Radiation and Environmental Biophysics

, Volume 49, Issue 2, pp 177–185 | Cite as

Radon and risk of death from cancer and cardiovascular diseases in the German uranium miners cohort study: follow-up 1946–2003

  • Michaela KreuzerEmail author
  • B. Grosche
  • M. Schnelzer
  • A. Tschense
  • F. Dufey
  • L. Walsh
Original Paper


Data from the German uranium miners cohort study were analyzed to investigate the radon-related risk of mortality from cancer and cardiovascular diseases. The Wismut cohort includes 58,987 men who were employed for at least 6 months from 1946 to 1989 at the former Wismut uranium mining company in Eastern Germany. By the end of 2003, a total of 3,016 lung cancer deaths, 3,355 deaths from extrapulmonary cancers, 5,141 deaths from heart diseases and 1,742 deaths from cerebrovascular diseases were observed. Although a number of studies have already been published on various endpoints in the Wismut cohort, the aim of the present analyses is to provide a direct comparison of the magnitude of radon-related risk for different cancer sites and cardiovascular diseases using the same data set, the same follow-up period and the same statistical methods. A specific focus on a group of cancers of the extrathoracic airways is also made here, due to the assumed high organ doses from absorbed radon progeny. Internal Poisson regression was used to estimate the excess relative risk (ERR) per unit of cumulative exposure to radon in working level months (WLM) and its 95% confidence limits (CI). There was a statistically significant increase in the risk of lung cancer with increasing radon exposure (ERR/WLM = 0.19%; 95% CI: 0.17%; 0.22%). A smaller, but also statistically significant excess was found for cancers of the extrathoracic airways and trachea (ERR/WLM = 0.062%; 95% CI: 0.002%; 0.121%). Most of the remaining nonrespiratory cancer sites showed a positive relationship with increasing radon exposure, which, however, did not reach statistical significance. No increase in risk was noted for coronary heart diseases (ERR/WLM = 0.0003%) and cerebrovascular diseases (ERR/WLM = 0.001%). The present data provide clear evidence of an increased radon-related risk of death from lung cancer, some evidence for an increased radon-related risk of death from cancers of the extrathoracic airways and some other extrapulmonary cancers, and no evidence for mortality from cardiovascular diseases. These findings are consistent with the results of other miner studies and dosimetric calculations for radon-related organ doses.


Radon Radon Concentration Excess Relative Risk Radon Exposure Radon Progeny 
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The authors thank the German Federation of Institutions for Statutory Accident Insurance and Prevention (Hauptverband der Gewerblichen Berufsgenossen-schaften) in St. Augustin (Dr. Otten, Dr. Koppisch) and the Miners’ Occupational Compensation Board (Bergbau-Berufsgenossenschaften) in Gera (Dr. Lehmann) for providing relevant data on miners and assessment of exposure to radiation. The authors also thank the Institute for Dangerous Materials (Institut für Gefahrstoffe) in Bochum (Prof. Bauer, Dr. Stoyke, Dr. Dahmann) for developing the JEM on dust and arsenic, the Federal Institution for Occupational Medicine and Safety (Bundesanstalt für Arbeitsmedizin und Arbeitsschutz) in Berlin and Chemnitz (Dr. Bernhardt, Dr. Gille, Dr. Gellissen, Dr. Möhner) and the Wismut Company GmbH in Chemnitz for providing additional information for the follow-up. Part of this work was funded by the EC under contracts FI4P-CT95-0031, FIGH-CT-1999-00013 and 516483 (FIP6).


