Table 1 Reviewed articles on physical hazards and leukemia
Researcher | Year | Type of study | Exposure | Main findings |
|---|---|---|---|---|
A. Ionizing radiation and leukemia | ||||
1) Update of LSS study findings | ||||
Little et al. [6] | 2009 | Review | Ionizing radiation | Leukemia RR follows the pattern of LSS study for low dose (occupational) exposure - Lower RR per dose unit for higher doses of radiation |
Richardson et al. [9] | 2009 | Cohort study | Ionizing radiation | Exposure to >5 mGy of radiation is responsible for 1/3 of leukemia cases after 5 decades – ERR/Gy follows a quadratic dose-response model for AML. ALL and CML mortality follow a linear dose-response model. |
2) Cleanup workers employed in Chernobyl nuclear incident | ||||
Rahu et al. [27] | 2006 | Cohort study | Ionizing radiation | No significant increase in leukemia incidence among workers (SIR 1.53, 95% CI 0.62 - 3.17). A marginally significant increase has been observed among Latvian workers but it was based on a small number of cases. |
Abramenko et al. [28] | 2008 | Cohort study | Ionizing radiation | Among a cohort of CLL patients, specific genetic polymorphisms where observed more frequently among cleanup workers exposed to radiation following the nuclear accident in Chernobyl than in non-exposed CLL patients |
2008 | Nested case-control study | Ionizing radiation | Positive linear trend (p = 0.03) between increasing exposure to radiation and leukemia risk. The ERR/Gy for leukemia was 3.44 (95% CI 0.47 – 9.78). A linear dose - response relationship has been shown for ALL and (surprisingly) for CLL. | |
Kesminiene et al. [31] | 2008 | Case-control study | Ionizing radiation | A statistically significant association was shown (at 90% but not at 95% level) between AL and employment as a cleanup worker in the surrounding area (<30 km) of Chernobyl accident site (OR 8.31, 90% CI 1.17 - 122). |
3) Workers in nuclear industry | ||||
Boice et al. [32] | 2006 | Cohort study | Ionizing radiation | No significant increase in leukemia mortality (SMR 1.21, 95% CI 0.69- 1.97) or increased leukemia risk for the highly-exposed group (RR 1.34, 95% CI 0.73–2.45) was shown among workers. |
Richardson et al. [33] | 2007 | Cohort study | Ionizing radiation (& exposure to chemicals) | A borderline significant increase of leukemia mortality was shown (at 90% but not at 95% level) only for operators and manual workers (SMR 1.36, 90% CI 1.02 - 1.78) and for workers employed >30 years (SMR 1.63, 90% CI 1.07 - 2.52). |
Richardson et al. [34] | 2007 | Nested case-control study | Ionizing radiation | Assuming a 3-year time lag, no significantly increased ERR/10 mSv was shown for all leukemias (0.041, 90% CI -0.001 – 0.116), for leukemias excluding CLL (0.077, 90% CI 0.014 – 0.198) or for myeloid leukemia (0.123, 90% CI 0.021 - 0.354). |
Schubauer-Berigan et al. [35] | 2007 | Nested case-control study | Ionizing radiation | A non-significant positive association between radiation dose and leukemia risk was shown for doses 10 - 100 mSv, with an estimated ERR/10 mSv of 0.068 (95% CI -0.029 - 0.24). |
Schubauer-Berigan et al. [36] | 2007 | Nested case-control study | Ionizing radiation | A non-significant positive association between radiation dose and CLL risk was shown for doses 10 - 100 mSv, with an estimated ERR/10 mSv of 0.20 (95% CI -0.035 – 0.96). |
Matanoski et al. [37] | 2008 | Cohort study | Ionizing radiation | No statistically significant increase of leukemia mortality (SMR 0.91, 95% CI 0.56 – 1.39 and 0.42, 95% 0.11 – 1.07 for exposure to > 5.0 mSv and <5.0 mSv of radiation respectively) was shown among workers |
Ashmore et al. [38] | 2010 | Review | Ionizing radiation | Previous study of IARC (2005) who found no statistically significant association between leukemia and radiation exposure among workers in nuclear industry could be biased due to inaccurate estimation of exposure. |
4) Medical applications of radiation | ||||
Lie et al. [39] | 2008 | Cohort study | Ionizing radiation | No significant increase in leukemia risk was found for the group nurses with the longest (> 30 years) employment in posts exposed to radiation compared to the group of non-exposed nurses (RR 0.77, 95% CI 0.35 – 1.69). |
Samerdokiene et al. [40] | 2009 | Cohort study | Ionizing radiation | No significant increase in leukemia incidence (SIR 3.3, 95% CI 0.68- 9.63 for men and 2.67, 95% CI 0.92-4.2 for women) was shown among personnel employed in medical applications of ionizing radiation. |
Ramos et al. [41] | 2008 | Case-control study (exposure assessment) | Ionizing radiation | The projected risk of leukemia cases/1000 person-years based on cumulative radiation exposure among a group of interventional radiologists differed between 2 methods of exposure assessment (1.07-3.98 according to the physical method compared to 1.07-11.21 for the biological method) suggesting a potential improper use of personal dosimeters. |
Ramos et al. [42] | 2009 | Molecular epidemiological study | Ionizing radiation | The projected LAR of leukemia (cases/1000 person-years) among interventional radiologists due to radiation exposure, was much higher according to biological methods of exposure assessment (9.2) compared to physical methods (2.18). |
5) Industrial applications of ionizing radiation | ||||
Ahn et al. [43] | 2008 | Cohort study | Ionizing radiation (industrial applications) | No statistically significant increase of leukemia SMR or SRR was shown among personnel exposed to radiation (workers in medical applications, research laboratories, nuclear facilities, non-destructive testing, military facilities etc.). |
6) Extraction and use of uranium compounds | ||||
Storm [44] | 2006 | Cohort study | Depleted uranium | No statistically significant increase of leukemia incidence was found among military personnel exposed to depleted uranium used during military operations (SIR 1.4, 95% CI 0.4 - 3.5). |
Mohner [45] | 2006 | Case-control study | Uranium mining (radionuclides) | No significant increase of leukemia risk was found in the group with the highest cumulative exposure to radon (> 400 mSv) compared to the low exposure group (OR 2.21, 90% CI 1.25–3.91). |
Mohner [46] | 2010 | Case-control study | Uranium mining (radionuclides) | No significant increase of leukemia risk was found among the group of workers with the highest (> 200 mSv) cumulative exposure (OR 1.33, 90% CI 0.82-2.14). |
B. Non-ionizing radiation (EMF) and leukemia | ||||
Roosli [47] | 2007 | Cohort-study | ELF EMF | A significantly increased Hazard Ratio was shown for myeloid leukemia among the workers with the highest exposure to ELF EMF (HR 4.74, 95% CI 1.04-21.6, p=0.035). |
Kheifets [48] | 2008 | Meta-analysis | EMF | A small but statistically significant increase in leukemia risk was found among the exposed group (RR 1.16, 95% CI 1.11-1.22 for all leukemias). |