Central nervous system tumours and occupational ionising radiation exposure: a nested case-control study among the ORICAMs cohort of healthcare workers in France

BMJ Open. 2024 Jun 19;14(6):e084285. doi: 10.1136/bmjopen-2024-084285.

Abstract

Objective: This study aimed at investigating the relationship between occupational exposure to external ionising radiation and central nervous system (CNS) tumours mortality in healthcare workers working in France.

Design and setting: The Occupational Radiation-Induced Cancer in Medical staff (ORICAMs) nested case-control study was conducted based on the dosimetric records of the national register of occupational dosimetry (Système d'information de la surveillance de l'exposition aux rayonnements ionisants).

Participants and methods: 33 CNS tumour deaths occurred between 2002 and 2012 among the ORICAMs cohort composed of 164 015 healthcare workers. Each case was matched to five controls alive at the time of the corresponding case's death, based on sex, year of birth, date of enrolment in the cohort and duration of follow-up. All participants were badge monitored for external radiation exposure, expressed in Hp(10). Conditional logistic regression was used to analyse the dose-response relationship between radiation dose and CNS mortality.

Results: Cases were exposed to a mean cumulative career radiation dose of 5.8±13.7 (max: 54.3) millisievert (mSv) compared with 4.1±15.2 (142.2) mSv for controls. No statistically significant association was found between CNS tumour mortality and cumulative whole-body career dose (OR=1.00, 95% CI 0.98 to 1.03), duration of exposure (OR=1.03; 95% CI 0.95 to 1.12) or age at first exposure (OR=0.98; 95% CI 0.91 to 1.06).

Conclusion: We found no evidence of an association between external radiation exposure and CNS tumour risk in healthcare workers. Limitations of the study include low statistical power and short duration of follow-up.

Keywords: epidemiology; mortality; neurological oncology; occupational & industrial medicine.

MeSH terms

  • Adult
  • Case-Control Studies
  • Central Nervous System Neoplasms* / epidemiology
  • Central Nervous System Neoplasms* / etiology
  • Central Nervous System Neoplasms* / mortality
  • Dose-Response Relationship, Radiation
  • Female
  • France / epidemiology
  • Health Personnel*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms, Radiation-Induced* / epidemiology
  • Neoplasms, Radiation-Induced* / mortality
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology
  • Occupational Diseases / mortality
  • Occupational Exposure* / adverse effects
  • Occupational Exposure* / statistics & numerical data
  • Radiation Exposure / adverse effects
  • Radiation, Ionizing*
  • Risk Factors