title: Risk of melanoma among radiologic technologists in the United States.
abstract: Our study examines the risk of melanoma among medical radiation workers in the U.S. Radiologic Technologists (USRT) study. We evaluated 68,588 white radiologic technologists (78.8% female), certified during 1926-1982, who responded to a baseline questionnaire (1983-1989) and were free of cancer other than nonmelanoma skin at that time. Participants were followed through completion of a second questionnaire (1994-1998). We identified 207 cases, 193 subjects who reported first primary melanoma and 14 decedents with melanoma listed as an underlying or contributory cause of death. We examined risks of occupational radiation exposures using work history information on practices, procedures, and protective measures reported on the baseline questionnaire. Based on Cox proportional hazards regression, melanoma was significantly associated with established risk factors, including constitutional characteristics (skin tone, eye and hair color), personal history of nonmelanoma skin cancer, family history of melanoma and indicators of residential sunlight exposure. Melanoma risk was increased among those who first worked before 1950 (RR = 1.8, 95% CI = 0.6-5.5), particularly among those who worked 5 or more years before 1950 (RR = 2.4; 0.7-8.7; p (trend) for years worked before 1950 = 0.03), when radiation exposures were likely highest. Risk was also modestly elevated among technologists who did not customarily use a lead apron or shield when they first began working (RR = 1.4; 0.8-2.5). Clarifying the possible role of exposure to chronic ionizing radiation in melanoma is likely to require nested case-control studies within occupational cohorts, such as this one, which will assess individual radiation doses, and detailed information about sun exposure, sunburn history and skin susceptibility characteristics.
authors.affiliation: Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Room 7087, 6120 Executive Boulevard, Bethesda, MD 20892, USA. mf101e@nih.gov
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.forename: Alice
authors.initials: A
authors.lastname: Sigurdson
authors.forename: R Sowmya
authors.initials: RS
authors.lastname: Rao
authors.forename: Michael
authors.initials: M
authors.lastname: Hauptmann
authors.forename: Bruce
authors.initials: B
authors.lastname: Alexander
authors.forename: Aparna
authors.initials: A
authors.lastname: Mohan
authors.forename: Michele
authors.initials: M
authors.lastname: Morin Doody
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
mesh_terms: D000328:Adult; D000368:Aged; D000488:Allied Health Personnel; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology* / Q000517:prevention & control*; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects; D011839:Radiation, Ionizing; D011874:Radiometry; D012306:Risk; D012307:Risk Factors; D013679:Technology, Radiologic; D013997:Time Factors; D014481:United States