title: Cancer and non-cancer mortality among French uranium cycle workers: the TRACY cohort.
abstract: OBJECTIVE
  The health effects of internal contamination by radionuclides, and notably by uranium, are poorly characterised. New cohorts of uranium workers are needed to better examine these effects. This paper analyses for the first time the mortality profile of the French cohort of uranium cycle workers. It considers mortality from cancer and non-cancer causes.
  
  
  METHODS
  The cohort includes workers employed at least 6 months between 1958 and 2006 in French companies involved in the production of nuclear fuel. Vital status and causes of death were collected from French national registries. Workers were followed-up from 1 January 1968 to 31 December 2008. Standardised mortality ratios (SMRs) were computed based on mortality rates for the French general population.
  
  
  RESULTS
  The cohort includes 12,649 workers (88% men). The average length of follow-up is 27 years and the mean age at the end of the study is 60 years. Large mortality deficits are observed for non-cancer causes of death such as non-cancer respiratory diseases (SMR=0.51 (0.41 to 0.63)) and circulatory diseases (SMR=0.68 (0.62 to 0.74)). A mortality deficit of lower magnitude is also observed for all cancers combined (SMR (95% CI): 0.76 (0.71 to 0.81)). Pleural mesothelioma is elevated (SMR=2.04 (1.19 to 3.27)).
  
  
  CONCLUSIONS
  A healthy worker effect is observed in this new cohort of workers involved in the uranium cycle. Collection of individual information on internal uranium exposure as well as other risk factors is underway, to allow for the investigation of uranium-related risks.
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire (IRSN), Laboratoire d'épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Samson
authors.affiliation: AMAREXIA, Paris, France.
authors.forename: Irwin
authors.initials: I
authors.lastname: Piot
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire (IRSN), Laboratoire d'épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France.
authors.forename: Sergey
authors.initials: S
authors.lastname: Zhivin
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire (IRSN), Laboratoire d'épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.affiliation: AREVA, Direction de la santé, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Laroche
authors.affiliation: AREVA, Direction de la santé, Paris, France.
authors.forename: Ana-Paula
authors.initials: AP
authors.lastname: Serond
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire (IRSN), Laboratoire d'épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Laurier
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire (IRSN), Laboratoire d'épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Laurent
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D055848:Nuclear Power Plants; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies; D014501:Uranium / Q000633:toxicity*; D055815:Young Adult
chemical_list: D014501:Uranium
keywords: Cohort; Mortality; Radionuclides; Uranium; Workers