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Evidence of confounding by smoking of associations between radiation and lung cancer mortality among workers at the Savannah River Site.

Authors
Richardson-DB; Wing-S
Source
Am J Ind Med 2011 Jun; 54(6):421-427
NIOSHTIC No.
20039590
Abstract
Background: This study investigates confounding by cigarette smoking of associations between occupational exposure to ionizing radiation and lung cancer mortality among workers at the Savannah River Site (SRS). Methods: Thirteen thousand two hundred sixty-five white males hired at SRS between 1950 and 1986 were followed through 2002 to ascertain causes of death. Estimates of radiation doses from external sources and internal tritium uptakes were derived from dosimetry records. Logistic regression methods were used to derive discrete-time estimates of rate ratios. An indirect approach to control for unmeasured confounding by smoking was employed that involves joint modeling of lung cancer and chronic obstructive pulmonary disease (COPD) mortality. Results: Prior to indirect adjustment for smoking, there was minimal evidence of association between lung cancer mortality and cumulative radiation dose under a 10-year lag assumption (RR at 100 mSv=0.90; 90% CI: 0.80-1.01). Subsequent to indirect adjustment for smoking, the association between lung cancer mortality and cumulative radiation dose under a 10-year lag was positive (RR at 100 mSv = 1.33; 90% CI: 1.01-1.77). Conclusions: In this cohort, there is evidence of negative confounding of radiation dose-lung cancer mortality associations by cigarette smoking.
Keywords
Biohazards; Biological-effects; Biological-monitoring; Biological-systems; Biostatistics; Cancer-rates; Epidemiology; Exposure-assessment; Exposure-methods; Health-surveys; Ionizing-radiation; Mathematical-models; Medical-monitoring; Mortality-data; Mortality-rates; Mortality-surveys; Occupational-diseases; Occupational-exposure; Occupational-hazards; Occupational-health; Physical-reactions; Physiological-effects; Physiological-factors; Physiological-measurements; Physiological-response; Pulmonary-disorders; Pulmonary-system-disorders; Quantitative-analysis; Radiation-effects; Radiation-exposure; Radiation-levels; Radiation-measurement; Risk-analysis; Risk-factors; Smoking; Statistical-analysis; Work-areas; Work-environment; Worker-health; Work-operations; Author Keywords: bias (epidemiology); lung neoplasms/epidemiology/etiology; occupational exposure/adverse effects; smoking/adverse effects; ionizing radiation
Contact
David B. Richardson, Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
CODEN
AJIMD8
Publication Date
20110601
Document Type
Journal Article
Email Address
david.richardson@unc.edu
Funding Type
Grant
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007871; B09282011
Issue of Publication
6
ISSN
0271-3586
Priority Area
Research Tools and Approaches: Cancer Research Methods
Source Name
American Journal of Industrial Medicine
State
NC
Performing Organization
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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