**REPORT ON THE FEASIBILITY OF A STUDY**

**OF THE HEALTH CONSEQUENCES**

**TO THE AMERICAN POPULATION**

**FROM NUCLEAR WEAPONS TESTS CONDUCTED**

**BY THE UNITED STATES AND OTHER NATIONS**

Volume 1

Technical Report

Prepared for the U.S. Congress

by the

Department of Health and Human Services

Centers for Disease Control and Prevention

and the

National Cancer Institute

May 2005

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Acknowledgment

This report is the culmination of an effort involving many individuals
who contributed technically or provided other support. Foremost, we
offer our thanks to the authors of each chapter for the time and
expertise they dedicated to this project. We also wish to acknowledge
the valuable efforts of the science staff of the Centers for Disease
Control and Prevention and the National Cancer Institute and
contractors, and communications staff from both agencies. We would like
to thank the Office of the Deputy Assistant Secretary for Science Policy
of the Department of Health Human Services for valuable guidance in the
development of this report, the Advisory Committee for Energy-Related
Epidemiology Research and members of the public for their thoughtful
comments during the development of the draft report, and the National
Academy of Sciences' review committee for their comments and
recommendations on the draft report.

+----------------------------------+-----------------------------------+
| Charles Miller, Ph.D.            | André Bouville, Ph.D.             |
+----------------------------------+-----------------------------------+
| Co-Principal Investigator        | Co-Principal Investigator         |
|                                  |                                   |
| Radiation Studies Branch         | Radiation Epidemiology Branch     |
|                                  |                                   |
| National Center for              | Division of Cancer Epidemiology   |
| Environmental Health             | and Genetics                      |
|                                  |                                   |
| Centers for Disease Control and  | National Cancer Institute         |
| Prevention                       |                                   |
|                                  | National Institutes of Health     |
+----------------------------------+-----------------------------------+

*Inquiries and requests for copies should be directed to:*

*Charles Miller, PhD*

*Radiation Studies Branch*

*National Center for Environmental Health*

Centers for Disease Control and Prevention

*Mail Stop E39*

*1600 Clifton Road NE*

*Atlanta, GA 30333*

List of Contributors

(in alphabetical order)

[Centers for Disease Control and Prevention]{.underline}

Paul Garbe

Charles W. Miller

Joan Morrissey

Claudia Parvanta

Judy Qualters

J. Felix Rogers

James M. Smith

Diana Swindel

Robert C. Whitcomb, Jr.

Charles M. Wood

[National Cancer Institute]{.underline}

André Bouville

Betsy Duane-Potocki

Ethel Gilbert

Charles Land

Anne Lubenow

Nicholas Luckyanov

Kiyohiko Mabuchi

Elaine Ron

Steven L. Simon

Robert M. Weinstock

[Consultants]{.underline}

Lynn R. Anspaugh

Harold L. Beck

Abstract

For the first time, doses and risks of related health effects have been
estimated for representative persons in all counties of the contiguous
United States from a set of important radionuclides produced from
testing of nuclear weapons from 1951 through 1962 by the United States
and other nations. The estimated doses and risks, while rudimentary in
nature, demonstrate that it is feasible to conduct a more detailed study
of the health impact on American people as a result of exposure to
radioactive fallout from the testing of nuclear weapons in the United
States and abroad. However, significant resources would be required to
implement such a study, and careful consideration should be given to
public health priorities before embarking on that path. To assist in the
process of making a decision about conducting future fallout-related
research, five different options were developed for consideration and
were subsequently reviewed by the National Academy of Sciences. Those
options were:

Option 1: Conduct no additional fallout-related work;

Option 2: Retrieve and archive only the historic documentation related
to radioactive fallout from nuclear weapons testing conducted by the
United States and other nations;

Option 3: Conduct a more detailed dose reconstruction of radioactive
fallout from global nuclear weapons testing for Iodine-131, the most
significant radionuclide identified in this study;

Option 4: Conduct a more detailed dose reconstruction for multiple
radionuclides in radioactive fallout from both Nevada Test Site and
global nuclear weapons testing;

Option 5: Conduct a detailed study of the health effects of nuclear
weapons testing fallout including, in a single project, dose estimation,
risk analysis, and communication of the results to interested parties.

Precise estimates of the resources needed to complete each option
considered have not been developed. However, the actual cost of some
past projects is presented in the report for purposes of illustration
only.

The National Academy of Sciences' Committee on Assessment of CDC
Radiation Studies, in its review of the feasibility study, recommended
that Options 2 and 3 should be further considered by CDC and NCI.

