Department of Preventive Medicine, Keimyung University College of Medicine, Daegu, South Korea.
Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.
Environ Int. 2016 Feb;87:42-8. doi: 10.1016/j.envint.2015.11.006. Epub 2015 Nov 28.
There has been public concern regarding the safety of residing near nuclear power plants, and the extent of risk for thyroid cancer among adults living near nuclear power plants has not been fully explored. In the present study, a systematic review and meta-analysis of epidemiologic studies was conducted to investigate the association between living near nuclear power plants and the risk of thyroid cancer. A comprehensive literature search was performed on studies published up to March 2015 on the association between nuclear power plants and thyroid cancer risk. The summary standardized incidence ratio (SIR), standardized mortality ratio (SMR), and 95% confidence intervals (CIs) were calculated using a random-effect model of meta-analysis. Sensitivity analyses were performed by study quality. Thirteen studies were included in the meta-analysis, covering 36 nuclear power stations in 10 countries. Overall, summary estimates showed no significant increased thyroid cancer incidence or mortality among residents living near nuclear power plants (summary SIR=0.98; 95% CI 0.87-1.11, summary SMR=0.80; 95% CI 0.62-1.04). The pooled estimates did not reveal different patterns of risk by gender, exposure definition, or reference population. However, sensitivity analysis by exposure definition showed that living less than 20 km from nuclear power plants was associated with a significant increase in the risk of thyroid cancer in well-designed studies (summary OR=1.75; 95% CI 1.17-2.64). Our study does not support an association between living near nuclear power plants and risk of thyroid cancer but does support a need for well-designed future studies.
公众一直对居住在核电站附近的安全性表示关注，而居住在核电站附近的成年人患甲状腺癌的风险程度尚未得到充分探讨。本研究对调查居住在核电站附近与甲状腺癌风险之间关系的流行病学研究进行了系统评价和荟萃分析。对截至 2015 年 3 月关于核电站与甲状腺癌风险之间关系的研究进行了全面的文献检索。使用荟萃分析的随机效应模型计算了标准化发病率比（SIR）、标准化死亡率比（SMR）和 95％置信区间（CI）的汇总值。通过研究质量进行了敏感性分析。荟萃分析共纳入了 13 项研究，涵盖了 10 个国家的 36 个核电站。总体而言，汇总估计表明，居住在核电站附近的居民甲状腺癌的发病率或死亡率没有明显增加（汇总 SIR=0.98；95％CI 0.87-1.11，汇总 SMR=0.80；95％CI 0.62-1.04）。汇总估计并未显示出风险的性别、暴露定义或参考人群的不同模式。但是，根据暴露定义进行的敏感性分析表明，居住在距离核电站 20 公里以内的人群与甲状腺癌风险的显著增加相关（汇总 OR=1.75；95％CI 1.17-2.64）。我们的研究不支持居住在核电站附近与甲状腺癌风险之间存在关联，但确实支持未来需要进行精心设计的研究。
