Smith P G, Douglas A J
Br Med J (Clin Res Ed). 1986 Oct 4;293(6551):845-54. doi: 10.1136/bmj.293.6551.845.
The mortality of all 14,327 people who were known to have been employed at the Sellafield plant of British Nuclear Fuels at any time between the opening of the site in 1947 and 31 December 1975 was studied up to the end of 1983. The vital state of 96% of the workers was traced satisfactorily and 2277 were found to have died, 572 (25%) from cancer. On average the workers suffered a mortality from all causes that was 2% less than that of the general population of England and Wales and 9% less than that of the population of Cumberland (the area in which the plant is sited). Their mortality from cancers of all kinds was 5% less than that of England and Wales and 3% less than that of Cumberland. In the five years after their first employment Sellafield workers had an overall mortality that was 70% of that of England and Wales, probably due to healthier members of the population being selected for employment. Raised death rates from cancers of several specific sites were found, but only for those of ill defined and secondary sites was the excess statistically significant (30 observed, 19.7 expected). For cancers of the liver and gall bladder there was a significant deficit of deaths (four observed, 10.5 expected). Workers in areas of the plant where radiation exposure was likely were issued with dosimeters to measure their external exposure to ionising radiations. Personal dose records were maintained for workers who entered such areas other than infrequently. Workers with personal dose records ("radiation" workers) had lower death rates from all causes combined than other workers but the death rates from cancer in the two groups were similar. Compared with the general population radiation workers had statistically significant deficits of liver and gall bladder cancer, lung cancer, and Hodgkin's disease. There were excesses of deaths from myeloma (seven observed, 4.2 expected) and prostatic cancer (19 observed, 15.8 expected) but these were not significant and there was no evidence of an excess of leukaemia (10 deaths observed, 12.2 expected) or cancer of the pancreas (15 observed, 17.8 expected). Non-radiation workers had a significant deficit of leukaemia (one death observed, 5.1 expected) and a significant excess of cancers of ill defined and secondary sites (13 deaths observed, 5.8 expected). For no type of cancer was the ratio of observed to expected deaths significantly different between radiation and non-radiation workers.(ABSTRACT TRUNCATED AT 400 WORDS)
对1947年该场地开放至1975年12月31日期间曾在英国核燃料公司塞拉菲尔德工厂工作过的所有14327人的死亡率进行了研究,直至1983年底。令人满意地追踪到了96%工人的生命状况,发现其中2277人已经死亡,572人(25%)死于癌症。总体而言,这些工人的全因死亡率比英格兰和威尔士的普通人群低2%,比坎布里亚郡(该工厂所在地区)的人口低9%。他们各类癌症的死亡率比英格兰和威尔士低5%,比坎布里亚郡低3%。在首次就业后的五年里,塞拉菲尔德工厂的工人总体死亡率是英格兰和威尔士的70%,这可能是因为被挑选来就业的是健康状况较好的人群。发现了几个特定部位癌症的死亡率有所上升,但只有那些部位不明和继发性癌症的死亡率超出具有统计学意义(观察到30例,预期19.7例)。肝脏和胆囊癌的死亡人数明显不足(观察到4例,预期10.5例)。可能受到辐射照射的工厂区域的工人会发放剂量计以测量他们受到的外部电离辐射剂量。对于不常进入此类区域的工人则不保存个人剂量记录。有个人剂量记录的工人(“辐射”工人)全因综合死亡率低于其他工人,但两组的癌症死亡率相似。与普通人群相比,辐射工人的肝脏和胆囊癌、肺癌以及霍奇金病的死亡率在统计学上有明显不足。骨髓瘤(观察到7例,预期4.2例)和前列腺癌(观察到19例,预期15.8例)的死亡人数有所超出,但并不显著,也没有证据表明白血病(观察到10例死亡,预期12.2例)或胰腺癌(观察到15例,预期17.8例)有超出情况。非辐射工人白血病死亡率明显不足(观察到1例死亡,预期5.1例),部位不明和继发性癌症的死亡率明显超出(观察到13例死亡,预期5.8例)。对于任何一种癌症,辐射工人和非辐射工人的观察死亡数与预期死亡数之比均无显著差异。(摘要截选至400字)