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
Occupational Energy Research Program
c. 010CT97
Oak Ridge Reservation
Environmental Health Archives
(ORREHA)
Document Number
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<^oiM1oo2s
National Institute for
Occupational Safety and Health
October 1997
US EPA REGION 4 LIBRARY
AFC-TOWER 9™ FLOOR
61 FORSYTH STREET SW
ATLANTA, GA. 30303
Health-Related Energy Research Branch
Division of Surveillance, Hazard Evaluations, and Field Studies
4676 Columbia Parkway, R-44
Cincinnati, Ohio 45226
CENTERS FOR DISEASE CONTROL
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w"2y+.
H g°
Larry Elliott, Chief
(513) 841-4400 (V)
(513) 841-4470 (F)
E-mail: Ije0@cdc.gov
Health-Related Energy Research Branch
Qivision of Surveillance, Hazard Evaluations, and Field Studies
4676 Columbia Parkway, R-44
Cincinnati, Ohio 45226
CDC
CENTERS FOR DISEASE CONTROL
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TABLE OF CONTENTS
Research Issues/Needs Tab A
Vision/Mission/Goals Tab B
Research Agenda Tab C
Accomplishments Tab D
NIOSH FY 98 Funding Request Tab E
NIOSH FY 99 Funding Request Tab F
Completed Research /.Tab G
Ongoing Research Tab H
Research Partners... Tab I
Proposed Research Tab J
Surveillance Grants/Activities Tab K
Points of Contact by Study Tab L
Research Activities at DOE Sites Tab M
Status of Previous DOE Studies Tab N
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NIOSH ENERGY-RELATED RESEARCH HEALTH PROGRAM
RESEARCH ISSUES AND NEEDS
Relevant to Department of Energy Workers
And Applicable to All Radiation Exposed Workers
The health risks associated with low-level protracted exposure to ionizing radiation need to be
identified, fully examined, understood, and effectively communicated.
The dose-response for health effects from ionizing radiation needs to be established to determine
the shape of the response curve and whether practical thresholds can be derived.
The form of radiation dose (external vs internal) associated with specific cancer types (multiple
myeloma and leukemia) need to be clearly established.
The effect of exposure to multiple agents needs to be examined for confounding and effect
modifying when studying the association of health effects and radiation exposure.
The influence and contribution of non-occupational radiation doses in combination with the
occupational acquired dose and associated health outcomes need to be evaluated.
Exposures and stressors being experienced by the current and future Department of Energy
workforce needs to be characterized.
Health effects other than cancer mortality (neuro-behavorial effects, chronic beryllium disease,
biomarkers, pulmonary fibrosis from plutonium, cancer incidence, psychological and
organizational stress effects) warrant study.
Complete (both genders and minorities included) and mature (adequate latency) occupational
cohort studies which include well designed internal comparison strategies are needed.
Case-control study designs allowing for more detailed exposure assessment and analysis are
warranted.
Institutional memory of past practices, activities, exposures, and record systems which is
invaluable to retrospective epidemiologic studies is rapidly diminishing as the cohort ages and
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NIOSH ENERGY-RELATED HEALTH RESEARCH PROGRAM
Vision:
To promote the health and well-being of all workers.
Mission:
To conduct a thorough and unbiased analysis of the health risks from exposure to
physical, chemical, and other stressors potentially affecting current and former
Department of Energy workers using the best available methods in order to promote
adequate protection of all workers.
Purposes:
To more fully understand radiation cancer risk factors in occupational cohorts.
To evaluate significance of health outcomes in the Department of Energy workforce.
To inform workers, the scientific community, and the public of the health risks associated
with exposures to radiation, chemicals, and others stressors.
Program Goals:
Assure that energy-related health research addresses pertinent occupational health
questions and provides a framework for intervention.
Conduct research in an open environment with meaningful communication among all
interested parties.
Capture the vanishing opportunities to study groups of people with unique exposure to
radiation, chemical, and other stressors.
Develop improved methods for associating occupational exposures and consequent risks
to health.
Recommend improved protective measures for workers, where scientific evidence
indicates that regulations or practices are inadequate.
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NIOSH ENERGY-RELATED HEALTH RESEARCH PROGRAM
Process Goals:
Epidemiologic Research
Evaluate possible relationships between workplace exposures and injury or disease using
the best available methodology.
Analyze combined populations to assess whether certain rare cancers are related to past
occupational exposures.
Examine the relationships of mixed exposures on worker health.
Provide epidemiologic findings which enhance the understanding of the effects of low-
level protracted exposure to ionizing radiation in Department of Energy workers and
others.
Exposure Assessment
Improve exposure assessment methods to reduce uncertainty in mortality and morbidity
studies.
Characterize the combination of exposures experienced by Department of Energy
workers for use in epidemiologic analyses.
Emphasize quantitative (vs. qualitative) relationships between exposure and health
outcomes. Evaluate the quality and validity of the worker exposure data that are
available.
Communication
Develop better mechanisms for generating research hypotheses by expanding the
involvement of partners and actively seeking their input.
Conduct research in an open environment with attention to clear and accurate worker and
public education.
Provide information which enhances the understanding of risks associated with radiation-
induced health effects.
Solicit and consider worker interests and the public's concerns.
Provide relevant occupational exposure and health outcome information for public health
research and policy as allowed by law.
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NIOSH ENERGY-RELATED HEALTH RESEARCH BRANCH
Performance Measures:
The conceptualization, development and use of novel research applications and
methodology which successfully enhances the understanding of exposure and effect in
the Department of Energy workforce.
The extent to which program findings are considered in the development of
recommendations for intervention and prevention.
The extent to which recommendations for intervention and prevention are utilized to
protect worker health.
The use of program findings in risk assessments by standard setting organizations.
The timeliness and cost efficiency of conducting scientifically appropriate and feasible
health research studies.
The timeliness of presenting study findings, publication of significant results, and
effective communication of study conclusions.
The quality and range of research projects, partners engaged in the research program, and
the nature of interactions with stakeholders.
Assumptions:
Near-term budgets will remain constrained.
Community, labor and Tribal needs and concerns will continue to influence agency
decision making and need to be addressed within the program agenda.
Collaboration will increase between CDC and DOE.
Performance will be measured and based on defined outcomes.
Interdisciplinary scientific approaches will enhance quality of accomplishments.
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NIOSH Energy-Related Health Research Program
Research Agenda
Background:
Despite the research conducted over the past
several decades, essential data required for
risk assessment from radiation exposures are
lacking. There is growing evidence that the
current occupational limit of 5 rem per year
may not provide adequate protection to
workers exposed to chronic, low-level
radiation. Scientific opinions regarding the
magnitude of risk associated with chronic
low-level radiation exposure are polarized
and the subject of current debate. For many
vitally important reasons, the next decade is
the best possible time to study low-level
radiation exposure among the Department of
Energy (DOE) workforce. The information
from such research will certainly be used to
develop better estimates of risk.
The earlier research assembled a number of
cohorts of workers from DOE sites. Results
from analyses of these cohorts, although
somewhat ambiguous, have shown that
workers' health has been affected. Most
notable, is the substantial evidence of
cancers. Now, the workers in these cohorts
are dying at increasing rates. Larger
numbers of deaths in mortality studies
translate directly into greater power to detect
changes in risk of death from chronic
diseases potentially caused by radiation and
chemical exposures. Additionally, the fact
that these DOE site workers were monitored
for radiation exposure provides distinct
study advantages over environmental or
community based studies. Risk estimates
based on future analysis of these mature
cohorts will substantially reduce the current
uncertainty, perhaps leading to changes in
exposure limits.
Also at this time, there are enough survivors
within these cohorts to assist in the
development of more accurate and precise
exposure estimates. Their memories hold
much of the necessary information on actual
practices and exposure potentials, required
for more precise exposure assessments. The
institutional memory of the DOE operations
will be essentially diminished when this
group of workers dies.'
Reasons for an Energy-Related
Health Research Program
Adequate latency in DOE cohorts is now
achieved
Current 5 rem occupational limit may be
inadequate to protect workers
DOE records and institutional memory are
currently available
Occupational Cohorts are more relevant than
Atomic Bomb Survivor or Medically
Exposed Cohorts
Controversy surrounds low-level chronic
exposure and linear non -threshold
risk model
Past cohort studies did not include both sexes
or minorities, nor make internal
comparisons
Findings are relevant to 300,000 nuclear
facility workers, to 1.5 million U.S.
radiation exposed workers, and of potential
importance to understanding community
risk.
To address confounding exposures and effect
modifiers
In response to concerns and interests of all
stakeholders
Concurrently, and just as important, the
science of epidemiology and the art of
exposure assessment have also matured.
Advanced epidemiologic methods, when
combined with more refined exposure
assessments, make possible the detection of
associations between exposures and health
effects which previously have gone
undetected.
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Research Agenda
It is axiomatic in health research to examine
occupational cohorts for adverse health
effects because the exposures are almost
always the greatest in these populations.
DOE has employed over one million
workers at its many facilities and has
extensive exposure and work history records
in permanent locations. These cohorts are
ideal for examining the health effects which
may be related to past exposures to
chemicals and radiation. The reliability of
epidemiology studies and dose-response
analyses is greatly improved by including
detailed knowledge of all exposure
potentials. Such information can be
developed for occupational cohorts
whenever work history and exposure records
are available. DOE sites maintain radiation
exposure data for their workers as
permanent records and exposures have been
assessed for individual workers. Further,
work history data for DOE workers are
reliable due to the consistency of operations
over time and the highly specialized skills
required for many operations. These
detailed employment records maintained at
many DOE facilities allow workers to be
followed over time in order to assess their
morbidity or mortality status. Thus,
estimating exposures and determining health
status for DOE workers is perhaps more
precise than in any other retrospective
cohort analysis.
The NIOSH Energy-Related Health
Research Program will lead to better risk
estimates for exposure to radiation and
chemicals, not only for DOE workers, but
for all workers. Yet it is important to
recognize that no single study will remove
all extant uncertainty from the current risk
estimates. Only through the collective
analysis of multiple studies may the true
relationship of health effects from these
exposures be discovered and appropriately
characterized. NIOSH, and its Health-
Related Energy Research Branch (HERB),
is now committed to a strategic planning
process which will make this research
agenda even more coherent. Only then will
it be possible to take full advantage of
present opportunities to examine these
critically important issues for workers
worldwide.
Who is HERB?
HERB is the Health-Related Energy
Research Branch at the National Institute for
Occupational Safety and Health in
Cincinnati, Ohio. The Branch, which was
organized in 1991, is staffed with scientists in
epidemiology and exposure assessment and
experts in record management and data
analysis. Research is conducted under a
Memorandum of Understanding with the
U.S. Department of Energy which provides
funding.
NIOSH Research Program Agenda:
NIOSH, HERB staff have developed and
implemented a research program that
addresses the needs of the workers in the
DOE system, as well as the radiation
research community. The agenda for this
program has been developed and updated
with frequent input from experts in relevant
research fields, representatives of labor and
community organizations, and American
Indian Tribes. The Department of Health
and Human Services' (DHHS) Advisory
Committee for Energy-Related
Epidemiologic Research (ACERER) has
reviewed and evaluated the NIOSH
research agenda. In addition, the DOE
Office of Epidemiology and Health
Surveillance has recommended research
topics which have been adopted in most
cases.
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Research Agenda (contJ
HERB is currently engaged in
approximately 25 research projects
addressing current and historical DOE site
work forces. This research is being
performed intramurally by HERB
researchers or extramuraily through
contracts, grants, or cooperative agreements.
Each of these studies addresses vitally
important health issues related to chemical
and radiation exposures at DOE facilities.
Careful examination of Table 1 (at the end
of this chapter) reveals a balanced research
program which supports the mission and
attempts to achieve the goals of this agenda.
