1. Leukemia Case-Control Study

   Project Officer: Mary Schubauer-Berigan, Ph.D.

   Study Period: 1995-2006

   Summary:

   This multi-site case-control study will explore the relation between external radiation and leukemia risk. About 250 leukemia deaths have been identified at five DOE sites and Portsmouth Naval Shipyard when the vital status is updated through 1996. Confounding exposures to internal radiation, chemicals and electromagnetic fields will be evaluated for all cases and controls.

   Significance:

   This is a followup to recent positive findings of leukemia and radiation in cohort studies. It is the largest study of its kind ever done. The study design allows control of confounders. It is a companion to a study of multiple myeloma (hematopoietic cancer, also) conducted at the same sites. The study includes update of vital status of Hanford and Savannah River cohorts.

   Manuscripts:

   Daniels RD, Schubauer-Berigan MK [2005].  Bias and uncertainty of penetrating photon dose measured by film dosimeters in an epidemiologic study of US nuclear workers.  Radiat Prot Dosimetry., 113(3):275-289 NIOSHTIC-2 Abstract

   Daniels RD, Lodwick CJ, Schubauer-Berigan MK, Spitz HB [2005].  " Assessment of plutonium exposures for an Epidemiological study of US nuclear workers", Radiat Prot Dosimetry. 2005 Aug 4; 0144-8420 NIOSHTIC-2 Abstract

   Schubauer-Berigan MK, Wenzl TB. Leukemia mortality among radiation-exposed workers. Occup Med 2001 Apr-2001 Jun 30; 16(2):271-87. NIOSHTIC-2 Abstract

   Schubauer-Berigan MK, Daniels RD, Fleming D, Markey A, Couch J, Ahrenholz S, Burphy JL, Anderson J, Tseng C-Y [2007]. Risk of myeloid and acute leukemia mortality following exposure to ionizing radiation among workers at four U.S. nuclear weapons facilities and a nuclear naval shipyard, Radiat Res, Feb; 167(2):222-232. PDF Manuscript

   Anderson JL and Daniels RD [2006]. Bone marrow dose estimates from work-related medical X-ray examinations given between 1943 and 1966 for personnel from five U.S. nuclear facilities. Health Phys; 90(6):544-53.NIOSHTIC-2 Abstract

2. Multiple Myeloma Case-Control Study at the Oak Ridge Gaseous Diffusion Plant (K-25)

   Project Officer: James Yiin, Ph.D.

   Study Period: 1995-2006

   Summary:

   This case-control study of multiple myeloma deaths among workers at the Oak Ridge (K-25) gaseous diffusion plant complements the multisite, multiple myeloma study recently completed by the University of North Carolina. Exposures to multiple sources of external and internal ionizing radiation and chemicals are fully characterized in this study. The vital status of the K-25 cohort is being updated through 1998.

   Significance:

   This is the largest single-site study of multiple myeloma. The relatively large number of cases provides reasonable statistical power to evaluate a dose-response relationship in the presence of multiple exposures and potential confounders.

   Manuscripts:

   Anderson JL, Spitz HB, Yiin JH [2007]. Characterization of internal exposure to enriched uranium at a former gaseous diffusion plant. Health Phys, Dec;93(6):636-44. NIOSHTIC-2 Abstract

   Anderson JL, Spitz HB, Yiin JH [2007]. Estimating active bone marrow dose from occupational exposure to uranium at a former gaseous diffusion plant. Health Phys 93(2): 113-119. NIOSHTIC-2 Abstract

3. Cohort Mortality Study of Department of Energy (DOE) Chemical Laboratory Workers

   Project Officers: Travis Kubale, Ph.D.

   Study Period: 1996-2006

   Summary:

   In limited studies of chemical laboratory workers, an increased risk of cancer was reported. A cohort mortality study and exposure assessment of DOE chemical laboratory workers is being conducted. The sites selected include Savannah River and three facilities at Oak Ridge (X-10, Y-12, and K-25). To address sample size needs, a fifth site (Hanford) is under evaluation for inclusion. The exposures of interest include external ionizing radiation, internal radiation, and chemicals. SMR analysis and a dose response assessment will be conducted.

