ML20059N594

Transcript of 900928 Public Meeting in Rockville,Md Re Studies of Cancer in Populations Near Nuclear Facilities, Including TMI

ML20059N594
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Site:	Crane
Issue date:	10/04/1990
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REF-10CFR9.7 NUDOCS 9010160341
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{{#Wiki_filter:-_ w i i UNITED STATES OF AMERICA NUCLEAR REGULATORY COMMIS SION I I l 6 .h ('} g,' BRIEFING ON STUDIES OF CANCER IN POPULATIONS NEAR NUCLEAR FACILITIES, INCLUDING inR"E MILE ISLAND l l i t h LOCat10D ROCKVILLE, MARYLAND f b3k6 SEPTEMBER 28, 1990 l Pages: 33 RACES i F h r i NEALR.GROSSANDC0.,INC, 1 C O L' R T REPORTERS AND TRANSCRIBERS 1323 Rhode Island Avenue, Northwest Washington, D.C. 20005 l (202) 234-4433 l i 9010160341 901004 PDR 10CFR PT9.7 PNV j

. ~.. 1 DISCLAIMER l l This is an unofficial transcript of a meeting of 1 the United States Nuclear Regulatory Commission held on i sentember 28. 1990, in the Commission's office at One i White Flint North, Rockville, Maryland. The meeting was i i open to public attendance and observation. This transcript { I has not been reviewed, corrected or edited, and it may contain inaccuracies. The transcript is intended solely for general informational purposes. As provided by 10 CFR 9.103, it is ]- not part of the formal or informal record of decision of the matters discussed. Expressions of opinion in this transcript do not necessarily reflect final determination or beliefs. No pleading or other paper may be filed with the Commission in any proceeding as the result of, or addressed to, any statement or argument contained herein, i except as the Commission may authorize. i I l i NEAL R. GROSS CoVRT REPoRfft$ AND TRANSChittt$ 1333 RHoDG llLAND AVINUt. N.W. [ (202) PM 4433 WA$NINOfoN. 0.C. 2000$ (202) 232-6600

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9-t- UNITED STATES OF AMERICA NUCLEAR REGULATORY COMMISSION BRIEFING ON STt! DIES OF CANCER IN POPULATIONS NEAR NtfCLEAR FACILITIES, INCLUDING TilREE MILE ISLAND PUBLIC MEETING Nuclear Regulatory Commission One White Flint North t Rockville, Maryland Friday, September 28, 1990 i The Commission met in open

session, pursuant io notice, at 2:00

p. m.

. James R.

Curtiss, Commissioner, presiding.

COMMISSIONERS PRESENT: KENNETH C. ROGERS, Commissioner JAMES R. CURTISS, Commissioner j. FORREST J. REMICK, Commissioner l 1 i u -- NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

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g -- r-t e r i fT- . STAFF AND PRESENTERS SEATED AT THE' COMMISSION TABLE:' .t SAMUEL J.-CHILK,. Secretary 5', i JOE SCINTO, Office of;the General Counsel. .1 -c;

s JOHN,BOICE, JR.,

Na t i onal': Cancer : Ins t i tu t e/NIN ' SEYMOUR JABLON, National; Cancer Institute /NIHf if I' l, l 1 i 7 q ,i s + .i. s 5 o ' t I, i lq 1.tr 4 . I 4 t 'i ) J ?! -.w y .,s ~ l V i s P -j 1 - i t 9 r

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z -l r-3' i '~ l P-R-0-C-E-E-D-I-N-G-S i 2 2:05 p.m. [ l 3 COMMISSIONER CURTISS: Welcome. -4 Chairman Carr will not be with us this 5 afternoon. G The Commission meets today to hear the 7 results of the National Cancer Inst it ute's recent ly 8 completed study of ' cancer rates in the vicinity. of' ] 9-nuclear facilities in the United. States. This study, 10 which represents an important contribution to-an area 11 that has generated a great deal of interest over.the 12 years, covers all commercial nuclear power plant sites i 13 that were operating before 1982', as well as nine 14 Department of Energy sites and the West ' Valley lsi't e in 15 New York. In view of the Commission's responsibility-j 16 for the licensing and regulation of. commercial nuclear l 17 power plants, we will be especially interested in.your 18 conclusions about these facilities. 19 Doctor Hatch of the Columbia University 20 School of Public Health,-who was to"present.the work- ? 21 undertaken on behalf of the TMI Public Health Pund,' 22 has had an unavoidable conflict this afternoon 'and' 23 accordingly will not be present today. Ini view - of. -1 24

that, the results of her work, which is entitled f

25 " Cancer Near the Three-Mile Island Nuclear Plant j .u NE Ali R. GROSS 1323 Rhode Island Avenue, N.W. } Washington, D;C, .20005 i' .(202):234-4433

E .,O l l 4 1 Radiation-Emissions,"- and which appeared in the-2 September issue of The American .Tournal of 3 Epidemiology, will be placed in the record of today's [ 4 meeting. i l 5 Ile f o r e we begin, do eit her of myl fellow G Commissioners have any comments? I 7 I f.

not, Ilo c t o rs ' Iloi ce and

Jablon, we 8

welcome you.to-the Commission and you may proceed.- 9 DOCTOR BOICE: (S)ide) May I have the 10 first slide, please?' 11 My name -is John Boice and I'm Chief of the 12 Radiation - Epidemiology Branch -at the Nat ional Cancer 13 Institute, und Mr. Jablon - is an experti wit hin the I 14 program, an expert in epidemiology and' biostatistics,. [ 'i 15 and he is the principal investigator for thel study. 16 And, as mentloned, we will be discussin'g.this recent1y j 17 conducted study of cancer in popul a't ions' living near i L 18 nuclear facilitles. 19 I'll start with a brief. overview of the. L 20 study and then Mr.- Jablon will-present-the-study. j 21 design,. methods. and

results,

then I'll conclude t

22 briefly with the comments made from our oversight-23 committee which-monitor the progress = of the 24 investigation. 25 (Slide) The'next slide. .i l NEAl..R. GROSS; 1323~Rhode Island Avenue, N.W.. Washington, D.C.- 20005 -(202) 234-4433'

-o 5 l i l The study: was initiated in 1987 after f ~ i 2 reports from -- could I..have the next slide, please? 3 COMMISSIONER CURTISS: Takes them a while- [ 4 there sometines. t h 5 DOCTOR BOICE: Takes.them a while, okay; i G There we go. The st udy 'was. start ed. in 7 1987, after-reports from the United' Kingdom suggested .l 8 elevated rates of childhood leukemia around certain { 9 nuclear installations. A protocol: was devel oped.: and i 10 reviewed in 1988 and an advisory committee was 11 establinhed. The committce met three. times and t he-12 report was published this month' by t he. Government [ 13 Printing Office. 14 (Slide) Next slide. 15. The advisory committee consisted of seven l 16 scientists outside t he'. Uni t ed. S tat es government. and 17 their charge was to provide overall.

guidance, t o.

18 assist in the interpretation, and to=sugges't' areas for 19 further study. The members included Doctor Roswell P 20 Boutwell from the University of Wisconsin; Doctor I 21 Pelayo Correa from Louisiana-State University; Doctor.- L 22 Clark

Heath, Vice President-for Epidemiology and

_[ 23 Biost atistics at the American Cancer. Society; Doctor 24 Colin Muirhead, _'a member of the' National. Radiation 25. Protection Board in England;. Doctor Donald Pierce from u i NEAL R. GROSS 1323 Rhode Isl and. Avenue', N.W.- Washington, D.C.- 120005- .-( 2 0 2 ). 2 3 4.4 4 3 3 - 4

l r I G l 1 Oregon State University; Doctor Moyses Szklo, Johns 2 Hopkins University; and Doctor Arthur Upton, New York l f 3 University. Doctor Upton was also the Chairman of the 4 recent National Academy of Sciences committee, the i 5 BEIR.V Report, which published their ' findings on low G level radiation effects enrlier this year. l l 7 (Slide) Now, the next slide. 8 In 1987, the Office of Population Census' 9 and Surveys in the United Kingdom published a 10 comprehensive volume of cancer risk in the vicinity of ~ [ 11 their nuclear installations. They. reported a 12 significant excess of childhood leukemia around l 13 certain facilities, specifically defense and fuel 14 reprocessing-plants. In large

part, this 15 investigation prompted us to initiate a similar survey

~ 16' based on routinely collected vital statistics ' dat a in i 17 the United States. Our study of county death rates 18 used similar methodology as that used in the United 19 Kingdom. 20 (Slide) Could I have--the next slide? I 21 In the United Kingdom,- the excess of 22 childhood leukemia was particularly noted around the 23 Sellafield Nuclear Fuel Reprocessing-Plant shown here, t -24 There was. lit t le evidence of excess risk around the 25 nuclear power plants that generated electricity. Most t i f NEAL R. GROSS 1323 Rhode. Island. Avenue. N.W. Washington, D.C. 20005 + L --(202) 234-4433

7 1

recently, the Sellafield excess was suggested to be-

'2 possibly related to occupational exposure 'of the l 3 fathers prior to conceptlon. 4 (Slide) Could I have the next slide? [ 5 As Mr. Jablon will. discuss in. detail, our G study includes nine Department ' of Energy facilities, 7 one commercial reprocessing plant 'that was active in. j 8 -New York but-eventually closed,.and 52 ; commercial-9 nuclear power plants that' began operat ing - prior t o-l t 10 1982. t l 11 (Slide) Could I have the next slide?' 12 This map shows the distribution of study- ) {- 13 counties in blue and the control counties'in yellow, 14 which were selected for the analysis. There were 107 15 counties with or adjacent to' nuclear - inst all'ntions, 16 and 292 control counties. I think it'is important._to { 17-note that the methods used.to study cancer deaths at s 18 the county level have been _ used : ef fectively by the 19 National Cancer Institute in the past. 20 (Slide) Next slide. 21 For example, this map is ;taken' from our r 22 published cancer maps and ' displays levels of' lung 23 cancer deaths for each of the more than-3,000-f 24 counties in the United States. Red' represents 25 counties at highest risk. Although risk is seen to i 3 u-E NEAL-R. GROSS 1323 Rhode Island Avenue, N.W. Wa s h i ng t on',. D. C. 20005-(202).234-4433

p' i A .i i 8 1 vary across the United' States, most remarkable are the 2 high rates of lung cancer in counties along the South 3 Atlantic and the' Gulf Coasts. Subsequent studies link-4 the excess rates to asbestos exposure in. shipyards,' 5 particularly-during.World. War II. l G (Slide) The next. slide. [ 7-In another survey,. counties. with non-8 ferrous smelters and refineries showed elevat ed rut es - 9 of lung cancer denths. Subsequent analytic: studies 10 . linked the excess risk to residential. exposure to 11 arsenic released by smelters-into the general 1 12-environment. These examples'are just to indicate that 13 studies of cancer deaths at the. county level,'despite

i 14 their limitations which we will discuss,

they - have. 15 been valuable in the past in identifying environment al- 'i 16 factors responsible for some geographic patt erns of 17

cancer, j

~ i 18 (Slide) Could I have.the..next slide?.' 19 Returning now to our survey around nuclear i 20 i n s t a l l a t i *.n s, the. study. once again includes the .3 21 Department of Energy facilities such 'as: this one at ( 22 Hanford. 23 (S.ide)

And, the next- = slide, and. 5 2.-

24 nuclear power stations', such' as this o n e. a t, Calvert 25 Cliffs in Maryland. NEAL R. GROSS 1323 Rhode Island Avenue,-N.W. -Washington,-D.C. 20005 I -(202) 234.-4433.: r

i a f f l 9 ' ~ 1 (Slide) The next slide. 1 2 Now, just to give - you a feeling for the l t 3 numbers involved,.there were G2 nuclear facilities in 4 107 of the counties-in' the United States. 5 Approximat ely '19 ~ million people live in or near to-G counties with nuclear facilities. 7 The-number of cancer deaths from 1950 t [ 8 through 1984 was, approximat ely-900,000. The cancer -9 rates for 16 causes of death due to cancer were f 10 contrasted for the cont rol counties, which were 292 11 contrni counties, which had a population of 33 million i, 12 people based on the 1980. c ensus, and 1.8 million 13 . cancer deaths occurred during this 35 year period. 1 14 The average population -- t 15 COMMISSIONER-REMICK: Excuse me, would you l l 1 IG mind if I ask. a question at this point or'would you l 7 17 prefer -- 18 DOCTOR-BOICE: If it'stfor clarification. 19 We do have a presentation. 20 COMMISSIONER REMICK:- :-I was.just wondering' j l t L 21. how you decided upon the. cont rol counties-and the i 22 number, how that was decided. 23 . DOCTOR BOICE: M r.- Jablon will present 24 that in detail,-so that you'll see that. I 25 COMMISSIONER REMICK: Fine. 1 1 p w.-. ~ NEAL R. GROSS 4 A 1323 Rhode Island Avenue, N.W. Washingt on, D.. c.1 20005 (202)s234-4433, ~ f

