Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis

원전종사자의 방사선 노출과 암사망 위험도와의 관련성에 대한 메타분석

  • Park, Eun-Sook (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Moon, Ki-Eun (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Kim, Han-Na (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Lee, Won-Jin (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Jin, Young-Woo (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.)
  • 박은숙 (한국수력원자력(주) 방사선보건연구원 방사선영향연구팀) ;
  • 문기은 (한국수력원자력(주) 방사선보건연구원 방사선영향연구팀) ;
  • 김한나 (한국수력원자력(주) 방사선보건연구원 방사선영향연구팀) ;
  • 이원진 (고려대학교 의과대학 예방의학교실) ;
  • 진영우 (한국수력원자력(주) 방사선보건연구원 방사선영향연구팀)
  • Received : 2009.08.26
  • Accepted : 2009.12.08
  • Published : 2010.03.31
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Abstract

Objectives: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. Methods: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. A publication bias was tested for using Egger's test. The homogeneity test was performed before the integration of each of the standardized mortality ratios (SMRs) and the result proved that the studies were heterogeneous. Results: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. Conclusions: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

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