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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries</title><author><name sortKey="Cardis, E" sort="Cardis, E" uniqKey="Cardis E" first="E" last="Cardis">E. Cardis</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Vrijheid, M" sort="Vrijheid, M" uniqKey="Vrijheid M" first="M" last="Vrijheid">M. Vrijheid</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Blettner, M" sort="Blettner, M" uniqKey="Blettner M" first="M" last="Blettner">M. Blettner</name><affiliation><nlm:aff id="aff2"> Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Germany</nlm:aff></affiliation></author><author><name sortKey="Gilbert, E" sort="Gilbert, E" uniqKey="Gilbert E" first="E" last="Gilbert">E. Gilbert</name><affiliation><nlm:aff id="aff3"> Radiation Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Hakama, M" sort="Hakama, M" uniqKey="Hakama M" first="M" last="Hakama">M. Hakama</name><affiliation><nlm:aff id="aff4"> University of Tampere, Tampere, Finland</nlm:aff></affiliation></author><author><name sortKey="Hill, C" sort="Hill, C" uniqKey="Hill C" first="C" last="Hill">C. Hill</name><affiliation><nlm:aff id="aff5"> Institut Gustave-Roussy, Villejuif, France</nlm:aff></affiliation></author><author><name sortKey="Howe, G" sort="Howe, G" uniqKey="Howe G" first="G" last="Howe">G. Howe</name><affiliation><nlm:aff id="aff6"> Mailman School of Public Health, Columbia University, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Kaldor, J" sort="Kaldor, J" uniqKey="Kaldor J" first="J" last="Kaldor">J. Kaldor</name><affiliation><nlm:aff id="aff7"> National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Muirhead, C R" sort="Muirhead, C R" uniqKey="Muirhead C" first="C R" last="Muirhead">C R Muirhead</name><affiliation><nlm:aff id="aff8"> Radiation Protection Division, Health Protection Agency, Chilton, Didcot, Oxfordshire</nlm:aff></affiliation></author><author><name sortKey="Schubauer Berigan, M" sort="Schubauer Berigan, M" uniqKey="Schubauer Berigan M" first="M" last="Schubauer-Berigan">M. Schubauer-Berigan</name><affiliation><nlm:aff id="aff9"> Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Yoshimura, T" sort="Yoshimura, T" uniqKey="Yoshimura T" first="T" last="Yoshimura">T. Yoshimura</name><affiliation><nlm:aff id="aff10"> Fukuoka Institute of Health and Environmental Sciences, Fukuoka, Japan</nlm:aff></affiliation></author><author><name sortKey="Bermann, F" sort="Bermann, F" uniqKey="Bermann F" first="F" last="Bermann">F. Bermann</name><affiliation><nlm:aff id="aff11"> Conseiller Médical du CEA, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Cowper, G" sort="Cowper, G" uniqKey="Cowper G" first="G" last="Cowper">G. Cowper</name><affiliation><nlm:aff id="aff12"> Atomic Energy Commission of Canada, Deep River, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Fix, J" sort="Fix, J" uniqKey="Fix J" first="J" last="Fix">J. Fix</name><affiliation><nlm:aff id="aff13"> Pacific Northwest National Laboratory, Richland, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Hacker, C" sort="Hacker, C" uniqKey="Hacker C" first="C" last="Hacker">C. Hacker</name><affiliation><nlm:aff id="aff14"> Safety and Radiation Science, Australian Nuclear Science and Technology Organisation, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Heinmiller, B" sort="Heinmiller, B" uniqKey="Heinmiller B" first="B" last="Heinmiller">B. Heinmiller</name><affiliation><nlm:aff id="aff15"> AECL Radiation Biology and Health Physics Branch, Chalk River Laboratories, Chalk, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Marshall, M" sort="Marshall, M" uniqKey="Marshall M" first="M" last="Marshall">M. Marshall</name><affiliation><nlm:aff id="aff16"> Twin Trees, Blewbury, Didcot, Oxfordshire</nlm:aff></affiliation></author><author><name sortKey="Thierry Chef, I" sort="Thierry Chef, I" uniqKey="Thierry Chef I" first="I" last="Thierry-Chef">I. Thierry-Chef</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Utterback, D" sort="Utterback, D" uniqKey="Utterback D" first="D" last="Utterback">D. Utterback</name><affiliation><nlm:aff id="aff9"> Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Ahn, Y O" sort="Ahn, Y O" uniqKey="Ahn Y" first="Y-O" last="Ahn">Y-O Ahn</name><affiliation><nlm:aff id="aff17"> Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea</nlm:aff></affiliation></author><author><name sortKey="Amoros, E" sort="Amoros, E" uniqKey="Amoros E" first="E" last="Amoros">E. Amoros</name><affiliation><nlm:aff id="aff18"> Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment; French National Institute for Transport and Safety Research (INRETS), Arcueil, France</nlm:aff></affiliation></author><author><name sortKey="Ashmore, P" sort="Ashmore, P" uniqKey="Ashmore P" first="P" last="Ashmore">P. Ashmore</name><affiliation><nlm:aff id="aff19"> Radiation Protection Bureau, Health Canada, Ottawa, Canada</nlm:aff></affiliation></author><author><name sortKey="Auvinen, A" sort="Auvinen, A" uniqKey="Auvinen A" first="A" last="Auvinen">A. Auvinen</name><affiliation><nlm:aff id="aff4"> University of Tampere, Tampere, Finland</nlm:aff></affiliation></author><author><name sortKey="Bae, J M" sort="Bae, J M" uniqKey="Bae J" first="J-M" last="Bae">J-M Bae</name><affiliation><nlm:aff id="aff20"> Department of Preventive Medicine, Cheju National University College of Medicine, Cheju, Korea</nlm:aff></affiliation></author><author><name sortKey="Solano, J Bernar" sort="Solano, J Bernar" uniqKey="Solano J" first="J Bernar" last="Solano">J Bernar Solano</name><affiliation><nlm:aff id="aff21"> AMYS, UNESA, Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Biau, A" sort="Biau, A" uniqKey="Biau A" first="A" last="Biau">A. Biau</name><affiliation><nlm:aff id="aff22"> Institute of Radioprotection and Nuclear Security, DESTQ/DEAS, Le Vésinet, France</nlm:aff></affiliation></author><author><name sortKey="Combalot, E" sort="Combalot, E" uniqKey="Combalot