.2 M jf, .n 4. l .o% 4:. ~ !j 6 10 t 'W i ~ 1 DOCTOR BOICE: Anot her. int erest ing. f act', I i 2 think, would be that the median population ' size for e i 3 .these counties was approximately 00,000 individuals. [ 4 (Slide) Could I have the next slide? i t ( .5 As ment ioned,- t he, result s were published j G this month in 'three-volumes,: approximately 1,700 i 7 paEes. -We are also' preparing an article. for [ 8 submission t o a peer review,iournal at t his time.. 1 9 'And now, Mr.-'Jablon w'ill_ discuss the.stu'y. l d t 10 design and the methods'and the'results in some detail., { i 11 DOCTOR JABLON: 'Thank you, John.- l 12 I may say. t hat-if 1 you would like to ? 13 interrupt me for ~ question at'any time,-please feel a 14 free to do so. } 15 (Slide) May I have-'the -first' slide, 16 please? 17 My presentation is divided into 'several i i 18 sections. i 19 First, why do a; study? 20 'What are-the data that are available? l 21 Which facilities and counties: were 22 -studied' j 23 How were. control-countics: selected? 24 What's the form. of: analysis'.and the 25-process of interpretation? f 1 i l ' t l -I 'NEAL R. GROSS 1323 Rhode Island Avenue, N.W. I Washington, D.C.; 2200054 i (202) 234-4433 i

T' II I ^ - 1 What was' found for childhood-leukemia or 2 for other cancers? t 3 What are the limitations and_ strengths of 4 the study? [ { 5 And what-are the. conclusions? G (Slide) May' I have the next slido. 7 please? 8 In

1983,

,Yorkshire TV. broadcast-a i 9 documentary indicating excessive mortality-from 10 leukemia among young persons who lived near the: 11 Sellafield Nuclear Fuel Reprocessing

Plant in.

l. 12 Cumberland. This.nroused considerable interest and f 13 the Ministry of Health asked a commi t t ee - chai red by 14 Sir Douglas Black to invest igat e. t he situation. This 15 shows the essence of'what:the Black Committee' reported 16 in the next year, 1984. There were.only a-few cases-i 17' of leukemia in young ' persons, but the -number was 18 clearly excessive. There were eight cases, while only-19 2.3 would have been expected at national ~ mortality 20 rates, so there were 3.5 t imes _ as many.' deat hs. from. 21 leukemia as would have occurred had'the leukemia ~ rate 22 been the same as in. England _and Wales. Other forms.of' 23 cancer, however, were not increased. "4-In

1985, the-government established.

a !~ 25 commi t t ee on the medical aspects of. radiation in the r-u_ + l NEAl, R. GROSS. 1323 Rhode Island-Avenue, N.W.. i . Washington, D.C. 20005 [ (202) 234-44331

i i F 12-i i 1 environment called COMARE to: investigate further, and 2 in 1986 the scope of the investigation was broadened 3-when the Scottish a u t h o ri t i'es - reported on the. l 4 incidence of.1cukemia-in-the neighborhood of the .5 Dounreay Reprocessing Plant, a facility that had much' i 6 lower radiation emissions..than'Sellafield. i 7 '( S l i d e) May I have the next

slide,

( 8 please? 1 9 Near Dounreny ithere were only, four cases 10 of childhood leukemia, but the population'ia not large 11 and at nationni rates less than half n case would be i 12 expected. The number of cases was nearly 12 times the 13 number expected. These reports have stimulated 'n 14 large number of studies of individual nuclear plants 15 in Britain and the ll.S. 16 (Slide) Next slide, please. 17 In particular, COMARE investigated the 18 situation near the Aldermaston and Burghfield military. 19 weapons plants ~ and found some increases in. childhood. 20 cancer, not only leukemia but other forms of. cancer 21

also, unlike the situat ion around Sellafield where 22 childhood leukemia mortality was. increased but. not i

23 deaths from other forms of cancer. The-leukemia 24 increase was, however, much smaller 'than at t lie 'two i i 25 reprocessing plants. l 1 I i NEAl. R. GROSS' 1323 Rhode Island. Avenue, N.W. . Washington,. D.C.1 .20005' .i (202)'234-4433

r i e r- - - 13 "~ 1 The British Office of Population Census' 2-and Surveys then published a massive study. of 3 populations near every nuclear' facility in.the'. United-4 Kingdom-and this stimulated the National. Cancer. 5 Institute to mount a parallel study in t h'e ~ U n i t e d 0 States mnking use of the county datn thnt-were 7 available, as Doctor Boicehas. told you.. 8.. (Slide) Next

slide, please.

What dat a 9 are available? Next slide, please. 10 The data available included ' count s ofTthe-11 numbers of deaths each year i n-each county. 12 Population data, which are needed:- t o ' chi cul'at e' ra t es, 13 were also available, i 14 (Slide) Next slide. 15 Although incidence ' dat a that. is,- the 16 number of cases of disease di agnosed are very' 17 desirable for research purposes, they existed only for 18 a few states and-.' cities, while-the' mortality data were-19 available for every count y in the U.S. for each year 20-from 1950 forward'.. clas'sified by-couse.of death, age,- 21 . sex, and race. .Also, the ' findings in' t he U.K. had 22 largely been based on mortality' data. l 23 (Slide) Next-slide, please. 24 COMMISSIONER CURTISS: Just out-of 25 curiosity, is the incidence data collected < at the .. i u _. NEAL R. GROSS 1323 Hhode Island-Avenue,.N.W. Washington, D.C. 20005 (202): 234-4433--

= F~"" 14 r 1 discretion of the states.or why do we have it Just for 2 some limited states here? 3 . DOCTOR J ABLON: Well, it's-largely at-the 4 discretion 'of the states. Some years

ago, the 5

National Cancer Institute organized a program called G- " Surveillance, Epidemiology,.and End Results," or SEER l 7 for s ho r t', and there-are now ten SEER registries. In 8 ten different s t at es. Other states have started tumor 9 registries also that are not part of the SEER program. 10 Most of the registries now existent have' start'ed I 11 relatively recent1y,- so i t 's'; no t easy to do_a long-12-term longitudinal study: for those states. We could i 13 for two states, as we shall=see. I 14 COMMISSIONER'CURTISS: If-you 'could, just 'I 15 slide over in front of that mike so the people in the i I 16 back can hear you. Junt speak in the box _there. 1 17 DOCTOR JABLON:' Is this better?- I \\ 18 COMMISSIONER CURTISS: They're hard to. =r 19 pick'up, i 20 DOCTOR JABLON: Okay. 21 COMMISSIONER CURTISS: Can you hear.back 22 there? .i 23 DOCTOR JABLON: I don ' t' know which slide j 24 we're on now. Okay. Well, which facilities. 25 (Slide) 'May,1 hav'e the next, please?- No. l k l NEAL R. GROSS l L '1323 Rhode Island Avenue, N.W. ( ' Washington, D.C._._-20005 ~ (202t 234-4433: 't

l 15 l ' ~ l Back two. Well, all right. l 2' Though incidence data that .i s, the i i are very 3 number of cases of disease diagnosed i 4 desireable for research purposes, they existed only. j 5 for a few states and cities while the mortality. data G were available for.every county. Well', 1 guess we had .f 7 gone through that. 8 Every nuclear generating plant in the-9 United States that went into service before 1982 was 10 included in-the survey, in addition to nine facilitles 11 operated for the Department of Energy and one former i 12 commercial reprocessing plant. The. DOE plants include "~ 13 reprocessing plants such as

Hanford, and nuclear i

14 weapons manufacturing plants analogous to Aldermaston 15 and Burghfield such as Rocky. Flats,

Fernald, and t

16 others. Sellafield and Dounreay are both reprocessing 17

plants, so there was much interest in similar 18 facilities in this country.

19 Besides the reprocessing plants and other 20 Department of Energy'~ facilities,' 52 commercial nuclear ] 21 electric plants ~ are included in the survey. So, 22 there's a total of 62 facilities. The. nuclear -r 23 electric plants have been treated in three groups. 24 (Slide) Next slide, please. 25 The early plants,- those that went.into r 1 s .NEAL R. GROSS 1323 Rhode Island Avenue .N.W. Washington,- D.C.: '20005 .(202) 234-4433-

r-"- 16 ~ l service before 1970,- generally had much lower power 2 levels than the later

plants, but they have been 3

active long enough that if their emissions or other 4 characteristics were responsible for the induction of S leukemia or other

cancer, the increase might be 6

detected in mortality data through 1984. 7 (Slide) Next slide, please. 8 Many more electric generating plants came 9 into service in the years 1970 to 1974. The minimum 10 time for the development-of a radiation induced 11 leukemia _ is thought to be about two years. So, if 12 these plants are associated with excess deaths from 13

leukemia, that fact might possibly be detected from 14 mortality data through 1984.

The elapsed time is 15 rather short, however, for detection of other forms of 16 radiation-induced cancer which generally take ten or l 17 more years to develop. l 18 (Slide) Next slido, please. 1 19 The last group of facilities, those that 20 started service in 1975 or later, conceivably could be 21 associated with detectable deaths from leukemia, but 22 other forms of cancer, if induced after plant start-23 up, would not be reflected in mortality data through 24

1984, since less than ten years would have elapsed 25 since the earliest possible radiation exposure to the i

NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

.= a o. i 17 f ~ l neighboring population. i 2 (Slide) Next slide, please. 3 There are 107 counties that is, 4 counties that either contain or are a d,J a ce n t to'one of i 5 the facilities -- which account for 20 percent or. more. i G of the area within t en miles of t he facility. I J 7 (Slide) Next slide please. 8 Three control or comparison countien wero 9 chosen for. each study county, at tempt ing to match on 10 several-characteristics t'h a t -are important for af 11 mortality rates. For purposes of analysis, dat a for. 12 all o f -: t he study counties for

a. particular facility I

~ 13 were added together as were the data for the 14 comparison counties to create study-areas and 15 ' corresponding comparison areas':for.that facility. 10 (Slide) Next slide. 17 Doct or Bolce - has' shown you t he t otali ty of-f 18 study and comparison areas ~ as shown here, and it's 19 plain that the. counties in the West are of ten much 20 larger than are the Eastern-counties. I 21 (Slide).Next slide. 22 How are the data presented and analyzed?' F -23 (Slide) Next slide, please, j, 24 The data are presented as the number of 25

deaths, the expected number at concurrent rates -for L,.

, u._ a NEAL R. GROSS' 1323 Rhode. Island Avenue, N.W. i Washington,-D.C. 20005 ~! 6 (202) 234-4433

-,l a-F, i i 18 u. ~ l the United

States, and the. ratio of the observed i

2' number ~to-the expected number. i 3 (Slide) Next slide, please. 4 1:xpected numbers of deaths were calculated 5 taking account.of age, sex, race, and year. Although l 6 age was considered in. five yenr groups when expected 2 7-values were calculated, for presentation the dat af have 1 8' been combined into five age classes, i 9 (Slide) Next s'lide, please. 10 -One to,10, 10 to 19, and so' fort h, plus-11 the all. ages group.- 12 (Slide) Next.siido, p1 ease. 13 Standardized mortality

ratios, or SMRs, 14 are simply the ratios-of the.. observed number of deaths 15 to the number expected at U.S.

death rates;- while-16 standardized registration ratios, called SRRs,- refer 17 to the numbers of cases of disease diagnosed rather 18' than deaths caused. They measuret by what percent the t 19 disease in question is iincreased or. decreased over 20 national or other standard rates.- 21 (Slide) Next slide, please. 22 The relative risk ' or - briefly, the-RR, 23 measures the excess or deficit of e-disease ' in ' one 24 group compared with another. An RR of.1.0 shows that i 25 the amount of disease in,the two groups is the same, - o l. -NEAL R. GROSS 1323 Rhode.-Island Avenue, N.W.- Washington,-D.C. 20005 (202)'234-4433

f, 19 p -- i 1 while an HR of 1.1, for

example, would. imply - t en -

i 2-percent more disease in one group.t han. i n the other, 3 while an.RR of 0.9 would show. ten percent less l 4 disease. I 5 In this survey,- we compare the' f'requency' 3 6 of disease in counties with nuclear f acili t ies -: wi t h 7 the frequency in control. counties and compare the 8 amount of disease before a facility went into service I 9 with the amount afterwarda, All relative r i's k s,- when-10 the numbers werer large' enough .to-sustain the i 11 calculation, were tested 'for what's called 12 " statistical significance"'to determine whether'or not i! 13 the difference could be the result of chance. t 14 (Slide) Next slide,fplease. 15 Sixteen kinds.of; cancer.have been examined- [ 16 including leukemia, all other cancers combined, and 17 particular forms of cancer, including breast. ' cancer,- 18 lung cancer, and other types known to'be sensitive to 19 induction by radi'ation. 20 (Slide) Next slide, please. 21 Here's an extract from the data in th'e l l 22 report. These data are-for mortality in children 23 below age ten for all facilities' combined. 24 The first column-shows the-numbers of 1 25 deaths in the study area before plant start-up, and' l u NEAL R. GROSS 1323 Rhode: Island Avenue, N.W. Washington, D.C. 20005L (202).234-4433 l

r 20 f I the second column the corresponding SMR or 2 standardized mortality ratio. There were 2,020 3 leukemia deaths before start-up and the SMR was 1.07. 't 4' That is,.the number of deaths was seven percent. more S than 'the number expected at U.S. national death-_ rates, f G The next two columns show ~ corresponding-l 7 data for'the control areas also for the. period before~ 8 plant start-up. I 9 The next four columns show parallel ' data '10

• for -the period after start-up.

