NIOSH-IREP technical documentation

Appendix I (continued): NIOSH-IREP program output

Results of NIOSH-IREP
Probability of Causation:

1* percentile 0.0%
5" percentile 0.0%
50" percentile 0.81%
95" percentile 5.29%
99" percentile 10.22%

June 18, 2002

Name of Analyst:
Title:

Signature:
Date:

Name of Reviewer:
Title:

Signature:
Date:

Page 70 of 73


NIOSH-IREP technical documentation June 18, 2002

McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni Jr JF, Smoking and cancer mortality among U.S.
veterans: a 26-year follow-up. Int. J. Cancer 60:190-193, 1995,

Miller AB, Gaudette LA. Cancers of skin, bone, connective tissues, brain, eye, thyroid and other
specified and unspecified sites in Inuit. Acta Oncologica. 35:617-616, 1996.

Miller DL, Weinstock MA. Nonmelanoma skin cancer in the United States: Incidence. J. Am. Acad.
Dermatol. 30:774-778, 1994.

Modan B, Keinan L, Blumstein T, Sadetzki S. Cancer following cardiac catheterization in childhood.
Int. J. Epidemiol. 29:424-428, 2000.

Moore II DH, Patterson HW, Hatch F, Discher D, Schneider JS, Bennett D, Mendelsohn ML. Case-
control study of malignant melanoma among employees of the Lawrence Livermore National
Laboratory, Am. J. Ind. Med. 32:377-391, 1997.

Muir C, Waterhouse J, Mack T, Powell J, Whelan S,. Cancer Incidence in Five Continents, Vol. V.
International Agency for Research on Cancer (IARC). IARC Scientific Publications No. 88. Lyon:
IARC press, 970 pp, 1987.

Muirhead CR, Goodill AA, Haylock RGE, Vokes J, Little MP, Jackson DA, O’Hagan JA, Thomas
JM, Kendall GM, Silk TJ, Bingham D, and Berridge GLC. Occupational radiation exposure and
mortality second analysis of the National Registry for Radiation Workers. J Radiol Prot 19:3-26, 1999.

National Academy of Sciences/National Research Council. Health Risks of Radon and Other
Internally Deposited Alpha-Emitters, BEIR IV. Washington, DC: National Academy Press. 602 pp,
1988.

National Academy of Sciences/National Research Council (NAS/NRC). Health Effects of Exposure to
Low Levels of Ionizing Radiation (BEIR V). Washington DC: National Academy Press, 421 pp, 1990.

National Academy of Sciences/National Research Council (NAS/NRC). Health Effects of Exposure to
Radon (BEIR VI). Washington DC: National Academy Press, 500 pp, 1999.

National Academy of Sciences/National Research Council (NAS/NRC). A Review of the Draft
Report of the NCI-CDC Working Group to Revise the “1985 Radioepidemiological Tables”, 2000.

National Cancer Institute (NCI). Draft Report of the NCI-CDC Working Group to Revise the 1985
NIH Radioepidemiological Tables, May 31, 2000.

Page 64 of 73


EL Jo ss Beg

(esed Surmoj][oy uo ponunuod st ajquy)

SZ 01 S'€ WY sonyea 01 pausisse Auigegosd %QZ
SS°€ 01 €'7 WOY sonyea 0} pousisse Ayyiqegord %O¢
5-7 01 0'] Woy sontea o} poustsse Ajtiqeqord %OE
ve ve (as oTuoIyD APN 07 < F
CT aa Tl snoy — YIM TonNQ sip Waojtun ostadays £ ‘ASA O01 > a
Ob 01 O'S Woy sonyea 0} pousisse AyyIqeqord %OZ
£0°8 61 O'p Woy sonqea 0} poudisse Ayiqeqord %OS
{0°7 01 0° Woy sone 0} pousisse Aupiqeqoid %OE
ss VL ¢1 oruory ASW 07-7 = 4
9€ oS el aynoy — WPlas UoRNGLAsIp uxtoyrm asrmdaig ‘A®% OOT-O1 =F
16 vas Sz soTuory) 09 pure 0°7 Usemjoq
09 It 07 andy | [BAJOJUT soUapyUOs YG TIM VONNGUYsIp yeULIOUsOT ghPW 7-10 = 3
sorgiaue WOMEN,
wsl6 8600S BSc pepUroy na]
Cage) 1079¥y ssauaayoayyo
JBAIOJA] BIUSPIFUOD %SG ainsodxy woNneIpe.s Jo TONNGLYSIP GIquqorg adA} 1o00RD
S19IUBD JO

uoHesnes Jo Aqeqo.d pux syst SuNvIAsSo UF pasn oq 0} (SATAY) S10}IJ SSauDANIAZJo UONKIpL. Jo suONNGLYSIp AVPIqugosg :sUO.NEN “OS 21421

ZO0z ‘81 sung

uopejuautnoop feoruy9er {7YI-HSOIN


NIOSH-IREP technical documentation June 18, 2002

Appendix II: Glossary of ICD-9 codes and their cancer descriptions!

