OBJECTIVES: Radon is carcinogenic, but more studies are needed to understand relationships with lung cancer and extrathoracic cancers at low exposures. There are few studies evaluating associations with cancer incidence or assessing the modifying effects of smoking. METHODS: We conducted a case-cohort study with 16 434 underground uranium miners in the Czech Republic with cancer incidence follow-up 1977-1996. Associations between radon exposure and lung cancer, and extrathoracic cancer, were estimated with linear excess relative rate (ERR) models. We examined potential modifying effects of smoking, time since exposure and exposure rate. RESULTS: Under a simple ERR model, assuming a 5-year exposure lag, the estimated ERR of lung cancer per 100 working level months (WLM) was 0.54 (95% CI 0.33 to 0.83) and the estimated ERR of extrathoracic cancer per 100 WLM was 0.07 (95% CI -0.17 to 0.72). Most lung cancer cases were observed among smokers (82%), and the estimated ERR of lung cancer per 100 WLM was larger among smokers (ERR/100 WLM=1.35; 95% CI 0.84 to 2.15) than among never smokers (ERR/100 WLM=0.12; 95% CI -0.05 to 0.49). Among smokers, the estimated ERR of lung cancer per 100 WLM decreased with time since exposure from 3.07 (95% CI -0.04 to 10.32) in the period 5-14 years after exposure to 1.05 (95% CI 0.49 to 1.87) in the period 25+ years after exposure. CONCLUSIONS: We observed positive associations between cumulative radon exposure and lung cancer, consistent with prior studies. We observed a positive association between cumulative radon exposure and extrathoracic cancers, although the estimates were small. There was evidence that the association between radon and lung cancer was modified by smoking in a multiplicative or super-multiplicative fashion.

• Klíčová slova
• cancer, ionizing, miners, radiation, radon,
• MeSH
• dceřiné produkty radonu škodlivé účinky   MeSH
• dospělí MeSH
• horníci statistika a číselné údaje   MeSH
• incidence MeSH
• kohortové studie MeSH
• kouření škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic epidemiologie   MeSH
• nádory vyvolané zářením epidemiologie   MeSH
• nádory epidemiologie   MeSH
• pracovní expozice škodlivé účinky   MeSH
• radon škodlivé účinky   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• uran MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Intramural MeSH
• Research Support, U.S. Gov't, P.H.S. MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• dceřiné produkty radonu MeSH
• radon MeSH
• uran MeSH

OBJECTIVES: Epidemiological studies of underground miners have provided clear evidence that inhalation of radon decay products causes lung cancer. Moreover, these studies have served as a quantitative basis for estimation of radon-associated excess lung cancer risk. However, questions remain regarding the effects of exposure to the low levels of radon decay products typically encountered in contemporary occupational and environmental settings on the risk of lung cancer and other diseases, and on the modifiers of these associations. These issues are of central importance for estimation of risks associated with residential and occupational radon exposures. METHODS: The Pooled Uranium Miner Analysis (PUMA) assembles information on cohorts of uranium miners in North America and Europe. Data available include individual annual estimates of exposure to radon decay products, demographic and employment history information on each worker and information on vital status, date of death and cause of death. Some, but not all, cohorts also have individual information on cigarette smoking, external gamma radiation exposure and non-radiological occupational exposures. RESULTS: The PUMA study represents the largest study of uranium miners conducted to date, encompassing 124 507 miners, 4.51 million person-years at risk and 54 462 deaths, including 7825 deaths due to lung cancer. Planned research topics include analyses of associations between radon exposure and mortality due to lung cancer, cancers other than lung, non-malignant disease, modifiers of these associations and characterisation of overall relative mortality excesses and lifetime risks. CONCLUSION: PUMA provides opportunities to evaluate new research questions and to conduct analyses to assess potential health risks associated with uranium mining that have greater statistical power than can be achieved with any single cohort.

• Klíčová slova
• Radon, cancer, cardiovascular, low-level ionising radiation, uranium miners,
• MeSH
• hodnocení rizik MeSH
• horníci * MeSH
• kohortové studie MeSH
• kouření cigaret epidemiologie   MeSH
• lidé MeSH
• nádory plic epidemiologie   mortalita   MeSH
• nádory vyvolané zářením epidemiologie   mortalita   MeSH
• nemoci z povolání epidemiologie   MeSH
• pracovní expozice škodlivé účinky   MeSH
• radon škodlivé účinky   MeSH
• uran * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, P.H.S. MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Severní Amerika epidemiologie   MeSH
• Názvy látek
• radon MeSH
• uran * MeSH

A brief description is given of the study of West Bohemian uranium miners, and recent and ongoing efforts to improve the quality of the data are summarized. Three recent analyses of the data from the cohort have led to rather different estimates of the excess relative risk of mortality from lung cancer per working-level month. The reasons for these different estimates are described, and it is concluded that estimates of lung cancer risk are strongly influenced by the quality of the exposure estimates, especially by the omission of some exposures accumulated during employment at other uranium mines, following the closure of most of the shafts at the original two mines. The most recent analysis has shown that, in common with other cohorts of radon-exposed miners, the excess relative risk of lung cancer per working-level month is modified by age and time since exposure. An inverse effect of exposure rate was also demonstrated, but it affected only men at very high concentrations and appears to be related to the time pattern of exposure. In addition, the risk was found to differ between the two main mines, possibly due to the influence of arsenic in the dust of the mines.

• MeSH
• hornictví * MeSH
• kohortové studie MeSH
• lidé MeSH
• nádory plic etiologie   MeSH
• nádory vyvolané zářením etiologie   MeSH
• radon škodlivé účinky   MeSH
• riziko MeSH
• uran MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• radon MeSH
• uran MeSH