   Significance:

   The study addresses hazards outside the DOE complex, including chemical and mixed exposures. The study will advance our knowledge about cancer risks in chemical laboratory workers.

   Manuscripts:

   Henn SA, Utterback DF, Waters KM, Markey AM, Tankersley WG [2007]. Task- and time-dependent weighting factors in a retrospective exposure assessment of chemical laboratory workers. J Occup Environ Hyg, Feb; 4(2):71-9. NIOSHTIC-2 Abstract

4. Chronic Lymphocytic Leukemia (CLL)

   Project Officer: Sharon Silver, M.S.

   Study Period: 2004-2005

   Summary:

   CLL is commonly assumed to be non-radiogenic due to negative findings in studies of the atomic bomb survivors and in several large studies of patients treated therapeutically with radiation.  Thus, CLL is currently the only cancer assigned a probability of causation of 0 under the US Energy Employees Occupational Illness Compensation Program Act of 2000.  Recently, NIOSH received a Congressional mandate to further investigate the radiogenicity of CLL.  The systematic review project will examine the available literature, published and unpublished, to assess the epidemiologic evidence of a relationship between ionizing radiation and CLL.  Studies of occupationally exposed workers, including nuclear facility workers, nuclear test participants, radiologists/radiologic technologists, as well as studies of patients treated therapeutically with radiation, will be evaluated in the review.

   Significance:

   The findings of the systematic review may have indications for reconsideration of CLL as a compensable cancer.

   Manuscripts:

   Linet MS, Schubauer-Berigan MK, Weisenburger DD, Richardson DB, Landgren O, Blair A, Silver S, Field RW, Caldwell G, Hatch M, Dores GM. Chronic lymphocytic leukaemia: an overview of aetiology in light of recent developments in classification and pathogenesis. Br J Haematol. 2007 Dec;139(5):672-86. NIOSHTIC-2 Abstract

   Shim YK, Silver SR, Caporaso NE, Marti GE, Middleton DC, Linet MS, Vogt RF. B cells behaving badly. Br J Haematol. Dec 2007;139(5):658-62. NIOSHTIC-2 Abstract

   Silver SR, Hiratzka SL, Schubauer-Berigan MK, Daniels RD. Chronic lymphocytic leukemia radiogenicity: a systematic review. Cancer Causes Control. Dec 2007;18(10):1077-1093. Epub 2007 Aug 13. NIOSH [2005]. ]. NIOSHTIC-2 Abstract

   NIOSH [2005]. Report of Public Meeting to Seek Input on Gaps in Chronic Lymphocytic Leukemia (CLL) Radiogenicity Research Held July 21, 2004. Cincinnati, OH; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2006-100

5. Portsmouth Naval Shipyard (PNS) Lung Cancer Case-Control Study

   Project Officer: Sharon Silver, M.S.

   Study Period: 1995-2005

   Summary:

   This nested case-control study examines the relationship between lung cancer mortality and external exposure to ionizing radiation in civilian workers employed between 1/1/1952 and 12/31/1992 at the Portsmouth Naval Shipyard (PNS).  Additional data has been collected for potential confounders and effect modifiers such as asbestos and welding fume exposures and smoking.  The study findings will be submitted for publication in the peer-reviewed scientific literature.

   Significance:

   The long-term impact will be to determine if there is an association between occupational exposure to external ionizing radiation and lung cancer among PNS workers after accounting for confounders and effect modifiers such as sex, race, and exposure to asbestos, welding fume, and smoking; to compare the patterns of smoking among radiation-monitored workers and workers not monitored for radiation, where smoking data are available.

   Manuscripts:

   Yiin JH, Silver SR, Daniels RD, Zaebst DD, Seel EA, and Kubale TL [2007]. A nested case-control study of lung cancer risk and ionizing radiation exposure at the Portsmouth Naval Shipyard. Radiat Res, Sep; 168(3):341-348 NIOSHTIC-2 Abstract

   Seel E, Zaebst D, Hein M, Liu J, Nowlin S, Chen P [2007]. Inter-rater agreement for a retrospective exposure assessment of asbestos, chromium, nickel and welding fumes in a study of lung cancer and ionizing radiation. Ann Occup Hyg. 2007 Oct;51(7):601-10. Epub 2007 Sep 10. NIOSHTIC-2 Abstract

   Daniels RD, Yiin J [2006]. A comparison of statistical methods for estimation of less than detectable ionising radiation exposures. Radiat Prot Dosimetry; 121(3):240-251. NIOSHTIC-2 Abstract NIOSHTIC-2 Abstract

6. Cohort Mortality Study of Fernald Environmental Management Plant (FEMP)

   
   K-65 No. 3 dust collector removal at Fernald. Fernald, Ohio. Date unknown. Photo courtesy of the U.S. Department of Energy.