  1. Bauer HD (2000) Studie zur retrospektiven Analyse der Belastungssituation im Uranberzbergbau der ehemaligen SDAG Wismut mit Ausnahme der Strahlenbelastung für die Zeit von 1946 bis 1990. Hauptverband der gewerblichen Berufsgenossenschaften, Sankt AugustinGoogle Scholar
  2. BEIR (1999) Committee on biological effects of ionizing radiation (BEIR VI). Health effects of exposure to radon—BEIR VI. National Academy Press, Washington DCGoogle Scholar
  3. Brüske-Hohlfeld I, Schaffrath Rosario A, Wölke G, Heinrich J, Kreuzer M, Kreienbrock L, Wichmann HE (2006) Lung cancer risk among former uranium miners of the Wismut company in Germany. Health Phys 90:208–216CrossRefGoogle Scholar
  4. Dahmann D, Bauer HD, Stoyke G (2008) Retrospective exposure assessment for respirable and inhalable dust, crystalline silica and arsenic in the former German uranium mines of SAG/SDAG Wismut. Int Arch Occup Environ Health 81:949–958CrossRefGoogle Scholar
  5. Darby SC, Whitley E, Howe GR, Hutchings SJ, Kusiak RA, Lubin JH, Morrison HI, Tirmarche M, Tomásek L, Radford EP (1995) Radon and cancers other than lung cancer in underground miners: a collaborative analysis of 11 studies. J Natl Cancer Inst 87:378–384CrossRefGoogle Scholar
  6. Darby SC, Hill D, Auvinen A, Baysson H, Bochicchio F, Deo H, Falk R, Forastiere F, Hakama M, Heid I, Kreienbrock L, Kreuzer M, Lagarde F, Mäkeläinen I, Muirhead C, Oberaigner W, Pershagen G, Ruano-Ravina A, Ruosteenoja E, Rosario AS, Tirmarche M, Tomásek L, Whitley E, Wichmann HE, Doll R (2005) Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies. BMJ 330:223–227CrossRefGoogle Scholar
  7. Grosche B, Kreuzer M, Kreisheimer M, Schnelzer M, Tschense A (2006) Lung cancer risk among German male uranium miners: a cohort study, 1946–1998. Br J Cancer 95:1280–1287CrossRefGoogle Scholar
  8. HVBG, BBG (2005) Belastung durch ionisierende Strahlung, Staub und Arsen im Uranerzbergbau der ehemaligen DDR (Version 08/2005). Bergbau BG (BBG), Gera, Hauptverband der gewerblichen Berufsgenossenschaften (HVBG), St. Augustin (CD-Rom)Google Scholar
  9. IARC (1988) Man-made mineral fibres and radon. IARC Monographs on the evaluation of carcinogenic risks to humans, vol 43. IARC, LyonGoogle Scholar
  10. Kendall GM, Smith TJ (2002) Doses to organs and tissues from radon and its decay products. J Radiol Prot 22:389–406CrossRefGoogle Scholar
  11. Kreuzer M, Kreisheimer M, Kandel M, Tschense A, Grosche B (2006) Mortality from cardiovascular diseases in the German uranium miners cohort study, 1946–1998. Radiat Environ Biophys 45:159–166CrossRefGoogle Scholar
  12. Kreuzer M, Walsh L, Schnelzer M, Tschense A, Grosche B (2008) Radon and risk of extrapulmonary cancers: results of the German uranium miners cohort study, 1960–2003. Br J Cancer 99:1946–1953CrossRefGoogle Scholar
  13. Kreuzer M, Schnelzer M, Tschense A, Walsh L, Grosche B (2009) Cohort profile: the German uranium miners cohort study (WISMUT cohort), 1946–2003. Int J Epidemiol online first doi: 10.1093/ije/dyp216
  14. Krewski D, Lubin JH, Zielinski JM, Alavanja M, Catalan VS, Field RW, Klotz JB, Létourneau EG, Lynch CF, Lyon JL, Sandler DP, Schoenberg JB, Steck DJ, Stolwijk JA, Weinberg C, Wilcox HB (2005) Residential radon and risk of lung cancer: a combined analysis of 7 North American case-control studies. Epidemiology 16:137–145CrossRefGoogle Scholar
  15. Laurier D, Tirmarche M, Mitton N, Valenty M, Richard P, Poveda S, Gelas JM, Quesne B (2004) An update of cancer mortality among the French cohort of uranium miners: extended follow-up and new source of data for causes of death. Eur J Epidemiol 19:139–146CrossRefGoogle Scholar
  16. Lehmann F, Hambeck L, Linkert KH, Lutze H, Reiber H, Renner HJ, Reinisch A, Seifert T, Wolf F (1998) Belastung durch ionisierende Strahlung im Uranerzbergbau der ehemaligen DDR. Hauptverband der gewerblichen Berufsgenossenschaften, Sankt AugustinGoogle Scholar
  17. Little MP, Tawn EJ, Tzoulaki I, Wakeford R, Hildebrandt G, Paris F, Tapio S, Elliott P (2008) A systematic review of epidemiological associations between low and moderate doses of ionizing radiation and late cardiovascular effect, and their possible mechanisms. Radiat Res 169:99–109CrossRefGoogle Scholar
  18. Little MP, Tawn EJ, Tzoulaki I, Wakeford R, Hildebrandt G, Paris F, Tapio S, Elliott P (2009) Review and meta-analysis of epidemiological associations between low/moderate doses of ionizing radiation and circulatory disease risks, and their possible mechanisms. Radiat Environ Biophys. doi: 10.1007/s00411-009-0250-z
  19. Lubin JH, Boice JD, Edling C, Hornung RW, Howe G, Kunz E, Kusiak RA, Morrison HI, Radford EP, Samet JM, Tirmarche M, Woodward A, Xiang YS, Pierce DA (1994) Radon and lung cancer risk: a joint analysis of 11 underground miners studies. NIH, Washington DCGoogle Scholar