Most estimates of risk for occupational
exposure to ionizing radiation have been
based on the atomic bomb data from World
War II or on doses administered to medical
patients in treatment programs. These were
relatively high doses delivered over a short
time period. Radiation workers are typically
exposed to low levels of radiation over
decades. A new "Gold Standard" for
occupational radiation risk assessment is
needed. Current and future NIOSH energy-
related research, partially because it is
underway at this opportunistic time, will
collect and analyze the essential information
to establish such a standard.
Most of what is known about risks of cancer
associated with exposure to ionizing
radiation is derived from studies of
populations that are not representative of
U.S. workers. Studies of the atomic bomb
survivors are based on acute, high-dose
levels of ionizing radiation with little to no
dose-level monitoring data. Recent studies
of nuclear workers in the former Soviet
Union may provide additional information
on radiation and cancer, but suffer from
differences in worker exposures and
ethnicity.
Recent'occupational studies (under HERB's
sponsorship and direction) have shown
evidence that the current 5 rem per year
occupational limit may not provide adequate
protection to workers exposed to chronic,
low-level radiation. Findings of a dose-
response relationship between external
radiation dose and the risk of mortality from
lung cancer (Fernald) and leukemia
(Savannah River) must be investigated
further. Also, the recent multi-national
study by the International Agency for
Research on Cancer (LARC) showed a dose-
response relationship for external
radiation and leukemia. Because of these
findings, HERB is 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
will be initiated this year. These
retrospective studies will provide the best
information to date for protecting radiation
workers.
Current Radiation Workers
Approximately 120,000 workers are
currently monitored each year for radiation |
exposure at DOE facilities. In addition, the §
results of the NIOSH research program will |
be relevant to the approximately 300,000 |
workers potentially exposed to radiation each |
year at commercial nuclear facilities. The |
National Council on Radiation Protection |
and Measurements (NCRP) estimates that 1.5 1
million TLS. workers are occupationally 1
exposed to ionizing radiation each year. §
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Research Agenda
Workers at DOE facilities have also
experienced exposure to a variety of
chemicals, some of which are unique. The
extent to which these chemical exposures
confound or modify the epidemiologic
analysis must be addressed.
Additionally, whether these chemical
exposures may actually be the primary
causative agent for certain health outcomes
must also be examined. Studies which are
examining the effects of beryllium and
mercury are now underway or have been
completed. Chemical exposure data are
being collected for use in all of the case-
control studies and several of the cohort
studies underway. Careful collection of data
is essential to early detection of adverse
health effects and NIOSH is developing
strategies to ensure these data are available.
There are also numerous health issues of
relevance to current workers at DOE sites.
Aside from their past exposures, adaptation
to a new mission, new programs, and
technologies bring a host of issues to the
forefront.
Current DOE Workers:
As DOE's primary mission changes from
production and testing of nuclear weapons
to decontamination and decommissioning
©
(i.e., "clean-up"), the challenges facing its
workforce have also changed dramatically.
NIOSH investigators are conducting a
phased approach to define and characterize
exposure hazards encountered by workers
involved with waste handling and waste-site
clean-up activities within the DOE complex.
Another concern faced by current DOE
workers are the adverse effects relating to
re-organization and downsizing. The health
consequences of these phenomena are of
concern not only to those individuals whose
jobs are lost, but also to those remaining on
the job. A NIOSH cooperative agreement
seeks to identify health problems related to
downsizing, and to develop and implement
preventive strategies.
National Occupational
Research Agenda
(NORA)
NIOSH,HERB's research program also
addresses several of the NORA priority
research areas. These include: mixed
exposures, organization of work, special
populations at risk, fertility and pregnancy
abnormalities, cancer research methods,
exposure assessment methods, and
surveillance research methods. For more
information on NORA see NIOSH Pub.No.
96-115.
isss
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Research Agenda fcont)
Development of a Research
Program
NIOSH, HERB'S initial research program
was based on recommendations from the
Secretarial Panel for Evaluation of
Epidemiologic Research Activities
(SPEERA). Since then, the program has
been refined with input from a variety of
sources, including experts from relevant
research fields, labor and community
organizations, and American Indian Tribes.
The DOE Office of Epidemiology and Health
Surveillance has recommended research
areas which have been added to the program.
The DHHS Advisory Committee for Energy-
Related Epidemiologic Research (ACERER)
is responsible for evaluating and
recommending approval of the NIOSH
research agenda. All studies in the NIOSH,
HERB research program have been brought
before the ACERER for consideration.
Exposure Assessment:
A principal NIOSH objective is the
development and use of an improved
estimation of uncertainties and biases in
exposure assessments (e.g., using new
methods, sensitivity analyses) and more
comprehensive exposure assessments of
internal and external radiation, as well as
chemicals. A primary focus of each
epidemiologic study being performed by
NIOSH is the exposure assessment of the
radiologic hazards encountered by workers.
In addition, NIOSH is funding three
activities whose purpose is to provide
insight into improved methodologies for use
in epidemiologic studies.
Study Design:
Most epidemiologic studies of radiation
workers have been cohort mortality studies,
which, until recently, were limited largely to
relatively crude overall measures of death
rates (standardized mortality ratios
comparing the monitored working
population to the general U.S. death rates).
NIOSH has developed or sponsored several
research projects to improve upon the
limitations of the cohort mortality study,
including a cancer incidence study at the
Rocky Flats Plant, and multi-site case-
control studies of leukemia, multiple
myeloma, and lung cancer.
Combined Cohorts:
With few exceptions, occupational
epidemiologic studies of DOE radiation
workers have been restricted to individual
sites, with little or no effort to combine
populations across facilities. Multi-site
studies have the benefits of increasing study
power, and comparing populations with
similar exposures, or contrasting populations
with different exposures. NIOSH is
currently conducting or funding several such
research efforts. Among these is a cohort
mortality study of females employed at
twelve DOE sites. In addition, the results
generated in mortality studies at five sites
being conducted by NIOSH will be used in
an international study of nuclear workers in
fourteen countries. This large
epidemiologic study is being performed by
investigators from the International Agency
for Research on Cancer.
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Research Agenda
Outcomes Other Than Cancer:
Most previous studies of health effects
experienced by DOE workers have focused
exclusively on the occurrence of cancer.
Though this is clearly a major health
problem in evaluating the effects of
radiation, it is not the only adverse health
outcome of concern in this population.
NIOSH has performed preliminary work to
assess the feasibility of studying adverse
reproductive effects on both men and
women exposed to radiation. In addition,
NIOSH 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.
Exposures Other than Radiation:
A wide variety of chemical and other
physical hazards has also been prevalent at
DOE facilities. Workers have been exposed
to solvents, metals, and other substances, as
well as excessive noise, heat, and non-
ionizing radiation. These hazards have been
shown in other populations to cause a
variety of health effects, including cancer.
All epidemiology studies being performed
or funded by NIOSH attempt, to the extent
possible, to quantify exposure to these
hazards. Both the leukemia and lung cancer
case control studies include detailed
exposure assessments. NIOSH is also
studying the health effects of non-ionizing
radiation, as well as chemicals, such as
mercury and beryllium.
Cohort Development:
Many of the approximately 20 major DOE
sites have been studied epidemiologicaUy,
some of them for decades, by previous DOE
contractors. NIOSH is considering
continuation or update of these studies as
waiTanted by public health and scientific
considerations. As these cohorts age, and as
more powerful epidemiologic study designs
become available, new studies of these
workers should provide the best information
on health risk associated with radiation
exposure. Additionally, workers at several
DOE sites have not been studied. These
sites include five of the national
laboratories, and the Nevada Test Site.
Based on preliminary evaluations of
potential exposures experienced at these
facilities, studies of these sites have not been
initiated. However, NIOSH is currently
conducting the first analytical epidemiology
study of one of the DOE's largest facilities,
the Idaho National Engineering and
Environmental Laboratory (INEEL), which
has employed over 70,000 workers since
construction began in 1949. As information
on this cohort is being assembled, a primary
concern is to include the broadest
representation of workers including women
and minorities.
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Table 1
NIOSH Energy Research Program
Objectives Addressed by Research Projects
cancer
risks
radiation
exposure .
assessment
non-cohort
mort. study
designs
combined
cohorts
other
health
outcomes
non-rad
exposures
current
workers
continued
studies
unstudied
sites
.Coiftpfoted Rwearclj
Multiple myeloma
case-control
X
X
X
X
Mercury workers
X
X
X
Historical plutonium
bioassay
X
Errors in radiation dose
estimates
X
Cohort mortality of PODP
X
X
X
X
On^GoiagResearch
Case-control of PODP
X
X
X
X
X
Cohort mortality of INEEL
X
X
X
Cohort mortality of PNS
X
X
X
Leukemia case-control
X
X
X
X
X
Multiple myeloma at K-25
X
X
X
Clean-up workers (Phase I)
X
X
X
X
Cohort mortality of
chemical lab workers
X
X
X
Cohort mortality of Pantex
X
X
X
Lung cancer case-control
X
X
X
X
X
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NIOSH Energy Research Program
Objectives Addressed by Research Projects
cancer
risks
radiation
exposure
assessment
non-cohort
mort. study
designs
combined
cohorts
other
health
outcomes
non-rad
exposures
current
workers
continued
studies
unstudied
sites
On'GotnftReMfirch (coiit)
Construction workers mortality
X
X
X
X
Childhood leukemia
case-control
X
X
X
X
X
X
Cancer incidence and
mortality of Rocky Flats
X
X
X
X
X
IARC combined study
X
X
X
X
Stress and downsizing
X
X
X
X
X
Chronio beryllium disease
X
X
X
X
X
Beryllium disease natural
histoiy
X
X
X
X
X
Mortality among females
X
X
X
X
Glycophorin A biodosimetry
X
X
X
Measurement error in
underground miner studies
X
Lung fibrosis in
plutonium workers
X
X
Heat stress in carpenters
X
X
X
X
Mortality of Hanford workers
X
X
X
X
Dose estimation from daily
and weekly dosimetry
X
Acute radiation syndrome
in Russian workers
X
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NIOSH Energy Research Program
Objectives Addressed by Research Projects
cancer
risks
radiation
exposure
assessment
non-cohort
mort. study
designs
combined
cohorts
other
health
outcomes
non-rad
exposures
current
workers
continued
studies
unstudied
sites
PMiUd Rcmarcii
Clean-up workers
(Phases II & IE)
X
X
X
X
Bladder oancer at K-25
X
X
X
X
Cohort mortality of Mound
X
X
X
X
Medical/ofT-site radiation
exposures -
X
X
X
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Accomplishments
All of the occupational studies transferred under the original MOU have
been completed or concluded.
A comprehensive occupational health research plan has been developed and
initiated.
Several of the NIOSH-initiated studies have been completed or are nearing
completion.
An occupational radiation and energy-related grants program has been
established to provide extramural researchers with the opportunity to
propose and conduct additional research independent of the NIOSH research
agenda.
Extramural research is now conducted by a more diverse group of partners,
and the awarding of contracts, grants, and cooperative agreements is a more
competitive and open process.
More DOE historical exposure record systems are available for use in
occupational research by a broader based research community than ever
before.
A Radiation Agenda Workshop has been held to identify areas of research in
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a
i
£
I
Z
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NIOSH FY98 FUNDING REQUEST
I Cooperative Agreements
13%
I Equipment 0 5%
El Supplies 0 5%
~ Grants
17%
¦ Contracts, Intramural
10%
S Salary/Benefits
32%
H T ravel 2%
~ Postage/Cartage 0 08%
HRent, utilities 0 41%
¦ Printing 0 05%
0 Contracts, Extramural
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HERB FY 98 FUNDING REQUEST
ANALYTIC EPIDEMIOLOGY
MEMORANDUM OF UNDERSTANDING
October, 1997
OBJECT CLASS
TOTAL
11/12 Salary/Benefits
2,352,258
21 Travel
189,666
22 Postage/Cartage
6,322
23 Rent, Utilities
31,611
24 Printing
3,793
25 Contracts Extramural
1,879,914
25 Contracts Intramural
770^272
26 Supplies
37,933
31 Equipment
37,933
41 Cooperative Agreements
1,030,044
41 Grants
1,318,658
Total
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s.
