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March 20, 1991, Vol 265, No. 11 >
ARTICLE | March 20, 1991

Mortality Among Workers at Oak Ridge National Laboratory: Title and subTitle BreakEvidence of Radiation Effects in Follow-up Through 1984 FREE

Steve Wing, PhD; Carl M. Shy, MD; Joy L. Wood, MS; Susanne Wolf, MPH; Donna L. Cragle, PhD; E. L. Frome, PhD
[+] Author Affiliations

Reprint requests to Department of Epidemiology, CB 7400, University of North Carolina, Chapel Hill, NC 27599-7400 (Dr Wing).


JAMA. 1991;265(11):1397-1402. doi:10.1001/jama.1991.03460110063025
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References

White men hired at the Oak Ridge (Tenn) National Laboratory between 1943 and 1972 were followed up for vital status through 1984 (N = 8318, 1524 deaths). Relatively low mortality compared with that in US white men was observed for most causes of death, but leukemia mortality was elevated in the total cohort (63% higher, 28 deaths) and in workers who had at some time been monitored for internal radionuclide contamination (123% higher, 16 deaths). Median cumulative dose of external penetrating radiation was 1.4 mSv; 638 workers had cumulative doses above 50 mSv (5 rem). After accounting for age, birth cohort, a measure of socioeconomic status, and active worker status, external radiation with a 20-year exposure lag was related to all causes of death (2.68% increase per 10 mSv) primarily due to an association with cancer mortality (4.94% per 10 mSv). Studies of this population through 1977 did not find radiation-cancer mortality associations, and identical analyses using the shorter follow-up showed that associations with radiation did not appear until after 1977. The radiation-cancer dose response is 10 times higher than estimates from the follow-up of survivors of the bombings of Hiroshima and Nagasaki, Japan, but similar to one previous occupational study. Dose-response estimates are subject to uncertainties due to potential problems, including measurement of radiation doses and cancer outcomes. Longer-term follow-up of this and other populations with good measurement of protracted low-level exposures will be critical to evaluating the generalizability of the results reported herein.

(JAMA. 1991;265:1397-1402)

