NIOSH/OERP: Completed NIOSH-Initiated Research

Completed NIOSH-Initiated Research

Multi-Site Multiple Myeloma Case-Control Study

Contractor:: University of North Carolina (Steven Wing, Ph.D.)
Award Period:: 1993-1997
Summary:: This multisite case-control study focused on external radiation and chemical exposures at five DOE sites: Savannah River, Los Alamos National Laboratory, Los Alamos National Laboratory-Zia, Oak Ridge National Laboratory, and Hanford. Ninety-eight workers who died from multiple myeloma and 391 age-matched controls were selected from the combined roster of 115,143 workers hired before 1979. These workers were followed for vital status through 1990 (1986 for Hanford). Cases were disproportionately African-American, male, and hired before1948. Although an association between multiple myeloma and cumulative whole body ionizing radiation dose was not observed, external penetrating radiation doses received at age 45 and above were associated with multiple myeloma.
Manuscript:: Wing S, Richardson D, Wolf S, Mihlan G, Crawford-Brown D, Wood J [2000]. A case control study of multiple myeloma at four nuclear facilities. Ann Epidemiol 10: 144-153. PDF version of report: pages 1-50 (6566KB); pages 51-100 (3416KB); pages 101-150 (5744KB); pages 151-202 (4283KB).
Significance:: This study complements the HERB intramural leukemia case-control study being done at the same sites and the myeloma case-control study with internal radiation exposure at the Oak Ridge Gaseous Diffusion Plant (K-25). The role of age at exposure in ionizing radiation studies was examined.

Mercury Workers Health Study

Contractor:: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)
Award Period:: 1993-1996
Summary:: This is a followup study of neurologic health outcomes in workers exposed to elemental mercury at the Y-12 Plant (Oak Ridge) between 1953-1966. Neurologic effects of relatively heavy exposure to mercury were still detectable more than 30 years after exposure ceased. 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. Study participants were notified of their individual results, overall study results were presented to a labor-management group in April 1997, and a technical report was prepared for NIOSH at the end of the study.
Manuscript:: Departments of Behavioral Sciences and Health Education and of Environmental and Occupational Health; Rollins School of Public Health of Emory University, and The Center for Epidemiologic Research Environmental and Health Sciences Division; Oak Ridge Associated Universities, [Undated]. A study of the health effects of exposure to elemental mercury: a followup of mercury exposed workers at the Y-12 plant in Oak Ridge, Tennessee. (DHHS Contract 200-93-2629, Final Technical Report.) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH,134 pg. PDF version available. (5119KB)
Significance:: This morbidity study of noncancer neurologic outcomes associated with chemical exposure is applicable to surveillance efforts.

Historical Plutonium Bioassay Measurements

Contractor:: New York University (Norman Cohen, Ph.D.)
Award Period:: 1993-1995
Summary:: 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.
Significance:: This study includes an analysis and is needed for internal exposure assessment of plutonium.

Accounting for Errors in Radiation Dose Estimates

Grantee:: Battelle Pacific Northwest Laboratories (Ethel Gilbert, Ph.D.)
Award Period:: 1994-1996
Summary:: This study developed an approach to accounting for random uncertainties in estimates of cumulative external dose and applied the model to Hanford data. The analysis included evaluation of photon energy, angle of photon incidence, and different dosimeter designs. The effect of these factors on estimates of organ dose and on dose-response analysis in epidemiology studies was also evaluated.
Manuscript:: Gilbert E, Fix JJ, Baumgartner WV [1996]. An approach to evaluating bias and uncertainty in estimates of external dose obtained from personal dosimeters. Health Physics 70 (3):336-345.
Significance:: Uncertainty analysis; accounting for bias in external dose estimates.

Cohort Mortality Study of Portsmouth Gaseous Diffusion Plant, Piketon, Ohio

Investigator:: NIOSH intramural study (Project officer: Robert Rinsky, Ph.D.)
Study Period:: 1992-2001
Summary:: The mortality of workers at Portmouth Gaseous Diffusion Plant was updated through 1992. Radiation exposure assessments were performed for internal and external ionizing radiation, certain chemicals, and electromagnetic fields. No significantly elevated standardized mortality ratios (SMRs) were observed for overall or specific causes of death. Case-control analyses of lung, lymphoma, hematopoietic, and stomach cancers and exposures to internal soluble alpha dose, fluorines, nickel, and uranium were done.
Manuscript:: NIOSH [2001]. Mortality patterns among uranium enrichment workers at the Portsmouth Gaseous Diffusion Plant Piketon, Ohio. Final Technical Report. Cincinnati, OH: U.S. Department of Health and Human Services; Public Health Service; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Division of Surveillance, Hazard Evaluations and Field Studies; Health-related Energy Research Branch, 179 pg. PDF version available (1140 KB) Summary report (61 KB)
Significance:: This study, initiated by a response to a congressional request, assessed lung cancer in this previously studied cohort and extensive exposure assessment for chemicals and radiation were completed.

Feasibility Study of Assessing Adverse Reproductive Outcomes Among Females Employed at DOE Facilities

Cafeteria. Idaho National Engineering and Environmental Laboratory, Idaho Falls, Idaho. 1957. Photo courtesy of the U.S. Department of Energy.

