Synopsis Of The National Institute Of Occupational Safety And Health (Niosh) Program Of Independent Occupational And Environmental Research Conducted At Oak Ridge, Tennessee Department Of Energy (Doe) Facilities With Funding From The Doe : Oak Ridge Reservation Environmental Health Archives (Orreha) Document Number Xxvii.


Oak Ridge Reservation
Environmental Health Archives
Current as of 10FEB99
Compiled by
Captain John R. Stockwell, M.D., M.P.H.
U.S. Public Health Service
A Synopsis of the National Institute of
Occupational Safety and Health (IMIOSH) Program
of Independent Occupational and Environmental
Research Conducted at Oak Ridge, Tennessee
Department Of Energy (DOE) Facilities with
Funding from the DOE
06JAN99
Oak Ridge Reservation
Environmental Health Archives
(ORREHA)
Document Number

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Previous DOE Human Health Effect Research Involving Oak Ridge DOE
for Which NIOSH Has Assumed Responsibility
Industrial Facility
Contaminant of Concern
Relevant Disease
or Health Effect
X-10
Internal radionuclide
contamination
t Leukemia mortality

External radiation
I Cancer mortality
Y-12
???
t Lung cancer deaths

???
Small f in brain and
lymphatic cancer

???
Small T in pancreatic cancer
deaths

Uranium dust
f Lung cancer risk for
workers 45 years or older
K-25
???
All causes of death
significantly elevated

???
Statistically significant
increases among the white
male population

???
Higher death rates than
similar workers employed
only at X-10 and Y-12 due
to differences among the
facilities for lung cancer,
leukemia, and other
lymphatic cancers
TEC
???
Higher death rates than
similar workers employed
only at X-10 and Y-12

