Nested Case-control Study of Occupational Radiation Exposure and Breast and Esophagus Cancer Risk among Medical Diagnostic X Ray Workers in Jiangsu of China

  • Wang, Fu-Ru (Department of Radiation protection, JiangSu Provincial Center for Disease Prevention and Control) ;
  • Fang, Qiao-Qiao (Department of Respiratory Medicine, Nanjing Children's Hospital Affiliated to Nanjing Medical University) ;
  • Tang, Wei-Ming (Department of Epidemiology, Fielding School of Public Health, University of California) ;
  • Xu, Xiao-San (Department of Radiation protection, JiangSu Provincial Center for Disease Prevention and Control) ;
  • Mahapatra, Tanmay (Department of Epidemiology, Fielding School of Public Health, University of California) ;
  • Mahapatra, Sanchita (Department of Epidemiology, Fielding School of Public Health, University of California) ;
  • Liu, Yu-Fei (National Institute for Radiological Protection) ;
  • Yu, Ning-Le (Department of Radiation protection, JiangSu Provincial Center for Disease Prevention and Control) ;
  • Sun, Quan-Fu (National Institute for Radiological Protection)
  • Published : 2015.06.26


Medical diagnostic X-ray workers are one occupational group that expose to the long-term low-dose external radiation over their working lifetime, and they may under risk of different cancers. This study aims to determine the relationship between the occupational X-ray radiation exposure and cancer risk among these workers in Jiangsu, China. We conducted Nested case-control study to investigate the occupational X-ray radiation exposure and cancer risk. Data were collected through self-administered questionnaire, which includes but not limits to demographic data, personal behaviors and family history of cancer. Retrospective dose reconstruction was conducted to estimate the cumulative doses of the x-ray workers. Inferential statistics, t-test and 2 tests were used to compare the differences between each group. We used the logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of cancer by adjusting the age, gender. All 34 breast cancer cases and 45 esophageal cancer cases that detected in a cohort conducted among health workers between 1950~2011 were included in this presented study, and 158 cancer-free controls were selected by frequency-matched (1:2). Our study found that the occupational radiation exposure was associated with a significantly increased cancer risk compared with the control, especially in breast cancer and esophageal cancer (adjusted OR=2.90, 95% CI: 1.19-7.04 for breast cancer; OR=4.19, 95% CI: 1.87-9.38 for esophageal cancer, and OR=3.43, 95% CI: 1.92-6.12 for total cancer, respectively). The occupational X-ray radiation exposure was associated with increasing cancer risk, which indicates that proper intervention and prevention strategies may be needed in order to bring down the occupational cancer risk.


Nested case-control study;occupational radiation;medical diagnostic X ray workers;cancer risk


Grant : Innovation Platform for Public Health Emergency Preparedness and Response


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