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Occupational Energy Research Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

May 2001
This document is in the public domain and

may be freely copied or reprinted.

Disclaimer: Mention of any company

or product does not constitute

endorsement by NIOSH

Ordering Information

To receive documents or more information about occupational

safety and health topics, contact the National Institute for

Occupational Safety and Health (NIOSH) at

NIOSH–Publications Dissemination 

4676 Columbia Parkway

Cincinnati, OH 45226–1998

Telephone: 1–800–35–NIOSH (1–800–356–4674)

Fax: 513–533–8573

E-mail: Pubstaft@cdc.gov

or visit the NIOSH Web site at

www.cdc.gov/niosh

DHHS (NIOSH) Publication Number 2001-133
Preface

This Occupational Energy Research Program book presents an overview of the

occupational health research program conducted under the 2000 Memorandum of

Understanding between the Department of Energy (DOE) and the Department of

Health and Human Services (DHHS). The Centers for Disease Control and

Prevention/National Institute for Occupational Safety and Health (NIOSH) HealthRelated Energy Research Branch (HERB) within DHHS conducts a program of

independent occupational research with funding from DOE. The reader will find

information addressing studies conducted internally by NIOSH staff; studies conducted

externally through NIOSH-supported contracts, grants, and cooperative agreements;

DOE worker surveillance projects with NIOSH involvement; and administrative and

programmatic details. The time frame presented includes current and proposed

occupational research activities through Fiscal Year (FY) 2000. The information in this

document is current as of December 1, 2000, and replaces the previous Occupational

Energy Research Program book dated October 1998.

The DOE Office of Health Studies (EH–6) serves as the primary DOE liaison to NIOSH.

This office also oversees the DOE worker surveillance cooperative agreement projects.

Comments, questions, corrections, and concerns regarding this document or its contents

may be directed to

Chief

Health-Related Energy Research Branch

National Institute for Occupational Safety 

 and Health 

Centers for Disease Control and Prevention

4676 Columbia Parkway, Mail Stop R–44

Cincinnati, Ohio 45226–1998

Phone: 513–841–4400 

Fax: 513–841–4470

iii
List of Acronyms, Abbreviations and Symbols

ACERER Advisory Committee on Energy-Related Epidemiologic Research

ATSDR Agency for Toxic Substances and Disease Registry

Bq Bequerel

Centers for Disease Control and Prevention

Comprehensive Epidemiologic Data Resource

CI Confidence Interval

CNS Central Nervous System

DHHS Department of Health and Human Services

DOE

FTE Full-Time Equivalent

FY Fiscal Year

Health Hazard Evaluation

International Agency for Research on Cancer

K–25 Codename for Oak Ridge Gaseous Diffusion Plant

mSv Millisievert

Sample Size/Number of Subjects

National Center for Environmental Health

National Cancer Institute

nCi

NIOSH

NORA

ORAU Oak Ridge Associated Universities

ORISE Oak Ridge Institute for Science and Education

ORNL Oak Ridge National Laboratory

P (Probability) Value

Battelle Pacific Northwest Laboratory

Po Polonium

Pu

REM

RR Rate Ratio, Risk Ratio, Relative Risk

SMR Standard Mortality Ratio

SRR Standard Rate Ratio

SRS Savannah River Site

WWII World War II

X–10

Y–12 Codename for Oak Ridge Y-12 Plant

Zia Zia Company, a Los Alamos National Laboratory contractor

iv
Table of Contents

Preface............................................................................................................................................iii

Acronyms and Abbreviations.........................................................................................................iv

Research Agenda......................................................................................................................Tab 1

Vision/Mission/Goals...............................................................................................................Tab 2

Research Issues/Needs..............................................................................................................Tab 3

Community Involvement and Worker Outreach......................................................................Tab 4

Accomplishments.....................................................................................................................Tab 5

Ongoing Research.....................................................................................................................Tab 6

Completed NIOSH-Initiated Research.....................................................................................Tab 7

Previous DOE Studies..............................................................................................................Tab 8

Proposed Research....................................................................................................................Tab 9

Medical Surveillance Grants/Activities Program...................................................................Tab 10

Occupational Energy Research Program Study Sites.............................................................Tab 11

Research Partners....................................................................................................................Tab 12

Points of Contact by Study.....................................................................................................Tab 13

NIOSH Health Energy-Related Research Branch Staff.........................................................Tab 14

Glossary..................................................................................................................................Tab 15

Study Index.............................................................................................................................Tab 16
NIOSH Energy-Related Health Research Program: Tab 1: Page 1

Research Agenda

Research Agenda

Background

Despite the research conducted over the past several decades, essential data are lacking for

assessing health risks from radiation exposures. The magnitude of risks associated with chronic

low-level radiation exposure is the subject of much scientific and policy debate. The results

from many occupational studies provide evidence that the current occupational limit of 5

roentgen equivalent man (rem) per year may

not adequately protect workers exposed to

chronic, low-level radiation. Further studies

are needed on workers exposed to low-level

ionizing radiation to better understand

attendant health risks and provide greater

protection of workers’ health.

A number of worker cohorts at U.S.

Department of Energy (DOE) sites have been

previously studied. Results from these

cohorts, although somewhat inconsistent and

uncertain, have lead many scientists to believe

that workers’ health has been affected. Most

notable is the substantial evidence of excess

cancer risk.

For many important reasons, the next decade

is the best possible time to continue

epidemiologic studies of DOE workers. The

workers are dying at increasing rates as this

population ages. Larger numbers of deaths in

mortality studies mean greater power to detect

meaningful changes in risk that might be

associated with radiation and chemical

exposures. Also, DOE site workers were

monitored for radiation exposure and, over the

past decade, many methods have been

developed to better account for bias and

uncertainty in monitoring data. Risk estimates

based on continuing analysis of these mature

cohorts will substantially reduce the current uncertainty and perhaps suggest the need for

changes in exposure limits. Futhermore, risk estimates based on survivors within these cohorts

may lead to the development of more accurate and precise exposure estimates. In contrast to

external radiation monitoring, available information about other forms of radiation exposures

Reasons for an Energy-Related

Health Research Program

1. Current 5 rem occupational limit may be

inadequate to protect workers.

2. Worker cohorts are more relevant to

occupational exposure limits than atomic bomb

survivor cohorts.

3. Past cohort studies did not include minorities or

women.

4. Latency in DOE cohorts is now sufficient to

study cancer and other chronic health effects.

5. DOE records and institutional memory are

currently available.

6. Multiple exposures and other demographic and

lifestyle factors can be addressed in study

design and analysis.

7. Application of the linear nonthreshold risk

model for low-level chronic exposure warrants

further study.

8. Findings are relevant to 300,000 nuclear facility

workers and the 1.5 million radiation- exposed

U.S. workers and to all stakeholders.
NIOSH Energy-Related Health Research Program: Tab 1: Page 2

Research Agenda

Who is HERB?

HERB is the Health-Related Energy

Research Branch at the National Institute

for Occupational Safety and Health in

Cincinnati, Ohio. The Branch, which was

organized in 1991, is staffed with

scientists in health physics, 

epidemiology, and exposure assessment

and experts in record management and

data analysis. Research is conducted

under a Memorandum of Understanding

with the U.S. Department of Energy

which provides funding.

and chemical exposures is much more limited. Workers’ memories of practices and exposure

potentials may be used to increase the precision and accuracy of exposure estimates. The

capacity to characterize significant exposures associated with DOE operations will continue to

diminish as more and more of these workers die.

The reliability of epidemiology studies is greatly improved by incorporating detailed and

accurate exposure metrics into analyses. Advanced data systems are now available that increase

the ability to combine records from an array of sources and perform analyses that were

previously impractical.

NIOSH Research Program Agenda

The agenda for the National Institute for Occupational Safety and Health (NIOSH)/HealthRelated Energy Research Branch (HERB) radiation research program has been developed and

updated with input from experts in relevant research

fields, representatives of labor and community

organizations, and American Indian Tribes. The

Department of Health and Human Services’ (DHHS)

Advisory Committee for Energy-Related

Epidemiologic Research (ACERER) has reviewed

and evaluated the NIOSH research agenda. In

addition, the DOE Office of Health Studies (formerly

the Office of Epidemiology and Health Surveillance)

has recommended research topics that have been

adopted in most cases. 

HERB is currently engaged in more than 25 research

projects to characterize exposure and health effects in

current and historical DOE site work forces. This

research is being conducted intramurally by HERB

researchers and through extramural contracts, grants, or cooperative agreements. Each of these

studies (Table I) addresses vital health issues related to chemical and radiation exposures at DOE

facilities.

The NIOSH epidemiology research program described in this booklet will lead to more reliable

risk estimates for exposures to radiation and chemicals not only for DOE workers, but for all

workers. Because no single study can remove all uncertainty from the current risk estimates,

multiple studies are included in this agenda.

Current limits on occupational exposures to ionizing radiation are based on data from the atomic

bomb survivors and from medical patients in radiation treatment programs. These populations

are largely not representative of U.S. workers. The atomic bomb survivors are of Japanese

ethnicity and the studies of this population continue to revise exposure estimates because of the

absence of monitoring data. Importantly, both the bomb survivors and the medical patients
NIOSH Energy-Related Health Research Program: Tab 1: Page 3

Research Agenda

received relatively high radiation doses over short time periods. In contrast, workers are

typically exposed to low levels of radiation over decades, and personal monitoring data are

available for most study subjects.

Recent occupational studies completed under HERB’s sponsorship and direction have shown

evidence that the 5 rem per year occupational limit may not provide adequate protection to

workers. Multisite retrospective studies currently underway will provide the additional

information to evaluate the adequacy of the current limit.

Study Designs

Most epidemiologic studies of radiation workers have

been cohort mortality studies that, until recently, were

limited largely to relatively crude overall measures of

death rates (SMRs comparing the monitored working

population with the general U.S. death rates). NIOSH

has developed or sponsored several research projects to

improve the limitations of the cohort mortality study,

including a cancer incidence study at the Rocky Flats

plant. NIOSH is implementing current analytic

methods in multisite case-control studies of leukemia,

multiple myeloma, and lung cancer. The combined

cohorts in these multisite studies increase power by

comparing populations with similar exposures, or with

different exposures. Cohorts of female workers

employed across twelve DOE sites have also been

combined for a mortality study that has been

completed.

Most previous studies of DOE workers have focused exclusively on the occurrence of cancer. 

Though this is clearly a major health problem in evaluating the effects of radiation, it is not the

only adverse health outcome of concern in this population. NIOSH has funded studies of

neurologic impairment among mercury-exposed DOE workers, as well as chronic beryllium

disease (a serious debilitating lung disease) among workers at DOE facilities. Although it is

difficult to conduct traditional studies of clinically recognized pregnancy outcomes among DOE

workers (because of the number of women required for these studies), the reproductive health of

male and female DOE workers may be assessed using appropriate biomarker studies with much

smaller numbers of workers. NIOSH is proposing studies of this type.

Current Radiation Workers

The National Council on Radiation

Protection and Measurements

estimates that 1.5 million U.S. workers

are occupationally exposed to ionizing

radiation each year. Of this number,

approximately 120,000 workers are

monitored each year for radiation

exposure at DOE facilities. In

addition, the results of the NIOSH

research program will be relevant to

the approximately 300,000 workers

potentially exposed to radiation each

year at commercial nuclear facilities.
NIOSH Energy-Related Health Research Program: Tab 1: Page 4

Research Agenda

Hanford worker handles

plutonium residues in a

glovebox. 200 West Area,

Hanford Site, Richland,

Washington. December 1995. 

Photo courtesy of the U.S.

Department of Energy.

Exposure Assessment

In addition to radiation exposures, workers at DOE facilities have also experienced exposure to a

variety of physical agents and chemicals, some of which are unique to these facilities. The

contribution of these exposures to worker health risks is being determined in many studies. In

some cases, the chemical exposures may actually be the primary concern for certain health

outcomes. For example, studies on the effects of beryllium and mercury have been or will be

completed. Additionally, exposure data are being collected for use in all of the case-control

studies and several of the cohort studies underway.

Principal objectives in the NIOSH studies are (1) to develop and use improved methods to

estimate uncertainties and biases in exposure assessments, and (2) conduct more comprehensive

exposure assessments of internal and external radiation, as well as chemicals. A wide variety of

chemical and other physical hazards has been prevalent at DOE facilities. Many workers have

been exposed to solvents, metals, and other substances, as well as excessive noise, heat, and nonionizing radiation. 

All epidemiology studies being performed or funded by NIOSH

attempt, to the extent possible, to quantify exposure to these

hazards since many cause a variety of health effects, including

cancer. In addition, NIOSH is funding three activities whose

purpose is to provide improved exposure assessment

methodologies for use in epidemiologic studies.

New Study Sites

Many of the workers at approximately 20 major DOE sites have

been studied epidemiologically, some of them for decades. 

NIOSH continues to update these studies as warranted by public

health and scientific considerations. As these cohorts age, and as

more powerful epidemiologic study designs become available,

new studies of these workers should provide better information

about health risks associated with radiation exposure.

On the other hand, workers at several DOE sites have not been

well studied. These sites include five of the national laboratories

and the Nevada test site. Based on the preliminary evaluations of 

exposures experienced at these facilities, studies of these sites

have not been initiated; however, NIOSH is currently conducting the first analytical

epidemiology study of one of the largest DOE facilities, the Idaho National Engineering and

Environmental Laboratory, which has employed over 70,000 workers since construction began

in 1949. 
NIOSH Energy-Related Health Research Program: Tab 1: Page 5

Research Agenda

Automatic Count recorder for Radioactive Test

Engine. Idaho National Engineering and

Environmental Laboratory, Idaho Falls, Idaho. 

1955. Photo courtesy of the U.S. Department of

Energy.

National Occupational 

Research Agenda (NORA)

NIOSH - HERB’s research program also

addresses several of the NORA priority

research areas. These include: mixed

exposures, organization of work, special

populations at risk, fertility and pregnancy

abnormalities, cancer research methods,

exposure assessment methods, and

surveillance research methods. For more

information on NORA, see (DHHS) NIOSH

Publication No. 96-115.

Current DOE Workers

As the primary mission at DOE changes from production and testing of nuclear weapons to

decontamination and decommissioning (i.e.,“cleanup”), the challenges facing its

workforce have also changed dramatically. NIOSH investigators are conducting a phased

approach to define and characterize exposure hazards encountered by workers who handle

wastes or are otherwise involved with cleanup activities within the DOE complex. 

Another substantial concern faced by current DOE workers is the potential adverse health effects

of re-organization and downsizing. These health consequences may affect not only those

workers whose jobs are lost, but also those remaining on the job. A recently completed NIOSH

cooperative agreement identified health problems related to downsizing, and suggested multiple

prevention and intervention strategies.

The composition of the ongoing epidemiologic studies at NIOSH and elsewhere helps to

ensure the public health of workers and communities, not only in the United States, but

around the world.
NIOSH Energy-Related Health Research Program: Tab 2: Page 1

Vision/Mission/Goals

Vision/Mission/Goals

Vision

Through scientific research, promote the health and well-being of all workers.

Mission

To conduct thorough and unbiased research on the health risks from exposure to physical,

chemical, and other stressors for current and former DOE workers using the best available

methods to promote adequate protection for all workers.

Purposes

To more fully understand radiation cancer risk factors in occupational cohorts.

To evaluate the significance of health outcomes in the DOE and other radiation exposed

workers.

To inform workers, the scientific community, and the public of the health risks associated

with exposures to radiological, chemical, and other stressors.

Program Goals

Assure that energy-related health research addresses pertinent occupational health questions

and provides a framework for intervention.

Conduct research in an open environment with meaningful communication among all

interested parties.

Capture the vanishing opportunities to study groups of people with unique exposure to

radiation, chemical, and other stressors.

Develop improved methods for associating occupational exposures and consequent health

risks.

Recommend improved protective measures for workers if scientific evidence indicates that

regulations or practices are inadequate.
NIOSH Energy-Related Health Research Program: Tab 2: Page 2

Vision/Mission/Goals

Research Goals

Epidemiologic Research

Evaluate possible relationships between workplace exposures and injury or disease using

the best available methodologies.

Analyze combined populations to assess whether certain rare cancers are related to past

occupational exposures.

Examine the relationships of mixed exposures and worker health.

Provide epidemiologic research findings which enhance the understanding of the effects of

low-level protracted exposure to ionizing radiation in Department of Energy workers and

others.

Exposure Assessment

Improve exposure assessment methods to reduce uncertainty in mortality and morbidity

studies.

Characterize the combined exposures experienced by Department of Energy workers for

use in epidemiologic analyses.

Emphasize quantitative (vs. qualitative) relationships between exposure and health

outcomes.

Evaluate the quality and validity of the available worker exposure data.

Communication Goals

Develop better mechanisms for generating research hypotheses by expanding the

involvement of partners and actively seeking their input.

Conduct research in an open environment with attention to clear and accurate education of

workers and the public.

Provide information that enhances the understanding of risks associated with radiationinduced health effects.

Solicit and consider worker interests and the public’s concerns.

Provide relevant occupational exposure and health outcome information for public health

research and policy.
NIOSH Energy-Related Health Research Program: Tab 2: Page 3

Vision/Mission/Goals

NIOSH Energy-Related Health Research Branch

Performance Measures

The number of novel research methods and applications conceptualized, developed, and

used to enhance understanding of exposures and health effects in the DOE workforce.

The extent to which program findings are considered in developing of recommendations for

intervention and prevention.

The extent to which recommendations for intervention and prevention are used to protect

worker health.

The use of program findings in risk assessments by standard setting organizations.

The timeliness and cost efficiency of scientifically appropriate and feasible health research

studies.

The timeliness of presenting study findings, publication of significant results, and effective

communication of study conclusions.

The quality and range of research projects, partners engaged in the research program, and 

the nature of interactions with stakeholders.
NIOSH Energy-Related Health Research Program: Tab 3: Page 1

Research Issues and Needs

Research Issues and Needs

Relevant to Department of Energy Workers 

and Applicable to All Radiation-Exposed Workers 

The following research issues and needs were identified by HERB staff, stakeholders,

and NIOSH research partners:

Health risks associated with low-level protracted exposure to ionizing radiation need to be

identified, fully examined, understood, and effectively communicated.

The exposure-response relationship between health effects and low-level ionizing

radiation, including dose rate, needs to be characterized to determine whether practical

thresholds can be derived.

Forms of radiation (e.g., external vs. internal) associated with specific cancer types need to

be clearly established.

The effect of exposure to multiple physical and chemical agents needs to be addressed in

the design and analysis of radiation health effects studies.

The contribution to health effects from nonoccupational radiation exposures, including

medical treatment or diagnostic procedures, needs to be evaluated.

Exposures and stressors experienced by the current DOE workforce, including site

remediation workers, need to be characterized.

Health effects other than cancer mortality warrant study (including chronic beryllium

disease, pulmonary fibrosis from plutonium and other nonmalignant respiratory diseases,

and reproductive, neurobehavioral, psychological and organizational stress effects).

Complete (minorities and both genders included) and mature (adequate latency)

occupational cohort studies that include well designed internal comparison strategies are

needed. Within these studies, case-control designs allowing for detailed exposure

assessment and analysis are warranted.

Efforts to record workers’ institutional memories of past practices, activities, exposures,

and record systems are essential for retrospective epidemiologic studies. Sources for the

information are rapidly diminishing as the cohort ages and the DOE sites change mission

or are shut down.
NIOSH Energy-Related Health Research Program: Tab 3: Page 2

Research Issues and Needs

The impact of worker age on the relation between occupational radiation exposure and

health effects needs to be characterized and incorporated into study design and analysis.

Analytic and design methods to account for exposure and demographic differences across

sites need to be developed for and applied to multisite studies.

