Gilbert, E. S., Koshurnikova, N. A., Sokolnikov, M., Khokhryakov, V. F., Miller, S., Preston, D. L., Romanov, S. A., Shilnikova, N. S., Suslova, K. G. and Vostrotin, V. V. Liver Cancers in Mayak Workers.
Liver cancer mortality risks were evaluated in 11,000 workers who started working at the “Mayak” Production Association in 1948–1958 and who were exposed to both internally deposited plutonium and external γ radiation. Comparisons with Russian liver cancer incidence rates indicate excess risk, especially among those with detectable plutonium body burdens and among female workers in the plutonium plant. Comparisons within the Mayak worker cohort which evaluate the role of plutonium body burden with adjustment for cumulative external dose indicate excess risk among workers with burdens estimated to exceed 7.4 kBq (relative risk = 17; 95% CI = 8.0–36) and among workers in the plutonium plant who did not have routine plutonium monitoring data based on urine measurements (relative risk = 2.8; 95% CI = 1.3–6.2). In addition, analyses treating the estimated plutonium body burden as a continuous variable indicate increasing risk with increasing burden (P < 0.001). Relative risks tended to be higher for females than for males, probably because of the lower baseline risk and the higher levels of plutonium measured in females. Because of limitations in current plutonium dosimetry, no attempt was made to quantify liver cancer risks from plutonium in terms of organ dose, and risk from external dose could not be reliably evaluated.