Radon exposure and cancers other than lung cancer among uranium miners in West Bohemia

doi:10.1016/0140-6736(93)91212-5

The Lancet

Volume 341, Issue 8850, 10 April 1993, Pages 919-923

https://doi.org/10.1016/0140-6736(93)91212-5 Get rights and content

Abstract

Recent observations have suggested that radon in the ambient air may cause cancers at sites other than the lung, but the evidence is indirect. We have studied site-specific cancer mortality in 4320 uranium miners in West Bohemia who have been followed-up for an average of 25 years, and in whom a four-fold radon-related excess of lung cancer has already been established.

For all cancers other than lung cancer the number of deaths observed was slightly greater than that expected from national rates, but the increase was not significant statistically (ratio of observed to expected deaths [O/E]=1·11, 95% confidence interval [Cl]=0·98-1·24) and mortality did not increase with duration of employment underground or with cumulative exposure to radon. Non-lung cancer mortality was significantly raised among men who started mining work aged under 25 but the increase was not related to cumulative radon exposure. When twenty-eight individual sites and types of cancer were examined, significantly increased risks were found for cancers of the liver (O/E=1·67) and gallbladder and extrahepatic bileducts (O/E=2·26). For liver cancer, mortality did not increase with duration of employment underground or with cumulative radon exposure. For cancer of the gallbladder and extrahepatic bileducts, mortality did not increase with duration of employment, but increased with cumulative exposure to radon. Mortality from multiple myeloma, although not significantly increased overall (O/E=1·08), increased with cumulative exposure to radon. Mortality from leukaemia was not increased overall (O/E=0·91) and was not related to cumulative radon exposure, but did increase with increasing duration of employment in the mines.

There is no evidence in these miners that a radon-rich atmosphere increases the risk of any cancer other than lung cancer. Possible exceptions are cancer of the gallbladder and extrahepatic bileducts and multiple myeloma but further study is needed before it can be concluded that the associations found are causal.

References (31)

Dl Henshaw et al.
Radon as a causative factor in induction of myeloid leukaemia and other cancers
Lancet
(1990)
Jp Eatough et al.
Radon and prostate cancer
Lancrt
(1990)
Ba Bridges et al.
Possible association between mutant frequency in peripheral lymphocytes and domestic radon concentrations
Lancet
(1991)
Committee on Biological Effects of Ionizing Radiation (BEIR IV)
Health risks of radon and other internally deposited alpha-emitters
(1988)
Sc Darby et al.
Radon in houses: how large is the risk?
Radiat Protect Aust
(1990)
Rb Richardson et al.
Dose to red bone marrow from natural radon and thoron exposure
Br J Radiol
(1991)
Jp Eatough et al.
Radon dose to the skin and the possible induction of skin cancers
Radiat Protect Dosim
(1991)
Jp Eatough et al.
Radon and thoron associated dose to the basal layer of the skin
Phys Med Biol
(1992)
AC. James, Dosimetry of radon and thoron exposures: implications for risks from indoor exposure, Proceedings of the...
J. Ševc et al.
Lung cancer in uranium miners and long term exposure to radon daughter products
Health Phys
(1976)

J. Ševc, L. Tomášek, E. Kunz, V. Placek, D. Chmelevsky, D. Barclay, AM. Kellerer, A survey of the Czechoslovak...

Aj Fox et al.

Low mortalitiy rates in industrial cohort studies due to selection for work and survival in the industry

Br J Prev Soc Med

(1976)

AJ. Fox

Vinyl chloride and mortality?

Lancet

(1976)

UNSCEAR. Sources, effects and risks of ionizing radiation

(1988)

M. Andersson et al.

Cancer incidence among Danish Thorotrast-exposed patients

J Natl Cancer Inst

(1992)

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To assess the association between exposure to radon and genitourinary cancer in a mining population through a systematic review of the scientific literature.
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ARTICLESRadon exposure and cancers other than lung cancer among uranium miners in West Bohemia

Abstract

Lancet

Lancrt

Lancet

Health risks of radon and other internally deposited alpha-emitters

Radon in houses: how large is the risk?

Radiat Protect Aust

Dose to red bone marrow from natural radon and thoron exposure

Br J Radiol

Radon dose to the skin and the possible induction of skin cancers

Radiat Protect Dosim

Radon and thoron associated dose to the basal layer of the skin

Phys Med Biol

Lung cancer in uranium miners and long term exposure to radon daughter products

Health Phys

Low mortalitiy rates in industrial cohort studies due to selection for work and survival in the industry

Br J Prev Soc Med

Vinyl chloride and mortality?

Lancet

UNSCEAR. Sources, effects and risks of ionizing radiation

Cancer incidence among Danish Thorotrast-exposed patients

J Natl Cancer Inst

ARTICLES
Radon exposure and cancers other than lung cancer among uranium miners in West Bohemia