REFERENCES

1 +
Shore RE.  Occupational radiation studies . Health Phys. 1990;;59:63-68.
2 +
Checkoway H, Mathew RM, Shy CM, et al.  Radiation, work experience, and cause-specific mortality among workers at any energy research laboratory . Br J Ind Med. 1985;;42:525-533.
3 +
Gilbert ES, Fry SA, Wiggs LD, Voelz GL, Cragle DL, Peterson GR.  Analyses of combined mortality data on workers at the Hanford Site, Oak Ridge National Laboratory, and Rocky Flats Nuclear Weapons Plant . Radiat Res. 1989;;120:19-35.
4 +
Gilbert ES, Fry Sa, Wiggs LD, Voelz GL, Cragle DL, Petersen GR.  Methods for analyzing combined data from studies of workers exposed to low doses of radiation . Am J Epidemiol. 1990;;131:917-927.
5 +
Monson RR.  Analysis of relative survival and proportional mortality . Comput Biol Res. 1974;; 7:325-332.
6 +
Frome EL.  The analysis of rates using Poisson regression models . Biometrics . 1983;;39:665-674.
7 +
Breslow NE, Day NE. Statistical Methods in Cancer Research, II: The Design and Analysis of Cohort Studies . Lyons, France: International Agency for Research on Cancer; 1987;.
8 +
Tornqvist L, Vartia P, Varia YO.  How should relative changes be measured? Am Stat. 1985;; 39:43-46.
9 +
Report of the National Institutes of Health Ad Hoc Working Group to Develop Radioepidemiological Tables . Bethesda, Md: National Institutes of Health; 1985;. NIH publication 85-2748.
10 +
McMichael AJ.  Standardized mortality ratios and the 'healthy worker effect.' J Occup Med. 1976;;18:165-168.
11 +
Fox AJ, Collier PF.  Low mortality rates in industrial cohort studies due to selection for work and survival in the industry . Br J Prev Soc Med. 1976;;30:225-230.
12 +
Pearce NE, Checkoway H, Shy CM.  Timerelated factors as potential confounders and effect modifiers in studies based on an occupational cohort . Scand J Work Environ Health . 1986;;12: 97-107.
13 +
Devesa SS, Blot WJ, Fraumeni JF Jr.  Declining lung cancer rates among young men and women in the United States . J Natl Cancer Inst. 1989;;81:1568-1571.
14 +
Wing S.  Social inequalities in the decline of coronary mortality . Am J Public Health . 1988;; 78:1415-1416.
15 +
Wilcosky T, Wing S.  The healthy worker effect: selection of workers and work forces . Scand J Work Environ Health . 1987;;13:70-72.
16 +
National Academy of Science, National Research Council. Health Effects of Exposure to Low Levels of Ionizing Radiation . The Committee on the Biological Effects of Ionizing Radiation (BEIR V). Washington, DC: National Academy Press; 1990;.
17 +
Land CE.  Estimating cancer risks from low doses of ionizing radiation . Science . 1980;;209:1197-1203.
18 +
Kohn HI, Fry RJM.  Radiation carcinogenesis . N Engl J Med. 1984;;310:504-511.
19 +
Upton AC.  Carcinogenic effects of low-level ionizing radiation . J Natl Cancer Inst. 1990;;82: 448-449.
20 +
Copeland KT, Checkoway H, McMichael AJ, Holbrook RH.  Bias due to misclassification in the estimation of relative risk . Am J Epidemiol. 1977;;105:488-495.
21 +
Shy CM, Kleinbaum DG, Morgenstern H.  The effect of misclassification of exposure status in epidemiological studies of air pollution health effects . Bull N Y Acad Med. 1978;;54:1155-1165.
22 +
Axelson O.  Confounding from smoking in occupational epidemiology . Br J Ind Med. 1989;;46: 505-507.
23 +
Beral V, Fraser P, Carpenter L, Booth M, Brown A, Rose G.  Mortality of employees of the Atomic Weapons Establishment, 1951-82 . BMJ . 1988;;297:757-770.
24 +
Woolhandler S, Himmelstein DV.  Militarism and mortality: an international analysis of arms spending and infant death rates . Lancet . 1985;; 1:1375-1378.
25 +
Leaf A.  Potential health effects of global climatic and environmental changes . N Engl J Med. 1989;;321:1577-1583.
26 +
Clapp RW, Cobb S, Chan CK, Walker B Jr.  Leukemia near Massachusetts Nuclear Power Plant . Lancet . 1987;;2:1324-1325.
27 +
Morris M, Knorr RS. Investigation of Leukemia Incidence in 22 Massachusetts Communities, 1978-1986 . Boston: Massachusetts Department of Public Health; 1990;.
28 +
Gardner MJ, Snee MP, Hall AJ, et al.  Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria . BMJ . 1990;;300:423-429.
29 +
Gilbert E.  An evaluation of several methods for assessing the effects of occupational exposure to radiation . Biometrics . 1983;;39:161-171.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Shore RE.  Occupational radiation studies . Health Phys. 1990;;59:63-68.
