Third mortality follow-up of the Mallinckrodt uranium processing workers, 1942-2019.

INTRODUCTION: Mallinckrodt Chemical Works was a uranium processing facility during the Manhattan Project from 1942 to 1966. Thousands of workers were exposed to low-dose-rates of ionizing radiation from external and internal sources. This third follow-up of 2514 White male employees updates cancer and noncancer mortality potentially associated with radiation and silica dust. MATERIALS AND METHODS: Individual, annualized organ doses were estimated from film badge records (n monitored = 2514), occupational chest x-rays (n = 2514), uranium urinalysis (n = 1868), radium intake through radon breath measurements (n = 487), and radon ambient measurements (n = 1356). Silica dust exposure from pitchblende processing was estimated (n = 1317). Vital status and cause of death determination through 2019 relied upon the National Death Index and Social Security Administration Epidemiological Vital Status Service. The analysis included standardized mortality ratios (SMRs), Cox proportional hazards, and Poisson regression models. RESULTS: Vital status was confirmed for 99.4% of workers (84.0% deceased). For a dose weighting factor of 1 for intakes of uranium, radium, and radon decay products, the mean and median lung doses were 65.6 and 29.9 mGy, respectively. SMRs indicated a difference in health outcomes between salaried and hourly workers, and more brain cancer deaths than expected [SMR: 1.79; 95% confidence interval (CI): 1.14, 2.70]. No association was seen between radiation and lung cancer [hazard ratio (HR) at 100 mGy: 0.93; 95%CI: 0.78, 1.11]. The relationship between radiation and kidney cancer observed in the previous follow-up was maintained (HR at 100 mGy: 2.07; 95%CI: 1.12, 3.79). Cardiovascular disease (CVD) also increased significantly with heart dose (HR at 100 mGy: 1.11; 95%CI: 1.02, 1.21). Exposures to dust ≥23.6 mg/m3-year were associated with nonmalignant kidney disease (NMKD) (HR: 3.02; 95%CI: 1.12, 8.16) and kidney cancer combined with NMKD (HR: 2.46; 95%CI: 1.04, 5.81), though without evidence of a dose-response per 100 mg/m3-year. CONCLUSIONS: This third follow-up of Mallinckrodt uranium processors reinforced the results of the previous studies. There was an excess of brain cancers compared with the US population, although no radiation dose-response was detected. The association between radiation and kidney cancer remained, though potentially due to few cases at higher doses. The association between levels of silica dust ≥23.6 mg/m3-year and NMKD also remained. No association was observed between radiation and lung cancer. A positive dose-response was observed between radiation and CVD; however, this association may be confounded by smoking, which was unmeasured. Future work will pool these data with other uranium processing worker cohorts within the Million Person Study.

Mortality among Tennessee Eastman Corporation (TEC) uranium processing workers, 1943-2019.

BACKGROUND: There are few occupational studies of women exposed to ionizing radiation. During World War II, the Tennessee Eastman Corporation (TEC) operated an electromagnetic field separation facility of 1152 calutrons to obtain enriched uranium (235U) used for the Hiroshima atomic bomb. Thousands of women were involved in these operations. MATERIALS AND METHODS: A new study was conducted of 13,951 women and 12,699 men employed at TEC between 1943 and 1947 for at least 90 days. Comprehensive dose reconstruction techniques were used to estimate lung doses from the inhalation of uranium dust based on airborne measurements. Vital status through 2018/2019 was obtained from the National Death Index, Social Security Death Index, Tennessee death records and online public record databases. Analyses included standardized mortality ratios (SMRs) and Cox proportional hazards models. RESULTS: Most workers were hourly (77.7%), white (95.6%), born before 1920 (58.3%), worked in dusty environments (57.0%), and had died (94.9%). Vital status was confirmed for 97.4% of the workers. Women were younger than men when first employed: mean ages 25.0 years and 33.0 years, respectively. The estimated mean absorbed dose to the lung was 32.7 mGy (max 1048 mGy) for women and 18.9 mGy (max 501 mGy) for men. The mean dose to thoracic lymph nodes (TLNs) was 127 mGy. Statistically significant SMRs were observed for lung cancer (SMR 1.25; 95% CI 1.19, 1.31; n = 1654), nonmalignant respiratory diseases (NMRDs) (1.23; 95% CI 1.19, 1.28; n = 2585), and cerebrovascular disease (CeVD) (1.13; 95% CI 1.08, 1.18; n = 1945). For lung cancer, the excess relative rate (ERR) at 100 mGy (95% CI) was 0.01 (-0.10, 0.12; n = 652) among women, and -0.15 (-0.38, 0.07; n = 1002) among men based on a preferred model for men with lung doses <300 mGy. NMRD and non-Hodgkin lymphoma were not associated with estimated absorbed dose to the lung or TLN. CONCLUSIONS: There was little evidence that radiation increased the risk of lung cancer, suggesting that inhalation of uranium dust and the associated high-LET alpha particle exposure to lung tissue experienced over a few years is less effective in causing lung cancer than other types of exposures. There was no statistically significant difference in the lung cancer risk estimates between men and women. The elevation of certain causes of death such as CeVD is unexplained and will require additional scrutiny of workplace or lifestyle factors given that radiation is an unlikely contributor since only the lung and lymph nodes received appreciable dose.