&
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NIOSH FY99 FUNDING REQUEST
~ Contracts, Extramural
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HERB FY 99 FUNDING REQUEST
ANALYTIC EPIDEMIOLOGY
MEMORANDUM OF UNDERSTANDING
October, 1997
OBJECT CLASS TOTAL
11/12 Salary/Benefits 2,422,826
21 Travel 199,149
22 Transport of Tilings 6,322
23 Rent, Utilities 37,933
24 Printing 3,793
25 Contracts Extramural 1,936,311
25 Contracts Intramural 739,577
26 Supplies 37,933
31 Equipment 37,933
41 Cooperative Agreements 774,470
41 Grants 1,551,705
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0!
X
o
DC
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NIOSH Energy-Related Health Research Program
Completed Research
1. Multi-Site Multiple Myeloma Case-Control Study
Contractor:
Award Period:
Summary:
Significance:
University of North Carolina (Steven Wing, Ph.D.)
10/1/93 - 3/28/97
This multi-site case-control study evaluated possible etiologic risk
factors, focusing on external radiation and chemical exposures. Five
sites were included: Savannah River, Los Alamos National Laboratory
(LANL), LANL-Zia, Oak Ridge National Laboratory, and Hanford. The
final report and the study files and data have been provided to NIOSH.
Extended penetrating radiation doses received at age 45 and above were
found to be associated with multiple myeloma.
follow-up of dose-response between multiple myeloma and external
radiation; complements leukemia case-control study being done at same
sites and multiple myeloma case-control study with internal radiation
exposure at the Oak Ridge Gaseous Diffusion Plant
Total Cost:
$904,000
*************************************
2. Mercury Workers Health Study
Contractor: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)
Award Period: 10/1/93 - 11/30/96
Summary:
Significance:
This is a follow-up study of neurologic health outcomes in 219 workers
exposed to high levels of elemental mercury at the Y-12 plant (Oak
Ridge) between 1953-1963. Study participants have been notified
individually of their test results, and the final report has been received by
NIOSH. Neurologic effects of relatively heavy exposure to mercury
were still detectable more than 30 years after cessation of exposure. The
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. The
study results were presented to a labor-management group in April 1997.
morbidity study ; non-cancer effect; chemical exposure; follow-up of
previous group; applicable to surveillance
Total Cost:
S731,000
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Completed Research (cont.1
3. Historical Plutonium Bioassay Measurements
Contractor:
Award Period:
Summary:
Significance:
New York University (Norman Cohen, Ph.D.)
10/1/93 - 12/31/95
This research evaluated the bias, uncertainty, and selectivity of
plutonium bioassay procedures used by DOE over time, since they may
affect the retrospective dosimetry of plutonium workers. The research
has been completed but, due to the illness of the Principal Investigator,
the final report has not yet been submitted.
uncertainty analysis; needed for internal exposure assessment of
plutonium
Total Costs:
$445,700
*************************************
4. Accounting for Errors in Radiation Dose Estimates
Grantee:
Award Period:
Summary:
Significance:
Total Cost:
Battelle Pacific Northwest Laboratories (Ethel Gilbert, PLD.)
10/1/94 - 9/29/96
This study developed an approach for accounting for all random
uncertainties in estimates of cumulative external dose and applied the
model to Hanford data. This grant has been completed. A manuscript
summarizing the findings has been published (Gilbert et al: Health
Physics 70 (3): 336-345,1996).
uncertainty analysis; accounting for bias in external dose estimates
$131,000
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Completed Research (cont.>
5. Cohort Mortality Study of Portsmouth Gaseous Diffusion Plant
(PGDP), Piketon, Ohio
Investigator:
Study Period:
Summary:
Significance:
Total Cost:
NIOSH intramural study (Project Officer: Robert Rinskv, Ph.D.)
2/1/92- 12/31/96
The mortality of workers at PGDP was updated through 1992. Exposure
assessments were performed for internal and external ionizing radiation,
chemicals, and electromagnetic fields No significantly elevated
standardized mortality ratios (SMRs) were observed for overall or
specific causes of death. However, case-control analyses are being done
for lung, stomach and hematopoietic cancers to investigate possible dose-
response relationships. These findings have been presented to worker
and management representatives
Congressional request; more data on lung cancer and role of
confounders; enhanced exposure assessment for chemical and radiation
doses, compared with previous study
$498,000
*************************************
6. Feasibility Study of Assessing Adverse Reproductive Outcomes Among
Females Employed at DOE Facilities
Investigator:
Study Period:
Summary:
Significance:
Total Cost:
NIOSH intramural study (Project Officer- Barbara Massoudi, Ph.D.)
1/95 - 6/96
The feasibility of conducting an epidemiologic study of adverse
reproductive outcomes among females employed at DOE is dependent
upon four factors: availability of an appropriate study population; a valid
case definition and means of ascertainment, exposure to the agent(s) in
question and sufficient data to characterize such exposure; and, adequate
sample size to demonstrate an effect. In order to address these issues,
several sources of data were collected and evaluated by NIOSH
investigators. Data obtained on females employed at 20 sites previously
studied epidemiological^ included distributions over time related to
demographic characteristics, radiation monitoring data, and vital status
was examined. Information was collected on all existing birth defects
registries in states in which DOE facilities are located. This report
concluded that the opportunity for an epidemiologically sound study is
not present at this time.
non-cancer outcomes; female populations
$10,000
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u
CO
o
CO
i
o
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NIOSH Energy-Related Health Research Program
Ongoing Research
I. Intramural Research
1. Case-Control Analyses of the Portsmouth Gaseous Diffusion Plant
(PGDP), Piketon, Ohio
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
Robert Rinsky, Ph.D.
1/1/97-12/31/98
In follow-up to the completed cohort analyses (see Completed Studies),
case-control analyses are being considered for lung, stomach, and
hematopoietic cancers to investigate possible dose-response
relationships. It is considered unlikely that additional study of this
facility alone would be beneficial. The site may. however, be part of the
lung cancer case - control project. These analyses are expected to be
complete by April 1998.
Congressional request; more data on lung cancer and radiation exposure
and role of confounders
FY97: $157,000
$117,200
FY98: $61,000 FY99: $1,200
* Projected FY99 funds to support notification efforts
2. Cohort Mortality Study of Idaho National Engineering and
Environmental Laboratory (INEEL)
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
David Utterback, Ph.D.
10/1/92-9/30/98
An all-cause cohort mortality study is underway at INEEL, a previously
unstudied site. Exposures of interest are external ionizing radiation and a
variety of chemicals. More than 70,000 workers have been employed at
this site. The first phase of the study (SMR analy sis) is planned for
completion by December 1998.
Governor's request, Congressional interest; previously unstudied site;
data will be used in other studies, i.e., LARC study of nuclear workers,
childhood leukemia
FY97: $356,200
$3,260,000
FY98: $352,300 FY99; $362,900
* Projected FY99 funds if case-control studies performed
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On-Going Research: Intramural Studies (conLl
Cohort Mortality Study of Portsmouth Naval Shipyard (PNS), Kittery,
Maine
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
Robert Rinsky, Ph.D.
10/1/93 -9/30/98
The mortality study of civilian employees at PNS is being updated
through 1995. The cohort has been expanded to include all workers
employed through 1992. Naval Sea Systems Command will provide
access to records and facilities.- Case-control studies will also be done, as
indicated by the SMR analysis
exposure to external ionizing radiation exclusively; study supported by
US Navy; data will be used in other studies, i.e., NIOSH leukemia case-
control study and IARC study
FY97: $270,200
FY98: $232,000
FY99: $239,000
$874,400
* Projected FY99 funds if case-control studies performed
*************************************
4. Leukemia Case-Control Study
Project Officer: Thuiman Wenzl, Sc.D.
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
7/1/95 - 9/30/99
This multi-site case-control study will explore the relationship between
external radiation and leukemia risk. About 250 leukemia deaths will be
identified at five DOE sites and PNS when the vital status is updated
through 1995. Confounding exposures to internal radiation, chemicals
and EMF will be evaluated for all cases and controls. Expected date of
completion is September 1999.
follow-up to recent positive findings of leukemia and radiation in cohort
studies, largest study of its kind ever done, study design allows control
of confounders; companion to stud}' of multiple myeloma (hematopoietic
cancer, also) at same sites; includes update of vital status of Hanford and
Savannah River cohorts
FY97: $196,700
$1,076,000
FY98: $394,700
FY99: $406,500
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On-Going Research: Intramural Studies (conO
5. Multiple Myeloma Case-Control Study at K-25 Plant (Oak Ridge
Gaseous Diffusion Plant)
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
M. Kathryn Brown, Ph. D.
10/1/95 -6/30/98
This case-control study of 63 multiple myeloma (MM) cases at K-25
complements the MM study (see Completed Studies, above) that focused
on external radiation. The K-25 workforce was exposed primarily to
internal radiation. Both radiation and chemical exposure will be
included in the exposure assessment The study is expected to be
complete by mid-1998.
addresses question of whether multiple myeloma is related to internal or
externa] exposure; evaluates potential confounders; large number of
cases provides reasonable statistical power
FY97: $340,900
$1,177,400
FY98: $281,300
FY99: $289,800
*************************************
6. Exposure Assessment of Hazardous Waste, Decontamination and
Decommission, and Clean-up Workers - Phase I
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
Steven Ahrenholz, Ph.D.
5/1/96-10/31/98
Exposures encountered by hazardous waste, clean-up, and
decontamination and decommissioning workers will be characterized. In
Phase L background information will be collected at seven DOE sites to
assess working conditions, and to identify issues and research needs at
the sites. This phase had been proposed to be completed by late 1998;
however, access problems threaten to delay this completion date.
addresses exposures to current workers; assesses feasibility of tracking
workforce for future studies; evaluates mixed exposures; supports
surveillance activities
FY97: $238,000
$890,500
FY98: $282,200
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On-Going Research: Intramural Studies (cont.1
7. Cohort Mortality Study of DOE Chemical Laboratory Workers
Project Officers:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
David Utterback. Ph.D.; Beth Atkins, M.P.H.
10/1/96-9/30/98
In limited studies of chemical laboratory workers, an increased risk of all
cancers and several specific cancers has been found. A mortality study
of DOE chemical laboratory workers is feasible using available data sets.
A draft protocol has been prepared, and data sets are being collected .An
SMR analysis can be completed by March 1998.
addresses hazards that are applicable outside the DOE complex; chemical
exposures; female workers, mixed exposures
FY97- 96.000
$686,400
FY98: $290,800
FY99. $299,600
Projected FY98 funds if case-control studies performed
*************************************
8. Cohort Mortality Study of Pantex Plant, Amarillo, Texas
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
Pam Anderson, Ph.D.
10/1/96-9/30/99
A study of Pantex workers published in 1985 was limited by the small
number of deaths and short follow-up, although the risk of several
cancers was elevated. Vital status will be updated through 1995 and an
SMR analysis will be completed by September 1997. The need for
additional research will be evaluated at that time.
plant is not being downsized; although mission has changed, similar
exposures will be encountered by current and future workers; addresses
suggestive findings of original study
FY97: $87,300
FY98: $337,600
FY99: $347,700
$858,200
* Projected FY98 and FY99 funds if case-control studies performed
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On-Going Research: Intramural Studies (cont)
9. Lung Cancer Case-Control Study
Project Officer:
Study Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
To be determined
9/30/97 - 9/29/00
Concern has been raised about lung cancer risk in workers exposed to
internal and external radiation in cohort mortality- studies at Feraald and
Oak Ridge. A multi-site case-control study is needed to address these
concerns. This study design allows an in-depth exposure assessment and
examination of a potential dose-response relationship, with attempt to
control for potential confounding factors, such as smoking and exposure
to chemicals.
follow-up on results at Femald and Y-12 that were limited by lack of
internal dose data and control of confounders
FY97: $439,400
$1,066,200
FY98: $290,800
FY99: $299,600
*************************************
10. Construction Workers Mortality Study
Project Officer:
Study Period:
Summary:
Significance.
