Checkoway H, Pearce N, Crawford-Brown D J, Cragle D L
Department of Epidemiology, University of North Carolina, School of Public Health, Chapel Hill.
Am J Epidemiol. 1988 Feb;127(2):255-66. doi: 10.1093/oxfordjournals.aje.a114801.
A historical cohort mortality study was conducted among 6,781 white male employees from a nuclear weapons materials fabrication plant for the years 1947-1979. Exposures of greatest concern are alpha and gamma radiation emanating primarily from insoluble uranium compounds. Among monitored workers, the mean cumulative alpha radiation dose to the lung was 8.21 rem, and the mean cumulative external whole body penetrating dose from gamma radiation was 0.96 rem. Relative to US white males, the cohort experienced mortality deficits from all causes combined, cardiovascular diseases, and from most site-specific cancers. Mortality excesses of lung and brain and central nervous system cancers were seen from comparisons with national and state rates. Dose-response trends were detected for lung cancer mortality with respect to cumulative alpha and gamma radiation, with the most pronounced trend occurring for gamma radiation among workers who received greater than or equal to 5 rem of alpha radiation. These trends diminished in magnitude when a 10-year latency assumption was applied. Under a zero-year latency assumption, the rate ratio for lung cancer mortality associated with joint exposure of greater than or equal to 5 versus less than 1 rem of both types of radiation is 4.60 (95% confidence limits (CL) 0.91, 23.35), while the corresponding result, assuming a 10-year latency, is 3.05 (95% CL 0.37, 24.83). While these rate ratios, which are based on three and one death, respectively, lack statistical precision, the observed dose-response trends indicate potential carcinogenic effects to the lung of relatively low-dose radiation. There are no dose-response trends for mortality from brain and central nervous system cancers.
1947年至1979年间，对一家核武器材料制造工厂的6781名白人男性员工进行了一项历史性队列死亡率研究。最受关注的暴露源是主要来自不溶性铀化合物的α和γ辐射。在接受监测的工人中，肺部的平均累积α辐射剂量为8.21雷姆，γ辐射的平均累积全身外照射穿透剂量为0.96雷姆。与美国白人男性相比，该队列在所有原因、心血管疾病以及大多数特定部位癌症方面的死亡率均有所下降。与国家和州的死亡率相比，发现肺癌、脑癌和中枢神经系统癌症的死亡率有所上升。就累积α和γ辐射而言，检测到肺癌死亡率的剂量反应趋势，在接受大于或等于5雷姆α辐射的工人中，γ辐射的趋势最为明显。当采用10年潜伏期假设时，这些趋势的幅度有所减小。在零年潜伏期假设下，两种辐射联合暴露大于或等于5雷姆与小于1雷姆相比，肺癌死亡率的率比为4.60（95%置信区间（CL）0.91，23.35），而在假设10年潜伏期的情况下，相应结果为3.05（95%CL 0.37，24.83）。虽然这些率比分别基于3例和1例死亡，缺乏统计精度，但观察到的剂量反应趋势表明，相对低剂量辐射可能对肺部具有致癌作用。脑癌和中枢神经系统癌症的死亡率没有剂量反应趋势。
