title: Histopathologic findings of lung carcinoma in German uranium miners.
abstract: BACKGROUND
  This study evaluates the histopathology of lung carcinoma in relation to underground radon exposure.
  
  
  METHODS
  Two hundred forty uranium miners of the former Wismut Company in Eastern Germany with histologically or cytologically confirmed primary lung carcinoma were recruited from 3 study clinics between 1991 and 1995. Information on smoking history was obtained by personal interviews, whereas job histories were derived from original payrolls provided by the Wismut Company. Quantitative estimates of occupational radon exposure were based on a job-exposure matrix.
  
  
  RESULTS
  Squamous cell carcinoma (SqCC) was the predominant cell type (43%), followed by adenocarcinoma (AC; 26%), small cell lung carcinoma (SCLC; 23%), and other cell types (8%). Nearly all patients were smokers. Time since first occupational exposure was 42 years on average, the mean cumulative radon exposure 506 working level months. Adenocarcinoma appeared to be more likely than both SCLC and SqCC among miners with low cumulative radiation exposure, long time since first exposure, an older age at diagnosis, and among ex- and never-smokers. In current smokers, lung carcinomas developed at a much lower level of radiation exposure than in ex- and never-smokers. The increase in the relative frequency of SCLC and SqCC at the expense of AC with increasing cumulative radiation exposure was more pronounced among ex- and never-smokers and seemed to be masked among current smokers.
  
  
  CONCLUSIONS
  The authors' data suggest that all cell types were associated with radon exposure, but high radiation exposure tended to increase the proportion of SCLC and SqCC.
authors.affiliation: Federal Office for Radiation Protection, Institute of Radiation Hygiene, Neuherberg, Germany. mkreuzer@bfs.de
authors.forename: M
authors.initials: M
authors.lastname: Kreuzer
authors.forename: K M
authors.initials: KM
authors.lastname: Müller
authors.forename: A
authors.initials: A
authors.lastname: Brachner
authors.forename: M
authors.initials: M
authors.lastname: Gerken
authors.forename: B
authors.initials: B
authors.lastname: Grosche
authors.forename: T
authors.initials: T
authors.lastname: Wiethege
authors.forename: H E
authors.initials: HE
authors.lastname: Wichmann
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002274:Carcinogens, Environmental / Q000009:adverse effects; D018288:Carcinoma, Small Cell / Q000209:etiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005858:Germany; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000473:pathology*; D008906:Mining; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects*; D011886:Radon / Q000009:adverse effects; D012044:Regression Analysis; D012907:Smoking / Q000009:adverse effects; D014501:Uranium / Q000009:adverse effects*
chemical_list: D002274:Carcinogens, Environmental; D014501:Uranium; D011886:Radon