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Lung cancer mortality associated with protracted low‐dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983‐2012
Author(s) -
VelazquezKronen Raquel,
Gilbert Ethel S.,
Linet Martha S.,
Moysich Kirsten B.,
Freudenheim Jo L.,
WactawskiWende Jean,
Simon Steven L.,
Cahoon Elizabeth K.,
Alexander Bruce H.,
Doody Michele M.,
Kitahara Cari M.
Publication year - 2020
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.33141
Subject(s) - medicine , lung cancer , poisson regression , lung cancer screening , cohort , cumulative dose , confounding , nuclear medicine , ionizing radiation , relative risk , cohort study , lung , confidence interval , population , environmental health , irradiation , physics , nuclear physics
In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low‐dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack‐years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time‐dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0‐810 mGy). During the 1983 to 2012 follow‐up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: −0.02, 95% CI: <0‐0.13). However, significant dose‐response relationships were observed for some subgroups, which might be false‐positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub‐multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01‐1.15) for those who smoked <20 pack‐years and −0.03 (95% CI: <0‐0.15) for those who smoked ≥20 pack‐years. Our study provides some evidence that greater protracted radiation exposure in the low‐dose range is positively associated with lung cancer mortality.