E" first="E" last="Combalot">E. Combalot</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Deboodt, P" sort="Deboodt, P" uniqKey="Deboodt P" first="P" last="Deboodt">P. Deboodt</name><affiliation><nlm:aff id="aff23"> Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium</nlm:aff></affiliation></author><author><name sortKey="Sacristan, A Diez" sort="Sacristan, A Diez" uniqKey="Sacristan A" first="A Diez" last="Sacristan">A Diez Sacristan</name><affiliation><nlm:aff id="aff24"> Operational Radiological Protection, Nuclear Safety Council, Spain</nlm:aff></affiliation></author><author><name sortKey="Eklof, M" sort="Eklof, M" uniqKey="Eklof M" first="M" last="Eklof">M. Eklof</name><affiliation><nlm:aff id="aff25"> Statens Vattenfallsverk Forsmark, Osthammer, Sweden</nlm:aff></affiliation></author><author><name sortKey="Engels, H" sort="Engels, H" uniqKey="Engels H" first="H" last="Engels">H. Engels</name><affiliation><nlm:aff id="aff23"> Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium</nlm:aff></affiliation></author><author><name sortKey="Engholm, G" sort="Engholm, G" uniqKey="Engholm G" first="G" last="Engholm">G. Engholm</name><affiliation><nlm:aff id="aff26"> Institute for East-European Studies, Uppsala University, Sweden</nlm:aff></affiliation></author><author><name sortKey="Gulis, G" sort="Gulis, G" uniqKey="Gulis G" first="G" last="Gulis">G. Gulis</name><affiliation><nlm:aff id="aff27"> Department of Hygiene and Epidemiology, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovak Republic</nlm:aff></affiliation></author><author><name sortKey="Habib, R" sort="Habib, R" uniqKey="Habib R" first="R" last="Habib">R. Habib</name><affiliation><nlm:aff id="aff28"> Faculty of Health Sciences, American University of Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Holan, K" sort="Holan, K" uniqKey="Holan K" first="K" last="Holan">K. Holan</name><affiliation><nlm:aff id="aff29"> Slovenske Elektrárne, Bratislava, Slovak Republic</nlm:aff></affiliation></author><author><name sortKey="Hyvonen, H" sort="Hyvonen, H" uniqKey="Hyvonen H" first="H" last="Hyvonen">H. Hyvonen</name><affiliation><nlm:aff id="aff30"> Doseco Ltd, Jyvaskyla, Finland</nlm:aff></affiliation></author><author><name sortKey="Kerekes, A" sort="Kerekes, A" uniqKey="Kerekes A" first="A" last="Kerekes">A. Kerekes</name><affiliation><nlm:aff id="aff31"> “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene of the “Fodor József” National Centre for Public Health, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Kurtinaitis, J" sort="Kurtinaitis, J" uniqKey="Kurtinaitis J" first="J" last="Kurtinaitis">J. Kurtinaitis</name><affiliation><nlm:aff id="aff32"> Lithuanian Cancer Registry, Vilnius University Oncology Institute, Vilnius, Lithuania</nlm:aff></affiliation></author><author><name sortKey="Malker, H" sort="Malker, H" uniqKey="Malker H" first="H" last="Malker">H. Malker</name><affiliation><nlm:aff id="aff33"> Vasternorrland County Council, Department of Research and Development, Sundsvall, Sweden</nlm:aff></affiliation></author><author><name sortKey="Martuzzi, M" sort="Martuzzi, M" uniqKey="Martuzzi M" first="M" last="Martuzzi">M. Martuzzi</name><affiliation><nlm:aff id="aff34"> WHO European Centre for Environment and Health, Rome, Italy</nlm:aff></affiliation></author><author><name sortKey="Mastauskas, A" sort="Mastauskas, A" uniqKey="Mastauskas A" first="A" last="Mastauskas">A. Mastauskas</name><affiliation><nlm:aff id="aff35"> Radiation Protection Centre, Vilnius, Lithuania</nlm:aff></affiliation></author><author><name sortKey="Monnet, A" sort="Monnet, A" uniqKey="Monnet A" first="A" last="Monnet">A. Monnet</name><affiliation><nlm:aff id="aff36"> Serono International SA, Geneva, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Moser, M" sort="Moser, M" uniqKey="Moser M" first="M" last="Moser">M. Moser</name><affiliation><nlm:aff id="aff37"> Physics and Biology Section, Radiation Protection Division, Federal Office of Public Health, Bern, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Pearce, M S" sort="Pearce, M S" uniqKey="Pearce M" first="M S" last="Pearce">M S Pearce</name><affiliation><nlm:aff id="aff38"> School of Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne</nlm:aff></affiliation></author><author><name sortKey="Richardson, D B" sort="Richardson, D B" uniqKey="Richardson D" first="D B" last="Richardson">D B Richardson</name><affiliation><nlm:aff id="aff39"> Department of Epidemiology, School of Public Health, Chapel Hill, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Rodriguez Artalejo, F" sort="Rodriguez Artalejo, F" uniqKey="Rodriguez Artalejo F" first="F" last="Rodriguez-Artalejo">F. Rodriguez-Artalejo</name><affiliation><nlm:aff id="aff40"> Department of Preventive Medicine and Public Health, School of Medicine, University Autonoma de Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Rogel, A" sort="Rogel, A" uniqKey="Rogel A" first="A" last="Rogel">A. Rogel</name><affiliation><nlm:aff id="aff41"> Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France</nlm:aff></affiliation></author><author><name sortKey="Tardy, H" sort="Tardy, H" uniqKey="Tardy H" first="H" last="Tardy">H. Tardy</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Telle Lamberton, M" sort="Telle Lamberton, M" uniqKey="Telle Lamberton M" first="M" last="Telle-Lamberton">M. Telle-Lamberton</name><affiliation><nlm:aff id="aff41"> Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France</nlm:aff></affiliation></author><author><name sortKey="Turai, I" sort="Turai, I" uniqKey="Turai I" first="I" last="Turai">I. Turai</name><affiliation><nlm:aff id="aff31"> “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene of the “Fodor József” National Centre for Public Health, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Usel, M" sort="Usel, M" uniqKey="Usel M" first="M" last="Usel">M. Usel</name><affiliation><nlm:aff id="aff42"> Medical Inspectorate of Factories, Geneva, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Veress, K" sort="Veress, K" uniqKey="Veress