School of Public Health, Soochow University, Suzhou, China.
J Toxicol Environ Health B Crit Rev. 2012;15(5):332-47. doi: 10.1080/10937404.2012.689555.
Despite the fact that animal and human epidemiological studies confirmed a link between radon exposure in homes and increased risk of lung cancer in general population, other types of cancers induced by radon, such as leukemia, have not been consistently demonstrated. The aim of this review was to summarize data published thus far from ecological and case-control studies in exposed populations, taking into account radon dose estimation and evidence of radon-induced genotoxicity, in an effort to clarify the correlation between home radon exposure and incidence of childhood leukemia. Among 12 ecological studies, 11 reported a positive association between radon levels and elevated frequency of childhood leukemia, with 8 being significant. In conjunction with ecological studies, several case-control studies on indoor radon exposure and childhood leukemia were examined, and most investigations indicated a weak association with only a few showing significance. A major source of uncertainty in radon risk assessment is radon dose estimate. Methods for radon exposure measurement in homes of children are one of the factors that affect the risk estimates in a case-control study. The effects of radon-induced genetic damage were studied both in vitro and in vivo using genetic endpoints including chromosomal aberration (CA), micronuclei (MN) formation, gene mutation, and deletions and insertions. By applying a meta-analysis, an increased risk of childhood leukemia induced by indoor radon exposure was noted for overall leukemia and for acute lymphoblastic leukemia (ALL). Data thus indicated an association between environmental radon exposure and elevated leukemia incidence, but more evidence is required in both human investigations and animal mechanistic research before this assumption may be confirmed with certainty.
尽管动物和人类流行病学研究证实了家庭氡暴露与一般人群肺癌风险增加之间存在关联,但氡引起的其他类型癌症,如白血病,并没有得到一致证实。本综述的目的是总结迄今为止在暴露人群中进行的生态和病例对照研究中发表的数据,同时考虑氡剂量估计和氡诱导遗传毒性的证据,以阐明家庭氡暴露与儿童白血病发病率之间的相关性。在 12 项生态学研究中,有 11 项报告了氡水平与儿童白血病发病率升高之间存在正相关,其中 8 项具有统计学意义。结合生态学研究,还对室内氡暴露与儿童白血病的几项病例对照研究进行了检查,大多数研究表明与儿童白血病存在弱相关性,只有少数具有统计学意义。氡风险评估中的一个主要不确定性来源是氡剂量估计。儿童家庭氡暴露测量方法是影响病例对照研究风险估计的因素之一。利用包括染色体畸变(CA)、微核(MN)形成、基因突变、缺失和插入在内的遗传终点,在体外和体内研究了氡诱导的遗传损伤的影响。通过应用荟萃分析,注意到室内氡暴露与总体白血病和急性淋巴细胞白血病(ALL)的儿童白血病风险增加有关。因此,数据表明环境氡暴露与白血病发病率升高之间存在关联,但在人类研究和动物机制研究中需要更多的证据,才能确定这一假设。