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Russell A. Brown, MS
Idaho Falls, Idaho

JAMA. 1991;266(5):652-653.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Wing et al¹ reported a 63% elevation of leukemia mortality (28 deaths observed, 17.2 deaths expected) in a population of Oak Ridge (Tenn) National Laboratory white male employees with a median cumulative radiation dose of 1.4 mSv or 0.14 rem; the 95% confidence interval for the standardized mortality ratio (SMR) was 1.08 to 2.35. Although the total cancer SMR was 21% lower than normal, a "radiation-cancer dose response" of 4.94% per 10 mSv (1 rem) was claimed for all cancers.

The analysis is invalid. Seven of the 28 leukemia deaths were caused by chronic lymphocytic leukemia (CLL), which has been clearly identified as nonradiogenic by all major studies of cancer and radiation.^2-5 Wing et al noted that CLL "is not in some lists of radiation-related leukemia," but used the CLL data to calculate the SMR and predict dose-response factors for radiogenic leukemia.

The effect of . . . [Full Text PDF of this Article]

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