And they show that'- 4 11 leukemia was one percent high compared with the.U.S. 4 12 in the study

areas, while o t lie r forms - of cancer 13 mortality were three percent high, and so forth.

I 14 COMMISSIONER CURTISS: That chart is for ] 15 both DOE and NRC facilities? 16 DOCTOR.JABLON: That's everything, i 17 COMMISSIONER'CURTISS: Okay. 18 DOCTOR.JABLON: The last two columns show l 19 the same -data for the cont rol areas., In the report 20 itself, data are shown in the same format for all' 16 21 kinds of cancer for each of the six age groups E for- ] 22 each individual facility and for. various groupings'of 23 facilities such as all plants other.than elect ric 24 utilities, and so forth. 25 (Slide)- Next slide, please. l r-l ~NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C.- 1.20005 (202) 234-4433-'

l E 1 i 21 ' ~ l Each. table, lik'e the preceding one, is 2 paired with a .t abl e showing relative risks which 3 compare.the study areas with the' corresponding control j 4 areas before start-up and after start-up. The 5 relative risks also compare the study and - cont rol. .[ G areas after start-up with themselves before. O'n e can, i ? therefore, not 'only compare the study and control 8 areas af ter start-up, but see if-the comparison 3 9 changed after the plant s' went into operation and 'see 10 what the time trends were in euch group seporntely. 11 For leukemia, the relative risk was 1.08 .q 12 for the study counties before start-up and only 1.03 -.L 13 afterwards. The relative risk 1.08 la marked by two L-. 14 asterisks, signifying that-the relative risk was 15 unlikely to arise by chance. That is, it's '[ t IG significantly elevated.

)i 17 Also, before start-up, the relative risk

~ t 18 for all cancer other than leukemia was significantly 19

low, only 0.94.

For

leukemia, the relative - risks-20 comparing after start-up with'before are 0.93 in the f

21 study areas and 0.95'in the control, so that in.both-J 22 the study and comparison areas the risk of death from

v 23 childhood leukemia went down after plant start-up.

.f 24-(Slide) Next slide, please. i 25-A very: large numberlof s'ignificance tests ( ( + l 4-. J NEAL R. GROSS' 1323'Rhode-Island Avenue, N.W. ' i Washington, D.C. --20005 l (202r 234-4433-

• [

g - 4

e <o. F '2C I have been made, more than.shown here. Computers make 2 such wholesale testing possibl~e, and I'm not sure that 3 it's necessarily.-a. good thing. It must be remembered 4 thnt one test in 20 will turn out to be significant' 5 purely an.a consequence of random variatlon. So more 6 than 1,000 of these 25,000 tests will t'rn out to be-u 7 "significant."

Further, a

statistical test of 8 significance speaks only to the mathematical meaning 9 of a= comparison and not about-the- ' biological 10 significance or relevance. 11 (Slide) Next slide, please. 12 The report is quite-voluminous, as you 13 know. The tabulated data for all facilities combined 14 as well as certain groups: of facilities such. as DOE 15 plants,'all electric generating plants, early and late 10 plants are included in the first volume. The second 17 and third volumes contain the det led' data concerning 18 individual facilities, and eac. has, m o r e t h'an 700 19 pages. The data in volume 111 are shown in.five year 20 periods, which permits an assessment-of whether. cancer 21 rates are increasing relative to'the U.S.', decreasing, 22 or not changing. 23 (Slide) Next slide. 24 What was found for childhood leukemia or 25 for other cancers? NEAL R. GROSS 1323=Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234.-4433-

9 r--.. 23- ~ l (Slide) Next slide, please. 2 The table shown here concerns childhood ?, leukemia, which some consider almost as a-bell weather 4 indicator of radiation carcinogenesis. Shown_are the 5 numbers of deaths in the' st udy and control areas for 6 the groups of facilities before plant start-up and 7 after, and the relative risks both before and after 8 start-up. 9 All of-the relative risks before start-up 10 are larger than 1.0, and three of them are 11 statistically significant. The relative. risks for 12 after start-up are sometimes more than 1.0 and 13 sometimes less, but are never significantly different L_ 14 from 1. 0. - It is presumably mere coincidence that the 15 relative risks before start-up are in every. case 16 larger than those after start-up. 17 (Slide) Next slide. please. 18 These-are the data ~ for all cancer except 19 leukemia for all the facilities for all' of the age 20 groups. The overall relative risks. are

1. 0 before.

21 start-up and 1.01 after. The> 1argest relative risk 22 after start-up is' for.the -Department of Energy 23 facilities, but the value is only 1.04-and:is actually. 24-less than the

value, 1.06,~

before start-up. The 25 number of deaths included here is more than two 7r-- ,l... NEAL R. GROSS 1323 Rhode IslandLAvenue, N.W. Washington,:D;c.t 20005 i (202) 234-4433

24 1 million, so-that even trivial and probably meaningless 2 relative-risks such as

1. 02 for_' _ the later elect ric

) 1 3

plants, but before

' start-up, are statistically -4 significant. 5 (Slide) Next' slide, please. 6 These are the summary relative riska { 7 combining all' facilities for leukemia and for ot her' 8 cancers.. For childhood. leukemia, the relative risks 9 are larger than

1. 0 ' bo t h before and after :: t a r t - u p,

i .i 10 but actually a little larger before start-up than -l 1 11 after. Similarly; for all ages combined, the leukemia a 12 relative risk went-down after start-up to a value of 13 less than.1.0. For1 other cancers, the relative risks l l '~ 14 for children were both less than 1.0, and for all-ages 1 i 15 only 1.01 after start-up, a one percent increase. { 16 (Slide) Nex t -'a lide, please. t 17 We also examined data on childhood- .] 18 leukemia for every. individual plant. This' shows the 19 distribution of the ratios of the relative risks after 20 start-up to before. If thcre were increases in 21 childhood leukemia after start-up, the ratios for more l 22 of the facilities would_.be larger than.l.0 and shifted 23 to the right. In-

fact, as can_ be seen,-

-the i 24 distribution i s. approximately s ymme t r' i ca l.

And, in 25 fact, 17 of the ratios are less than 1.0 and only 15 r---

i. l NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

25 i 1 larger. 2 (Slide) Next' slide, please. 3 We have searched' for every significant i 4 statistical test of a relative risk of leukemia that-5 -- differed from 1.0 af t er. s t art-up for any facility for G any age group. We found 18. Since there were 390 7 such tests in total. Nineteen-and a half could,have 8 been anticipated to be statistically significant as a 9 result of chance, so the actual number was very close 10 -to the number that chance alone would have produced. 11 It's noteworthy that'14 of'the significant 12' comparisons were f o r I'o w rel t,t ive ri s ks,. while only 13 four.were high. Further, alt. hough the excesses in the i 14 U.K. concerned childhood leukemia, only.a single one 15 of-the significant comparisons was for children under 16 age 10, and there were three s i g n i fi c an t l'y._ low 17 comparisons for children'10 to 19.. The significantly 18 high value was foundfin the data onLincidence for the l 19 Millstone Nuclear-Electric Plant in New London County, [ i L 20 Connecticut, i 21 (Slide) Next slide, please. 22 Data on cancer - incidence "were available 23 from two states, Iowa and Connecticut,.for the study-d 24 and comparison counties' for four comme r ci es) nuclear t 25 electric generating stations. Inzview of the British j l'. 1-s -u._ i h NEAL R. GROSS-1323 Rhode Island' Avenue, N.W. Washington, D.C'.

20005-(202) 234-4433

4 e e 26 i l , reports, we were especially interested in ~ leukemia in. ~ 2 young children. 3 These are. leukemia incidence data-for 4 children under age 10. in .the-study areas in 5 Connecticut and Iowa. Adding together the G observations for the four facilities, the standardized 7 registration: rat-ios are: 1.36, which is significantly. .8-

high, after start-up; and 1.13,.

not-significantly. 9 high, before start-up. 1 10 For.ind.ividual plants,- the' -> numbers for -11 Port Calhoun are too small to.be meaningi'ul. For 12 neither.Duane Arnold nor Haddam: Neck was.-the relative 13 risk af ter start-up significantly elevated. 14 For Millstone..in New-London

County, 15

however, the SRR after. start-up. was. significantly 16

high, 1.55, compared withL only 1.19 before start-up.

17 The ratio for mortality was a li t t le amall er. than the i '18 incidence

ratio, 1.45 compared with 1.55.

The 19 mortality ratio was not significantly. high. There l 20 were only 17 deaths,- however, in : contrast with '44 21 incident cases, t 22 The raised'SRR near Millstone may simp ~1y t 23 be a; chance finding, or some other characteristic o f-. } 24 New London County. may be responsible. The SRR was' t 25-somewhat high even before start-up. In any case, the I l NEAL R._ GROSS 1323 Rhode Is1and Avenue, N.W. Washington, D.C..'20005 (202) 234-4433

.1 4 1 e 27 r--- 1. 1 doses to persons in the area from radioactive - i 2 emissions from Fi11 stone have been reported to be less 3 than three percent of the doses from. natural 4 hackground,-at a maximum, to any person, 5 The Connecticut Department of Health G Services in 1987 report ed on a study of cancer rates 7 in relation to the Haddam Neck and Millstone power 8 plants and. report ed no association bet ween. leukemia 9 rates or rates for other cancers in proximity to those L 10

plants, 11-

.I should interject at-this point that less 12 than a week ago we learned that in'1972 a-~ report on u i 13 " leukemia cluster" in the town of Waterford was - r-I 14 investigated by CDC. Waterfor'd is, as you know, the 15 -town in which Mi11 stone is located. In 1972 there A 1G

were, I

think it.was, 11 cases = of. leukemia. and 17 .lymphoma compared with an expected number of som'ething l 18 like a quarter of that.- That -was a. significant 19' elevation. a 20 One of the hypotheses-was that it was. -5 21 somehow related to Millstone, but there was no -- on 22 looking at the- -exact geographic location of these 23 persons, no relationship could be found. ~In any case,. l 24 Millstone on'ly went into service in-1972, if f 1'm' not 25 -mistaken, so there certainly would not have been time . u NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. ,20005' (202) 234-4433 j f

e. i 28 _ l. - _1 for Millstone to have~ caused excess-cases of leukemia 2 before it went on-line. 3 It's interesting that the. excesses of 4 childhood leukemia in the county -- I don't have data 5 for.Waterford, but in the~ county'of.New London -- have O centinued to be high. So presumably something is 7. causing childhood leukemia ~in New London County, What' 8 it is we don't know,.but it seems unlikely1that it's 9 related to the operation of. Millstone. 10 In summary, there's.little indicat ion-of 11 an lucrease in risk in the, study counties after the 12 facilities went into service. 'Our adviso'ry' committee, 13 in fact, concluded that "even the-highest relative ~ 14 risks for individual facilities were compatible with 15 the general level of variation'seen." 16 (Slide) Next alide, please. 17 What are the limitations land strengths of l 18 the survey? There are both, l 19 (Slide) Next alide. 20

