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2013 ; 70
(1
): 41-8
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Risk of leukaemia mortality from exposure to ionising radiation in US nuclear
workers: a pooled case-control study
#MMPMID23000827
Daniels RD
; Bertke S
; Waters KM
; Schubauer-Berigan MK
Occup Environ Med
2013[Jan]; 70
(1
): 41-8
PMID23000827
show ga
OBJECTIVE: To follow-up on earlier studies of the leukaemogenicity of
occupational ionising radiation exposure. METHODS: We conducted a nested
case-control analysis of leukaemia mortality in a pooled cohort of US nuclear
workers followed through 2005. Each case was matched to four controls on attained
age. Exposures were estimated from available records. General relative risk
models were used to estimate the excess relative risk (ERR) of leukaemia,
excluding chronic lymphocytic (CLL), acute myeloid leukaemia, chronic myeloid
leukaemia and CLL while controlling for potential confounders. Preferred exposure
lags and time-windows of risks were calculated using joint maximum likelihood.
Dose-response was also examined using linear, linear-quadratic, categorical and
restricted cubic spline models. RESULTS: There were 369 leukaemia deaths in 105
245 US nuclear workers. The adjusted ERR for non-CLL leukaemia was 0.09 (95% CI
-0.17 to 0.65) per 100 mGy. Elevated non-CLL risks were observed from exposures
occurring 6-14 years prior to attained age of cases (ERR per 100 mGy=1.9; 95% CI
<0 to 8.0). Lagged models indicated non-linearity of risk at very low (<10 mGy)
and high (>100 mGy) doses, which contributed to the imprecision of results in
linear models. Similar risk attenuation was not evident in time-windows-based
models. CONCLUSIONS: Risk estimates were in reasonable agreement with previous
estimates, with the temporality of non-CLL leukaemia risk as a dominant factor in
dose-response analyses. Future research should focus on methods that improve
evaluations of the dose-response, particularly in the low-dose range.