Abstract
This study was aimed to examine the association between the effective radiation dose of diagnostic radiation workers in Korea and their risk for cancer. A total of 36,394 diagnostic radiation workers (159,189 person-years) were included in this study; the effective dose and cancer incidence were analyzed between the period 1996 and 2002. Median (range) follow-up time was 5.5 (0.04–7) years in males and 3.75 (0.04–7) years in females. Cancer risk related to the average annual effective dose and exposure to more than 5 mSv of annual radiation dose were calculated by the Cox proportional hazard model adjusted for occupation and age at the last follow-up. The standardized incidence ratio of cancer in radiation workers showed strong healthy worker effects in both male and female workers. The relative risk of all cancers from exposure of the average annual effective dose in the highest quartile (upper 75% or more of radiation dose) was 2.14 in male workers (95% CI: 1.48–3.10, p-trend: <0.0001) and 4.43 in female workers (95% CI: 2.17–9.04, p-trend: <0.0001), compared to those in the lower three quartiles of radiation exposure dose (less than upper 75% of radiation dose). Cancer risks of the brain (HR: 17.38, 95% CI: 1.05–287.8, p-trend: 0.04) and thyroid (HR: 3.88, 95% CI: 1.09–13.75, p-trend: 0.01) in female workers were significantly higher in the highest quartile group of radiation exposure compared to those in the lower three quartiles, and the risk of colon and rectum cancers in male workers showed a significantly increasing trend according to the increase of the average annual radiation dose (HR: 2.37, 95% CI: 0.99–5.67, p-trend: 0.02). The relative risk of leukemia in male workers and that of brain cancer in female workers were significantly higher in the group of people who had been exposed to more than 5 mSv/year than those exposed to less than 5 mSv/year (HR: 11.75, 95% CI: 1.08–128.20; HR: 63.11, 95% CI: 3.70–1,075.00, respectively). Although the present study involved a relatively young population and a short follow-up time, statistically significant increased risks of some cancers in radiation workers were found, which warrants a longer follow-up study and more intensive protective measures in this population.
Highlights
Radiation is increasingly used in modern medicine since the introduction of numerous new radiologic procedures [1]
A total of 36,394 diagnostic radiation workers (159,189 person-years) were analyzed in this study after excluding those with incorrect or duplicated personal identification number (PID) (4,072 persons), those who were not employed by Jan 2003 or whose dosimetry data were missing before Jan 2003 (24,563 persons), previous cancer diagnosis before January 1996 (63 persons), deceased before January 1996, cancer diagnosis before entry time (32 persons), aged less than 20 years (206 persons), and missing information on gender (34 persons) (Figure 1)
We found that the risk of all cancers in radiation workers, leukemia in male workers, and cancers of the brain and thyroid in female workers with exposure from the higher radiation dose were significantly increased compared to those with exposure of the lower radiation dose in the present study involving relatively young subjects with a short follow-up period
Summary
Radiation is increasingly used in modern medicine since the introduction of numerous new radiologic procedures [1]. Radiation exposure of radiological technologists is about two times higher than that of other occupation groups in the fields of diagnostic radiation workers, such as physicians, dentists, dental hygienists, and nurses [3,4]. In Korea, 15,197 workers in 1996 and 41,108 in 2006 working in the diagnostic radiation fields were monitored and reported regarding their occupational radiation exposure [3]. The average annual effective radiation dose of the monitored diagnostic radiation workers in Korea from 1996 to showed a decreasing tendency [3], the levels were about double the reported worldwide average in the early 1990s [4]. Health effects associated with occupational radiation exposure in Korean diagnostic radiation workers have not yet been assessed. This study was aimed to examine the association between the monitored effective radiation dose of diagnostic radiation workers and their cancer risk
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