{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:18:14Z","timestamp":1792660694051,"version":"4.5.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004598","name":"Institute for Radiological Protection and Nuclear Safety","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004598","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical workers are the largest group of workers occupationally exposed to low doses of ionizing radiation (IR) worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This review presents all the cohorts of medical workers exposed in the world and summarizes cancer risks associated with radiation exposure in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/occmed\/kqaa130","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T07:10:11Z","timestamp":1594105811000},"page":"476-484","source":"Crossref","is-referenced-by-count":52,"title":["Occupational low-dose irradiation and cancer risk among medical radiation workers"],"prefix":"10.1093","volume":"70","author":[{"given":"H","family":"Chartier","sequence":"first","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"},{"name":"Percy Hospital, Radiological Protection Service of the Armed Forces (SPRA), Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Fassier","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Leuraud","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Jacob","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-1548","authenticated-orcid":false,"given":"C","family":"Baudin","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Laurier","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5807-4596","authenticated-orcid":false,"given":"M-O","family":"Bernier","sequence":"additional","affiliation":[{"name":"PSE-SANTE\/SESANE\/LEPID, Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"2020102714305152300_CIT0001","article-title":"Effects of ionizing radiation: UNSCEAR 2006 Report to the General Assembly, with scientific annexes","author":"United Nations Scientific Committee reports to General Assembly","year":"2009"},{"key":"2020102714305152300_CIT0002","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1667\/RR14492.1","article-title":"Solid cancer incidence among the life span study of atomic bomb survivors: 1958-2009","volume":"187","author":"Grant","year":"2017","journal-title":"Radiat Res"},{"key":"2020102714305152300_CIT0003","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1667\/RR2629.1","article-title":"Studies of the mortality of atomic bomb survivors, Report 14, 1950\u20132003: an overview of cancer and noncancer diseases","volume":"177","author":"Ozasa","year":"2012","journal-title":"Radiat Res"},{"key":"2020102714305152300_CIT0004","doi-asserted-by":"crossref","first-page":"e276","DOI":"10.1016\/S2352-3026(15)00094-0","article-title":"Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study","volume":"2","author":"Leuraud","year":"2015","journal-title":"Lancet Haematol"},{"key":"2020102714305152300_CIT0005","doi-asserted-by":"crossref","first-page":"h5359","DOI":"10.1136\/bmj.h5359","article-title":"Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS)","volume":"351","author":"Richardson","year":"2015","journal-title":"Br Med J"},{"key":"2020102714305152300_CIT0006","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1667\/RR2014.1","article-title":"Historical review of occupational exposures and cancer risks in medical radiation workers","volume":"174","author":"Linet","year":"2010","journal-title":"Radiat Res"},{"key":"2020102714305152300_CIT0007","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1667\/RR3433.1","article-title":"Estimating historical radiation doses to a cohort of U.S. radiologic technologists","volume":"166","author":"Simon","year":"2006","journal-title":"Radiat Res"},{"key":"2020102714305152300_CIT0008","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/00004032-198705000-00016","article-title":"Does radiation exposure produce a protective effect among radiologists?","volume":"52","author":"Matanoski","year":"1987","journal-title":"Health Phys"},{"key":"2020102714305152300_CIT0009","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1259\/bjr.74.882.740507","article-title":"100 years of observation on British radiologists: mortality from cancer and other causes 1897\u20131997","volume":"74","author":"Berrington","year":"2001","journal-title":"Brit J Radiol"},{"key":"2020102714305152300_CIT0010","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1016\/j.ijcard.2012.04.124","article-title":"Interventional cardiologists and risk of radiation-induced cataract: results of a French multicenter observational study","volume":"167","author":"Jacob","year":"2013","journal-title":"Int J Cardiol"},{"key":"2020102714305152300_CIT0011","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1016\/j.amjcard.2012.12.060","article-title":"Brain and neck tumors among physicians performing interventional procedures","volume":"111","author":"Roguin","year":"2013","journal-title":"Am J Cardiol"},{"key":"2020102714305152300_CIT0012","doi-asserted-by":"crossref","first-page":"e10000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2020102714305152300_CIT0013","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1093\/occmed\/51.2.124","article-title":"Occupational health guidelines for the management of low back pain at work: evidence