Half-century archives of occupational medical data on French nuclear workers: a dusty warehouse or gold mine for epidemiological research?

Abstract

This article discusses the availability and completeness of medical data on workers from the AREVA NC Pierrelatte nuclear plant and their possible use in epidemiological research on cardiovascular and metabolic disorders related to internal exposure to uranium. We created a computer database from files on 394 eligible workers included in an ongoing nested case-control study from a larger cohort of 2897 French nuclear workers. For each worker, we collected records of previous employment, job positions, job descriptions, medical visits, and blood test results from medical history. The dataset counts 9,471 medical examinations and 12,735 blood test results. For almost all of the parameters relevant for research on cardiovascular risk, data completeness and availability is over 90 %, but it varies with time and improves in the latest time period. In the absence of biobanks, collecting and computerising available good-quality occupational medicine archive data constitutes a valuable alternative for epidemiological and aetiological research in occupational health. Biobanks rarely contain biological samples over an entire worker's carrier and medical data from nuclear industry archives might make up for unavailable biomarkers that could provide information on cardiovascular and metabolic diseases.

Mortality (1968–2008) in a French cohort of uranium enrichment workers potentially exposed to rapidly soluble uranium compounds

“…The JEM exposure score used in this study was calculated individually as a product of frequency, intensity and duration of exposure, allowing for quantitative exposure–response analyses in the absence of internal uranium doses. In the short term, the lack of information on potential lifestyle confounders may be overcome by conducting nested case–control studies 28. After the available bioassay data have been collected for this cohort, internal dose estimation will be possible.…”

Circulatory disease in French nuclear fuel cycle workers chronically exposed to uranium: a nested case–control study

“…Medical examinations spanned from 1959 to 2011 and were generally annual, but some of the workers received biannual or trimestral check-ups, depending on their radiation exposure status 15. Medical follow-up was not compulsory after retirement, so no data were available postretirement.…”

“…That analysis considered proxy of uranium exposure (exposure score from job exposure matrix (JEM)) and did not have data on lifestyle risk factors, with the exception of smoking data for a subset of the cohort. To address these questions, we conducted a case–control study nested in this cohort15 to analyse the relationship between organ-specific uranium doses estimated from individual uranium biomonitoring data and CSD.…”

Radiation databases and archives – examples and comparisons

“…In 2005 a retrospective pilot study began with a goal of determining the health risks from low-dose, long-term, internal exposure to uranium. Cumulative exposure estimates were calculated systematically and semi-quantitatively on all individuals that worked in the plant at least six months between 1958(Guseva Canu et al 2010Garsi et al 2014). Data compiled from several sources include: date and place of birth, gender, recruitment and departure dates, socioeconomic status, vital status and date of death, and cause of death (Guseva Canu et al 2010).…”