Table 1.
Reports of the risk of thyroid cancer (TC) incidence of radiation-exposed workers and health care occupations
| Overall | Men | Women | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | Study Design | Study Years | Study Size/Age Information |
Country | Source of Exposure Information |
Exposure Measure | Exposed N cases |
Risk Estimate | Exposed N cases |
Risk Estimate | Exposed N cases |
Risk Estimate |
| Cohort studies | ||||||||||||
| Ivanov 2008 [51] | I-PC | 1986-2003 | 103427; avg age first employment: 30-35 | Russia | O-ER | Chernobyl emergency workers | 87 | SIR=3.47 (2.80-4.25) | ||||
| D | Chernobyl emergency workers, risk per unit dose | 67 | ERR/Gy=−0.29 (−3.18-3.24) | |||||||||
| O-ER | Chernobyl emergency workers involved in early recovery operations | 34 | SIR=6.62 (4.63-9.09) | |||||||||
| Jeong 2010 [52] | I-PC | 1992-2005 | 16236; avg age 41.3 at end of follow-up for radiation exposed | Republic of Korea | O-ER | Nuclear power radiation workers | 10 | SIR=5.93 (2.84-10.9) | ||||
| D | Nuclear power radiation workers, risk per unit dose | 10 | ERR/Sv=45.2 (<−12.1-97.4) | |||||||||
| D | Nuclear power radiation workers, 100+ mSV compa red to 0 mSV | 2 | RR=18.51 (1.7-204.3) | |||||||||
| Kjaer 2009 [65] | I-RC | 1980-2003 | 92140; age range: 18-66 | Denmark | O-ER | Nurses | 76 | SIR=1.3 (0.99-1.6) | ||||
| Li e 2008 [64] | I-RC | 1953-2002 | 43316; age range <35 to 80+ | Norway | O-ER | Nurses, risk by time since first exposure (40 years) | 18 | RR=0.96 (0.36-2.61) | ||||
| Shaham 2003 [66] | I-RC | 1960-1997 | 4300; avg age: 29.1 | Israel | O-ER | Laboratory worker | 11 | SIR=1.44 (0.72-2.58) | 11 | SIR=1.61 (0.80-2.87) | ||
| Laboratory worker, 20 year latency | 5 | SIR=4.86 (1.58-11.3) | ||||||||||
| Sigurdson 2003 [58] | I-PC | 1983-1998 | 90305; age range: <18 to not reported | United States | O-I | Radiologic technologist | 124 | SIR=1.61 (1.34-1.88) | 17 | SIR=2.23 (1.29-3.59) | 107 | SIR=1.54 (1.24-1.83) |
| Wang 1990 [59] | I-RC | 1950-1985 | 27,011 x-ray workers; 25,782 physicians not using x-ray; avg age first employment: 26 | China | O-ER | X-ray workers (diagnostic x-ray) | 8 | RR=1.7 | 5 | RR=1.7 | ||
| Wong 2006 [56] | I-RC | 1989-1998 | 3,317; 130 cases; age range: 3-69 | China | O-ER linked to JEM | Electromagnetic field, ionizing radiation, 10+ years | 64 | HR=0.88 (0.59-1.29) | ||||
| Zabel 2006* [60] | I-PC | 1982-1998 | 73080; age range: <18 to not reported | United States | O-Q | X-ray technologist, holding patients 50 or more times | 71 | HR=1.47 (1.01-2.15) | ||||
| X-ray technologist, had X-rays practiced on self | 17 | HR=1.46 (0.86-2.46) | ||||||||||
| X-ray technologist, total years worked >25 compared to <5 | 12 | HR=2.29 (0.99-5.32) | ||||||||||
| X-ray technologist, worked before age 20 | 56 | HR=1.02 (0.71-1.47) | ||||||||||
| X-ray technologist, years worked before 1950, >5 compared to 0 | 11 | HR=3.04 (1.01-10.78) | ||||||||||
| Zielinski 2009 [55] | I-RC | 1951-1987 | 67562; age data not reported | Canada | O-ER | Medical workers | 65 | SIR=1.74 (1.40-2.14)** | 14 | SIR=2.10 (1.27-3.29)** | 51 | SIR=1.66 (1.30-2.10)** |
| Population-based studies: JEMs and self-reported x-ray work | ||||||||||||
| Hallquist 1993 [47] | C-C | 1980-1989 | 180 cases; 360 controls; age range: 20-70 | Sweden | SR | X-ray work (papillary thyroid cancer) | 9 | OR=2.9 (1.1-8.3) | 7 | OR=3.3 (1.2-9.8) | ||
