title: Nonmelanoma skin cancer in relation to ionizing radiation exposure among U.S. radiologic technologists.
abstract: Ionizing radiation (IR) is an established cause of nonmelanoma skin cancer, but there is uncertainty about the risk associated with chronic occupational exposure to IR and how it is influenced by ultraviolet radiation (UVR) exposure. We studied 1,355 incident cases with basal cell carcinoma (BCC) and 270 with squamous cell carcinoma (SCC) of the skin in a cohort of 65,304 U.S. white radiologic technologists who responded to the baseline questionnaire survey in 1983-1989 and the follow-up survey in 1994-1998. Cox's proportional-hazards model was used to estimate relative risks of BCC and SCC associated with surrogate measures of occupational exposure to IR and residential UVR exposure during childhood and adulthood, adjusted for potential confounders including pigmentation characteristics. Relative risks of BCC, but not of SCC, were elevated among technologists who first worked during the 1950s (RR = 1.42; 95% CI = 1.12-1.80), 1940s (RR = 2.04; 95% CI = 1.44-2.88) and before 1940 (RR = 2.16; 95% CI = 1.14-4.09), when IR exposures were high, compared to those who first worked after 1960 (p for trend < 0.01). The effect of year first worked on BCC risk was not modified by UVR exposure, but was significantly stronger among individuals with lighter compared to darker eye and hair color (p = 0.013 and 0.027, respectively). This study provides some evidence that chronic occupational exposure to IR at low to moderate levels can increase the risk of BCC, and that this risk may be modified by pigmentation characteristics.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. yosinaga@nirs.go.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshinaga
authors.forename: Michael
authors.initials: M
authors.lastname: Hauptmann
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Sigurdson
authors.forename: Michele Morin
authors.initials: MM
authors.lastname: Doody
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.forename: Elaine
authors.initials: E
authors.lastname: Ron
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Mabuchi
mesh_terms: D000328:Adult; D000368:Aged; D000488:Allied Health Personnel; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology*; D011839:Radiation, Ionizing; D011871:Radiology; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012880:Skin Pigmentation; D000078329:Workforce