Ritz B
Department of Epidemiology, School of Public Health, University of California, Los Angeles 90095-1772, USA.
Epidemiology. 1999 Sep;10(5):531-8.
Data from the Comprehensive Epidemiology Data Resource (CEDR) allowed me to study patterns of cancer mortality in a cohort of 4,014 uranium-processing workers. Employing risk-set analysis for cohort data, I estimated the effects of external (gamma) and internal (alpha) radiation on cancer mortality. My results indicate that Fernald workers exposed to ionizing radiation experienced an increase in mortality from total cancer (per 100 mSv external dose rate ratio (RR) = 1.92; 95% confidence interval (CI) = 1.11-3.32), radiosensitive solid cancer (RR = 2.00; 95% CI = 1.02-3.94), and lung cancer (RR = 2.77; 95% CI = 1.29-5.95). Effects were strongest when exposure had occurred at older ages (>40 years). In addition, I observed an increase in lung-cancer mortality for workers exposed to > or =200 mSv of internal (alpha) radiation (RR = 1.92; 95% CI = 0.53-6.96). Furthermore, my results demonstrate the importance of a long follow-up time when studying solid cancers, the potential for bias due to worker selection associated with concomitant chemical exposures, problems of exposure measurement, confounding, and effect modification due to age at exposure. Owing to lack of data, a previous pooled analysis of uranium-processing workers could only partially address these issues.
综合流行病学数据资源（CEDR）的数据使我能够研究4014名铀加工工人队列中的癌症死亡率模式。通过对队列数据进行风险集分析，我估计了外部（γ）和内部（α）辐射对癌症死亡率的影响。我的结果表明，暴露于电离辐射的费纳德工人的总癌症死亡率有所增加（每100毫希沃特外部剂量率比（RR）=1.92；95%置信区间（CI）=1.11 - 3.32），放射敏感性实体癌死亡率增加（RR = 2.00；95% CI = 1.02 - 3.94），肺癌死亡率增加（RR = 2.77；95% CI = 1.29 - 5.95）。当在较高年龄（>40岁）发生暴露时，影响最为强烈。此外，我观察到暴露于≥200毫希沃特内部（α）辐射的工人肺癌死亡率增加（RR = 1.92；95% CI = 0.53 - 6.96）。此外，我的结果表明在研究实体癌时长期随访时间的重要性，由于与伴随化学暴露相关的工人选择可能导致的偏差，暴露测量问题，混杂因素以及暴露年龄导致的效应修饰。由于缺乏数据，先前对铀加工工人的汇总分析只能部分解决这些问题。
