Occupational low-dose irradiation and cancer risk among medical radiation workers

Abstract

Background: Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.

Aims: This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.

Methods: Epidemiological studies on health professionals exposed to IR published from 1975 to 2019 were reviewed. Strength of evidence was assessed according to the modified Royal College of General Practitioners three-star system.

Results: Among the 16 epidemiological studies focusing on cancers from 11 cohorts among medical staff exposed to radiation, higher risks of cancer were observed for pre-1950 exposure and for medical workers who performed fluoroscopically guided interventional procedures or radionuclides procedures compared to those who did not. However, strength of evidence supporting the associations remains moderate as several methodological limits including the lack of dosimetry data, lifestyle factors and recent updates may obscure the link between medical occupational exposure and cancer occurrence.

Conclusions: Excess risk of cancer is suspected for high and former exposures. The more highly exposed professions, i.e. interventional physicians and nuclear medicine workers, should be monitored carefully. Collaborative projects aiming to increase the quantity and quality of information of the studied populations would be a key point.

Keywords: Cancer risk; cohorts; ionizing radiation; radiation workers.