Investigator:: NIOSH intramural study (Project officer: Barbara Massoudi, Ph.D.)
Study Period:: 1995-1996
Summary:: The feasibility of conducting a retrospective cohort study of adverse reproductive outcomes among women employed at DOE sites depends on four factors: (1) availability of an appropriate study population; (2) a valid case definition and means of ascertainment; (3) exposure to the agent(s) in question and sufficient information to characterize such exposure; (4) and adequate sample size to demonstrate an effect. To address these issues, several sources of data were collected and evaluated by NIOSH investigators. Data obtained on women who worked at 20 previously studied DOE sites included demographic characteristics, radiation monitoring data, and vital status. Information was collected on birth defects registries in states near DOE facilities. Assembly of a cohort of female DOE workers to examine clinically recognized outcomes such as miscarriage and birth defects would be difficult. However, other study designs to assess reproductive health in the DOE workforce may be feasible.
Manuscript:: Massoudi BL [1996]. Adverse reproductive outcomes among females employed at Department of Energy facilities: The feasibility of epidemiologic studies. Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH. [Final Report] Unpublished. 18 pg. PDF version available (2175KB)
Significance:: This feasibility assessment addresses issues relevant to current women workers and noncancer outcomes.

Childhood Leukemia Case-Control Study

Installing reactor vessel. Idaho National Engineering and Environmental Laboratory, Idaho Falls, Idaho. Date unknown. Photo courtesy of the U.S. Department of Energy.

Awardee:: Batelle Laboratories (Lowell Sever, Ph.D.)
Award Period:: 1992-1997
Summary:: This case-control study assessed the potential association between paternal exposure to ionizing radiation and risk of leukemia in offspring, a finding observed in Sellafield, England by Gardner et al. (1990). The study follows up on previous findings of birth defects (Central nervous system [CNS] tumors) at Hanford. The study, initiated at the Hanford Site, was expanded to Oak Ridge and Idaho National Engineering and Environmental Laboratory, and included non-Hodgkin's lymphoma and central nervous system CNS tumors as outcomes. The study found no evidence of a link between childhood cancer risk and father's radiation work at the DOE sites included in the study. This finding did not change if each site was looked at alone or all together. A much weaker finding that relates only to Hanford children was noted. Children whose fathers worked at Hanford were more likely to get CNS cancer than children whose fathers worked at the other sites. However, this finding was not statistically significant and was based on a small number of cases. The study was completed in November 1997; communication of results to workers and management at the sites studied occurred in October 1998.
Manuscript:: Sever LE, Gilbert ES, Tucker K, Greaves J, Greaves C, Buchanan J [1997]. Epidemiologic evaluation of childhood leukemia and paternal exposure to ionizing radiation. Seattle, WA: Battelle Memorial Institute; (CDC Cooperative Agreement U50/CCU012545-01, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 51 pg. PDF version available (3045KB)
Significance:: Three other studies since the report of the results for Sellafield have not shown an increase in childhood cancers among children whose fathers were exposed to radiation before their child's conception. This NIOSH-sponsored study agrees with and supports those study findings.

Time-Related Factors in Radiation-Cancer Dose Response

Grantee:: University of North Carolina (Steven Wing, Ph.D.; David Richardson, Ph.D.)
Award Period:: 1996-1997
Summary:: This study expanded, updated and re-analyzed a cohort of workers at the Oak Ridge National Laboratory, that was originally analyzed by Checkoway. The cohort included persons employed at Oak Ridge National Laboratory between 1943 and 1972. Special emphasis was given to the associations between radiation, cancer, and time-related factors including age-at-exposure, latency, and time since exposure. Evidence was found of a stronger dose response association between exposure and cumulative dose received at older ages.
Manuscript:: Richardson DB, Wing S [1998]. Methods for investigating age differences in the effects of prolonged exposures. Am J Ind Med 33:123-130.
Significance:: Dose received after age 45 is strongly predictive of all-cancer-combined mortality as well as lung cancer, which has implications for future occupational epidemiologic research and exposure standards.

Dose Estimation from Daily and Weekly Dosimetry Data

Grantee:: Oak Ridge National Laboratory (George Ostrouchov, Ph.D.)
Award Period:: 1997-1998
Summary:: Statistical methods were used to estimate distributions of external radiation exposures for workers included in epidemiology studies at the Oak Ridge National facilities. The method took into account measurement errors from film badge and pocket meter systems, from recording left-censored doses as zeros, and from other practices and policies. The amount of bias in previously used estimates of exposure was substantial, although incorporation of the daily pocket chamber readings reduced uncertainty in some estimates but increased it in others.
Manuscript:: Ostrouchov G, Frome EL, Kerr GD [1998]. Dose estimation from daily and weekly dosimetry data. Oak Ridge, TN: Oak Ridge National Laboratory; (CDC-NIOSH Grant RO1 OH12956, Final Draft.) 38 pg. PDF version available (4277KB)
Significance:: This study involved exposure assessment methods development and uncertainty analysis for external radiation exposure estimates used in previous and current studies of workers at Oak Ridge facilities.

Cohort Mortality Study of Workers at Fernald Feed Materials Production Center

Feed Materials Production Center (FMPC). Fernald, 20 miles outside Cincinnati, Ohio. January 1, 1987. Photo courtesy of the U.S. Department of Energy.

Contractor:: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)
Award Period:: 1992-1997
Summary:: Mortality patterns were examined for 4,014 white males hired at the Fernald Feed Materials Production Center between 1951 and 1981. Vital status ascertainment through 1989 found 1,064 deaths among this population. Exposure estimates were developed for internal radiation, because of the potential for exposure to uranium dust and for external ionizing radiation. Although salaried workers showed a healthy worker effect, a significant increase for stomach cancer deaths was found in this subcohort. Hourly workers did not demonstrate a healthy worker effect and had excess mortality from all cancers, lung cancer, and motor vehicle injuries. For all workers, chronic non-malignant respiratory disease showed a positive dose-response relationship with internal exposure. These findings were produced without controlling for other lung carcinogens that were likely present in the work environment, such as radon and other chemicals.
Manuscript:: Cragle DL, Watkins JP, Ingle JN, Robertson-Demers K, Tankersley WG, West CM [1995]. Mortality among a cohort of white male workers at a uranium processing plant: Fernald feed materials production center, 1951-1989. Oak Ridge, TN: Center for Epidemiologic Research, Oak Ridge Institute for Science and Education. Unpublished. 29 pg.
Significance:: This assessment of a previously unstudied cohort complements Mallinckrodt studies and includes exposure assessment for both internal and external radiation.

