Health Risks of Ionizing Radiation: - Clark University

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and Sont et al. (2001a) analyzed cancer mortality and incidence using the National Dose Registry for Canada, a database for radiation workers. This study is a useful addition to the literature for a number of reasons. First, this cohort is large, including roughly 200,000 workers. Second, this cohort is truly a low-dose cohort, with a mean dose of 6 mSv and a relatively large proportion of workers with dose less than 100 mSv 30 . Finally, this study included an analysis of cancer incidence, which can be more revealing than mortality studies, particularly for cancers with good survival rates. One of the reasons that doses were so low is that the cohort includes medical and dental occupations. This can be seen as a limitation because it increased the variability in exposure conditions and dose estimation methods. Incidence data were analyzed by Sont et al. (2001a). Risk estimates based on dose-response trends were very uncertain due to the relatively low number of higher doses but were significantly positive for a number of sites 31 . Leukemia had an ERR of 5.4/Sv (0.2-20). This was higher than the corresponding mortality estimate, although that estimate was very uncertain (Ashmore et al. 1998) 32 . Solid cancer (cancer other than leukemia) showed an ERR of 2.3/Sv (1.1-3.9), very similar to the mortality estimate of 3.0/Sv (1.1-4.9; Ashmore et al. 1998) but much higher than in other large studies including the atomic bomb survivors (see Table 4- 1). Pooled US data. Gilbert et al. (1993) conducted an analysis of mortality data for workers at the Hanford, Oak Ridge, and Rocky Flats facilities. This study focused exclusively on dose-response relationships within the cohort and found significant trends. Hodgkin’s disease and cancers of the esophagus and larynx. The dose-response trend for multiple myeloma was positive and of borderline significance while the dose-response trend for leukemia was negative. Pooled ERR estimates were –1.3/Sv (90% CI
86 Radiation Workers Figure 6-14. A facility at Hanford for treating persons injured by embedded radioactive particles (circa 1967). In this shielded operating cell, a mock patient is flanked by a surgeon (right) and a radiation monitor (left) (www.eh.doe. gov/.../photos/handord/fig1.html). internal and external radiation exposure. Pooled international data. Cardis et al. (1995) pooled data from the Canadian, UK and US cohorts. This combined cohort of 95,673 workers included fewer Canadian workers (11,355) than the analyses of Asmore et al. (1998) and Sont et al. (2001), but included virtually the entire cohorts analyzed by Gilbert et al. (1993) and Carpenter et al. (1994, 1998). In the combined group there were significant trends with dose for leukemia, multiple myeloma and uterine cancer 34 . There was also a significant doseresponse trend for noncancer circulatory disease. The pooled estimates of risk for leukemia and solid cancer (all cancer except leukemia) were 1.55/Sv (90% CI –0.2-4.7) and –0.07 (90% CI –0.4-0.3). The central estimate for solid cancer risk from the threecountry cohort is negative and the upper confidence limit is less than the atomic bomb survivors estimate of 0.47/Sv (Preston et al. 2003). The leukemia risk by subtype is shown in Table 6-1 and is discussed further below. 6.5 Discussion The studies reviewed in this section paint a variety 34 The estimated ERR of multiple myeloma was 4.2/Sv (90% CI 0.3-14.4). of pictures, and this variety can be partly explained by differences in the analytical methods that were employed by the authors. This is particularly true in the case of Hanford; utilizing basically the same data pool Gilbert et al. (1993) found no significant evidence of heath risks aside from multiple myeloma while Kneale and Stewart (1993) found risks greater than would be expected based on the atomic bomb survivor data and also detected an increased sensitivity in association with exposure at older ages. Perhaps more important than methodological differences are differences among facilities. The range of radiological and chemical exposures that workers experience depends on the type of activity a facility is engaged in; some workers experience external exposure to gamma radiation and other workers inhale one or more radionuclides. In addition, exposure monitoring has varied by facility and over time. Interpreting the results of facility-specific studies is complicated by these real differences and is further complicated by the role of chance and small numbers of workers at risk. In general, inconsistencies are expected and individual results should be judged in a broader context. The kidney cancer mortality results from a few of the studies described above provide a useful illustration. Dupree-Ellis et al. (2000) reported that there was a significantly positive dose-response trend for kidney cancer mortality among Mallinckrodt Chemical Works workers. This was based on ten deaths and had wide a confidence interval (ERR 10.5/Sv, 0.6-57.4). Omar et al. (1999), on the other hand, reported the reverse relationship in Sellafield workers. This study found a significantly negative dose-response relationship based on thirteen deaths. Follow-up time was very similar in these two studies (1942-1993 and 1947-1992) and so was mean dose (48 and 130 mSv), so something else must explain the difference in the results. This could be study design, although this would probably not result in such dramatic differences. But the difference could also be chance. Although Mancuso et al. (1977) and Loomis and Wolf (1996) found evidence suggesting a kidney cancer risk at Hanford and Oak Ridge, this result has not been confirmed in other studies. The international pooled workers study found no
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Health Risks of Ionizing Radiation:
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Contents List of Tables ...........
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Contents iii Rocky Flats ..........
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Contents v APPENDIX A .............
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List of Figures Figure 1-1 Average
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We are indeed grateful to those who
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2 Introduction 1.2 A brief history
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4 Introduction Figure 1-2. The evol
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6 Introduction Figure 1-5(a). Alpha
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8 Introduction In epidemiological s
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10 Introduction precision to detect
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12 Introduction available informati
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14 Background Radiation Figure 2-1.
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16 Background Radiation Figure 2-3.
