BACKGROUND: The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany and the USA. METHODS: Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. RESULTS: There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16 633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). CONCLUSIONS: Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.

• Klíčová slova
• Radon, cohort studies, mortality study, occupational diseases, uranium miners,
• MeSH
• kohortové studie MeSH
• lidé MeSH
• nádory plic * MeSH
• nemoci z povolání * MeSH
• pracovní expozice * škodlivé účinky   MeSH
• radon * MeSH
• uran * MeSH
• Check Tag
• lidé MeSH
• mužské 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
• Francie MeSH
• Kanada epidemiologie   MeSH
• Německo MeSH
• Severní Amerika epidemiologie   MeSH
• Názvy látek
• 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

Concerns on health effects from uranium (U) mining still represent a major issue of debate. Any typology of active job in U mines is associated with exposure to U and its decay products, such as radon (Rn), thorium (Th), and radium (Ra) and its decay products with alpha-emission and gamma radiation. Health effects in U miners have been investigated in several cohort studies in the USA, Canada, Germany, the Czech Republic, and France. While public opinion is particularly addressed to pay attention to the safety of nuclear facilities, health hazard associated with mining is poorly debated. According to the many findings from cohort studies, the most significant positive dose-response relationship was found between occupational U exposure and lung cancer. Other types of tumors associated with occupational U exposure are leukemia and lymphoid cancers. Furthermore, it was found increased but not statistically significant death risk in U miners due to cancers in the liver, stomach, and kidneys. So far, there has not been found a significant association between U exposure and increased cardiovascular mortality in U miners. This review tries to address the current state of the art of these studies.

• Klíčová slova
• Cancers, Occupational cohorts, Radon exposure, Uranium miners,
• MeSH
• lidé MeSH
• nádory plic * MeSH
• nemoci z povolání * MeSH
• pracovní expozice * MeSH
• radon * MeSH
• uran * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH
• Francie MeSH
• Kanada MeSH
• Německo MeSH
• Názvy látek
• radon * MeSH
• uran * MeSH

OBJECTIVES: Radon is a ubiquitous occupational and environmental lung carcinogen. We aim to quantify the association between radon progeny and lung cancer mortality in the largest and most up-to-date pooled study of uranium miners. METHODS: The pooled uranium miners analysis combines 7 cohorts of male uranium miners with 7754 lung cancer deaths and 4.3 million person-years of follow-up. Vital status and lung cancer deaths were ascertained between 1946 and 2014. The association between cumulative radon exposure in working level months (WLM) and lung cancer was modelled as the excess relative rate (ERR) per 100 WLM using Poisson regression; variation in the association by temporal and exposure factors was examined. We also examined analyses restricted to miners first hired before 1960 and with <100 WLM cumulative exposure. RESULTS: In a model that allows for variation by attained age, time since exposure and annual exposure rate, the ERR/100 WLM was 4.68 (95% CI 2.88 to 6.96) among miners who were less than 55 years of age and were exposed in the prior 5 to <15 years at annual exposure rates of <0.5 WL. This association decreased with older attained age, longer time since exposure and higher annual exposure rate. In analyses restricted to men first hired before 1960, we observed similar patterns of association but a slightly lower estimate of the ERR/100 WLM. CONCLUSIONS: This new large, pooled study confirms and supports a linear exposure-response relationship between cumulative radon exposure and lung cancer mortality which is jointly modified by temporal and exposure factors.

• Klíčová slova
• Cancer, Miners, Radiation, Radon,
• MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic * etiologie   MeSH
• nádory vyvolané zářením * epidemiologie   etiologie   MeSH
• nemoci z povolání * epidemiologie   etiologie   MeSH
• pracovní expozice * škodlivé účinky   MeSH
• proteiny regulující apoptózu MeSH
• radon * škodlivé účinky   MeSH
• uran * škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, P.H.S. MeSH
• Názvy látek
• proteiny regulující apoptózu MeSH
• radon * MeSH
• uran * MeSH

Recent data from deep uranium mines in Czechoslovakia indicated that in addition to radon daughter products, miners are also exposed to chemical mutagens. Mycotoxins were identified as a possible source of mutagenicity present in the mines. Various methods of biomonitoring were used to examine three groups of miners from different uranium mines. Cytogenetic analysis of peripheral lymphocytes, unscheduled DNA synthesis (UDS) in lymphocytes, and lipid peroxidation (LPO) in both plasma and lymphocytes were studied on 66 exposed miners and 56 controls. Throat swabs were taken from 116 miners and 78 controls. Significantly increased numbers of aberrant cells were found in all groups of miners, as well as decreased UDS values in lymphocytes and increased LPO plasma levels in comparison to controls. Molds were detected in throat swabs from 27% of miners, and 58% of these molds were embryotoxic. Only 5% of the control samples contained molds and none of them was embryotoxic. The following mycotoxins were isolated from miners' throat swab samples: rugulosin, sterigmatocystin, mycophenolic acid, brevianamid A, citreoviridin, citrinin, penicilic acid, and secalonic acid. These data suggest that mycotoxins are a genotoxic factor affecting uranium miners.