Uranium dust
1 Lung cancer risk for
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Completed NIOSH-lnitiated Human Health Effects Research
at Oak Ridge DOE
Industrial Facility
Contaminant of Concern
Relevant Disease
or Health Effect
X-10
External penetrating
radiation
I Multiple myeloma for
workers 45 years or older
Y-12
High levels of elemental
mercury
T Neurological effects
(primarily involving the
peripheral nervous system)
observed even 30 years
after exposure
I Postural tremor
K-25
Internal ionizing radiation
and "chemicals"
t Multiple myeloma for
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Ongoing Human Health Effects Research at Oak Ridge DOE
Industrial Facility
Contaminant of Concern
Relevant Disease
or Health Effect
X-10
External ionizing radiation
I Mortality from lung
cancer
Y-12
—
—
K-25
Internal ionizing radiation
and "chemicals"
Methylene dianiline (MDA)
Trichloroethylene
Methylene chloride
Multiple myeloma deaths
t Bladder cancer
Construction workers at all
three of the above sites
Asbestos
Silica-containing dusts
Beryllium particulates
Lung cancer
Silicosis
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Environmental Medicine Back Grounder on Multiple Myleoma
Multiple myeloma is primarily a tumor of marrow elements
It is rare in people under 50 years of age
In most instances the lesions are widespread and involve many bones, hence multiple
Multiple myeloma chiefly affects flat bones (ribs, skull, sternum, vertebrae)
The normal bone marrow is usually crowded out by soft gelatinous masses composed of plasma
cells, many of which are atypical and immature
Usually multiple myeloma remains confined to bone
Pain, fractures, and symptoms of compression of the spinal cord or nerve roots are common and
are due to bone destruction
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Environmental Medicine Back grounder on Chronic Beryllium Disease
Pneumoconiosis is the collective term for the pathologic changes caused by particulate matter
which has beeii-inhaled into the lungs
Most cases of pneumoconiosis are occupational in origin, occurring among miners and
processors of certain harmful substances
Beryllium pneumoconiosis (berylliosis) is produced by occupational exposure to the dust or
fumes of the metal and its compounds
Beryllium metal and its oxide, fluoride, sulfate, and hydroxide, and lamp phosphor (ZnMnBeSiO,)
have been implicated as causes
Fibrosis is often extensive in the lungs
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Environmental Medicine Back Grounder on IUI0SH Research Relevant to Department of
Energy (DOE) Workers, Including Those at Oak Ridge, Tennessee
NIOSH IS...
•	Examining the health risks associated with low-level protracted exposure to ionizing radiation
•	Establishing the dose-response for health effects from ionizing radiation to determine the shape
of the response curve and whether practical thresholds can be derived
•	Establishing the form of radiation dose (external vs. internal) associated with specific cancer
types (multiple Myeloma and leukemia)
•	Establishing the effect of exposure to multiple agents and their association with radiation
exposure
•	Evaluating the influence and contribution of non-occupational radiation doses in combination
with the occupational acquired dose and the associated health outcomes of these combined
exposures
•	Studying health effects other than cancer mortality (neuro-behavioral effects, chronic beryllium
disease, biomarkers, pulmonary fibrosis from plutonium, and cancer incidence)
•	Designing more complete (both genders and minorities included) and mature (adequate latency)
occupational cohort studies
•	Designing case-control studies to allow more detailed exposure assessment and analysis
•	Investigating further findings of a dose-response relationship between external radiation dose
and the risk of mortality from lung cancer (Fernald) and leukemia (Savannah River)
•	Estimates that approximately 120,000 workers are currently monitored each year for radiation
exposure at DOE facilities
•	Conducting a multi-site case-control study of leukemia and external radiation to determine if
there is an effect of dose-rate, and to evaluate the effect of possible confounders and effect
modifiers; a similar multi-site study of lung cancer has been initiated this year (1998)
•	Has funded studies of neurologic impairment among mercury-exposed DOE workers, as well as
chronic beryllium disease (a serious debilitating lung disease) among workers exposed to
beryllium at DOE facilities
•	Has recently shown evidence that the current 5 rem per year occupational limit may not provide
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I. Introduction
National Institute of Occupational Safety and Health (NIOSH) motto:
Delivering on the Nation's promise: Safety and health for all people through