First, the limitations.-

.So many 21 comparisons have been made that some significant 22 differences would result f r o m c h a n c e.- For leukemia i 23 after start-up, there were 390 comparisons in the y 24 different. study areas nnd age' groups..Just over 19 of 25 the 3GG of the 390 comparisons could be expected t o-Li NEAL R. GROSS 1323 Rhode Island Avenue,-N.W. Washington, D.C. .20005 (202) 234-4433

? ,= 29 1-have probabilities >below 0.05, and the number actually 2 was-18. 3 The study is based upon counties, some of, .4 which - are very large and contain large cities. for 5-distant from the ' f acili ty. Por example, San Onofre, G in San D iego Coun t y, Cali forni a, and Turkey Point in: 7 Dade County, Florida, f 'I 8 (Slide) Nexti slide, please, } l 9 Many of th'o f acilit les began operations j 10-only in recent yeai's and.not enough time may' have 11 passed to permit the detection of any cancers that may 3 12 have been associated with their operations. j ] 13 For mont of the f acili t les studied, only r-1 "~ 14 mortality data were available. Incidence data, which 15 are.needed for the st udy-of thyroid cancer and which d I 16 are h'ighly desirable for> childhood leukemia and. female I .l 17 breast

cancer, were available for only four

] 18 facilities. l 19 There are, however, also some considerable i 20 strengths. j 21 (Slide) Next slide. 22 It was posaible to examine data for 'ach j e 23 study area over a span of 35 years, which iin most 24 instances allowed for comparison between cancer risks i l-25 before and after nuclear' facilities began operation, q u-NEAL R. GROSS IJ 1323 Rhode Is1and Avenue, N.W. .f Washington,.D.C.. 20005 l (202) 234-4433 i [

n

4

.Q - l fi 30 1 (Slide) Next slide, please. 2 The very large number of facilitles-in the 3-United States provided ample.-opportunity for the 4' expression of risk. There were more than 35,000 5 deaths from leukemia and half a million deaths from G other cancers in the study areas af t er plant start-up. 7 (Slide). Next slide, please. 8

And, as-Doctor Bolce ' hos mentionod, the 9

study of county ' data- ' lie s in previous' studies 10 successfu))y identified ' lung cancer risks associated 11-with-asbestos exposures-in . shipyards and -with '12 arsenical : air pollution-from the smelt.ing of non-13 ferrous ores. 14 (Slide) Next slide, please. 15 What are the final' conclusions, the' bottom 16 line? L 17 (S.1ide) Next slide,yplease. 18 No evidence was found' that operat ions. at 19 .ny of the nuclear facilities studied caused excess 20 deaths from childhood leukemia or from. other cancers. 21 in the counties in-which they 'are 'locat ed.- ~The 22 increases i n' childhood leukemia seen 'in the ' United - 23 Kingdom occurred near reprocessing and weapons plants. -24 'No-parallel increases near such plants are apparent in' 25 the United States. l NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C.= '20005 (202) 234-4433

ia-31 I 1 The study does provide general background 2 information that can help to guide any. future-studies: 3 around nuclear facilities'. 4 Doc t or - Iloi ce wi11 close the session. 5 DOCTOR Il01CE: Yes. I thought it might be 6 informative to the Commission t o' hear what our 7 advisory committee concluded.with regard to the study 8 and also what their recommendations were. 9 (Slide) Could 1 have the first - slide,- i 10-next slide? 11 Once

again,

.there were seven eminent 12 scientists who served on our committee'.- They were 1 13 expert'in radiation carcinogenesis and other relevant-i 14 areas. They met three timos to provide advice. and 15 guidance. They were extremely helpful and-their 16 consensus statement was also published in the volumes ~ 17 available from GPO. i 18 (Slide) Go to the next slide,;please. 1 l 19 "The Committee concludes that the survey 20 has produced no evidence that'an excess occurrence of 4 21 cancer has resulted from-living near nuclear' 22 facilities.

Further, measurements of, -radioactive i.

L 23 releases trom nuclear facilities indicate that the 24 dose from routine operations is generally much below 25 natural background radiation, and hence may ~be l u - NE AL R.: GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. '20005. (202) 234-4433 s

'(

.c 32 i. l' ~ unlikely to produce observable' ef fect s on the health 2 of surrounding populations." 3 (Slide) Could I have the next slide?- 4 They go'on to state, "however, there have 5 been releases from 'some facilities,> such.- a s ' _at i G'

Hanford, that were high, and t here _ continues to be 7

widespread -public,and scientific

concern, in-par.t j

8 raised by .the. unexpected findings in the-United t 9 Kingdom that have not' yet been fully explained, i 10 Consideration should be given, therefore, to further-i 11 investigations and monitoring,. including attention-to-12 the following-points." q 13 (Slide) Could I have the next slide?- t i. 1 14 These are the committee's considerations 15 for further study. 16 Consider surveys. of. smaller. population i l 17

groups, such us census tracts.

The-Department ofx 18 Energy with investigators at the_ University of 19 California a t-Berkeley have initiated such a study 1 20 around the DOE facilitles and also nuclear power .t ) 21 plants. Departments of public health in Connecticut' o i 22 and other states have also conducted surveys at the 23 town rather than the coun t y --level. t 24 Continue monitoring of mortality rates. 25 This is something that we can do relatively easily and u I 3 NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

'I 33 o 1 which we will do periodically, perhaps every five 2 years. 3 Exploro the use of cancer incidence data. 4 We were able to use several registries in the current i 5 i n v e s t i g a t i o n ', but in 'only two-states. There are-G other cancer registries - in the United Stat esi and it .7 might. _be possible to expand t'he Jnvestigntion l 8 accordingly. 9 The Committee stated tlint case-control-10 studies in small areas. -around-' nuclear facilities are il potentially; informative,'but should be-undertaken only i 12 after careful consideration. l Specific studies were 13 not recommended because-of the overall. lack of excess l 14 cancer deaths around nuclear facilitie's and the lack-15 of consistency with the U.K. studies. 16 Once again,; recall that -in the United' i 17 Kingdom small clusters of childhood leukemia were 18 noted around nuclear fuel reprocessing plants and l 19 weapons installations. The DOE facilities'in the'U.S. 20 were most .similar

to these' insta'llations, but

~ l-21 elevations in childhood-leukemia werc'not; observed. 1 22 Some additional-types of studies, however, 23 perhaps based on linking -rosters of records together, 24 might be feasible. 25 Consider replicating the United Kingdom s.- NEAL R. GROSS' 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 I (202)'234-4433

34 I I worker study of-preconception effects-that was 2 conduc t ed - around t he..Sellafield fuel reprocessing plant 3 in this regard, scientists at the Pacific Northwest 4 Laboratories' in. Washington State have 'initinted-a j 5 study around the Hanford site to-learn whether 6 childhood leukemia. could possibly be linked to "any 7 occupational exposures of the parents.

Also, t 'i e 8

Nat'ional Cancer institute is currently conducting-a 9 large collaborative study of 2,000 children who 10 developed leukemia, ' which will evaluate the~. risk of 11 preconception radiation from . diagnostic x'- r a y s, i 12 environmental exposures, and parental. occupation. 13 And'

finally, cooperate with others-r 14 conducting similar research.

We-certainly believe 15 that this is important and we have attempted to. keep 10 in contact wit.h .t h e Department of Energy 17 investigations, t hose being-conducted - by the Centers 18 for. Disease control,'and others. l 19

Also, I

should. add 'that; we have been 1 i 20 interested for several years =in studying the workers l 1 3 l. 21 at. nuclear power stations,. and with.the Nuclear 22 Regulatory Commission we have recommended changing the l 23 requirements for reporting occupational doses-so that' 24 a registry of radiation workers. might. be created. -1 t 25 understand that the proposed changes will be published NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington,- D.C.. 20005 (202) 234-4433-

'Q 35 r 1 in the near _ f e' ure but-perhaps.- t his' volume in front 2 of me indicates ' that-it has been published in .t he-3 Federal Registry. 4 (Slide) The next slide. + 5 In conclusion, while the overall findings 6 are reassuring,. it should be kept in-mind t h a t. t h e 7 size of some of the -count'ies may be too 'large to 8 detect risks that are present only in limited areas: 9 around plants and that no study can in fact prove-the 10 absence of an effect.- t 11 However, if any excess cancer. risks-due-to 12 radiation pollution-is-- present in' counties: with 13 nuclear facilities', the r'isk may just.be-too small Jo r-t E 14 be detected by t he met hods used. This study should 15 thus not be considered the definitive one, but rather j 16 a first st ep -in provi din g -- b ack g round information 'to - 17 help guide further studies. V r I 18 Thanks very much. for' your attention. L 19 Seymour Jablon and I will. be' glad t o.. address- ~ any 20 questions that you might have, j i 21 COMMISSIONER REMICKi Severaliquestions. 22 You mentioned that around Sellafield they L 23 found that occupational exposures might. be thef cause j 24 of the cancer. What type of occupational' exposure? 25 Did they ' find those?. I assume that's industrial, i u NEAL R. GROSS 1323 Rhodel Island Avenue, N.W. Washington, D.C. 20005 i (202)-'234-4433.'

t ,0 l36'

I

~ i ~ l rather than radiological. 2= DOCTOR BOICE: What t h e y. d i d - -- - 3 COMMISSIONER REMICK: It is radiological? 4 DOCTOR BOICE: It is radiological, yes. 5 COMMISSIONER REMICK: I see. G DOCTOR JABLON: .They did a: case controlled f 7 study on the' leukemias and found..t here. were five -8 childhood leukemia deaths in the town ~'of

Seascale,

.9 - which is-only about three kilometers..from the 10-Sellafield plant. Four of the fathers' were definitely 11 identified in the Sellafield work force, and the fifth 12 one probably was a Sellafield - worker also although-m 13 notes'could not be-obtained for-h'im. 14 The fathers of these

cases, the four 15 fathers, had occupational doses exceeding ~ ten rem, if l

16 you'll allow me to use an antiquated' term. 17 COMMISSIONER ROGERS: I feel very-18 comfortable with it. 'i 19 DOCTOR JABLON: Ten rem ov r their i 20 lifetime work, and,one rem. presumably in the' six 21 months prior to conception. Doctor Gardner, who did L 22 the study, had a number of controls selected for each 23 case and in those four -imtances.in every case the 24 dose to the father exceeded the~ dose - to any of the. i 25 controls.

Now, this created a lot of excitement in l

i NEAL H. GROSS 1323 Rhode Island Avenue,-N.W. I Washington, D.C. '20005 (202) 234-4433'

i 5 37-r_ 1 the United Kingdom, of course, but there are problems. 2 There are problems. 3 The first

problem, the first thing that i

4 was mentioned was that no such excess related to t 5 preconception irradiation .had been seen' in lthe t G Japanese survivors. But that really is not a ) 7 pertinent observation,

because,

.i f - you're:. talking I i 8 about only six months prior to conception, theretwere [ t 9 very few children born ~ in Hiroshima or Nagasaki that .i 10 had been conceived-during that' time whose fathers had c 11 ~had any dose. 12 Studies a r e,. as you. can

imagine, 13 continuing.

