Premium
Chronic lymphocytic leukaemia and radiation: findings among workers at five US nuclear facilities and a review of the recent literature
Author(s) -
SchubauerBerigan Mary K.,
Daniels Robert D.,
Fleming Donald A.,
Markey Andrea M.,
Couch James R.,
Ahrenholz Steven H.,
Burphy Jenneh S.,
Anderson Jeri L.,
Tseng ChihYu
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2007.06843.x
Subject(s) - medicine , ionizing radiation , confidence interval , chronic lymphocytic leukemia , cohort , relative risk , environmental health , nuclear medicine , leukemia , irradiation , physics , nuclear physics
Summary The aetiology of chronic lymphocytic leukaemia (CLL) is largely unknown. Despite compelling evidence for ionising radiation as a cause of most forms of leukaemia, CLL was not found to be radiogenic in early studies. Herein we describe the recent evidence for causation of CLL by ionising and non‐ionising radiation, including a nested case‐control study conducted within a cohort of 94 517 US workers at four nuclear weapons facilities and a nuclear naval shipyard. Forty‐three cases of CLL deaths and 172 age‐matched controls were identified with follow‐up up to between 1990 and 1996. Radiation exposure from external sources and plutonium (lagged 10 years) was assessed for each worker, based on monitoring records. The excess relative rate (ERR) was estimated for workers receiving elevated doses compared to unexposed workers, controlling for possible risk factors. The ERR per 10 mSv was −0·020 (95% confidence interval: <0, 0·14) based on all exposed workers. However, for workers receiving <100 mSv, the ERR per 10 mSv was 0·20 (−0·035, 0·96). Recent studies of uranium miners and other populations have shown elevations of CLL possibly associated with ionising and non‐ionising radiation. New studies should use incident cases and sufficient latency to account for the expected lengthy induction period for CLL.