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Analysis of the association between ionizing radiation and mortality in uranium workers from five plants involved in the nuclear fuel production cycle in France

  • Ségolène Bouet
  • Estelle Davesne
  • Eric Samson
  • Iris Jovanovic
  • Eric Blanchardon
  • Cécile Challeton-de Vathaire
  • David B. Richardson
  • Klervi Leuraud
  • Dominique Laurier
  • Olivier LaurentEmail author
Original Article
  • 66 Downloads

Abstract

Purpose

The aim is to investigate associations between mortality and exposure to ionizing radiation in a cohort of uranium workers with potential for internal and external radiation exposures.

Methods

Workers employed for at least 6 months between 1958 and 2006 in five plants involved in the French nuclear fuel cycle were included and followed up between 1968 and 2013. Cause-specific standardized mortality ratios were calculated. Analyses of associations between individual cumulative radiation dose (both internal and external, lagged by 5–15 years) and mortality were conducted using Poisson regression.

Results

The cohort includes 4541 workers. The mean cumulative external dose was 11.12 mGy. Mean cumulative internal doses ranged, depending on modelling hypotheses, from 0.05 to 0.09 mGy (liver) and from 4.22 to 10.90 mGy (lung). At the end of the follow-up, 838 workers were deceased and 28 lost to follow-up. A healthy worker effect was observed. The risk of prostate and lung cancers mortality was significantly higher for workers exposed to cumulative external dose above 50 mGy compared to non-exposed, but these associations were based only on three cases and became non-significant, although of similar magnitude, after adjustment for smoking. Associations with internal dose showed no consistent pattern.

Conclusions

For the first time, a study was conducted in a French cohort of uranium workers with a complete reconstruction of internal dose. Results are preliminary and must be interpreted with caution because of the limited cohort size and significant sources of uncertainty. Future steps of this study will overcome these limitations.

Keywords

Internal exposure Uranium Circulatory diseases Cancers Ionizing radiation 

Notes

Acknowledgements

The authors would like to thank all the persons who contributed to the construction of the cohort.

Funding

This study was jointly funded by the IRSN and AREVA (bilateral collaborative agreement in epidemiology research). This co-funding has no impact on the analyses or interpretation of the results, which are exclusively under the responsibility of the IRSN.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

French Data Protection Authority « Commission Nationale de l’Informatique et des Libertés » (CNIL)—agreement number DR-2012-611.

Informed consent

The French data protection authority (CNIL) waived requirements for informed consent because of the practical impossibility to contact all subjects individually to collect signed consent. Collective information was provided to subjects though several ways (website and internal journals of the companies, postings in occupational medicine waiting rooms), mentioning the rights of subjects to access and correct their personal data and to be withdrawn from the study.

Supplementary material

420_2018_1375_MOESM1_ESM.docx (316 kb)
Supplementary material 1 (DOCX 315 KB)