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18 Background Radiation
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20 Medical Exposures Fi
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22 Medical Exposures
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24 Medical Exposures with national
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26 Medical Exposures localized expo
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28 Medical Exposures (2.1-28.7). Th
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30 Medical Exposures posed 2.69 tim
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32 Medical Exposures with diagnosti
Page 45 and 46: 34 Medical Exposures Table 3-1. Stu
Page 47 and 48: 36 Medical Exposures
Page 55 and 56: 44 Atomic Bomb Survivors Figure 4-2
Page 57 and 58: 46 Atomic Bomb Survivors
Page 59 and 60: 48 Atomic Bomb Survivors approximat
Page 61 and 62: 50 Atomic Bomb Survivors (ALL), acu
Page 63 and 64: 52 Atomic Bomb Survivors of the 8 t
Page 69 and 70: 5 Nuclear Weapons Testing Over 500
Page 71 and 72: 60 Nuclear Weapons Testing by disti
Page 73 and 74: 62 Nuclear Weapons Testing Figure 5
Page 75 and 76: 64 Nuclear Weapons Testing near the
Page 77 and 78: 66 Nuclear Weapons Testing
Page 79 and 80: 68 Nuclear Weapons Testing
Page 81 and 82: 6 RADIATION WORKERS Introduction Th
Page 83 and 84: 72 Radiation Workers • 50 rem (0.
Page 85 and 86: 74 Radiation Workers work, reports
Page 87 and 88: 76 Radiation Workers Figure 6-5. A
Page 89 and 90: 78 Radiation Workers Figure 6-8. To
Page 91 and 92: 80 Radiation Workers Figure 6-10. A
Page 93 and 94: 82 Radiation Workers Feed Material
Page 95: 84 Radiation Workers by Beral et al
Page 99 and 100: 88 Radiation Workers Table 6-1. Leu
Page 101 and 102: 90 Radiation Workers No
Page 103 and 104: 92 Radiation Workers N
Page 105 and 106: 94 Radiation Workers S
Page 107 and 108: 96 Radiation Workers ERR estim
Page 109 and 110: 98 Mayak Workers Table 1. Dose (Gy)
Page 111 and 112: 100 Mayak Workers workers at the ra
Page 113 and 114: 102 Mayak Workers
Page 115 and 116: 104 Uranium Miners enrichment facil
Page 117 and 118: 106 Uranium Miners Samet et al. (19
Page 119: 108 Uranium Miners were selected 12
Page 122 and 123: Uranium Miners 111
Page 124 and 125: 9 RADIATION EXPOSURE IN FLIGHT The
Page 126 and 127: DNA damage (a chemical change in DN
Page 128 and 129: 10 PRECONCEPTION EXPOSURES Several
Page 130 and 131: of risk in the lowest dose groups,
Page 132 and 133: found elevated solid cancer risk wi
Page 134 and 135: preconception doses between 2.5 and
Page 136 and 137: Table 10-1. Preconception irradiati
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Page 140 and 141: Tracheoesophageal fistula and conge
Page 142 and 143: cancer were both associated with th
Page 144 and 145: 0.10-4.71) while respiratory system
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elationship was not significant for
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times higher than in less-contamina
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Nuclear Power Accidents 139
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12 COMMUNITIES NEAR NUCLEAR FACILIT
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levels (this could not in itself be
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Figure 12-3. Native Americans from
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of leukemia was measured over a lar
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(RR 1.06; 1.00-1.11) and risks of s
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more that we can say about this app
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Communities Near Nuclear Facilities
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54 observed vs. 46.1 expected death
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13 DISCUSSION Our intention in crea
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myeloid leukemia) was significantly
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0.1-3.5 WLM; this is roughly equiva
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adon (Lubin et al. 1997). These res
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Leukemia Leukemia, a general term t
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vical cancer. The doses to these pa
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England have found it convenient to
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Thyroid disease Thyroid cancer is a
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1986 through 1995. These workers sh
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dence of this disease includes elev
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Analysis of preconception exposure
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Paternal age, education, drinking O
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Gardner et al. 1990 Employed at Sel
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we consider this group of a few hun
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Leukemia risk (excluding CLL) among
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Glossary of Terms for Epidemiology
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Glossary 199 Beta radiation: Stream
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Dosimetry: Measurement or estimatio
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Glossary 203 Hypothyroidism: The cl
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Glossary 205 Metastasis: 1. Movemen
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Glossary 207 waves, ultra violet (U
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Glossary 209 Thyroid Disease: disea
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Bibliography ATSDR. Public Health A
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Bhatia S, Sklar C. Second cancers i
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Bibliography 215 Cavallo D, Tomao P
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Bibliography 217 Department of Ener
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Bibliography 219 Gardner MJ, Hall A
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Haldorsen T, Reitan JB, Tveten U. C
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Bibliography 223 Howe GR, Nair R, N
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of Mayak, A comparison of numerical
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Bibliography 227 Laird NM. Thyroid
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control population. International J
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Bibliography 231 Neel JV, Schull WJ
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2003.160:381-407. Bibliography 233
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Bibliography 235 Saccomanno G, Auer
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Bibliography 237 analysis of cancer
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Bibliography 239 Tokarskaya ZB, Sco
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Journal of Epidemiology 1987.125(2)
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Actinium, 84 Acute lymphocytic leuk
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and Nevada Test Site, 60-61, 62 nuc
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Hashimoto’s thyroiditis, 185 Heal
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studies, 101-2 Medical exposure, 19
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(RERF), 43 Radiation Exposure Compe
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Viruses, 118, 154, 193 West Germany
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