Annual Budgets:
Projected Total:
Beth Atkins, M.P.H.
10/1/97 - 9/30/99
This all-cause retrospective cohort mortality study of former DOE
construction workers provides an opportunity to further define the risks
associated with asbestors fibers, silica-containing dusts, beryllium
particulates, and other exposures regularly encountered by past
construction worker
Relatively few mortality studies have been conducted among
construction workers. Former construction workers at DOE sites have
represented a more stable workforce than regularly encountered in
construction studies. Therefore, an SMR study of past construction
workers at nuclear energy sites will provide useful information
applicable to the present construction workforce.
FY97: $0 FY98: $224,700 FY99: $231,400
$456,100
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On-Going Research: Intramural Studies (conO
11. Decontamination and Decommission Workers Surveillance Registry
Project Officer: Beth Atkins, M.P.H.
Study Period: 10/01/97- 9/30/99
Summary: Hundreds of surplus nuclear fuel fabrication plants, commercial reactors,
and chemical processing plants across the United States are currently
slated for decontamination and decommissioning (D&D). A vast amount
of D&D work has been sub-contracted to small construction businesses
and independent contractors, raising concerns about current exposure
monitoring, record keeping practices, and future follow-up of current and
future D&D workers. Exposures and other hazards encountered by these
workers are similar to those experienced by other workers in the
construction industry. This project seeks to establish a sound
methodologic approach to building a registry of D&D workers across
DOE sites. This will be accomplished by identifying the key elements
necessary for constructing a registry, the sources of those data, and
potential barriers to accessing those sources. The methodology
constructed in this project will then be pilot tested at DOE's Femald site
in southwestern Ohio.
Significance: At present, there are no established registries that will allow
identification and tracking of these current and future workers. Such a
registry will serve as the foundation for future epidemiologic studies
among current and future D&D workers and may yield potentially useful
knowledge for the construction industry.
Annual Budgets: FY97: $0 FY98:579,800 FY99: $82,200
Projected Total: $162,100
****************************
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On-Going Research fcont ")
Ila. Extramural Research (Cooperative Agreements)
1. Childhood Leukemia Case-Control Study
2.
Awardee:
Award Period:
Summary:
Significance:
Battelle Laboratories (Lowell Sever, Ph.D.)
9/29/92 - 3/31/97
This case-control study assessed the potential association between
paternal exposure to ionizing radiation and risk of leukemia in
offspring, a finding observed by Gardner et al. (1990). The study,
initiated at the Hanford Site, was expanded to Oak Ridge and
Idaho, and also included non-Hodgkin's lymphoma and central
nervous system (CNS) tumors as outcomes. A draft final report
has been reviewed by NIOSH. Receipt of the final report is
anticipated in the near future. In addition, notification efforts and
submission of data files to CEDR are still required.
of three CDC studies following up on findings of Sellafield, only
one evaluating occupational exposures; following up on previous
findings regarding birth defects (CNS tumors) at Hanford
Annual Budgets: FY97: $19,300
Projected Total: SI,071,500
FY98: $0
FY99: $0
*************************************
Cancer Incidence Study of Rocky Flats Plant
Awardee:
Colorado Department of Public Health and Environment
(Normie Morin, Ph D)
Award Period: 9/30/93 - 9/29/98
Summary:
Significance:
Annual Budgets:
Projected Total:
Based on the findings of a previous study, a cancer incidence study
was initiated as well as an update of the mortality study. The
dosimetry data for neutrons and plutonium are being improved.
Preliminary job exposure matrices have been completed for
chemical exposures. Other data collection efforts continue.
cancer incidence study; reevaluation and upgrade of dosimetry
data benefits DOE and contractor and will be used in grant
studying lung fibrosis.
FY97: $712,000 FY98: $349,900 FY99: $360,400
$3,740,200
* Projected FY98 and FY99 funds to complete study
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On-Going Extramural Research: Cooperative Agreements (cont.)
International Collaborative Study of Nuclear Industry Workers
Awardee:
Award Period:
Summary:
Significance:
International Agency for Research on Cancer (IARC)
(Elisabeth Cardis, Ph.D.)
4/1/95-3/31/99
IARC has undertaken a cancer mortality study of nuclear workers
in 14 countries. Five U.S. cohorts are included in the study Vital
status and dose data from these countries will be combined to
increase the power to quantify small increases in cancer risk in
workers exposed to low doses of ionizing radiation.
largest study of nuclear workers ever done; collaboration among
14 countries; collaboration with WHO/1ARC
Annual Budgets: FY97: S28,200
Projected Total: $220,600
FY98: $30,300
FY99: $30,300
*************************************
Prevention of Stress and Health Consequences of Downsizing
and Reorganization
Awardee:
Award Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
Boston University School of Public Health (Lew Pepper, M.D.)
9/30/95 - 9/29/98
(with possibility of additional 2 years to
complete intervention research)
Job stressors, i.e., work-related conditions implicated in disease
development, include job dissatisfaction, lack of job control, and
under-utilization of abilities. Sudden job change through strike,
retirement, layoff, relocation, or job loss, may trigger these
stressors. This multi-site project is studying the effects of
downsizing on organizational climate, worker health, and
performance. Significant access problems have arisen which
threaten to impair the ability to complete this study as designed,
and within the originally projected time frame and budget.
other than cancer/mortality study; applicable to current and future
workers; evaluation of interventions; applicable to surveillance
FY97: $363,400 FY98: $381,600 FY99: $381,600
$1,853,400
* Projected FY99 funds if intervention studies performed
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On-Going Extramural Research: Cooperative Agreements (contJ
Chronic Beryllium Disease Among Beryllium-Exposed Workers
Awardee:
Award Period:
Summary:
Significance:
Michigan State University (Kenneth Rosenman, M.D)
9/30/95 - 9/29/2000
This cross-sectional study of 1000 workers at 2 plants will
examine the natural history of chronic beryllium disease (CBD)
and evaluate the utility of the -lymphocyte transformation test
(LTT) in detecting beryllium sensitization and predicting CBD
development. The effectiveness of medical treatment of sensitized
workers and of control measures in preventing oven CBD will also
be evaluated.
characterizes disease process; health outcome other than cancer;
morbidity study; pertinent to current workers; applicable to
surveillance
Annual Budgets: FY97: $ 237,000 FY98' S 248,900 FY99: S 248,900
Projected Total: $1,208,800
ft************************************
Beryllium Disease Natural History and Exposure Response
Awardee:
Award Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
National Jewish Center for Immunology and Respiratory Medicine
(Lee Newman, M.D.)
9/30/95 - 9/29/2000
This investigation will determine the natural history of beryllium
sensitization and subclinical CBD and identify specific beryllium
compounds and processes associated with CBD. Exposure-
response relationships for both sensitization and CBD will also be
determined. Exposure assessment is underway at an Alabama
plant where take-home toxicants are being assessed for 60
employees.
characterizes disease process; evaluation of intervention methods;
health outcome other than cancer; morbidity study; pertinent to
current workers; applicable to surveillance
FY97: $ 237,000
$1,208,800
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On-Going Research (conO
lib. Extramural Research (Grants)
Mortality Among Female Nuclear Weapons Workers
Grantee:
Award Period:
Summary:
Significance:
University of Texas Medical Branch (Gregg Wilkinson, Ph.D.)
9/30/94 - 9/29/98
Although 80,000 female workers have been employed at DOE
facilities over the years, small numbers of female workers at any
one facility has limited previous health studies. Female workers
from 12 DOE plants will be combined in this cohort mortality
study. Risk estimates will be developed for exposure to ionizing
radiation or to chemical hazards. As of July 1, 1997, the Principal
Investigator was relocated to the State University of New York at
Buffalo.
only study of females at DOE sites; assessment of potential
confounders
Annual Budgets:
Projected Total:
FY97: $135,000
$818,000
FY98: $0
FY99: $0
*************************************
Glycophorin A Biodosimetry in 1-131 Treated Patients
Grantee:
Award Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
University of Pittsburgh (William Bigbee, Ph.D.)
9/30/94 - 9/29/97
This research will evaluate the glycophorin A (GPA)-based human
in vivo somatic cell mutation assay as a retrospective biodosimeter
for use in epidemiologic studies. The response of the assay as a
biodosimeter of radiation exposure will be validated in a
longitudinal study of patients receiving 131I therapy for thyroid
disease.
evaluation of exposure biomarker
FY97: $0 FY98: $0 FY99: $0
$230,000
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On-Going Extramural Research: Grants (contt
3. Measurement Error Methods for Underground Miner Studies
Grantee:
Award Period:
Summary:
Significance:
University of Southern California (Dan Stram, Ph.D.)
9/30/95 - 9/29/98
This study will develop methods to deal with radiation exposure
measurement errors when exposures are extended over time and
apply them in a reanalysis of exposure-time-response (including
dose rate effects) in lung cancer mortality for uranium miner
cohorts in the Colorado Plateau and New Mexico.
developing statistical methods for addressing measurement
uncertainty; may be useful to Department of Justice in disposition
of uranium miner compensation issues
Annual Budgets:
FY97: $189,000
FY98: $0
FY99: SO
Projected Total:
5536,000
*************************************
4. Lung Fibrosis in Plutonium Workers
Grantee:
Award Period:
National Jewish Center for Immunology and Respiratory Medicine
(Lee Newman, M.D.)
9/30/95 - 9/29/98
Summary:
Significance:
Annual Budgets:
Plutonium-induced lung fibrosis has been observed in multiple
species, but non-malignant respiratory disease has not been studied
in an exposed worker population. This project will determine if
workers are at increased risk for developing radiographic
abnormalities consistent with fibrosis; the relationship between
239Pu and other exposures and lung fibrosis will be examined in
lung biopsies of RFP workers.
morbidity study, non-cancer health outcome; uses data from RFP
mortality study; other than radiation exposure
FY97- $158,000 FY98: $0 FY99: $0
Projected Total:
$466,000
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On-Going Extramural Research: Grants (conO
5. Study of Heat Stress and Performance in Carpenters at DOE Sites
Grantee:
Award Period:
Summary:
United Brotherhood of Carpenters Health and Safety Fund
(Kenneth Rosenman. M.D.)
9/30/95 - 9/29/98
This study will determine if heat stress from the use of protective
clothing affects performance of carpenters and other construction
workers in remediation and hazardous waste work at Hanford and
Oak Ridge. Physiologic measures of heat stress and
neurobehavioral performance will be assessed under actual
working conditions.
non-radiation study; non-mortality study; applicable to current
workers; preponderance of work at DOE sites; applicable to
surveillance
Annual Budgets: FY97: $190,000 FY98: $0 FY99: SO
Projected Total: $556,000
*************************************
Ionizing Radiation and Mortality Among Hanford Workers
Significance:
Grantee:
Award Period:
Summary:
Significance:
Annual Budgets:
Projected Total:
University of North Carolina (Steven Wing, Ph.D.)
9/30/96 - 9/29/99
This study will reanalyze cancer and non-cancer mortality among
Hanford workers with chronic, low-level external radiation
exposure. New methods will be used to estimate doses previously
assumed to be zero and to consider internal dose in analyses of
health risks. Loss to follow-up will be evaluated in the life-table
analyses. Appropriate methods will be used in considering time-
related exposure effects.
update of previous cohort study (increased latency); application of
new methodologies for epidemiologic analyses
FY97 $195,000
$587,000
FY98: $195,000 FY99: $0
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On-Going Extramural Research: Grants (cont.^
Dose Estimation from Daily and Weekly Dosimetry Data
Grantee:
Award Period:
Summary:
Significance:
Annual Budgets:
Oak Ridge National Laboratory (George Ostrouchov, Ph.D.)
