ML20149E873
| ML20149E873 | |
| Person / Time | |
|---|---|
| Issue date: | 07/07/1994 |
| From: | Taylor J NRC OFFICE OF THE EXECUTIVE DIRECTOR FOR OPERATIONS (EDO) |
| To: | |
| References | |
| SECY-94-178, NUDOCS 9408080140 | |
| Download: ML20149E873 (71) | |
Text
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\\..... * ',a, POLICY ISSUE July 7, 1994 SECY-94-178 (NEGATIVE CONSENT) g:
The Commissioners Enqm:
James M. Taylor Executive Director for Operations Sub.iect:
EPIDEMIOLOGIC STUDIES OF RADIATION INDUCED THYR 0ID DISEASE IN BELARUS AND UKRAINE Egrpgie:
To obtain Commission approval to assist DOE in funding the scientific research protocols for Belarus and Ukraine under the Joint Coordinating Committee for Civilian Nuclear Reactor Safety (JCC/CNRS) Working Group 7 (WG 7).
i Backaround:
l Originally, the JCC/CNRS was created under an agreement with the former Soviet i
Union. Upon dissolution of the former Soviet Union, Russia and Ukraine became i
separate members of the JCC/CNRS. WG 7 " Health Effects and Environmental Considerations" is concentrating on the epidemiologic studies of the human health impacts of the accident at the Chernobyl Atomic Power Station. Work with Belarus began with the original JCC/CNRS charter and is continuing based on letter exchange between DOE and the Ministry of Health of Belarus.
In February 1994, Dr. Harry Pettengill, Department of Energy (DOE) Deputy l
Assistant Sec otary for Health, assumed the U.S. leadership for WG 7.
Dr.
l Shlomo S. Yaniv, Sr. Technical Advisor, Office of Nuclear Regulatory Research l
1s the NRC member of WG 7.
I 1
Discussion:
A scientific research protocol was signed between the Ministry of Health of Belarus and the U.S. Department of Energy (DOE) on May 26, 1994 (attached).
The purpose of the protocol is to develop and implement a long-term epidemiologic study to assess the risk of thyroid disease among persons, particularly children, who were exposed to iodine radioisotopes during and/or following the Chernobyl accident. This scientific research will involve approximately 15,000 children in Belarus.
Contacts:
NOTE:
TO BE MADE PUBLICLY AVAILABLE 504 3
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r S. Yaniv, RES n
415-6239 9408C60140 940707 8
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The National Cancer Institute (NCI), acting as the implementing agent for DOE, was the U.S. agency responsible for developing the protocol and obtaining required approvals and will serve as the principal on the U.S. side for the protocol's implementation. The U.S.-Belarus scientific team estimated that the total study effort will last at least 20 years and will be phased in over the next 2-3 years.
U.S. start-up costs are estimated to be approximately $3 million for the first two years.
Under the Belarus cooperative research protocol, Belarus will provide the trained scientific and technical specialists, and clerical personnel as well as the clinical, laboratory, and office and other space as may be necessary to carry out the study.
The U.S.
will provide specialized training, assistance in quality control, cooperation in data analysis, consultant services, supplies and equipment.
It is anticipated that the research will assess the relationship, between thyroiddisease,especiallycangr,andtheradiationdosetothethyroid, with emphasis on the dose from I.
The primary focus will be on dose-response analyses of person-year incidence data with stratification by sex, age at exposure, geographic area, and time.
In addition to producing risk coefficients for thyroid cancer ar.d other thyroid diseases in children as a function of sex and age at the time of exposure, it is expected that the galyseswillcontributenewknowledgeofthecarcinogeniceffectivenessof I in comparison with that of x-ray and gamma radiation.
This information will fill a major gap in the world's knowledge of radiation effects, and ould provide guidance for radiation protection and public health policies wherever nuclear reactors are in operation.
The combined effect of these efforts should also have a positive effect on the local public health infrastructure.
It is anticipated that a similar protocol, with the same objectives and cost estimates as in Belarus, will be signed later in 1994 with Ukraine, potentially involving approximately 60,000 children.
Additional protocols are presently being developed with Ukraine for epidemiological studies of leukemia and cataracts among people that received large doses as a result of the Chernobyl accident.
The finalization of these protocols is projected to be some time in the next 1-2 years.
It is anticipated that the bulk of the funding will be provided by DOE.
We plan to assist DOE in this effort.
The Belarus thyroid protocol specifies (page 7.12) that funding for the U.S. portion of the agreement will be provided by NCI as available via agreements with DOE and the NRC.
In SECY 238, we have previously provided support ($500 thousand) for the JCC/CNRS Working Group 7.
These dollars were in support of research in collecting and analyzing environmental and health effects from the Chernobyl accident.
We plan to enter into an agreement with DOE and provide them approximately $1 million dollars for the combined first two year efforts on the thyroid protocols in Belarus and Ukraine. The remainder of the estimated ',5 million is projected to be provided by D0E.
Funding for the NRC contribution was not previously budgeted, but it will be provided from currently available agency resources.
We anticipate this inter-agency agreement with DOE will be signed during FY 1994.
Future funding for the remainder of the study is projected to
The Commissioners 3
be substantially less than the first two years where the majority of the costs for equipment, supplies and training are incurred.
NRC future contributions will be based on the perceived benefits to our public, health and safety mission.
Appendix C, Staffing Pattern (Belarus), represents estimated Belarussian staff requirements and associated salaries in conducting the signed protocol.
Appendix C was compiled to reflect the Belarussian contribution to the protocol and will not be funded from U.S. Government financial resources.
Recommendation:
That the Commission:
Note that unless otherwise directed by the Commission, the staff intends to provide approximately $1 million through an inter-agency agreement with DOE for support of epidemiologic ttudies of radiation induced thyroid disease with Belarus and Ukraine, es M. Tay r xecutive Director for Operations
Attachment:
As s '.ted SECY NOTE:
In the absence of instructions to the contrary, SECY will notify the Staff on Friday, July 22, 1994, that the Commission, by negative consent, assents to the action proposed in this paper.
DISTRIBUTION-Commissioners OGC OCAA OPA OIP OCA OPP EDO ACRS ACNW SECY 1
I e
i SCIENTIFIC PROTOCOE
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1 FOR THE STUDY OF.
THYROID CANCER AND OTHER THYROID DISEASE.
IN BELARUS FOLLOWING THE CHERNOBYL ACCIDENT L
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s LETTER ARRANGEMENT FOR CONTINUING COOPERATION BETWEEN THE MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS AND THE UNITED STATES DEPARTMENT OF ENERGY ON THE IMPLEMENTATION OF THE SCIENTIFIC PROTOCOL FOR THE STUDY OF THYROID CANCER AND OTHER THYROID DISEASE IN BELARUS FOLIDWING THE CHERNOBYL ACCIDENT Pursuant to the Letter Arrangement for Continuing cooperation signed April 27, 1992 in Minsk by representatives of the Ministry of Health of Belarus and the U.S.
Department of Energy, Belarus and the United States agree to implement the attached scientific protocol according to the specific provisions identified therein and according to the following general responsibilities:
1 1.
The Ministry of Health of Belarus shall provide Belarussian medical, scientific, technical and support personnel, their salaries, and such facilities and space as may be needed for the study, including project office space for on-site U.S. technical representatives.
2.
The United States shall provide to the Ministry of Health of Belarus such equipment and supplies as may be needed to carry out these studies, relevant medical, scientific and technical consultation, and, as appropriate, an on-site U.S. technical representative and provision for training of Belarussian personnel.
The undersigned recognize that the implementation of this scientific protocol is in the interest of both countries and of the world community in that it will yield a better understanding of the risk of thyroid cancer and other thyroid diseases resulting from exposure to radioactive isotopes of iodine that may be released from nuclear facilities.
Signed this twenty-sixth day of May, 1994 in Washington, D.C.
M Vasily S. Kazakov Tara O'Toole, M.D.,
M.P.H.
Minister of Health Assistant Secretary for Belarus Environment, Safety and Health United States Department of Energy i
l e
A ATTACHMENTS i
i SCIENTIFIC PROTOCOL FOR THE STUDY OF THYROID CANCER AND OTHER THYROID DISEASE IN BEIARUS FOLI4 WING THE CHERNOBYL ACCIDENT t
i I
LIST OF EQUIPMENT AND SUPPLIES IN ACCORDANCE WITH THE PHASED IMPLEMENTATION OF THE STUDY
k b
February 23, 1994 SCIENTIFIC PROTOCOL FOR THE STUDY OF THYROID CANCER AND OTHER THYROID DISEASE IN BELARUS FOLLOWING THE CHERNOBYL ACCIDENT l
Prepared by U.S. Comittee Belarussian Comittee David V. Becker, M.D., Chairman Vladimir Matyukhin, M.D., Chairman Lynn R. Anspaugh, Ph.D.
Larisa Astakhova, M.D.
Gilbert W. Beebe, Ph.D.
Yuri Gavrilin, Ph.D.
Andre Bouville, Ph.D.
Yakov Kenigsberg, M.D.
... Bertrand Brill, M.D., Ph.D.
Sergei Korytko, M.D.
Jacob Robbins, M.D.
Viktor Minenko, Ph.D.
Roy E. Shore, Ph.D.
Konstantin Moshik, M.D.
Lester Van Middlesworth, M.D., Ph.D.
Sergei Nalivko, M.D.
Bruce W. Wachholz, Ph.D.
i Jan Wolff, M.D., Ph.D.
l
Outline S.1
SUMMARY
1.1 1.
BACKGROUND AND SIGNIFICANCE 2.1 2.
OBJECTIVES 3.1 3.
METHODS 3.1 3.1 Thyroid Dosimetry.......................
3.1.1 Measurements of I-131 Activity in the Thyroid 3.1 3.1.2 Dose Reconstruction Based on Thyroid Measurements 3.3 3.1.3 Contribution of Short-lived Radiciodines and of Te-132..... 3.6 3.1.4 Contribution of External Irradiation and of Internal Irradiation from Radiocesium to the Thyroid Dose....... 3.8 3.1.5 Estimation of Uncertainties Attached to the Dose Estimates... 3.8 3.9 3.1.6 Dose to Fetal Thyroids.....................
3.2 Sampling Plan: Cohort Study of Morphologic 3.9 and Functional Changes....................
3.9 3.2.1 Objectives to be Addressed by Sampling Plan 3.10 3.2.2 Selection of Sample......................
3.11 3.2.3 Study Cohort..........................
3.20 3.3 Clinical and Diagnostic Methods 3.20 3.3.1 Palpation and Ultrasound Examination..............
3.21 3.3.2 Ascertainment of Thyroid Cancer 3.21 3.3.3 Ascertainment of Hypothyroidism 3.21 t
3.3.4 Ascertainment of Iodine Nutrition 3.22 j
3.3.5 Ascertainment of Lymphocytic Thyroiditis............
3.22 i
3.3.6 Ascertainment of Hyperparathyroidism..............
3.22 j
3.3.7 Central Laboratory.......................
i 3.4 Interview and Questionnaire Procedures 3.22 and Examination Records...................
3.22 3.4.1 Information on Personal History................
3.23 3.4.2 Information from Medical Examination..............
i 3.24 3.4.3 Information for Record Linkage.................
4.1 l
4.
STANDARDIZATION AND QUALITY CONTROL 4.1 4.1.
Dosimetry...........................
4.1 4.1.1.
Data Entry..........................
4.1 4.1.2.
Range Checks.........................
4.1 4.1.3.
Computer Code Verification 4.1 4.1.4.
Hand Verification.......................
4.1 4.1.5.
Review of Extreme Values 4.1 4.1.6.
Participation in International Model-Validation Studies....
4.2 4.2.
Characteristics of Subjects, Interviews, Questionnaires....
4.2 4.2.1.
General Principles 4.2 4.2.2.
Characteristics of Subjects......
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4.2 4.2.3.
Interviews 4.2 4.2.4.
Questionnaires 4.3 4.3.
Clinical Procedures......................
4.3 4.3.1.
Palpation of Thyroid Gland 4.3 4.3.2.
Ultrasound Examination....................
i 4.3 4.4.
Laboratory Procedures.....................
4.3 Central Laboratory.......................
4.4.1.
4.4.2.
Kits for Testing Thyroid Function and Anti-thyroid Antibodies. 4.3 4.3 l
4.4.3.
Indivi dual Runs........................ 4.3 4.4.4.
Control Sera.........................
4.3 4.4.5.
Inter-laboratory Comparisons I
4.4 4.5.
Pathology...........................
4.4 4.5.1.
Histopathology........................
4.4 4.5.2.
Aspiration Cytology......................
4.4 i
4.6.
Comparability of Observations.................
5.1 5.
DATA COLLECTION, STORAGE, AND RETRIEVAL............
5.1 5.1.
Assumptions..........................
5.1 5.1.1.
Data Acquisition Locations 5.1 5.1.2.
Central Data Analysis Resource 5.1 5.1.3.
Data To Be Accessioned 5.1 5.1.4.
Length of Study........................
5.1 5.1.5.
Size of Study Group......................
5.1 5.1.6 Frequency of Examination 5.1 5.1.7.
Data Storage Requirements...................
5.2 5.2.
Data Encoding and Verification System.............
5.2 5.3.
Data Recording Storage, and Analysis Resources 5.2 5.3.1.
Computer Requirements.....................
5.3 5.3.2.
Ultrasound Data........................
5.3 5.3.3.
Computer Back-up.......................
5.3 5.3.4.
Software...........................
5.4 5.3.5.
Other Equipment........................
L 6.1 6.
ANALYSIS...........................
7.1 7.
IMPLEMENTATION........................
7.1 7.1.
Personnel...........................
7.1 7.1.1.
Clinical and Laboratory Personnel...............
7.3 7.1.2.
Other Types of Personnel 7.5 7.1.3.
Procurement..........................
7.5 7.1.4.
Training........................... 7.6 7.1.5.
U.S. Participation......................
7.6 7.2.
Equipment...........................
7.6 7.2.1.
Equipment for Clinical Work.................. _,_
7.7 7.2.2.
Equipment for Clinical Laboratory Work 7.8 7.2.3.
Equipment for Pathology Laboratory Support 7.8 7.2.4.
Equipment for Computer Support 7.8 7.2.5.
Dosimetry Equipment......................
7.9 7.2.6.
Other Equipment........................
7.9 7.3.
Supplies 7.9 7.3.1.
Supplies for Clinical Work 7.10 7.3.2.
Supplies for Other Procedures.................
7.10 7.4.
Pattern of Bi-National Collaboration 7.11 7.5.
Funding............................
7.11 7.5.1.
Estimated Budgets (Years 1-3).................
7.11 7.5.2.
Sources of Funds 8.
PUBLIC ACCEPTANCE AND ADMINISTRATIVE APPROVALS 8.1 8.1 8.1.
Administrative Approvals 8.1 8.1.1.
Bel a ru s............................
8.1 8.1.2.
U.S.
8.1 8.1.3.
Informed Consent and Institutional Review...........
8.1 8.2.
Public Acceptance in Belarus 9.1 9.
REPORTS, PUBLICATIONS......................
9.1 9.1.
General Principles 9.1 9.1.1.
Scientific Publications....................
9.1 9.1.2.
Press Releases and Public Announcements............
9.1.3.
Review and Release of Scientific Reports for Publication 9.1 9.1 9.1.4.
Authorship of Scientific Reports 9.2 Transmittal of Examination Results to Subjects 9.1 10.
PROJECT HANAGEMENT 10.1 10.1.
Oversight Group.......................
10.1 10.2.
Management 10.2 1
11.
STAGES OF STUDY OVER TIME..................
11.1 11.1.
The First Six Months 11.1 11.2.
The Second Six Months....................
11.1
\\
11.3.
Year Two 11.2 11.4.
Years 3-5..........................
11.2 11.5.
Subsequent Years 11.2
- iii -
A.1 APPENDIX A.
Estimated budgets (Years 1-3)
A.1 A.I.
Personnel Costs........................
A.1 A.2.
Equipment Costs........................
A.3 A.3.
Costs of Supplies.......................
APPENDIX B.
Curricula Vitae of Principals, U.S. and Belarussian B.1 APPENDIX C.
Staffing Pattern (Belarus)................
C.1 D.1 APPENDIX D.
Organization Charts i
- iv -
1
SUMMARY
Iodine-131 (*I) and other radioisotopes of Iodine are contained in fallout from atmospheric nuclear weapons tests and are among the radionuclides most In spite of nearly 50 likely to be released in a nuclear reactor accident.
yearsofexperience,theris(ofthyroiddisease,especiallythyroidcancer, attributable to exposure to I remains unknown, although the carcinogenic potential of x-ray and gamma-ray exposure of the thyroid is reasonably well The available data also indicate that children face greater risks of known.
radiation-induced thyroid cancer than do adults.
The nuclear power plant accident at Chernobyl released large quantities of *I and other radioisotopes of iodine into the atmosphere, contaminating thousands It is proposed that a of square kilometers and exposing millions of people.
well-defined subset of Belarussian children aged 0-18 years at the time of the accident be examined by well-trained specialists for thyroid disease at least A cohort of 15,000 children has been biennially for up to 30 years.
identified, all of whom had their thyroids measured for radioactivity during the weeks immediately following the accident. Under a rigid research protocol these children will receive complete diagnostic thyroid examinations, including palpation, ultrasound scanning, thyroid hormone and other laboratory Cancer will be determined tests, and fine-needle aspiration, as appropriate.In addition to the analysis of by expert pathology examination of tissue.
thyroid radiation measurements made in May-June,1986, efforts will be made to reconstruct each person's exposure and to estimate the radiation doses to the This will involve the reconstruction of deposition patterns and thyroid.
environmental pathways of the radioiodines, and of the location, dietary characteristics, and lifestyle of each person throughout the exposure period.
The data will be analyzed to evaluate the relationship, if any, between thyroid disease, especially cangr, and the radiation dose to the thyroid, I.
The primary focus will be on dose-with emphasis on the dose from response analyses of person-year incidence data with stratification by sex, Confounding factors, age at exposure, geographic area, time, and age at risk.
e.g., use of potassium iodide (KI) as a prophylactic measure, will be evaluated and controlled in the analysis, and the uncertainty of the dose estimates will be taken into account.
In addition to producing risk coefficients for thyroid cancer and other thyroid diseases in children as a function of sex and age at the time of exposure, it is expected that the galyses will contribute new knowledge of I in comparison with that of x-ray and the carcinogenic effectiveness ofThis information will fill a major gap in the world's gamma radiation.
knowledge of radiation effects, and will provide guidance for radiation protection and public health policies wherever nuclear reactors are in operation.
- S.1 -
~
l 1.
BACKGROUND AND SIGNIFICANCE There is ample evidence that external radiation is associated with thyroid cancer, and a number of reliable epidemiological studies show that the risk is appreciable and that the thyroid gland is one of the more sensitive human tissues (Shore 1992).
Moreover, the magnitude of risk is related to age at irradiation, and higher for children than for adults. Thus, for subjects 6 excess cancers per 10,000 persons yr',the,(weighted mean) abs irradiated under the age of 20 years, Gy. Available data are consistent with a linear dose response curve over much of the exposure range, although cell killing may flatten such curves at very high doses.
It is noteworthy that risk of thyroid cancer has been associated with external radiation doses as low as 0.09 Gy (Shore 1992).
The thyroid gland is potentially at risk in the presence of radioactive This is due in part to its ability both to concentrate iodide by a fallout.
factor of about 10,000 above ambient iodide concentrations and to incorporate As a result, the iodide into thyroglobulin, which has a slow turgver rate.
effective half life of iodine isotopes (except I) is nearly as long as the physical half life.
ik There has been considerable interest in the nodule and cancer associated with internal irradiation from iodine isotopes (chiefly 'f s I, half life of 8.05 days). The most reliable data, with good statistical power, derive from long-term f,ollow-up studies of patients receiving diagnosti therapeutic doses of g I.
in these studies of mainly adult patients.
It is uncertain to what extent these results are influenced by the possibility of preexisting thyroid disease for which these procedures were carried out.
In two large studies of subjects treated for hyperthyroidism with mean doses of 88-113 Gy, similarly, there was no increase in risk for thyroid cancer. The gi,sk of thyroid disease, including cancer, resulting from exposure to I contained in fallout from atmospheric nuclear weapons tests is much more complicated, primarily because the radiation dose to the thyroid must be reconstructed.
Such dose reconstructions require known or assumed values for environmental transport and metabolic parameters.
These permit estimates of dose based upon estimates of gposure; the estimates of exposure are based upon both the of Because iodine is concentrated igthe milk of cows and of goats, personsI from f drinking milk contaminated with more highly exposed; consequently, children are likely to be more exposed than are adults because of their propensity for milk.
There have been two studies of health effects resulting from exposure to Both of these studies have fallout from atmospheric nuclear weapons tests.
In a study of dose reconstruction techniques such as those referred to above.
children (at the time of the tests) living in Utah downwind from the Nevada Test Site, the small excess of thyroid cancers was not statistically significant (Stevens et al. 1992).
The absolute risk of persons in the Marshall Islands exposed to fallout was 1.1 and 1.3 per 10,000 subjects yr
Gy" for children irradiated under 18 years of age or adults, respectively.
- 1.1 -
\\
Seven excess cancers have been observed during the 40 years since the fallout occurred.
Attempts have been made to explain the remarkable difference in the rates of thyroid-cancer induction caused by external and internal irradiation.
Dose rate is considered to play a major role: most data on external irradiation were obtained from acute doses.
In studies where divided doses were given the risk appeared to be decidedly smaller (Shore 1992).
It has been suggested that the intermediate risk of thyroid cancer for the Marshall livedisotopes(gmayjebecageabout80%ofthe.dosederivedfromtheshort-Island populatio I,
I and I; gd <10% external). By contrast the diagnostic and therapeutic use of I implies a rather low dose rate.
Whether this low Effectiveness Factor (EF) has other causes is not clear at present and animal studies are inconclusive.
The accident at Unit 4 of the Chernobyl nuclear power plant, which occurred in April 1986, was the most severe in the nuclear industry. The accident caused the death of 31 power plant employees and firemen from acute radiation exposures and burns, brought about the evacuation of 135,000 people, and resulted in the contamination of vast territories of Belarus, Russia, and Ukraine.
Radioactive materials were released into the atmosphere during a period of ten days. Theradionuclidesthatareresponp3,blejormostgthe 1
es received by members of the public are I,
Cs, and Cs. The radiation dop3'I caused high thyroid exposures, especially among children, short-lived duringthefirstfewwegsfollowingtheaccident. The longer-lived *Cs, and, more importantly, Cs, deliver doses to the entire body and will be present in the environment for decades to come.
The Chernobyl power plant is located in Ukraine, about 30 km south of the border with Belarus. The winds during the accident blew toward the north most of the time, so that the radioactive materials released were transported over the territory of Belarus. A fraction of the radioactive materials present in the radioactive cloud was deposited on the ground, essentially as a result of scavenging by precipitation.
The contamination of the ground resulted, in turn, in the contamination of milk and other foodstuffs.
In Belarus the population to be strictly controlled was estimated by the authorities to amount to 467,000 people, including 37,000 children who were less than 7 years old at the time of the accident. The content of radiciodine in the thyroid was measured in more than 200,000 persons in the first few weeks following the accident; a preliminary estimate of the thyroid doses received indicates that they ranged up to 40 Gy. The number of observed thyroid cancers among the 2,30.0,000 Belarussian children, which was about 2 or 3 per year for the country before the accident, rose to 6 in 1989, 29 in 1990, and 55 in 1991.
Since the Chernobyl accident in 1986 the staff of the Institute of Radiation Medicine, Ministry of Health, has been examining tens of thousands of children in heavily contaminated areas of Belarus. This program of case-finding has involved both fixed medical installations such as the clinic in Aksakovtchina and the Minsk Dispensary, and field teams that have made week-long expeditions to areas distant from Minsk. The examinations have routinely included ultrasonography and extensive laboratory tests.
The present proposal builds on that experience within an epidemiologic framework calculated to
- 1.2 -
create dose-pp'ecific information on the risk of thyroid disease following exposure to I.
By July 1, 1992, 131 cases of thyroid cancer had been the identified among the children of Belarus (Kazakov et al.1992).
The large population exposed to radioiodine after the Chernobyl accident permits an assessment of the extent to which radiciodine (primarily 3'I) does, in fact, lead to a significant increase in the occurrence of thyroid nodules and cancer. Although it will be important to evaluate the contribution of short-lived iodine isotopes and protracted external irradiation to the thyroid dose,theirseparateeffectsongeriskofthyroidnodulesandcancermaynot be easily isolated from that of I in this experience.
REFERENCES
- 1. Kazakov V.S., Demidchik E.P., Astakhova L.N. Thyroid cancer after Chernobyl.
Letter to the Editor. Nature 359:21; 1992.
- 2. Shore R.E.
Issues and epidemiological evidence regarding radiation-induced thyroid cancer.
Radiation Research 13:98-111; 1992.
- 3. Stevens W., Till J.E., Thomas D.C., et al.
Report of a cohort study of thyroid disease and radioactive fallout from the Nevada Test Site.
University of Utah; July 1992.
- 1.3 -
i 2.
OBJECTIVES The primary objective of this collaborative investigation is to carry out valid and credible assessments of the early and late morphologic and functional changes in the thyroid glands of persons exposed to radiation from radioactive materials released as a consequence of the Chernobyl nuclear power plant accident. The emphasis is on dose-and time-related changes among children, including but not limited to the following specific areas:
- Risk estimates, as a function of dose, for morphologic changes (i.e.,
nodules and cancer) in relation both to sex and to age in 1986; comparison of the relative effectiveness of I-131 with that of published x-ray and gamma irradiation in inducing thyroid nodules and cancer.
- Risk estimates, as a function of dose, for induction of hypothyroidism in relation both to sex and to age in 1986.
In the course of the study other possible risk factors will be examined including dietary iodine intake during and after 1986 and the ingestion of potassium iodide for thyroid protection shortly after the accident.
An evaluation will be made of the contribution of Iodine-131, of short-lived radiciodine isotopes, and of external radiation, to the radiation dore to the thyroid.
Supplemental objectives include the detection of hyperparathyroidism and lymphocytic thyroiditis and the determination of any relations to thyroid dose.
1 The investigations are designed to provide knowledge of the correlation of such thyroid diseases with radiation dose in order to assist in the mitigation of such effects on the public health.
i l
l
- 2.1 -
~
3.
METHODS 3.1.
THYROID DOSIMETRY.
The iodine-131 content in the thyroids of about 200,000 people in Belarus was measured in May-June 1986 with use of various detector systems.
The results of these mass examinations form the basis of the current estimates of individual thyroid doses in children arid adults from the Chernobyl l
accident.
Efforts are being made in Belarus to establish a thyroid-dosimetry data bank.
The individual thyroid doses will be specified on the basis of the results of the direct radiation measurements of the thyroid in 1986, of information on the extent of radioactive contamination of the territory, of data on the radioactivity of foodstuffs and water, and on the knowledge of lifestylehppits.
It is recognized that the database on the deposition density of I and of its concentration in environmental materials, e.g.I37 pasture, milk, and leafy vegetables, is rather limited. The database on Cs ismoreextensivebutthosegasurementsareonlymarginally,pelpfu,1toderive 37 I environmental levels as the I to Cs reliable information on the actigi,ty ratios igfallout were quite variable. A more appropriate surrogate for I could be I, which is a long-lived radioisotope of iodine that also wasreleasedintotheatmosphereduringthepgeident. Thus, a pilot study on the utility of contemporary measurements of I in soil and other environmental materials will g carried out. The purposes of the pilot study will be to dete gine: (1) if I fallout from Chernobyl can be readily separated from I resulting from worldwide releases from nucleg fuel'3'I 0f the I to reprocessing plants, and (2) if the spatial variability,3'I to '37 ratio in Chernobyl fallout is smaller than that of the Cs ratio.
Detailed measurements of gamma-ray emitters in soil will be required. If the pilotstudyprovidesencouragingresultsfortheprospectofdecreasipgthe uncertainty in calculated thyroid doses, the measurement program for I will be expanded.
3.1.1.
Measurements of 3'I activity in the thyroid.
3.1.1.1.
Background Information.
The gama radiation emitted during radioactive decay of the '3'I present s measured by means of radiation in the thyroids of the people examined wp3'I activity content in the thyroid detectors placed against the neck. The was derived using the calibration factor appropriate to the type of detector that was used to make the measurement.
Within a fg weeks following the accident, approximately 200,000 I activity in the thyroid of people were made in Belarus, measurements of principally in the 9 districts of the Gomel region and in the 5 districts of the Mogilev region that were the most contaminated areas of the Republic.
I
- 3.1 -
The measurements were primarily carried out with the aid of DP-5 portable gama dosimeters (Geiger-Muller detectors) and of SRP-68-01 or DRG3-02 gama radiometers (NaI(T1) scintillators), which were part of the equipment of subdivisions of the civil defense and of the facilities of sanitary inspectors (Gavrilin et al.1990).
In addition, a limited number of measurements were carried out using gama-ray spectrometers.
In the majority of cases, the subjects did not change clothes and were not decontaminated prior to the thyroid measurements.
The detector probes were not equipped with collimators, so that the gama radiation that was detected originated not only from the thyroid, but also from other organs such as the lungs (reflecting inhalation intake), from the entire body (reflecting the radiocesium activity), and from the surrounding ground (reflecting external irradiation from deposited radionuclides).
For this reason, a background measurement was taken, in some cases in the area of the shoulder, in most cases in the absence of the measured person at the same location. However, the background measurement was not sufficient in itself to refine the thyroid measurement.
Gavrilin et al. (1990) divided the thyroid measurements according to three categories of reliability:
o the highest reliability corresponds to the thyroid measurements made by qualified personnel with the aid of instruments of the SRP-68-01 and DRG3-02 types; the uncertainty in the estimated thyroid activity is judged to be no greater than 50%. Approximately 10,000 persons belong to that category; o the intermediate reliability category corresponds to the thyroid measurements made with DP-5 instruments, usually in areas of relatively low contamination; the uncertainty in the estimated thyroid activity is assessed to be from 50 to 300%. Approximately 40,000 persons are in this category; o the lowest reliability is assigned to the thyroid measurements carried out with the aid of DP-5 instruments directly at the places of residence of inhabitants of the contaminated areas. Approximately 150,000 persons are in this category.
Measurements made with the DP-5 dosimeter were sometimes carried out under conditions that deviated from the standard measurement procedures.
Fortunately, about 300 persons that were examined with the DP-5 detector were also measured with another type of detector (SRP-68-01 or DGk?-02).
This helped to resolve ambiguities as to the manner in which the DP-5 detector was used in various locations and to establish ratios of readings among instruments.
As of June 1992, the thyroid measurements related to about 120,000 persons had been processed.
- 3.2 -
1
3.1.1.2.
Work to be Done.
As these measurements were made hurriedly under conditions of stress and with different detector systems that could be operated under different conditions, it will take several years to complete a preliminary analysis of them. At that point, the entire set of data will need to be reviewed and an estimate of uncertainty prepared for each measurement. Also, retrospective quality-assurance procedures must be employed, as specified in Section 4.
A special effort will be made to rg, evaluate the responses of the I activity in the thyroid; detectors that were used to measure the (1) the calibration of the detectors will be re-assessed as a function of the energy of the incident gamma rays; (2) the influence of the size of the thyroid and of its location in the neck will be studied; (3) the importance of the presence of radionuclides other than '3'I in the body, and of radionuclides deposited on the ground, will be assessed; (4) the errors due to non-observance of the recommended procedures will detector window in an open o' closed position, detector not be examined:
placed against the neck, and influence of contamination of the skin, clothes,
)
and shoes.
Because the measurement data form a crucial database for determining the individuals to be included in the cohort, an early effort will be made to ensure that these data as complete as possible, including full names, addresses, dates of birth, and other relevant data that can be used to link to other records.
