Mortality among workers at the Los Alamos National Laboratory, 1943–2017

Boice, John D.; Cohen, Sarah S.; Mumma, Michael T.; Golden, Ashley P.; Howard, Sara C.; Girardi, David J.; Ellis, Elizabeth D.; Bellamy, Michael; Dauer, Lawrence T.; Samuels, Caleigh; Eckerman, K.F.; Leggett, Richard W.

doi:10.1080/09553002.2021.1917784

Cited by 35 publications

(40 citation statements)

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“…Out of the 21 studies that considered this outcome, 13 were on nuclear workers and uranium miners. The majority of them did not report any statistically significant results, whether the authors compared the mortality of workers to that of an external reference population (SMR) or they assessed dose–response relationships (ERR) [ 33 , 35 , 36 , 39 , 42 , 44 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…In a cohort of 4977 U.S. mound workers potentially exposed to external or internal (polonium-210, plutonium isotopes, or tritium) radiation (mean dose from external radiation: 26.1 mSv; max: 939.1 mSv; mean lung dose from external and internal radiation combined: 100.1 mSv; max: 17.5 Sv; mean liver dose from external and internal radiation: 34.6 mSv; max: 2.3 Sv), the mortality due to diseases of the nervous system was not different from that of the general population, regardless of the radiation status of the workers or the type of radionuclides for those with intakes, but a positive trend was suggested as SMRs increased with increasing categories of occupational cumulative dose primarily due to photons ( p = 0.03) [ 42 ]. In a cohort of 26,328 Los Alamos National Laboratory workers exposed to a combination of photons, neutrons, tritium, and plutonium (among which 17,053 workers were monitored for a combination of external and internal sources for plutonium; brain radiation absorbed dose: mean: 11.6 mGy; max: 760 mGy), Boice et al (2021) reported among the whole cohort a non-significant SMR for nervous system diseases compared with national rates based on 815 deaths, but a borderline significant increase in mortality due to Parkinson’s disease was observed (SMR = 1.16; 95% CI: 1.00, 1.34; n deaths = 193), and a positive dose–response relationship was suggested (ERR at 100 mGy = 0.16; 95% CI: −0.07, 0.40; n deaths = 273) [ 33 ]. In a cohort of 22,377 Mayak workers exposed to chronic IR (mean cumulative dose from external gamma rays absorbed in the brain: 0.46 Gy (max: 8.01 Gy) for men and 0.36 Gy (max: 6.14 Gy) for women), a statistically significant linear association was found between the incidence of Parkinson’s disease and cumulative gamma dose after adjusting for sex and attained age (ERR per Gy = 1.02; 95% CI: 0.59, 1.63; n diseases = 300) [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

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Risk of Developing Non-Cancerous Central Nervous System Diseases Due to Ionizing Radiation Exposure during Adulthood: Systematic Review and Meta-Analyses

et al. 2022

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Background: High-dose ionizing radiation (IR) (>0.5 Gy) is an established risk factor for cognitive impairments, but this cannot be concluded for low-to-moderate IR exposure (<0.5 Gy) in adulthood as study results are inconsistent. The objectives are to summarize relevant epidemiological studies of low-to-moderate IR exposure in adulthood and to assess the risk of non-cancerous CNS diseases. Methods: A systematic literature search of four electronic databases was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled standardized mortality ratios, relative risks, and excess relative risks (ERR) were estimated with a random effect model. Results: Forty-five publications were included in the systematic review, including thirty-three in the quantitative meta-analysis. The following sources of IR-exposure were considered: atomic bomb, occupational, environmental, and medical exposure. Increased dose-risk relationships were found for cerebrovascular diseases incidence and mortality (ERRpooled per 100 mGy = 0.04; 95% CI: 0.03–0.05; ERRpooled at 100 mGy = 0.01; 95% CI: −0.00–0.02, respectively) and for Parkinson’s disease (ERRpooled at 100 mGy = 0.11; 95% CI: 0.06–0.16); Conclusions: Our findings suggest that adult low-to-moderate IR exposure may have effects on non-cancerous CNS diseases. Further research addressing inherent variation issues is encouraged.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk of Developing Non-Cancerous Central Nervous System Diseases Due to Ionizing Radiation Exposure during Adulthood: Systematic Review and Meta-Analyses

