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切尔诺贝利事故应急工作人员实体癌的发病率和死亡率:1992 - 2009年随访期辐射风险评估

Incidence and mortality of solid cancer among emergency workers of the Chernobyl accident: assessment of radiation risks for the follow-up period of 1992-2009.

作者信息

Kashcheev V V, Chekin S Yu, Maksioutov M A, Tumanov K A, Kochergina E V, Kashcheeva P V, Shchukina N V, Ivanov V K

机构信息

Federal State Institution, Medical Radiological Research Center, Russian Ministry of Health, 4 Korolyov Street, 249036, Obninsk, Kaluga Region, Russia.

出版信息

Radiat Environ Biophys. 2015 Mar;54(1):13-23. doi: 10.1007/s00411-014-0572-3. Epub 2014 Oct 15.

Abstract

This paper presents the results of a retrospective cohort study of cancer incidence and mortality among emergency workers of the Chernobyl accident, for the follow-up period 1992-2009. The cohort selected for analysis consists of 67,568 emergency workers who worked in the Chernobyl exclusion zone in 1986-1987. External radiation whole-body absorbed dose varied from 0.0001 gray (Gy) to 1.24 Gy, with a median of 0.102 Gy. Over the follow-up period 1992-2009, a total of 4,002 solid cancers of different sites were identified as the result of annual compulsory health examination, and a total of 2,442 deaths from all solid cancers in the study cohort were reported. Poisson regression was applied for the analysis of cancer incidence and mortality. The analysis of the standardized incidence ratio (SIR) has shown a statistically significant increase in cancer incidence in the cohort as compared with baseline cancer incidence among males of Russia. The average excess over the entire follow-up period is 18 % [SIR = 1.18, 95 % confidence interval (CI) 1.15; 1.22]. In contrast, however, no increase in the mortality from all cancers among the emergency workers as compared to the baseline mortality in Russian men was found. Values of excess relative risk of cancer incidence and mortality per 1 Gy (ERR Gy(-1)) are 0.47 (95 % CI 0.03; 0.96, p value = 0.034) and 0.58 (95 % CI 0.002; 1.25, p value = 0.049), respectively. These values are statistically significant.

摘要

本文呈现了一项针对切尔诺贝利事故应急工作人员1992 - 2009年随访期内癌症发病率和死亡率的回顾性队列研究结果。用于分析的队列由1986 - 1987年在切尔诺贝利禁区工作的67568名应急工作人员组成。全身外照射吸收剂量从0.0001格雷(Gy)到1.24 Gy不等,中位数为0.102 Gy。在1992 - 2009年的随访期内,通过年度强制健康检查共确诊了4002例不同部位的实体癌,研究队列中共有2442例因所有实体癌死亡的报告。采用泊松回归分析癌症发病率和死亡率。标准化发病率比(SIR)分析显示,与俄罗斯男性的基线癌症发病率相比,该队列中的癌症发病率有统计学显著增加。整个随访期的平均超额发病率为18% [SIR = 1.18,95%置信区间(CI)1.15;1.22]。然而,相比之下,未发现应急工作人员中所有癌症的死亡率与俄罗斯男性的基线死亡率相比有所增加。每1 Gy癌症发病率和死亡率的超额相对风险值(ERR Gy(-1))分别为0.47(95% CI 0.03;0.96,p值 = 0.034)和0.58(95% CI 0.002;1.25,p值 = 0.049)。这些值具有统计学显著性。

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