Original article

Scand J Work Environ Health 2006;32(5):368-373    pdf

doi:10.5271/sjweh.1032

Cancer incidence among physicians occupationally exposed to ionizing radiation in Finland

by Jartti P, Pukkala E, Uitti J, Auvinen A

Objectives Occupational radiation exposure was estimated, and the cancer incidence among physicians working with radiation was compared to that of unexposed physicians.

Methods A cohort of 1312 physicians was identified from the Finnish occupational radiation exposure registry. Radiation exposure data were obtained from 1970 to 2001 on the basis of individual dosimeters. Never-monitored Finnish physicians (N=15 821) were used as a reference group, identified from census data of Statistics Finland. Incident cancer cases were identified by record linkage with the Finnish Cancer Registry.

Results The cumulative radiation dose exceeded the recording level (0.3–3.0 mSv during a 3-month period for 1029 radiation-exposed physicians (59.8%). Six percent of the radiologists had received a cumulative dose of 50 mSv or more. Altogether there were 41 cancers observed among the radiation-exposed physicians and 998 cases found in the never-monitored group. Standardized incidence ratios (SIR) for all cancers were comparable with those of the general population among physicians monitored for radiation [SIR 1.0, 95% confidence interval (95% CI) 0.7–1.4] and other physicians (SIR 1.0, 95% CI 1.0–1.1). For specific cancer sites, a slightly elevated risk of female breast cancer was found among monitored physicians when compared with other physicians (rate ratio 1.7, 95% CI 1.0–3.1). No obvious dose-response relationship was found for the overall cancer incidence.

Conclusions According to the results from a nationwide cohort, occupational exposure to medical radiation is not a strong risk factor for cancer among physicians. Possible excess risk could not be reliably demonstrated even after the follow-up of a nationwide cohort for up to 30 years.