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Article ; Online: Occupational radiation and haematopoietic malignancy mortality in the retrospective cohort study of US radiologic technologists, 1983-2012.

Linet, Martha S / Little, Mark P / Kitahara, Cari M / Cahoon, Elizabeth K / Doody, Michele M / Simon, Steven L / Alexander, Bruce H / Preston, Dale L

Occupational and environmental medicine

2020 Volume 77, Issue 12, Page(s) 822–831

Abstract: Objectives: To evaluate cumulative occupational radiation dose response and haematopoietic malignancy mortality risks in the US radiologic technologist cohort.: Methods: Among 110 297 radiologic technologists (83 655 women, 26 642 men) who completed ... ...

Abstract	Objectives: To evaluate cumulative occupational radiation dose response and haematopoietic malignancy mortality risks in the US radiologic technologist cohort. Methods: Among 110 297 radiologic technologists (83 655 women, 26 642 men) who completed a baseline questionnaire sometime during 1983-1998, a retrospective cohort study was undertaken to assess cumulative, low-to-moderate occupational radiation dose and haematopoietic malignancy mortality risks during 1983-2012. Cumulative bone marrow dose (mean 8.5 mGy, range 0-430 mGy) was estimated based on 921 134 badge monitoring measurements during 1960-1997, work histories and historical data; 35.4% of estimated doses were based on badge measurements. Poisson regression was used to estimate excess relative risk of haematopoietic cancers per 100 milligray (ERR/100 mGy) bone-marrow absorbed dose, adjusting for attained age, sex and birth year. Results: Deaths from baseline questionnaire completion through 2012 included 133 myeloid neoplasms, 381 lymphoid neoplasms and 155 leukaemias excluding chronic lymphocytic leukaemia (CLL). Based on a linear dose-response, no significant ERR/100 mGy occurred for acute myeloid leukaemia (ERR=0.0002, 95% CI <-0.02 to 0.24, p-trend>0.5, 85 cases) or leukaemia excluding CLL (ERR=0.05, 95% CI <-0.09 to 0.24, p-trend=0.21, 155 cases). No significant dose-response trends were observed overall for CLL (ERR<-0.023, 95% CI <-0.025 to 0.18, p-trend=0.45, 32 cases), non-Hodgkin lymphoma (ERR=0.03, 95% CI <-0.2 to 0.18, p-trend=0.4, 201 cases) or multiple myeloma (ERR=0.003, 95% CI -0.02 to 0.16, p-trend>0.5, 112 cases). Findings did not differ significantly by demographic factors, smoking or specific radiological procedures performed. Conclusion: After follow-up averaging 22 years, there was little evidence of a relationship between occupational radiation exposure and myeloid or lymphoid haematopoietic neoplasms.
MeSH term(s)	Aged ; Allied Health Personnel/statistics & numerical data ; Cohort Studies ; Female ; Hematologic Neoplasms/mortality ; Humans ; Male ; Middle Aged ; Neoplasms, Radiation-Induced/mortality ; Occupational Diseases/mortality ; Occupational Exposure ; Radiation Dosage ; Radiation Exposure ; Retrospective Studies ; Risk Factors ; Technology, Radiologic/statistics & numerical data ; United States/epidemiology
Language	English
Publishing date	2020-09-23
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2019-106346
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Article ; Online: Radiation exposure and leukaemia risk among cohorts of persons exposed to low and moderate doses of external ionising radiation in childhood.

British journal of cancer

2023 Volume 129, Issue 7, Page(s) 1152–1165

Abstract: Background: Many high-dose groups demonstrate increased leukaemia risks, with risk greatest following childhood exposure; risks at low/moderate doses are less clear.: Methods: We conducted a pooled analysis of the major radiation-associated ... ...