Dose reconstruction based on thyroid measurements.
3.1.2.
The tgroid measurement leads to the determination of the activity From this I in the thyroid at a particular point in time, t,,.
content of The information, the thyroid dose rate at time t, can be derived easily.the dose dosimetric endpoint of the study, however, is the time integral o[33 I in the I
rate from the beginning of the accident to the complete decay of The information needed to reconstruct thejbyroid dose resulting thyroid.
I,is:
from the intake, by inglation or by ingestion, ofI intake by the measured indiv o the history of after the thyroid measurement at time t ; ando the metabolic data to p dose.
Although the intake of '3'I was responsible for most of the thyroid dose for the majority of individuals, there also were contributions from other (a) internal irradgtion resulting from the intake of short-radionuclides:
Te; (b) internal irradiation from the livedradiciodineisogopesandofCs; and (c) external irradiation from radionuclides intake of long-lived deposited on the ground. Those contributions to the thyroid dose are considered separately.
- 3.3 -
~
3.1.2.1.
History of '3'I Intake.
The presence of '3'I in the thyroid is due to one or more of the following exposure pathways:
o inhalation of air contaminated with '3'I, o ingestion of milk (cows', goats', mothers',...) contaminated with 13'I,
o ingestion of leafy vegetables contaminated' with '3'I, and, occasionally, o ingestion o other foodstuffs (eggs,...)
or of materials (soil,...)
contaminatedwith{'I.
The thyroid doses for people with thyroid measurements have so far been estimated on the basis of simple assumptions (inhalation of radioactive materials the first day after the accident or ingestion of contaminated milk at a constant rate).
3.1.2.2.
Metabolic data.
Themetabolicgtaofinterestarethemgsofthethyroidgland,the thyroidal uptake of I, and the half-time of I in the thyroid gland.
These metabolic data vary as a function of age, intake of stable iodine, and physiological status of the thyroid.
In the absence of specific information, default values taken from the literature, such as are found in ICRP publications 23 (ICRP 1973) and 56 (ICRP 1989), have been used.
3.1.2.3.
Current estimates of thyroid doses.
Average thyroid doses and thyroid dose distributions for individuals in the 9 most contaminated districts of the Gomel Oblast and for the 5 most contaminated districts of the Mogilev Oblast have been roughly estimated on the basis of thyroid measurements of about 120,000 people (available as of The average thyroid dose received by the total population of June 1992).
those 14 districts is estimated to be approximately 0.3 Gy (Gavrilin et. al.
1992). Of particular interest are the thyroid doses received by young children. The estimated thyroid dose distribution for the population of the children in the 14 contaminated districts of Gomel and Mogilev who were less I
than 7 years old at the time of the accident (46,660 children) is presented in l
Table 3.1.1.
The thyroid doses range up to 40 Gy, and about half of the doses i
are less than 0.3 Gy. The arithmetic means of the thyroid doses estimated for urban and rural children are presented in Table 3.1.2; rural children are estimated to have received thyroid doses about twice those received by urban i
i children.
l l
- 3.4 -
Table 3.1.1.
Extrapolated thyroid dose distribution among children of the most heavily contaminated Districts of Belarus who were less than 7 years old at the time of the accident (Gavrilin et al.1992).
Thyroid dose 9 Districts of 5 Districts of 14 Districts of range (Gy)
Gomel Region Mogilev Region Gomel and Mogilev (32420 children)
(14240 children)
Reaions (46660) number number number 0 - 0.3 15128 46.66 9637 67.68 24765 53.08 0.3 - 0.75 8951 27.61 2975 20.88 11926 23.55 0.75 - 2 4924 15.18 1345 9.45 6269 13.44 2-5 2428 7.49 251 1.76 2679 5.74 5 - 10 693 2.14 28 0.20 721 1.55 10 - 20 274 0.85 4
0.03 278 0.60 20 - 30 20 0.06 20 0.04 30 - 40 2
0.01 2
<a.01 Table 3.1.2.
Estimated arithmetic mean thyroid doses to children under age 7 in the most contaminated Districts of Belarus (Gavrilin et al.1992).
Oblast Number of Population Population Mean thyroid Districts type size dose (Gy) q Gomel 9
Rural 23900 1.06 Urban 8600 0.44 Mogilev 5
Rural 9300 0.44 Urban 4900 0.21 Gomel &
14 Rural 33200 0.88 Mogilev Urban 13500 0.36 3.1.2.4.
Work to be Done.
The thyroid dose estimates will be refined using the answers to a detailed questionnaire requesting individual information on residence history, dietary habits, and use of potassium iodide. Topics for such a questionnaire are provided in Section 3.4.1.
The refinement of the thyroid-dose estimates through the analysis of the questionnaire constitutes a major activity that may take se*>eral years. A special effort will be made to determine if and when each individual ingested potassium iodide for prophylactic reasons as this will affect the metabolic data, and in turn, the dose conversion factors to be applied.
- 3.5 -
The variation in time of the intake of '3'I wi]31 be ascertained for I from inhalation and In principle, the relative intakes of In fact, the individual.
fromingestionaresufficienttodetermgethethyroiddose.I would be extremely valuable as the absolute values of the intake rates of would provide a way to validate the dose rate obtained from the thyroid measurement.
In the case of inhalation, knowledge of the variation with time of the
'3'I concentrations in ground-level air would be desirable.
In the case of ingestion, knowledge would be desirable not only of the
'3'I concentrations in the foodstuffs consumed but also the places where the foodstuffs were grown and whether they were grown privately or on a collective or state farm.
The information available on the environmental concentra on the commercial distribution of foodstuffs will be provided by Belarus.
Contribution of Short-lived Radiciodines and of '33re.
3.1.3.
3.1.3.1.
Background Information.
f '3'I within a short time after the k
accident (upto5 days),gtionintaeoI is expected to have been accompaged In the case of inha substantial amounts of short-lived radiciodines (principally The whichcontributedtosomeextenttothethyroiddose(Figurg3.1.1).Te decreases with relative importance of the short-lived radiciodines and of In the extreme case of a single inhalation corresponding to the radionuclide compogtfon in the time after the accident.
I in the body) from short-lived radiciodines and from Te (vigdecay toIt is, however, possible I.
would be almost equa],,to the thyroid dose fromTe released may not have been that the amounts ofthe radionuclide composition in fuel because of filtration effe environmental release.
In the case of ingestion, the delay between deposition on the ground an ingestion of contaminated foodstuffs is assumed to be long enough to ensur that short-lived radiciodines did not contribute substantially to the thyroid In addition, the transfer of tellurium from deposition to milk is much dose.
less efficient than is that of iodine.
3.1.3.2.
Work to be Done.
Because the dose from short-lj3,ed radionuclides would have been de v I, thereby possibly affecting the at dose rates higher than that ofinduction of thyroid cancer, it is importa radionuclides be recorded separately.
The thyroid doses from short-lived radioiodines and from '32 Te will be estimated for individuals who were exposed through inhalation withi after the beginning of the accident.
- 3.6 -
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measurements of radiciodines and of '32Te concentrations in the thyroids of people monitored within 48 hours5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> after the beginning of the accident.
Contribotion of External Irradiation and of Internal 3.1.4.
Irradiation from Radiocesium to the Thyroid Dose.
3.1.4.1.
Background Information.
External irradiation from radionuclides deposited on the ground and internal irradiation from incorporated radiocesium result in doses that are gemost relatively homogeneous over the whole body including the thyroid.
Cs that important contributor to this component of the thyroid dose is the will be present in the environment for tens of years and will deliver doses at Forpeoplewhohavehadthesamgresidenceanddietaryhabits low rates.
Cs are expected to be much since the accident, the g roid doses fromHowever, for people who received relatively low I.
smaller thagthose fromI, either because they were away from a contaminated area du doses from the month following the accident and later moved to a contaminated area, or because they found themselves out of the path of the radioactive cloud and refrained from eating contaminated foods during the month following the accident, the thyroid doses from external irradiation from radionuclides deposited on the ground and internal irradiation from incorporated radiocesium may be relatively important.
3.1.4.2.
Work to be Done.
The thyroid doses resulting from external irradiation from the radionuclides deposited on the ground will be estimated fogeach individual on the basis of (a) the measurements of exposure rate and of Cs deposition densities at the locations where individuals spent a substantial amount ofIt is time, and (b) personal data on physical location as a function of time.
recognized that the database on exposure rates in the few weeks following the accident is rather limited. Thus, a pilot study on the utility of contemporary measurements of total exposure in appropriate materials (ceramics, china, tiles, etc.) will be carried out by means of thermoluminescent radiation measurements.
d doses resulting from consumption of foodstuffs contaminated Thethyrg3Cs will be estimated on the basis of whole-bg measurements with *Cs and Cs in the food of radiocesium combined with (a) measured concentrations of consumed at the locations of interest, and (b) personal data on consumption rates obtained from the questionnaire on personal history (See section 3.4.1).
Doses from external irradiation and internal irradiation from radiocesium should be recorded separately.
Estimation of Uncertainties Attached to the Oose Estimates.
3.1.5.
The uncertainties attached to (a) the concentration of '3'I in the thyroid derived from thyroid measurements, (b) the dose received before the thyroid measurement, and (c) the dose received after the thyroid measurement,
- 3.8 -
~
will be estimated and combined to obtain the uncertainty related to the thyroid dose for each individual.
If feasible, a stochastic model will be developed to estimate the probability distribution of the thyroid dose for each individual.
3.1.6.
Dose to Fetal Thyroids.
It is likely that a substantial number of pregnant women had their As the fetal thyroid develops thyroids measured following the accident.
during the last six months of gestation, it may receive fairly large doses if exposed to radiciodines. A special stochastic model to calculate the distribution of expected fetal thyroid gse will be developed. The evaluation of the fetal dose will be based on the I content of the mother's thyroid and on information about her dietary habits.
COHORT STUDY OF MORPH 0 LOGIC AND FUNCTIONAL CHANGES 3.2.
SAMPLING PLAN:
3.2.1.
Obiectives To Be Addressed by Samolina Plan.
Since the full carcinogenic potential of the radioiodines is unknown, while that of gamma and x radiation is well known and is highly effective, the primary objective of the plan is to select samples likely to be adequate to establish risk coefficients for radioiodine of sufficient precision to establish whether they differ to an important degree from those for external exposure to gamma and x radiation. Risk estimates are needed per unit radiation dose for children at the time of exposure.
A secondary objective is to establish time-response functions for radiogenic thyroid cancer and nodules, particularly with respect to the Also of interest is distinction between absolute and relative risk models.
the determination of the minimum latent period and, ultimately, the duration of the carcinogenic effect.
Functional changes are also of interest but because there is no known basis for estimating their frequency at the thyroid doses presently estimated, the sampling plan is necestarily dictated by the presumed neoplastic effect.
3.2.2.
Selection of Samole.
3.2.2.1.
General.
Appropriate sample selection should minimize the likelihood of bias and Since the provide sufficient power to attain the objectives of the study.
cohort is expected to be defined on the basis of a pre-existing file of subjects with estimated thyroid doses, the potential bias to be guarded against is that arising from any preferential inclusion in that file of Since measurements were subjects with both thyroid symptoms and high doses.
made early, before radiogenic thyroid effects could appear, one would no expect the sampling to introduce bias.
were reconstructed because they presented with thyroid symptoms and there was a presumption of radiation etiology because of high levels of exposure, then
- 3.9 -
the inclusion of such subjects could introduce bias into the study to some degree depending on their number. More needs to be known about the way in which subjects were chosen for measurement and dose-reconstruction, but in general the more independent the selection was of etiologic presumptions the less likely the bias.
Such considerations might lead to the rejection of certain segments of the file defined on the basis of the circumstances surrounding dose reconstruction, or the absence of measurements in the weeks immediately after the accident.
Children aged 0-18 or in utero at the time of the accident are to be tht.
subjects of the study.
Subjects in utero will be restricted to those with maternal thyroid measurements.
3.2.2.2.
Availability of Dose Estimates.
The sampling strategy will be to select all eligible subjects with estimated doses above a certain value and to choose at random an appropriate number from among those at a lower dose level. Table 3.2.1 provides preliminary distributions of thyroid doses among children. All children exposed in utero will be included.
3.2.2.3.
Other Criteria of Eligibility.
Any other criteria of eligibility will have to be developed.
For example, it might also depend on residence in certain regions accessible to the examining centers and visiting teams.
3.2.2.4.
Limiting Dates for Study Operations:
For both morphologic and functional changes an entirely prospective approach will be taken so that ascertainment begins with the initial examination.
For morphologic changes, person-years of exposure will be calculated from the initial examination. Since functional changes are likely to be viewed in terms of their prevalence, rather than incidence, a variable date of survey should not introduce undesirable statistical complications.
The importance of the topic merits a long term (30-year) survey. In addition, a retrospective assessment of thyroid cancer in the cohort will be made since the cohort is defined on the basis of thyroid measurements made in 1986.
3.2.3.
Study Cohort 3.2.3.1.
General Considerations This is a gospective cohort (follow-up) study of children who received a wide range of I doses.
As such it provides opportunities to examine the dose-response relationship between 'gI and thyroid gi,sease, especially cancer, and to evaluate risks at (relatively) low doses of I.
There are two basic questions pertaining to statistical power. One is whether the study has a high probability of detecting a significant effect (i.e., testing the null hypothesis), given the number of persons with documented thyroid doses and the distribution of doses.
The other pertains to whether the study has power to discriminate among various theoretically
- 3.10 -
e expected sizes of effects (i.e., magnitude of risk per unit dose).
Specifically,the,reisarangeofuncertaintyregardingtheEffectiveness Factor (EF) of I relative to acute external radiation exposure in inducing thyroid cancer (or other thyroid lesions), and data from this study will provide needed information concerning the EF. An attempt has also been made to evaluate the statistical power and the " discriminating power" of the proposed study, as described below.
Estimates of the statistical power and discriminating ability of the study are made here with respect to thyroid cancer, the most important health endpoint in question.
Thyroid adenomas or nodules show elevations in risk following thyroid irradiation similar to that of thyroid e.ancer.
- However, since adenomas or nodules occur several times more frequently than thyroid cancer, there should be greater statistical power to detect dose relationships for them than for thyroid cancer. Therefore, statistical power will not be analyzed with respect to adenomas or nodules; the thyroid cancer results will be used as a lower bound estimate of power for these endpoints.
3.2.3.2.
Assumptions.
Because the correct parameters for projecting the probable results of the study are unknown, several combinations of parameters were examined.
(A)
Period of Risk.
For the purpose of calculating sample size it was l
assumed that thyroid cancer risk would begin five years after irradiation, an assumption in keeping with the findings of other studies of radiogenic thyroid cancer, and would continue indefinitely. Other studies have documented protracted elevations in thyroid cancer risk, extending out to over 45 years after irradiation.
(B)
Lenoth of Follow-uo. The results of a study for 30 years at risk (i.e., after an initial four years when no risk was assumed) are examined.
Similarly, the results at the end of 15 years at risk are examined.
(C)
Risk Model and Risk Coefficients. There is disagreement in the literature regarding the choice of a risk model (for acute external irradiation). The NCRP (1985) and L'NSCEAR (1988) used a linear absolute excess risk model, while the BEIR V Report (NAS-NRC 1990) used a linear excess childhoodirradiation(uptoage18)is2.5casesper10[iskcoefficientfor relative risk model.
The NCRP/UNSCEAR absolute excess persons per Gy per year. The NCRP built in a further two-fold sex difference by multiplying this coefficient by 4/3 for females and 2/3 for males.
However, since the Belarus population with estimated doses is approximately equally divided by sex, use of the overall risk coefficient would give a good estimate of the combined sex-specific results, and sex-specific risks are not needed.
childhood irradiation is 7.3 per Gy.ps relative risk (ERR) coefficient for The BEIR V (NAS-NRC 1990) exce Since male and female baseline thyroid cancer rates differ approximately in proportion to their radiation sensitivity i For example, an ERR = 7.3 implies that the relative risk at 0.5 Gy = 1 + 0.5
- 7.3 - 4.65; at 2 Gy the RR = 1 + 2
- 7.3 = 15.6, etc.
- 3.11 -
~
(i.e., the ERRS are about the same for both sexes), there is no need to build in a sex-specific factor for this either.
One could also potentially evaluate the statistical power characteristics of non-linear functions of dose.
However, the evidence to date suggests that the dose-response relationship is reasonably linear, so non-linear curves will not be examined.
(D)
Biolocical Effectiveness of Iodine-131.
Since estimates of the Effectiveness Factor (EF) for ""I to acute external radiation haveganged from 1 to 1/10, several were evaluated. The NCRP suggested that "
I be considered to be no more than one-third as effective as external radiction in the induction of thyroid cancer" (NCRP 1985, p. 54). To cover the range, EFs of 1,1/3,1/6 and 1/10 were therefore evaluated.
(E) Lgsses to Follow-Uo.
It was assumed that over a 30 year period the continued participation rate would be 50%.
It was therefore assumed that the number on study would decrease as a negative exponential with time until it reached 50% at the end of 30 years. This implies that the average percent on follow-up over the 30 years would be 72%.
For a 15-year study the average percent on follow-up would be 85%.
(F)
Number of Study Sub.iects. The number of juveniles with dose measurements according to dose ranges was provided by Dr. Minenko (letter to Dr. A. Bouville,12/8/91) and is presented in Table 3.2.1.
In addition to showing the full cohort with measured thyroid doses (about 27,000), the table also gives for comparison other options for a reduced number of subjects, under the assumption that logistical and resource constraints will limit the number of subjects. The options considered were 21,000 and 15,000 total study subjects.
(G) Foontaneous Thyroid Cancer Rates. To estimate spontaneous thyroid cancer risk, rates from Slovakia and the (former) German Democratic Republic (Waterhouse et ai.1982) were averaged, after weighting each by 50% female and 50% male.
(Slovakia and the GDR are the two largest tumor registries in Eastern Europe.) To obtain estimated aurage rates for the childhood cohort over the period of follow-up, thyroid cancer rates for ages 5-44 were averaged, which yielded a rate of almost 2 per 100,000 persons per year, so an average incidence of 2/100,000 was used as the baseline rate for the cohort.
If screening appreciably elevates the rates of detected thyroid cancer over an extended period of time (e.g, the Hiroshima-Nagasaki data (Prentice et al. 1982) suggest that repeated screening may double the rate of diagnosed thyroid cancer), then these rates may be too low.
If so, then the statistical power results to be reported here err on the conservative side.
3.2.3.3.
Statistical Power.
The statistical power of the study to detect a dose-response relationship for *I radiation was estimated for various scenarios, using the method of Nam (1987) adapted so as to calculate statistical power rather than sample size and to incorporate a correction for continuity (Mantel 1963).
By convention, a statistical power of about 80% is usually considered adequate, although 90% or better is desirable.
- 3.12 -
Table 3.2.2 indicates that a 30-year study shows adequate statistical power with either the excess relative risk (ERR) or the absolute excess risk (AR) model, even if the Effectiveness Factor (EF) is as low as 1/6.
The results for the ERR model are marginal with an EF - 1/10, but they are adequate for the AR model.
For a 15-year study the power is adequate if EF is 1/3 or greater with either model.
For the 15-year ERR model, the statistical power is marginal for EF - 1/6 and inadequate for EF = 1/10.
For the 15-year AR model, the power is adequate for EF - 1/6 or higher, but marginal for EF -
1/10. Hence, for most of the projections, which cover a wide range of EFs, J
the statistical power ranges from marginal to excellent.
It is notable in Table 3.2.2 that the statistical power does not change greatly as the sample size goes form 27,000 to 21,000 to 15,000.
The sampling strategy was to retain all the higher-dose persons in the study, since there are fewer of them than of the low-dose persons. The effect of this choice was that the statistical power diminished only modestly as the sample size decreases. Had there been a proportional diminution in the number of higher-dose subjects, the statistical power would have dropped appreciably more. The results shown in Table 3.2.2 are a good indication that a smaller sample can i
be used with minimal statistical loss.
l
- 3.13 -
~
Tab]"e 3.2.1.
Alternative Sample-Size Plans:
Numbers of Subjects (Ages 0-18 at I Exposure) According to Measured Thyroid Dose Range, and Expected Numbers of Spontaneous Thyroid Cancers Dose Assumed No. Subiects Exoected Cancers Group Mean N=
N=
N-N=
N-N-
6 d
(Gy)
Dose 27.000 21,000*
15,000 27,000 21,000 15,000 0-0.3 0.15 13,556 7,339 3,988 5.9 3.2 1.7 0.3-1 0.55 8,631 8,631 5,982 1.7 3.7 2.6 1-2 1.4 2,803 2,806 2,806 1.2 1.2 1.2 2-5 3.2 1,743 1,743 1,743 0.8 0.8 0.8 5-10 7.1 370 370 370 0.2 0.2 0.2 10+
15.0 111 111 111 0.05 0.05 0.05 Total 27,217 21,000 15,000 Total No. Spontaneous Cancers for:
30-yr Study 11.8 9.1 6.5 15-yr Study 6.9 5.4 3.8 Spontaneous cancers given for a 30-year study.
Number of subjects with measured thyroid doses in the stated ranges, according to data provided by Dr. Minenko (Minsk, Belarus).
Dose group 0-0.3 Gy was reduced in size to permit a total of 21,000 study subjects.
Lowest two dose groups were reduced in size to permit a total of 15,000 subjects, but to keep 2/3 as many subjects in the 0-0.3 Gy group as in the 0.3-1 Gy group.
- 3.14 -
i i
l
=
Table 3.2.2.
Statistical Power (Percent) for Dose-Response Analyses under gcess Relative Risk and Absolute Excess Risk Models, Assuming Various "True" I Effectiveness Factors and Follow-Up Periods of 15 or 30 Years.
Based on Total Sample Sizes of 27,000, 21,000 or 15,000 Subjects PERCENT STATISTICAL POWER l
Follow-up Relative Risk Model Absolute Risk Model Period /
'3'I Effectiveness Factor
'3'I Effectiveness Factor Sample Size 1
1/3 1/6 1/10 1
1/3 1/6 1/10 30-vr Follow-un N = 27,217
>99 97 83 67
>99
>99 95 84 N = 21,000
>99 96 81 64
>99 99 93 82 N - 15,000
>99 94 78 61
>99 99 92 79 15-vr Follow-uo r
N = 27,217
>99 89 71 54
>99 97 86 71 N - 21,000
>99 87 68 51
>99 96 83 69 N - 15,000 99 84 64 48
>99 95 80 65 1
I 4
h n
i i
f
- 3.15 -
3.2.3.4.
Discrimination among Effectiveness Factors for
- I.
The second major statistical-power question pertains to how well the projected study is likely to be able to discriminate among various Effectiveness Factors (EFs).
The primary concern is whether, if the EF is in fact less than one (e.g., 1/3, 1/6 or 1/10), the study would have enough orecision to " rule out" (i.e., be incompatible with) a risk of the magnitude corresponding to an EF of one.
To examine this issue, projected dose-response data were generated for the various scenarios shown in Table 3.2.3.
For these simulated data, the risk coefficients and their associated confidence intervals were calculated with the AMFIT program that is used for most of the Japanese atomic-bomb analyses of cancer data (Preston et al.1991).
The question, then, is whether the unoer 95% confidence limit for an analysis with an EF < 1 is lower than the risk coefficient (i.e., central estimate) generated when the EF - 1.
If the upper confidence limit is lower, then the study would probably have the ability to discriminate between the particular EF and an EF of one.
Table 3.2.3 presents confidence intervals for the EFs of 1/3,1/6 and 1/10, scaled to the corresponding risk coefficient when EF-1 (i.e., the risk coefficients that are given in assumption (C) above). A description of how to interpret the confidence interval data is given in the footnote to Table 3.2.3.
Under either the relative or absolute models of risk, a 30-year study would be able to " rule out" (i.e., be incompatible with) an EF - 1 if the true EF were 1/6 or 1/10 (Table 3.2.3).
If the true Ef were 1/3, then a 30-year study would have marginal / inadequate ability to rule out an EF-1.
For a 15-year study, an EF-1 would likely be ruled out if the true EF were 1/10, and marginally so if the EF were 1/6.
It is unlikely that an EF of 1/3 could be discriminated from an EF of 1 in a 15-year study.
As expected, sample sizes of 21,000 or 15,000 have less discriminating power than one of 27,000. Nevertheless, the differences are relatively moJest.
If the baseline thyroid cancer rates are indeed higher than the conservative ones used here, as has been suggested by the recent Belarus reports of high rates of childhood thyroid cancer, either because of the repeated systematic screening (as mentioned above) or other factors, then the discriminating power with a sample of 15,000 will increase over what has been shown here.
3.2.3.5.
Discussion and Summary.
For a 30-year follow-up, the proposed study has good statistical power to detect g excess risk of thyroid cancer, even if the Effectiveness Factor (EF) for I is as low as 1/6, with some potential to detect an excess if the EF is 1/10. A 15-year study shows somewhat less statistical power; the power is good for EFs of I or 1/3, and moderate for an EF of 1/6.
There is an excellent prospect that the 30-year study will be able to discriminate EFs of 1/6 or 1/10 from an EF-1, but less prospect of a discrimination between EF-1 and EF-1/3.
- 3.16 -
I Table 3.2.3.
Range of Compatible *I Effectiveness Factors based on Dose-Various ' Analyses under Relative Risk and Absolute Risk Models, Assuming
Response
1 I Effectiveness Factors and Follow-Up Periods of 15 or 30 Years.
Based on Total Sample Sizes of 27,000, 21,000 or 15,000 Subjects Relative Risk Model Absolute Risk Model Date of
- I Effectiveness Factor
- 1 Effectiveness Factor Birth 1/3 1/6 1/10 1/3 1/6 1/10 30-vr Follow-uo N - 27,217 0.1-1.0 0-0.6 0-0.4 0.1-1.0 0.1-0.5 0-0.4 N - 21,000 0.1-1.3 0-0.7 0-0.5 0.1-1.3 0-0.6 0-0.4 N - 15,000 0.1-1.6 0-0.9 0-0.7 0.1-1.7 0-0.8 0-0.5 15-vr Follow-un N - 27,217 0.1-1.5 0-0.9 0-0.7 0.1-1.4 0-0.7 0-0.5 N - 21,000 0.1-1.9 0-1.1 0-0.9 0.1-2.0 0-1.0 0-0.7 N - 15,000 0-2.7 0-1.5 0-1.2 0-2.9 0-1.3 0-0.9 NOTE:
Interpretation of the values in the table:
The tabled values give the confidence intervals on the expected data with Effectiveness Factors (EFs) of 1/3,1/6 or 1/10, divided by the coefficient of risk when EF-1.
Thus, when a confidence interval encompasses 1, this means that the study could not rule out an EF of 1 if the "true" EF was the stated value (e.g., 1/3).
- However, when the upper bound of the confidence interval is less than 1, this means that if the "true" EF in the population was the stated value, the study would have the capability of " ruling out" an EF-1 (i.e., the expected confidence interval would exclude the risk estimate value for an EF-1).
Similar comparisons can be performed for other EFs.
For example, if the upper bound for an EF - 1/10 is less than 0.33, then an EF of 1/3 could be distinguished from an EF - 1/10.
- 3.17 -
These results need to be viewed in the perspective of the other '3'I studies available currently or in the foreseeable future.
Since the data on external radiation exposure of the thyroid gland have shown that children are at much higher risk from thyroid radiation exposure than adults (Akiba 1991),
childhood data are clearly needed to assess risk and establish exposure guidelines. gof the currently available childhood studies of thyroid cancer risk from
'I has had adequate statistical power to detect an elevation 1988; Rallison et al.1990; Shore 1992; Stevens et al.1992).p9; Holm et al.
in risk commensurate with even an EF of 1 (Hamilton et al.19 This is because the sample sizes of juveniles were appreciably smaller and the dose distributionsmuchlowerthanintppproposedstudy. As to a comparison with the ongoing Hanford environmental I study, a precise comparison cannot be made because of the limited amount of information available concerning it (Cate et al.1990).
Nevertheless, two features stand out:
(a) the present study has measured thyroid doses, whereas the Hanford cohort will have only crude dose estimates based on models of air dispersion, milk consumption, etc.
(b) the number of subjects at high dose levels in this study appears to be much greater than in the Hanford study, which means that the proposed study will have appreciably greater statistical precision and power.
In conclusion, this study has the potential to provide better scientificinformationthfnanyotherstudyontwokeyissues:
(a) on the magnitude of effects of I exposure in young people, whge the current data are very sparse, and (b) on the magnitude of effects of I relative to those expected from a similar dose of external radiation.
Based on the calculations of statistical power and precision, it is concluded that a sample of 15,000 (aged 0-18 or in utero at the time of the accident, and including all measured persons with estimated doses of one or more Gy plus a random sample of those withlowerdoses)isreasonablyadequatetoprovideigportantinformation about the human thyroid cancer risk associated with ' I.
Therefore, the sampling plan will include all subjects with estimated thyroid doses greater than 1 Gy, and additional randomly selected subjects (aged 0-18 at the time of the accident), and all in utero subjects with maternal thyroid measurements.
2 This excludes the Marshall Islands study, because over 80% of the dose in this study was from short-lived radioiodines or external radiation.
(Lessard, E. et al. 1985).
- 3.18 -
3.3.
CLINICAL AND OfAGNOSTIC METHODS.
To ensure uniformity in detection and interpretation of clinical and diagnostic findings, key individuals will receive training (primarily in the U.S. A.) in the performance of thyroid palpation, thyroid ultrasound, thyroid j
cytology and pathology, and clinical chemistry. These individuals will i
instruct others in Belarus in the methods to be employed.
(See section 7.1.4 on training). Screening frequency and intensity should be independent of dose and other risk factors, and, to the extent possible, examiners should not be aware of the estimated dose.
3.3.1.
Paloation and Ultrasound Examination.
1 Palpation and ultrasound examination of the thyroid gland will be performed at intervals of (preferably) one or (at most) two years. Two examiners, one of whom may be the ultrasonographer, will assess thyroid size and nodular characteristics independently. The findings will be drawn over a diagram of the neck, and any nondiffuse structural features will be labeled; e.g., nodules, pyramidal lobe, local lymph nodes, hardness and local tenderness, etc.
Palpability does not, in and of itself, necessarily signify enlargement or abnomality. A uniform size classification system should be adopted.
This will be the WHO classification, since it will be more widely understood outside of the former Soviet Union (Table 3.3.1).
Table 3.3.1.
WHO Classification of Goiter, Size (Dunn and VanderHoar 1990).
Er_itda Descriotion 0
No goiter.
IA Thyroid lobes larger than ends of thumbs.
IB Thyroid enlarged, visible with head tilted back.
2 Thyroid enlarged, visible with neck in normal position.
3 Thyroid greatly enlarged, visible from about 10 meters.
Thyroid pathology will also be assessed by ultrasound examination.
The ultrasound examination will also be used to measure the size of the nodules and the overall size of the gland. A positive finding by either method will require further follow-up.
Standardized protocols for ultrasound imaging will be followed for all subjects in the study and the data recorded on videotapes.
The video-recorded data will be digitized at the Clinical Center and the data stored in machine-readable fomat for image analysis and high-quality image display.
- 3.19 -
i
3.3.2.
Ascertainment of Thyroid Cancer.
The health authorities of Belarus will be expected to:
Establish indications for fine-needle biopsy and uniformly apply them for all subjects of the thyroid cohort study.
Inform the subject's physicians and appropriate family member (s) of the results of the thyroid aspiration.
Establish uniform criteria for surgical intervention and apply them uniformly to all appropriate subjects.
Cytology slides will be preserved for reevaluation and review.
