Risk of Occupational Exposure to Ionizing Radiation among Medical Workers in Canada

Medical workers are exposed to chronic low dose ionizing radiation from a variety of sources. Potential cancer risks associated with ionizing radiation exposures have been derived from cohorts experiencing acute high intensity exposure, most notably the Japanese atomic bomb survivors. Since such extrapolations are subject to uncertainty, direct information on the risk associated with chronic low dose occupational exposure to ionizing radiation is needed. We examined possible associations with cancer incidence and mortality in a cohort of medical workers ascertained by the National Dose Registry of Canada (NDR). Data from the NDR were used to assess the exposure to ionizing radiation incurred between 1951 to 1987 inclusive in a cohort of 67,562 subjects classified as medical workers. Standardized mortality (SMRs) and incidence (SIRs) ratios were ascertained by linking NDR data with the data maintained by Statistics Canada in the Canadian Mortality and in the Canadian Cancer Incidence Databases respectively. Dosimetry information was obtained from the National Dosimetry Services of the Radiation Protection Bureau of Health Canada. There were 23,580 male and 43,982 female medical workers in the cohort. During the follow-up period, 1309 incident cases of cancer (509 in males, 800 in females) and 1,325 deaths (823 in males, 502 in females) were observed. Mortality from cancer and noncancer causes was generally below expected compared to the Canadian population. Thyroid cancer incidence was significantly elevated in both males and females, with a combined SIR of 1.74 and 90% confidence interval (90% CI: 1.40-2.10). Our result of an increased risk of thyroid cancer among medical workers occupationally exposed to ionizing radiation confirms previous reports. Over the last 50 years, radiation protection measures have been effective in reducing occupational exposures of medical workers to ionizing radiation to current very low levels.