Updated mortality analysis of the Mallinckrodt uranium processing workers, 1942-2012.

PURPOSE: Mallinckrodt Chemical Works (MCW) was the earliest uranium processing facility in the United States, and in 1942 produced the uranium oxide used for the first sustained and controlled nuclear fission chain-reaction at the University of Chicago. A second follow-up through 2012 was conducted of 2514 White male workers employed 1942-1966 at the MCW for dose-response analyses for selected causes of death. MATERIALS AND METHODS: Organ/tissue-specific dose reconstruction included both external (12,686 MCW film badge records, 210 other facility film badge records, and 31,297 occupational chest x-rays) and internal sources of uranium and radium (39,451 urine bioassays, 2341 breath radon measurements, and 6846 ambient radon measurements). Dust measurements from pitchblende facilitated quantitative risk estimates for non-radiogenic effects on the lung and kidney. Vital status was determined from multiple sources including the National Death Index and the Social Security Administration. Cox regression models were used for dose response analyses. RESULTS: Vital status was determined for 99% of the workers, of whom 75% had died. The mean lung dose from all sources of external and internal radiation combined was 69.9 mGy (maximum 885 mGy; percent workers >100 mGy, 10%) and there was no evidence for a dose response for lung cancer (Hazard Ratio (HR) of 0.95 (95% CI = 0.81-1.12) at 100 mGy). A significant association with radiation was found for kidney cancer (HR of 1.73 (95% CI = 1.04-2.79) at 100 mGy) and suggested for nonmalignant kidney diseases (HR of 1.30 (95% CI = 0.96-1.76) at 100 mGy). A non-radiation etiology could not be discounted, however, because of the possible renal toxicities of uranium, a heavy metal, and silica, a component of pitchblende dust. Non-significant HRs at 100 mGy for other sites of a priori interest were 0.36 (0.06-2.03) for leukemia other than CLL, 0.68 (0.17-2.77) for liver cancer, and 1.23 (0.79-1.90) for non-Hodgkin lymphoma. The HR at 100 mGy was 1.09 (0.99-1.20) for ischemic heart disease. An association was seen between dust and combined malignant and non-malignant lung disease, HR at 10 mgm-3year-1 of 1.01 (1.00-1.02). CONCLUSIONS: A positive radiation dose response was observed for malignant and non-malignant kidney disease, and a negative dose response for malignant and non-malignant lung disease. Cumulative measures of dust were significantly associated with malignant and non-malignant lung disease and suggested for malignant and non-malignant kidney disease. Small numbers preclude definitive interpretations which will await the combination with similar studies of early uranium processing workers.

Mining and Environmental Health Disparities in Native American Communities.

