The International Nuclear Workers Study (INWORKS) contributes knowledge on the dose-response association between predominantly low dose, low dose rate occupational exposures to penetrating forms of ionizing radiation and cause-specific mortality. By extending follow-up of 309,932 radiation workers from France (1968–2014), the United Kingdom (1955–2012), and the United States (1944–2016) we increased support for analyses of temporal variation in radiation-cancer mortality associations. Here, we examine whether age at exposure, time since exposure, or attained age separately modify associations between radiation and mortality from all solid cancers, solid cancers excluding lung cancer, lung cancer, and lymphohematopoietic cancers. Multivariable Poisson regression was used to fit general relative rate models that describe modification of the linear excess relative rate per unit organ absorbed dose. Given indication of greater risk per unit dose for solid cancer mortality among workers hired in more recent calendar years, sensitivity analyses considering the impact of year of hire on results were performed. Findings were reasonably compatible with those from previous pooled and country-specific analyses within INWORKS showing temporal patterns of effect measure modification that varied among cancers, with evidence of persistent radiation-associated excess cancer risk decades after exposure, although statistically significant temporal modification of the radiation effect was not observed. Analyses stratified by hire period (< 1958, 1958+) showed temporal patterns that varied; however, these analyses did not suggest that this was due to differences in distribution of these effect measure modifiers by hire year.

国际核工作者研究 （INWORKS） 提供了关于主要低剂量、低剂量率职业暴露于穿透性电离辐射与特定原因死亡率之间的剂量反应关联的知识。通过扩大对来自法国 （1968-2014）、英国 （1955-2012） 和美国 （1944-2016） 的 309,932 名放射工作人员的随访，我们增加了对辐射-癌症死亡率关联时间变化分析的支持。在这里，我们检查了暴露年龄、暴露后的时间或达到年龄是否分别改变了所有实体癌、不包括肺癌、肺癌和淋巴造血癌的实体癌的辐射与死亡率之间的关联。多变量泊松回归用于拟合描述每单位器官吸收剂量线性超额相对速率修改的一般相对速率模型。鉴于有迹象表明在最近日历年雇用的工人中每单位剂量的实体癌死亡风险更高，因此进行了考虑雇用年份对结果影响的敏感性分析。研究结果与 INWORKS 中先前汇总和特定国家分析的结果合理一致，显示效果测量修改的时间模式因癌症而异，有证据表明暴露几十年后持续与辐射相关的超额癌症风险，尽管未观察到辐射效应的统计学显着时间改变。按雇佣期分层的分析（x3C 1958， 1958+）显示时间模式不同;然而，这些分析并未表明这是由于这些效应测量调节因子按雇佣年份的分布差异造成的。