Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study

Klervi Leuraud; David B. Richardson; Elisabeth Cardis; Robert D. Daniels; Michael Gillies; Richard Haylock; Monika Moissonnier; Mary K. Schubauer-Berigan; Isabelle Thierry-Chef; Ausrele Kesminiene; Dominique Laurier

doi:10.1007/s00411-020-00890-7

Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study

Klervi Leuraud^*, David B. Richardson, Elisabeth Cardis, Robert D. Daniels, Michael Gillies, Richard Haylock, Monika Moissonnier, Mary K. Schubauer-Berigan, Isabelle Thierry-Chef, Ausrele Kesminiene, Dominique Laurier

^*Corresponding author for this work

Radiation Effects

Research output: Contribution to journal › Article › peer-review

41 Citations (Scopus)

Abstract

The Life Span Study (LSS) of Japanese atomic bomb survivors has served as the primary basis for estimates of radiation-related disease risks that inform radiation protection standards. The long-term follow-up of radiation-monitored nuclear workers provides estimates of radiation-cancer associations that complement findings from the LSS. Here, a comparison of radiation-cancer mortality risk estimates derived from the LSS and INWORKS, a large international nuclear worker study, is presented. Restrictions were made, so that the two study populations were similar with respect to ages and periods of exposure, leading to selection of 45,625 A-bomb survivors and 259,350 nuclear workers. For solid cancer, excess relative rates (ERR) per gray (Gy) were 0.28 (90% CI 0.18; 0.38) in the LSS, and 0.29 (90% CI 0.07; 0.53) in INWORKS. A joint analysis of the data allowed for a formal assessment of heterogeneity of the ERR per Gy across the two studies (P = 0.909), with minimal evidence of curvature or of a modifying effect of attained age, age at exposure, or sex in either study. There was evidence in both cohorts of modification of the excess absolute risk (EAR) of solid cancer by attained age, with a trend of increasing EAR per Gy with attained age. For leukemia, under a simple linear model, the ERR per Gy was 2.75 (90% CI 1.73; 4.21) in the LSS and 3.15 (90% CI 1.12; 5.72) in INWORKS, with evidence of curvature in the association across the range of dose observed in the LSS but not in INWORKS; the EAR per Gy was 3.54 (90% CI 2.30; 5.05) in the LSS and 2.03 (90% CI 0.36; 4.07) in INWORKS. These findings from different study populations may help understanding of radiation risks, with INWORKS contributing information derived from cohorts of workers with protracted low dose-rate exposures.

Original language	English
Pages (from-to)	23-39
Number of pages	17
Journal	Radiation and Environmental Biophysics
Volume	60
Issue number	1
DOIs	https://doi.org/10.1007/s00411-020-00890-7
Publication status	Published - Mar 2021

Bibliographical note

Funding Information:
This report makes use of data obtained from the Radiation Effects Research Foundation (RERF), Hiroshima and Nagasaki, Japan. RERF is a private, non-profit foundation funded by the Japanese Ministry of Health, Labour and Welfare (MHLW) and the U.S. Department of Energy (DOE), the latter in part through DOE Award DE-HS0000031 to the National Academy of Sciences. The conclusions in this report are those of the authors and do not necessarily reflect the scientific judgment of RERF or its funding agencies. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization.

Funding Information:
The IRSN thanks all persons from the French Atomic Energy Commission, Orano, and EDF who cooperated in the elaboration of the French cohort. The construction of the UK cohort was undertaken by Public Health England (PHE) who operates the UK?s National Registry for Radiation Workers (NRRW). PHE thanks all of the organizations and individuals participating in the NRRW for their cooperation, and the NRRW Steering Group for their continued support.

Funding Information:
The work was funded, in part, by the National Institute for Occupational Safety and Health, the United States (U.S.) Department of Energy through an agreement with the U.S. Department of Health and Human Services and through a grant received by the University of North Carolina from the National Institute for Occupational Safety and Health (R01OH011409) and by the Ministry of Health, Labour and Welfare of Japan (GA No 2012-02-21-01). The construction of the French cohort was realized by the Institut de Radioprotection et de Sûreté Nucléaire (IRSN), with partial funding from Orano and Electricité de France (EDF).

Publisher Copyright:
© 2021, The Author(s).

Keywords

A-bomb survivors
Cancer
Epidemiology
Ionizing radiation
Low dose
Low dose-rate
Nuclear workers

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00411-020-00890-7

Cite this

Leuraud, K., Richardson, D. B., Cardis, E., Daniels, R. D., Gillies, M., Haylock, R., Moissonnier, M., Schubauer-Berigan, M. K., Thierry-Chef, I., Kesminiene, A., & Laurier, D. (2021). Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study. Radiation and Environmental Biophysics, 60(1), 23-39. https://doi.org/10.1007/s00411-020-00890-7

