Omar R Z, Barber J A, Smith P G
London School of Hygiene and Tropical Medicine, UK.
Br J Cancer. 1999 Mar;79(7-8):1288-301. doi: 10.1038/sj.bjc.6690207.
The mortality of all 14 319 workers employed at the Sellafield plant of British Nuclear Fuels between 1947 and 1975 was studied up to the end of 1992, and cancer incidence was examined from 1971 to 1986, in relation to their exposures to plutonium and to external radiation. The cancer mortality rate was 5% lower than that of England and Wales and 3% less than that of Cumbria. The significant excesses of deaths from cancer of the pleura and thyroid found in an earlier study persist with further follow-up (14 observed, 4.0 expected for pleura; 6 observed, 2.2 expected for thyroid). All of the deaths from pleural cancer were among radiation workers. For neither site was there a significant association between the risk of the cancer and accumulated radiation dose. There were significant deficits of deaths from cancers of mouth and pharynx, liver and gall bladder, and larynx and leukaemia when compared with the national rates. Among all radiation workers, there was a significant positive association between accumulated external radiation dose and mortality from cancers of ill-defined and secondary sites (10-year lag, P = 0.04), leukaemia (no lag, P = 0.03; 2-year lag, P = 0.05), multiple myeloma (20-year lag, P = 0.02), all lymphatic and haematopoietic cancers (20-year lag, P= 0.03) and all causes of death combined (20-year lag, P= 0.008). Among plutonium workers, there were significant excesses of deaths from cancer of the breast (6 observed, 2.6 expected) and ill-defined and secondary cancers (29 observed, 20.1 expected). No significant positive trends were observed between the risk of deaths from cancers of any specific site, or all cancers combined, and cumulative plutonium and external radiation doses. For no cancer site was there a significant excess of cancer registrations compared with rates for England and Wales. Analysis of trends in cancer incidence showed significant increases in risk with cumulative plutonium plus external radiation doses for all lymphatic and haematopoietic neoplasms for 0-, 10- and 20-year lag periods. Taken as a whole, our findings do not suggest that workers at Sellafield who have been exposed to plutonium are at an overall significantly increased risk of cancer compared with other radiation workers.
对1947年至1975年期间受雇于英国核燃料公司塞拉菲尔德工厂的所有14319名工人的死亡率进行了研究，直至1992年底，并对1971年至1986年期间的癌症发病率进行了检查，研究内容涉及他们对钚和外部辐射的暴露情况。该工厂的癌症死亡率比英格兰和威尔士低5%，比坎布里亚郡低3%。早期研究中发现的胸膜癌和甲状腺癌死亡人数显著过多的情况在进一步随访中仍然存在（胸膜癌观察到14例，预期4.0例；甲状腺癌观察到6例，预期2.2例）。所有胸膜癌死亡病例均发生在辐射工作人员中。对于这两个部位，癌症风险与累积辐射剂量之间均无显著关联。与全国发病率相比，口腔和咽喉癌、肝癌和胆囊癌以及喉癌和白血病的死亡人数存在显著不足。在所有辐射工作人员中，累积外部辐射剂量与不明和继发性癌症的死亡率（10年滞后，P = 0.04）、白血病（无滞后，P = 0.03；2年滞后，P = 0.05）、多发性骨髓瘤（20年滞后，P = 0.02）、所有淋巴和造血系统癌症（20年滞后，P = 0.03）以及所有死因合并（20年滞后，P = 0.008）之间存在显著正相关。在钚作业工人中，乳腺癌（观察到6例，预期2.6例）和不明及继发性癌症（观察到29例，预期20.1例）的死亡人数显著过多。在任何特定部位癌症或所有癌症合并的死亡风险与累积钚和外部辐射剂量之间均未观察到显著的正趋势。与英格兰和威尔士的发病率相比，没有一个癌症部位的癌症登记人数显著过多。对癌症发病率趋势的分析表明，在0年至10年和20年的滞后期间，所有淋巴和造血系统肿瘤的风险随累积钚加外部辐射剂量显著增加。总体而言，我们的研究结果并不表明，与其他辐射工作人员相比，接触过钚的塞拉菲尔德工厂工人患癌症的总体风险显著增加。