K" first="K" last="Veress">K. Veress</name><affiliation><nlm:aff id="aff43"> Institute of Public Health, Semmelweis University, Budapest, Hungary</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">15987704</idno><idno type="pmc">558612</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC558612</idno><idno type="RBID">PMC:558612</idno><idno type="doi">10.1136/bmj.38499.599861.E0</idno><date when="2005">2005</date><idno type="wicri:Area/Pmc/Corpus">000F62</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F62</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries</title><author><name sortKey="Cardis, E" sort="Cardis, E" uniqKey="Cardis E" first="E" last="Cardis">E. Cardis</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Vrijheid, M" sort="Vrijheid, M" uniqKey="Vrijheid M" first="M" last="Vrijheid">M. Vrijheid</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Blettner, M" sort="Blettner, M" uniqKey="Blettner M" first="M" last="Blettner">M. Blettner</name><affiliation><nlm:aff id="aff2"> Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Germany</nlm:aff></affiliation></author><author><name sortKey="Gilbert, E" sort="Gilbert, E" uniqKey="Gilbert E" first="E" last="Gilbert">E. Gilbert</name><affiliation><nlm:aff id="aff3"> Radiation Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA</nlm:aff></affiliation></author><author><name sortKey="Hakama, M" sort="Hakama, M" uniqKey="Hakama M" first="M" last="Hakama">M. Hakama</name><affiliation><nlm:aff id="aff4"> University of Tampere, Tampere, Finland</nlm:aff></affiliation></author><author><name sortKey="Hill, C" sort="Hill, C" uniqKey="Hill C" first="C" last="Hill">C. Hill</name><affiliation><nlm:aff id="aff5"> Institut Gustave-Roussy, Villejuif, France</nlm:aff></affiliation></author><author><name sortKey="Howe, G" sort="Howe, G" uniqKey="Howe G" first="G" last="Howe">G. Howe</name><affiliation><nlm:aff id="aff6"> Mailman School of Public Health, Columbia University, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Kaldor, J" sort="Kaldor, J" uniqKey="Kaldor J" first="J" last="Kaldor">J. Kaldor</name><affiliation><nlm:aff id="aff7"> National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Muirhead, C R" sort="Muirhead, C R" uniqKey="Muirhead C" first="C R" last="Muirhead">C R Muirhead</name><affiliation><nlm:aff id="aff8"> Radiation Protection Division, Health Protection Agency, Chilton, Didcot, Oxfordshire</nlm:aff></affiliation></author><author><name sortKey="Schubauer Berigan, M" sort="Schubauer Berigan, M" uniqKey="Schubauer Berigan M" first="M" last="Schubauer-Berigan">M. Schubauer-Berigan</name><affiliation><nlm:aff id="aff9"> Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Yoshimura, T" sort="Yoshimura, T" uniqKey="Yoshimura T" first="T" last="Yoshimura">T. Yoshimura</name><affiliation><nlm:aff id="aff10"> Fukuoka Institute of Health and Environmental Sciences, Fukuoka, Japan</nlm:aff></affiliation></author><author><name sortKey="Bermann, F" sort="Bermann, F" uniqKey="Bermann F" first="F" last="Bermann">F. Bermann</name><affiliation><nlm:aff id="aff11"> Conseiller Médical du CEA, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Cowper, G" sort="Cowper, G" uniqKey="Cowper G" first="G" last="Cowper">G. Cowper</name><affiliation><nlm:aff id="aff12"> Atomic Energy Commission of Canada, Deep River, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Fix, J" sort="Fix, J" uniqKey="Fix J" first="J" last="Fix">J. Fix</name><affiliation><nlm:aff id="aff13"> Pacific Northwest National Laboratory, Richland, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Hacker, C" sort="Hacker, C" uniqKey="Hacker C" first="C" last="Hacker">C. Hacker</name><affiliation><nlm:aff id="aff14"> Safety and Radiation Science, Australian Nuclear Science and Technology Organisation, NSW, Australia</nlm:aff></affiliation></author><author><name sortKey="Heinmiller, B" sort="Heinmiller, B" uniqKey="Heinmiller B" first="B" last="Heinmiller">B. Heinmiller</name><affiliation><nlm:aff id="aff15"> AECL Radiation Biology and Health Physics Branch, Chalk River Laboratories, Chalk, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Marshall, M" sort="Marshall, M" uniqKey="Marshall M" first="M" last="Marshall">M. Marshall</name><affiliation><nlm:aff id="aff16"> Twin Trees, Blewbury, Didcot, Oxfordshire</nlm:aff></affiliation></author><author><name sortKey="Thierry Chef, I" sort="Thierry Chef, I" uniqKey="Thierry Chef I" first="I" last="Thierry-Chef">I. Thierry-Chef</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Utterback, D" sort="Utterback, D" uniqKey="Utterback D" first="D" last="Utterback">D. Utterback</name><affiliation><nlm:aff id="aff9"> Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA</nlm:aff></affiliation></author><author><name sortKey="Ahn, Y O" sort="Ahn, Y O" uniqKey="Ahn Y" first="Y-O" last="Ahn">Y-O Ahn</name><affiliation><nlm:aff id="aff17"> Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea</nlm:aff></affiliation></author><author><name sortKey="Amoros, E" sort="Amoros, E" uniqKey="Amoros E" first="E" last="Amoros">E. Amoros</name><affiliation><nlm:aff id="aff18"> Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment; French National Institute for Transport and Safety Research (INRETS), Arcueil, France</nlm:aff></affiliation></author><author><name sortKey="Ashmore, P" sort="Ashmore, P" uniqKey="Ashmore P" first="P" last="Ashmore">P. Ashmore</name><affiliation><nlm:aff id="aff19"> Radiation Protection Bureau, Health Canada, Ottawa, Canada</nlm:aff></affiliation></author><author><name sortKey="Auvinen, A" sort="Auvinen, A" uniqKey="Auvinen A" first="A" last="Auvinen">A. Auvinen</name><affiliation><nlm:aff id="aff4"> University of Tampere, Tampere, Finland</nlm:aff></affiliation></author><author><name sortKey="Bae, J M" sort="Bae, J M" uniqKey="Bae J" first="J-M" last="Bae">J-M Bae</name><affiliation><nlm:aff id="aff20"> Department of Preventive Medicine, Cheju National University College of Medicine, Cheju, Korea</nlm:aff></affiliation></author><author><name