title: Malignant pleural mesothelioma risk among nuclear workers: a review.
abstract: Exposure to ionising radiation has been suggested as a causal risk factor for malignant pleural mesothelioma (MPM). Studies of patients treated by radiotherapy for primary cancers have suggested that radiation contributes to the development of secondary MPM. Here we examined the risk to nuclear workers of MPM related to exposure to low doses of occupational radiation at low dose rates. All results concerning MPM risk in published studies of nuclear workers were examined for their association with radiation exposure and potential confounders. We found 19 relevant studies. Elevated risks of pleural cancer were reported in most (15/17) of these studies. Eight reported risks higher for radiation monitored workers than for other workers. However, of 12 studies that looked at associations with ionising radiation, only one reported a significant dose-risk association. Asbestos was an important confounder in most studies. We conclude that studies of nuclear workers have not detected an association between ionising radiation exposure and MPM. Further investigations should improve the consideration of asbestos exposure at the same time as they address the risk of MPM related to occupational exposure of nuclear workers to low doses of ionising radiation at low dose rates.
authors.affiliation: Laboratory of Epidemiology, Institute of Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France. camille.metz@irsn.fr
authors.forename: C
authors.initials: C
authors.lastname: Metz-Flamant
authors.forename: I
authors.initials: I
authors.lastname: Guseva Canu
authors.forename: D
authors.initials: D
authors.lastname: Laurier
mesh_terms: D006801:Humans; D008654:Mesothelioma / Q000453:epidemiology*; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D009688:Nuclear Reactors / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010997:Pleural Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors