ML20134C786
ML20134C786 | |
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Issue date: | 03/25/1996 |
From: | Mangano J NRC |
To: | Roxanne Summers NRC |
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To: Roxanne Sununers From: Joe Mangano Date: March 25, 1996 Please accept the following written testimony for the March 26 hearing. If there are any problems or questions, I can be reached at 718-857-9825.
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9610080187 960326 PDR ACRS GENERAL PDR
03/25/.1996 ,15: 41 17188574986 os c, m Europron Journal o! Cam er Prcrentwn 1996. 5. *1$.81 J
d A post-Chernobyl rise in thyroid cancer in Connecticut, USA I
J J Mangano
{ (Received 25 August I995; accepted 8 November i993)
Y Recent analyses of children in Belarus and the Ukraine are the first to doceneet large nomibers of excess thyroid cancer cases only 4 years after exposure to radiation. In Connecticut (USA), a thyroid cancer increase of a modi I wneller magnitude occurred in 1990-93, 4-7 years after the Chernobyl accident, for both chDdren and adults.
Similar changes also occurred in the states of Iowa and Utah, which like Connecticut were exposed to low levels of l radionuclides from Chernobyl fallout during May and June of 1986. Historical data from C:--- At slee reseal substantial increase in thyroid cancer incidence about 5 years after large releases of iodine 131 from distant US
, nuclear mespons plants, after the largest atmospheric US atomic weapons tests la Nevada, and after subatantial
- releases of iodine-131 from the Millstone nuclear power plant in Connecticut. Further analysis of this apt,arent 5-year latency period will enhance understanding of ionizing radiation's effects on thyroid function and on human health in general.
Key nords: Chernobyl iodine, radioactivity, thyroid cancer.
=
d i
4 Introduction i Sescral recent sepom have documented a dramatic able latency may have occurred in Hiroshima /
increase in thyroid cancer in children under 15 lising Nagasaki survivors, but no systematic study was near Chernobyl following the nuclear accident on 26 performed until 1958-61, 13.16 years after the Aptt! 1986. Beponing in 1990, sharp incidence rises bombings, when 21 cases in a population of 15,000 j
occurred in the downumd Belarus region (Kazakov er were diagnosed (Socolow et al,1963) In Rongelap, al,1992) and upwind Ukrame (1.ikhtarev et al.1995). Marshall Islands, which received a large amount of I By 1991-94, the Belarus thyroid cancer rate had risen fallout after a 1954 thermonuclear device test, the first 100 times and the I;krainian rate seven times from the case of thyroid cancer was not documented until 1965 levels m 1981 85. The number of cases m 1991-94 (Conard et al,1970). Six thyroid cancer cases (vs 1.4
'. was 2R6 in Belaru and 149 m the Ukraine (Stsjakhko expected) were found among Mormons living in et al.1995). Because pre cancerous thyroid conditions southwest Utah in 1958-66, about 5 years after the in children are currently more common than 1951-62 US atmospheric bomb tests in nearby carcinomas, health officials in the area expect future Nevada (Johnson,1984). For Utah residents under thyroid cancer tales to con .nue nsing (Shapiro, 30, a total of 39 thyroid caxers (vs an expected 17) were detected from 1958 to 1962 (Weiss et al,1967y 1995) i These reports represent the first instance that large Average time between exposure to childhood i excesses of thponj cancer have been documented as therapeutic head and neck irradiation and diagnosis early as 4 years after radiauon exposure. A compar- of thyroid carcinoma is about 25-35 years Iron er al.
Radsatrem aM fuh!rc 'fentrh Vrom t 7M C'arroll Street nV Brooklyn. New York. NY 11213. USA C 1996 asp,d Scunse Puhlmhet.
