Finkelstein M M
Family Medicine Centre, Mt Sinai Hospital, Toronto, Ontario.
Can J Cardiol. 1998 Nov;14(11):1385-8.
To assess the plausibility of radiation as a cause of the statistically unusual event of two cardiologists in Toronto, Ontario who were diagnosed with brain tumours in 1997.
Computation of the expected occurrence of brain cancer in Ontario cardiologists and review of the epidemiological literature pertaining to radiation and brain cancer.
The occurrence of these two cases is a statistically unusual event--a 'cluster'. There are several plausible explanations for this cluster. First, this may be a chance occurrence, and the tumours may have no causative factors in common. Second, the cause may be radiation exposure. A connection to occupational radiation exposure is biologically plausible, but risk assessment suggests that it is unlikely that this effect would have been observable in the small population of Ontario cardiologists.
Initiation of brain tumours during cardiac fluoroscopic procedures is plausible. Physicians are reminded to practise radiation safety methods during fluoroscopic procedures. The diagnosis of two additional brain tumours in Canadian interventional cardiologists during the past 10 years would confirm the occupational causation theory. The author invites physicians to report knowledge of the diagnosis of brain tumours in Canadian cardiologists to the author or to the editors.
评估辐射作为安大略省多伦多市两名心脏病专家在1997年被诊断出患有脑肿瘤这一统计学上异常事件的病因的合理性。
计算安大略省心脏病专家中脑癌的预期发病率，并回顾与辐射和脑癌相关的流行病学文献。
这两例病例的发生是一个统计学上的异常事件——一个“聚集性病例”。对于这个聚集性病例有几种合理的解释。首先，这可能是偶然发生的，肿瘤可能没有共同的致病因素。其次，病因可能是辐射暴露。与职业辐射暴露的联系在生物学上是合理的，但风险评估表明，在安大略省心脏病专家这一小群体中不太可能观察到这种影响。
在心脏荧光镜检查过程中引发脑肿瘤是合理的。提醒医生在荧光镜检查过程中采取辐射安全措施。在过去10年中，加拿大介入心脏病专家中再诊断出两例脑肿瘤将证实职业病因理论。作者邀请医生将加拿大心脏病专家脑肿瘤诊断的相关信息报告给作者或编辑。