| Fincham 2000 [50] | C-C | 1986-1988 | 1,272 cases; 2,666 controls; | Canada | SR | Ionizing radiation | 65 | OR=1.03 (0.60-1.77) | ||||
| age data not 2992166; | Electromagnetic fields | 19 | OR=1.59 (0.80-3.15) | |||||||||
| Lope 2006 [48] | R-RC | 1971-1989 | age range 24+ to not reported | Sweden | O-R linked to JEM | Electromagnetic fields, >0.35 uT compared to <0.15 uT | 155 | RR=1.06 (0.85-1.33) | 23 | RR=0.64 (0.42-0.97) | ||
| O-R linked to JEM | Ionizing radiation, medium intensity | 23 | RR=0.96 (0.63-1.45) | |||||||||
| Ionizing radiation, high intensity | 11 | RR=1.85 (1.02-3.35) | ||||||||||
| Population-based studies: health care occupations | ||||||||||||
| Carstensen 1990 [57] | R-RC | 1961-1979 | Sweden; 4,167 cases; age range: 20-69 | Sweden | O-R | Medical and other health service | 117 | SIR=1.07 | 22 | SIR=1.82 | 95 | SIR=.98 |
| X-ray operators, lab assistants | 12 | SIR=2.44 | 9 | SIR=2.24 | ||||||||
| Fincham 2000 [50] | C-C | 1986-1988 | 1,272 cases; 2,666 controls; age data not reported | Canada | O-Q | Medicine and health | 100 | OR=1.08 (0.83-1.39) | ||||
| Haselkorn 2000 [63] | R-RC | 1972-1995 | Los Angeles County; 8820 cases; age range: 0 to 85+ | United States | O-R | Dentists | 12 | PIR=388.4 (200.5-678.5) | ||||
| Physicians | 34 | PIR=240.6 (166.6-336.2) | 12 | PIR=164.6 (85.0-287.6) | ||||||||
| Radiologic technicians | 5 | PIR=425.8 (137.2-993.6) | ||||||||||
| Lope 2005 [61] | R-RC | 1971-1989 | 1,066,346 women; 1,496 cases | Sweden | O-R | Nurses and orderlies | 121 | RR=1.22 (1.01-1.47) | ||||
| Medical technicians | 11 | RR=1.85 (1.02-3.35) | ||||||||||
| Pukkala 2009 [46] | R-RC | 1961-2005 | O-R | Laboratory worker | 8 | SIR=0.95 (0.41-1.88) | 52 | SIR=1.08 (0.80-1.41) | ||||
| 15,000,000; 6,487 cases; age range 30-64 | Denmark, Finland, Iceland, Norway, Sweden | Physicians | 25 | SIR=0.82 (0.53-1.22) | 23 | SIR=0.88 (0.56-1.32) | ||||||
| Dentists | 12 | SIR=1.05 (0.54-1.83) | 17 | SIR=0.94 (0.55-1.51) | ||||||||
| Nurses | 329 | SIR=1.08 (0.97-1.20) | ||||||||||
| Assistant nurses | 8 | SIR=1.01 (0.44-2.00) | 393 | SIR=1.05 (0.95-1.16) | ||||||||
| Other health workers | 27 | SIR=1.22 (0.80-1.77) | 228 | SIR=1.04 (0.91-1.18) | ||||||||
| Wingren 1995 [62] | C-C | 1977-1989 | 185 cases; 426 controls; age range 20-60 | Sweden | O-Q | Dentist/dental assistant | 7 | OR=13.1 (2.1-289) | ||||
The risk of thyroid cancer was reported as standardized incidence ratio (SIR), odds ratio (OR), relative risk (RR), hazard ratio (HR), incidence rate ratio (IRR), and proportional incidence ratio (PIR). Bolding indicates a significant effect.
If the confidence interval is not presented with the risk estimate, it is because that information is not available in the original article.
D, Dosimetry; B, Biological Monitoring; O-R, Occupation from registry; O-Q, Occupation from questionnaire; O-I, Occupation from interview; O-ER, Occupation from employment records; SR, self-reported exposure; JEM, job-exposure matrix.
I-RC, industry-based retrospective cohort; I-PC, industry-based prospective cohort; R-RC, registry-based retrospective cohort; RB-CC, registry-based case-control; C-C, case-control study.
*
Additional stratified analyses available in publication not presented here.