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Oak Ridge Reservation: CDC Public Health Activities
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Conducting public health activities at Department of Energy (DOE) sites is the responsibility of two groups in the Centers for Disease Control and Prevention (CDC):

National Institute for Occupational Safety and Health (NIOSH)

The National Institute for Occupational Safety and Health (NIOSH) has a broad program of occupational health research across the DOE complex. NIOSH interacts with DOE and DOE workers in three ways.

NIOSH Studies on the Health of Oak Ridge Workers

Researchers at NIOSH, in collaboration with others, have conducted numerous studies of health effects among workers at the Oak Ridge Reservation. Findings of the studies include the following :

  • Mortality Among Workers at Oak Ridge National Laboratory
    The Oak Ridge National Laboratory (X-10) has been the subject of long-term epidemiologic study. A mortality analysis of 8,375 white males through 1977 found no cause of death that was higher than expected based on the U.S. general population. However, leukemia mortality was related to length of employment in engineering and maintenance jobs. A follow-up study reported that the death rate from leukemia through 1984 was greater than the U.S. rate, particularly among workers monitored for internal radiation contamination.

    A positive trend was reported for all cancers combined by level of cumulative external dose but not for leukemia. In the most recent study of deaths through 1990, none of the rates for the four causes of death reported, all causes of death combined, all cancers combined, lung cancer, and leukemia, was higher than the corresponding U.S. rates.

    A recent study of deaths through 1990 reported that radiation doses received after age 45 years strongly predict the all cancers combined mortality rate; an earlier X-10 study noted that employees age 65 years and older at exposure were at higher risk.

  • Mortality of Workers at a Nuclear Materials Production Plant at Oak Ridge (Y-12)
    The first study of Y-12 workers included 18,869 white males who ever worked at the plant and mortality through 1974 was identified. The second study was restricted to 6,781 men who worked at least 30 days with mortality through 1979. A third study was expanded to include 10,597 nonwhite workers and females with deaths through 1990. The death rate from lung cancer was higher than the U.S. rate in the most recent two studies. Analysis of deaths through 1979 did not confirm positive trends for any cause of death with either external or internal exposure to ionizing radiation although a weak trend was observed for lung cancer.

    During the early operation of the Y-12 plant from 1942-1947, a group of 694 male workers was exposed to phosgene gas on a chronic basis and 106 males and 91 females received acute exposures. A control group of 9,280 workers who also worked at Y-12 during the same era, but who did not have phosgene exposure, was also described. All groups were followed through the end of 1978 with particular interest in respiratory diseases and lung cancer. There was no evidence for increased mortality from respiratory diseases in this group.

  • Mercury Workers Health Studies
    Between 1953 and 1963 the Y-12 Plant used metallic mercury in a process to produce large quantities of enriched lithium. There were 5,663 workers categorized by exposure based on results of urinalysis data. Analysis of deaths through 1978 revealed no differences in the mortality patterns for mercury exposed workers as a whole, workers with the highest mercury exposures, and workers employed more than a year in a mercury process. A total of 502 mercury workers were also involved in a clinical neurology study. Clinical measurements revealed some deficiencies in neurological function particularly among those workers with the highest exposures, but these were not associated with the duration of exposure. A follow up study of 219 of the original subjects in the 1990s revealed that some neurologic effects were still detectable.

  • Morbidity and Mortality Among Workers Employed at a Uranium Gaseous Diffusion Facility at Oak Ridge (K-25)
    Studies of workers at K-25 found that white males had high rates relative to the U.S. general population for all causes of death; cancer of the respiratory system, particularly lung cancer; bone cancer; mental disorders; all respiratory diseases, particularly pneumonia; symptoms, senility, and ill-defined conditions; all external causes of death, particularly accidents and specifically motor vehicle accidents. White females had a high rate for symptoms senility, and ill-defined conditions.

    Powdered nickel was used at K-25 to produce the barrier material that separates and enriches uranium. Death rates for 814 nickel workers who made the barriers were compared to 1,600 controls. No differences in the death rates for the exposed and non-exposed workers by cause of death through 1972 were detected. A later study compared the mortality of the 814 nickel workers through 1977 and 7,552 non-exposed workers. There were no causes of death with a rate higher than the U.S. rate and no differences between exposed and non-exposed workers.

  • Follow-Up of Morbidity Study of Bladder Cancer and Chemical Exposures at K-25, Oak Ridge, Tennessee
    Epoxy resins and solvents were common exposures among K-25 gas centrifuge workers. In Phase I of a study of centrifuge workers, 263 workers with the most exposure were compared with 271 workers with no exposure at the plant during the same period. The centrifuge process workers reported five bladder cancers versus none reported by the non-centrifuge group. The standardized incidence rate ratio was 7.8 for process workers versus comparison workers. In Phase II of the study, a larger group, who had lower levels of exposure to the centrifuge process, was studied. One additional case was found in a centrifuge worker and two additional cases were found in maintenance workers who were assigned to work in centrifuge areas. An equal number of cases of bladder cancer were found in the comparison group in Phase II. A specific cause for the increase in bladder cancer was not identified.

