Recent results from the study of West Bohemian uranium miners exposed to radon and its progeny (original) (raw)
Related papers
Lung Cancer and Radon: Pooled Analysis of Uranium Miners Hired in 1960 or Later
Environmental Health Perspectives
BACKGROUND: Despite reductions in exposure for workers and the general public, radon remains a leading cause of lung cancer. Prior studies of underground miners depended heavily upon information on deaths among miners employed in the early years of mine operations when exposures were high and tended to be poorly estimated. OBJECTIVES: To strengthen the basis for radiation protection, we report on the follow-up of workers employed in the later periods of mine operations for whom we have more accurate exposure information and for whom exposures tended to be accrued at intensities that are more comparable to contemporary settings. METHODS: We conducted a pooled analysis of cohort studies of lung cancer mortality among 57,873 male uranium miners in Canada, Czech Republic, France, Germany, and the United States, who were first employed in 1960 or later (thereby excluding miners employed during the periods of highest exposure and focusing on miners who tend to have higher quality assessments of radon progeny exposures). We derived estimates of excess relative rate per 100 working level months (ERR/100 WLM) for mortality from lung cancer. RESULTS: The analysis included 1:9 million person-years of observation and 1,217 deaths due to lung cancer. The relative rate of lung cancer increased in a linear fashion with cumulative exposure to radon progeny (ERR/100 WLM = 1:33; 95% CI: 0.89, 1.88). The association was modified by attained age, age at exposure, and annual exposure rate; for attained ages <55 y, the ERR/100 WLM was 8.38 (95% CI: 3.30, 18.99) among miners who were exposed at ≥35 years of age and at annual exposure rates of <0:5 working levels. This association decreased with older attained ages, younger ages at exposure, and higher exposure rates. DISCUSSION: Estimates of association between radon progeny exposure and lung cancer mortality among relatively contemporary miners are coherent with estimates used to inform current protection guidelines.
International Archives of Occupational and Environmental Health, 2019
It is well established that high radon exposures increase the risk of lung cancer mortality. The effects of low occupational exposures and the factors that confound and modify this risk are not clear and are needed to inform current radiation protection of miners. The risk of lung cancer mortality at low radon exposures (< 100 working-level months) was assessed in the joint cohort analysis of Czech, French, and Canadian uranium miners, employed in 1953 or later. Statistical analysis was based on linear Poisson regression modeling with grouped cohort survival data. Two sensitivity analyses were used to assess potential confounding from tobacco smoking. A statistically significant linear relationship between radon exposure and lung cancer mortality was found. The excess relative risk per working-level month was 0.022 (95% confidence intervals: 0.013-0.034), based on 408 lung cancer deaths and 394,236 person-years of risk. Time since exposure was a statistically significant modifier; risk decreased with increasing time since exposure. A tendency for a decrease in risk with increasing attained age was observed, but this was not statistically significant. Exposure rate was not found to be a modifier of the excess relative risk. The potential confounding effect of tobacco smoking was estimated to be small and did not substantially change the radon-lung cancer mortality risk estimates. This joint cohort analysis provides strong evidence for an increased risk of lung cancer mortality from low occupational radon exposures. The results suggest that radiation protection measures continue to be important among current uranium miners.
Lung cancer risk among German male uranium miners: a cohort study, 1946–1998
British Journal of Cancer, 2006
From 1946 to 1990 extensive uranium mining was conducted in the southern parts of the former German Democratic Republic. The overall workforce included several 100 000 individuals. A cohort of 59 001 former male employees of the Wismut Company was established, forming a large retrospective uranium miners' cohort for the time period 1946-1998. Mean duration of follow-up was 30.5 years with a total of 1 801 630 person-years. Loss to follow-up was low at 5.3%. Of the workers, 16 598 (28.1%) died during the study period. Based on 2388 lung cancer deaths, the radon-related lung cancer risk is evaluated. The excess relative risk (ERR) per working level month (WLM) was estimated as 0.21% (95% CI: 0.18-0.24). It was dependent on time since exposure and on attained age. The highest ERR/WLM was observed 15-24 years after exposure and in the youngest age group (o55 years of age). While a strong inverse exposure-rate effect was detected for high exposures, no significant association was detected at exposures below 100 WLM. Excess relative risk /WLM was not modified by duration of exposure. The results would indicate the need to re-estimate the effects of risk modifying factors in current risk models as duration of exposure did not modify the ERR/WLM and there was only a modest decline of ERR/WLM with increasing time since exposure.
