Does radon cause diseases other than lung cancer? Findings on mortality within the German uranium miners cohort study, 1946–2018
基于德国铀矿工队列数据，研究氡暴露与肺癌以外多种疾病死亡率的关系，发现除肺癌外，氡暴露与部分癌症和缺血性心脏病风险小幅增加有关，但总体证据不充分。
OBJECTIVES: This analysis aimed at investigating the relationship between death from diseases other than lung cancer and radon exposure in the German uranium miners cohort study with follow-up data from 1946 to 2018. METHODS: The cohort includes 58 975 men who were employed between 1946 and 1990 at the former 'Wismut' uranium mining company in Eastern Germany. Occupational exposure to radon progeny in working level month (WLM) was retrospectively assessed using a comprehensive job-exposure matrix. Based on internal Poisson regression, excess relative rates (ERRs) per 100 WLM were estimated for cumulative lagged exposure to radon for numerous outcomes. Sensitivity analyses examined possible confounding by occupational exposure to silica dust and gamma radiation. RESULTS: Small but statistically significantly increased excess rates were found for the group of all cancers other than lung cancer (n=6126; ERR/100 WLM=0.014 (95% CI 0.007; 0.022)) and for ischaemic heart diseases (n=6182; 0.010 (95% CI 0.003; 0.016)). The increase in risk was particularly observed at very high exposure levels. No clear association between radon exposure and other causes of death, comprising other subgroups of circulatory system diseases, non-malignant respiratory diseases excluding pneumoconiosis, neurodegenerative diseases and the many considered individual cancer sites was present. Notable were the estimates for myeloid leukaemia (n=114; 0.076 (95% CI -0.011; 0.164)) and pharynx cancer (n=112; 0.070 (95% CI -0.041; 0.182)). CONCLUSIONS: The findings of the Wismut cohort indicate small increased risks for a few selected outcomes. Overall, the study does not provide convincing evidence for an increased risk for other diseases than lung cancer due to radon.