title: Significance of radiation exposure from work-related chest X-rays for epidemiological studies of radiation workers.
abstract: BACKGROUND
  Previous epidemiologic studies of workers at nuclear weapons facilities have not included X-ray exposures as part of the occupational radiation exposure. The research objective was to determine the contribution of work-related chest X-ray (WRX) exposure relative to the cumulative occupational radiation exposure.
  
  
  METHODS
  Cases and controls were identified from a cohort of workers whose employment began as early as 1943. Medical records for 297 subjects were used to determine the bone marrow dose from their X-ray examinations. Individual dose data, however, were only available for 45 workers. Bone marrow dose estimates were calculated by converting the entrance-skin-exposure (from X-ray procedures) and occupational exposure (from monitoring data) to dose.
  
  
  RESULTS
  Stereoscopic photofluorography delivered a bone marrow dose nearly 100 times that delivered by today's chest X-ray technique. Photofluorography was the predominant radiation source during the 1940s and 1950s. The cumulative WRX dose was, on average, 50 times their occupational doses. No correlation between occupational and WRX dose was found, but may be due to the small study size and incomplete dose data.
  
  
  CONCLUSIONS
  These findings illustrate the importance of including WRX doses in retrospective epidemiological studies of radiation workers, especially if photofluorographic chest X-rays were performed and occupational exposure to ionizing radiation is low.
authors.affiliation: National Institute for Occupational Safety & Health, Robert A Taft Laboratories (R-44), Health-Related Energy Research Branch, 4676 Columbia Parkway, Cincinnati, Ohio 45226, USA. jcardarelli@cdc.gov
authors.forename: J
authors.initials: J
authors.lastname: Cardarelli
authors.forename: H
authors.initials: H
authors.lastname: Spitz
authors.forename: C
authors.initials: C
authors.lastname: Rice
authors.forename: R
authors.initials: R
authors.lastname: Buncher
authors.forename: H
authors.initials: H
authors.lastname: Elson
authors.forename: P
authors.initials: P
authors.lastname: Succop
mesh_terms: D001853:Bone Marrow / Q000528:radiation effects*; D016022:Case-Control Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009101:Multiple Myeloma / Q000401:mortality; D009381:Neoplasms, Radiation-Induced / Q000401:mortality; D009688:Nuclear Reactors; D016273:Occupational Exposure; D011829:Radiation Dosage; D013902:Radiography, Thoracic / Q000379:methods*; D014965:X-Rays / Q000009:adverse effects*