Search

Your search keyword '"Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID)"' showing total 11 results
Start Over Author "Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID)" Language undetermined
11 results on '"Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID)"'

1. Shapley effects and proportional marginal effects for global sensitivity analysis: application to computed tomography scan organ dose estimation

Author

Foucault, Anais, Il Idrissi, Marouane, Iooss, Bertrand, Ancelet, Sophie, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Performance, Risque Industriel, Surveillance pour la Maintenance et l’Exploitation (EDF R&D PRISME), EDF R&D (EDF R&D), EDF (EDF)-EDF (EDF), Institut de Mathématiques de Toulouse UMR5219 (IMT), Université Toulouse Capitole (UT Capitole), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut National des Sciences Appliquées (INSA)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS), Saclay Industrial Lab for Artificial Intelligence Research (SINCLAIR AI Lab), THALES [France]-TOTAL FINA ELF-EDF (EDF), Méthodes d'Analyse Stochastique des Codes et Traitements Numériques (GdR MASCOT-NUM), and Centre National de la Recherche Scientifique (CNRS)

Subjects
FOS: Computer and information sciences, [STAT.AP]Statistics [stat]/Applications [stat.AP], Epidemiology, Proportional marginal effects, Radiation dose, Applications (stat.AP), Shapley effects, Statistics - Applications, Simulation
Abstract

Concerns have been raised about possible cancer risks after exposure to computed tomography (CT) scans in childhood. The health effects of ionizing radiation are then estimated from the absorbed dose to the organs of interest which is calculated, for each CT scan, from dosimetric numerical models, like the one proposed in the NCICT software. Given that a dosimetric model depends on input parameters which are most often uncertain, the calculation of absorbed doses is inherently uncertain. A current methodological challenge in radiation epidemiology is thus to be able to account for dose uncertainty in risk estimation. A preliminary important step can be to identify the most influential input parameters implied in dose estimation, before modelling and accounting for their related uncertainty in radiation-induced health risks estimates. In this work, a variance-based global sensitivity analysis was performed to rank by influence the uncertain input parameters of the NCICT software implied in brain and red bone marrow doses estimation, for four classes of CT examinations. Two recent sensitivity indices, especially adapted to the case of dependent input parameters, were estimated, namely: the Shapley effects and the Proportional Marginal Effects (PME). This provides a first comparison of the respective behavior and usefulness of these two indices on a real medical application case. The conclusion is that Shapley effects and PME are intrinsically different, but complementary. Interestingly, we also observed that the proportional redistribution property of the PME allowed for a clearer importance hierarchy between the input parameters.

Published
2023
Full Text
View/download PDF

2. Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study

Author

Michael Hauptmann, Graham Byrnes, Elisabeth Cardis, Marie-Odile Bernier, Maria Blettner, Jérémie Dabin, Hilde Engels, Tore S Istad, Christoffer Johansen, Magnus Kaijser, Kristina Kjaerheim, Neige Journy, Johanna M Meulepas, Monika Moissonnier, Cecile Ronckers, Isabelle Thierry-Chef, Lucian Le Cornet, Andreas Jahnen, Roman Pokora, Magda Bosch de Basea, Jordi Figuerola, Carlo Maccia, Arvid Nordenskjold, Richard W Harbron, Choonsik Lee, Steven L Simon, Amy Berrington de Gonzalez, Joachim Schüz, Ausrele Kesminiene, Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, International Agency for Research on Cancer (IARC), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), University of Mainz, Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU), SCK CEN, Norwegian Radiation Protection Authority, Danish Cancer Society Research Center, neuroradiology department, Karolinska Institutet [Stockholm, Sweden], Cancer Registry of Norway, U1018, INSERM (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, The Netherlands Cancer Institute [Amsterdam, The Netherlands], Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Luxembourg Institute of Science and Technology (LIST), Mainz University, Barcelona Institute for Global Health (ISGlobal), Centre d'Assurance qualité des Applications Technologiques dans le domaine de la Santé (CAATS), Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Newcastle University, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), CE, IRSN, INCA, Ligue contre le cancer, and European Project: 269912,EC:FP7:Fission,FP7-Fission-2010,EPI-CT(2011)

Subjects
Male, Adult, Neoplasms, Radiation-Induced, Brain Neoplasms, Glioma, Radiation Exposure, Radiation Dosage, Cohort Studies, Young Adult, Oncology, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Child, Tomography, X-Ray Computed
Abstract