Cohort Mortality Study of Workers at Savannah River Plant

L-Reactor Facility. L Area, Savannah River Site, South Carolina. September 16, 1982. Photo courtesy of the U.S. Department of Energy.

Contractor:: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)
Award Period:: 1992-1997
Summary:: A cohort mortality study of 9,757 white male workers at the Savannah River site employed between 1952 and 1974 reported 1,722 deaths, with followup complete through 1986. A strong healthy worker effect was noted in the SMR analysis, with no significant excesses noted. However, when trend tests were performed by external dose category, a significant positive dose-response relation was observed for external radiation and leukemia mortality when doses were lagged 2 years. The estimated for excess relative risk per Sievert for leukemia mortality was 13.61, which is consistent with the estimates derived for the Canadian (19.0 per Sievert) and Sellafield (13.92 per Sievert) populations. A draft final report was prepared for NIOSH in 1996.
Manuscript:: Cragle D [1998]. Mortality among workers at the Savannah River nuclear fuels production facility. In: ASA 1998 proceedings of the section on statistics in epidemiology. Alexandria, VA: American Statistical Association, pp. 83-87.
Significance:: This cohort, included in the leukemia case-control study, demonstrated a significant dose-response for leukemia. Both internal and external radiation exposures were evaluated.

Mine Specific Exposure Information for Uranium Miners Study

Investigator:: NIOSH intramural study (Project officer: Mark Methner, Ph.D.)
Study Period:: 1998-1999
Summary:: Additional mine-specific assignment of exposure levels identified in historic records were entered into a database and delivered to the principal investigator on the Measurement Error Methods for Underground Miner Studies. The data will be used to examine exposure measurement errors 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.
Manuscript: Methner MM, Feng AH, Utterback DF [2001]. Use of Historical Uranium Air Sampling Data to Estimate Worker Exposure Potential to Airborne Radioactive Particulate in a Uranium Processing Facility. Appl Occ and Env Hyg Vol 16(12): pp. 1150-1157.
Significance:: Lung cancer risks identified for underground uranium miners exposure to radon have been used extensively for setting residential and occupational exposure limits.

Assessment of Electric and Magnetic Field Exposures of Transportation Workers

Project Officer:: NIOSH intramural study (Project officer: Thurman Wenzl, Sc.D.)
Study Period:: 1996-2000
Summary:: Personal exposures to power-frequency magnetic fields were measured among airline employees and employees of a municipal electric bus system. Among the bus workers, only electricians and those assigned to work downtown (including police and supervisors) had elevated average exposures; the downtown exposures appeared to be due to various sources not necessarily related to the electric bus. Among airline maintenance and ground personnel system, only maintenance supervisors had slightly elevated exposures. Agents working on reservations and at ticket counters had exposures equivalent to typical magnetic fields.
Manuscripts:: Kaune WT [1999]. Study of occupational magnetic-field personal exposures of non-flying airline employees. Richland, WA: EM Factors; (CDC NIOSH Contract 200-94-2837, Contractor report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 52 pg. PDF version available (1105KB); Factors EM [1999]. Study of occupational magnetic-field personal exposures associated with Seattle metro transit's electric trolley system. Richland, WA: EM Factors; (CDC NIOSH Contract 200-94-2837, Contractor report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 67 pg. PDF version available (2753KB)
Significance:: Since little is known of workers' magnetic field exposures outside of electric utilities, these measurement surveys have clarified that few of these transport workers have elevated exposures.

Cohort Mortality Study of Pantex Plant, Amarillo, Texas

Project Officer:: NIOSH intramural study (Project officer: Sharon Silver, MS)
Study Period:: 1996-2005
Summary:: 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 was updated through 1995. An SMR analysis with examination of dose-response was conducted; however, it was not possible to update exposure information for the cohort (duration of employment was used as a surrogate for dose). A decision to return to the facility to conduct an updated analysis is pending.
Manuscript:: Silver SR, Anderson-Mahoney P, Burphy J, Hiratzka S, Schubauer-Berigan MK, Waters KM [2005]. Mortality Update for the Pantex Weapons Facility: Final Report (NIOSH Intramural Study). Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 31 pgs. PDF version available. Summary Report.
Significance:: Pantex is an operating facility that had not been downsized. Similar exposures will be encountered by current and future workers.

Cancer Incidence and Sentinel Event Registries

Project Officer:: NIOSH intramural study (Project officer: Sara Foster, M.P.H.)
Study Period:: 1998-2000
Summary:: Because a standardized national registry system does not exist in the United States, incidence-based studies often depend on State disease registries. This project examined population-based State cancer and sentinel event registries to determine the feasibility and suitability of these registry systems for occupational studies. Information was collected from statewide cancer registries in 16 States of sixteen states containing DOE sites and those in the immediately adjacent States. Despite limitations in state-wide cancer registry systems, it is feasible to use many statewide registries for occupational health studies.
Manuscript:: Foster S, Espinoza R [ 2000]. Cancer incidence and sentinel event registries. Cincinnati, OH: National Institute for Occupational Safety and Health/Health-Related Energy Research Program. [Final draft report] Unpublished. 107 pg.
Significance:: This study will help researchers design incidence and morbidity studies near DOE sites.