When surgical excision is performed, a gross description of the surgical specimen will be made, blocks from nodular and paranodular (normal) tissue will be preserved, and slides will be sent for review by the consulting Additional samples from normal and pathological tissue will be pathologists.
quick-frozen and preserved at -70 degrees Celsius.
3.3.3.
Ascertainment of Hvoothyroidism.
Serum (not plasma) will be obtained at 1 or 2 year intervals for by immunoassay.
Serum should be measurement of TSH, free T4 and total T4 separated as soon as feasible from red cells and hemolysis should be kept to a Abnormal test results will be repeated at least once before minimum.
replacement therapy is begun, and will be correlated with findings on history Duplicate serum samples will be stored at -20 C or and physical examination.
lower in separate freezers for reevaluation or for confirmatory tests such as If free T4 measurements are found to be satisfactory, total T4 T immunoassay.
measurement may be discontinued after the first year.
3 3.3.4.
Ascertainment of Iodine Nutrition.
Iodine nutrition will be evaluated by urine iodine content and will be Randomly selected urine samples will be performed once during the study.obtained from subjects in each district (raio and at the University of Massachusetts for total iodine and creatinine.The Results will be reported as iodine / creatinine ratio and,g iodine /dl.
total sample examined at the University of Massachusetts will not exceed 1,000 subjects.
- 3.20 -
3.3.5.
Ascertainment of Lymoboevtic Thyroiditis.
Serum obtained under 3.3.3 will be used to measure antithyroid peroxidase (Anti-TPO) at 1 or 2 year intervals.
Serum will be stored for reevaluation and for determination of antithyroglobulin antibodies in cases positive for antimicrosomal antibodies.
3.3.6.
63certainment of Hvoeroarathyroidism.
Serum obtained under 3.3.3 at 1 or 2 year intervals will be used to measure calcium and albumin. Serum will be stored as above for reevaluation and for immunoassay of parathyroid hormone in cases with hypercalcemia.
3.3.7.
Central Laboratory.
Blood tests will be performed in the central laboratory in Minsk, especiali f organized and equipped for this study.
Selected duplicate urinary samples will be measured at the University of Massachusetts in Worcester.
3.4.
INTERVIEW. OUESTIONNAIRE PROCEDURES. AND EXAMINATION RECORDS.
3.4.1.
Information on Personal History.
3.4.1.1 Information for Dosimetry.
The following topics will be developed in a format for interview, with cross-checks, and pre-tested:
A. Location 26 April - 30 June, 1986 Residence Occupation Fraction of time spent outdoors Main type of building material used in the residence and in the workplace (or school)
B. Milk Consumption 26 April - 30 June,1986 Amount of milk consumed daily Type of milk consumed (cow's, goat's, mother's..)
Origin of milk consumed (privately owned animal, collective farm,..)
Changes in amounts, type, and origin of milk consumed in this period C. Consumption of Leafy Vegetables 26 April - 30 June,1986 kaount of leafy vegetables consumed daily 1986 Type of leafy vegetables consumed (lettuce, scallions,...)
Origin of leafy vegetables consumed (own garden, collective farm,..)
Changes in amounts, type, and origin of leafy vegetables consumed in this period
- 3.21 -
D. Iodine Prophylaxis Administered or not?
If administered:
Type of medication (pills, drops,..)
Date when medication was first taken Number of times medication was taken Duration E. Medical Irradiation (Before and After the Accident)
Irradiation of any part of the body for therapeutic purposes (dates, reason for treatment, place of treatment)
Fluorographic examinations (dates, reasons, places) radon baths, thyroiduptakewith,gte Self-administered procedures:
I and other studies Radionuclide studies:
Out-of-region medical care 3.4.1.2.
Information on Medical History.
o Patient's history:
General health status Physical development Neuropsychological development Sexual development Abnormal thyroid function (high/ low)
Goiter Surgery for thyroid disease Tracheal or esophageal Compression o Medications for thyroid Iodine prophylaxis-side effects (skin rash, fever, neck pain, other)
Other (iodine, thyroid hormones, antithyroid drugs):
type, dosage, duration o Family history Abnormal thyroid function Goiter Surgery for thyroid disease i
o Iodine nutrition Goiter in community 3.4.2.
Information from Medical Examination.
o Physical examination General health Physical and sexual development Signs of thyroid dysfunction (pulse, skin, hair, eyes, neuromuscular)
Thyroid size (WHO classification)
Thyroid nodule (s)
Location (diagram)
Size, consistency, mobility, pain
- 3.22 -
Cervical lymph node (s) location (diagram)
Size, consistency Tracheal deviation Laryngeal nerve damage o Ultrasound Thyroid gland Volume Homogeneity, calcification nodule (s) (location, size, echogenicity)
Cervical lymph node (s) (location, size) o Tests performed TSH, T, Free T, anti-TPO, Calcium, Albumin 4
4 T, anti-Tg, Tg, PTH 3Urine iodine 3.4.3.
Information for Record Linkaae.
All records should contain a uniform set of identifiers that remain to be established.
In addition to full name and sex, information needed includes:
the full date of birth, any passport number of the subject, and, for a child without a passport number, full name, date of birth, and passport number of father or mother.
REFERENCES Akiba S. What should be done in thyroid cancer studies in the future?
Brit. Inst. Radiol. Rpt. 1991; 22:67-68.
Cate S, Ruttenber A, Conklin A. Feasibility of an epidemiologic study of thyroid neoplasia in persons exposed to radionuclides from the Hanford nuclear facility between 1944 and 1956. Health Phys. 1990; 59:169-178.
Dunn, JT, Van der Hoar F. A practical guide to the correction of iodine deficiency.
WHO Technical Manual No. 3, 1990.
Gavrilin Yu.I., Gordeev K.I., Ivanov V.K., 11'in L.A., Kondruser, A.I.,
Margulis U.Ya., Stepanenko V.F., Khrushch V.T., Shinkarev S.M.
Estimation of thyroid radiation according to the results of radiation internal monitoring of the Byelorussian population after the Chernobyl accident:
Features and results.
BECMHYR AMN, No. 2, pager 35-43; 1992.
Gavrilin Yu.I., Gordeev K.I.,
Ivanov V.K., 11'in L.A., Margulis U.Ia.,
Stenapenko V.F., Khrushch V.T., Shinkarev S.M.
Thyroid irradiation levels in inhabitants of Belorussian SSR exposed to radiation effect from the accident at the Chernobyl nuclear power plant. Paper presented at the WHO meeting in Chernigov, December 1990.
Hamilton P, Chiacchierini R, Kaczmarek R.
A Follow-up of Persons who had Iodine-131 and Other Diagnostic Procedures during Childhood and Adolescence.
CDRH-Food & Drug Administration, Publ. FDA 89-8276, Rockville, MD, 37, 1989.
- 3.23 -
Holm L, Wiklund K, Lundell N, et al. Thyroid cancer after diagnostic doses of iodine-131: A retrospective cohort study.
J. Natl. Cancer Inst. 1988; 80:1132-1138.
ICRP Publication 23. Report on Reference Man. Pergamon Press; 1973.
ICRP Publication 56. Age-dependent doses to members of the public from intake of radionuclides: Part 1. Chapter 7. Iodine; pp. 45-51. Pergamon Press; 1989.
Lessard, ET, Miltenberger RA, Conard RA, et al.: Thyroid absorbed dose for people at Rangelap, Utirik, and Sifo on March 1,1954. Brookhaven National Laboratory, Upton, NY. BNL 51882, 1985.
Mantel N. Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure. J. Am. Stat. Assoc. 1963; 58:690-700.NAS-NRC.
Health Effects of Exposure to Low Levels of Ionizing Radiation (BEIR V).
National Academy of Sciences - National Research Council.1990; National Academy Press, Washington, DC, 421 pp.
NCRP. Induction of Thyroid Cancer by Ionizing Radiation. National Council on i
Radiation Protection and Measurements. Bethesda, MD. 1985; Report No. 80, 93 l
pp.
Nam J. A simple approximation for calculating sample sizes for detecting linear trend in proportions. Biometrics. 1987; 43:701-705.UNSCEAR. Sources, Effects and Risks of Ionizing Radiation. United Nations, New York. 1988; 647 pp.
Prentice R, Kato H, Yoshimoto K, Mason M. Radiation exposure and thyroid cancer incidence among Hiroshima and Nagasaki residents. Natl. Cancer Inst.
Monogr. 1982; 62:207-212.
Preston DL, Lubin J, Pierce D. EPICURE: Risk Regression and Data Analysis Software. HiroSoft International Corporation.1991; Seattle, WA.
Rallison M, Lotz T, Bishop M, et al.
Cohort study of thyroid disease near the Nevada test site: a preliminary report. Health Phys. 1990; 59:739-746.
Shore R. Issues and epidemiological evidence regarding radiation-induced thyroid cancer. Radiation Research 1992: 131: 98-111.
l l
Stevens W, Till JE, Thomas DC, et al. Report of a cohort study of thyroid l
disease and radioactive fallout from the Nevada test site. University of Utah, l
Salt Lake City, Utah, July 1992.
Waterhouse J, Muir C, Shanmugaratnam K, Powell J. Cancer incidence in five continents. IARC Scientific Publ. 42, Intl. Agency for Research on Cancer, Lyon, France. 1982; Vol. IV, 811 pp.
1 1
- 3.24 -
l
4.
STANDARDIZATION AND OUALITY CONTROL.
Only rigorous control procedures can ensure the quality of the observational data, whatever their source.
Written procedures, training, repetition, and comparison for agreement or consistency are only some of the ways in which quality can be maintained. Standardization and quality control are a bi-national responsibility; both sides will participate in ensuring that quality is maintained.
(See Section 10.2 below).
4.1.
DOSIMETRY.
4.1.1.
Data Entry.
All data entered into any supporting data bases will be checked against the original source to verify their correctness.
Standard quality-control procedures will be used to assess the acceptability of such data bases.
4.1.2.
Ranae Checks.
Computer algorithms will be developed to check individual data points that lie outside their anticipated range so that such values can be rechecked.
4.1.3.
Computer Code Verification.
i Any connuter codes developed to calculate doses to individuals will be verified to make sure that they are performing the calculations as planned.
They also will be validated against other codes or other measured values to
)
ensure that the planned calculations are reasonable and proper.
4.1.4.
Hand Verification.
A randomly selected sample of individual dose calculations will be reproduced by hand to ensure that all calculations are being done properly and that all accesses to data bases are performed properly.
4.1.5.
Review of Extreme Values.
The higher two percent of the individual doses and the lower two percent will be examined carefully to ensure that the data and the calculations are correct.
4.1.6.
Particioation in International Model-Validation Studies.
Scientists from both countries will participate in international model-validation studies, such as BIOMOVS (Biosphere Model-Validation Study, organized by the National Institute of Radiation Protection, Stockholm) and VAMP (Validation of Model Predictic,ns, organized by the International Atomic i
Energy Agency, Vienna).
- 4.1 -
4.2.
CHARACTERISTICS OF SUBJECTS. INTERVIEWS. OVESTIONNAIRES.
4.2.1.
General Princioles.
Quality control starts with written manuals of tested procedures for carefully selected, trained personnel. Where data are available from different sources, their retrieval and examination for consistency can be highly useful.
Extraction of information from existing sources is subject to error that can be controlled by re-abstracting information on a randomly chosen fraction of records. The quality of interviews will be ascertained through re-interviewing a fraction of subje-ts, comparison of answers with independently recorded information, and building into the interview questions requiring consistent answers.
4.2.2.
Characteristics of Sub.iects.
The cohort will be defined initially en the basis of the thyroid dosimetry file at the Ministry of Health.
Some of the information in that file, identifiers, demographic characteristics, etc. may be checked against the Ministry file of Chernobyl registrants, as well as extended with new information not in these sources. After the development and testing of an appropriate abstracting form, abstractors will be trained on a manual and individually monitored throughout the period during which abstracts are prepared. Abstracts should be reviewed for completeness before the source records are returned to file.
4.2.3.
Interviews.
Quality control starts from the purposes of the study and the selection of those needed observations that seem best made by interview.
The next step is pre-testing the interview for its usefulness in collecting the information desired.
Then, in addition to the manual, training, and continuous supervision, main reliance will be placed on editing the record of the interview (for completeness and clarity) and repeat interviewing of a When information is representative sample of the work of each interviewer.
gathered by interview with respect to evacuation, use of potassium iodide (KI), or other events shared by other subjects, it will be cross-checked with In addition, information provided by subjects who shared the same experience.
some of the information may be checked against record sources.
4.2.4.
Questionnaires.
The content of questionnaires similarly will address the purposes of the study and the ascertainment of the specific items of information that can appropriately be obtained by questionnaire. The first level of control is the inclusion of questions the answers to which can be tested for consistency.
Next come pre-testing, the preparation of a coding manual and the training of persons to carry out the coding of the data obtained. Also, as with interviews, the information requested will be checked for consistency with any pre-existing record sources. Finally, repeat questionnaires will be used for a representative fraction of the subjects after a suitable interval.
- 4.2 -
i l
e 4.3.
CLINICAL PROCEDURES.
4.3.1.
Paloation of Thyroid Gland.
An endocrinologist who is expert in thyroid examination will confirm each nodule that is palpated and will confirm WHO gland size classification, as well as negative findings, in approximately 1 in 10 examinees.
4.3.2.
Ultrasound Examination.
I An expert in ultrasonography will confirm each nodule detected by examining the permanent records. This person also will confirm approximately 1 in 10 negative records.
Ultrasound instruments will be of a uniform make or capability and operators will be trained not only in operating and interpreting the results, but also in troubleshooting and making elementary repairs, preferably in factory training programs. Duplicate records will be kept for permanent storage and for use by consultants. Ultrasound phantoms will be imaged on a weekly basis, and the data stored on thermal records and on videotapes for computer analysis of changes in performance.
4.4.
LABORATORY PROCEDURES.
4.4.1.
Central laboratory.
A state-of-the art, high-technology central laboratory for thyroid function tests will be established to permit maximum use of the most sensitive current standardized methodologies.
4.4.2.
Kits for Testino Thyroid Function and Anti-Thyroid Antibodies.
Kits for these tests will be carefully selected and the supplies will be provided in amounts sufficient to permit the same kit to be used over an extended period.
If kits have to be changed, or new " lots" used, there should be enough overlap time to permit extensive comparison between kits.
4.4.3.
Individual Runs.
All standards suppit:d in kits will be run in duplicate with each run.
All unknown sera and control sera will be run in duplicate and each individual serum must be inspected for satisfactory agreement between these or the test must be repeated. Control serum will be checked against the established mean (see below) to assure the quality of each day's run. The usefulness of duplicate patient samples will be reevaluated after the first year.
4.4.4.
Control Sera.
Control sera will be acquired in large enough amounts to permit continuous use for at least 2-3 years.
These come lyophilized in vials (6-10 ml) that can be reconstituted with distilled water and can be kept (cold) for a week.
Such sera are supplied at three concentration levels and each level will be tested with each day's run.
Controls will be repeatedly checked for
- 4.3 -
s about 30 runs to arrive at a mean which will then be used as the comparison value for the controls run in the coming 2-3 years. Such a test allows one to detect variation between lot numbers of the same make of kit or between kits if necessary.
Before control sera are exhausted, new control sera will be obtained early enough to permit checks (at least 20 assays) against the previous control sera for several months.
4.4.5.
Inter-Laboratory Comoarisons.
Quality control and comparison samples will be exchanged between the study laboratory and an independent reference laboratory in the U.S.
It is expected that the appropriate authorities in both countries will facilitate transport of biological materials across national boundaries.
4.5.
PATHOLOGY.
4.5.1.
Histocatholoav.
A panel of expert thyroid pathologists (at least three, one of whom is frcm the U.S.A.) will review all pathology slides and will recut blocks as required for optimum examination.
4.5.2.
Asoiration Cytoloav.
An expert cytopathologist will review the cytology slides for adequacy and accuracy of diagnosis at least 4 times a year.
4.6.
COMPARABILITY OF OBSERVATIONS.
The importance of assuring comparable frequency and intensity of screening and surveillance of study participants across the whole range of This needs to be an intrinsic part of the dose cannot be overemphasized.
design of study procedures and it will require repeated data monitoring and attention by the management staff of the study. One aid in maintaining comparability is to keep examiners unaware of the thyroid dose status of study subjects.
Since the examiners would likely know the addresses of the examinees, this device would be effective only insofar as there were a wide distribution of dose within a geographic area served by the examining center.
- 4.4 -
\\-
DATA COLLECTION. STORAGE. AND RETRIEVAL.
5.
The number and kind of systems needed for the study are sensitive to a These include sample size, intensity of follow-up, size number of factors.
and character of the information to be recorded and stored, and the number of sites at which these operations are conducted.
5.1.
ASSUMPTIONS.
l l
5.1.1.
Data accuisition locations:
two fixed regional centers (Minsk and Gomel) and two l
clinical data:
mobile teams.
one fixed center (Minsk) and field teams.
dosimetry data:
5.1.2.
Central data analysis resource: To be established 5.1.3.
Data to be accessioned:
obtained 5.1.3.1.
Basic data: Biographic, and dosimetric information:
initially and updated at scheduled and unscheduled intervals 5.1.3.2.
Previous e4 amination data:
Physical examination Thyro'.d and parathyroid test data Pathclogy Clinical diagnosis 5.1.3.3.
Prospective survey data Physical examination Thyroid and parathyroid test data Pathology Clinical diagnosis Thyroid ultrasound Morbidity and mortality data 5.1.4.
Lenoth of Study: 30 years I
5.1.5.
Size of study Groun: 15,000 children 5.1.6 Frecuency of examination: Annual physical ' examinations, laboratory studies, and ultrasound The following assumptions are made for 5.1.7.
Data storace reouirements:
Better estimates planning purposes, and are considered to be conservative.
will be made when forms and procedures are developed and analyses planned.
The forms and the lexicon defining the exact meaning of entries need to be developed, following which the actual data storage requirements can be estimated. Current estimates include:
Basic record: 10 KB Previous examination: 5 KB Prospective survey data: 2 KB
- 5.1 -
Film records will be stored at the regional center at which ine patient is being followed clinically. Machine readable data will be stored on computer media for archiving and for subsequent analysis.
Summary of initial estimate of clinical data storage requirement:
- 1. Basic and retrospective data: 15,000 subjects x 15,000 bytes per subject - 225 MBytes
- 2. Prospective data: 15,000 subjects x 2,000 bytes per subject x 30 years - 900 MBytes
- 3. Total storage requirement: 900 MBytes + 225 MBytes = 1125 MBytes rounded to 1.2 GBytes 5.2.
DATA ENCODING AND VERIFICATION SYSTEM.
At each patient examination center, patient data from history and physical examination will be entered into computer at the time of the examination.
Programs will test for inconsistent, and out of range, entries using programs already developed by the data center staff for this purpose.
The acquired printed record will be reviewed by the physician prior to patient release for accuracy. The computer floppy disc on which the data are recorded will be transmitted to the central data analysis resource at frequent intervals (approximately weekly) for central archiving and backup. The hard disk used in the primary data entry system will be backed up weekly to provide a secondary backup of data.
The original paper record will be filed at the center at which the patient is being followed.
If the patient is referred to the clinical center for additional examinations, a copy of this record will be generated from the floppy disk transmitted information on file at the central data analysis resource.
5.3.
DATA RECORDING STORAGE. AND ANALYSIS RESOURCES.
5.3.1.
Comouter Reouirements.
j The central system will consist of one 486 Network Server (Aksakovtchina Clinical Center outside Minsk, denoted thereafter as Center) hard wire network coupled to one 486 personal computer (PC) for program development (Center),
and one 486 personal computer for data entry and statistical processing (Center). The Network Server will have a Fax / modem for Internet and local communications, and will be equipped with a UPS monitor and a 600-watt power stabilizer.
There will be five 386/486 personal computers that will be connected by modem (Novell communication network) to the Network Server:
one at Gomel for analysis and communication of the clinical data; one at the Institute of Radiation Medicine (Minsk) for epidemiology; one at the Institute of Radiation Medicine (Minsk) for dosimetry data; one at the Minsk Dispensary for data entry; one in Director's office at the Center.
- 5.2 -
1
Other 386/486 personal computers (without modems):
ten (either 386 or 486), three being for dosimetry, one for pathology, four for ultrasound, and two in the Center (one for data analysis and one for program development), both of which are hard-wire connected to the Network Server.
Laptop computers are also required for field work:
four for dosimetry, including one spare two for epidemiology; two for the mobile ultrasound systems (one per unit);
two for the clinical mobile teams for patient data entry (one per mobile team).
Sumary of Computer Systems: See Section 7.2.4. for locations and numbers of computers, and Appendix A for budget items.
Additional System Definition:
The Network Server will have a 1.2 GB hard drive, and 16 MB memory.
Other personal computers will have 200 MB hard drives, and 8 MB memory.
The server will have a dedicated 9600 baud line for an Internet comunication link and communication via modem with the personal computers.
5.3.2.
Ultrasound Data.
Each of the ultrasound systems will have a computer controllable videocassette recorder (VCR) to record the data. A video digitizer at the Center (with optical disk, a frame buffer, and a computer controllable VCR (NEC)), will be used.
It will provide high quality film records on a Matrix laser printer for selected clinical and computer processed images.
5.3.3.
Comouter Backuo.
One streamer tape system with 50 cartridges will be used.
Frequent system backup on streamer tapes will be done to protect data from computer glitches and to provide security for longterm storage in a safe, remote place.
Optical disk storage will be included on the ultrasound image analysis system, and possibly on the major systems (Center, Dosimetry, Epidemiology),
and on each of the ultrasound systems if direct recording of ultrasound data on optical disk becomes feasible.
Spare parts will be maintained on site to permit rapid replacement of components that fail.
- 5.3 -
5.3.4.
Software.
MS disk operating system 5.0, Btrieve single user 6.0 Xtrieve Netware386 3.11 SQL, XQL (User is aface for SQL)
SAS Paradox (spreadsheet)
Statgraph Windows 3.1 5.3.5.
Other eouioment.
Five Canon copiers located at Center, Dosimetry, Epidemiology, Gomel, and Dispensary.
Three laser printers at Center, Dosimetry, and Epidemiology.
iiine Epson printers.
Ten bubble-jet style printers.
- 5.4 -
l 1
4 6.
ANALYSIS.
The analyses of data from the pro inasmuch as they will be largely dose posed study will necessarily be complex, response analyses of incidence data with stratification by sex, age at exposure, person-year geographic area, and time / age at risk.
Other factors, such as variation in the frequency of 1
thyroid screening, will have to be evaluated as possible confounders and i
controlled if necessary.
It will be desirable to conduct analyses that take into account the uncertainties in the thyroid dosimetry, which may vary from
)
t individual to individual.
It is, therefore, important that the data be I
analyzed with epidemiologic sophistication and state-of-the-art statistical methods by Belarussian and U.S. scientists.
- 6.1 -
7.
IMPLEMENTATION.
This topic is considered from the standpoint of the resources and their utilization. The complexity of the project requires maximum flexibility in implementation.
It is, therefore, expected that the required staff personnel, l
equipment, and supplies will be acquired as they are naeded to carry out study objectives.
Resource requirements are predicated on the following basic assumptions:
o Three thousand subjects will be seen the first year, 9,000 the second year, and by the end of the third year,15,000 subjects should be seen annually.
o One fixed screening center will be established in the first year at the Dispensary in Minsk; a second screening center will be located in Gomel as soon as feasible.
o Two mobile examining teams will be formed, one attached to each fixed examining center.
o Diagnostic and referral services, both outpatient and inpatient, are to be supported at the existing clinic in Aksakovtchina outside Minsk.
o A central laboratory for biochemistry and cytology will be located at the clinic in Aksakovtchina.
o A central pathology laboratory will be established at the Oncology Center.
7.1.
PERSONNEL.
Appendix C gives a tentative table of organization and staffing pattern for the project over the initial three-year period. The following summary gives estimated staff requirements for full implementation of the study.
7.1.1.
Clinical and Laboratory Personnel.
7.1.1.1.
Staffing Needs for each of 2 Fixed and 2 Mobile Screening Teams.
o 2 medical doctors (MD) endocrinologists, each examining 15 patients / day, or 2,000/ year (10/ day in the field, 20/ day at a fixed location);
one MD will be team manager o 2 MD ultrasonographers, same patient load as endocrinologists o 2 nurses, venipuncture, etc o 1 nurse assistant for urine collection, etc.
o 2 computer data entry operators o 1 vehicle driver o 1 medical clerk Total staff for the 4 screening teams:
4 x 11 - 44.
- 7.1 -
7.1.1.2.
Staffing Needs for Clinic at Aksakovtchina.
o 2 endocrinologists for 750 patients / year, based on 5 percent of population screened annually (15,000 subjects) o 1 MD ultrasonographer who also does thyroid biopsies o 1 procedure nurse, venipuncture, etc.
o 4.5 nurses, ward duty, 24-hou:' coverage o 4.5 assistant nurses, ward duty, 24-hour coverage o 1 computer operator for ultrasound Total staff of unit:
14 7.1.1.3.
Staffing Needs for Central Laboratory at Aksakovtchina.
o1 MD biochemist, manager, independent research o 11 MD biochemists 75 Ca++, albumin tests / day (year 3 projection) 25 TSH, T-4, anti-TP0/ day (year 3 projection) o 1 MD cytologist, responsible for biopsy and cytology o I senior' laboratory technician o 3 laboratory technicians o 3 orderlies /dieners Total staff of unit:
20.
7.1.1.4.
Staffing Needs for Pathology Laboratory (Oncology Center) o 2 MD pathologists o 1 pathology technician Total staff of unit: 3 7.1.1.5.
Tabular Summaries.
Table 7.1 provides a summary of the personnel requirements by unit and year of operation for the first three years, and Table 7.2 gives a distribution of the total personnel requirement by type of personnel and unit.
Table 7.1.
Total Personnel Projections by Unit and Year of Operation Unit Year 1 Year 2 Year 3 l
l Minsk Dispensary 11 11 11 l
Gomel branch 11 11 i
Mobile teams 11 11 22 l
Aksakovtchina clinic 8
14 14 l
Central laboratory 12 14 20 Patholooy laboratory 3
3 3
Total 45 64 81
- 7.2 -
l
1 Table 7.2.
Total Personnel Projection by Unit and Type of Personnel Personnel Tvoe of Unit Screening Clinic Central Pathology Total Teams Lab Lab l
Endocrinologists 8
2 10 Ultrasonographers 8
1 9
f Nurses 8
5.5 13.5 Nurse assistants 4
4.5 8.5 l
Data entry clerks 8
8 Vehicle drivers 4
4 Medical clerks 4
4 Computer operator 1
1 Biochemists 12 12 Sr lab technician 1
1 Lab technicians 3
1 4
Dieners 3
3 Cytology physician 1
1 Pathologists 2
2 Total 44 14 20 3
81 7.1.2.
OTHER TYPES OF PERSONNEL.
7.1.'.i.
Epidemiologists.
The epidemiology department will supervise the implementation of the study design as defined in the Protocol.
Epidemiologists will also assist in the development and pilot testing of questionnaires, and in interviewer training and monitoring of interviewing procedures.
They will work with the computer personnel in developing computerized data entry programs that optimize the checking of data entries for accuracy.
They will supervise the system for incating and eliciting the participation of subjects.
They will monitor the epidemiologic progress of the study, e.g., to ensure that subject location and surveillance procedures are applied unifonnly across the dose range. To this end, a staff of three epidemiologists and two computer operators is requested for years one and two, to be increased to four epidemiologists and tw5 computer operators in year three.
7.1.2.2.
Dosimetry Personnel.
The personnel of the dosimetry department will consist of three groups in addition to a Department manager:
Group 1: individual lifestyle data (dosimetry questionnaire and dose reconstruction)
Group 2: environmental radiation data (collection and measurement)
Group 3: maintenance of the database.
- 7.3 -
The staff will remain at a constant level of 29 people from years I to 3.
The distribution of the personnel according to specialty is indicated in Table 7.3.
Table 7.3.
Distribution of Dosimetry Personnel Manaaer Group 1 Group 2 Group 3 Total Department manager 1
1 Health physicist 5
2 2
9 Programing engineer 1
1 Dosimetry engineer 2
3 5
Computer operator 4
4 Laboratory assistant 1
1
~
2 Technician 4
4 Driver 1
2 3
Total 1
9 12 7
29 c
7.1.2.3.
Computer Personnel.
The computer personnel will be responsible for data entry, programing, file handling, data retrieval, and other computer operations.
The distribution of the computer personnel is indicated in Table 7.4.
Table 7.4.
Distribution of Computer Personnel f
Year 1 Year 2 Year 3 Manager 1
1 1
Computer operation 2
3 4
Programming engineer 2
3 3
i Computernets engineer 1
1 1
Computer maintenance engineer 1
1 1
Total 7
9 10 7.1.2.4.
Surgical Division.
o 1 Division manager o 1 Surgeon oncologist o 2 Medical sisters o 1 Aid woman j
The numbers will not change from year 1 to year 3.
- 7.4 -
9 7.1.2.5.
Quality Control Service.
The distribution of tlie experts involved in the quality control operations is indicated in Table 7.5.
Table 7.5.
Distribution of Experts Involved in Quality Control Year 1 Year 2 Year 3 Endocrinologist (expert) 1 1
1 Ultrasonic specialist (expert) 0.5 1
1 Biochemist (expert))
0.5 1
1 Cytologist (expert) 0.5 1
1 Epidemiologist (expert) 0.5 1
1 Total 3
5 5
7.1.2.6.
Management Personnel, o 1 President (Minister of Health) o 1 Scientific supervisor o 1 Scientific coordinator o 1 Scientific secretary o 1 Manager o 1 Chief of Gomel Centre o 1 Executive secretary o 2 Interpreters o 1 Scientific supervisor assistant o 1 Chief of endocrinology department o 1 Chief of ultrasonic diagnostic department o 1 Chief accountant o 1 Economic accountant o 1 Scientific consultant o 1 Quality control officer l
TOTAL 16 7.1.3.
Procurement.
Personnel for the project will be chosen on a competitive basis by the Belarussian side, and contacts will be concluded with highly qualified specialists from the Institute of Radiation Medicine and other Belarussian i
medical institutions.
In certain cases, specialists from member nations of the Commonwealth of Independent States will be recruited for positions in i
important fields of specializations.
- 7.5 -
7.1.4.
Trainina.
Arrangements for training of Belarus personnel are already under way. A tentative list of types of personnel to be trained follows:
o 2 Endocrinologists o 2 Ultrasonographers o 1 Pathologist o 2 Epidemiologists o ? Interviewers (as needed; trained locally) v 2 Computer system engineers o 1 Manager, central lab and quality control o 2 Dosimetrists Professional training will be primarily in the U.S.A. but consideration will be given to other countries depending on the language of choice or necessity (i.e., French, German, Russian).
U.S. assistance in establishing local, on-site programs will be provided as required.
7.1.5.
U.S. particioation.
No permanent posting of U.S. personnel in Belarus is planned but tours of substantial length will be considered as the project develops. The U.S. side will appoint an Associate Project Director based in Bethesda. The U.S. side will, in addition, endeavor to send experienced scientists to Minsk on a rotating basis, perhaps for tours of several weeks or months, to serve in a liaison capacity.
Specialists also will be provided for consultation, surveillance, and quality control.
The U.S. will continue to provide specialized training opportunities in the U.S. as long as necessary, and will make an effort to find bi-lingual personnel for on-site training as may be needed.
7.2.
EOUIPMENT.
The equipment needed for the project is listed below along with its justification, based on an enumeration of the tasks that need to be accomplished to carry out the protocol within Belarus.
The equipment to be purchased is scheduled for phased delivery over the first 3-years of the study.
Single issues of equipment that will require complex installation, learning, programming and de-bugging, and development of quality control procedures, should be installed very early so that data acquisition and storage can proceed when examinations begin under the protocol.
