Lung cancer mortality associated with protracted low-dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983-2012

Raquel Velazquez-Kronen, Ethel S. Gilbert, Martha S. Linet, Kirsten B. Moysich, Jo L. Freudenheim, Jean Wactawski-Wende, Steven L. Simon, Elizabeth K. Cahoon, Bruce H. Alexander, Michele M. Doody, Cari M. Kitahara

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low-dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack-years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time-dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0-810 mGy). During the 1983 to 2012 follow-up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: −0.02, 95% CI: <0-0.13). However, significant dose-response relationships were observed for some subgroups, which might be false-positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub-multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01-1.15) for those who smoked <20 pack-years and −0.03 (95% CI: <0-0.15) for those who smoked ≥20 pack-years. Our study provides some evidence that greater protracted radiation exposure in the low-dose range is positively associated with lung cancer mortality.

Original languageEnglish (US)
Pages (from-to)3130-3138
Number of pages9
JournalInternational Journal of Cancer
Issue number11
StatePublished - Dec 1 2020

Bibliographical note

Funding Information:
Intramural Research Program of the National Cancer Institute, National Institutes of Health; National Cancer Institute (NCI) Interdisciplinary Training Grant in Cancer Epidemiology, Grant/Award Number: R25CA113951 Funding information

Publisher Copyright:
© 2020 UICC


  • cigarette smoking
  • ionizing radiation
  • lung neoplasms
  • occupational exposure
  • prospective studies
  • radiation exposure
  • risk assessment
  • surveys and questionnaires


Dive into the research topics of 'Lung cancer mortality associated with protracted low-dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983-2012'. Together they form a unique fingerprint.

Cite this