Prevention of Stress and Health Consequences of Downsizing and Reorganization

Awardee:: Boston University (Lew Pepper, M.D.)
Award Period:: 1995-2000
Summary:: 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. In this multisite project, five DOE sites (Idaho National Engineering and Environmental Laboratory, Los Alamos National Laboratory, Nevada Test Site, Oak Ridge Y-12 Plant, and Pantex) were selected to study the effects of downsizing on organizational climate, worker health, and performance. Data gathering included interviews, workplace observations, employee discussion groups, an employee survey distributed to more than10,500 employees, and a historical record review. Fore each downsizing organization, researcher 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.
Manuscript:: Pepper L [2000]. The Health effects of downsizing in the nuclear industry: findings at the Idaho National Engineering and Environmental Laboratory. Boston, MA: Department of Environmental Health, Boston University School of Public Health; (CDC Cooperative Agreement U60 CCU 112215, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 129 pg. PDF version available (501KB); Pepper L [2000]. The Health effects of downsizing in the nuclear industry: findings at the Los Alamos National Laboratory. Boston, MA: Department of Environmental Health, Boston University School of Public Health; (CDC Cooperative Agreement U60 CCU 112215, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 135 pg. PDF version available (537KB); Pepper L [2000]. The Health effects of downsizing in the nuclear industry: findings at the Nevada Test Site. Boston, MA: Department of Environmental Health, Boston University School of Public Health; (CDC Cooperative Agreement U60 CCU 112215, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 125 pg. PDF version available (527KB); Pepper L [2000]. The Health effects of downsizing in the nuclear industry: Pantex. Boston, MA: Department of Environmental Health, Boston University School of Public Health; (CDC Cooperative Agreement U60 CCU 112215, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH, 133 pg. PDF version available (470KB); Pepper L [2000]. The Health effects of downsizing in the nuclear industry: findings at the Y-12 Plant, Oak Ridge Reservation. Boston, MA: Department of Environmental Health, Boston University School of Public Health; (CDC Cooperative Agreement U60 CCU 112215, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 129 pg. PDF version available (532KB)
Significance:: This psychosocial morbidity study is relevant to current and future workers, and could be used as the basis of future intervention or surveillance efforts.

Mortality Among Female Nuclear Weapons Workers

Grantee:: State University of New York (Gregg Wilkinson, Ph.D.)
Award Period:: 1994-2000
Summary:: Although 80,000 female workers have been employed at DOE facilities over the years, the small numbers of female workers at any one facility has limited their inclusion in previous health studies. Female workers from 12 DOE plants were combined in this cohort mortality study. Risk estimates were developed for exposure to ionizing radiation or to chemical hazards. A strong healthy worker effect was demonstrated for all causes of death among these workers. 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 suggestively associated with increased relative risks for all cancers combined and for breast cancer.
Manuscript:: Wilkinson GS, Trieff, N, Graham, R [2000]. Study of mortality among female nuclear weapons workers. Buffalo, NY: Department of Social and Preventative Medicine, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York; (DHHS Grant Numbers: 1R01 OHO3274, R01/CCR214546, R01/CCR61 2934-01, Final Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 447 pg. PDF version available (1053KB)
Significance:: The first multisite mortality study of women workers at DOE facilities.

Glycophorin A Biodosimetry in I-131 Treated Patients

Grantee:: University of Pittsburgh (William L. Bigbee, Ph.D.)
Award Period:: 1994-1999
Summary:: This research evaluated the in vivo glycophorin A-based somatic cell mutation assay as a retrospective biodosimeter for use in epidemiologic studies. The response of the assay as a biodosimeter of radiation exposure was investigated in a longitudinal study of patients receiving I-131 therapy for thyroid disease. Assessment of the glycophorin A assay in this project demonstrated that the biological response recorded by the glycophorin A assay is substantially reduced for low dose/low dose rate radiation exposures compared to that observed for acute exposures. The assay appears to be sensitive only to exposures exceeding 50 cSv.
Manuscript:: Bigbee WL, Brown ML, Burmeister LA, Carty SE, Swanson D, Watson CG [1998]. Glycophorin A (GPA) biodosimetry in I-131 treated patients. Center for Environmental and Occupational Health and Toxicology; Department of Environmental and Occupational Health; Graduate School of Public Health; University of Pittsburgh, Pittsburgh, PA. (DHHS Grant 5 RO1 OH03276, Final performance report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 36 pg. PDF version available (2171KB)
Significance:: This research evaluated a biomarker of radiation exposure.

Specificity of the National Death Index and the Social Security Administration Death Master File When Information on Social Security Number is Lacking

Project Officer:: NIOSH intramural study (Project officer: Mary Schubauer-Berigan, Ph.D.)
Study Period:: 1999-2000
Summary:: Epidemiologic researchers rely on the National Death Index and the Social Security Administration (SSA) Death Master File for ascertainment of vital status. This study evaluated the specificity of name and date of birth in ascertaining deaths through the National Death Index and the SSA Death Master File, and the sensitivity of this information for the latter. The sensitivity and specificity of the SSA Death Master File were 86.92% and 98.62%, respectively. The comparable specificity for the National Death Index was 99.51%. Specificity increased when more complete identifying information was used, and was higher for persons with uncommon names. When name and date of birth are used to ascertain vital status from national databases, specificity and sensitivity vary with the accuracy and completeness of these identifiers.
Manuscript:: Foster SO, Schubauer-Berigan MK, Waters KM [ 2000]. The specificity of the National Death Index and Social Security Administration Death Master File when information on Social Security Number is lacking. (In press).
Significance:: This methods study outlines ways for researchers to achieve accurate vital status ascertainment with incomplete information.

