I. Guseva Canu

Uranium carcinogenicity in humans might depend on the physical and chemical nature of uranium and its isotopic composition: results from pilot epidemiological study of French nuclear workers.

ObjectiveTo study the cancer risk related to protracted, low-dose exposure to different industrial uranium compounds, paying attention to their isotopic composition and solubility.MethodsTwo thousand and ninety-seven workers employed at the AREVA NC uranium processing plant (France) were followed up for mortality from 1960 to 2006. Historical exposure to uranium and other carcinogenic chemical and physical pollutants was assessed on the basis of the plant-specific job-exposure matrix. For each type of uranium, Cox regression models stratified on sex and calendar period, and adjusted for socioeconomic status and potentially confounding co-exposures were used to estimate hazard ratios (HRs) for mortality from lung cancer (53 deaths) and lymphatic and hematopoietic tissue malignancies (21 deaths).ResultsWe observed that exposure to reprocessed uranium entails increasing risks of mortality from lung cancer and lymphatic and hematopoietic malignancies (the most significant HR being respectively 1.14 (95% CI: 1.00–1.31) and 1.20 (95% CI: 1.01–1.43) per unit of a time-lagged log-transformed continuous exposure scores), and that the HRs tend to increase with decreasing solubility of the compounds.ConclusionOur results suggest that uranium carcinogenicity may depend on isotopic composition and solubility of uranium compounds. This study is the first to show the carcinogenic effect of slowly soluble reprocessed uranium on two uranium target organs. This finding is consistent with data from epidemiological and experimental studies on similar compounds but need to be confirmed in the more powerful dose–response analysis.

Malignant pleural mesothelioma risk among nuclear workers: a review

Exposure to ionising radiation has been suggested as a causal risk factor for malignant pleural mesothelioma (MPM). Studies of patients treated by radiotherapy for primary cancers have suggested that radiation contributes to the development of secondary MPM. Here we examined the risk to nuclear workers of MPM related to exposure to low doses of occupational radiation at low dose rates. All results concerning MPM risk in published studies of nuclear workers were examined for their association with radiation exposure and potential confounders. We found 19 relevant studies. Elevated risks of pleural cancer were reported in most (15/17) of these studies. Eight reported risks higher for radiation monitored workers than for other workers. However, of 12 studies that looked at associations with ionising radiation, only one reported a significant dose-risk association. Asbestos was an important confounder in most studies. We conclude that studies of nuclear workers have not detected an association between ionising radiation exposure and MPM. Further investigations should improve the consideration of asbestos exposure at the same time as they address the risk of MPM related to occupational exposure of nuclear workers to low doses of ionising radiation at low dose rates.

Characterisation of protracted low-level exposure to uranium in the workplace: A comparison of two approaches.

Retrospective estimates of internal doses received by workers in the nuclear industry following intake of radionuclides, based on bioassay data, are a benchmark method in epidemiological studies. Nonetheless, full information relative to thousands of people included in an epidemiological cohort is rarely available, thus implying difficulties to estimate exposure precisely. To evaluate the cumulative exposure to uranium in a cohort of the AREVA NC Pierrelatte plant workers, we compared the epidemiological Job Exposure Matrix (JEM) method with the dosimetric method based on biological monitoring of exposure for 30 workers randomly selected within the cohort. A moderate to strong correlation was observed between the estimators resulting from the two approaches, thereby validating the JEM as a tool that can be used to characterise cumulative exposure to uranium in the cohort. In addition, this study showed that the JEM is a valuable complement to the interpretation of bioassy, (1) in providing information on exposure periods as well as on physical and chemical form of the radionuclides and (2) in compensating for the lack of exposure data regarding the very earliest periods. Combining the two methods may improve the precision in reconstructing cumulative exposure for epidemiological studies.

Effets de la contamination chronique à l’uranium sur la mortalité : bilan d’une étude-pilote chez les travailleurs de l’industrie nucléaire en France

BACKGROUND This article presents the mortality data compiled among a cohort of workers at risk of internal uranium exposure and discusses the extent to which this exposure might differentiate them from other nuclear workers. METHODS The cohort consisted of 2897 Areva-NC-Pierrelatte plant workers, followed from 1st January 1968 through 31st December 2006 (79,892 person-years). Mortality was compared with that of the French population, by calculating Standardized Mortality Ratios (SMR) and 95% confidence intervals (CI95%). External radiation exposure was reconstructed using external dosimetry archives. Internal uranium exposure was assessed using a plant-specific job-exposure-matrix, considering six types of uranium compounds according to their nature (natural and reprocessed uranium [RPU] and solubility [fast-F, moderate-M, and slow-S]). Exposure-effect analyses were performed for causes of death known to be related to external radiation exposure (all cancers and circulatory system diseases) and cancer of uranium target-organs (lung and hematopoietic and lymphatic tissues, HLT). RESULTS A significant deficit of mortality from all causes (SMR=0.58; CI95% [0.53-0.63]), all cancers (SMR=0.72; CI95% [0.63-0.82]) and smoking related cancers was observed. Non-significant 30%-higher increase of mortality was observed for cancer of pleura (SMR=2.32; CI95 % [0.75-5.41]), rectum and HLT, notably non-Hodgkins lymphoma (SMR=1.38; CI95 % [0.63-2.61]) and chronic lymphoid leukemia (SMR=2.36; CI95% [0.64-6.03]). No exposure-effect relationship was found with external radiation cumulative dose. A significant exposure-effect relationship was observed for slowly soluble uranium, particularly RPU, which was associated with an increase in mortality risk reaching 8 to 16% per unit of cumulative exposure score and 10 to 15% per year of exposure duration. CONCLUSION The Areva-NC-Pierrelatte workers cohort presents a non-significant over-mortality from HLT cancers, notably of lymphoid origin, unrelated to external radiation exposure. The pilot study suggests an association between mortality from the HLT and lung cancers and exposure to slowly soluble RPU compounds. The results of this study should be investigated further in more powerful studies, with a dose-response analysis based on individual assessment of uranium absorbed dose to uranium-target organs.