Risk of hematological malignancies among Chernobyl liquidators.
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.
Kesminiene
Ausrele
A
International Agency for Research on Cancer, Lyon, France. kesminiene@iarc.fr
Evrard
Anne-Sophie
AS
Ivanov
Viktor K
VK
Malakhova
Irina V
IV
Kurtinaitis
Juozas
J
Stengrevics
Aivars
A
Tekkel
Mare
M
Anspaugh
Lynn R
LR
Bouville
André
A
Chekin
Sergei
S
Chumak
Vadim V
VV
Drozdovitch
Vladimir
V
Gapanovich
Vladimir
V
Golovanov
Ivan
I
Hubert
Phillipe
P
Illichev
Sergei V
SV
Khait
Svetlana E
SE
Kryuchkov
Viktor P
VP
Maceika
Evaldas
E
Maksyoutov
Marat
M
Mirkhaidarov
Anatoly K
AK
Polyakov
Semion
S
Shchukina
Natalia
N
Tenet
Vanessa
V
Tserakhovich
Tatyana I
TI
Tsykalo
Aleksandr
A
Tukov
Aleksandr R
AR
Cardis
Elisabeth
E
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