Review of the Hanford Thyroid Disease Study Draft Final Report (2000) / Chapter Skim
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3 Evaluation of Epidemiologic and Clinical Methods
3 Evaluation of Epidemiologic and Clinical Methods
Pages 49-60
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From page 49... ...
The sample was based on an almost complete census of eligible subjects who were born in selected years and lived in what are believed to be the high-dose regions and subjects born in the same years who lived in regions where the doses from Hanford releases were lower. Efforts to locate subjects and to elicit study 49
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From page 50... ...
For example, the residence-milk interviews with parents or the subjects to obtain residence and milk consumption-rate histories were conducted before, clinical examination so that neither subjects nor interviewers would know subjects thyroid status (except in the case of previously diagnosed thyroid disease)
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From page 51... ...
A questionnaire (called the CATI, for computerassisted telephone interview, in the HTDS Draft Final Report) was developed to obtain information on residence history and milk sources and amounts during 1944-1957 from the mother or a surrogate (such as father or older sibling)
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From page 52... ...
of questionnaire efficacy in estimating true dietary intake generally requires careful study as a separate issue (Willett, 1990) before the questionnaire is used to relate food intake to risk of disease.
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From page 53... ...
Subjects were given physical examinations, including thyroid palpation by thyroid specialists, an ultrasonographic examination, and appropriate thyroid-hormone and thyroid-antibody blood tests. Quality control of the laboratory tests and ultrasonographic examinations was good.
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From page 54... ...
. For others, such as thyroid cancer, it is more complex (combinations of palpable nodule smaller than I.5 cm, palpable nodule of at least I.5 cm, nonpalpable nodule of at least I.5 cm, FNA, surgery, prior diagnosis, cancer
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From page 55... ...
These variables would give a broad-brush view of thyroid disease in relation to |3~{ dose, which would help to ensure that the fine diagnostic categories used in the HTDS report did not miss possible variations in broad categories of thyroid disease. However, a still broader category of "any thyroid disease" is not recommended, because combining pathophysiologically unrelated outcomes lacks biologic plausibility.
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From page 56... ...
Thyroid cancer could also be listed as a contributory condition on the death certificate, but this is rather unlikely unless it was part of the chain of disease leading to death, which again would have a low probability. A consultant to our subcommittee indicated that, of the ~ 19 thyroid-cancer cases he had seen that were diagnosed before the age of 20 and had an average of 20 years of followup after diagnosis, only one led to death from thyroid cancer (Ernest Mazzafern, personal communication)
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From page 57... ...
Thyroid cancer is not a common disease, and it would be reasonable in future epidemiology surveys to identify, document, and investigate clusters with molecular-biology probes to characterize genetic polymorphisms that could make people more sensitive to ionizing radiation or to look for oncogene prevalence in affected subgroups. These methods are developing rapidly, and will probably play a role in future environmentalepidemiology studies.
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From page 58... ...
and categorizing people accordingly. In the Draft Final Report, people are categorized by year of birth.
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From page 59... ...
AMERICAN INDIAN TRIBAL ISSUES The subcommittee had some concerns about the extremely low number of American Indians in the study. The low compliance or cooperation might not be completely the fault of the .
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From page 60... ...
However, the thyroid dose resulting from aquatic pathways was likely to have been much smaller than that due to the consumption of fresh milk or leafy vegetables.
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