References

  1. Azizova T, Grigorieva E, Hunter N, Pikulina M, Moseeva M (2015) Risk of mortality from circulatory diseases in Mayak workers cohort following occupational radiation exposure. J Radiol Prot 35(3):517CrossRefGoogle Scholar
  2. Behrens T et al (2017) Shift work and the incidence of prostate cancer: a 10-year follow-up of a German population-based cohort study. Scand J Work Environ Health 43(6):560–568.  https://doi.org/10.5271/sjweh.3666 Google Scholar
  3. Blanchardon E, Bingham D, Bull R, Challeton de Vathaire C, Cockerill R, Davesne E (2014) Dosimetric protocol (CURE internal deliverable D2. 2). DoReMi—Low Dose Research Towards Multidisciplinary Integration—task 58 ‘CURE projectGoogle Scholar
  4. Bouet S, Samson E, Jovanovic I, Laurier D, Laurent O (2018) First mortality analysis in the French cohort of uranium millers (F-Millers), period 1968–2013. Int Arch Occup Environ Health 91(1):23–33CrossRefGoogle Scholar
  5. Breslow NE, Day NE (1975) Indirect standardization and multiplicative models for rates, with reference to the age adjustment of cancer incidence and relative frequency data. J Chronic Dis 28(5–6):289–303CrossRefGoogle Scholar
  6. Canu IG, Ellis ED, Tirmarche M (2008) Cancer risk in nuclear workers occupationally exposed to uranium-emphasis on internal exposure. Health Phys 94(1):1–17.  https://doi.org/10.1097/01.HP.0000281195.63082.e3 CrossRefGoogle Scholar
  7. Cuzick J et al (2014) Prevention and early detection of prostate cancer. Lancet Oncol 15(11):e484–e492CrossRefGoogle Scholar
  8. Davesne E et al (2017) EURADOS report: uncertainties in internal dose assessment: lifetime dose assessment for three example workers occupationally exposed to uranium-analysing the intercomparison resultsGoogle Scholar
  9. Davesne E, Laurent O, Lopez MA (2018) How to assess internal doses for epidemiological studies and for emergency response? An overview of differences with routine operational radiation protection approach. Radiat Measure 115:20–28.  https://doi.org/10.1016/j.radmeas.2018.04.014 CrossRefGoogle Scholar
  10. Drubay D, Caër-Lorho S, Laroche P, Laurier D, Rage E (2015) Mortality from circulatory system diseases among French uranium miners: a nested case-control study. Radiat Res 183(5):550–562CrossRefGoogle Scholar
  11. Dupree EA, Cragle DL, McLain RW, Crawford-Brown DJ, Teta MJ (1987) Mortality among workers at a uranium processing facility, the Linde air products company ceramics plant, 1943–1949. Scand J Work Environ Health 13(2):100–107CrossRefGoogle Scholar
  12. Dupree EA, Watkins JP, Ingle JN, Wallace PW, West CM, Tankersley WG (1995) Uranium dust exposure and lung cancer risk in four uranium processing operations. Epidemiology 6(4):370–375CrossRefGoogle Scholar
  13. EPA (2011) 402-R-11-001. Radiogenic Cancer Risk Models and Projections for the US PopulationGoogle Scholar
  14. Feuardent J, Scanff P, Crescini D, Rannou A (2013) Occupational external exposure to ionising radiation in France (2005–2011). Radiat Protect Dosimet 157(4):610–618.  https://doi.org/10.1093/rpd/nct165 CrossRefGoogle Scholar
  15. Gilbert ES et al (2013) Lung cancer risks from plutonium: an updated analysis of data from the Mayak worker cohort. Radiation research 179(3):332–342.  https://doi.org/10.1667/RR3054.1 CrossRefGoogle Scholar
  16. Grellier J et al (2017) Risk of lung cancer mortality in nuclear workers from internal exposure to alpha particle-emitting radionuclides. Epidemiology.  https://doi.org/10.1097/EDE.0000000000000684 Google Scholar
  17. Guseva Canu I, Jacob S, Cardis E and al (2011) Uranium carcinogenicity in humans might depend on the physical and chemical nature of uranium and its isotopic composition: results from pilot epidemiological study of French nuclear workers. Cancer Causes Control 22(1563)  https://doi.org/10.1007/s10552-011-9833-5
  18. Guseva Canu I et al (2012) Does uranium induce circulatory diseases? First results from a French cohort of uranium workers. Occup Environ Med 69(6):404–409.  https://doi.org/10.1136/oemed-2011-100495 CrossRefGoogle Scholar
  19. Guseva Canu I et al (2014) [Effects of chronic uranium internal exposure on mortality: results of a pilot study among French nuclear workers]. Revue d’epidemiologie et de sante publique 62(6):339–350.  https://doi.org/10.1016/j.respe.2014.09.006 CrossRefGoogle Scholar
