title: Cancer and circulatory disease risks in US radiologic technologists associated with performing procedures involving radionuclides.
abstract: OBJECTIVE
  The number of nuclear medicine procedures has increased substantially over the past several decades, with uncertain health risks to the medical workers who perform them. We estimated risks of incidence and mortality from cancer and circulatory disease associated with performing procedures involving the use of radionuclides.
  
  
  METHODS
  From a nationwide cohort of 90,955 US radiologic technologists who completed a mailed questionnaire during 1994-1998, 22,039 reported ever performing diagnostic radionuclide procedures, brachytherapy, radioactive iodine therapy, or other radionuclide therapy. We calculated multivariable-adjusted HRs and 95% CIs for incidence (through 2003-2005) and mortality (through 2008) associated with performing these procedures.
  
  
  RESULTS
  Ever (versus never) performing radionuclide procedures was not associated with risks for most end points examined. However, we observed increased risks for squamous cell carcinoma of the skin (HR=1.29, 95% CI 1.01 to 1.66) with ever performing diagnostic radionuclide procedures, for myocardial infarction incidence (HR=1.37, 95% CI 1.10 to 1.70), all-cause mortality (HR=1.10, 95% CI 1.00 to 1.20) and all-cancer mortality (HR=1.20, 95% CI 1.01 to 1.43) with ever performing brachytherapy, and for mortality from all causes (HR=1.14, 95% CI 1.01 to 1.30), breast cancer (HR=2.68, 95% CI 1.10 to 6.51), and myocardial infarction (HR=1.76, 95% CI 1.02 to 3.04) with ever performing other radionuclide therapy procedures (excluding brachytherapy and radioactive iodine); increasing risks were also observed with greater frequency of performing these procedures, particularly before 1980.
  
  
  CONCLUSIONS
  The modest health risks among radiologic technologists performing procedures using radionuclides require further examination in studies with individual dose estimates, more detailed information regarding types of procedures performed and radionuclides used, and longer follow-up.
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Drozdovitch
authors.affiliation: Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.affiliation: Hirosoft International, Eureka, California, USA.
authors.forename: Dale L
authors.initials: DL
authors.lastname: Preston
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Simon
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Brill
authors.affiliation: Information Management Systems, Inc., Calverton, Maryland, USA.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Miller
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Little
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Preetha
authors.initials: P
authors.lastname: Rajaraman
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Doody
mesh_terms: D000328:Adult; D001918:Brachytherapy; D001943:Breast Neoplasms / Q000209:etiology / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D009369:Neoplasms / Q000209:etiology* / Q000401:mortality; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D011868:Radioisotopes / Q000009:adverse effects*; D012306:Risk; D012878:Skin Neoplasms / Q000209:etiology; D011795:Surveys and Questionnaires; D013679:Technology, Radiologic; D014481:United States / Q000453:epidemiology; D014937:Work
chemical_list: D011868:Radioisotopes