Raaschou-Nielsen Ole
Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
Radiat Prot Dosimetry. 2008;132(2):175-81. doi: 10.1093/rpd/ncn288. Epub 2008 Nov 14.
This paper summarises the epidemiological literature on domestic exposure to radon and risk for childhood leukaemia. The results of 12 ecological studies show a consistent pattern of higher incidence and mortality rates for childhood leukaemia in areas with higher average indoor radon concentrations. Although the results of such studies are useful to generate hypotheses, they must be interpreted with caution, as the data were aggregated and analysed for geographical areas and not for individuals. The seven available case-control studies of childhood leukaemia with measurement of radon concentrations in the residences of cases and controls gave mixed results, however, with some indication of a weak (relative risk < 2) association with acute lymphoblastic leukaemia. The epidemiological evidence to date suggests that an association between indoor exposure to radon and childhood leukaemia might exist, but is weak. More case-control studies are needed, with sufficient statistical power to detect weak associations and based on designs and methods that minimise misclassification of exposure and provide a high participation rate and low potential selection bias.
本文总结了关于家庭接触氡与儿童白血病风险的流行病学文献。12项生态学研究结果显示，在平均室内氡浓度较高的地区，儿童白血病的发病率和死亡率呈现出一致的更高模式。尽管此类研究结果有助于提出假设，但由于数据是按地理区域汇总和分析的，而非针对个体，所以在解释时必须谨慎。现有的7项针对儿童白血病的病例对照研究测量了病例和对照住所中的氡浓度，结果不一，不过有迹象表明与急性淋巴细胞白血病存在弱关联（相对风险<2）。迄今为止的流行病学证据表明，室内接触氡与儿童白血病之间可能存在关联，但关联较弱。需要开展更多病例对照研究，具备足够的统计效力以检测弱关联，并基于能尽量减少暴露错误分类、提供高参与率和低潜在选择偏倚的设计和方法。
