PhD, University of Cincinnati, 2011, Medicine: Epidemiology (Environmental Health)
Context: Nearly four million U.S. workers are potentially exposed to ionizing radiation in the course of their employment each year. Although, evidence exists that unequivocally establishes ionizing radiation as a human carcinogen, little is known about the effects of protracted low-dose exposures.
Objective: Conduct a case-control analysis examining the relation between protracted low-dose ionizing radiation exposure and leukemia in a cohort of U.S. nuclear workers.
Methods: Each case was matched to four controls on attained age. Ionizing radiation exposures were assessed using measurements and employment histories. Conditional logistic regression analyses were conducted using general relative risk models to estimate the excess relative risk (ERR) of all leukemia, leukemia excluding CLL, AML, CML, and CLL while controlling for potential confounding by race, sex, benzene exposure, social economic status, and either hire date or birth date. Results were tested under differing exposure lag assumptions and time windows of exposure.
Results: There were 369 leukemia cases identified in a population of 105,245 U.S. nuclear workers. Positive, but imprecise risk estimates were observed for all outcomes excluding CLL, although the observed dose response for non-CLL leukemia, AML, and CML showed attenuated risk in the low dose (<10 mGy) and high dose (>100 mGy) regions. The linear ERR per 10 mGy absorbed dose to bone marrow was 0.009 (95% CI:-0.014, 0.051). A three-piece linear spline model best fit the non-CLL data, where slope estimates (ERR·10 mGy-1) were statistically significant in the first two segments: -0.68 (95% CI: -0.92, -0.33) for doses =8.0 mGy; 0.20 (95% CI: 0.082, 0.35), dose=8<-46 mGy; and -0.016 (95% CI: <-0.022, 0.018), dose=46+ mGy. Leukemia risks were characterized by a “wave-like” function of time, where peak risks were observed from exposures occurring from five to ten years prior to the age at death of the index AML case (ERR·10 mGy-1 = 0.76; 95% CI: 0 (open full item for complete abstract)
Committee: Susan Pinney PhD (Committee Chair); Mary Schubauer-Berigan PhD (Committee Member); Charles Ralph Buncher ScD (Committee Member); Richard Hornung DrPH (Committee Member); Henry Spitz PhD (Committee Member)
Subjects: Epidemiology