Report to Congress 

Radiation Exposure Screening and Education 

Grant Program 

(FY 2006) 

Department of Health and Human Services 

Health Resources and Services Administration 
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TABLE OF CONTENTS 

 Background ...................................................................................... 3 

Purpose ............................................................................................ 3 

Table 1 - FY 2006 Grantees ............................................................ 4 

FY 2006 Program Activities ......................................................... 5-6 

Table 2 - Program Users by Type of Service .................................. 7 

Chart 1- Percent Program Users by Race and Ethnicity ................. 8 

Chart 2 - Percent Program Users by Age Group ............................. 9 

Chart 3 - Percent Program Users with Non-malignant Disease .... 10 

Chart 4 - Percent Program Users with Malignant Disease...........11 

Definitions, RECA Eligibility and Screening Requirements....12-14 

 
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Report to Congress

 

Radiation Exposure Screening and Education Program 

Section 417C of the Public Health Service (PHS) Act, “Grants for Education, Prevention, and 

Early Detection of Radiogenic Cancers and Diseases,” includes a requirement that the Secretary 

submit an annual report summarizing the expenditures and programs funded under this section. 

BACKGROUND 

The Radiation Exposure Compensation Act (RECA) Amendments of 2000 (P. L. 106-245), 

amended the PHS Act to add section 417C, “Grants for Education, Prevention, and Early 

Detection of Radiogenic Cancers and Diseases.” Section 417C provides the authority for 

competitive grants to States, local governments, and appropriate health care organizations to 

initiate and support programs for: (1) individual cancer screening, (2) medical referrals, 

(3) public information dissemination, and (4) facilitation of RECA claim documentation. 

Administration for this authority designated as the Radiation Exposure Screening and Education 

Program (RESEP) was delegated by the Secretary of the Department of Health and Human 

Services to the Health Resources and Services Administration (HRSA). 

PURPOSE 

The purpose of the RESEP is to aid those individuals who may have been adversely affected by 

the mining, transporting and processing of uranium, and the testing of nuclear weapons for the 

Nation’s weapons arsenal. The people exposed included those who participated onsite in a test 

involving the atmospheric detonation of a nuclear device within the official boundaries of the 

Nevada or Trinity Test Sites; or those who were physically present in one of the affected areas 

downwind of the Nevada Test Site. In addition, uranium mine employees were exposed to large 

doses of radiation and other airborne hazards in the mine environment that together are presumed 

to have produced an increased incidence of lung cancer and respiratory diseases among these 

mine workers. This prevention grant program is designed according to its Congressional intent 

to help individuals and their families detect potential radiological illnesses earlier, allowing them 

to be treated more successfully and cost effectively. 

In September 2006, HRSA continued awards to seven organizations in five southwestern States 

(Arizona, Colorado, Nevada, New Mexico and Utah). Table 1 provides a description of the 

seven grantees, the proposed service area, and the amount awarded. For ease of review, 

Definitions, Eligibility, and Screening Requirements are defined on pages 12-14 of this report. 
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Table 1

FY 2006 Radiation Exposure Screening and

Education Program (RESEP) Grantees

Grantee Proposed Service Area Award Amount 

Intermountain Health Services 

d.b.a. Dixie Regional Medical 

Center 

St. George, Utah 

Nye, Lincoln, NE Clarke, 

NV; Kane, Garfield, 

Washington, Iron, Beaver, 

UT; Northern Mohave and 

Coconino, AZ 

$ 279,180 

Mountain Park Health Center 

Phoenix, Arizona 

Apache, Coconino, Gila, 

Mohave, Navajo, 

Maricopa, Yavapai, AZ 

$ 157,915 

Northern Navajo Medical 

Center 

Shiprock, New Mexico 

Navajo Nation (NM, AZ, 

UT) 

$ 332,640 

St. Mary's Hospital 

Grand Junction, Colorado 

W. Colorado 

Grand and San Juan 

counties, UT 

$ 272,745 

Board of Regents 

University of Nevada 

Reno, Nevada 

University of New Mexico 

Albuquerque, New Mexico 

Eureka, Lander, Lincoln, 

Nye, White Pine, Clark 

(portion), NV 

Grants, NM; Pueblos of 

Acoma, Canoncito and 

Laguna 

$178,200 

$ 182,898 

Utah Navajo Health System 

Montezuma Creek, Utah 

Utah State except Kane, 

Garfield, Washington, Iron, 

Beaver counties 

$182,903 

TOTAL: $1,586,481 
The seven RESEP grantees have implemented programs consistent with legislative and program 

requirements. The remainder of this report is based on data and information provided by the 

grantees and reflects operations during the period September 1, 2006 through August 31, 2007. 