• MeSH
• chromozomální aberace MeSH
• DNA biosyntéza   MeSH
• dospělí MeSH
• hornictví * MeSH
• lidé MeSH
• monitorování životního prostředí MeSH
• mutace * MeSH
• mykotoxiny škodlivé účinky   MeSH
• nádory plic etiologie   MeSH
• nemoci z povolání etiologie   MeSH
• peroxidace lipidů MeSH
• pracovní expozice MeSH
• uran * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH
• Názvy látek
• DNA MeSH
• mykotoxiny MeSH
• uran * MeSH

OBJECTIVES: Uranium miners in Příbram, Czech Republic were exposed to low and moderate levels of radon gas and other hazards. It is unknown whether these hazards increase the risk of mortality or cancer incidence when compared with the general Czech population. METHODS: A cohort of 16 434 male underground miners employed underground for at least 1 year between 1946 and 1976, and alive and residing in the Czech Republic in 1977, were followed for mortality and cancer incidence through 1992. We compared observed deaths and cancer incidence to expectation based on Czech rates. Standardised mortality ratios (SMRs), standardised incidence ratios (SIRs) and causal mortality ratios were calculated. RESULTS: Underground workers in the Příbram mines had higher rates of death than expected due to all causes (SMR=1.23, 95% CI 1.20 to 1.27), all cancers (SMR=1.52, 95% CI 1.44 to 1.60), lung cancer (SMR=2.12, 95% CI 1.96 to 2.28) and extrathoracic cancer (SMR=1.41, 95% CI 1.15 to 1.77). Similar excess was observed in cancer incidence analyses, with the addition of stomach cancer (SIR=1.37, 95% CI 1.11 to 1.63), liver cancer (SIR=1.70, 95% CI 1.16 to 2.25) and rectal cancer (SIR=1.41, 95% CI 1.16 to 1.66). The SIR was elevated for all leukaemias (SIR=1.51, 95% CI 1.08 to 2.07) and for lymphatic and haematopoietic cancers combined (SIR=1.31, 95% CI 1.05 to 1.61), but results for specific subtypes were imprecise. Deaths due to hazardous mining conditions resulted in 0.33 person-years of life lost per miner. CONCLUSIONS: Occupational exposure to the Příbram mines resulted in excess cancers at several sites, including sites previously linked to radon and uranium exposure. Incidence analyses showed relative excess of several additional cancer subtypes.

• Klíčová slova
• cancer, epidemiology, mining, radon, uranium,
• MeSH
• dospělí MeSH
• horníci * MeSH
• incidence MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory vyvolané zářením epidemiologie   mortalita   MeSH
• pracovní expozice škodlivé účinky   MeSH
• příčina smrti MeSH
• radon škodlivé účinky   MeSH
• senioři MeSH
• uran škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví 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
• radon MeSH
• uran MeSH

Micronuclei can be used as markers of past radiation exposure, but only few studies have dealt with uranium miners. In this paper, we report on micronuclei in lymphocytes from individuals currently working at Rožná, Czech Republic, the last functioning uranium mine in the European Union. A modified micronucleus-centromere test was applied to assess the occurrence of micronuclei in stimulated lymphocytes, as well as their content in terms of whole chromosomes or fragments. Compared with unexposed individuals, the miners had higher frequencies of micronucleus-containing lymphocytes and higher percentages of micronuclei without centromeres, and the differences were significant for both parameters (0.74 ± 0.60 vs. 0.50 ± 0.42, p = 0.017 and 49 ± 44 vs. 12 ± 21, p = 0.0002; means ± standard deviations). There were also significant correlations between one or other of these parameters on the one hand and various dose values on the other, in particular with a 'retrievable' dose, that is, a dose whose effect should still be recognisable in lymphocytes assuming a half-life of 3 years. The 'retrievable' dose at which a doubling of the micronucleus frequency was observed was around 35 mSv, corresponding to a total dose of 90 mSv received while working in the mines. Altogether, our data show that the micronucleus-centromere test is a valuable tool for the assessment of past radiation exposure in uranium miners. The scatter in the data is of course far too great to allow individual dosimetry, but for groups of a few dozen exposed individuals, the method can be used to monitor doses clearly below 100 mSv.