research and prevention
A.	NIOSH conducts a program of independent occupational and environmental
research with funding from the Department of Energy (DOE)
B.	This occupational health program is conducted under the 1996
Memorandum of Understanding (MOU) between DOE and the Department of
Health and Human Services (DHHS)
C.	The Occupational Energy Research Program, which is conducted by the
Health-Related Energy Research Branch (HERB) of the Division of
Surveillance, Hazard Evaluations and Field Studies (DSHEFS), NIOSH
D.	Larry J. Elliott, MSPH, CIH is Branch Chief of HERB. NIOSH, 4676 Columbia
Parkway, Mail Stop R-44, Cincinnati, OH 45226-1998
Phone:	513/841-4400
Fax:	513/841-4470
E-mail:	Ije1@cdc.gov
E.	The DOE Office of Epidemiologic Studies (EH-62) serves as the primary DOE
liaison to NIOSH
F.	The DOE Office of Occupational Medicine and Medical Surveillance (EH-61)
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II Previous DOE Studies for Which NIOSH Has Assumed
Responsibility
A. Oak Ridge National Laboratory (X-10)
•	NIOSH is studying white males hired at the Oak ridge National
Laboratory (X-10) between 1943 and 1972 and following these
workers up for vital status through 1984 (N = 8318)
•	NIOSH has learned that leukemia mortality was elevated in the total
cohort (63% higher, 28 deaths) and in workers who had at some time
been monitored for internal radionuclide contamination (123% higher,
16 deaths)
•	NIOSH has determined that external radiation with a 20-year exposure
lag was related to all causes of death (2.68%, increase per 10 mSv),
primarily due to an association with cancer mortality (4.94%, per 10
mSv)
•	Manuscript: Shy C, Wing S: A Report on Mortality Among Workers
at Oak Ridge National Laboratory: Follow-up Through
1990.
B. Y-12 Plant, Oak Ridge
•	NIOSH is examining the mortality experience of a cohort of 10,597
males and females who worked at Y-12 between 1947 and 1974
•	Deaths from lung cancer were significantly elevated (SMR = 1.17,
95% CI = 1.01, 1.34)
•	There was also a small excess of^Braiii and lymphatic cancer
(SMRs=1.13 and 1.32, respectively)
•	A small increase in pancreatic cancer deaths was also noted
(SMR= 1.36)
•	Manuscript: Loomis D, Wolf S: Mortality of Workers at a Nuclear
Materials Production Plant in Oak Ridge, Tennessee,
1947-1990. American Journal of Industrial Medicine,
29:131-141, 1996
C. Oak Ridge Gaseous Diffusion Plant (K-25)
• NIOSH has investigated mortality patterns among 35,712 workers
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•	For white males, the SMR for all causes of death was significantly
elevated (SMR = 1.03, CI = 1.01. 1.05)
•	Other statistically significant increases among the white male
population included the bone, mental disorders, and respiratory
diseases, and all accidents
•	Manuscript: Dupree E., Watkins j, et al: Uranium Dust Exposure and
Lung Cancer Risk in Four Uranium Processing
Operations. Epidemiology 6(4): 370-375, 1995.
D. Combined Oak Ridge Facilities (Tennessee Eastman Corporation [TEC], Y-12,
X-10, K-25) (ORFCOM)
•	Analysis was conducted of 27,982 deaths occurring among 106,020
persons employed for at least thirty days at four nuclear facilities, in
Oak Ridge, Tennessee (TEC, Y-12 [after 1947], X-10, or K-25)
between 1943 and 1983
•	Workers employed at TEC, K-25, and multiple facilities had higher
death rates than similar workers employed only at X-10 and Y-12
•	These elevations were due to differences among the facilities for lung
cancer, leukemia, and other lymphatic cancers
•	These elevations were due to differences among the facilities for lung
cancer, leukemia, and other lymphatic cancers
•	Manuscript: Frome E, Cragle D, et al: A Mortality study of
Employees of the Nuclear Industry in Oak ridge,
Tennessee. Radiation Research. 148: 64-80, 1997
E. Welders at Oak Ridge Facilities
•	The overall mortality and all causes of death was examined among
1,211 white male welders employed at three DOE facilities in Oak
Ridge, from 1943 through 1989
•	There was a slight excess in emphysema deaths in the overall cohort,
and a slight excess of deaths from diseases of the respiratory system
among workers exposed to nickle oxides
•	The SMR for lung cancer in the total cohort also reached statistical
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•	Elevations in deaths due to ulcers and prostate cancer were also noted
among workers exposed to nickle oxides
•	Manuscript: Wells S, Cragle D, et al: An Update of Mortality Among
Welders, Including a Group Exposed to Nickel Oxides.
Final Report, Oak Ridge Associated Universities,
Document 98-0790. National Technical Information
F. Uranium Case-Control Study (TEC, Y-12, Fernald, Mallinckrodt)
•	The relationship between uranium dust exposure and lung cancer
mortality among workers employed in four uranium processing or