Exposure Assessment of Hazardous Waste, Decontamination and Decommissioning, and Cleanup Workers - Phase I

Recovery or placement of waste storage drums in shallow earth site. Idaho National Engineering and Environmental Laboratory, Idaho Falls, Idaho. 1979. Photo courtesy of the U.S. Department of Energy.

Project Officer:

Greg Kinnes, M.S.

Study Period:

5/1/96 - 12/1/2000

Summary:

Some remediation workers who have worked at DOE sites cannot be identified. Complete rosters of current and former remediation workers do not exist. Reconstruction of rosters from multiple data sources at the sites is labor intensive and may exclude some groups of workers.

Accurate and complete exposure, work history, and medical records data are not available for this population. Although radiation exposure records appear to be complete, decentralized responsibility for chemical exposure assessment and other records has led to gaps in exposure, work history, and medical data.

Individual workers cannot consistently be linked to their exposure and medical data. The storage of data and records in hard copy format, on incompatible software platforms, and on media produced by now obsolete hardware has diminished the ability to identify workers and link them with their work history, exposure, and medical data. The failure to standardize data collection and archiving both within and among DOE sites will hinder linkage of individuals to their data.

At the present time the necessary information to conduct epidemiologic, exposure assessment, or hazard surveillance studies of remediation workers is not available. The absence of worker rosters, the difficulty of creating such rosters with currently available data, gaps in work history, exposure, and medical data, and data linkage problems limit the ability to conduct accurate and comprehensive studies of remediation workers.

Manuscript:

Silver SR, CF Robinson, Kinnes G, Taulbee T, Ahrenholz S [2000]. Evaluation of data for DOE site remediation workers. (NIOSH Intramural Study, Final Report) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH, 37 pg. PDF version available (168KB)

Significance:

This study addresses exposures to current workers assesses feasibility of tracking workforce for future studies evaluates mixed exposures and supports surveillance activities.

Study of Heat Stress and Performance in Carpenters at DOE Sites

Grantee:: United Brotherhood of Carpenters Health and Safety Fund (Kenneth Rosenman, M.D.)
Award Period:: 9/30/95 - 9/29/00
Summary:: 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.
Manuscript:: Rosenman KD, Gardiner J, Cameron W, Anger KW [2000] United Brotherhood of Carpenters Health and Safety Fund. (DHHS Grant 5 R01 CCR311859, Final performance report.) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, Ohio, 76 pg.
PDF copies: Final report (26 KB), Appendix I, Instruction Manual for Testing (2575 KB), Appendix II, Baseline Medical Questionnaire (82 KB), Appendix II, Pre-Shift Questionnaire (33 KB), Appendix II, Mid-Shift Questionnaire (67 KB), Appendix II, Post-Shift Questionnaire (69 KB), Appendix III, Consent Form (34 KB), Appendix IV, Outline of Data Analysis (72 KB), Appendix V, Add-On Study of mRNA (148 KB)
Significance:: This is a nonradiation and nonmortality study. It is applicable to current workers to a preponderance of work at DOE sites and applicable to surveillance.

Acute Radiation Syndrome in Russian Nuclear Workers

Grantee:: University of Pittsburgh (Neil Wald, M.D.)
Award Period:: 12/1/1996-5/1/2002
Summary:: The purpose of this study, performed in collaboration with the Russian Southern Urals Biophysics Institute, was to facilitate the acquisition of diagnostic and prognostic information to help nonexpert medical and paramedical personnel with the early recognition of acute radiation syndrome in hospital and field conditions. The study used data from 59 acute radiation syndrome cases that occurred from 1948 to 1953 among workers at the Mayak nuclear facilities in Russia.
Significance:: This is a noncancer study that involves international collaboration.
Manuscript:: Wald N, Day R, Shekhter-Levin S, Vergona R, Aimin Z [2001]. Acute Radiation Syndrome in Russian Nuclear Workers. Pittsburgh, PA: University of Pittsburgh; (NIOSH Grant #1 R01 CCR312952-01, Final Report) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH, 59 pg. PDF version available. (179 KB)

Surveillance Methods for Solvent-Related Hepatotoxicity, a Cross-Sectional Study at Hanford

Grantee:: University of Washington (Carl A. Brodkin, M.D.)
Award Period:: 10/1/98-9/29/01
Summary:: The purpose of this cross-sectional study at the Hanford Nuclear Reservation was to establish a scientific basis for surveillance of hepatic effects in solvent exposed workers. One hundred industrial painters exposed subacutely and chronically to a variety of solvent mixtures over their working careers were compared with a referent group of 100 nonexposed carpenters matched by age, gender and race. The study examined the hypothesis that solvent-related hepatic injury is characterized by parenchymal changes of steatosis and fibrosis without associated necrotic changes, which are detected by elevated hepatic transaminases in blood.
Significance:: The non-invasive surveillance methods address a priority research area of the National Occupational Research Agenda.
Manuscript:: Brodkin CA, Checkoway H, Bushley A, Stover Bert, McDonald G, Lee S, Wang K, Carpenter K, Dubinsky T, Green D [2001]. Surveillance Methods for Solvent-Related Hepatotoxicity. Seattle, Washington: University of Washington; (NIOSH Grant SERCA 1 K01 OH00165-01, Technical Report) Available from the National Institute for Occupational Safety and Health/Health-related Energy Research Branch, Cincinnati, OH, 7pg. PDF version available. (15 KB) Tables (146 KB)