ICD-9 code Cancer description

140 Malignant neoplasm of lip

141 Malignant neoplasm of tongue

142 Malignant neoplasm of major salivary glands

143 Malignant neoplasm of gum

144 Malignant neoplasm of floor of mouth

145 Malignant neoplasm of other and unspecified parts of mouth

146 Malignant of neoplasm of oropharynx

147 Malignant neoplasm of nasopharynx

148 Malignant of neoplasm of hypopharynx

149 Malignant of neoplasm other and ill-defined sites within the lip, oral cavity,
and pharynx

150 Malignant of neoplasm of esophagus

151 Malignant of neoplasm of stomach

152 Malignant of neoplasm of small intestine, including duodenum

153 Malignant of neoplasm of colon

154 Malignant of neoplasm of rectum, rectosigmoid junction, and anus

155 Malignant neoplasm of liver and intrahepatic bile ducts

156 Malignant neoplasm of gall bladder and extrahepatic bile ducts

157 Malignant neoplasm of pancreas

158 Malignant neoplasm of retroperitoneum and peritoneum

159 Malignant neoplasm of other and ill-defined sites within the digestive organs
and peritoneum

'The International Classification of Diseases Clinical Modification (9" Revision) Volumes I&II.
[1991] Department of Health and Human Services Publication No. (PHS) 91-1260, U.S. Government
Printing Office, Washington, D.C.

Page 71 of 73


NIOSH-IREP technical documentation June 18, 2002

Appendix II (continued): Glossary of ICD-9 codes and their cancer descriptions

ICD-9 code Cancer description

191 Malignant neoplasm of brain

192 Malignant neoplasm of other an unspecified parts of nervous system
193 Malignant neopiasm of thyroid gland

194 Malignant neoplasm of other endocrine glands and related structures
195 Malignant neoplasm of other and ill-defined sites

196 Secondary and unspecified neoplasms of the lymph nodes

197 Secondary neoplasms of the respiratory and digestive organs

198 Secondary neoplasms of other tissue and organs

199 Malignant neoplasm without specification of site

200 Lymphosarcoma and reticulosarcoma

201 Hodgkin's disease

202 Other malignant neoplasms of lymphoid and histiocytic tissue

203 Multiple myeloma and other immunoproliferative diseases

204 Lymphoid leukemia

205 Myeloid feukemia

206 Monocytic leukemia

207 Other specified leukemia

208 Leukemia of unspecified cell type

Page 73 of 73


NIOSH-IREP technical documentation June 18, 2002

Appendix I: NIOSH-IREP program output

NIOSH-Interactive RadioEpidemiological Program
Probability of Causation Results

Date of Run: 06/12/2002 DOL District Office: DE
Time of Run: 12:00:05 PM NIOSH-IREP version: 5.2
NIOSH ID# 123456 Claimant SSN: 123-45-6789

Claimant Name: John Q. Doe

Claimant Cancer Diagnoses:

Primary Cancer #1: Prostate (ICD-9 185) Date of Diagnosis: 10/20/1988
Primary Cancer #2: N/A Date of Diagnosis: N/A
Primary Cancer #3: N/A Date of Diagnosis: N/A
Secondary Cancer #1: Lung (ICD-9 197.0) Date of Diagnosis: 03/13/1994
Secondary Cancer #2: N/A Date of Diagnosis: N/A
Secondary Cancer #3: N/A Date of Diagnosis: N/A

Claimant Information Used In Probability of Causation Calculation:

Gender: Male Race (skin cancer only): N/A
Birth Year: 1920 Year of Diagnosis: 1988
Cancer Model: All Male Genitalia (185-187)

Should alternate cancer model be run?: No

Smoking history (trachea, bronchus, or lung cancer only): N/A

NIOSH-IREP Assumptions and Settings:

User Defined Uncertainty Distribution: _Lognormal (1,1)
Number of Iterations: 2000
Random Number Seed: 99

Page 68 of 73


NIOSH-IREP technical documentation June 18, 2002

V. References

Altman A, Rosen T, Tschen JA, Hoffmann T, Bruce S, Siegel DM, Levy ML, Schaefer D, Goldberg
LH. Basal cell epithelioma in black patients. J. Am. Acad. Dermatol. 17:741-745, 1987.

Andersson, M, Carstensen B, Visfeldt J. Leukemia and other related hematological disorders among
Danish patients exposed to Thorotrast. Radiat Res. 134:224-233, 1993.

Anonymous. Leads from the Morbidity and Mortality Weekly Report, Atlanta, GA: Cigarette smoking
among adults—United States, 1992, and changes in definition of smoking. J. Am. Med. Assoc. 272:14-
16, 1994.

Austin DF, Reynolds PJ. Investigation of an excess of melanoma among employees of the Lawrence
Livermore National Laboratory. Am. J. Epidemiol. 145:524-531, 1997.

Austin DF, Reynolds PJ, Snyder MA, Biggs MW, Stubbs HA. Malignant melanoma among employees
of Lawrence Livermore National Laboratory. Lancet 1981:712-716, 1981.

Baron JA, Rohan TE. The causes of cancer: Tobacco. Chapter 14 in Cancer Epidemiology and
Prevention, 2" Edition, D Schottenfeld and JF Fraumeni Jr, eds. New York: Oxford University
Press, 1996.

Bernstein L, Ross RK, Pike MC, Casagrande JT, Henderson BE. Urinary estrogens and male-to-
female breast cancer ratios. Int. J. Cancer 44:954-956, 1989.

Boice Jr JD, Land CE, Preston DL. Ionizing Radiation. Ch 16 in Cancer Epidemiology and
Prevention, 2" Edition, Schottenfeld D, Fraumeni Jr JF, eds. New York: Oxford University Press.
1996, 1521 pp.

Brenner DJ, Miller RC, Marino SA, Geard CR, Randers-Pehrson G, Hall EJ. Inverse dose rate effects
for neutrons: general features and biophysical consequences. Radiat. Protect. Dosim. 44:45-48, 1992.

Brenner DJ, Hall EJ, Randers-Pehrson G, Miller RC. Mechanistic considerations on the dose-rate/LET
dependence of oncogenic transformation by ionizing radiations. Radiat. Res. 133:365-369, 1993.