9/30/96 - 9/29/97
New methodology will be developed and tested to account for
uncertainty and bias in historical dosimetry data at ORNL from
1945-1955. Daily pocket meter and weekly film-badge data will
be combined to estimate annual occupational radiation doses to
individuals. The resulting dose estimates will be in the form of a
probability distribution, providing the most general measure of
uncertainty.
methods development for exposure assessment; useful to
uncertainty analysis
FY97: $0
FY98: $0
FY99: SO
Projected Total: $149,000
*************************************
8. Acute Radiation Syndrome in Russian Nuclear Workers
Grantee:
Award Period:
Summarv:
University of Pittsburgh (Neil Wald, M.D.)
12/1/96- 11/30/98
The long-term objective is to facilitate the acquisition of clinical
diagnostic and prognostic information needed to improve the early
recognition of the Acute Radiation Syndrome (ARS) by non-expert
medical and paramedical personnel in hospital and field
conditions. The study will utilize data from 59 ARS cases that
occurred from 1948 to the present among workers at the Mayak
nuclear facilities in Russia.
Significance: international collaboration; non-cancer study
Annual Budgets: FY97:5172,000 FY98: $87,000 FY99: $0
Projected Total: $259,000
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NIOSH Energy-Related Health Research Program
Research Partners
The Health-Related Energy Research Branch has established numerous productive partnerships
in the conduct of its intramural and extramural research. These include.
Academia/Other:
Battelle Pacific Northwest Labs.
Battelle Memorial Institute
Boston University School of Public Health
Computer Science Corporation
Dynamic Science Corporation
HGO Technology
International Agency for Research on Cancer
Michigan State University
National Jewish Center for
Immunol, and Resp. Medicine
New York University
Oak Ridge Associated Universities
Survey Research Associates, Inc.
United Brotherhood of Carpenters
University of California at Los Angeles
University of Cincinnati
University of Colorado
University of North Carolina
University of Pittsburgh
University of Southern California
University of Texas Medical Branch
University of Washington
Westat Corporation
National Institute for Occupational Safety and Health (NIOSH):
Division of Surveillance, Hazard Evaluations and Field Studies
Hazard Evaluations and Technical Assistance Branch
Industrywide Studies Branch
Support Services Branch
Surveillance Branch
Division of Biomedical and Behavioral Sciences
Division of Respiratory Disease Studies
Centers for Disease Control and Prevention (CDC):
National Center for Environmental Health
National Center for Health Statistics
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Department of Health and Human Services:
Agency for Toxic Substances and Disease Registry (ATSDR)
Office for the Protection from Research Risks (OPRR)
National Cancer Institute (NCI)
National Institute of Environmental Health Sciences (NIEHS)
Other Government:
Department of Energy
Office of Environment, Safety and Health
Office of Environmental Management
Office of Energy Efficiency and Renewable Energy
Environmental Protection Agency
State Health Departments (Colorado, Idaho, Oregon, Tennessee. Washington)
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NIOSH Energy-Related Health Research Program
Proposed Research
As stated previously, the NIOSH energy-related health research agenda addresses objectives that
have been identified with input from a variety of sources. These objectives are listed in the
section titled "Research Agenda " Each of the proposed activities outlined below addresses one
or more of these research objectives. In addition, each has been presented to and approved by
the DHHS Advisory Committee. However, these research objectives should not be considered a
final and/or comprehensive list addressing all research opportunities or knowledge gaps. In the
near future, it is our intention to work with the Advisory Committee to refine and prioritize the
research objectives that have served as the cornerstone for the NIOSH research agenda. Future
research activities will reflect those discussions.
Funding estimates for these activities are not presented here. However, they have been factored
into the FY98 and FY99 funding requests.
Exposure Assessment of Hazardous Waste, Decontamination and
Decommission, and Clean-up Workers (Phases II and III)
Summary:
Significance:
Phase II would require that site visits, additional site information,
and feasibility considerations be done in conjunction with
hypothesis generation from data obtained during Phase I. A
prioritization of research efforts addressing hazards and exposures
encountered by these workers will also be performed. Phase II
will conclude with the identification of several research hypotheses
for study in Phase 1H.
pertinent to current and future workers; applicable to surveillance;
many sites are undergoing clean-up and remediation activities
*************************************
Follow-up of Morbidity Study of Bladder Cancer and Chemical
Exposures at K-25, Oak Ridge, Tennessee
Summary:
Significance:
A limited morbidity study of about 1135 workers at K-25 showed a
significant excess of bladder cancer in workers potentially exposed
to MDA, trichlorethylene and methylene chloride. In the last 10
years additional cases may have occurred that can be identified by
the state cancer registry. Pre-cancerous cell changes (biomarkers)
could be evaluated also. The feasibility of follow-up screening and
updating the exposure estimates will be examined.
biomarker of effect that could be used in surveillance; cancer
incidence study
-------
-------
Proposed Research (cont)
3. Update of Cohort Mortality Study of Mound Workers, Miamisburg,
Ohio
Summary:
This facility has engaged in operations involving exposures to
polonium-210, plutonium-238, and tritium A mortality study
through 1979 showed elevated lung cancer mortality in workers
employed from 1943-1959 and a significant dose-response
relationship between plutonium-238 exposure and lymphopoietic/
hematopoietic cancers and leukemia. An update would allow an
additional 16 years of follow up, and use validated bioassay.
Significance:
improved assessment of exposure to polonium-210 (using more
current models)
*************************************
Medical/Off-Site Radiation Exposures
Summary:
The effect of medical and off-site exposures to ionizing radiation
on epidemiologic studies of workers has never been evaluated.
Risk estimates from studies that do not consider the possible
effects of these exposures could be biased. The study will
determine the feasibility of using medical and off-site records for
workers and, if feasible, doses would be recalculated using
information from these additional sources of radiation.
Significance:
improved risk estimates
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-------
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NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
OVERVIEW
NIOSH medical surveillance of former Department of Energy(DOE) workers is divided into two
separate areas under different enabling authorizations. Ln accordance with these authorizations,
NIOSH administers research grant activities and also evaluates research progress for ongoing
DOE cooperative agreements in medical surveillance.
First, under the Memorandum of Understanding between DOE and the Department of Health and
Human Services (HHS), NIOSH administers five DOE-funded research grants. These grants
support projects intended to assist in the identification and enumeration of former worker
cohorts at risk of adverse health effects due to their energy-related occupational exposures and to
specify necessary medical screening protocols for these cohorts based on their exposure patterns
and existing states of health.
Secondly, under the requirements of the Defense Authorization Act of 1993, DOE must work
with HHS, the Centers for Disease Control and Prevention (CDC) and the National Institute for
Occupational Safety and Health (NIOSH) "regarding determinations of significant health risk
resulting from DOE work-related exposures." Under the Memorandum of Understanding
between DOE and HHS, DOE has therefore asked that NIOSH independently conduct peer
reviews of six medical surveillance needs assessment projects and make recommendations to
DOE regarding continuation of these projects. Similar requests are likely to be received for four
new medical surveillance cooperative agreements recently initiated by DOE.
*************************
RESEARCH GRANTS ADMINISTRATION
1. IMPROVED SYSTEMS FOR WORKER EXPOSURE SURVEILLANCE
(Grant 5R01 CCR412029-02)
Grantee: Oak Ridge Associated Universities (William Tankersley, M.S.)
Grants Office Advisor: David Pedersen, Ph.D.
Award Period: 9/30/95 - 3/31/97
Summary: Heightened awareness of the association between exposures and
occupational disease makes it increasingly important to provide and
improve worker exposure surveillance. This project provided a study of
existing hazard surveillance and exposure assessment systems at a DOE
site, developed a system for computerized worker classification based on
occupational exposures, and pilot tested a functional system for continual
tracking of workers by work area and primary potential exposures.
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NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
Significance: Use of the Potential Exposure Profile System (PEPS) concept developed
by this project would provide more quantitative data to hazard
surveillance programs based on standardized exposure inventories. It
would also improve the precision and quality of the data used in
identifying and selecting worker groups at high risk, minimizing
misdirected and ineffective interventions.
Annual Budgets: FY95: $236,800 FY96. $131,200
Projected Total: $467,000
2. WORK HISTORIES EVALUATING NEW PARTICIPATORY METHODS
(Grant R01 CC512026-01)
Grantee: University of Cincinnati Eula Bingham, Ph D
Grants Office Advisor: David Pedersen, Ph D
Award Period: 9/30/95 - 9/30/97
Summary: Workers in the construction trades are exposed to a wide variety of
chemical and radiological agents at DOE sites. Creation of an exposure
history for these workers is difficult due to the difficulty in recalling their
complex exposure patterns across a large number of short-term workplace
assignments. In order to provide an improved basis for the
characterization of worker occupational exposures over time, this project
is aimed at developing and testing several innovative techniques for
improving occupational history recall. The technique found to be the most
efficient and effective in identifying workers at higher risk will then be
tested at a different DOE site with a new cohort, to validate guidelines and
formats for the maintenance of personal work histories.
Significance: Validated improvements in assembling retrospective occupational
exposure histories have general application in increasing the validity of
studies of the associations between exposure histories and health risk(s)
Specific benefits from this improvement include increased capability to
allocate medical surveillance resources more effectively, thus reducing
unnecessary and duplicative effort.
Annual Budgets: FY95: $338,000 FY96: $344,800 FY97: $333,500
Projected Total: $1,016,300
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NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
3. COMPREHENSIVE OCCUPATIONAL HEALTH SURVEILLANCE
(Grant 1R01 CC12031-01)
Grantee: University of Washington
Scott Barnhart, Ph.D.
Grants Office Advisor: David Pedersen. Ph D
Award Period: 9/30/95 - 9/30/97
Summary: This project is concerned with the design and implementation of a model
occupational safety and health surveillance system. The goal of this
system is to gather appropriate occupational medicine and industrial
hygiene data to provide data for the systematic identification of hazardous
exposures and adverse health outcomes.
Significance: Readily available computerized information on workplace exposures and
health status organized by specific tasks through a Employee Job Task
Analysis (EJTA) provides the information for accurate risk assessments
leading to reduction of hazardous exposures. This level of documentation
also supports objective evaluation of occupational health program
intervention effectiveness, and contributes to worker
(stakeholder)involvement in prevention efforts.
Annual Budgets: FY95: $418,000 FY96: $410,000 FY97: $396,900
Projected Total: $1,125,800
******************************
4. HAZARD SURVEILLANCE IN THE DEFENSE NUCLEAR INDUSTRY
(Grant 1 R01 CC912034-01)
Grantee: University of California at Los Angeles John Froines, Ph.D.
Grants Office Advisor: David Pedersen, Ph. D.
Award Period: 9/30/95 - 9/30/97
Summary: This project is intended to develop an integrated approach to statistical
models for exposure assessment, especially characterization of
occupational exposure to complex mixed exposures to chemical and
biomechanical problems. Based on measured task-specific exposure data,
the project is dedicated to the identification of appropriate statistical tools
to model single- and mixed-agent exposures and resulting internal doses
-------
-------
NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
Significance: This research has application in complex exposure situations through
provision of an additional avenue for evaluating the relationships between
exposure concentration and worker dose. And, the modeling capabilities
of the developed system will provide a risk-based estimation of adverse
health effect incidence on the basis of assessed environmental exposures
to guide health interventions, including medical surveillance.
Annual Budgets: FY95 5397,300 FY96. $410,400 FY97: $393,300
Projected Total: $1,200,922
5. SENTINEL EXPOSURE EVENT SURVEILLANCE/EVALUATION
AT DOE SITES
(Grant 1 R01 CCR812044-01)
Grantee: University of Colorado James Ruttenber, M.D.
Grants Office Advisor: David Pedersen, Ph.D.
Award Period: 9/30/95 - 9/30/97
Summary: This project is intended to develop a generic hazard surveillance and
evaluation system for exposures to chemical and radiation exposures.
Based on a job/task evaluation and analysis, the Sentinel Exposure Event
(SEE) system will include exposure level measurements, worker-specific
task definitions, and observation data (controls, conditions of exposure,
and defined health and safety policies). This input will be incorporated
into a system for evaluating exposures, enhancing worker
communications, and identifying necessary interventions through
internally generated reports.