   Project Officer: James Yiin, Ph.D.

   Project Period: 1998-2006

   Summary:

   This study is updating the mortality status of Fernald workers through 1998, and expanding the cohort to include females and all races. Additionally, NIOSH will conduct a retrospective exposure assessment for external and internal radiation, radon, asbestos, uranium dust, and acid mists. A previous cohort mortality study found a statistically significant excess of lung cancer mortality among hourly workers (SMR=1.26), and a statistically significant excess of stomach cancer among salaried workers (SMR=2.61). Dose-response associations were seen between lung cancer and external radiation exposure, and between nonmalignant respiratory disease and internal exposure.

   Significance:

   This study is an update of a previous cohort study (increased latency). It includes an underrepresented populations (women and nonwhite men) and additional assessments of chemical and physical hazards (radon, uranium dusts, asbestos, and acid mists).

Extramural Research (Grants)

1. Health Effects of Occupational Exposures in Paducah Gaseous Diffusion Plant Workers

   Grantee: University of Louisville/University of Kentucky (David J. Tollerud , MD, MPH - University of Louisville )

   Award Period: 2002-2008

   Summary:

   The objective of this research is to assess the impact of Paducah Gaseous Diffusion Plant (PGDP) operations upon the health of the PGDP workforce. The primary function of the Paducah Gaseous Diffusion Plant (PGDP) has been to produce enriched uranium for use by commercial reactors or as feed material for other plants that further enrich the uranium. Workers, government officials, and the surrounding community have raised concerns about potential health effects from current and past exposures at the plant. The proposed studies will develop new information to help address these concerns.

   Significance:

   Worker mortality studies have been conducted at the two other uranium enrichment facilities (gaseous diffusion plants or GDPs) within Department of Energy (DOE) . This workforce is the one remaining GDP workforce for which a mortality study has not been conducted.

2. Stochastic Models for Radiation Carcinogenesis: Temporal Factors and Dose-Rate Effects

   Grantee: Fred Hutchinson Cancer Center/University of Washington (Suresh H. Moolgavkar , Ph.D.)

   Award Period: 2002-2005

   Summary:

   Current radiation protection standards are based largely on the experience of the cohort of A-bomb survivors. An important question, however, is whether the risks estimated in a Japanese war-time population exposed to instantaneous radiation can be transported to contemporary western populations exposed typically to protracted radiation in the workplace or elsewhere. Can such inconsistencies be resolved? The main goals of these analyses are to explore the effects of various age- and time-related factors and of protraction of exposure on the risk of radiation carcinogenesis.

   Significance:

   This research will influence radiation protection standards that are based largely on the experience of the cohort of A-bomb survivors. Whether the risks estimated in a Japanese war-time population exposed to instantaneous radiation can be transported to contemporary western populations exposed typically to protracted radiation in the workplace or elsewhere.

   Manuscripts:

   Hazelton WD, Moolgavkar SH, Curtis SB, Zielinski JM, Ashmore JP, Krewski D [2006]. Biologically based analysis of lung cancer incidence in a large Canadian occupational cohort with low-dose ionizing radiation exposure, and comparison with Japanese atomic bomb survivors. J Toxicol Environ Health A. Jun;69(11):1013-38. NIOSHTIC-2 Abstract

   Shin H, Ramsay T, Krewski D, Zielinski JM [2005]. The effect of censoring on cancer risk estimates based on the Canadian National Dose Registry of occupational radiation exposure. J Expo Anal Environ Epidemiol. Sep;15(5):398-406. NIOSHTIC-2 Abstract

   Meza R, Luebeck EG, Moolgavkar SH [2005]. Gestational mutations and carcinogenesis. Math Biosci Oct;197(2):188-210. NIOSHTIC-2 Abstract