Cardarelli JC. A potential consequence of excluding work-required x-ray exposures when computing

cumulative occupational radiation dose at a uranium enrichment plant. University of Cincinnati, PhD
Dissertation, 2000.

Page 60 of 73


NIOSH-IREP technical documentation June 18, 2002

Table 6. Smoking category definitions for lung cancer claims under NIOSH-IREP

Smoking category

Definition

Never Smoked fewer than 100 cigarettes (throughout lifetime) prior to cancer diagnosis
Former Quit smoking five years or more before date of cancer diagnosis
Current (? cig/day) Smoked at time of cancer diagnosis (or quit fewer than 5 years before),
quantity unknown
Current (<10 cig/day) Smoked at time of cancer diagnosis (or quit fewer than 5 years before), average of

fewer than 10 cigarettes per day

Current (10-19 cig/day)

Smoked at time of cancer diagnosis (or quit fewer than 5 years before), average of
10-19 cigarettes per day

Current (20-39 cig/day)

Smoked at time of cancer diagnosis (or quit fewer than 5 years before), average of
20-39 cigarettes per day

Current (40+ cig/day)

Smoked at time of cancer diagnosis (or quit fewer than 5 years before), average of
40 or more cigarettes per day

Page 57 of 73



€L JO 9g oBeg

“portdde st yoayyo 0y2I-2SOp SSIAUT OY} OJ JUMODOE 0} 10]9BF UONIALIO9 ‘ATU asodxe oruomGo Jo suoTIpUOD Jopuy,

‘suoX]NoU UoIssy Jo uNyoads sopnjout osue1 ABI0Ug,

“sooueo o1jAd0yduisy pur ‘sewoyduity ‘seruzayne] 0} A[dde suonngqinstp Aiqeqosd poumssy,,

O'E ONjeA OF poudtsse AyIqeqord %¢

‘0°Z onyea 0} pousisse Aiqeqoid %¢ 1

Sg’ | onyea 0} pousisse Aipiqeqoid %OE

SO'L anyea 0} pousisse Aupiqeqord %0¢
— HEM UONNAHSIp o}o10SICL

— suoxnou 0} samsodxe o1moIYO Joy 199JJ9 918I-9SOP OSIOAUT JOJ UOTIALIOD

ZI} pz Woy sonjes 0) pousisse Aupiqeqord %OZ
‘v7 019°] WO sonyeA 0} pausisse Aupiqeqosd %O¢
9°] 0} 0" [ Woy sonjea 0} pousisse Ayiqeqoid YE
oT ve ims oro), APW 07 < 4
II 61 TI anoy — Im wonqusrp wroyrun ostmdayg {A°F OL > F
07 01 0'¢ WO sonjeA oj poudisse AUpqeqoid %OZ
‘0°S 03 OE Woy sanjea 0} pausisse AyyIqeqoid %OS
{O'€ 01 OT Woy sonea 0} pousisse Ayqeqord %OE
87 LY rT ormolgy) APW 07-7 =
81 se (ai aynoy — Yylaa voRNqUystp woyrm asimdayg SA2X OOL-O1 = 7
LY OL ve ormom) O€ puke O° UoamJoq
is LL oc aynoy | [PATOL souapyuo. % 66 YPM UONNGMsIp [eULOUsOT (PW 7-10 =4
sordious UONNON
WSl6 Boos Use SOUR POS
qa) 40398] ssauaarjoayya
[VAIO] BUIpYWOD %SGE aansodxy DOHEIpEs Jo WONNGLYSIP QYEqeqoig ad Ay 19008

SLOPIF SSOUDATJIOJJO UOHLIPLL JO SUOHNGLSIp AWHIQUqoIg :suOINaNy “(penuywod) Os qe

Zoe “81 aun

woneqoumnsop eoruyos {TAI-HSOIN


NIOSH-IREP technical documentation

Appendix I (continued): NIOSH-IREP program output

GENERAL EXPOSURE INFORMATION:

June 18, 2002

Exposure # | Exposure | Organ Dose (cSv) | Exposure Radiation Type
Year Rate
1 1955 Lognormal (0.5,1.8) | acute photons E=30-250keV
2 1955 Lognormal (0.7,1.8) | acute photons E>250keV
3 1956 Lognormal (0.1,1.8) | chronic neutrons E=100keV-2MeV
4 1956 Lognormal (0.4,2.5) | acute photons E>250keV
5 1957 Uniform (0.1,4) chronic alpha
6 1957 Lognormal (1.3,1.8) | acute photons E>250keV
7 1958 Uniform (0.05,5.6) | chronic alpha
8 1958 Lognormal (0.2,1.8)} acute photons E>250keV
9 1959 Lognormal (0.5,2.5) | chronic neutrons E=100keV-2MeV
10 1959 Lognormal (0.1,1.8) | acute photons E>250keV
11 1960 Lognormalt (0.5,1.8) | acute photons E>250keV
12 1960 Lognormal (0.1,2.5) | chronic neutrons E=100keV-2MeV
13 1961 Lognormal (0.3,1.8) | acute photons E>250keV
14 1961 Lognormal (0.2,2.5) | chronic neutrons E=100keV-2MeV
15 1962 Lognormal (0.1,1.8) | acute photons E>250keV

Radon Exposure Information:

N/A (applies only to cases of Lung Cancer with Radon Exposures)

Page 69 of 73


NIOSH-IREP technical documentation June 18, 2002

Table 7 (continued). Primary cancers (ICD-9 codes) for which probability of causation is to be calculated, if on
a secondary cancer site is known. “M” indicates cancer site should be used for males only, and “F” indicates
cancer site should be used for females only. Whenever “173" is indicated, the “non-melanoma skin-basal cell”

model should be used.