Ewogman Journal orCancer Prevenoon vol 3 im 75
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03/25/1.996 15: 4 17188574986 FAULKER AND GRAY PAGE 03 r -
JJ Mangano i
1987; Schneider et al,1993), one study showed only 12 Between 1960 and 1990, when it ceased such of 309 (4%) of thyroid cancers developed withm.10 reporting, the US Environmental Protection Agency years of exposure (Schneider et al,1993). Recently, a reported monthly levels of vanous radionuclides in link between a suriev of Lrays and elevated thyroid milk in about 60 US cities; one of these elements is cancer rates was identified. especially for papillary iodine-13), exposure to which poses a risk factor for '
carcinoma. beginnmg with a latency of 5 years thyroid cancer. The average level of "'l in pasteunsed between exposure and dugnosis (Hallquist er al, milk in Hartford, Connecticut from 1983 to 1985 was about 0.02 Bq/1, but between 12 May and 2 June 1986. !
1994).
With a short latency for radiation induced thyroid after Chernobyl fallout reached the US, six consecu.
cancer near Chernobyl apparent, the question anses tive readings between 0.19 and 0.85 were recorded, as whether distant popul.itions also cxperienced adverse well as a level of 196 on 23 June, before the readings effects. Fallout Irom Chernobyl travelled long retumed to customary levels (Natio tal Air and distances, crossing the Atlantic Ocean and reachmg Radiation Environmental Laboratory,1986). The .
~
the Americas. Wlule tesels of post-Chernobyl radio- May-June readings will correspond to changes in radioactivity ingested through the food chain, since no nuclides m the US enuronment were much lower than those in Belarus and the Ukraine, few studies have yet measures to restrict consumption were taken or
- been performed on any potential health efTects of such suggested by American health officials. By July, small doses of thesc Ntopes (Sperlmg et al,1994). most of the U'I from Chemobyl had decayed and was no longer detectabic, as the element has a physical halflife of 8.05 days (Table 1).
The May-June 1986 readings are higher than normal, but lower than the peak average of 2.59 Thyroid cancer incidence for the state of Connecticut (USA) was selected for the study of post-Chernobyl Bq/1 in September-October 1%2, a time of heavy fallout from atmospheric weapons testing in Nevada.
effects. Connecticut. located 7200 km west of Chemobyl, has the oldest comprehenstse tumour Except for late 1961 and 1962, only a few samples above 0.37 Sq were recorded during the 1960s and registry in the US. datmg from 1935. The registry collects data from Connecticut hospital admitting 1970s. Between 1960 and 1974, readings below 0.37 records, hospital outpatient pathology / radiology Bq/1 were not specified, precluding any precise records, death certiricates and autopsies, and obtams analysis of efTects of "'I during these years (US information from physicians, hospitals and health Public Health Service, 1960-1974).
Although exposure to radioactive iodine has been departments in other states (Connecticut Department of Health Services.1984). Due to the multiple sources directly linked with thyroid cancer, it should be noted of data and the age of the registry, cancer reporting is that there other radionuclides were also released from Chemobyl. These include isotopes that affect the cells probably as complete in Connecticut as it is anywhere in the bone marrow (and thus, the immune system).
in the US.
Table 1. Becquerels per litre of iodme-131 and caesium-137 iri pasteunzed milk; Hartford. Connecucut, US A, 1983-90 No of tradmgs Average radioact vity (Bq/1) ,
b:ar
!"' Ca'" .
12 0.01 0 05 t 90 0.08 12 0.00 t984 0.10 11 0.03 1955 9116 4 0.08 0.07 Jare Apr 6 0.30 0 13 5 Mar 22 May 0 63 0 49 27 May-23 Jun 5 6 0.08 0 25 Jul Dec 0.23 12 0 10 in7 I1 0.10 0.f 8 19NR 0.09 0 06
- 9 il 8 0 18 0.17 1990 76 eso n som.;,%u pm m on. voi s im
/1996 15: 41 171.88574986 FAULKrER AND GRAY PAGE 04 05 Thyroid cancer post-Chernohyl such as barium-140 ("Ba), and others that disperse Results themselves throughout all tissues. such as caesium-137('"Cs). The half life of "Ba is 12.8 days, and that Table 2 presents f.ge adjusted thyroid cancer incidence for Connecticut residents from 1935-93, along with of "'Cs is about 30 ) ears. Levels of these two rates for individual age groups.
