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1.
Radiat Environ Biophys ; 59(3): 423-437, 2020 08.
Article in English | MEDLINE | ID: mdl-32567014

ABSTRACT

Epidemiological data on cohorts of occupationally exposed uranium miners are currently used to assess health risks associated with chronic exposure to low doses of ionizing radiation. Nevertheless, exposure uncertainty is ubiquitous and questions the validity of statistical inference in these cohorts. This paper highlights the flexibility and relevance of the Bayesian hierarchical approach to account for both missing and left-censored (i.e. only known to be lower than a fixed detection limit) radiation doses that are prone to measurement error, when estimating radiation-related risks. Up to the authors' knowledge, this is the first time these three sources of uncertainty are dealt with simultaneously in radiation epidemiology. To illustrate the issue, this paper focuses on the specific problem of accounting for these three sources of uncertainty when estimating the association between occupational exposure to low levels of γ-radiation and lung cancer mortality in the post-55 sub-cohort of French uranium miners. The impact of these three sources of dose uncertainty is of marginal importance when estimating the risk of death by lung cancer among French uranium miners. The corrected excess hazard ratio (EHR) is 0.81 per 100 mSv (95% credible interval: [0.28; 1.75]). Interestingly, even if the 95% credible interval of the corrected EHR is wider than the uncorrected one, a statistically significant positive association remains between γ-ray exposure and the risk of death by lung cancer, after accounting for dose uncertainty. Sensitivity analyses show that the results obtained are robust to different assumptions. Because of its flexible and modular nature, the Bayesian hierarchical models proposed in this work could be easily extended to account for high proportions of missing and left-censored dose values or exposure data, prone to more complex patterns of measurement error.


Subject(s)
Lung Neoplasms/epidemiology , Models, Statistical , Neoplasms, Radiation-Induced/epidemiology , Radiation Dosage , Bayes Theorem , France , Gamma Rays/adverse effects , Humans , Mining , Occupational Exposure/adverse effects , Uncertainty , Uranium/adverse effects
2.
Int J Epidemiol ; 21(6): 1063-73, 1992 Dec.
Article in English | MEDLINE | ID: mdl-1483810

ABSTRACT

A case-control study has been performed for occupational risk factors of acute leukaemia, based on 185 cases more than 30 years old and 513 matched controls. There was a significant excess of polyvalent farming and electronic engineers among professions of cases, and, in addition of metal workers when considering the professions pursued for more than 5 years. The corresponding exposures were analysed through a detailed questionnaire, and assessed by an industrial hygienist after blinding the case-control status. The odds ratios (OR) were computed after adjustment on matching variables and prior chemo- or radiotherapy treatment, and after stratification for the level and total duration of exposure. There was no excess of professional exposure to ionizing radiation among cases. A significant relationship was observed between acute leukaemia and high or medium exposure to benzene, as well as over 10 years high or medium exposure to exhaust gas. In addition a significant relationship was observed with exposure to pesticides--insecticides and/or weed killers--and to electric and magnetic fields (EMF). The relationship with pesticides was significant when considering high or medium exposure to weed killers and more than 10 years exposure to both subtypes of pesticides. The relationship with pesticides and EMF remained significant when confounding factors were taken into consideration and after adjustment on co-exposure to benzene. The cytological studies showed that acute leukaemias following exposure to benzene (high or medium) and to EMF were only of myelogenous subtypes, whereas those following exposure to pesticides were divided between lymphoblastic and myeloblastic subtypes. Cytogenetic studies failed to show increased frequency of chromosomal abnormalities, as described in acute leukaemias secondary to anti-cancer treatments. Our study adds credence to the hypothesis that pesticides and EMF are leukaemogenic agents, together with benzene.


Subject(s)
Leukemia, Radiation-Induced/etiology , Leukemia/chemically induced , Occupational Diseases/chemically induced , Occupational Exposure/adverse effects , Acute Disease , Adult , Aged , Agricultural Workers' Diseases/epidemiology , Agricultural Workers' Diseases/etiology , Case-Control Studies , Electromagnetic Fields/adverse effects , Female , France/epidemiology , Herbicides/adverse effects , Humans , Leukemia, Radiation-Induced/epidemiology , Male , Middle Aged , Occupational Diseases/epidemiology , Pesticides/adverse effects , Radiation Dosage , Risk Factors , Solvents/adverse effects
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