title: Mortality from cancers of the extra-thoracic airways in relation to radon progeny in the Wismut cohort, 1946-2008.
abstract: OBJECTIVE
  Inhalation of radon progeny can cause high lung and respiratory tract radiation doses. The aim of this paper was to examine the relationship between radon progeny and cancers of the extra-thoracic airways in the German uranium miner cohort for an extended follow-up through 2008.
  
  
  METHODS
  The cohort included 58,690 workers employed between 1946 and 1989 at the Wismut company. Exposure to radon progeny in Working Level Months (WLM) was determined from a comprehensive job-exposure matrix. The mean (max) cumulative exposure to radon among exposed cohort members (86%) was 280 WLM (3,224 WLM). Internal Poisson regression models were applied to estimate the linear Excess Relative Risk (ERR) per unit of cumulative exposure to radon.
  
  
  RESULTS
  A small increase in the mortality from all cancers of the extra-thoracic airways combined with increasing cumulative exposure to radon was found (ERR/100 WLM = 0.036, p = 0.12), based on 234 deaths. The estimated ERR per 100 WLM for relevant cancer sub-groups were: 0.017 (p > 0.5) larynx (n = 94); 0.077 (p = 0.20) pharynx (n = 74); and 0.030 (p > 0.5) tongue and mouth (n = 55).
  
  
  CONCLUSIONS
  RESULTS indicated a small but not statistically significant increase in mortality from cancers of the extra-thoracic airways in relation to radon. Low statistical power and uncontrolled confounding were limitations of this study.
authors.affiliation: Federal Office for Radiation Protection, Department of Radiation Protection and Health , Neuherberg , Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Kreuzer
authors.forename: Florian
authors.initials: F
authors.lastname: Dufey
authors.forename: James W
authors.initials: JW
authors.lastname: Marsh
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.forename: Maria
authors.initials: M
authors.lastname: Schnelzer
authors.forename: L
authors.initials: L
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005858:Germany; D006801:Humans; D008168:Lung / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D008906:Mining; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D009784:Occupational Diseases / Q000401:mortality; D016273:Occupational Exposure; D016012:Poisson Distribution; D017687:Radon Daughters; D012142:Respiratory Tract Neoplasms / Q000401:mortality*; D012306:Risk; D013997:Time Factors; D014501:Uranium / Q000737:chemistry
chemical_list: D017687:Radon Daughters; D014501:Uranium
keywords: Alpha emitters; epidemiology; radiation-induced tumours