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1946 - 1979年英国原子能管理局员工的死亡率

Mortality of employees of the United Kingdom Atomic Energy Authority, 1946-1979.

作者信息

Beral V, Inskip H, Fraser P, Booth M, Coleman D, Rose G

出版信息

Br Med J (Clin Res Ed). 1985 Aug 17;291(6493):440-7. doi: 10.1136/bmj.291.6493.440.

Abstract

An analysis was conducted of 3373 deaths among 39 546 people employed by the United Kingdom Atomic Energy Authority between 1946 and 1979, the population having been followed up for an average of 16 years. Overall the death rates were below those prevailing in England and Wales but consistent with those expected in a normal workforce. At ages 15-74 years the standardised mortality ratios (SMRs) were 74 for deaths from all causes and 79 for deaths from all cancers. Mortality from only four causes was above the national average--namely, testicular cancer (SMR 153; 10 deaths), leukaemia (SMR 123; 35 deaths), thyroid cancer (SMR 122; three deaths), non-Hodgkin's lymphoma (SMR 107; 20 deaths)--but in none was the increase significant at the 5% level. Half of the authority's employees were recorded as having been monitored for exposure to radiation, their collective recorded exposure being 660 Sv (65 954 rem). Among these prostatic cancer was the only condition with a clearly increased mortality in relation to exposure. Of the 19 men who had a radiation record and died from prostatic cancer at ages 15-74 years, nine had been monitored for several different sources of exposure to radiation. The standardised mortality ratios were 889 (six deaths) in employees monitored for contamination by tritium, 254 (nine deaths) in those monitored for contamination by other radionuclides, and 385 (nine deaths) in those with dosimeter readings totalling more than 50 mSv (5 rem); but the same nine subjects tended to account for each of these significantly raised ratios. Because multiple exposures were common and other relevant information was not available the reason for the increased mortality from prostatic cancer in this population could not be determined and requires further investigation. Excess mortality rates of 2.2 and 12.5 deaths per million person years per 10 mSv (1 rem) were estimated for leukaemia and all cancers, respectively. The confidence limits around these estimates were wide, included zero, and made it unlikely that the International Commission on Radiological Protection's cancer risk coefficients were underestimated by more than 15-fold. Thus despite this being the largest British workforce whose mortality has been reported in relation to low level ionising radiation exposure, even larger populations will need to be followed up over longer periods before narrower ranges of risk estimates can be derived.

摘要

对1946年至1979年间英国原子能管理局雇佣的39546人中的3373例死亡进行了分析,这些人员平均随访了16年。总体而言,死亡率低于英格兰和威尔士的普遍水平,但与正常劳动力预期的死亡率一致。在15 - 74岁年龄段,所有原因导致死亡的标准化死亡比(SMR)为74,所有癌症导致死亡的标准化死亡比为79。仅四种死因的死亡率高于全国平均水平,即睾丸癌(SMR 153;10例死亡)、白血病(SMR 123;35例死亡)、甲状腺癌(SMR 122;3例死亡)、非霍奇金淋巴瘤(SMR 107;20例死亡),但在5%的水平上,这些增加均无统计学显著性。该管理局一半的员工被记录为接受过辐射暴露监测,他们的集体记录暴露量为660 Sv(65954雷姆)。在这些员工中,前列腺癌是唯一一种与暴露相关死亡率明显增加的疾病。在15 - 74岁因前列腺癌死亡且有辐射记录的19名男性中,9人接受过几种不同辐射源的暴露监测。接受氚污染监测的员工标准化死亡比为889(6例死亡),接受其他放射性核素污染监测的员工为254(9例死亡),剂量计读数总计超过50 mSv(5雷姆)的员工为385(9例死亡);但这9名受试者往往导致了这些显著升高的比率。由于多重暴露很常见且没有其他相关信息,无法确定该人群前列腺癌死亡率增加的原因,需要进一步调查。估计白血病和所有癌症的超额死亡率分别为每百万人年每10 mSv(1雷姆)2.2例和12.5例死亡。这些估计值的置信区间很宽,包含零,这使得国际放射防护委员会的癌症风险系数被低估超过15倍的可能性不大。因此,尽管这是已报告低水平电离辐射暴露死亡率的最大英国劳动力群体,但在得出更窄的风险估计范围之前,还需要对更大的人群进行更长时间的随访。

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