For example, the automatic laboratory analyzer (IMX) should be installed and put into operation with high priority to ensure that blood sample analysis will proceed l
expeditiously.
l The itemized list of equipment that follows is the best estimate of that which is needed to implement the study. Modifications of the study needs, and the specific equipment best suited to fulfill the assigned tasks, will be made as experience is obtained in the conduct of the project.
- 7.6 -
~
7.2.1.
Eouioment For Clinical Work.
o ULTRASONOGRAPHY MACHINES - Seven machines wi'.h video storage of imaged data for patient data archiving. A video image analyzee will be provided for digitizing, analyzing, and displaying the ultrasound data. The system proposed is a PC-based system with a fram.e grabber, from which video recorded data is digitized, analyzed, and stored (on optical disk) using programs developed in the United States for a multi institutional collaborative study of carotid artery Doppler flow data. If ultrasound equipment with direct storage onto optical disk becomes available, this option would be favored, and Computer would be accomplished at no additional cost to the project.
controllable VCRs (NEC) will be connected to each ultrasound system, and one A Matrix-type laser printer will be located will be at the video digitizer.
at the image processing station for hard copy output from VCR records, and from the computer processed data.
Four quality control test phantoms will be provided for use with the fixed and mobile systems.
7.2.2.
Eouioment For Clinical laboratory Work.
o FLUOROMETRIC DEVICES (two) FOR HORMONE DETERMINATIONS (fren Ts, total T, Ts, TSH) - With supplies and spare parts. The first system will be provided in year one, and the second when needed, as the work load increases, 4
and to provide back-up in the event of system downtime.
o RADIOIMMUNOASSAY (RIA) ANALYZER. For RIA hormone sample analysis (Anti-TPO,Tg,AntiTg,PTH).
o FREEZERS.
Two for long-term tissue archive (minus 80 degrees Celsius), one at the Central Laboratory and one at Gomel, with special low temperature labels, and emergency back-up power supply. The preservation of tissue is viewed as a high priority need to permit future analyses as new methods are developed for Replicate tissue samples will be pathophysiologic and/or dosimetric purposes.
stored in the two locations to guard against sample loss due to catastrophic occurrences.Two small portable freezers for sample transport for use by mobile field teams.Eight freezers for blood sample archive (minus 40 degrees Celsius).
o REFRIGERATORS.
Ten for sample and supply storage, and two small portable systems for use by the mobile field teams, attributed as follows.
Four large refrigerators will be obtained in year one for storage of samples and materials for laboratory determinations (two at the Clinical One smaller refrigerator, and a small
)
Center and two at the Dispensary).
freezer will be obtained for transport of samples and reagents for use in the field also in year 1.
In year two, when the Gomel center begins cperation, j
along with its field team, an additional portable refrigerator, and a portable i
An additional two freezer will be obtained for use by its mobile field team.
refrigerators will be obtained for use in Gomel and in the clinical chemistry laboratories to keep up with the expansion of sample size in year 2. An additional two will be needed for the Clinical Center in year 3.
- 7.7 4
1 o CENTRIFUGES.
Three bench-top (room temperature) and one refrigerated for use in the central laboratory, plus 2 bench-top centrifuges for use in each cf the two mobile field teams. The last two units will be obtained in year 2 of the project, when the second mobile team is put into the field.
o SPECTROPHOTOMETER.
For use in urine iodine measurements'"
o EMERGENCY POWER GENERATORS.
Eight in all. Two deployed with the low temperature freezers, and six with other critical devices.
o MISCELLANEOUS LABORATORY EQUIPMENT.
Items of equipment needed for the operations of the chemistry laboratory are listed in Appendix budget summary sheets. These include temperature controlled water baths (2), pH meter, vortex shaker, automatic pipettes, a horizontal shaker, and two Barnstead type water stills.
7.2.3.
Eouioment For Patholoav Laboratory Succort.
Two light microscopes (dark field and polarizing objectives and photomicrography equipment), microtome, cryomicrotome, and tissue processor.
i 7.2.4.
Eouioment For Comouter Sucoort.
The distribution of equipment for camputer support is indicated in Table 7.6.
- 7.8 -
Table 7.6.
Distribution of Equipment Needed for Computer Support 386/486 386/486 Laptop Epson Laser Without Modems With Modems Printer **
Printer Aksakovtchina Server 1
1 Data / Program 2
1 1
Ultrasound 2
Dosimetry 3
1 4
4 3
1 Epidemiology 1
2 2
1 Pathology 1
1 Dispensary Data 1
1 Ultrasound 1
Gomel Data 1
1 Ultrasound 1
Mobile Teams (1 Gomel/l Dispensary-based) 2 Teams 4
4 Director's Office 1
1 i
Total 10 6
10(*)
10 9
3
(*)
8 bought by the cohort study, 2 from units transferred at end of case-control study
(**)
Canon bubble jet style printers for laptops.
- 7.9 -
7.2.5 Dosimetry Ecuioment.
o Two four-wheel drive vehicles for field measurements, interview of parents, and search for environmental data.
o Five gamma ray spectrometry systems, two of which will be stationary low background systems for measurement of Cs-137 and other gamma-ray emitters in samples of soils, foodstuffs, water, etc. and three will be mobile systems for in-situ determination of the deposition density of gamma ray emitters.
o Liquid nitrogen containers for the gamma-ray spectrometry systems:
three 30-liter Dewars with a transfer system for liquid nitrogen and one large-volume tank of liquid nitrogen with atransfer system.
o One Thermoluminescent Dosimet:y System (TLD) including a printer, a powder dispenser, and a vacuum tweezer, for retrospective exposure measurements in ceramic materials.
o Two phantoms for re-evaluation of the detectors used for the thyroid measurements.
oSixprogrammablecalculators,HewlettPac[4rd95LX.
oRadioactiveStgdards:
three sources of Cs, three sources of '33Ba, and three sources of Cr.
7.2.6.
Other Ecuioment.
VEHICLES FOR MOBILE EXAMINING TEAMS - One van is needed to transport o
equipment to the field for mobile team measurements. The size of the van will be sufficient to carry ultrasound equipment with computer, two laptops for patient data entry, a freezer for patient serum storage, a refrigerator for reagent storage, 2 desktop centrifuges for specimen preparation, a patient bed for ultrasound measurements, 2 desks for patient interviewing, and sample handling equipment and supplies. The equipment trt'*fer vans will have a hoist mechanism such as is used for assisting the e
,y of handicapped persons. A second vehicle will be provided in year one to transport staff to the field location, and to contact patients while in the field and bring them to the field study location.
The design and cost of the transport vehicles needed for supporting the second field team in the 3rd year of the study have not been determined, but ideally will be outfitted for carrying out the investigations within the van itself.
Such an outfitted van should have two separate doors for patient entry and exit.
o VEHICLES FOR TRANSPORTING SUBJECTS - Two rented and 2 owned buses presently exist and are used for this purpose at the fixed center in Minsk.
Support for costs of operation of these buses is included in the budget for the project.
o MOTOR POOL - A rnutor pool will be establir.hed and supported by the Belarus staff to provide maintenance and scheduling of the use of field vehicles.
o IMPROVED COMMUNICATION CHANNELS - Internet communication channels and local area networks will be established, including modems for local and international communications connected to the different sites in Belarus via the Server.
These will be used for study related communications within Belarus and for communications with U.S. collaborators.
In addition, access to library resources in the U.S.A. will be facilitated in this fashion.
- 7.10 -
Machine readable data will be exchanged by E-mail and optical image transfer will be accomplished by FAX transmission.
For these purposes FAX machines are provided at the main study locations. Transmission of library documents from U.S. libraries will utilize the Ariel transmission system and pratocol to enable high-quality, reliable, and rapid transmission of documoats to Belarus.
A FAX / Modem on the Network Server will facilitate communication between the Server and FAX-based locations.
7.3.
SUPPLIES.
It is difficult at this time to estimate the quantities of supplies with any confidence. Needs have been identified and costs estimated in the budget.
7.3.1.
Sucolies for Clinical Work.
The supplies for clinical work will be sufficient to carry out the following studies:
o TSH KITS - For all subjects (Duplicate samples) o Tc KITS - For all subjects (Duplicate samples) o FREE T KITS - For all subjects in year 1.
Thereafter either T or Free 4
4 T tests will be carried out only in patients with abnormal thyroid test 4results (an estimated 5% of the patients examined), unless the results in year 1 indicate the need to test all subjects.
o ANTITHYROID PEROXIDASE (Anti-TPO) KITS - For all subjects.
o ANTIT}{YR0 GLOBULIN ANTIBODY KITS - For all subjects with positive Anti-TP0 assay results (an estimated 5% of the patients examined).
o THYR 0 GLOBULIN ASSAY KITS - For subjects with thyroid nodules (an i
estimated 5% of all patients examined).
o T KITS - For patients with any thyroid test abnorpJity (an estimated 35% of all patients examined).
o CALCIUM AND ALBUMIN REAGENTS - For all subjects.
o PARATHYROID HORMONE RIA ASSAY KITS - For selected subjects (an estimated 2% of all patients examined).
o DISPOSABLE NEEDLES AND SYRINGES - For drawing blood samples; boxes for disposal.
o PLASTIC GLOVES - The number estimated in budget summaries is based on I/ day per patient and physician examiner, and 5/ day for a technician handling blood samples.
7.3.2.
SUPPLIES FOR OTHER PROCEDURES.
o PATHOLOGY:
Slides, cover slips, stains, embedding materials, knives, sharpening and filing materials:
Needs estimated on the basis of 5% of subjects receiving needle or open biopsies in a year.
o DOSIMETRY:
15,000 ziplock polyethylene bags for environmental samples.
o 0FFICE:
Paper for patient study reports, computer print outs, computer diskettes (3.5" and 5.25"), printer ribbons and Canon copiers (and replacement cartridges) at major study sites (Director's office, 3 major computer locations, Dispensary, and Gomel).
A 35 mm slide projector, an overhead projer. tor for use in presentations and study review sessions, and office supplies (pencils, pens, staplers, staples, paper clips, scotch tape, etc.).
- 7.11 -
7.4.
PATTERN OF Bi-NATIONAL COLLABORATION.
The bi-national collaboration is scientific, managerial, and fiscal in nature. Belarus will provide the trained scientific and technical specialists, and clerical personnel as well as the clinical, laboratory, and office and such other space as may be necessary to carry out the study in a satisfa.: tory. -
manner.
Belarus will also make available to the Belarussian and U.S. project participants and funding agencies the data and scientific information t' tat i
have been accumulated since the accident, as well as those developed under this project.
Belarus will he responsible for locating the subjects, fo,-
estimating their thyroid doses, and for performing the clinical and laboratory examinations specified in the protocol (Section 3.3).
It will implement, through the Project Director, the decisions made by the Oversight Group (cf Section 10 below).
The fiscal contribution of the Belarussian side will extend to (a) the salaries of Belarussian personnel involved in the study, (b) the provision of clinical, laboratory, office and other space needed, and (c) the provision of supplies and equipment that are not to be provided by the U.S. (cf Section 7.5 below).
The U.S. will provide specialized training, assistance in quality control, cooperation in data analysis, and expertise in protocol revision, manuscript preparation, and other areas.
It will participate in the authorship of joint publications only to the extent that individual U.S.
scientists contribute in a substantive way, such as in data acquisition, analysis, interpretation, or presentation of findings. Through its representation on the Oversight Group for the project (cf sec.10 below) it will participate in the development of management policy.
It will provide consultants in clinical, laboratory, pathology, computer, and other aspects of the work as may be needed and agreed upon.
Its fiscal contribution will extend to (a) the support of Belarussian personnel while in the U.S. for training, workshops, or consultation, and (b) the provision of equipment and supplies as specified in 7.5 below or as may be agreed upon with the U.S.
Associate Director (cf 10.2).
7.5.
FUNDING.
7.5.1.
Estimated Budaets (Yeart 1-3).
o BELARUSSIAN (RUBLE) BUDGET:
Financial expenses towards the costs of paying the Belarussian personnel, upkeep of the clinic, sanitarium, scientific laboratories, offices, and other facilities and space; purchase of such equipment and materials which are not stipulated in the protocol as a U.S.
responsibility; and business trips, transportation and comunication expenses of Belarussian personnel in the territory of Belarus, will be provided by the Belarus Ministry of Health.
These expenses are represented by the original cost estimate which does not include the base cost of the provided accomodations or of the accomodations in locations of patient examinations.
o U.S. (DOLLAR) BUDGET:
Funds will be provided by the National Cancer Institute as they are available via agreements with the U.S. Department of Energy and the Nuclear Regulatory Comission. Specific expenses are estimated in Appendix A for the equipment and supplies for which the U.S. will be responsible; these will be provided by the U.S. Department of Energy through the Lawrence Livermore National Laboratory.
- 7.12 -
7.5.2.
Sources of Funds, o IN BELARUS - Funds will be provided by the Ministry of Health.
o IN THE U.S. - Funds will be provided by the National Cancer Institute I
l as they are available via agreements with the U.S. Department of Energy and the Nuclear Regulatory Comission, and by the U.S. Department of Energy via agreement with the Lawrence Livermore National Laboratory.
l l
l i
- 7.13 -
8.
PUBLIC ACCEPTANCE AND ADMINISTRATIVE APPROVALS.
8.1.
ADMINISTRATIVE APPROVALS.
8.1.1.
Bel arus.
Belarus will submit the scientific program to the " Radiation Medicine Coordination Council" of the Health Ministry of Belarus for consideration and approval.
Thereupon the Siinister will submit the scientific program and funding request to the Council of Ministers fo'% sideration and for the r
Government of the Republic to adopt an appropriate resolution.
Any changes in the protocol required by administrative authorities will be submitted to the U.S. for consideratioii.
8.1.2.
LL.
The U.S. undertakes to present the scientific protocol, including its budget estimates, to the appropriate U.S. authorities for their scientific review and funding, both initially and throughout the life of the project.
Any revisions requested by such authorities will be reviewed with Belarus.
8 l.3.
Informed Consent and Institutional Review.
The' purpose and methods of the project will be submitted to the customary institutional review boards for approval in both Belarus and the United States.
Submittal will include an informed consent document that will explain the purposes, procedures, and risks to individual subjects and will indicate that their participation is voluntary. They will be free to refuse any or all procedures without prejudice to themselves.
For minors, consent will be i
obtained from a parent or guardian.
Steps will be taken to keep medical records confidential.
Information with subject identification will not be released to uther parties without the express written consent of the subject or, for minors, a parent or guardian.
8.2.
PUBLIC ACCEPTANCE IN BELARUS.
Belarus undertakes to ensure public and professional understanding and recognition of the project. To this end the following public comunication procedures will be utilized:
o Publication of a special Red Cross memorandum listing the objectives of the project and results to be expected from its conduct.
i o Dissemination of the memorandum among the population.
o Issuance of an information poster in a joint effort with the Republic Health Center.
o Publication of articles and interviews by the Health Minister and the Institute's leading specialists in the central and local newspapers of the Republic.
o Production of a news program suitable for TV broadcasting and for showing in local movie theaters together with feature-length films, o Lectures to the local population.
o Special attention will be devoted to familiarizing teachers, l
physicians, parents, and employees of local administrative jurisdictions, with the scientific and medical aspects of the project.
1
- 8.1 -
9.
REPORTS. PUBLICATIONS.
9.1.
GENERAL PRINCIPLES.
9.1.1.
Scientific Publications.
Scientific publicatiBlis should be accurate and objective, authoritat5e,
~
and promptly available.
They should reflect the best scientific judgment of the investigators and of the Oversight Group representing both Belarussian and U.S. sponsors (cf,10.2 below).
9.1.2.
Press Releases and Public Announcements.
The Project Director and the Associate Project Director shall have responsibility for the release of scientific conclusions and interpretations to the public, but only with the prior approval of the Oversight Group and after publication in a scientific journal.
Information about plans for the study, its objectives, procedures, and progress, however, may be reported through a mechanism designated by the Project Director.
9.1.3.
Review and Release of Scientific Reports for Publication.
Procedures will be developed for the guidance of the staff and the Oversight Group.
In general it is expected that draft reports will be circulated among the Belarussian and U.S. participants in the project for comment, among a select group of outside reviewers chosen for their knowledge of the subject, and finally to the Oversight Group after the authors have made any necessary revisions.
Members of the Oversight Group may consult additional outside reviewers before acting on the proposed draft.
Scientific reports must be approved by the Oversight Group prior to submittal for publication.
9.1.4.
Authorshio of Scientific Reports.
Authors should be confined to those who generated the observations, analyzed them, or wrote the reports.
U.S. scientists will be expected to co-author scientific reports only if they participated actively in one or another major aspect of the work.
9.2.
TRANSMITTAL OF EXAMINATION RESULTS TO SUBJECTS.
Examined subjects will be sent the results of their examinations in writing and promptly.
l
- 9.1 -
W.,
4 g-m aa-m aw--
a-v w
a
_4 a
'i 10.
PROJECT MANAGEMENT.
10.1. OVERSIGHT GROUP.
l Primary responsibility for the conduct of scientific, administrative, and fiscal aspects of the project will be vetted in a bi-national Oversight Group l
i consisting of 10 members, five to be named by the Belarussian authorities and five to be named by the U.S. authorities. The Belarussian authority for naming initial members of the Oversight Group will rest with The Ministry of Health.
Initial U.S. representatives will be named by the U.S. Nation.al.
S Cancer 4 M titute rfter consultation with othe~r U.S. sponsoring agencids. Each of the national authorities will strive to name one representative with a well-established reputation from each of the following areas of expertise:
endocrinology, radiation biology, radiation dosimetry, radiation epidemiology,
)
and clinical sciences / pathology.
Following its establishment the Oversight Group will be a self-perpetuating body selecting future members from among l
those nominated by the two sponsoring agencies and by its own membership.
)
Members of the Oversight Group will serve five-year terms except that, initially, reprenntatives will be appointed for one, two, three, four-and five-year terms from each national authority in order to facilitate orderly rotattorrof member.s. Members may not serve more than two terms. The Project Director (Scientific Supervisor in Appendix C), the Associate Project Director, and their deputies (see 10.2 below) may not serve as members of the Oversight Group.
The Oversight Group will select its own co-chairmen, one Belarussian and one American, and will meet at least once a year in Belarus.
It may hold other meetings when and where it deems suitable. The co-chairmen will jointly administer the activities of the Oversight Group and agree on such matters as the agenda, number of meetings each year, alternation of chairmanship (e.g.,
by day, by year), etc.
The Oversight Group will ratify the appointment of the Project Director and endow the Director with the responsibilities specified in section 10.2 below.
The Oversight Group will be responsible for (1) recommending modifications of the research protocol to the respective national authorities, (2) approval of protocol modifications jointly agreed upon between the U.S.
and Belarus, (3) review and approval of budgets prior to their presentation to national authorities for funding, and (4) Continuous and contemporaneous scientific and administrative oversight on a regular basis (including on-site scientific peer reviews with written reviews / critiques provided to both national bodies and to the Project Director and Associate Project Director) on a regular basis, and for publication policy (including internal and external review procedures and publication criteria). With the approval of the co-chairmen, data and other information will be made available to individual members of the Oversight Group on request. The Oversight Group will determine its own agenda and operating rules of procedure, including removal of individual members, and reserve the right to convene in Executive Session.
The Project Director will provide secretarial and other logistic support for its meetings and activities, including the issuance of minutes following their
- 10.1 -
approval by the Oversight Group. All oral and written communication involving the Oversight Group will be in both languages, and the Project Director will provide competent interpreters and translators for these purposes.
Expenses of the members of the Oversight Group will be defrayed by whichever side made the nomination.
10.2.
MANAGEMENT.
The Project Director will be appointed by the Minister of Health and confirmed by the Oversight Group.
The Project Director will serve as the day-to-day manager foi che project in Belarus and will be responsible for scientific activities (e.g., clinical, laboratory, dosimetric, epidemiologic),
for administration (e.g., personnel, data management, training, fiscal matters, allocation of resources), for preparation of bilingual annual and other progress reports, for communication with the Belarussian press and with entities of'the Belarussian Government, and for support of the activities of the Oversight Group.
Reallocation of equipment and supplies provided by the U.S. will require consent from the U.S. side. The Project Director will maintain active liaison with any U.S. representatives on site in Belarus and with the Associate Project Director based at the National Cancer Institute (see paragraph below).
If the Project Director should require a deputy, this appointment will be subject to the approval of the Oversight Group. Among other designated staff assignments the Project Director may make, one obligatory appointment will be to the position of Quality Control Officer.
Inventory control of supplies and equipment will be the responsibility of the Project Directors and their deputies.
Regular reports will be made to the Oversight Committee.
The U.S. National Cancer Institute will appoint an Associate Project Director for liaison
h the Project Director and the Oversight Group. He will be responsible for selecting U.S. consultants and other U.S. personnel to work on the project in Belarus, for arranging training in the U.S. for Belarussian personnel, for the procurement of equipment and supplies specified in the protocol or by the Oversight Group, and for transmitting progress reports and budgets for presentation to appropriate U.S. authorities. He will keep the Project Director and the Oversight Group fully informed of developments in the U.S. with respect to the project.
He will attend all meetings of the Oversight Group and arrange for any workshops or other meetings held in the U.S. in support of the project.
If required, the Associate Project Director may appoint a Deputy Associate Project Director.
- 10.2 -
11.
STAGES OF STUDY OVER TIME.
Many aspects of the feasibility of the study have already been demonstrated.
In large part the present protocol represents a formalization and strengthening of procedures that have been followed for several years by the Institute of Radiation Medicine.
In addition the preliminary case-control study has already demonstrated that U.S. and Belarussian investigators can work together easily and effectively.
f 11.1. THE FIRST SIX MONTHS.
With approval of the project by authorities of both countries, and assurance of funding by both sides, the Oversight Group would be confirmed, the Project Director appointed, the staff appointed at senior and intermediate levels, training begun, the organizational structure established (see Appendix C), a U.S. Associate Project Director appointed, and study procedures and software developed and tested as required by protocol.
The first examining center would be prepared in the Minsk Dispensary, the central laboratory established in Aksakovtchina, and the central office for the study designated.
l Equipment and supplies needed early would be purenased, largely in the U.S.
The program of professional and scientific training in the U.S. would continue l
and technical training in procedures begun. The study cohorts would be I
established and the effort to locate and communicate with them begun. The i
basic file structure would be put in place in the first examining center, in the central laboratory, and in the central office for the study.
By the end j
of about 6 months it should be possible for the clinical examinations to begin for cohort subjects, provided that sufficient equipment and supplies are in j
place in the Minsk Dispensary and sufficient subjects have been located.
Consideration would have been given to the scheduling of visits by the first mobile screening team.
11.2.
THE SECOND SIX MONTHS.
i In this period the examination of children according to protocol will have begun, technical training in study procedures would continue, these procedures themselves reviewed in light of the early clinical and laboratory experience, and programs written for data transfer, computer storage, anc data retrieval. The procedures used by the dosimetry group to collect information on the lifestyle habits and on environmental radiation data will have been t
worked out and the process of collecting information by interview and integrating it with the early thyroid measurements will have begun.
Appropriate equipment would be in place and tested.
U.S. clinical and i
laboratory consultants would make periodic visits to review with the Project i
Director the quality of the clinical and laboratory work visualized in the i
protocol. Other consultants would review epidemiologic procedures and data i
collection, and would examine the adaptation of computer technology to the i
study operations. At the end of the first year the Director would prepare a report for review by the Oversight Group.
The first report would cover such topics as:
j i
+
l
- 11.1 -
t-0
)
o Organization of the study, including its relations to other local institutions.
o Staffing pattern, with Curriculum Vitae information on professional staff o Progress made in developing and testing procedures for the study o Review of equipment and of its functioning o Description of the cohorts established for the study o A summary of the work of the first examining center, the central laboratory, and the central office for the study o A report on all known cases of thyroid cancer, 1986-1992, and a plan for their pathology review in year 2.
o A fiscal report o A report on the procurement of supplies and equipment o A preliminary report on the examination of the children The Oversight Group would meet to assess the progress made in the first year.
11.3.
YEAR TWO.
Building on the first year's experience in screening subjects at the Minsk Dispensary and by the initial mobile screening team, the second fixed examining center would be established in Gomel and its mobile screening team established. Additional equipment and supplies would be provided by the U.S.
and U.S. scientists would continue to visit, reporting to the Director and the Oversight Group. Changes in protocol or procedures requested by the Oversight Group at the end of the first year would be made. Otherwise the second year would be one of expansion and consolidation, improvement of procedures for quality control, assessment of the adequacy of the dosimetry information, and pursuit of those members of the cohort on whom information was missing or incomplete. Additional equipment might be needed and the requirements would be reviewed. The Director would prepare a comprehensive report for the Oversight Group which would meet again at the end of the second year.
11.4.
YEARS 3-5.
Clinical and laboratory examinations would continue as scheduled, subjects lost to follow-up more actively sought, efforts would be made to fill gaps in dosimetry information, and preparations would be made for the first major scientific report covering the first 10 years after the accident.
The Oversight Group would meet annually in this period and at one meeting would plan the kind of a 10-year report it considered appropriate and feasible.
U.S. scientists would continue to make periodic visits. Administrative procedures would be reviewed. The tasks involved in analyzing the data and drafting the first comprehensive scientific report would be assigned with attention paid to the participation by scientists on both sides.
11.5.
SUBSEOUENT YEARS.
The 10-year report and scientific advances in the field generally would presumably shape the program in subsequent years, with any necessary modifications of protocol and study procedures.
- 11.2 -
APPENDIX A ESTIMATED BUDGETS (years 1-3)
At this writthg $udgetary information is incomplete, especially for equipment and supplies, as it has not been possible to specify, or to obtain i
cost estimates, for everything needed.
Personnel costs are well estimated for clinical and laboratory personnel but for some other categories of personnel (cf Section 7.1.2) estimates are lacking.
A.I.
PERSONhEL COSTS Estimates for personnel are given in current rubles. It must be expected that the personnel costs will change drastically even over the three-year period and perhaps even before the project starts. An annual budget is provided in Appendix C for the first year together with the staffing for all three years.
A.2.
EQUIPMENT COSTS:
The following estimates are for equip:nent not already available in Belarus, are tentative, and are to be reviewed as the project develops.
EOUIPMENT:
Year 1 Year 2 Year 3 Iqtal INX 60,000 60,000 120,000 RIA Analyzer 30,000 30,000 Microtome / cryostat 8,965 8,965 Microtome /waterbath 5,895 5,895 Tissue processor 19,735 19,735 Microtome / knife sharpener 5,075 5,075 Microtome / mise.
3,845 3,845 Microscope / Photo 9 20,000 20,000 20,000 40,000 Ultrasound Equipment: 980,000 240,000 240,000 80,000 560,000 Freezers:
-80 degrees (path) 19,348 19,348
-40 (blood) 97,037 14,074 14,074 28,148 56,296
-20 (portable) 92,000 2,000 2,000 4,000 7
Radioactive Standards 2,000 2,000 Thyroid and anthropomorphic phantoms 10,000 10,000 Ultrasound quality control phantoms 4,000 4,000 8,000 Internet Comunication Ariel Adapter 399 399 HP Scan Jet Plus with Scanner Interface 1,500 1,500 CD Rom Reader 1,000 1,000
- A.1
Spectrophotometer (Iodine measure) 8,000
.8,000 HPGe Spectrometers 940,000 120,000 40,000 40,000 200,000 Dewar with Transfer System 92,000 2,000 2,000 Dewar Portable 91,000 3,000 3,000 Vehicles 4 wd for Dosimetry 915,000 30,000 30,000
(
Pt. transport 9 25,000 50,000 50,000 t
Equip Transport (field) 930,000 30,000 30,000 60,000 TLD Measurement System 930,000 30,000 30,000 Refrigerators:
l 21.2 cu.ft. 92300 9,200 9,200 4,600 23,000 Portable (field unit) 91,500 1,500 1,500 3,000 Centrifuges:
room temp desk top 92190 6,570 6,570 cooled 7,578 7,578 Water bath: Temp cont. 9760 1,520 1,520 I
pH meter 9640 640 640 Water Stills 9 1200 2,400 2,400 i
Vortex shaker 91266 1,266 1,266 Auto Pipetters j!
Eppendorf: 9298 1,788 298 298 2,384 MLA Pipetter 985 1,020 170 170 1,360 Horizontal shaker 92252 2,252 2,252 Projectors 35 mm 9300.
300 300 Overhead 9400.
400 400 i
Video Cassette /TV monitor 1,000 1,000 Gas generator PS 91,000 4,000 2,000 4,000 10,000 l
Computers (with printers)
I 486 Server 6,000 6,000-Laptops 92,900 23,200 5,800 29,000 i
386/486 system 94,000 40,000 24,000 64,000 Optical disks 9$2,500 7,500 7,500 Video digitizer 20,000 20,000 t
Matrix Laser Printer 15,000 15,000 j
Modems 9300.
1,500 300 1,800 Laser Printers 92,000 6,000 6,000 i
VCRs (NEC) 9$2,000 8,000 6,000 2,000 16,000 Typewriter (U.S. keyboard)9800.
800 800 Copier (Canon) 4,500 4,500 TOTAL 894,770 377,342 241,216 1,513,328
- A.2 -
i
[
. _ - _ _ = _ _.__-. ~
I' A.3.
COSTS OF SUPPLIES The cost estimates for supplies are also tentative and subject to review and revision. No account has been taken of local supply needs, for example.
In addition, certain supplies are tied to specific pieces of equipment, and changes in the latter may change the costs of related supplies.. _Parcer.tages in parenthesis indicate the percentage of subjects to whom such tests are i
estimated to apply.
3 SUPPLIES:
Year 1 Year 2 Year 3 Jggg],
Thyroid function Test Kits Free T4 (100%)
11,200 10,800 28,000 50,000 TSH (100%)
14,720 22,080 36,800 73,600 T 4 (100%) yr 1, 5% thereafter 6,000 450 750 7,200 T3 (5%)
680 1,020 1,700 3,400 l
IMX Misc. reagents Controls, Calibrator. diluents 6,400 9,600 16,000 32,000 n
Equip spares / supplies 1,200 3,600 6,000 10,800 PTH Assay Xits RIA (2%)
975 2,925 4,875 8,775 Supplies 500 1,500 2,500 4,500-Thyroglobulin RIA kits 2,000 6,000 9,000 17,000 TP0 RIA (100%)
36,480 54,720 91,200 182,400 Anti-Tg Ab RIA (5%)
2,000 6,000 10,000 18,000 Ca/ Albumin Assay Kits (100%)
2,000 3,000 5,000 10,000-j lodine in urine 9 $25. (U. Mass.)
6,250 6,250 12,500 25,000 Minsk supplies 1,000 3,000 6,000 10,000 Blood Drawing supplies:
11,800 35,400 59,000 106,200 Plastic gloves: 90.30 1,500 4,500 12,500 18,500 Autopipetter supplies:
2,000 5,000 7,000 14,000 Consummables for lab tests 5,000 15,000 25,000 45,000 Office Supplies 5,000 10,000 10,000 25,000 (filing materials / misc)
Computer Supplies 5,000 15,000 25,000 45,000 Office Supplies-(paper) 15,000 30,000 60,000 105,000
- A.3 -
.-.... J
I Ultrasound Supplies:
Gels, Film, Thermal paper 5,000 15,000 25,000 45,000 i
Optical Disks 9$100 1,600 4,800 9,000 15,400 Video tapes 9$5.00 250 750 1,000 2,000 Communications Materials 5,000 15,000 25,000 45,000 Communications Costs:
5,000 15,000 25,000 45,000 Computer Software:
l Netware 386 3.11 3,500 3,500 Btr. eve + Xtrieve 1,000 1,000
[
SQL + XQL 520 520 SAS 510 510 Windows 3.1 9$200 200 200 MS-DOS 5.0 #$150 750 750 l
Other 2,000 2,000 UPS monitor & UPS 600 W 4,000 2,000 2,000 8,000 Surge Suppressors 920.
