贝叶斯法识别和估算法国铀矿工人最新队列(1946-2014 年)中与氡相关的癌症死亡危险增加率

IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Julie Fendler, Chantal Guihenneuc, Sophie Ancelet
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引用次数: 0

摘要

目的 最近对法国铀矿工人队列进行了更新,增加了七年的随访数据。我们利用这些新数据寻找新的可能与氡相关的增加风险,并改进对累积氡辐照与肺癌、肾癌、脑和中枢神经系统(CNS)癌以及白血病(不包括慢性淋巴细胞白血病,后者不是辐射诱发的)这四种癌症之间潜在关联的估计。方法我们提出了几种参数生存模型,并在贝叶斯范式下进行了拟合和比较,以进行新的和原创的辐照风险分析。根据联合国辐射科委最近的建议,我们将与时间相关的效应修饰因子和暴露率视为潜在的效应修饰因子。我们使用贝叶斯模型选择标准来确定与氡相关的增加危险率。结果在辐照-风险线性关系的假设下,我们发现大量证据表明,累积氡辐照对法国铀矿工人肺癌死亡率的危险率有严格的正效应。根据目前现有的数据,在线性或对数线性辐照风险关系的假设下,无法得出长期辐照氡气对肾癌死亡危险率没有或存在严格正效应的结论。至于脑癌和中枢神经系统癌症导致的死亡,有大量证据表明不存在与氡气有关的影响。结论 本研究在贝叶斯框架以及线性和对数线性暴露风险关系假设下,调查了肺癌、肾癌、脑癌、中枢神经系统癌和白血病的死亡风险是否存在与氡相关的增加。如果说对肺癌、脑癌和中枢神经系统癌的研究结果的解释毫无疑问,那么对肾癌和白血病(不包括 CLL)的研究结论就不那么明确了。今后对法国队列进行更新,增加对矿工的跟踪时间,可能有助于对这两种癌症得出更明确的结论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Bayesian identification and estimation of radon-related increased hazard rates of cancer death in the updated French cohort of uranium miners (1946–2014)

Bayesian identification and estimation of radon-related increased hazard rates of cancer death in the updated French cohort of uranium miners (1946–2014)

Objective

A recent update of the French cohort of uranium miners added seven years of follow-up data. We use these new data to look for new possible radon-related increased risks and refine the estimation of the potential association between cumulative radon exposure and four cancer sites: lung cancer, kidney cancer, brain and central nervous system (CNS) cancer and leukemia (excluding chronic lymphocytic leukemia, which is not radiation-induced).

Methods

Several parametric survival models are proposed, fitted and compared under the Bayesian paradigm, to perform new and original exposure-risk analyses. In line with recent UNSCEAR recommendations, we consider time-related effect modifiers and exposure rate as potential effect modifying factors. We use Bayesian model selection criteria to identify radon-related increased hazard rates.

Results

Under the assumption of a linear exposure-risk relationship, we found a substantial evidence for a strictly positive effect of cumulative radon exposure on the hazard rate of death by lung cancer among French uranium miners. Given the current available data under the assumptions of a linear or log-linear exposure-risk relationship, it is not possible to conclude in favour of the absence or the existence of a strictly positive effect of chronic exposure to radon on the hazard rate of death by kidney cancer. Regarding death by brain and CNS cancer, there is a substantial evidence for the absence of radon-related effect. Finally, under the assumption of a log-linear exposure-risk relationship, a small positive radon-related effect appears when looking at the risk of death by leukemia (excluding CLL).

Conclusion

This study investigates the existence of radon-related increased risk of death by lung cancer, kidney cancer, brain and CNS cancer and leukemia under a Bayesian framework and assumptions of linear and log-linear exposure-risk relationships. If there is no doubt in the interpretation of the results for lung cancer and brain and CNS cancer, the conclusion is less clear-cut in the case of kidney cancer and leukemia (excluding CLL). A future update of the French cohort, increasing the follow-up time for miners, may help to reach a clearer conclusion for these two cancer sites.

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来源期刊
International Archives of Occupational and Environmental Health
International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
6.70%
发文量
127
审稿时长
3 months
期刊介绍: International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.
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