Lung cancer risk among former uranium miners of the WISMUT Company in Germany.
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Rosario, Angelika Schaffrath
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AbstractAfter 1946, the WISMUT Company developed the third-largest uranium-mining province in the world in the German Democratic Republic. METHODS: A case-control study among former WISMUT miners was conducted to investigate the lung cancer risk in relation to attained age, time since exposure, exposure duration, and exposure rate. It consisted of 505 patients with lung cancer and 1,073 controls matched to cases according to the year of birth. The cumulative exposure to radon and radon decay products was calculated as the sum of yearly exposures and expressed in Working Level Months (WLM). Cases had a mean cumulative exposure of 552 WLM compared to 420 WLM in controls. RESULTS: There was a statistically significant increase in lung cancer risk for cumulative exposures above 800 WLM. Under the assumption of a linear risk model, there was a significant increase in the relative risk of 0.10 per 100 WLM after adjusting for smoking and asbestos exposure. For current smokers the increase in relative risk was lower (0.05 per 100 WLM), whereas it was higher (0.20 per 100 WLM) among nonsmokers and longtime ex-smokers. After correcting in a sensitivity analysis for the fact that the controls of this study had a higher average exposure than the population of WISMUT workers they were recruited from, the adjusted ERR increased to 0.24 per 100 WLM. Lung cancer risk declined with time since exposure, except for exposures received 45 or more years ago. No inverse dose rate effect was observed.
CitationLung cancer risk among former uranium miners of the WISMUT Company in Germany. 2006, 90 (3):208-16notHealth Phys
DescriptionLifestyle modulation of cancer & cancer biomarkersLifestyle element evaluated: attained age, time since exposure, exposure duration, and exposure rateOutcome studied (cancer or cancer biomarker): lung cancerMethod of biomarker analysis: job-exposure-matrix (JEM) by reference (Kreuzer M, Brachner A, Lehmann F, Martignoni K, Wichmann HE, Grosche B. Characteristics of the German uranium miners cohort study. Health Phys 83:26 -34; 2002)Study type (in vitro, animals, humans): humansStudy design (if human): case-controlStudy size (if human):505 patients, 1073 controlsDescription of cohort(s) studied (if human): WISMUT minersConfounders controlled for: smoking, exposure to asbestos, fibres, arsenicImpact on outcome: highest exposure and small cell carcinoma adjusted OR _ 4.96 (95%-CI 1.70, 14.4), squamous cell carcinoma OR _ 3.89 (95%-CI 1.65, 9.16), and adenocarcinoma OR _ 2.86 (95%-CI 1.12, 7.28)The linear increase in relative risk per 100 WLM was estimated as ERR _ 0.067 (95%-CI 0.033, 0.114) in the crude analysis, and the ERR adjusted for smoking and asbestos was 0.100 (95%-CI 0.051, 0.168).Attained age: The excess relative risk for lung cancer was highest [ERR _ 0.13 (95%-CI 0.07, 0.22)] in the age category 65-74 yCancer epidemiologyCancer type: lung cancerStudy design: case-controlStudy size: 505 patients, 1073 controlsDescription of cohort(s) studied: cases-552 WLM, control- 420 WLMExposure(s) evaluated: ionizing radiationConfounders controlled for: smoking, exposure to asbestos, fibres, arsenicImpact on risk: as above. KEYWORDS CLASSIFICATION: analysis;Aged;Arsenic;Asbestos;cancer epidemiology;Case-Control Studies;epidemiology;etiology;Environment;Germany;Humans;Lung;Lung Neoplasms;Male;Middle Aged;Mining;Models,Statistical;Occupational Diseases;Occupational Exposure;radionuclide imaging;Radon;Radon Daughters;Research;Risk;Smoking;toxicity;Time Factors;Uranium.