Mortality among Uranium Miners in North America and Europe: The Pooled Uranium Miners Analysis (PUMA) - IRSN - Institut de radioprotection et de sûreté nucléaire Accéder directement au contenu
Article Dans Une Revue International Journal of Epidemiology Année : 2021

Mortality among Uranium Miners in North America and Europe: The Pooled Uranium Miners Analysis (PUMA)

Résumé

Background: The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany, and the United States. Methods: Vital status and cause of death were ascertained and compared to expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall, and by categories of time-since-first-hire, calendar period of first employment, and duration of employment as a miner. Results: There were 51,787 deaths observed among 118,329 male miners (SMR=1.05; 95%CI: 1.04, 1.06). The SMR was elevated for all cancers (n=16,633, SMR=1.23; 95%CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n=7,756, SMR=1.90; 95%CI: 1.86, 1.94), liver and gallbladder (n=549, SMR=1.15; 95%CI: 1.06, 1.25), larynx (n=229, SMR=1.10; 95%CI: 0.97, 1.26), stomach (n=1,058, SMR=1.08; 95%CI: 1.02, 1.15) and pleura (n=39, SMR=1.06; 95%CI: 0.75, 1.44). Lung cancer SMRs increased with duration of employment, decreased with calendar period, and persisted with time-since-first-hire. Among non-malignant causes, the SMR was elevated for external causes (n=3,362, SMR=1.41; 95%CI: 1.36, 1.46) and respiratory diseases (n=4,508, SMR=1.32; 95%CI: 1.28, 1.36), most notably silicosis (n=814, SMR=13.56; 95%CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n=1,729, SMR=0.98; 95%CI: 0.93, 1.02). Conclusions: While there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time-since-first-hire as a uranium miner underscores the importance of long-term follow-up of these workers.
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Dates et versions

hal-03348206 , version 1 (17-09-2021)

Identifiants

Citer

David Richardson, Estelle Rage, Paul A Demers, Minh Do, Nathan Debono, et al.. Mortality among Uranium Miners in North America and Europe: The Pooled Uranium Miners Analysis (PUMA). International Journal of Epidemiology, 2021, 50 (2), pp.633-643. ⟨10.1093/ije/dyaa195⟩. ⟨hal-03348206⟩
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