The European EPI-CT study aims to quantify cancer risks from CT examinations of children and young adults. Here, we assess the risk of brain cancer.We pooled data from nine European countries for this cohort study. Eligible participants had at least one CT examination before age 22 years documented between 1977 and 2014, had no previous diagnosis of cancer or benign brain tumour, and were alive and cancer-free at least 5 years after the first CT. Participants were identified through the Radiology Information System in 276 hospitals. Participants were linked with national or regional registries of cancer and vital status, and eligible cases were patients with brain cancers according to WHO International Classification of Diseases for Oncology. Gliomas were analysed separately to all brain cancers. Organ doses were reconstructed using historical machine settings and a large sample of CT images. Excess relative risks (ERRs) of brain cancer per 100 mGy of cumulative brain dose were calculated with linear dose-response modelling. The outcome was the first reported diagnosis of brain cancer after an exclusion period of 5 years after the first electronically recorded CT examination.We identified 948 174 individuals, of whom 658 752 (69%) were eligible for our study. 368 721 (56%) of 658 752 participants were male and 290 031 (44%) were female. During a median follow-up of 5·6 years (IQR 2·4-10·1), 165 brain cancers occurred, including 121 (73%) gliomas. Mean cumulative brain dose, lagged by 5 years, was 47·4 mGy (SD 60·9) among all individuals and 76·0 mGy (100·1) among people with brain cancer. A significant linear dose-response relationship was observed for all brain cancers (ERR per 100 mGy 1·27 [95% CI 0·51-2·69]) and for gliomas separately (ERR per 100 mGy 1·11 [0·36-2·59]). Results were robust when the start of follow-up was delayed beyond 5 years and when participants with possibly previously unreported cancers were excluded.The observed significant dose-response relationship between CT-related radiation exposure and brain cancer in this large, multicentre study with individual dose evaluation emphasises careful justification of paediatric CTs and use of doses as low as reasonably possible.EU FP7; Belgian Cancer Registry; La Ligue contre le Cancer, L'Institut National du Cancer, France; Ministry of Health, Labour and Welfare of Japan; German Federal Ministry of Education and Research; Worldwide Cancer Research; Dutch Cancer Society; Research Council of Norway; Consejo de Seguridad Nuclear, Generalitat de Catalunya, Spain; US National Cancer Institute; UK National Institute for Health Research; Public Health England.

Published
2022
Full Text
View/download PDF

3. Living Labs and other participatory approaches applied to research on multiple environnemental exposures and chronic risks

Author

Mariette Gerber, Yara Carrejo Gironza, Brigitte Trousse, Christian Mougin, Olivier Armant, Sylvie Bortoli, Sylvie Platel, Arthur David, Stéphanie Cormier, Sylvie Charron, Denis Bard, Simon Schraub, Alain Rannou, Olivier Laurent, Sonia Grimbuhler, Hélène Desqueyroux, Philippe Chamaret, Arnaud Vanzemberg, Sophie Ancelet, Lionel Larqué, Céline Boudet, Laurence Payrastre, Rodolphe Gilbin, Katia Baumgartner, Stéphane Grison, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Laboratoire d'écotoxicologie des radionucléides (IRSN/PRP-ENV/SERIS/LECO), Service de Recherche et d'Expertise sur les Risques environnementaux (IRSN/PRP-ENV/SERIS), Société francophone de santé environnement (SFSE), France Nature Environnement (FNE), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de l'Environnement Industriel et des Risques (INERIS), Institut Ecocitoyen pour la Connaissance des Pollutions [Fos-sur-Mer], Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire d'étude et de recherche en environnement et santé (LERES), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Santé Environnement Travail et Génie Sanitaire (DSETGS), Agence de l'Environnement et de la Maîtrise de l'Energie (ADEME), Association nationale des comités et commissions locales d'information [Teteghem] (ANCCLI), Information – Technologies – Analyse Environnementale – Procédés Agricoles (UMR ITAP), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Laboratoire de radiotoxicologie et radiobiologie expérimentale (IRSN/PSE-SANTE/SESANE/LRTOX), ALLISS Sciences Sociétés [Paris], Ecologie fonctionnelle et écotoxicologie des agroécosystèmes (ECOSYS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Toxicologie Intégrative & Métabolisme (ToxAlim-TIM), ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Service de la programmation, des partenariats, de la prospective et de l’appui à l’innovation (IRSN/DST/SP3IN), Direction de la Stratégie (IRSN/DST), Ligue Nationale Contre le Cancer - Paris, Ligue Nationale Contre le Cancer (LNCC), Centre Permanent d'Initiatives pour l'Environnement des Pays de l'Aisne (CPIE des Pays de l'Aisne), Service des politiques d’ouverture à la société (IRSN/DST/SPOS), Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INP - PURPAN), Laboratoire d'épidémiologie des rayonnements ionisants (LEPID), Laboratoire d'écotoxicologie des radionucléides (PRP-ENV/SERIS/LECO), Institut Ecocitoyen [Fos-sur-Mer] (IECP), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Ligue Nationnale Contre le Cancer

Subjects
Multiple exposures, methods in environmental health research, [SDE]Environmental Sciences, General Earth and Planetary Sciences, Citizen journalism, Sociology, Living Lab, Environmental planning, co-creation, General Environmental Science
Abstract

