Background An increased risk of leukaemia following exposures of acute high doses of ionising radiation is well established, while the risks associated with protracted low dose or internal exposures are less clear.
Methods Analyses were conducted in a cohort of 58.972 German uranium miners with mortality follow-up from 1946 to 2013. The red bone marrow (RBM) dose for low-linear energy transfer (LET) (mainly external gamma radiation) and high-LET (mainly radon gas) radiation was estimated based on a job-exposure-matrix and biokinetic/dosimetric models. Linear excess relative risks (ERR) and 95% confidence intervals (CI) were estimated via Poisson regression models for chronic lymphatic leukaemia (CLL) and non-CLL.
Results The mean cumulative low- and high LET RBM doses among the 86% radiation exposed workers were 47 mGy and 9 mGy, respectively. There was a positive non-significant linear dose response for mortality from non-CLL (n = 120) in relation to low-LET (ERR/Gy = 2.2; 95% CI: −0.4; 6.4) and high-LET dose (ERR/Gy = 16.7; 95%: −1.1; 46.8). This excess was mainly related to chronic myeloid leukaemia (n = 31) with an ERR/Gy of 7.2 (95% CI: 0.5; 24.5) and 42.4 (95% CI: −0.9; 170.6) for low- and high-LET dose, respectively. The ERR/Gy tended to be about five to ten times higher for high- versus low- LET RBM dose, however, the confidence intervals largely overlap. Results do not indicate any association of death from CLL (n = 70) with any of the two types of radiation.
Conclusion Our findings support an increased risk of death from non-CLL in relation to chronic low-LET radiation and alpha-radiation and no such relation for CLL.
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