sortKey="Solano, J Bernar" sort="Solano, J Bernar" uniqKey="Solano J" first="J Bernar" last="Solano">J Bernar Solano</name><affiliation><nlm:aff id="aff21"> AMYS, UNESA, Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Biau, A" sort="Biau, A" uniqKey="Biau A" first="A" last="Biau">A. Biau</name><affiliation><nlm:aff id="aff22"> Institute of Radioprotection and Nuclear Security, DESTQ/DEAS, Le Vésinet, France</nlm:aff></affiliation></author><author><name sortKey="Combalot, E" sort="Combalot, E" uniqKey="Combalot E" first="E" last="Combalot">E. Combalot</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Deboodt, P" sort="Deboodt, P" uniqKey="Deboodt P" first="P" last="Deboodt">P. Deboodt</name><affiliation><nlm:aff id="aff23"> Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium</nlm:aff></affiliation></author><author><name sortKey="Sacristan, A Diez" sort="Sacristan, A Diez" uniqKey="Sacristan A" first="A Diez" last="Sacristan">A Diez Sacristan</name><affiliation><nlm:aff id="aff24"> Operational Radiological Protection, Nuclear Safety Council, Spain</nlm:aff></affiliation></author><author><name sortKey="Eklof, M" sort="Eklof, M" uniqKey="Eklof M" first="M" last="Eklof">M. Eklof</name><affiliation><nlm:aff id="aff25"> Statens Vattenfallsverk Forsmark, Osthammer, Sweden</nlm:aff></affiliation></author><author><name sortKey="Engels, H" sort="Engels, H" uniqKey="Engels H" first="H" last="Engels">H. Engels</name><affiliation><nlm:aff id="aff23"> Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium</nlm:aff></affiliation></author><author><name sortKey="Engholm, G" sort="Engholm, G" uniqKey="Engholm G" first="G" last="Engholm">G. Engholm</name><affiliation><nlm:aff id="aff26"> Institute for East-European Studies, Uppsala University, Sweden</nlm:aff></affiliation></author><author><name sortKey="Gulis, G" sort="Gulis, G" uniqKey="Gulis G" first="G" last="Gulis">G. Gulis</name><affiliation><nlm:aff id="aff27"> Department of Hygiene and Epidemiology, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovak Republic</nlm:aff></affiliation></author><author><name sortKey="Habib, R" sort="Habib, R" uniqKey="Habib R" first="R" last="Habib">R. Habib</name><affiliation><nlm:aff id="aff28"> Faculty of Health Sciences, American University of Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Holan, K" sort="Holan, K" uniqKey="Holan K" first="K" last="Holan">K. Holan</name><affiliation><nlm:aff id="aff29"> Slovenske Elektrárne, Bratislava, Slovak Republic</nlm:aff></affiliation></author><author><name sortKey="Hyvonen, H" sort="Hyvonen, H" uniqKey="Hyvonen H" first="H" last="Hyvonen">H. Hyvonen</name><affiliation><nlm:aff id="aff30"> Doseco Ltd, Jyvaskyla, Finland</nlm:aff></affiliation></author><author><name sortKey="Kerekes, A" sort="Kerekes, A" uniqKey="Kerekes A" first="A" last="Kerekes">A. Kerekes</name><affiliation><nlm:aff id="aff31"> “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene of the “Fodor József” National Centre for Public Health, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Kurtinaitis, J" sort="Kurtinaitis, J" uniqKey="Kurtinaitis J" first="J" last="Kurtinaitis">J. Kurtinaitis</name><affiliation><nlm:aff id="aff32"> Lithuanian Cancer Registry, Vilnius University Oncology Institute, Vilnius, Lithuania</nlm:aff></affiliation></author><author><name sortKey="Malker, H" sort="Malker, H" uniqKey="Malker H" first="H" last="Malker">H. Malker</name><affiliation><nlm:aff id="aff33"> Vasternorrland County Council, Department of Research and Development, Sundsvall, Sweden</nlm:aff></affiliation></author><author><name sortKey="Martuzzi, M" sort="Martuzzi, M" uniqKey="Martuzzi M" first="M" last="Martuzzi">M. Martuzzi</name><affiliation><nlm:aff id="aff34"> WHO European Centre for Environment and Health, Rome, Italy</nlm:aff></affiliation></author><author><name sortKey="Mastauskas, A" sort="Mastauskas, A" uniqKey="Mastauskas A" first="A" last="Mastauskas">A. Mastauskas</name><affiliation><nlm:aff id="aff35"> Radiation Protection Centre, Vilnius, Lithuania</nlm:aff></affiliation></author><author><name sortKey="Monnet, A" sort="Monnet, A" uniqKey="Monnet A" first="A" last="Monnet">A. Monnet</name><affiliation><nlm:aff id="aff36"> Serono International SA, Geneva, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Moser, M" sort="Moser, M" uniqKey="Moser M" first="M" last="Moser">M. Moser</name><affiliation><nlm:aff id="aff37"> Physics and Biology Section, Radiation Protection Division, Federal Office of Public Health, Bern, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Pearce, M S" sort="Pearce, M S" uniqKey="Pearce M" first="M S" last="Pearce">M S Pearce</name><affiliation><nlm:aff id="aff38"> School of Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne</nlm:aff></affiliation></author><author><name sortKey="Richardson, D B" sort="Richardson, D B" uniqKey="Richardson D" first="D B" last="Richardson">D B Richardson</name><affiliation><nlm:aff id="aff39"> Department of Epidemiology, School of Public Health, Chapel Hill, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Rodriguez Artalejo, F" sort="Rodriguez Artalejo, F" uniqKey="Rodriguez Artalejo F" first="F" last="Rodriguez-Artalejo">F. Rodriguez-Artalejo</name><affiliation><nlm:aff id="aff40"> Department of Preventive Medicine and Public Health, School of Medicine, University Autonoma de Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Rogel, A" sort="Rogel, A" uniqKey="Rogel A" first="A" last="Rogel">A. Rogel</name><affiliation><nlm:aff id="aff41"> Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France</nlm:aff></affiliation></author><author><name sortKey="Tardy, H" sort="Tardy, H" uniqKey="Tardy H" first="H" last="Tardy">H. Tardy</name><affiliation><nlm:aff id="aff1"> International Agency for Research on Cancer, Lyons, France</nlm:aff></affiliation></author><author><name sortKey="Telle Lamberton, M" sort="Telle Lamberton, M" uniqKey="Telle Lamberton M" first="M" last="Telle-Lamberton">M. Telle-Lamberton</name><affiliation><nlm:aff