Liu Jason J, Freedman D Michal, Little Mark P, Doody Michele M, Alexander Bruce H, Kitahara Cari M, Lee Terrence, Rajaraman Preetha, Miller Jeremy S, Kampa Diane M, Simon Steven L, Preston Dale L, Linet Martha S
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Occup Environ Med. 2014 Dec;71(12):819-35. doi: 10.1136/oemed-2013-101859. Epub 2014 May 22.
There have been few studies of work history and mortality risks in medical radiation workers. We expanded by 11 years and more outcomes our previous study of mortality risks and work history, a proxy for radiation exposure.
Using Cox proportional hazards models, we estimated mortality risks according to questionnaire work history responses from 1983 to 1989 through 2008 by 90,268 US radiological technologists. We controlled for potential confounding by age, birth year, smoking history, body mass index, race and gender.
There were 9566 deaths (3329 cancer and 3020 circulatory system diseases). Mortality risks increased significantly with earlier year began working for female breast (p trend=0.01) and stomach cancers (p trend=0.01), ischaemic heart (p trend=0.03) and cerebrovascular diseases (p trend=0.02). The significant trend with earlier year first worked was strongly apparent for breast cancer during baseline through 1997, but not 1998-2008. Risks were similar in the two periods for circulatory diseases. Radiological technologists working ≥5 years before 1950 had elevated mortality from breast cancer (HR=2.05, 95% CI 1.27 to 3.32), leukaemia (HR=2.57, 95% CI 0.96 to 6.68), ischaemic heart disease (HR=1.13, 95% CI 0.96 to 1.33) and cerebrovascular disease (HR=1.28, 95% CI 0.97 to 1.69). No other work history factors were consistently associated with mortality risks from specific cancers or circulatory diseases, or other conditions.
Radiological technologists who began working in early periods and for more years before 1950 had increased mortality from a few cancers and some circulatory system diseases, likely reflecting higher occupational radiation exposures in the earlier years.
关于医学放射工作人员的工作经历与死亡风险的研究较少。我们将之前关于死亡风险和工作经历(作为辐射暴露的替代指标)的研究扩展了11年,并增加了更多结局指标。
我们使用Cox比例风险模型,根据90268名美国放射技师在1983年至1989年至2008年期间问卷中工作经历的回答来估计死亡风险。我们对年龄、出生年份、吸烟史、体重指数、种族和性别等潜在混杂因素进行了控制。
共有9566人死亡(3329例癌症和3020例循环系统疾病)。女性乳腺癌(p趋势=0.01)、胃癌(p趋势=0.01)、缺血性心脏病(p趋势=0.03)和脑血管疾病(p趋势=0.02)的死亡风险随着开始工作年份的提前而显著增加。在基线期至1997年期间,乳腺癌首次工作年份越早的显著趋势非常明显,但在1998 - 2008年期间则不明显。循环系统疾病在这两个时期的风险相似。1950年之前工作≥5年的放射技师患乳腺癌(风险比=2.05,95%置信区间1.27至3.32)、白血病(风险比=2.57,95%置信区间0.96至6.68)、缺血性心脏病(风险比=1.13,95%置信区间0.96至1.33)和脑血管疾病(风险比=1.28,95%置信区间0.97至1.69)的死亡率升高。没有其他工作经历因素与特定癌症、循环系统疾病或其他疾病的死亡风险始终相关。
1950年之前早期开始工作且工作年限较长的放射技师患某些癌症和一些循环系统疾病的死亡率增加,这可能反映了早期较高的职业辐射暴露。