350 350 i
Diskettes:
i 90.70/5.25",1.00/3.5" 1,000 2,000 3,000 6,000 Streamer tapes 925 1,000 3,000 5,000 9,000 Internet Communication Software 479 479 Subscription, NLM 2,000 2,000 2,000 6,000 Document Transmittal 3,000 4,000 6,000 13,000
[
Maintenance contracts:
i 107,of Equip cost / year: Cum.
89,500 127,200 151,300 368,000 i
Gasoline (cars & gas generators) 6,000 9,000 12,000 27,000 Spare Parts Inventory 20,000 20,000 TOTAL Supplies 289,364 445,595 695,125 1.430,044
[
Total Equipment 894,770 377,342 241,216 1,513,328 GRAND TOTAL 1,184,134 822,937 936,341 2,943,412 i
i i
t i
- A.4 -
i
[
i i
APPENDIX B CURRICULA VITAE OF PRINCIPALS, U.S. AND BELARUSSIAN 9
l
-v-
=
s N
CukRICULun v!TAE INFCAn4 TION ON MANAGEMENT OFFICER OF T*E mER1CAN-BEL 9RUSS!AN GRG-JECT FOR THE STUDY OF THysco!D CHNCER dND OTHER THvRO!D DISEAM IN BELARUS FOLLOW!NG f,-E GradRNO3vL ACCIDENT sCIENT!-t 8tELD GCST IN I N1sT I TUT ION p.en!Ly
?
r!TLE OF TME POST t
AND lis LO-
' FIC DES-! QF PeOJECT
- NAME, LATION EEE AND ! ETUDy ? MANAGEMENT FIRST
' YEAR OF !
NAnE t
desAAD t
e t
s Vlastmar
- Daractor, 220600.Mansk Meetcal Rastats-Pro.tect Matyuanin Research Ra-nasnerov ave, Doctor on mee t - 5c t en t s -
diatton Meet-23 (1967) cine.
fac Co-cane Insts tu-Tel sof f ) 2a9390 Raatast-oratnator te. Healtn (home8a901U9 on eto-Mintstry,Re-Fans 601723269360 logy euelic o+ Se-larus.
Acaesesetan.
Musesan Aca-
)
esey of Moe1-cal Sctences l
(19667 1I. t-rof esaa ona 1 and Roseeren axoertonce 1947 - 1950 - Student of Chelt estnok MeetcaL Instatute 1990 - 1992 - Stueent of Kiev Meetcal Institute 1952 - 1953 - Student of Military and Naval Faculty of Lentnerse Me-dice! Institute 1953 - 192 - Cht ef of ima t Meet cal Servace 1998 - 1960 - Physician-Ametologtet of Naval Lateratory 1940 - 1966 - Mees Fleet Raetotegist-Tomtselegast tne Prestd1ue 19ae - 1978 = Monter of Apollee Preelses Section of 1
Of the 12 Wit Acasemy of Sc1ences,peevesaearsa 1978 - 1998 - Director, Inststute of Pnvetelogy of Steertan Depart-ment of tne USSR Acaceav of Reetcal Sctonces 1968 - Daretter. Rast atton moettnne Institute, Mealtn Minist-innce ev, Reeuette o, Belarus
- Chat rean, Matt enas Ceemasst en on Madiatt en Protection.
1989 - 1991 USSR twealtn Ministrv inance 1992 - Cnetreen. Mattonal COest ation on Reet atten Protects on, Counct& 04 Ministers of Belarus
e acas. Matvunnan nas mace 15a westten cuolteattons on +unoamental ano acoltee stuetes, among enem - 6 monograons ano stueses in tne d iese ractation medicine anc ractation otology. Tne main worms concernt eg o,tne consteuences of tne Cnernoova accament are the following:
- 1. S&ctsacolootcal Situatton in solarus Fo11oeeang sne Cnernosyl acet-cent. neetcal-stologscal Ef+ects and Sci entt + t c Grouner o+ nessures
+or Raetat1on Protect 2on of Pooulatton. Mtnew.1991. 2-na Recuoitcan iscs ont1fic Conf eronce
- 2. Healtn State of Bel arusst an Pooul ation A4 4 U; tee my Raet one-t t ees as a result of tne Cnernooy1 Accseent. Mansu, 1992, Resuol a c an Sci en-t t + 1 c Conf er ence
- 3. Rastat1on and Ecologscal Situat1on one Meetcal-Stological aspects of tne Cnernonv1 Aceteent Consteuences in Belarus. Mansu, 1992.
I SO ee
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uesacturyte 1963-1955 rr. - HaManHMx usaMuncRoR cayE6W MactM i
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MenHxo-6HonorWecxue nocaencisHa H HayvHee occcHesaMue we.
- asapHH, ponpMaTHa no paaHauMoHHon sumate MaceaeHHz. r.MHHex,1991 r.,
2-as PecnydauxaxcKaA HayMHaK FoH$epeHUMK.
- 2. CoctenuHe snopossa HaceaeHHs BesapycH, nessepreerecx ses:ca.
etsuo panHoHyxaMaos a ennsH e anapHeR Ha 4A3C. r.MHHex.1992 r.,
~
PecnydaHxaxcxas Hayvwas xoH$epeHUHK.
- 3. PaAHannoMHo-3xoRorHMeCxaK CMTyauMM M Me1Hxo-dHoAcrWeCxHe acnexTu noCAeACTBHR RBapHH HA M3C 8 3eRapyCH. r.MMHCx,1992 r.
e 9
i
=
CURRICULUM VITAE I
ASTAKHO7A LARISA HICOLAK7NA Deputy director of Radiation Medicine Institute
=f Health Ministry 220600 Minsk Masherov sve. 23.tel.38-36-48.997-336.99-73-48 office 51-41 home. FAX (0172) 28-93-60 Doctor of Medicine from j
1988. ped iatr ic s. endocr ino logy. nuc lear med ic ine,
Project Director Frofessional and research experience I
1957-1963 - student of Minsk Medical Institute of Health Ministry.
1983-1984 -pediatricina in Halorita hospital of Brest region A
1984-1965 -head of children department in Malorita central district hospital of Brest region i
1985-1988 -post-graduate student of pediatrics chair at Minsk Medical l
Institute 1989-1970 -junior research associate at the Mother and Child Protection
)
Institute of Realth Ministry 1970-1975 -assistaat of faculty pediatrics chair at Minsk Medical Institute 1984-1988 -chief pediatrician at Realth Ministry. assistant professor of faculty podiatrics chair at Minsk Medical Institute 1988-1988 - professor. head of 2rd chair of childrea with a course of children endocrinology at Minsk diseases I
Medical Institute I
Trom 1988 - Deputy director of Radiation Medicine Institute 4 sonographs in co-f 92 scientific works have been published.aaong them:
f authorship.8 methodical recommendations.25 scientific papers on Chernobyl themes, among them:
)
- 1. hyroid system state and peculiarities of its patology formati:n in population living in the territory of BSSR in conditions of combined radiation and goitrogenious factors effect. Materials of ist scientific and practical couterence.Minsk.26-27.III.1989.part.II.p.41-53
- 2. Thyroid system state in BSSR population effected by iodine radionuclides due to the Chernobri accident. Idravookhransnie of Belarus, June 1990,N.6,p.11-18 3.Foripheral blood indices in children living in zones of strict control. Zdravookhranonie of Belarus January 1991,N1.p.8-11.
- 4. Thyroid microsomal antybodies dynamics in children with thyroid enlargement from districts effected br radionuclides Zdravookhranente
~
of Belarus. March 1991,N3,p. 4-4.
5.Ultrasosiothyroidstudyofchildrenwithautoimmunethrrektitis.
Zdravookhranesis of Belarus June 1992.NS.p.12-15.
s.Bealth state of Belarus population effected by radionuclides due to the Chernobyl accident. Theses of papers at 3rd Republican conference,Minsk,1992,part 1,p.83-87..
7 Thyroid diseases diagnostics based on cytometric analysis of Iraphocytes population from bioper material. Theses of papers at 3rd Republiosa conference,Minsk,1992.part 2.p:108-109,
- 8. Diagnostics immunologic tests search in thyroid children cancer.Theese of papers at 3rd Republican conference,Minsk.1992,part 2,p.III-112.
- 9. Isotope investigation methods for the estiaation of thyroid system status in children living in contaminated districts of Srelorussia.
Reprint from " Developments in radioimmunoassar and related j
procedures",IAEA,Yionna 1992.
e<
l GAVRI:.:N 7'.:e ~etter :: 12::rs::r-/
f YVRY
- ! *.he ~.S * *. "..e
! 310:7.121:s :! tr.e.N:'.;:
7ANOVICH Ees.*r. M'.n'.s : r :! :ie.tastan ?edera:1:n EDUCC:CN
- NST::" : N MC ;;;17: :t I ?.II TIA.R
? 2
?
5-. Y to::a 5tste University, Fr sic's:
1971 Solid-state (MSU); Moscow, Russia prJsics Institute of Bio':hisics cf Can11:' ate 1986 Radisticn the Public Health Ministr7 Of safety of the Russian Federation Techni:a1 (IBF); Moscow, Russia 5cien:e RESEARCH AND FROFESSIONAL EKFIRIINCE Participating in research tegan at the M5U in the field of reentgenstructure analysis in 1969.
1972 to date:
Institute cf Bicar,7 sics of the Public Realth Ministry of the Russian Federstien. Positions:Junicr scientific Oc111borator (1W6 gineer senior en 1986).
(1 W2-1 W6).
senier scientific collabcrator (1986-1988).
- ead:.ng scientific collaccrater (1988 to date
)
and vice-leader of *. ate stcry (1988 to date) since 1972, the field of scientific and practi:a1 activities includes radiation safety of workers and pcpulation with some nuclear sources used (routi.ng and accident 111 situati:ns1.
He energy articir.4ted in the man **= ment of the CherneDy1 accident (since May 1 f986).
In early 1987, tc initiated a large-scale wort en thyr { ether with E.*.KIRU5HCE. he oid dose recenstruction fer the pooulati:n f
contaminsteri locations of the Baylorussia Republic (5.5 hint.aryc7
- oined in the work in 1987).
FUBLICATIONS He with co-authors have priparei 19 publicaticns, about 55 scientific reports. He have got 25 aventien certificates of the USSR granted.
REFELBICES (1989-1992) l
!. T33pn..::n D.X., Ipyz B.T., BDotapes C.M. FacH;eassent Ios odaytenn
.tTota.snoa asassu astexoro KouTurrenin a maceasamur tr/Extax catenet
.~:Me.u.cKet ocaecTE. sarpasatasus a esass e saapues as u.A3C.
'TesRev Bcocomencro Cossaanax "AK;7a.itbane serpecu csnueTpxx
- .u aza EnyrpeENero 062TieuxA", P.TCMcAh, 2C-2I comiscpA I989. c.25.
- 2. Tssca.':mm D.N.. retutses K.M., Mapr72c Y.R..
Ipys B.T..
Darxapes perocccesistnet cuouxz snavexxt
- ..1.
Me;ose.wrx'reczke
---a
- c<.'stzR.27s.usMI ros cc.'
- 71efa A nT:an: Rot tezesu y mateaet Seacpycen.
4.
9A3C.- !au ze.
- sepi u;A pa2xauncacuy to:reAc;su npu anspII na
- .29.
- 3. 31Tr111n Yu.I., Gcrdest K.I., Il.n L. A., DrJaach V.T.,
Margu.113
Ys..
Shinkarer 5.M.,
Ivanor V.K.,
Stepanenko 7.7.
Thyr:16
- rrsdiat:.cn levels of in.ha:itants of Syeler.issia af ter the Cht:r.cD71
'l
-.nf.er.:. - A:e:.s:: :f reper: -. 3 6:. 3 ' _m :..
- .e eff-: s r.
- s
- .;/--1 *, : :
iIpcsea OcpC3.*.: P 2 -. M *.;
- . s
..3 r.: 71 1;;' ti.i.
..4 5' : r.3.
. : *.: e
- r r;.: :e.
3-6 secember
- m. -
c.e-.gc7,01/13 7371 r. 13 Nevet:er '990.
>e.-
4 D.7.73RpxAxx.
K.M.T:T:ees.
.~. A. 7. *,s.
Y. 5. M a : r y. :t,
3. T. I:,-".
- .9..:;cascek. 5.K.Manscs.' 5.C.
etr.Nexxc. y;can 3@ ;eMMer: cJ:y-sc.1 0eEc 7H E x.~.Eiec:ges:R Otenic:
_::-:snmi EeAe2W X Me;;;;rt!CCe 00:
.s ur:est MaceAeHHNI t /xxTes 3 2:No rec:x::: xcx;peaA s T:xeatex a :t e3nCW ;ec /0.xx1x:x:t K0xcepeut::n ucr m eencR cdAacTAI 5CCP.
Hsytxc.caxTx7eene screx E : ;txex2A 2:07:2hM at:ta.
- .zer.m r, a.mtmes:wy sossenc sa s pesy.ntste ant;zu un ~~een,:wak r.:n' A3C.
h.MMNex. IZ-I4 M3pTa !?9!. c.!33
- 5. D.M..~ascxAxx. K.M.Toprees. 5.K.22ance.
X.A.Mahux, 1.2.K m pyces.
7..t.MapryAke, B.S.Cronameno 5.T.Xpym.
C.M.ccc< ace s.
CeccoxxacTa :t esyAhrary c::?eAeasuxA Jc3 anyreHHere C1479enA ::2Tcs7.;/ :R seAe3W 3..A fisceAeuxA seriAssessur patenes fec:r/ct:xxx Eeaapy:n.
BecTuzz AxazeMax MeJXuxxcazz Hyn",,Icys 8.K2, c.35-43.T., Dixxapes C.M., CTeraneaxo 3.0..
Museuxo 1992 G. TampxAxx D.4.
tssero cer/ tenA Extenan A meae3s r..A B.@. FoxoxcTDyxuan ]tos say':5e.13pych. 3srpazzennux a pesyntaTe esa x:t T.a. m.;_e.u.
22TeRet Tatokos Fec:rycAzan w
=.= u n.'.ar.. n..a.r.m...e_uwe n,e_t.w.,. s e v.e.n n. wum. *. m n.n..wwm. a n..,v,wan...
2cxasses 3-R pecnydAuxascKo2 xcMCepeMintz "Kay'Uto-anru9oexne ac::exTg
- txxca owy sosseAc;3ns a ass annet, cc:se;2 A3C", pamauror.TcueAh,15-I7 anpem I592, cc axeuna sao na 9epsocs.nexc pes nTate asa c.7 -77.
g ggi,IIR PUBIaICATIWS r
sas I. D.W.Tas
, Y.M.Mapry :sc. S.I.Xpys. K;norennut upocoo:cca.nnx "ususpaensaA yassJtna pa2 Roam amass rates M asposcAet.
I985 N5.
Texxrsa"$.Sopscos, 2.
M.
A.M.Bopscess.
D.M.TampxAxx, y.M.MacryAnc.
H.B.IIstpasos, 8.T.Ipys. Mecae.20sexRe esc 2 cts paRoexTRBEMI ftpC8xTea a rasesut sud car c comosat naxercs asaAITutoexxx tuanTpos x
a "ID'FTA-K".- B cc. ",Texantocrat sporgccKPS-I?" sun.!(u.).
M..
XpnorexIoro Soot 6o i
H2cTem a CCCP I
aTcunct upo assucc.. Cagna:
2netreatownsasT, B M.$an. IC5-IC7.
1987 c mmeen n n. A. Man.w A
n e n n,...n.psAxx, K.H.T 4a mn.
D.M. Tam as.
3.3.C.A2.@.besa.
n n..
3t vm e,
a n v-veu-i 1
l t
i t
1 i
GAVRILIN. YURIY IVANOVICH PUBLICATIONS 1989 1992 1.
Yu. l. Gavnlin. V. I Dnchch. 5. M. Shinkaryov. *The Distnbution of Thyroid Gland Irndiacon Doses in Children from Communities in Distnets of the Gomel Region Whten ere Contaminated as a Result of the Chernobyl Acetdent."
Summaries of Repons w
Delivend at an All-Union Conference on ' Urgent Problems of Internal Irradiation Deskastry." Gomel, September 20 21.1989, p 25.
2.
Yu.1. Gavnlin, K. l. Gordeyev U. Ya Margulis, V. T Drushch, S. M. Shinkaryov.
" Methodological Pnneiples of Retrospective Estimates of Individual Doses of Thyroid Gland Irradiation Among the Residents of Belorussia Exposed to Radianon as a Result of the Chernobyl Accident." Ibid, p 39.
4 Yu. l. Gavnlin, K.1. Gordtyev. L. A. flyin, U. Ya. Margulls V. 7 Drushch. S. M.
Shinkaryov, V. K. Ivanov, V. F. Stepanenko. *I.4vels of Internal nyroid Irradiation and Methodological Aspecu of Quanutative Estimates of These I.svels for Residents of Communities Inside the Closely Monitored Areas of Gomel and Mogilyev Regions of l
Belontsma." Sununaries of Reports Delivend at a Republican Conference on "The Scleatine and Techalemi Aspects of Preserving the Health of Individuals Exposed to Radiation as a Result of the Chernobyl Accident." Minsk, March 1214,1991, p 133.
5.
Yu.1. Gavnlin, K. L Gordeyev. L. A. flyin, A. l. Kondrusev, U. Ya. Margulis. V. F.
Stepanenko, V. 7 Drushch, S. M. Shinkaryov. 'The Charactenstics and Results of i
Determinations of Intemal Thyroid Irmdiation Doses for the Population of Contammated
(
Areas of the Republic of Belants." YestmA Akademil Medicinskikh Nauk (Journal of the j
Academy of Medical Sciences). 1992, No 2, pp 35-43.
6.
Yu. L Gavrilin, V. 7 Drushch S. M. Shinkaryov, V. F. Stepanenko, V. F. Minenko.
'Reconstmenng Internal Thyroid Gland Irradiation Doses for Residents of Areas of the i
Republic of Belarus Which Were Contammated as a Result of the Chemobyl Accident *
(Status and Urgent Problems for the Future). Sununaries of Reports Delivered at the Third Republican Conference on 'The Selentific and Tachateal Aspects of Preserving the Health of Individuals Exposed to Radiation as a Result of the Chernobyl Accident." Gemel, April 1517.1992, pp 75 71.
REPRESENTATIVE EARLIER PUBUCATIONS 1.
Yu. L Gavrilln, U. Ya. Margulis, V. 7 Drushch, 'A Cryogenic Sample Taker for Trapping Radioactive Gases and Aerosols." Innentelnaya tekhmka (Instrumentanon),
1986, No 5.
2.
N. B. Sortsov, L. I. Borisove. Yu. L Gavrilin, U. Ya. Margulls, l. Y. Petryanov V. T.
Drushch, "A Study of the Properties of Radioactive Products in Gas Discharges By l
Means of Packets of Analytical Filters and the PURGA K Cryogenic Sample Taker." In the collecuon Technological Advances in the Nuclear ladustry. The senes Isotopes in the USSR. KRB IV. No 1(72), Moscow, Energoatomirdat,1987, pp 105-107.
3.
Z. F. Arefyeva. V.1. Badyin. Yu. I. Gasnlin. K.1. Gardeyev. L. A. Ilynn. V. P Kryuchkov. U. Ya. Margulis. D. P. Osanov, V. T. Khnahch. Handbook for Estimating Thyroid Imdlation Dosas Resulting frorn the Uptake of Radioactive Iodine isotopes in the Human Body. Moscow, Energoatomt:dat.1988. 50 pp.
.t.
V. T. }0srushch, Yu.1. Gavnlin. Yu. O. Konstannnov. O. A. Kochetkov. U. Ya.
Margulis. V.1. Popov. V. S. Repun. V. V. Chumak. ' A Descnpuon of Inhalzuon Uptake of Radionuclides." In the book he Med!c2! Aspects of the Accident at the Chennobyl Nuclear Power Plant. Reports Deuvered at a Scientific Conference Held May 11 18 in Kiev. Z4orovye Publishing House. Kiev.1988. pp 76 87.
e i
F t
l l.
1 CURRICULUM VITAE INFCRMATION l
oN MANAoExBNT orrICER or TxE AxERICAN-sELARussIAN
~
PROJECT FOR TER STUDY OF THYROID CANCER AND OTHER THYECID DISEASE IN BELARUS FOLLOWING THE CHERNOBYL ACCIDENT l
s FAMILY TITLE OF INSTITUTION SCIENTIFIC FIELD POST IN
- NAME, TEE POST AND ITS LOCATION DEGREE AND OF FROJECT FIRST YEAR OF STUDY MANAGEMENT NAME ANARD l
Yakov Deputy 220600, Minsk Medical Radiation Scientific Kenigsberg Director Masherov ave.
- Doctor, Hygiene Consultant for 23 1968.
research Tel(off1269480 Doctor of
- work, (homel344595 Biology Research Fax 0172-269360 l
Radiation Medicine l
Institute l
PROFESSIONAL AND RESE&kCE REFERIENpE 1
1956 - 1962 - Student of Minsk Medical Institute 1962 - 1964 - Physician, Gomel 1964 - 1988 - Research Fellow, Sanitary Institute, Minsk Medical Institute since 1988 -' Senior Research Fellow, Chief, Laboratory of Radiation Eygiene, Deputy Director, Research Radiation Medicine Institute Y.
Kenigsberg has made 115 research works on the problems of hygiene and toxicology, including:
1 1.
Radiomar.4 of hydrophobia virus. Noecew, 1971.
2.
Study of @ ood animale for testing of immunogenesis. Moscow, 1973.
3.
Applicaties of radiation methods in poeticide toxicology.
Moscow, 1976.
l 4.
Indocrime and Y===
eystems state under the pesticides influence. Moscow, 1980.
5.
Radiation and ecological situation in Byeloruesta and esposure doses of I
population.
Bulletin, Academy of Medical Sciences of the USSR, 1991, Nil.
6.
Mealth state of population of the Reptblic of Belarus, affected by radionuclides due to the Chernobyl accident. Minsk, 1992.
1 1
l
t.uhn!CULun vtlat INFOmmaf10N as 9s4AGEMENT OFFICER OF Tkt aM(MICAN.9E1.aRUeSlaN 6ad.1ECT FOR 14 STUDY OF TWvm0!D CANCER aMD OTWER TWvec!D niegnsE IN BELNeue Fot. LOW!he THE CwtRwasvL ACCIDENT
' t.e I L v f1TLE OF i
INeT!Tuf!ON
? eCIENft ' FIEl.3 ? POET IN sND I Til LL)=
? FIC DEe-! OF
? PeOJECT Nr.<%.
INE PORT CsTION f REE aNS t STU3Y I MaNacEMENT FIRST t
Nanh f VEAR OF !
e
! ANARS t
Organisa-nanager 31ee ge n Weed Dester.
223032.ninsk nervekn L:s t nt e, Aete= dietetet, tien of aren Rastatt-aksskovenshina Health on Meettine Tel(ofd5362464
- Service, Institute, (Neee8937416 Ultrase-Health Minte-Fau t&01721269360 nie sia-try, Recualic gneetate of Islarus, Pnyetrien of I oualifica-tien esgree.
emOFESSIC3404. AND RESEAeCH EXPERIEM:t tvA9 - 197"I - Mtueent of Ermene neet cal Institute 197M - 1976 - Thorsey Internente, Pinar Hoen1.tal, te76 - 1979 - Mead Dester of District Meesttet 1979 - 1981 - Citatea1 stuelee es Theracy Department, Minsk medical Instttute 1944 - Chied, Citnteet Department, Senatertue *ammakevanchtna*
1941 19e9 - Moes Bester. Senatertwo "Ameakevenantne" 1966 stece 1989 - Mead Bester, Clints, WeseartM Reetatten Meestne Institute Screej norytke systeesttrally attenese savances training eeurses on teoreev, seres ology, fietsstenal st agneettee, neelta servtse.
Eerees Karytko nas ease a nuseer of owitten publicattene. #meng these
- t. Area tasnary roeults of gastraf1heessesta of populat1en af f ested cy raatatten. Mines, 1991.
- 2. maattn state analyste of seeste utta essess parettaelo levet e4 Co-ts7 esotenuet tese sneerparatten, senerves in therapy seeartment of C11nte, Remescan Radiatten Meetegne Institute in 1991 - 1993.
Minek, 1992.
- 3. Health state analygts of Chernemyl clean-we workers in the synantse o+ nost-acessental pertes asserting to the date of Clinit therapy cesartment, Researen Rastatten moetegne Institute. Mines,1992.
4 Internat eteesses pecultarstaes in Cnernesyt clean-we merwere.
nines, 1992.
FF w umesoner* ooram :,recxor tw am,,na,mou:
SiOGRAPHICAL SKETCH Give me seesmag prermeen ser ine may peserve ano consunants ano coaanormers. sep em me unrenas s
eveengenertgregram cirocaer. P*etocopy ines page for eacn person.
ON N 338t11888 1460P4ftpfte. Jaectat:;ss sitets patsassositi $6c!gggggs :
3HKT07 $fA0pOBHM MHHeHKO lettst'sti klf tilaanscauci statanut qqron 1: +.= mes onceamwome er ;e near aroressenet meen. se as nurmat. ano ma,no oesroacxeret.
,J i
vsAn I
rNSTm/nON AND t.OCAT10N l
DEGREE CONPEARED I F1 ELD OP STUDY SeAopyCCKMA rOCyA&pCTBeHHWA
@H3HK 1972 FAAHauMOHHAM 6Ho@H3HK3 YHH3epCHTeT. NHMCK. SeaopyCCHR HHH oHK020rHM M M.AHuiaexoA KaHA.
isse p.AHeeHer..rHn.
PAAH020rHM. MMHCK. Bea opy C CHR 6HOA.
A03HMeTTHS mEsEAACM AND PROPseermani gxpEAIENCE. Geenseng um prenere sw est. m wowmagios erger, preneus aneusymww. esoonence. ano tenere. Kay perserem monase me armosol wwesegener one any emer moveems une seressem a me soonsac eewoomeru er enesumen a me crosec Key pereerem tysumme we manaes es wevenaam won essere er emer seweemans stayees. sw m same prosess we moues renvowas e ine maswr r
neseeneurees ave preases rey serereues a e ausesstow wey w ine noensac esvenement er sessusen w me protesz. inause arosers mwrewsruo en any aness oevemmere senayemnessy esmmene. use, m evenoegem ereer. me sees. as aumere. ens eenenme reierences e as pusecame t
p pas rvos years ans a repremerenew eerser maanneens pererera e me ecomessert 00 NOT EXCEED TWO PAGES.
l 1972-1986 -
HHH oHK020rHM M McAHuMHCKOR PAAHOKorHH. 3&HHMacMWe i
AoAxMcCTM' M MEe M e p **@H 3 H K. CTRpBMA HHKeMep. CTAPEHA H&yMMWA CCTpyAHHK.
3aHMM&eMAR ACAXHOCTb:
HHH P&AHAUH0HMCA MeAHuHHW.
1988-no 3A8eAymEHR A&60pATopHeA.
i HACTOKEce speMa pyKos0AMTeAb CTAEALHoro M&nphSReHHK HCCJeACBAHHA 1990-no MaC;onEce ToCyAapC;e3HHoA nporpaMMW HeoT20EMWx Mep 3
speMs.
PeCny6AxKe SeampyCE no AMKBMA&UHH NOCACACTSMH l
j asapMM Ha 9epHC6WAbCKon A3C.
l l
M2eH 5eAapyCCKoA MauMOHa2bHOR KOMMCCHH no l
1991-no Ha cionmee pa2MauMoMHOA 1AEHTe. PVKOSCAMTeAb rpynnW A03HMeTpHH l
i speMM J
F:
Jorm esse si e g.
- s na sae, Sw i
%.a.o., o.c.. w n.
v ei = nwa swow,wi m neo ca a oo %.. v.
n a s 23
'.i,
%yenxxosaxo denee 50 May9xwx pacc7 ::
a::; caw
- saxeTpna, a
sacaTe xa:enexxx
- 7 pa:x:cuencrzu, pa2xauxonnca cesenaca:cTu f
pa:Manacxxcro so3:eAc; sus, :pe:H x T:pwx:
- 7. IT.. TypMuosHM,
S.B.~.asneux3.
3.@.MHueux.
- d.T TapyTMH.
A.C.y3ynda:KaxCs PaAH:$oT0nDMunectexTxW2 0:3HWeTp :
MxxMa7tpxWMM seTexT paux. Assoc;xx AH CCCP. cepux ?x3xwecxas. M.
197.
- 7. c..
l N 7.
2.
B.4.Munexxo.
Cueuxa 3$$exTussocTx ny9esoro nexexxx nouenho HCH npx paanx9xux yenosaxx odaywouxa.
Meaxuxxcxas paaxonorxx, M., 1983, N 3.
- 3. B.B.Apossenx9, S.4.Munexxo, A.B.ynamesexx1, E.B.Eeuxxxua.
Upornos :os odnyyenus xacenaxxx 5CCP or paxxonseTones nesxx.
MuncK, 1989.
- 4. B.4.Muxexxo,
A. B. YnaxoscKm2.
PannoMeTpx9ecxut KoxTpons odny9euxx xacenexxx 5CCP. Snapsooxpanexue 5enopyecxx, Munex, 1990, 7
N 6.
- 5. B.B.Apossonx9, B.4.Mxuexxo. Queuxa renosos sosu odny9exxx xaceneuxx. 3 xx.: Haynxo-npaxTx9ecxue acnexTu coxpanexxx azepombs nones, nonzeprmuxcx paaxcaxTuswouy soonesetsun a pesynbTaTe anapxx na Mepuedunbexet A3C.
Tes.
pecaydnuxanexon xou$epexuxa,
- Muxex, 1991.
[
5.
B.4.Munexxo.
A.B.ynaxonexat, C.B.Kopueen.
CocTexxue x
nepecnexTxsw xoxTposa anyTpexxere odny9exxx xacenouxx SCCP. B xx.
MeTo:x x
epeacTsa paanoaxTusucro xcxTpons.
Tes.
sexnaza pec::ydnuxanexon wayguo-Texxxweenet xoxtepexuxx, Munex,1991.
t 7.
B.A.MaTexxx, K.3.Keuvredepr.
B.4.Maxexxo.
Paanannouxo-l axonernwecuas exTyauxx a 5enopyecxx x sosu odny9emma nacenexxx.
BecTxxx Azaaeums Measuxxcxxx xayx CCCP, M., 1991, N 11.
t i
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LUMRICULun vfTAE INFORMATION 1
QN DEPARTMENT nANAGER (dRLDEms GF TaE AeERICAN-5ELARuSSI Aes i
-=udECT FOR T4 STUQv GF TavE01D Ca*NCER aND OTesR THvRO1D j
D i titAGE IN ssLMMuS FOLLOWING 1**ti CFkRNOSYL ACCIDENT ECIF.NT1-t FIELD
- #0sT IN sNSTITUTION TITLa' OF W eg t L v FIC DES-! OF*
rROJECT THE POST t
AND 1IS LO-Nmne[.
e CATION 8 REE deND
- STUDY MaNaGEPENT FIRST Nemed i YEAR OF t e
- amaRD nonstantan Cn t ef,
229eOC.Mansk Meetcal Eo n cent -
Es t e emt o-noencntw Lamoratory o+
namnerov ave.
Doctor ology of logy De-Raetat1on if-23 1983 non-snfoc-partment
+ects fotoe_
Tel t of f ) 234785 ttous on-Manager
- atology, (none>545434 seases wesearen Ra-Fawi40172)269360 statton nost-eine Instatute, toen1or mesearen F el l oss.