review","volume":"51","author":"Waddell","year":"2001","journal-title":"Occup Med (Lond)"},{"key":"2020102714305152300_CIT0014","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1093\/occmed\/49.4.225","article-title":"A review of the healthy worker effect in occupational epidemiology","volume":"49","author":"Li","year":"1999","journal-title":"Occup Med (Lond)"},{"key":"2020102714305152300_CIT0015","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1136\/oem.54.6.388","article-title":"Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants","volume":"54","author":"Carpenter","year":"1997","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0016","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1259\/0007-1285-64-761-455","article-title":"Cancer risk among staff at two radiotherapy departments in Denmark","volume":"64","author":"Andersson","year":"1991","journal-title":"Br J Radiol"},{"key":"2020102714305152300_CIT0017","doi-asserted-by":"crossref","first-page":"368","DOI":"10.5271\/sjweh.1032","article-title":"Cancer incidence among physicians occupationally exposed to ionizing radiation in Finland","volume":"32","author":"Jartti","year":"2006","journal-title":"Scand J Work Environ Health"},{"key":"2020102714305152300_CIT0018","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/oxfordjournals.aje.a112086","article-title":"The current mortality rates of radiologists and other physician specialists: deaths from all causes and from cancer","volume":"101","author":"Matanoski","year":"1975","journal-title":"Am J Epidemiol"},{"key":"2020102714305152300_CIT0019","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1148\/radiol.2016152472","article-title":"Long-term mortality in 43 763 U.S. radiologists compared with 64 990 U.S. psychiatrists","volume":"281","author":"Berrington de Gonzalez","year":"2016","journal-title":"Radiology"},{"key":"2020102714305152300_CIT0020","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1148\/radiol.2017161306","article-title":"Mortality in U.S. physicians likely to perform fluoroscopy-guided interventional procedures compared with psychiatrists, 1979 to 2008","volume":"284","author":"Linet","year":"2017","journal-title":"Radiology"},{"key":"2020102714305152300_CIT0021","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1038\/bjc.2016.292","article-title":"Breast cancer risk and protracted low-to-moderate dose occupational radiation exposure in the US radiologic technologists cohort, 1983-2008","volume":"115","author":"Preston","year":"2016","journal-title":"Br J Cancer"},{"key":"2020102714305152300_CIT0022","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1136\/oemed-2013-101859","article-title":"Work history and mortality risks in 90,268 US radiological technologists","volume":"71","author":"Liu","year":"2014","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0023","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1136\/oemed-2015-102834","article-title":"Cancer and circulatory disease risks in US radiologic technologists associated with performing procedures involving radionuclides","volume":"72","author":"Kitahara","year":"2015","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0024","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.2214\/AJR.15.15265","article-title":"Cancer risks in U.S. radiologic technologists working with fluoroscopically guided interventional procedures, 1994\u20132008","volume":"206","author":"Rajaraman","year":"2016","journal-title":"Am J Roentgenol"},{"key":"2020102714305152300_CIT0025","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1136\/oemed-2015-102880","article-title":"Occupational ionising radiation and risk of basal cell carcinoma in US radiologic technologists (1983\u20132005)","volume":"72","author":"Lee","year":"2015","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0026","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1002\/ijc.22065","article-title":"Thyroid cancer and employment as a radiologic technologist","volume":"119","author":"Zabel","year":"2006","journal-title":"Int J Cancer"},{"key":"2020102714305152300_CIT0027","doi-asserted-by":"crossref","first-page":"3080","DOI":"10.1002\/cncr.11444","article-title":"Cancer incidence in the US radiologic technologists health study, 1983-1998","volume":"97","author":"Sigurdson","year":"2003","journal-title":"Cancer"},{"key":"2020102714305152300_CIT0028","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1136\/oem.2005.020826","article-title":"Incidence of haematopoietic malignancies in US radiologic technologists","volume":"62","author":"Linet","year":"2005","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0029","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.2214\/AJR.16.16964","article-title":"Occupational radiation exposure and deaths from malignant intracranial neoplasms of the brain and CNS in U.S. radiologic technologists, 1983\u20132012","volume":"208","author":"Kitahara","year":"2017","journal-title":"Am J Roentgenol"},{"key":"2020102714305152300_CIT0030","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1002\/ijc.31270","article-title":"Occupational radiation exposure and thyroid cancer incidence in a cohort of U.S. radiologic technologists, 1983\u20132013","volume":"143","author":"Kitahara","year":"2018","journal-title":"Int J Cancer"},{"key":"2020102714305152300_CIT0031","first-page":"149","article-title":"Health outcomes of low-dose ionizing