  20. Haylock RGE, Gillies M, Hunter N, Zhang W, Phillipson M (2018) Cancer mortality and incidence following external occupational radiation exposure: an update of the 3rd analysis of the UK national registry for radiation workers. Br J Cancer.  https://doi.org/10.1038/s41416-018-0184-9 Google Scholar
  21. ICRP (1980) Report of the task group on reference man: a report. ICRP Publication 23 (1975). Ann ICRP 4(3–4):III–III.  https://doi.org/10.1016/0146-6453(80)90047-0 Google Scholar
  22. ICRP (1994) Human respiratory tract model for radiological protection. ICRP Publication 66. Annals of the ICRP 24Google Scholar
  23. ICRP (1995) Age-dependent doses to member of the public from intake of radionuclides: Part 3 Ingestion dose coefficients. ICRP Publication 69. Annals of the ICRP 25Google Scholar
  24. ICRP (2002) Basic anatomical and physiological data for use in radiological protection reference values. ICRP Publication 89. Ann. ICRP 32(3–4)Google Scholar
  25. ICRP (2007) The 2007 recommendations of the International Commission on Radiological Protection ICRP Publication 103. Ann ICRP 37:2–4Google Scholar
  26. ICRP (2010) Publication 115. Lung cancer risk from radon and progeny and statement on radon. Ann ICRP 40(1). http://www.icrp.org/publication.asp?id=ICRP%20Publication%20115
  27. Kondo H, Soda M, Mine M, Yokota K (2013) Effects of radiation on the incidence of prostate cancer among Nagasaki atomic bomb survivors. Cancer Sci 104(10):1368–1371.  https://doi.org/10.1111/cas.12234 CrossRefGoogle Scholar
  28. Kreuzer M, Sobotzki C, Schnelzer M, Fenske N (2017) Factors modifying the radon-related lung cancer risk at low exposures and exposure rates among german uranium miners. Radiat Res 189(2):165–176CrossRefGoogle Scholar
  29. Laurent O et al (2016) Concerted Uranium Research in Europe (CURE): toward a collaborative project integrating dosimetry, epidemiology and radiobiology to study the effects of occupational uranium exposure. J Radiol Protect 36(2):319–345.  https://doi.org/10.1088/0952-4746/36/2/319 CrossRefGoogle Scholar
  30. Leuraud K et al (2015) Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study. Lancet Haematol 2(7):e276–e281.  https://doi.org/10.1016/S2352-3026(15)00094-0 CrossRefGoogle Scholar
  31. Li C-Y, Sung F-C (1999) A review of the healthy worker effect in occupational epidemiology. Occup Med 49(4):225–229CrossRefGoogle Scholar
  32. Liddell FD (1984) Simple exact analysis of the standardised mortality ratio. J Epidemiol Commun Health 38(1):85–88CrossRefGoogle Scholar
  33. Marchand JL (2010) [Generating person-years and calculating SMR using SAS: a simple program for exact calculations]. Revue d’epidemiologie et de sante publique 58(5):370–374.  https://doi.org/10.1016/j.respe.2010.03.004 CrossRefGoogle Scholar
  34. Marsh JW et al (2014) Doses and lung cancer risks from exposure to radon and plutonium. Int J Radiat Biol 90(11):1080–1087.  https://doi.org/10.3109/09553002.2014.942919 CrossRefGoogle Scholar
  35. NCRP (2018) Commentary No. 27 – Implications of recent epidemiologic studies for the linear-nonthreshold model and radiation protection. ISBN: 9781944888022, ISBNe: 9781944888039. https://ncrponline.org/shop/commentaries/commentary-no-27-implications-of-recent-epidemiologic-studies-for-the-linear-nonthreshold-model-and-radiation-protection-2018/
  36. Nomura AM, Kolonel LN (1991) Prostate cancer: a current perspective. Epidemiol Rev 13(1):200–227CrossRefGoogle Scholar
  37. NRC (2006) Health risks from exposure to low levels of ionizing radiation: BEIR VII. In: Press NA (ed). Washington DCGoogle Scholar
  38. Ozasa K et al (2012) Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: an overview of cancer and noncancer diseases. Radiat Res 177(3):229–243CrossRefGoogle Scholar
  39. Putnam SD et al (2000) Lifestyle and anthropometric risk factors for prostate cancer in a cohort of Iowa men. Ann Epidemiol 10(6):361–369CrossRefGoogle Scholar
  40. Rage E et al (2012) Risk of lung cancer mortality in relation to lung doses among French uranium miners: follow-up 1956–1999. Radiat Res 177(3):288–297CrossRefGoogle Scholar
