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1992 - 2005年韩国核电行业工人队列中的辐射暴露与癌症发病率

Radiation exposure and cancer incidence in a cohort of nuclear power industry workers in the Republic of Korea, 1992-2005.

作者信息

Jeong Meeseon, Jin Young-Woo, Yang Kwang Hee, Ahn Yoon-Ok, Cha Chang-Yong

机构信息

Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., 388-1 Ssangmoon-Dong, Dobong-Gu, Seoul, 132-703, Korea.

出版信息

Radiat Environ Biophys. 2010 Mar;49(1):47-55. doi: 10.1007/s00411-009-0247-7. Epub 2009 Oct 13.

Abstract

This study examines for the first time cancer incidence between radiation and non-radiation workers in nuclear power facilities in the Republic of Korea. Radiation workers were defined as persons who were issued with a dosimeter at nuclear power facilities, until 2005. All analyses were conducted on male workers only (in total 16,236 individuals) because of the sparseness of females. Statistical analyses were carried out using the standardized incidence ratio (SIR), to compare the cancer risks of radiation and non-radiation workers with those of the general population, and the chi(2) trend test was used to investigate any increase in cancer rates with dose. Poisson regression was also used to estimate the rate ratio (RR) and the excess relative risk (ERR) after considering the confounding effect due to smoking. During 1992-2005, 99 cancer cases in 63,503 person-years were observed among 8,429 radiation workers, while 104 cancer cases were observed in 48,301 person-years among 7,807 non-radiation workers. When compared with the site- and age-specific cancer rates for the male population of Korea, the SIR for all cancers combined was 1.07 [95% confidence interval (CI) 0.87-1.30] for radiation workers, and 0.88 (95% CI 0.72-1.06) for non-radiation workers, respectively. The RR for radiation workers compared with non-radiation workers was 1.18 (95% CI 0.89-1.58) for all cancers combined. The SIRs for thyroid cancer were noticeably high for both radiation and non-radiation workers, possibly due to the screening effect, but analysis of the RR showed that there was no statistically significant difference in thyroid cancer incidence rates between the two groups. For lung cancer, radiation workers showed a higher incidence rate as compared to non-radiation workers, with the RR being 3.48 (95% CI 1.19-11.48). A chi(2) trend test showed that there was no evidence for an increase in cancer rate with increasing cumulative dose for all cancers combined (p = 0.5108). The ERR per Sievert was estimated to be 1.69 (95% CI -2.07 to 8.21) for all cancers combined assuming a 10 years lag time. Consequently, a significant excess of cancer incidence among radiation workers in the nuclear power industry in Korea was not observed. Further follow-up and an expansion of the cohort are needed to overcome the lack of statistical power in the study.

摘要

本研究首次调查了韩国核电站辐射工作人员与非辐射工作人员之间的癌症发病率。辐射工作人员定义为截至2005年在核电站领取剂量计的人员。由于女性样本稀少,所有分析仅针对男性工作人员进行(共计16236人)。采用标准化发病比(SIR)进行统计分析,以比较辐射工作人员和非辐射工作人员与普通人群的癌症风险,并使用卡方趋势检验来研究癌症发病率随剂量的增加情况。在考虑吸烟的混杂效应后,还使用泊松回归来估计发病率比(RR)和超额相对危险度(ERR)。在1992 - 2005年期间,8429名辐射工作人员在63503人年中观察到99例癌症病例,而7807名非辐射工作人员在48301人年中观察到104例癌症病例。与韩国男性人群的特定部位和年龄的癌症发病率相比,辐射工作人员所有癌症合并的SIR为1.07 [95%置信区间(CI)0.87 - 1.30],非辐射工作人员为0.88(95% CI 0.72 - 1.06)。所有癌症合并时,辐射工作人员与非辐射工作人员的RR为1.18(95% CI 0.89 - 1.58)。辐射工作人员和非辐射工作人员的甲状腺癌SIR均明显较高,可能是由于筛查效应,但RR分析表明两组之间甲状腺癌发病率无统计学显著差异。对于肺癌,辐射工作人员的发病率高于非辐射工作人员,RR为3.48(95% CI 1.19 - 11.48)。卡方趋势检验表明,所有癌症合并时,没有证据表明癌症发病率随累积剂量增加而升高(p = 0.5108)。假设滞后时间为10年,所有癌症合并时每西弗特的ERR估计为1.69(95% CI -2.07至8.21)。因此,未观察到韩国核电行业辐射工作人员的癌症发病率显著过高。需要进一步随访并扩大队列以克服研究中统计效力不足的问题。

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