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The German Thorotrast Cohort Study: a review and how to get access to the data

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Abstract

It is well known that exposures like those from 226Ra, 224Ra and Thorotrast® injections increase the risk of neoplasia in bone marrow and liver. The thorium-based radioactive contrast agent Thorotrast® was introduced in 1929 and applied worldwide until the 1950s, especially in angiography and arteriography. Due to the extremely long half-life of several hundred years and the life-long retention of the thorium dioxide particles in the human body, patients suffer lifetime internal exposure. The health effects from the incorporated thorium were investigated in a few cohort studies with a German study being the largest among them. This retrospective cohort study was set up in 1968 with a follow-up until 2004. The study comprises 2326 Thorotrast patients and 1890 patients of a matched control group. For those being alive at the start of the study in 1968 follow-up was done by clinical examinations on a biannual basis. For the others, causes of death were collected in various ways. Additionally, clinical, radiological and biophysical studies of patients were conducted and large efforts were made to best estimate the radiation doses associated with incorporation of the Thorotrast. The aim of this paper is to describe the cohort, important results and some open questions. The data from the German Thorotrast Study are available to other interested researchers. Information can be found at http://storedb.org.

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Acknowledgments

The authors gratefully acknowledge the work of the many former scientists and technical staff who contributed to the German Thorotrast Study. The authors are deeply indebted to Ms Jutta Helber: over many years she put enormous efforts in the final data preparation.

Funding

The German Thorotrast Study was supported by the German federal authorities and the radiation protection programme—EURATOM—of the Commission of the European Communities through different contracts. STORE was and is funded under contract numbers 232628 (STORE), 249689 (DoReMi) and 662287 (CONCERT) from the EC EURATOM Programme. Additional funding came from the German Ministry for the Environment, contract no. 3613S70035.

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Correspondence to M. Birschwilks.

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The authors declare that they have no conflict of interest.

Informed consent

For this type of study, i.e. a review, formal consent is not required, but informed consent was obtained from all individual participants included in those parts of the cited studies which included examinations.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

A Kaul: Formerly Federal Office for Radiation Protection, Salzgitter, Germany.

H Wesch, G van Kaick: Formerly German Cancer Research Center, Heidelberg, Germany.

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Grosche, B., Birschwilks, M., Wesch, H. et al. The German Thorotrast Cohort Study: a review and how to get access to the data. Radiat Environ Biophys 55, 281–289 (2016). https://doi.org/10.1007/s00411-016-0651-8

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