Studies of current workers need to include, when appropriate, biological markers of

exposure and health effects to enhance records-based or self-reported information. 
Tab 3: Page 3

Table I: Research Issues Addressed by Research Projects

NIOSH Occupational Energy Research Program

December 2000

(See Notes at end of Table)

Majorresearch issues

Ongoing projects

Cohort Mortality Studyof Idaho Engineeringand EnvironmentalLaboratory Workers

Study ID: INEL

Cohort MortalityStudy of PortsmouthNaval ShipyardStudy ID: PNSP

Leukemia Case-ControlStudyStudy ID: LCCS

Multiple Myeloma CaseControl Study at the OakRidge Gaseous DiffusionPlant ( K–25)Study ID: MMCC

Cohort MortalityStudy of DOEChemical LaboratoryWorkersStudy ID: CLWS

Unstudied sites INLNew followup data K–25 K–25, Y–12, ORN, SRPUnstudied factors PNS HNF, LAN, PNS, SRP, X–10 K–25 K–25, Y–12, ORN, SRPNon-cancer effectsPrimarily externalradiation

PNS

Internal emitters K–25 K–25, Y–12, ORN, SRPChemical exposures PNS HNF, LAN, PNS, SRP, X–10 K–25, Y–12, ORN, SRPExposure methods K–25, Y–12, ORN, SRPCurrent workersUnderserved groups INL HNF, LAN, PNS, SRP, X–10 K–25 K–25, Y–12, ORN, SRPMultiple sites HNF, LAN, PNS, SRP, X–10 K–25, Y–12, ORN, SRPStakeholder requests INL K–25Contribute to otherstudies

INL PNS

Support surveillanceSupport intervention

Continued
Tab 3: Page 4

(Continued)

Exposure Assessmentof Hazardous Waste,Decontamination, andDecommissioning, andCleanup Workers (Phase I)Study ID: HAWW 

Lung Cancer CaseControl StudyStudy ID: LUNG

Construction WorkersMortality StudyStudy ID: CONS

Feasibility Study for anIntegrated Database forDOE Site RemedationWorkers Study ID: DDWR

Cohort MortalityStudy of FernaldEnvironmentalManagement PlantStudy ID: FNUP

Unstudied sitesNew followup data HNF, INL, SRP, X–10 X–10, HNF FRNUnstudied factors FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

Non-cancer effects FRNPrimarily externalradiation

HNF, INL, SRP, X–10

Internal emittersChemical exposures FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

FRN

Exposure methods FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

X–10, HNF FRN

Current workers FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

X–10, HNF FRN

Underserved groups FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

HNF, INL, SRP, X–10 FRN

Multiple sites FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

HNF, INL, SRP, X–10 X–10, HNF

Stakeholder requests FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

HNF, INL, SRP, X–10 X–10, HNF FRN FRN

Contribute to otherstudiesSupport surveillance FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

HNF, INL, SRP, X–10 FRN

Support intervention FRN, HNF, MND, SRP, ORN,

K–25, Y–12, INL, RFP

HNF, INL, SRP, X–10

Continued
Tab 3: Page 5

Exposure Assessmentof RadiologicTechnologists forEpidemiology StudiesStudy ID: XRAY

Cancer IncidenceStudy of Rocky FlatsPlantStudy ID: RKFL

InternationalCollaborative Study ofNuclear IndustryWorkers Study ID: IARC

Chronic BerylliumDisease AmongBeryllium-ExposedWorkersStudy ID: BER1

Beryllium DiseaseNaturalHistory and ExposureResponseStudy ID: BER2

Unstudied sites INLNew followup data RFP INL, PNSUnstudied factorsNon-cancer effects Non-DOE Non-DOEPrimarily externalradiation

XRAY INL, PNS

Internal emittersChemical exposures RFP Non-DOE Non-DOEExposure methods XRAY INL, PNS Non-DOE Non-DOECurrent workers Non-DOE Non-DOEUnderserved groups XRAY RFPMultiple sites XRAY INL, PNS Non-DOE Non-DOEStakeholder requests RFP Non-DOE Non-DOEContribute to otherstudies

INL, PNS

Support surveillance Non-DOE Non-DOESupport intervention Non-DOE Non-DOE

Continued
Tab 3: Page 6

Measurement ErrorMethods forUnderground MinerStudiesStudy ID: MEUM

Studies of Heat Stressand Performance inCarpenters at DOESitesStudy ID: HTST

Ionizing Radiation andMortality AmongHanford WorkersStudy ID: HANF

Acute RadiationSyndrome in RussianNuclear WorkersStudy ID: ARSR

Surveillance Methodsfor Solvent-RelatedHepatotoxicity, aCross-SectionalStudy at HanfordStudy ID: SEES

Unstudied sitesNew followup data HNFUnstudied factors HNFNon-cancer effects HNF, ORN HNF Non-DOE HNFPrimarily externalradiationInternal emitters UChemical exposuresExposure methods U HNF, ORN HNFCurrent workers HNF, ORN HNFUnderserved groups UMultiple sitesStakeholder requests U HNF, ORN HNFContribute to otherstudiesSupport surveillance HNF, ORN HNFSupport intervention

Continued
Tab 3: Page 7

Radon and CigaretteSmoking ExposureAssessment in FernaldWorkersStudy ID: PFRS

Correcting forMeasurement Errors inRadiation ExposureStudy ID: CMER

Epidemiologic Studiesto Evaluate HealthEffects of UraniumMillingStudy ID: EPUM

Dose of BerylliumCausing Sensitization andDiseaseStudy ID: DCDS

Analysis forCharacterizingPlutonium Exposureto Improve LungCancer RiskEstimates Study ID: ACPE

Unstudied sitesNew followup dataUnstudied factors TBD TBDNon-cancer effectsPrimarily externalradiation

TBD

Internal emitters TBD TBDChemical exposures FRN TBD TBDExposure methods FRN TBD TBD TBD TBDCurrent workers FRNUnderserved groups TBDMultiple sitesStakeholder requests FRNContribute to otherstudies

FRN TBD TBD TBD

Support surveillance FRNSupport intervention

Continued
Tab 3: Page 8

Cohort Mortality Study ofCivilian Nuclear PowerWorkersStudy ID: CNPW

Evaluating Time-RelatedVariables inOccupationalEpidemiologic StudiesStudy ID: AEWP 

Neutron ExposureAssessment inEpidemiology Studies ofDOE CohortsStudy ID: NUTR

Documentation of HistoricalDosimetry Practices at DOESitesStudy ID: HDP1

Exposure Assessmentof Hazardous Waste,Decontamination, andDecommissioning, andCleanup Workers (Phases II & III) Study ID: HAWW

Unstudied sites TBD TBDNew followup data TBDUnstudied factors TBD TBD TBD TBDNon-cancer effectsPrimarily externalradiation

TBD TBD

Internal emittersChemical exposures TBDExposure methods TBD TBD TBDCurrent workers TBD TBD

Underserved groups TBD TBDMultiple sites TBD TBD TBD TBDStakeholder requests TBD TBD TBDContribute to otherstudies

TBD

Support surveillance TBDSupport intervention TBD

Continued
Tab 3: Page 9

Update of CohortMortality Study ofMound WorkersStudy ID: MCMS

Medical/Off-SiteRadiation ExposuresStudy ID: MORE

Brain Cancer CaseControl StudyStudy ID: BRAN

Bone Cancer Case-ControlStudyStudy ID: BONE

JEM Data SensitivityAnalysisStudy ID: JEMS

Unstudied sitesNew followup data MND TBD TBDUnstudied factors K–25 TBD TBDNon-cancer effectsPrimarily externalradiation

K–25 TBD

Internal emittersChemical exposuresExposure methods K–25 TBDCurrent workersUnderserved groupsMultiple sitesStakeholder requestsContribute to otherstudies

K–25

Support surveillanceSupport intervention
NIOSH Energy-Related Health Research Program: Tab 3: Page 10

Research Issues and Needs

Notes for Table I: Major research issues for proposed projects

at various DOE sites

This table communicates the purpose, variety and content of the NIOSH/HERB

Occupational Radiation Research Program. It identifies the major research issues within

each project and also contains the name of the DOE sites or facilities where each study is

being conducted. The following information is a key to the site and facility acronyms and

a brief description for the titles of the research issues.

Abbreviation Key 

FRN Feed Materials Production Center (Fernald). Ohio

HNF Hanford Site. Washington

INL Idaho National Engineering and Environmental Laboratory. Idaho

K–25 K-25 Site. Tennessee

LAN Los Alamos National Laboratory. New Mexico

MND Mound Site. Ohio

ORN Oak Ridge Site. (Includes K-25, X-10, Y-12) Tennessee

PNS Portsmouth Naval Shipyard. Maine

RFP Rocky Flats Plant. Colorado

SRP Savannah River Plant. South Carolina

TBD To be determined

U Uranium Miners Cohort. Colorado, Utah, New Mexico

Radiation Technologists Study (in collaboration with National Cancer

Institute). All States

X–10 Oak Ridge National Laboratory. Tennessee

Y–12 Y-12 Plant. Tennessee

Research Issues Key (Brief Descriptions)

Unstudied sites: Conduct epidemiologic studies among workers at DOE sites that have

not been studied to date.

New followup data: Improve study statistical power with new follow-up data (for

example, adding additional worker years of experience to update a previous mortality

study).

Unstudied factors: Improve study precision by analyzing previously unstudied factors
NIOSH Energy-Related Health Research Program: Tab 3: Page 11

Research Issues and Needs

(for example, chemicals) in appropriate study designs.

Non-cancer effects: Study the relationship between worker exposures and the risk of

noncancer health effects (for example, stress in workers in downsized facilities).

Primarily external radiation: Evaluate work exposure to primarily external radiation at

sites where internal radiation exposure is minimal.

Internal emitters: Evaluate work exposure to separate the effects of internal emitter

exposures from effects due to other exposures. 

Chemical exposures: Evaluate the effects of contributions from chemical exposures.

Exposure methods: Develop methods of exposure assessment from sets of existing data.

Current workers: Conduct epidemiologic studies among current workers at DOE sites.

Underserved groups: Identify and study female and minority worker groups of sufficient

size to offer meaningful health effects information to these groups.

Multiple sites: Conduct epidemiologic studies among workers at multiple DOE sites to

strengthen study statistical power and broaden applicability of study findings.

Stakeholder requests: Respond to stakeholder requests to address study issues.

Contribute to other studies: Use study data to contribute to other significant multisite

studies or to improve/enhance other research study efforts. 

Support surveillance: Use study findings to support and enhance medical or exposure

surveillance activities at sites.

Support intervention: Use study findings to suggest, support, or enhance intervention

activities at DOE sites.
NIOSH Energy-Related Health Research Program: Tab 4: Page 1

Community Involvement and Worker Outreach

Worker Outreach

and Communication

The Health-Related Energy Research Branch (HERB) has a responsibility to communicate

with the workers, the community, Native American Tribes, DOE, and the scientific

community about its research on the health risks associated with exposure to radiologic,

chemical, and other stressors.

One of the goals of the HERB research program is to “conduct research in an open

environment with meaningful communication among all interested parties.” This is of

critical importance. The historic perceptions of secrecy and the heightened awareness and

concern regarding the impact of DOE sites on health necessitate the conduct of

occupational health research in an open manner. We have set forth several objectives that

we believe will help us to achieve this goal:

1. Interact and maintain a dialogue with all interested parties

2. Identify a variety of ways to conduct and enhance worker outreach 

3. Communicate all study findings effectively and without bias

4. Provide individual worker notification of study results when appropriate

5. Evaluate effectiveness of all phases of worker outreach/community involvement

The efforts that we have undertaken (or are planning), to address these objectives are

discussed below.

Objective 1: Interact and maintain a dialogue with all interested parties

The NIOSH/DOE partners and stakeholders meeting historically has been held annually at

the NIOSH Hamilton Laboratory in Cincinnati, OH. The meeting is sponsored by NIOSH

in coordination with DOE for the extramural research groups that have cooperative

agreements, contracts, or grants with NIOSH in energy-related epidemiologic research. 

DOE medical surveillance cooperative agreement holders are also invited to attend and

participate as a part the NIOSH role to provide for oversight review. 
NIOSH Energy-Related Health Research Program: Tab 4: Page 2

Community Involvement and Worker Outreach

The goals of the meeting are as follows:

• Allow NIOSH and DOE to present an overview of their intramural and extramural

occupational research programs in energy-related epidemiologic and medical

surveillance areas associated with the DOE nuclear weapons complex.

• Provide a forum for the extramural research groups to present their current progress

and anticipated future activities as they relate to the various Federal legislative

mandates and the programmatic interests of DOE and NIOSH.

• Allow discussion of general and site-specific issues of interest that are unique to

DOE contractor and subcontractor workers.

• Provide an opportunity for scientific exchange, collaboration, and cooperation

among the extramural research groups and the DOE and NIOSH staffs. 

The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic

Substances and Disease Registry (ATSDR) have initiated a community involvement

program. In 1994, CDC and ATSDR chartered the Citizens Advisory Committee on

Public Health Service Activities and Research at DOE sites after holding meetings with

stakeholders. HERB has historically sought to include workers and workplace issues in

this program. The Citizens Advisory Committee is composed of five health effects

subcommittees (the Hanford site, the Savannah River plant, the Idaho National

Engineering and Environmental Laboratory, the Oak Ridge facilities, and the Fernald

plant). The purpose of the Citizens Advisory Committee is to provide CDC and ATSDR

with consensus advice and recommendations regarding issues and concerns at DOE sites.

HERB staff communicates with site-specific health effects subcommittees on a variety of

issues, as needed (e.g., study protocols, peer reviewers, progress reports, study results, and

problems encountered). Currently, NIOSH devotes most of its efforts to enhancing

communication with current and former workers of the DOE facilities. NIOSH holds

meetings with labor representatives to discuss research activities and solicit any questions

and concerns workers may have. Additionally, NIOSH provides labor groups with

supplemental materials (NIOSH pamphlets, one-page study summaries, NIOSH-HERB

Program Book, etc.).
NIOSH Energy-Related Health Research Program: Tab 4: Page 3

Community Involvement and Worker Outreach

Objective 2: Identify and use methods to conduct and enhance worker outreach

Multiple methods are used that enable NIOSH/HERB to communicate effectively with

current and former workers about occupational research activities it conducts at DOE sites. 

These communications also give workers the opportunity to learn about the availability of

NIOSH technical assistance such as Health Hazard Evaluations, the NIOSH toll free

number for occupational health and safety information, and NIOSH technical documents

and CD-ROMs that can be used to address safety and health concerns. Communication

methods include the following:

• Conference calls and on-site meetings that allow workers to learn more about

current and proposed NIOSH occupational health research and discuss their

concerns about health problems and exposures.

• An extensive worker e-mail listing allows NIOSH to communicate quickly with

many current and former workers at several different DOE sites simultaneously. 

NIOSH materials that provide site–specific information about current and proposed

research projects and the availability of NIOSH occupational research information

on an as-needed basis have been developed and distributed.

• The Internet gives NIOSH an opportunity to post all information about completed,

current, and proposed occupational research at all DOE sites for anyone to view. 

The address is www.cdc.gov/niosh/oeindex.html.

• One-page study summaries have been developed that clearly communicate the

purpose, activities, or findings of NIOSH studies that are proposed, ongoing, or

completed at the DOE sites. These one-page summaries are converted to a

conventional file format (portable document file or pdf) so that they can be easily

placed in site newsletters, on bulletin boards, and on Web sites. They are also

distributed directly to workers as an e-mail attachment.

• An extensive computerized list of labor representatives at all the DOE sites enables

NIOSH to conduct frequent, fast, and efficiently targeted mailings to workers. 

Objective 3: Communicate all study findings effectively without bias

Project researchers have an obligation to the site workforce, the community near the site,

the DOE and its site contractors, and the media to report the results of their research. 

When a study is completed, the workers and management at the participating sites are

always informed of the study results before informing the health effects subcommittee of

the study site, the community or the general public. To do this, researchers coordinate a
NIOSH Energy-Related Health Research Program: Tab 4: Page 4

Community Involvement and Worker Outreach

sequence of communication activities for the release of study results with DOE

headquarters, DOE site point of contacts, and labor representatives. These communication

activities involve the release of our one-page study summaries, which include the

following information:

• Name of the principal investigator

• Type of study conducted

• Description of the study population

• Description of the main study findings

• Limitations of the study

• Glossary of terms

• Date, time, and location for satellite presentation or site visit, if applicable

• A DOE site contact and DOE reading room information

• Instructions on how to obtain a copy of the study abstract, full report, and/or

videotaped presentation.

• Phone numbers (NIOSH-HERB main number and the toll free NIOSH workplace

hazards information number) to call for more information

Researchers also coordinate subsequent communication activities so that the principal

investigator or study team can present findings through a site visit, satellite presentation, or

other subsequent presentation of the study results. Lecture format presentations are

videotaped, and copies are made available to all DOE study site reading rooms and/or

libraries.

When doing presentations, researchers keep in mind three basic concerns:

1. The study findings must be presented in an understandable manner. A short, easyto-read summary of study findings is developed.

2. The presentation must be as unbiased as possible.

3. The study results and the distribution of final reports occur regardless of whether

the results are considered to be positive, negative, or indeterminate.

It is important to report study findings to as wide an audience as possible, since workers at

other sites may have similar exposures or health concerns to those of the study group. 

HERB is examining ways to assure that all DOE sites, workers, and communities are

informed of study findings in a timely manner.

Finally, the research is regularly presented at scientific meetings and published in

scientific journals.
NIOSH Energy-Related Health Research Program: Tab 4: Page 5

Community Involvement and Worker Outreach

Objective 4: Provide individual worker notification of study results

In addition to reporting research results to the workers in a group, individual notification of

the workers in the study cohort is sometimes warranted. NIOSH published policy and

procedures for worker notification in the1988 NIOSH Worker Notification Procedures

Manual. Individual notification occurs most frequently in studies in which direct

interaction has occurred between researchers and all members of the study group. A

number of study criteria and study result considerations are addressed to determine

whether and when individual worker notification is appropriate. To date, researchers have

not had a study finding that necessitated formal individual worker notification.

Objective 5: Evaluate effectiveness of all phases of worker outreach/community

involvement

We continue to seek ways to evaluate the effectiveness of our efforts to communicate

study findings, enhance worker input, and improve our community involvement. This

includes tools such as one-page study summaries that are incorporated into the

communication process. The development of these summaries was the result of outreach

activities with numerous workers and DOE staff who provided input on the forms of

communication best suited for communicating with current and former workers. During

FY 2000, NIOSH/HERB used these one-page study summaries to help communicate the

findings of three completed studies to more than 150,000 current and former DOE

workers. DOE workers have commented that the summaries are clear, easy to read, and

effective in communicating study results. 

In summary, we think we have made progress in meeting these objectives. We continue to

learn and expect challenges ahead as we strive to improve communication efforts,

stakeholder involvement, and worker outreach. Additionally, we continue to seek different

approaches and invite feedback to address the needs and characteristics of the various

sites, worker populations, and studies.
NIOSH Energy-Related Health Research Program: Tab 5: Page 1

Program Accomplishments

Program Accomplishments

A total of 21 occupational studies transferred under the original memorandum of understanding have been completed or concluded. A complete listing of studies and accompanying final reports and manuscripts is provided in Tab 8.

A comprehensive occupational health research agenda has been developed and initiated.

Studies completed in the last 6 months have yielded important findings:

• Dose–response relationships were between ionizing radiation exposures and leukemia mortality among female nuclear weapons workers.

• Health studies of DOE cleanup workers will be more feasible in the future if work

history, exposure, and medical data for this group are improved.

• Workers who continue employment after a downsizing event at a DOE site may

exhibit stress-related health consequences similar to terminated workers.

Additional completed NIOSH-initiated research projects are listed in Tab 7.

An ongoing occupational radiation and energy-related grants program has provided extramural researchers opportunities to independently propose and conduct research supporting

the NIOSH research agenda. A total of 5 cooperative agreements, 2 contracts, and 7 grants

have been awarded to 14 different research partners. A listing is provided in Tab 13.

More historical DOE exposure record systems are available for occupational research.

A radiation agenda workshop was held to identify areas of research in exposure assessment

and epidemiology that need to be addressed.

NIOSH responded to the Fernald Health Effects Subcommittee request for an exposure

assessment and updated mortality study of Fernald workers.

Results of seven completed NIOSH studies have been presented to the workers at sites

where the studies were conducted. Additionally, three technical reports on NIOSH methods were completed.

DOE-requested Health Hazard Evaluations (HHE) at the Idaho National Engineering and

Environmental Laboratory and the Portsmouth Gaseous Diffusion Plant were completed.

The requested NIOSH Occupational Energy Research Program final reports were submitted to the Committee on the Biological Effects of Ionizing Radiations (BEIR VII).
NIOSH Energy-Related Health Research Program: Tab 5: Page 2

Program Accomplishments

Labor contact networks were established at all DOE study sites.

Greater emphasis was given to multiple exposures, chemical exposure contact, external

neutron, and internal radiation.

Program book was developed that identifies program activities, research contracts, synopsis of completed reports, etc as initially recommended by the Advisory Committee on

Energy-Related Epidemiologic Research.
NIOSH Energy-Related Health Research Program: Tab 6: Page 1

Ongoing Research

Ongoing Research Activities

Intramural Research

1. Cohort Mortality Study of Idaho National Engineering and Environmental

Laboratory Workers

Project Officer: Mary Schubauer-Berigan, Ph.D.

Study Period: 10/1/92–3/30/01

Summary: An all-cause cohort mortality study is underway at

INEEL, a previously unstudied site. More than 70,000

workers employed at this site between 1952 and 1991

have been followed to ascertain causes of death in

workers who died. Exposures of interest are external

ionizing radiation and a variety of chemicals. The first

phase of the study (Standard mortality ratio [SMR]

analysis) is planned for completion by March 2001.

Significance: This study of a previously unstudied site was initiated at

a governor's request and from congressional interest. 

Data from the study will be used in other studies, e.g.,

lung cancer case-control study.

2. Cohort Mortality Study of Portsmouth Naval Shipyard, Kittery, Maine

Project Officer: Tim Taulbee, M.S.

Study Period: 10/1/93–9/30/02

Summary: The mortality study of civilian employees at Portsmouth

Naval Shipyard is being updated through 1996. The

cohort has been expanded to include all workers

employed through 1992. Naval Sea Systems Command

has provided access to records and facilities. In addition

to the cohort update, cases and controls have been chosen

for leukemia and lung cancer nested case-control studies

of this population. Detailed coding of radiation exposure

has been determined for all cases and controls. Original

records of workers’ dosimetry have been located and
NIOSH Energy-Related Health Research Program: Tab 6: Page 2

Ongoing Research

copied in preparation to study rate of exposure, a unique

aspect of this study. 

Significance: Exposure was to external ionizing radiation almost

exclusively. The study was supported by US Navy. 

Data will be used in other studies, such as the, NIOSH

leukemia case-control study and International Agency for

Research Center study.

3. Leukemia Case-Control Study

Project Officer: Thurman Wenzl, Sc.D.

Study Period: 7/1/95–12/31/01

Summary: This multi-site case-control study will explore the

relation between external radiation and leukemia risk. 

About 250 leukemia deaths have been identified at five

DOE sites and Portsmouth Naval Shipyard when the vital

status is updated through 1996. Confounding exposures

to internal radiation, chemicals and electromagnetic

fields will be evaluated for all cases and controls.

Significance: This is a followup to recent positive findings of leukemia

and radiation in cohort studies. It is the largest study of

its kind ever done. The study design allows control of

confounders. It is a companion to a study of multiple

myeloma (hematopoietic cancer, also) conducted at the

same sites. The study includes update of vital status of

Hanford and Savannah River cohorts.

4. Multiple Myeloma Case-Control Study at the Oak Ridge Gaseous

Diffusion Plant (K-25)

Project Officer: Cynthia Robinson, Ph.D.

Study Period: 10/01/95–09/30/02

Summary: This case-control study of multiple myeloma deaths

among workers at the Oak Ridge (K–25) gaseous

diffusion plant complements the multisite, multiple

myeloma study recently completed by the University of

North Carolina. Exposures to multiple sources of
NIOSH Energy-Related Health Research Program: Tab 6: Page 3

Ongoing Research

external and internal ionizing radiation and chemicals are

fully characterized in this study. The vital status of the

K-25 cohort is being updated through 1998.

Significance: This is the largest single-site study of multiple myeloma.

The relatively large number of cases provides reasonable

statistical power to evaluate a dose-response relationship

in the presence of multiple exposures and potential

confounders.

5. Exposure Assessment of Hazardous Waste, Decontamination and

Decommissioning, and Cleanup Workers - Phase I

Project Officer: Greg Kinnes, M.S. 