Lung Fibrosis in Plutonium Workers

Grantee:: National Jewish Hospital (Lee Newman, M.D.)
Award Period:: 1995-1999
Summary:: This project studied whether workers were at increased risk for developing radiographic abnormalities consistent with fibrosis. The relationship between 239Pu and other exposures and lung fibrosis was examined in chest x-rays of 327 plutonium- exposed Rocky Flats Plant workers and 194 workers without plutonium exposure.
Significance:: Plutonium-induced lung fibrosis was observed in a plutonium exposed worker population consistent with results in animal testing using multiple species.
Manuscript:: Newman LS, Mroz MM, Ruttenber JA [2002]. Lung fibrosis in plutonium workers. Division of Environmental and Occupational Health Sciences; National Jewish Medical and Research Center, Denver, CO. (DHHS Grant R01 811855. Revised final performance report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 19 pg. PDF version available (53KB) Summary Report (99KB)

Epidemiologic Evaluation of Cancer and Occupational Exposures at the Rocky Flats Environmental Technology Site

Awardee:

Colorado Department of Public Health and Environment

Award Period:

1993-2003

Summary:

This study included Rocky Flats workers who died between 1952 and 1996, and had three main components:

Cohort Mortality Study: This component examined the causes of death among 16,303 Rocky Flats production workers employed for 6 months or more between 1952 and 1989.

Nested Lung Cancer Case Control Study: A case-control study was implemented to compare 180 workers who died and had been diagnosed with lung cancer with a control group of 720 workers who had not been diagnosed with lung cancer. The goal of this component was to determine whether subjects with lung cancer had higher internal lung doses than those who did not have lung cancer, and to determine whether smoking frequency or other variables could have affected this relationship.

Exposure Assessment: Plant records were used to estimate annual external penetrating radiation doses, cumulative internal exposure to plutonium, and estimates of annual exposures to asbestos, beryllium, and eight other toxic chemicals for workers in the cohort.

Manuscript:

Ruttenber AJ, Schonbeck M, Brown S, Wells T, McClure D, McCrea J, Popken D, Martyny J [2003]. Report of Epidemiologic Analyses Performed for Rocky Flats Production Workers Employed Between 1952-1989: Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH. [Final Report] Unpublished. 75 pg. PDF version available: Summary (30 KB)

A version of this report, created after a final report was received by NIOSH and communicated with site workers and management, is available on the Colorado Department of Public Health and Environment web site. The link to that site is http://www.cdphe.state.co.us/rf/rfpworkerstudy/RockyFlatsFinalNIOSHReport_text.pdf

Correcting for Measurement Errors in Radiation Exposure

Grantee:: New York University (Xiaonan Xue, Ph.D.)
Award Period:: 7/1/99-6/30/02
Summary:: This research will develop methods for correcting radiation exposure measurement errors, including both systematic and random errors. In this research, a joint model for measurement error and dose- response relationship will be developed, and may be used for more precise and accurate risk assessment.
Significance:
The methods for modeling and correcting measurement errors developed from this research will apply to ongoing and future worker radiation studies and analysis of other environmental exposure-response data.
Manuscripts:
: Xue X. Correcting for Measurement Errors in Radiation Exposure. (DHHS Contract 1R01 CCR215746, Final Performance Report.) Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 16 pgs. PDF version available. Summary Report.; Xue X, Shore RE [2003]. A Method for Estimating Occupational Radiation Doses Subject to Minimum Detection Levels. Health Phys., 84(1):61-71. Abstract available.
: Xue X, Shore RE, Ye X, Kim MY [2004]. Estimating the Dose Response Relationship for Occupational Radiation Exposure Measured with Minimum Detection Level. Health Phys., 87(4):397-404.

Measurement Error Methods for Underground Miner Studies

Grantee:: University of Southern California (Dan Stram, Ph.D.)
Award Period:: 9/30/95 -5/31/02
Summary:: 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.
Significance:: The study addresses developing statistical methods for addressing measurement uncertainty. It may be useful to the Department of Justice in the disposition of uranium miner compensation issues.
Manuscripts:: Stram DO. Measurement Error Methods for Underground Miner Studies. (DHHS Contract R01 CCR11869-06, Final Report). Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 4 pgs. PDF version available. Summary Report.
: Langholz B, Thomas D, Xiang A, Stram DO [1999]. Latency Analysis in Epidemiologic Studies of Occupational Exposures: Application to the Colorado Plateau Uranium Miners Cohort. Am J Ind Med., 35:246-56. Abstract available.
: Stram DO, Langholz B, Huberman M, Thomas DC [1999]. Correcting for Exposure Measurement Error in a Reanalysis of Lung Cancer Mortality for the Colorado Plateau Uranium Miners Cohort. Health Phys., 77(3):265-75. Abstract available.; Stram DO [2000]. Correcting for Exposure Measurement Error in Uranium Miners Studies: Impact on Inverse Dose-Rate Effects. Radiat Res., 154(6):738-39.
: Stram DO, Kopecky KJ [2002]. Power Analysis of Epidemiological Studies of Radiation-Related Disease Risk when Dose Estimates are Based on a Complex Dosimetry System with an Application to the Hanford Thyroid Disease Study. Radiat Res., 158(6):797-99.; Stram DO, Kopecky KJ [2003]. Power and Uncertainty Analysis of Epidemiological Studies of Radiation-Related Disease Risk in which Dose Estimates are Based on a Complex Dosimetry System: Some Observations. Radiat Res., 160:408-17. Abstract available.