Abstract	Background: Many high-dose groups demonstrate increased leukaemia risks, with risk greatest following childhood exposure; risks at low/moderate doses are less clear. Methods: We conducted a pooled analysis of the major radiation-associated leukaemias (acute myeloid leukaemia (AML) with/without the inclusion of myelodysplastic syndrome (MDS), chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL)) in ten childhood-exposed groups, including Japanese atomic bomb survivors, four therapeutically irradiated and five diagnostically exposed cohorts, a mixture of incidence and mortality data. Relative/absolute risk Poisson regression models were fitted. Results: Of 365 cases/deaths of leukaemias excluding chronic lymphocytic leukaemia, there were 272 AML/CML/ALL among 310,905 persons (7,641,362 person-years), with mean active bone marrow (ABM) dose of 0.11 Gy (range 0-5.95). We estimated significant (P < 0.005) linear excess relative risks/Gy (ERR/Gy) for: AML (n = 140) = 1.48 (95% CI 0.59-2.85), CML (n = 61) = 1.77 (95% CI 0.38-4.50), and ALL (n = 71) = 6.65 (95% CI 2.79-14.83). There is upward curvature in the dose response for ALL and AML over the full dose range, although at lower doses (<0.5 Gy) curvature for ALL is downwards. Discussion: We found increased ERR/Gy for all major types of radiation-associated leukaemia after childhood exposure to ABM doses that were predominantly (for 99%) <1 Gy, and consistent with our prior analysis focusing on <100 mGy.
MeSH term(s)	Humans ; Risk Factors ; Leukemia/epidemiology ; Radiation Exposure/adverse effects ; Incidence ; Leukemia, Lymphocytic, Chronic, B-Cell ; Radiation, Ionizing ; Neoplasms, Radiation-Induced/epidemiology ; Neoplasms, Radiation-Induced/etiology ; Radiation Dosage
Language	English
Publishing date	2023-08-18
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Intramural
ZDB-ID	80075-2
ISSN	1532-1827 ; 0007-0920
ISSN (online)	1532-1827
ISSN	0007-0920
DOI	10.1038/s41416-023-02387-8
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Article ; Online: Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures.

Bernier, Marie Odile / Doody, Michele M / Van Dyke, Miriam E / Villoing, Daphné / Alexander, Bruce H / Linet, Martha S / Kitahara, Cari M

Occupational and environmental medicine

2018 Volume 75, Issue 8, Page(s) 533–561

Abstract: Introduction: Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work ... ...

Abstract	Introduction: Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. Methods: From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. Results: During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. Conclusion: Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.
MeSH term(s)	Adult ; Aged ; Cohort Studies ; Employment ; Female ; Health Personnel ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms ; Neoplasms, Radiation-Induced/epidemiology ; Neoplasms, Radiation-Induced/etiology ; Neoplasms, Radiation-Induced/mortality ; Nuclear Medicine ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Occupational Diseases/mortality ; Occupational Exposure/adverse effects ; Procedures and Techniques Utilization ; Radiation Protection ; Risk Assessment ; Surveys and Questionnaires ; Technology, Radiologic ; United States/epidemiology
Language	English
Publishing date	2018-05-02
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2017-104559
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Article ; Online: Lung cancer mortality associated with protracted low-dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983-2012.

Velazquez-Kronen, Raquel / Gilbert, Ethel S / Linet, Martha S / Moysich, Kirsten B / Freudenheim, Jo L / Wactawski-Wende, Jean / Simon, Steven L / Cahoon, Elizabeth K / Alexander, Bruce H / Doody, Michele M / Kitahara, Cari M

International journal of cancer

2020 Volume 147, Issue 11, Page(s) 3130–3138

Abstract: In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low-dose, protracted radiation, such studies ... ...