Significance: The practice of using job/task definition as the fundamental unit of
observation in a comprehensive exposure evaluation and reporting system
provides generic capabilities for the identification and direction of
occupational health interventions and enhanced worker communications.
The potential for indicating and guiding improvements in occupational
health program initiatives may have direct impact on the conduct of
medical surveillance programs.
Annual Budgets: FY95: $274,900 FY96: $351,300 FY97: $258,800
Projected Total: $884,900
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NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
EVALUATION OF MEDICAL SURVEILLANCE NEEDS ASSESSMENT REPORTS
OVERVIEW
DOE is funding a number of cooperative agreements at various DOE sites to develop a program
of medical evaluation for former DOE workers at significant risk for health problems due to
exposures to hazardous or radioactive substances. These studies were divided into two phases.
The first phase is a comprehensive needs assessment which involves identification of the worker
cohort at risk and an evaluation of their occupational exposures and potential for adverse health
effects. The second phase, based upon approval of first phase activity results, focuses on the
development of necessary medical screening protocols for "groups of workers at significant risk
for health effects."
DOE determines the need for Phase II activities based on review and evaluation of the reports of
Phase I activity, and supports Phase II efforts only for those studies which adequately
demonstrate the need for continued study. This finding is based in large part on the NIOSH
review. In order to comply with the formal DOE request that NIOSH (Division of Surveillance,
Hazard Evaluations, and Field Studies) provide Phase I reviews and evaluations, a formal panel
review process was established.
This process involves the selection of multi disciplinary panels for each cooperative agreement
report. These panel consist of representative professionals from such disciplines as occupational
medicine, industrial hygiene, health physics, epidemiology, and records management, along with
other expertise as required. The panel expertise mix is specific to each research effort, and
members are selected by Mr. Larry Elliott and Dr. David Pedersen. Panel members operate
independently in their evaluation of the cooperative agreement reports in accordance with
standardized formal directions assembled by Dr. Pedersen, acting as review panel coordinator.
The coordinator also collates the individual panel member evaluations into a summary report,
which is sent to DOE. Four such evaluations have been completed, two more are being sent to
NIOSH for evaluation, and it is anticipated that DOE will also request that the Phase I reports of
four newly-signed cooperative agreements will also be subject to NIOSH review.
Department of Energy (COOPERATIVE AGREEMENTS REVIEWED)
1. SURVEILLANCE FOR FORMER WORKERS AT THE ROCKY FLATS
ENVIRONMENTAL TECHNOLOGY SITE
Principal Investigator:
James Ruttenber, M.D.
Review Coordinator:
David Pedersen, Ph.D.
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-------
NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
2. Medical Surveillance Program for Construction Workers at Oak Ridge, Tennessee
Principal Investigator:
Eula Bingham, Ph.D.
Review Coordinator:
David Pedersen, Ph.D.
3. Medical Surveillance of Former Hanford Workers
Principal Investigator:
Scott Barnhart, M.D., M.P.H.
Review Coordinator:
David Pedersen, Ph.D.
4. Medical Surveillance for Former Workers at the Nevada Test Site
Principal Investigator:
Lewis Pepper, Ph.D.
Review Coordinator:
Larry Elliott, M.S.
DOE (COOPERATIVE AGREEMENTS PENDING REVIEW)
1. A Medical Surveillance Program for Former Department of Energy Workers
Principal Investigator:
Robert Wages
2. Former Workers' Notification and Medical Screening/Hanford Building Trades
Principal Investigator:
Kurt Ringen, Dr.P.H.
3. Medical Surveillance for Former Idaho Falls, Idaho Workers
Principal Investigator:
Robert Wages
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-------
NIOSH ENERGY-RELATED MEDICAL SURVEILLANCE PROGRAM
4. Medical Surveillance of Former Department of Energy Workers
Principal Investigator:
David Hoel, Ph.D.
5. Former Workers' Notification and Medical screening Program, Savannah River
Building Trades
Principal Investigator:
Kurt Ringen. Dr P.H
6. Development of a Medical Surveillance Program for Former
Los Alamos National Laboratory Workers
Principal Investigators):
Brian Schwartz, M.D., M.S.
Patrick Brevsse, Ph.D.
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October 1997
Page 1 of 5
National Institute for Occupational Safety and Health (NIOSH)
Health-Related Energy Research Branch (HERB)
i^——i
—
—Ml
INTRAMURAL STUDIES:
Cohort Mortality Study of Portsmouth
Gaseous Diffusion Plant (PGDP)
Robert Rlnsky, PhD
513-841-4131
513-841-4470 (fax)
rar1@cdc.gov
N/A
N/A
Cohort Mortality Study of Idaho Natl
Engineering Laboratory (INEL)
David Utterback, PhD
513-841-4492
513-841-4470 (fax)
dfuO@cdc.gov
N/A
N/A
Cohort Mortality Study of Portsmouth
Naval Shipyard (PNS)
Robert Rlnsky, PhD
513-841-4131
513-841-4470 (fax)
rar1@cdc.gov
N/A
N/A
Chemical Lab Workers Mortality
David Utterback, PhD
513-841-4492
513-841-4470(fax)
dfu0@cdc.gov
N/A
i
N/A
Construction Workers Mortality
Elizabeth Atkins MPH
513-841-4313
513-841-4470(fax)
bba2@cdc.gov
N/A :
N/A
D&D Surveillance Registry
Elizabeth Atkins MPH
513-841-4313
513-841-4470(fax)
bba2@cdc.gov
N/A
N/A
Leukemia Case-Control Study
Thurman Wenzl, ScD
513-841-4490
513-841-4470 (fax)
tyw1@cdc.gov
N/A
N/A
Lung Cancer Case Control
Larry Elliott, MS, CIH
513-841-4465
513-841-4470(fax)
Ije1@cdc.gov
N/A
N/A
Multiple Myeloma Case-Control Study
at K-25 Plant
M. Kathryn Brown,Ph.D.
513-841-4468
' 513-841-4470 (fax)
JJcO@cdc.gov
N/A
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October 1997
Page 2 of 5
Exposure Assessment of Hazardous
Waste/Clean-up Workers (Phase I)
Steve Ahrenholz, PhD
513-841-4471
513-841-4470 (fax)
sha1@cdc.gov
N/A
N/A
Feasibility of Cohort Mortality Study of
DOE Chemical Laboratory Workers
David Utterback, PhD
513-841-4492
513-841-4470 (fax)
dfuO@cc.gov
N/A
N/A
Pantex Plant Mortality Study
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
Ije1@cdc.gov
N/A
N/A
Site/Community Outreach Activities
William Murray, MS
513-841-4463
513-841-4470 (fax)
wem2@cdc.gov
N/A
N/A
EXTRAMURAL STUDIES
(Cooperative Agreements):
Childhood Leukemia Case-Control
Study
Larry Elliott, MS, CIH
513-841 -4465513-841-4470
(fax)
Ije1@cdc.gov
Lowell Sever, PhD
Battelle
206-528-3348
206-528-3553 (fax)
sever@battelle.org
Cancer Incidence/Mortality Study of
Rocky Flats Plant
Dennis Zaebst, MS, CIH
513-841-4459
513-841-4470 (fax)
ddz1@cdc.gov
Norma Morin, PhD
Colorado DPH
303-692-2636
303-782-0188 (fax)
normle.morln@state.co.us
International Collaborative Study of
Nuclear Industry Workers
William Murray, MS
513-841-4463
513-841-4470 (fax)
wem2@cdc.gov
Elisabeth Cardis, PhD
IARC
011-334-7273-8508
011-334-7273-8575 (fax)
cardis@larc.fr
Chronic Beryllium Disease Among
Beryllium-Exposed Workers
Paul Henneberger, ScD
304-285-5756
304-285-5861 (fax)
pkh0@cdc.gov
Ken Rosenman, MD
Michigan State Univ.
517-353-1846
517-432-3606 (fax)
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October
Page 3 o^j
Beryllium Disease Natural History and
Exposure Response
Paul Henneberger, ScD
304-285-5756
304-285-5861 (fax)
pkhO@cdc.gov
Lee Newman, MD
Natl. Jewish Center
for Immun. & Resp.
Med.
303-398-1725
303-398-1851 (fax)
newman1@njc.org
Prevention of Stress and Health
Consequences of Downsizing and
Reorganization
Larry Murphy, PhD
513-533-8171
513-533-8596 (fax)
Irm2@cdc.gov
Lewis Pepper, MD
Boston University
617-638-4620
617-638-4857 (fax)
lpepper@bu.edu
EXTRAMURAL STUDIES
(Contracts):
Multi-Site Multiple Myeloma Case-
Control Study
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
Ije1@cdc.gov
Steve Wing, PhD
Univ. North Carolina
919-966-7416
919-542-4403 (fax)
swing@sphvax.sph.unc.edu
Mercury Workers Health Study
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
Ije1@cdc.gov
Donna Cragle, PhD
ORAU
423-576-2866
423-576-9557 (fax)
cragled@orau.gov
BWMlilMI
18——
B—
Historical Plutonium Bloassay
Measurements
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
IJe1@cdc.gov
Norman Cohen, PhD
New York University
914-351-4368
914-351-3489 (fax)
norman@chariotte.med.nyu.
edu
Technical Support Activities
Marcus Wilkins
513-841-4546
513-841-4470 (fax)
mcw5@cdc.gov
Frank Moran
Westat
Donna Cragle, PhD
ORAU
301-251-4255
301-294-2040 (fax)
moranfl @westat.com
423-576-2866
423-576-9557 (fax)
cragled@orau.gov
EXTRAMURAL STUDIES
(Grants):
Mortality Among Female Nuclear
Weapons Workers
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
IJe1@cdc.gov
Gregg Wilkinson, PhD
Univ. Texas Med. Br.
409-772-2335
409-772-9127 (fax)
gwilklns@prmchpo.pmchs1.
utmb.edu
Glycophorln A Blodosimetry in 1-131
Treated Patients
Thomas Reld, Ph.D.
513-533-8294
513-533-8510
tar9@cdc.gov
William Bigbee, PhD
Univ. Pittsburgh
412-967-6534
412-624-1020 (fax)
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October 1997
Page 4 of 5
Measurement Error Methods for
Underground Miner Studies
Larry Elliott, MS, CIH
513-841-4465
513-841-4470 (fax)
IJe1@cdc.gov
Dan Stram, PhD
Univ. Southern Calif.
213-342-1817
213-342-2349 (fax)
stram@rcf.usc.edu
Lung Fibrosis in Plutonium Workers
Steve Ahrenholz, Ph.D.
513-841-4471
513-841-4470 (fax)
sha1@cdc.gov
Lee Newman, MD
Natl. Jewish Center
for
Immun. & Resp. Med.
303-398-1725
303-398-1851 (fax)
newmanl @nJc.org
Study of Heat Stress and
Performance In Carpenters at DOE
Sites
Jean-Louis Belard, MD,
PhD
304-285-5987
304-285-6047 (fax)
jfb6@cdc.gov
Ken Rosenman, MD
Unit. Brthd.