Study Period: 5/1/96–[Awaiting Manuscript]

Summary: Exposures encountered by hazardous waste, clean–up,

and decontamination and decommissioning workers will

be characterized. In Phase I, background information

will be collected at seven DOE sites to assess working

conditions, and to identify issues and research needs at

the sites. This phase will be completed by late 2000.

Significance: This study addresses exposures to current workers

assesses feasibility of tracking workforce for future

studies evaluates mixed exposures and supports

surveillance activities.

Recovery or placement of waste storage drums in

shallow earth burial site. Idaho National Engineering

and Environmental Laboratory, Idaho Falls, Idaho. 1979. 

Photo Courtesy of the U.S. Department of Energy
NIOSH Energy-Related Health Research Program: Tab 6: Page 4

Ongoing Research

6. Cohort Mortality Study of DOE Chemical Laboratory Workers

Project Officers: Cynthia Robinson, Ph.D.

Study Period: 10/1/96–9/30/01

Summary: In limited studies of chemical laboratory workers, an

increased risk of cancer was reported. A cohort mortality

study and exposure assessment of DOE chemical

laboratory workers is being conducted. The sites

selected include Savannah River and three facilities at

Oak Ridge (X–10, Y–12, and K–25). To address sample

size needs, a fifth site (Hanford) is under evaluation for

inclusion. The exposures of interest include external

ionizing radiation, internal radiation, and chemicals. 

SMR analysis and a dose response assessment will be

conducted.

Significance: The study addresses hazards outside the DOE complex,

including chemical and mixed exposures. The study will

advance our knowledge about cancer risks in chemical

laboratory workers.

7. Lung Cancer Case-Control Study

Project Officer: Sharon Silver, M.A.

Study Period: 9/30/97–9/29/03

Summary: Five recent epidemiologic studies have shown a doseresponse relationship between lung cancer and external

ionizing radiation. The occupational settings studied, 

however, have involved exposures to other potential 

lung carcinogens. The current project will investigate the

relation between lung cancer mortality and exposure to

external ionizing radiation among nuclear reactor

operators. The sites identified include Hanford (Area

100), Savannah River (Area 100), Oak Ridge National

Laboratory (X-10), and the Idaho National Engineering

and Environmental Laboratory (Naval reactor facility

and test reactor area).
NIOSH Energy-Related Health Research Program: Tab 6: Page 5

Ongoing Research

Significance: Internal dose and confounder data available for this

project were limitations of previous studies.

8. Cohort Mortality Study of DOE Construction Workers

Project Officer: Cynthia Robinson, Ph.D.

Study Period: 10/1/97–[Suspended pending re-evaluation and

additional funding]

Summary: This all-cause retrospective cohort mortality study of

DOE construction workers provides an opportunity to

further define the risks for construction trades associated

with radiation, asbestos fibers, silica-containing dusts,

beryllium particulates, and other exposures regularly

encountered by construction workers on DOE sites.

Significance: Only a few studies have been conducted among

construction worker cohorts; most have been PMR

studies of union or association populations. DOE work

sites often maintain stable construction worker

populations. The study is relavent to the present

construction and site remediation workforces and is an

opportunity to evaluate effects of combined radiation and

chemical exposures. 

9. Feasibility Study for an Integrated Database for DOE Site Remediation

Workers

Project Officer: Cynthia Robinson, Ph.D.

Study Period: 10/1/97–[Suspended pending re-evaluation and

additional funding]

Summary: Workers involved in the site remediation

(decontamination and decommissioning) process 

underway at the Fernald site encounter exposures

different from those in the production phase. This project

will gather historical, radiologic, industrial hygiene,

work history, and medical data for each worker

(including the subcontractors) for use in a pilot study. 

The pilot study will test whether existing site systems

can be used to prepare an integrated database that might
NIOSH Energy-Related Health Research Program: Tab 6: Page 6

Ongoing Research

K-65 no. 3 dust collector removal at Fernald. 

Fernald, Ohio. Date Unknown. Photo courtesy of the

U.S. Department of Energy

be used to identify, track, and evaluate health risks for all

site remediation workers. A report will be written that

assesses the results of the pilot study and identifies key

variables for the database. 

Significance: This study was requested by The Advisory Committee on

Energy-Related Epidemiologic Research (ACERER). 

No registries have been established that allow

identification and tracking of current and future site

remediation workers on DOE or any other sites. Only a

few health studies of site remediation workers are

available.

10. Cohort Mortality Study of Fernald Environmental Management

Plant (FEMP)

Project Officer: John Cardarelli II, Ph.D.

Project Period: 09/01/98–09/31/02

Summary: This study is updating the mortality status of Fernald

workers through 1996, and expanding the cohort to 

include females and all races. Additionally, NIOSH will

conduct a retrospective exposure assessment for external

and internal radiation, radon, asbestos, uranium dust, and

acid mists. A previous cohort mortality study found a
NIOSH Energy-Related Health Research Program: Tab 6: Page 7

Ongoing Research

statistically significant excess of lung cancer mortality

among hourly workers (SMR=1.26), and a statistically

significant excess of stomach cancer among salaried

workers (SMR=2.61). Dose-response associations were

seen between lung cancer and external radiation

exposure, and between nonmalignant respiratory disease

and internal exposure.

Significance: This study is an update of a previous cohort study

(increased latency). It includes an underrepresented

populations (women and nonwhite men) and additional

assessments of chemical and physical hazards (radon,

uranium dusts, asbestos, and acid mists).

11. Exposure Assessment of Radiologic Technologists for Epidemiology Studies

Project Officer: James Neton, Ph.D.

Study Period: 1/1/99–9/30/01

Summary: Radiation exposure estimates will be developed for

epidemiology studies of radiologic technicians being

conducted by the National Cancer Institute (NCI). This

large cohort of radiation exposed workers (>145,000)

began in 1982 and includes case-control incidence

studies for breast, thyroid and lung cancer as well as

leukemia. Survey data have been collected for diet,

smoking status, family history of breast cancer, and other

pertinent information. Radiation exposure records are

incomplete and widely scattered. Use of common

surrogates for exposure, such as duration of employment

or years certified as a radiologic technician, have not

proved fruitful.

Significance: Collaboration with external partner; mostly female

population; cancer incidence data has been collected. 
NIOSH Energy-Related Health Research Program: Tab 6: Page 8

Ongoing Research

EXTRAMURAL RESEARCH (COOPERATIVE AGREEMENTS)

1. Cancer Incidence/Mortality Study of Rocky Flats Plant

Awardee: Colorado Department of Public Health and Environment 

(Normie Morin, Ph.D) 

Award Period: 9/30/93–[Awaiting final report]

Summary: Based on the findings of a previous study, a cancer

incidence study and an update of the mortality study at

the Rocky Flats Plant were intiated. The dosimetry data

for neutrons and plutonium are being improved. Job

exposure matrices have been completed for chemical

exposures and are being assessed through a field study

and expert panel review. The study roster is complete,

followup has been completed, and deaths have been

coded. A nested case control study of lung cancer at

Rocky Flats is being conducted as well.

Significance: This is a cancer incidence study. Re-evaluation and

upgrade of dosimetry data benefits DOE and the

contractor and will be used in a grant to study lung

fibrosis.

2. International Collaborative Study of Nuclear Industry Workers

Awardee: International Agency for Research on Cancer (IARC)

(Elisabeth Cardis, Ph.D.)

Award Period: 4/1/95–6/30/01

Summary: IARC has undertaken a cancer mortality study of nuclear

workers in 17 countries. Two U.S. cohorts are included

in the study. Vital status and dose data from these

countries will be combined to increase the power to

quantify small increases in cancer risk in workers

exposed to low doses of ionizing radiation. 

Significance: This is the largest study of nuclear workers ever done. It

involves collaboration among 17 countries and with The

World Health Organization (WHO)/IARC.
NIOSH Energy-Related Health Research Program: Tab 6: Page 9

Ongoing Research

3. Chronic Beryllium Disease Among Beryllium-Exposed Workers

Awardee: Michigan State University (Kenneth Rosenman, M.D.)

Award Period: 9/30/95–[Awaiting final report]

Summary: This cross-sectional study of 1000 workers at 2 plants

will examine the natural history of chronic beryllium

disease and evaluate the utility of the lymphocyte

transformation test in detecting beryllium sensitization

and predicting chronic beryllium disease development. 

The effectiveness of medical treatment of sensitized

workers and of control measures in preventing overt

chronic beryllium disease will also be evaluated.

Significance: This study characterizes disease process and a health

outcome other than cancer. It is a morbidity study that is

pertinent to current workers and applicable to

surveillance.

4. Beryllium Disease Natural History and Exposure Response

Awardee: National Jewish Center (Lee Newman, M.D.)

Award Period: 9/30/95–[Awaiting final report]

Summary: This investigation will determine the natural history of

beryllium sensitization and subclinical chronic beryllium

disease and identify beryllium compounds and processes

associated with chronic beryllium disease. Exposureresponse relationships for both sensitization and chronic

beryllium disease will also be determined. Exposure

assessment is underway at an Alabama plant where takehome toxicants are being assessed for 60 employees.

Significance: This study characterizes the disease process and

evaluates intervention methods. It describes a health

outcome other than cancer. It is a morbidity study that is

pertinent to current workers and applicable to

surveillance.
NIOSH Energy-Related Health Research Program: Tab 6: Page 10

Ongoing Research

EXTRAMURAL RESEARCH (GRANTS)

1. Measurement Error Methods for Underground Miner Studies

Grantee: University of Southern California (Dan Stram, Ph.D.)

Award Period: 9/30/95 –5/31/02

Summary: This study will develop methods to deal with radiation

exposure measurement errors when exposures are

extended over time and apply them in a reanalysis of

exposure-time-response (including dose– rate effects) in

lung cancer mortality for uranium miner cohorts in the

Colorado Plateau and New Mexico.

Significance: The study addresses developing statistical methods for

addressing measurement uncertainty. It may be useful

to the Department of Justice in the disposition of

uranium miner compensation issues. 

2. Study of Heat Stress and Performance in Carpenters at DOE Sites

Grantee: United Brotherhood of Carpenters Health and Safety

Fund (Kenneth Rosenman, M.D.)

Award Period: 9/30/95 – [Awaiting final report]

Summary: This study will determine if heat stress from the use of

protective clothing affects performance of carpenters

and other construction workers in remediation and

hazardous waste work at Hanford and Oak Ridge. 

Physiologic measures of heat stress and neurobehavioral

performance will be assessed under actual working

conditions.

Significance: This is a nonradiation and nonmortality study. It is

applicable to current workers to a preponderance of

work at DOE sites and applicable to surveillance.
NIOSH Energy-Related Health Research Program: Tab 6: Page 11

Ongoing Research

Storage tanks for high-level liquid radioactive

waste at Hanford. Hanford Site, Richland,

Washington. October 31, 1984. Photo courtesy of the

U.S. Department of Energy

3. Ionizing Radiation and Mortality Among Hanford Workers

Grantee: University of North Carolina (Steven Wing, Ph.D.)

Award Period: 9/30/96–9/30/01

Summary: This study will re-analyze cancer and noncancer

mortality among Hanford workers with chronic, lowlevel external radiation exposure. New methods will be

used to estimate doses previously assumed to be zero

and to consider internal dose in analyses of health risks.

New analytic methods will be used to consider timerelated exposure effects, such as age at exposure.

Significance: Update of important previous cohort study (increased

time of observation). Application of new methodologies

for epidemiologic analyses.
NIOSH Energy-Related Health Research Program: Tab 6: Page 12

Ongoing Research

4. Acute Radiation Syndrome in Russian Nuclear Workers

Grantee: University of Pittsburgh (Neil Wald, M.D.)

Award Period: 12/1/96–[Awaiting final report]

Summary: The long-term objective of this study is to facilitate the

acquisition of diagnostic and prognostic information.

This information will help nonexpert medical and

paramedical personnel with the early recognition of

acute radiation syndrome in hospital and field

conditions. The study will use data from 59 acute

radiation syndrome cases that occurred from 1948 to the

present among workers at the Mayak nuclear facilities in

Russia.

Significance: This is a noncancer study that involves international 

collaboration.

5. Surveillance Methods for Solvent-Related Hepatotoxicity, a cross-sectional

study at Hanford

Grantee: University of Washington (Carl A. Brodkin, M.D.)

Award Period: 10/1/98–9/29/01

Summary: To establish a scientific basis for surveillance of hepatic

effects in solvent exposed workers, a cross-sectional study

is being conducted at the Hanford Nuclear Reservation. 

One hundred industrial painters exposed subacutely and

chronically to a variety of solvent mixtures over their

working careers will be compared with a referent group of

100 nonexposed carpenters matched by age, gender and

race. The proposed study will examine the hypothesis

that solvent–related hepatic injury is characterized by

parenchymal changes of steatosis and fibrosis without

associated necrotic changes, which are detected by

elevated hepatic transaminases in blood.

Significance: The non–invasive surveillance methods address a priority

research area of the National Occupational Research 

Agenda.
NIOSH Energy-Related Health Research Program: Tab 6: Page 13

Ongoing Research

6. Radon and Cigarette Smoking Exposure Assessment in Fernald Workers

Grantee: University of Cincinnati (Susan Pinney, Ph.D.)

Award Period: 7/1/99– 6/30/01

Summary: This study proposes to develop yearly and cumulative

individual radon exposure estimates for Fernald workers

using a variety of data resources. Exact work location

for about 2,500 workers can be assigned using data from

occupational history interviews collected previously.

Site information will be used to determine work location

for others. Smoking history information from an

ongoing medical surveillance program will be extended

to living workers not enrolled. Surrogate data will be

collected from family members of the deceased. Risk

estimates for lung cancer will then be calculated for the

Fernald workers.

Significance: A previous mortality study of this cohort reported a

significant excess risk of lung cancer deaths among

hourly workers. Detailed assessment of occupational

radon exposure in this cohort, along with the collection

of smoking history, will improve future risk

assessments.

7. Correcting for Measurement Errors in Radiation Exposure

Grantee: New York University (Xiaonan Xue, Ph.D.)

Award Period: 7/1/99–6/30/02

Summary: This research will develop methods for correcting

radiation exposure measurement errors, including both

systematic and random errors. In this research, a joint

model for measurement error and dose– response

relationship will be developed, and may be used for

more precise and accurate risk assessment.

Significance: The methods for modeling and correcting measurement

errors developed from this research will apply to
NIOSH Energy-Related Health Research Program: Tab 6: Page 14

Ongoing Research

ongoing and future worker radiation studies and analysis

of other environmental exposure-response data.

8. Epidemiologic Studies to Evaluate Health Effects of Uranium Milling

Grantee: University of New Mexico

(William E. Lambert, Ph.D.)

Award Period: 9/30/97–[Awaiting final report]

Summary: This study will investigate the long-term health effects

of exposures in uranium mills in Non-Hispanic white,

Hispanic, and American Indian former uranium millers

in New Mexico and Colorado. Although the high risk of

uranium miners for lung cancer is well known, the risks

associated with uranium milling have not been as

extensively studied. The limited available data suggest

that former millers may have increased risk for nonmalignant respiratory diseases and renal disease.

Significance: Gains are anticipated in understanding the long-term

health effects of uranium milling that may allow

identification of exposed workers at risk for lung and

renal diseases.

9. Dose of Beryllium Causing Sensitization and Disease

Grantee: National Jewish Center (Lee S. Newman, M.D.)

Award Period: 7/1/99–6/30/02

Summary: This research aims to determine the personal beryllium

dose that produces beryllium sensitization and chronic

beryllium disease in beryllium machinists, and to

characterize the beryllium aerosol and lung deposition

that produce beryllium sensitization and chronic

beryllium disease in these individuals.
NIOSH Energy-Related Health Research Program: Tab 6: Page 15

Ongoing Research

Significance: This research will influence prevention by providing

data on which to base a new beryllium exposure

standard and help direct engineering and industrial

hygiene practices to reduce exposure.

10. Analysis for Characterizing Plutonium Exposure to Improve Lung Cancer

Risk Estimates

Grantee: University of Colorado (James Ruttenbur, Ph.D.)

Award Period: 8/1/99–7/31/02

Summary: This research will explore important issues of

measurement errors in quantifying exposures and their

effects on risk estimates in epidemiologic studies.

Significance: This research will benefit future epidemiologic studies

by: (1) developing and exploring methods to assess the

measurement of radiation doses, (2) developing methods

for analyzing exposure data from different sources, and

(3) evaluating current methods and developing new ones

for incorporating of measurement error estimates for

radiation doses into risk estimates.
NIOSH Energy-Related Health Research Program: Tab 7: Page 1

Completed NIOSH-Initiated Research

Completed NIOSH-Initiated Research

1. Multi-Site Multiple Myeloma Case-Control Study

Contractor: University of North Carolina (Steven Wing, Ph.D.)

Award Period: 1993–1997

Summary: This multisite case-control study focused on external

radiation and chemical exposures at five DOE sites:

Savannah River, Los Alamos National Laboratory, Los

Alamos National Laboratory-Zia, Oak Ridge National

Laboratory, and Hanford. Ninety-eight workers who died

from multiple myeloma and 391 age-matched controls were

selected from the combined roster of 115,143 workers hired

before 1979. These workers were followed for vital status

through 1990 (1986 for Hanford). Cases were

disproportionately African–American, male, and hired

before1948. Although an association between multiple

myeloma and cumulative whole body ionizing radiation dose

was not observed, external penetrating radiation doses

received at age 45 and above were associated with multiple

myeloma.

Manuscript: Wing S, Richardson D, Wolf S, Mihlan G, Crawford-Brown

D, Wood J [2000]. A case control study of multiple myeloma

at four nuclear facilities. Ann Epidemiol 10: 144-153.

Significance: This study complements the HERB intramural leukemia

case-control study being done at the same sites and the

myeloma case-control study with internal radiation exposure

at the Oak Ridge Gaseous Diffusion Plant (K–25). The role

of age at exposure in ionizing radiation studies was

examined.
NIOSH Energy-Related Health Research Program: Tab 7: Page 2

Completed NIOSH-Initiated Research

2. Mercury Workers Health Study

Contractor: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)

Award Period: 1993–1996

Summary: This is a followup study of neurologic health outcomes in

workers exposed to elemental mercury at the Y–12 Plant

(Oak Ridge) between 1953–1966. Neurologic effects of

relatively heavy exposure to mercury were still detectable

more than 30 years after exposure ceased. The adverse

effects were observed primarily for the peripheral nervous

system (by both clinical examination and electrodiagnostic

evaluation). Postural tremor was also associated with past

mercury exposure. Study participants were notified of their

individual results, overall study results were presented to a

labor-management group in April 1997, and a technical

report was prepared for NIOSH at the end of the study.

Manuscript: Departments of Behavioral Sciences and Health Education

and of Environmental and Occupational Health; Rollins

School of Public Health of Emory University, and The

Center for Epidemiologic Research Environmental and

Health Sciences Division; Oak Ridge Associated

Universities, [Undated]. A study of the health effects of

exposure to elemental mercury: a followup of mercury

exposed workers at the Y–12 plant in Oak Ridge, Tennessee. 

 (DHHS Contract 200–93–2629, Final Technical Report.) 

Available from the National Institute for Occupational

Safety and Health/Health-related Energy Research Branch,

Cincinnati, OH,134 pg.

Significance: This morbidity study of noncancer neurologic outcomes

associated with chemical exposure is applicable to

surveillance efforts. 
NIOSH Energy-Related Health Research Program: Tab 7: Page 3

Completed NIOSH-Initiated Research

3. Historical Plutonium Bioassay Measurements

Contractor: New York University (Norman Cohen, Ph.D.)

Award Period: 1993–1995

Summary: This research evaluated the bias, uncertainty, and selectivity

of plutonium bioassay procedures used by DOE over time,

since they may affect the retrospective dosimetry of

plutonium workers. 

Significance: This study includes an analysis and is needed for internal

exposure assessment of plutonium.

4. Accounting for Errors in Radiation Dose Estimates

Grantee: Battelle Pacific Northwest Laboratories

(Ethel Gilbert, Ph.D.)

Award Period: 1994–1996

Summary: This study developed an approach to accounting for random

uncertainties in estimates of cumulative external dose and

applied the model to Hanford data. The analysis included

evaluation of photon energy, angle of photon incidence, and

different dosimeter designs. The effect of these factors on

estimates of organ dose and on dose-response analysis in

epidemiology studies was also evaluated.

Manuscript: Gilbert E, Fix JJ, Baumgartner WV [1996]. An approach to

evaluating bias and uncertainty in estimates of external

dose obtained from personal dosimeters. Health Physics

70 (3):336–345.

Significance: Uncertainty analysis; accounting for bias in external dose

estimates.
NIOSH Energy-Related Health Research Program: Tab 7: Page 4

Completed NIOSH-Initiated Research

5. Cohort Mortality Study of Portsmouth Gaseous Diffusion Plant, Piketon, Ohio

Investigator: NIOSH intramural study

(Project officer: Robert Rinsky, Ph.D.)

Study Period: 1992–2001

Summary: The mortality of workers at Portmouth Gaseous Diffusion

Plant was updated through 1992. Radiation exposure

assessments were performed for internal and external

ionizing radiation, certain chemicals, and electromagnetic

fields. No significantly elevated standardized mortality

ratios (SMRs) were observed for overall or specific causes of

death. Case-control analyses of lung, lymphoma,

hematopoietic, and stomach cancers and exposures to

internal soluble alpha dose, flourines, nickel, and uranium

were done. The results of the analysis have been

incorporated into a draft final report, which is in branch

review. A presentation of the findings is being prepared for

labor and management. 

Manuscript: Pending

Significance: This study, initiated by a response to a congressional request,

assessed lung cancer in this previously studied cohort and

extensive exposure assessment for chemicals and radiation

were completed.

6. Feasibility Study of Assessing Adverse Reproductive Outcomes Among

Females Employed at DOE Facilities

Investigator: NIOSH intramural study

(Project officer: Barbara Massoudi, Ph.D.)

Study Period: 1995–1996

Summary: The feasibility of conducting a retrospective cohort study of

adverse reproductive outcomes among women employed at

DOE sites depends on four factors: (1) availability of an

appropriate study population; (2) a valid case definition and

means of ascertainment; (3) exposure to the agent(s) in

question and sufficient information to characterize such

exposure; (4) and adequate sample size to demonstrate an
NIOSH Energy-Related Health Research Program: Tab 7: Page 5

Completed NIOSH-Initiated Research

Cafeteria. Idaho National Engineering and Environmental

Laboratory, Idaho Falls, Idaho. 1957. Photo courtesy of the U.S.