Abstract	In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low-dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack-years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time-dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0-810 mGy). During the 1983 to 2012 follow-up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: -0.02, 95% CI: <0-0.13). However, significant dose-response relationships were observed for some subgroups, which might be false-positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub-multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01-1.15) for those who smoked <20 pack-years and -0.03 (95% CI: <0-0.15) for those who smoked ≥20 pack-years. Our study provides some evidence that greater protracted radiation exposure in the low-dose range is positively associated with lung cancer mortality.
MeSH term(s)	Cigarette Smoking/adverse effects ; Cigarette Smoking/epidemiology ; Cohort Studies ; Confounding Factors, Epidemiologic ; Female ; Humans ; Incidence ; Lung Neoplasms/etiology ; Lung Neoplasms/mortality ; Male ; Neoplasms, Radiation-Induced/mortality ; Occupational Exposure/adverse effects ; Radiation Exposure/adverse effects ; Surveys and Questionnaires ; Technology, Radiologic ; United States/epidemiology
Language	English
Publishing date	2020-07-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural
ZDB-ID	218257-9
ISSN	1097-0215 ; 0020-7136
ISSN (online)	1097-0215
ISSN	0020-7136
DOI	10.1002/ijc.33141
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Zs.A 478: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Cataract Risk in a Cohort of U.S. Radiologic Technologists Performing Nuclear Medicine Procedures.

Bernier, Marie-Odile / Journy, Neige / Villoing, Daphnee / Doody, Michele M / Alexander, Bruce H / Linet, Martha S / Kitahara, Cari M

Radiology

2017 Volume 286, Issue 2, Page(s) 592–601

Abstract: Purpose To estimate the risk of cataract in a cohort of nuclear medicine (NM) radiologic technologists on the basis of their work histories and radiation protection practices. Materials and Methods In the years 2003-2005 and 2012-2013, 42 545 radiologic ... ...

Abstract	Purpose To estimate the risk of cataract in a cohort of nuclear medicine (NM) radiologic technologists on the basis of their work histories and radiation protection practices. Materials and Methods In the years 2003-2005 and 2012-2013, 42 545 radiologic technologists from a U.S. prospective study completed questionnaires in which they provided information regarding their work histories and cataract histories. Cox proportional hazards models, stratified according to birth-year cohort (born before 1940 or born in 1940 or later) and adjusted for age, sex, and race, were used to estimate hazard ratios (HRs) for the risk of cataract in radiologic technologists according to NM work history practices according to decade. Results During the follow-up period (mean follow-up, 7½ years), 7137 incident cataracts were reported. A significantly increased risk of cataract (HR, 1.08; 95% confidence interval [CI]: 1.03, 1.14) was observed among workers who performed an NM procedure at least once-as opposed to never. Risks of cataract were increased in the group who had performed a diagnostic (HR, 1.07; 95% CI: 1.01, 1.12) or therapeutic (HR, 1.10; 95% CI: 1.04, 1.17) NM procedure. Risks were higher for those who had first performed diagnostic NM procedures in the 1980s to early 2000s (HR, 1.30; 95% CI: 1.08, 1.58) and those who had performed therapeutic NM procedures in the 1970s (HR, 1.11; 95% CI: 1.01, 1.23) and in the 1980s to early 2000s (HR, 1.14; 95% CI: 1.02, 1.29). With the exception of a significantly increased risk associated with performing therapeutic NM procedures without shielding the radiation source in the 1980s (HR, 1.32; 95% CI: 1.04, 1.67), analyses revealed no association between cataract risk and specific radiation protection technique used. Conclusion An increased risk of cataract was observed among U.S. radiologic technologists who had performed an NM procedure at least once. This association should be examined in future studies incorporating estimated lens doses.
MeSH term(s)	Cataract/etiology ; Cohort Studies ; Female ; Humans ; Male ; Medical Laboratory Personnel/statistics & numerical data ; Middle Aged ; Nuclear Medicine/statistics & numerical data ; Occupational Diseases/etiology ; Occupational Exposure/adverse effects ; Radiation Protection ; Radiologists ; Risk Factors ; Surveys and Questionnaires ; Technology, Radiologic/statistics & numerical data ; United States
Language	English
Publishing date	2017-10-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2017170683
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Article ; Online: Hyperthyroidism, Hypothyroidism, and Cause-Specific Mortality in a Large Cohort of Women.

Journy, Neige M Y / Bernier, Marie-Odile / Doody, Michele M / Alexander, Bruce H / Linet, Martha S / Kitahara, Cari M

Thyroid : official journal of the American Thyroid Association

2017 Volume 27, Issue 8, Page(s) 1001–1010

Abstract: Background: The prevalence of hyperthyroidism and hypothyroidism is 0.5-4% in iodine-replete communities, but it is 5-10 times higher in women than in men. Those conditions are associated with a broad range of metabolic disorders and cardiovascular ... ...

