Auvinen A, Hakama M, Arvela H, Hakulinen T, Rahola T, Suomela M, Söderman B, Rytömaa T
Finnish Centre for Radiation and Nuclear Safety, Helsinki.
BMJ. 1994 Jul 16;309(6948):151-4. doi: 10.1136/bmj.309.6948.151.
To assess effects of fallout from Chernobyl on incidence of childhood leukaemia in Finland.
Nationwide cohort study. External exposure measured for 455 Finnish municipalities with instruments driven 19,000 km throughout the country. Values specific to municipalities corrected for shielding due to houses and fallout from A bomb testing. Internal exposure estimated from whole body measurements on a random sample of 81 children. Mean effective dose for two years after incident calculated from these measurements. Data on childhood leukaemia obtained from Finnish cancer registry and verified through hospitals treating childhood cancers.
Finland, one of the countries most heavily contaminated by the Chernobyl accident; the population was divided into fifths by exposure.
Children aged 0-14 years in 1976-92.
Standardised incidence ratio of childhood leukaemia and relative excess risk of childhood leukaemia per mSv. From incidence data of Finnish cancer registry for 1976-85, expected numbers specific to sex and age group (0-4, 5-9, and 10-14 years) were calculated for each municipality for three periods (1976-85, 1986-8, and 1989-92) and pooled as exposure fifths. Dose response was estimated as regression slope of standardised incidence ratios on mean doses for fifths for each period.
Population weighted mean effective doses for first two years after the accident were 410 microSv for the whole country and 970 microSv for the population fifth with the highest dose. In all Finland the incidence of childhood leukaemia did not increase 1976-92. The relative excess risk 1989-92 was not significantly different from zero (7% per mSv; 95% confidence interval -27% to 41%).
An important increase in childhood leukaemia can be excluded. Any effect is smaller than eight extra cases per million children per year in Finland. The results are consistent with the magnitude of effect expected.
评估切尔诺贝利核事故沉降物对芬兰儿童白血病发病率的影响。
全国性队列研究。用仪器在芬兰455个市镇进行外部照射测量，仪器在全国行驶了19000公里。根据房屋屏蔽和原子弹试验沉降物对各市政当局的特定值进行校正。通过对81名儿童的随机样本进行全身测量来估计内部照射。根据这些测量结果计算事故发生后两年的平均有效剂量。从芬兰癌症登记处获得儿童白血病数据，并通过治疗儿童癌症的医院进行核实。
芬兰是受切尔诺贝利事故污染最严重的国家之一；根据照射情况将人口分为五等份。
1976 - 1992年期间0至14岁的儿童。
儿童白血病的标准化发病率以及每毫希沃特儿童白血病的相对超额风险。根据芬兰癌症登记处1976 - 1985年的发病率数据，计算出每个市镇在三个时期（1976 - 1985年、1986 - 1988年和1989 - 1992年）按性别和年龄组（0 - 4岁、5 - 9岁和10 - 14岁）划分的预期病例数，并汇总为照射五分位数。剂量反应估计为每个时期五分位数的标准化发病率对平均剂量的回归斜率。
事故发生后头两年，全国人口加权平均有效剂量为410微希沃特，剂量最高的人口五分位数为970微希沃特。在芬兰全境，1976 - 1992年期间儿童白血病发病率没有增加。1989 - 1992年的相对超额风险与零无显著差异（每毫希沃特7%；95%置信区间为 - 27%至41%）。
可以排除儿童白血病显著增加的情况。在芬兰，任何影响都小于每年每百万儿童中新增8例病例。结果与预期的影响程度一致。
