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Mortality risk in a historical cohort of nuclear power plant workers in Germany: results from a second follow-up

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Abstract

Possible health effects of low and protracted doses of ionizing radiation are relevant for persons who are exposed to an occupational context like nuclear industry workers. A historical cohort study was therefore conducted to examine mortality risks following occupational radiation exposure among 4,844 German nuclear power plant workers. This cohort included workers from ten nuclear power plants with an observational period from 1991 until 1997. The results of an enlarged cohort with 8,972 workers from all 17 nuclear power plants in West Germany are now available. During the extended follow-up period from 1991 to 2008, a total of 310 deaths among men were observed. The standardized mortality ratio (SMR) from all causes of deaths was estimated at 0.50 [95 % confidence interval (CI) 0.45–0.56]. A total of 126 deaths due to cancer occurred (SMR = 0.65; 95 % CI 0.51–0.82) and seven deaths due to leukemia (SMR = 1.23; 95 % CI 0.42–2.84). Overall, a reduced mortality compared to the general population of West Germany was observed indicating a healthy worker effect. In the dose–response analysis, no statistically significant risk due to ionizing radiation was seen. The hazard ratio (HR/mSv) for leukemia excluding chronic lymphocytic leukemia was estimated at 1.004 (95 % CI 0.997–1.011). In conclusion, the cohort is small and made up of young workers, most of whom were still employed at the end of the observational period in 2008. Results of the external analysis are difficult to interpret as influenced by a healthy worker effect. In the internal analysis, no excess of risk due to radiation was detected.

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Acknowledgments

The study was funded by the Berufsgenossenschaft Energie Textil Elektro Medienerzeugnisse (BGETEM), Köln. Conduct and analysis of the cohort study were advised by independent researchers. Members of the scientific advisory board were Prof. Claudia Kühni (Universität Bern, Medizinische Fakultät, Institut für Sozial- und Präventivmedizin), Prof. Dr. Wolfgang-Ulrich Müller (Universitätsklinikum Essen, Institut für Strahlenbiologie), Prof. Dr. Werner Rühm (Helmholtz Zentrum München GmbH, Institut für Strahlenschutz). The authors would like to thank especially Dr. Günter Seitz (BGETEM) who supported the study with his excellent knowledge, enthusiasm and persistence.

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Correspondence to Hiltrud Merzenich.

Appendix

Appendix

See Table 7.

Table 7 Definition of causes of death according to the International Classification of Diseases (ICD)

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Merzenich, H., Hammer, G.P., Tröltzsch, K. et al. Mortality risk in a historical cohort of nuclear power plant workers in Germany: results from a second follow-up. Radiat Environ Biophys 53, 405–416 (2014). https://doi.org/10.1007/s00411-014-0523-z

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