Secondary cancer

ICD-9 code of likely primary cancers

Other digestive organs (197.8)

150 (M), 151, 153, 157, 162, 174 (F), 185 (M)

Kidney (198.0)

153, 162, 174 (F), 180 (F), 185 (M), 188, 189, 202 (F)

Other urinary organs (198.1)

153, 174 (F), 180 (F), 183 (F), 185 (M), 188, 189 (F)

Skin (198.2)

153, 162, 171 (M), 172, 173 (M), 174 (F), 189 (M)

Brain and spinal cord (198.3)

162, 172 (M), 174 (F)

Other parts of nervous system (198.4)

162, 172 (M), 174 (F), 185 (M), 202

Bone and bone marrow (198.5)

162, 174 (F), 185 (M)

Ovary (198.6)

153 (F), 174 (F), 183 (F)

Suprarenal gland (198.7)

153 (F), 162, 174 (F)

Other specified sites (198.8)

153, 162, 172 (M), 174 (F), 183 (F), 185 (M), 188 (M)

Page 59 of 73



NIOSH-IREP technical documentation

June 18, 2002

Table 4 (continued). Cancer models to be used in calculation of probability of causation.
Derivation of NIOSH-IREP models is described in Section II-B. Abbreviations: MN
{malignant neoplasm), CIS (carcinoma in situ), NUB (neoplasm of uncertain behavior),
NUM (neoplasm of unspecified nature).

Primary neoplasm ICD-9 code NIOSH-IREP model for
calculating PC
NUB of liver and biliary passages 235.3 Liver
NUB of retroperitoneum and 235.4, 235.5 All digestive
peritoneum, and other and unspecified
digestive organs
NUB of larynx, pleura, thymus, 235.6, 235.8, Other respiratory
mediastinum, and other and unspecified] 235.9
respiratory organs
NUB of trachea, bronchus and lung 235.7 Lung
NUB of uterus, and other and 236.0, 236.1, Female genitalia, less ovary
unspecified female genital organs 236.3
NUB of ovary 236.2 Ovary
NUB of prostate, testis and other male | 236.4, 236.5, All male genitalia
genital 236.6
NUB of bladder 236.7 Bladder
NUB of other and unspecified urinary | 236.9, 237.2 Urinary organs less bladder
tract, and suprarenal gland
NUB of pituitary, pineal and other and | 237.0, 237.1, Thyroid
unspecified endocrine glands 237.4
NUB of paraganglia, brain and spinal j 237.3, 237.5, Nervous system
cord, and other nervous system 237.6, 237.7,
237.9
NUB of bone and articular cartilage 238.0 Bone
NUB of connective and other soft tissug 238.1 Connective tissue
NUB of skin 238.2 Malignant melanoma AND Non-

melanoma skin-Basal cell

Page 51 of 73


NIOSH-IREP technical documentation June 18, 2002

radioactivity. In: Epidemiology applied to health physics. Proceedings of the 16" meeting of the Health
Physics Society. Albuquerque, NM: 1983:125-142.

Henderson BE, Pike MC, Bernstein L, Ross RK. Breast Cancer. Ch 47 in Cancer Epidemiology
and Prevention, 2" Edition, Schottenfeld D, Fraumeni Jr JF, eds. New York: Oxford University
Press. 1996, 1521 pp.

Hiatt RA, Fireman B. The possible effect of increased surveillance on the incidence of malignant
melanoma. Preventive Med. 15:652-660, 1986.

Hiatt RA, Krieger N, Sagebiel RW, Clark Jr WH, Mihm Jr MC. Surveillance bias and the excess risk
of malignant melanoma among employees f the Lawrence Livermore National Laboratory. Epidemiol.
4:43-47, 1993.

Hildreth NG, Shore RE, Hempelmann LH, Rosenstein M. Risk of extrathyroid tumors following
radiation treatment in infancy for thymic enlargement. Radiat. Res. 102, 378-391, 1985.

Hornung RW, Meinhardt TJ. Quantitative risk assessment of lung cancer in U.S. uranium miners.
Health Phys. 52:417-430, 1987.

Hsing AW, McLaughlin JK, Cocco P, Co Chien HT, Fraumeni JF. Risk factors for male breast cancer
(United States). Cancer Causes Control 9:269-275, 1998.

International Agency for Research on Cancer (IARC). [ARC Monographs on the Evaluation of
Carcinogenic Risks to Humans. Vol. 75. Ionizing Radiation, Part 1: X- and Gamma (y)-Radiation, and
Neutrons. Lyon, France: IARC press. 491 pp, 2000.

International Agency for Research on Cancer (IARC). IARC Monographs on the Evaluation of
Carcinogenic Risks to Humans. Vol. 78. Ionizing Radiation, Part 2: Some Internally Deposited
Radionuclides. Lyon, France: LARC press. 595 pp, 2001.

International Commission on Radiological Protection (ICRP). The biological basis for dose limitation in
the skin, Annals of the ICRP, vol 22, No. 2, ICRP Publication 59, 104 pp, 1991a.

International Commission on Radiological Protection (ICRP). 1990 Recommendations of the
International Commission on Radiological Protection. Annals of the ICRP, Vol 21, No. 1-2. ICRP
Publication 60, 1991b.

International Commission on Radiological Protection (ICRP). Human respiratory model for radiological
protection. Annals of the ICRP, vol 24 No.1-4. ICRP Publication 66, 482 pp., 1994.

Page 62 of 73


NIOSH-IREP technical documentation June 18, 2002

Cardis E, Gilbert ES, Carpenter L, et al. Effects of low doses and low dose rates of external ionizing
radiation: cancer mortality among nuclear industry workers in three countries. Radiat. Res. 142:117-
132, 1995.

