Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Am J Epidemiol. 2013 Mar 15;177(6):562-8. doi: 10.1093/aje/kws362. Epub 2013 Feb 20.
The Life Span Study of atomic bomb survivors is an important source of risk estimates used to inform radiation protection and compensation. Interviews with survivors in the 1950s and 1960s provided information needed to estimate radiation doses for survivors proximal to ground zero. Because of a lack of interview or the complexity of shielding, doses are missing for 7,058 of the 68,119 proximal survivors. Recent analyses excluded people with missing doses, and despite the protracted collection of interview information necessary to estimate some survivors' doses, defined start of follow-up as October 1, 1950, for everyone. We describe the prevalence of missing doses and its association with mortality, distance from hypocenter, city, age, and sex. Missing doses were more common among Nagasaki residents than among Hiroshima residents (prevalence ratio = 2.05; 95% confidence interval: 1.96, 2.14), among people who were closer to ground zero than among those who were far from it, among people who were younger at enrollment than among those who were older, and among males than among females (prevalence ratio = 1.22; 95% confidence interval: 1.17, 1.28). Missing dose was associated with all-cancer and leukemia mortality, particularly during the first years of follow-up (all-cancer rate ratio = 2.16, 95% confidence interval: 1.51, 3.08; and leukemia rate ratio = 4.28, 95% confidence interval: 1.72, 10.67). Accounting for missing dose and late entry should reduce bias in estimated dose-mortality associations.
原子弹幸存者寿命研究是用于为辐射防护和赔偿提供信息的风险估计的重要来源。对 20 世纪 50 年代和 60 年代幸存者的访谈提供了估算接近爆炸中心的幸存者辐射剂量所需的信息。由于缺乏访谈或屏蔽的复杂性，对于 68119 名接近幸存者中的 7058 人，剂量信息缺失。最近的分析排除了剂量缺失的人，尽管为了估算一些幸存者的剂量而需要长时间收集访谈信息，但所有人的随访开始时间都定义为 1950 年 10 月 1 日。我们描述了剂量缺失的普遍性及其与死亡率、与爆心距离、城市、年龄和性别之间的关联。与广岛居民相比，长崎居民的剂量缺失更为常见（流行率比=2.05；95%置信区间：1.96，2.14），与远离爆炸中心的人相比，接近爆炸中心的人更常见，与年龄较大的人相比，年龄较小的人更常见，与女性相比，男性更常见（流行率比=1.22；95%置信区间：1.17，1.28）。剂量缺失与所有癌症和白血病死亡率相关，特别是在随访的头几年（所有癌症的发生率比=2.16，95%置信区间：1.51，3.08；白血病的发生率比=4.28，95%置信区间：1.72，10.67）。考虑剂量缺失和晚期入组应该会减少剂量-死亡率相关性估计中的偏差。