fabrication operations located in Missouri, Ohio, and Tennessee
i
•	A total of 787 cases was identified
•	Although no increasing risk with increasing dose was not
demonstrated, there was a suggestion of an exposure effect for.
workers hired at age 45 years or older
•	Manuscript: Dupree E, Watkins j, et al: Uranium dust exposure and
Lung Cancer Risk in Four Uranium Processing
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Completed NIOSH-lnitiated Health Research at Oak Ridge DOE
Facilities
NIOSH has funded studies of neurologic impairment among mercury-exposed DOE
workers, including a follow-up study of neurologic outcomes in 219 workers
exposed to high levels of elemental mercury at the Y-12 plant at Oak Ridge,
Tennessee between 1953-1963
•	Neurologic effects of relatively heavy exposure to mercury were still
detectable more than 30 years after cessation of exposure
•	These adverse effects were observed primarily for the peripheral nervous
system (by both clinical examination and electrodiagnostic evaluation
•	Postural tremor was also associated with past mercury exposure
Contact Information:
Contractor	Oak Ridge Associated Universities
Principal Investigator	Donna Cragle, Ph.D.
Phone	423/576-9557
Fax	423/576-9557
E-mail	cragled@orau.gov
Award Period:	010CT93 — 30NOV96
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B. Multi-Site Multiple Myeloma Case-Control Study
•	NIOSH has conducted a multi-site multiple myeloma case-control study which
includes workers at Oak Ridge National Laboratory
•	External penetration radiation doses received at age 45 and above were
found to be associated with multiple myeloma
•	Contact Information:
Contractor
Principal Investigator
Phone
Fax
E-mail
University of North Carolina
Steven Wing, Ph.D.
919/996-7416
919/542-4403
swing@sphvax.sph.unc.edu
Award Period:
Total Cost:
010CT93 - 28MAR97
$904,000
C. Multiple Myeloma Case-Control Study at the Oak Ridge Gaseous Diffusion Plant
(K-25)
This case-control study of multiple myeloma deaths among workers at the
Oak Ridge (K-25) Gaseous Diffusion Plant addresses the exposures to internal
ionizing radiation and chemicals
Study found time-related factors in radiation - cancer dose response
Dose received after age 45 is strongly predictive of all - cancer - combined
mortality as well as lung cancer
• Contact Information:
Contractor	University of North Carolina
Principal Investigator	Steven Wing, Ph.D.
Phone	919/996-7416
Fax	919/542-4403
E-mail	swing@sphvax.sph.unc.edu
Award Period:	010CT93 - 28MAR97
Total Cost:
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Ongoing Research
A. Multiple myeloma case - control study at he Oak Ridge Gaseous diffusion
plant (K-25)
•	This is a case control study of multiple myeloma deaths among
workers at the Oak Ridge (K-25) gaseous diffusion plant which
addresses the exposures to internal ionizing radiation and chemicals
•	This is the largest single - site study of multiple myeloma
•	Contact Information:
NIOSH Project Officer
Phone
Fax
E-mail
Study Period
Total Cost
M. Kathryn Brown
513/841-4468
513/841-4470
kgb4@cdc.gov
010CT95 — 30SEP99
$1,177,400
B. Bladder Cancer Incidence study at K-25 Plant (Oak Ridge Gaseous Diffusion
Plant)
• A limited morbidity study of about 1,135 workers at K-25 showed a
significant excess of bladder cancer in workers potentially exposed to:
- Methylene dianiline (MDA)
Trichlorethylene
Methylene chloride
•	State cancer registry and other health data sources will be used to
determine whether additional cases of bladder cancer have occurred in
this population
•	Contact Information:
NIOSH Project Officer
Phone
Fax
E-mail
• Study Period:
Sharon Silver, M.A.
513/841-4313
513/841-4470
zre4@cdc.gov
010CT98 — 30SEP01
Total Cost:
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c.
Lung Cancer Case-Control Study
Project will investigate the association of mortality from lung cancer
and exposure to external ionizing radiation among DOE workers
Sites were selected to target workers primarily exposed to external
radiation and include those involved in reactor operations
Oak Ridge National Laboratory (X-10) is included as one of the sites
• Contact Information:
NIOSH Project Officer
Phone
Fax
E-mail
•	Study Period:
•	Projected Total:
Barbara Grajewski, Ph.D.
513/841-4429
513/841-4470
bag2@cdc.gov
30SEP97 -- 29SEP00
$1,555,600
D. Construction Mortality Study
Study of former DOE construction workers to further define risks
associated with asbestos fibers, silica-containing dusts, beryllium
particulates, and other exposures regularly encountered by past
construction worker
• Contact Information:
NIOSH Project Officer	Cynthia Robinson, Ph.D.
Phone	513/841-4217
Fax	513/841-4470
E-mail	cfr2@cdc.gov
Study Period:	010CT97 - 30SEP00
Projected Total:
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