Health Risks of Ionizing Radiation: - Clark University

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(RR 1.06; 1.00-1.11) and risks of several cancer types were also significantly positive 23 . The Zorita and Trillo facilities from 1989-99 were specifically investigated in a case-control study (Silva-Mato et al. 2003). Cancer risk was significantly increased within 10 km of the Trillo plant, particularly for the group of cancers known to be induced by radiation (OR 1.86; 1.22-2.83). The excess was concentrated in the 1997-99 period (OR 4.61; 1.96-10.9), ten years after Trillo began operations, and this is consistent with the latency of solid cancers. Risk declined with distance from both facilities although the trend was only significant in the case of Trillo. Gulis and Fitz (1998) studied 1985-95 cancer incidence near the Jaslovske Bohunice nuclear facility in the Slovak Republic using five zones of distance away from the facility. This study found significantly increased risks of several cancers at some distances but also found about as many significantly reduced risks; with over 100 SIRs presented these results could be largely explained as random variations in the data, and indeed the mix of positive and negative results does not appear consistent with radiation-induced cancers in other settings. The correlation between proximity to the facility and cancer incidence was calculated but these data also show a mix of positive and negative results with no clear pattern. Gadekar and Gadekar (1994) looked at congenital malformations near the Rajasthan Atomic Power Station near Rawatbhata India. This study considered the exposed (proximal) area to be the area within 10 km of the plant and downwind during monsoon season (when precipitation and deposition of pollutants would be greatest). The control area was 50-60 km upwind of the plant and was similar geographically, industrially, and socially. The authors found a significant excess of deformities in proximal villages. Children born since the start of both reactors at the facility had a relative risk of 5.08 (2.14-12.06) for birth defects. Exposures of community residents around Communities Near Nuclear Facilities 153 the Mayak nuclear weapons production complex in Russia have been much greater than exposures received by communities in other settings. The facility began operation in 1948 and until 1956 nuclear waste was discharged directly into the Techa River. Between 1953 and 1961 over 7,000 people were evacuated and over 100,000 people have been exposed to elevated levels of radiation. Kossenko (1996) investigated the health status of residents who lived along the river and used river water for drinking and food preparation; roughly two-thirds of this cohort had bone marrow doses greater than 0.2 Gy and 8% of the cohort had doses greater than 1 Gy. The leukemia mortality dose-response relationship corresponded to a linear model or a model with reduced risk at higher doses; the relative risk estimates for the three lowest dose categories were 1.0 (0.4-2.3) at 0.17 Gy, 2.0 (1.3-3.1) at 0.18 Gy, and 2.6 (0.9-7.1) at 0.29 Gy of bone marrow dose. The solid cancer dose-response did not fit any conventional risk models and risk estimates were not significantly different from each other. The solid cancer mortality relative risk estimates for the three lowest dose categories were 1.1 (0.9-1.2) at 0.03 Gy, 1.2 (1.1-1.3) at 0.04 Gy and 1.3 (1.1-1.6) at 0.05 Gy 24 . 12.5 Discussion Studies of communities near nuclear facilities, and studies of childhood leukemia in particular, have been reviewed several times (for example Shleien et al. 1991, Laurier and Bard 1999, Laurier et al. 2002). These reviews note that although many studies have produced estimates of elevated risk, most do not have the information on exposure and dose that would be necessary to make a strong case for causation. A leukemia cluster near a facility might be caused by emissions from a facility but it might also be caused, in part or totally, by a different risk factor. Kinlen (1988), for example, has presented evidence that childhood leukemia clusters might be 23 The following relative risks were calculated for all nuclear fuel facilities: 1.12 (1.02-1.25; lung cancer), 1.51 (1.05- 2.18; bone cancer), 1.53 (1.12-2.08; ovarian cancer), 1.37 (1.07-1.76; kidney cancer), 1.15 (1.01-1.32; colorectal cancer). 24 Relative risk estimates from Kossenko (1996) were extracted from figures and are therefore less exact than they appear.