• MeSH
• centromera genetika   účinky záření   MeSH
• hornictví * MeSH
• lidé MeSH
• lymfocyty patologie   účinky záření   MeSH
• mikrojaderné testy MeSH
• mikrojádra chromozomálně defektní účinky záření   MeSH
• pracovní expozice škodlivé účinky   analýza   MeSH
• uran škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• uran MeSH

Exposure to radon and its decay products is one of the three parts that create the total effective dose of uranium miners. Photons from gamma radiation and exposition to long-lived alpha emitters which are members of uranium family are the other two parts. The monthly total effective dose of uranium miners in mine Rozna I (Czech republic) is determined by the personal dosemeter ALGADE, which ensures the continual individual monitoring of all three parts. The exposed dosemeters are evaluated in the National Institute for Nuclear, Chemical and Biological Protection in Kamenna near Pribram. This paper describes the individual parts of miners' total effective dose considering the different types of work activities and workplaces. The main input data are the evaluation results of the uranium miners' personal dosemeters ALGADE in mine Rozna I in the time period from 2000 till 2012.

• MeSH
• hornictví * MeSH
• lidé MeSH
• monitorování radiace * MeSH
• pracovní expozice analýza   MeSH
• radioaktivní znečišťující látky analýza   MeSH
• radon analýza   MeSH
• uran analýza   MeSH
• vztah dávky záření a odpovědi MeSH
• záření gama MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• radioaktivní znečišťující látky MeSH
• radon MeSH
• uran MeSH

Epidemiological evidence of lung cancer risk from radon is based mainly on studies of underground miners where occupational exposures were, historically, relatively high in comparison to residential indoor exposure. However, radiation protection measures have caused radon levels in uranium mines to decrease significantly in more recent periods. Miners' occupational exposure is limited to their working years while they are exposed to environmental radon at home over their entire lifetime. Even during their limited working years, workers spend much more time at home than in workplaces. The biological effect of radon in mines cannot be distinguished from the biological effect of residential radon. Therefore, for an exposure-risk relationship study of former uranium miners, excess radon-induced lung cancer cases should be related to the combined radon exposure cumulated in workplaces and at homes in excess of the radon exposure of the reference population. This is especially important when residential radon levels differ or vary significantly between miners and the reference population over the course of extended follow-up years. This paper reviews some recent studies on former uranium miners, shares what seems controversial to the author and wonders whether lifetime exposure at home to widely varying radon concentrations can actually impact the quality of exposure assessment, and hence impact the results of the exposure-risk relationship.

• Klíčová slova
• Exposure assessment, Radon-222, Risk assessment, Uranium miners,
• MeSH
• bydlení MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• hornictví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory vyvolané zářením epidemiologie   MeSH
• nemoci z povolání epidemiologie   MeSH
• pracovní expozice * MeSH
• radioaktivní látky znečišťující vzduch * MeSH
• radon * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• uran * MeSH
• znečištění vzduchu ve vnitřním prostředí 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
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Francie epidemiologie   MeSH
• Názvy látek
• radioaktivní látky znečišťující vzduch * MeSH
• radon * MeSH
• uran * MeSH

BACKGROUND: Despite reductions in exposure for workers and the general public, radon remains a leading cause of lung cancer. Prior studies of underground miners depended heavily upon information on deaths among miners employed in the early years of mine operations when exposures were high and tended to be poorly estimated. OBJECTIVES: To strengthen the basis for radiation protection, we report on the follow-up of workers employed in the later periods of mine operations for whom we have more accurate exposure information and for whom exposures tended to be accrued at intensities that are more comparable to contemporary settings. METHODS: We conducted a pooled analysis of cohort studies of lung cancer mortality among 57,873 male uranium miners in Canada, Czech Republic, France, Germany, and the United States, who were first employed in 1960 or later (thereby excluding miners employed during the periods of highest exposure and focusing on miners who tend to have higher quality assessments of radon progeny exposures). We derived estimates of excess relative rate per 100 working level months (ERR/100 WLM) for mortality from lung cancer. RESULTS: The analysis included 1.9 million person-years of observation and 1,217 deaths due to lung cancer. The relative rate of lung cancer increased in a linear fashion with cumulative exposure to radon progeny (ERR/100 WLM=1.33; 95% CI: 0.89, 1.88). The association was modified by attained age, age at exposure, and annual exposure rate; for attained ages <55 y, the ERR/100 WLM was 8.38 (95% CI: 3.30, 18.99) among miners who were exposed at ≥35 years of age and at annual exposure rates of <0.5 working levels. This association decreased with older attained ages, younger ages at exposure, and higher exposure rates. DISCUSSION: Estimates of association between radon progeny exposure and lung cancer mortality among relatively contemporary miners are coherent with estimates used to inform current protection guidelines. https://doi.org/10.1289/EHP10669.

• MeSH
• dceřiné produkty radonu MeSH
• horníci * MeSH
• lidé MeSH
• nádory plic * MeSH
• nádory vyvolané zářením * epidemiologie   etiologie   MeSH
• nemoci z povolání * epidemiologie   etiologie   MeSH
• pracovní expozice * MeSH
• radon * MeSH
• uran * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• dceřiné produkty radonu MeSH
• radon * MeSH
• uran * MeSH