id="aff41"> Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France</nlm:aff></affiliation></author><author><name sortKey="Turai, I" sort="Turai, I" uniqKey="Turai I" first="I" last="Turai">I. Turai</name><affiliation><nlm:aff id="aff31"> “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene of the “Fodor József” National Centre for Public Health, Budapest, Hungary</nlm:aff></affiliation></author><author><name sortKey="Usel, M" sort="Usel, M" uniqKey="Usel M" first="M" last="Usel">M. Usel</name><affiliation><nlm:aff id="aff42"> Medical Inspectorate of Factories, Geneva, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Veress, K" sort="Veress, K" uniqKey="Veress K" first="K" last="Veress">K. Veress</name><affiliation><nlm:aff id="aff43"> Institute of Public Health, Semmelweis University, Budapest, Hungary</nlm:aff></affiliation></author></analytic><series><title level="j">BMJ : British Medical Journal</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objectives</bold> To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental, occupational, and medical diagnostic exposures.</p><p><bold>Design</bold> Multinational retrospective cohort study of cancer mortality.</p><p><bold>Setting</bold> Cohorts of workers in the nuclear industry in 15 countries.</p><p><bold>Participants</bold> 407 391 workers individually monitored for external radiation with a total follow-up of 5.2 million person years.</p><p><bold>Main outcome measurements</bold> Estimates of excess relative risks per sievert (Sv) of radiation dose for mortality from cancers other than leukaemia and from leukaemia excluding chronic lymphocytic leukaemia, the main causes of death considered by radiation protection authorities.</p><p><bold>Results</bold> The excess relative risk for cancers other than leukaemia was 0.97 per Sv, 95% confidence interval 0.14 to 1.97. Analyses of causes of death related or unrelated to smoking indicate that, although confounding by smoking may be present, it is unlikely to explain all of this increased risk. The excess relative risk for leukaemia excluding chronic lymphocytic leukaemia was 1.93 per Sv (< 0 to 8.47). On the basis of these estimates, 1-2% of deaths from cancer among workers in this cohort may be attributable to radiation.</p><p><bold>Conclusions</bold> These estimates, from the largest study of nuclear workers ever conducted, are higher than, but statistically compatible with, the risk estimates used for current radiation protection standards. The results suggest that there is a small excess risk of cancer, even at the low doses and dose rates typically received by nuclear workers in this study.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title>BMJ : British Medical Journal</journal-title><issn pub-type="ppub">0959-8138</issn><issn pub-type="epub">1468-5833</issn><publisher><publisher-name>BMJ Publishing Group Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">15987704</article-id><article-id pub-id-type="pmc">558612</article-id><article-id pub-id-type="publisher-id">el-ppr77</article-id><article-id pub-id-type="doi">10.1136/bmj.38499.599861.E0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Papers</subject></subj-group></article-categories><title-group><article-title>Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Cardis</surname><given-names>E</given-names></name><role>head of radiation group</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Vrijheid</surname><given-names>M</given-names></name><role>scientist</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Blettner</surname><given-names>M</given-names></name><role>professor</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Gilbert</surname><given-names>E</given-names></name><role>expert</role><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Hakama</surname><given-names>M</given-names></name><role>research professor</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Hill</surname><given-names>C</given-names></name><role>epidemiologist</role><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Howe</surname><given-names>G</given-names></name><role>professor of epidemiology</role><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Kaldor</surname><given-names>J</given-names></name><role>deputy director</role><xref ref-type="aff" rid="aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Muirhead</surname><given-names>C R</given-names></name><role>group leader epidemiology</role><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Schubauer-Berigan</surname><given-names>M</given-names></name><role>senior research epidemiologist, industrywide studies branch</role><xref ref-type="aff" rid="aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Yoshimura</surname><given-names>T</given-names></name><role>director</role><xref ref-type="aff" rid="aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Bermann</surname><given-names>F</given-names></name><role>medical counsellor</role><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Cowper</surname><given-names>G</given-names></name><role>consultant to IARC</role><xref ref-type="aff" rid="aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Fix</surname><given-names>J</given-names></name><role>staff scientist</role><xref ref-type="aff" rid="aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Hacker</surname><given-names>C</given-names></name><role>health physicist</role><xref ref-type="aff" rid="aff14">14</xref></contrib><contrib contrib-type="author"><name><surname>Heinmiller</surname><given-names>B</given-names></name><role>senior scientist</role><xref ref-type="aff" rid="aff15">15</xref></contrib><contrib contrib-type="author"><name><surname>Marshall</surname><given-names>M</given-names></name><role>consultant to IARC on radiation dosimetry</role><xref ref-type="aff" rid="aff16">16</xref></contrib><contrib contrib-type="author"><name><surname>Thierry-Chef</surname><given-names>I</given-names></name><role>postdoctoral