Radium dial workers: issues concerning dose response and modeling

The mortality pattern of women who began employment as luminizers in the radium dial industry before 1930 was followed through 1990. Hazard models with time-dependent covariates were used on mortality data either organized by individual death times or grouped into cross-classified person-year tables. These models were used to quantify trends in mortality associated with either death from or diagnosis of bone sarcoma or head carcinoma. The accumulation of skeletal doses from 226Ra and 225Ra was an important predictor of the risk of death from bone sarcoma. Women exposed to 226Ra at ages associated with active bone growth were at greater risk of bone sarcoma than women receiving even larger exposures at an age when their skeletons would have been fully developed. Exposure to only 226Ra was found to be an important predictor of risk for carcinoma of the mastoid air cells and paranasal sinuses. For the cranial sites, where adult dimensions are attained early in life, an effect of age at exposure could not be detected.