Steindorf K, Lubin J, Wichmann H E, Becher H
Division of Epidemiology, German Cancer Research Centre, Heidelberg.
Int J Epidemiol. 1995 Jun;24(3):485-92. doi: 10.1093/ije/24.3.485.
There is substantial epidemiological and experimental evidence that exposure to radon at levels found in underground mines can cause lung cancer. Although radon levels measured in homes are normally substantially lower, there is concern about the presence of a known lung carcinogen in a residential setting.
Using national survey data on radon concentrations in homes in the former West Germany, the proportion and absolute numbers of lung cancer deaths attributable to radon are estimated. As lung cancer risk models derived directly from residential radon studies are not yet available, the risk model developed recently by Lubin et al. from a joint analysis of 11 underground miners' studies is applied. For an estimate of the impact of smoking on radon-attributable lung cancers, three different approaches are used and compared.
Our analysis shows that after adjusting for dosimetry differences between mines and homes about 7% of all lung cancer deaths in the western part of Germany may be due to residential radon. This corresponds to a total of about 2000 deaths (95% CI: 500-8200), 400 in females and 1600 in males. Adjusting for the intermediate relationship for smoking and radon, the attributable risk is estimated to be about 4-7% for smokers and 14-22% in non-smokers.
Our analysis basically confirms the results of former calculations with regard to the total number of lung cancer deaths attributable to radon in West Germany. However, we show that the standard practice that applies the same model to smokers and non-smokers may result in biased estimates for these groups.
有大量的流行病学和实验证据表明，在地下矿井中发现的氡暴露水平可导致肺癌。尽管家庭中测量的氡水平通常要低得多，但人们对居住环境中存在已知的肺癌致癌物仍感到担忧。
利用前西德家庭中氡浓度的全国调查数据，估算归因于氡的肺癌死亡比例和绝对数量。由于尚未有直接从住宅氡研究得出的肺癌风险模型，因此应用了Lubin等人最近通过对11项地下矿工研究的联合分析开发的风险模型。为了估计吸烟对归因于氡的肺癌的影响，使用并比较了三种不同的方法。
我们的分析表明，在调整了矿井和家庭之间的剂量学差异后，德国西部约7%的肺癌死亡可能归因于住宅氡。这相当于总共约2000例死亡（95%可信区间：500 - 8200），其中女性400例，男性1600例。调整吸烟与氡之间的中间关系后，吸烟者的归因风险估计约为4 - 7%，非吸烟者为14 - 22%。
我们的分析基本证实了以前关于西德归因于氡的肺癌死亡总数的计算结果。然而，我们表明，对吸烟者和非吸烟者应用相同模型的标准做法可能会导致对这些群体的估计有偏差。