PURPOSE OF REVIEW: More than a century of hard rock mining has left a legacy of >160,000 abandoned mines in the Western USA that are home to the majority of Native American lands. This article describes how abrogation of treaty rights, ineffective policies, lack of infrastructure, and a lack of research in Native communities converge to create chronic exposure, ill-defined risks, and tribal health concerns. RECENT FINDINGS: Recent results show that Native Americans living near abandoned uranium mines have an increased likelihood for kidney disease and hypertension, and an increased likelihood of developing multiple chronic diseases linked to their proximity to the mine waste and activities bringing them in contact with the waste. Biomonitoring confirms higher than expected exposure to uranium and associated metals in the waste in adults, neonates, and children in these communities. These sites will not be cleaned up for many generations making it critical to understand and prioritize exposure-toxicity relationships in Native populations to appropriately allocate limited resources to protect health. Recent initiatives, in partnership with Native communities, recognize these needs and support development of tribal research capacity to ensure that research respectful of tribal culture and policies can address concerns in the future. In addition, recognition of the risks posed by these abandoned sites should inform policy change to protect community health in the future.

The social costs of uranium mining in the US Colorado Plateau cohort, 1960-2005.

OBJECTIVES: Long-term social costs associated with underground uranium mining are largely unknown. This study estimated health costs of Native American and white (Hispanic and non-Hispanic origin) uranium miners in the US Public Health Service Colorado Plateau cohort study. METHODS: Elevated uranium miner person-years of life lost (PYLL) were calculated from the most recent study of the Colorado Plateau cohort over 1960-2005. Nine causes of death categories were included. Costs to society of miner PYLL were monetized using the value of a statistical life-year approach. RESULTS: Costs over 1960-2005 totaled $2 billion USD [95% CI: $1.8, $2.2], or $2.9 million per elevated miner death. This corresponds to $43.1 million [95%: $38.7, $48.7] in annual costs. Lung cancer was the most costly cause of death at $1.4 billion [95%: $1.3, $1.5]. Absolute health costs were largest for white miners, but Native Americans had larger costs per elevated death. Annual excess mortality over 1960-2005 averaged 366.4 per 100,000 miners; 404.6 (white) and 201.5 per 100,000 (Native American). CONCLUSIONS: This research advances our understanding of uranium extraction legacy impacts, particularly among indigenous populations.

Health Effects and Environmental Justice Concerns of Exposure to Uranium in Drinking Water.

We discuss the recent epidemiologic literature regarding health effects of uranium exposure in drinking water focusing on the chemical characteristics of uranium. While there is strong toxicologic evidence for renal and reproductive effects as well as DNA damage, the epidemiologic evidence for these effects in people exposed to uranium in drinking water is limited. Further, epidemiologic evidence is lacking for cardiovascular and oncogenic effects. One challenge in characterizing health effects of uranium in drinking water is the paucity of long-term cohort studies with individual level exposure assessment. Nevertheless, there are environmental justice concerns due to the substantial exposures for certain populations. For example, we present original data suggesting that individuals living in the Navajo Nation are exposed to high levels of uranium in unregulated well water used for drinking. In 10 out of 185 samples (5.4 %), concentrations of uranium exceeded standards under the Safe Drinking Water Act. Therefore, efforts to mitigate exposure to toxic elements in drinking water are warranted and should be prioritized.

Assessment and indirect adjustment for confounding by smoking in cohort studies using relative hazards models.

Workers' smoking histories are not measured in many occupational cohort studies. Here we discuss the use of negative control outcomes to detect and adjust for confounding in analyses that lack information on smoking. We clarify the assumptions necessary to detect confounding by smoking and the additional assumptions necessary to indirectly adjust for such bias. We illustrate these methods using data from 2 studies of radiation and lung cancer: the Colorado Plateau cohort study (1950-2005) of underground uranium miners (in which smoking was measured) and a French cohort study (1950-2004) of nuclear industry workers (in which smoking was unmeasured). A cause-specific relative hazards model is proposed for estimation of indirectly adjusted associations. Among the miners, the proposed method suggests no confounding by smoking of the association between radon and lung cancer--a conclusion supported by adjustment for measured smoking. Among the nuclear workers, the proposed method suggests substantial confounding by smoking of the association between radiation and lung cancer. Indirect adjustment for confounding by smoking resulted in an 18% decrease in the adjusted estimated hazard ratio, yet this cannot be verified because smoking was unmeasured. Assumptions underlying this method are described, and a cause-specific proportional hazards model that allows easy implementation using standard software is presented.

