基于不同危险系数的矿工肺癌归因研究

doi:10.27045/j.1000-8187.202605009

摘要/Abstract

摘要： 氡及其子体为1类致癌物,矿工职业高氡暴露所致肺癌的归因判断是职业性放射性肿瘤诊断的关键。为优化我国氡致肺癌归因方法、降低跨人群风险转移带来的归因偏差,本研究依托我国铀矿工队列研究获取的氡致肺癌超额相对危险(ERR)系数构建归因新方法,选取177例有吸烟史的矿工肺癌病例,同步采用新方法与 GBZ 97—2017 现行标准方法开展归因分析,对比不同方法的归因结果并分析差异成因。结果表明,两种方法总归因率相近(新方法45%、标准方法43%),但在<20 WLM低剂量区域差异极显著,新方法可归因率仅3%,为标准方法的1/4;共16例病例归因结果存在分歧,其中6例低氡暴露、低发病年龄病例按标准方法可归因、新方法不可归因,10例高氡暴露、高发病年龄病例按新方法可归因、标准方法不可归因。综上,基于本土队列ERR系数的新方法剂量相关性更高、发病年龄相关性更低,可有效规避使用国外人群数据导致的不确定性,契合我国人群特征与职业卫生政策延续性,为我国氡致肺癌归因方法的优化升级提供了核心方法学支撑与数据参考。

关键词: 氡致肺癌, 超额相对危险, 病因概率。

Abstract: Radon and its progeny are classified as Group 1 carcinogens. The attribution determination of lung cancer caused by high radon exposure among miners is key to the diagnosis of occupational radioactive tumors. To optimize the attribution method for radon-induced lung cancer in China and reduce the attribution bias caused by the transfer of risks across populations, this study constructed a new attribution method based on the excess relative risk (ERR) coefficient of radon-induced lung cancer obtained from the uranium miner cohort study in China. 177 cases of miner lung cancer with a history of smoking were selected, and the attribution analysis was conducted simultaneously using both the new method and the method of GBZ 97—2017. The attribution results of different methods were compared and the causes of the differences were analyzed. The results showed that the total attribution rates of the two methods were similar (new method 45%, standard method 43%), but there was a significant difference in the <20WLM low-dose area. The attributable rate of the new method was only 3%, which was 1/4 of the standard method. A total of 16 cases had conflicting attribution results. Among them, 6 cases with low radon exposure and low attained age could be attributed by the standard method but not by the new method, and 10 cases with high radon exposure and high attained age could be attributed by the new method but not by the standard method. In summary, the new method based on the ERR coefficient of the local cohort has a higher dose correlation and lower age correlation, which can effectively avoid the uncertainty caused by using data from foreign populations and is in line with the characteristics of the Chinese population and the continuity of occupational health policies. It provides core methodological support and a data reference for the optimization and upgrading of the attribution method for radon-induced lung cancer in China.

Key words: radon-induced lung cancer, excess relative risk(ERR), probability of causation(PC)

中图分类号:

R144

任越, 李幼忱, 刘森林. 基于不同危险系数的矿工肺癌归因研究[J]. 辐射防护, 2026, 46(5): 456-461.

REN Yue, LI Youchen, LIU Senlin. Research on the attribution of lung cancer in miners based on different risk factors[J]. RADIATION PROTECTION, 2026, 46(5): 456-461.

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