title: Case-control assessment of the association between non-Hodgkin's lymphoma and occupational radiation with doses assessed using a job exposure matrix.
abstract: BACKGROUND
  Epidemiologic data for an association between radiation exposure and non-Hodgkin's lymphoma (NHL) have been inconclusive though the strongest evidence has been provided by studies of patients treated with radiotherapy.
  
  
  METHODS
  We evaluated the association between occupational radiation exposure and non-Hodgkin's lymphoma in men using a population-based case-control study with 1,056 case and 1,860 control subjects sampled from eight geographic areas in the United States. Because dosimetry data were not available, doses were estimated for individuals who reported occupational radiation exposure using a radiation job exposure matrix developed for this purpose. Conditional logistic regression was used to model the association between reported occupational radiation exposure and NHL incidence.
  
  
  RESULTS
  We found that most men (> 90%) did not report exposure to occupational sources of radiation. Among those who reported exposure, estimated cumulative doses were low, with an estimated mean of less than 0.02 Gray and a maximum of 0.12 Gray. The risk for NHL was not associated with ever having reported an occupational radiation exposure (OR = 0.90, 95% CI = 0.74-1.10) nor was there evidence of a dose-response relationship between risk and either the estimated cumulative doses or duration of exposure.
  
  
  CONCLUSIONS
  The findings in this study are consistent with results from most current research on occupational radiation and NHL risk that have found no increased risk of NHL at low levels of occupational radiation exposure. While it should be noted that exposure misclassification likely biased our results toward the null, this large population-based case-control study adds to existing evidence which suggests that there is little to no increased risk for NHL associated with exposure to low levels of radiation such as that commonly found in many occupational settings.
authors.affiliation: Radiation Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia. cre1@cdc.gov
authors.forename: C R
authors.initials: CR
authors.lastname: Eheman
authors.forename: P E
authors.initials: PE
authors.lastname: Tolbert
authors.forename: R J
authors.initials: RJ
authors.lastname: Coates
authors.forename: O
authors.initials: O
authors.lastname: Devine
authors.forename: J W
authors.initials: JW
authors.lastname: Eley
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003625:Data Collection; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000453:epidemiology*; D018570:Risk Assessment; D015996:Survival Rate