Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA.
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA.
Int J Cancer. 2020 Dec 1;147(11):3130-3138. doi: 10.1002/ijc.33141. Epub 2020 Jul 6.
In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low-dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack-years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time-dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0-810 mGy). During the 1983 to 2012 follow-up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: -0.02, 95% CI: <0-0.13). However, significant dose-response relationships were observed for some subgroups, which might be false-positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub-multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01-1.15) for those who smoked <20 pack-years and -0.03 (95% CI: <0-0.15) for those who smoked ≥20 pack-years. Our study provides some evidence that greater protracted radiation exposure in the low-dose range is positively associated with lung cancer mortality.
在日本原子弹幸存者中，已经表明肺癌的风险随着电离辐射的急性暴露量的增加而增加。尽管在暴露于低剂量、长期辐射的人群中也观察到了类似的发现，但这些研究缺乏有关吸烟史的信息，而吸烟史是一个潜在的混杂因素。在一项由 106068 名美国放射技师组成的队列中，我们研究了职业辐射暴露所致估计累计肺吸收剂量与肺癌死亡率之间的关系。使用泊松回归模型，根据获得的年龄、性别、出生队列、吸烟包年数和戒烟后年数进行调整，使用时间依赖性累计肺吸收剂量，滞后 10 年，计算每 100 mGy 的线性超额相对风险（ERR）。肺的平均累计吸收剂量为 25 mGy（范围：0-810 mGy）。在 1983 年至 2012 年的随访期间，有 1090 名参与者死于肺癌。总的来说，职业辐射肺剂量与肺癌死亡率之间没有关联（每 100 mGy 的 ERR：-0.02，95%CI：<0-0.13）。然而，对于某些亚组观察到了显著的剂量-反应关系，考虑到进行的统计检验数量，这些结果可能是假阳性的。与其他关于辐射和吸烟的研究一样，辐射和吸烟之间的相互作用似乎呈亚乘法关系，对于吸烟<20 包年的人，每 100 mGy 的 ERR 为 0.41（95%CI：0.01-1.15），对于吸烟≥20 包年的人，ERR 为-0.03（95%CI：<0-0.15）。我们的研究提供了一些证据，表明在低剂量范围内，长期辐射暴露的增加与肺癌死亡率呈正相关。