A study will probably appear this fall, a 14 parallel around Dounreay where there's also'an excess. 15 It's regarded as a hypothesis: 'which-has not been 16 proved, but which is kind.of suggestive. 17 One of the problems is that one. must 18 presume that not ever.y worker at Sellafield does 19 exactly-the same thing, that workers whose work imply 20 collecting.large doses are doing different kin'ds of 21 workifrom other workers. There are a lot of~ chemical 22 processes that-go on at Sellafield. It's.coneeivable 23 that these people are' bringing something.home on their. 24 clothing. I don't know what'it is, but we can be'sure 'f 25 that the-British are going. to investigate every 6 _. 1 NEAL.R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 '(202) 234-4433

c -38 I 1 possible aspect.of.that problem. 2 COMMISSIONER REMICK: Thank you. 3 In several

cases, you've indicated that-1 4

one of. the limitatlons of the study and ways of 5 improving the= study would be toyhave access to cancer i G incidence information. To the best of my knowledge, 7 our health prot ection standards are based on cancer 8 mortality. Is there anything based on the atudy, to 9 your knowledge, which would indicate that we're not 10 --being conservative enough by=using cancer mortality in 'l l contrast to cancer incidence'or-using both? Is there 12 anything to suggest that? 13 DOCTOR BOICE: Well', I-think-on the basis 14 of, you

know, radiation effects, -you lwould get a

15 fuller expression of'any adverse effects if you had' i 16 cancer incidence, dat e' 'of the-occurrence of. ' cases. 17 Unfortunately, this is' Just not readily available and i 18 it's very difficult'to obtain data on cancer incidence l-19 in the United States.or in any other country. 20 For some cancer sites such as thyroid 21 cancer, incidence data definit ely - would be preferred. 1 22 I'm not sure how much'further.you could express that. i 23 If you were able to set r e comnie nd a t i on s based on-3 24 cancer incidence, that might 'be a more completo 25 picture. E NEAL R. GROSS I 1323 Rhode Island Avenue, N.W. Washington, D.C; -20005-(202) 234-4433

1 s 39 r 1 COMMISSIONER CURTISS: Let me follow-up on- ~ 2' that. r 3. COMMISSIONER REMICK: Sure. 4 COMMISSIONER CURTISS: For the four sites G w'here you,had cancer incidence data, did the analysis -f 6 of that informat ion pret ty much confirm what L you would-7 have concluded just based upon' cancer mortalit'y data? 8 DOCTOR BOTCE: I think that's true, ' tha t-9 the patterns were the same. You'just get more. cases. 10 The occurrence of cancer,.there is"more cases, so that. j 11-could lead to more significant findings or a clearer .i 12 picture of ~ what.' t he - pat terns might be. .But.in large-13

part, the mortality does pattern after the incidence r-14 for most cancers, l

thyroid' cancer, which 15 Noted exceptions are 16 has a great cure rate -- perhaps.-90 to 95 percent of 17 all. thyroid cancers ' arei ~ cured and now childhood' 18' leukemia, in which. great advances have'been made now. t 19 So there's an increased survival'in;those areas. And 20 there are a - number of - other cancers where incidence .t 21 would be preferred. 22 DOCTOR -J ABLON: ~I t hink the New ~ Lo'ndon. 23 situation shows what happens.

Actually, the ratios

+ 24 were'very close for mortality or..for. cancer incidence, { 25 but if one looked only at the mortality-data, 'one-I u._ l NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-'4433 j a

<f .c-40 . I. l ~ would shrug one's - shoulders end say, "Well, it 'looks .l 2 .like. a' chance blip."- It was i not "statistica))y-3 si gni fi can t i "' l 4 'But we had-44 incident cases, as opposed' 1' 5' -t o only 17-cancer deaths, and those 44 cases.we re ' .i 1 1 6 significantly.high, so that. for those. cancers 'which 7 have' cure rates which are: s'i gn i fican t,. 1 i ke chiIdhood f1 cancer now, like.. female breast -cancer, like thyroidL 9

cancer, all' of.

which are radiosensitive. cancers, 10 incidence data:is very much to be desired, much.more i 11 sensitive. COMMIS' IONER 'REMICK: The-TMI study, if I 12 S 13 recall, was based' on cancer incidence. Is t his - t he. m_ 14 type of: s tudy that. you have in mind? 15 DOCTOR DOICE: No. That ~ was '-- as'other 16 states and local-communities have con' ducted-some-17 surveys ' based-on the hospitals and the -towns and l-18 closer ' geographic. regions, they've --- they had to 19 co'llect the data themselves retrospectivelyLfor years. 20 In' terms. of_ looking at the United States 21 comprehensively for all nuclear

sites, cancer

.22 incidence data is not available. What is' available,g 23 what's reported-and is available at the national level 24 are mortality data at the counties. 20 Even the Department of. Energy, through the i 1 5 NEAL R. GROSS l 1323 Rhode Island Avenue, N.W. iWashington, D.C. 20005' I (202) 234-4433

a + ? 41 1 University of California at Berkeley, they're going to 2 t ry ' t o replicate our study but use ;consus tracts,- a 3 smaller geographical area. They' re ' going t o-do -i t t 4 from-mortality. .It's just so difficult. It doesn't-i 5 exist' comprehensively for the= entire United States.: G And now, even in the United States today, f 7-there are more cancer regist ries, but comprehensive 8 areas just aren't covered. The National Cancer. 9 Institute cancer registries only cover ten'percentLof 10 the United States populatio'niend they began-in 1973.. o 11 COMMISSIONER REMICK: Is there anything'in 12 this study which would indicate a -- that' you-can r - 13-validate or' refute the use of the linear' hypothesis in 14 setting radiation-protection-standards? 15 DOCTOR BOICE: I-don't-think~so. 16 DOCTOR"JABLON: No.. j I 17 DOCTOR BOICE: This: is not 'the t ype - of. 18 study that would address the. issue of; low dose 19, radiation effects. 20 COMMISSIONER REMICK: Does'the st udy. 'show '21 us tell us=anything1more about the ef fects -of. low-22 levels of radiation? 23 DOCTOR -J ABLON: No.- If-you. assume that -24 low levels cause harm proportional to the dose,. one 25 would predict from the risk estimates at high levels I r-NEAL R. GROSS 1323.Rhode-Island Avenue, N.W. Washington,-D.C.. 20005 .(202)-234-4433

o -c I 42 I 1 that youlwouldn't be able to see it, and we didn't see 2 it. Now whether that validates it or-not, I don't l 3 know. 4 DOCTOR DOICE: 'I think'it's important t o 1 5 remember that oneLof the reasons why ~ st art ed, this we 6 survey was.because of the findings coming out of the-7 United Kingdom where. they did a comprehensive _ 8 mortality survey around their facilities.- And they- -9 reperted in a number of their ' inst ances. t hat ' excess - 10 ichildhood leukemia was. occurring. We : tried to L f 11 replicate that and did not find that in the United 12 States. 13 COMMISSIONER REMICK: 1-was just trying to 14 find if there were findings in_the survey that weren't_ 15 in your conclusions. 'And certainly, these are'some of 16 the ones we' re in t eres t ed ini. a 17 I have.no further questions,.but I wantito 18 thank you for a very succinct and. clear presentation 19 of quite an extensive survey. It.'s been very helpful. 20 COMMISSIONER ROGERS:

I was

thinking, I

21 take it that childhood leukemia, is quite radiation 22 . specific. It's-a good way to look at radiation-23 induced cancers. 24 So,. the; question I had was would there be 4 25 any point in trying to extend this study to areas' I NEAL R. GROSS l 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

'O. I 43 .I 1 around~ coal-fired fossil fuel plants,- ~ which. t end to '~- 2. emit about ten times the radiation of. a typical 3-nuclear ' power plant? And there are - a lot more of 4 them, so that you've got. another point on that curve S. because you're ten times up from the typical emissions G of a nuclear power plant. And of course, they've been 7-around'for n longer time, so'you have probably-a lot i 8-more data to go on an'd 1 to look at' childhood leukemia 9 in the countles surrounding coal-fired power plants. 10-DOCTOR. BOICE: -I think that's a good 11 point, and we have in fact been discussing that in the 12 last several weeks. 13 The National Cancer Institute-has, in r-14

fact, been using the mappings-of. cancer sincu the 15 1970s to try to ge t.

leads for cancer etiology and the i 16 environmental factors that' 'cause cancer in our 17 society. And we ~ had' county based mort ality surveys 18 trying to link rates with non-ferrous

smelters, p

-3 19 shipyards, and a lot of'other chemical-factories. And 20 we have, in fact, been discussing the possibility that 21 perhaps coal-burning plants. or other fossil' fuel-l 22 facilities might be a useful area tio study and perhaps 23 provide -leads to cancer elevations in various. 4 l. 24 counties. i 25 COMMISSIONER ' ROGERS:

Well, I was just r..-

NEAL R. GROSS 1323'Rhode Island-Avenue, N.W. W a s h i n g t o n ',. D. C.

20005 g ;-

.(202)-234-4433

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i

~' I thinking that you'might;be' able to.even more directly. 2 connect it with radiation, because'it's on'other,cource -3 of radiation that is about ten times higher than the + 4 power L pl ant s that' you' re studying now, nuclear power 5 plants you're studying now. So i f -i t 's. very radia t ion G specific, in a sense, so that the other' emissions that 7 come out of the atacklare not as important in inducing 8 childhood

leukemia, then it might be a very,- very 9

useful piece _of additional data. 10 ' DOCTOR BOICE: Yes, thank you, 11 COMMISSIONER ROGERS: What-do you seet as a 12 follow-up to the. Gardner study.here? I

mean, is 13 there-- here or,elsewhere,.is this_ going to be left"as l:

14 a big unanswered > question, you-think,.1or do-you th' ink 15 there will be some way'of -- l 16 DOCTOR BOICE:. Well, I 17. COMMISSIONER ROGERS: -- ' 'down this 18 question of hereditary effects of radiation? 19 DOCTOR BOICE: certainly. The one plant L l 20 or facility in t he.. Uni ted States that 's_ most' similar 21 to Sellafield is the-Hanford plant, which started: in t 22 1943. And at this

time, the Pacific l Northwest 23 Laboratories,

Batelle, has initiated a

study to l L 24 replicate the Gardner findings. They're doing 'a 25 survey of childhood

leukemia, lymphoma around' the 1

i I NEAl, R. GROSS 1323 Rhode Island' Avenue,. N.W. Washington, D.C. 20005 -(202) 234-4433

45 1 1 plant

area, and then they'll link that. roster, 2

identify the parents and. link the rosters to the. 3 radiation workers at Hanford to see if they can, in 4 fact, here in--the lini t ed S t a't e s, if we can replicate 5 that finding. p e c u l'i a r

finding, you know,-

G I t' is a 7 hecause ther.,'s not evidence in genetics that leukemia 8 is a perticular heritable -disease. And-Lthe 9 geneticluts and molecular biologists' that have' 10' reviews,d the report,;they_ questio'n it based on what's-11' known about biology, that it would perhaps!be peculiar 12 that leukemia itself would be passed on and not all 13 the other types of known genetic diseases such. as j i 14 retinoblastoma and Wilm's Tumor or-excesses-of 15 congenital malformation, whichrhave not.been noted in 16 the'Cumbria area. So.I think people are looking at 17 alternative explanations in addition to preconception. .18 One of.the other explanations ' that 'have 19 come from t he.' Un i t ed Kingdom was the response-to a 20 virus in a viral infection. When you-have n' rural .i <21 community and populations are moving in because --o f a ~ 22 large industrial complex-and the local community 23 somehow does not have an -immunity built.up, they're. 24 susceptible to a common infection and childhood 25 leukemia results. So there's' activit y in the United

t. --

NEAL R. GROSS 1333 Rhode Island Avenue, N.W. Washington, D.C. 20005' (202)-234-4'33 4 3

t j ^,,. - e 7 j' oa 46 r~'~~ ) ~ l Kingdom trying to evaluate that particular factor. 2

Also, chemical exposures is another 3

possibility,.as Seymour mentioned. A number of these .l 4 people, although they did-receive meaningful radiation 5 doses, over ten rem -- that's prior to conception -- I G think f o u'r of'the five or five of the key nine were a 7 analytical chemists and also were exposed to -- o r il chemical - engineers exposed to a lot of the c h e nii c a l - 9 processing that goes around withipluto'nium works; 10 COMMISSIONER-ROGERS: 1s there any -- you 11 have such -- you have a' fair amount of' data. It's, I? 12 guess,. the largest study of its kind that's every been 13 conducted on this type. Can you look! 'a't any other i 14

effects, such as the effect of, well, sbcioeconomic

[

15 effects such as nut rit ion - an'd.t hings like = that ? Is 16 that too low? Arc.there too few cases where.you<could ~ 17. differentiate that way? Is that more cor. less what :you= ~18 were saying in some of your recommendations, don'.t'try 19 to differentiate below where you'veidon'e so far? l 20 DOCTOR BOICE: I guess-there are several 21 levels. If you' re ' doing. a comprehensive study, you-- j 22 have to -- you know, covering all plants and' the 23 entire United States -- you have'to Just work with the-24 data that-you have at hand. And real' specific' data, 25 such as smoking characteristics, dietary

factors, 1.

l 1 NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D. C '.. 20005 -(202) 234-4433