!1 PROFES$10NAL AND RESEARCH EXPERIENCE 1964 - 1949 - Stueent of 3 rest Medical College 1969 - 1972 - meetcal attensant 1973 - 1979 - Stueent of Mtnsa Medical Institute 1979 - 1942 - Post-grasuste Institute of Varelogy, USWt Acaseey of Medical Setonces Senarusstan Researen i net s tute o+ Es t eens ol ogy and nt croo t el ogv 1982 - 1963 - Junter Researen Fe11oes 19e4 - 1966 - Sent or Researen e'el t oes ntnsa meetcal Inststute 1987 - 1984 - Sent or Reessaren Felloes, Central Researen Lasoratorv kesearen Maatatton Meetetne Institute, Moeltn Minsstry. Reouoinc o, Belarus 1ved - ment or Aeeearen Foi A ese Sn nce &+44 - Neae. Lamorstorv of Anet at1on Ef f octs Eos e**1el09v
nas mace in ene researen institutions K.ncsnensw Dursng CM8 "erk l
acol1es stuotes anc orcolems of ooscento-22 ser s sten puoi a c ati ons on among them - 11 on Cnernonvi sneme, suen aos toav.
- 1. netnoes of ossomatologscal analvets of inf ecti ous ano non-s n+ ec-tr ous as sesses. ntn'sw.4749.
- 2. norosonty of entleren s pooulat1on 1avsng an regtons under contre 1 of G 'el ans mog11ev Uelast. Mansk,1991. Proceeetngs o+ Recuatican Sc a ens t f t c W.t er enCE.
Belarus some eseograons e snda ces in the regs on of
- 3. Desc~ s ott on of 1991, Co11ected scaenttftc isocus et affected my rassetson. Mi nsk,
Inststute.
tne ReMarrn Rastatton noenctne 4
Esteesselogscal aspects of adult population moros esty of non-sn+ee-tsous enseases frN ene regsons unser control of Gomen and Mogtlev Oolast. Msnok, 1991, Collected Sctontafac teorks et tne Researen Raet ation Meet elne Inst 1tute.
tne Belarusst an analysse proolems of neaatn state of
- 5. Esteentologscal Mansk, 1992. Proceeeings of the population affected By raatatson.
Repue11can Scsentsfac Conferonce.
e Vtantear MatyukMan.
- Director, Researen Raetatson M.edictne Inststute.
~
acessesesan,
~
Russaan aceaemy of Meetcal Scsences t
l wm
-v--
e y
&--4 e
Anto6sorpa4rweeras enpaarn wn sas.:- e;:w 3 y;ewa: : yy auspuxaxo_
casopycesoro apoorta no waywomeo paxa a :;yrwx ceaeswen xtesu:xen u.a.
su Semapycu nocae 9epHo6wnexen xatacepo$u.
Y m as
, US*FY"'8 r
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rea mm
, ee,,3e
,annapan sua i
saame
, waxouenose g,,
i
, cywaewma,
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- 11. Prof eest anal and Researen Emportance 1956 - 1962 - Student of ninek noescal Institute 1962 - 1965 - Meae Docter of a Neematan an Seest On1act Reneeren Cutaneeus-venorono9v Instatute 1944 - 1978 - Aeeeeren Fe11ow 1975 - 1982 - Senter Researen Felton 1982 - 1987 - Scienttfle escretarv j
mosearen Raetatton neetetne Institute j
i I
1988 - 1991 - Cnted of Scientsf ts-Orgentaational Doeartment atetoe as Scients e nc betretary of tne inetstute (1988-19898 l
Since 1992 - Scientt+tc Secretary of the Institutes Acts as Cated of Sct ents f ts-Organtsatsenal Deeartment tne meeearen Restatten noetssne Institute of uus* t eg sne isort at Nealtn ntntstry of tne Recuelle of Belarus S.M.Neitvke nas mese 32 es t-ten oueltcat1one on tne orcolees of neeltn servtce orgent atton one on tne assis se etuat es incluaang tnose of tne Cnernocyn speces i
- 1. Organt z ation of mass meetcal examinations o*
Islarussten entleren s coaut at1on af f octeo av ract at1on 4 c1 & outng tne Cnernoova
- acctcent, etnsk.1991
- 2. Pecui1arsttes of C1antcal WWamtnat1on o' the 381aruss&en cooulat3on a+*ectee av raetonucitees +ollowsmg t " C.ernocy! accacent. etnew.
1991. Pr oc eed t egs of tne Recuoltcan Con +weence.
- 3. some results of sne Repualacan noeacal Escert Counc 1 act3vst3es on the oeteretnatton of causal rel at t onsn t o of assesses ans essantistv
=s tn the carryt ng out of sne caernooy! clean-us works, 1991, ntnem, Proceoetngs of tne Repue11can Conf erence.
As an Executs ve Secretary of tne Institute Editorn al Counct a, S.N4=
lavmonas presarse artsten sueltcations of the proceecangs of tne A-st 2-ns, ane J-e Repuet t can Conf erencoe, cet tectee set ents f t e norms of tne Insts tute and collectee asetnt strattve encuments on tne orooleas of sne Cnernosyi acctment.
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- Director, kesearen Rastation moetegne Inststute (ac a d e s t e t a n,
Russt an Acacomy of neetcal nc1ences.
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!OLc4rcN sepa =* '
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'.943 Columbia University M.A.
'964 i
Psyca:'.:gy New York University Col.less of Medicine M.D.
1968 Meet::n.
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, en, earmseems e m e amorene e x.y serienrenymener we caems as consues se essera y emer erwensens asynes as a some paese =svesemere or eseaman av me wo neesseurono sue prevens swy senmouse e a manewwwe soy a me amargne esseewne,nt w esseusen any seems Qeverrvnen semesumes, serveness. Les. m enrennepas ereer. me sees. as meurs. an sese swee yees one e remensnue== easter amesemane eerwent a me assessmen. Do NOT EXCEED ONO PAGES.
Research, Teaching and Hospital Appientments:
Director. Clinical Isotope Unit. Brook Army Hospital. Tt. Sam. Houston. Texas 1952-1954' Director. Division of Nuclear Medicine. The New York Hospital-Cornell Medical Center.
New York. NY 1955 present Attending Radiologist. The New York Hospital-Cornell Medical Center. New York 1971-prese:'
Prof.essor of Radiology. Cornell University Medical College. New York 1972-present Professor of Medicine. Cornell University Medical College. New York 1975-present Attending Physician, The New York Hospital-Cornell Med. Ctr. New York 1975-present Organizational Positionst Member - National Council on Radiation Protection & Measurement Scientific C::ncittes No. 57. 1978-present Technical Advisory Committee on Radiation to the Health Cosatissioner of the City :f New York 1978-1983 Trustee - National Society of Nuclear Medicine 1978-1986 Member - Ad Hoc Working Group on Thyroid-Iodine 131 Assessment. National Cancer Institute. Bethesda, MD 1983-present Member - Constittee on Public Health, and its Executive ComeLittee. New York Academy of Medicine. New York. NY 1984-present Chairman. Working Group on Health Aspects of Radiation. New York Academy of Medic:.ne.
New York. NY 1985-present Consultant - Office of Health Affairs / Center for Devices and Radiological Health (CORE).
Food and Drug Administration 1987-present Consultant - Radiological Devices Panel / Center f or Devices and Radiological Healta (CDRE). Food and Drug Administration 1987-present Member - National Cancer Institute Thyroid / Iodine-131 Assessments Committee 1987-present Member - New Ye3 State Department of Health Radiological Health Advisory l
Comas.ttee 1987-present Member - World Realth Organization /Coselission of the European Communities Worksnop on Iodine Prophylaxis Following Nuclear Accidents 1988-present Consultant - New York State Department of Health. Sureau of Environmental Radiati:n Protection 1988-present i
e=s ass imer Min wansa seses awsommer a su emene ownwynews se asemommen. vorm esos si e ge n
F De nurwee sum.as man as aa. Ja.
r;!'_ *:.s-* : :
The Resu.:s :f Ract:::c; s Treatmen* :f syper nyr::t;ss.
A Pre.;n;..ary Ee::::
- f : e T-vr:::xi:: sis Therapy i:ll:V-2; 3:usy.
!accer.
0.'t.. M:C::aney 4.3..
- yns. 3.M.
7 nptins.
E., Shell e.
.I.,
and W::Anan..'.3.
Pr:c. :f :..e ;;
- ternat::341 Thyroid ::nference..i 0.
Tur:ner Advances in Thyr:Ld Resear:n.
Id::::s:
.<. Tellinger and R. s:ter. Jer;:g ser Wiener Mac ::::sacaen Axacen e.
603-609..971.
Necrosis :f i:11;:214r Calls and Disc arge of "hyrstd *: dine *nduces :v Acninistertag ::cise to *: dine-Deficient Dogs.
Selsnav. 3.E. and Se:4er, D.7.
J Clan Enocrin & Metao 36:.66--7. 1973.
Malignant and Senign Neoplasms of the Thyroid in Patients Treated f:r Hyper:..yr::::ss:
A Report of the Cooperative Thyrotoxicosis Therapy Fo11ovup Study.
Oo'yns.
3.M.,
a Shaline. G.E., Workman. J.5.. Tompkins. E. A.. McConaaey. W.M. and Becke r. 0. l.
J Clin Endocrin 6 Metab 38:976-998, 1974.
The Role of Radiciodine Treatment in Childhood Hyperthyroidism.
Becker. D.7.
J Nuci Med 20:890-894 1979.
Thyroid Suppression and Stimulation Testics:
The Place of Scanning in the Evaluati:n of Nodular Thyroid Disease. Hurley, J.R. and Becker. D.V.
Seminars Nuci Med 11:149-160. 1981.
Physiological Basis o f the Use of Potassius Iodide as Thyroid Blocking Agent.
Logistic Issues in its Distribution.
Beckets D.V.
Bull of the New York Acad of Med 59:1003-1008, 1983.
Radionuclide Thyroid Imaging in 135 Cats with Hyperthyroidise.
Peterson M.E.
and Becker. D.V. Vet Radiol 23:23-27. 1984.
The Use of Iodine as a Thyroidal Blocking Agent in the Event of a Reactor Accident.
Becker. D.V.. Braversan. L.E., Dunn J.T., Gaitan. E.. German. C.,
Maxon. H., Schneider. A.B., Van Kiddlesworth. L.. Wolff. J. JAMA 252:659-661. '.384 Choice of Therapy f or Graves' Hyperthyroidism. Becker. D.V. N Engl J Med 311:464-466.1984 (invited editorial).
Neonatal Thyroid Scintigraphy in Congenital Hypothyroi6dsa:
Evaluation and optimization of the Cost-benefit Ratio. Zanaonico. P.R., Becker.
D.V.,
Hurley. J.R., and Katz, M.
Presented at the 1987 Annual Meeting of the American Thyrmid Association. Washington. DC. September 16-19. 1987.
Reactor Accitests Public Health Strategies and Their Medical Implications.
Becker. D.V.
JAMA 158:649-454 1987.
Also published in JAMA. Southeast Asia Edition 4: 35-40. 1988 and the JAKA French Edition 13:33-40, 1988.
Autonomy of Growth and of Iodine Metabolism in Hyperthyroid Teline Gotters Transplanted onto Nude Mice.
Peter. H.J.. Gerber. E., Studer. H., Becker. D.V..
and Peterson. M.E.
J Clin Invest 80:491-498. 1987.
Radioactive Iodine Treatment of a Tunctional Thyroid Carcinosa Producing Hyperthyroidisa in a Dog.
Peterson. M.E.. Kintzer. P.P., Hurley, J.R.,
and Becker. D.V.
J Vet Int Med 3:20-25. 1989.
Camparison of Technetium-99s and Iodine-123 Imaging of Thyroid Nodules:
Correlation with Pathoicgic Findings.
Kusic, Z.. Becker. D.V.. Saenger.
E.*..
Paras. P.. Cartside.
P., Wessler. T. and Spaventi. S.
J Nuci Med 31:393-398 fE-
? ?3 *. ::AT::N5
- n: nuec)
Aut: : nous GroVen and Puncts:n :f C iturec I'.vr:tt I:llit.as fr:n "ats..cn 5pentaneous Hyperthyr:1 disc.
P e t e r..*. H., J e r:e r, d.. S tuc e r. E.. Pe t e r s en.
M.I.. Becker. D.V.. Or scurts. P.
Thyre td. : 3 3 ' -3 3 8..99..
BOOK CHA?! IRS
- nducti:n f Thyr:1d Cancer by Iontzing Radiatt:n.
Maxen. H.R..
h :as.
5.R.,
3eener. D.*.*.. Books. S.A. and Bunener. C.R.
Natt:nai Council :n Ractat :
Protection and Measurements. NCRP Report No. 80. Maren 1985.
Safety of I-131~ Treatment of Hypertnyroidisa.
5 r 111. A. B.. B e c k e r. D. *!.
Chapter in: The Thyroid Gland: A Practical Clinical Treatise. Guest Editor:
Lester van Middlesworth. Ph.D., M.D., 1986.
Radiciodine Treatment of Hyperthyroidism.
Becker. D.V..
Hurley, J.R.
In:
Diagnostic Nuclear Medicine Volume 1. Second Edition. eds. Gottschalk.
Hoffer. Potchen, and Berger. Williams and Wilkins. Baltimore. L988.
Treatment of Thyroid Carcinosa with Radiciodine. Hurley. J.R. and Becker. D.V.
In: Diagnostic Nucisar Medicine. Volume 1. Second Edition, eds. Gottschalk.
Hoffer. Potchen and Berger. Williams and Wilkins. Saltimore.1988.
Medical Radiation:
Comparison of Iodine-131 Therapy and Alternative Treatments of Hyperthyroidism. Becker. D.V.
In:
Radiation and the Thyroid, eds.
Nagataki. S.
Excerpta Medica 1990.
Treatment of hyperthyroidisa with 131-I:
Continuation of antichyroid drugs does not adversely affect therapy and in 'small pool' patients reduces the extrathyroidal radiation dose.
Becker. D.V..
Zanzonico. P.B., Hurley, J.R.,
Kusic. Z..
Sanderson.
L., Tsen.
0.. and Straus. A.
In:
Progress in Thyroid Research. Gordon. Gross and Hennemann (eds). Salkeaa. Rotterdam 1991.
pegs 223-226.
Different continuous call lines from adenomatous feline gotters widely l
dif f er in sorphologic, functional and growth parameters. Gerber.
H.,
Peter. H., Bosiger. J., Studer. H., Drews. R., Perguson D.C.. Peterson. M.E.,
Becker. D.V.
In:
Progress in' Thyroid Research. Gordon. Gross and Hennemann (eds). Balkama. Rotterdam, 1991. pas $41-544 Radiation Hasards in Children Born to Mothers Exposed to 131-Iodine. Zanzonico.
P.S.. Becker. D.V.
In: The Thyroid and Pregnancy. C. Beckers. D. Reinwein (eds).
- ncernational MERCK Symposium in Brussels. January 31-Pebruary 2.1991. pgs 189-202.
I l
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SIOGRAPHICAL SKETCH Gw me meewwg rawmenen tw m may pweennea are coneutaris ano ennamorames seen em a annoosi cveanoamrmroerem orecer P%=coor me sees ior eacn oween wwg POSmON TITLE Andrd Bouville Senior Radiation Physicist Radiation Effects Branch, NCI, NIH EDUCAT10N /Bep mem escsadh#esW w emer runel prweeadonet saucemen. eWon af nurevy arW mcame gassepoorg are rung )
YEAA peSTTT1/ DON AND LOCAT10N oeGmaE cop #ammao FIELD OF STUDY l
University Paul Sabatier, Toulouse, France B.S. (eq.)
1960 Physics University Paul-Sabatter, Toulouse, France M.S. (eq.)
1963 Nuclear Physics University Paul-Sabatier, Teulouse, France Ph.D. (eq.)
1970 Physics masaAncH ANo enormascNAL ExposueNet Counseng am preews poemen, mm. m Wewunges war p steermru uponence and noners. Nor perseres seems me armeow swesesmer we any emer sevewes *= peressem m me emmene es memen w e,s.msn e me yo,ect mer perusans typseer we neues as revuham esm semers w eest premamens empreen, ma m sono pres a. we menses ance.a as a mamws or sessmeuroene eve prenses vor serwause m a nameneve =or = es amwess ee emmen w emmunen a me,,eism. inaume areews momewone en any reeers eenemmere mass seemory esamese um. m entwe= pes oreer, me seen, en amore. ens es,me rwww.se e u nimessesne onne m p.m eres roers ww a repreewess meer memessens puenwu a r= esensamen. oo not axcaso Two PAGas.
Previous emnlovmant Paul-Sabatier,Toulouse,rtmentofAtomicPhysics, University Graduate Assistant Depa 1962-1965 -
France.
1965-1966 - Exchange Student, National Atmospheric and Oceanic Administration, Silver Spring, M.
j 1967-1970
- Graduate Assistant, Department of Atomic Physics, University Paul-Sabatter, Toulouse, France.
1970-1972 - Scientific Secretary, United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), New York, NY, and consultant to that organization from 1973 to date.
1972-1984 - Assistant to the Director of Protection at the French Atomic Energy Commission, Fontenay aux-Roses. France (following promotions from physicist to Group Chief and to Deputy Director of a Division).
1984-1992 - Expert, Radiation Effects Branch of the National Cancer Institute (NCI),
Bethesda, M.
1992-Date - Senior Radiation Physicist, Radiation Effects Branch of the National Cancer Institute (NCI), Bethesda, M.
Ernerience and honors Consultant, United Nations Scientific Connittee on the Effects of Atomic Radiation (UNSCEAR).
{
Member, Cosesittee 2 of the International Commission on Radiological Protection (ICRP).
Team Leader, International Chernobyl project of the International Atomic Energy Agency (IAEA).
Member, Working groups 7.1 and 7.2 of the US-USSR Joint Coordinating Committee on Civilian Nuclear Reactor Safety.
Member, Consnittee on an Assessment of CDC Radiation Studies of the National Research Council (NRC).
- ,4 aos ime, een
<Fwm Peos si Peo.
emarinerseems -
. m se enemm evengnma tw sammemuert De act ene e mas een as 3s Ja.
BIOGRAPHICAL SKETCH Chairman, Scientific Comittee 5716 and member of Scientific Comittees 6416 and 84-1 of the National Council on Radiation Protection and Measurements (NCRP).
Member. NCI Site Review Comittee for University of Utah Contract for Epidemiology Studies.
Member Dose Evaluation and Risk Assessment Advisory Panel (State of Idaho, Department of Health and Welfare).
Chevalier, Ordre des Palmes Academiques France.
Relevant out,lications A. Souville," M. Dreicer, H.L. Beck, and 8.W. Wachholz.
" Assessment of lodine-131 transfer to cow's milk and to man resulting from the Nevada weapons tests of the 1950's'.
Seventh International Congress of the IRPA. Radiation Protection Practice, pp. 1387-1390, Pergamon Press, 1988.
M. Dreicer and 8.W. Wachholz.
" Transfer of lodine-131 from deposition to milk:
estimation of pasture intake".
Seventh International Congress of the IRPA.
Radiation Protection Practice, pp. 1383 1386. Pergamon Press, 1988.
M. Dretcar and A. Bouville.
" Methodology to assess the lodine-131 transferred to cow's milk as a result of the Nevada nuclear weapons tests of the 1950's".
Serichte der Naturwissenschaftlich-Medizinischen Vereinigung in Salzburg, 9:165-167 (1988).
8.G. Bennett and A. Bouville.
" Radiation doses in countries of the Northern Hemisphere from the Chernobyl nuclear reactor accident".
Environment International.
14 (No. 2); 75-82 (1988).
A. Bouville, M. Dreicer, H.L. Beck, W.H. Hoecker and B.W. Wachholz.
"Models of radiciodine transport to populations within the continental U.S.".
Health Physics 59 (5):659-668 (1990).
M. Drelcer. A. Boetille and S.W. Wachholz.
" Pasture practices, milk distribution, and consumption in the continental U.S. in the 1950s". Health Physics 59 (5):
627-636 (1990).
H. Beck, I.K. Helfer, A. Bouville and M. Dreicer.
" Estimates of fallout in the continental U.S. from Nevada weapons testing based on gummed-film monitoring data".
Health Physics SS(5):565-576 (1990).
A. Bouville, M. Dretcer and B.W. Wachholz.
" Assessment of exposures to '3'I in the continental United States resulting from the Nevada atmospheric nuclear tests".
l Proceedings of the CEC Seminar on Methods and Codes for Assessing the Consequences of Nuclear Accidents.
Athens, May 7-11, 1990. Commission of the European Coisnunities report EUR 13013, pages 239-262.
A. Bouville and J.-C. Nenot.
" Assessment of world wide contamination and doses from the Chernobyl accident".
Proceedings of the International Conference on Nuclear Accidents and the Future of Energy.
Lessons learned from Chernobyl.
Paris.
April 15-17, 1991.
SFEN/SNC report, pages 1/9-206.
l 2
1 1
F8:
e-reces ieveonoster 8. ige Odocer Last. *st -ope '
BIOGRAPHICAL SKETCH G. e tw wo=rg etomenon 'er te mov oe'soere+ ano ceasonarts ane :enamorators segm m me sene.oai irwengaror program cirocor **etococv ws sage or eacn norson.
usat
- Cs.T.ON Tm !
w Statistician (Mealth)
Gilbert W. Beebe Clinical Ecidemiology Branch. NCI. NIH EDUCADON_ (Segpn man seemosureem or orner vweer ororessenar sovessoa suc* as avrsmg ano deuse aceropereret r e,arny.
YEAR iNSTmmere AND LOCATION OEGREE CONFEnnto rigLc ca 3,;ov Dartmouth College; Hanover, N.H.
A.B.
1933
' Sociology 1938
' Sociology Columbia University; New York City A.M.
Columbia University; New York City Ph.D.
1942 Sociology and Statistics l
l
=aa== Amo a== sx ca. cen ng wem -
e - eres,. - - e.oerme ane norers. Eey personne nouse me arveem e=esageur ano any emer woveuen was seremose a me amenonc eeveemment or esecupon of ine oro.ee key screennel tysmosy we amuss se senaams we saaerm or emer prosessens omgrees. aut e esmo paese we nouse deviouse at me masters or nessaeureen toves ersumme may senmous e a enasereve wey w ins scermac seemesment or eassusen et me prosect mouse present memoorsne er any Foserm Government swooc meneery aerswinese. Lat. m encoroegem creer. me sees. as aumers. age sermees reverences to an puoacatters ownng me past twee years ans e reyesenmove eener suomessons po'enent to mes a-==an. oO NOT Exet D TWO PAGas.
P0$1T100t$ HELD 1934 - 1941 Statistician, Nations 1 Committee on Maternal Health, New York City 1939 - 1941 Assearch Associate, Milbank Memorial Fund, New York City 1941 - 1944 Member of technical staff, Milbank Memorial Fund, New York City 1942 - 1944 Captain, U.S. Army, Office of the Surgeon General, Washington, DC 1944 - 1950 Consultant to The Surgeon General, U.S. Amy, Historical Division 1944 Consultant to the Cossaission on Reorganization of the Executive Branch of the Government (Hoover Cossaission) 1946 - 1958 Professional Associate, National Academy of Sciences-National Research Council 1958 - 1977 Director, Medical Follow-up Agency, National Academy of Sciences-National Research Council 1958 - 1960 Chfef, Department of Statistics, Atomic Bomb Casualty Commission 1966 - 1968 Chief Department of Epidemiology and Statistics, Atomic 1973 - 1975 Bomb Casualty Cosumission 1975 Member,
Dearst of Directors,
and Chief Scientist, Radiation Effects Research Foundation Hiroshima, Japan 1977 - present Professional Staff, Clinical Epidesfology Branch, National Cancer Institute, National Institutes of Health I
Bethesda, Maryland AWARM phf data Kappa, 1933 - Dartmouth College Cutter Lecturer on Preventive Medicine,1979 - Harvard University School of Public Health Wade #ampton frost lecturer,1980 - American Public Health Association Special Recognf tfon Avarif,1983 - Public Health Service Director's Ararif,1985 - National Institutes of Health e-s aos ia. nn
's
- ege s'
- age
%-o =, = -.,. m. wr. -w -. see eme e. wr.u
+.
i.c a a a
4 4
81BL10 GRAPHY 1.
Beebe GW. Dose-effect relationships.
In Proceedings of the International Symposium on Biological Effects of Low Level Radiation, Nanjing, China, Nov.
23-26, 1986, Beijing, Chinese Medical Association,1987.
2.
Land CE and Beebe GW. Selecting presumably radiogente cancers for compensation. (Letter) Am J Public Health 11:93-94, 1987.
3.
Beebe GW. C-itical Review of Current Epideatological Studies on Members of the Public. In Proceedings of the Workshop.on Epidemiology and Radiation Protection, Nuclear Energy Agency, Organization for Economic Cooperation and Development, Paris, 1987, 97 pp.
4.
Seeff L8, Beebe GW, Hoofnagle JH, Norman JE, Buske11-Bales I, Waggoner JG, Kaplowitz N. Koff RS, Petrini JL Jr, Schiff ER, Shorey J, and Stanley MM. A serologic follow-up of the 1942 epidemic of post-vaccination hepatitis in the United States Army. N Eng1 J Med H1:965-970, 1987.
5.
Beebe GW. Carcinogenic Effects of Nuclear Radiation. J Washington Acad sci ZA: 101-116, 1948.
6.
Beebe GW: Studies of cancer among the Japanese A-bomb survivors. Cancer Investigation. 1:417-426, 1988.
7.
Beebe GW. Cancer in atomic bomb survivors. In: Accomplishments in Cancer Research.
General Motors Cancer Research Foundation, Philadelphia, Lippincott, 1989.
8.
Upton AC, Albert RE. Barrett JC, Beebe GW, Nebert DW, Ray AV, Tice RR, Wilson R, and Yuspa SH. Comparative Carcinogen 1 city of Ionizing Radiation and Chemicals, NCRP Report No. 96, National Council on Radiation Protection and Measurements, Bethesda, MD, 1989, 179 pp.
9.
Wang Z, Boies JO Jr, Wei L. Beebe GW, Zha Y, Kaplan MM, Tao Z, Maxon HR
!!!, Zhang 5, schneider AB, Tan B. Wesseler TA, Dequing C, Ershow AG, Kleinerman RA, Littlefield LG, and Preston D. Thyroid nodularity and chromosome aberrations among women in areas of high background radiation in China.
JNCI A1:478-485, 1990.
10.
San S Setlow RS, Bender MA, Ezaki H Hiracka T, Yamane M. Nishiki M, Dohi K, Awa AA, Miller RC, Parry DM, Mulvihill JJ, and Beebe GW.
Radiosensitivity of skin fibroblasts from atomic bomb survivors with and without breast cancer. Cancer Res 12:4050-4055, 1990.
II.
Seebe GW, and Norman JE. Study of the likelihood of hepatocellular carcinosa following the 1942 U.S.-Army epidemic of hepatitis 8.
In: Tabor E, DiBisceglia AM, Purcell RH (eds).
Etiology, Pathology, and Treatment of Hepatocellular Carcinosa in North America. Portfolio, TX,1991.
8-coes ieweenossoreo scram > rec:. uer. arrr. ammese BIOGRAPHICAL SKETCH
,.v. ine om no c'or neson eor me sev o.monee. a.,o corswrtar.is ano conanorment segun -m"ne onnamaa avesGatortprogram erecer 8"otoccoy trws ooge 'or osan cereen NAME 8CSmON Tr*.E St ooay si:s st, Oi vi sion.eacer E v'
- - e ta
..!8"M',8' Sciences Canter /8aegram Lynn itienars Anscaugn c Director U sa EDUCAnoN <seg a =m meaneewome er einer cent across orssi eew.eson sen as nursmg ano cause cosenciarer resrong.,
yEAn
'NSTm#1CN aNO LOCAT10N OEGnEE CONFEMED r: ELD OF STUDY Environmental $ctences Division, L-*53 S.A.
1959 1 **yst es Laurence Livermero National Lasoratory
- M.8t oraciology,
1961 i meat en 8mysics P.O. Sea 808 Pm.D.
1963 Stoonysics Livermore, CA 94551 9900 I
l nasaracuNo monissom.mxpenienca.ce,mo.n..m.o nnen en.
o.g o.
.--. sor,ence ana supers. Key sereenne senses me armamel swesegmar one ery emor se naaess une eeraamme ei me seenene sevenemeru er eseaween er me.eiect.
l x.y sorserow steamsy we emuse as movmass we seases er emer arosemens seynes. out a some erasem we cause novanans a me maswes or messemesses www ysvens voy senmauen m a summensve way a me seenens sevemorrent er naammen er me armeet. teenase.esent mommemnie on
., nos Go e
remes,====. L m ereeno.eme neer.me e as summe. ans me m
.m ene..
so. ammine sonne :ne pest svos years ans a reeremonuevo aerner mansarens sevennni a res amassemen. 00 NOT EXCEED TWO PaGEs.
Dr. Anapeugh has been acetve in research on the underessading of the fees and transport of radionuclides released to the envvenment and on the enacts of the radionuclide on man. His own research has mchaded studies on microdoetmetry of 1311in the thyrend and on the environsnental behavior of mrium and plusonsum. He was the 5aanunc Diracaer of the Erst US nuger done resoneenarinen enady, which was ameerned with the radiamon domes reenved by the people living downwed of the US Noveds Tat Sees (NTS in the 1980s and 1Mos.
."-e.;4 the Ni,1 acendent. Dr. Anspaugh parecipated in both the US and the United Nations ScientiAc Commines on the ENsas of Atomic Radistian (UNSCEAR) studies of the impecu of the accidett, and he was a member of the incarnestenal O--._,1 Advtsery Coeuestems, which performed a
- quality.easuranse audit" on the sospense of the Soviet prvernmen to the esadent. At the present tists, he is the US leader of the joint C
"-- ; Caensumes on Civilian Nucieer Reeceer Sefery's Wortdag Gesup 7.1 on Envtronmeten! Transport.
Dr. Anapough has been the author or so. author of more than 150 artteles and reports. He is a Fellow of the Health Phyeles 5senery and a member of the incarnational Union of Radassaologises, the Somery for Risk Analyus, and the AAAS. He is an einesed member of the US National Counm! on Radiamon Pra===an and Measurveient (NCRPL and is an advseer to the US 7-
- % e the UNSCEAR.
1.
LA A _7@ Spenal PreHemes of Thyroid Dee mistry: Censiderasieme of IIII Deer as a Tenerna of Crees Sisa and
, uvermore. CA. UGL 1282 QM5).
leAesiegeneses Durribuisses,lawsumen uvermore Nanonal t_E 1 7 2.
LA Ac, 3 JJ. Essenda, W.L Roblema, and JA Martin. 'The Does e Man Via Food Chain Transfer Resulting from Erposuse a Trtassed Weser Yaper,"in Trdema. A.A. Mol iest and M.W.Carur, Eds. ("
g-Campiums. Las Vales,1971),
h pp.4(5421.
1 R.C. Pendiesen, JJ. Karenda. W.W. Wagner, P.L Phelps. R.D. Uoyd, LR. A7 p., and WJL Chapman. "Radioscolopcal Seudies in Utah M ;-- t a the Beneberry Event,* m 8hh in Essoysemes, DJ. Nelson, Ed. (Nanonal Technscal Informs 1on Servtsen, SpringAsid, VA,1FFD, pp.1501W.