Department of Energy.

effect. To address these issues, several sources of data were

collected and evaluated by NIOSH investigators. Data

obtained on women who worked at 20 previously studied

DOE sites included demographic characteristics, radiation

monitoring data, and vital status. Information was collected

on birth defects registries in states near DOE facilities. 

Assembly of a cohort of female DOE workers to examine

clinically recognized outcomes such as miscarriage and birth

defects would be difficult. However, other study designs to

assess reproductive health in the DOE workforce may be

feasible.

Manuscript: Massoudi BL [1996]. Adverse reproductive outcomes

among females employed at Department of Energy facilities:

The feasibility of epidemiologic studies. Available from the

National Institute for Occupational Safety and

Health/Health-related Energy Research Branch, Cincinnati,

OH. [Final Report] Unpublished. 18 pg.

Significance: This feasibility assessment addresses issues relevant to

current women workers and noncancer outcomes. 
NIOSH Energy-Related Health Research Program: Tab 7: Page 6

Completed NIOSH-Initiated Research

Installing reactor vessel. Idaho National Engineering and

Environmental Laboratory, Idaho Falls, Idaho. Date

unknown. Photo courtesy of the U.S. Department of Energy.

7. Childhood Leukemia Case-Control Study

Awardee: Batelle Laboratories (Lowell Sever, Ph.D.)

Award Period: 1992–1997

Summary: This case-control study assessed the potential association

between paternal exposure to ionizing radiation and risk of

leukemia in offspring, a finding observed in Sellafield,

England by Gardner et al. (1990). The study follows up

on previous findings of birth defects (Central nervous

system [CNS] tumors) at Hanford. The study, initiated at the

Hanford Site, was expanded to Oak Ridge and Idaho

National Engineering and Environmental Laboratory, and

included non-Hodgkin’s lymphoma and central nervous

system CNS tumors as outcomes. The study found no

evidence of a link between childhood cancer risk and

father’s radiation work at the DOE

sites included in the study. This

finding did not change if each site was

looked at alone or all together. 

A much weaker finding that relates

only to Hanford children was noted. 

Children whose fathers worked at

Hanford were more likely to get CNS

cancer than children whose fathers

worked at the other sites. However,

this finding was not statistically

significant and was based on a small

number of cases. The study was

completed in November 1997;

communication of results to workers

and management at the sites studied

occurred in October 1998.
NIOSH Energy-Related Health Research Program: Tab 7: Page 7

Completed NIOSH-Initiated Research

Manuscript: Sever LE, Gilbert ES, Tucker K, Greaves J, Greaves C,

Buchanan J [1997]. Epidemiologic evaluation of childhood

leukemia and paternal exposure to ionizing radiation. 

Seattle, WA: Battelle Memorial Institute; (CDC Cooperative

Agreement U50/CCU012545–01, Final Report.) Available

from the National Institute for Occupational Safety and

Health/Health-Related Energy Research Branch, Cincinnati,

OH, 51 pg.

Significance: Three other studies since the report of the results for

Sellafield have not shown an increase in childhood cancers

among children whose fathers were exposed to radiation

before their child’s conception. This NIOSH–sponsored

study agrees with and supports those study findings.

8. Time-Related Factors in Radiation-Cancer Dose Response

Grantee: University of North Carolina (Steven Wing, Ph.D.;

David Richardson, Ph.D.)

Award Period: 1996–1997

Summary: This study expanded, updated and re-analyzed a cohort of

workers at the Oak Ridge National Laboratory, that was

originally analyzed by Checkoway. The cohort included

persons employed at Oak Ridge National Laboratory

between 1943 and 1972. Special emphasis was given to the

associations between radiation, cancer, and time-related

factors including age-at-exposure, latency, and time since

exposure. Evidence was found of a stronger dose response

association between exposure and cumulative dose received

at older ages. 

Manuscript: Richardson DB, Wing S [1998]. Methods for investigating

age differences in the effects of prolonged exposures. Am J

Ind Med 33:123-130.

Significance: Dose received after age 45 is strongly predictive of allcancer-combined mortality as well as lung cancer, which has

implications for future occupational epidemiologic research

and exposure standards.
NIOSH Energy-Related Health Research Program: Tab 7: Page 8

Completed NIOSH-Initiated Research

9. Dose Estimation from Daily and Weekly Dosimetry Data

Grantee: Oak Ridge National Laboratory (George Ostrouchov, Ph.D.)

Award Period: 1997–1998

Summary: Statistical methods were used to estimate distributions of

external radiation exposures for workers included in

epidemiology studies at the Oak Ridge National facilities. 

The method took into account measurement errors from film

badge and pocket meter systems, from recording leftcensored doses as zeros, and from other practices and

policies. The amount of bias in previously used estimates of

exposure was substantial, although incorporation of the daily

pocket chamber readings reduced uncertainty in some

estimates but increased it in others.

Manuscript: Ostrouchov G, Frome EL, Kerr GD [1998]. Dose estimation

from daily and weekly dosimetry data. Oak Ridge, TN: Oak

Ridge National Laboratory; (CDC-NIOSH Grant RO1

OH12956, Final Draft.) 38 pg.

Significance: This study involved exposure assessment methods

development and uncertainty analysis for external radiation

exposure estimates used in previous and current studies of

workers at Oak Ridge facilities.

10. Cohort Mortality Study of Workers at Fernald Feed Materials Production

Center

Contractor: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)

Award Period: 1992–1997

Summary: Mortality patterns were examined for 4,014 white males

hired at the Fernald Feed Materials Production Center

between 1951 and 1981. Vital status ascertainment through

1989 found 1,064 deaths among this population. Exposure

estimates were developed for internal radiation, because of

the potential for exposure to uranium dust and for external

ionizing radiation. Although salaried workers showed a

healthy worker effect, a significant increase for stomach

cancer deaths was found in this subcohort. Hourly workers
NIOSH Energy-Related Health Research Program: Tab 7: Page 9

Completed NIOSH-Initiated Research

Feed materials Productions Center (FMPC). Fernald, 20 miles

outside Cincinnati, Ohio. January 1, 1987. Photo courtesy of the U.S.

Department of Energy.

did not demonstrate a healthy worker effect and had excess

mortality from all cancers, lung cancer, and motor vehicle

injuries. For all workers, chronic non-malignant respiratory

disease showed a positive dose-response relationship with

internal exposure. These findings were produced without

controlling for other lung carcinogens that were likely

present in the work environment, such as radon and other

chemicals.

Manuscript: Cragle DL, Watkins JP, Ingle JN, Robertson-Demers K,

Tankersley WG, West CM [1995]. Mortality among a

cohort of white male workers at a uranium processing plant:

Fernald feed materials production center, 1951–1989. Oak

Ridge, TN: Center for Epidemiologic Research, Oak Ridge

Institute for Science and Education. Unpublished. 29 pg.

Significance: This assessment of a previously unstudied cohort

complements Mallinckrodt studies and includes exposure

assessment for both internal and external radiation. 
NIOSH Energy-Related Health Research Program: Tab 7: Page 10

Completed NIOSH-Initiated Research

L-Reactor Facility. L Area, Savannah River Site, South

Carolina. September 16, 1982. Photo courtesy of the U.S.

Department of Energy.

11. Cohort Mortality Study of Workers at Savannah River Plant

Contractor: Oak Ridge Associated Universities (Donna Cragle, Ph.D.)

Award Period: 1992–1997

Summary: A cohort mortality study of 9,757 white male workers at the

Savannah River site employed between 1952 and 1974

reported 1,722 deaths, with followup complete through 1986. 

A strong healthy worker effect was noted in the SMR

analysis, with no significant excesses noted. However, when

trend tests were performed by external dose category, a 

significant positive dose-response relation was observed for

external radiation and leukemia mortality when doses were

lagged 2 years. The estimated for excess relative risk per

Sievert for leukemia mortality was 13.61, which is consistent 

with the estimates derived for the Canadian (19.0 per

Sievert) and Sellafield (13.92 per Sievert) populations.

A draft final report was prepared for NIOSH in 1996. 

Manuscript: Cragle D [1998]. Mortality among workers at the Savannah

River nuclear fuels production facility. In: ASA 1998

proceedings of the section on statistics in epidemiology. 

Alexandria, VA: American Statistical Association,

pp. 83–87.

Significance: This cohort, included

in the leukemia casecontrol study,

demonstrated a

significant doseresponse for

leukemia. Both

internal and external

radiation exposures

were evaluated.
NIOSH Energy-Related Health Research Program: Tab 7: Page 11

Completed NIOSH-Initiated Research

12. Mine Specific Exposure Information for Uranium Miners Study

Investigator: NIOSH intramural study

(Project officer: Mark Methner, Ph.D.)

Study Period: 1998–1999

Summary: Additional mine-specific assignment of exposure levels

identified in historic records were entered into a database

and delivered to the principal investigator on the

Measurement Error Methods for Underground Miner

Studies. The data will be used to examine exposure

measurement errors over time and apply them in a reanalysis

of exposure-time-response (including dose rate effects) in

lung cancer mortality for uranium miner cohorts in the

Colorado Plateau and New Mexico.

Significance: Lung cancer risks identified for underground uranium miners

exposure to radon have been used extensively for setting

residential and occupational exposure limits.

13. Assessment of Electric and Magnetic Field Exposures of Transportation

Workers

Project Officer: NIOSH intramural study (Project officer: Thurman Wenzl,

Sc.D.)

Study Period: 1996–2000

Summary: Personal exposures to power-frequency magnetic fields were

measured among airline employees and employees of a

municipal electric bus system. Among the bus workers, only

electricians and those assigned to work downtown (including

police and supervisors) had elevated average exposures; the

downtown exposures appeared to be due to various sources

not necessarily related to the electric bus. Among airline

maintenance and ground personnel system, only

maintenance supervisors had slightly elevated exposures.

Agents working on reservations and at ticket counters had

exposures equivalent to typical magnetic fields.
NIOSH Energy-Related Health Research Program: Tab 7: Page 12

Completed NIOSH-Initiated Research

Manuscripts: Kaune WT [1999]. Study of occupational magnetic-field

personal exposures of non-flying airline employees. 

Richland, WA: EM Factors; (CDC NIOSH Contract

200–94–2837, Contractor report.) Available from the

National Institute for Occupational Safety and

Health/Health-Related Energy Research Branch, Cincinnati,

OH, 52 pg.

Factors EM [1999]. Study of occupational magnetic-field

personal exposures associated with Seattle metro transit’s

electric trolley system. Richland, WA: EM Factors; (CDC

NIOSH Contract 200–94–2837, Contractor report.)

Available from the National Institute for Occupational

Safety and Health/Health-Related Energy Research Branch,

Cincinnati, OH, 67 pg.

Significance: Since little is known of workers’ magnetic field exposures

outside of electric utilities, these measurement surveys have

clarified that few of these transport workers have elevated

exposures.

14. Cohort Mortality Study of Pantex Plant, Amarillo, Texas

Project Officer: NIOSH intramural study

(Project officer: Barbara Grajewski, Ph.D.)

Study Period: 1996–1999

Summary: A study of Pantex workers published in 1985 was limited by

the small number of deaths and short follow-up, although the

risk of several cancers was elevated. Vital status was

updated through 1995. An SMR analysis with examination

of dose-response was conducted; however, it was not

possible to update exposure information for the cohort

(duration of employment was used as a surrogate for dose). 

No statistically significant elevations in SMRs were found. 

A decision to return to the facility to conduct an updated

analysis is pending.

Manuscript: Pending
NIOSH Energy-Related Health Research Program: Tab 7: Page 13

Completed NIOSH-Initiated Research

Significance: Pantex is an operating facility that had not been downsized. 

Similar exposures will be encountered by current and future

workers.

15. Cancer Incidence and Sentinel Event Registries

Project Officer: NIOSH intramural study

(Project officer: Sara Foster, M.P.H.)

Study Period: 1998–2000

Summary: Because a standardized national registry system does not

exist in the United States, incidence-based studies often

depend on State disease registries. This project examined

population-based State cancer and sentinel event registries to

determine the feasibility and suitability of these registry

systems for occupational studies. Information was collected

from statewide cancer registries in 16 States of sixteen states

containing DOE sites and those in the immediately adjacent

States. Despite limitations in state-wide cancer registry

systems, it is feasible to use many statewide registries for

occupational health studies. 

Manuscript: Foster S, Espinoza R [ 2000]. Cancer incidence and sentinel

event registries. Cincinnati, OH: National Institute for

Occupational Safety and Health/Health-Related Energy

Research Program. [Final draft report] Unpublished. 107 pg.

Significance: This study will help researchers design incidence and

morbidity studies near DOE sites.

16. Prevention of Stress and Health Consequences of Downsizing and

Reorganization

Awardee: Boston University (Lew Pepper, M.D.)

Award Period: 1995–2000

Summary: Job stressors (i.e., work-related conditions implicated in

disease development) include job dissatisfaction, lack of job

control, and under-utilization of abilities. Sudden job change

through strike, retirement, layoff, relocation, or job loss may

trigger these stressors. In this multisite project, five DOE
NIOSH Energy-Related Health Research Program: Tab 7: Page 14

Completed NIOSH-Initiated Research

sites (Idaho National Engineering and Environmental

Laboratory, Los Alamos National Laboratory, Nevada Test

Site, Oak Ridge Y–12 Plant, and Pantex) were selected to

study the effects of downsizing on organizational climate,

worker health, and performance. Data gathering included

interviews, workplace observations, employee discussion

groups, an employee survey distributed to more than10,500

employees, and a historical record review. Fore each

downsizing organization, researcher identified opportunities

to reduce job stress that could lead to improved employee

health and organizational well-being. Suggested

intervention strategies were proposed for further research.

Manuscript: Pepper L [2000]. The Health effects of downsizing in the

nuclear industry: findings at the Idaho National Engineering

and Environmental Laboratory. Boston, MA: Department of

Environmental Health, Boston University School of Public

Health; (CDC Cooperative Agreement U60 CCU 112215,

Final Report.) Available from the National Institute for

Occupational Safety and Health/Health-Related Energy

Research Branch, Cincinnati, OH, 129 pg.

Pepper L [2000]. The Health effects of downsizing in the

nuclear industry: findings at the Los Alamos National

Laboratory. Boston, MA: Department of Environmental

Health, Boston University School of Public Health; (CDC

Cooperative Agreement U60 CCU 112215, Final Report.)

Available from the National Institute for Occupational

Safety and Health/Health-Related Energy Research Branch,

Cincinnati, OH, 135 pg.

Pepper L [2000]. The Health effects of downsizing in the

nuclear industry: findings at the Nevada Test Site. Boston,

MA: Department of Environmental Health, Boston

University School of Public Health; (CDC Cooperative

Agreement U60 CCU 112215, Final Report.) Available from

the National Institute for Occupational Safety and

Health/Health-Related Energy Research Branch, Cincinnati,

OH, 125 pg.

Pepper L [2000]. The Health effects of downsizing in the

nuclear industry: Pantex. Boston, MA: Department of

Environmental Health, Boston University School of Public
NIOSH Energy-Related Health Research Program: Tab 7: Page 15

Completed NIOSH-Initiated Research

Health; (CDC Cooperative Agreement U60 CCU 112215,

Final Report.) Available from the National Institute for

Occupational Safety and Health/Health-related Energy

Research Branch, Cincinnati, OH, 133 pg.

Pepper L [2000]. The Health effects of downsizing in the

nuclear industry: findings at the Y–12 Plant, Oak Ridge

Reservation. Boston, MA: Department of Environmental

Health, Boston University School of Public Health; (CDC

Cooperative Agreement U60 CCU 112215, Final Report.)

Available from the National Institute for Occupational

Safety and Health/Health-Related Energy Research Branch,

Cincinnati, OH, 129 pg.

Significance: This psychosocial morbidity study is relevant to current and

future workers, and could be used as the basis of future

intervention or surveillance efforts.

17. Mortality Among Female Nuclear Weapons Workers

Grantee: State University of New York (Gregg Wilkinson, Ph.D.)

Award Period: 1994–2000

Summary: Although 80,000 female workers have been employed at

DOE facilities over the years, the small numbers of female

workers at any one facility has limited their inclusion in

previous health studies. Female workers from 12 DOE

plants were combined in this cohort mortality study. Risk

estimates were developed for exposure to ionizing radiation

or to chemical hazards. A strong healthy worker effect was

demonstrated for all causes of death among these workers. 

For the entire pooled cohort, mortality from mental

disorders, diseases of the genitourinary system, and from illdefined conditions was higher than expected. External

ionizing radiation exposure in these workers appeared to be

associated with increased relative risk for leukemia and

suggestively associated with increased relative risks for all

cancers combined and for breast cancer.

Manuscript: Wilkinson GS, Trieff, N, Graham, R [2000]. Study of

mortality among female nuclear weapons workers. Buffalo,

NY: Department of Social and Preventative Medicine,
NIOSH Energy-Related Health Research Program: Tab 7: Page 16

Completed NIOSH-Initiated Research

School of Medicine and Biomedical Sciences, University of

Buffalo, State University of New York; (DHHS Grant

Numbers: 1R01 OHO3274, R01/CCR214546, R01/CCR61

2934–01, Final Report.) Available from the National

Institute for Occupational Safety and Health/Health-Related

Energy Research Branch, Cincinnati, OH, 447 pg.

Significance: The first multisite mortality study of women workers at DOE

facilities.

18. Glycophorin A Biodosimetry in I-131 Treated Patients

Grantee: University of Pittsburgh (William Bigbee, Ph.D.)

Award Period: 1994–1999

Summary: This research evaluated the in vivo glycophorin A-based

somatic cell mutation assay as a retrospective biodosimeter

for use in epidemiologic studies. The response of the assay

as a biodosimeter of radiation exposure was validated in a

longitudinal study of patients receiving I-131 therapy for

thyroid disease. Assessment of the glycophorin A assay in

this project demonstrated that assay results are substantially

reduced for low dose/low dose rate radiation exposures.

Manuscript: Bigbee WL, Brown ML, Burmeister LA, Carty SE, Swanson

D, Watson CG [1998]. Glycophorin A (GPA) biodosimetry

in I-131 treated patients. Center for Environmental and

Occupational Health and Toxicology; Department of

Environmental and Occupational Health; Graduate School of

Public Health; University of Pittsburgh, Pittsburgh, PA.

(DHHS Grant 5 RO1 OH03276, Final performance report.) 

Available from the National Institute for Occupational

Safety and Health/Health-Related Energy Research Branch,

Cincinnati, OH, 36 pg.

Significance: This research evaluated a biomarker of radiation exposure. 
NIOSH Energy-Related Health Research Program: Tab 7: Page 17

Completed NIOSH-Initiated Research

19. Specificity of the National Death Index and the Social Security Administration

Death Master File When Information on Social Security Number is Lacking

Project Officer: NIOSH intramural study

(Project officer: Mary Schubauer-Berigan, Ph.D.)

Study Period: 1999–2000

Summary: Epidemiologic researchers rely on the National Death Index

and the Social Security Administration (SSA) Death Master

File for ascertainment of vital status. This study evaluated

the specificity of name and date of birth in ascertaining

deaths through the National Death Index and the SSA Death

Master File, and the sensitivity of this information for the

latter. The sensitivity and specificity of the SSA Death

Master File were 86.92% and 98.62%, respectively. The

comparable specificity for the National Death Index was

99.51%. Specificity increased when more complete

identifying information was used, and was higher for

persons with uncommon names. When name and date of

birth are used to ascertain vital status from national

databases, specificity and sensitivity vary with the accuracy

and completeness of these identifiers.

Manuscript: Foster SO, Schubauer-Berigan MK, Waters KM [ 2000]. 

The specificity of the National Death Index and Social

Security Administration Death Master File when

information on Social Security Number is lacking. 

(In press).

Significance: This methods study outlines ways for researchers to achieve

accurate vital status ascertainment with incomplete

information.

20. Lung Fibrosis in Plutonium Workers

Grantee: National Jewish Hospital (Lee Newman, M.D.)

Award Period: 1995–1999

Summary: This project studied whether workers were at increased

risk for developing radiographic abnormalities consistent

with fibrosis. The relationship between 239Pu and other
NIOSH Energy-Related Health Research Program: Tab 7: Page 18

Completed NIOSH-Initiated Research

exposures and lung fibrosis was examined in chest x-rays

of 327 plutonium-exposed Rocky Flats Plant workers

and 194 workers without plutonium exposure. A

significantly higher proportion of abnormal chest

radiographs was found among plutonium workers

(17.4%) compared with nonplutonium workers (7.2%). 

Inhaled plutonium may cause lung fibrosis in humans at

absorbed lung doses above 5 Sv.

Manuscript: Newman LS, Ruttenber JA, Mroz MM [1999]. Lung

fibrosis in plutonium workers. Division of Environmental

and Occupational Health Sciences; National Jewish

Medical and Research Center, Denver, CO. (DHHS

Grant RO1 811855, Final performance report.) 

Available from the National Institute for Occupational

Safety and Health/Health-Related Energy Research

Branch, Cincinnati, OH, 19 pg.

Significance: Plutonium-induced lung fibrosis was observed in a

plutonium exposed worker population consistent with

results in animal testing using multiple species.
NIOSH Energy-Related Health Research Program: Tab 8: Page 1

Previous DOE Studies

Previous DOE Studies

Under the original 1990 memorandum of understanding NIOSH assumed responsibility for

the management of a number of ongoing studies, then being conducted by four DOE

contractors: Oak Ridge Associated Universities, which became the Oak Ridge Institute for

Science and Education (ORISE); Los Alamos National Laboratory, Battelle Pacific

Northwest Laboratory, and Hanford Environmental Health Foundation. Approximately

40 research efforts were itemized in the memorandum of understanding. Ten projects were

performed by ORISE, five by Los Alamos National Laboratory, and five by Hanford

Environmental Health Foundation and Battelle Pacific Northwest Laboratory were

transferred for management by NIOSH. In most of these cases, the research efforts were

well under way by the time of the implementation of the memorandum of understanding;

therefore, NIOSH had minimal opportunity to provide scientific or technical input. 