I 47 1 these things-that you would like to do in a more.- -we 2 use the t erm " analytic" study, where you ~ go into: an-1 3 area and you ask the

people, their spouses, ;what 4

factors-- what are their lifestyle f act ors,- what. are-5 their occupations, what are their other exposures -- 1 G COMMISSIONER ROGERS:= You-justudoh't Ehave 7 any of that? 8-DOCTOR BOICE: Tt's not 'available. I t 's. 9 just not available.. There are, though, studies thati 10 are trying to'get'that type of information now in the 11 United Kingdom and the United-States, 12 The Centers for Disease ' Control is 13 supporting another ' study around the. llanford s'ite, r-- 14 because, as:you're probably; aware, d'uring World War II 15 there w a's a rather massive release ~o f 'radioact ive 16 iodine. Radioactive. iodine' would have4 been 17 concentrated in the. thyroid and-that' would be th'e 18 disease of interest, thyroid disorders.- So,.with the ~ 19 Fred Hutchinson Cancer Center, they're conducting a 20 real detailed study.trying to find: these people over 21 the 'las t 50 years, 45 years, and then t rying to, get 1 22 de t ailed information on. disease histories,- as well 'as 23 other factors. 24. Several state governments-are - also p-l~ 25 conducting more detailed studies around their sites. u.-- .NEAL R. GROSS 1323 Rhode Island Avenue, N.W. Washington, D.C. 20005 (202) 234-4433

f 2 a ~4 8 I ~ l COMMISSIONER ROGERS: I'd just like to say 2 that it seems-to < me.that you've handled this whole 3 thing'in-a very admirable way, because there was very, 4 .very littic' leakage along the way of what your results I 5 were-going to come Lout t o- - b e, and ;I. think that's 1 G really the way it ought to_ be. Until its out,=it 7 shouldn't' be out. And it seems as if-it's a very-8 excellent study, t ha t.whil e. it ' will never settleJall 9 ' questions it's certainly-a' very import ant _ piece _of - 10 research in guiding.our thinking?on such matters. 11; What do you think will be the impact of 12 your study? It seems to me so far, other than a brief m 13 flurry of press attention. when the report was 14 released, it-hasn't seemed to -- it doesn't seem to-be 15 getting very much discussion, probably because-it's _l IG the wrong kind of result. We all like to discuss 1the 17 doomsday scenarios,:but the opposite predictions don't l l 18 seem to excite people very~much. What 'do you think L 10 the impact _will be of your study? 20 DOCTOR BOICE: Gosh, that's~hard for me to say. I think it's'too early to tell. The~studyshas only been out for less than two weeks, so I think it's 4 bard to see how others will' respond to it. 24 COMMISSIONER ROGERS: Yes, but you know if l-25 the results had been quite different it would have l. NEAI, R. GROSS 1323 Rhode-Island Avenue, N.W. L Washington, D.C. 20005 (202) 234-_4433-

4 I 49 I been a bombshell. It would have been talked about-on j i 2 radio, television-time and time again. The fact that-1 3 the results are _ negative seems to totally dissipated 4 at least the media's interest in it. 5 DOCTOR BOICE: I think. that's -true in-I G general, of course. In most of the studies-that we're 7-involved in in terms of epidemiology,- whether 'it's 8- -radiation or chemicals or occupation there -does? seen '9 t o' be a lot more media or public interest when you. 10 have a significant finding. 1.think t hat. might: jus t 11 be characteristic of our society. 1 12 COMMISSIONER ROGERS: Oh,.I think-you;had e - 13 a significant finding. It just wasn't a' negative--one, l 1 14 DOCTOR BOICE: Right, sure. IS COMMISSIONER. ROGERS:

Well, I'.d also'like i

16 to add my commendations to the very fine-work that's 17 been done here. l 18 DOCTOR BOICE: Thanks. 19 COMMISSIONER ROGERS: Thank you. 20 COMMISSIONER CURTISS: I.just-have a-f 21 handful of questions here, 22 Doctor Jablon, -I wasn't sure I understood 23 your explanation of the. significance of statistical 24 significance. I take.it, from your explanation, what-i 25 could be statistically-insignificant in one ca

ight

.i u -- 'l NEAL R. GROSS. 1323 Rhode Island Avenue, N.W. Washington, D.C.g 20005 a (202) 234-4433'

+ f 50 1 be statistically significant -in another. Let's say 2 five ' percent in-one case might be statistically 3 significant in one-place but not _anot her.- Why is 4 that?' _Without getting-into a detailed explanation of ] 5 how you calculate-that,_ what -is t he ' explanat ion for-G that? a i I 7 DOCTOR - J ABLON: "Signif1cance" is' -a bad i i 8- -word. Statisticians, you know, took it over and 'it 9 has connotations.= 1t's a purely mathemntical term, as-10 it's used. It asks this. question. You_have t e certain 11 nomber of deaths that' you might have expected from j -l 12 leukemia or something else, and there were-a certain 4 13 number that you' observed. And that,-of course, is not-m_ 14 exactly the same. There's a certain amount-ofl random' ) 15 variation. 4 -i 1G The' ques tion is, what is the: probability 1 y 17 that a difference that large might have aricenL by j 18 chance? And i f-that. probability i s - 'l e s s - - t h a n some 19 nominal amount, 1ike five; in a hundred or one. in'a '4' 20 hundred, that's called "significant.",But that's all .i a 21 it means,- that_ this is -a' difference which 'is 22 sufficiently large that random variatlon would have 1 23 produced it only five times in a hundred. But-i.f l 24 you've.done 25 thousand tests, you'know, you're going 1 25 to get a f air number of them. I 1 NEAI R. GROSS 1323 Rhode Island Avenue, N.W. Washington,_D.C.; ~20005 .j L(202)_234-4433

, r-- 51 1 Now what determines whether it's 2 significant? It's a product of two things.

First, 3

how big is the difference? If you've observed two 4 cases and you expected one, that's a relative risk or 5 an SMR of 2.0, but it's not significant because if you G expect one you could easily get two. But if' your 7 expectation was 100 and you actually observe 200, boy, 8 that would be very significant. So there_arn formulas 9 for calculating what is the probability that this 10 would have arisen by chance, and that's what it comen 11 to. 12 COMMISSIONER C11HTI S S : All right. A 13 couple of other quick questions. The Gardner study r-1 14 that you referred to, is that the only study that has 15 reached conclusions of that nature on preconception 16 effects? Are there any others that have reached 17 similar conclusions? 18 DOCTOR JABLON: I'm not aware of any 19 others. Well, there have been: others.- The Tristate 20 Leukemia Study, which was done a considerable number 21 of years

ago, found some excesses of,

'I

guess, 22 preconception irradiation to -the parents.

I don't' 23 think-it was taken very seriously.. Again, part of.the 24 problem was that the data 'concerning parental 25 irradiation were a little on the soft side. They were I NEAL R.. GROSS-1323 Rhode Island Avenue, N.W. - Washingt on', D.C; 20005 (202) 234-4433'

V ,e. -7 52 ~ l - obtained by' int erview - and they did some checking. of -2 doet or's - of fices, - but when you ask ' people - about prior 3 radiological. examinations you're likely to get some: .4 very, incomplet e information. Sometimes people-think' 5 that they're being x-rayed when actually the procedure-0 was something else. 7 And'I guess. Alice Stewart 's original e.t udy B in the 1957-pub 1icalion -on The Oxford Surrey of S Childhood Cancer. She had a small excess. She had an' 10 excess - in a small-: number of cases of. preconception 11 irradiation and.she dismissed that as just one of 12 these chance things. She may.have changed her mind 13 about t hat now. 1 don't know. 14 COMMISSIONER CURTISS: Okay. 15 DOCTOR ' J ABLON: There are a few littleL 10 indications. 17 COMMISSIONER CURTISS:- One final-questi'on, 18 1 guess.- Doctor Hatch, of course, isn't here, but 1 19 assume you've read the study that. was done for the TMI 20 Public Health Fund..'Is there anything between the two 21 studies t hat - you detect ed. const itut e an inconsistency 22 or have'they reached pretty much the some conclusions? 23 DOCTOR JABLON: I was very-pleased.when-I 24 saw hera. You know, we couldn't find anything going. 25 on around TMI. and I was somewhat relieved that she 1 t NEAL R. GROSS- >1323 Rhode Island Avenue, N.' W. i Washington,:D.C.- 20005 { (202) 234-4433-f{

] o-53 F i I hadn't found muel, either. t 2 COMMISSIONER ' CURTISS: It did st rike me i 3 that t he. dif ferent methodologies that were used to I t i 4 reach the same conclusion confirmed the results. 5 DOCTOR JABLON:. Right. G COMMISSIONER CURTISS: Other questions? 7

Well, let me.

'thank you for the i 8 presentation this afternoon. I must say 1 found the j 9 resulta quite interesting and the resul t a of ' t he s t udy. 10 somewhat reassuring. I t'; 11 As Commissioner Rogers indicated, I 12' suspect the debate on this subject will go on, but the j 13 contribution which you've made and in particular I i 1 14 guess the credibility-that the National ~ Cancer 15 Institute brings to this subject constitutes a 'real 10 service not just to-the country as-a whole but I think ' 17 to those of us who are interestedlin.the subject on a 18 day to day basis and I'd like to,thank you. 19 We s t atid adj ou rned.-- t 20 -(Whereupon,. < n t 3 : 14 : p. m.', t h e hearing.was 21 adjourned.) l 22 L 23 t 24 i 25-L i t. NEAL R.: GROSS' 1323 Rhode? Island' Avenue, N.W. Washington, D. C '. - '20005- .(202):. 234-4433 u.-

{ CERTIFICATE OF TRANSCRIBER l This is to certify that the attached events of a meeting + of the United States Nuclear Regulatory Commission entitled: TITLE OF MEETING: BRIEFING ON STUDIES OF CANCER IN POPULATIONS NEAR NUCLEAR FACILITIES, INCLUDING THREE MILE ISLAND J PLACE OF MEETING: ROCKVILLE, MARYLAND DATE OF MEETING: SEPTEMBER 28, 1990 were transcribed'by me. I further certify that said transcription is accurate and complete, to the best of my ability, and that the j transcript is a true and accurate record of the foregoing events. AA H M, A) Reporter's name: Peter' Lynch b t t 1 1 i NEAL R. GROSS COUtf Af9ORTIt$ AND TRANSChille$ 1333 kNODt l$tAND AVENUE, N.W. (202) 2$4-4433 WASHINGTON, D.C. 2000$ (2o2) 232 6600' e-. -w

[

l l

i 1, t L 4-i i CANCER IN POPULATIONS l LIVING NEAR NUCLEAR FACILITIES i i NATIONAL CANCER INSTITUTE ) i l i i NIH PUBL No. 90-874 l i i i I i l t 1 1

+ l AD HOC ADVISORY COMMITTEE i i DR. ROSWELL BOUTWELL UNIVERSITY OF WISCONSIN i I l DR. PELAYO CORREA LOUISIANA STATE UNIVERSITY l DR. CLARK HEATH AMERICAN CANCER SOCIETY i l l DR. COLIN MUIRHEAD NATIONAL F.ADIATION PROTECTION BOARD, ENGLAND i i DR. DONALD PIERCE OREGON STATE UNIVERSITY I DR. MOYSES SZKLO JOHNS HOPKINS UNIVERSITY i DR. ARTHUR UPTON NEW YORK UNIVERSITY t I

e .i 2 l 1 \\ STUDY OVERVIEW i i-i INITIATED AFTER 1987 REPORTS FROM U.K. ). [ PROTOCOL REVIEWED AT 1988 SITE VISIT i i i i ADVISORY COMMITTEE MET 3 TIMES -1989-1990 i (- l REPORT PUBLISHED 1990 J t l i i i i 1 i i l l

i i NUCLEAR FACILITIES STUDIED i i l i 9 DOE INSTALLATIONS i i i 1 COMMERCIAL FUEL REPROCESSING PLANT 52 COMMERCIAL NUCLEAR POWER PLANTS i i i I l l 1 { \\. . ~. - - \\

i ~ l j 1 7 I j i NUMBER NUMBER i NUMBER NUMBER CA DEATHS RESIDENTS i AREA FACILITIES COUNTIES (MILLIONS) (MILLIONS) 1 j STUDY 62 107 0.9 18.7 i i, CONTROL 0 292 1.8 33.0 I e b o i i } . ~ -... - - ~.

!r i i i "THE COMMITTEE CONCLUDES THAT THE SURVEY HAS PRODUCED NO EVIDENCE THAT AN EXCESS l OCCURRENCE OF CANCER HAS RESULTED FROM LIVING NEAR NUCLEAR FACILITIES.

