Preston Dale L, Shimizu Yukiko, Pierce Donald A, Suyama Akihiko, Mabuchi Kiyohiko
Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan.
Radiat Res. 2003 Oct;160(4):381-407. doi: 10.1667/rr3049.
This continues the series of general reports on mortality in the cohort of atomic bomb survivors followed up by the Radiation Effects Research Foundation. This cohort includes 86,572 people with individual dose estimates, 60% of whom have doses of at least 5 mSv. We consider mortality for solid cancer and for noncancer diseases with 7 additional years of follow-up. There have been 9,335 deaths from solid cancer and 31,881 deaths from noncancer diseases during the 47-year follow-up. Of these, 19% of the solid cancer and 15% of the noncancer deaths occurred during the latest 7 years. We estimate that about 440 (5%) of the solid cancer deaths and 250 (0.8%) of the noncancer deaths were associated with the radiation exposure. The excess solid cancer risks appear to be linear in dose even for doses in the 0 to 150-mSv range. While excess rates for radiation-related cancers increase throughout the study period, a new finding is that relative risks decline with increasing attained age, as well as being highest for those exposed as children as noted previously. A useful representative value is that for those exposed at age 30 the solid cancer risk is elevated by 47% per sievert at age 70. There is no significant city difference in either the relative or absolute excess solid cancer risk. Site-specific analyses highlight the difficulties, and need for caution, in distinguishing between site-specific relative risks. These analyses also provide insight into the difficulties in interpretation and generalization of LSS estimates of age-at-exposure effects. The evidence for radiation effects on noncancer mortality remains strong, with risks elevated by about 14% per sievert during the last 30 years of follow-up. Statistically significant increases are seen for heart disease, stroke, digestive diseases, and respiratory diseases. The noncancer data are consistent with some non-linearity in the dose response owing to the substantial uncertainties in the data. There is no direct evidence of radiation effects for doses less than about 0.5 Sv. While there are no statistically significant variations in noncancer relative risks with age, age at exposure, or sex, the estimated effects are comparable to those seen for cancer. Lifetime risk summaries are used to examine uncertainties of the LSS noncancer disease findings.
这是辐射效应研究基金会对原子弹爆炸幸存者队列死亡率进行的系列综合报告中的一篇。该队列包括86,572名有个人剂量估计值的人员，其中60%的人剂量至少为5毫希沃特。我们对实体癌和非癌疾病的死亡率进行了另外7年的随访。在47年的随访期间，有9335人死于实体癌，31881人死于非癌疾病。其中，19%的实体癌死亡和15%的非癌死亡发生在最近7年。我们估计，约440例（5%）实体癌死亡和250例（0.8%）非癌死亡与辐射暴露有关。即使对于0至150毫希沃特范围内的剂量，实体癌的超额风险似乎在剂量上呈线性关系。虽然与辐射相关癌症的超额发生率在整个研究期间都在增加，但一个新发现是，相对风险随着达到的年龄增加而下降，并且如先前所述，对于儿童时期受照者来说相对风险最高。一个有用的代表性数值是，对于30岁时受照者，70岁时实体癌风险每西弗升高47%。实体癌相对或绝对超额风险在不同城市之间没有显著差异。特定部位分析凸显了区分特定部位相对风险的困难以及需要谨慎对待。这些分析还揭示了在解释和推广寿命研究统计（LSS）暴露年龄效应估计值方面的困难。辐射对非癌死亡率影响的证据仍然很强，在随访的最后30年中，风险每西弗升高约14%。心脏病、中风、消化系统疾病和呼吸系统疾病出现了统计学上的显著增加。由于数据存在大量不确定性，非癌数据与剂量反应中的一些非线性现象一致。对于小于约0.5西弗的剂量，没有辐射效应的直接证据。虽然非癌相对风险在年龄、暴露年龄或性别方面没有统计学上的显著差异，但估计的效应与癌症所见效应相当。寿命风险总结用于检验寿命研究统计（LSS）非癌疾病研究结果的不确定性。