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abstract = "The Life Span Study (LSS) of Japanese atomic bomb survivors has served as the primary basis for estimates of radiation-related disease risks that inform radiation protection standards. The long-term follow-up of radiation-monitored nuclear workers provides estimates of radiation-cancer associations that complement findings from the LSS. Here, a comparison of radiation-cancer mortality risk estimates derived from the LSS and INWORKS, a large international nuclear worker study, is presented. Restrictions were made, so that the two study populations were similar with respect to ages and periods of exposure, leading to selection of 45,625 A-bomb survivors and 259,350 nuclear workers. For solid cancer, excess relative rates (ERR) per gray (Gy) were 0.28 (90% CI 0.18; 0.38) in the LSS, and 0.29 (90% CI 0.07; 0.53) in INWORKS. A joint analysis of the data allowed for a formal assessment of heterogeneity of the ERR per Gy across the two studies (P = 0.909), with minimal evidence of curvature or of a modifying effect of attained age, age at exposure, or sex in either study. There was evidence in both cohorts of modification of the excess absolute risk (EAR) of solid cancer by attained age, with a trend of increasing EAR per Gy with attained age. For leukemia, under a simple linear model, the ERR per Gy was 2.75 (90% CI 1.73; 4.21) in the LSS and 3.15 (90% CI 1.12; 5.72) in INWORKS, with evidence of curvature in the association across the range of dose observed in the LSS but not in INWORKS; the EAR per Gy was 3.54 (90% CI 2.30; 5.05) in the LSS and 2.03 (90% CI 0.36; 4.07) in INWORKS. These findings from different study populations may help understanding of radiation risks, with INWORKS contributing information derived from cohorts of workers with protracted low dose-rate exposures.",

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author = "Klervi Leuraud and Richardson, {David B.} and Elisabeth Cardis and Daniels, {Robert D.} and Michael Gillies and Richard Haylock and Monika Moissonnier and Schubauer-Berigan, {Mary K.} and Isabelle Thierry-Chef and Ausrele Kesminiene and Dominique Laurier",

note = "Funding Information: This report makes use of data obtained from the Radiation Effects Research Foundation (RERF), Hiroshima and Nagasaki, Japan. RERF is a private, non-profit foundation funded by the Japanese Ministry of Health, Labour and Welfare (MHLW) and the U.S. Department of Energy (DOE), the latter in part through DOE Award DE-HS0000031 to the National Academy of Sciences. The conclusions in this report are those of the authors and do not necessarily reflect the scientific judgment of RERF or its funding agencies. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization. Funding Information: The IRSN thanks all persons from the French Atomic Energy Commission, Orano, and EDF who cooperated in the elaboration of the French cohort. The construction of the UK cohort was undertaken by Public Health England (PHE) who operates the UK?s National Registry for Radiation Workers (NRRW). PHE thanks all of the organizations and individuals participating in the NRRW for their cooperation, and the NRRW Steering Group for their continued support. Funding Information: The work was funded, in part, by the National Institute for Occupational Safety and Health, the United States (U.S.) Department of Energy through an agreement with the U.S. Department of Health and Human Services and through a grant received by the University of North Carolina from the National Institute for Occupational Safety and Health (R01OH011409) and by the Ministry of Health, Labour and Welfare of Japan (GA No 2012-02-21-01). The construction of the French cohort was realized by the Institut de Radioprotection et de S{\^u}ret{\'e} Nucl{\'e}aire (IRSN), with partial funding from Orano and Electricit{\'e} de France (EDF). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

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Leuraud, K, Richardson, DB, Cardis, E, Daniels, RD, Gillies, M, Haylock, R, Moissonnier, M, Schubauer-Berigan, MK, Thierry-Chef, I, Kesminiene, A & Laurier, D 2021, 'Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study', Radiation and Environmental Biophysics, vol. 60, no. 1, pp. 23-39. https://doi.org/10.1007/s00411-020-00890-7

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AU - Leuraud, Klervi

AU - Richardson, David B.

AU - Cardis, Elisabeth

AU - Daniels, Robert D.

AU - Gillies, Michael

AU - Haylock, Richard

AU - Moissonnier, Monika

AU - Schubauer-Berigan, Mary K.

AU - Thierry-Chef, Isabelle

AU - Kesminiene, Ausrele

AU - Laurier, Dominique

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N2 - The Life Span Study (LSS) of Japanese atomic bomb survivors has served as the primary basis for estimates of radiation-related disease risks that inform radiation protection standards. The long-term follow-up of radiation-monitored nuclear workers provides estimates of radiation-cancer associations that complement findings from the LSS. Here, a comparison of radiation-cancer mortality risk estimates derived from the LSS and INWORKS, a large international nuclear worker study, is presented. Restrictions were made, so that the two study populations were similar with respect to ages and periods of exposure, leading to selection of 45,625 A-bomb survivors and 259,350 nuclear workers. For solid cancer, excess relative rates (ERR) per gray (Gy) were 0.28 (90% CI 0.18; 0.38) in the LSS, and 0.29 (90% CI 0.07; 0.53) in INWORKS. A joint analysis of the data allowed for a formal assessment of heterogeneity of the ERR per Gy across the two studies (P = 0.909), with minimal evidence of curvature or of a modifying effect of attained age, age at exposure, or sex in either study. There was evidence in both cohorts of modification of the excess absolute risk (EAR) of solid cancer by attained age, with a trend of increasing EAR per Gy with attained age. For leukemia, under a simple linear model, the ERR per Gy was 2.75 (90% CI 1.73; 4.21) in the LSS and 3.15 (90% CI 1.12; 5.72) in INWORKS, with evidence of curvature in the association across the range of dose observed in the LSS but not in INWORKS; the EAR per Gy was 3.54 (90% CI 2.30; 5.05) in the LSS and 2.03 (90% CI 0.36; 4.07) in INWORKS. These findings from different study populations may help understanding of radiation risks, with INWORKS contributing information derived from cohorts of workers with protracted low dose-rate exposures.

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Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study

Abstract

Bibliographical note

Keywords

UN SDGs

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