Ahn Yeon-Soon, Park Robert M, Koh Dong-Hee
Department of Occupational Medicine, Dongguk University International Hospital, Dongguk University College of Medicine, Goyang, Korea.
J Occup Environ Med. 2008 Jul;50(7):791-803. doi: 10.1097/JOM.0b013e318167751d.
Cancer mortality and morbidity are described for the first time in all Korean workers exposed to ionizing radiation.
Based on hospital admissions, Standardized Rate Ratios (SRR) and Standardized Mortality Ratios (SMR) were modeled with Poisson regression.
Cancer admissions during 2000 to 2005 were low compared with autoworkers with the exception of nuclear power workers (SRR = 1.13, 95% CI = 0.94-1.36). Thyroid cancer was statistically significantly elevated in women radiation workers in medical (SRR = 2.90, 95% CI = 1.05-7.94) and research institutions (SRR = 3.91, 95% CI = 1.36-11.0) and industry (SRR = 5.07, 95% CI = 1.56-15.6), and in all nuclear power workers (SRR = 2.59, 95% CI = 1.33-5.13), and there was a significant association with dose (ERR = 20.4 per Sv, 90% CI = -8 to 60, one-tailed P = 0.049). The 935 deaths revealed a healthy worker effect for all causes (SMR = 0.58, 95% CI = 0.54-0.62) and all-cancer (SMR = 0.73, 95% CI = 0.64-0.82). Lung cancer (SMR = 0.77, 95% CI = 0.55-1.05) and leukemia (SMR = 0.59, 95% CI = 0.28-1.06) mortalities were also less than expected. Compared with autoworkers, radiation workers displayed decreased all-cause mortality except for nuclear power workers (statistically not significant).
ERRs as high as 300 per Sv appear to be ruled-out in this population with regulated exposure to ionizing radiation while ERRs as high as 100 per Sv are not.
首次描述了所有暴露于电离辐射的韩国工人的癌症死亡率和发病率。
基于医院入院数据,采用泊松回归模型对标准化率比(SRR)和标准化死亡率比(SMR)进行建模。
与汽车工人相比,2000年至2005年期间癌症入院率较低,但核电工人除外(SRR = 1.13,95%可信区间 = 0.94 - 1.36)。医疗(SRR = 2.90,95%可信区间 = 1.05 - 7.94)、研究机构(SRR = 3.91,95%可信区间 = 1.36 - 11.0)和工业领域(SRR = 5.07,95%可信区间 = 1.56 - 15.6)的女性辐射工人以及所有核电工人的甲状腺癌在统计学上显著升高(SRR = 2.59,95%可信区间 = 1.33 - 5.13),并且与剂量存在显著关联(ERR = 每西弗20.4,90%可信区间 = -8至60,单尾P = 0.049)。935例死亡显示所有原因(SMR = 0.58,95%可信区间 = 0.54 - 0.62)和所有癌症(SMR = 0.73,95%可信区间 = 0.64 - 0.82)存在健康工人效应。肺癌(SMR = 0.77,95%可信区间 = 0.55 - 1.05)和白血病(SMR = 0.59,95%可信区间 = 0.28 - 1.06)死亡率也低于预期。与汽车工人相比,除核电工人外(统计学上不显著),辐射工人的全因死亡率有所降低。
在该电离辐射暴露受到规范的人群中,似乎可以排除高达每西弗300的ERRs,但高达每西弗100的ERRs则不能排除。