NIOSH worked with these contractors to complete the studies summarized below:

I. OAK RIDGE INSTITUTE FOR SCIENCE AND EDUCATION (ORISE)

The following studies were performed by investigators from the Center for

Epidemiologic Research of ORISE, under the leadership of Donna Cragle, Ph.D. The

analysis of the studies of two sites, X–10 and Y–12, were conducted by investigators

from the University of North Carolina, as a subcontract to Oak Ridge Associated

Universities.

Oak Ridge National Laboratory (X–10)

1. Manuscript: Wing S, Shy CM, Wood JL, Wolf S, Cragle DL, Frome EL [1991]. 

Mortality among workers at Oak Ridge National Laboratory. 

JAMA 265(11): 1397-1402.

Summary: White males hired at the Oak Ridge National Laboratory between

1943 and 1972 were followed up for vital status through 1984

(N=8,318). Relatively low mortality compared with that in U.S.

white males was observed for most causes of death. However,

leukemia mortality was elevated in the total cohort (63% higher,

28 deaths) and in workers who had at some time been monitored for

internal radionuclide contamination (123% higher, 16 deaths). 

External radiation with a 20-year exposure lag was related to all

causes of death (2.68%, increase per 10 mSv), primarily due to an

association with cancer mortality (4.94%, increase per 10 mSv).
NIOSH Energy-Related Health Research Program: Tab 8: Page 2

Previous DOE Studies

2. Manuscript: Shy C, Wing S [1994]. A report on mortality among workers at Oak

Ridge National Laboratory: followup through 1990. (PO 3C–70837,

Final Report). Oak Ridge, TN: Oak Ridge Associated Universities,

21 pg.

Summary: This study is a followup of the mortality experience of the cohort of

white males employed at the Oak Ridge National Laboratory,

originally described in 1991 (see preceding manuscript citation). An

additional 586 deaths were identified (compared with 1,524 deaths

in the original followup). The all-cause SMR, the all-cancer SMR,

and lung cancer SMR were unchanged from the previous update;

however, the leukemia SMR was 1.35, compared with 1.63. The

SMR for leukemia declined to 0.71 for the recent followup years

(1985–1990). This decline may reflect a leukemia-radiation

association due to relatively high doses in the 1940s and 1950s.

Y–12 Plant, Oak Ridge

Manuscript: Loomis D, Wolf S [1996]. Mortality of workers at a nuclear

materials production plant in Oak Ridge, Tennessee, 1947-1990. 

Am J Ind Med, 29:131-141.

Summary: The mortality experience of a cohort of 10,597 males and females

who worked at Y–12 between 1947 and 1974 was somewhat lower

than that of the United States population, and cancer mortality was

equal to that of the general population. Deaths from lung cancer

were significantly elevated (SMR=1.17, 95% CI=1.01, 1.34). Small

excesses of brain and miscellaneous lymphatic cancers were also

found (SMRs=1.13 and 1.32, respectively). A small increase in

pancreatic cancer deaths was also noted (SMR=1.36). 

Oak Ridge Gaseous Diffusion Plant (K–25)

Manuscript: Dupree EA, Wells SM, Watkins JP, Wallace PW, Davis NC [1994]. 

Mortality among workers employed between 1945 and 1984 at a

uranium gaseous diffusion facility. Oak Ridge, TN: Center for

Epidemiologic Research Medical Sciences Division; Oak Ridge

Institute for Science and Education; (DOE Contract DE-AC05-

760R00033, Final report.) Available from the National Institute for
NIOSH Energy-Related Health Research Program: Tab 8: Page 3

Previous DOE Studies

Oak Ridge K-25 Site. Oak Ridge, Tennessee. Date unknown. Photo

Courtesy of the U.S. Department of Energy.

Occupational Safety and Health/Health-Related Energy Research

Branch, Cincinnati, OH, 24 pg.

Summary: Mortality patterns among 35,712 workers ever employed for 30 days

or more at K–25 between 1945 and 1984 were investigated. For

white males, the SMR for all causes of death was significantly

elevated (SMR=1.03, CI=1.01, 1.05). Other statistically significant

increases among the white male population included cancers of the

respiratory system including lung cancer, cancer of the bone, mental

disorders, and respiratory diseases, and all injuries. Among

nonwhite males, no cause of death showed a statistically significant

increase.

Combined Oak Ridge Facilities (Tennessee Eastman Corporation [TEC], Y–12, 

X–10, K–25)

1. Manuscript: Watkins JP, Cragle DL, Frome EL, Reagan JL, West CM,

Crawford-Brown D, Tankersley WG [1997]. Collection, validation,

and treatment of data for mortality study of nuclear industry

workers. Appl Occup Environ Hyg 12(3):195-205.

Summary: This paper describes methodologic issues related to combining

facilities at Oak Ridge Operations in Tennessee. It includes

evaluation of 118,588 workers employed at TEC, Y–12, K–25, or

X–10. Validation and treatment of data for study members, and

characteristics of their radiation exposure are discussed. Findings
NIOSH Energy-Related Health Research Program: Tab 8: Page 4

Previous DOE Studies

suggest under-ascertainment of external dose during the early years

at two of the facilities. 

2. Manuscript: Frome EL, Cragle DL, Watkins JP, Wing S, Shy CM, Tankersley

WG, West CM [1997]. A mortality study of employees of the

nuclear industry in Oak Ridge, Tennessee. Radiation Res

148:64–80.

Summary: An analysis was conducted of 27,982 deaths occurring among

106,020 persons employed for at least thirty days at four nuclear

facilities in Oak Ridge, Tennessee [TEC, Y–12 (after 1947), X–10,

and K–25] between 1943 and 1983. Overall mortality and overall

cancer mortality estimates were in close agreement with national

rates. The only notable excesses occurred for lung cancer

(SMR=1.18) and nonmalignant respiratory disease (SMR=1.12)

among white males. Analysis showed that workers employed at

TEC, K–25, and multiple facilities had higher death rates than

similar workers employed only at X–10 and Y–12. These elevations

were due to differences among the facilities for lung cancer,

leukemia, and other lymphatic cancers.

Welders at Oak Ridge Facilities

3. Manuscript: Wells SM, Cragle DL, Tankersley WG [Undated]. An update of

mortality among welders, including a group exposed to metal

oxides. Oak Ridge, TN: Oak Ridge Associated Universities, Oak

Ridge Institute for Science and Education, Center for

Epidemiologic Research; (DOE Contract DE-AC05-76OR00033)

Unpublished. 22 pg.

Summary: Overall mortality and all causes of death were examined among

1,211 white male welders employed at three DOE facilities in Oak

Ridge, from 1943 through 1989. A slight excess in emphysema

deaths was noted in the overall cohort, and a slight excess of deaths

from diseases of the respiratory system among workers exposed to

nickel oxides. The SMR for lung cancer in the total cohort also

reached statistical significance (SMR=1.38, CI=1.03–1.82).

Elevations in deaths due to ulcers and prostate cancer were also

noted among workers exposed to nickel oxides.
NIOSH Energy-Related Health Research Program: Tab 8: Page 5

Previous DOE Studies

Lung Cancer Case-Control Study of Uranium Workers (TEC, Y–12, 

Fernald, Mallinckrodt)

Manuscript: Dupree EA, Watkins JP, Ingle JN, Wallace PW, West CM,

Tankersly WG [1995]. Uranium dust exposure and lung cancer risk

in four uranium processing operations. Epidemiology 6(4):

370–375.

Summary: This study sought to examine the relationship between uranium dust

exposure and lung cancer mortality among workers employed in

four uranium processing or fabrication operations located in

Missouri, Ohio, and Tennessee. A total of 787 cases were

identified. Odds ratios for lung cancer mortality for seven

cumulative internal dose groups did not demonstrate increasing risk

with increasing dose. However, an exposure effect was suggested

for workers hired at age 45 years or older. Categorizing workers by

facility, and further analyses for cumulative external dose and

exposures to thorium, radium, and radon did not reveal any

statistically significant association between exposure and increased

risk.

Mallinckrodt Chemical Works

 Manuscript: Dupree-Ellis E, Watkins JP, Ingle JN, Phillips JA [2000]. External

radiation exposure and mortality in a cohort of uranium processing

workers. Am Epidemiol 152:91-95.

Summary: This study investigated 2,514 white males employed in a uranium

processing plant between 1942 and 1966. Through 1993, a total of

1,013 deaths were ascertained. The SMR for all causes was

0.90 (95% CI, 0.85–0.96) and 1.05 (95% CI, 0.9 – 1.17) for all

cancers. Respiratory diseases, chronic nephritis, and lymphatic

cancers were significantly elevated. Trend test revealed a

statistically significant increase of kidney cancers with external

radiation based on 10 cases with an excess relative risk of 10.5 per

Sv of whole body exposure. The results must be considered

provisional, since external radiation exposure may be a surrogate for

internal radiation dose or chemical exposures that were not

considered in this study.
NIOSH Energy-Related Health Research Program: Tab 8: Page 6

Previous DOE Studies

The “gadget” in the Trinity Test Site tower awaiting detonation. 

Built in 1945 at the Los Alamos National Laboratory. Los

Alamos, New Mexico. Photo courtesy of the U.S. Department of

Energy.

5 Rem Study (multiple facilities)

Manuscript: Fry SA, Dupree EA, Sipe AH, Seiler DL, Wallace PW [1996]. A

study of mortality and morbidity among persons occupationally

exposed to >50mSv in a year: phase I, mortality through 1984. 

Appl Occup Environ Hyg 11(4):334-343.

 Summary: This study investigated the mortality experience of 3,145

individuals who reportedly received 50 mSv of penetrating

ionizing radiation in any calendar year of employment (1943

through 1978) at all facilities operated for DOE. A total of 588

deaths (19%) occurred. The overall mortality experience of the total

white male cohort was consistent with a healthy worker effect. 

SMRs for all causes of death, as well as diseases of the circulatory

and digestive systems, were significantly decreased. SMRs were

elevated for cancers of the esophagus and rectum, for

lymphosarcoma, and for benign neoplasms. However, no

statistically significant differences were found in mortality that were

due to these causes or due to cancers of any of the major organ

systems. 
NIOSH Energy-Related Health Research Program: Tab 8: Page 7

Previous DOE Studies

II. LOS ALAMOS NATIONAL LABORATORY

The following five studies were performed by investigators at Los Alamos National

Laboratory (principal epidemiologist: Laurie Wiggs, Ph.D.).

Mound Plant, Miamisburg, Ohio

1. Manuscript: Reyes M, Wilkinson GS, Tietjen GL, Wiggs LD, Galke WA [1991]. 

Mortality among workers at the Mound facility: a preliminary

report. (DOE Contract DE91 010482) Los Alamos National

Laboratory, Los Alamos, NM, 20 pg.

Summary: This technical report details an investigation of 4,697 white males

employed at least 30 days between 1943 and 1979. No statistically

significant elevations were found for the overall cohort. However,

SMRs for thyroid, pharyngeal, lung, and prostate cancers were

greater than 1.0. Significant elevations in lung cancer deaths were

found among polonium workers employed between 1943 and 1959. 

Among workers employed for less than two years between 1943 and

1959, significant elevations were found for all causes, lung cancer,

and for all injuries. 

2. Manuscript: Wiggs LD, Cox-DeVore CA, Wilkinson GS, Reyes M [1991]. 

Mortality among workers exposed to external ionizing radiation at a

nuclear facility in Ohio. J Occup Med 33(5): 632-637. 

Summary: This study investigated 4,182 white males employed at the Mound

facility between 1947 and 1979. No statistically significant

elevations for overall mortality or site-specific cancers were noted. 

A subcohort of 3,229 workers were monitored for external radiation. 

This subcohort was assessed for possible dose-response

relationships between mortality from various causes and external

exposure to ionizing radiation. No statistical differences in

mortality were observed between workers exposed to ionizing

radiation and unexposed workers. However, among workers

exposed to external radiation, a statistically significant doseresponse relationship was seen for lymphopoietic/hemotopoietic

cancers and for all leukemias. 
NIOSH Energy-Related Health Research Program: Tab 8: Page 8

Previous DOE Studies

3. Manuscript: Wiggs LD, Cox-DeVore CA, Voelz GL [1991]. Mortality among a

cohort of workers monitored for 210Po Exposure: 1944-1972. Health

Phy 61(1):71-76.

Summary: This study investigated mortality patterns among 2,181 white males

employed at the Mound facility between 1944 and 1972, years in

which polonium-210 was processed and urine monitoring was in

place. The SMR for all causes was less than 1.0. SMRs for cancers

of the thyroid, rectum, esophagus, lymphatic system, oral cavity,

and lung were elevated, though not significantly. Elevated SMRs

were seen for lung cancer among workers employed during WWII,

but not for the post-WWII group. No dose-response relationship

was noted between mortality and exposure to internal radiation.

Los Alamos National Laboratory (LANL)

Manuscript: Wiggs LD, Johnson ER, Cox-DeVore CA, Voelz GL [1991]. 

Mortality through 1990 among white male workers at Los Alamos

National Laboratory: Considering exposures to plutonium and

external ionizing radiation. Health Phy 67(6): 577–588.

Summary: A cohort mortality study was conducted of 15,727 white males

employed at LANL from 1943 to 1977. No cause of death was

elevated among this cohort. Mortality from all causes of death and

all cancers was significantly low, as was mortality from many other

cause-specific categories. SMR analyses were also conducted for a

subcohort of workers first employed during WWII. The SMRs for

the WWII subcohort indicated that mortality in this subcohort was

also low compared with the general population. No cause of death

was significantly elevated. Analyses of mortality comparing

plutonium-exposed with unexposed workers considering a 10-year

induction period also showed that no cause of death was

significantly elevated. However, dose-response relationships were

observed for cumulative dose of external ionizing radiation and

cancers of the brain/central nervous system, esophagus, and

Hodgkin’s disease. 
NIOSH Energy-Related Health Research Program: Tab 8: Page 9

Previous DOE Studies

Rocky Flats Nuclear Weapons Plant, Golden, Colorado

Manuscript: Wilkinson GS, Tietjen GL, Wiggs LD, Galke WA, Acquavella JF,

Reyes M, Voelz GL, Maxweiler RJ [1987]. Mortality among

plutonium and other radiation workers at a plutonium weapons

facility. Am J Epidemiol 125(2): 231-250.

Summary: Mortality patterns were examined for 5,413 white males employed

for at least two years at the Rocky Flats Plant from 1952 through

1979. Fewer than expected deaths were observed for all causes, all

cancers, and lung cancer. An excess of brain cancer was found for

the overall cohort. Elevated rate ratios (RRs) for all causes of death

and all lymphopoietic cancers were found, when comparing workers

with plutonium burdens of 2 nCi with those with body burdens < 2

nCi. Increased RRs were also observed for esophageal, stomach,

colon, and prostate cancers, as well as lymphosarcomas and

reticulum cell sarcomas. When workers with 1 rem were

compared with those with < 1 rem cumulative exposure, several

elevated RRs were observed (myeloid leukemia, lymphosarcomas

and reticulum cell sarcomas, liver neoplasm, and unspecified brain

tumors). No overall dose-response relationships were found for

either plutonium or external radiation exposure.

Zia Company, Los Alamos, New Mexico

1. Manuscript: Galke GA, Johnson ER, Tietjen GL [1992]. Mortality in an

ethnically diverse radiation exposed occupational cohort. 

Los Alamos, NM: Los Alamos National Laboratory; 

Unpublished. 70 pg.

Summary: A total of 5,424 workers employed at Zia between 1946 and 1978

who were monitored for exposure to either plutonium or external

ionizing radiation were included in this retrospective cohort

mortality study. Among male workers, significantly elevated SMRs

were seen for stomach cancer, senility and ill-defined conditions, all

injuries, all incidents, and motor vehicle incidents. SMRs for

female workers were consistent with mortality rates in the general

population. Hispanic male workers, however, had significantly

higher mortality from stomach cancer, all injuries, all incidents, and

motor vehicle incidents. Non-Hispanic males had significantly

higher mortality from all causes, all cancers, lung cancer, all
NIOSH Energy-Related Health Research Program: Tab 8: Page 10

Previous DOE Studies

circulatory diseases, and all respiratory diseases. Stratified rate

ratio (RR) analyses were conducted to test the association between

radiation exposure and mortality. No significantly high RRs were

seen in either Hispanic or non-Hispanic males in the plutonium or

external ionizing radiation analyses. 

Plutonium Workers (Los Alamos National Laboratory, Zia)

2. Manuscript: Voelz GL, Johnson ER, Lawrence JNP [1993]. Mortality of 244

male workers exposed to plutonium. Los Alamos, NM: Los Alamos

National Laboratory; Unpublished. 16 pg.

Summary: This paper describes an updated mortality study of 224 male

workers exposed to plutonium at the Los Alamos National

Laboratory and Zia. Study subjects were selected by searching the

Los Alamos plutonium dosimetry records for all workers who were

estimated to have plutonium depositions over 370 Bq. Two types of

mortality analyses were performed: (1) SMRs (calculated as of

1990) based on mortality rates of white males in the U.S. general

population, and (2) mortality RRs to compare deaths occurring in

the exposed group with those in an unexposed comparison group. 

The SMRs for all malignant neoplasms were below 1.0. Only the

SMR for bone cancer was elevated (SMR=10.6, CI=0.15, 59),

though this is based on only one case. All mortality rate ratios

(RRs) were calculated with a 10-year cancer induction time. The

ratios for all causes of death and all malignant neoplasms were not

significantly elevated. Only the standardized rate ratio (SRR) for

digestive system cancer was above 1.0 (SRR=1.13, CI=0.42, 3.08). 

III. HANFORD ENVIRONMENTAL HEALTH FOUNDATION

BATTELLE PACIFIC NORTHWEST LABORATORIES

Several research projects were performed jointly by investigators at the Hanford

Environmental Health Foundation(principal epidemiologist: Ellen Omohundro, Ph.D.) and

Pacific Northwest Laboratory (principal investigator: Ethel Gilbert, Ph.D.). Hanford

Environmental Health Foundation was responsible for the collection and verification of

mortality, occupational history, and medical and personal health history data. Pacific

Northwest Laboratory gathered radiation dosimetry data and was responsible for data

integration and analysis. With the exception of the combined studies, all the research

efforts by these contractors pertained to the Hanford Site. 
NIOSH Energy-Related Health Research Program: Tab 8: Page 11

Previous DOE Studies

Hanford Site, Richland, Washington

1. Manuscript: Gilbert ES, Omohundro E, Buchanan JA, Holter NA [1993]. 

Mortality of workers at the Hanford Site: 1945–1986. Health Phy

64(6):577-590.

Summary: This study investigated mortality among contractor employees

initially employed at the Hanford site from 1944–1978. Both the

SMR for overall mortality and mortality from malignant neoplasms

for all workers were below 1.0. SMRs for diseases of the

musculoskeletal system among all workers, for cancer of the

pancreas in males not monitored for external radiation, and for all

other solid tumors in males not monitored for external radiation

were elevated, but not significantly. Comparisons of death rates by

radiation dose within the cohort showed no evidence of a correlation

for all causes of death, all cancers, or leukemia with radiation dose. 

Cancer of the pancreas (p=0.07) and Hodgkin’s disease (p=0.04)

showed positive correlations with radiation dose. Rates for multiple

myeloma death in this cohort continue to be elevated, consistent

with a previous report.

2. Manuscript: Omohundro E, Gilbert E [1993]. An evaluation of the adequacy of

vital status follow-up in the Hanford Worker Mortality Study. 

Richland, WA: Hanford Environmental Health Foundation; (DOE

Contract DE-AC06-76RLO 1830, report prepared for the National

Institute for Occupational Safety and Health/Health-Related Energy

Research Branch, Cincinnati, OH). Available from NTIS,

Springfield, VA; DE94005179, 40 pg.

Summary: This report was designed to evaluate the completeness of vital status

ascertainment in the Hanford worker cohort. Identifying

information about 17,708 Hanford workers was submitted to

Equifax Government and Special Systems. For the period 1945–86,

Equifax ascertained only 12 new deaths. To evaluate the adequacy

of the methods used by Equifax, information about 2,254 Hanford

workers who had been previously identified as dead were also

submitted. Equifax missed less than 2% of known Hanford deaths

during 1965–86, but missed about 18% of deaths occurring before

1965. For the period 1987–89, Equifax identified 49 new deaths. A

stratified random sample of 1,600 of the 17,708 workers with

unknown vital status was submitted to Equifax for a more extensive
NIOSH Energy-Related Health Research Program: Tab 8: Page 12

Previous DOE Studies

Oak Ridge Graphite Reactor,

code-named “X-10,” produced the

world’s first quantities of plutonium.

Oak Ridge Graphite Reactor Landmark,

Oak Ridge National Laboratory,

Tennessee. Date not provided. Photo

courtesy of the U.S. Department of

Energy.

investigation of followup status. Information about these workers

was compared with consumer credit databases to determine the last

date these workers were known to be alive. The results of this part

of the study indicate that if these procedures had been applied to all

workers with unknown vital status, about 90% of these workers

would have been confirmed to be alive. About 5% of the total study

population would have remained lost to followup. 

Combined U.S. Cohorts (Hanford, Oak Ridge National Laboratory, Rocky Flats)

Manuscript: Gilbert ES, Cragle DL, Wiggs LD [1993]. Update analyses of

combined mortality data on workers at the Hanford Site, Oak Ridge

National Laboratory, and Rocky Flats Nuclear Weapons Plant. 

Radiation Res 136:408–421.

Summary: Combined analyses of mortality data for 44,943 workers from

Hanford, Oak Ridge National Laboratory, (X–10), and Rocky Flats

were undertaken to assess cancer risks associated with protracted

low-dose exposure to ionizing radiation. Of 24 cancer sites

evaluated, 12 showed positive correlations with radiation dose, and

12 showed negative correlations. Cancer of the esophagus, cancer

of the larynx, and Hodgkin’s disease showed

statistically significant correlations with radiation

dose, but these correlations were likely to have

resulted from bias or chance fluctuations. Evidence

of an increase in the excess relative risk with

increasing age at risk was found for all cancer in both

Hanford and Oak Ridge National Laboratory. Both

populations showed significant correlations of all

cancer with radiation dose among those 75 years and

older. Although this age effect may have resulted

from bias in the data, its presence suggests that

summary risk estimates for nuclear workers be

interpreted cautiously.
NIOSH Energy-Related Health Research Program: Tab 8: Page 13

Previous DOE Studies

Combined International Studies (U.S., Canada, U.K.)

