Sharp L, Black R J, Harkness E F, McKinney P A
Department of Medicine and Therapeutics, University of Aberdeen, Foresterhill, Scotland.
Occup Environ Med. 1996 Dec;53(12):823-31. doi: 10.1136/oem.53.12.823.
The primary aims were to investigate the incidence of leukaemia and non-Hodgkin's lymphoma in children resident near seven nuclear sites in Scotland and to determine whether there was any evidence of a gradient in risk with distance of residence from a nuclear site. A secondary aim was to assess the power of statistical tests for increased risk of disease near a point source when applied in the context of census data for Scotland.
The study data set comprised 1287 cases of leukaemia and non-Hodgkin's lymphoma diagnosed in children aged under 15 years in the period 1968-93, validated for accuracy and completeness. A study zone around each nuclear site was constructed from enumeration districts within 25 km. Expected numbers were calculated, adjusting for sex, age, and indices of deprivation and urban-rural residence. Six statistical tests were evaluated. Stone's maximum likelihood ratio (unconditional application) was applied as the main test for general increased incidence across a study zone. The linear risk score based on enumeration districts (conditional application) was used as a secondary test for declining risk with distance from each site.
More cases were observed (O) than expected (E) in the study zones around Rosyth naval base (O/E 1.02), Chapelcross electricity generating station (O/E 1.08), and Dounreay reprocessing plant (O/E 1.99). The maximum likelihood ratio test reached significance only for Dounreay (P = 0.030). The linear risk score test did not indicate a trend in risk with distance from any of the seven sites, including Dounreay.
There was no evidence of a generally increased risk of childhood leukaemia and non-Hodgkin's lymphoma around nuclear sites in Scotland, nor any evidence of a trend of decreasing risk with distance from any of the sites. There was a significant excess risk in the zone around Dounreay, which was only partially accounted for by the sociodemographic characteristics of the area. The statistical power of tests for localised increased risk of disease around a point source should be assessed in each new setting in which they are applied.
主要目的是调查居住在苏格兰七个核设施附近的儿童白血病和非霍奇金淋巴瘤的发病率,并确定是否有证据表明患病风险随与核设施的居住距离存在梯度变化。次要目的是评估在苏格兰人口普查数据背景下,针对点源附近疾病风险增加进行统计检验的效力。
研究数据集包括1968年至1993年期间确诊的1287例15岁以下儿童白血病和非霍奇金淋巴瘤病例,并对其准确性和完整性进行了验证。围绕每个核设施构建了一个研究区域,该区域由25公里范围内的普查区组成。计算预期病例数,并根据性别、年龄、贫困指数和城乡居住情况进行调整。评估了六种统计检验方法。将斯通最大似然比(无条件应用)用作研究区域内总体发病率普遍增加的主要检验方法。基于普查区的线性风险评分(有条件应用)用作次要检验方法,以检验患病风险是否随距每个设施的距离增加而降低。
在罗斯思海军基地(观察值/预期值为1.02)、查佩尔克罗斯发电站(观察值/预期值为1.08)和敦雷后处理厂(观察值/预期值为1.99)周围的研究区域中,观察到的病例数多于预期。最大似然比检验仅在敦雷达到显著水平(P = 0.030)。线性风险评分检验未显示出患病风险随距七个设施中任何一个设施的距离而变化的趋势,包括敦雷。
没有证据表明苏格兰核设施周围儿童白血病和非霍奇金淋巴瘤的患病风险普遍增加,也没有证据表明患病风险随距任何一个设施的距离增加而降低。敦雷周围区域存在显著的超额风险,该区域的社会人口统计学特征只能部分解释这一现象。在每次应用针对点源周围疾病局部风险增加的检验时,都应评估其统计效力。