elements m H.uttordi rutsteunzed milk rose sharply dunng May and June of 1986, due to Chernobyl The data reveal a substantial increase between 1985-89 and 1990-93 in the state's age adjusted fallout. incidence of 26.2% (P < 0.0001), following 10 years Table I also meludes histoncal readings of "'Cs in Hartford rmik Le$cls reached a record high of 5.55 of virtually no change. Likewise. the rate rose for Bq/l between June 1963 and May 1964, just after persons aged 0-19 (44%),20-39 (27%; P < 0.05),40-cessation of atmospheric nuclear weapons tests, and 64 (23%; P < 0.05) and 65 or over (27%; P < 0.05).
ste-dily declired thercetter. By the 198N. levels were Incidence for persons aged 0-14 more than doubled, -
moving from 0.16 to 0.35; however, with only five and generally below 020 Bq/1. and even readings in May rnd June 1986 (013 0.49) were just a small fraction nine cases reported during these two periods, this increase has limited statistical significance (P < 0.15). ,
of those of the e.u) 19r,n3 (US Public Ilealth Service, While females account for nearly three-quaners of all .
1963.-1964).
The post-Chernobyl iodine levels in the Connecticut thyroid cancer cases in the state, the increase for males an increase in the amount (28%) was roughly equal to that for females (25%).
milk supply 'imify t absorbed by the population, especially fetuses and Prior analysis has shown that much of the historical change involves papillary carcinoma, the type of infants. Normally, a nursmp" Connecticut infant's I per year, assuming thyroid cancer most affected by exposure to ionizing thyroid absorb 4 3 mtad of the mether mgest> 11 of milk with 0.074 Bq of "'I radiation (Pottern et al,1980).
Connecticut's age adjusted thyroid cancer incidence each day and that the mfant absorbs 10 mrad for in the early 1990s was compared with those for two every 37 Bq ot ;"! exposure, in 1986, the figure nearly doubled, reaching 13.5 mrad. For fetuses, assumms a other American states with established tumour registries, Iowa and Utah. These states also received thyroid gland 10/.. the size of an infant's during the 1:st 180 days of gestation (Beierwaltes et al,1960), the fallout from Chernobyl, perhaps in greater amounts than did Connecticut. The average level of "'I in usual level of u mrad would have risen to 100.8 in 1986 (Committee on Food Protection,1973). The pasteurised milk m Des Moines, Iowa was 0.76 Bq/l for the period 20 May-25 June 1986 (seven readings, figure of 100 8 mrad is more than double the 50 mrad with a high of 1.37), compared with 0.03 Bq/l for the of background r.idation typically absorbed in 6 months, previous 6 months. "'I samples in Salt Lake City.
Table 2. Thyroid cancer incidence rate per 100,000 adjusted to 1970 US standard and by age group; Connecticut, 1935-93 20-39 40-64 65+
0-14 0-19 ye, Al; ges .
Rate No. Rate No. Rate Rate No Rate No No Rate % change N o.
0.07 27 1.14 25 4 23 .
o 0 00 4 0.15 2 -
1935-39 $8 0 79 -
42 1.5B 30 4.20 0 00 0.04 6 0 20 I940-44 79 0 94 I82 0 1 0.80 47 1 66 36 4.39 0.05 i O 04 25 1 09 15.5 1 1945-.49 609 1 70 105 3 42 65 5.79 f 0 04 2 0.06 55 l950-54 22- 2 02 86 0 123 67 $ 96 0 06 7 0 17 68 2.08 Ill 195% 59 21 2 04 09 2 3 13 92 7 29 0 13 16 0.33 99 2.94 117 2 45 19.9 5 6 69 1960-64 324 3 57 168 4.13 92 4 0 10 11 0 20 131 1 % 5-69 402 2 'S 12.4 3 65 106 4 60 107 7 07 0 07 19 0 35 146 1970 14 49 29' 80 3 4 41 237 5 64 105 6.20 0.23 27 0 54 198 1975 79 56' 3 di 15.3 8 4.24 260 6.19 127 6 66 0 25 17 0.38 216 1980-84 620 3 46 09 8 278 6 43 149 7 04 0.16 19 0.44 196 3.58 1985-89 642 3 45 -0.2 5 257 7.58 163 8 96 0 35 21 0 63 195 4 55 4 15 26.2 9 1990-93* e 8 4 yem.
