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[1979 - 1995年中国阳江高本底辐射地区的癌症死亡率]

[Cancer mortality in high background radiation area of Yangjiang, China, 1979-1995].

作者信息

Tao Z, Cha Y, Sun Q

机构信息

Laboratory of Industrial Hygiene, Ministry of Health, Beijing 100088, China.

出版信息

Zhonghua Yi Xue Za Zhi. 1999 Jul;79(7):487-92.

Abstract

OBJECTIVE

To estimate cancer risk associated with the low level radiation exposure of average annual effective dose of 6.4 mSv in HBRA the high background radiation area (HBRA) of Yangjiang, China.

METHODS

The cancer mortality data of 1979-1986 were collected from a dynamic cohort by prospective survey. The data of 1987-1995 were obtained from a fixed cohort by retrospective and/or prospective survey. The mortality investigation on the spot consisted of two steps, i.e. the follow-up of the members in the cohort and the ascertainment of the death causes. The estimate of cumulative individual dose of the cohort members included that of the exposure from natural external and internal sources. Both direct (TLD measurement) and indirect (environmental measurement and occupancy pattern) approaches were used for individual external dose estimate. On the basis of the hamlet-specific average annual external dose, the cohort members were classified into four groups for internal comparison: high, medial and low dose groups from HBRA and control group from control area (CA). Relative risk (RR) and excess relative risk coefficient (ERR per sievert) and its 95% confidence interval (CI) was estimated using AMFIT program in Epicure.

RESULTS

During the period 1979-1995, there were 10,415 total deaths and 1003 cancer deaths among 1,698,350 person-years at risk in the cohort of 125,079 subjects. The adjusted RR (95% CI) with sex and age group for all cancers of whole HBRA was 0.99 (0.87-1.14). As for the site-specific cancer of whole HBRA, the RRs of cancers of stomach, colon, liver, lungs, bone, female breast, and thyroid were less than one, while the RRs of cancers of nasopharynx, esophagus, rectum, pancreas, skin, cervix uterus, brain and central nervous system, leukemia and lymphoma were larger than one. However, all of them except for esophagus cancer were not different statistically from one (P > 0.05). The homogeneity tests of RRs for all cancers and for site-specific cancer among the three dose groups in HBRA revealed that the RRs in these dose groups were not different statistically (P > 0.05) for all. The ERR (95% CI)/Sv of all cancers for both sexes and all ages was -0.10 (-0.67, 0.69).

CONCLUSION

An increased cancer risk associated with the high levels of natural radiation in HBRA was not found. On the contrary, the mortality of all cancers in HBRA was generally lower than that in CA, but not significant statistically.

摘要

目的

评估中国阳江高本底辐射地区(HBRA)平均年有效剂量为6.4 mSv的低水平辐射暴露所带来的癌症风险。

方法

1979 - 1986年的癌症死亡率数据通过前瞻性调查从动态队列中收集。1987 - 1995年的数据通过回顾性和/或前瞻性调查从固定队列中获取。现场死亡率调查包括两个步骤,即队列成员的随访和死亡原因的确定。队列成员累积个体剂量的估计包括来自天然外照射和内照射的剂量。个体外照射剂量估计采用直接(热释光剂量测量)和间接(环境测量和居住模式)两种方法。根据自然村特定的年平均外照射剂量,将队列成员分为四组进行内部比较:来自HBRA的高、中、低剂量组和来自对照区(CA)的对照组。使用Epicure中的AMFIT程序估计相对风险(RR)、超额相对风险系数(每西弗特的ERR)及其95%置信区间(CI)。

结果

在1979 - 1995年期间,125,079名研究对象的队列中,1,698,350人年的总死亡人数为10,415人,癌症死亡人数为1003人。整个HBRA地区所有癌症经性别和年龄组调整后的RR(95%CI)为0.99(0.87 - 1.14)。对于整个HBRA地区特定部位的癌症,胃癌、结肠癌、肝癌、肺癌、骨癌、女性乳腺癌和甲状腺癌的RR小于1,而鼻咽癌、食管癌、直肠癌、胰腺癌、皮肤癌、子宫颈癌、脑和中枢神经系统癌、白血病和淋巴瘤的RR大于1。然而,除食管癌外,所有这些癌症的RR与1在统计学上无差异(P>0.05)。HBRA地区三个剂量组中所有癌症和特定部位癌症RR的齐性检验表明,这些剂量组中的RR在统计学上无差异(P>0.05)。所有性别和年龄的所有癌症的ERR(95%CI)/Sv为 - 0.10( - 0.67,0.69)。

结论

未发现HBRA地区高水平天然辐射与癌症风险增加有关。相反,HBRA地区所有癌症的死亡率总体上低于对照区,但在统计学上不显著。

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