National Council on Radiation Protection and Measurements, Bethesda, MD, USA.
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
Int J Radiat Biol. 2022;98(4):679-700. doi: 10.1080/09553002.2020.1787543. Epub 2020 Aug 3.
Approximately 235,000 military personnel participated at one of 230 U.S. atmospheric nuclear weapons tests from 1945 through 1962. At the Nevada Test Site (NTS), the atomic veterans participated in military maneuvers, observed nuclear weapons tests, or provided technical support. At the Pacific Proving Ground (PPG), they served aboard ships or were stationed on islands during or after nuclear weapons tests.
Participants at seven test series, previously studied with high-quality dosimetry and personnel records, and the first test at TRINITY formed the cohort of 114,270 male military participants traced for vital status from 1945 through 2010. Dose reconstructions were based on Nuclear Test Personnel Review records, Department of Defense. Standardized mortality ratios (SMR) and Cox and Poisson regression models were used in the analysis.
Most atomic veterans were enlisted men, served in the Navy at the PPG, and were born before 1930. Vital status was determined for 96.8% of the veterans; 60% had died. Enlisted men had significantly high all-causes mortality SMR (1.06); officers had significantly low all-causes mortality SMR (0.71). The pattern of risk over time showed a diminution of the 'healthy soldier effect': the all-causes mortality SMR after 50 years of follow-up was 1.00. The healthy soldier effect for all cancers also diminished over time. The all-cancer SMR was significantly high after 50 years (SMR 1.10) primarily from smoking-related cancers, attributed in part to the availability of cigarettes in military rations. The highest SMR was for mesothelioma (SMR 1.56) which was correlated with asbestos exposure in naval ships. Prostate cancer was significantly high (SMR 1.13). Ischemic heart disease was significantly low (SMR 0.84). Estimated mean doses varied by organ were low; e.g., the mean red bone marrow dose was 6 mGy (maximum 108 mGy). Internal cohort dose-response analyses provided no evidence for increasing trends with radiation dose for leukemia (excluding chronic lymphocytic leukemia (CLL)) [ERR (95% CI) per 100 mGy -0.37 (-1.08, 0.33); = 710], CLL, myelodysplastic syndrome, multiple myeloma, ischemic heart disease, or cancers of the lung, prostate, breast, and brain.
No statistically significant radiation associations were observed among 114,270 nuclear weapons test participants followed for up to 65 years. The 95% confidence limits were narrow and excluded mortality risks per unit dose that are two to four times higher than those reported in other investigations. Significantly elevated SMRs were seen for mesothelioma and asbestosis, attributed to asbestos exposure aboard ships.
从 1945 年到 1962 年，大约有 235000 名军事人员参加了美国在 230 个地点进行的 230 次大气核武器试验。在内华达试验场（NTS），原子老兵参加军事演习，观察核武器试验，或提供技术支持。在太平洋试验场（PPG），他们在核试验期间或之后在船上服役或驻扎在岛屿上。
此前，对七个试验系列的参与者进行了研究，这些参与者具有高质量的剂量测定和人员记录，以及 Trinity 的第一次试验，形成了 114270 名男性军事参与者的队列，这些参与者从 1945 年到 2010 年进行了追踪以确定其生存状况。剂量重建基于核试验人员审查记录，美国国防部。标准化死亡率比（SMR）和 Cox 和 Poisson 回归模型用于分析。
大多数原子老兵是入伍士兵，在 PPG 服役，出生于 1930 年之前。确定了 96.8%的退伍军人的生存状况；60%的人已经死亡。入伍士兵的全因死亡率 SMR 明显较高（1.06）；军官的全因死亡率 SMR 明显较低（0.71）。随着时间的推移，风险模式显示“健康士兵效应”减弱：50 年随访后全因死亡率 SMR 为 1.00。随着时间的推移，所有癌症的“健康士兵效应”也减弱。50 年后所有癌症的 SMR 明显升高（SMR 1.10），主要是由于与吸烟有关的癌症，部分原因是军队口粮中提供了香烟。间皮瘤的 SMR 最高（SMR 1.56），这与海军舰艇中的石棉暴露有关。前列腺癌明显升高（SMR 1.13）。缺血性心脏病明显较低（SMR 0.84）。估计各器官的平均剂量较低；例如，红骨髓的平均剂量为 6 毫戈瑞（最大 108 毫戈瑞）。内部队列剂量-反应分析没有提供证据表明白血病（不包括慢性淋巴细胞白血病（CLL））[每 100 毫戈瑞的超额风险（95%CI）-0.37（-1.08，0.33）； = 710]、CLL、骨髓增生异常综合征、多发性骨髓瘤、缺血性心脏病或肺癌、前列腺癌、乳腺癌和脑癌的辐射剂量呈上升趋势。
在对多达 114270 名核武器试验参与者进行的长达 65 年的随访中，没有观察到与辐射相关的统计学显著关联。95%置信区间狭窄，排除了每单位剂量死亡率风险比其他研究报告的高出两到四倍的风险。间皮瘤和石棉沉着症的 SMR 明显升高，归因于船上的石棉暴露。
