The mortality of all 14 319 workers employed at the Sellafield plant of British Nuclear Fuels between 1947 and 1975 was studied up to the end of 1992, and cancer incidence was examined from 1971 to 1986, in relation to their exposures to plutonium and to external radiation.

The cancer mortality rate was 5% lower than that of England and Wales and 3% less than that of Cumbria.

The significant excesses of deaths from cancer of the pleura and thyroid found in an earlier study persist with further follow-up (14 observed, 4.0 expected for pleura ; 6 observed, 2.2 expected for thyroid).

All of the deaths from pleural cancer were among radiation workers.

For neither site was there a significant association between the risk of the cancer and accumulated radiation dose.

There were significant deficits of deaths from cancers of mouth and pharynx, liver and gall bladder, and larynx and leukaemia when compared with the national rates.

Among all radiation workers, there was a significant positive association between accumulated external radiation dose and mortality from cancers of ill-defined and secondary sites (10-year lag, P=0.04), leukaemia (no lag, P=0.03 ; 2-year lag, P=0.05), multiple myeloma (20-year lag, P=0.02), all lymphatic and haematopoietic cancers (20-year lag, P=0.03) and all causes of death combined (20-year lag, P=0.008).

Among plutonium workers, there were significant excesses of deaths from cancer of the breast (...)