FURTHER, i

MEASUREMENTS OF RADIOACTIVE RELEASES FROM NUCLEAR FACILITIES INDICATE THAT THE DOSE FROM ROUTINE OPERATIONS IS GENERALLY l MUCH BELOW NATURAL BACKGROUND RADIATION, AND HENCE MAY BE UNLIKELY TO PRODUCE l OBSERVABLE EFFECTS ON THE HEALTH OF ) SURROUNDING POPULATIONS." l l l

I i i "HOWEVER, THERE HAVE BEEN RELEASES FROM SOME FACILITIES, i 1 SUCH AS AT HANFORD, THAT WERE HIGH, AND THERE CONTINUES l TO BE WIDESPREAD PUBLIC AND SCIENTIFIC CONCERN, IN PART RAISED BY UNEXPECTED FINDINGS IN THE UNITED KINGDOM THAT i i HAVE NOT YET BEEN EXPLAINED FULLY. CONSIDERATION SHOULD l BE GIVEN, THEREFORE, TO FURTHER INVESTIGATIONS AND l l MONITORING, INCLUDING ATTENTION TO THE FOLLOWING POINTS." 1 l i i i i I L.-

I -j ~! ADV!SORY COMMITTEE CONSIDERATIONS FOR FURTHER STUDIES

• SURVEYS OF SMALLER POPULATION GROUPS, e.g., CENSUS TRACTS i

i

• CONTINUED MONITORING OF MORTALITY RATES
• EXPLORE USE OF CANCER INCIDENCE DATA
• USE CAUTION IN CONSIDERING CASE-CONTROL STUDIES-
• CONSIDER REPLICATING U.K. WORKER STUDY OF l

PRECONCEPTION EFFECT

• COOPERATE WITH OTHERS CONDUCTING SIMILAR l

RESEARCH -~ - ~

.I i I i 1 CONCLUSIONS i FINDINGS REASSURING, BUT L 1 -- COUNTY SIZE LARGE ~ j -- CAN NEVER PROVE ABSENCE i OF EFFECT-4 RISK MAY BE SMALL l t l PROVIDES BASELINE DATA i t i i l

i L i 1. WHY DO A STUDY? t l 2. WHAT DATA ARE AVAILABLE? 3. WHICH FACILITIES AND COUNTIES ARE STUDIED 7 L HOW WERE CONTROL COUNTIES SELECTED 7 i ) 4. WHAT IS THE FORM OF ANALYSIS ~ AND I . PROCESS OF INTERPRETATION? i i 5. WHAT WAS FOUND FOR CHILDHOOD LEUKEMIA? i c WHAT WAS FOUND FOR OTHER CANCERS? l i 6. WHAT ARE THE _ LIMITATIONS AND STRENGTHS OF.THE STUDY?. I i 7. WHAT ARE THE CONCLUSIONS?- I i i [ i

1 i ..l h i DEATHS FROM CANCER-AROUND SELLAFIELD AGE 0-24, MILLOM RURAL DISTRICT, 1963-80 l L j i I i OBSERVED EXPECTED NUMBER NUMBER RATIO O/E 1 i l t LEUKEMIA 8 2.31 3.5 * * \\ l I l I OTHER CANCER 5 5.03 1.0

• p < 0.01 (BLACK,1984) l i

i

1 ? a I LEUKEMIA INCIDENCE AROUND DOUNREAY AGE 0-14 <12.5 KM FROM DOUNREAY l 1 i l I PERIOD LEUKEMIA CASES OBS/EXP P -l j 1979-84 4 11.73 <0.001 i (COMARE II,1988) i l i i i

l i

4 + i l i ~ l ~ ~

~ -: t i 2 i CANCER INCIDENCE AGE O-14 NEAR ALDERMASTON & BURGHFIELD I i 4 i. ELECTORAL WARDS <10 KM FROM AN ESTABLISHMENT OBSERVED EXPECTED NUMBER NUMBER RATIO.O/E i i l LEUKEMIA 41 28.6 1.4

• i i

i OTHER CANCER 61 47.5 1.3

• i l

1 i

• p. < 0.05 '

(COMARE 111, 19 8 9) i 4 i

t l 1. WHY DO A STUDY? .j 2. WHAT DATA ARE AVAILABLE? 1 3. WHICH FACILITIES AND COUNTIES ARE STUDIED? i HOW WERE CONTROL COUNTIES SELECTED 7 i .i 4. WHAT IS THE FORM OF ANALYSIS AND j i PROCESS OF INTERPRETATION?. i l-5. WHAT WAS'FOUND FOR CHILDHOOD LEUKEMIA?- WHAT WAS FOUND FOR OTHER CANCERS? 1 l 6. WHAT ARE THE LIMITATIONS AND STRENGTHS OF THE STUDY? L j-7. WHAT ARE THE CONCLUSIONS? i i i 4

F l DATA AVAILABLE FOR COUNTIES i i 'I { DEATHS: ANNUAL BY CAUSE, SEX, RACE, AGE i l l POPULATIONS: ESTIMATES BY YEAR, SEX, RACE, AGE l \\ INCIDENT CANCERS: BY KIND OF CANCER, SEX, RACE, AGE i FOR COUNTIES IN. CONNECTICUT AND IOWA l I i i I I l I l

^ i i 1

• .f I

WHY MORTALITY? 1 i-

• NATIONAL DATA ALREADY AVAILABLE IN NCI DATABANK, 1950-84
• DATA FOR EVERY COUNTY BY i

-- YEAR I t -- AGE l --SEX i 4 L -- RACE

• METHODOLOGY SUCCESSFUL IN PAST t

s a l i I i 6 t - f i i l

4 -.j 1 i i l l-l 1. WHY DO A STUDY? 2. WHAT DATA ARE AVAILABLE? 3. WHICH FACILITIES AND COUNTIES ARE STUDIED? HOW WERE CONTROL COUNTIES SELECTED? i i i 4. WHAT IS THE FORM OF ANALYSIS AND ) l PROCESS OF INTERPRETATION?- L 5. WHAT WAS FOUND FOR CHILDHOOD LEUKEMIA? j i WHAT WAS FOUND FOR OTHER CANCERS? i 6. WHAT ARE THE LIMITATIONS AND STRENGTHS OF THE STUDY? i 7. WHAT ARE THE CONCLUSIONS?- i

i .-? l DEPARTMENT OF ENERGY FACILITIES i YEAR l. OPERATIONS BEGUN HANFORD 1943 l OAK RIDGE NAT. LAB. 1943 1 MOUND .1947 l lDAHO NAT. ENG. LAB. 1949 l PADUCAH 1950 l i l SAVANNAH RIVER 1950 j l FERNALD 1951 PORTSMOUTH 1952 ROCKY FLATS-1953 NUCLEAR FUEL SERVICES 1966 I (COMMERCIAL REPROCESSING) j t i e i 4 1 t I i i. 1 i.. I

O ELECTRICITY-GENERATING PLANTS IN SERVICE BEFORE 1970 YEAR COMMERCIAL POWER SHIPPINGPORT/ 1957-BEAVER VALLEY-1976 DRESDEN 1 1959 YANKEE.ROWE 1960 BIG ROCK POINT 1962 HALLAM 1962 INDIAN POINT 1

1962 FERMI 1 1963' HUMBOLDT BAY 1963 PATHFINDER 1964 HADDAM NECK 1967-LA CROSSE-1967 SAN ONOFRE 1-1967 GINNA 1969 NINE MILE POINT 1969 OYSTER CREEK 1969

.m _s.2

i ELECTRICITY-GENERATING PLANTS IN SERVICE 1970-1974 YEAR YEAR j ~ MILLSTONE 1970 BROWNS FERRY 1973 POINT BEACH / 1970 FORT CALHOUN 1973 KEWAUNEE 1974 OCONEE-1973 ROBINSON 1970 PRAIRIE ISLAND 1973 MONTICELLO 1971 ARKANSAS 1974 PALISADES 1971 CALVERT -CLIFFS 1974 i MAINE YANKEE 1972 COOPER STATION 1974 i PILGRIM-1972 DUANE ARNOLD 1974 QUAD CITIES 1971 HATCH 1974 TU K Y POINT ANCHO SECO 1 VERMONT YANKEE 1972 THREE MILE ISLAND 1974 ZION-1973 i 1 ~ i. r v v ,,3 ,.m-4 ~,m

l 1 ELECTRICITY-GENERATING PLANTS IN SERVICE 1975-1981 YEAR COMMERCIAL POWER-1 [ BRUNSWICK 1975 COOK 1975 TROJAN 1975 FORT ST. VRAIN 1976 SALEM 1976 3. i ST. LUCIE 1976 l. CRYSTAL RIVER 1977 DAVIS BESSE 1977 FARLEY - 1977 l NORTH ANNA 1978 j SEQUOYAH 1980 l MCGUIRE 1981 i i i i i

l, T STUDY COUNTIES 4 107 COUNTIES THAT (A) CONTAIN A NUCLEAR FACILITY (64), OR (B) ARE ADJACENT TO A COUNTY WITH A FACILITY l AND ACCOUNT FOR >20% OF THE AREA WITHIN 10 MILES (43) l i i e i l I i i i l i-i t t

292 CONTROL COUNTIES THREE SELECTED FOR EACH STUDY COUNTY (A) USUALLY SAME STATE (B) ALWAYS SAME REGION MATCHED ON (1979 DATA) (A) MEAN FAMILY INCOME, NET MIGRATION RATE, INFANT DEATH RATE, POPULATION (1980) (B) PERCENT OF POPULATION ~ WHITE, BLACK, HISPANIC, URBAN, RURAL FARM, EMPLOYED IN MANUFACTURING, HIGH SCHOOL GRADUATE, OVER AGE 25

NUCUBAR B48TALLATIONS, CONE N M

9

-- jg jl i =- ;;[$R7L \\ KEY COUNTIES WITH OR NEAR psa FAN CONTROI, COUNTIES FIGURE 1 AU. OTHER COUNTIES

" ' ' " ' ~ ~ - - - - ' e t i 1. WHY DO A STUDY? 2. WHAT. DATA ARE AVAILABLE?. 3. WHICH FACILITIES. AND COUNTIES ARE STUDIED? HOW WERE CONTROL COUNTIES SELECTED? 4. WHAT IS THE FORM OF ANALYSIS AND PROCESS -OF INTERPRETATION? 5. WHAT -WAS FOUND FOR CHILDHOOD LEUKEMIA? WHAT1WAS FOUND FOR OTHER CANCERS? 6. WHAT ARE THE. LIMITATIONS AND STRENGTHS OF THE STUDY? . 7. LWHAT1ARE THE CONCLUSIONS? m.

FORM OF DATA PRESENTATION OBSERVED DEATHS NUMBER EXPECTED AT CONCURRENT NATIONAL RATES STANDARDIZED MORTALITY RATIO (SMR): NUMBER OBSERVED / NUMBER EXPECTED

EXPECTED VALUES CALCULATED FOR STUDY AND CONTROL' COUNTIES FROM U.S. RATES SPECIFIC FOR i AGE (5-YEAR GROUPS) a SEX t RACE (WHITE, NON-WHITE) 1 YEAR i l l l 4 I i 4 .i i.

DATA STANDARDIZED FOR SEX AND RACE SHOWN FOR EACH~ CANCER FOR AGES: UNDER 10 I 10-19 i 20-39 40-59. i 60 AND OVER- ~ ( ALL AGES i. i l L l v.o-.- .-..,7 e ~.,s p ..p.--- y m_..

i N 1 4 i 'l h j -h 1 r OBSERVED DEATHS-t SMR: NO. EXPECTED AT U.S. RATES 1a t i L OBSERVED CASES SRR:. e NO. EXPECTED AT STATE RATES-I l ? s t l l (= i i I . i f. I i' u -- o. 4 -'w r,--,-e.. .-r..-...,. - - -, ---

i -1 RELATIVE RISKS RATIO OF SMRs t (A) STUDY VS. CONTROL - BEFORE STARTUP STUDY VS. CONTROL - AFTER STARTUP e i (B) STUDY: COUNTY AFTER STARTUP VS. BEFORE STARTUP 1 (. CONTRQL COUNTY AFTER STARTUP VS. BEFORE START I L i F i

e KINDS OF CANCER I 4 i 16

CLASSES, INCLUDING LEUKEMIA, NON-LEUKEMIA i

CANCER, LYMPHOMA, MULTIPLE MYELOMA, CANCER l OF THE BREAST,

LUNG, STOMACH,

COLON, BONE, l

THYROID, BLADDER, LIVER, BRAIN l t-i I f e t-

.i a ~ ~f AGE -AT DEATH: UNDER 10 ALL FACILITIES ~ COMBINED i i 1 BEFORE STARTUP AFTER STARTUP J STUDY CONTROL . STUDY CONTROL 1 OBS ~SMR OBS SMR OBS SMR OBS SMR LEUKEMlA & ALEUKEMIA 2020 1.07 4251 0.99 1390 1.01 i ' 2572 .O.97 ' ~ ALL CANCER. EXCL LEUK 196,9. 0.99-4623 1.03. 1717 1.03 - 3243 1.02-1 i. 6 HODGKIN*S DISEASE - 42 1.33-69 - 0.95- -13 0.75 .26 0.78 l-OTHER LYMPHOMA 266 0.99 584-0.96 217 1.13-397-. 1.08 i i f i .i 4 .i 1 e .m yo f-m. j..w:_,6- ..,w... y y,- ,p.-,_

f 1 AGE AT DEATH: UNDER 10 ALL FACILITIES COMBINED t i RELATIVE RISKS-STUDY VS. CONTROL 'AFTER VS. BEFORE l i t I BEFORE AFTER STUDY CONTROL LEUKEMIA & ALEUKEMIA-1.08-1.03 "O.93 - 0.95 -l l ALL CANCER, EXCL LEUK O.94-0.99 1.05 0.96 t l HODGKIN'S DISEASE 1.41 0.90 0.94 0.99 i OTHER LYMPHOMA 'O.94

1.00 0.93 0.94' T

-i I

0.01 ;< P <= 0.05

• * : 0.001 < P <= 0.01 '

i: l ,. - ~.