The Influence of Radon Exposures on Lung Cancer Mortality in German Uranium Miners, 1946–2003
Radiation Research, 2010
Extensive uranium extraction took place from 1946 until 1990 at the former Wismut mining company in East Germany. A total of 58,987 male former employees of this company form the largest single uranium miners cohort that has been followed up for causes of mortality occurring from the beginning of 1946 to the end of 2003. The purpose of this study was to investigate and evaluate different forms of models for the radon exposure-related lung cancer mortality risk based on 3,016 lung cancer deaths and 2 million person years. Other exposure covariables such as occupational exposure to external c radiation, long-lived radionuclides, arsenic, fine dust and silica dust are available. The standardized mortality ratio for lung cancer is 2.03 (95% CI: 1.96; 2.10). The simple cohort excess relative risk (ERR/WLM) for lung cancer is estimated as 0.0019 (95% CI: 0.0016; 0.0022). The BEIR VI model produced risks similar to those obtained with a selected mathematically continuous ERR model for lung cancer. The continuous model is linear in radon exposure with exponential effect modifiers that depend on the whole range of age at median exposure, time since median exposure, and radon exposure rate. In this model the central estimate of ERR/ WLM is 0.0054 (95% CI: 0.0040; 0.0068) for an age at median exposure of 30 years, a time since median exposure of 20 years, and a mean exposure rate of 3 WL. The ERR decreases by 5% for each unit of exposure-rate increase. The ERR decreases by 28% with each decade increase in age at median exposure and also decreases by 51% with each decade increase in time since median exposure. The method of determination of radon exposure (i.e., whether the exposures were estimated or measured) did not play an important role in the determination of the ERR. The other exposure covariables were found to have only minor confounding influences on the ERR/WLM for the finally selected continuous model when included in an additive way.
Clinical measures, smoking, radon exposure, and risk of lung cancer in uranium miners
Occupational and Environmental Medicine, 1996
Objectives-Exposure to the radioactive daughters of radon is associated with increased risk of lung cancer in mining populations. An investigation of incidence of lung cancer following a clinical survey of Ontario uranium miners was undertaken to explore whether risk associated with radon is modified by factors including smoking, radiographic silicosis, clinical symptoms, the results of lung function testing, and the temporal pattern of radon exposure. Methods-Miners were examined in 1974 by a respiratory questionnaire, tests of lung function, and chest radiography. A random selection of 733 (75%/6) of the original 973 participants was followed up by linkage to the Ontario Mortality and Cancer Registries. Results-Incidence of lung cancer was increased threefold. Risk of lung cancer among miners who had stopped smoking was half that of men who continued to smoke. There was no interaction between smoking and radon exposure. Men with lung function test results consistent with airways obstruction had an increased risk of lung cancer, even after adjustment for cigarette smoking. There was no association between radiographic silicosis and risk oflung cancer. Lung cancer was associated with exposures to radon daughters accumulated in a time window four to 14 years before diagnosis, but there was little association with exposures incurred earlier than 14 years before diagnosis. Among the men diagnosed with lung cancer, the mean and median dose rates were 2*6 working level months (WLM) a year and 1l8 WLM/year in the four to 14 year exposure window. Conclusions-Risk of lung cancer associated with radon is modified by dose and time from exposure. Risk can be substantially decreased by stopping smoking.
British journal of cancer, 2008
Data from the German miners' cohort study were analysed to investigate whether radon in ambient air causes cancers other than lung cancer. The cohort includes 58,987 men who were employed for at least 6 months from 1946 to 1989 at the former Wismut uranium mining company in Eastern Germany. A total of 20,684 deaths were observed in the follow-up period from 1960 to 2003. The death rates for 24 individual cancer sites were compared with the age and calendar year-specific national death rates. Internal Poisson regression was used to estimate the excess relative risk (ERR) per unit of cumulative exposure to radon in working level months (WLM). The number of deaths observed (O) for extrapulmonary cancers combined was close to that expected (E) from national rates (n=3340, O/E=1.02; 95% confidence interval (CI): 0.98-1.05). Statistically significant increases in mortality were recorded for cancers of the stomach (O/E=1.15; 95% CI: 1.06-1.25) and liver (O/E=1.26; 95% CI: 1.07-1.48), w...