P.L Phelps. LA Aasposgh, JJ. Karanda, and C.W. Huckabey, *A Portable Ca(u) Desecuer for Field Measurement of 4
Itadianucildes a the Sponsomment." EEE Trees. Necf. Se.19,199 210 0972).
i LA Anspsugh. J.H. S$en, F.L Phelps, and N.C. Kennedy "*
, ---M and Radiarribunon of Plusonnum m Soils." Heelt4 1
rhys. an.571.am umL LR, Anspaugh, *ls Site Mahods for C____ _ff g SpecsAc Radionucliden.* IEEE Trees. Nusf. Sei. 25,119011M of76).
LA Anspaugh and Y.C. Ng, Estamese of Thyroid Deses for Desid A. Timothy med fene Carrell from Neende Tset Sise Imal 7.
Taasms, Lawrenes Ltvermore Neannel I.shormeery, uverewre. CA, UCID 30SE2 0950L LA Anspeugh and B.W. Church, *Hiseortcal Isamanes of External Camma Esposure and Collecieve External Camma Expaeurs from Tenang at the Noveda Test 5ses. I. Test Series Through Handtack 11.1958.* Hash 4 Phys. SL 35 51 n986L LA Anspaugh, R.J. Catha, and M. Goldman. *The Clobal Impact of the C3tervoobyl Emmauer Amandant," Scener 242.15j 9.
n9est
- 10. LA Anspeugh. 5.C. Bennett, A. SouvGs, L Frieelli, A. Hagen and 0. Pavlovsky (contronnang authors). " Exposures from the Chernobyl Accadent.* Ansum D in Se=ress. Effects and Au4s of lensmag Aedienen, Uruend Nanons SciennAc Commmes on the Effens of Anosuc.*C_-e 193: Report to the Geners! Assembly, with Armenes (Urused Nonons. New York.1968L Sales No. ERIX.7.
==
e-s am iae. mi go,,, e t,e e, e,e s
%wase' asset seasem** er ime en"1**g'edi tae ammessen De aor ee s *ees secr as as. 30.
s
Criscria and Reumawumeu v
- 11. LA Ansoeu6. Radioecmty
- tn Esslaaties of Military FiaW Wetar q%shry. voluaw 4 h*
5tsm4*rds for Chamical CJasserkrets of Militsry Concern. J.l. Durusts. Ed.. Lwrence Livermore Nationa4 ! aeoratorv Uvermom. CA, UCRL 21008, pp. At throu6h 554 099%
- 12. F.A. Mariner. W A Smelaar L Anspeu6h, C. Edinpon. J.H. Harley, R.C. Ricks. P B. Selby. E.W. Webserr, and H.O. Wvekerf.
"The 1986 and 1988 UNSCEAR Reports: Findtnp and Implicanons; Hasith Firys.sa.2412500990L
- 13. M. Coldman, LA Anspaugh, ).O. Stanton, Ll Sollinger. M.D. Hoover. C.M. Marmato, T.F. McCrew, R.C. Nelson.
W.S. Osburn. J.F. Park, and W.L Tempimon, Bremedical and Environmental Effects 5=& penal Arport for Ulysus.
Interagency Nucient Salary Ravww Panet, Washington. DC. INSRP 9M6 0990).
- 14. LA A:wpeu6. S.C. Black. C.F. Cosen. DA Elle. E.H. Essington, R.O. CLIbet. D.A. Consalec. LB. Hunter. R.D, McArthur.
h P.A. Medica. T.P. CTFarrell S.E. Petson, E.M. Roerwy. J.H. Stuna, and C.S. Thompson. "Radianon Re'.ated Moturonng and Envtronmeneal Ramensch at the Nevada Test Site. in Eneereamensal Menu *riat Reaerenen and Assessanns: what H,, en Laerned1, R.H. Croy, Ed. (Baseelin. Pectac Northwest Lhoretones, Richland, WA 1990L pp.159167.
- 15. LA. Anspaugh,Yi Richer.5.C.Back. LF. Crossman, D.L Whamier, B.W. Church, and V1 Quina. *Histoncal Esnmatn of Esternal TEsposure and CaGeestve Essernal Y Exposure from Tenang at the Nevada Tout Sles. E. iset Senes atee 19sa, and Summary? Huh 4 Phys. 39.525 532 n990L 10 LT. Cederwen, Yi Richer, P.L CaderwaL D.N. Homan, and LR. Anspough,"Cround Gesed Air Sampling Measurements Nant the Noveda Test Sise aster Atmosphanc Nuclant Temen" Hemish Phys. se,55440 0990L
- 17. B.W. Church, D.L Wheeler, C.M. Camphen. R.V. Nutley, and LL Anspeugh. "Overvtew of the Department of Energy s Of 4ies Radiation Exposure Revww Proyect (ORERPL' Helik Phys. 39,30b510 0950).
IL Y.C. N, LA Anspou6, and R.T. Caderwen,'ORERP Inernal Dose Eastanmes fr.e Individuals? Haslik Phys. 39,69k713 0990) 5 h
- 19. L Anspaugh, A. SouvtBa, T. Grant. 5. Haywood. T. Kirchner, W. Maner, M. Ods, and J.V. Ramsdelt "Does Raconstrueno Presselings of the CIC/ DOE Wertshop en um.-.y Analyse, Smass Fe, NM, Nee,wder 1316,198f, C1 Elderkan and i
C.N. KaDy, Eds., Paciac Nenhwest Laborsesriss. Richland. WA. PNL.EA 18372, pp. 25 27.
- 20. M. Goldman, R.C. Nelson, L Boninger, M.D. Hoover, W.Templeson, and L Anspaugh, " Potential Health Risks from Posndened Aacidenes involvtag the Pu.238 RTC on the Ulysses Solar Emploration Miss6on? in Freemdiep of #As Eignsh Syuipsessa se spear Noaiser Pouer Synesses, Part one, Mi D. Conk and M.D. Hoover, Eds. (Amancan Insatuse of 4
New Yosk, NY,19P1h pp.132164.
4
- 21. JA Karcher and LL P ;: 7; " Analysis of the Nevada Applied-Ecology. Croup Model of Transuranic Radionuclide i
Transport and Dese? f. Enewen. Andeses.13,19121609F1h
- 22. L shigameau, M. nossa. LA Anspaugh, V.C. Ear'yskhtar. 5.C.teaman. C.H. Coppen. L Coulon. F. Pry, CA Cheoryhw V.A.Cubanov, J. Jovanovtch, N. Kany, A. Kurmanoso, TA be F.A.Mertler, Jr., A. Salo, L Smales. F. Semnhausler,of A.V.1; rb, V.V. Voloshchuk, and P. Walght, The lasermanenel CJwrnstyi Project-An Oserews Aassassient Radiedepaal Canasguemass and Eeniananse of Protectrer Messurse, Internanonal Asoeue Energy Agency, Vienna, A
!$Ni F2 01290P14 09P1).
- 23. L Anspou6h, D. Calmet. A. Carnelismen, S. Mobbs. P. Moskowitz, and R.W. Pouack. Lee Lassi Radience An Esslansnes of Reerts Censpareng Cases and Lesed Based Depsmal Opresas. Internas6 anal Anosuc Energy Ag Ausana. LAEA-TE' DOC 462 n998.
I
- 24. LA. Anspough,"A Raply esc L#s AR Floy by the Samw Runas? Henkh Phys.61,14&180 09PIL
- 25. l. Shigesnatsu, LA Anspeugh, V.C. Bar'yskhtar, B.C. Denneet, C.H.coppes. R.coulon, F. Fry, CA Cheorgh V.A.Cukenov, J.Jovensvtch, N. Katy, A. Kuramoso. TA Lee, F.A. Maader, M. Rasen. A. Salo. L 5 males, F.Samahs A.V. Seepas.amho, V.V.Voissheksk, and P. Walght. The to:. r" Chsmetyl Proposs-Taaluiaal Report A Aadielepaal Canampasnes and tesheseus of Prosassrer Measurse. Internartonal Adytsory Coatsurtes, la Energy Agency,Vlamm Auerta09FIL
- 26. H.L Seck and LL Aaepengh, E ', -~ ef the County Di.W Estansess of Espemawe Assas and Timess af Ar Taue s := the CRERP Phase D' Area: Camperinen muk Commistser Depassieu Donary Estenssas Baand Raesspanner and Haserauf Seal C-phs Unteed Sasses Department of Enseyy, bs Vegas, NY, DOE /NV 3 i
- 27. LA Anspough and 5.M. Headnckaon, Eds., PP'r'sw A**Pt. l**rimag Croup 7J en Isenessasosal Tr Camantase en Ciedies Nuclasr Asseter safety, bwrenes Livermore Nanonal bhorneory, Livermore.
Caerdenssiat UCR,1AD.110062 09F2).
f 8ael
- 24. L Anspaugh, A. Bouvdle, S.C. Denneet. and 3.W. Wachht,Ir. " Radiation Exposure of the Populante and Essiastica of Chernseyt Prepct. Prsessdiep of an lasernaswasl Conferrear. Asassesesst of Aadioispaal '*--;
Preescerer Masanaus (IAEA, Visana, Ausena,1991L pp. 27-32.
- 29. M. Roesn. C.O. Compvchhs. F.A. Metler, P.H. Jensen. LR. Anspeugh. F. SedahAusler, A. Canuno, A. Eg 1
and C.). Huyukans, Panel Members. " Panel Discussion: The 1.ansons Lantned? in The fasarustaena Precasdiep of an interestsemal Conference, Assessment of Radielepeal Cenasguances and losimass Massares (IAEA.Vismna. Ausena.1991L pp.61-76.
N
- tema e creer d.aw. 4m. maser BIOGRAPHICAL. SKETCH me to ehuog Hummen ter tw ear peinvie we emn,ance en saame.come, e.gn e en pensam tweemans,wayesn eumw Pe smaner tw one, ter ame, ennen, w
w at Pommen rm.a
- 1. Bertrand Brille M.D., Ph.D.
Professor of Nue16ar Medicine apuc470s 1hers -e,ammmmmwess asewmerasenswer asumanos mean as maars ow manae.
.;rarouw vsAm mermin0N AND LOCATION DEGPEE cod'Weqm PgE.D OFETUDY orianell College, leva A.B.
1949 Zeelegy/Channistry Duiveasiry of Utah E.D.
1956 Medicias Daiversity wt Califers.ta, Barkalay Ph.D.
1961 Bisphysiae REEANOM #8 PUCPERWONaL E4PWWCR Qwuhdrg adri pense sammen, en h coundagang say, presses gegepves, agem house. Her pe'insvN mmune fu peienf bussegner arW ey seur mestaans urie swassians > 9e asses emensmers er anamen W to arem Esy pouarsial ippammer es mamme af hedsmas sei esumal a sour grunnesevel espues. ma m sans pasms as masses beastames s eu suun humuusewesse trei postemd ter emuanas m a aanwese sur a se essenes emeusmers a escaden W pie pigen, bumma pesarammina
- srv puesrel Genevenue pass assemy sunsenas.uss > evenouglast ser, to ama, af amurs, and suisses sevenne e af paamuses asme ses esse peers mW m supressrumme sareur passmass partiers e et assamari. DO 8807 Em Two Pm Imanarch and/ar Profmaniena} Eznarianna:
1956 1957 medicias lasernship, Univ. of Utah, Salt hke city i
Gemaral Esepital 1957 1959 Easearsk Assos., Medicina Ei Staciaties AtesLis Somb j
Camenity Ceaum.. Iirsabina, Japan 1959-1941 muniaar Madisins re611swahip, Deimer laboratory 1957 1964 U.S. F55.8., sur. Radial. Emaiset, Radiatima Epid.
1964 1979 Prof. of Radialegr, Yanderbilt Daivarniry, Easlerilla Dirmater Buslaar Medialme Divisien 1979 1984 Sr. Estantist and man. Med. Progem Coordiaster, Ned.
Dept. 3:eekhavsa Natismal Imberatory, Upten. New Teek
)
1987-present Profenest of Nealear Medisins, Direeter of Saalear Madisine Basearah, University of Eameashuserta Medieal Center, Werenatar. Massembusetta Maier tammarch Incarmar:
suelaar Eadisine (diagnosis, therapy, and radiabielegy), imetrimmataties and samystar appliaatimes in andisine.
Emanzal A. 5. Oriana11 College, Espers in Zeelegy/Chamistry 1949 Fellow I.E.E.E.E. Weslaar Saisness; Feller, Amerissa Collags of Ihsalaar Physialans President, Seetaty of Eustaar Medicine (Southeastern Chapter), 1969 70 l
Nuclear BeSalas Faller, Dounse Laboratety. U. of Califemala, Sarkeley, 1959 60 figma 21 Enlactad Puh11aarfama-1.
Fatten JA and Brill AB:
1-ray fluersaeance techniques for tiryroid imaging.
a methods sad results. Is Radioaktive Isetope in E11aus ad Persehung. Tel. 13 34.
E.. Enfer and E. Bergmasus. Verlag 1. Epsamma,1978, pp. 287-198.
1.
rateen JA. Prime as., rartain CI., and trill As Punesimaal Imasins *f the Thyroid. Proceedinos of the lith Aasmal Synyesita es sha Sharing of Camputar Programs and Techasiegr la Nualmar Medicias. hastional Mappias of Organ Pystans and Other Computer Tepias Ed. P.D. Esser Published by The Seaiety of Waalaar Madteina, if$1, pp 21 29.
M 1 m m er. soil (Perm Pues op Ps F
%seur asse.
m.m.er e en esens esmene se usammes an ersua esm.ee
.ri se m. m.
3.
Brill AB, Adalstein SJ, Seek IN. Clauciar EJ. Tord M1. Johnston EE. Number of P.,
Tay1La G7. Winchall A: Naalser Medicina Tseters !afluencias the Choles and Use of Radienuelidas in Diassoais and brapy. NG P 1 sport No. 70, 1982.
A.
Lassard IT Art 11 AB. Adams WE: Thyroid cancar in the Marsha11ase: Ra'1stive risk of short-lived internal ed::ters and asternal radiatica amposure. F C -- % s of Fourth Iansanationalladiopharmaceutiaal Sympoelma, Oak Ridge, TN.,1985, pp 628-447.
5.
Parker FL, 3rt11 AB, Griana WE. Rahn 3 Jacoba DS, Wassen EC:
h Potencial ceasequeeses of Tritius and other Isotopes Disebarged in Treated Three E12e Island Aasident Generstad fasts Waters. ECRP Import of sc.38 Task Own an Aasidaat osmarated vasta fatar, 1985.
6.
14e OS, Sandler MF, Faccan JA. Retil AB:
Serial tiryrsta iodina centent in hyperthyroid patients treated with radieLedias. C11aisal Dualear Medisins, Ye1.
II No. 2:115-118. Feb. 1986.
7.
John EE. Tang Y.N. Brill AS. Young E, and One 1: Double. labeled metabella maps of menery. seianse,133 :L187-1175, 1986.
8.
14mmen JJ, art 11 AB. Som F. Cheless E. Esassa AL, Jonas It, and celevisk 5:
Studies of the biodistributies of almina in brain tiseum. J Sial Traes Element Res. 13:43-53, 1987.
9.
Reseigne A. Thahnsr AE Brill AB, Mariani a: Trasar kinettes: A propeesi for umLfied symbols sad aseenalature. Ptrye Mad Biol 35:4Af.A45, 1990.
10.
D41mmata= FA. Weber DA. Cederre JA. Joel DD, Shi E.C, Malaban CE, Saut F. Tang Y.
N, Yelker ED, Yee C. Brill AS:
A high resolutisa 575:2 systen based on a starochamasi. plats imager. LEEE Trans Wual Set 37:647-495, 1990.
11.
King MA, less DT, 3rt11 AS: SPECT votes quantitatian: Infinamaa of spatial resolucien, seeres sias and abape, and vessi sise. Med Phys 18:1018 1924. 1991.
a
)
Fr
- ~ eon, ~.e o ore ; gram deaar wt wr.
BlCGRAPHICAl. SKETCH s,. m..-, e,o-eson,, re.e, roonn.no enoonte arcoa orem s.,in m e -
i rNeengarorrorogram cirector 8 accmay mee page 'or secn goamen j
w ee
- csmos mts 4 cob m Chief. Endoennology Sectum, j
Cenenes and Biocherrustry Branch. NTDDK. NIH EDUCAfloN Sepn.e meccessursets or omer evasi povessenal sou:ason sucn as awesaw. aner enawee mossucctoret re,nsmp i l
l YEAR cEGREE I CoNFEmptD r:E',3 cp g;ygv
'NSM. mon ANo NT1oN 1944 Chemtstry j
Cornell University; Ithaca, New York A.B.
s l1947 Mediane Comell Univoruty Medies! College; M.D.
i New York New York I
i t
masaAnCM ANo PROFES$aQNAl. EXPERW8CE; Cenaueng um poeere seamen. EsL e Weeneseem woor, povow w'esyment, enseerte. anc runers. Mar peresnre nause em annseel enresegent ans eriy emer moviaaem wns seronese m me oesnene sevenemere er enesween er me artiee:.
Ker personna rysemer was cause es seemass woi esaura er seer erweenens asynes. ma e some armese we ecmase noviana er me maem or basessurene noved prevene fu*/ senmouse m a momerose wey a me soormac esvenement er essaugen er me prosect, inenses groesnt memoronio en erir passa oevemmen asseromven, esmmene. tasi, e eronneeses ereer. co sees. as merers. ene asnoem rewences e as aussessons eunne : e sem evee years one a coerenereenve eereer mennesere aeronere e me emessemen. Do Not Excsso Two Pacts.
POSITIONS HELD 1947 1944 -
itsern M Medcine, The New Yom Hoscetal. New Yo*
r 1948 1940 -
Amandant Rescient in Medaine, Memonal Hoegdtal. New Yo*
1946 1960 -
Acedont M Medcene. Memonal Hossetal, New York 1949 1963 -
Researen Feeser. Sloan Kettenn0 Insutute. New York 1963 1964 -
Amosesnt Amendnp Physeman. Memonal Corner, New York i
1963 1964 -
Aansesnf. Sloan Ketterin0 inattute, New York 1960 1964 -
fnetrucsot M Maddne, Cemet Uruversty Medcal Cote 0s, New York 196419e1 -
invessgesor, Cartcal Endocrinology Branch, Naslonal insetute of Diabetes and Digeseve and Kkmey Diosanes, Natonal insetAes of Heath, Bethesda, Maryland
'i insrucsor M Madcine, George WasNngton UrWversey School of Meecane, Wastwngton. D. C.
1966 1961 -
1966 1900 -
Visting Solenglar. Cartsberg Laborseory, Copenhagen. Denmark 1961 1983 -
AcWrg CNef, C8nical Endocrtnology Branch, NIAMDD, NIH, PHS 19 5 1991 -
CNef, C8nical Endocrinology Branch, NIDOK. NIH, PHS l
1964 1988 -
Esflorial 80ent. Jeumal of CInn6 cal Endocrinology and Metabellem i
19 5 1972 -
Ecflor dr>CNet. Endocrinology 7/67-4/67 -
Ufy Vieting PnWeasor, Statenboech Utoverwty. Capetoem. South Africa i
10/70 11/70 - Visming Prideasor, Japan Socloty lor Promoeon of Solence, Gunma Urtversity insalute of Endocnnology, Maeeastd. Japan 1989 1974 -
Dromor. Amortcan Thyread AASmehnq 1974 1975 -
Proedent Amencen Thyrood Associsson l
1991 2 Ctdef. Endocrtnology Seceon. Geneses and 86ocherfastry Branch: NIDOK. NIH, PHS Presefs -
AWARDS l
Post ente for Assespen,1944 - Cemet Ureversty Medcal Coaege Van Meter Awant. Honorelde Meteort,1963 Amencan Gotter Associsoon 1
Van Meter Awanf,1966 Amencan Gotter Assocanon Mentonous Serwcw Medef.1971 Putsc Heath Serwoe Parke-Cans Otsernpusshotf Leaureshp,1980 Amencan Thyroid Association Samuel Harnes lectureshc.1980 Mayo Ctrac DsDriguishogf Serece Awartf.1983 Amencan Thyroid Aaa==han
- =
. Form a ge 6 8 age n
- =5 3eg,a, Mit c
==,meer eseos
.c -
a. at tre seus'* t'"egaews me esecanoa De aer.no esse k cn as 34 25 j
l I
M MAPHY 205. Lakshmanan M. 5ctisser A. Robtans J. Reynolds J. Nonon J. A sunpbfied low iodine diet m 1131 scannang sad earupy of thymid cancar. Clin Nuclear Med 1186643.1983.
206. Moves E., Phy"" MA. Robbes J. Phlorean mhitats estluist upiaks of miodomyromne in hwnan liep G2 hq==r=cmoms cens. Endomnology 1M.19g81997.1999.
2g7. Besvenes S.Catamann HJ. Gregg R. Robbes J. Binding of thymune to human pisams low denary lapopmem emagh pacine maracoon wah spokpopreima 3 (spoB 100). Biochunse 21,263 263.1939, 208. havesen 5. Em1====== HJ Gregg R. Rottnas J. Characuruanon of the bindes of thyrauns so lush damsey hpigenesses and apolapopmassa A.L J Clin Endocnaal Memb g 10671072.1989.
239. Robesas Jamab. Goncalves E. Lakshmansa M. Fcsi D. Thymed hormons irumsport fme tdood into braan caus. la: lates la hs Brus. Danong GR. Robtuns J. Comdhffe PG.(eds). Pleamsc New York.1989, pp 39 50.
214. Poessourvi A. Robemas J. De pismus membruns and ihyrood hannons easy inno esAs. Trends a Eadomnology sad Membouse 1,90 94,1999.
211. Duasudf ED. Joss RT Lakshmansa MC. Robinns J sad Rabaow DR. Fu g,--M.;; manifessmans of shmed Ihymed assa. Amar J Psychmasry 142,94 99.1990.
212. Benvengs 5 ed Robtnas J. Enhancement of thymune entry ine low denery hpopreissi (LDL) receptor.
ra=p=== fibrobinas by LDL: an additional mode of entry of thymnas ine caus. Endocnnology g, 933-941. 1990.
213. Roldmar J. De thyred a a model endoenne symam. la: Consul of tbs Thymed GlauL Ekhohn R. Kahn LD, Woumme SH. (eds). Planeau New Yest.1989. pp.14.
214. Robtens J. Aduas WH. Radsamon anses a the Marshnu talanda Ir.: Radisson and the nymsL Nagsutd 5. (ed). Escarpia Mahas: Ammerdam,1989, pp.ll.24.
215. Brown RT. Polansky RJ lakatsmansa MC. Robtnas J. Baucous CE. Changes in blood preusse and piamma songmasphnes is shm imm r,, ;.,. ". Clia Endooraziogy 3,63543g.1999.
216. Genesives E.12ksammmmma MC Poessairvi A. Robtens J. Thyred harmons sansport in a human glioma ceu lies. Moi Calkdar Endommel 8,157165.1990.
217. Marmo M. Kannedy 5. Nonen J. Robinas J. Planal evidwomma try mamsmac thymed carcinces ' mil cs5 i
vanma': as imuassi occurnmos. Surg Puhol 1. 5944, 1990.
218. Lakshmanen M. Goncalves L lassly G. Fasi D. #ahh== J. hs Transport of eyronas isso mouse asumtdamoms csEs (NB41A3): De eSect of L sysum ammo scada. Emex: mology 13,3245 3250,1990.
1 219. Benvessa. 5. raha==== IU. Rotemas J. I ar=1==== of the tirytoune.badas sans a apohpoprossa i
B.100 of lumaan now dansey hpopnuses. Emdoennelogy 131,22412246.1990.
223. Gonostwes. E.1 h M. r*ah===== HJ. Robinas J. High sHinity bandag c( thymid hannomes to nanotdemoms plamns membrassa. Biochen Biophys Ama 1911,151156,1990.
221. Besvangs 5. Caisemann 10. Rohhus J. The nyrouns.hinding aus of human spobpopsonne A.1: Lamamos in the N-urmasi domman. Eadocnnology 13,547 532.1991.
222. Robbes J. Dynnd gised sad ks hannones. In: Encyclopods of Human Biology. Nhamo R. (ed). vgLI, Asadness Piens.1991.
483-491.
223. Robtmas J. Matse M. Boies JD Rat E. Am KB. Alesander IUt Nonen JA. Reynolds J. Thyroid cancer:
j A lethal sadomus amapA=== Aan let Med.111133147.1991.
124. Farsan A. - T. Desversas B. Robtnns J. Nikoden V. Massentar hans of ihyroul humans regulanos of eyehn beme prosus gems expresman m rodsat tema. J Biol Chen. E 23226 23232.1991.
225. Lakansnanas M.Gaonives L Ponssearvi A. Robbes J. Difenmaal sGem of a new thynsnesoc on truodoshymmas sunsport uno
,M" sad hopanoms and neumisismens asus. Biochun Biophys Ace.11, l 213 217. 1991. Warnst sad 226. Robtans J. Dyroad hannons transport pmeses and the phymology of hannons badang. la: Ingbar, ns Thynnd. Besvennan LE Utiger RD (eds). JB Uppeacosc Ptuladelphas.1991, pp.111 125. l f (
- F 8-acca, ves T,atC' 8 *W ar.
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.Js- -- - oc e ~ SiOGDaPHICAL SKETCH , e *e 3. car eg ****attom 'or *e sev oe'sC*Pe' 4PC Scasw tarts and ::*aDortterl Seg.*. ra e :r-c =a' r a.esigator proges- ;'tector ** 'occov s sage 'or esem co son smE 80517 CN **.E ?.oy E. Shore Professor of Inv;ron= ental Medi:::e 5 _:s CN sep,n arre w=manceme w crewe e,rw storess.c"ar eeucano" s.c. as *vess"9 a'e *c'uon xs::cc c'ar "snaq vEse instr?UTCN ANO LoCAfcN ^ OEG8EE 00NpEseED e E'.3 05 5%Cv Hougston College B.A. 1962 Psychology Syracuse University Ph.D. 1967 Psychology /Statista: Columbia University Dr. P.H. 1982 Epidemiology atssAmew ano poortsnoeAi. ExpeniaNet. canauseo =im wonem osamen. aat e enroemeem woor. areveue emoevmat. esoeaeace are aoners. x.y sorswee caeme we eveem e,essener one any seer veeuen was oorsomem e me es aene sevenement or esecut.on e, o oro,eet Wey pereorms typeesy me esame as nuevahes man essers er seer preressens asynes, out a some ersecu we vuewee cerrowa e at :ne asters or passeeurseus eve provese may eeneouse an a suonaneve way a me soerent esvenomont er esecuten er me erasect. moues present -ea oersmio an any Feeers Govemmem suces eeneery esmmeos. Lat. e ennensevne ereer. me esos. as maert, are semesse reveronese e ad puoecanoes cunng ~e pese aves years ans a repeeenuevo eener massemens eersnear o me asemassen. Do Not sXcEED Two P AGas. PROFESSIONAL EXPERIENCE: 1969-1987 Ranks of Associate Research Scientist, Research Scientist Assistant Professor and Aunt, ate Pmfassor, Institute of Environmental Medtems, New York University Medical Center. New York, New York. 1987-Present Professor. Institute of Environmental Medicine, New York University Medica 16 enter, New York, New York. Currently Head, Enytronmental Epidenuology Unit and Assoclass Director. Division of Epidemiology and Biostatisnes. HONORS: Fellow, American College of Epamiology,1982 Present MERrr award from NIH,1986 Member, National Council on Radiation Protecnon and Measurements,1983-Present SELECTED GOVERNMENT & PUBLIC ADVISORY CObOvut tr.e,5: NCI, Board of Scientific Counselors, Division of Cancer Etiology. (1984-1991) (Nanonal Cancer Insutute, NIH). NCI, Advisory Commians to the NCI Acrylonitrile Epe=Jalagy Study, Chairman (1986 Present) ICRP Task Group on the Biologu:a1 Basis for Dose Limitanon in the Skin (1988-92) (Internanonal Commission on Radiological Proenenon) Editorial Advisory Boards, Journal of the Nananal t%e-innimte (1988-Present): fasst 5:nid:-ininev. Blasamv4 mon & Prevennan (1991-Present); neeidaeavv Toricaleev and % (1992-Prums) NAS-NRC r'meania== on an Assessment of CDC Radianon Studies (1991-Present) (National Academ of SciencesNedonal Reemarch Counctl) SELECTED PUBLICATIONS: Upton A, Albert R, Burns F. Short R. (eds.) Radiation Cartmogenests. New York: E 459 pp. Shore R. Hemaalmman L. Woodard E. Caremogenic Effects of Radianon on the Human "Ihy Gland. In: Radianon Car %--*. Upton A, et 41(eds.), New York: Elsevier,1986, pp. 293-309. Shore R. Hildreth N. Woodard E, Dvoretsky P, Hempalmaan L. Pasternack B. Breast cancer amon women given x ray therapy for acuta postpartum masutis. J Nati Cancer Inst.,77:68
== e m neess,e e. o m e-s m,new s u %.agee oogse a _ _ a 18e assum ia.egets fme espeseen 06 Mr.ao awftsee tecn as 3a. Jo. ,, _ - -. -. ~
.I Collingwood X. Pasternack B. Shore R. An mdustry wide study of respiratory cancer m :..m.a workers exposed to chloromethyl ethers. J Natl Cancer Inst. 1987: 78:1127 1136. Shore R. Electromagnene radianons and cancer: Cause and prevennon. Cancer. 1988: 62:1T.i 54 Baxter D. Brooks B 1.anzi L. Shore R. Stansbury P. Wynveen R. Exposure of the U.S. Populacen from Occupanonal Radiamon. Nanonal Council on Radianon Protecton and Measurements. Betnesca. MD.1989,106 pp. Bums F. Hosselet S. Wolman S. Perle M. Shore R. Garte S. De radiosensinvity of skin fibroclasts l from patients with muluple radianon induced skm cancers (abstract). Proc. Am. Assoc. Cancer Res. l 1989: 30:771. l Shore RE. Radianon epidemiology: old and new challenges. Environ. Health Perspec. 1989: 61:153-156. Shore RE. Risk of thyroid cancer after diagnostic doses of radiciodine (lener). J. Nati. Cancer Inst. l i 1989; 81:715. Hildreth N, Shore R Dvoretsky P. Risk of breast cancer following thymic irradiation in infancy. N. Engl. J. Med. 1989; 321:1231 1234. Greenberg HL, Ott M, Shore R. Men assigned to ethylene oxide production or other ethylene onde related chemical manufactunng: a monality study. Br. J. Indust. Med. 1990: 47:221 230. Shore RE. Overview of radiation induced skin cancer in humans. Int. J. Rad. Biol. 1990: 57:809-827 Shore RE. Occupational radiation studies: status, problems and pmspects. Health Phys. 1990: 59:63 68. Shore RE, Harley N. Passemack B, Gladstein A. Skin cancer susceptibility among irradiated patients (lener). J. Am. Acad. Dermatol. 1990: 22:859. Shore RE, Hildreth N. Cancer among thymic triadiated children. (Abstract) J. Cancer Res. Clin. Oncol. 116(Suppl.):788,1990. Shore RE. Ep%Jology of neoplasms of the foot. In: Neoplasms of the Foot and Leg, Cole D and DeLauro T, Eds., Saunders, Phila. 1990: 24-32. Steinfeld AD Shore R. Second malignancies followmg radiotherapy for tesocular seminoma. Clin. Oncol.1990; 2:273-76. Toniolo PO, Passamack B, Shore R, Sonnenschein E, Koenig K. Rosenberg C, Strax P Strax S. Endogenous hormones and breast cancer: A prospective cohort study. Breast Cancer Res. Treat. 1991; 18:523-526. Koenig KL, Passamack B, Shore R, Strax P. Hair dye use and breast cancer: a case-control study among screenmg parucipants. Am. J. FpMM. 1991; 133:985-995. Little MP, Hawkins M Shore R. Charles M. Hildreth N. Time vananons in the risk of cancer following irradiation in childhood. Radiat. Ras. 1991; 126:306-316. Shore RE. 7he epidemiology of radianon-induced thyrtnd cancart research issues and needs. Ent. j Inst. Radiot. Raporta. 1991; 22:61 66. Shore RE. Noaionsang radiation. In: Enytronmental and LW% Medicme, Rom W Ed., Little, Broes & Co. 1992; 1093-1108. Upton AC, Shese R. Harley H. De health effects of low-level iomams radiation. Annu. Rev. Pu Health. 1992; 13:127-150. Shore RE, Iyer V, Altshuler B, Passamack B. Use of human data in quantitative risk assessm Impact on epidemiologic pracuce and the regulatory process. Regul. Toccol caremogens: Pharmacol., 1992; 15:100 221. Shore RE, Hildreth N Moseson M. Studies of skin cancer and thynnd tumors aAer irradianon of t head and neck. Proc Inti Conf Radiat Effects Ac Proesct (Mito, Japan). 1992; 77-79. Shore RE. Issues and epd==Jologic evidence regarding radianon-induced thynnd cancer. R 1992; 131:93 111. Shore RE, Hildreth N, Dvoretsky P. Andresen E, Moseson M. Passmack B. Thyroid cancer among persons given x ray utatment in infancy for enlarged thymus glands. 1992; Submitted. " " ' ' ' ' ' * ^ ~ ~ n : m-n
FF eaaceae msgainto ;grer ':.,eoer *.,ast. 4rst. -'efte' BIOGRAPHICAL SKETCH lWe the % :-g areor"wton 'er me key personnel an, onreAat ts and codamereiere segin w'in tne er rosas investepeiorgregram erector,*etaceey rus page tot eacn screen.