  • Studies of Combined Oak Ridge Facilities (Tennessee Eastman Corporation, Y-12, X-10, K-25)
    Several studies have considered all ORR workers, the most recent one updated mortality through 1984. Mortality from all causes of death combined and all cancers combined were similar to overall U.S. rates. There were substantial differences in death rates among workers at the various ORR plants, particularly the rates for lung cancer, leukemia and other lymphatic cancer. Within the second study, data for 28,374 workers at X-10 and Y-12 were analyzed and positive trends were reported with increasing external radiation dose for all causes of death combined and all cancers combined.

    Three studies of brain cancer across the four ORR facilities have been published. The exposure analysis of 26 chemicals found that none were positively associated with brain cancer. No positive trends for brain cancer were found with increasing external radiation dose and internal dose as measured by the lung dose Although workers with brain cancer were more likely than other workers to have worked at ORR more than 20 years, there was no trend of increasing cancer with the number of years worked.

    Mortality data through 1974 and through 1989 were analyzed for about 1,059 white male welders at ORR. No death rates were higher than the U.S. rate through 1974. When deaths through 1989 were considered, welders bad higher rates of lung cancer, cancer of the prostate, and gastric ulcers. The risk of each cause was different among the facilities. The risk of lung cancer among welders exposed to nickel oxides did not differ from non-exposed welders.

  • Multi-Site Multiple Myeloma Case-Control Study
    A multi-site study of multiple myeloma deaths included workers from X-10. Although the death rate was not higher than expected, higher risks were encountered by workers whose radiation exposures occurred after age 45.

  • Childhood Leukemia Case-Control Study
    A study of the potential association between paternal exposure to ionizing radiation and risk of childhood cancer found no link between leukemia and paternal employment at ORR. Children whose fathers worked at the Hanford Nuclear Reservation were more likely to get CNS (central nervous system) cancer than children whose fathers worked at other sites, including ORR, but this finding was based on small numbers and was not statistically significant.

  • Cyanide Health Hazard Evaluation at K-25
    A NIOSH health hazard evaluation, requested by K-25 site employees, investigated possible worker exposure to cyanides. The evaluation indicated that employees are not occupationally exposed to hydrogen cyanide, cyanide salts, or a wide variety of other compounds that contain the cyanide ion.

  • The Oak Ridge National Laboratory, sponsored by a NIOSH grant, investigated statistical estimation of dose from daily and weekly dosimetry data for ORR radiation workers included in previous epidemiologic studies. The study found that diferences between the two methods were substantial, and recommended methods of reducing uncertainly for some estimates.

  • Improved Systems for Worker Exposure Surveillance
    The Oak Ridge Associated Universities, under a NIOSH grant, developed a project at ORR to develop a system for the prioritization of industrial hygiene and medical surveillance efforts. The Worker Exposure Surveillance System (WESS) was designed for easy data merger with traditional occupational health systems utilizing environmental level analyses, occupational titles, and area descriptors.

  • Work Histories Evaluating New Participatory Methods
    Exposure History for the Construction Trades (WHEP). The University of Cincinnati, under a NIOSH grant, created an exposure history for the construction trades at ORR, which was aimed at improving worker recall of complex occupational exposures across a large number of short-term workplace assignments. New techniques were used to establish guidelines and formats for personal work histories. This study has recently been completed and the results will be published in 2001.

  • Exposure Assessment of Hazardous Waste, Decontamination and Decommissioning, and Clean-up Workers----Phase I Feasibility Study
    Exposure assessment of hazardous waste, decontamination and decommissioning, cleanup workers (HAWW). Feasibility studies at seven DOE sites, including ORR, determined that the availability of records to identify workers and their primary activities, exposures, work histories, and medical information varied significantly from site to site. The necessary information to conduct exposure assessment, hazard surveillance, or epidemiology studies of remediation workers is currently not readily available. Within sites, data systems are fragmented and data management is inconsistent in the current environment of decentralized management and increased subcontracting.

  • Prevention of Stress and Health Consequences of Downsizing and Reorganization
    Prevention of stress and health consequences of downsizing (STDN). The effects of downsizing on organizational climate, worker health, and performance were studied at several DOE sites, including ORR. Data gathering included interviews, workplace observations, employee discussion groups, an employee survey distributed to more than 10,500 employees, and a historical record review. Researchers identified opportunities to reduce job stress that could lead to improved employee health and organizational well-being. Suggested intervention strategies were proposed for further research.

  • Mortality Among Female Nuclear Weapons Workers
    Study of mortality among female nuclear workers (MAFN). A study of female workers from 12 DOE plants, including ORR, was combined in a cohort mortality study, and risk estimates were developed for exposure to ionizing radiation or to chemical hazards. For the entire pooled cohort, mortality from mental disorders, diseases of the genitourinary system, and from ill-defined conditions was higher than expected. External ionizing radiation exposure in these workers appeared to be associated with increased relative risk for leukemia and, to a lesser degree, associated with increased relative risks for all cancers combined and for breast cancer.