154 Communities Near Nuclear Facilities caused by viruses that are transmitted more readily in areas where new population mixing is occurring; some of the towns near new nuclear facilities fit this description. These studies are further limited in many cases by simplistic and uninformative study designs. For example, in most studies a circle of distance is drawn around a facility and everyone inside is assumed to have the same potential risk 25 . Radioactive contamination from a facility is unlikely to be dispersed so uniformly. Soil plutonium around Rocky Flats, for example, is distributed almost exclusively in a south-east direction (Johnson 1981). In some cases we can see disease patterns that suggest nonuniform patterns of contamination. Hoffman et al. (1997) found six cases of childhood leukemia within 5 km of the Krummel nuclear power plant in Germany where only 1.3 cases were expected. All six cases occurred on the south bank of the Elbe, which cut the study area in half (Krummel is on the north bank). This may have occurred by chance, but only 20% of the population in the study area lived on the south side. If it were the case that contamination from Krummel only affected the south side of the river then we would want to calculate the risk for that area: the SIR for the whole 5-km radius was 4.6 (2.1-10.3) while considering only the south half of the circle gives an estimate of 24.0 (10.8-53.4). Although the studies are limited in many ways there is still a great deal of information that we can try to interpret. Although we have little or no dose information we do have information on some important differences in endpoints. Studies of adults and children have produced different results, and this is not surprising considering what we know about the unique sensitivity of children. We can also differentiate between studies of mortality and studies of incidence, or between studies of different types of nuclear facility. The highest exposures considered in this section were experienced by Techa River residents near the Mayak facility in Russia. Studies of this community have shown a significantly positive leukemia risk at doses as low as 0.18 Gy bone marrow dose (RR 2.0; 1.3-3.1) and a significantly positive solid cancer risk at 0.04 Gy soft-tissue dose (RR 1.2; 1.1-1.3). Studies of adults (or all ages combined) at lower doses have had variable results (Table 12-1). Studies of Oak Ridge and Rocky Flats, both weapons plants, have produced evidence of increased local cancer risks attributable to the plants (Mangano 1994, Johnson 1981, Crump 1987). These facilities have had unique operating histories with greater potential for radioactive releases than commercial nuclear sites. Most studies of commercial facilities have not detected a significant excess of adult cancer and no individual cancer site stands out from these analyses as a unique high-risk endpoint. Based on studies of nuclear workers we might have an a priori interest in myeloma among adults. Dousset (1989) found 3 cases (1.1 expected) within 10 km of La Hague and Lopez-Abente et al. (1999) found relative risks of 1.62 (0.73-3.58) and 1.13 (0.70-1.85) around Spanish power plants and fuel facilities, respectively. Boice et al. (2003b) found an increased myeloma incidence around the Apollo and Parks facilities in Pennsylvania (SIR 1.91; 0.95- 3.42). Forman et al. (1987), on the other hand, found that myeloma mortality was significantly less than expected around nuclear sites in England and Wales. Since no consistent patterns emerge from studies of commercial facilities we can conclude that any real risks are presumably low and masked by the variety of background rates and study designs. Childhood cancer, on the other hand, and childhood leukemia in particular, appear to be consistently associated with nuclear facilities. This is most apparent in studies of leukemia (and lymphoma) incidence (Table 12-2). Each site has had a unique history of radioactive releases, each study design is different from the next, and each study area has a unique pattern of background cancer; for these reasons we should not expect risk estimates to be of a similar value. That said, looking at Table 12-2 we see that most studies of childhood leukemia around nuclear facilities have found a significant or nearly significant excess; an ‘average’ excess would be two-fold or less. There is not much 25 There were some exceptions in this section. Gadekar and Gadekar (1994), Mangano (1994), Mangano et al. (2002) and Morris and Knorr (1996) all took weather patterns into account to some degree and Johnson (1981) and Crump et al. (1987) made use of soil plutonium measurements.
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Health Risks of Ionizing Radiation:
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Contents List of Tables ...........
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Contents iii Rocky Flats ..........
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Contents v APPENDIX A .............
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List of Figures Figure 1-1 Average
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We are indeed grateful to those who
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2 Introduction 1.2 A brief history
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4 Introduction Figure 1-2. The evol
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6 Introduction Figure 1-5(a). Alpha
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8 Introduction In epidemiological s
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10 Introduction precision to detect
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12 Introduction available informati
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14 Background Radiation Figure 2-1.
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16 Background Radiation Figure 2-3.
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18 Background Radiation
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20 Medical Exposures Fi
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22 Medical Exposures
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24 Medical Exposures with national
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26 Medical Exposures localized expo
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28 Medical Exposures (2.1-28.7). Th
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30 Medical Exposures posed 2.69 tim
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32 Medical Exposures with diagnosti
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34 Medical Exposures Table 3-1. Stu
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44 Atomic Bomb Survivors Figure 4-2
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46 Atomic Bomb Survivors
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48 Atomic Bomb Survivors approximat
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50 Atomic Bomb Survivors (ALL), acu
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52 Atomic Bomb Survivors of the 8 t
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5 Nuclear Weapons Testing Over 500
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60 Nuclear Weapons Testing by disti
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62 Nuclear Weapons Testing Figure 5
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64 Nuclear Weapons Testing near the
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66 Nuclear Weapons Testing
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68 Nuclear Weapons Testing
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6 RADIATION WORKERS Introduction Th
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72 Radiation Workers • 50 rem (0.