   Zielinski JM, Garner MJ, Krewski D, Ashmore JP, Band PR, Fair ME, Jiang H, Letourneau EG, Semenciw R, Sont WN [2005]. Decreases in occupational exposure to ionizing radiation among Canadian dental workers. J Can Dent Assoc. Jan;71(1):29-33. NIOSHTIC-2 Abstract

   Heidenreich WF, Luebeck EG, Moolgavkar SH [2004]. Effects of exposure uncertainties in the TSCE model and application to the Colorado miners data. Radiat Res Jan;161(1):72-81. NIOSHTIC-2 Abstract

3. Susceptibility and Occupational Radiation Risks

   Grantee: University of North Carolina (David Richardson, Ph.D.)

   Award Period: 2002-2005 ( received application for extension)

   Summary:

   Epidemiological studies of U.S. nuclear weapons workers allow evaluation of the effects of low dose, low dose rate radiation exposures accrued in an environment of mixed radiological and non-radiological exposures associated with the Department of Energy (DOE) weapons complex. Researchers will investigate differences between workers in the carcinogenic effects of exposures accrued at the Savannah River Site (SRS). Mechanistic models of carcinogenesis suggest that initiating exposure to some non- radiologic carcinogens may modify the effects of subsequent ionizing radiation exposures.

   Significance:

   Study results for this large DOE cohort will be evaluated in relation to observations from studies of other DOE facilities. Study data will be compiled in a manner that will facilitate future pooled analyses. In this way, the proposed work will substantially strengthen the available epidemiological information about low level radiation effects in DOE cohorts.

   Manuscripts:

   Richardson DB, Wing S, Wolf S [2007]. Mortality among workers at the Savannah River Site. Am J Ind Med. 2007 Oct 4; [Epub ahead of print] NIOSHTIC-2 Abstract

   Richardson DB and Wing S [2007]. Leukemia mortality among workers at the Savannah River Site. Am J Epidemiol. Nov 1;166(9):1015-22. Epub 2007 Jul 27. NIOSHTIC-2 Abstract

   Richardson DB [2006]. The impact on relative risk estimates of inconsistencies between ICD-9 and ICD-10. Occup Environ Med. Nov;63(11):734-40. NIOSHTIC-2 Abstract

   Richardson DB [2006]. Use of multiple causes of death data in cancer mortality analyses. American Journal of Industrial Medicine. Am J Ind Med. Aug;49(8):683-9. NIOSHTIC-2 Abstract

   Richardson DB, Wing S, Daniels RD [2006]. Evaluation of external radiation dosimetry records at the Savannah River Site,1951-1989. J Expo Sci Environ Epidemiol. 2006 Jun 28; [Epub ahead of print]. NIOSHTIC-2 Abstract

4. Radon and Cigarette Smoking Exposure Assessment in Fernald Workers

   Grantee: University of Cincinnati (Susan Pinney, Ph.D.)

   Award Period: 1999-2002

   Summary:

   This study proposes to develop yearly and cumulative individual radon exposure estimates for Fernald workers using a variety of data resources. Exact work location for about 2,500 workers can be assigned using data from occupational history interviews collected previously. Site information will be used to determine work location for others. Smoking history information from an ongoing medical surveillance program will be extended to living workers not enrolled. Surrogate data will be collected from family members of the deceased. Risk estimates for lung cancer will then be calculated for the Fernald workers.

   Significance:

   A previous mortality study of this cohort reported a significant excess risk of lung cancer deaths among hourly workers. Detailed assessment of occupational radon exposure in this cohort, along with the collection of smoking history, will improve future risk assessments.

   Manuscripts:

   Hornung RW, Pinney SM, Lodwick J, Killough GG, Brewer DE, Nasuta J [2008]. Estimation of radon exposures to workers at the Fernald Feed Materials Production Center 1952-1988. J Expo Sci Environ Epidemiol; doi:10.1038/sj.jes.7500645 [Epub ahead of print] NIOSHTIC-2 Abstract

   Woo JG, Pinney SM [2002]. Retrospective smoking history data collection for deceased workers: completeness and accuracy of surrogate reports. J Occup Environ Med, 44(10):915-23.