Carpenters
517-353-1846
517-432-3606 (fax)
21770kdr@msu.edu
Ionizing Radiation and Mortality
Among Hanford Workers
Robert Rlnsky, PhD
513-841-4131
513-841-4470 (fax)
rar1@cdc.gov
Steve Wing, PhD
Univ. North Carolina
919-966-7416
919-542-4403 (fax)
swlng@sphvax.sph.unc.edu
Dose Estimation from Daily and
Weekly Dosimetry Data
David Utterback, PhD
513-841-4492
513-841-4470 (fax)
dfuO@cdc.gov
George Ostrouchov,
PhD
ORNL
423-574-3137
423-574-0680
ost@ornl.gov
MMMlllgil
11S1MIIS
DOE SURVEILLANCE GRANTS:
Hazard Surveillance In Defense
Nuclear Industry
David Pedersen, PhD
513-841-4223
513-841-4489 (fax)
dhp1@cdc.gov
John Frolnes, PhD
UCLA
310-206-6141
310-206-9903 (fax)
jfrolnes@ucla.edu
Improved Systems for Worker
Exposure Surveillance
David Pedersen, PhD
513-841-4223
513-841-4489 (fax)
dhp1@cdc.gov
Wm. Tankersley, MS
ORAU
423-576-3141
423-576-9557 (fax)
tankersb@orau.gov
Work Histories - Evaluating New
Participatory Methods
David Pedersen, PhD
513-841-4223
513-841-4489 (fax)
dhpl @cdc.gov
Eula Bingham, PhD
Univ. Cincinnati
513-558-5728
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October 1997
Page 5 of 5
Sentinel Exposure Events
Surveillance/Evaluation at DOE Sites
David Pedersen, PhD
513-841-4223
513-841-4489 (fax)
dhp1@cdc.gov
James Ruttenber, MD
Univ. Colorado
303-315-5627
303-315-3183 (fax)
jim.ruttenber@uchsc.edu
Comprehensive Occupational Health
Surveillance
David Pedersen, PhD
513-841-4223
513-841-4489 (fax)
dhpl ©cdc.gov
Scott Barnhart, PhD
Univ. Washington
206-731-3388
206-731-8247 (fax)
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NIOSII Conducted or Sponsored Research Activities at DOE Sites
October 1997
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NIOSH Conducted or Sponsored Research Activities at DOE Sites (continued)
October 1997
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NIOS1I Intramural and Extramural Studies at DOE Sites
October 1997
Site Abbreviations:
LANL-
Los Alamos National Laboratory
Zia
Zia Company (former maintenance contractor at LANL)
LLNL -
Lawrence Livermore National Laboratory
KCP -
Kansas City Plant
INEL -
Idaho National Engineering Laboratory
NTS -
Nevada Test Site
ORNL-
Oak Ridge National Laboratory (also known as X-IO)
PGDP -
Portsmouth Gaseous Diffusion Plant (Piketon, Ohio)
RFP -
Rocky Flats Plant
SRP -
Savannah River Plant
PNS -
Portsmouth Naval Shipyard (Not a DOE site, but included
since involved in several on-going studies)
Codei:
1 - study in progress, data sources evaluated mid data collected
2 - study initiated, site selected
S - technical support of varying nature performed by Westat/ORAU
(may include data inventory, data collection, coding, evaluation of existing data sets, etc )
L - epidemiologic evaluation performed under previous contract to DOE by LANL;
data sets, manuscript(s) available
O - epidemiologic evaluation performed under previous contiact to DOE by ORAU;
data sets, manuscript(s) available
H - epidemiologic evaluation performed under previous contract to DOE by HEH1; and Battclle;
data sets, manuscript(s) available
N - epidemiologic evaluation performed previously by NIOSH
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NIOSH Energy-Related Health Research Program
Previous DOE Studies
Under the original Memorandum of Understanding (MOU), NIOSH assumed responsibility for
the management of a number of on-going studies, then being conducted by four contractors of
the Department of Energy [Oak Ridge Associated Universities (ORAU), which became the Oak
Ridge Institute for Science and Education (ORISE), Los Alamos National Laboratory (LANL),
and Hanford (Battelle Pacific Northwest Laboratory (PNL) and Hanford Environmental Health
Foundation (HEHF))]. Approximately 40 research efforts were itemized in the MOU. Several
of these, however, were completed prior to the actual transfer of the studies, or were duplicate
citings of the same research project. Ten projects being performed by ORISE, five by LANL,
and five by HEHF/PNL were actually transferred for management by NIOSH. In most of these
cases, the research efforts were well under way by the time of the implementation of the MOU;
therefore, there was minimal opportunity for NIOSH to provide scientific or technical input.
NIOSH worked with these contractors toward the completion of all of these research endeavors.
A brief summary of the report generated for each is provided below:
I. OAK RIDGE INSTITUTE FOR SCIENCE AND EDUCATION (ORISE)
The following studies were performed by investigators from the Center for
Epidemiologic Research of ORISE, under the leadership of Donna Cragle, Ph.D. The
analysis of the studies of two sites, X-10 and Y-12, were conducted by investigators from
the University of North Carolina, as a sub-contract to ORAU.
1. Oak Ridge National Laboratory (X-10)
Manuscript: Wing S, Shy C, et al: Mortality among workers at Oak Ridge National
Laboratory. J Amer Med Assoc 265(11): 1397-1402, 1991.
Summary: White males hired at the Oak Ridge National Laboratory between 1943
and 1972 were followed up for vital status through 1984 (N=8318).
Relatively low mortality compared with that in US white males was
observed for most causes of death. However, 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). 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).
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Manuscript: Shy C, Wing S: A report on mortality among workers at Oak Ridge
National Laboratory: Follow-up through 1990. Draft Final Report, March
31, 1994.
Summary: This is a follow-up of the mortality experience of the cohort of white
males employed at the ORNL, originally described in 1991 (see above).
An additional 586 deaths were identified (compared with 1524 deaths in
the original follow-up). The all-cause SMR, the all-cancer SMR, and lung
cancer SMR were all unchanged from the previous update; however, the
leukemia SMR was 1.35, as compared with 1.63. The SMR for leukemia
does decline to 0.71 for the recent follow-up years (1985-1990), possibly
reflective of a leukemia-radiation association due to relatively high doses
in the 1940s and 1950s.
2. Y-12 Plant, Oak Ridge
Manuscript: Loomis D, WolfS: Mortality of workers at a nuclear materials production
plant at Oak Ridge, Tennessee, 1947 - 1990. Amer J Indust Med 29: 131-
141, 1996.
Summary: The mortality experience of a cohort of 10,597 males and females who
worked at Y-12 between 1947 and 1974 was somewhat lower than that of
the United States population, and cancer mortality was equal to that of the
general population. Deaths from lung cancer were significantly elevated
(SMR=1.17, 95% CI=1.05, 1.31). There was also a small excess of brain
and lymphatic cancer (SMRs=l .13 and 1.27, respectively). A small
increase in pancreatic cancer deaths was also noted (SMR=1.14).
3. Oak Ridge Gaseous Diffusion Plant (K-25)
Manuscript: Dupree E, Wells S, et al: Mortality among workers employed between
1945 and 1984 at a uranium gaseous diffusion facility. Draft Final Report,
April 13, 1994.
Summary: Mortality patterns among 35,712 workers ever employed for 30 days or
more at K-25 between 1943 and 1984 was investigated. 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 cancers of the respiratory system, including lung
cancer, cancer of the bone, mental disorders, and respiratory diseases, and
all accidents. Among nonwhite males, no cause of death showed a
statistically significant increase.
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Combined Oak Ridge Facilities (Tennessee Eastman Corporation [TEC],
Y-12, X-10, K-25)
Manuscript: Watkins J, Cragle D, Frome E. Collection, validation, and treatment of
data for mortality study of nuclear industry workers Appl Occup Environ
Hyg 12 (3): March, 1997.
Summary: This paper describes methodologic issues related to the Oak Ridge facility
combined mortality study (ORFCOM) conducted on 118,588 workers
employed at TEC, Y-12, K-25, or X-10. Discussed are issues of
validation and treatment of data for study members, and characteristics of
their radiation exposure.
Manuscript: Frome E, Cragle D, et al: A mortality study of employees of the nuclear
industry in Oak Ridge, Tennessee. Radiation Res, to be published in June
1997.
Summary: An 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. Overall mortality and overall cancer mortality estimates were
in close agreement with national rates. The only notable excesses
occurred for lung cancer (SMR=1.8) and nonmalignant respiratory disease
(SMR=1.12) among white males. Analysis showed that 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.
5. Welders at Oak Ridge Facilities
Manuscript: Wells S, Cragle D, et al: An update of mortality among welders,
including a group exposed to nickel oxides. Draft Final Report, 1994.
Summary: Overall mortality and all causes of death were 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 nickel oxides. The SMR
for lung cancer in the total cohort also reached statistical significance
(SMR=1.38, CI=1.03-1.82). Elevations in deaths due to ulcers and
prostate cancer were also noted among workers exposed to nickel oxides.
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6. Savannah River Plant, Aiken, South Carolina
Manuscript: Cragle DL, Robertson-Demers K, Watkins JP: Mortality among workers
at a nuclear fuels production facility: The Savannah River Site, 1952-
1986. Draft Final Report, 1996.
Summary: A retrospective cohort mortality study was conducted among workers
employed at the Savannah River site between 1952 and 1974, with the
primary task of production of nuclear fuels and other materials. A strong
healthy worker effect was noted, reflected by significantly fewer deaths
from all causes, all cancers, all diseases of the circulatory system, all
respiratory diseases, and all digestive system diseases. These occurred
among both hourly (N=7,299) and salaried employees (N=2,561). A
positive and significant dose-response relationship for leukemia was
observed, with the increase in mortality per 10 mSv estimated to be 7.81
percent with a two-year lag using a multiplicative relative risk model, and
18.28 percent using an excess relative risk model.
7. Feraald Feed Materials Production Center, Ohio
Manuscript: Cragle D, et al: Mortality among a cohort of white male workers at a
uranium processing plant: Femald Feed Materials Production Center,
1951-1989. Draft Final Report, 1996.
Summary: Included in the study were 4,014 white males first hired at the plant
between 1951 and 1981. Vital status follow-up was through the end of
1989. For salaried workers, the overall death rate was significantly below
that predicted based on the U.S. rates. Other specific differences in this
salaried worker group included deficits of lung cancer, circulatory system,
respiratory disease, and accidental deaths. A significant increase was
observed for deaths from stomach cancer. Among hourly workers,
significant deficits were observed for deaths from diseases of the
circulatory and genitourinary system. Significant increases were observed
for deaths from lung cancer. Among the entire population, the lung cancer
death rate was observed to increase with increasing levels of external
dose. All other cancer causes did not show the same dose-response
relationship.
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8. Uranium Case-Control Study (TEC, Y-12, Fernald, Mallinckrodt)
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.
Summary:
9.
This study sought to examine 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. A total of 787 cases was identified. Odds ratios for lung
cancer mortality for seven cumulative internal dose groups did not
demonstrate increasing risk with increasing dose. However, there was a
suggestion of an exposure effect for workers hired at age 45 years or
older. Further analyses for cumulative external dose and exposures to
thorium, radium, and radon did not reveal any clear association between
exposure and increased risk, nor did categorizing workers by facility.
Mallinckrodt Chemical Works, St. Louis, Missouri
Manuscript: Dupree E, Wallace P: Mortality among men employed between 1942 and
1966 at a uranium processing plant. Draft Final Report, March 1994.
Summary: A retrospective cohort mortality study was conducted of2542 white males
employed by the Uranium Division of Mallinckrodt Chemical Works
(MCW) for at least 30 days between 1942 and 1966. Deaths due to
external causes were significantly decreased in this population. The
SMRs for all cancers, all diseases of the genitourinary system, skin and
connective tissue, as well as senility and ill-defined conditions were
greater than expected, but not significantly elevated. Increases were also
noted for cancers of the brain and central nervous system. However,
SMRs for these cancers did not reach statistical significance.
10. 2 5 Rem Study (multiple facilities)
Manuscript: Fry S, Dupree E, Sipe D, et al: A study of mortality and morbidity among
persons occupationally exposed to > 50 mSv in a year: Phase I, mortality
through 1984. Appl Occup Environ Hyg 11(4). 334-343, 1996.
Summary: This study investigated the mortality experience of 3145 individuals who
reportedly received >50 mSv of penetrating ionizing radiation in any
calendar year of employment (1943 through 1978) at all facilities operated
for DOE. 588 deaths (19%) occurred. The overall mortality experience of
the total white male cohort was consistent with a healthy worker effect.
SMRs for all causes of death, as well as diseases of the circulatory and
digestive systems, were significantly decreased..
