Seo Songwon, Lim Wan Young, Lee Dal Nim, Kim Jung Un, Cha Eun Shil, Bang Ye Jin, Lee Won Jin, Park Sunhoo, Jin Young Woo
Laboratory of Low Dose Risk Assessment, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Korea.
Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
BMJ Open. 2018 Mar 30;8(3):e017359. doi: 10.1136/bmjopen-2017-017359.
The cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure.
Approximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose-response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status.
This study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings of the study will be disseminated through scientific peer-reviewed journals and be provided to the public, including radiation workers, via the study website (http://www.rhs.kr/) and onsite radiation safety education.
中高剂量范围内辐射暴露的癌症风险已得到充分证实。然而，在低剂量范围且低剂量率长期暴露（这是职业暴露的典型情况）下，风险仍不明确。韩国已对辐射工作人员开展了多项流行病学研究，但多数情况下数据是回顾性分析的。此外，像工业放射技师这类暴露剂量相对较高的群体被忽视了。因此，我们对所有韩国辐射工作人员开展了一项前瞻性队列研究，以评估职业辐射暴露相关的健康影响。
2016年至2017年向核安全与保安委员会登记的约4.2万名韩国辐射工作人员是本研究的初始目标人群。队列参与者将通过2016年5月24日至2017年6月30日期间全国范围的自填式问卷调查进行招募。截至2017年3月31日，22982名工作人员已纳入研究，应答率为75%。这种招募将每5年持续进行一次，以更新现有研究参与者的信息并招募新入职的工作人员。调查数据将通过个人识别码与国家剂量登记处、国家癌症登记处、国家人口动态统计登记处和国家健康保险数据相链接。将计算特定年龄和性别的标准化发病率和死亡率比值，用于癌症风险的总体比较。对于剂量反应评估，将在对出生年份和潜在混杂因素（如生活方式因素和社会经济地位）进行调整后，估计超额相对风险（每戈瑞）和超额绝对风险（每戈瑞）。
本研究已获得韩国放射医学科学研究所机构审查委员会的伦理批准（IRB编号：K-1603-002-034）。所有参与者在入组前均提供了书面知情同意书。研究结果将通过科学同行评审期刊传播，并通过研究网站（http://www.rhs.kr/）和现场辐射安全教育提供给公众，包括辐射工作人员。