  41. Rage E, Caër-Lorho S, Drubay D, Ancelet S, Laroche P, Laurier D (2015) Mortality analyses in the updated French cohort of uranium miners (1946–2007). Int Arch Occup Environ Health 88(6):717–730CrossRefGoogle Scholar
  42. Rapisarda V et al (2018) Cadmium exposure and prostate cancer: insights, mechanisms and perspectives. Front Biosci (Landmark Ed) 23:1687–1700CrossRefGoogle Scholar
  43. Richardson DB, Wing S (2006) Lung cancer mortality among workers at a nuclear materials fabrication plant. Am J Ind Med 49(2):102–111.  https://doi.org/10.1002/ajim.20254 CrossRefGoogle Scholar
  44. Richardson DB et al (2015) Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS). BMJ 351:h5359.  https://doi.org/10.1136/bmj.h5359 CrossRefGoogle Scholar
  45. Richardson DB et al (2018) Site-specific solid cancer mortality after exposure to ionizing radiation: a cohort study of workers (INWORKS). Epidemiology 29(1):31–40.  https://doi.org/10.1097/EDE.0000000000000761 CrossRefGoogle Scholar
  46. Sahmoun AE, Case LD, Jackson SA, Schwartz GG (2005) Cadmium and prostate cancer: a critical epidemiologic analysis. Cancer Investig 23(3):256–263CrossRefGoogle Scholar
  47. Samson E et al (2016) Cancer and non-cancer mortality among French uranium cycle workers: the TRACY cohort. BMJ Open 6(4):e010316.  https://doi.org/10.1136/bmjopen-2015-010316 CrossRefGoogle Scholar
  48. Shimizu Y et al (2010) Radiation exposure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950–2003. BMJ 340:b5349CrossRefGoogle Scholar
  49. Taylor N (1991) Estimation of dose received when dosemeter results are recorded below a threshold level. J Radiol Prot 11(3):191CrossRefGoogle Scholar
  50. UNSCEAR (2008) UNSCEAR 2006 report to the general assembly with scientific annexes. Effects of ionizing radiation. Report and annexes A and B, vol 1. United Nations, New YorkGoogle Scholar
  51. UNSCEAR (2016) Sources, effects and risks of Ionizing Radiation. Annex D. Biological effects of selected internal emitters - uranium. United Nations, New YorkGoogle Scholar
  52. Yiin JH et al (2017) Mortality in a combined cohort of uranium enrichment workers. Am J Ind Med 60(1):96–108.  https://doi.org/10.1002/ajim.22668 CrossRefGoogle Scholar
  53. Yiin JH, Anderson JL, Bertke SJ, Tollerud DJ (2018) Dose–response relationships between internally-deposited uranium and select health outcomes in gaseous diffusion plant workers, 1948–2011. Am J Ind Med 61(7):605–614.  https://doi.org/10.1002/ajim.22858 CrossRefGoogle Scholar
  54. Zhivin S, Laurier D, Guseva Canu I (2014) Health effects of occupational exposure to uranium: do physicochemical properties matter? Int J Radiat Biol 90(11):1104–1113.  https://doi.org/10.3109/09553002.2014.943849 CrossRefGoogle Scholar
  55. Zhivin S et al (2016) Mortality (1968–2008) in a French cohort of uranium enrichment workers potentially exposed to rapidly soluble uranium compounds. Occup Environ Med 73(3):167–174.  https://doi.org/10.1136/oemed-2015-103142 CrossRefGoogle Scholar
  56. Zhivin S et al (2018) Circulatory disease in French nuclear fuel cycle workers chronically exposed to uranium: a nested case-control study. Occup Environ Med 75(4):270–276.  https://doi.org/10.1136/oemed-2017-104575 CrossRefGoogle Scholar
  57. Zu K, Giovannucci E (2009) Smoking and aggressive prostate cancer: a review of the epidemiologic evidence. Cancer Causes Control 20(10):1799–1810CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ségolène Bouet
    • 1
  • Estelle Davesne
    • 2
  • Eric Samson
    • 1
  • Iris Jovanovic
    • 3
  • Eric Blanchardon
    • 2
  • Cécile Challeton-de Vathaire
    • 2
  • David B. Richardson
    • 4
  • Klervi Leuraud
    • 1
  • Dominique Laurier
    • 5
  • Olivier Laurent
    • 1
    Email author
  1. 1.Laboratoire d’épidémiologie des Rayonnements Ionisants (PSE-SANTE/SESANE/LEPID)Institut de Radioprotection et de Sûreté NucléaireFontenay-aux-RosesFrance
  2. 2.Laboratoire d’Evaluation de la Dose Interne (PSE-SANTE/SDOS/LEDI)Institut de Radioprotection et de Sûreté Nucléaire (IRSN)Fontenay-aux-RosesFrance
  3. 3.AmplexorMontigny-le-BretonneuxFrance
  4. 4.University of North CarolinaChapel HillUSA
  5. 5.PSE-SANTE/SESANEInstitut de Radioprotection et de Sûreté Nucléaire (IRSN)Fontenay-aux-RosesFrance

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