radiation exposure among medical workers: a cohort study of the Canadian national dose registry of radiation workers","volume":"22","author":"Zielinski","year":"2009","journal-title":"Int J Occup Med Environ Health"},{"key":"2020102714305152300_CIT0032","doi-asserted-by":"crossref","first-page":"2875","DOI":"10.1002\/ijc.30036","article-title":"Solid cancer incidence among Chinese medical diagnostic x-ray workers, 1950\u20131995: estimation of radiation-related risks","volume":"138","author":"Sun","year":"2016","journal-title":"Int J Cancer"},{"key":"2020102714305152300_CIT0033","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/00004032-200204000-00004","article-title":"Cancer incidence and risk estimation among medical x-ray workers in China, 1950\u20131995","volume":"82","author":"Wang","year":"2002","journal-title":"Health Phys"},{"key":"2020102714305152300_CIT0034","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2188\/jea.9.61","article-title":"Cancer mortality among radiological technologists in Japan: updated analysis of follow-up data from 1969 to 1993","volume":"9","author":"Yoshinaga","year":"1999","journal-title":"J Epidemiol"},{"key":"2020102714305152300_CIT0035","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s00420-014-1002-1","article-title":"The radiologic technologists\u2019 health study in South Korea: study design and baseline results","volume":"88","author":"Lee","year":"2015","journal-title":"Int Arch Occup Environ Health"},{"key":"2020102714305152300_CIT0036","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1136\/oemed-2018-105019","article-title":"Mortality among diagnostic medical radiation workers in South Korea, 1996\u20132015","volume":"75","author":"Lee","year":"2018","journal-title":"Occup Environ Med"},{"key":"2020102714305152300_CIT0037","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1111\/eci.12628","article-title":"Risk of cancer among cardiologists who frequently perform percutaneous coronary interventions: a population-based study","volume":"46","author":"Ho","year":"2016","journal-title":"Eur J Clin Invest"},{"key":"2020102714305152300_CIT0038","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12940-019-0460-z","article-title":"Thyroid cancer risks among medical radiation workers in South Korea,1996\u20132015","volume":"18","author":"Lee","year":"2019","journal-title":"Environ Health"},{"key":"2020102714305152300_CIT0039","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1148\/radiol.2332031119","article-title":"Cancer risks among radiologists and radiologic technologists: review of epidemiologic studies","volume":"233","author":"Yoshinaga","year":"2004","journal-title":"Radiology"},{"key":"2020102714305152300_CIT0040","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1051\/radiopro\/2014015","article-title":"Use of personal radiation protection tools and individual dosimetric monitoring in a sample of interventional cardiologists in France, 2005\u20132009","volume":"49","author":"Jacob","year":"2014","journal-title":"Radioprotection"},{"key":"2020102714305152300_CIT0041","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1536\/jhj.43.159","article-title":"Sister chromatid exchange analysis and chromosoma aberration studies in interventional cardiology laboratory workers: one war follow up study","volume":"43","author":"Erol","year":"2002","journal-title":"Jpn Heart J"},{"key":"2020102714305152300_CIT0042","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/occmed\/kqq062","article-title":"Biological effects of low-dose ionizing radiation exposure on interventional cardiologists","volume":"60","author":"Zakeri","year":"2010","journal-title":"Occup Med (Lond)"},{"key":"2020102714305152300_CIT0043","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1667\/RR13413.1","article-title":"Association of chromosome translocation rate with low dose occupational radiation exposures in U.S. radiologic technologists","volume":"182","author":"Little","year":"2014","journal-title":"Radiat Res"},{"key":"2020102714305152300_CIT0044","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.mrrev.2012.05.003","article-title":"Ionizing radiation biomarkers for potential use in epidemiological studies","volume":"751","author":"Pernot","year":"2012","journal-title":"Mutat Res"},{"key":"2020102714305152300_CIT0045","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.jclinepi.2012.06.015","article-title":"Overviews of reviews often have limited rigor: a systematic review","volume":"65","author":"Pieper","year":"2012","journal-title":"J Clin Epidemiol"}],"container-title":["Occupational Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/occmed\/article-pdf\/70\/7\/476\/34044756\/kqaa130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/occmed\/article-pdf\/70\/7\/476\/34044756\/kqaa130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T14:31:57Z","timestamp":1603809117000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/occmed\/article\/70\/7\/476\/5881260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,5]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,8,5]]},"published-print":{"date-parts":[[2020,10,27]]}},"URL":"https:\/\/doi.org\/10.1093\/occmed\/kqaa130","relation":{},"ISSN":["0962-7480","1471-8405"],"issn-type":[{"value":"0962-7480","type":"print"},{"value":"1471-8405","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,8,5]]}}}