IJE Advance Access originally published online on July 31, 2007
International Journal of Epidemiology 2007 36(5):1126-1135; doi:10.1093/ije/dym138
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Mortality from diseases other than cancer following low doses of ionizing radiation: results from the 15-Country Study of nuclear industry workers
1International Agency for Research on Cancer, Lyon, France.
2Radiation Protection Bureau, Health Canada, Ottawa, Canada. Currently at McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.
3University of Tampere, Tampere and STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland.
4Department of Preventive Medicine, Cheju National University College of Medicine, Chejudo, Korea.
5The Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium.
6Radiation Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
7Department of Hygiene and Epidemiology, Faculty of Health Care and Social Work, Trnava University, Department of Hygiene and Epidemiology, Trnava, Slovak Republic.
8Faculty of Health Sciences, American University of Beirut, Lebanon.
9Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
10Lithuanian Cancer Registry, Vilnius University Oncology Institute, Vilnius, Lithuania.
11Midsweden Research and Development Center, Sundsvall Hospital, Sundsvall, Sweden.
12Radiation Protection Division, Health Protection Agency, Chilton, Didcot, UK.
13Department of Epidemiology, School of Public Health, Chapel Hill, NC, USA.
14Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autonoma de Madrid, Spain.
15Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France.
16National Institute for Occupational Safety and Health, Cincinnati, USA.
17Office Cantonal de l'Inspection et des Relations du Travail, Genève, Suisse.
18Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
Deceased.
*Corresponding author. International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372 Lyon Cedex 08, France. E-mail: vrijheid{at}iarc.fr
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Abstract |
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Background Ionizing radiation at very high (radio-therapeutic) dose levels can cause diseases other than cancer, particularly heart diseases. There is increasing evidence that doses of the order of a few sievert (Sv) may also increase the risk of non-cancer diseases. It is not known, however, whether such effects also occur following the lower doses and dose rates of public health concern.
Methods We used data from an international (15-country) nuclear workers cohort study to evaluate whether mortality from diseases other than cancer is related to low doses of external ionizing radiation. Analyses included 275 312 workers with adequate information on socioeconomic status, over 4 million person-years of follow-up and an average cumulative radiation dose of 20.7 mSv; 11 255 workers had died of non-cancer diseases.
Results The excess relative risk (ERR) per Sv was 0.24 [95% CI (confidence intervals) –0.23, 0.78] for mortality from all non-cancer diseases and 0.09 (95% CI –0.43, 0.70) for circulatory diseases. Higher risk estimates were observed for mortality from respiratory and digestive diseases, but confidence intervals included zero. Increased risks were observed among the younger workers (attained age <50 years, identified post hoc) for all groupings of non-cancer causes of death, including external causes. It is unclear therefore whether these findings reflect real effects of radiation, random variation or residual confounding.
Conclusions The most informative low-dose radiation study to date provides little evidence for a relationship between mortality from non-malignant diseases and radiation dose. However, we cannot rule out risks per unit dose of the same order of magnitude as found in studies at higher doses.
Keywords Radiation, ionizing, radiation effects, cohort studies, occupational diseases, cardiovascular diseases, digestive system diseases, respiratory tract diseases
Accepted 6 June 2007
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