Reconstruction of Doses for Chernobyl Liquidators

Grantee:: International Agency for Research on Cancer (Elisabeth Cardis, Ph.D.)
Award Period:: 9/30/99 -12/29/02
Summary:: Two case-control studies were conducted among Chernobyl liquidators in Belarus, Estonia, Latvia, Lithuania and Russia. The study objective was to estimate the risk of developing leukemia/non-Hodgkin lymphoma and thyroid cancer from protracted exposure to low-to-medium (0-500 mSv) radiation dosage.
Manuscripts:: Cardis E [2002]. Reconstruction of Doses for Chernobyl Liquidators (DHHS Grant 5R01 CC015763-03, NIOSH Closeout Summary). Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 2 pgs. PDF version available. Summary Report.
: Cardis E, Krjuchkov VP, Anspaugh L, Bouville A, Chumak VV, Drozdovich V, Gavrilin Y, Golovanov I, Hubert P, Illychev S, Ivanov VK, Kesminiene A, Kurtinaitis J, Maceika E, Malakhova IV, Mirhaidarov AK, Pitkevitch VA, Stengrevics A, Tekkel M, Tenet V, Tsykalo A [2003]. Reconstruction of Doses for Chernobyl Liquidators (Final Performance Report). Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 53 pgs. PDF version available.; Kesminiene A, Cardis E, Tenet V, Ivanov Vk, Kurtinaitis J, Malakhova I, Stengrevics A, Tekkel M [2002]. Studies of Cancer Risk Among Chernobyl Liquidators: Materials and Methods. J. Radiol. Prot., 22:137-41. Abstract available.

Cohort Mortality Study of Idaho National Engineering and Environmental Laboratory (INEEL) Workers

Project Officer:: Mary Schubauer-Berigan, Ph.D.
Study Period:: 1992-2004
Summary:: This study is an all-cause cohort mortality study to evaluate causes and numbers of deaths among workers at the INEEL facility, and to determine if and how past radiation exposures were associated with cancers among INEEL workers. This study included 63,561 civilian workers employed by the Department of Energy (DOE), its contractors and subcontractors, or the Naval Reactors Facility (NRF) at the INEEL at any time between 1949 and the end of 1991. Causes of death prior to 12/31/1999 were obtained for deceased workers using the National Death Index and death certificates. Gamma and neutron radiation doses were estimated for each worker from individual dosimetry records at the INEEL and the NRF. Mortality risks for most causes of death were lower among INEEL workers compared to the regional population. However, cancer rates were slightly elevated, and differ by the type of work conducted at the INEEL. While the results of the study suggest that there may be a relationship between workplace radiation exposures and the risk of brain tumors, leukemia, and lymphatic cancers, the numbers were not statistically significant. The findings provide guidance for further research needed to determine conclusively if past radiation exposures were associated with a risk of cancer.

Mortality risks for most causes of death were lower among INEEL workers compared to the regional population. However, cancer rates were slightly elevated, and differ by the type of work conducted at the INEEL. While the results of the study suggest that there may be a relationship between workplace radiation exposures and the risk of brain tumors, leukemia, and lymphatic cancers, the numbers were not statistically significant. The findings provide guidance for further research needed to determine conclusively if past radiation exposures were associated with a risk of cancer.
Manuscripts:: Schubauer-Berigan MK, Macievic GV, Utterback DF, Tseng CY, Flora JT [2005]. An Epidemiologic Study of Mortality and Radiation-Related Risk of Cancer Among Workers at the Idaho National Engineering and Environmental Laboratory, a U.S. Department of Energy Facility (NIOSH Intramural Study, Final Report). Available from the National Institute for Occupational Safety and Health/Health-Related Energy Research Branch, Cincinnati, OH, 220 pgs. PDF version available. Summary Report.
Signifigance:: This study of a previously unstudied site was initiated at a governor's request and from congressional interest. Data from the study may be used in future studies of this work force.

Cohort Mortality Study of Portsmouth Naval Shipyard, Kittery, Maine

Project Officer: Sharon Silver, M.S.

Study Period:
1993-2004

Summary:
This study was done to evaluate the causes of deaths for all Portsmouth Naval Shipyard (PNS) workers and to evaluate whether a relationship exists between exposure to low-level external ionizing radiation and death from certain cancers.

The study included all 37,853 civilian workers employed at PNS for at least one day between January 1, 1952 and December 31, 1992. This cohort was divided into three subgroups: exposed radiation workers, unexposed radiation workers, and non-radiation-monitored workers. Causes of death were determined through 1996 for the entire PNS cohort. External radiation exposure information was collected and verified for each radiation-monitored worker. Likelihood of smoking and exposures to asbestos, welding fume and solvents were also considered in the analysis.

Overall, mortality for the PNS cohort was slightly less than expected. Several findings differed by subgroup: elevations in asbestosis deaths were seen only in radiation-monitored workers, and higher risk of death was observed for several smoking-related causes of death among non-radiation-monitored workers. A dose-response association was observed between external ionizing radiation exposure and leukemia mortality, but not lung cancer, after including information about other exposures.

Manuscript:
Silver SR, Daniels RD, Taulbee TD, et al. [2004]. Differences in Mortality by Radiation Monitoring Status in an Expanded Cohort of Portsmouth Naval Shipyard Workers. JOEM , 46(7):677-689. Abstract available.

Yiin JH, Schubauer-Berigan MK, Silver SR, Daniels RD, Kinnes GM, Zaebst DD, Couch JR, Kubale TL, Chen P-H [2005]. Risk of Lung Cancer and Leukemia from Exposure to Ionizing Radiation and Potential Confounders among Workers at the Portsmouth Naval Shipyard. Rad Res. , 163:603-613. Abstract available. Summary report.

Significance:
This study is part of an ongoing program of research to evaluate whether occupational exposures are associated with adverse health effects among workers at U.S. nuclear facilities. The PNS study is part of an ongoing research effort involving partnership between NIOSH, the U.S. Navy, PNS employees and the U.S. Department of Energy.

