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Confounding Effects of Lifestyle Factors in Cancer Risk Estimation for Occupational Radiation Exposure
Eun Jung Park1,2, Ye Jin Bang1, Won Jin Lee1,2
1Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Safety and Health at Work
|October 6, 2025
Summary
Lifestyle factors showed minimal confounding effects on cancer risk in South Korean radiation workers. Further research is needed to refine radiation risk estimates by exploring unknown confounders.
Area of Science:
- Occupational Health
- Radiation Epidemiology
- Cancer Research
Background:
- Lifestyle factors can confound occupational studies, especially for small risk magnitudes.
- Assessing confounding is crucial for accurate radiation exposure risk assessment.
Purpose of the Study:
- To evaluate the confounding effects of lifestyle factors on the association between radiation exposure and cancer incidence.
- To determine if lifestyle adjustments alter cancer risk estimates in medical radiation workers.
Main Methods:
- Utilized national registry data for Korean diagnostic medical radiation workers (up to 2018).
- Calculated excess relative risks (ERRs) for cancer using Poisson regression.
- Imputed lifestyle factors (smoking, alcohol, BMI, exercise, sleep, night shifts) and assessed confounding by comparing adjusted vs. unadjusted ERRs.
Main Results:
- Baseline ERR for cancer incidence per Sievert was 0.44 (95% CI: -0.94, 1.83) after basic adjustments.
- Adjusting for lifestyle factors resulted in minimal changes (0-13.6%) to the risk coefficient.
- Sensitivity and sex-stratified analyses confirmed consistent findings.
Conclusions:
- Found little evidence of significant confounding from measured lifestyle factors among medical radiation workers.
- Further research is recommended to investigate unmeasured confounders for improved radiation risk accuracy.
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