  20. Lubin JH, Wang ZY, Boice JD Jr, Zy Xu, Blot WJ, De Wang L, Kleinerman RA (2004) Risk of lung cancer and residential radon in China: pooled results of two studies. Int J Cancer 109:132–137CrossRefGoogle Scholar
  21. Marsh JW, Bessa Y, Birchall A, Blanchardon E, Hofmann W, Nosske D, Tomasek L (2008) Dosimetric models used in the alpha-risk project to quantify exposure of uranium miners to radon gas and its progeny. Radiat Prot Dosimetry 130:101–106CrossRefGoogle Scholar
  22. McGale P, Darby SC (2005) Low doses of ionizing radiation and circulatory diseases: a systematic review of the published epidemiological evidence. Radiat Res 163:247–257CrossRefGoogle Scholar
  23. Moehner M, Lindtner M, Otten H, Gille HG (2006) Leukemia and exposure to ionizing radiation among German uranium miners. Am J Ind Med 49:238–248CrossRefGoogle Scholar
  24. Moehner M, Lindtner M, Otten H (2008) Ionizing radiation and risk of laryngeal cancer among German uranium miners. Health Phys 95:725–733CrossRefGoogle Scholar
  25. Preston DL, Lubin JH, Pierce DA, McConney ME (1998) Epicure, release 2.10. HiroSoft, SeattleGoogle Scholar
  26. Preston DL, Shimizu Y, Pierce DA, Suyama A, Mabuchi K (2003) Studies of mortality of atomic bomb survivors. Report 13: solid cancer and noncancer disease mortality: 1950–1997. Radiat Res 160:381–407CrossRefGoogle Scholar
  27. Rericha V, Kulich M, Rericha R, Shore DL, Sandler DP (2006) Incidence of leukemia, lymphoma, and multiple myeloma in Czech uranium miners: a case-control study. Environ Health Perspect 114:818–822CrossRefGoogle Scholar
  28. Schnelzer M, Hammer G, Kreuzer M, Tschense A, Grosche B (2009) Accounting for smoking in the radon related lung cancer risk among German uranium miners: results of a nested case-control study. Health Phys (accepted for publication)Google Scholar
  29. Schubauer-Berigan MK, Daniels RD, Pinkerton LE (2009) Radon exposure and mortality among white and American Indian uranium miners: an update of the Colorado Plateau Cohort. Am J Epidemiol 169:718–730CrossRefGoogle Scholar
  30. Tomasek L, Zarska H (2004) Lung cancer risk among Czech tin and uranium miners-comparison of lifetime detriment. Neoplasma 51:255–260Google Scholar
  31. Tomasek L, Darby SC, Swerdlow AJ, Placek V, Kunz E (1993) Radon exposure and cancers other than lung cancer among uranium miners in West Bohemia. Lancet 341:919–923CrossRefGoogle Scholar
  32. Tomasek L, Swerdlow AJ, Darby SC, Placek V, Kunz E (1994) Mortality in uranium miners in west Bohemia: a long term cohort study. Occup Environ Med 51:308–315CrossRefGoogle Scholar
  33. Tomasek L, Rogel A, Tirmarche M, Mitton N, Laurier D (2008) Lung cancer in French and Czech uranium miners: radon-associated risk at low exposure rates and modifying effects of time since exposure and age at exposure. Radiat Res 169:125–137CrossRefGoogle Scholar
  34. Vacquier B, Caer S, Rogel A, Feurprier M, Tirmarche M, Luccioni C, Quesne B, Acker A, Laurier D (2008) Mortality risk in the French cohort of uranium miners: extended follow-up 1946–1999. Occup Environ Med 65:597–604CrossRefGoogle Scholar
  35. Vacquier B, Rogel A, Leuraud K, Caer S, Acker A, Laurier D (2009) Radon-associated lung cancer risk among French uranium miners: modifying factors of the exposure-risk relationship. Radiat Environ Biophys 48:1–9CrossRefGoogle Scholar
  36. Villeneuve PJ, Morrison HI (1997) Coronary heart disease mortality among Newfoundland fluorspar miners. Scand J Environ Health 23:221–226Google Scholar
  37. Villeneuve PJ, Morrison HI, Lane R (2007a) Radon and lung cancer risk: an extension of the mortality follow-up of the Newfoundland fluorspar cohort. Health Phys 92:157–169CrossRefGoogle Scholar
  38. Villeneuve PJ, Lane R, Morrison HI (2007b) Coronary heart disease mortality and radon exposure in the Newfoundland fluorspar miners’ cohort, 1950–2001. Radiat Environ Biophys 46:291–296CrossRefGoogle Scholar
  39. Walsh L, Tschense A, Schnelzer M, Dufey F, Grosche B, Kreuzer M (2009) The influence of radon exposures on lung cancer mortality in German uranium miners, 1946–2003. Radiat Res (accepted for publication)Google Scholar
  40. Xuan XZ, Lubin JH, Li JY, Yang LF, Luo As, Lan Y, Wang JZ, Blot WJ (1993) A cohort study in southern China of tin miners exposed to radon and radon decay products. Health Phys 64:123–131Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Michaela Kreuzer
    • 1
    Email author
  • B. Grosche
    • 1
  • M. Schnelzer
    • 1
  • A. Tschense
    • 1
  • F. Dufey
    • 1
  • L. Walsh
    • 1
  1. 1.Department of Radiation Protection and HealthFederal Office for Radiation ProtectionNeuherbergGermany

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