student</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Utterback</surname><given-names>D</given-names></name><role>chief, health-related energy research branch</role><xref ref-type="aff" rid="aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Ahn</surname><given-names>Y-O</given-names></name><role>professor</role><xref ref-type="aff" rid="aff17">17</xref></contrib><contrib contrib-type="author"><name><surname>Amoros</surname><given-names>E</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff18">18</xref></contrib><contrib contrib-type="author"><name><surname>Ashmore</surname><given-names>P</given-names></name><role>affiliate scientist at the McLaughlin Centre</role><xref ref-type="aff" rid="aff19">19</xref></contrib><contrib contrib-type="author"><name><surname>Auvinen</surname><given-names>A</given-names></name><role>research professor</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Bae</surname><given-names>J-M</given-names></name><role>associate professor</role><xref ref-type="aff" rid="aff20">20</xref></contrib><contrib contrib-type="author"><name><surname>Solano</surname><given-names>J Bernar</given-names></name><role>head of division of research</role><xref ref-type="aff" rid="aff21">21</xref></contrib><contrib contrib-type="author"><name><surname>Biau</surname><given-names>A</given-names></name><role>director of scientific and technical assessment</role><xref ref-type="aff" rid="aff22">22</xref></contrib><contrib contrib-type="author"><name><surname>Combalot</surname><given-names>E</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Deboodt</surname><given-names>P</given-names></name><role>health physicist</role><xref ref-type="aff" rid="aff23">23</xref></contrib><contrib contrib-type="author"><name><surname>Sacristan</surname><given-names>A Diez</given-names></name><role>inspector</role><xref ref-type="aff" rid="aff24">24</xref></contrib><contrib contrib-type="author"><name><surname>Eklof</surname><given-names>M</given-names></name><xref ref-type="aff" rid="aff25">25</xref></contrib><contrib contrib-type="author"><name><surname>Engels</surname><given-names>H</given-names></name><role>nuclear inspector</role><xref ref-type="aff" rid="aff23">23</xref></contrib><contrib contrib-type="author"><name><surname>Engholm</surname><given-names>G</given-names></name><role>principal administrative officer</role><xref ref-type="aff" rid="aff26">26</xref></contrib><contrib contrib-type="author"><name><surname>Gulis</surname><given-names>G</given-names></name><role>associate professor</role><xref ref-type="aff" rid="aff27">27</xref></contrib><contrib contrib-type="author"><name><surname>Habib</surname><given-names>R</given-names></name><role>assistant professor</role><xref ref-type="aff" rid="aff28">28</xref></contrib><contrib contrib-type="author"><name><surname>Holan</surname><given-names>K</given-names></name><role>senior adviser</role><xref ref-type="aff" rid="aff29">29</xref></contrib><contrib contrib-type="author"><name><surname>Hyvonen</surname><given-names>H</given-names></name><role>managing director</role><xref ref-type="aff" rid="aff30">30</xref></contrib><contrib contrib-type="author"><name><surname>Kerekes</surname><given-names>A</given-names></name><role>head</role><xref ref-type="aff" rid="aff31">31</xref></contrib><contrib contrib-type="author"><name><surname>Kurtinaitis</surname><given-names>J</given-names></name><role>chief</role><xref ref-type="aff" rid="aff32">32</xref></contrib><contrib contrib-type="author"><name><surname>Malker</surname><given-names>H</given-names></name><role>research director</role><xref ref-type="aff" rid="aff33">33</xref></contrib><contrib contrib-type="author"><name><surname>Martuzzi</surname><given-names>M</given-names></name><role>technical officer</role><xref ref-type="aff" rid="aff34">34</xref></contrib><contrib contrib-type="author"><name><surname>Mastauskas</surname><given-names>A</given-names></name><role>head</role><xref ref-type="aff" rid="aff35">35</xref></contrib><contrib contrib-type="author"><name><surname>Monnet</surname><given-names>A</given-names></name><role>senior statistical programmer</role><xref ref-type="aff" rid="aff36">36</xref></contrib><contrib contrib-type="author"><name><surname>Moser</surname><given-names>M</given-names></name><role>chief</role><xref ref-type="aff" rid="aff37">37</xref></contrib><contrib contrib-type="author"><name><surname>Pearce</surname><given-names>M S</given-names></name><role>senior research associate</role><xref ref-type="aff" rid="aff38">38</xref></contrib><contrib contrib-type="author"><name><surname>Richardson</surname><given-names>D B</given-names></name><role>assistant professor</role><xref ref-type="aff" rid="aff39">39</xref></contrib><contrib contrib-type="author"><name><surname>Rodriguez-Artalejo</surname><given-names>F</given-names></name><role>professor of preventive medicine and public health</role><xref ref-type="aff" rid="aff40">40</xref></contrib><contrib contrib-type="author"><name><surname>Rogel</surname><given-names>A</given-names></name><role>epidemiologist</role><xref ref-type="aff" rid="aff41">41</xref></contrib><contrib contrib-type="author"><name><surname>Tardy</surname><given-names>H</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Telle-Lamberton</surname><given-names>M</given-names></name><role>epidemiologist</role><xref ref-type="aff" rid="aff41">41</xref></contrib><contrib contrib-type="author"><name><surname>Turai</surname><given-names>I</given-names></name><role>head chief physician</role><xref ref-type="aff" rid="aff31">31</xref></contrib><contrib contrib-type="author"><name><surname>Usel</surname><given-names>M</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff42">42</xref></contrib><contrib contrib-type="author"><name><surname>Veress</surname><given-names>K</given-names></name><role>lecturer</role><xref ref-type="aff" rid="aff43">43</xref></contrib></contrib-group><aff id="aff1"><label>1</label> International Agency for Research on