Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.
National Institute of Environmental Health Sciences, Research Triangle, North Carolina.
Am J Ind Med. 2020 Oct;63(10):859-867. doi: 10.1002/ajim.23167. Epub 2020 Aug 9.
This study aims to estimate the association between radon and site-specific cancer mortality among a large contemporary cohort of male uranium miners.
Annual occupational radon exposure was estimated based on a worker's duration of underground mining in a year and estimates of potential alpha energy of radon progeny in their location of work. Cancer mortality over the period 1977-1992 was ascertained for a cohort of 16 434 male underground uranium miners employed in the Czech Republic between 1946 and 1992. Poisson regression was used to estimate relationships between cumulative radiation exposure (in working level months [WLM]) and site-specific cancer mortality.
Radon is positively associated with lung cancer mortality (excess relative rate [ERR] per 100 WLM = 0.2; 95% confidence interval [CI]: 0.10, 0.37). The best fit of the dose-response relationship between radon and lung cancer mortality was linear and estimates of radon-lung cancer associations varied by windows of time-since-exposure. Positive associations between radon and several types of cancer other than lung cancer were identified, notably chronic lymphocytic leukemia (CLL) (ERR/100 WLM = 0.24; 95% CI: [not determined [ND], 5.10]) and extrathoracic cancer (ERR/100 WLM = 0.12; 95% CI: [ND, 0.69]). We observed no associations between radon and stomach cancer, nor between radon and several hematopoietic cancer subtypes.
This study confirms the established radon-lung cancer association and suggests that radon may also be associated with other types of cancer mortality. Further investigations of extrathoracic and CLL cancer, with the aim of obtaining more precise estimates, are warranted to understand associations between radon and cancers other than lung.
本研究旨在评估氡与当代大型男性铀矿工特定部位癌症死亡率之间的关联。
根据工人在一年中的地下采矿时间和工作地点的氡子体潜在α能估算值,估算每年的职业氡暴露量。1977 年至 1992 年期间,对 1946 年至 1992 年间在捷克共和国从事地下铀矿开采的 16434 名男性地下矿工的队列进行了癌症死亡率的确定。使用泊松回归来估计累积辐射暴露(以工作水平月[WLM]计)与特定部位癌症死亡率之间的关系。
氡与肺癌死亡率呈正相关(每 100 WLM 超额相对率[ERR]为 0.2;95%置信区间[CI]:0.10,0.37)。氡与肺癌死亡率之间的剂量-反应关系最佳拟合为线性,氡与肺癌关联的估计值因暴露后时间窗口而异。除肺癌外,还发现氡与几种其他类型的癌症之间存在正相关,尤其是慢性淋巴细胞白血病(CLL)(ERR/100 WLM 为 0.24;95%CI:[未确定[ND],5.10])和胸腔外癌症(ERR/100 WLM 为 0.12;95%CI:[ND,0.69])。我们未发现氡与胃癌之间的关联,也未发现氡与几种血液癌症亚型之间的关联。
本研究证实了已确立的氡-肺癌关联,并表明氡可能也与其他类型的癌症死亡率相关。进一步研究胸腔外和 CLL 癌症,以获得更精确的估计值,对于了解氡与除肺癌以外的癌症之间的关联是必要的。