International audience; BACKGROUND AND AIM: Participatory research in environmental health is still rare in France. The objectives of environmental health research, in general, can be very diverse (e.g.: identifying situations associated with risks estimating exposures and effects, testing the effectiveness of preventive actions) and related methods are diverse as well. Opportunities for greater implication of the civil society and related challenges differ at each step of research activities. These aspects need to be better known and shared collectively. The LILAS project aimed to 1) co-construct, among institutional researchers, academics and civil society representatives, a mutual understanding of the main problematics and research methods in environmental health, their stakes for different actors, but also the requirements, strengths and limitations of these methods 2) identify expected benefits and points of vigilance related to stronger degrees of participation as part of such environmental health research projects. METHODS: LILAS gathered institutional researchers, academics and civil society representatives interested in multiple exposures (chemical, radiological). Several meetings allowed to collectively identify different types of study (including environmental epidemiological studies) and reflect about the added value, limitations, and methodological principles related to the introduction of growing participation as part of such studies. An analysis matrix was co-created and filled by participants. RESULTS:For different types of studies (studies for assessment of environmental exposures, identification of their determinants, interventions on these exposures, development of sensors, quantitative risk assessment, environmental epidemiological studies, experimental research, studies on the health of ecosystems…), the matrix lists expected benefits for several categories of stakeholders, fundamental methodological principles and practical constraints, advantages and limitations related to the use of participatory approaches (such as the living lab one) or more “classical” approaches. CONCLUSIONS:LILAS has allowed, through a cross-acculturation process, to develop consolidated grounds for the co-construction of future participatory research projects on multiple environmental exposures.

Published
2021
Full Text
View/download PDF

4. Dose Estimation for the European Epidemiological Study on Pediatric Computed Tomography (EPI-CT)

Author

Choonsik Lee, Jérémie Dabin, Johannes Hermen, Steven L. Simon, Marie-Odile Bernier, Jordi Figuerola, Magda Bosch de Basea, Hilde Merete Olerud, Roman Pokora, Andreas Jahnen, Elisabeth Cardis, Carlo Maccia, Graham Byrnes, Neige Journy, Johanna M. Meulepas, Isabelle Thierry-Chef, Tore S. Istad, Ausrele Kesminiene, Françoise Malchair, Lucian Le Cornet, Gilles Ferro, Richard W Harbron, Monika Moissonnier, Michael Hauptmann, ATHENA, Irsn, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), International Agency for Research on Cancer (IARC), German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), SCK CEN, Norwegian Radiation Protection Authority, Luxembourg Institute of Science and Technology (LIST), Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Centre d'Assurance qualité des Applications Technologiques dans le domaine de la Santé (CAATS), CAATS, Newcastle University, Barcelona Institute for Global Health (ISGlobal), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Radiation Programme, Institute of Biometry and Registry Research, Brandenburg Medical School Theodor Fontane, U1018, INSERM (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, The Netherlands Cancer Institute [Amsterdam, The Netherlands], Mainz University, and National Cancer Institute - NCI

Subjects
Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], Biophysics, Radiation Dosage, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Dosimetry, Humans, Radiology, Nuclear Medicine and imaging, Young adult, Child, Radiation, business.industry, Phantoms, Imaging, Infant, Newborn, Infant, [SDV] Life Sciences [q-bio], Europe, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Absorbed dose, Child, Preschool, Cohort, Abdomen, Body region, Female, Tomography, business, Nuclear medicine, Tomography, X-Ray Computed
Abstract

International audience; Within the European Epidemiological Study to Quantify Risks for Paediatric Computerized Tomography (EPI-CT study), a cohort was assembled comprising nearly one million children, adolescents and young adults who received over 1.4 million computed tomography (CT) examinations before 22 years of age in nine European countries from the late 1970s to 2014. Here we describe the methods used for, and the results of, organ dose estimations from CT scanning for the EPI-CT cohort members. Data on CT machine settings were obtained from national surveys, questionnaire data, and the Digital Imaging and Communications in Medicine (DICOM) headers of 437,249 individual CT scans. Exposure characteristics were reconstructed for patients within specific age groups who received scans of the same body region, based on categories of machines with common technology used over the time period in each of the 276 participating hospitals. A carefully designed method for assessing uncertainty combined with the National Cancer Institute Dosimetry System for CT (NCICT, a CT organ dose calculator), was employed to estimate absorbed dose to individual organs for each CT scan received. The two-dimensional Monte Carlo sampling method, which maintains a separation of shared and unshared error, allowed us to characterize uncertainty both on individual doses as well as for the entire cohort dose distribution. Provided here are summaries of estimated doses from CT imaging per scan and per examination, as well as the overall distribution of estimated doses in the cohort. Doses are provided for five selected tissues (active bone marrow, brain, eye lens, thyroid and female breasts), by body region (i.e., head, chest, abdomen/pelvis), patient age, and time period (1977-1990, 1991-2000, 2001-2014). Relatively high doses were received by the brain from head CTs in the early 1990s, with individual mean doses (mean of 200 simulated values) of up to 66 mGy per scan. Optimization strategies implemented since the late 1990s have resulted in an overall decrease in doses over time, especially at young ages. In chest CTs, active bone marrow doses dropped from over 15 mGy prior to 1991 to approximately 5 mGy per scan after 2001. Our findings illustrate patterns of age-specific doses and their temporal changes, and provide suitable dose estimates for radiation-induced risk estimation in epidemiological studies.

Published
2020
Full Text
View/download PDF

5. Individual radiation exposure from computed tomography: a survey of paediatric practice in French university hospitals, 2010–2013

Author

Hubert Ducou-le-Pointe, Jacqueline Payen-de-la-Garanderie, Didier Defez, Choonsik Lee, Jean-François Chateil, Dominique Sirinelli, Nathalie Boddaert, Bouchra Habib Geryes, Andreas Jahnen, Jean-Pierre Pracros, Marie-Odile Bernier, S. Dreuil, Jean-Marc Garcier, Isabelle Thierry-Chef, Neige M. Y. Journy, Joël Guersen, Laboratoire d'épidémiologie (IRSN), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Service de radiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche Public Henri Tudor [Headquarters] (CRP Henri Tudor), Centre de Recherche Public Henri-Tudor [Luxembourg] (CRP Henri-Tudor), Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, NIH, EPS Rockville, Hospices Civils de Lyon, Hospices Civils de Lyon (HCL), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), International Agency for Cancer Research (IACR), Service d'épidémiologie [Fontenay aux Roses], Laboratoire d'épidémiologie des rayonnements ionisants (IRSN/PRP-HOM/SRBE/LEPID), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])

Subjects
Male, medicine.medical_specialty, Percentile, Adolescent, Computed tomography, Radiation Dosage, 030218 nuclear medicine & medical imaging, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Age groups, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, medicine, Humans, Radiology, Nuclear Medicine and imaging, Medical physics, Child, ComputingMilieux_MISCELLANEOUS, Neuroradiology, medicine.diagnostic_test, Phantoms, Imaging, business.industry, Infant, Newborn, Infant, Mediastinum, Dose-Response Relationship, Radiation, Interventional radiology, General Medicine, Radiation Exposure, University hospital, 3. Good health, medicine.anatomical_structure, Child, Preschool, 030220 oncology & carcinogenesis, Abdomen, Female, France, Radiology, Tomography, X-Ray Computed, business
Abstract

To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs). The survey was conducted in radiology departments of six major university hospitals in France in 2010–2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms. CTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2–4 for most body parts, but 5–7 for abdominal examinations and 4–14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years). The results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children. • CTDIvol varied little with age for routine head scans. • CTDIvol was lowest in youngest children for chest or abdominal scans. • Individual and inter-department variability warrant enhanced standardisation of practices. • Recent surveys support the need for revised diagnostic reference levels. • More attention should be given to specific protocols (sinuses, neck, spine, mediastinum).

Published
2017
Full Text
View/download PDF

6. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion - an update

Author

Boveda, Serge, Garcia, Rodrigue, Defaye, Pascal, Piot, Olivier, Narayanan, Kumar, Barra, Sergio, Gras, Daniel, Providencia, Rui, Algalarrondo, Vincent, Beganton, Frankie, Perier, Marie-Cécile, Jacob, Sophie, Bordachar, Pierre, Babuty, Dominique, Klug, Didier, Leclercq, Christophe, Fauchier, Laurent, Sadoul, Nicolas, Deharo, Jean-Claude, Marijon, Eloi, Glikson, Michael, Wolff, Rafael, Hindricks, Gerhard, Mandrola, John, Camm, a John, Lip, Gregory, Betts, Tim, Lewalter, Thorsten, Saw, Jacqueline, Tzikas, Apostolos, Sternik, Leonid, Nietlispach, Fabian, Berti, Sergio, Sievert, Horst, Bertog, Stefan, Meier, Bernhard, Lenarczyk, Radoslaw, Nielsen-Kudsk, Jens Erik, Tilz, Roland, Kalarus, Zbigniew, Deneke, Thomas, Heinzel, Frank, Landmesser, Ulf, Hildick-Smith, David, Clinique Pasteur, Clinique Pasteur [Toulouse], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Cardiac Stimulation and Rhythmology, CHU Grenoble, Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France, Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hospital da Luz Arrabida, V. N. Gaia, Portugal, Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Université de Montréal (UdeM), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sudden Death Expertise Center [Paris] (Paris-SDEC), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie B, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Lille, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Tours], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Marseille, Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), The Hebrew University of Jerusalem (HUJ), Universität Leipzig, Liverpool Heart & Chest Hospital, Fondazione Toscana Gabriele Monasterio, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Universität Leipzig [Leipzig], and Clinical sciences

Subjects
medicine.medical_specialty, Catheters, Consensus, Statement (logic), medicine.medical_treatment, Left auricular appendage, MEDLINE, Catheter ablation, Left atrial appendage occlusion, [SHS]Humanities and Social Sciences, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Atrial Appendage, cardiovascular diseases, Thrombus, EHRA/EAPCI, EXPERT CONSENSUS STATEMENT, ComputingMilieux_MISCELLANEOUS, business.industry, Expert consensus, Atrial fibrillation, medicine.disease, Catheter, Ischemic stroke, cardiovascular system, Catheter Ablation, Cardiology, Cardiology and Cardiovascular Medicine, business, catheter-based left atrial appendage occlusion
Abstract

