title: [Mortality in nuclear workers of the French electricity company: period 1968-2003].
abstract: BACKGROUND
  We conducted a mortality study on a cohort of French nuclear workers employed at Electricité de France (EDF). A first cancer mortality analysis had covered the period 1968-1994. This paper presents results from a mortality analysis including nine additional years of follow-up to cover workers employed from 1968 to 2003.
  
  
  METHODS
  The cohort includes 22393 workers, 97% of whom are males. Employment data were updated using the EDF personnel file. Vital status was ascertained using the French National Registry of Population, and further completed using EDF personnel and pension files. Causes of death were obtained from the National registry of causes of death. Standardised Mortality Ratios (SMR) were computed using national rates as references. Variations of all causes and all cancers SMRs were studied according to demographic and occupational characteristics.
  
  
  RESULTS
  At the study end point (31/12/2003), 74% of workers are still in active employment. Only 0.3% of workers are lost to follow-up. The median duration of follow-up is 20 years. Causes are ascertained for 96% of deaths. The total number of deaths is 874, 307 of which are cancer deaths. SMRs for all causes and cancers show a significant deficit compared to the French national mortality. No significant excess was observed for any of the cancer sites studied. Non-significant excesses are observed for pancreatic, pleural, kidney and brain cancer. Significant variations of all causes SMRs according to age at study entry and attained age are observed. Significant variations of all causes and all cancers SMRs according to diploma at employment are observed, with a reduced SMR for a higher level of diploma.
  
  
  CONCLUSIONS
  There is a significant deficit of mortality compared to the general population, reflecting a strong Healthy Worker Effect. Although nine years of follow-up were added, this cohort is made up of young workers, most of whom are still in active service. Regular updating of the follow up of this cohort is planned, aiming for an occupational health surveillance of workers occupationally exposed to ionizing radiation in France.
authors.affiliation: Laboratoire d'Epidémiologie, Institut de Radioprotection et de Sûreté Nucléaire, DRPH/SRBE/LEPID, 31 Avenue de la Division-Leclerc, BP 17, 92262 Fontenay-Aux-Roses Cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Rogel
authors.forename: K
authors.initials: K
authors.lastname: Joly
authors.forename: C
authors.initials: C
authors.lastname: Metz-Flamant
authors.forename: O
authors.initials: O
authors.lastname: Laurent
authors.forename: M
authors.initials: M
authors.lastname: Tirmarche
authors.forename: D
authors.initials: D
authors.lastname: Hubert
authors.forename: Y
authors.initials: Y
authors.lastname: Garcier
authors.forename: D
authors.initials: D
authors.lastname: Laurier
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007221:Industry; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D009688:Nuclear Reactors; D011159:Population Surveillance; D012042:Registries