title: The 15-Country Collaborative Study of Cancer Risk Among Radiation Workers in the Nuclear Industry: design, epidemiological methods and descriptive results.
abstract: Radiation protection standards are based mainly on risk estimates from studies of atomic bomb survivors in Japan. The validity of extrapolations from the relatively high-dose acute exposures in this population to the low-dose, protracted or fractionated environmental and occupational exposures of primary public health concern has long been the subject of controversy. A collaborative retrospective cohort study was conducted to provide direct estimates of cancer risk after low-dose protracted exposures. The study included nearly 600,000 workers employed in 154 facilities in 15 countries. This paper describes the design, methods and results of descriptive analyses of the study. The main analyses included 407,391 nuclear industry workers employed for at least 1 year in a participating facility who were monitored individually for external radiation exposure and whose doses resulted predominantly from exposure to higher-energy photon radiation. The total duration of follow-up was 5,192,710 person-years. There were 24,158 deaths from all causes, including 6,734 deaths from cancer. The total collective dose was 7,892 Sv. The overall average cumulative recorded dose was 19.4 mSv. A strong healthy worker effect was observed in most countries. This study provides the largest body of direct evidence to date on the effects of low-dose protracted exposures to external photon radiation.
authors: International Agency for Research on Cancer, Lyon, France. vrijheid@iarc.fr
authors: M
authors: M
authors: Vrijheid
authors: E
authors: E
authors: Cardis
authors: M
authors: M
authors: Blettner
authors: E
authors: E
authors: Gilbert
authors: M
authors: M
authors: Hakama
authors: C
authors: C
authors: Hill
authors: G
authors: G
authors: Howe
authors: J
authors: J
authors: Kaldor
authors: C R
authors: CR
authors: Muirhead
authors: M
authors: M
authors: Schubauer-Berigan
authors: T
authors: T
authors: Yoshimura
authors: Y-O
authors: YO
authors: Ahn
authors: P
authors: P
authors: Ashmore
authors: A
authors: A
authors: Auvinen
authors: J-M
authors: JM
authors: Bae
authors: H
authors: H
authors: Engels
authors: G
authors: G
authors: Gulis
authors: R R
authors: RR
authors: Habib
authors: Y
authors: Y
authors: Hosoda
authors: J
authors: J
authors: Kurtinaitis
authors: H
authors: H
authors: Malker
authors: M
authors: M
authors: Moser
authors: F
authors: F
authors: Rodriguez-Artalejo
authors: A
authors: A
authors: Rogel
authors: H
authors: H
authors: Tardy
authors: M
authors: M
authors: Telle-Lamberton
authors: I
authors: I
authors: Turai
authors: M
authors: M
authors: Usel
authors: K
authors: K
authors: Veress
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004651:Employment / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007221:Industry / Q000706:statistics & numerical data*; D007391:International Cooperation; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D009688:Nuclear Reactors / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D012107:Research Design; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D014915:Whole-Body Counting / Q000706:statistics & numerical data*