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There were no statistically significant differences in mortality due to
cancers of the major organ systems including those strongly associated
with exposure to high levels of radiation in other populations.
n. LOS ALAMOS NATIONAL LABORATORY (LANL)
The following five studies were performed by investigators at Los Alamos National
Laboratory (principal epidemiologist: Laurie Wiggs, Ph.D.).
1. Mound Plant, Miamisburg, Ohio
Manuscript: Reyes M, et al: Mortality among workers at the Mound facility: a
preliminary report. Los Alamos Technical Report, April 1991.
Summary: This paper reports an investigation of4697 white males employed at least
30 days between 1943 and 1979. No significant elevations were found for
the overall cohort. However, SMRs for thyroid, pharyngeal, lung, and
prostate cancers were above 1.0. Significant elevations in lung cancer
were found among polonium workers employed between 1943 and 1959.
Among workers employed for less than two years between 1943 and 1959,
significant elevations were found for all causes and lung cancer.
Manuscript: Wiggs L, etal: Mortality among workers exposed to external ionizing
radiation at a nuclear facility in Ohio. J Occup Med 33(5): 632-637, 1991.
Summary: This study investigated 3229 white males employed 1947 and 1979,
assessing possible dose-response relationships between mortality from
various causes and external exposure to ionizing radiation. No
statistically significant elevations for overall mortality or site-specific
cancers were noted. In addition, no differences in mortality were observed
between workers exposed to ionizing radiation and unexposed workers.
However, among exposed workers, a significant dose-response
relationship was seen for lymphopoietic/hematopoietic cancers and all
leukemias.
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Wiggs L, et al: Mortality among a cohort of workers monitored for 210Po
exposure: 1944-1972. Health Physics 61(1)' 71-76, 1991.
This study investigated mortality patterns among 2,181 white males
employed between 1944 and 1972, years in which polonium-210 was
processed and urine monitoring was in place. All causes mortality was
less than 1.0 SMRs for cancers of the thyroid, rectum, esophagus,
lymphatic system, oral cavity, and lung were elevated, though not
significantly. Elevated SMRs were seen for lung cancer among workers
employed during WWII, but not for the post-WWII group No dose-
response relationship was noted between mortality and exposure to
internal radiation.
2. Los Alamos National Laboratory (LANL)
Manuscript: Wiggs L, Johnson E, et al: Mortality through 1990 among white male
workers at the Los Alamos National Laboratory: Considering exposures to
plutonium and external ionizing radiation. Health Physics 67(6): 577-588,
1991.
Summary: A cohort mortality study was conducted of 15,727 white males employed
at LANL from 1943 to 1977. No cause of death was elevated among this
cohort. Mortality from all causes of death and all cancers was
significantly low, as was mortality from many other cause-specific
categories. SMR analyses were also conducted for a subcohort of workers
first employed during WWII. The SMRs for the WWII subcohort
indicated mortality in this subcohort was also low compared with the
general population. No cause of death was significantly elevated.
Analyses of mortality comparing plutonium-exposed and unexposed
workers considering a 10-year induction period also showed that no cause
of death was significantly elevated. However, dose-response relationships
were observed for cumulative dose of external ionizing radiation and
cancers of the brain/central nervous system, esophagus, and Hodgkin's
disease.
Manuscript:
Summary:
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3. Rocky Flats Nuclear Weapons Plant, Golden, Colorado
NIOSH funded LANL to complete an update of the vital status of the Rocky Flats cohort,
through 1990. This update is being used in the current mortality/incidence study being
performed (see On-Going Extramural Research). For reference, a summary of the
previous manuscript is provided below.
Wilkinson GS, Tietjen GL, Wiggs LD, et al: Mortality among plutonium
and other radiation workers at a plutonium weapons facility. Amer J
Epidemiol 125 (2): 231-250, 1987.
Mortality patterns were examined for 5413 white males employed for at
least two years at the Rocky Flats Plant from 1952 through 1979. Fewer
than expected deaths were observed for all causes, all cancers, and lung
cancer. An excess of brain cancer was found for the overall cohort.
Elevated rate ratios (RRs) for all causes of death and all lymphopoietic
cancers were found, when comparing workers with plutonium burdens of
>2 nCi with those with body burdens < 2 nCi. Increased RRs were also
observed for esophageal, stomach, colon, and prostate cancers, as well as
lymphosarcomas and reticulum cell sarcomas. Comparing workers with
s 1 rem with those with < 1 rem cumulative exposure, several elevated
RRs were observed (myeloid leukemia, lymphosarcomas and reticulum
cell sarcomas, liver neoplasm, and unspecified brain tumors). No overall
dose-response relationships were found for either plutonium or external
radiation exposure.
4. Zia Company, Los Alamos, New Mexico
Manuscript: Galke W, Johnson E, et al: Mortality in an ethnically diverse radiation
exposed occupational cohort, Draft Final Report, November 24, 1992.
Summary: 5,424 workers employed at Zia between 1946 and 1984 who were
monitored for exposure to either plutonium or external ionizing rational
were included in this retrospective cohort mortality study. Among males,
significantly elevated SMRs were seen for stomach cancer, senility and
ill-defined conditions, all injuries, all accidents, and motor vehicle
accidents. SMRs for females were consistent with mortality rates in the
general population. Flispanic males, however, had significantly higher
mortality from stomach cancer, all injuries, all accidents, and motor
vehicle accidents. Non-Hispanic males had significantly higher mortality
from all causes, all cancers, lung cancer, all circulatory diseases, and all
respiratory diseases. Stratified rate ratio analyses were conducted to test
the association between radiation exposure and mortality. No
significantly high RRs were seen in either Flispanic or non-Hispanic males
in the plutonium or external ionizing radiation analyses.
Manuscript:
Summary:
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5.
Plutonium Workers (LANL, Zia)
Manuscript: Voelz G, Johnson E, et al: Mortality of 224 male workers exposed to
plutonium. Draft Final Report, February 9, 1993.
Summary: This paper describes an updated mortality study of a group of workers
exposed to plutonium at the LANL and Zia. Study subjects were selected
by searching the Los Alamos plutonium dosimetry records for all workers
who were estimated to have plutonium depositions over 370 Bq. Two
types of mortality analyses were performed 1) SMRs (calculated as of
1990) based on morality rates of white males in the U S general
population, and 2) mortality RRs to compare deaths occurring in the 224
exposed group with those in an unexposed comparison group. The SMRs
for all malignant neoplasms were below 1.0. Only the SMR for bone
cancer was elevated (SMR=10.6, CI=0.15, 59), though this is based on
only one case. All mortality RRs were calculated with a 10-year cancer
induction time. The ratios for all causes of death and all malignant
neoplasms were not significantly elevated. Only the SRR for digestive
system cancer was above 1.0 (SRR=1.13, CI=0.42, 3.08).
m. HANFORD ENVIRONMENTAL HEALTH FOUNDATION (HEHF)
BATTELLE PACIFIC NORTHWEST LABORATORIES (PNL)
Several research projects were performed jointly by investigators at the Hanford
Environmental Health Foundation (HEHF) (principal epidemiologist: Ellen Omohundro,
Ph.D.) and Battelle Pacific Northwest Laboratories (PNL) (principal investigator: Ethel
Gilbert, Ph.D.). HEHF was responsible for the collection and verification of mortality,
occupational history, and medical and personal health history data. PNL gathered
radiation dosimetry data and was responsible for data integration and analysis. With the
exception of the combined studies, all the research efforts by these contractors pertained
to the Hanford Site.
1. Hanford Site, Richland, Washington
Manuscript: Gilbert E, Omohundro E, et al: Mortality of workers at the Hanford Site:
1945-1986. Health Physics 64(6): 577-590, 1993.
Summary: This study investigated mortality among contractor employees initially
employed at the Hanford site from 1944-1978. Both the SMR for overall
mortality and mortality from malignant neoplasms for all workers were
below 1.0. SMRs for diseases of the musculoskeletal system among all
workers, for cancer of the pancreas in males not monitored for external
radiation, and for all other solid tumors in males not monitored for
external radiation were elevated, but not significantly.
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Comparisons of death rates by radiation dose within the cohort showed no
evidence of a correlation for all causes of death, all cancers, or leukemia
with radiation dose. Cancer of the pancreas (p=0.07) and Hodgkin's
disease (p=0.04) showed positive correlations with radiation dose.
However, these correlations are regarded as spurious Of note is the fact
that rates of multiple myeloma deaths in this cohort continue to be
elevated.
Manuscript: Omohundro E, Gilbert E: An evaluation of the adequacy of vital status
follow-up in the Hanford Worker Mortality Study. PNL Technical Report
(PNL-8981), November 1993.
Summary: This report was designed to evaluate the completeness of vital status
ascertainment in the Hanford worker cohort. Identifying information on
17,708 Hanford workers was submitted to Equifax Government and
Special Systems. For the period 1945-86, Equifax ascertained only 12
new deaths. In order to evaluate the adequacy of the methods used by
Equifax, information on 2,254 Hanford workers who had been previously
identified as dead was also submitted. Equifax missed less than 2% of
known Hanford deaths occurring in the period 1965-86, but missed about
18% of deaths occurring before 1965. For the period 1987-89, Equifax
identified 49 new deaths. A stratified random sample of 1,600 of the
17,708 workers with unknown vital status was submitted to Equifax for a
more extensive investigation of follow-up status. Information on these
workers was compared against consumer credit databases to determine the
last date these workers were known to be alive. The results of this part of
the study indicate that if these procedures had been applied to all workers
with unknown vital status, about 90% of these workers would have been
confirmed to be alive. About 5% of the total study population would have
remained lost to follow-up.
2. Combined U.S. Cohorts (Hanford, ORNL, Rocky Flats)
Manuscript: Gilbert E, Cragle D et al: Updated analyses of combined mortality data on
workers at the Hanford Site, Oak Ridge National Laboratory, and Rocky
Flats Nuclear Weapons Plant. Radiation Res 136: 408-21, 1993.
Summary: 44,943 workers from Hanford, ORNL (X-10), and Rocky Flats were
studied for a direct assessment of health risks resulting from protracted
low-dose exposure to ionizing radiation. Of 24 cancer types tested, 12
showed positive correlations with radiation dose and 23 showed negative
correlations. Cancer of the esophagus, cancer of the larynx, and
Hodgkin's disease showed statistically significant correlations with
radiation dose, but these correlations were interpreted as likely to have
resulted from bias or chance fluctuations.
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Evidence of an increase in the excess relative risk with increasing age at
risk was found for all cancer in both Hanford and ORNL, and both
populations showed significant correlations of all cancer with radiation
dose among those 75 years and older Although this age effect may have
resulted from bias in the data, its presence suggests that risk estimated
based on nuclear worker data be interpreted cautiously.
3. Combined International Studies (U.S., Canada, U.K.)
Manuscript: Cardis E, Gilbert E, et al: Effects of low dose and low dose rates of
external ionizing radiation: Cancer mortality among nuclear industry
workers in three countries. Radiation Res 142: 117-132, 1995.
Summary: This paper presents the results of combined analyses of mortality data on
95,673 workers monitored for external exposure to ionizing radiation and
employed for 6 months or longer in the nuclear industry in three countries.
There was no evidence of an association between radiation dose and
mortality from all causes or from all cancers. Mortality from leukemia,
excluding chronic lymphocytic leukemia, was significantly associated
with cumulative external radiation dose. Among 31 other specific types of
cancer studied, a significant association was observed only for multiple
myeloma, and this was attributable primarily to the associations reported
previously between this disease and radiation dose in the Hanford and
Sellafield cohorts. The relative risk of all cancers excluding leukemia was
0.99, and 1.22 for leukemia excluding CLL for a cumulative protracted
dose of 100 mSv compared to 0 mSv.
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Health-Related Energy Research
Branch
ORGANIZATIONAL CHART
October 1997
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Delivering on the Nation's promise:
Safety and health at work for all people
Through research and prevention
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