Carpenter L, Higgins C, Douglas A, Fraser P, Beral V, Smith P. Combined analysis of mortality in
three United Kingdom nuclear industry workforces, 1946-1988. Radiat. Res. 138:224-238, 1994.

Casagrande JT, Hanisch R, Pike MC, Ross RK, Brown JB, Henderson BE. A case-control study of
male breast cancer. Cancer Res. 48:1326-1330, 1988.

Correa P. Morphology and natural history of cancer precursors. Chapter 4 in: Cancer Epidemiology
and Prevention, 2" Edition, D Schottenfeld and JF Fraumeni Jr, eds. New York: Oxford University
Press, 1996.

Curtis RE, Boice JD Jr, Stovall M, et al. Relationship of leukemia risk to radiation dose following
cancer of the uterine corpus. J Natl Canc Inst 86:1315-1324, 1994.

Darby SC Doll R, Gill SK, et al. Long-term mortality after a single treatment course with X-rays in
patients treated for ankylosing spondylitis, Br J Cancer 55:179-190, 1987.

Davis MM, Hanke CW, Zollinger TW, Montebello JF, Hornback NB, Norins AL. Skin cancer in
patients with chronic radiation dermatitis. J Amer Acad Dermatol 20:608-616, 1989.

Greene MH, Goedert JJ, Bech-Hansen NT, McGuire D, Paterson MC, Radiogenic male breast cancer
with in vitro sensitivity to ionizing radiation and bleomycin. Cancer Investigation 1:379-386, 1983.

Grippo, PJ, and EP Sandgren. Highly invasive transitional cell carcinoma of the bladder in a simian virus
40 T-antigen transgenic mouse model. Am. J. Pathol. 157:805-813, 2000.

Grogan HA, Sinclair WK, Voilleque PG, Till JE. Final Report. Assessing Risks of Exposures to
Plutonium, Revision 2. Radiological Assessments Corporation Report No. 5-CDPHE-RFP-1998-
FINAL(Rev.2), February 2000.

Grogan HA, Sinclair WK, and Voillequé PG. Risks of fatal cancer from inhalation of °”°Plutonium
by humans: a combined four-method approach with uncertainty evaluation. Health Physics 80:447-461,
2001.

Harley N, Kolber A, Shore R, Albert RE, Altman SM, Pasternack BS. The skin dose and response for
the head and neck in patients irradiated with x-ray for tinea capitis: implications for environmental

Page 61 of 73


NIOSH-IREP technical documentation

June 18, 2002

Table 7. Primary cancers (ICD-9 codes‘) for which probability of causation is to be calculated, if only a
secondary cancer site is known. “M” indicates cancer site should be used for males only, and “F” indicates
cancer site should be used for females only. Whenever “173" is indicated, the “non-melanoma skin-basal

cell” model should be used.

Secondary cancer

ICD-9 code of likely primary cancers

Lymph nodes of head, face and neck (196.0)

141, 142 (M), 146 (M), 149 (F), 161 (M), 162, 172, 173, 174
(F), 193 (F)

Intrathoracic lymph nodes (196.1)

150 (M), 162, 174 (F)

Intra-abdominal lymph nodes (196.2)

150 (M), 151 (M), 153, 157 (F), 162, 174 (F), 180 (F), 185
(M), 189, 202 (F)

Lymph nodes of axilla and upper limb (196.3)

162, 172, 174 (F)

Inguinal and lower limb lymph nodes (196.5)

154 (M), 162, 172, 173 (F), 187 (M)

Intrapelvic lymph nodes (196.6)

153 (M), 154 (F), 162 (IM), 180 (F), 182 (F), 185 (M), 188

Lymph nodes of multiple sites (196.8)

150 (M), 151 (M), 153 (M), 162, 174 (F)

Lymph nodes, site unspecified (196.9)

150 (M), 151, 153, 162, 172, 174 (F), 185 (M)

Lung (197.0)

153, 162, 172 (M), 174 (F), 185 (M), 188 (M), 189

Mediastinum (197.1)

150 (M), 162, 174 (F)

Pleura (197.2)

150 (M), 153 (M), 162, 174 (F), 183 (F), 185 (M), 189 (M)

Other respiratory organs (197.3)

150, 153 (M), 161, 162, 173 (M), 174 (F), 185 (M), 193 (F)

Small intestine, including duodenum (197.4)

152, 153, 157, 162, 171, 172 (M), 174 (F), 183 (F), 189 (M)

Large intestine and rectum (197.5)

153, 154, 162, 174 (F), 183 (F), 185 (M)

Retroperitoneum and peritoneum (197.6)

151, 153, 154 (M), 157, 162 (MD), 171, 174 (F), 182 (F), 183
®)

Liver, specified as secondary (197.7)

151 (M), 153, 154 (MN), 157, 162, 174 (F)

'The International Classification of Diseases Clinical Modification (9" Revision) Volumes I&II.
[1991] Department of Health and Human Services Publication No. (PHS) 91-1260, U.S. Government

Printing Office, Washington, D.C.