Portsmouth Naval Shipyard (PNS) Leukemia Case-Control Study

Project Officer:
Travis Kubale, Ph.D.

Award Period:
1996-2005

Summary:
This study analyzed the relationship between external ionizing radiation and leukemia mortality among civilian employees of the PNS to help determine whether occupational exposures to radiation were associated with a risk for leukemia. Exposure assessments for benzene and carbon tetrachloride were also completed since these chemicals might also cause leukemia.

The study population included 115 PNS employees who had died from leukemia. They were compared with a total of 460 other PNS workers who served as controls. All workers in this study were selected from the 37,853 civilians employed at the Shipyard for at least one day between January 1, 1952 and December 31, 1992. Thirty-four of the leukemia cases and 167 controls were monitored for ionizing radiation exposures while employed at PNS.

The case-control study results suggest that leukemia mortality risk increased with increasing cumulative occupational ionizing radiation dose among PNS workers. The magnitude of increase in leukemia risk is consistent with other radiation epidemiology study results. Workers potentially exposed to benzene or carbon tetrachloride for longer periods of time also appear to have greater risk of death from leukemia. Uncertainty in the risk estimates, i.e., the rather wide confidence intervals, is attributed to the relatively small number of leukemia deaths (34) among radiation-monitored workers and reliance on job titles and shops to estimate benzene and carbon tetrachloride exposures instead of individual monitoring results for these chemicals.

Manuscript:
Kubale TL, Daniels RD, Yiin JH, Kinnes GM, Couch JR, Schubauer-Berigan MK, Silver SR, Nowlin SJ, Chen P-H [2004]. A Nested Case-Control Study of Leukemia and Ionizing Radiation at the Portsmouth Naval Shipyard. Cincinnati, OH: National Institute for Occupational Safety and Health/Health-Related Energy Research Branch; DHHS (NIOSH) Publication No. 2005-104; 182 pgs. PDF version available. Summary report.

Significance:
This study is part of an ongoing program of research to evaluate whether occupational exposures are associated with adverse health effects among workers at U.S. nuclear facilities. The PNS studies were completed through the partnership of NIOSH, the U.S. Navy, PNS employees, and the U.S. Department of Energy.

International Collaborative Study of Nuclear Industry Workers

Awardee:
International Agency for Research on Cancer (IARC) (Elisabeth Cardis, Ph.D.)

Award Period:
4/1/95-6/30/01

Summary:
This report examines cancer mortality among more than 400,000 nuclear industry workers in 15 countries including workers from three U.S. Department of Energy (DOE) facilities: Hanford, the Oak Ridge National Laboratory (ORNL), and the Idaho National Laboratory (formerly called Idaho National Engineering and Environmental Laboratory; INEEL). The three DOE sites were selected for inclusion by IARC study subcommittees because workers at those sites were exposed to primarily external sources of radiation and the data were readily available.

The IARC study found that radiation exposure was significantly associated with risk of death from non-leukemia cancer. Results for leukemia were inconclusive, but suggest a positive association with workplace radiation exposure. The report does not contradict the findings of the previous NIOSH INEEL study (Schubauer-Berigan, et al. 2004). (Cooperative Agreement 1R01 CCR014477-01)

Manuscript: Cardis E, Vrijheid M, Blettner M, et al. [2005]. Cancer Risk Following Low Doses of Ionizing Radiation - A 15-country Study. BMJ, doi:10.1136/bmj.38499.599861.E0. Abstract available. Summary Report.

Significance: This is the largest study of nuclear workers ever done. It involves collaboration among 15 countries and with The World Health Organization (WHO)/IARC.

Ionizing Radiation and Mortality Among Hanford Workers

Grantee:
University of North Carolina (Steven Wing, Ph.D.)

Award Period:
1996-2003

Summary:
This study examined whether there are associations between occupational exposure to external ionizing radiation and mortality, particularly from cancer, among workers employed at the Hanford Site.

The study included 26,389 employees of prime contractors who were hired at the Hanford site between 1944 and 1978 and monitored for ionizing radiation exposures during employment.

This study suggests that external radiation exposures of Hanford workers at ages 55 and older increased their risks of dying from lung cancer. However, the possible contributions of plutonium and smoking to this risk could not be directly estimated due to limitations in the available information. (DHHS Grant # 3R01 CC412931-03)

Manuscripts:
Richardson D., Wing S, Watson J, Wolf S [1999]. Missing Annual External Radiation Dosimetry Data Among Hanford Workers. J of Exp Analysis and Environ Epi. , 9:575-585. Abstract available.

Richardson D, Wing S, Watson J, Wolf S [2000]. Evaluation of Annual External Radiation Doses at Values Near Minimum Detection Levels of Dosimeters at the Hanford Nuclear Facility. J of Exp Analysis and Environ Epi. , 10:27-35. Abstract available.

Wing S, Richardson D, Stewart A [1999]. The Relevance of Occupational Epidemiology to Radiation Protection Standards. New Solutions. 9(2):133-151. Abstract available.

Wing S, Richardson DB [2005]. Age at Exposure to Ionizing Radiation and Cancer Mortality Among Hanford Workers: Follow-up Through 1994. Occup and Environ Med. , 62:465-472. Abstract available. Summary report.

Wing S, Richardson D, Wolf S, Mihlan G [2004]. Plutonium-Related Work and Cause-Specific Mortality at the U.S. Department of Energy Hanford Site. Am J of Ind. Med. , 45:153-164. Abstract available. Significance: Update of important previous cohort study (increased time of observation). Application of new methodologies for epidemiologic analyses.

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NIOSH Energy-Related Health Research Program

Completed NIOSH-Initiated Research