title: Health outcomes of low-dose ionizing radiation exposure among medical workers: a cohort study of the Canadian national dose registry of radiation workers.
abstract: BACKGROUND
  Medical workers can be exposed to low-dose ionizing radiation from various sources. The potential cancer risks associated with ionizing radiation exposure have been derived from cohort studies of Japanese atomic bomb survivors who had experienced acute, high-level exposure. Since such extrapolations are subject to uncertainty, direct information is needed on the risk associated with chronic low-dose occupational exposure to ionizing radiation.
  
  
  OBJECTIVE
  To determine the occupational doses of ionizing radiation and examine possible associations with mortality rates and cancer incidence in a cohort of medical workers deriving from the National Dose Registry of Canada (NDR) over the period of 1951-1987.
  
  
  METHODS
  Standardized mortality and incidence ratios (SMR and SIR, respectively) were ascertained by linking NDR data for a cohort of 67 562 medical workers (23 580 males and 43 982 females) with the data maintained by the Canadian Mortality, and Cancer Incidence databases. Dosimetry information was obtained from the National Dosimetry Services.
  
  
  RESULTS
  During the follow-up period, 1309 incident cases of cancer (509 in males, 800 in females) and 1325 deaths (823 in males, 502 in females) were observed. Mortality from cancer and non-cancer causes was generally below expected as compared to the general Canadian population. Thyroid cancer incidence was significantly elevated both among males and females, with a combined SIR of 1.74 and 90% CI: 1.40-2.10.
  
  
  CONCLUSIONS
  The findings confirm previous reports on an increased risk of the thyroid cancer among medical workers occupationally exposed to ionizing radiation. Over the last 50 years, radiation protection measures have been effective in reducing radiation exposures of medical workers to the current very low levels.
authors: Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada. jan_zielinski@hc-sc.gc.ca
authors: Jan M
authors: JM
authors: Zielinski
authors: Michael J
authors: MJ
authors: Garner
authors: Pierre R
authors: PR
authors: Band
authors: Daniel
authors: D
authors: Krewski
authors: Natalia S
authors: NS
authors: Shilnikova
authors: Huixia
authors: H
authors: Jiang
authors: Patrick J
authors: PJ
authors: Ashmore
authors: Willem N
authors: WN
authors: Sont
authors: Martha E
authors: ME
authors: Fair
authors: Ernest G
authors: EG
authors: Letourneau
authors: Robert
authors: R
authors: Semenciw
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000453:epidemiology* / Q000401:mortality; D011839:Radiation, Ionizing; D012042:Registries; D018570:Risk Assessment