Manuscript: Cardis E, Gilbert E, Carpenter L, Howe G, Kato I, Armstrong BK,

Beral V, Cowper G, Douglas A, Fix J, Fry SA, Kaldor J, Lave C,

Salmon L, Smith PG, Voelz GL, Wiggs LD [1995]. Effects of a low

dose and low rates of external ionizing radiation: Cancer mortality

among nuclear industry workers in three countries. Radiation Res

142:117–132.

Summary: This paper presents the results of combined analyses of mortality

data for 95,673 workers monitored for external exposure to ionizing

radiation and employed for 6 months or longer in the nuclear

industry in the United States, the United Kingdom, and Canada. No

evidence was found of an association between radiation dose and

mortality from all causes or from all cancers. Mortality from

leukemia, excluding chronic lymphocytic leukemia, showed a

statistically significant association with cumulative external

radiation dose. Among 31 other cancer sites evaluated, a

statistically significant association with external dose was observed

only for multiple myeloma. This was attributable primarily to the

associations reported previously in the Hanford and Sellafield

cohorts. The relative risk of all cancers excluding leukemia was

0.99, and 1.22 for leukemia excluding chronic lymphopoietic

leukemia for a cumulative protracted dose of 100 mSv compared to

0 mSv. 
NIOSH Energy-Related Health Research Program: Tab 9: Page 1

Proposed Research

Proposed Research

Each of the proposed activities outlined below addresses one or more of the NIOSH

Energy-Related Health Research Agenda objectives and has been approved by the DHHS

Advisory Committee on Energy Related Epidemiologic Research (ACERER). These

research objectives are not a comprehensive list of research opportunities or knowledge

gaps for occupational hazards at DOE sites. A new Advisory Committee to replace

ACERER is being considered, and NIOSH will work with the new committee to refine and

prioritize the research objectives that will guide future energy-related research. 

1. Civilian Nuclear Power Workers

Summary: Establish a cohort from the more than 500,000 civilian nuclear

power workers who have been primarily exposed to external

radiation with estimated cumulative dose averages between 2.2 and

4.2 rem. This cohort would also present opportunities to contrast

neutron exposures. Records have been collected on this cohort in

support of the cooperative agreement with IARC on the

International Collaborative Study of Nuclear Industry Workers.

2. Evaluating Time-Related Variables in Occupational Epidemiolgic Studies

Summary: Several epidemiologic studies have suggested that time-related

variables, including age at time of radiation exposure may have a

significant effect on risk of cancer. Methods for statistically

modeling this biological effect are not well defined. Following a

literature review, a statement of work was prepared to create

age–based analysis files and propose analytic approaches to these

issues.

3. Neutron Exposure Assessment

Summary: Work environments with substantial neutron exposure records are

being evaluated to develop methods for neutron exposure estimation

and the appropriate incorporation of these estimates in

epidemiologic studies. Additionally, numerous reports indicate that

substantial uncertainties in estimating neutron exposure may have

caused bias in the neutron dose estimates. Currently, risk estimates

for neutron exposures are derived from animal studies.
NIOSH Energy-Related Health Research Program: Tab 9: Page 2

Proposed Research

Decontamination and monitoring of a truck. 

Idaho National Engineering and Environmental

Laboratory, Idaho Falls, Idaho. 1975. Photo

courtesy of the U.S. Department of Energy.

4. Historical Dosimetry Practices

Summary: Documents that describe historical dosimetry practices at DOE

facilities will be identified, collected, and summarized to better

describe uncertainties in exposure estimates in epidemiology studies

at those facilities. A list of key contacts with knowledge of

historical dosimetry practices at each site is being developed. 

5. Exposure Assessment of Hazardous Waste, Decontamination and

Decommission, and Cleanup Workers (Phases II and III)

Summary: Phase I of this research project is described in Ongoing Research. If

the analysis of Phase I information indicates a need for further

evaluation, Phase II would include visits to collect additional site

information and develop hypotheses for further study based on

priorities of hazards and exposures. Phase III would include studies

to test the hypotheses.
NIOSH Energy-Related Health Research Program: Tab 9: Page 3

Proposed Research

6. Update of Cohort Mortality Study of Mound Workers, Miamisburg, Ohio

Summary: This facility engaged in operations with potential exposures to

polonium-210, plutonium-238, and tritium. A mortality study

through 1979 showed elevated lung cancer mortality in workers

employed from 1943–1959 and a significant dose-response

relationship between plutonium-238 exposure and

lymphopoietic/hematopoietic cancers and leukemia. Because of

these suggestive results, the health effects of tritium, polonium, and

external radiation along with potential chemical exposures at the

Mound plant should be further investigated. An update would allow

an additional 20 years of followup and use of validated bioassay.

7. Medical/Off-Site Radiation Exposures

Summary: The precision of occupational epidemiology studies will be

improved by characterizing multiple exposure conditions. The

potential effect of medical and off-site exposures to ionizing

radiation in occupational epidemiologic studies has never been

evaluated. Risk estimates from studies without characterization of

these exposures could be biased. At K–25, an investigation has

found that routine fluoroscopic chest x-ray examinations in the

1940s and 1950s may have resulted in substantial whole–body

equivalent radiation exposures. This study will determine the

feasibility of using medical and off-site records for workers and, if

feasible, whole-body doses would be estimated using information

from these additional sources of radiation. 

8. Case-Control Study of Brain Cancer

Summary: Mortality studies at Los Alamos, Oak Ridge, Y–12, and Rocky Flats

have found nonsignificant excesses in brain cancer. Individually,

these studies lacked sufficient power to evaluate exposure response

associations because of the rarity of brain cancer and the relatively

small size of the cohorts. Preliminary feasibility analysis indicates

that sufficient brain cancer cases exist across the DOE complex to

support a multisite case-control study that would evaluate any

association of the disease with chemical and ionizing radiation

exposures.
NIOSH Energy-Related Health Research Program: Tab 9: Page 4

Proposed Research

9. Case-Control Study of Bone Cancer

Summary: Uranium and plutonium have well known tumorigenic potential. 

Worker cohort studies at sites with potential uranium or plutonium

exposures have not demonstrated significant elevated risk for bone

cancer primarily because of low statistical power to detect an

excess. Bone cancer deaths from combined DOE cohorts should be

reviewed to determine whether a multisite study is warranted where

uranium or plutonium was present in the work environment. This

study would provide the most sensitive evaluation of excess bone

cancer in nuclear workers possible.

10. JEM Data Sensitivity Analysis

Summary: When actual monitoring data on individual workers are absent,

exposures may be estimated from facility, building, or job

information through exposure matrices. Because of the extensive

individual external radiation monitoring information at DOE sites,

the reliability of grouped estimates for chemicals or internal sources

may be evaluated when they are derived under various conditions

from exposure matrices. A sensitivity analysis will be performed to

determine “how much data is enough” to construct a reasonably

accurate job exposure matrix. This study will: (1) identify a set of

health physics monitoring data with known work histories and tasks;

(2) use programming to remove various portions of the data

(e.g., collapse job titles and reduce sample sizes within jobs)

according to preset criteria; (3) determine indicators of instability or

unreliability using various modeling techniques; and (4) determine

the level of uncertainty of the estimates at each level of data

completeness.
NIOSH Energy-Related Health Research Program: Tab 10: Page 1

Medical Surveillance Grants/Activities Program Overview

Medical Surveillance Grants

Activities Program Overview

NIOSH medical surveillance of former DOE workers is divided into two separate areas

under different enabling authorizations. Under a Memorandum of Understanding between

DOE and the Department of Health and Human Services (DHHS), NIOSH administered

five DOE-funded research grants. One of these grants was completed in 1998, and a final

report and evaluation were released. The remaining four grant activities were completed in

1999, and final reports are being submitted to the NIOSH Grants Office. These grants are

summarized under Research Grants Administration.

Under the requirements of the Defense Authorization Act of 1993, DOE must work with

DHHS, the Centers for Disease Control and Prevention (CDC), and the National Institute

for Occupational Safety and Health (NIOSH) “regarding determinations of significant

health risk resulting from DOE work-related exposures.” Under a Memorandum of

Understanding, DOE has asked that NIOSH independently conduct peer reviews of DOE

former worker medical surveillance projects and make recommendations regarding the

conduct of these projects. These DOE efforts are summarized under Department of

Energy Medical Surveillance Activity.

Research Grants Administration

1. Improved Systems for Worker Exposure Surveillance 

(Grant 1 R01 CCR412029-01)

Grantee: Oak Ridge Associated Universities

William G. Tankersley, M.S.

Summary: This project will (1) evaluate current exposure–monitoring programs

and data bases at the DOE Y–12 plant, (2) develop a new system for

classification of workers based on substances with which they

commonly work, and (3) develop and test in a working environment,

a system based on readily available bar code technology for

continual tracking of workers and recording the primary substances

with which they work.

Manuscript: West CM, Rutherford BF, Tankersley WG [1997]. Current

programs for estimating dose and chemical exposure: Volume I. 

Oak Ridge, TN: Oak Ridge Associated Universities; (CDC Grant

R01/CCR412029) Available from the National Institute for
NIOSH Energy-Related Health Research Program: Tab 10: Page 2

Medical Surveillance Grants/Activities Program Overview

Occupational Safety and Health/Health-Related Energy Research

Branch, Cincinnati, OH, 140 pg.

West CM, Rutherford BF, Tankersley WG [1997]. Current

programs for estimating dose and chemical exposure: Volume II. 

Oak Ridge, TN: Oak Ridge Associated Universities; (CDC Grant

R01/CCR412029) Available from the National Institute for

Occupational Safety and Health/Health-Related Energy Research

Branch, Cincinnati, OH, 122 pg.

Significance: The evaluation will be useful for future researchers conducting

epidemiologic studies at this facility. Additionally, the development

and testing of these practical and cost-effective informational

systems will complement the existing worker exposure assessment

programs and provide surveillance for a greater percentage of the

worker population.

2. Work Histories Evaluating New Participatory Methods

(Grant R01 CC512026–01)

Grantee: University of Cincinnati

Eula Bingham, Ph.D.

Grants Office Advisor: David Pedersen, Ph.D

Award Period: 9/30/95–9/29/99

Summary: Workers in the construction trades are exposed to a wide variety of

chemical and radiological agents at DOE sites. Creation of an

exposure history for these workers is difficult because complex 

exposure patterns across a large number of short-term workplace

assignments must be recalled. To provide an improved basis for the

characterization of worker occupational exposures over time, this

project is aimed at developing and testing several innovative

techniques for improving occupational history recall. The technique

found to be the most efficient and effective in identifying workers at

higher risk will be tested at a different DOE site with a new cohort,

to validate guidelines and formats for maintaining personal work

histories.

Manuscript: Awaiting final report.
NIOSH Energy-Related Health Research Program: Tab 10: Page 3

Medical Surveillance Grants/Activities Program Overview

Significance: Validated improvements in assembling retrospective occupational

exposure histories have general application in increasing the validity

of studies of the associations between exposure histories and health

risk(s). Benefits from this improvement include increased capability

to allocate medical surveillance resources more effectively, thus

reducing unnecessary and duplicative effort.

3. Comprehensive Occupational Health Surveillance 

(Grant 1R01 CC12031)

Grantee: University of Washington

Scott Barnhart, Ph.D.

Grants Office Advisor: David Pedersen, Ph.D.

Award Period: 9/30/95–9/29/99

Summary: This project is concerned with the design and implementation of a

model occupational safety and health surveillance system. The goal

of this system is to gather appropriate occupational medicine and

industrial hygiene data to provide information for the systematic

identification of hazardous exposures and adverse health outcomes. 

Manuscript: Ertell K, Takaro T, Shorter C, Stover B, Beaudet N, Barnhart S,

Rabito F, White LE [2000]. Results of Employee Job Task

Analysis (EJTA) quality assessment: Combined analysis for

fourteen Hanford contractors. Seattle, WA: University of

Washington; (NIOSH Grant 1R01 CC12031, Final Report.)

Available from the National Institute for Occupational Safety

and Health/Health-Related Energy Research Branch,

Cincinnati, OH, 34 pg.

Significance: Readily available computerized information about workplace

exposures and health status organized by tasks through an employee

job task analysis provides information for accurate risk assessments

leading to reduction of hazardous exposures. This level of

documentation also supports objective evaluation of occupational

health program intervention effectiveness and contributes to worker

(stakeholder) involvement in prevention efforts.
NIOSH Energy-Related Health Research Program: Tab 10: Page 4

Medical Surveillance Grants/Activities Program Overview

Worker. Idaho National Engineering

and Environmental Laboratory, Idaho

Falls, Idaho. 1957. Photo courtesy of

the U.S. Department of Energy.

4. Hazard Surveillance in the Defense Nuclear Industry 

(Grant 1 R01 CC912034)

Grantee: University of California at Los Angeles

John Froines, Ph.D.

Grants Office Advisor: David Pedersen, Ph.D.

Award Period: 9/30/95–9/29/99

Summary: This project is intended to develop an integrated approach to

statistical models for exposure assessment, especially

characterization of occupational exposure to complex, mixed

exposures to chemicals and biomechanical problems. Based on

measured task-specific exposure data, the project is dedicated to

identifying appropriate statistical tools to model single- and mixedagent exposures and resulting internal doses.

Manuscript: Awaiting final report.
NIOSH Energy-Related Health Research Program: Tab 10: Page 5

Medical Surveillance Grants/Activities Program Overview

Significance: This research has application in complex exposure situations by

providing an additional avenue for evaluating the relationships

between exposure concentration and worker dose. The modeling

capabilities of the developed system will provide a risk-based

estimation of adverse health effect incidence on the basis of assessed

environmental exposures to guide health interventions, including

medical surveillance.

5. Sentinel Exposure Event Surveillance/Evaluation at DOE Sites

(Grant 1 R01 CCR8120441)

Grantee: University of Colorado

James Ruttenber, M.D.

Grants Office Advisor: David Pedersen, Ph.D.

Award Period: 9/30/95–9/29/99

Summary: This project is intended to develop a generic hazard surveillance and

evaluation system for exposures to chemical and radiation

exposures. According to a job/task evaluation and analysis, the

sentinel exposure event system will include exposure level

measurements, worker-specific task definitions, and observation

data (controls, exposure conditions, and defined health and safety

policies). This input will be incorporated into a system for

evaluating exposures, enhancing worker communications, and

identifying necessary interventions through internally generated

reports.

Manuscript: Awaiting final report.

Significance: The practice of using job/task definition as the fundamental unit of

observation in a comprehensive exposure evaluation and reporting

system provides generic capabilities identifying and directing

occupational health interventions and enhanced worker

communications. The potential for indicating and guiding

improvements in occupational health program initiatives may have

direct impact on the conduct of medical surveillance programs.
NIOSH Energy-Related Health Research Program: Tab 10: Page 6

Medical Surveillance Grants/Activities Program Overview

Department of Energy Medical Surveillance Activity

1. Medical Monitoring Program for Former Workers at Rocky Flats

Environmental Technology Site

Grantee: University of Colorado

James Ruttenber, M.D., Ph.D.

Exposure Concerns: Internal/external radiation, asbestos, lead, heavy metals,

solvents, formaldehyde

Target Population: Former Rocky Flats production workers (excluding cleanup 

workers) who were involved with weapons production

between 1951 and 1989. The phase I effort estimated the

target population at 14,430 former production workers.

Current Status: This project is in the second year of phase II activity. 

A roster of more than 15,000 former workers has been

developed, and interviews with former workers regarding

their occupational exposures are being conducted. 

The project anticipates the notification of more than 7,500

former workers in the current project year, accompanied by

approximately 700 selective medical screening examinations

based on exposure assessments and physician input.

2. Surveillance of Former Construction Workers at the Oak Ridge Reservation

Grantee: University of Cincinnati

Eula Bingham, Ph.D.

Exposure Concerns: Asbestos, silica, beryllium, heavy metals, solvents, welding

fumes.

Target Population: Former construction workers who worked on selected

buildings at the Oak Ridge site, including the Gaseous

Diffusion Plant (K–25), the Y–12 Plant and the Oak Ridge

National Laboratory (X–10). The needs assessment phase

estimated that at least 7,000 former workers were eligible for

medical screening in the second phase, based on selection

from construction workers employed since 1943 (the start of

construction at Oak Ridge). 
NIOSH Energy-Related Health Research Program: Tab 10: Page 7

Medical Surveillance Grants/Activities Program Overview

Current Status: This project is in the second year of phase II activity. The

project has completed an initial contact mailing to more than

1,200 former construction workers, and has conducted more

than 200 worker interviews. Medical screening

examinations, based on assessment of occupational

exposures and medical considerations, are scheduled to

begin in the current project year.

3. Medical Surveillance of Former Hanford Workers (Nonconstruction Trade

Workers)

Grantees: University of Washington

Drew Brodkin, M.D., Tim Takaro, M.D.

Exposure Concerns: Asbestos, noise, beryllium

Target Population: Following the phase I needs assessment, the investigators

limited this notification/medical screening program to former

(1943–1997) nonconstruction trade workers who were

potentially exposed to asbestos (~10,000 workers ), noise

(~14,000 workers), or beryllium (~6,000 workers). The

investigators also intend to evaluate available site records to

determine whether data on other hazardous exposures would

identify more candidates for medical screening.

Current Status: This project is currently in the second year of phase II

activity, and has sent out more than 12,000 letters

announcing the project to identified workers, intending to

continue the outreach process in the current year. The

project has collected more than 700 occupational exposure

histories and has assessed the hazardous exposures for these

workers. At the end of the first year of phase II, the project

had performed more than 100 medical screening

examinations, and is continuing them in the current project

year.
NIOSH Energy-Related Health Research Program: Tab 10: Page 8

Medical Surveillance Grants/Activities Program Overview

4. Medical Surveillance for Former Department of Energy Workers at the

Nevada Test Site

Grantee: Boston University

Lewis Pepper, Ph.D., M.D.

Exposure Concerns: External/internal radiation, various chemical exposures,

diesel exhaust, beryllium

Target Population: Former Nevada test site construction trade workers

(underground and excavation construction workers and reentry crews) who were employed between 1956 and 1991. 

Approximately 16,400 workers were represented by six

construction trade unions for this period. The phase I

investigation estimated that approximately 15,000 of these

workers might be eligible for the program. The investigators

were particularly concerned with exposures to internal and

external radiation and were evaluating other hazardous

exposures.

Current Status: This project is currently in the third year of phase II activity. 

Continuing research has indicated that more than 10,000

workers are potential candidates for the screening process,

and more than 2,500 of these were individually notified in

the second year of phase II. The project has provided

medical screening for more than 700 workers, and intends to

continue occupational history interview and medical

screening efforts at similar levels in the current project year.

5. Former Worker Medical Surveillance Program at Department of Energy

Gaseous Diffusion Plants

Grantees: Queens College, NY

Steven Markowitz, M.D.

Paper, Allied Industrial, Chemical and Energy Workers

Union (PACE)

Robert Wages

Exposure Concerns: Beryllium, plutonium, radiation
NIOSH Energy-Related Health Research Program: Tab 10: Page 9

Medical Surveillance Grants/Activities Program Overview

Target Population: Former DOE production workers at the gaseous diffusion

plants in Portsmouth, Ohio; Paducah, Kentucky; and the Oak

Ridge, Tennessee K–25 complex. The investigators limited

the notification and medical screening programs to (1) those

workers with potential risk for bladder cancer at K–25

(estimated to be 500–600 workers who might be located and

be eligible) and (2) those workers at the Paducah and

Portsmouth sites at risk for a variety of lung diseases,

including chronic obstructive lung disease, pneumoconioses

and lung cancer. The phase I investigation estimated a first

priority group of workers at risk of lung disease to be

2,300–3,500 workers at K–25, 300–400 workers at

Portsmouth and 200–300 workers at Paducah; a second

priority group was estimated to include 5,000–7,000 workers

at K–25, 3,000–5,000 workers at Portsmouth and about

2,000 workers at Paducah.

Current Status: The project is currently in the second year of phase II

activity. The project developed extensive worker contacts

and outreach mechanisms and engaged in risk-mapping and

exposure data investigations in the first year of phase II. 

Plans for the second year of phase II activity include the

continued administration of occupational exposure history

questionnaires, and the provision of more than 1,000 medical

screening examinations.

6. Medical Surveillance of Former Construction Workers at Hanford

Grantee: Center to Protect Workers’ Rights

Knut Ringen, Dr.P.H.

Exposure Concerns: Asbestos, beryllium, silica, heavy metals, solvents

Target Population: Former construction workers at Hanford who were involved

in building construction from 1950 to 1963, excluding

workers from before 1950 because of their age and a lack of

records. The initial target population was estimated at

59,000, and narrowed down to 29,100 after determination of

vital status and excluding those lost to followup.

Current Status: This project has just begun the third year of phase II activity. 

In years 1 and 2, this project contacted more than 2,500
NIOSH Energy-Related Health Research Program: Tab 10: Page 10

Medical Surveillance Grants/Activities Program Overview

Worker at Oak Ridge Gaseous Diffusion Plant uses special

leak-detection device to examine large piping of process

equipment at the plant. K-25 Site, Oak Ridge, Tennessee. Date

unknown. Photo courtesy of the U.S. Department of Energy.

workers, conducted more than 950 worker interviews, and

provided more than 500 medical screening examinations.

7. Medical Surveillance for Former Workers at the Idaho National Engineering

and Environmental Laboratory

Grantees: Queens College, NY

Steven Markowitz, M.D.

Paper, Allied Industrial, Chemical and Energy Workers

Union (PACE)

Robert Wages

Exposure Concerns: External/internal radiation, beryllium, solvents, noise

Target Population: The target population includes all former workers at the

Idaho National Engineering and Environmental Laboratory

site. During phase I, the investigators estimated that the

number of workers eligible for the medical screening

program might be as high as 17,500. The investigators also

identified a number of exposures (including asbestos,

beryllium, solvents, chromium, and radiation) that may

further identify the study cohort for the site.
NIOSH Energy-Related Health Research Program: Tab 10: Page 11

Medical Surveillance Grants/Activities Program Overview

Laundry worker. Idaho National Engineering

and Environmental Laboratory, Idaho Falls,

Idaho. 1957. Photo courtesy of the U.S.