A Survey of the Czechoslovak Follow-up of Lung Cancer Mortality in Uranium Miners
Health Physics, 1993
The major Czechoslovak cohort of uranium miners (S-cohort) is surveyed in terms of diagrams illustrating dependences on calendar year, age, and exposure to radon and radon progeny. An analysis of the dose dependence of lung Cancer mortality is performed by nonparametric and, subsequently, by parametric methods. In the first step, two-dimensional isotonic regression is employed to derive the lung cancer mortality rate and the relative excess risk as functions of age attained and of lagged cumulated exposure. In a second step, analytical fits in terms of relative risk models are derived. The treatment is largely analogous to the methods applied by the BEIR IV Committee to other major cohorts of uranium miners. There is a marked dependence of the excess risk on age attained and on time since exposure. A specific characteristic of the Czechoslovak data is the nonlinearity of the dependence of the lung cancer excess risk on the cumulated exposure; exposures on the order of 100 working level months or less appear to be more effective per working level month than larger exposures but, in the absence of an internal control group, this cannot be excluded to be due to confounders such as smoking or environmental exposures. A further notable Observation is the association of larger excess risks with longer protraction of the exposures.
Risk of lung cancer and other cancers in the German uranium miners cohort study
To evaluate the risk of cancer associated with low and high levels of radon exposure one of the largest single cohort studies on uranium miners is being conducted in Germany. It includes 58,940 men who were employed for at least 6 months between 1946 and 1989 at the former Wismut uranium company in Eastern Germany. Information on job histories was collected from the original pay rolls. Exposure to radon and its progeny, long-lived radionuclides and gamma radiation was estimated by using a detailed job-exposure matrix. For 94% of the cohort members the vital status has been ascertained from the date of entry to 31 December 1998. For 87% of the deceased cohort members causes of death were identified. The different causes of death were compared with the age-and calendar-year specific national death rates of Eastern Germany, formerly GDR. Standardized mortality ratios (SMR) with 95% confidence limits (CI) were calculated. The total number of person-years under observation was 1,795,195, with a mean duration of follow-up of 30 years. In this period a total of 4,692 malignant cancer deaths including 2,335 lung cancer deaths occurred. The observed overall mortality in the cohort was significantly lower than that expected from national rates (SMR=0.93, 95% CI: 0.91-0.94), demonstrating a possible healthy worker effect. The SMR for lung cancer was 1.83 (95% CI: 1.76-1.91), showing a clear increase with increasing cumulative radon exposure. When other sites of cancer were considered, a non-significant excess was observed for cancers of larynx and liver. These results were consistent to the results of the joint analyses of the 11 miner cohort studies. A potential limitation of this first analysis concerns the comparison group. Therefore internal risk analyses will be performed in a next step.
Radiation Research, 2011
A combined analysis of three case-control studies nested in three European uranium miner cohorts was performed to study the joint effects of radon exposure and smoking on lung cancer death risk. Occupational history and exposure data were available from the cohorts. Smoking information was reconstructed using self-administered questionnaires and occupational medical archives. Linear excess relative risk models adjusted for smoking were used to estimate the lung cancer risk associated with radon exposure. The study includes 1046 lung cancer cases and 2492 controls with detailed radon exposure data and smoking status. The ERR/WLM adjusted for smoking is equal to 0.008 (95% CI: 0.004-0.014). Time since exposure is shown to be a major modifier of the relationship between radon exposure and lung cancer risk. Fitting geometric mixture models yielded arguments in favor of a sub-multiplicative interaction between radon and smoking. This combined study is the largest case-control study to investigate the joint effects of radon and smoking on lung cancer risk among miners. The results confirm that the lung carcinogenic effect of radon persists even when smoking is adjusted for, with arguments in favor of a submultiplicative interaction between radon and smoking. g 2011 by Radiation Research Society
Modifiers of exposure-response estimates for lung cancer among miners exposed to radon progeny
1995
The association between lung cancer and exposure to radon decay products has been well established. Despite agreement on this point, there is still some degree of uncertainty regarding characteristics of the exposure-response relationship. The use of studies of underground miners to estimate lung cancer risks due to residential radon exposure depends upon a better understanding of factors potentially modifying the exposure-response relationship. Given the diversity in study populations regarding smoking status, mining conditions, risk analysis methodology, and referent populations, the risk estimates across studies are quite similar. However, several factors partially contributing to differences in risk estimates are modified by attained age, time since last exposure, exposure rate, and cigarette smoking patterns. There is growing agreement across studies that relative risk decreases with attained age and time since last exposure. Several studies have also found an inverse exposure-rate effect, i.e., low exposure rates for protracted duration of exposure are more hazardous than equivalent cumulative exposures received at higher rates for shorter periods of time. Additionally, the interaction between radon exposure and cigarette smoking appears to be intermediate between additive and multiplicative in a growing number of studies. Quantitative estimates of these modifying factors are given using a new analysis of data from the latest update of the Colorado Plateau uranium miners cohort.