Abstract	Background: The prevalence of hyperthyroidism and hypothyroidism is 0.5-4% in iodine-replete communities, but it is 5-10 times higher in women than in men. Those conditions are associated with a broad range of metabolic disorders and cardiovascular diseases. Biological evidence of a role of thyroid hormones in carcinogenesis also exists. However, the association between thyroid dysfunction and cardiovascular disease or cancer mortality risk remains controversial. In a large cohort of women, the associations of hyperthyroidism and hypothyroidism with cause-specific mortality were evaluated after nearly 30 years of follow-up. Methods: The prospective study included 75,076 women aged 20-89 years who were certified as radiologic technologists in the United States in 1926-1982, completed baseline questionnaires in 1983-1998 from which medical history was ascertained, and reported no malignant disease or benign thyroid disease except thyroid dysfunction. A passive follow-up of this cohort was performed through the Social Security Administration database and the National Death Index-Plus. Cause-specific mortality risks were compared according to self-reported thyroid status, with proportional hazards models adjusted for baseline year and age, race/ethnicity, body mass index, family history of breast cancer, and life-style and reproductive factors. Results: During a median follow-up of 28 years, 2609 cancer, 1789 cardiovascular or cerebrovascular, and 2442 other non-cancer deaths were recorded. Women with hyperthyroidism had an elevated risk of breast cancer mortality after 60 years of age (hazard ratio [HR] = 2.04 [confidence interval (CI) 1.16-3.60], 13 cases in hyperthyroid women) compared to women without thyroid disease. Hypothyroid women had increased mortality risks for diabetes mellitus (HR = 1.58 [CI 1.03-2.41], 27 cases in hypothyroid women), cardiovascular disease (HR = 1.20 [CI 1.01-1.42], 179 cases), and cerebrovascular disease (HR = 1.45 [CI 1.01-2.08], 35 cases, when restricting the follow-up to ≥10 years after baseline). Other causes of death were not associated with hyperthyroidism or hypothyroidism, though there was a suggestion of an elevated risk of ovarian cancer mortality in hyperthyroid women based on very few cases. Conclusion: The excess mortality risks observed in a large, prospective 30-year follow-up of patients with thyroid dysfunction require confirmation, and, if replicated, further investigation will be needed because of the clinical implications.
MeSH term(s)	Adult ; Breast Neoplasms/epidemiology ; Breast Neoplasms/mortality ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/mortality ; Cerebrovascular Disorders/epidemiology ; Cerebrovascular Disorders/mortality ; Cohort Studies ; Comorbidity ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/mortality ; Female ; Follow-Up Studies ; Humans ; Hyperthyroidism/epidemiology ; Hyperthyroidism/physiopathology ; Hypothyroidism/epidemiology ; Hypothyroidism/physiopathology ; Medical Laboratory Personnel ; Ovarian Neoplasms/epidemiology ; Ovarian Neoplasms/mortality ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Registries ; Risk Factors ; Self Report ; Technology, Radiologic/manpower ; Thyroid Gland/physiopathology ; United States/epidemiology
Language	English
Publishing date	2017
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	1086044-7
ISSN	1557-9077 ; 1050-7256
ISSN (online)	1557-9077
ISSN	1050-7256
DOI	10.1089/thy.2017.0063
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Zs.A 3307: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Association of Radioactive Iodine Treatment With Cancer Mortality in Patients With Hyperthyroidism.

Kitahara, Cari M / Berrington de Gonzalez, Amy / Bouville, Andre / Brill, Aaron B / Doody, Michele M / Melo, Dunstana R / Simon, Steven L / Sosa, Julie A / Tulchinsky, Mark / Villoing, Daphnée / Preston, Dale L

JAMA internal medicine

2019 Volume 179, Issue 8, Page(s) 1034–1042

Abstract: Importance: Radioactive iodine (RAI) has been used extensively to treat hyperthyroidism since the 1940s. Although widely considered a safe and effective therapy, RAI has been associated with elevated risks of total and site-specific cancer death among ... ...