**Table of Contents**

**Volume 1: Technical Report**

**[Page]{.underline}**

Acknowledgment ii

List of Contributors (in alphabetical order) iii

Abstract iv

List of Figures vii

List of Tables ix

Executive Summary 1

Chapter 1 12

Introduction 12

1.1 Background 12

1.2 Scope of work 13

1.3 Issues outside the scope of this report 15

1.4 Organization of this report 16

Chapter 2 18

Fallout from Nuclear Weapons 18

2.1 Fallout Production Mechanisms 18

2.2 Brief Review of Nuclear Weapons Tests 20

2.3 List of Nuclear Weapons Tests 21

Chapter 3 25

Estimation of Doses from Fallout 25

3.1 Introduction 25

3.2 NTS Fallout 27

3.3 Global Fallout 55

3.4 Comparison of NTS and Global Fallout Doses 79

3.5 Summary 81

3.6 Considerations for Further Research 89

Chapter 4 99

Potential Health Consequences from Exposure of the United States
Population to Radioactive Fallout 99

4.1 Introduction 99

4.2 Health Effects of Ionizing Radiation 100

4.3 Risk Analysis 107

4.4 Conclusions 122

Chapter 5 129

Communications Approach 129

5.1 Introduction 129

5.2 Components of a Proposed Communications Plan 130

5.3 Using NCI's ^131^I/NTS Communications Project as a Model 131

5.4 Audience Profiling and Message Development 135

5.5 Developing Working Partnerships 149

5.6 Coordinating with Other Programs 150

5.7 Implementation 153

5.8 Additional Work Outside the Scope of this Report 157

5.9 Conclusion 157

Chapter 6 162

Conclusions and Options for Future Work 162

6.1 Introduction 162

6.2 Options for Future Work 162

6.3 Conclusions 168

Glossary 170

**Volume 2: Appendices**

Appendix A: CDC and NCI Responses to Key NAS Recommendations

Appendix B: Summary of the National Cancer Institute Report

Appendix C: ACERER Issues

Appendix D: Document Preservation and Retrieval: Current and Potential
Future Activities

Appendix E: External Dose Estimates from NTS Fallout

Appendix F: Internal Dose Estimates from NTS Fallout

Appendix G: External Dose Estimates from Global Fallout

Appendix H: Internal Dose Estimates from Global Fallout

Appendix I: Communications Materials

List of Figures

**[Page]{.underline}**

Figure 2.1. Locations of sites where tests were conducted prior to 1963
with greater than one megaton total explosive yield. 22

Figure 3.1. Total ^137^Cs (Bq) deposited in the United States from NTS
tests as a function of year of tests 33

Figure 3.2. Cesium-137 deposition density (Bq/m^2^) due to all NTS
tests. 33

Figure 3.3. Strontium-90 deposition density (Bq/m^2^) due to all NTS
tests. 34

Figure 3.4. Plutonium (239+240) deposition density (Bq/m^2^) due to all
NTS tests. 35

Figure 3.5. Estimated fractions of total ^137^Cs deposited in the United
States from NTS by year of test. 36

Figure 3.6. External dose (mGy) to the red bone marrow and the thyroid
gland for both children and adults resulting from all NTS tests. 40

Figure 3.7. Fraction of food that is assumed to be locally produced for
several different food categories. Values for eggs are the same as those
for milk. From Whicker and Kirchner (1987). 43

Figure 3.8. Consumed fraction of non-leafy vegetables and fruits assumed
to be freshly produced. From Whicker and Kirchner (1987). 44

Figure 3.9. Monthly values of integrated intake for four age groups for
^90^Sr. Data were derived from Whicker and Kirchner (1987). 45

Figure 3.10. Monthly values of integrated intake for four age groups for
^131^I. Data were derived from Whicker and Kirchner (1987). 45

Figure 3.11. Monthly values of integrated intake for four age groups for
^137^Cs. Data were derived from Whicker and Kirchner (1987). 46

Figure 3.12. Internal dose (mGy) to red bone marrow of persons born 1
January 1951 from all NTS tests. 48

Figure 3.13. Internal dose (mGy) to the thyroid of persons born 1
January 1951 from all NTS tests. 48

Figure 3.14. Total (external + internal) dose (mGy) to the red bone
marrow of adults in 1951 from all NTS tests. 53

Figure 3.15. Total (external + internal) dose (mGy) to the red bone
marrow of persons born on 1 January 1951 from all NTS tests. 54

Figure 3.16. Total (external + internal) dose (mGy) to the thyroid of
adults in 1951 from all NTS tests. 54

Figure 3.17. Total (external + internal) dose (mGy) to the thyroid of
persons born on 1 January 1951 from all NTS tests. 55

Figure 3.18. Cesium-137 deposition density (Bq/m^2^) due to global
fallout. 61

Figure 3.19. External dose (mGy) to the red bone marrow and the thyroid
gland resulting from global fallout. 63

Figure 3.20. Contribution to external exposure from global fallout from
individual radionuclides as a function of year. 65

Figure 3.21. Time-dependence of external dose (population-weighted or
per capita) from global fallout from individual radionuclides and as sum
total. 66

Figure 3.22. Cumulative (1953 through 1963) thyroid dose as a function
of birth year. The cumulative dose for an adult, or a person who was
born before 1 January 1933, is about 400 Sv. 70

Figure 3.23. Annual dose as a function of time following the release of
1 PBq of ^3^H to the atmosphere of the northern hemisphere. Results are
based upon the NCRP (1979) model of tritium in the hydrological cycle.
71

