Leukaemia mortality and low-dose ionising radiation in the WISMUT uranium miner cohort (1946-2013).
To examine the risk of death from leukaemia in relation to occupational chronic low-level external and internal radiation exposure in a cohort of 58 972 former German uranium miners with mortality follow-up from 1946 to 2013.



The red bone marrow (RBM) dose from low-linear energy transfer (LET) (mainly external γ-radiation) and high-LET (mainly radon gas) radiation was estimated based on a job-exposure matrix and biokinetic/dosimetric models. Linear excess relative risks (ERR) and 95% CIs were estimated via Poisson regression for chronic lymphatic leukaemia (CLL) and non-CLL.



The mean cumulative low-LET and high-LET RBM doses among the 86% radiation-exposed workers were 48 and 9 mGy, respectively. There was a positive non-significant dose-response for mortality from non-CLL (n=120) in relation to low-LET (ERR/Gy=2.18; 95% CI -0.41 to 6.37) and high-LET radiation (ERR/Gy=16.65; 95% -1.13 to 46.75). A statistically significant excess was found for the subgroup chronic myeloid leukaemia (n=31) in relation to low-LET radiation (ERR/Gy=7.20; 95% CI 0.48 to 24.54) and the subgroup myeloid leukaemia (n=99) (ERR/Gy=26.02; 95% CI 2.55 to 68.99) for high-LET radiation. The ERR/Gy tended to be about five to ten times higher for high-LET versus low-LET radiation; however, the CIs largely overlapped. Results indicate no association of death from CLL (n=70) with either type of radiation.



Our findings indicate an increased risk of death for specific subtypes from non-CLL in relation to chronic low-LET and high-LET radiation, but no such relation for CLL.
Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany.
Michaela
M
Kreuzer
Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany.
Christina
C
Sobotzki
Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany.
Nora
N
Fenske
Public Health England, Chilton, UK.
James W
JW
Marsh
Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany.
Maria
M
Schnelzer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007938:Leukemia / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D008906:Mining; D009381:Neoplasms, Radiation-Induced / Q000401:mortality* / Q000473:pathology; D009784:Occupational Diseases / Q000401:mortality* / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D000069079:Radiation Exposure / Q000009:adverse effects* / Q000032:analysis; D011839:Radiation, Ionizing; D012044:Regression Analysis; D012307:Risk Factors; D014501:Uranium / Q000009:adverse effects*
D014501:Uranium