- S * '**
Lester Van Middesworth, Ph.D., M.D. Professor Ementus Medicine. Physiology and Biophysics. EDUCATION (Sepa se sensassense or emer vuest wesessener eena: arm suan es nureais. Aric anetmo semaseveral tranw YsAA l i wttm.rfitsi ANo Location DEGREE CONFEmREo l OELD OF STUDY une.orsey es virprue. Cnemensovine e a a us. ites a ines che neiry Uswwereer of Virgenee. Chessieovese ut 1944 enyoneaegy unssosesy at Casserne, seester shA 194e ehyeawegy useveresy of Tennessee useems unis, usegne un 1961 Womene 1981.t s64 C eting bassa. coy of Wesuche Hegede mesaAncM ANo PoortsacudL exPsmiaNet. cwendne eam presere seamen, nn. e envenemone esser. semis em ymenc. oueenence. an, nuese. may serewves mamse sepesos evenw are wir emer moveem one enrossem e es essens es memwn w useuswi e = we,eci. mey serienner typussy we wuhes es mene. seas e n seemrw or emer pressemenes agrees. tut a some pasons we values neveweis at tne masiere er monomeweses w a peens esy owwaum e a sw.une y w me onwame sevenemeen er saammen a sw armosunoswee resent momeerin, en wir peers oevemmere paeneummes, esmmese As. e evenemens weer. es sees. as meners. ere some== roerwege a es owe =catione ewen, me som swee yeare ans a reponerneve serier sunserene senern is tres espeeseen, oo NOT EXCaso TWo PAGas. i POSmONS HELD: Teaching Appointments, Un8versity of Tennessee Center for the Health Sciences, Memphis: i Physiology, Biophysics and Medicine: Instructor to Professor, 1945 1959. Professor of Meclicine, Physiciogy and Biophysics, 1959 1989. Professor Emeritus of Medicine', Physiology and Biophysics,1989.present. 4 Staff Physcian in the Thyroid and Endocrine Clinic, Regional Medical Center, Memphis, TN,1953.present. Funded Medical Research Grants: Career Research Award, US Public Health Service Grant AM 0004,* lodine Metabolism and the Basic Cause of Goiter July 1982 to retirement date, July 1989. U S A E C; U. S. ERDA: U.S. DOE " Studies in lodine MetaboEsm," 1950 1988. Defense Nuclear Agency, ' Monitoring of Radioacthrity in Animal Thyroids,* 1987 1989. Westinghouse Savannah River Co. 'Radioiodine in the Environment" 1991 1993. Consultant: Crocker Radiation Laboratory, University of California, Berkeley,19461947. Oak Ridge Institute of Nuclear Studies,19501954. Methodist Hospital, Isotope Laboratory, Maps Tsanceses,19561963 Federej Radation Council on the Biological Effect of Thyroid irradiation,1982. World Health Organization, Regional OfHee, Brussels, Belgium,1988 US Center tor Disease Control Committee,* Stockpiling potassium iodide around nuclear reactor sites *,1990-U.S.A. Delegation to USSR, Fallout Radiation Effects on the Thyroid,1990-Awards: Outstanding Teacher Award. 1970, 1983, 1987, 1988. Distinguished Service Award. Medical Staff of Regional Med Center, Memphis,1985. Sigma Xi Research Award, 1944, 1988: Distinguished Visiting Professor.1989 91. Distinguished Professor of Medicine, Physiology, and Biophysics, (19881989). Society Membership: Amercan Chemical Society Amercan Society for Clincal investigation Health Physics Society The Endoenne Society The Amercan Thyroid Association i Se ! e-s mae, w swm,a,. is,e_._ a es -e-. .e, e, ~ ese.- ~ e ee n os,e...e e-.v. e.w e. x a
t t Publications: Medical Books 1 Textbook Chapters 10: Journal Articles 118; Abstracts 162. In chronological order, publications pertinent to the subject of thyroid radletion and references to additional publications during the past three years. i Biological Effects of Atomic Radiation (BEAR) committee. Shield Warren, chairman: (Van Middleswortn, L member, pane! of experts). Pathological Effects of Thyroid i Irradistion. National Academy of Sciences, Federal Radiation Council Washington, D. C., July, 1962. Van Middlesworth, L Factors influencing the Thyroid Uptake of lodine isotopes from Nuclear Fission. Health Physics 9:1197 1211, 1963. f Van Middlesworth, L The Thyroid and Nuclear Reactors. Thyroid-Today to: No. 2, 1 5, 1987. Van Middlesworth, L and U. Loos. Cesium 137 and 1311 in thyroids of cattle and sheep after nuclear accdonts and weapons tests. Health Physics 55: 809-811, 1988. Van Middlesworth, L, Worldwide lodine 131 Fallout in Animal Thyroid Glands, 1954 1987. Nagatski, S., (ed.), Radiation and the Thyroid, p 38 55. Excerpta Medica. Princeton, NJ, 1989. Van Middlesworth. L Effects of radiation on the thyroid gland. Advances in intomal Medic.ne, Stollerman, G. (ed.), Yearbook Med. Publishers, 34: 265-284, 1989. i 131 1 in Thyroids of Grazing Animals, Van Middlesworth, L Three Decades of Monitoring Environmental Monitoring, Restoration and Assessment: What Have We Laamed?, Gray, ~ RH,oditor.p 15 24,US Dept Energy & Battelle Pacific Northwest Labs,Richland,WA,1990. Savannah RNor Site Environmental Report. Savannah Rker Site, Aiken, SC, 1984,1985, 1988,1987,1948,1989,1990 and 1991. j Van Middlesworth, L Physiology of the Thyroid and Parathyroid. In Cummir$s, C.W. ed. Otolaryngology H6ad and Neck Surgery Second Edition, Mosby Year Book, Inc.,1992. Van Middlesworth, L.
- Relationship between iodine def' iency disorders (IDD!and thyroid c
cancet* Presented in Tashkent. Uzbekistan, has been translated into Russian for publicaten in bimonthly Problemy Endocrinologii, Nov.1992. 137 s Fission Products in Thyroids of Animals, 1984 1991. 129 and C Van Middlesworth, L 1 Healtn Physics. Vol. 83 No. 6. Dec.1992. j i i j
2- : :a,.es ca":' *
- 7 6~ ~ 'et*:
.ss' ~ ~ :: e BIOGRAPHICAL SKETCH ,.e e to..eg -: aoce *er e 1ev oorscare' are ::essarts s c ::uacorators Segir..~ e : ::a ,estgator er:grAr":'*ect:r **:::c:cv -'s : age er eac :eesen NAME SC s " ON ~ * : e nief, Rac1ation E'#ects Branen Bruce W. 4ACHHOLI National Cancer Ins:1:Ute, NIH E; C A~ C% Beve -'e :acceansr**!* cr atte' emeu cr:retscear ec.carc-s.cn as stsrq s~c ecree ocsrcocrerar ~a e, q vEAA NsTr*'.;-'CN ANo LOCAYiON OEGAEE C rJE A AED 8 E' : Or 5*.:v valcaraiso university; ialparaiso, Inciana A.B 1958 Physics &.*a: nema: :s University of Recnester; Rocnester, NY M.S. 1959 Raciation Sici:gy anc Biconystes University of Rocnester; Rochester, NY Ph.D. 1967 Radiation Biol:gy and BioonvSics i mEsEARCH ANo PAOFEsSCNAL EXPERIENCE. Conevoeg wem present cosmon. hst. m enronoegcal oroer. orevous errocyment esoeee ee a o nonors. *ey oorsonnet inciuos tne onncoat inveengstor ano any omer ironouais wno paroccate e the soentme oevecoment or execuoce :, e =r:.ect + wey personne4 ryocany we metuas as memousas witn ooctorni or otner cro'essenaJ oog'oos. out m some protects we inctuos arenneva s at re aste*s :r eaccaisureate sevet proveso iney conmoute in a suostanove way to the soonatic covecoment or esecunon of tne protect. tectuos crese-t e-:e'sme :- ar'y Feoeral Govemment puowc aavisory commmee. Lat. m g.,v,% oroer. tne ones. ad autnors. ano comonete re'erences to an ouoncst'ces :ar g e e i cast three years anc to reoresentaeve oaner en awaaane perenent to men anchcanort o0 NOT EXCEED TWO PaGEs. 1966-1971 Senior Research Scientist, Pacific Northwest Laboratories. Battelle Memortai Institute, Richland, Washington 1971-1976 Radiation Biologist, Division of Biomedical and Environmental Research, U.S. Atomic Energy Cossaission, Washington, D.C. i l 1976-1979 Policy Analyst, Office of Technology Impacts, U.S. Dept. of Energy, Washington, D.C. 1979 1983 Manager, Special Projects, Office of Health and Environmental Research, U.S. Dept. of Energy, Washington, D.C. 1983-Present Chief, Radiation Effects Branch, National Cancer Institute, National Institutes of Health Bethesda, Maryland Orcanizational Activities (Selected) 1984-Present Member, Committee on Interagency Radiation Research and Policy Coordination, Office of Science and Technology Policy, Office of the President, Washington, D.C. Chairman, Sub-Panel on High LET Radiation 1983-Present Chairman, Federal Advisory Cossaittee on Thyroid / Iodine-131 Assessments, National Cancer institute, Bethesda, Maryland 1991 Consultant. The International Chernobyl Project, International Atomic Energy Agency, Vienna, Austria 1978 - 1982 Member, Consmittee on Radiation Protection and Public Health. Nuclear Energy Agency Organization for Economic Cooperation and Development, Paris, France a-s ase tae, a sii . Form page si a ge n ve.' e coe eu.m.m me= e in. u ---. oo %ro e,e. cn es u
Bair d.J., Healy. J.W. and Wachnolz, B.W. The Enewetax Atoll Today. J.S. Dept. of Energy, Washing:en, DC. 1979. Bair, W.J., Healy, J.W., and Wachholz, B.W. The Meaning of Radiation at Bikini Atoll. U.S. Dept. of Energy, Washington. DC. 1980. Bair. W.J., Healy, J.W., and Wachholz, B.W. The Meaning of Radiation for Those Atolls in the Northern Part of the Marshall Islands That Were Surveyed in 1978. U.S. Dept. of Energy, Washington, DC, 1982. Bender, M.A., Awa, A.A., Brooks, A.L., Evans, H.J., Groer P.G., Littlefield, L.G., Pereira, C., Preston, R.J., and Wachholz, B. Current Status of Cytogenetic Procedures to Detect and Quantif/ Previous Exposures to Radiation. Mutation Research, 196:103-159, 1988. Wachholz, B.W. Overview of the National Cancer Institute's Activities Related + to Exposure of the Public to Fallout from the Nevada Test Site. Health Physics, 59:511-514, 1990.
- Bouville, A., and Wachholz, B.W.
Pasture Practices, Milk Distribution, and Consumption in the Continental U.S. in the 1950s. Health Physics, 59:627-636, 1990. Dreicer, M., Beck, H.L., Hoecker, W.H., and Wachholz, B.W. Models of Radiciodine Transport to Populations within the Continental U.S. Health Physics, 59:659-668, 1990. Steinhiusler, F., Valkovic, V., Zombori, P., Stegnar, P., and Wachholz, B.W. " Environmental Contamination," In: The International Chernobyl Project, Proceedings of an International Conference, Assessment of Radiological Consequences and Evaluation of Protective Measures (IAEA, Vienna, Austria, 1991), pp. 19-26.
- Anspaugh, L., Bouville, A., Bennett, B.G., and Wachholz, B.W.
" Radiation Exposure of the Population " In: The International Chernobyl Project, Proceedings of an International Conference, Assessment of Radiological Consequences and Evaluation of Protective Measures (IAEA, Vienna, Austria, 1991), pp. 27-32. Wachholz, B.W. Assessment of Techniques to Determine Previous Radiation Exposures (Esphastring Exposures occurring Decades Earlier): Introducttan and t Summary. Health Physics, 60(suppl. 1):1-2, 1991. Toohey, R., Palmer, E., Anderson, L., Berger, C., Cohen, N., Eisele, C., Wachholz, B., and Burr, Jr., W. Current Status of Whole-Body Counting as a Means to Detect and Quantify Previous Exposures to Radioactive Materials. Health Physics, 60(suppl. 1):7-42, 1991.
- Boecker, B., Hall, R., Inn, K., Lawrence, J., Ziemer, P. Eisele, G., Wachholz, B.,
and Burr, Jr., W. Current Status of Bioassay Procedures to Detect and Quantify Previous Exposures to Radioactive Materials. Health Physics, 60(suppl. 1):45-100, 1991.
== '--:':a. ves: ca:: s :: a-Vee:.ast s- - :: e e BIOGRAPHICAL SKETCH
- .e re oao..eq * : a:en : e oev :e scree' anc :: sst rts ara : occera:ces 5 gie.it-e :- ::a a
eves:4qat: :r:; a-:?e: t **ct:::cv nes : age er eacn :e soe 80517:CN*; U VME %.t,, e.t:~L** ** .;OC::..e :L:r.e 1. Odn NCiff
- 20: rat::"f Of bi:0.ca :a1 Pnar 20010cf, 'i~- T, I
E:u;aT CH sepe a.re saccenureete :r : tee, ernar a : ess.c-a* ecucaso" sucn as eurs es a-c -eci.co cosiccc-: si rarere l YDR 'N5*: J*1CN AND t.OCAON OE3AE! CONFE8mE: ag,; Or5*.:* Universitf cf Ca*.iferr.ia l A.B. 1945 3: :c. c.:.s:: f ~ " A. 1946 Phys:.:lo:-/ Ur. verstr/ cf Ca11fer.*.a Ph.D. 1949 Phys:.:'.yf Ur.1verstr/ of Califer-.:.a Harvar:8. Universief Bost:n, MA M.D.
- 1953 I
l RESEAACM AND PeCF15310NaL EXPERitNCE. Cone:wong w m cresent season, ut. m enfonoegem oreer. crevous emeier-eat er:e+e :s a : nonors. Key personne ecswee me onneena r'veengener ano any ciner comausas wne persecate e the sc:enunc covecoment =r esee te- :? e : : e:- ster oorsonnes ryocasy me ecaeos as movmias win cac:crai er ::ner pro sesens esprees out e some oroec:s edi ec: wee ' nome.a:s at es aste s :- neocasaureate ovos provese sney conmovie e a suostanove me,:n tne soensac eevenement of esecusen o' tno protect.resce treseat e-:e s : :- any Soesre Goremment amoursemesey commmee. L st e enroecogen oreer. the sees. as authors. ane coreciete re*e onces o sit c.cacar:ces :. ; e past inroe years ano to represeniseve earner suoncanone certnent :o :nrs aconcason. CO NOT E,XCEED TWO P AGES. 1945-1949 Research Ass:s ant, epartment o' Phys :; y, University of Calif::::a 1946 Teaching Assistant, Department of Phys;:1:qy, Univers :y of Cal;f rn:.a S umrea r 19 51 Research Assistant, Hecper roundati:n, Un' ers; y c' Californi:. 1953-1954 Intsen, Massacnusetts General Hospital 1955-1959 surgeon, Nata:nal Institutes cf Heal:3, Bet.esda, Maryland 1958-1959 National Scia.:e Foundati:n Te'.1:w a :.:. Ts. */. 7;; - Rivers at Mill Hill, London, and . Rec..e and R. Michel at the College de Trance, Paris 1959-1963 Senior Surgeon, Natt:nal Institutes cf Health. Bethesda, Maryland 1961-1973 Editorial Board, Endocrinology 1963 Medical Mirec sr, National Institutes of Heal:n, Bethesda, Maryland 1965 Associate Chief, Clinical Endocrincicqy Branca. NIAMDD, National Institutes of Health,
- Betnesda, Maryland Tall 1968 Visiting Professor at University of Naples, Naples consultant, TDA 1976-present Chief, Section en Endocrine Biochemistry, CES, NIAODK, 1978 National Institutes of Health, Setbssda, Maryland 1972-1988 Research collaborator, Brookhaven National Laterat:ry, Marshall Islands Tena 1977 and 1978 1975-1979 Consultant, Natacnal Council on Radiation Protecticn and Measuremen:
Public Mealth Service Emergenc; Respense to Three Mile '979 Island Nuclear Reactor accidens, March 28, 1979 1978-1984 Editorial Board, 31ochialca Blaphysica Acta .9b2-1987 Editorial
Deard,
Journal of 3;.cgical Cheadstry 1983 Visiting Pr:fessor (INSERM), :aculte de Medactne A-arrel, Lyon, Trance
- 5. Colegate to Ukraine to s.udy thyrcid s:TJelae of ec. 199C
?.he Chernecyl Reacter accident N:::K, Cct. 1991 1hief, Section on Endccrine Biochemistry, Lal, National Inst:tutes of Health, Bethesda, Maryland 1 - \\ I e s m iae. m 3 - >sei>aise
- s *er se uses soc as :a so
{ . e., sace, c:. ee...., a: +e secoms ows : e acar canoa
P ROFES S::NAI., SCC:ZT:IS : E..d:crine Society $ccLety for Clinical :nvess.ga: :.. Amer:can Thyroid Assoc:.ati:n - ft: a: :::t:::: i A.e:::an 5:::.ety f:: 5 :1:g:.:a; One. :::y & M:le:ula: B:.:;:qy P:::sta See:s y PRCTESSIONAL HCNCR$ : i Sigma Ki, Phi Beta Kappa, A'.pha C.ega Alpha, E1:. Lilly Award. Merits:icus Service Medal cf the Put;;: Heal:n Serv:.:e, Meda; :: I the Societe de Chimie Biol:g:.:;.:e, Marsei'.le, Trance l l l t i Publi:ations during past th:se yea:s: Wolff, J.: Excess iodide inhibits tne thy::id by multiple mechanisms. In: Control of the Thyroid Gland, R. EkhcL:., L. D. Kohn & 5. H. Wo;;:". ann (eds), Plenum Publishing Corp., NY, pp 2:1-244 (1989).
- Gentile, T.,
- Knipling, L.
G.,
- Sackett, D.
L., and Wolf f, J:
- .va s :.ve adenylate cyclase of Screatella per usst.s: payst:al, cataly :.: and : x::
properties. J. 21ol. Chem. 255: 13186-10852 (1390). i
- Sackett, D.
L.,
- Knutson, J.
R., and Wolff, J.- Hydr:ph:bt: su::a:es of tubulin probed by time-resolved and steady state flu::sscence :f n:.;e red. J. Biol. Chem. 265: 14899-14906 (;95: 1 i 'nipling, L. G.,
- Cahnmann, M.
J., and Palu=2c, G.: Oi:e::
- Wolff, J.,
K I photoaf finity labelir.g of tubu'in with c:1:hicane. Pr:c. Natl. Acad. I Sci. USA II: 2820-2824 (1991). t
- Sackett, D.
L.,
- Knipling, L.
G., and Wolff. J.: Isolation of. mit:stubule protein from mammalian brain frozen for extended periods cf tame. Protein Expression and furification 2: 390-393 (1991).
- Herman, R.
C., Naghshineh, S., Cushman, 5. W.,
- Wolff, J.,
- Simpson, I.
A., and Londes, C.: Cholera and pertussis toxins modify regulation of glucose transport in rat adipose cells. Cellular Signalling 4, 87-98 (1992).
- Shiver, T.,
- Sackett, D.
L., and Wolff, J.: Disruption of intermediate filaments stimulates steroidogenes:.s in Y-1 ad:enal cells. Endocrinology 131, 201-201 (1992).
- Wolff, J.,
- Kwang, J.,
- Sackett, D.
L., and Knipling, L.: Colchitine photosensitizes covalent tubulin dime:1:stion. Blochemistry 31, 3935-3940 (1992). Le Systeme te Transport Actif. Chapter in la Wolff, J.: Iodure 2 4 Thyroide De la Physiologie Cellulaise aux Dysfonc:f ons--Des Concep: la Pracitus. Redacteurs: J. Lecler:. J.
- Crgitati, 5.
- Rousset, J.
L. Schlieng:, and J. L. Womaan (in press).
- Nauman, J.
and Wclff, J.: Iodine prophylaxis .n Poland after the Cr.ernobyl accident--benefits and risks. Am..r. Med. (submitted).
I Earlier references per ;nen: :: :.e 7:esen: pr :e::: Wolff, J.:
- odide w iser an
..e
- .a r.a
- .;:g:.: ef: n: cf ex:a::s :.:d:.
Amer. J. Med. 47, 101-124, 1963. Wolff, J.: Iodine nemeestasis. .. Kle n, E. and Reanwein. O. (Eds. ). Regulation of Thyroid rune::en. 5:::: ard-New Y rx, T.K. Sena tuer Verlag, 1976, pp. 65-92.
- Saenger, E.
L.,
- Eisentud, M.,
Goldsma:n, R.O., Ingraham. M. S., S t a..tu ry, J.
- 3. Wolff, J.
oc al.: P r: tecta:n of tne tny-2.'.d gland in the even-cf releases of radiciodine (NORP Report Nc. 55). Wasningt:n, DC, Nata:nal Council en Radiatiott Protec-1:n and Measurenants,1977, pp.1-60.
- Larsen, P.
R., Canard. R. A., Knudsen, K., Rettins, J., Wolf f, J., Ra!.1, J. E. and Debyns, 3.: Thyrcad hypofunction appearing as a da!.ayed manifestation of acciduntal exposure to radioactive fall-out an a Marsha11 esse population. In Late a:=2ogical Effects of Ionizing Radiacion, vol. I, pp. 101-115. Internati:na! At mic Energy Agency, vienna, 1978. Wolff, J.: Physiological aspects of iodine excess in relation to radiati n protection. J. Molec. Med. 4: *ft *65, 1780.
- Tradkin, J.
E. and Wolff, J..
- dide-induced thyrz:=ricosis.
Medicine 62: 1-20, 1983. Wolff, J.: Risks for stable and radicactive icdine in radiation pr:tection of the thyroid. In Hall, R. and Kcteerling, J. (e ca l : Thyrcad Discrders Associated with !cdine Deficiency and Excess, Secono Symp., Raven Press, New York, 1985, 22: 111-128. i 1 1 )
APPENDIX C STAFFING PATTERN (BELARUS) l l 1993 l94l95l l l....................l...l...l l l l Monthly lYearsuml l l l POST lNo.l salary l total lNo.lNo.l 1l 2 l 3l 4 l 5 l 6l 7l
- 1. MANAGEMENT PERSONNEL 1 l President (Minister of Health) l 1l 20000l 240000l 1l 1l 2 l Scientific supervisor l
1l 17000l 204000l 1l 1l 3 l Scientific coordinator l 1l 15000l 180000l 1l 1l 4lScientificsecretary l 1l 12000l 144000l 1l 1l 5l Manager l 1l 13000l 156000l 1l 1l 6 l Chief of Gomel Centre l 1l 10000l 120000l 1l 1l 7lExecutivesecretary l 1l 7000l 84000l 1l 1l 8l Interpreter l 2l 8000l 192000l 2l 2l 9 l Scientific supervisor asst. l 1l 10000l 120000l 1l 1l 10 l Chief of endocrinology dept. l 1l 12000l 144000l 1l 1l 11 l Chief of ultrasonic diagnostic l 1l 12000l 144000l 1l 1l l department l l l l l l 12lChiefaccountant l 1l 10000l 120000l 1l 1l l 13lEconomicaccountant l 1l 9000l 108000l 1l 1l 14 l Scientific consultant l 2l 14000l 336000l 2l 2l 15 l Quality control off.icer l 1l 12000l 144000l 1l 1l l TOTAL l16l l2436000l16l16l .................................................................l
- 2. SCREENING TEAMS (mobile and fixed) 1lTeammanager(physicianendocr.)
2l 11000l 264000l 3l 4l 2lPhysicianendocrinologist l 2l 10000l 240000l 3l 4l 3lUltrasonicspecialist l 4l 10000l 480000l 6l 8l 4lComputeroperator l 4l 6000l 288000l 6l 8l 5 l Sister in charge of blood taking 4l 8000l 384000l 6l 8l 6 l Medical registrant l 2l 6000l 144000l 3l 4l l 7lAidwoman l 2l 6000l 144000l 3l 4l 8l Driver l 3l 8000l 288000l 4l 4l i TOTAL l24l l2232000l34l44l - C.1 -
l l 1993 l94l95l l l......______.......l...l...l l l l Monthly lYearsuml l l l POST lNo.l salary l total lNo.lNo.l 1l 2 l 3l 4 l 5 l 6l 7l
- 3. DEPARTMENTS, DIVISIONS, LABORATORIES 3.1. Epidemiology department l
1lDepartmentmanager(epidemiol.)l 1l 11000l 132000l 1l 1l l 2lPhysicianepidemiologist l 2l 9000l 216000l 2l 3l i 3lComputeroperator l 2l 6000l 144000l 2l 2l TOTAL l 5l l 492000l 5l 6l .................................................................l 3.2. Dosimetry department 1lDepartmentmanager l 1l 12000l 144000l 1l 1l 2lDosimetryengineer j 5l 6000l 360000l 5l 5l 3l Technician l 4l 5000l 240000l 4l 4l 4lHealthphysicist l 9l 8000l 864000l 9l 9l 5lProgrammingengineer l 1l 7000l 84000l 1l 1l 6 l Laboratory assistant l 2l 5500l 132000l 2l 2l 7l Driver l 3l 6000l 216000l 3l 3l 8lComputeroperator l 4l 6000l 288000l 4l 4l TOTAL l29l l2328000l29l29l 3.3. Endocrinology department 1lPhysicianendocrinologist l 1l 10000l 120000l 2l 2l 2lUltrasonicspecialist l 1l 10000l 120000l 1l 1l 3 l Sister of medical procedures l 1l 8000l 96000l 1l1l 4lWardnurse l 2l 7000l 168000l4.5l4.5l 5lAidwoman l 2l 6000l 144000l4.5l4.5l l 6lComputeroperator l 1l 6000l 72000l 1l 1l l l TOTAL l 8l l 720000l14l14l - C.2 -
l l 1993 l94l95l l j....................l...l...l l l l Monthly lYearsuml l l l POST lNo.l salary l total lNo.lNo.l 1l 2 l 3l 4 l 5 l 6l 7l 3.4. Surgery division 1lDivisionmanager(surgeon) l 1l 12000l 144000l 1l 1l 2 l Surgeon oncologist l 1l 10000l 120000l 1l 1l 3lMedicalsister l 2l 7000l 168000l 2l 2l 4lAidwoman l 1l 6000l 72000l 1l 1l TOTAL l 5l l 504000l 5l 5l 3.5. Central laboratory 1lLaboratorymanager(biochemist)l 1l 12000l 144000l 1l 1l 2lLaboratoryphysician l 4l 10000l 480000l 6l11l 3lCytologyphysician l 1l 10000l 120000l 1l 1l 4 l Senior laboratory assistant l 1l 8000l 96000l 1l 1l 5lLaboratoryassistant l 3l 7000l 252000l 2l 3l 6lAidwoman l 2l 6000l 144000l 3l 3l TOTAL l12l l1236000l14l20l .................................................................l 3.6. Pathology laboratory 1lLaboratorymanager l 1l 11000l 132000l 1l 1l 2 l Pathologist l 1l 10000l 120000l 1l 1l 3lLaboratoryassistant l.1l 7000l 84000l 1l 1l TOTAL l 3l l 336000l 3l 3l 3.7. Quality Control service 1l Endocrinologist (expert) l 1l 10000l 120000l Il 1l 2lUltrasonicspecialist(expert)l0.5l 9000l 54000l 1l 1l 3l Biochemist (expert) l0.5l 9000l 54000l 1l 1l 4l Cytologist (expert) l0.5l 9000l 54000l 1l 1l 5l Epidemiologist (expert) l0.5l 9000l 54000l 1l 1l TOTAL l 3l l 336000l 5l 5l - C.3 -
i 4 l l 1993 l94l95l l l.....______.........l...l...l l l l Monthly lYearsuml l l l POST lNo.l salary l total lNo. lNo. l Il 2 l 3l 4 l 5 l 6l 7l 3.8. Computer centre 1l Manager l 1l 10000l 120000l 1l 1l 2lProgrammingengineer l 2l 7000l 168000l 3l 3l 3lComputernetsandtelecom-l 1l 8000l 96000l 1l 1l I l munication system engineer l l l l l l 4lComputermaintenanceengineer l 1l 8000l 96000l 1l 1l l 5lComputeroperation l 2l 6000l 144000l 3l 4l TOTAL l 7l l 624000l 9l10l 0VERALL TOTAL 112l 11244000l134l152l l Note: monthly salaries should be provided according to prices at the beginning of 1992. i s ? + I i i t l - c.4 b o
e r APPENDIX D ORGANIZATION CHARTS
BELARUS hlMISitY OF HEAllid i P 1 I I i i Endocrinology Scientific Research Institute Center of Thyreld Minsk Medical Center of New Dispensary-Gomel of Radiation Medicine (SRIM) Tumor Studies Institute Medical Technology i I I l Oncoloey Dent l l Patholour Dept i I Gomel Division Mogilev Divisten Vitebsk Olvisten Scientific Cilnical Dispensary for Radiation Hygiene (SRIM) (SRIM) (SRIM) and Departe Clinic Radiation Effects Department Screenine 1 -a -.-n,---w .m, m--- ~n..n-a +.,-w- ,w--
PROJECT STRUCTURE Ministry of Health F , Dr. Vasily S. Kazakov N 's s I 's s 's s l %,' s i s e \\s* Oversight Committee Institute of Radiation Medicine --) Project Director 5 specialists -- Belarus Dr. Vladlair A. Matyukhin (--- Dr. Larisa N. Astakhova - - - - - - + 5 specialls'.s -- U.S. s - Management (I.) 4_______ Quality Control (3.7) , r s e s e s e s-l Central Endocrinology (3.3) Dispensary Dept. -- Gomel Center Surgery Division (3.4) Laboratory (3.5) Minsk Endocrine Dispensary Center of Thyroid lumors 4 4 l Moblie Team (2.) Mobile Team (2.) .a % 9 % 9 %f Pathology Lab (3.6) Dosimetry Dept. (3.2) Epideolology Dept. (3.1) Computer Center (3.8) I 4 l}}