The United States Navy and Employees with Cancer: The Time for Change Is Now.

ABSTRACT: The US Navy, including the US Marine Corps and Naval Nuclear Propulsion Program (NNPP), has a robust radiological protection and monitoring program meeting (and typically exceeding, in the name of conservatism) federal law requirements. The program covers the variety of ways in which the Navy produces and uses ionizing radiation and radioactive sources: in medicine, nuclear ship propulsion and repair, industrial and aircraft radiography, and myriad other unique uses in carrying out its vital mission. In executing these programs, thousands of people across the world are employed as active-duty Sailors and Marines, government civilians, and government contractors. These workers include physicians, reactor operators, radiation safety officers, and nuclear repair workers, to name but a few. The health protection standards for these workers are promulgated in the publicly available Navy Medicine P-5055 Radiation Health Protection Manual (NAVMED P-5055), published February 2011 with Change 2 published December 2022, and are applicable to Navy and Marine Corps and NNPP radiation protection programs. The NAVMED P-5055 outlines the individual medical requirements for those qualified and able to receive exposure to ionizing radiation as part of their duties and requires that "Radiation workers receive focused medical examinations to establish whether or not cancer is present which would medically disqualify a person from receiving occupational radiation exposure." Additionally, without scientific or medical basis, the NAVMED P-5055 requires disqualifying those employees who have a history of cancer, cancer therapy, radiation therapy including radiopharmaceuticals received for therapeutic purposes, or bone marrow suppression from drawing dosimetry, entering radiation areas, or handling radioactive material. This policy, which exists regardless of lifetime occupational radiation dose or projected future radiation dose, applies to all cancers except adequately treated basal cell carcinoma. The policy is not supported by relevant scientific and medical literature; does not align with reasonable professional ethical standards; does not conform to US Navy radiological training, which stipulates the assumed increased risk of developing cancer from Navy and Marine Corps and NNPP occupational radiation exposure is small; and removes critical leadership and mentoring capability from the workforce unnecessarily. This article discusses in detail (1) this policy and its ramifications to the Navy and Marine Corps and NNPP workforce and (2) recommendations, benefits, and impacts for the Navy and Marine Corps and NNPP to remove this policy and still maintain a robust radiation protection program.

Impact analysis of age on radiation casualty estimations for nuclear detonation scenarios.

Purpose: The purpose of this research was to demonstrate the impact of accounting for age-based radiation response when estimating radiation casualties in a nuclear detonation scenario.Materials and methods: Three nuclear device detonation scenarios were simulated using densely populated regions to compare traditional casualty estimates with age-dependent casualty estimates. Fatalities were estimated using age-based dose-response curves. The surviving population was assumed injured (requiring medical care) if their dose exceeded a lower bound, represented by the minimum dose required to cause deterministic effects, for each age group.Results: In each of the three scenarios, the affected area increased significantly for radiosensitive age groups. In two of the three scenarios, accounting for age-dependent radiosensitivity resulted in up to a 10% increase in fatalities and up to a 12% increase in radiation injuries compared to traditional estimates. This study demonstrates that the differences in casualty estimates are dependent on the relative density and location of radiosensitive populations.Conclusions: These results demonstrate that the inclusion of age-based demographic data and associated dose responses may result in significantly higher estimates of casualties depending on the location and age of the affected population. This information could be useful for the emergency management planning community.