Boice John D, Cohen Sarah S, Mumma Michael T, Dupree Ellis Elizabeth, Eckerman Keith F, Leggett Richard W, Boecker Bruce B, Brill A Bertrand, Henderson Brian E
International Epidemiology Institute, Rockville, Maryland 20850, USA.
Radiat Res. 2006 Jul;166(1 Pt 1):98-115. doi: 10.1667/RR3582.1.
A retrospective cohort mortality study was conducted of workers engaged in nuclear technology development and employed for at least 6 months at Rocketdyne (Atomics International) facilities in California, 1948-1999. Lifetime occupational doses were derived from company records and linkages with national dosimetry data sets. International Commission on Radiation Protection (ICRP) biokinetic models were used to estimate radiation doses to 16 organs or tissues after the intake of radionuclides. Standardized mortality ratios (SMRs) compared the observed numbers of deaths with those expected in the general population of California. Cox proportional hazards models were used to evaluate dose-response trends over categories of cumulative radiation dose, combining external and internal organ-specific doses. There were 5,801 radiation workers, including 2,232 monitored for radionuclide intakes. The mean dose from external radiation was 13.5 mSv (maximum 1 Sv); the mean lung dose from external and internal radiation combined was 19.0 mSv (maximum 3.6 Sv). Vital status was determined for 97.6% of the workers of whom 25.3% (n = 1,468) had died. The average period of observation was 27.9 years. All cancers taken together (SMR 0.93; 95% CI 0.84-1.02) and all leukemia excluding chronic lymphocytic leukemia (CLL) (SMR 1.21; 95% CI 0.69-1.97) were not significantly elevated. No SMR was significantly increased for any cancer or for any other cause of death. The Cox regression analyses revealed no significant dose-response trends for any cancer. For all cancers excluding leukemia, the RR at 100 mSv was estimated as 1.00 (95% CI 0.81-1.24), and for all leukemia excluding CLL it was 1.34 (95% CI 0.73-2.45). The nonsignificant increase in leukemia (excluding CLL) was in accord with expectation from other radiation studies, but a similar nonsignificant increase in CLL (a malignancy not found to be associated with radiation) tempers a causal interpretation. Radiation exposure has not caused a detectable increase in cancer deaths in this population, but results are limited by small numbers and relatively low career doses.
对1948年至1999年期间在加利福尼亚州罗克韦尔公司(原子国际公司)设施中从事核技术开发且工作至少6个月的工人进行了一项回顾性队列死亡率研究。终生职业剂量来自公司记录以及与国家剂量测定数据集的关联。使用国际辐射防护委员会(ICRP)的生物动力学模型来估计摄入放射性核素后16个器官或组织所接受的辐射剂量。标准化死亡比(SMR)将观察到的死亡人数与加利福尼亚州普通人群中预期的死亡人数进行了比较。使用Cox比例风险模型来评估累积辐射剂量类别中的剂量反应趋势,将外部和内部器官特异性剂量结合起来。共有5801名辐射工作人员,其中2232人接受了放射性核素摄入量监测。外部辐射的平均剂量为13.5毫希沃特(最大值为1希沃特);外部和内部辐射合并后的肺部平均剂量为19.0毫希沃特(最大值为3.6希沃特)。确定了97.6%的工作人员的生命状态,其中25.3%(n = 1468)已经死亡。平均观察期为27.9年。所有癌症合计(SMR 0.93;95%置信区间0.84 - 1.02)以及除慢性淋巴细胞白血病(CLL)外的所有白血病(SMR 1.21;95%置信区间0.69 - 1.97)均未显著升高。任何癌症或任何其他死因的SMR均未显著增加。Cox回归分析显示,任何癌症均无显著的剂量反应趋势。对于除白血病外的所有癌症,100毫希沃特时的相对危险度(RR)估计为1.00(95%置信区间0.81 - 1.24),对于除CLL外的所有白血病,RR为为1.34(95%置信区间0.73 - 2.45)。白血病(不包括CLL)的非显著增加与其他辐射研究的预期一致,但CLL(一种未发现与辐射相关的恶性肿瘤)的类似非显著增加削弱了因果解释。在这一人群中,辐射暴露并未导致可检测到的癌症死亡增加,但由于样本量小和职业剂量相对较低,结果受到限制。