What are the health costs of uranium mining? A case study of miners in Grants, New Mexico.

BACKGROUND: Uranium mining is associated with lung cancer and other health problems among miners. Health impacts are related with miner exposure to radon gas progeny. OBJECTIVES: This study estimates the health costs of excess lung cancer mortality among uranium miners in the largest uranium-producing district in the USA, centered in Grants, New Mexico. METHODS: Lung cancer mortality rates on miners were used to estimate excess mortality and years of life lost (YLL) among the miner population in Grants from 1955 to 2005. A cost analysis was performed to estimate direct (medical) and indirect (premature mortality) health costs. RESULTS: Total health costs ranged from $2·2 million to $7·7 million per excess death. This amounts to between $22·4 million and $165·8 million in annual health costs over the 1955-1990 mining period. Annual exposure-related lung cancer mortality was estimated at 2185·4 miners per 100 000, with a range of 1419·8-2974·3 per 100 000. CONCLUSIONS: Given renewed interest in uranium worldwide, results suggest a re-evaluation of radon exposure standards and inclusion of miner long-term health into mining planning decisions.

Measurement of radioactivity levels and assessment of radioactivity hazards of soil samples in Karaman, Turkey.

In this study, the levels of the natural and artificial radioactivity in soil samples collected from surrounding of Karaman in Turkey were measured. Activity concentrations of the concerned radionuclides were determined by gamma-ray spectrometry using a high-purity germanium detector with a relative efficiency of 40 % at 1.332 MeV. The results obtained for the (238)U series ((226)Ra, (214)Pb and (214)Bi), (232)Th series ((228)Ac), (40)K and fission product (137)Cs are discussed. To evaluate the radiological hazard of radioactivity in samples, the radium equivalent activity (Raeq), the absorbed dose rate (D), the annual effective dose and the external (Hex) and internal hazard index (Hin) were calculated and presented in comparison with the data collected from different areas in the world and Turkey.

Assessment of indoor absorbed gamma dose rate from natural radionuclides in concrete by the method of build-up factors.

The specific absorbed gamma dose rates, originating from natural radionuclides in concrete, were calculated at different positions of a detection point inside the standard room, as well as inside an example room. The specific absorbed dose rates corresponding to a wall with arbitrary dimensions and thickness were also evaluated, and appropriate fitting functions were developed, enabling dose rate calculation for most realistic rooms. In order to make calculation simpler, the expressions fitting the exposure build-up factors for whole (238)U and (232)Th radionuclide series and (40)K were derived in this work, as well as the specific absorbed dose rates from a point source in concrete. Calculated values of the specific absorbed dose rates at the centre point of the standard room for (238)U, (232)Th and (40)K are in the ranges of previously obtained data.

[Radiation risk assessment for plant reference species (Pinus sylvestris and Vicia cracca) from the area of radium production waste storage].

The risk of an enhanced level of radionuclides of the uranium and thorium decay series in the environment for reference plant species (Pinus sylvestris and Vicia cracca) was assessed. 238U, 230Th, 226Ra, 210Po, 232Th and 228Th concentration factors for plants were found to be lower than one. The aboveground parts of Vicia cracca sampled from the area of the radium production waste storage mainly accumulated 22Ra, Pinus sylvestris branches--210Pb, 226Ra and 210Po. LOEDR calculated for the chromosome aberration frequency in both plant studies was 17-71 microGy/h. LOERD values for the reproductive capacity decrease in P. sylvestris and V. cracca were 17-71 microGy/h and 116-258 microGy/h, correspondingly. EDR10 for the chromosome aberration frequency in P. sylvestris and V. cracca were 148 and 347 microGy/h, that is, correspondingly, 255 and 708 times higher that background values. EDR10 for the plant reproductive capacity was 11-34 microGy/h, which 19-69 times increases the background values.

To recycle or not to recycle? An intergenerational approach to nuclear fuel cycles.

