Second follow-up of a German cohort on childhood cancer incidence after exposure to postnatal diagnostic x-ray.

Studies on children exposed to ionizing radiation by computed tomography (CT) indicate an increased risk of leukemia and central nervous system (CNS) tumors. Evidence of the risks associated with diagnostic X-ray examinations, the most frequent examination in pediatric radiology, in which the radiation dose is up to 750 times lower compared to CT examinations, is less clear.a#13; This study presents results of the second follow-up for the risk of childhood cancer in a cohort of children (alt;15 years) with diagnostic X-ray exposure at a large German hospital during 1976-2003 followed for additional 10 years until 2016.a#13; With a latency period of six months, 92,998 children contributed 79…

Is cancer risk of radiation workers larger than expected?

Occupational exposures to ionising radiation mainly occur at low-dose rates and may accumulate effective doses of up to several hundred milligray. The objective of the present study is to evaluate the evidence of cancer risks from such low-dose-rate, moderate-dose (LDRMD) exposures. Our literature search for primary epidemiological studies on cancer incidence and mortality risks from LDRMD exposures included publications from 2002 to 2007, and an update of the UK National Registry for Radiation Workers study. For each (LDRMD) study we calculated the risk for the same types of cancer among the atomic bomb survivors with the same gender proportion and matched quantities for dose, mean age att…

Childhood Cancer Risk From Conventional Radiographic Examinations for Selected Referral Criteria: Results From a Large Cohort Study

OBJECTIVE: Little is known about the long-term effects of exposure to diagnostic ionizing radiation in childhood. Current estimates are made with models derived mainly from studies of atomic bomb survivors, a population that differs from today's patients in many respects. MATERIALS AND METHODS: We analyzed the cancer incidence among children who underwent diagnostic x-ray exposures between 1976 and 2003 in a large German university hospital. We reconstructed individual radiation doses for each examination and sorted results by groups of referral criteria for all cancers combined, solid tumors, and leukemia and lymphoma combined. RESULTS: A total of 68 incidence cancer cases between 1980…

A Cohort Study of Childhood Cancer Incidence after Postnatal Diagnostic X-Ray Exposure

Ionizing radiation is an established cause of cancer, yet little is known about the health effects of doses from diagnostic examinations in children. The risk of childhood cancer was studied in a cohort of 92.957 children who had been examined with diagnostic X rays in a large German hospital during 1976-2003. Radiation doses were reconstructed using the individual dose area product and other exposure parameters, together with conversion coefficients developed specifically for the medical devices and standards used at the radiology department. Newly diagnosed cancers occurring between 1980 and 2006 were determined through record linkage to the German Childhood Cancer Registry. The median ra…

Epidemiological studies of cancer in aircrew.

Exposure to cosmic ionising radiation, in addition to other specific occupational risks, is of concern to aircrew members. Epidemiological studies provide an objective way to assess the health of this occupational group. We systematically reviewed the epidemiological literature on health of aircrew members since 1990, focusing on cancer as the endpoint of interest. Sixty-five relevant publications were identified and reviewed. Whereas overall cancer incidence and mortality was generally lower than in the comparison population, consistently elevated risks were reported for breast cancer incidence in female aircrew members and for melanoma in both male and female aircrew members. Brain cancer…

Shift Work and Prostate Cancer Incidence in Industrial Workers

In 2007 the International Agency for Research on Cancer (IARC) classified shift work involving circadian disruption as a probable human carcinogen (1). Most of the evidence for this is based on animal experiment models and only a few reliable epidemiological studies. The cancer best described to date is breast cancer; this has mainly been investigated in female nurses and flight attendants (2, 3). Shift work can also increase the incidence of prostate cancer, as plausibly described in a review article published in 2012 (4). Mechanistically, it is possible that nocturnal light exposure and disrupted circadian rhythms cause cancer, or that tumor growth is favored by hormonal mediation. Noctur…

Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960-2014.

ObjectivesTo determine cancer mortality compared with the general population and to examine dose-response relationships between cumulative occupational radiation dose and specific cancer outcomes in the German aircrew cohort.MethodsFor a cohort of 26 846 aircrew personnel, standardised mortality ratios (SMR) were calculated. Dose-response analyses were carried out using Poisson regression to assess dose-related cancer risks for the period 1960–2014. Exposure assessment comprises recently available dose register data for all cohort members and newly estimated retrospective cabin crew doses for 1960–2003.ResultsSMR for all-cause, specific cancer groups and most individual cancers were reduced…

Epidemiological investigations of aircrew: an occupational group with low-level cosmic radiation exposure.

Aircrew and passengers are exposed to low-level cosmic ionising radiation. Annual effective doses for flight crew have been estimated to be in the order of 2-5 mSv and can attain 75 mSv at career end. Epidemiological studies in this occupational group have been conducted over the last 15-20 years, usually with a focus on radiation-associated cancer. These studies are summarised in this note. Overall cancer risk was not elevated in most studies and subpopulations analysed, while malignant melanoma, other skin cancers and breast cancer in female aircrew have shown elevated incidence, with lesser risk elevations in terms of mortality. In some studies, including the large German cohort, brain c…

Inzidenz von Kinderkrebs nach Röntgendiagnostik im Patientenkollektiv der Jahre 1976 – 2003 einer Universitäts-Kinderklinik

Purpose: Although the carcinogenic effect of ionizing radiation is well known, knowledge gaps persist on the health effects of low-dose radiation, especially in children. The cancer incidence rate in a cohort of 92,957 children diagnosed using X-rays in the years 1976-2003 in the radiology department of a large university clinic was studied. Materials and Methods: Individual radiation doses per examination were reconstructed using an algorithm taking into account the dose area product and other exposure parameters together with conversion factors computed specifically for the equipment and protocols used in the radiology department. Incident cancer cases in the period 1980-2006 were identif…

Reply to ‘Comment on: Baaken D, Hammer GP, Seidenbusch MC, Schneider K, Spix C, Blettner M, Pokora R and Lorenz E 2019 Second follow-up of a German cohort on childhood cancer after exposure to postnatal diagnostic x-ray J. Radiol. Prot. 39 1074–91’

Kosmische Strahlung und Gesundheit bei Flugreisen

Testicular cancer risk associated with occupational radiation exposure: a systematic literature review.