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74 Radiation Workers work, reports
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76 Radiation Workers Figure 6-5. A
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78 Radiation Workers Figure 6-8. To
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82 Radiation Workers Feed Material
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84 Radiation Workers by Beral et al
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88 Radiation Workers Table 6-1. Leu
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90 Radiation Workers No
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92 Radiation Workers N
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94 Radiation Workers S
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96 Radiation Workers ERR estim
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98 Mayak Workers Table 1. Dose (Gy)
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100 Mayak Workers workers at the ra
Page 113 and 114: 102 Mayak Workers
Page 115 and 116: 104 Uranium Miners enrichment facil
Page 117 and 118: 106 Uranium Miners Samet et al. (19
Page 119: 108 Uranium Miners were selected 12
Page 122 and 123: Uranium Miners 111
Page 124 and 125: 9 RADIATION EXPOSURE IN FLIGHT The
Page 126 and 127: DNA damage (a chemical change in DN
Page 128 and 129: 10 PRECONCEPTION EXPOSURES Several
Page 130 and 131: of risk in the lowest dose groups,
Page 132 and 133: found elevated solid cancer risk wi
Page 134 and 135: preconception doses between 2.5 and
Page 136 and 137: Table 10-1. Preconception irradiati
Page 138 and 139: Preconception Exposures 127
Page 140 and 141: Tracheoesophageal fistula and conge
Page 142 and 143: cancer were both associated with th
Page 144 and 145: 0.10-4.71) while respiratory system
Page 146 and 147: elationship was not significant for
Page 148 and 149: times higher than in less-contamina
Page 150 and 151: Nuclear Power Accidents 139
Page 156 and 157: 12 COMMUNITIES NEAR NUCLEAR FACILIT
Page 158 and 159: levels (this could not in itself be
Page 160 and 161: Figure 12-3. Native Americans from
Page 162 and 163: of leukemia was measured over a lar
Page 166 and 167: more that we can say about this app
Page 168 and 169: Communities Near Nuclear Facilities
Page 176 and 177: 54 observed vs. 46.1 expected death
Page 178 and 179: 13 DISCUSSION Our intention in crea
Page 180 and 181: myeloid leukemia) was significantly
Page 182 and 183: 0.1-3.5 WLM; this is roughly equiva
Page 184 and 185: adon (Lubin et al. 1997). These res
Page 186 and 187: Leukemia Leukemia, a general term t
Page 188 and 189: vical cancer. The doses to these pa
Page 190 and 191: England have found it convenient to
Page 192 and 193: Thyroid disease Thyroid cancer is a
Page 194 and 195: 1986 through 1995. These workers sh
Page 196 and 197: dence of this disease includes elev
Page 198 and 199: Analysis of preconception exposure
Page 200 and 201: Paternal age, education, drinking O
Page 202 and 203: Gardner et al. 1990 Employed at Sel
Page 204 and 205: we consider this group of a few hun
Page 206 and 207: Leukemia risk (excluding CLL) among
Page 208 and 209: Glossary of Terms for Epidemiology
Page 210 and 211: Glossary 199 Beta radiation: Stream
Page 212 and 213: Dosimetry: Measurement or estimatio
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Glossary 203 Hypothyroidism: The cl
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Glossary 205 Metastasis: 1. Movemen
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Glossary 207 waves, ultra violet (U
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Glossary 209 Thyroid Disease: disea
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Bibliography ATSDR. Public Health A
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Bhatia S, Sklar C. Second cancers i
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Bibliography 215 Cavallo D, Tomao P
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Bibliography 217 Department of Ener
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Bibliography 219 Gardner MJ, Hall A
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Haldorsen T, Reitan JB, Tveten U. C
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Bibliography 223 Howe GR, Nair R, N
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of Mayak, A comparison of numerical
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Bibliography 227 Laird NM. Thyroid
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control population. International J
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Bibliography 231 Neel JV, Schull WJ
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2003.160:381-407. Bibliography 233
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Bibliography 235 Saccomanno G, Auer
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Bibliography 237 analysis of cancer
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Bibliography 239 Tokarskaya ZB, Sco
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Journal of Epidemiology 1987.125(2)
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Actinium, 84 Acute lymphocytic leuk
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and Nevada Test Site, 60-61, 62 nuc
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Hashimoto’s thyroiditis, 185 Heal
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studies, 101-2 Medical exposure, 19
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(RERF), 43 Radiation Exposure Compe
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Viruses, 118, 154, 193 West Germany
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