title: Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality.
abstract: This study examined cancer incidence (1986-2008) and mortality (1986-2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardised incidence ratio (SIR) and standardised mortality ratio (SMR), respectively. Poisson regression was used to analyse the effects of year of arrival, duration of stay and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93-1.20 (232 cases). Elevated risks were found for cancers of the pharynx, the oesophagus and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96-1.08 (1018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted.
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia. kaja.rahu@tai.ee
authors.forename: Kaja
authors.initials: K
authors.lastname: Rahu
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
authors.forename: Timo
authors.initials: T
authors.lastname: Hakulinen
authors.forename: Mare
authors.initials: M
authors.lastname: Tekkel
authors.forename: Peter D
authors.initials: PD
authors.lastname: Inskip
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: John D
authors.initials: JD
authors.lastname: Boice
authors.forename: Mati
authors.initials: M
authors.lastname: Rahu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D047852:Chernobyl Nuclear Accident; D015331:Cohort Studies; D003666:Decontamination / Q000706:statistics & numerical data*; D004957:Estonia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D055848:Nuclear Power Plants / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult