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Although similar findings have been observed in populations exposed to low\u2010dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106\u2009068\u2009U.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\u2010years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100\u2009mGy, using time\u2010dependent cumulative lung absorbed dose, lagged 10\u2009years. Mean cumulative absorbed dose to the lung was 25\u2009mGy (range: 0\u2010810\u2009mGy). During the 1983 to 2012 follow\u2010up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100\u2009mGy: \u22120.02, 95% CI: &lt;0\u20100.13). However, significant dose\u2010response relationships were observed for some subgroups, which might be false\u2010positive 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\u2010multiplicative with an ERR per 100\u2009mGy of 0.41 (95% CI: 0.01\u20101.15) for those who smoked &lt;20 pack\u2010years and \u22120.03 (95% CI: &lt;0\u20100.15) for those who smoked \u226520 pack\u2010years. Our study provides some evidence that greater protracted radiation exposure in the low\u2010dose range is positively associated with lung cancer mortality.<\/jats:p>","DOI":"10.1002\/ijc.33141","type":"journal-article","created":{"date-parts":[[2020,6,7]],"date-time":"2020-06-07T15:10:32Z","timestamp":1591542632000},"page":"3130-3138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Lung cancer mortality associated with protracted low\u2010dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983\u20102012"],"prefix":"10.1002","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5744-4866","authenticated-orcid":false,"given":"Raquel","family":"Velazquez\u2010Kronen","sequence":"first","affiliation":[{"name":"Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services  Bethesda Maryland USA"},{"name":"Department of Epidemiology and Environmental Health School of Public Health and Health Professions, University at Buffalo, The State University of New York  Buffalo New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethel S.","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha S.","family":"Linet","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten 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