Page 58 of 73



NIOSH-IREP technical documentation June 18, 2002

Appendix II (continued): Glossary of ICD-9 codes and their cancer descriptions

ICD-9 code Cancer description

160 Malignant neoplasm of nasal cavities, middle ear, an accessory sinuses

161 Malignant neoplasm of larynx

162 Malignant neoplasm of trachea, bronchus an lung

163 Malignant neoplasm of pleura

164 Malignant neoplasm of thymus, heart, and mediastinum

165 Malignant neoplasm of other and ill-defined sites within the respiratory
system and intrathoracic organs

170 Malignant neoplasm of bone and articular cartilage

171 Malignant neoplasm of connective and other soft tissue

172 Malignant melanoma of skin

173 Other malignant neoplasm of skin

174 Malignant neoplasm of female breast

175 Malignant neoplasm of male breast

179 Malignant neoplasm of uterus, not otherwise specified

180 Malignant neoplasm of uterine cervix

181 Malignant neoplasm of placenta

182 Malignant neoplasm of uterine corpus (body of uterus)

183 Malignant neoplasm of ovary and other uterine adnexa

184 Malignant neoplasm of other and unspecified female genital organs

185 Malignant neoplasm of prostate

186 Malignant neoplasm of testis

187 Malignant neoplasm of penis and other male genital organs

188 Malignant neoplasm of urinary bladder

189 Malignant neoplasm of kidney and other and unspecified urinary organs

190 Malignant neoplasm of eye

Page 72 of 73


EL JO ys Beg

“~OaJJO BWI-9SOP OSIOAUT JO¥ WOH}SALIOD OY} SapNoUT UOHNGUySIC,
“soseo [Je ut porfdde st soponred vydye 0} amsodxe ormory Jo suonpucs
Japtn OaZJo oBI-OSOp aSIAAUt JOJ JUNIE 0} 10}0RJ UOOALIOD ‘Inod0 jou pyNoys A[jeIsUes saprfonuorpes Aq pots soporied eydye 0} somnsodxe anoy,,

“€ onyeA 0} pousisse Ayiqeqord %¢°z
‘0°% onyeA 0} pousisse Ayiqeqord % 9"
‘¢"| onyea 0} pousisse Aypiqeqord %07
‘O° onyea 0} pausisse Ayyiqegord %OL

— WIM voRNAUIsIP a}o10S1q

ssoporred vydye 01 somsodxa [ye 10J JoaJJo OJLI-SOp OSIOAUT JOJ UONIALIOD,

soponred eydye
ql 01 81 ve 08 PUe ¢ WooMjeq [eAIOIUT SoUOPYtIOD YG YIM UOTNGUASIp [euLIOUsOT Jo solssous Ty

SIOUVING POS

p09 pure 0'T
TO9M4OQ [BAIOJUI SOUSPIFUOD % CFG YIM UONNQLISIp [eULIOUSO] 0} pousisse Ajpiqeqoid %¢Z

SS] pur OT
UsaaKjoq [BAIOIUT BOUAPYTOD %CG TIM VONNGIYSTp TeULIOUZO] 0} pausisse Aytpqeqord %OS

SO'T onTeA 0} pousisse Aypiqeqosd %SZ

soporsed eydye
ach Ty OT — (ls vonginstp puqAH Jo sofsiou [TV
MS'L6 m0'0S ws'e sermeyne’y

Ca) 10}9vy ssousansayyo
[BAIOJU] BUEPYWOD %SG Wonerpes Jo wonnqLysip AyTIqeqoig adA} 1290K%D

$199089 JO DoNEsned Jo AIquqoi1d
pUL systA SuBeLUTse UT pasn oq 07 (SA AY) $10)9"J SsoMAATIOZJo WOLIPLs Jo SMOF|NGLYSIP ATIqeqo1g :sapHaed vydry “qs a1qeL

7007 ‘gf ung uonejuemundop jeornyoe} gTaI-HSOIN


NIOSH-IREP technical documentation June 18, 2002

National Cancer Institute (NCI). Draft Report of the NCI-CDC Working Group to Revise the 1985
NIH Radioepidemiological Tables, May 17, 2002, 109 pp.

National Council on Radiation Protection and Measurements (NCRP) . Uncertainties in fatal cancer
risk estimates used in radiation protection. Recommendations of the National Council on Radiation
Protection and Measurement. NCRP Report No. 126, 1997, 112 pp.

National Institutes of Health (NIH). Report of the National Institutes of Health Ad Hoc Working
Group to Develop Radioepidemiological Tables. NIH Publication No. 85-2748. 355 pp, 1985.

Olsson H, Ranstam J. Head trauma and exposure to prolactin-elevating drugs as risk factors for male
breast cancer. J. Natl. Canc. Inst. 80:679-683, 1988.

Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer Incidence in Five Continents,
Volume VII. International Agency for Research on Cancer (IARC). IARC Scientific Publications No.
143. Lyon: IARC press, 1240 pp, 1997.

Pierce DA, Mendelsohn ML, A model for radiation-related cancer suggested by atomic bomb survivor
data. Radiat. Res. 152:642-654, 1996.

Pierce DA, Preston DL, Joint analysis of site-specific cancer risks for the A-bomb survivors. Radiat.
Res. 137:134-142, 1993.

Pierce DA, Preston DL Radiation-related cancer risks at low doses among atomic bomb survivors.
Radiat, Res. 154:178-186, 2000.

Pierce DA, Shimizu Y, Preston DL, Vaeth M, Mabuchi K. Studies of the mortality of atomic bomb
survivors. Report 12, Part I. Cancer: 1950-1990. Radiat. Res. 146:1-27, 1996.

Preston DL, Kusumi S$, Tomonaga M, Izumi S, Ron E, Kuramoto A, Kamada N, Dohy H, Matsui T,
Nonaka H, Thompson DE, Soda M, Mabuchi K. Cancer incidence in atomic bomb survivors. Part III:
Leukemia, lymphoma and multiple myeloma, 1950-1987. Radiat. Res. 137:S68-S97, 1994.

Radiation Exposure Compensation Act (RECA) Committee. Final Report of the Radiation Exposure
Compensation Act Committee. Submitted to the Human Radiation Interagency Working Group, July
1996.