The rationale for the quest to close the left atrial appendage (LAA) for stroke prevention is composed of three elements: the concept that atrial fibrillation (AF) causes strokes, the concept that strokes are associated with thrombus formation in the LAA, and that these thrombi cause strokes by embolisation to the cerebral circulation. There are strong data supporting an association between AF and stroke. The Framingham study following 5,070 patients over 34 years demonstrated an approximately fivefold higher stroke risk in individuals with AF than in those without.1 Though this does not prove a causal relationship, it is important to mention that this risk remained even after adjustment for other risk factors such as hypertension, coronary artery disease, congestive heart failure, and age. Another element to support LAA closure is that there must be proof that thrombus formation occurs predominantly in the LAA. One would imagine that there are abundant data to support the concept that, in AF, thrombus formation occurs predominantly in the LAA; however, in almost all texts discussing the pathophysiology of stroke in AF there are few publications cited to support this concept. Blackshear et al included 1,288 patients with non-valvular AF who underwent either transoesophageal echocardiography (TOE) or autopsy. 2 Thrombus formation was reported in 222 patients, 91% of which was located in the LAA. It was further supported by a more comprehensive meta-analysis by Mahajan et al who demonstrated that 89% of thrombi in the left atrium (LA) were located in the LAA.3 This was corroborated by a study in the realm of degenerative aortic stenosis by Parashar et al.4 In this study, all left atrial thrombi resided in the LAA. It is worth mentioning that the LAA is the most common site of intracardiac thrombi not only in patients with AF but also in patients in sinus rhythm.5 More direct evidence is now available proving that a large proportion of strokes in AF are the result of thrombus in the LAA. The PROTECT AF and PREVAIL studies (described later in this document) provide evidence for the protective effect of LAA closure on thromboembolic events (Chapter 5), although some have debated the evidence (Chapter 6).6 In order to justify LAA closure it is important to show that, when thrombus occurs in the LAA, it can embolise in the cerebral circulation. o demonstrate this, a thrombus embolising to the brain would have to be caught in the act. Parekh et al describe real-time imaging capture of LAA thrombus embolisation during TOE with subsequent stroke after a delay of 4 hours of the witnessed embolisation, possibly due to initial retention at a non-occlusive location with subsequent fragmentation and delayed more distal embolisation.7 The fact that LAA closure prevents thromboembolic events as detailed above is also indirect proof for embolisation from LAA as a cause of embolic events.

Published
2019
Full Text
View/download PDF

7. Comparison of Outcome of Possible Versus Definite Infective Endocarditis Involving Native Heart Valves

Author

Boveda, Serge, Narayanan, Kumar, Jacob, Sophie, Providencia, Rui, Algalarrondo, Vincent, Bouzeman, Abdeslam, Beganton, Frankie, Defaye, Pascal, Perier, Marie-Cécile, Sadoul, Nicolas, Piot, Olivier, Klug, Didier, Gras, Daniel, Fauchier, Laurent, Bordachar, Pierre, Babuty, Dominique, Deharo, Jean-Claude, Leclercq, Christophe, Marijon, Eloi, Pericart, Lauriane, Bernard, Anne, Bourguignon, Thierry, Bernard, Louis, Angoulvant, Denis, Clementy, Nicolas, Clinique Pasteur [Toulouse], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de RadioBiologie et d'Epidémiologie (IRSN/DRPH/SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), Cardiac Stimulation and Rhythmology, CHU Grenoble, Laboratoire d'Electronique des Systèmes TEmps Réel (LESTER), Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS), Centre cardiologique du Nord (CCN), Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Nouvelles Cliniques Nantaises, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire des Écoulements Géophysiques et Industriels [Grenoble] (LEGI ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Service de Médecine Interne et Maladies Infectieuses [Tours], Cellules Dendritiques, Immunomodulation et Greffes, and CHU Trousseau [Tours]

Subjects
Male, medicine.medical_specialty, Time Factors, Heart Valve Diseases, 030204 cardiovascular system & hematology, Duke criteria, [SHS]Humanities and Social Sciences, Academic institution, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Mitral valve, Cause of Death, medicine, Humans, 030212 general & internal medicine, Heart valve, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Aged, 80 and over, Endocarditis, business.industry, Middle Aged, medicine.disease, Prognosis, Heart Valves, Survival Rate, medicine.anatomical_structure, Echocardiography, Infective endocarditis, Cardiology, Female, France, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