NUMBER OF SIGNIFICANCE TESTS ON RELATIVE RISKS 61 STUDY AREAS, TIMES 6 AGE GROUPS, TIMES 16 CANCER CLASSES, TIMES. ~4 COMPARISONS (STUDY VS.. CONTROL, AFTER VS. BEFORE) 23,424 ~ ~

i! i 2 l: CONTENTS OF REPORT l 1 t. VOL 1: DESCRIPTION, DATA FOR GROUPS OF FACILITIES, I DISCUSSION AND CONCLUSIONS t i VOL 2: DATA FOR EACH FACILITY,. BEFORE AND AFTER STARTUP j i VOL 3: ' DATA FOR EACHLFACILITY, BY 5 YEAR TIME PERIODS '1 i l i i 1 j. i i 1-l 'l _1 - i., m

t 1 1 f i y i 3 1. WHY DO A STUDY?. l 2. WHAT DATA ARE AVAILABLE? l 3. WHICH FACILITIES AND COUNTIES ARE STUDIED? HOW WERE CONTROL COUNTIES SELECTED? i 4. WHAT IS THELFORM OF ANALYSIS AND i . PROCESS -OF INTERPRETATION? 5. WHAT;WAS1FOUND FORLCHILDHOOD LEUKEMIA? WHAT WAS.FOUND FOR OTHER CANCERS? ( j 6. WHAT ARE THE LIMITATIONS AND: STRENGTHS-OF :THE. STUDY? i l ~WHAT-ARE THE. CONCLUSIONS? 7. t . ~ -

1 l MORTALITY FROM LEUKEMIA, UNDER AGE 10, BY TYPE OF FACILITY t l 1 - i BEFORE STARTUP AFTER STARTUP l NUMBER OF DEATHS NUMBER OF DEATHS TYPE OF f l FACILITY STUDY CONTROL. RR STUDY CONTROL RR j DEPT. OF ENERGY 39 '48 1.45 601 -1009 1.06 a . ELECTRIC UTILITIES BEFORE 1970 593 1035 1.03 534. 993 1.00 l j 1970-1974 996. 2383. 1.09 227 482 1.06 i i .1975-1981' 392 785 1.11 28 88 0.82 . TOTAL-1981' 4203-1.08' 789 1563 1.01 -1, ALL FACILITIES 2020 4251 1.08' 1390 2572 1.03 i 4-1 a- . ~ -

MORTALITY FROM ALL CANCER EXCEPT LEUKEMIA, ALL AGES, BY TYPE OF FACILITY r BEFORE STARTUP AFTER STARTUP l NUMBER OF DEATHS NUMBER OF DEATHS 4 TYPE OF FACILITY . STUDY CONTROL RR STUDY CONTROL RR DEPT. OF ENERGY 5780 '8991 1.06 141635 247308 1.04 1, ELECTRIC UTILITIES-j BEFORE 1970 479902.4 157745 1.00 197158 364675 1.01 1970-1974 179208.471890 0.98 139175 317206 - 0.9 8. 1975-1981 69310 157884 1.02 26325 68785 0.99 j TOTAL 328420 787519 0.99 362658 750666' O.99 ALL FACILITIES 334200' 796510 1.00. 504293 997974 1.01 ^ i , n._

l T l f i OVERALL FINDINGS ~ 1 f RELATIVE RISK 1 i BEFORE STARTUP AFTER STARTUPL l LEUKEMIA ] CHILDHOOD 1.08 1.03 - ALL AGES 1.02 0.98~ l p } OTHER CANCER LCHILDHOOD .0.94 0.99 i p L ALL AGES 1.00 1.01 i 1 I 1 I i f <i 4 +3- ,em-._r -.,,,*w, w-w-, a - ~ - - -

s 1 1. WHY DO A STUDY? 2. WHAT DATA ARE AVAILABLE? 3. WHICH FACILITIES AND COUNTIES ARE STUDIED? HOW.WERE CONTROL COUNTIES SELECTED 7 4. WHAT lS THE FORM OF ANALYSIS AND PROCESS OFLINTERPRETATION? c i 5. WHAT.WAS FOUND FOR CHILDHOOD LEUKEMIA? WHAT1WAS FOUND.:FOR OTHER CANCERS? l 6. WHAT: ARE THE LIMIT. ATIONS AND STRENGTHS 3 L TOFxTHE STUDY? 7. WHAT.!ARE THE CONCLUSIONS?. y ) i ...~--

.:.q Distribution of RATIOS of Relative Risks (RR1/ RR2) of CHILDHOOC LEUKEfvDA RR1 Study vs. Control County After Startup i RR2 Study vs. Control County Before Startup l I RR1/RR2<1.0 RR1/RR221.0 \\

l. j n = 17 9-

. n = 15 53% 47% i 25 - i 7 l l 20 - -6 .j i E l ' 15 - l \\ i 10 - .l 2 I I 5-j 0 i i i i i i i i i 0.25

0.5 -

1.0 - 2.0 - 4.0 j Ratio of Relative Risks f ^ J i ) {L .a .= = ^

.} t ...~-{ FACILITIES WITH RELATIVE RISKS l 3 SIGNIFICANTLY DIFFERENT FROM 1.00 i ALL LEUKEMIA, STUDY VS. CONTROL AFTER STARTUP FACILITY AGE GROUP RELATIVE RISK ] LARGER THAN 1.00 Millstone (Incidence) <10 3.04 l Savannah River 20-39' 1.83 Prairie Island 40-59 2.41 o Salem' 40 1.45- [ LESS 'THAN 1.00 L San Onofre 10-19 0.75 i Quad Cities 10-19 0.29 i Vermont Yankee 10-19 0.09 l j Hanford - 40-59 ~0.71 o Mound 60+ 0.92 Robinson 60+ 0.64-c L Maine-Yankee 60+ 0.64 i l Turkey Point' 60+ 0.88 1 Brunswick 60+ 0.15 l l-Fernald All - 0.94' Humboldt Bay' All .O.47 Turkey Point . All 0.93 Pilgrim-All 0.87 a Brunswick. All 0.51-( .a ._.,,,,,a

.. = INCIDENCE DATA i ~ LEUKEMIA,.UNDER 10 ~YR BEFORE AFTER OBS SRR OBS SRR HADDAM NECK,- CT (1967) 15 0.98- -16 0.97 i i MILLSTONE, CT (1970). 49 1.19 44-1.55 FT. CALHOUN, NE -(1973)' 1 1.91 4 3.13 .DUANE: ARNOLD, IA (1974) 9 1.04 '17 : 1.26 TOTALL .74 1.13 81-c1.36 q .l i i 1 =x ~..., -

l-1. WHY DO A STUDY? .2. WHAT DATA ARE AVAILABLE7-3. WHICH FACILITIES AND COUNTIES ARE STUDIED? l HOW WERE CONTROL' COUNTIES. SELECTED?-- 4. WHAT:IS THE FORM OF ANALYSIS :AND. PROCESS OF INTERPRETATION 7 5. WHAT LWAS FOUND1FOR CHILDHOOD LEUKEMIA? y WHAT WAS-FOUND FORf 0THER CANCERS?- 6. WHAT^ARE THE LIMITATIONS AND STRENGTHS-d OF THE STUDY?- I q i 7. WHATRARE THELCONCLUSIONS? j j ~ ._.,_,_,_._._g .-_.-:.,.-__[_ -___,.__._n_ t,

a LIMITATIONS OF THE STUDY. i l i

1. -

SO. MANY COMPARISONS HAVE BEEN MADE THAT SOME 'SIGNIFICANT' DIFFERENCES' WILL RESULT ~FROM CHANCE. i FOR LEUKEMIA. AFTER ~STARTUP THERE' ARE 61 STUDY AREAS AND 6' AGE GROUPINGS. JUST OVER '18 OF THE '366 COMPARISONS COULD BE EXPECTED TO HAVE PROBABILITIES 'BELOW 0.05, : AND THE NUMBER 'ACTUALLY.- 1 WAS 18.

2. -

THE STUDY IS BASED UPON. COUNTIES, SOME OF WHICH l ARE VERY' LARGE AND. CONTAIN LARGE CITIES FARLDISTANT FROM THE. FACILITY, ~e.g., SAN ONOFRE, IN SAN - DIEGO. COUNTY, CA AND TURKEY: POINT IN DADE COUNTY, FL. -i l l h ^

.. 3 t - I i l .i 3. MANY OF THE FACILITIES BEGAN OPERATIONS IN RECENT i YEARS AND NOT ENOUGH TIME MAY HAVE PASSED TO ALLOW FOR THE DETECTION OF CANCERS ASSOCIATED WITH THEIR OPERATION. j 4. FOR MOST OF THE FACILITIES STUDIED ONLY MORTALITY i DATA WERE AVAILABLE; INCIDENCE DATA, NEEDED. FOR THE1 l I . STUDY.OF THYROID CANCER AND HIGHLY DESIRABLE FOR j CANCERS SUCH: AS THOSE OF :THE FEMALE BREAST,.WERE1 1 AVAILABLE FOR ONLYFOUR. FACILITIES.. i. t I. t i l .~ i

m-O e* STRENGTHS 1. IT HAS BEEN POSSIBLE TO EXAMINE DATA FOR EACH STUDY AREA OVER A SPAN OF 35 YEARS: WHICH, LIN MOST INSTANCES, ALLOWED LFOR-COMPARISON: BETWEEN CANCER RISKS; BEFORE AND LAFTER NUCLEAR FACILITIES' l BEGAN OPERATION.

s l L i 2. THE VERY LARGE NUMBER OF FACILITIES lN THE UNITED STATES PROVIDED AMPLE OPPORTUNITY. FOR THE EXPRESSION OFL RISK; THERE WERE-MORE THAN 35,000 DEATHS FROM LEUKEMIA -AND HALF A MILLION DEATHS FROM OTHER i CANCERS IN ~THE. STUDY LAREAS AFTER PLANT. STARTUP. g i i. t t i }~ l l [ I L ~

3 _ l i i i k i 1 3. THE STUDY OF COUNTY DATA

HAS, IN PREVIOUS 1

STUDIES, SUCCESSFULLY IDENTIFIED LUNG CANCER RISKS ASSOCIATED WITH ASBESTOS i. EXPOSURES IN SHIPYARDS AND WITH ARSENICAL AIR POLLUTION FROM~ THE SMELTING OF' NON-l- FERROUS ORES. j i a i 1 2 i .a.

.~

~ .. - ~ ~ = - =

i e., m .. ro l ] CONCLUSIONS ln a NO EVIDENCE WAS FOUND THAT OPERATIONS AT ANY OF THE NUCLEAR FACILITIES STUDIED CAUSED EXCESS l DEATHS FROM CHILDHOOD LEUKEMIA OR iFROMJOTHER i CANCERS IN THE-COUNTIES IN-WHICH THEY ARE LOCATED. THE INCREASES IN-CHILDHOOD LEUKEMIA L SEEN IN THE UNITED -KINGDOM OCCURRED NEAR l l REPROCESSING :AND ' WEAPONS PLANTS.. NO' PARALLEL. INCREASES NEAR SUCH PLANTS ~ ARE APPARENT IN THE a UNITED STATES.. THIS STUDY PROVIDES GENERAL BACKGROUND 3 INFORMATION THAT.CAN HELP TO GUIDE ANY FUTURE STUDIES AROUND NUCLEAR FACILITIES. i f c. l L i 1. ~... _, _... ~,... _. _, ~}}