title: Lung cancer risks from plutonium: an updated analysis of data from the Mayak worker cohort.
abstract: Workers at the Mayak nuclear facility in the Russian Federation offer a unique opportunity to evaluate health risks from exposure to inhaled plutonium. Risks of mortality from lung cancer, the most serious carcinogenic effect of plutonium, were evaluated in 14,621 Mayak workers who were hired in the period from 1948-1982, followed for at least 5 years, and either monitored for plutonium or never worked with plutonium. Over the follow-up period from 1953-2008, there were 486 deaths from lung cancer, 446 of them in men. In analyses that were adjusted for external radiation dose and smoking, the plutonium excess relative risk (ERR) per Gy declined with attained age and was higher for females than for males. The ERR per Gy for males at age 60 was 7.4 (95% CI: 5.0-11) while that for females was 24 (95% CI: 11-56). When analyses were restricted to plutonium doses <0.2 Gy, the ERR per Gy for males at age 60 was similar: 7.0 (95% CI: 2.5-13). Of the 486 lung cancer deaths, 105 (22%) were attributed to plutonium exposure and 29 (6%) to external exposure. Analyses of the 12,708 workers with information on smoking indicated that the relationship of plutonium exposure and smoking was likely sub-multiplicative (P = 0.011) and strongly indicated that it was super-additive (P < 0.001). Although extensive efforts have been made to improve plutonium dose estimates in this cohort, they are nevertheless subject to large uncertainties. Large bioassay measurement errors alone are likely to have resulted in serious underestimation of risks, whereas other sources of uncertainty may have biased results in ways that are difficult to predict.
authors: Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20852, USA. gilberte@mail.nih.gov
authors: E S
authors: ES
authors: Gilbert
authors: M E
authors: ME
authors: Sokolnikov
authors: D L
authors: DL
authors: Preston
authors: S J
authors: SJ
authors: Schonfeld
authors: A E
authors: AE
authors: Schadilov
authors: E K
authors: EK
authors: Vasilenko
authors: N A
authors: NA
authors: Koshurnikova
mesh_terms: D000293:Adolescent; D000328:Adult; D002273:Carcinogens / Q000633:toxicity*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D016273:Occupational Exposure; D011005:Plutonium / Q000633:toxicity*; D012307:Risk Factors; D012426:Russia; D012907:Smoking; D055815:Young Adult
chemical_list: D002273:Carcinogens; D011005:Plutonium
references: Radiat Res. 2008 Feb;169(2):125-37
references: 18220460
references: Radiat Res. 2004 Oct;162(4):377-89
references: 15447045
references: Radiat Res. 1999 Oct;152(4):352-63
references: 10477912
references: Br J Cancer. 1999 Mar;79(7-8):1288-301
references: 10098774
references: Ann ICRP. 2003;33(4):1-117
references: 14614921
references: Radiat Res. 2004 Nov;162(5):505-16
references: 15624305
references: Am J Epidemiol. 2004 Jul 15;160(2):163-72
references: 15234938
references: Radiat Environ Biophys. 2007 Nov;46(4):383-94
references: 17562061
references: Radiat Environ Biophys. 2003 Jul;42(2):129-35
references: 12851829
references: Int J Cancer. 2008 Aug 15;123(4):905-11
references: 18528867
references: Health Phys. 2005 Jul;89(1):33-45
references: 15951690
references: Health Phys. 1997 Oct;73(4):611-9
references: 9314220
references: Health Phys. 2002 Dec;83(6):833-46
references: 12467291
references: Health Phys. 2007 Sep;93(3):190-206
references: 17693770
references: Health Phys. 1994 Dec;67(6):577-88
references: 7960779
references: Radiat Res. 2007 Jul;168(1):1-64
references: 17722996
references: Radiat Res. 2003 Jun;159(6):787-98
references: 12751962
references: J Natl Cancer Inst. 1995 Jun 7;87(11):817-27
references: 7791231
references: Radiat Res. 2010 Jul;174(1):72-82
references: 20681801