There are very few data on the prognosis of possible versus definite infective endocarditis (IE). We studied data from 365 consecutive patients with IE involving native heart valve seen in an academic institution from 1990 to 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 101, 28%) and those with definite IE (n = 264, 72%). Patients with possible IE were older than those with definite IE (66 ± 15 vs 62 ± 16, p = 0.05). A causative microorganism was identified in 66% of patients with possible IE versus all patients with definite IE (p0.0001) and only 41% had major echocardiographic criteria (vs 100%; p0.0001). Overall, 139 patients died over a mean ± SD follow-up of 3.9 ± 4.5 years (median 2.2, interquartile range 5.9 years). Patients with possible and definite IE had a similar risk of death. Independent predictors of long-term mortality were increasing age (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1.01 to 1.04; p = 0.0009), vegetation length15 mm (HR 1.87, 95% CI 1.14 to 3.06; p = 0.01), and stroke (HR 4.10, 95% CI 1.84 to 9.17; p = 0.0006), whereas infection of mitral valve (HR 0.57, 95% CI 0.34 to 0.94; p = 0.03) and surgery (HR 0.43, 95% CI 0.19 to 0.99; p = 0.05) were associated with a better prognosis. Patients with definite IE and those with possible IE who did not undergo surgery had a worse prognosis than their counterparts with surgery. In conclusion, unselected patients with possible IE (Duke criteria) had a similar prognosis than those with definite IE.

Published
2016
Full Text
View/download PDF

8. CEA-EXPO: A facility exposure matrix to assess passed exposure to chemical carcinogens and radionuclides of nuclear workers

Author

P. Bouville, S. Marot, D. Bergot, M. Telle-Lamberton, J.M. Giraud, M. Gagneau, J. M. Gelas, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Institut de Veille Sanitaire (INVS), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), COGEMA, Laboratoire d'épidémiologie des rayonnements ionisants (LEPID), and Institut de Radioprotection et de Sûreté Nucléaire (IRSN)

Subjects
Ionizing radiation, Exposure durations, Epidemiology, [SDV]Life Sciences [q-bio], Health, Toxicology and Mutagenesis, Nuclear fuel reprocessing, Job-exposure matrix, Toxicology, Matrix (chemical analysis), 03 medical and health sciences, Nuclear reactors, 0302 clinical medicine, Nuclear industry, Environmental health, Chemical carcinogens, 030212 general & internal medicine, Safety, Risk, Reliability and Quality, Waste Management and Disposal, Radioisotopes, Epidemiological studies, Radionuclide, Renewable Energy, Sustainability and the Environment, Public Health, Environmental and Occupational Health, Nuclear workers, Internal contaminations, Occupational exposure, Contamination, 030210 environmental & occupational health, Waste treatment, Fuel fabrications, Nuclear reprocessing, Nuclear Energy and Engineering, Chemical exposure, Carcinogens, Job exposure matrix, Radiation chemistry
Abstract

A "Facility-Exposure Matrix" (FEM) is proposed to assess exposure to chemical carcinogens and radionuclides in a cohort of nuclear workers. Exposures are to be attributed in the following way: a worker reports to an administrative unit and/or is monitored for exposure to ionising radiation in a specific workplace. These units are connected with a list of facilities for which exposure is assessed through a group of experts. The entire process of the FEM applied in one of the nuclear centres included in the study shows that the FEM is feasible: exposure durations as well as groups of correlated exposures are presented but have to be considered as possible rather than positive exposures. Considering the number of facilities to assess (330), ways to simplify the method are proposed: (i) the list of exposures will be restricted to 18 chemical products retained from an extensive bibliography study; (ii) for each of the following classes of facilities: nuclear reactors, fuel fabrication, high-activity laboratories and radiation chemistry, accelerators and irradiators, waste treatment, biology, reprocessing, fusion, occupational exposure will be deduced from the information already gathered by the initial method. Besides taking into account confusion factors in the low doses epidemiological study of nuclear workers, the matrix should help in the assessment of internal contamination and chemical exposures in the nuclear industry. © 2005 EDP Sciences.

Published
2005
Full Text
View/download PDF

9. The performance of functional methods for correcting non-Gaussian measurement error within Poisson regression: corrected excess risk of lung cancer mortality in relation to radon exposure among French uranium miners

Author

Dominique Laurier, Estelle Rage, Rodrigue S. Allodji, Stéphane Henry, Anne C. M. Thiébaut, Klervi Leuraud, Jacques Benichou, Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Pharmacoépidémiologie et maladies infectieuses (PhEMI), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), AREVA, Groupe AREVA, CHU Rouen, Normandie Université (NU), This work was partly supported by AREVA NC, in the framework of a bilateral IRSN-AREVA-NC agreement., ATHENA, Irsn, PRPHOM, SRBE, LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), and Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Lung Neoplasms, Epidemiology, Calibration (statistics), [SDV]Life Sciences [q-bio], Normal Distribution, MESH: Risk Assessment, 01 natural sciences, MESH: Regression Analysis, MESH: Occupational Exposure, 030218 nuclear medicine & medical imaging, Cohort Studies, 010104 statistics & probability, 0302 clinical medicine, Statistics, Econometrics, MESH: Bias, Poisson Distribution, MESH: Cohort Studies, Mathematics, Absolute risk reduction, MESH: Mining, [SDV] Life Sciences [q-bio], Radon, Cohort, symbols, Regression Analysis, Uranium, France, Statistics and Probability, chemistry.chemical_element, Risk Assessment, MESH: Radiation Monitoring, Mining, MESH: Poisson Distribution, 03 medical and health sciences, symbols.namesake, MESH: Computer Simulation, Bias, Radiation Monitoring, Occupational Exposure, Humans, Computer Simulation, Poisson regression, 0101 mathematics, MESH: Normal Distribution, Observational error, MESH: Humans, MESH: Lung Neoplasms, MESH: France, chemistry, Relative risk, MESH: Uranium, Correction for attenuation, MESH: Radon
Abstract