FY 2006 RESEP PROGRAM ACTIVITIES 

Intermountain Health Services d.b.a. Dixie Regional Medical Center, St. George, Utah: 

• Service Area: Southwestern Utah and adjacent regions in Arizona and Nevada; 

• Number of Service Delivery Sites: three; 

• Users: Downwinders; 

• Screening: 429 patients and made 1,307 medical referrals; 

• Education: Disseminated cancer-related educational materials. Held 31 presentations on 

atmospheric nuclear testing and downwinder risks; and 

• Outreach: Distributed over 3,812 pamphlets, brochures and fliers; organized 13 TV 

spots, and composed three newspaper articles. 

Mountain Park Health Center, Phoenix, Arizona: 

• Service Area: Counties of Apache, Coconino, Gila, Mohave, Navajo and Yavapai 

Counties; 

• Number of Service Delivery Sites: four; 

• Users: Downwinders; 

• Screening: 59 patients and made 36 medical referrals; 

• Education: Conducted 41 educational presentations, disseminated 1,500 educational 

brochures; and 

• Outreach: Disseminated 14 newspaper articles and 17 letters about the program. 

Northern Navajo Medical Center, Shiprock, New Mexico: 

• Service Area: Navajo Nation of NM, AZ; Apache County, AZ; Navajo County, AZ; 

Coconino County, AZ; McKinley County, NM; San Juan County, NM; and in UT, 

including San Juan County, UT; 

• Number of Service Delivery Sites: five; 

• Users: Miners, millers, ore transporters, downwinders; 

• Screening: 378 individuals and made 83 medical referrals; 

• Education: Educated providers and patients on the importance of screening. Held. five 

presentations and disseminated 1,200 program brochures; 

• Outreach: Participated in various activities including public service announcements and 

continuing medical education programs. Held 34 radio advertisements and wrote 800 

letters. 

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St. Mary’s Hospital, Grand Junction, Colorado: 

• Service Area: Western Slope of Colorado, Southeastern Utah, and Wyoming; 

• Number of Service Delivery Sites: one; 

• Users: Miners, millers, and ore transporters; 

• Screening: 176 individuals for radiogenic disease and made 317 medical referrals; 

• Education: Conducted four presentations to community organizations; and 

• Outreach: Distributed 300 promotional pamphlets; wrote two newspaper articles 

reaching several thousand individuals. 

Board of Regents, University of Nevada, Reno, Nevada: 

• Service Area: Eureka, Lander, Lincoln, Nye, White Pine, and portion of Clark counties; 

• Number of Service Delivery Sites: one; 

• Users: Downwinders, and onsite participants; 

• Screening: 246 individuals for radiogenic disease and made 211 medical referrals; 

• Education: Disseminated 3,632 program brochures on health risks associated with radiation 

exposure and 34 presentations; and 

• Outreach: Conducted one radio announcement, one TV spot, 43 news articles and wrote 38 

letters. 

University of New Mexico, Albuquerque, New Mexico: 

• Service Area: Residents of New Mexico who do not live on the Navajo Nation; 

• Number of Service Delivery Sites: two; 

• Users: Miners, millers and ore transporters; 

• Screening: 94 individuals for radiogenic disease and made 36 medical referrals; 

• Education: Disseminated 1,214 informational brochures on health risks associated with 

radiation exposure and conducted 14 educational presentations; and 

• Outreach: Distributed 802 letters and wrote 4 newspaper articles. 

Utah Navajo Health System, Montezuma Creek, Utah: 

• Service Area: State-wide Utah except for Washington, Iron, and Kane counties; 

• Number of Service Delivery Sites: three; 

• Users: Miners, millers, ore transporters, and downwinders; 

• Screening: 82 individuals for radiogenic disease and made four medical referrals; 

• Education: Conducted 26 group sessions with 867 attendees; and 

• Outreach: Held 30 presentations at various community events and venues, disseminated 

537 brochures and wrote 2,005 letters and 6 newspaper articles. 

RESULTS 

Approximately 41,347 individuals were informed through the outreach and education activities 

including program brochures, presentations, and letters of the possible effects of exposure to 

radiation as well as the services available through the RESEP. The grantees have also 

successfully shared information with several thousand individuals through various media 

including TV ads, radio spots, public service announcements, and newspaper articles. 

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Table 2 illustrates the number of medical screening exams, medical referrals, and RECA 

eligibility assistance provided by each grantee. Compared to the FY 2005 program year, the 

program experienced minor decreases in the number of medical screening exams and the RECA 

eligibility assistance categories by 87 and 1,873 respectively. However, there was an increase 

in the number of medical referrals by 334. 