Testicular cancer is a rare disease, affecting mainly young men aged 15-49. There have been some recent reports that it might be associated with radiation exposure. We have systematically reviewed this topic. English-language articles published between 1990 and 2008 studying the relationship between occupational radiation exposure and testicular cancer were included. Risk of bias was assessed using a modified version of the EPHPP checklist. For ionising radiation we subdivided study populations into occupational groups. No pooled analysis was performed due to the heterogeneity of studies. Seven case-control and 30 cohort studies were included in the review. For radiation workers, one incide…

Estimated radiation exposure of German commercial airline cabin crew in the years 1960-2003 modeled using dose registry data for 2004-2015.

Exposure to ionizing radiation of cosmic origin is an occupational risk factor in commercial aircrew. In a historic cohort of 26,774 German aircrew, radiation exposure was previously estimated only for cockpit crew using a job-exposure matrix (JEM). Here, a new method for retrospectively estimating cabin crew dose is developed. The German Federal Radiation Registry (SSR) documents individual monthly effective doses for all aircrew. SSR-provided doses on 12,941 aircrew from 2004 to 2015 were used to model cabin crew dose as a function of age, sex, job category, solar activity, and male pilots' dose; the mean annual effective dose was 2.25 mSv (range 0.01–6.39 mSv). In addition to an inverse …

Testicular cancer and viral infections: A systematic literature review and meta-analysis

In 1984, Newell and coworkers were the first to suggest that testicular cancer might have a viral etiology since it showed similar characteristics to Hodgkin's lymphoma. A systematic literature review and meta-analysis was conducted to investigate a possible association between viral infections (EBV, CMV, Parvovirus B19, HPV, and HIV) and testicular cancer. Articles published from 1985 through June 2010 were located from MEDLINE and EMBASE databases, 21 articles were finally included in the review. For infection with EBV, CMV, Parvovirus B19, and HIV the pooled OR were 4.80 (95% CI 0.98–23.54), 1.85 (95% CI 0.92–3.70), 2.86 (95% CI 0.35–23.17), and 1.79 (95% CI 1.45–2.21) respectively. No p…

Ionising radiation and lens opacities in interventional physicians: results of a German pilot study

We assessed the feasibility of an epidemiological study on the risk of radiation-related lens opacities among interventional physicians in Germany. In a regional multi-centre pilot study associated with a European project, we tested the recruitment strategy, a European questionnaire on work history for the latter dosimetry calculation and the endpoint assessment. 263 interventional physicians and 129 non-exposed colleagues were invited. Questionnaires assessed eligibility criteria, risk factors for cataract, and work history relating to occupational exposure to ionising radiation, including details on type and amount of procedures performed, radiation sources, and use of protective equipmen…

Avoiding Bias in Observational Studies

Background Many questions in human health research can only be answered with observational studies. In contrast to controlled experiments or well-planned, experimental randomized clinical trials, observational studies are subject to a number of potential problems that may bias their results.

Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography.

Abstract Background The frequent use of computed tomography is a major cause of the increasing medical radiation exposure of the general population. Consequently, dose reduction and radiation protection is a topic of scientific and public concern. Aim We evaluated the available literature on physicians’ knowledge regarding radiation dosages and risks due to computed tomography. Methods A systematic review in accordance with the Cochrane and PRISMA statements was performed using eight databases. 3091 references were found. Only primary studies assessing physicians’ knowledge about computed tomography were included. Results 14 relevant articles were identified, all focussing on dose estimatio…

Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study

Abstract Aim To investigate the cancer risk among residents of Rhineland-Palatinate winegrowing communities in an ecological study. Methods On the basis of the Rhineland-Palatinate cancer-registry, we calculated age-adjusted incidence rate ratios for communities with a medium area under wine cultivation (>5 to 20 percent) and a large area under wine cultivation (>20 percent) in comparison with communities with a small area under wine cultivation (>0 to 5 percent). In a side analysis, standardized cancer incidence ratios (SIR) were computed separately for winegrowing communities with small, medium and large area under wine cultivation using estimated German incidence rates as refere…

Mortality from cancer and other causes in commercial airline crews: a joint analysis of cohorts from 10 countries.

Background Commercial airline crew is one of the occupational groups with the highest exposures to ionising radiation. Crew members are also exposed to other physical risk factors and subject to potential disruption of circadian rhythms. Methods This study analyses mortality in a pooled cohort of 93 771 crew members from 10 countries. The cohort was followed for a mean of 21.7 years (2.0 million person-years), during which 5508 deaths occurred. Results The overall mortality was strongly reduced in male cockpit (SMR 0.56) and female cabin crews (SMR 0.73). The mortality from radiation-related cancers was also reduced in male cockpit crew (SMR 0.73), but not in female or male cabin crews (SMR…