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Lung cancer mortality associated with protracted low‐dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983‐2012
Ist Teil von
International journal of cancer, 2020-12, Vol.147 (11), p.3130-3138
Ort / Verlag
Hoboken, USA: John Wiley & Sons, Inc
Erscheinungsjahr
2020
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low‐dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack‐years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time‐dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0‐810 mGy). During the 1983 to 2012 follow‐up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: −0.02, 95% CI: <0‐0.13). However, significant dose‐response relationships were observed for some subgroups, which might be false‐positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub‐multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01‐1.15) for those who smoked <20 pack‐years and −0.03 (95% CI: <0‐0.15) for those who smoked ≥20 pack‐years. Our study provides some evidence that greater protracted radiation exposure in the low‐dose range is positively associated with lung cancer mortality.
What's new?
Long‐term, low‐dose radiation exposure is associated with increased lung cancer risk. However, few studies have examined confounding effects of cigarette smoking in persons with protracted occupational radiation exposure. In this investigation, which included more than 106 000 radiologic technologists, no overall evidence of excess lung cancer was found in relation to occupational radiation dose. Some subsets of technologists, however, including those born in the 1930s and who began working in the 1950s, exhibited positive dose‐response relationships. Significant dose‐response was also observed for non‐smokers and light smokers but not heavy smokers, warranting additional study to better understand relationships between smoking and radiation.