Table 2. Number of Program Users by Type of Service 

Grantee Organization Screening 

Exams 

Medical 

Referrals 

RECA 

Eligibility 

Assistance 

Dixie Regional Medical 

Center 

429 1307 5137 

Mountain Park Health Center 

 

 59 43 381 

Northern Navajo Medical 

Center 

378 83 440 

Utah Navajo Health System 82 4 97 

Board of Regents 

University of Nevada 

 246 211 74 

University of New Mexico 94 36 528 

St. Mary’s Hospital 176 317 526 

TOTAL 1464 2001 7183 

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Chart 1 illustrates that the largest percent of program users screened was White at 59 percent. 

The second largest number of users was American Indian/Alaskan Native at 37 percent, and the 

smallest percent of program users were Hispanic at 4 percent. 

Chart 1. Percent Distribution of Program Users by Race and Ethnicity 

 

Hispanic

4% American Indian / 

Alaskan Native

37%

White

59%

American Indian / Alaskan

Native

White

Hispanic

 

 

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Chart 2 illustrates that the largest age group of the program users screened was between the 65-

69 years of age, which made up 20 percent of program users. Those between 40 and 44 years of 

age made up the smallest group, with less than one percent of program users. 

Chart 2. Percent Distribution of Program Users by Age Group 

 

40-44 yrs

<1%

60-64yrs

17%

55-59yrs

14%

50-54yrs

9%

45-49 yrs

4%

85 years + 

3%

80-84yrs

75-79yrs 6%

12%

70-74yrs

15%

65-69yrs

20%

40-44 yrs

45-49 yrs

50-54yrs

55-59yrs

60-64yrs

65-69yrs

70-74yrs

75-79yrs

80-84yrs

85 years + 

 

 

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Chart 3 illustrates the percent distribution of program users with non-malignant disease by 

exposure category. Downwinders represent the largest exposure category at 42 percent; while 

miners represent the second largest exposure category at 33 percent of all users. Onsite 

participants and ore transporters each represent about one percent of program users; and 15 

percent of the users are exposed to multiple sources of radiation. 

Chart 3. Percent Distribution of Program Users with Non-Malignant Disease 

by Source of Exposure 

 

 Multiple Exposure

15%

Onsite Participant

1%

Uranium Miners

33%

Ore Transporters

1%

Uranium Millers

Downwinder 8%

42%

Uranium Miners

Uranium Millers

Ore Transporters

Downwinder

Onsite Participant

Multiple Exposure

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Chart 4 illustrates the percent distribution of program users with malignant disease by exposure 

category. Seventy-two percent of the program users with malignant disease are Downwinders; 

while uranium miners and millers represent 11 and 6 percent respectively; and nine percent of 

the users experienced multiple sources of exposure to radiation. 

Chart 4. Percent Distribution of Program Users with Malignant Disease by Source of 

Exposure 

 

 

 

Onsite Participants

<1 %

Multiple Exposure

9%

Uranium Miners

11 % Uranium Millers

6%

Ore Transporters

2%

Downwinders

72%

Uranium Miners

Uranium Millers

Ore Transporters

Downwinders

Onsite Participants

Multiple Exposure

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The following are Definitions, Eligibility, and Screening Requirements for Compensation under 

the Radiation Exposure Compensation Act amendments of 2000. 

Uranium Miners

Definition: Individual must have been employed in an above-ground or underground uranium 

mine located in Colorado, New Mexico, Arizona, Wyoming, South Dakota, Washington, Utah, 

Idaho, North Dakota, Oregon, or Texas at any time during the period beginning on January 1, 

1942, and ending on December 31, 1971. 

Eligibility: Individual must have been exposed to 40 or more working level months of radiation 

while employed in a uranium mine during the time period referenced above. 

Screening Requirements: Provided for the following diseases: primary lung cancer and certain 

non-malignant respiratory diseases including pulmonary fibrosis; cor pulmonale resulting from 

fibrosis, silicosis, and pneumoconiosis. 

Uranium Millers 

Definition: Individual must have been employed in a uranium mill located in Colorado, New 

Mexico, Arizona, Wyoming, South Dakota, Washington, Utah, Idaho, North Dakota, Oregon, or 

Texas at any time during the period beginning on January 1, 1942, and ending on December 31, 

1971. The term 'uranium mill' includes milling operations involving the processing of uranium 

ore or vanadium-uranium ore, including both carbonate and acid leach plants. 

Eligibility: Individual must have worked for at least 1 year during the time period referenced 

above. 