International audience; A broad variety of methods for measurement error (ME) correction have been developed, but these methods have rarely been applied possibly because their ability to correct ME is poorly understood. We carried out a simulation study to assess the performance of three error-correction methods two variants of regression calibration (the substitution method and the estimation calibration method) and the simulation extrapolation (SIMEX) method. Features of the simulated cohorts were borrowed from the French Uranium Miners' Cohort in which exposure to radon had been documented from 1946 to 1999. In the absence of ME correction, we observed a severe attenuation of the true effect of radon exposure, with a negative relative bias of the order of 60% on the excess relative risk of lung cancer death. In the main scenario considered, that is, when ME characteristics previously determined as most plausible from the French Uranium Miners' Cohort were used both to generate exposure data and to correct for ME at the analysis stage, all three error-correction methods showed a noticeable but partial reduction of the attenuation bias, with a slight advantage for the SIMEX method. However, the performance of the three correction methods highly depended on the accurate determination of the characteristics of ME. In particular, we encountered severe overestimation in some scenarios with the SIMEX method, and we observed lack of correction with the three methods in some other scenarios. For illustration, we also applied and compared the proposed methods on the real data set from the French Uranium Miners' Cohort study. © 2012 John Wiley and Sons, Ltd.

Published
2011
Full Text
View/download PDF

10. External radiation exposure and mortality in a cohort of French nuclear workers

Author

J. M. Gelas, Catherine Hill, Denis Bard, B. Quesne, Margot Tirmarche, J.M. Giraud, M. Telle-Lamberton, C. Metz-Flamant, D. Bergot, E. Samson, Francis Bermann, M.O. Neron, Sylvaine Caer, Philippe Hubert, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Groupe AREVA, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Laboratoire d'épidémiologie des rayonnements ionisants (LEPID), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), and Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN)

Subjects
nuclear power plant, [SDV]Life Sciences [q-bio], pharynx cancer, radiation exposure, 030218 nuclear medicine & medical imaging, Cohort Studies, cause of death, 0302 clinical medicine, Nuclear Reactors, Medicine, Melanoma, Cause of death, education.field_of_study, Leukemia, adult, Mortality rate, article, X ray, 3. Good health, Occupational Diseases, female, priority journal, 030220 oncology & carcinogenesis, Cohort, symbols, Original Article, France, Multiple Myeloma, chronic lymphatic leukemia, radiation injury, Cohort study, alcohol psychosis, alcohol consumption, liver cirrhosis, Population, 03 medical and health sciences, symbols.namesake, male, Statistical significance, Occupational Exposure, controlled study, human, Poisson regression, education, Radiometry, business.industry, gamma radiation, Public Health, Environmental and Occupational Health, Nuclear Energy, major clinical study, mortality, Relative risk, business, Nuclear medicine, worker, Demography
Abstract

Objective: To analyse the effect of external radiation exposure on the mortality of French nuclear workers. Methods: A cohort of 29 204 workers employed between 1950 and 1994 at the French Atomic Energy Commission (Commissariat a l’Energie Atomique (CEA)) or at the General Company of Nuclear Fuel (COmpagnie GEnerale des MAtieres nucleaires (Cogema, now Areva NC)) was followed up for an average of 17.8 years. Standardised mortality ratios (SMRs) were computed with reference to French mortality rates. Dose-effect relationship were analysed through trend tests and Poisson regression, with linear and log-linear models. Results: The mean exposure to X and gamma radiation was 8.3 mSv (16.9 mSv for exposed worker population). A total of 1842 deaths occurred between 1968 and 1994. A healthy worker effect was observed, the number of deaths in the cohort being 59% of the number expected from national mortality statistics. Among the 21 main cancer sites studied, a statistically significant excess was observed only for skin melanoma, and an excess of borderline statistical significance was observed for multiple myeloma. A dose-effect relationship was observed for leukaemia after exclusion of chronic lymphoid leukaemia (CLL). The relative risk observed for non-CLL leukaemia, n = 20, was 4.1 per 100 mSv (90% CI 1.4 to 12.2), linear model and 2.2 per 100 mSv (90% CI 1.2 to 3.3), log-linear model. Significant dose-effect relationship were also observed for causes of deaths associated with alcohol consumption: mouth and pharynx cancer, cirrhosis and alcoholic psychosis and external causes of death. Conclusion: The risk of leukaemia increases with increasing exposure to external radiation; this is consistent with published results on other nuclear workers cohorts.