European Journal or Cancer Prevente 9015 (M 77
03/25/$996 15: 41 17188574986 FAULKNER AND GPAY PAGE 06 Thyroid ca*tcer post.Chernobyl over the subsequent 25 years (Hanford Health caused Amencans to ingest radioactive products.
Information Network.1994). At' Oak Ridge, Tennes- including iodine. Although itcords were only kept in see, exact amounts of "'I emissions are unknown, but nine US cities (none in Connecticut)in the late 1950s, because the stack at the plarit were unfiltered from ') I levels in New York City (160 km southwest of 1943 to 1948. releases were large. For example,2.4 x Connecticut) averaged as much as 8.02 Bq/1 in raw 10" Bq of "'I were released from the Oak Ridge milk, from September to November 1957. Children National Laboratory m 1947 (Tennessee Department born in New York City in 1957 were estimated to of Health.199.h. have absorbed a dose of about 620 mrad of "'I to The penod 1960 64 is about 5 years after the US their thyroid gland by 1963, slightly more than the 600 atmosphenc weapons tests in Nevada yielding the mrad absorbed through background radiation.
greatest kilotonnage. The 1957 test series had the Amounts for children in other US cities such as St highest yield (.t46 kilotons); this series followed those Louis and Salt Lake City were nearly three times as m 1955 (167 kt) and 1953 (252 kt). These 3 years much as those in New York City (US Public Health account for about 85% of all yields from atmospheric Service, 1963, 1 % 9).
testing in Neuda from 1951-62. In addition, US The period 1975-79 is approximately 5 years after atmosphenc detonations in the Pacific during 1954-56 the opening of the Millstone nuclear power plant in and 1956-58 produced a yield of 103,000 kt, about Waterford, Connecticut, which emitted relatively 80% of the tota! output from Pactfic tests from 1946 to large amounts of fission products into the atmosphere 1962 (Norris and Cochran,1994). Fallout from these during its first years. Millstone began operations in 1970, and released 1.15 x 10 i2 Bq of "'I from 1970 to tests (especially those in Nevada) driflod eastward acrow the contmental US, carried by prevailing 1979 compared with 5.42 x 10 Bq from 1980 to winds, and entered the environments of many states 1986. The greatest annual release (3.69 x 10" Bq)
(including Connecticut), often through precipitation. occurred in 1975 (Nuclear Regulatory Commission, Introduction of fallou*. particles into the food chain 1970-1986). Table 4 presents historical data from TaWe 4. Thyroid cancer cases, all ages and sexes: Middlesex and New London counties, Connecticut, USA, 1950-93
)m No. of cases Crude rate in county County Rest or state wddlesen county 1950.52' 4 1 92 (-) 2.15 (-)
1953 57 9 2 30 (+ 19.8%) 1.92 (-10.7%)
1958 62 10 2.25 (-2.2%) 2 40 (+25 0%)
1963 67 13 2.55 (+13.3%) 2.46 (+2.5%)
(144ddam Neck reactor start up) 1%IL 72 14 2.44 (-4.3%) 2 86 (+16.3%) !