  • Multiple Myeloma Case-Control Study at K-25 Plant
    DOE's epidemiologic surveillence assess the overall health of the current DOE work force at 14 DOE sites, including ORR (Y-12), Oak Ridge National Laboratory (X-10), and East Tennessee Technology Park (K-25). The goal is to identify groups of workers that may be at increased risk for occupation-related injuries.

  • Cohort Mortality Study of DOE Chemical Laboratory Workers
    An indendent panel of nationally recognized occupational health physicians is conducting individual medical evaluations to assess occupational health complaints and symptoms of 53 current an former Lockheed Martin Energy Systems workers at the East Tennessee Technology Park (formerly called the K-25 site). These medical evaluations include reviews of prior health studies; visits to workers' workplaces and surroundings; work history interviews with individual workers; reviews of worker medical records; physical examinations; and sepcialized follow-up inquiries and testing.

  • The DOE Beryllium Worker Medical Surveillance Program, which includes an intensive, coordinated health-risk communication effort, is designed to detect and diagnose chronic beryllium (CBD) among current and former workers exposed to beryllium throughout the DOE complex, including ORR. Information from this program is used to improve and evaluate worker protection and control measures, to monitor trends in CBD frequency, and to strengthen work planning to minimize worker exposures.

  • DOE's Former Worker Program is a pilot program designed to provide medical surveillance for selected former DOE workers at risk of work-related illness as a result of exposures while working at DOE facilities. The following projects are underway at ORR:

    • The former construction worders project is led by Dr. Eula Bingham of the University of Cincinnati in cooperation with the United Brotherhood of Carpenters Health and Safety Fund, the Center to Protect Workers' Rights, and Duke University Medical Center. The Phase I assessment identified approximately 800 former construction workers. Phase II will focus on medical screening of workers exposed to asbestos, beryllium, noise, silica, solvents, and heavy metals.

    • The project involving former production workers from the Oak Ridge K-25, Paducah, and Portsmouth gaseous diffusion plants is led by Dr. Steven Markowitz of Queens College, City University of New York, and Mr. Robert Wages of the Oil, Chemical, and Atomic Workers International Union, in cooperation with the University of Massachussetts at Lowell. The Phase I assessment identified approximately 1,260 former production workers as potentially at high risk. Phase II will focus on medical screening of workers exposed to asbestos, beryllium, bladder carcinogens, chlorinated solvents, flourine compounds, nickel, noise, silica, uranium, welding fumes, and heavy metals.

  • DOE plans to expand the Former Worker Medical Surveillance Program to Current workers and additional former workers at the three gaseous diffusion plants.

National Center for Environmental Health (NCEH)

The National Center for Environmental Health (NCEH) conducts environmental dose reconstructions, radiation epidemiology studies, and radiation risk analysis and communication at DOE sites.

Community Health Investigations and Activities

The NCEH conducted the following health strategies to evaluate reported illnesses afflicting residents in communities surrounding the Oak Ridge Reservation.

In 1983 the Tennessee Department of Health and Environment and the Centers for Disease Control and Prevention's (CDC) National Center for Environmental Health (NCEH) conducted a pilot survey in Oak Ridge in response to community concerns about mercury contamination in the East Fork Poplar Creek flood plain and the sewer line beltway. The pilot survey concluded that residents and workers in Oak Ridge are not likely to be at increased risk for having significantly high mercury levels. Mercury concentrations in hair and urine samples were below levels associated with known health effects.

In 1993 ATSDR and CDC facilitated laboratory support from the National Center for Environmental Health at CDC for clinical evalautions of selected patients who had been referred to Howard Frumkin, MD, DrPH, of the Emory University School of Public Health. Dr. Frumkin conducted individual clinical evaluations of the Oak Ridge physicians patients and did not report any hazardous substance exposure to public health agencies

According to the 1998 CDC health investigation of the Scarboro community, the results of the self-reporting health survey indicated elevated rates of asthma and wheezing. The asthma rate was 13% among children in Scarboro, compared to national estimates of 7% among all children aged 0-18 years, and 9% among African American children aged 0-18 years, which is less that the 14.5% Chicago rate. The wheezing rate among children in Scarboro was 35%, compared to international estimates of 1.6% to 36.8%.

No statistically significant association was found between exposure to common environmental triggers of asthma (e.g., tobacco smoke, pests, unvented gas stoves, and dogs or cats in the home) or potential occupational exposures (e.g., living with an adult who works at ORR or living with an adult who works with dust and fumes and brings exposed clothes home) and asthma or wheezing illness.

The physical examinations of 23 Scarboro children who were identified in the survey as possibly having asthma indicated that all were generally healthy and no urgent health problems were identified. Only one child had a lower respiratory illness, and none were wheezing at the time of the physical examination.

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This page last updated on February 16, 2005
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