Screening Requirements: Provided for the following diseases: primary lung cancer, certain nonmalignant respiratory diseases (including pulmonary fibrosis, cor pulmonale resulting from 

fibrosis, silicosis, and pneumoconiosis), renal cancer, and other chronic renal diseases including 

nephritis and kidney tubal tissue injury. 

Ore Transporters 

Definition: Individual must have been employed in the transport of uranium ore or vanadiumuranium ore from mines or mills located in Colorado, New Mexico, Arizona, Wyoming, South 

Dakota, Washington, Utah, Idaho, North Dakota, Oregon, or Texas at any time during the period 

beginning on January 1, 1942, and ending on December 31, 1971. 

Eligibility: Individual must have worked for at least 1 year during the time period referenced 

above. 

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Screening Requirements: Provided for the following diseases: primary lung cancer, certain nonmalignant respiratory diseases, renal cancer, and other chronic renal diseases including nephritis 

and kidney tubal tissue injury. 

Downwinders

Definition: Individual must have been physically present in one of the affected areas downwind 

of the Nevada Test Site during a period of atmospheric nuclear testing. The individual must 

have lived or worked downwind of atmospheric nuclear tests in certain counties in Utah, 

Nevada, or Arizona for a period of at least 2 years during the period beginning on January 21, 

1951, and ending on October 31, 1958, or for the period beginning on June 30, 1962, and ending 

on 

July 31, 1962. 

Eligibility: The designated affected areas for the Nevada Test Site are in the State of Utah, the 

counties of Beaver, Garfield, Iron, Kane, Millard, Piute, San Juan, Sevier, Washington, and 

Wayne; in the State of Nevada, the counties of Eureka, Lander, Lincoln, Nye, White Pine, and 

that portion of Clark County that consists of townships 13 through 16 at ranges 63 through 71; 

and in the State of Arizona, the counties of Apache, Coconino, Gila, Navajo, and Yavapai. 

Screening Requirements: Provided for the following cancers: leukemia (other than chronic 

lymphocytic leukemia), lung cancer, multiple myeloma, lymphomas (other than Hodgkin’s 

disease), and primary cancer of the thyroid, male or female breast, esophagus, stomach, pharynx, 

small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary bladder, brain, colon, 

ovary, or liver (except if cirrhosis or hepatitis B is indicated). 

Onsite Participants

Definition: The individual must have participated onsite in a test involving the atmospheric 

detonation of a nuclear device. The individual must have been present “onsite” above or within 

the official boundaries of the Nevada, Pacific, Trinity, or South Atlantic Test Sites at any time 

during a period of atmospheric nuclear testing and must have “participated” during that time in 

the atmospheric detonation of a nuclear device. (While onsite participants at the Pacific and 

South Atlantic test sites are eligible for RECA compensation, organizations located in these 

areas are not eligible to apply for RESEP grant funds.) 

Eligibility: On-site means physical presence above or within the official boundaries of any of the 

following locations: 

• The Nevada Test Site, Nevada – in the State of Utah, the counties of Beaver, Garfield, Iron, 

Kane, Millard, Piute, San Juan, Sevier, Washington, and Wayne; in the State of Nevada, the 

counties of Eureka, Lander, Lincoln, Nye, White Pine, and that portion of Clark County that 

consists of townships 13 through 16 at ranges 63 through 71; and in the State of Arizona, the 

counties of Apache, Coconino, Gila, a portion of Mohave County (located north of the Grand 

Canyon), Navajo, and Yavapai. 

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• The Pacific Test Sites - Bikini Atoll, Enewetak Atoll, Johnston Island, Christmas Island, the 

test site for the shot during Operation Wigwam, the test site for Shot Yucca during Operation 

Hardtack I, and the test sites for Shot Frigate Bird and Shot Swordfish during Operation 

Dominic I and the official zone around each site from which non-test affiliated ships were 

excluded for security and safety purposes. 

• The Trinity Test Site, New Mexico. 

• The South Atlantic Test site for Operation Argus and the official zone around the site from 

which non-test affiliated ships were excluded for security and safety purposes. 

• Any designated location within a Naval Shipyard, Air Force Base, or other official 

government installation where ships, aircraft or other equipment used in an atmospheric 

nuclear detonation were decontaminated. 

• Any designated location used for the purpose of monitoring fallout from an atmospheric 

nuclear test conducted at the Nevada Test Site. 

Screening Requirements: Provided for the following cancers: leukemia (other than chronic 

lymphocytic leukemia), primary lung cancer, multiple myeloma, lymphomas (other than 

Hodgkin’s disease), and primary cancer of the thyroid, male or female breast, esophagus, 

stomach, pharynx, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary 

bladder, brain, colon, ovary, or liver (except if cirrhosis or hepatitis B is indicated).