title: Mortality from internal and external radiation exposure in a cohort of male German uranium millers, 1946-2008.
abstract: OBJECTIVE
  To examine exposure-response relationships between ionizing radiation and several mortality outcomes in a subgroup of 4,054 men of the German uranium miner cohort study, who worked between 1946 and 1989 in milling facilities, but never underground or in open pit mines.
  
  
  METHODS
  Mortality follow-up was from 1946 to 2008, accumulating 158,383 person-years at risk. Cumulative exposure to radon progeny in working level months (WLM) (mean = 8, max = 127), long-lived radionuclides from uranium ore dust in kBqh/m(3) (mean = 3.9, max = 132), external gamma radiation in mSv (mean = 26, max = 667) and silica dust was estimated by a comprehensive job-exposure matrix. Internal Poisson regression models were applied to estimate the linear excess relative risk (ERR) per unit of cumulative exposure.
  
  
  RESULTS
  Overall, a total of 457, 717 and 111 deaths occurred from malignant cancer, cardiovascular diseases and non-malignant respiratory diseases, respectively. Uranium ore dust and silica dust were not associated with mortality from any of these disease groups. A statistically significant relationship between cumulative radon exposure and mortality from all cancers (ERR/100 WLM = 1.71; p = 0.02), primarily due to lung cancer (n = 159; ERR/100 WLM = 3.39; p = 0.05), was found. With respect to cumulative external gamma radiation, an excess of mortality of solid cancers (n = 434; ERR/Sv = 1.86; p = 0.06), primarily due to stomach cancer (n = 49, ERR/Sv = 10.0; p = 0.12), was present.
  
  
  CONCLUSIONS
  The present findings show an excess mortality from lung cancer due to radon exposure and from solid cancers due to external gamma radiation in uranium millers that was not statistically significant. Exposure to uranium was not associated with any cause of death, but absorbed organ doses were estimated to be low.
authors.affiliation: Department of Radiation Protection and Health, Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany, mkreuzer@bfs.de.
authors.forename: M
authors.initials: M
authors.lastname: Kreuzer
authors.forename: F
authors.initials: F
authors.lastname: Dufey
authors.forename: D
authors.initials: D
authors.lastname: Laurier
authors.forename: D
authors.initials: D
authors.lastname: Nowak
authors.forename: J W
authors.initials: JW
authors.lastname: Marsh
authors.forename: M
authors.initials: M
authors.lastname: Schnelzer
authors.forename: M
authors.initials: M
authors.lastname: Sogl
authors.forename: L
authors.initials: L
authors.lastname: Walsh
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D004391:Dust; D005720:Gamma Rays / Q000009:adverse effects; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008906:Mining / Q000706:statistics & numerical data*; D009381:Neoplasms, Radiation-Induced / Q000401:mortality; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D016012:Poisson Distribution; D000069079:Radiation Exposure / Q000009:adverse effects*; D011886:Radon / Q000633:toxicity; D012306:Risk; D014501:Uranium / Q000633:toxicity*
chemical_list: D004391:Dust; D014501:Uranium; D011886:Radon