Abstract	Importance: Radioactive iodine (RAI) has been used extensively to treat hyperthyroidism since the 1940s. Although widely considered a safe and effective therapy, RAI has been associated with elevated risks of total and site-specific cancer death among patients with hyperthyroidism. Objective: To determine whether greater organ- or tissue-absorbed doses from RAI treatment are associated with overall and site-specific cancer mortality in patients with hyperthyroidism. Design, setting, and participants: This cohort study is a 24-year extension of the multicenter Cooperative Thyrotoxicosis Therapy Follow-up Study, which has followed up US and UK patients diagnosed and treated for hyperthyroidism for nearly 7 decades, beginning in 1946. Patients were traced using records from the National Death Index, Social Security Administration, and other resources. After exclusions, 18 805 patients who were treated with RAI and had no history of cancer at the time of the first treatment were eligible for the current analysis. Excess relative risks (ERRs) per 100-mGy dose to the organ or tissue were calculated using multivariable-adjusted linear dose-response models and were converted to relative risks (RR = 1 + ERR). The current analyses were conducted from April 28, 2017, to January 30, 2019. Exposures: Mean total administered activity of sodium iodide I 131 was 375 MBq for patients with Graves disease and 653 MBq for patients with toxic nodular goiter. Mean organ or tissue dose estimates ranged from 20 to 99 mGy (colon or rectum, ovary, uterus, prostate, bladder, and brain/central nervous system), to 100 to 400 mGy (pancreas, kidney, liver, stomach, female breast, lung, oral mucosa, and marrow), to 1.6 Gy (esophagus), and to 130 Gy (thyroid gland). Main outcomes and measures: Site-specific and all solid-cancer mortality. Results: A total of 18 805 patients were included in the study cohort, and the mean (SD) entry age was 49 (14) years. Most patients were women (14 671 [78.0%]), and most had a Graves disease diagnosis (17 615 [93.7%]). Statistically significant positive associations were observed for all solid cancer mortality (n = 1984; RR at 100-mGy dose to the stomach = 1.06; 95% CI, 1.02-1.10; P = .002), including female breast cancer (n = 291; RR at 100-mGy dose to the breast = 1.12; 95% CI, 1.003-1.32; P = .04) and all other solid cancers combined (n = 1693; RR at 100-mGy dose to the stomach = 1.05; 95% CI, 1.01-1.10; P = .01). The 100-mGy dose to the stomach and breast corresponded to a mean (SD) administered activity of 243 (35) MBq and 266 (58) MBq in patients with Graves disease. For every 1000 patients with hyperthyroidism receiving typical doses to the stomach (150 to 250 mGy), an estimated lifetime excess of 19 (95% CI, 3-40) to 32 (95% CI, 5-66) solid cancer deaths could occur. Conclusions and relevance: In RAI-treated patients with hyperthyroidism, greater organ-absorbed doses appeared to be modestly positively associated with risk of death from solid cancer, including breast cancer. Additional studies are needed of the risks and advantages of all major treatment options available to patients with hyperthyroidism.
Language	English
Publishing date	2019-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2019.0981
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Article ; Online: Historical Patterns in the Types of Procedures Performed and Radiation Safety Practices Used in Nuclear Medicine From 1945-2009.

Van Dyke, Miriam E / Drozdovitch, Vladimir / Doody, Michele M / Lim, Hyeyeun / Bolus, Norman E / Simon, Steven L / Alexander, Bruce H / Kitahara, Cari M

Health physics

2016 Volume 111, Issue 1, Page(s) 37–46

Abstract: The authors evaluated historical patterns in the types of procedures performed in diagnostic and therapeutic nuclear medicine and the associated radiation safety practices used from 1945-2009 in a sample of U.S. radiologic technologists. In 2013-2014, 4, ... ...