19?3-77 23 3.77 ( 54 7%) 3.35 (+18 2%)
1978 82 23 3 57 (-5.3%) 3.47 (+2.7%)
190 87 30 4 41 (+ 23.5%) 4.20 (+21.0%)
1988 92 26 3.63 (-17 7%) 4 61 (+ 9.8 %)
New 1.ondon county 19155 15 1 91 (-) 2.06 (-)
1956 60 14 1.57 (-17 8%) 1.97 (-4 4%) i 1961 65 17 1.71 (+8 9%) 2.39 (+ 21.3%) I 1 54 (-9 9%) 2 75 (+15 0%) l 19A6 to 17 Millione reactor start.upt 1971 15 20 1.72 (+ 117%) 3 04 ( + 10.5% )
1976 80 38 3 21 (+86 8%)* 3 41 ( +12.2%)
42 34s (+7 4%) 4 04 (+ 18.5%) l 1981 85 I 1986 90 62 4 93 (+42.9%) 4 24 (+ 5.0%)
1991 93* SI 6.69 (+35 7%) 4 98 (+17 5%)
p . n oi
- I yedrs.
European Journal of Cancer Prevenoon vol 5 19% 79 l
03/25/1,996 15: 41 17188574996 FAULIOG M) GRAY pAGE 07 JJ Mangan l l
Millstone's home county (New London), as well as adverse health effect, increased thyroid cancer in local ,
Middlesex county (the location of Haddam Neck, children beginning 4 years after the accident, has been !
Connecticut's other nuelcar power plant). documented. This paper suggests a statistical link In the period 19 6 R0. 5 years after Millstone's between exposure to Chernobyl fallout and elevated early operations, the number of thyroid cancer cases thyroid car,cer rates m distant populations exposed to in New London county jumped from 20 to 38, an lower levels of iodine and other radionuclides; this increase in the crude rate of 86 R% (compared with link includes both children and adults. Future study 12.2% for the other *esen Connecticut counties). In on thyroid cancer patterns will greatly aid the Middlesex county, the number increased from 14 to understanding of Chernobyl's effecta, as well as the 23 (crude rate mcrease of 54.7%, n 18.2% elsewhere in effects of protracted, low level radiation exposures on the state) 5 years after Haddam Neck opened in 1967. human health.
Releases from Haddam Neck were considerably Power than at Millstone. Because only crude rates are -
available, these increases are imprecise. However, it References is clear that age-adjusted rates also rose substantially* Anspaugh LR, Catlin RJ. Goldman M (1988). The global .
beginning 5 years after the two Connecticut reactors impact of the Chernobyl reactor accident Scacece 2a2:
initiated operations. m these two counties. 1513-18.
Thyroid cancer inetilence has risen in Connecticut Beierwaltes WH, Crane HR, Wegst A et al (1960).
in all but one 5-> car penod since the 1930s, at an Radioscuve iodme concentration m the fetal human thyroid gland from fall-out. / Am Med Au 173: 1895-902.
average annual rate of about 3%. Thus, some increase Clark DE (1955). Association ofirradiauon with cancer of '
in the early 1990s can be expected, with or without the thynsid in children and adolescents. J Am Med An introduction ofiodme from a nuclear accident into the 199: 1007-9.
environment. However, the upswing after 1989 Committee on Food Protecuon (1973). Radionuclides m Foods. Washington DC: National Academy of Sciences.
follows 10 years of unchanged rates marked by Conard RA. Dobynn BM, Sutow WW (1970). Thyroid falling incidence for the population under age 40:
neoplasia as late effect of exposure to radioactive iodme the proportion of this group that received head and in fallout.1 Am Med Au 214: 316-24.
neck irradiation in childhood, a practice associated Connecticut Department of Health Services (1984). Fony-with thyroid cancer ruk th.it ceased by the late 1950s, five years of cancer in Connecucut (monograph).
is droppmg. After 19h9, however, rates increased for Hartford. CT. l O uld JM and Sternalass EJ (1989). Low-level radiation )
all age 8 roue 5, including the under-40 population. and mortahty. CHEMTEC# 19: 18-21.
Thus, the pattern m the early 1990s can be seen as a Hallquist A, Hardell L. Degerman A et al(1994L Medical departure from the trend espected from the previous diagnostic and therapeutic ionizmg radiation and the nsk 10 years. for thyroid cancer: a case-control study. Eur / Cancer prev 3: 259-67, Perhaps the most rescaling fmding of this study is Hanford Health Information Network (1994). The release that exposure to relaiisely low levels of radioactivity of radioactive matenals from Hanford. Seattle WA:
may add to cancer nsk after just a few years. Children Vol.2.
in Belarus and the Ukrame received several hundred Jablon S. Hrubec 2, Boice JD, Stone BJ (1990). Cancer in rads, or thousands of times the level of iodine than populations living near nuclear racilities. Washington.
their Connecticut counterparts (Anspaugh a al, DC: National Cancer Insutute.
