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白血病与父亲的辐射暴露。

Leukaemia and paternal radiation exposure.

作者信息

Watson G M

出版信息

Med J Aust. 1991 Apr 1;154(7):483-7. doi: 10.5694/j.1326-5377.1991.tb121186.x.

Abstract

OBJECTIVE

Recently, Gardner and colleagues inferred, from a case-control study of leukaemia incidence in young people near the Sellafield nuclear facility in West Cumbria, that an increase near Sellafield was real, and was probably caused by occupational exposure of the father to ionising radiation at the Sellafield plant. The intent of this paper is to dispute that attribution, and to suggest that confirmation of such an alarming and prejudicial conclusion should precede its dissemination. MATERIAL CONSIDERED: Critical comment is limited to the paper by the Gardner group presenting their results, the accompanying paper outlining their methods, a review from Mathews that provides some support for the Gardner proposal by suggesting a pathogenetic mechanism, and some observations on inherited tumours by Nomura that are quoted by Gardner et al. and Mathews in support of their beliefs. Other material quoted is from the general medical literature of the past 20 years relating to radiation biology, mutagenesis and carcinogenesis with some relevance to the Gardner contention; it is not exhaustive.

MAIN RESULTS

Statistical arguments suggest that it is almost impossible to be sure that a specific leukaemia "cluster", such as that near Sellafield, is not a chance finding. The study by Gardner et al. provides only weak statistical evidence for an association between leukaemia in children and parental occupational radiation exposure at Sellafield. The postulate of a causal relation between parental exposure at Sellafield and leukaemia in progeny is incompatible with what is known of the role of genetic mechanisms in leukaemia, with current views on the quantitative relation between radiation dose and mutagenetic effect, and with observations on the children of people exposed to radiation by the nuclear bombs used in Japan in 1945.

CONCLUSIONS

The suggestion that occupational exposure to ionising radiation of a father may be responsible for an increased risk of leukaemia in his children cannot be substantiated. It would be proper to seek confirmation from other groups of occupationally exposed persons before undertaking precipitous, and inevitably disturbing, action to remedy the supposed problem.

摘要

目的

最近,加德纳及其同事通过对西坎布里亚郡塞拉菲尔德核设施附近年轻人白血病发病率的病例对照研究推断,塞拉菲尔德附近白血病发病率的上升是真实存在的,且可能是由于父亲在塞拉菲尔德工厂接触电离辐射所致。本文旨在对这一归因提出质疑,并指出在传播如此惊人且有偏见的结论之前,应先对其进行证实。

考虑的材料

批判性评论仅限于加德纳团队发表研究结果的论文、概述其研究方法的附带论文、马修斯的一篇综述(该综述通过提出一种致病机制为加德纳的提议提供了一些支持),以及野村关于遗传性肿瘤的一些观察结果(加德纳等人和马修斯引用这些观察结果来支持他们的观点)。引用的其他材料来自过去20年与辐射生物学、诱变和致癌作用相关的一般医学文献,这些文献与加德纳的论点有一定相关性,但并不详尽。

主要结果

统计学观点表明,几乎不可能确定一个特定的白血病“聚集区”,比如塞拉菲尔德附近的聚集区,不是偶然发现。加德纳等人的研究仅提供了薄弱的统计证据,证明儿童白血病与父母在塞拉菲尔德的职业性辐射暴露之间存在关联。关于父母在塞拉菲尔德的暴露与子代白血病之间存在因果关系的假设,与已知的遗传机制在白血病中的作用、当前关于辐射剂量与诱变效应定量关系的观点,以及对1945年日本原子弹爆炸辐射暴露人群子女的观察结果均不相符。

结论

父亲职业性接触电离辐射可能导致其子女患白血病风险增加这一说法无法得到证实。在采取仓促且必然会引起困扰的行动来解决所谓的问题之前,应当从其他职业暴露人群组寻求证实。

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