Figure 3.24. Annual effective dose normalized to intake (µSv PBq^-1^)
following the release of 1 PBq of ^14^C to the atmosphere of the
northern hemisphere. Results are based upon the model of Titley et al.
(1995). 73

Figure 3.25. Internal dose (mGy) to red bone marrow of adults in 1951
from global fallout. 76

Figure 3.26. Total (external + internal) dose (mGy) to the red bone
marrow of adults in 1951 from global fallout. 76

Figure 3.27. Total (external + internal) dose (mGy) to the red bone
marrow of persons born 1 January 1951 from global fallout. 77

Figure 3.28. Cesium-137 deposition density (Bq/m^2^) due to NTS and
global fallout. 81

Figure 3.29. External dose (mGy) to the red bone marrow of adults
resulting from NTS and global fallout. 82

Figure 3.30. Internal dose (mGy) to red bone marrow of persons born 1
January 1951 from NTS and global fallout. 83

Figure 3.31. Total dose (mGy) to the red bone marrow of adults in 1951
from NTS and global fallout. 83

Figure 3.32. Total dose (mGy) to red bone marrow of persons born 1
January 1951 from NTS and global fallout. 84

Figure 3.33. Total dose (mGy) to red bone marrow of persons from 10
years of exposure to natural gamma radiation from the terrestrial
environment (based on data provided by the U.S. Geological Survey). 85

Figure 3.34. Total dose (mGy) to red bone marrow persons from 10 years
of exposure to cosmic ray radiation. (Map courtesy of Geological Survey
of Canada.) 86

Figure 5.1 Selecting Target Audiences. 137

List of Tables

**Page**

Table 1. Summary of average thyroid and red bone marrow doses (milliGray
\[mGy\]) from NTS and global fallout received as a result of exposure to
the most important radionuclides 3

Table 2.1. A summary of atmospheric nuclear tests by major site and
country (UNSCEAR 2000) 23

Table 3.1. Nuclear weapons tests conducted at NTS that are considered in
the feasibility study (based on NCI 1997) 28

Table 3.2. Radionuclides in NTS fallout for which deposition densities
(Bq m^-2^) were explicitly calculated on a county-by-county basis. 30

Table 3.3. Total deposition and population-weighted mean deposition
density for selected radionuclides for NTS fallout. 37

Table 3.4. Collective external dose and country-average dose from NTS
fallout as a function of year of testing 41

Table 3.5. Food-consumption rates used in the PATHWAY code (Whicker and
Kirchner 1987). Estimates are based primarily on data summarized by Rupp
(1980) for rural families. 43

Table 3.6. Population-weighted red marrow and thyroid doses from all NTS
tests (mGy). 49

Table 3.7. Population-weighted (adult) effective dose from ingestion,
calculated through year 2000, specified by year of testing. 49

Table 3.8. Population-weighted (adult) effective dose from ingestion for
the 16 nuclear explosions giving largest predicted doses. 50

Table 3.9. Comparison of population-weighted (adult) external dose,
internal red bone marrow and thyroid dose from all tests at the NTS
according to radionuclide, calculated through the year 2000. 51

Table 3.10. Estimates of population-weighted (adult) organ dose and
effective dose from ingestion through the year 2000 from all NTS tests.
52

Table 3.11. Estimates of Fission and Fusion Yields (Mt) by Year 56

Table 3.12. Radionuclides deposited in global fallout for which
deposition densities and doses were calculated. 59

Table 3.13. Total deposition and population-weighted deposition density
of selected radionuclides for NTS fallout and global fallout (sorted by
decreasing half-life). 62

Table 3.14. Collective dose and population-weighted external dose versus
year of exposure 64

Table 3.15. Percentage of external dose contributed by various fission
products from global and NTS fallout. 66

Table 3.16. Population-weighted (adult) organ doses (mGy) and effective
dose (mSv) from ingestion of ^131^I deposited in global fallout during
1953-1963. 69

Table 3.17. Population-weighted (child) organ doses (mGy) and effective
doses (mSv) to an individual born on 1 January 1951 from ingestion of
^131^I deposited in global fallout during 1953-1963. 69

Table 3.18. Effective dose (mSv) from ingestion from the creation or
release of ^3^H and ^14^C during the testing of large fusion weapons in
the Northern Hemisphere. 74

Table 3.19. Total population-weighted organ (mGy) and effective doses
(mSv) from the deposition of ^90^Sr and ^137^Cs in global fallout during
19531972. Upper values are for those who were adults in 1951; lower
values are for a person born on 1 January 1951. 75

Table 3.20. Comparison of fallout doses from internal irradiation from
NTS and from global fallout sources. 78

Table 3.21. Comparison of effective dose from reported concentrations of
^90^Sr, ^131^I, and ^137^Cs in milk with predicted doses from models
used in this report. 79

Table 3.22 Summary of population-weighted effective (mSv) and organ
doses (mGy) from NTS and global fallout as a result of exposure to the
most important radionuclides. Unless otherwise specified, the values are
for adults at the time of the tests. 80

Table 5.1. Broad Target Population Groups, Assumptions and Potential
Communications Channels and Activities 140