et al. 2022

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“…Before October 1, 1949, urine was analyzed by a cupferron method, the MDA was high, and the precision and accuracy was low. Urine data after 1957 are believed to be a less important source of error due to improved measurement techniques [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Plutonium in Manhattan Project workers: Using autopsy data to evaluate organ content and dose estimates based on urine bioassay with implications for radiation epidemiology

et al. 2021

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Purpose Radiation dose estimates in epidemiology typically rely on intake predictions based on urine bioassay measurements. The purpose of this article is to compare the conventional dosimetric estimates for radiation epidemiology with the estimates based on additional post-mortem tissue radiochemical analysis results. Methods The comparison was performed on a unique group of 11 former Manhattan Project nuclear workers, who worked with plutonium in the 1940s, and voluntarily donated their bodies to the United States Transuranium and Uranium Registries. Results Post-mortem organ activities were predicted using different sets of urine data and compared to measured activities. Use of urinalysis data collected during the exposure periods overestimated the systemic (liver+skeleton) deposition of 239Pu by 155±134%, while the average bias from using post-exposure urinalyses was –4±50%. Committed effective doses estimated using early urine data differed from the best estimate by, on average, 196±193%; inclusion of follow-up urine measurements in analyses decreased the mean bias to 0.6±36.3%. Cumulative absorbed doses for the liver, red marrow, bone surface, and brain were calculated for the actual commitment period. Conclusion On average, post-exposure urine bioassay results were in good agreement with post-mortem tissue analyses and were more reliable than results of urine bioassays collected during the exposure.

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“…Additional plutonium worker studies not listed in Table 1 are discussed separately. These are (1) a study of a European cohort (Grellier et al 2017), (2) a cohort at the Los Alamos National Laboratory (LANL) (Boice et al 2022), and (3) a cohort at Rocky Flats (Brown et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Implications of Recent Epidemiological Studies for Compensation of Veterans Exposed to Plutonium

Beyea

2022

Health Physics

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The objective of this paper is to compare post-2007 epidemiological results for plutonium workers to risk predicted by the software program NIOSH-IREP (IREP for short), which is used to determine the lowest dose for a US veteran to obtain cancer compensation. IREP output and methodology were used to predict excess relative risk per Gy (ERR Gy −1 ) for lung cancer at the 99 th credibility percentile, which is used for compensation decisions. Also estimated were relative biological effectiveness factors (RBE) predicted for workers using IREP methodology. IREP predictions were compared to results for Mayak and Sellafield plutonium workers, separately and pooled. Indications that IREP might underpredict 99 th -percentile lung cancer plutonium risk came from (1) comparison of worker RBEs and (2) from comparison of Sellafield results separately. When Sellafield and Mayak data were pooled, ERR Gy −1 comparisons at the 99 th percentile roughly matched epidemiological data with regression dose range restricted to < 0.05 Gy, the most relevant region to veterans, but overpredicted for the full dose range. When four plausible distributions for lung cancer risk, including both new and old data, were combined using illustrative weighting factors, compensation cutoff dose for lung cancer matched current IREP values unless regression results below 0.05 were chosen for Sellafield, producing a two-fold reduction. A 1997 claim of a dose threshold in lung cancer dose response was not confirmed in later literature. The benefit of the doubt is given to claimants when the science is unclear. The challenge for NIOSH-IREP custodians is dealing with the Sellafield results, which might best match US claimants.

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Mortality among workers at the Los Alamos National Laboratory, 1943–2017

Cited by 35 publications

References 129 publications

Risk of Developing Non-Cancerous Central Nervous System Diseases Due to Ionizing Radiation Exposure during Adulthood: Systematic Review and Meta-Analyses

Risk of Developing Non-Cancerous Central Nervous System Diseases Due to Ionizing Radiation Exposure during Adulthood: Systematic Review and Meta-Analyses

Plutonium in Manhattan Project workers: Using autopsy data to evaluate organ content and dose estimates based on urine bioassay with implications for radiation epidemiology

Implications of Recent Epidemiological Studies for Compensation of Veterans Exposed to Plutonium

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