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



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.


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.


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.


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.


Internal exposure Uranium Circulatory diseases Cancers Ionizing radiation 



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


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)


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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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