Cancer, Lyons, France</aff><aff id="aff2"><label>2</label> Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Germany</aff><aff id="aff3"><label>3</label> Radiation Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA</aff><aff id="aff4"><label>4</label> University of Tampere, Tampere, Finland</aff><aff id="aff5"><label>5</label> Institut Gustave-Roussy, Villejuif, France</aff><aff id="aff6"><label>6</label> Mailman School of Public Health, Columbia University, New York, USA</aff><aff id="aff7"><label>7</label> National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW, Australia</aff><aff id="aff8"><label>8</label> Radiation Protection Division, Health Protection Agency, Chilton, Didcot, Oxfordshire</aff><aff id="aff9"><label>9</label> Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA</aff><aff id="aff10"><label>10</label> Fukuoka Institute of Health and Environmental Sciences, Fukuoka, Japan</aff><aff id="aff11"><label>11</label> Conseiller Médical du CEA, Paris, France</aff><aff id="aff12"><label>12</label> Atomic Energy Commission of Canada, Deep River, ON, Canada</aff><aff id="aff13"><label>13</label> Pacific Northwest National Laboratory, Richland, WA, USA</aff><aff id="aff14"><label>14</label> Safety and Radiation Science, Australian Nuclear Science and Technology Organisation, NSW, Australia</aff><aff id="aff15"><label>15</label> AECL Radiation Biology and Health Physics Branch, Chalk River Laboratories, Chalk, ON, Canada</aff><aff id="aff16"><label>16</label> Twin Trees, Blewbury, Didcot, Oxfordshire</aff><aff id="aff17"><label>17</label> Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea</aff><aff id="aff18"><label>18</label> Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment; French National Institute for Transport and Safety Research (INRETS), Arcueil, France</aff><aff id="aff19"><label>19</label> Radiation Protection Bureau, Health Canada, Ottawa, Canada</aff><aff id="aff20"><label>20</label> Department of Preventive Medicine, Cheju National University College of Medicine, Cheju, Korea</aff><aff id="aff21"><label>21</label> AMYS, UNESA, Madrid, Spain</aff><aff id="aff22"><label>22</label> Institute of Radioprotection and Nuclear Security, DESTQ/DEAS, Le Vésinet, France</aff><aff id="aff23"><label>23</label> Nuclear Research Centre (SCK.CEN), Radiation Protection Division, Mol, Belgium</aff><aff id="aff24"><label>24</label> Operational Radiological Protection, Nuclear Safety Council, Spain</aff><aff id="aff25"><label>25</label> Statens Vattenfallsverk Forsmark, Osthammer, Sweden</aff><aff id="aff26"><label>26</label> Institute for East-European Studies, Uppsala University, Sweden</aff><aff id="aff27"><label>27</label> Department of Hygiene and Epidemiology, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovak Republic</aff><aff id="aff28"><label>28</label> Faculty of Health Sciences, American University of Beirut, Lebanon</aff><aff id="aff29"><label>29</label> Slovenske Elektrárne, Bratislava, Slovak Republic</aff><aff id="aff30"><label>30</label> Doseco Ltd, Jyvaskyla, Finland</aff><aff id="aff31"><label>31</label> “Frederic Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene of the “Fodor József” National Centre for Public Health, Budapest, Hungary</aff><aff id="aff32"><label>32</label> Lithuanian Cancer Registry, Vilnius University Oncology Institute, Vilnius, Lithuania</aff><aff id="aff33"><label>33</label> Vasternorrland County Council, Department of Research and Development, Sundsvall, Sweden</aff><aff id="aff34"><label>34</label> WHO European Centre for Environment and Health, Rome, Italy</aff><aff id="aff35"><label>35</label> Radiation Protection Centre, Vilnius, Lithuania</aff><aff id="aff36"><label>36</label> Serono International SA, Geneva, Switzerland</aff><aff id="aff37"><label>37</label> Physics and Biology Section, Radiation Protection Division, Federal Office of Public Health, Bern, Switzerland</aff><aff id="aff38"><label>38</label> School of Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne</aff><aff id="aff39"><label>39</label> Department of Epidemiology, School of Public Health, Chapel Hill, NC, USA</aff><aff id="aff40"><label>40</label> Department of Preventive Medicine and Public Health, School of Medicine, University Autonoma de Madrid, Spain</aff><aff id="aff41"><label>41</label> Laboratory of Epidemiology, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France</aff><aff id="aff42"><label>42</label> Medical Inspectorate of Factories, Geneva, Switzerland</aff><aff id="aff43"><label>43</label> Institute of Public Health, Semmelweis University, Budapest, Hungary</aff><author-notes><fn><p> Correspondence to: E Cardis <email>cardis@iarc.fr</email></p></fn></author-notes><pub-date pub-type="ppub"><day>9</day><month>7</month><year>2005</year></pub-date><volume>331</volume><issue>7508</issue><fpage>77</fpage><lpage>77</lpage><history><date date-type="accepted"><day>23</day><month>5</month><year>2005</year></date></history><copyright-statement>Copyright © 2005, BMJ Publishing Group Ltd.</copyright-statement><copyright-year>2005</copyright-year><abstract><p><bold>Objectives</bold> To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental, occupational, and medical diagnostic exposures.</p><p><bold>Design</bold> Multinational retrospective cohort study of cancer mortality.</p><p><bold>Setting</bold> Cohorts of workers in the nuclear industry in 15 countries.</p><p><bold>Participants</bold> 407 391 workers individually monitored for external radiation with a total follow-up of 5.2 million person years.</p><p><bold>Main outcome measurements</bold> Estimates of excess relative risks per sievert (Sv) of radiation dose for mortality from cancers other than leukaemia and from leukaemia excluding chronic lymphocytic leukaemia, the main causes of death considered by radiation protection authorities.