Kim Eun-A, Lee Eujin, Kang Seong-Kyu, Jeong Meeseon
1Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea.
2Korea Occupational Safety and Health Agency, Ulsan, Korea.
Ann Occup Environ Med. 2018 Jan 31;30:3. doi: 10.1186/s40557-018-0220-5. eCollection 2018.
Probability of causation (PC) is a reasonable way to estimate causal relationships in radiation-related cancer. This study reviewed the international trend, usage, and critiques of the PC method. Because it has been used in Korea, it is important to check the present status and estimation of PC in radiation-related cancers in Korea.
Research articles and official reports regarding PC of radiation-related cancer and published from the 1980s onwards were reviewed, including studies used for the revision of the Korean PC program. PC has been calculated for compensation-related cases in Korea since 2005.
The United States National Institutes of Health first estimated the PC in 1985. Among the 106 occupational diseases listed in the International Labor Organization Recommendation 194 (International Labor Office (ILO), ILO List of Occupational Diseases, 2010), PC is available only for occupational cancer after ionizing radiation exposure. The United States and United Kingdom use PC as specific criteria for decisions on the compensability of workers' radiation-related health effects. In Korea, PC was developed firstly as Korean Radiation Risk and Assigned Share (KORRAS) in 1999. In 2015, the Occupational Safety and Health Research Institute and Radiation Health Research Institute jointly developed a more revised PC program, Occupational Safety and Health-PC (OSH-PC). Between 2005 and 2015, PC was applied in 16 claims of workers' compensation for radiation-related cancers. In most of the cases, compensation was given when the PC was more than 50%. However, in one case, lower than 50% PC was accepted considering the possibility of underestimation of the cumulative exposure dose.
PC is one of the most advanced tools for estimating the causation of occupational cancer. PC has been adjusted for baseline cancer incidence in Korean workers, and for uncertainties using a statistical method. Because the fundamental reason for under- or over-estimation is probably inaccurate dose reconstruction, a proper guideline is necessary.
因果概率（PC）是估计辐射相关癌症因果关系的合理方法。本研究回顾了PC方法的国际趋势、使用情况及相关批评。由于该方法已在韩国使用，因此了解韩国辐射相关癌症中PC的现状和估计情况很重要。
回顾了20世纪80年代以来发表的有关辐射相关癌症PC的研究文章和官方报告，包括用于修订韩国PC程序的研究。自2005年以来，韩国已针对与赔偿相关的病例计算了PC。
美国国立卫生研究院于1985年首次估计了PC。在国际劳工组织第194号建议（国际劳工局，《国际劳工组织职业病清单》，2010年）列出的106种职业病中，PC仅适用于电离辐射暴露后的职业性癌症。美国和英国将PC用作决定工人辐射相关健康影响可赔偿性的具体标准。在韩国，PC最初于1999年作为韩国辐射风险与分配份额（KORRAS）开发。2015年，职业安全与健康研究所和辐射健康研究所联合开发了一个经过更多修订的PC程序，即职业安全与健康-PC（OSH-PC）。2005年至2015年期间，PC应用于16起工人辐射相关癌症赔偿索赔。在大多数情况下，当PC超过50%时给予赔偿。然而，在一个案例中，考虑到累积暴露剂量可能被低估，低于50%的PC也被接受。
PC是估计职业性癌症病因的最先进工具之一。PC已针对韩国工人的基线癌症发病率以及使用统计方法处理的不确定性进行了调整。由于估计不足或过度估计的根本原因可能是剂量重建不准确，因此需要适当的指导方针。