Rogot E, Murray JL. Smoking and causes of death among U.S. veterans: 16 years of observation.
Public Health Rep. 95:213-222, 1980.

Page 65 of 73


NIOSH-IREP technical documentation June 18, 2002

United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Sources,
Effects and Risks of Ionizing Radiation, No. E.94.LX.2, United Nations, New York, 1993.

United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Biological
effects at low radiation doses. Annex G in: Sources and Effects of Ionizing Radiation. Vol. Il. Effects.
75-175, 2000a.

United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Combined
effects of radiation and other agents. Annex H in: Sources and Effects of Ionizing Radiation. Vol. II.
Effects. 177-295, 2000b.

United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Epidemiological
evaluation of radiation-induced cancer. Annex I in: Sources and Effects of Ionizing Radiation. Vol. Il.
Effects. 297-450, 2000c.

United States Environmental Protection Agency (USEPA). Estimating Radiogenic Cancer Risks. EPA
Report 402-R-00-003, Washington, DC, May 1999.

van Daal WA, Goslings BM, Hermans J, Ruiter DJ, Sepmeyer CF, Vink M, van Vloten WA, Thomas
P. Radiation-induced head and neck tumours: is the skin as sensitive as the thyroid gland? Eur. J.

Cancer Clin. Oncol. 19:1081-1086, 1983.

Xuan XZ, Lubin JH, Li JY, Blot WJ. A cohort study in southern China of workers exposed to radon
and radon decay products. Health Phys. 64:120-131, 1993.

Page 67 of 73


EL JO E¢ o8eq

“oraz soyovoidde asop oy} se samsodxo oruosyo |e 0} soydde yey TAC Jo uonnquysip
Aypiqeqoid oy soyovoidde sonyea e]qissod yo uornqrysip oy} pue ‘porjdde si 0° { pesoxe ueo yey) TAUC # ‘AD 7'Q UeMP Ssay Sasop aynoe TY ‘OT
2q 0} pouunsse st ITU ‘4D2 7'O ULyB 1098013 sasop ajnow JW ‘onsodxe oruoIYD Jo suoyIpUOD Jepun porfdde skemye st JTYIAC ‘sxowny pros 104,

¢ pue
os ve ral Z'] Waemjog [BAIOIUT aoUApYyUOS %CG WIM WOENGUYSTp [eULOUsOT A® ST >A
(saojoyd A3iau9-s0ys1y
—- oO. QOUDIOFOI IOF NILA se OUTS 9q 0} posse) C"] Je ponyeA-s[Sulg APM ST <a
pemoe JO ory) $00.1)9910
g"] Jo umulrxeur
pur ‘¢"] Jo opow “Q"] Jo UMUTTUTUA WIM VONNGmNsIp reynsuer (2)
Pur {Ay 0S7-0¢ = “a Joy UoRNgUIsIp priggy (T)
19 ve TI — SMONNGLASIP OM} JO JoNPoIg APOE >
O'S pue Q'[ UseMJOq [eAIOJUT soUepyUCS
%S6 WIM UOHNAINsIp [euUoUso] 0} pausisse Ayyiqeqosd %¢/,
£O'L onyea 0} pousisse Aypiqeqord %¢Z
LY 61 OT — WM ToNNGLysIp puqhH A®F OST-0E =F
(uonerper
-——- OT _- oouarajer potunsse aie suojoyd ASIoue-JoYSIYy) O°] ye Ponyes-s[Surg A®10ST<A
WS'L6 mOOS Boe pomnde Jo oTMOIYD su0joyd
Caay) 10398; ssomaanoayyo
[eAtazUy VUIPYUOD %GG WOHeIpEs Jo BONNGLYsIp ATIGeqoig aamsodxy adAy uoneipey

$1900) JO DoHesHed jo ATIqeqoid pue sysit
SuyeUIyso UF pasn aq 0} (SAY) $10}9vJ SSoUsATIOTJo UONLIPL! Jo SHONNGLUYSIP ANLquqoig :sUO1daJ9 pue suo}O “VS 2qGRL

Z00Z “SI eung voHeyWaUMdOp [eoruyos} TTAI-HSOIN


NIOSH-IREP technical documentation June 18, 2002

Table 4 (continued). Cancer models to be used in calculation of probability of causation.
Derivation of NIOSH-IREP models is described in Section II-B. Abbreviations: MN
(malignant neoplasm), CIS (carcinoma in situ), NUB (neoplasm of uncertain behavior), NUM
(neoplasm of unspecified nature).

Primary neoplasm ICD-9 code NIOSH-IREP model for
calculating PC

NUB of breast 238.3 Breast

NUB of other lymphatic and 238,5-238.7 Lymphoma and multiple myeloma

hematopoietic

NUB of other specified and unspecified] 238.8, 238.9 Other and ill-defined sites
sites

Neoplasm of unspecified nature (NUN) 239.0 All digestive

of digestive system

NUN of respiratory system 239.1 Lung AND Other respiratory

NUN of bone and soft tissue 239.2 Bone

NUN of skin 239.2 Non-melanoma skin-Basal cell

NUN of breast 239.3 Breast

NUN of bladder 239.4 Bladder

NUN of other genitourinary organs 239.5 Female genital less ovary AND
Ovary AND All urinary organs (if
female)

All male genital AND All urinary
organs (if male)

NUN of brain and other parts of 239.6, 239.7 Nervous system

nervous system

NUN of endocrine glands 239.7 Thyroid AND Other endocrine
glands

NUN of other specified or unspecified | 239.8, 239.9 Other and ill-defined sites
sites

Page 52 of 73


NIOSH-IREP technical documentation June 18, 2002

Kaidbey KH, Agin PP, Sayre RM, Kligman AM. Photoprotection by melanin~a comparison of black
and Caucasian skin. J. Amer. Acad, Dermatol. 1:249-260, 1979.