Published
2007
Full Text
View/download PDF

11. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries

Author

A. Kerekes, G. Cowper, Rima R. Habib, H. Malker, G. Gulis, J. Bernar Solano, Anssi Auvinen, M. Telle-Lamberton, M. Moser, P. Deboodt, Geoffrey R. Howe, Yoon Ok Ahn, H. Tardy, Elisabeth Cardis, Fix Jj, G. Engholm, Fernando Rodríguez-Artalejo, Ethel S. Gilbert, P. Ashmore, A. Diez Sacristan, Isabelle Thierry-Chef, E. Combalot, Martine Vrijheid, A. Mastauskas, D. Utterback, M. Martuzzi, Colin R. Muirhead, M. Marshall, David B. Richardson, I. Turai, Mary K. Schubauer-Berigan, M. Usel, J. M. Bae, John M. Kaldor, M. Eklof, F. Bermann, H. Hyvonen, E. Amoros, A. Biau, B. Heinmiller, Matti Hakama, A. Monnet, Mark S. Pearce, K. Veress, C. Hacker, Agnès Rogel, Juozas Kurtinaitis, H. Engels, T. Yoshimura, Catherine Hill, Maria Blettner, K. Holan, Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), University of Tampere [Finland], Institut Gustave Roussy (IGR), Columbia Mailman School of Public Health, Columbia University [New York], National Centre in HIV Epidemiology and Clinical Research, Health Protection Agency, National Institute for Occupational Safety and Health [Cincinnati] (NIOSH), Centers for Disease Control and Prevention (CDC), University of Occupational and Environmental Health [Kitakyushu] (UEOH), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Pacific Northwest National Laboratory (PNNL), Australian Nuclear Science and Technology Organisation [Australie] (ANSTO), Chalk River Laboratories, Atomic Energy of Canada Ltd., Seoul National University [Seoul] (SNU), Institut National de Recherche sur les Transports et leur Sécurité (INRETS), Radiation Protection Bureau, Health Canada, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Centre d'Etude de l'Energie Nucléaire (SCK-CEN), Department of Economics and Institute for East European Studies, American University of Beirut Faculty of Medicine and Medical Center (AUB), WHO European Centre for Environment and Health [Bonn] (ECEH), Serono International SA (SERONO INTERNATIONAL SA), Serono International SA, School of Clinical Medical Sciences, University of Newcastle upon Tyne, Universidad Autónoma de Madrid (UAM), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Semmelweis University of Medicine [Budapest], Department of Preventive Medicine, College of Medicine, Seoul National University, Universidad Autonoma de Madrid (UAM), and Laboratoire d'épidémiologie des rayonnements ionisants (LEPID)

Subjects
Male, Neoplasms, Radiation-Induced, retrospective study, [SDV]Life Sciences [q-bio], cigarette smoking, radiation exposure, nuclear industry, cancer risk, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Japan, dose response, Neoplasms, cancer mortality, General Environmental Science, dosimetry, article, leukemia, General Engineering, Absolute risk reduction, clinical trial, General Medicine, cohort analysis, 3. Good health, Occupational Diseases, female, priority journal, 030220 oncology & carcinogenesis, Papers, Cohort, Workforce, epidemiology, Drug, ionizing radiation, radiation dose, Risk assessment, radiation injury, Cohort study, medicine.medical_specialty, Occupational disease, Risk Assessment, atomic bomb, electric power plant, Dose-Response Relationship, 03 medical and health sciences, manpower, Environmental health, medicine, follow up, Humans, human, industrial worker, Dose-Response Relationship, Drug, business.industry, Cancer, Retrospective cohort study, medicine.disease, major clinical study, mortality, Surgery, multicenter study, Radiation-Induced, Relative risk, occupational disease, General Earth and Planetary Sciences, solid tumor, Epidemiologic Methods, business, radiation protection, Power Plants
Abstract

Objectives: To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental, occupational, and medical diagnostic exposures. Design: Multinational retrospective cohort study of cancer mortality. Setting: Cohorts of workers in the nuclear industry in 15 countries. Participants: 407 391 workers individually monitored for external radiation with a total follow-up of 5.2 million person years. Main outcome measurements: Estimates of excess relative risks per sievert (Sv) of radiation dose for mortality from cancers other than leukaemia and from leukaemia excluding chronic lymphocytic leukaemia, the main causes of death considered by radiation protection authorities. Results: The excess relative risk for cancers other than leukaemia was 0.97 per Sv, 95% confidence interval 0.14 to 1.97. Analyses of causes of death related or unrelated to smoking indicate that, although confounding by smoking may be present, it is unlikely to explain all of this increased risk. The excess relative risk for leukaemia excluding chronic lymphocytic leukaemia was 1.93 per Sv (< 0 to 8.47). On the basis of these estimates, 1-2% of deaths from cancer among workers in this cohort may be attributable to radiation. Conclusions: These estimates, from the largest study of nuclear workers ever conducted, are higher than, but statistically compatible with, the risk estimates used for current radiation protection standards. The results suggest that there is a small excess risk of cancer, even at the low doses and dose rates typically received by nuclear workers in this study.

Published
2005
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results