Wing S, Richardson D B
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7400, USA.
Occup Environ Med. 2005 Jul;62(7):465-72. doi: 10.1136/oem.2005.019760.
Studies of workers at the plutonium production factory in Hanford, WA have led to conflicting conclusions about the role of age at exposure as a modifier of associations between ionising radiation and cancer.
To evaluate the influence of age at exposure on radiation risk estimates in an updated follow up of Hanford workers.
A cohort of 26 389 workers hired between 1944 and 1978 was followed through 1994 to ascertain vital status and causes of death. External radiation dose estimates were derived from personal dosimeters. Poisson regression was used to estimate associations between mortality and cumulative external radiation dose at all ages, and in specific age ranges.
A total of 8153 deaths were identified, 2265 of which included cancer as an underlying or contributory cause. Estimates of the excess relative risk per Sievert (ERR/Sv) for cumulative radiation doses at all ages combined were negative for all cause and leukaemia and positive for all cancer and lung cancer. Cumulative doses accrued at ages below 35, 35-44, and 45-54 showed little association with mortality. For cumulative dose accrued at ages 55 and above (10 year lag), the estimated ERR/Sv for all cancers was 3.24 (90% CI: 0.80 to 6.17), primarily due to an association with lung cancer (ERR/Sv: 9.05, 90% CI: 2.96 to 17.92).
Associations between radiation and cancer mortality in this cohort are primarily a function of doses at older ages and deaths from lung cancer. The association of older age radiation exposures and cancer mortality is similar to observations from several other occupational studies.
对华盛顿州汉福德钚生产工厂工人的研究,就暴露时的年龄作为电离辐射与癌症之间关联的修饰因素所起的作用得出了相互矛盾的结论。
在对汉福德工人的最新随访中评估暴露时的年龄对辐射风险估计的影响。
对1944年至1978年间雇用的26389名工人组成的队列进行随访,直至1994年,以确定生命状态和死亡原因。外部辐射剂量估计值来自个人剂量计。采用泊松回归估计所有年龄以及特定年龄范围内死亡率与累积外部辐射剂量之间的关联。
共确定8153例死亡,其中2265例将癌症列为根本或促成死因。所有年龄综合累积辐射剂量的每西弗特超额相对风险(ERR/Sv)估计值,全因死亡率和白血病为阴性,所有癌症和肺癌为阳性。35岁以下、35 - 44岁和45 - 54岁累积的剂量与死亡率几乎没有关联。对于55岁及以上(滞后10年)累积的剂量,所有癌症的估计ERR/Sv为3.24(90%可信区间:0.80至6.17),主要是由于与肺癌有关联(ERR/Sv:9.05,90%可信区间:2.96至17.92)。
该队列中辐射与癌症死亡率之间的关联主要是老年时剂量以及肺癌死亡的函数。老年时辐射暴露与癌症死亡率之间的关联与其他几项职业研究的观察结果相似。