Abstract
BackgroundEvidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels.MethodsWe investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education.ResultsWe did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation.ConclusionsFurther investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation.
Highlights
The carcinogenic effects of ionizing radiation have been extensively studied, and the association between human exposure to high doses of ionizing radiation and risk of solid tumours and leukemia is well-characterized [1]
Another population-based case-control study was conducted in Canada, which grouped the occupations by binary categorization of several occupational exposures, including radium, and uranium [14]: the results showed a 2- to 3-fold excess risk of non-Hodgkin Lymphoma (NHL) associated with occupations possibly involving such exposures, covering the broad spectrum of ionizing radiation, from α to γ radiation
Having ever being occupationally exposed to external ionizing radiation was not associated with risk of lymphoma; the result was likewise after restricting the analysis to B-cell lymphomas (OR = 0.9; 95% confidence interval (CI) 0.75, 1.14) (Table 2a)
Summary
The carcinogenic effects of ionizing radiation have been extensively studied, and the association between human exposure to high doses of ionizing radiation and risk of solid tumours and leukemia is well-characterized [1]. As it concerns hemolymphopoietic malignancies other than. Satta et al Environmental Health (2020) 19:43 case-control study explored NHL risk in relation to occupational exposure to ionizing radiation first with a standard job-exposure matrix (JEM) [12], and afterwards using a local JEM created for the purpose [13]; in both instances, the authors did not observe an association. Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, at low exposure levels
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