Comparison of radiation induced cancer risk between the INWORKS nuclear workers study and the A-bomb survivors study

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Comparison of radiation induced cancer risk between the INWORKS nuclear workers study and the A-bomb

survivors study

Klervi Leuraud, David Richardson, Dominique Laurier, Elisabeth Cardis, Robert Daniels, Michael Gillies, Richard Haylock, Monika Moissonnier, Mary

Schubauer-Berigan, Isabelle Thierry-Chef, et al.

To cite this version:

Klervi Leuraud, David Richardson, Dominique Laurier, Elisabeth Cardis, Robert Daniels, et al..

Comparison of radiation induced cancer risk between the INWORKS nuclear workers study and the A-bomb survivors study. Conference on Radiation & Health, CRH, Sep 2018, CHICAGO, United States. 2018. �hal-02635609�

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THE

INWORKS

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Klervi Leuraud1 (klervi.leuraud@irsn.fr), David B Richardson2, Dominique Laurier1, Elisabeth Cardis3, Robert D Daniels4, Michael Gillies5, Richard Haylock5, Monika Moissonnier6, Mary K Schubauer-Berigan6, Isabelle Thierry-Chef3,6, Ausrele Kesminiene6

1 Institut de Radioprotection et de Sûreté Nucléaire, France 2 University of North Carolina, USA 3 Barcelona Institute for Global Health, Spain 4 National Institute for Occupational Safety and Health, USA 5 Public Health England Centre for Radiation, Chemical and Environmental Hazards, UK 6 International Agency for Research on Cancer, France

ISGIobal

Background

Protection standards for nuclear workers and the public against risks associated with ionizing radiation exposure are primarily based on epidemiological studies of Japanese survivors of the atomic bombings of Hiroshima and Nagasaki in 1945.

However, the pattern of exposure in the cohort of the survivors, i.e. acute high dose rate exposure, is not typical of exposure received by most affected populations, i.e. protracted low dose rate exposures.

Objective

To compare cancer mortality radiation risk estimates derived from the Life Span Study (LSS) of Japanese atomic bomb survivors and INWORKS, a cohort of more than 300 000 nuclear workers from France, the UK and the USA exposed to protracted low dose or external radiations

Methods

• Selection of people exposed at ages 20 to 60 years in both cohorts LSS/INWORKS

• Poisson regression methods used to quantify associations between radiation dose and excess relative rate (ERR) and excess absolute rate (EAR) of solid cancer and leukemia, on a linear scale

• Risk estimates reported for the LSS are sex-averaged, using weights of 0.88 for men and 0.12 for women

Characteristics of the Life Span Study and INWORKS Subsets Used for Comparison

Life Span Study INWORKS N = 45,625 N = 259,350

Period of exposure 1945 1945-2005

Period of follow-up 1950-2003 1950-2005

Percentage of males 36% 88%

Age at exposurea (y), mean [range] 37.3 [20.1, 59.9] 37.7 [19.4, 71.5]

Colon doseb (mGy), mean [range] 115.7 [0.0, 2,905.2] 19.2 [0.0, 1,237.1]

RBM doseb (mGy), mean [range] 134.3 [0.0, 3,630.0] 17.6 [0.0, 1,131.5]

Person-years (millions) 1.48 6.18

Causes of deaths

All causes, n (%) 37,943 (83.2%) 59,118 (22.8%)

Solid cancer, n (% of total deaths) 7,982 (21.0%) 16,279 (27.5%) a age at atomic bombings in the LSS; age at mid-period of radiation monitoring in INWORKS, b cumulativ6 dose in INWORKS, c excluding chronic lymphocytic leukemia in INWORKS, RBM red bone marrow

Estimates of the Excess Relative Rate (ERR) and Excess Absolute Rate (EAR) for Solid Cancer and Leukemia* and 5-year Lagged Dose in Subsets of the Life Span Study and INWORKS

Life Span Study INWORKS

P per Gy 90%CI P per Gy 90%CI

Solid cancer (colon dose)

ERRa 0.28 0.18, 0.38 0.29 0.07, 0.53

EARb (per 10,000 person-years)

8.03 3.74,

13.07

1.68 <0, 7.55

Leukemia (RBM dose)

ERRa 2.75 1.73, 4.21 3.15 1.12, 5.72

EARb (per 10,000 person-years) 3.54 2.30, 5.05 2.03 0.36, 4.07 ' excluding chronic lymphocytic leukemia in INWORKS, a defined as À0(c,s,b,o)[1 + pd] where d is red bone marrow dose, c is city for the LSS and country for INWORKS, s is sex, b is birth year, a is attained age,b defined as Xo(c,s,b,a) + pd. The LSS ERR and EAR estimates are weighted averages over sex with a weight of 0.88 for males and 0.12 for females. CI: likelihood-based confidence interval.

Results

• Magnitude of the estimated ERR/Gy was similar in the LSS and INWORKS when fitting simple linear dose-response models for solid cancer and leukemia

• Absence of support for a linear-quadratic radiation dose-response function for solid cancer mortality but support for a linear-quadratic dose-response function only in the LSS

• Estimated EAR/Gy for solid cancer were quite different between the two cohorts but were close for leukemia

Discussion

• These analyses demonstrate the coherence of summary estimates of ERR/Gy in subsets of the LSS and INWORKS with a reasonable degree of comparability in the data with respect to ages at exposure and periods of follow-up

• INWORKS provides a useful complement to the LSS and helps improve our understanding of radiation risks at low doses and risks associations with low dose rate exposures

• These results should contribute to the consolidation of the radiation protection system for situations of chronic exposure, in contemporary occupational and environmental settings

DISCLAIMER 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. FUNDING Partial funding by the NIOSH, the U.S. DOE through a grant received by the University of North Carolinafrom the NIOSH (R03.OH-010056) 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 IRSN with partial funding from Orano and EDF.