Abstract	The authors evaluated historical patterns in the types of procedures performed in diagnostic and therapeutic nuclear medicine and the associated radiation safety practices used from 1945-2009 in a sample of U.S. radiologic technologists. In 2013-2014, 4,406 participants from the U.S. Radiologic Technologists (USRT) Study who previously reported working with medical radionuclides completed a detailed survey inquiring about the performance of 23 diagnostic and therapeutic radionuclide procedures and the use of radiation safety practices when performing radionuclide procedure-related tasks during five time periods: 1945-1964, 1965-1979, 1980-1989, 1990-1999, and 2000-2009. An overall increase in the proportion of technologists who performed specific diagnostic or therapeutic procedures was observed across the five time periods. Between 1945-1964 and 2000-2009, the median frequency of diagnostic procedures performed substantially increased (from 5 wk to 30 wk), attributable mainly to an increasing frequency of cardiac and non-brain PET scans, while the median frequency of therapeutic procedures performed modestly decreased (from 4 mo to 3 mo). Also a notable increase was observed in the use of most radiation safety practices from 1945-1964 to 2000-2009 (e.g., use of lead-shielded vials during diagnostic radiopharmaceutical preparation increased from 56 to 96%), although lead apron use dramatically decreased (e.g., during diagnostic imaging procedures, from 81 to 7%). These data describe historical practices in nuclear medicine and can be used to support studies of health risks for nuclear medicine technologists.
MeSH term(s)	Health Physics/history ; History, 20th Century ; History, 21st Century ; Radiation Protection/history ; Radionuclide Imaging/history ; Radiotherapy/history ; United States
Language	English
Publishing date	2016-05-24
Publishing country	United States
Document type	Historical Article ; Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	2406-5
ISSN	1538-5159 ; 0017-9078
ISSN (online)	1538-5159
ISSN	0017-9078
DOI	10.1097/HP.0000000000000519
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Article ; Online: Lymphoma and multiple myeloma in cohorts of persons exposed to ionising radiation at a young age.

Little, Mark P / Wakeford, Richard / Zablotska, Lydia B / Borrego, David / Griffin, Keith T / Allodji, Rodrigue S / de Vathaire, Florent / Lee, Choonsik / Brenner, Alina V / Miller, Jeremy S / Campbell, David / Sadetzki, Siegal / Doody, Michele M / Holmberg, Erik / Lundell, Marie / Adams, Michael Jacob / French, Benjamin / Linet, Martha S / Berrington de Gonzalez, Amy

Leukemia

2021 Volume 35, Issue 10, Page(s) 2906–2916

Abstract: There is limited evidence that non-leukaemic lymphoid malignancies are radiogenic. As radiation-related cancer risks are generally higher after childhood exposure, we analysed pooled lymphoid neoplasm data in nine cohorts first exposed to external ... ...

Abstract	There is limited evidence that non-leukaemic lymphoid malignancies are radiogenic. As radiation-related cancer risks are generally higher after childhood exposure, we analysed pooled lymphoid neoplasm data in nine cohorts first exposed to external radiation aged <21 years using active bone marrow (ABM) and, where available, lymphoid system doses, and harmonised outcome classification. Relative and absolute risk models were fitted. Years of entry spanned 1916-1981. At the end of follow-up (mean 42.1 years) there were 593 lymphoma (422 non-Hodgkin (NHL), 107 Hodgkin (HL), 64 uncertain subtype), 66 chronic lymphocytic leukaemia (CLL) and 122 multiple myeloma (MM) deaths and incident cases among 143,136 persons, with mean ABM dose 0.14 Gy (range 0-5.95 Gy) and mean age at first exposure 6.93 years. Excess relative risk (ERR) was not significantly increased for lymphoma (ERR/Gy = -0.001; 95% CI: -0.255, 0.279), HL (ERR/Gy = -0.113; 95% CI: -0.669, 0.709), NHL + CLL (ERR/Gy = 0.099; 95% CI: -0.149, 0.433), NHL (ERR/Gy = 0.068; 95% CI: -0.253, 0.421), CLL (ERR/Gy = 0.320; 95% CI: -0.678, 1.712), or MM (ERR/Gy = 0.149; 95% CI: -0.513, 1.063) (all p-trend > 0.4). In six cohorts with estimates of lymphatic tissue dose, borderline significant increased risks (p-trend = 0.02-0.07) were observed for NHL + CLL, NHL, and CLL. Further pooled epidemiological studies are needed with longer follow-up, central outcome review by expert hematopathologists, and assessment of radiation doses to lymphoid tissues.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Lymphoma/classification ; Lymphoma/etiology ; Lymphoma/pathology ; Male ; Multiple Myeloma/etiology ; Multiple Myeloma/pathology ; Neoplasms, Radiation-Induced/etiology ; Neoplasms, Radiation-Induced/pathology ; Prognosis ; Radiation, Ionizing ; Young Adult
Language	English
Publishing date	2021-05-28
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	807030-1
ISSN	1476-5551 ; 0887-6924
ISSN (online)	1476-5551
ISSN	0887-6924
DOI	10.1038/s41375-021-01284-4
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Article ; Online: Assessment of thyroid cancer risk associated with radiation dose from personal diagnostic examinations in a cohort study of US radiologic technologists, followed 1983-2014.

