External radiation dose and cancer mortality among French nuclear workers: considering potential confounding by internal radiation exposure

Fournier, L.; Olivier, Laurent; Samson, Eric; Caër-Lorho, Sylvaine; Laroche, Pierre; Guen, B. Le; Laurier, Dominique; Leuraud, Klervi

doi:10.1007/s00420-016-1152-4

Cited by 10 publications

(10 citation statements)

References 38 publications

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“…However, individual measurements of doses from radionuclide intakes are not available for the cohort members since this data has only recently been systematically collected and centralized in France. A companion paper investigated the potential confounding induced by internal contamination in the doserisk analysis in association with external radiation in the cohort, relying on a work-station exposure matrix (Fournier et al, 2015), and potential for internal contamination will not be considered in the present analysis.…”

Section: Radiation Exposure Datamentioning

confidence: 99%

“…Currently, in vivo and bioassay monitoring results for internal deposition of radionuclides are not available for all cohort members. To address that limit, a previous study on the cohort assessed the potential bias in the estimation of the doserisk relationship due to omitting information on internal contamination (Fournier et al, 2015). Workers at risk of potential internal contamination were identified based on a workstation-exposure matrix.…”

Section: Strengths and Potential Limitationsmentioning

confidence: 99%

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Mortality in the French cohort of nuclear workers

et al. 2017

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-Populations of nuclear workers are particularly relevant to study health effects of protracted exposures to low doses at low dose-rates of ionizing radiation. In France, a cohort of nuclear workers employed by the Commissariat à l'énergie atomique et aux énergies alternatives (CEA), AREVA Nuclear Cycle (AREVA NC), or Électricité de France (EDF), and badge-monitored for external radiation exposure, has been followed-up for several decades. Annual exposure to penetrating photons was reconstructed for each worker. Standardized mortality ratios were calculated using national mortality rates as the reference. Estimates of radiation dose-mortality associations were obtained using linear excess relative risk models. Mortality of 59 004 workers was followed-up between 1968 and 2004, for an average of 25 years. The mean cumulative photon H p (10) dose was 18.4 mSv in the whole cohort (median value: 2.1 mSv) and 25.7 mSv among exposed workers. At the end of the follow-up, workers were 56 years old on average and 6310 workers had died. A strong healthy worker effect was observed. Estimated dose-risk relationships were consistent with those from other worker studies for all solid cancers and leukaemia excluding chronic lymphocytic leukaemia, but remained associated to a large uncertainty. This cohort is the most informative study ever conducted in France among nuclear workers.

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Section: Radiation Exposure Datamentioning

confidence: 99%

Section: Strengths and Potential Limitationsmentioning

confidence: 99%

Mortality in the French cohort of nuclear workers

et al. 2017

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“…There is no centralised and computerised individual data on internal contamination in the cohort, but the potential for internal exposures to confound the external radiation risk has been studied in this cohort using an internal contamination indicator 22. That study concluded that, in this cohort, omitting information on internal contamination while studying the association between external dose and cancer mortality does not generate a substantial bias.…”

Section: Methodsmentioning

confidence: 98%

“…The cohort population has been described elsewhere 22. It comprises all French workers who were employed for at least 1 year by CEA civil or AREVA NC between 1950 and 1994 or by EDF between 1961 and 1994 and who were monitored for external radiation exposure.…”

Section: Methodsmentioning

confidence: 99%

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers

et al. 2017

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“…Data were excluded for all reviews, books and reports where workers were engaged in their activities for <1 year, and from all articles containing insufficient/incomplete data. Three articles were excluded, although they involved uranium workers and nuclear power (20,24) and uranium gaseous diffusion plants (25), as the radiation doses were closely controlled and were within the range considered as safe. Three articles on the Oak Ridge National Laboratory staff (26,27) and nuclear test participants (28) were also excluded.…”

Section: Data Collection Methodsmentioning

confidence: 99%

Low-dose ionizing radiation increases the mortality risk of solid cancers in nuclear industry workers: A meta-analysis

Gao

Tang

et al. 2018

mol clin onc

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Abstract. Low-dose ionizing radiation (LDIR) may increase the mortality of solid cancers in nuclear industry workers, but only few individual cohort studies exist, and the available reports have low statistical power. The aim of the present study was to focus on solid cancer mortality risk from LDIR in the nuclear industry using standard mortality ratios (SMRs) and 95% confidence intervals. A systematic literature search through the PubMed and Embase databases identified 27 studies relevant to this meta-analysis. There was statistical significance for total, solid and lung cancers, with meta-SMR values of 0.88, 0.80, and 0.89, respectively. There was evidence of stochastic effects by IR, but more definitive conclusions require additional analyses using standardized protocols to determine whether LDIR increases the risk of solid cancer-related mortality.

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External radiation dose and cancer mortality among French nuclear workers: considering potential confounding by internal radiation exposure

Cited by 10 publications

References 38 publications

Mortality in the French cohort of nuclear workers

Mortality in the French cohort of nuclear workers

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers

Low-dose ionizing radiation increases the mortality risk of solid cancers in nuclear industry workers: A meta-analysis

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