Department of Energy.

Current Status: This project is in the first year of phase II activity. Efforts

are ongoing to add to the existing former worker roster,

particularly from site contractor lists. Current exposure

assessment efforts rely on both construction of a job

exposure matrix and on the development of building/job

classification categories for the Idaho National Engineering

and Environmental Laboratory site. Medical screening

protocols have been developed.

8. Medical Surveillance Program for Former Los Alamos National Laboratory

Workers

Grantees: The Johns Hopkins University

Brian Schwartz, M.D., M.S. and Patrick Breysse, Ph. D.

Exposure Concerns: Ionizing radiation, chlorinated solvents, asbestos, beryllium,

lead

Target Population: The target population includes all former Los Alamos

National Laboratory workers employed since operations

began in 1943. The number of workers eligible for the 

medical screening program was estimated at about 36,000

during phase I. Hazardous exposures that may further define

the target populations were identified during phase I, and
NIOSH Energy-Related Health Research Program: Tab 10: Page 12

Medical Surveillance Grants/Activities Program Overview

include asbestos, beryllium, chlorinated solvents, ionizing

radiation, lead and noise.

Current Status: This project is in the first year of phase II activity. Existing

employee records have been analyzed for the refinement of

the study cohort, and a two-stage questionnaire process for

selecting workers for screening has been developed. 

Extensive procedures for communicating study results to

both affected workers and the community have been

developed. The investigators anticipate approximately 600

medical screening examinations and medical records

examinations in the first year of phase II.

9. Savannah River Medical Surveillance Program for Building Trades Workers

Grantee: Center to Protect Workers Rights

Knut Ringen, Dr.P.H.

Exposure Concerns: Asbestos, cadmium, heavy metals, lead

Target Population: The estimated target population includes about 62,000

former and current building trades workers at the Savannah

River site who worked from 1950 to the present. During

Phase I, the investigators concluded that approximately

38,000 of these workers are alive. Phase I investigations

estimated that medical screening tests might be administered

to approximately 8,000 of these workers. 

Current Status: This project is in the second year of phase II activity. In year

1, the project located nearly 6,000 workers, conducted

nearly 500 worker interviews, and provided more than100

medical screening examinations. In phase II, year 2, the

investigators anticipate locating an additional 2,500 workers,

interviewing 1,500, and conducting a total of more than

1,000 medical screening examinations.
NIOSH Energy-Related Health Research Program: Tab 10: Page 13

Medical Surveillance Grants/Activities Program Overview

10. Savannah River Medical Surveillance for Former Production Workers 

Grantees: Medical University of South Carolina

David Hoel, Ph.D.

and

University of South Carolina

David Adcock, M.D

Exposure Concerns: Asbestos, hydrazine, solvents, beryllium, internal/external

radiation, dioxane, noise

Target Population: Former production workers at the Savannah River site from

1962 to the present. In phase I, the investigators estimated

this to be approximately 23,000 living workers. Hazardous

exposures defining this population include asbestos,

beryllium, hydrazine, solvents, and internal and external

radiation.

Current Status: This project is in the second year of phase II activity. Efforts

to date have included developing screening questionnaires

and risk assessment and medical screening protocols. 

Worker outreach efforts are ongoing, and the investigators

have developed a Web site to assist in communications. 

Using existing hazard exposure and medical records, the

project recently began providing medical screening

examinations.

11. Medical Monitoring of Former Atomic Weapons Workers at the Iowa Army

Ammunition Plant in Burlington, Iowa

Grantees: University of Iowa

Laurence Fuortes, M.D.

Stephen Reynolds, Ph.D.

Exposure Concerns: Radioactive materials, explosives, solvents, epoxies, heavy

metals, and fibrogenic dusts

Target Population: Former production workers in the Line 1 facility of the Iowa

Army Ammunition Plant, which served as an atomic

weapons production and testing area operated by the Atomic

Energy Commission from 1945 to 1975. The primary focus

is on machinists employed in the area. An estimated 4,000
NIOSH Energy-Related Health Research Program: Tab 10: Page 14

Medical Surveillance Grants/Activities Program Overview

workers were employed in the Line 1 area, with

approximately 1,000 employed at any one time.

Current Status: This project is regarded by DOE as effectively operating in

phase II status at the time of project initiation. This is

because DOE concluded that the proposal adequately

demonstrated an understanding of the site and the exposures

of the target population, adequately documenting the need

for medical surveillance.

12. Amchitka Workers Medical Surveillance Program (Agreement in Principal

with the State of Alaska)

Grantee: Alaska Council of Labor

Knut Ringen, Dr.P.H. 

Exposure Concerns: The purpose of the program is to locate and provide medical

screening to former workers at the Amchitka site. This

screening is targeted to the occupational exposures of former

workers at the site, especially radiation.

Target Population: Former workers employed at Amchitka from 1963 to the

middle 1990s, when the U.S. government maintained a

nuclear testing facility on the island. Approximately 3,000

workers may have been employed at the site, and it is

estimated that about 1,500 will be located and screened.

Current Status: This project was initiated in 1999, and approximately 750

workers have been identified to date despite a wide

geographical distribution. About 100 of these were

deceased. Efforts to locate more former workers continue,

with the help of union and Alaska Native organizations.
NIOSH Energy-Related Health Research Program: Tab 11: Page 1

Ongoing and Completed Studies by State

NIOSH (Ongoing and Completed) Studies by State

COLORADO

Rocky Flats Plant

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning and Cleanup

Workers (Phase I)

& Cancer Incidence Study of Rocky Flats Plant

& Lung Fibrosis in Plutonium Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Mine Specific Exposure Information for Uranium Miners

Study

IDAHO

Idaho National Engineering and Environmental Laboratory

& Cohort Mortality Study of Idaho National Engineering

and Environmental Laboratory Workers

& Exposure Assessment of Hazardous Waste,

Decontamination and Decommissioning, and 

Cleanup Workers (Phase I)

& Lung Cancer Case-Control Study

& International Collaborative Study of Nuclear Industry

Workers

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Childhood Leukemia Case-Control Study
NIOSH Energy-Related Health Research Program: Tab 11: Page 2

Ongoing and Completed Studies by State

MAINE

Portsmouth Naval Shipyard

& Cohort Mortality Study of Portsmouth Naval Shipyard

& Lung Cancer Case-Control Study

& Leukemia Case-Control Study

& International Collaborative Study of Nuclear Industry

Workers

MISSOURI

Mallinckrodt Uranium Works

• Cohort Mortality Study of Mallinckrodt Workers

NEVADA

Nevada Test Site

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

NEW MEXICO

Los Alamos National Laboratory

& Leukemia Case-Control Study

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Multisite Multiple Myeloma Case-Control Study

& Mine– Specific Exposure Information for Uranium

Miners Study
NIOSH Energy-Related Health Research Program: Tab 11: Page 3

Ongoing and Completed Studies by State

NEW YORK

Linde Air Products

• Study of the Mortality Among Female Nuclear Weapons

Workers

OHIO

Feed Materials Production Center (Fernald)

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Feasibility Study for an Integrated Data Base for DOE

Site Remediation Workers

& Cohort Mortality Study of Fernald Environmental

Management Plant (Vital Status Followup through 1998)

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Radon and Cigarette Smoking Exposure Assessment in

Fernald Workers

& Cohort Mortality Study of Workers at Fernald Feed

Materials Production Center (Vitus Status Followup

Through 1989)

Mound Site

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Update of Cohort Mortality Study of Mound Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers*
NIOSH Energy-Related Health Research Program: Tab 11: Page 4

Ongoing and Completed Studies by State

Portsmouth Gaseous Diffusion Plant

& Cohort Mortality Study of Portsmouth Gaseous Diffusion

Plant

SOUTH CAROLINA

Savannah River Plant

& Leukemia Case-Control Study

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Clean-up

Workers (Phase I)

& Cohort Mortality Study of DOE Chemical Laboratory

Workers

& Lung Cancer Case-Control Study

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Multi-Site Multiple Myeloma Case-Control Study

& Cohort Mortality Study of Workers at the Savannah

River Plant

TENNESSEE

Oak Ridge K–25 Plant

& Multiple Myeloma Case-Control Study at the Oak Ridge

Gaseous Diffusion Plant ( K–25)

Oak Ridge National Laboratory (X–10 Site)

& Leukemia Case-Control Study

& Lung Cancer Case-Control Study

& Construction Workers Mortality Study 

& Multisite Multiple Myeloma Case-Control Study
NIOSH Energy-Related Health Research Program: Tab 11: Page 5

Ongoing and Completed Studies by State

Oak Ridge Y-12 Plant

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Mercury Workers Health Study

Combined Oak Ridge National Laboratory Sites: X–10, K–25, Y–12

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Cohort Mortality Study of DOE Chemical Laboratory

Workers

& Studies of Heat Stress and Performance in Carpenters at

DOE Sites

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Childhood Leukemia Case-Control Study

& Time-Related Factors in Radiation-Cancer Dose

Response

& Dose Estimation from Daily and Weekly Dosimetry Data

TEXAS

Pantex Plant

& Cohort Mortality Study of Pantex Plant, Amarillo, TX

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization
NIOSH Energy-Related Health Research Program: Tab 11: Page 6

Ongoing and Completed Studies by State

WASHINGTON

Hanford Site

& Leukemia Case-Control Study

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Lung Cancer Case-Control Study

& Construction Workers Mortality Study 

& Studies of Heat Stress and Performance in Carpenters at

DOE Sites

& Ionizing Radiation and Mortality Among Hanford

Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Surveillance Methods for Solvent-Related Hepatoxicity,

a cross-sectional study at Hanford

& Multisite Multiple Myeloma Case-Control Study

& Accounting for Errors in Radiation in Dose Estimates

& Childhood Leukemia Case-Control Study

Listing of NIOSH Studies by DOE Site

Feed Materials Production Center (Fernald), OH

& Exposure Assessment of Hazardous Waste,

Decontamination and Decommissioning, and Cleanup

Workers (Phase I)

& Feasibility Study for an Integrated Data Base for DOE

Site Remediation Workers

& Cohort Mortality Study of Fernald Environmental

Management Plant (Vital Status Followup Through

1998)
NIOSH Energy-Related Health Research Program: Tab 11: Page 7

Ongoing and Completed Studies by State

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Radon and Cigarette Smoking Exposure Assessment in

Fernald Workers

& Cohort Mortality Study of Workers at Fernald Feed

Materials Production Center (Vitus Status Followup

Through 1989)

Hanford Site, WA

& Leukemia Case-Control Study

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Lung Cancer Case-Control Study

& Construction Workers Mortality Study 

& Studies of Heat Stress and Performance in Carpenters at

DOE Sites

& Ionizing Radiation and Mortality Among Hanford

Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Surveillance Methods for Solvent-Related Hepatoxicity,

a cross-sectional study at Hanford

& Multisite Multiple Myeloma Case-Control Study

& Accounting for Errors in Radiation in Dose Estimates

& Childhood Leukemia Case-Control Study

Idaho National Engineering and Environmental Laboratory, ID

& Cohort Mortality Study of Idaho National Engineering

and Environmental Laboratory Workers
NIOSH Energy-Related Health Research Program: Tab 11: Page 8

Ongoing and Completed Studies by State

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Lung Cancer Case-Control Study

& International Collaborative Study of Nuclear Industry

Workers

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Childhood Leukemia Case-Control Study

Linde Air Products, NY

• Study of the Mortality Among Female Nuclear Weapons

Workers

Los Alamos National Laboratory, NM

& Leukemia Case-Control Study

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Multisite Multiple Myeloma Case-Control Study

Mallinckrodt Uranium Works, MO

& Cohort Mortality Study of Mallinckrodt Workers

Mound Site, OH

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Update of Cohort Mortality Study of Mound Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers
NIOSH Energy-Related Health Research Program: Tab 11: Page 9

Ongoing and Completed Studies by State

Nevada Test Site, NV

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

Oak Ridge, TN: All Oak Ridge Facilities Combined ( X–10, K–25, Y–12)

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and 

Cleanup Workers (Phase I)

& Cohort Mortality Study of DOE Chemical Laboratory

Workers

& Studies of Heat Stress and Performance in Carpenters at

DOE Sites

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Childhood Leukemia Case-Control Study

& Time-Related Factors in Radiation-Cancer Dose

Response

& Dose Estimation from Daily and Weekly Dosimetry Data

Oak Ridge, TN: K–25 Site

& Multiple Myeloma Case-Control Study at the Oak Ridge

Gaseous Diffusion Plant ( K–25)

Oak Ridge Laboratory, TN: X–10 Site

& Leukemia Case-Control Study

& Lung Cancer Case-Control Study

& Construction Workers Mortality Study
NIOSH Energy-Related Health Research Program: Tab 11: Page 10

Ongoing and Completed Studies by State

Oak Ridge, TN: Y–12 Plant

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

& Mercury Workers Health Study

Pantex Plant, TX

& Cohort Mortality Study of Pantex Plant, Amarillo, TX

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Prevention of Stress and Health Consequences of

Downsizing and Reorganization

Portsmouth Gaseous Diffusion Plant, OH

& Cohort Mortality Study of Portsmouth Gaseous Diffusion

Plant

Rocky Flats Plant, Colorado

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Cancer Incidence Study of Rocky Flats Plant

& Lung Fibrosis in Plutonium Workers

& Study of the Mortality Among Female Nuclear Weapons

Workers

Savannah River Plant, SC

& Leukemia Case-Control Study 

& Exposure Assessment of Hazardous Waste,

Decontamination, and Decommissioning, and Cleanup

Workers (Phase I)

& Cohort Mortality Study of DOE Chemical Laboratory

Workers
NIOSH Energy-Related Health Research Program: Tab 11: Page 11

Ongoing and Completed Studies by State

& Lung Cancer Case-Control Study

& Study of the Mortality Among Female Nuclear Weapons

Workers

& Multisite Multiple Myeloma Case-Control Study

& Cohort Mortality Study of Workers at the Savannah

River Plant

Other NIOSH Studies Related to DOE Workers

& Correcting for Measurement Errors in Radiation

Exposure

& Epidemiologic Studies to Evaluate Health Effects of

Uranium Milling

& Dose of Beryllium Causing Sensitization and Disease

& Analysis for Characterizing Plutonium Exposure to

Improve Lung Cancer Risk Estimates

& Acute Radiation Syndrome in Russian Nuclear Workers

& Feasibility Study of Assessing Adverse Reproductive

Outcomes Among Females Employed at DOE Facilities

& Assessment of Electric and Magnetic Field Exposures of

Transportation Workers

& Cancer Incidence and Sentinel Event Registries

& Glycophorin A Biodosimetry in I–131 Treated Patients

& Specificity of the National Death Index and the Social

Security Administration Death Master File when

Information on Social Security Number is Lacking
NIOSH Energy-Related Health Research Program: Tab 12: Page 1

Research Partners

Research Partners

The Health-Related Energy Research Branch has established numerous partnerships that have

proven productive in the conduct of intramural and extramural research program. These

partnerships are with labor, academia, contractors, international organizations, and State and other

governmental agencies. The research may be conducted within NIOSH and CDC (intramurally) or

extramurally through grants, contracts, and cooperative agreements with the partners listed.

Academia, Contractors, and Unions

Battelle Pacific Northwest Labs Tri-S Incorporated

Battelle Memorial Institute United Brotherhood of Carpenters

Boston University School of Public Health University of California at Los Angeles

Computer Science Corporation University of Cincinnati

HGO Technology University of Colorado

International Agency for Research on Cancer University of North Carolina

Michigan State University University of Pittsburgh

National Jewish Center for Immunology University of Southern California

and Respiratory Medicine University of Texas Medical Branch

New York University Medical Center University of Washington

Oak Ridge Associated Universities University of Buffalo

Oak Ridge Institute of Science and Energy Westat Corporation

Survey Research Associates, Inc.

Centers for Disease Control and Prevention (CDC)

National Center for Environmental Health (NCEH)

National Center for Health Statistics (NCHS)

Department of Health and Human Services (DHHS)

Agency for Toxic Substances and Disease Registry (ATSDR)

Office for the Protection from Research Risks (OPRR)

National Cancer Institute (NCI)

National Institute of Environmental Health Sciences (NIEHS)

Other Government

Department of Energy

Office of Health Studies

Environmental Protection Agency

State Health Departments (Colorado, Idaho, Oregon, Tennessee, Washington)
Continued

Tab 13: Page 1National Institute for Occupational Safety and Health (NIOSH) Health-Related Energy Research Branch (HERB) Study NIOSH Project officer phone/fax/email External principal investigator External principal investigator phone/fax/email

INTRAMURAL STUDIES:Cohort Mortality Study ofPortsmouth Gaseous DiffusionPlant

Steven Ahrenholz, M.S.,Ph.D., C.I.H.

513-841-4471513-841-4470(fax)sha1@cdc.gov

N/A N/A

Cohort Mortality Study of IdahoNatl Engineering Laboratory

Mary Schubauer-Berigan,Ph.D.

513-841-4251513-841-4470(fax)zcg3@cdc.gov

N/A N/A

Cohort Mortality Study ofPortsmouth Naval Shipyard

Timothy Taulbee, M.S. 513-841-4468

513-841-4470(fax)tgt4@cdc.gov

N/A N/A

Chemical Lab WorkersMortality

Cynthia Robinson, Ph.D. 513-841-4217

513-841-4470(fax)cfr2@cdc.gov

N/A N/A
National Institute for Occupational Safety and Health (NIOSH)

Health-Related Energy Research Branch (HERB)

Study NIOSH Project officer phone/fax/email

External principal

investigator

External principal 

investigator

phone/fax/email

Continued

Construction Workers Mortality Cynthia Robinson, Ph.D. 513-841-4217 513-841-4470(fax)

cfr2@cdc.gov

N/A N/A

DOE Feasibility Study for SiteRemediation Workers

Cynthia Robinson, Ph.D. 513-841-4217

513-841-4470(fax)cfr2@cdc.gov

N/A N/A

Leukemia Case-Control Study Thurman Wenzl, Sc.D. 513-841-4490

513-841-4470 (fax)tyw1@cdc.gov

N/A N/A

Lung Cancer Case Control Sharon Silver, M.A. 513-841-4313

513-841-4470(fax)zre4@cdc.gov

N/A N/A

Multiple Myeloma Case-Control Studyat K-25 Plant 

Cynthia Robinson, Ph.D. 513-841-4217

513-841-4470(fax)cfr2@cdc.gov

N/A N/A

Exposure Assessment of HazardousWaste/Cleanup Workers (Phase I)

Gregory Kinnes, M.S. 513-841-4409

513-841-4470 (fax)gmk1@cdc.gov

N/A N/A

Pantex Plant Mortality Study Barbara Grajewski, Ph.D. 513-841-4429

513-841-4470 (fax)bag2@cdc.gov

N/A N/A

Tab 13: Page 2
National Institute for Occupational Safety and Health (NIOSH)

Health-Related Energy Research Branch (HERB)

Study NIOSH Project officer phone/fax/email

External principal

investigator

External principal 

investigator

phone/fax/email

Continued

Fernald Cohort Mortality Study John Cardarelli, Ph.D. 513-841-4439

513-841-4470 (fax)jjc0@cdc.gov

Exposure Assessment of RadiologicTechnologists

Jim Neton, Ph.D. 513-841-4552

513-841-4470 (fax)jfn2@cdc.gov

N/A N/A

Tab 13: Page 3
National Institute for Occupational Safety and Health (NIOSH)

Health-Related Energy Research Branch (HERB)

Study NIOSH Project officer phone/fax/email

External principal

investigator

External principal 

investigator

phone/fax/email

Continued

EXTRAMURAL STUDIES (Cooperative Agreements):Cancer Incidence/Mortality Study ofRocky Flats Plant

Dennis Zaebst, M.S. 513-841-4459

513-841-4470 (fax)ddz1@cdc.gov

Norma Morin, Ph.D.Colorado DPH

303-692-2636303-782-0188 (fax)normie.morin@state.co.us

International Collaborative Study ofNuclear Industry Workers 

David Utterback, Ph.D. 513-841-4492

513-841-4470 (fax)dfu0@cdc.gov

Elisabeth Cardis, Ph.D.IARC

011-334-7273-8508011-334-7273-8575 (fax)cardis@iarc.fr

Chronic Beryllium Disease AmongBeryllium-Exposed Workers 

Paul Henneberger, Sc.D. 304-285-5756

304-285-5861 (fax)pkh0@cdc.gov

Ken Rosenman, M.D.Michigan State Univ.

517-353-1846517-432-3606 (fax)21770kdr@msu.edu

Beryllium Disease Natural Historyand Exposure Response

Paul Henneberger, Sc.D. 304-285-5756

304-285-5861 (fax)pkh0@cdc.gov

Lee Newman, M.D.Natl. Jewish Center forImmun. & Resp. Med.

303-398-1725303-398-1851 (fax)newman1@njc.org

Prevention of Stress and HealthConsequences of Downsizing andReorganization

Larry Murphy, Ph.D. 513-533-8171

513-533-8596 (fax)lrm2@cdc.gov

Lewis Pepper, M.D.Boston University

617-638-4620617-638-4857 (fax)lpepper@bu.edu

EXTRAMURAL STUDIES (Contracts):Historical Plutonium BioassayMeasurements

HERB Office 513-841-4400

513-841-4470 (fax)

Norman Cohen, Ph.D.New York University

914-351-4368914-351-3489 (fax)norman@charlotte.med.nyu.edu

Tab 13: Page 4
National Institute for Occupational Safety and Health (NIOSH)

Health-Related Energy Research Branch (HERB)

Study NIOSH Project officer phone/fax/email

External principal

investigator

External principal 

investigator

phone/fax/email

Continued

EXTRAMURAL STUDIES (Grants):Measurement Error Methods forUnderground Miner Studies 

Roy Fleming 404-639-2810

404-639-2196 (fax)rmf2@cdc.gov

Dan Stram, Ph.D.Univ. Southern Calif.