J hnson CJ (1984). Cancer incidence in an area of .
1988). However, thyroid cancer increases for children radioactive fallout from the Nevada test site. / Am Med since the late 1980s in Belarus (665%) and the Ukram.e An 251: 230-6.
(209%) are not thousands of times greater than that of Kazakov VS, Demidchik EP. Astakhova LN (1992). .
Connecticut children i117%) (Stsjakhko et al,1995). It Thyroid cancer after Chernobyl Nature 3s9: 21. .
Likhtarev IA, Sobolev BO. Kairo IA et al(1995). Thyroid is possible that efTects on thyroid function from low C '*
levels of iodine are greater than previously beheved. g,gj,y,g Afr a d d'ia io Env nr ental Laboratory and may resemble the supralinear dose response (1975 1990). Environmental Radiation Data Reports.
found by other researchers (Petkau,1972: Gculd Montgomery, AL: US Environmental Protection and Sternglass. !% Future studies on changes in Agency; Volume I. 64 Norns RS. Cochran TB (1994). United States Nucicar thyroid cancer and other diseases should assess the Tests. July 1945 to 31 December 1992. Washington DC:
dose-response relationship for various levels of Natural Resources Defense Council.
Chemobyl fallout Nuclear Regulatory Commission (1970-1986) Radioacuse The full health legacy of the Chemobyl disaster will Matenals Releaned from Nuclear Power Plants- Annm not be known for many years. Howeser. the first Reports Washington DC.
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a 03/25/1996. }5: 41 17188574986 FALUCER AND GRAY PAGE 08 Thyroid cancer post-Chernobyl Petkau A (1972). EITects of 22Na* en a phospholipid radiation: a summary of the fmdings in Hiroshima and membranc. Health Phyxire 22: 239. Nagasaki, New Eng/ / Med 268: 406-10 Pottern LM. Stone BJ. Day NE rt al(1980). nyroid cancer Sperling K. Pelz J. Wegner J cr al (1994). Sigmficant m Connecticut 10M-1975: an analysis by cell type. Am / increase in tnsomy-21 in Berlin nme months after the Epidemsol 112: 44 74. Chernobyl reactor accident: temporal correlation or Ries LAG. Miller BA. Hankey BF er al(1987-1990). SEER causal relation? Br Med / 30>.158-62.
i i Cancer Starnrio Rei tew. Hethesda. M D: National Stsjakhko VA. Tsyb AF. Tronko ND et al (1995).
Cancer Institute. Childhood thyroid cancer since accident at Chernobyl.
Ron E. Kicmerman RA. Boce JD ct al (1987) A Br Med / 310: 801.
population-based case-control study of thyroid cancer. / Tennessee Department of Health and the Oak Ridge Health Nail Cancer hnt 79 1 12. Agreement Steering Panel (1993). Oak Ridge health Schneider AB. Ron F.. Lubin J ct al(1993). Dose-response studies phase one report. Nashville TN: Division of relationship; l'on radi.ition-induced thyroid cancer and Environmental Epidemtoingy; Vol. II. Part 8: E4 E9.
thyroid nodule > esidence for the prolonged effects of US Public Health Service. Division of Radiolossal Health radistbn on the thyroid. / Clin Endocrinot Metohol 77: (1960-1974). Radiological Health Data and Reports.
362 9. Washmston, DC: US Department of Health, Education.
Shapiro M (1999 ChornobyTa 'foung Victims Pay Toll. and Welfare; Volumes 1.14.
l Wuihungton oni 24 June 1995. Al. Weiss ES, Olsen RE. Thompson GDC. Masi AT (1967).
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