Studies of miners provide
the basis for public health efforts to reduce
residential radon progeny exposure. Because
the preponderance of households do not have
members who smoke indoors, studies of nonsmoking
miners contribute essential data for risk
assessments for residential radon progeny
exposure. We studied a cohort of 2216 never
smokers who were underground uranium miners
employed in the western U.S. from 1956 to
the early 1990s and who participated in
a screening program for lung cancer conducted
by Saccomanno and colleagues. After determining
the vital status and cause of death in the
cohort, we conducted a nested case-control
study of 55 lung cancer deaths and 3 age-matched
controls for each case. We found a steep
nonlinear exposure response relationship
without an apparent threshold in this study
of male miners. The relative risk of lung
cancer was 29.2 (95% CI 5.1,167.2) for miners
with greater than 1450 WLM compared with
those exposed to less than 80 WLM. Temporal
factors affected risk, including average
dose rate, which was inversely associated
with lung cancer risk, and the length of
time since last exposure, which was directly
associated with decreased risk. As in studies
of nonsmokers and smokers combined, we observed
a nonlinear exposure response relationship
in never-smokers, which resulted, in part,
from an inverse dose rate effect and exposure
misclassification. Our finding may contribute
to risk assessment for residential radon
progeny exposure in nonsmoking households
and inform cost benefit analyses for remediation. |