213-342-1817213-342-2349 (fax)stram@rcf.usc.edu

Study of Heat Stress andPerformance in Carpenters at DOESites

Roy Fleming 404-639-2810

404-639-2196 (fax)rmf2@cdc.gov

Ken Rosenman, M.D.Unit. Brthd. Carpenters

517-353-1846517-432-3606 (fax)21770kdr@msu.edu

Acute Radiation Syndrome inRussian Nuclear Workers

Roy Fleming 404-639-2810

404-639-2196 (fax)rmf2@cdc.gov

Neil Wald, M.D.University of Pittsburgh

412-624-2735412-624-7534wasld@vms.cis.pitt.edu

Surveillance Methods forSolvent-related Hepatotoxicity

Cynthia Robinson, Ph.D. 513-841-4217

513-841-4470 (fax)cfr2@cdc.gov

Carl Brodkin, Ph.D.University of Washington

206-731-2527werd@u.wahington.edu

Radon and Cigarette SmokingExposure Assessment at Fernald

Jim Neton, Ph.D. 513-841-4552

513-841-4470 (fax)jfn2@cdc.gov

Susan Pinney, Ph.D.University of Cincinnati

513-558-0684513-558-4240 (fax)susan.pinney@uc.edu

Correcting for Measurement Errors inRadiation Exposure

Tim Taulbee, M.S. 513-841-4468

513-841-4470tgt4@cdc.gov

Xiaonam Xue, Ph.D.New York University

212-263-6114212-263-8570 (fax)xiaonan.xue@med.nyu.edu

Ionizing Radiation and MortalityAmong Hanford Workers

Sharon Silver, M.A. 513-841-4313

513-841-4470 (fax)zre4@cdc.gov

Steve Wing, Ph.D.Univ. North Carolina

919-966-7416919-542-4403 (fax)swing@sphvax.sph.unc.edu

Tab 13: Page 5
National Institute for Occupational Safety and Health (NIOSH)

Health-Related Energy Research Branch (HERB)

Study NIOSH Project officer phone/fax/email

External principal

investigator

External principal 

investigator

phone/fax/email

DOE SURVEILLANCE GRANTS:Hazard Surveillance in DefenseNuclear Industry

David Pedersen, Ph.D. 513-841-4223

513-841-4483 (fax)dhp1@cdc.gov

John Froines, Ph.D.UCLA

310-206-6141310-206-9903 (fax)jfroines@ucla.edu

Improved Systems for WorkerExposure Surveillance

David Pedersen, Ph.D. 513-841-4223

513-841-4483 (fax)dhp1@cdc.gov

Wm. Tankersley, M.S.ORAU

423-576-3141423-576-9557 (fax)tankersb@orau.gov

Work Histories—Evaluating NewParticipatory Methods

David Pedersen, Ph.D. 513-841-4223

513-841-4483 (fax)dhp1@cdc.gov

Eula Bingham, Ph.D.Univ. Cincinnati

513-558-5728513-558-5062 (fax)

Sentinel Exposure EventsSurveillance/Evaluation at DOE Sites

David Pedersen, Ph.D. 513-841-4223

513-841-4483 (fax)dhp1@cdc.gov

James Ruttenber, M.D.Univ. Colorado

303-315-5627303-315-3183 (fax)jim.ruttenber@uchsc.edu

Comprehensive Occupational HealthSurveillance

David Pedersen, Ph.D. 513-841-4223

513-841-4483 (fax)dhp1@cdc.gov

Scott Barnhart, Ph.D.Univ. Washington

206-731-3388206-731-8247 (fax)sbht@u.washington.edu

Tab 13: Page 6
NIOSH Energy-Related Health Research Program: Tab 14: Page 1

NIOSH Health Energy-Related Research Branch Staff

NIOSH Health-Related Energy Research Branch

The NIOSH Health-Related Energy Research Branch (HERB) staff consists of a variety of

professionals that work together on a research agenda supporting the NIOSH mission. 

Branch staff members include epidemiologists, health physicists, industrial hygienists,

computer programmers, biostatisticians, a public policy analyst, information specialists,

and administrative personnel. Various support contractor personnel, fellows, and student

interns supplement the human resource needs of the Branch depending on program

activities and expertise required. The organizational structure of the Branch is presented

on the following pages. The Branch structure consists of program management, two

sections (the Epidemiology and Exposure Assessment Sections), and program activities

(computer programming, biostatistics, health communication, and administrative support)

that report to program management.

The HERB staff members possess a variety of credentials and backgrounds, contributing to

the diversity and strength of the research program. Professional credentials held by staff

members include: masters and doctoral degrees, Certified Health Physicist (CHP), and

Certified Industrial Hygienist (CIH). The tenure among staff members in their respective

disciplines ranges from a few years to over 20.

Primary points of contact regarding the Branch, the Sections, and the program activities

are the following persons:

Branch Chief: Vacant

Assistant Branch Chief: Steven Ahrenholz

Epidemiology Section: Barbara Grajewski

Exposure Assessment Section: David Utterback

Surveillance Coordinator: David Pedersen

Branch Secretary: April Jenkins

All of these staff members may be reached at 513–841–4400, fax 513–841–4470.
NIOSH Energy-Related Health Research Program: Tab 14: Page 4

NIOSH Health Energy-Related Research Branch Staff

National Institute for Occupational Safety and Health

Health-Related Energy Research Branch 

Organizational Chart

December 2000

Branch

Chief

Office

Automation

Assistant

Computer

Specialist

Epidemiology

Section Chief

Surveillance

Coordinator

Branch

 Secretary

Statistician

Office

Automation

Assistant

Technical

Information

Specialist

Epidemiologist

ASPH Fellow

Epidemiologist

Epidemiologist

Epidemiologist

Computer

Specialist

Computer

Specialist

Computer

Specialist

Computer

Specialist

Health

Communications

ASPH Fellow

Health

Communications

Specialist

Industrial

Hygienist

Industrial

Hygienist

Industrial

Hygienist

Health Physicist

Health Physicist

Health Physicist

Health Physicist

Exposure

Assessment

Section Chief

Technical

Information

Specialist

Assistant

Branch Chief
NIOSH Energy-Related Health Research Program Tab 15: Page 1

Glossary

Glossary

Bequerel (Bq): The unit of activity equal to one disintegration per second. [37 billion

bequerels = 1 curie (Ci)]

Bioassay: A determination of the concentration of a substance in the body by the analysis

of urine, blood, feces, bone, or tissue. The use of the living organism to measure the

amount of a substance that has been absorbed.

Biomarkers: A cellular or molecular indicator of exposure, disease, or susceptibility to

disease.

Cancer incidence: The number of new cancer cases in a population within a period of

time.

Carcinogen: A substance or agent that can cause cancer.

Carcinogenic: Capable of causing cancer.

Case control study: A scientific study that compares a group of people with disease (such

as leukemia) to a similar group of people without that disease. This type of study

compares the levels of exposure (radiation or chemical) each group had before appearance

of the disease.

Cohort: A group of persons identified by common characteristics who are studied over a

period of time.

Cohort study: An epidemiology study that observes a large group of people over a period

of time. Within the cohort, morbidity or mortality rates can be calculated for group

members with different exposures.

Confidence Interval (CI): A range of numbers around a mean, proportion, or rate that

serves as a rough guide or minimum estimate of the inherent uncertainty in a

epidemiologic result. 

Confounder: Factors that distort or mask the true effect of exposure in an epidemiologic

study.

Curie: A measure of the amount of radioactivity in a material. One Curie is 37 billion

atoms undergoing radioactive decay each second.
NIOSH Energy-Related Health Research Program Tab 15: Page 2

Glossary

Cross-sectional study: A study that examines the relationship between exposure and

health outcome in a population at a certain point in time.

Dose: Amount of a substance that remains at a biological target during a time interval.

With radiation, the amount of energy deposited in biological tissue during a specified time.

Dose response: A relationship in which a change in the amount, intensity, or duration of

an exposure is associated with either an increase or decrease in risk of a specified health 

outcome.

Epidemiology: The study of factors that affect health and disease in groups of persons.

Exposure assessment: The process to estimate radiation and chemical exposures.

External radiation: Radiation capable of damaging human tissue that is given off by a

nuclear or x-ray source outside the body.

Gamma radiation: High energy electomagnetic radiation that is emitted from an atom’s

nucleus has no mass or electrical charge has high penetrating power, and can pass though

the human body.

Health physics: The science of radiation protection to reduce or prevent radiation

exposure. The study of effects of ionizing radiation on humans and their environment. 

Healthy worker effect: A study finding of fewer deaths for workers in an industry

compared with the U.S. population, usually because severely ill and chronically disabled

are excluded from employment. The general population may not be the best comparison

group for workers.

Incidence or incidence rate: The number of persons becoming ill in a defined population 

within a period of time.

Induction period: Time period between exposure to an agent and disease detection. 

Industrial hygiene: A science devoted to the protection and improvement of the health

and well-being of workers exposed to chemical and physical agents in their work

environment.

Institutional review board: A group of scientists and nonscientists who review proposed

studies to ensure that the rights of study participants are protected.

Internal radiation: Radiation given off by nuclear materials that have been inhaled,

swallowed, or absorbed into the body through a cut, puncture, or abrasion of the skin.
NIOSH Energy-Related Health Research Program Tab 15: Page 3

Glossary

Latency: Time period between disease occurrence and detection, sometimes used

interchangeably with induction.

MilliSievert (mSv): equal to one-thousandth of a sievert. See Sievert.

Mortality: Death.

Morbidity: Sickness or illness: departure from a state of physical or mental well-being.

Mortality rate: The proportion of a population that dies during a specified time period. 

Also referred to as the death rate.

Neutron: A particle that may be emitted from the nucleus of atoms and carries no

electrical charge.

Nanocurie (nCi): Unit amount of radioactivity measurement equal to one-billionth of a

curie. See Curie.

NIOSH Human Subjects Review Board: The NIOSH Institutional review board must

approve all proposed studies conducted in-house from the Health-Related Energy Research

Branch.

Odds ratio: Ratio of the odds of disease among the exposed compared with the odds of

disease among the unexposed. For rare diseases, including some cancers, the odds ratio is

an estimate of the relative risk.

Radiation (ionizing): Energy in the form of electromagnetic waves or particles capable of

damaging cells by removing electrons from atoms or molecules. This damage can lead to

cancer or other defects.

Relative risk: Ratio of the risk of disease or death among the exposed segment of the

population to the risk among the unexposed.

Rem: A unit for measuring absorbed doses of radiation received by the body that includes

an adjustment for the intensity of the damage to one or more cells. Rem is the abbreviation

of roentgen equivalent man.

Sentinel event registry: An ongoing data collection for illness or health conditions that

may be used to provide early notice of adverse health effects from one or more exposures.

Sievert: Unit of equivalent absorbed dose equal to 100 rems.
NIOSH Energy-Related Health Research Program Tab 15: Page 4

Glossary

Standard mortality ratio (SMR): Ratio of the number of deaths observed in the study

group to the number of deaths expected based on rates in a comparison population,

multiplied by 100.

Standard rate ratio (SRR): A ratio of the rates of death or morbidity that has been

adjusted (standardized) to the same population.

Statistical significance: The likelihood that an association between exposure and disease 

risk could have occurred by chance alone.

Stratified random sample: Process of separating a sample into several groups and

randomly assigning subjects to those groups.

Vital status: The determination of alive or deceased status for members of an

epidemiology study cohort.
NIOSH Energy-Related Health Research Program Tab 16: Page 1

Study Index

Study Index

Ongoing Research (Tab 6)

Cohort Mortality Study of Idaho National Engineering and 

Environmental Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 1

Cohort Mortality Study of Portsmouth Naval Shipyard,

Kittery, Maine ................................................ Tab 6, Page 1

Leukemia Case-Control Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 2

Multiple Myeloma Case-Control Study at the Oak Ridge Gaseous 

Diffusion Plant (K–25) ......................................... Tab 6, Page 2

Exposure Assessment of Hazardous Waste, Decontamination and

Decommissioning, and Cleanup Workers - Phase I ................... Tab 6, Page 3

Cohort Mortality Study of DOE Chemical Laboratory Workers ......... Tab 6, Page 4

Lung Cancer Case-Control Study ................................. Tab 6, Page 4

Cohort Mortality Study of DOE Construction Workers ................ Tab 6, Page 5

Feasibility Study for an Integrated Database for DOE Site

Remediation Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 5

Cohort Mortality Study of Fernald Environmental Management

Plant (FEMP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 6

Exposure Assessment of Radiologic Technologists for Epidemiology

Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 7

Cancer Incidence/Mortality Study of Rocky Flats Plant ................ Tab 6, Page 8

International Collaborative Study of Nuclear Industry Workers .......... Tab 6, Page 8

Chronic Beryllium Disease Among Beryllium-Exposed Workers ........ Tab 6, Page 9

Beryllium Disease Natural History and Exposure Response ............. Tab 6, Page 9
NIOSH Energy-Related Health Research Program Tab 16: Page 2

Study Index

Ongoing Research (Tab 6) Continued

Measurement Error Methods for Underground Miner Studies .......... Tab 6, Page 10

Study of Heat Stress and Performance in Carpenters at DOE Sites ...... Tab 6, Page 10

Ionizing Radiation and Mortality Among Hanford Workers ............ Tab 6, Page 11

Acute Radiation Syndrome in Russian Nuclear Workers .............. Tab 6, Page 12

Surveillance Methods for Solvent-Related Hepatotoxicity,

a Cross-Sectional Study at Hanford ............................... Tab 6, Page 12

Radon and Cigarette Smoking Exposure Assessment in Fernald 

Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 6, Page 13

Correcting for Measurement Errors in Radiation Exposure ............ Tab 6, Page 13

Epidemiologic Studies to Evaluate Health Effects of Uranium 

Milling ..................................................... Tab 6, Page 14

Dose of Beryllium Causing Sensitization and Disease ................ Tab 6, Page 14

Analysis for Characterizing Plutonium Exposure to Improve

Lung Cancer Risk Estimates .................................... Tab 6, Page 15

Completed NIOSH-Initiated Research (Tab 7)

Multi-Site Multiple Myeloma Case-Control Study .................... Tab 7, Page 1

Mercury Workers Health Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 2

Historical Plutonium Bioassay Measurements . . . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 3

Accounting for Errors in Radiation Dose Estimates . . . . . . . . . . . . . . . . . . . Tab 7, Page 3

Cohort Mortality Study of Portsmouth Gaseous Diffusion Plant, 

Piketon, Ohio ................................................. Tab 7, Page 4

Feasibility Study of Assessing Adverse Reproductive Outcomes

Among Females Employed at DOE Facilities ........................ Tab 7, Page 4
NIOSH Energy-Related Health Research Program Tab 16: Page 3

Study Index

Completed NIOSH-Initiated Research (Tab 7) Continued

Childhood Leukemia Case-Control Study ........................... Tab 7, Page 6

Time-Related Factors in Radiation-Cancer Dose Response ............. Tab 7, Page 7

Dose Estimation from Daily and Weekly Dosimetry Data . . . . . . . . . . . . . . Tab 7, Page 8

Cohort Mortality Study of Workers at Fernald Feed Materials 

Production Center ............................................. Tab 7, Page 8

Cohort Mortality Study of Workers at Savannah River Plant ........... Tab 7, Page 10

Mine Specific Exposure Information for Uranium Miners Study ........ Tab 7, Page 11

Assessment of Electric and Magnetic Field Exposures of

Transportation Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 11

Cohort Mortality Study of Pantex Plant, Amarillo, Texas ............. Tab 7, Page 12

Cancer Incidence and Sentinel Event Registries . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 13

Prevention of Stress and Health Consequences of Downsizing and 

Reorganization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 13

Mortality Among Female Nuclear Weapons Workers ................ Tab 7, Page 15

Glycophorin A Biodosimetry in I–31 Treated Patients ................ Tab 7, Page 16

Specificity of the National Death Index and the Social Security 

Administration Death Master File When Information on Social 

Security Number is Lacking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 7, Page 17

Lung Fibrosis in Plutonium Workers .............................. Tab 7, Page 17

Previous DOE Studies (Tab 8)

Oak Ridge National Laboratory X-10 

• Wing S, Shy C: Mortality Among Workers at Oak Ridge 

National Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 1
NIOSH Energy-Related Health Research Program Tab 16: Page 4

Study Index

Previous DOE Studies (Tab 8) Continued

• Shy C, Wing S: A report on Mortality Among Workers;

followup report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 2

Oak Ridge Y–12

• Loomis D, Wolf S: Mortality of Workers at a Nuclear Materials 

Production Plant ............................................ Tab 8, Page 2

Oak Ridge Gaseous Diffusion Plant K–25

• Dupree E, Watkins J: Mortality Among Workers Employed

between 1945-1984 at a Uranium Gaseous Diffusion Facility ........ Tab 8, Page 2

Combined Oak Ridge Facilities

• Watkins J, Cragle D, Frome E: Collection, validation and

treatment of data for mortality study of nuclear industry 

workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 3

• Frome E, Cragle D: A mortality study of employees of the nuclear

industry .................................................. Tab 8, Page 4

Welders at Oak Ridge Facilities

• Wells S, Cragle D: An update of mortality among welders,

 including group exposed to nickel oxides ........................ Tab 8, Page 4

Uranium Case-Control Study 

• Dupree E, Watkins J, Ingle J, Wallace P, West C, Tankersly W: 

Uranium dust exposure and lung cancer risk in four uranium 

processing operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 5

Mallinckrodt Chemical Works

• Dupree Ellis E, Watkins JP, Ingle JN, Phillips JA: External

radiation exposure and mortality in a cohort of uranium 

processing workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 5

5 Rem Study (Multiple Facilities)

• Fry S, Dupree E, Sipe D: A study of mortality and morbidity

among persons occupationally exposed to less than 

50mSv in a year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 6
NIOSH Energy-Related Health Research Program Tab 16: Page 5

Study Index

Previous DOE Studies (Tab 8) Continued

Mound Plant, Miamisburg, Ohio

• Reyes M: Mortality among workers at the mound facility;

preliminary report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 7

• Wiggs L: Mortality among workers exposed to external ionizing

 radiation at a nuclear facility in Ohio ........................... Tab 8, Page 7

• Wiggs L: Mortality among a cohort of workers monitored for 

210 Po Exposure, 1944-1972 .................................. Tab 8, Page 8

Los Alamos National Laboratory

• Wiggs L, Johnson E: Mortality through 1990 among white

male workers at Los Alamos National Laboratory . . . . . . . . . . . . . . . . . Tab 8, Page 8

Rocky Flats Nuclear Weapons Plant, Golden, Colorado

• Wilkinson GS, Tietjen GL, Wiggs LD: Mortality among

plutonium and other radiation workers at a plutonium 

weapons facility ............................................ Tab 8, Page 9

Zia Company, Los Alamos, New Mexico

• Galke W, Johnson E: Mortality in an ethnically diverse 

radiation exposed occupational cohort .......................... Tab 8, Page 9

Plutonium Workers (Los Alamos National Laboratory, Zia)

• Voelz G, Johnson E.: Mortality of 224 male workers exposed

to plutonium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 10

Hanford Site, Richland, Washington

• Gilbert E, Omohundro E: Mortality of workers at the

Hanford Site 1945–1986 .................................... Tab 8, Page 11

• Omohundro E, Gilbert E: An evaluation of the adequacy of

vital status follow-up in the Hanford Worker Mortality Study ....... Tab 8, Page 11

Combined U.S. Cohorts

• Gilbert E, Cragle D: Updated analyses of combined mortality

data on workers at the Hanford Site, Oak Ridge National

Laboratory, and Rock Flats Nuclear Weapons Plant ............... Tab 8, Page 12
NIOSH Energy-Related Health Research Program Tab 16: Page 6

Study Index

Previous DOE Studies (Tab 8) Continued

Combined International Studies (United States, Canada, U.K.)

• Cardis E, Gilbert: Effects of low dose and low dose rates of

 external ionizing radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 8, Page 13

Proposed Research (Tab 9)

Civilian Nuclear Power Workers .................................. Tab 9, Page 1

Evaluating Time-Related Variables in Occupational Epidemiologic

Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 9, Page 1

Neutron Exposure Assessment ................................... Tab 9, Page 1

Historical Dosimetry Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 9, Page 2

Exposure Assessment of Hazardous Waste, Decontamination, and

Decommission and Cleanup Workers (Phases II and III) ............... Tab 9, Page 2

Update of Cohort Mortality Study of Mound Workers, 

Miamisburg, Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 9, Page 3

Medical/Off-Site Radiation Exposures ............................. Tab 9, Page 3

Case-Control Study of Brain Cancer ............................... Tab 9, Page 3

Case-Control Study of Bone Cancer ............................... Tab 9, Page 4

JEM Data Sensitivity Analysis ................................... Tab 9, Page 4

Medical Surveillance Grants/Activities Program (Tab 10)

Improved Systems for Worker Exposure Surveillance ................ Tab 10, Page 1

Work Histories Evaluating New Participatory Methods ............... Tab 10, Page 2

Comprehensive Occupational Health Surveillance ................... Tab 10, Page 3

Hazard Surveillance in the Defense Nuclear Industry ................. Tab 10, Page 4
NIOSH Energy-Related Health Research Program Tab 16: Page 7

Study Index

Medical Surveillance Grants/Activities Program (Tab 10)

Continued

Sentinel Exposure Event Surveillance/Evaluation at DOE Sites ........ Tab 10, Page 5

Medical Monitoring Program for Former Workers at

Rocky Flats Environmental Technology Site ....................... Tab 10, Page 6

Surveillance of Former Construction Workers at the Oak Reservation . . . Tab 10, Page 6

Medical Surveillance of Former Hanford Workers 

(Non-Construction Trade Workers) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 7

Medical Surveillance for Former Department of Energy Workers at the

Nevada Test Site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 8

Former Worker Medical Surveillance Program at Department of

Energy Gaseous Diffusion Plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 8

Medical Surveillance of Former Construction Workers at Hanford ...... Tab 10, Page 9

Medical Surveillance for Former Workers at the Idaho National 

Engineering and Environmental Laboratory . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 10

Medical Surveillance Program for Former Los Alamos National

Laboratory Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 11

Savannah River Medical Surveillance Program for Building Trades

Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tab 10, Page 12

Savannah River Medical Surveillance for Former 

Production Workers .......................................... Tab 10, Page 13

Medical Monitoring of Former Atomic Weapons Workers at

the Iowa Army Ammunition Plant in Burlington, Iowa .............. Tab 10, Page 13

Amchitca Workers Medical Surveillance Program

(Agreement in Principal with the State of Alaska) . . . . . . . . . . . . . . . . . . Tab 10, Page 14