title: [Radiation exposure and cancer mortality among nuclear power plant workers: a meta-analysis].
abstract: OBJECTIVE
  We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers.
  
  
  METHODS
  We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included.
  
  
  RESULTS
  We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer.
  
  
  CONCLUSIONS
  Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.
authors.affiliation: Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Park
authors.forename: Kieun
authors.initials: K
authors.lastname: Moon
authors.forename: Han Na
authors.initials: HN
authors.lastname: Kim
authors.forename: Won Jin
authors.initials: WJ
authors.lastname: Lee
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Jin
mesh_terms: D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D055848:Nuclear Power Plants; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects; D011834:Radiation Monitoring