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7 Diseases, Populations, and Other Issues of Public Concern
Pages 172-204

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From page 172...
... Such groups include · US civilians residing or working in areas overseas that are not designated by RECA but that may have been contaminated by fallout from US atmospheric nuclear tests conducted in the region. · People living in the vicinity of mill tailings or in dwellings built with mill tailing or other mill or mine residues.
From page 173...
... are compensable as radiogenic diseases for downwinders and onsite participants but not for uranium miners, millers, or ore transporters. Non CLL leukemia is compensable in a number of other exposed populations.
From page 174...
... and bismuth-214 (214Bi) have sufficient range to deliver a dose of radiation to neighboring bone marrow cells, and this is the proposed pathway of the induction of leukemia in underground uranium miners.
From page 175...
... If leukemia is diagnosed, it may be compensable on those grounds based on PC/AS criteria adopted by RECA. Multiple Myeloma Multiple myeloma is compensated under RECA except in uranium miners, uranium millers, and ore transporters, and the committee was asked to reevaluate
From page 176...
... Incidence is related to low LET dose in some studies, and it is compensated in downwinders and onsite participants. However, there is no convincing epidemiologic evidence to warrant inclusion of miners, millers, or ore transporters for RECA compensation from multiple myeloma.
From page 177...
... In a more recent study of mortality from solid cancers between 1950 and 1997 among 86,572 members of the LSS cohort of atomic-bomb survivors, 60% of whom had radiation doses of at least 5 mSv (0.5 rem) , Preston et al.
From page 178...
... Conclusion On the basis of current epidemiologic evidence, the downwinders and civilian onsite participants covered by RECA are probably not at increased risk for death from renal cancer. Skin Cancer None of the RECA populations identified by RECA is eligible for compensation for any type of skin cancer.
From page 179...
... suggests a need for further studies to evaluate the role, if any, of ionizing radiation in its induction. Skin Cancer in Uranium Miners, Millers, and Ore Transporters Tomasek et al.
From page 180...
... . Conclusion The committee found no convincing epidemiologic or dosimetric evidence that uranium miners are at increased risk for death from basal-cell or other type of NMSC.
From page 181...
... Conclusion The committee concludes that currently no epidemiologic or dosimetric evidence that the radiation doses received by either the downwinders or the onsite participants increased their risk of NMSC or melanoma relative to that of the US general population. Thus, there is no epidemiologic justification for adding NMSC or melanoma to the list of compensable diseases under RECA.
From page 182...
... The committee found no epidemiologic basis for designating Hodgkin's Disease as a RECA-compensable disease. Colon Cancer Downwinders and onsite participants are eligible for compensation under RECA for colon cancer, but uranium miners, millers, and ore transporters are not and the committee was asked to reevaluate the justification for this exclusion.
From page 183...
... Thus, we found no basis for designating colon cancer in these occupational groups as compensable under RECA. Testicular Cancer Testicular cancer is another type that is not compensable in any of the populations designated under RECA or under other radiation compensation programs in the United States.
From page 184...
... On the basis of earlier epidemiologic studies, the susceptibility of prostate cancer to induction by ionizing radiation is very low or absent, especially in connection with the chronic or low exposure potentially experienced by the RECA populations. Studies of incidence and mortality among the atomic-bomb survivors have shown little indication of increased risks of prostate cancer during the 45 years of followup (Preston et al., 1994; Preston et al., 2003)
From page 185...
... On the basis of those findings, the authors concluded that there was an increased risk of NSTs even with radiation doses of under 1 Sv (100 rem)
From page 186...
... The apparent clustering of thyroid disease in some families in high-dose areas is consistent with the familial linkage that is a common feature of thyroid disease. The frequency of such clusters would be expected to increase in populations in which the incidence of thyroid nodules and thyroid cancer is increased, as in heavily exposed regions.
From page 187...
... Cancer distribution in populations living near nuclear power plants has been investigated to evaluate possible increases in radiation-related disease, but epidemiologic studies have failed to find a positive correlation; this might be expected because the low radiation doses released in normal plant operations (Jablon et al., 1991)
From page 188...
... Data from the atomic-bomb survivors provides the major quantitative basis for RECA decisions concerning compensation for those conditions. NONMALIGNANT DISEASES Chronic Renal Disease Among Uranium Miners It was brought to the committee's attention that under RECA, uranium miners are not eligible for compensation for chronic renal disease (CRD)
From page 189...
