title: Risk of hematological malignancies among Chernobyl liquidators.
abstract: A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries to assess the effect of low- to medium-dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked around the Chernobyl plant in 1986-1987. A total of 117 cases [69 leukemia, 34 non-Hodgkin lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue] and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The excess relative risk (ERR) per 100 mGy was 0.60 [90% confidence interval (CI) -0.02, 2.35]. The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90% CI -0.38, 5.7). It is slightly higher than but statistically compatible with those estimated from A-bomb survivors and recent low-dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over- or underestimation of the risk in this study.
authors.affiliation: International Agency for Research on Cancer, Lyon, France. kesminiene@iarc.fr
authors.forename: Ausrele
authors.initials: A
authors.lastname: Kesminiene
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Evrard
authors.forename: Viktor K
authors.initials: VK
authors.lastname: Ivanov
authors.forename: Irina V
authors.initials: IV
authors.lastname: Malakhova
authors.forename: Juozas
authors.initials: J
authors.lastname: Kurtinaitis
authors.forename: Aivars
authors.initials: A
authors.lastname: Stengrevics
authors.forename: Mare
authors.initials: M
authors.lastname: Tekkel
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Anspaugh
authors.forename: André
authors.initials: A
authors.lastname: Bouville
authors.forename: Sergei
authors.initials: S
authors.lastname: Chekin
authors.forename: Vadim V
authors.initials: VV
authors.lastname: Chumak
authors.forename: Vladimir
authors.initials: V
authors.lastname: Drozdovitch
authors.forename: Vladimir
authors.initials: V
authors.lastname: Gapanovich
authors.forename: Ivan
authors.initials: I
authors.lastname: Golovanov
authors.forename: Phillipe
authors.initials: P
authors.lastname: Hubert
authors.forename: Sergei V
authors.initials: SV
authors.lastname: Illichev
authors.forename: Svetlana E
authors.initials: SE
authors.lastname: Khait
authors.forename: Viktor P
authors.initials: VP
authors.lastname: Kryuchkov
authors.forename: Evaldas
authors.initials: E
authors.lastname: Maceika
authors.forename: Marat
authors.initials: M
authors.lastname: Maksyoutov
authors.forename: Anatoly K
authors.initials: AK
authors.lastname: Mirkhaidarov
authors.forename: Semion
authors.initials: S
authors.lastname: Polyakov
authors.forename: Natalia
authors.initials: N
authors.lastname: Shchukina
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tenet
authors.forename: Tatyana I
authors.initials: TI
authors.lastname: Tserakhovich
authors.forename: Aleksandr
authors.initials: A
authors.lastname: Tsykalo
authors.forename: Aleksandr R
authors.initials: AR
authors.lastname: Tukov
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cardis
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D047852:Chernobyl Nuclear Accident; D052918:Environmental Restoration and Remediation; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D016273:Occupational Exposure; D011829:Radiation Dosage; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D035501:Uncertainty