</p><p><bold>Results</bold> The excess relative risk for cancers other than leukaemia was 0.97 per Sv, 95% confidence interval 0.14 to 1.97. Analyses of causes of death related or unrelated to smoking indicate that, although confounding by smoking may be present, it is unlikely to explain all of this increased risk. The excess relative risk for leukaemia excluding chronic lymphocytic leukaemia was 1.93 per Sv (< 0 to 8.47). On the basis of these estimates, 1-2% of deaths from cancer among workers in this cohort may be attributable to radiation.</p><p><bold>Conclusions</bold> These estimates, from the largest study of nuclear workers ever conducted, are higher than, but statistically compatible with, the risk estimates used for current radiation protection standards. The results suggest that there is a small excess risk of cancer, even at the low doses and dose rates typically received by nuclear workers in this study.</p></abstract></article-meta><notes><fn-group><fn><p>We are grateful to Richard Doll, Jacques Estève, and Bruce Armstrong who helped to start this study; to the late Len Salmon who inspired the study of errors in doses; to past members of the dosimetry and epidemiology subcommittees (William Murray, Robert Rinsky) and of the international study group (the late E Gubéran, Y Hosoda, T Iwasaki, G Kendall, M Murata, T Rytomaa); to everyone in the participating countries who worked in the collection and validation of the data used in the study; and to the representatives and staff of the nuclear facilities included in the study for their open collaboration. This report uses data obtained from the Radiation Effects Research Foundation (RERF), Hiroshima and Nagasaki, Japan. RERF is a private, non-profit foundation funded by the Japanese Ministry of Health, Labour and Welfare and the US Department of Energy through the National Academy of Sciences. The conclusions in this report are those of the authors and do not necessarily reflect the scientific judgment of RERF or its funding agencies.</p></fn><fn><p>Contributors: ECa designed and coordinated the international study, took part in data analysis, interpretation, and writing of the paper, and is guarantor. MV took part in data analysis, interpretation, and writing of the paper for the international study. As members of the epidemiology subcommittee MB, EG, MH, CHi, GH, JKa, CM, MS-B, and TY contributed to the conception and design, the development of the analytical strategy, and the analysis and interpretation of the data of the international study. They also contributed to the collection and validation of data in their own countries. As members of the dosimetry subcommittee FB, GC, JJF, CHa, BH, MMarshall, IT-C, and DU developed the protocol for the study of errors in doses, collected data on dosimetry practices, and participated in the review and analysis of dosimetry questionnaires and in the identification and quantification of errors in photon dose estimates. The study of errors in doses was the topic of IT-C's PhD dissertation and postdoctoral fellowship, and she was involved in all of the steps of data acquisition, validation, and analysis and in the planning and conducting of the dosimetry experiments and the derivation of the dosimetric bias conversion factors. The other members of the international study group (YOA, PA, AA, JMB, JBS, AB, PD, ADS, ME, HE, GE, LMG, GG, RH, KH, HH, AK, JKu, HM, AMa, IT, MU) took part in the design of the common protocol and were responsible for implementation of the core protocol and the collection and validation of data in their countries. FR-A, AR, MT-L, and KV coordinated data collection or otherwise contributed to data acquisition, analysis, and interpretation of data at the national level in their countries. EA, ECo, AMo, and HT were responsible for management of the international database and for data validation and analysis at IARC. MMartuzzi and DBR assisted in validation of the data at the international level, implementation of the protocol at the national level, and provided assistance to national collaborators through contacts and site visits. MSP assisted in the validation and analysis of the international dataset. All authors critically reviewed earlier drafts for important intellectual content and approved the final version of the paper.</p></fn><fn><p>Funding: European Union (contracts F13P-CT930066, F14P-CT96-0062, FIGH-CT1999-20001); US Centers for Disease Control (Co-operative agreement U50/CCU011778); Canadian Nuclear Safety Commission; Japanese Institute for Radiation Epidemiology, Australian Nuclear Science and Technology Organisation; Nuclear Research Center (SCKCEN), Belgium; Health Canada and Statistics Canada; La Ligue Nationale contre le Cancer, France; La Compagnie Générale des Matière Nucléaire, France; Electricité de France; Ministry of Education, Culture, Sports, Science and Technology in Japan; Ministry of Science and Technology (MOST) in Korea; Spanish Nuclear Safety Council; US Department of Energy. These sponsors had no role in study design, data collection, analysis, or interpretation. IT-C received funding from the Association pour la Recherche contre le Cancer (ARC, France); MSP and DBR were the recipients, respectively, of an IARC postdoctoral fellowship and of an ORAU fellowship during their stay at IARC.</p></fn><fn><p>Competing interests: C Hacker, B Heinmiller, H Hyvonen, M Marshall, A Rogel, J Bernar Solano, M Eklöf, and K Holan are (or have been in the past five years) employees of the nuclear industry or have links to the nuclear industry in their country. They were appointed to the international study group and or the dosimetry subcommittee as experts because of their critical knowledge and experience in historical radiation protection practices and dosimetry. None of them had influence on decisions concerning analysis of the results.</p></fn><fn><p>Ethical approval: The study was approved by the IARC ethical review committee and by the relevant ethical committees of the participating countries.</p></fn></fn-group></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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