Doyle P, Maconochie N, Roman E, Davies G, Smith P G, Beral V
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, UK.
Lancet. 2000 Oct 14;356(9238):1293-9. doi: 10.1016/S0140-6736(00)02812-9.
There is some concern about the genetic effects of exposure to low-level ionising radiation, but the evidence is sparse and conflicting. Most work has concentrated on cancer in offspring and little has been done on adverse reproductive outcome. We aimed to assess whether the offspring of men and women who are occupationally exposed to ionising radiation are at increased risk of fetal death and congenital malformation.
We analysed pregnancies reported by an occupational cohort of nuclear industry workers in the UK, employed at establishments operated by the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels. Employment and radiation monitoring data supplied by employers was linked to each pregnancy.
11,697 men and 1903 women reported one or more singleton pregnancy conceived after first employment within the nuclear industry, the men reporting a total of 23,676 singleton pregnancies and the women 3585. The risks of fetal death and congenital malformation were not related to whether the father had been monitored before conception or to the dose of radiation received. Among pregnancies reported by women, the risk of early (<13 weeks of gestation) miscarriage was higher if the mother had been monitored before conception (odds ratio [OR] 1.3, 95% CI 1.0-1.6), but there was no trend with dose. The risk of stillbirth was also higher if the mother had been monitored before conception (OR 2.2, 95% CI 1.0-4.6), but the finding was based on only 29 cases (13 exposed). The risk of any major malformation, or of specific groups of malformations, was not associated with maternal monitoring, or dose received, before conception.
We found no evidence of a link between exposure to low-level ionising radiation before conception and increased risk of adverse reproductive outcome in men working in the nuclear industry. Similarly for women there was no evidence of an association between monitoring before conception and malformation in offspring. The findings relating maternal preconceptual monitoring to increased risk of fetal death are equivocal and require further investigation.
人们对低剂量电离辐射暴露的遗传效应存在一些担忧，但证据稀少且相互矛盾。大多数研究集中在后代患癌情况，而关于不良生殖结局的研究较少。我们旨在评估职业性暴露于电离辐射的男性和女性的后代出现胎儿死亡和先天性畸形的风险是否增加。
我们分析了英国核工业工人职业队列报告的妊娠情况，这些工人受雇于原子能管理局、原子武器机构和英国核燃料公司运营的机构。雇主提供的就业和辐射监测数据与每次妊娠相关联。
11697名男性和1903名女性报告在首次受雇于核工业后怀孕一次或多次单胎妊娠，男性共报告23676次单胎妊娠，女性报告3585次。胎儿死亡和先天性畸形的风险与父亲在受孕前是否接受监测或接受的辐射剂量无关。在女性报告的妊娠中，如果母亲在受孕前接受了监测，早期（妊娠<13周）流产的风险较高（比值比[OR]1.3，95%可信区间1.0 - 1.6），但与剂量无相关性。如果母亲在受孕前接受了监测，死产风险也较高（OR 2.2，95%可信区间1.0 - 4.6），但该发现仅基于29例病例（13例暴露）。任何重大畸形或特定畸形组的风险与受孕前母亲的监测或接受的剂量均无关联。
我们没有发现受孕前暴露于低剂量电离辐射与核工业男性不良生殖结局风险增加之间存在关联的证据。同样，对于女性，也没有证据表明受孕前监测与后代畸形之间存在关联。关于受孕前母亲监测与胎儿死亡风险增加之间的关联的研究结果不明确，需要进一步调查。