2 +
Checkoway H, Mathew RM, Shy CM, et al.  Radiation, work experience, and cause-specific mortality among workers at any energy research laboratory . Br J Ind Med. 1985;;42:525-533.
3 +
Gilbert ES, Fry SA, Wiggs LD, Voelz GL, Cragle DL, Peterson GR.  Analyses of combined mortality data on workers at the Hanford Site, Oak Ridge National Laboratory, and Rocky Flats Nuclear Weapons Plant . Radiat Res. 1989;;120:19-35.
4 +
Gilbert ES, Fry Sa, Wiggs LD, Voelz GL, Cragle DL, Petersen GR.  Methods for analyzing combined data from studies of workers exposed to low doses of radiation . Am J Epidemiol. 1990;;131:917-927.
5 +
Monson RR.  Analysis of relative survival and proportional mortality . Comput Biol Res. 1974;; 7:325-332.
6 +
Frome EL.  The analysis of rates using Poisson regression models . Biometrics . 1983;;39:665-674.
7 +
Breslow NE, Day NE. Statistical Methods in Cancer Research, II: The Design and Analysis of Cohort Studies . Lyons, France: International Agency for Research on Cancer; 1987;.
8 +
Tornqvist L, Vartia P, Varia YO.  How should relative changes be measured? Am Stat. 1985;; 39:43-46.
9 +
Report of the National Institutes of Health Ad Hoc Working Group to Develop Radioepidemiological Tables . Bethesda, Md: National Institutes of Health; 1985;. NIH publication 85-2748.
10 +
McMichael AJ.  Standardized mortality ratios and the 'healthy worker effect.' J Occup Med. 1976;;18:165-168.
11 +
Fox AJ, Collier PF.  Low mortality rates in industrial cohort studies due to selection for work and survival in the industry . Br J Prev Soc Med. 1976;;30:225-230.
12 +
Pearce NE, Checkoway H, Shy CM.  Timerelated factors as potential confounders and effect modifiers in studies based on an occupational cohort . Scand J Work Environ Health . 1986;;12: 97-107.
13 +
Devesa SS, Blot WJ, Fraumeni JF Jr.  Declining lung cancer rates among young men and women in the United States . J Natl Cancer Inst. 1989;;81:1568-1571.
14 +
Wing S.  Social inequalities in the decline of coronary mortality . Am J Public Health . 1988;; 78:1415-1416.
15 +
Wilcosky T, Wing S.  The healthy worker effect: selection of workers and work forces . Scand J Work Environ Health . 1987;;13:70-72.
16 +
National Academy of Science, National Research Council. Health Effects of Exposure to Low Levels of Ionizing Radiation . The Committee on the Biological Effects of Ionizing Radiation (BEIR V). Washington, DC: National Academy Press; 1990;.
17 +
Land CE.  Estimating cancer risks from low doses of ionizing radiation . Science . 1980;;209:1197-1203.
18 +
Kohn HI, Fry RJM.  Radiation carcinogenesis . N Engl J Med. 1984;;310:504-511.
19 +
Upton AC.  Carcinogenic effects of low-level ionizing radiation . J Natl Cancer Inst. 1990;;82: 448-449.
20 +
Copeland KT, Checkoway H, McMichael AJ, Holbrook RH.  Bias due to misclassification in the estimation of relative risk . Am J Epidemiol. 1977;;105:488-495.
21 +
Shy CM, Kleinbaum DG, Morgenstern H.  The effect of misclassification of exposure status in epidemiological studies of air pollution health effects . Bull N Y Acad Med. 1978;;54:1155-1165.
22 +
Axelson O.  Confounding from smoking in occupational epidemiology . Br J Ind Med. 1989;;46: 505-507.
23 +
Beral V, Fraser P, Carpenter L, Booth M, Brown A, Rose G.  Mortality of employees of the Atomic Weapons Establishment, 1951-82 . BMJ . 1988;;297:757-770.
24 +
Woolhandler S, Himmelstein DV.  Militarism and mortality: an international analysis of arms spending and infant death rates . Lancet . 1985;; 1:1375-1378.
25 +
Leaf A.  Potential health effects of global climatic and environmental changes . N Engl J Med. 1989;;321:1577-1583.
26 +
Clapp RW, Cobb S, Chan CK, Walker B Jr.  Leukemia near Massachusetts Nuclear Power Plant . Lancet . 1987;;2:1324-1325.
27 +
Morris M, Knorr RS. Investigation of Leukemia Incidence in 22 Massachusetts Communities, 1978-1986 . Boston: Massachusetts Department of Public Health; 1990;.
28 +
Gardner MJ, Snee MP, Hall AJ, et al.  Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria . BMJ . 1990;;300:423-429.
29 +
Gilbert E.  An evaluation of several methods for assessing the effects of occupational exposure to radiation . Biometrics . 1983;;39:161-171.

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