... Benign Tumors: Thyroid Nodules Thyroid Nodules None of the RECA populations is compensated for thyroid nodules. Thyroid nodules are common in the general population, and they increase in number with
From page 190...
... Occult cancers are by definition found only when the glands are removed surgically or at autopsy. Benign thyroid nodules have been found to be increased after high thyroid doses from radiation beams (typically x rays)
From page 191...
... No increased incidence of hypothyroidism has been found among the NTS downwinder, Hanford or Chornobyl populations, and it is unlikely that thyroid doses from NTS fallout could exceed threshold levels in persons without preexisting thyroid abnormalities. Conclusion Hypothyroidism is increased after high radiation doses delivered externally or internally.
From page 192...
... Conclusion There is no convincing evidence that cardiovascular or cerebrovascular disease is likely to be increased by the radiation doses of the magnitude received by RECA-defined populations. Cataracts Radiation-induced cataracts are known to occur after high doses of ionizing radiation to the lens of the eyes.
From page 193...
... It was used to detect and avoid delivery problems due to disproportions between the maternal pelvic anatomy and fetal anatomy, particularly head size and fetal position. Epidemiologic studies have documented an increased incidence of leukemia in the exposed offspring.
From page 194...
... The risk of thyroid damage is presumably highest around the transition from the first to second trimester, and 131I continues to be a threat to the fetal thyroid throughout the rest of pregnancy. Additional fetal total-body dose is received from gamma rays from 131I in the mother, but the fetal thyroid dose is 0.1-1% of what the fetal thyroid would have received if the 131I had been there.
From page 195...
... It is unlikely that detrimental effects would be discernible from the low doses received during in utero exposure. However, due to heightened radiation sensitivity assigned to the in utero period, it should be added to the NTS testing period during which the mother was eligible for RECA-defined benefits.
From page 196...
... ; these studies confirmed earlier findings of increased emotional, behavioral, and psychologic stress that in some cases have persisted for many years in survivors of radiation accidents. More recent information on the cascade of effects of emotional threats that involve radiation covers the nature of and risk factors in psychologic responses to such threats and their health consequences (Ginzberg, 1993)
From page 197...
... Later observations of unexpected, unaccounted-for health effects, accumulating knowledge and growing public awareness about the delayed health risks of radiation exposure, and gradual loss of trust in authority and professional figures could have prompted considerable stress in those populations and increased their risk of GAD, depression, and other psychiatric disorders. In contrast, uranium miners were working in environments already known to be harmful but without adequate information or protections to limit radon exposure.
From page 198...
... The committee concludes that core drillers and geologists who worked in the underground mines should be considered in the same category as uranium miners. They worked side by side with the miners collecting samples to assay the ore bodies, and they would have been subject to the same exposures as the miners.
From page 199...
... , but the committee is not aware of any epidemiologic studies that indicated an increased incidence of nonmalignant respiratory disease among the workers in question. Conclusion The committee concludes that there is no convincing evidence that radiation exposure of core drillers and geologists performing exploratory work in uranium areas resulted in adverse health effects.
From page 200...
... In the case of uranium mill tailings, the subject was addressed through the Uranium Mill Tailings Radiation Control Program, which evaluated and remediated "vicinity properties" and inactive mill-tailings piles and mills at 22 inactive mill sites across the United States. Earlier work had also been done by the federal government and the state of Colorado to remediate properties at Grand Junction, Colorado.
From page 201...
... The committee also recommends that their findings regarding potential health consequences of such exposures be evaluated to determine whether the PC/AS values based on these exposures rise to or exceed the levels used in RECA compensation. Emissions from Uranium Mines or Mills People living near uranium mines and mills may be exposed to airborne and waterborne effluents from them.
From page 202...
... Radiation doses from those discharges generally are not expected to exceed those from the airborne emissions. The committee is not aware of any measurements of radon concentrations in offsite areas from uranium mining (as opposed to uranium milling)
From page 203...
... The committee recommends that the radiation doses and estimates of risks from the radioactive releases from all NTS nuclear weapons tests, including underground tests that resulted in atmospheric releases, be included in determining the PC/AS. GROUPS AT RISK OF EXPOSURE OUTSIDE RECA'S TIME-SINCE-EXPOSURE INTERVALS Several people testified to the committee that, in practice, the length of time spent in an affected area or since the first exposure is determined by date of birth and does not include the period in utero.
From page 204...
... This is not, strictly speaking, a scientific matter. The Congress may wish to consider re-examining the restriction and allow millers and ore transporters to submit affidavits as proof of employment.


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