated association over the dose range of 0-100 mGy was similar in magnitude to that obtained over the entire dose range but less precise. Smoking and occupational asbestos exposure are potential confounders; however, exclusion of deaths from lung cancer and pleural cancer did not affect the estimated association. Despite substantial efforts to characterise the performance of the radiation dosimeters used, the possibility of measurement error remains.
WHAT THIS STUDY ADDS
The study provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality. Although high dose rate exposures are thought to be more dangerous than low dose rate exposures, the risk per unit of radiation dose for cancer among radiation workers was similar to estimates derived from studies of Japanese atomic bomb survivors. Quantifying the cancer risks associated with protracted radiation exposures can help strengthen the foundation for radiation protection standards.
FUNDING, COMPETING INTERESTS, DATA SHARING
Support from the US Centers for Disease Control and Prevention; Ministry of Health, Labour and Welfare of Japan; Institut de Radioprotection et de Surete Nucleaire; AREVA; Electricite de France; US National Institute for Occupational Safety and Health; US Department of Energy; and Public Health England. Data are maintained and kept at the International Agency for Research on Cancer.
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Details
- Title
- Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)
- Creators
- David B. Richardson - University of North Carolina at Chapel HillElisabeth Cardis - Pompeu Fabra UniversityRobert D. Daniels - National Institute for Occupational Safety and HealthMichael Gillies - Public Health EnglandJacqueline A. O'Hagan - Public Health EnglandGhassan B. Hamra - Drexel UniversityRichard Haylock - Public Health EnglandDominique Laurier - Institut de Radioprotection et de Sûreté NucléaireKlervi Leuraud - Institut de Radioprotection et de Sûreté NucléaireMonika Moissonnier - Centre International de Recherche sur le CancerMary K. Schubauer-Berigan - National Institute for Occupational Safety and HealthIsabelle Thierry-Chef - Centre International de Recherche sur le CancerAusrele Kesminiene - Centre International de Recherche sur le Cancer
- Publication Details
- BMJ (Online), v 351, h5359
- Publisher
- Bmj Publishing Group
- Number of pages
- 8
- Grant note
- AREVA 2012-02-21-01 / Ministry of Health, Labour and Welfare of Japan; Ministry of Health, Labour and Welfare, Japan R03 OH-010056 / University of North Carolina from the National Institute for Occupational Safety and Health US Department of Health and Human Services 5RO3 OH010056-02 / US Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA National Institute for Occupational Safety and Health; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA; National Institute for Occupational Safety & Health (NIOSH) EDF; Electricite de France (EDF) US Department of Energy; United States Department of Energy (DOE)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Environmental and Occupational Health
- Web of Science ID
- WOS:000364143900006
- Scopus ID
- 2-s2.0-84948163219
- Other Identifier
- 991021863001604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Radiology, Nuclear Medicine & Medical Imaging