Karagas MR, McDonald JA, Greenberg ER, Stukel TA, Weiss JE, Baron JA, Stevens MM. Risk of
basal cell and squamous cell skin cancers after ionizing radiation therapy. J. Natl. Canc. Inst. 88:1848-
1853, 1996.

Kerlikowske, K, Barclay J, Grady D, Sickles EA, Ernster V. Comparison of risk factors for ductal
carcinoma in situ and invasive breast cancer. J. Natl. Canc. Inst. 89:76-82, 1997.

Hultborn R, Hanson C, Kopf I, Verbiene I, Warnhammar E, Weimarck A. Prevalence of Klinefelter’s
syndrome in male breast cancer patients. Anticancer Res. 17:4293-4297, 1997.

Kocher DC, Apostoaei AI, Hoffman FO, Proposed radiation effectiveness factors for use in calculating
probability of causation of cancers. SENES Oak Ridge, Center for Risk Analysis. Final Internal
Report, May 2002.

Kollias N, Sayre RM, Zeise L, Chedekel MR. Photoprotection by melanin. J. Photochem. Photobiol.
B-Biol. 9:135-160, 1991.

Koshurnikova NA, Gilbert ES, Sokolnikov M, Khokhryakov VF, Miller S, Preston DL, Romanov SA,
Shilnikova NS, Suslova KG, Vostrotin VV. Bone cancers in Mayak workers. Radiat. Res. 154:237-
245, 2000.

Land CE, Hayakawa N, Machado S, Yamada Y, Pike MC, Akiba S, Tokunaga M. A case-control
interview study of breast cancer among Japanese A-bomb survivors. II. Interactions between
epidemiologic factors and radiation dose, Cancer Causes Control 5:167-176, 1994.

Leong GK, Stone JL, Farmer ER, Scotto J, Reizner GT, Burnett TS, Elpern DJ. Nonmelanoma skin
cancer in Japanese residents of Kauai, Hawaii. J. Am. Acad. Dermatol. 17:233-238, 1987.

Lichter MD, Karagas MR, Mott LA, Spencer SK, Stukel TA, Greenberg ER. Therapeutic ionizing
radiation and the incidence of basal cell carcinoma and squamous cell carcinoma. Arch. Dermatol.

136:1007-1011, 2000.

Little MP, Charles MW. The risk of non-melanoma skin cancer incidence in the Japanese atomic bomb
survivors, Int. J. Radiat. Biol. 71:589-602, 1997.

Lubin JH, Boice JD Jr, Edling C, et al. Lung cancer risk in radon-exposed miners and estimation of risk
from indoor exposure. J. Natl. Canc. Inst. 87:817-827, 1995.

Page 63 of 73


NIOSH-IREP technical documentation June 18, 2002

Ron E, Modan B, Preston D, et al. Radiation-induced skin carcinomas of the head and neck. Radiat.
Res. 125:318-325, 1991.

Ron E, Preston DL, Kishikawa M, Kobuke T, Iseki M, Tokuoka S, Tokunaga M, Mabuchi K. Skin
tumor risk among atomic-bomb survivors in Japan. Cancer Causes and Control 9:393-401, 1998.

Schwartzbaum JA, Setzer RW, Kupper LL. Exposure to ionizing radiation and risk of cutaneous
malignant melanoma: search for error and bias. Ann. Epidemiol. 4:487-496, 1994,

Scotto J, Fears TR, Fraumeni Jr JF. Incidence of nonmelanoma skin cancer in the United States. US
Department of Health and Human Services (DHHS) Publ]. No. 83-2433. Washington, DC: US Gov’t
Printing Office, 113 pp, 1983.

Scotto J, Fears TR, Kraemer KH, Fraumeni Jr JF, Nonmelanoma skin cancer. Chapter 60 in Cancer
Epidemiology and Prevention, 2nd Edition, Schottenfeld D, Fraumeni Jr JF, eds. New York:
Oxford University Press, 1521 pp, 1996.

Sevcova M, Seve J, Thomas J. Alpha irradiation of the skin and the possibility of late effects. Health
Phys. 35:803-806, 1978.

Shore R, Albert R, Reed M, Harley N, Pasternack B. Skin cancer incidence among children irradiated
for ringworm of the scalp. Radiat. Res. 100:192-204, 1984.

Shore RE. Overview of radiation-induced skin cancer in humans. Int. J. Radiat. Biol. 57:809-827,
1990.

Shore RE. Radiation-induced skin cancer in humans. Med. Pediat. Oncol. 36:549-554, 2001.

Thomas DB, Jimenez LM, McTiernan A, Rosenblatt K, Stalsberg H, Stemhagan A, Thompson WD,
Curnen MG, Satariano W, Austin DF. Breast cancer risk in men: risk factors with hormonal
implications. Am. J. Epidemiol. 135:734-748, 1992.

Thompson DE, Mabuchi K, Ron E, Soda M, Tokunaga M, Ochikubo S, Sugimoto S, Ikeda T,
Terasaki M, Izumi S, Preston DL, Cancer incidence in atomic bomb survivors. Part I: Solid Tumors,
1958-1987, Radiat. Res. 137:S17-S67, 1994.

Tomasek L, Darby SC, Fearn T, Swerdlow AJ, Placek V, Kunz E. Patterns of hing cancer mortality

among uranium miners in West Bohemia with varying rates of exposure to radon and its progeny.
Radiat. Res. 137:251-261, 1994.

Page 66 of 73