Little, Mark P / Lim, Hyeyeun / Friesen, Melissa C / Preston, Dale L / Doody, Michele M / Sigurdson, Alice J / Neta, Gila / Alexander, Bruce H / Chang, Lienard A / Cahoon, Elizabeth K / Simon, Steven L / Linet, Martha S / Kitahara, Cari M

BMJ open

2018 Volume 8, Issue 5, Page(s) e021536

Abstract: Objective: To assess whether personal medical diagnostic procedures over life, but particularly those associated with exposure in adulthood, were associated with increased thyroid cancer risk.: Design: Participants from the US Radiologic ... ...

Abstract	Objective: To assess whether personal medical diagnostic procedures over life, but particularly those associated with exposure in adulthood, were associated with increased thyroid cancer risk. Design: Participants from the US Radiologic Technologists Study, a large, prospective cohort, were followed from the date of first mailed questionnaire survey completed during 1983-1989 to the earliest date of self-reported diagnosis of thyroid cancer or of any other cancer than non-melanoma skin cancer (NMSC) in any of three subsequent questionnaires up to the last in 2012-2014. Setting: US nationwide, occupational cohort. Participants: US radiologic technologists with exclusion of: those who reported a previous cancer apart from NMSC on the first questionnaire; those who reported a cancer with an unknown date of diagnosis on any of the questionnaires; and those who did not respond to both the first questionnaire and at least one subsequent questionnaire. Primary outcome measure: We used Cox proportional hazards models with age as timescale to compute HRs and 95% CI for thyroid cancer in relation to cumulative 5-year lagged diagnostic thyroid dose. Results: There were 414 self-reported thyroid cancers (n=275 papillary) in a cohort of 76 415 persons. Cumulative thyroid dose was non-significantly positively associated with total (excess relative risk/Gy=2.29 (95% CI -0.91 to 7.01, p=0.19)) and papillary thyroid cancer (excess relative risk/Gy=4.15 (95% CI -0.39, 11.27, p=0.08)) risk. These associations were not modified by age at, or time since, exposure and were independent of occupational exposure. Conclusion: Our study provides weak evidence that thyroid dose from diagnostic radiation procedures over the whole of life, in particular associated with exposure in adulthood, influences adult thyroid cancer risk.
MeSH term(s)	Adult ; Allied Health Personnel/statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms, Radiation-Induced/epidemiology ; Neoplasms, Radiation-Induced/etiology ; Occupational Exposure/adverse effects ; Proportional Hazards Models ; Prospective Studies ; Radiation Dosage ; Radiation Exposure/adverse effects ; Risk Factors ; Self Report ; Technology, Radiologic ; Thyroid Neoplasms/epidemiology ; Thyroid Neoplasms/etiology ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2018-05-14
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	2747269-3
ISSN	2044-6055 ; 2044-6055 ; 2053-3624
ISSN (online)	2044-6055
ISSN	2044-6055 ; 2053-3624
DOI	10.1136/bmjopen-2018-021536
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