Hatch M C, Beyea J, Nieves J W, Susser M
Div. of Epidemiology, Columbia U. School of Public Health, New York, NY 10032.
Am J Epidemiol. 1990 Sep;132(3):397-412; discussion 413-7. doi: 10.1093/oxfordjournals.aje.a115673.
As a public charge, cancers among the 159,684 residents living within a 10-mile (16-km) radius of the Three Mile Island nuclear plant were studied relative to releases of radiation during the March 28, 1979, accident as well as to routine plant emissions. The principal cancers considered were leukemia and childhood malignancies. Estimates of the emissions delivered to small geographic study tracts were derived from mathematical dispersion models which accounted for modifying factors such as wind and terrain; the model of accident emissions was validated by readings from off-site dosimeters. Incident cancers among area residents for the period 1975-1985 (n = 5,493) were identified by a review of the records at all local and regional hospitals; preaccident and postaccident trends in cancer rates were examined. For accident emissions, the authors failed to find definite effects of exposure on the cancer types and population subgroups thought to be most susceptible to radiation. No associations were seen for leukemia in adults or for childhood cancers as a group. For leukemia in children, the odds ratio was raised, but cases were few (n = 4), and the estimate was highly variable. Moreover, rates of childhood leukemia in the Three Mile Island area are low compared with national and regional rates. For exposure to routine emissions, the odds ratios were raised for childhood cancers as a whole and for childhood leukemia, but confidence intervals were wide and included 1.0. For leukemia in adults, there was a negative trend. Trends for two types of cancer ran counter to expectation. Non-Hodgkin's lymphoma showed raised risks relative to both accident and routine emissions; lung cancer (adjusted only indirectly for smoking) showed raised risks relative to accident emissions, routine emissions, and background gamma radiation. Overall, the pattern of results does not provide convincing evidence that radiation releases from the Three Mile Island nuclear facility influenced cancer risk during the limited period of follow-up.
作为一项公共责任研究，对三里岛核电站半径10英里（16公里）范围内居住的159,684名居民的癌症情况进行了研究，分析其与1979年3月28日事故期间的辐射释放以及核电站日常排放的关系。主要研究的癌症类型为白血病和儿童恶性肿瘤。通过考虑诸如风和地形等修正因素的数学扩散模型，得出了输送到小地理研究区域的排放量估计值；事故排放模型通过场外剂量计的读数进行了验证。通过查阅所有当地和地区医院的记录，确定了1975 - 1985年期间该地区居民的癌症发病情况（n = 5,493）；并研究了癌症发病率在事故前后的趋势。对于事故排放，作者未能发现辐射暴露对被认为最易受辐射影响的癌症类型和人群亚组有明确影响。在成年人白血病或儿童癌症总体上未发现关联。对于儿童白血病，优势比有所升高，但病例数很少（n = 4），且估计值变化很大。此外，与全国和地区发病率相比，三里岛地区儿童白血病发病率较低。对于日常排放暴露，儿童癌症总体和儿童白血病的优势比有所升高，但置信区间很宽且包含1.0。对于成年人白血病，存在负向趋势。两种癌症类型的趋势与预期相反。非霍奇金淋巴瘤相对于事故排放和日常排放风险均升高；肺癌（仅间接针对吸烟进行了调整）相对于事故排放、日常排放和背景伽马辐射风险均升高。总体而言，这些结果模式并未提供令人信服的证据表明三里岛核设施的辐射释放在有限的随访期内影响了癌症风险。
