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Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study

http://www.thelancet.com/journals/lanhae/article/PIIS2352-3026%2815%2900094-0/abstract

Summary

Background

There is much uncertainty about the risks of leukaemia and lymphoma after repeated or protracted low-dose radiation exposure typical of occupational, environmental, and diagnostic medical settings. We quantified associations between protracted low-dose radiation exposures and leukaemia, lymphoma, and multiple myeloma mortality among radiation-monitored adults employed in France, the UK, and the USA.

Methods

We assembled a cohort of 308 297 radiation-monitored workers employed for at least 1 year by the Atomic Energy Commission, AREVA Nuclear Cycle, or the National Electricity Company in France, the Departments of Energy and Defence in the USA, and nuclear industry employers included in the National Registry for Radiation Workers in the UK. The cohort was followed up for a total of 8·22 million person-years. We ascertained deaths caused by leukaemia, lymphoma, and multiple myeloma. We used Poisson regression to quantify associations between estimated red bone marrow absorbed dose and leukaemia and lymphoma mortality.

Findings

Doses were accrued at very low rates (mean 1·1 mGy per year, SD 2·6). The excess relative risk of leukaemia mortality (excluding chronic lymphocytic leukaemia) was 2·96 per Gy (90% CI 1·17–5·21; lagged 2 years), most notably because of an association between radiation dose and mortality from chronic myeloid leukaemia (excess relative risk per Gy 10·45, 90% CI 4·48–19·65).

Interpretation

This study provides strong evidence of positive associations between protracted low-dose radiation exposure and leukaemia.

Funding

Centers for Disease Control and Prevention, Ministry of Health, Labour and Welfare of Japan, Institut de Radioprotection et de Sûreté Nucléaire, AREVA, Electricité de France, National Institute for Occupational Safety and Health, US Department of Energy, US Department of Health and Human Services, University of North Carolina, Public Health England.

 

ROSALIE BERTELL

Scientist Dr. Rosalie Bertell is a respected activist and lecturer, founder of several organizations, including the International Institute of Concern for Public Health. She is a member of the Roman Catholic Grey Nuns of the Sacred Heart. She led the Bhopal and Chernobyl Medical Commissions, is the recipient of the Right Livelihood Award and the United Nations Environmental Program Global 500 Award.

Rosalie received her Ph. D. degree in Biometrics with minors in Biology and Biochemistry from the Catholic University of America, in 1966. Since that time she has worked as a biometrician and environmental epidemiologist. By choice, Dr. Bertell works for the victims or potential victims of industrial, technological and military pollution with a particular emphasis on assisting the struggles of third world and indigenous people to preserve their Human Right to life and health. The major issues are the dangers associated with economic globalization, war and the proliferation of chemical and radioactive pollutants as the result of preparation for war and the toxic products and processes developed from weapons research and production.

The International Institute of Concern for Public Health (IICPH), of which she is Founder and Immediate Past President, opened its doors in 1984 in Toronto Canada and continues to serve as an institutional support for her work. She is also a founding member of the International Commission of Health Professionals, and the International Association of Humanitarian Medicine.

Among many projects she has headed, the most notable are: Director of the International Medical Commission Bhopal which investigated the aftermath of the Bhopal disaster in India, and organizer of the International Medical Commission Chernobyl to present testimony to the Permanent People’s Tribunal. She assisted the people of the Philippines with problems stemming from toxic waste left by the U.S. Military on their abandoned Subic and Clark military bases. She has worked with the government of Ireland to hold Britain responsible for the radioactive pollution of the Irish Sea, and is assisting the Gulf War Veterans and the Iraqi citizens dealing with the illness called Gulf War Syndrome. She acted as Consultant to local, Provincial and Federal Governments, unions and citizen organizations.

She is the recipient of five honourary degrees. Among her many awards can be numbered the Alternative Nobel Prize, Right Livelihood Award; World Federalist Peace Award; Ontario Premier’s Council on Health, Health Innovator Award; the United Nations Environment Programme Global 500 award and the Sean MacBride International Peace Prize. She has recently been selected to be one of the 1000 Peace Women nominated for the Nobel Peace Prize, 2005. Rosalie has published numerous articles, reviewed articles for professional journals and was editor of the journal, “International Perspectives in Public Health”. Her books, “No Immediate Danger: Prognosis for a Radioactice Earth” and “Planet Earth: The Latest Weapon of War” can be obtained from IICPH. “Handbook For Estimating Health Effects From Exposure To Ionizing Radiation” intended for the health Professionals, which she edited, is also obtainable from IICPH.