Department of Environmental Sciences, National University, Kiev, Ukraine.
Int J Cancer. 2010 Jul 15;127(2):412-26. doi: 10.1002/ijc.24834.
This case-control study was conducted to estimate the radiation-induced risk of acute leukemia during the period from 1987 to 1997 among residents 0-5 years of age at the time of the Chernobyl accident in the most radioactively contaminated territories of the Ukraine (Rivno, Zhytomyr, Chernihiv and Cherkasy regions). Data were collected from 246 leukemia cases diagnosed between 1 January, 1987, and 31 December, 1997. Each case was verified and interviewed. Verified cases were compared to 492 randomly selected controls matched by age, sex, type of settlement (rural, semirural and urban) and administrative region of residency. The cumulative level of radiation exposure from the time of the Chernobyl accident to the date of diagnosis was assessed for each case and corresponding controls. Four dose-range groups were selected for statistical analysis (0-2.9, 3-9.9, 10-99.9 and 100-313.3 mGy). The risk of leukemia was significantly increased (-2.4 [95%CI: 1.4-4.0]) among those with radiation exposure doses higher than 10 mGy (p = 0.01). The association between radiation exposure and risk was stronger among males (-2.8 [95%CI: 1.4-5.5, p = 0.01]), and for cases of acute leukemia that were diagnosed during the period from 1987 to 1992 (-2.5 [95%CI: 1.2-5.1, p = 0.05]), particularly acute myeloid leukemia (-5.8 [95%CI: 1.4-24.6, p = 0.05]). The influence of possible confounders and methods of selecting controls on the leukemia risk assessment was analyzed. The evaluated risk per unit dose is discussed.
本病例对照研究旨在估算 1987 年至 1997 年间切尔诺贝利事故期间,乌克兰受辐射污染最严重地区(里夫诺、日托米尔、切尔尼戈夫和切尔卡瑟地区)0-5 岁居民发生急性白血病的辐射诱发风险。研究数据来自于 1987 年 1 月 1 日至 1997 年 12 月 31 日期间诊断的 246 例白血病病例。每个病例均经过验证并进行访谈。验证后的病例与通过年龄、性别、居住类型(农村、半农村和城市)和居住地行政区相匹配的 492 名随机选择的对照进行比较。为每个病例及其对应的对照评估了自切尔诺贝利事故发生之日起至诊断日期的累计辐射暴露水平。为统计分析选择了四个剂量范围组(0-2.9、3-9.9、10-99.9 和 100-313.3 mGy)。结果显示,暴露于 10 mGy 以上辐射剂量的人群白血病风险显著增加(-2.4[95%CI:1.4-4.0])(p = 0.01)。暴露于辐射与风险之间的关联在男性中更强(-2.8[95%CI:1.4-5.5,p = 0.01]),在 1987 年至 1992 年期间诊断的急性白血病病例中更为明显(-2.5[95%CI:1.2-5.1,p = 0.05]),尤其是急性髓系白血病(-5.8[95%CI:1.4-24.6,p = 0.05])。分析了可能的混杂因素和对照选择方法对白血病风险评估的影响,并讨论了单位剂量评估的风险。