This paper approaches the choice between the open and closed nuclear fuel cycles as a matter of intergenerational justice, by revealing the value conflicts in the production of nuclear energy. The closed fuel cycle improve sustainability in terms of the supply certainty of uranium and involves less long-term radiological risks and proliferation concerns. However, it compromises short-term public health and safety and security, due to the separation of plutonium. The trade-offs in nuclear energy are reducible to a chief trade-off between the present and the future. To what extent should we take care of our produced nuclear waste and to what extent should we accept additional risks to the present generation, in order to diminish the exposure of future generation to those risks? The advocates of the open fuel cycle should explain why they are willing to transfer all the risks for a very long period of time (200,000 years) to future generations. In addition, supporters of the closed fuel cycle should underpin their acceptance of additional risks to the present generation and make the actual reduction of risk to the future plausible.

[Some health parameters in personnel contacting highly enriched uranium].

The authors analysed 20-years and longer observations over health state of personnel having occupational contact with highly enriched uranium. Findings are no determined effects as clinical manifestations of chronic uranium intoxication, presented by most frequently involved systems (hemopoietic, bronchopulmonary) and main organs accumulating uranium (liver, kidneys, bones). Long-term observations revealed malignancies in 11% of the examinees. Further medical observations over the personnel (risk group) are required to evaluate risk of aleatory effects in prolonged contact with various uranium compounds.

Uranium isotopes in public drinking water and dose assessment for man in Poland.

238U, 234U and 235U were determined in tap water from municipal water pipes that drew their supply from surface water or ground water in various locations in Poland. Average activity concentrations of 238U, 234U and 235U in tap water from surface water were 9.6 +/- 7.1, 12.8 +/- 9.7 and 0.41 +/- 0.31 Bq m(-3), respectively, whereas from ground water they were 4.5 +/- 6.0, 5.7 +/- 6.9 and 0.19 +/- 0.27 Bq m(-3), respectively. Activity concentrations of 234U were higher than 238U. Ratios of 234U/238U ranged from 1.07 to 2.60, indicating the lack of equilibrium between these isotopes. The average 235U/238U ratio was 0.043 +/- 0.008, being close to 0.046 for natural uranium. Average annual intake with water and food was 7.6 +/- 5.1 Bq for 238U and 9.5 +/- 6.6 Bq for 234U. Annual committed effective doses calculated from these intakes for adults were 0.34 +/- 0.23 and 0.47 +/- 0.32 microSv, respectively; 235U contributed to the total dose from the uranium isotopes by about 2%.

Uranium ores and depleted uranium in the environment, with a reference to uranium in the biosphere from the Erzgebirge/Sachsen, Germany.

The Erzgebirge ('Ore Mountains') area in the eastern part of Germany was a major source of uranium for Soviet nuclear programs between 1945 and 1989. During this time, the former German Democratic Republic became the third largest uranium producer in the world. The high abundance of uranium in the geological formations of the Erzgebirge are mirrored in the discovery of uranium by M. Klaproth close to Freiberg City in 1789 and the description of the so-called 'Schneeberg' disease, lung cancer caused in miners by the accumulation of the uranium decay product, radon, in the subsurfaces of shafts. Since 1991, remediation and mitigation of uranium at production facilities, rock piles and mill tailings has taken place. In parallel, efforts were initiated to assess the likely adverse effects of uranium mining to humans. The costs of these activities amount to about 6.5 10(9) Euro. A comparison with concentrations of depleted uranium at certain sites is given.

Military use of depleted uranium: assessment of prolonged population exposure.

This work is an exposure assessment for a population living in an area contaminated by the use of depleted uranium (DU) weapons. RESRAD 5.91 code was used to evaluate the average effective dose at depths of 1, 10, 20 cm of contaminated soil, in a residential farming scenario. Critical pathways and groups are identified in soil inhalation and ingestion; critical group is identified in children playing with the soil. From the available information on DU released at targeted sites, both critical and average exposure can produce toxicological hazards. The annual dose limit for the population can be exceeded within a few years from DU deposition for soil inhalation. As a result, clean up at targeted sites must be planned on the basis of measured concentration, when available, while special measures must be adopted anyway to reduce unaware exposures.