title: Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario.
abstract: BACKGROUND
  Evidence suggests that current levels of tritium emissions from CANDU reactors in Canada are not related to adverse health effects. However, these studies lack tritium-specific dose data and have small numbers of cases. The purpose of our study was to determine whether tritium emitted from a nuclear-generating station during routine operation is associated with risk of cancer in Pickering, Ontario.
  
  
  METHODS
  A retrospective cohort was formed through linkage of Pickering and north Oshawa residents (1985) to incident cancer cases (1985-2005). We examined all sites combined, leukemia, lung, thyroid and childhood cancers (6-19 years) for males and females as well as female breast cancer. Tritium estimates were based on an atmospheric dispersion model, incorporating characteristics of annual tritium emissions and meteorology. Tritium concentration estimates were assigned to each cohort member based on exact location of residence. Person-years analysis was used to determine whether observed cancer cases were higher than expected. Cox proportional hazards regression was used to determine whether tritium was associated with radiation-sensitive cancers in Pickering.
  
  
  RESULTS
  Person-years analysis showed female childhood cancer cases to be significantly higher than expected (standardized incidence ratio [SIR] = 1.99, 95% confidence interval [CI]: 1.08-3.38). The issue of multiple comparisons is the most likely explanation for this finding. Cox models revealed that female lung cancer was significantly higher in Pickering versus north Oshawa (HR = 2.34, 95% CI: 1.23-4.46) and that tritium was not associated with increased risk. The improved methodology used in this study adds to our understanding of cancer risks associated with low-dose tritium exposure.
  
  
  CONCLUSIONS
  Tritium estimates were not associated with increased risk of radiationsensitive cancers in Pickering.
authors.affiliation: Cancer Care Ontario, Toronto, Ontario, Canada. susitha.wanigaratne@cancercare.on.ca
authors.forename: S
authors.initials: S
authors.lastname: Wanigaratne
authors.forename: E
authors.initials: E
authors.lastname: Holowaty
authors.forename: H
authors.initials: H
authors.lastname: Jiang
authors.forename: T A
authors.initials: TA
authors.lastname: Norwood
authors.forename: M A
authors.initials: MA
authors.lastname: Pietrusiak
authors.forename: P
authors.initials: P
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D055848:Nuclear Power Plants; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D014316:Tritium / Q000633:toxicity*; D055815:Young Adult
chemical_list: D014316:Tritium
keywords: cancer; historical cohort study; nuclear power plant; tritium