BMJ 1997;315:1181-1188 (8 November)

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Cancer in the offspring of radiation workers: a record linkage study

G J Draper, director,a M P Little, principal scientific officer,b T Sorahan, reader in occupational epidemiology,c L J Kinlen, director,d K J Bunch, research officer,a A J Conquest, higher scientific officer,b G M Kendall, head of population exposure department,b G W Kneale, research fellow,e R J Lancashire, computer officer,e C R Muirhead, principal scientific officer,b C M O'Connor, study coordinator,a T J Vincent, research officer a

a Childhood Cancer Research Group, University of Oxford, Oxford OX2 6HJ, b National Radiological Protection Board, Chilton, Didcot OX11 0RQ, c Institute of Occupational Health, University of Birmingham, Birmingham B15 2TT, d CRC Cancer Epidemiology Research Group, Department of Public Health, University of Oxford, Radcliffe Infirmary, Oxford OX2 6 HE, e Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT

Correspondence to: Dr Draper gjd@ccrg.ox.ac.uk

Objectives: To test the "Gardner hypothesis" that childhood leukaemia and non-Hodgkin lymphoma can be caused by fathers' exposure to ionising radiation before the conception of the child, and, more generally, to investigate whether such radiation exposure of either parent is a cause of childhood cancer.
Design: Case-control study.
Setting: Great Britain.
Subjects: 35 949 children diagnosed as having cancer, together with matched controls.
Main outcome measures: Parental employment as radiation worker as defined by inclusion in the National Registry for Radiation Workers and being monitored for external radiation before conception of child; cumulative dose of external ionising radiation for various periods of employment before conception; dose during pregnancy.
Results: After cases studied by Gardner and colleagues were excluded, fathers of children with leukaemia or non-Hodgkin lymphoma were significantly more likely than fathers of controls to have been radiation workers (relative risk 1.77, 95% confidence interval 1.05 to 3.03) but there was no dose-response relation for any of the exposure periods studied; indeed, the association was greatest for those with doses below the level of detection. No increased risk was found for fathers with a lifetime preconception dose of 100 mSv or more, or with a dose in the 6 months before conception of 10 mSv or more. There was no increased risk for the group of other childhood cancers. Mothers' radiation work was associated with a significant increase of childhood cancer (relative risk 5.00, 1.42 to 26.94; based on 15 cases and 3 controls). Only four of the case mothers and no controls were radiation workers during pregnancy.
Conclusions: These results do not support the hypothesis that paternal preconception irradiation is a cause of childhood leukaemia and non-Hodgkin lymphoma; the observed associations may be chance findings or result from exposure to infective or other agents. If there is any increased risk for the children of fathers who are radiation workers, it is small in absolute terms: in Britain the average risk by age 15 years is 6.5 per 10 000; our best estimate, using all available data, is that the increase is 5.4 per 10 000. For mothers, the numbers are too small for reliable estimates of the risk, if any, to be made.

Key messages

  • The results of this study of occupational exposure to radiation before conception of a child do not support the hypothesis that paternal preconception irradiation is a cause of childhood leukaemia or non-Hodgkin lymphoma

  • The risk of leukaemia or non-Hodgkin lymphoma was significantly raised among the children of male radiation workers, but this risk was not related to preconception radiation dose; indeed, the association was greatest for the group with zero dose or doses below the level of detection

  • Paternal preconception irradiation was not associated with other childhood cancers

  • The risk of cancer in children of female radiation workers was significantly raised, but again there was no evidence for a relation with radiation dose; these conclusions were based on very small numbers

  • The absence of a relation between dose and risk in this study leads to the conclusion that these findings may be due either to chance or to some characteristic other than exposure to radiation of the occupational groups studied. The most likely of such explanations, at least for leukaemia, is exposure to an oncogenic infective agent resulting from high levels of population mixing


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Relevant Article

Cancer in the offspring of radiation workers
Freda Alexander, Cris Busby, Molly Scott Cato, Alice Stewart, G J Draper, M P Little, T Sorahan, and L J Kinlen
BMJ 1998 316: 1672. [Extract] [Full Text]

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