Mortality among U.S. military participants at eight aboveground nuclear weapons test series

Abstract

Background

Approximately 235,000 military personnel participated at one of 230 U.S. atmospheric nuclear weapons tests from 1945 through 1962. At the Nevada Test Site (NTS), the atomic veterans participated in military maneuvers, observed nuclear weapons tests, or provided technical support. At the Pacific Proving Ground (PPG), they served aboard ships or were stationed on islands during or after nuclear weapons tests.

Material and methods

Participants at seven test series, previously studied with high-quality dosimetry and personnel records, and the first test at TRINITY formed the cohort of 114,270 male military participants traced for vital status from 1945 through 2010. Dose reconstructions were based on Nuclear Test Personnel Review records, Department of Defense. Standardized mortality ratios (SMR) and Cox and Poisson regression models were used in the analysis.

Results

Most atomic veterans were enlisted men, served in the Navy at the PPG, and were born before 1930. Vital status was determined for 96.8% of the veterans; 60% had died. Enlisted men had significantly high all-causes mortality SMR (1.06); officers had significantly low all-causes mortality SMR (0.71). The pattern of risk over time showed a diminution of the ‘healthy soldier effect’: the all-causes mortality SMR after 50 years of follow-up was 1.00. The healthy soldier effect for all cancers also diminished over time. The all-cancer SMR was significantly high after 50 years (SMR 1.10) primarily from smoking-related cancers, attributed in part to the availability of cigarettes in military rations. The highest SMR was for mesothelioma (SMR 1.56) which was correlated with asbestos exposure in naval ships. Prostate cancer was significantly high (SMR 1.13). Ischemic heart disease was significantly low (SMR 0.84). Estimated mean doses varied by organ were low; e.g., the mean red bone marrow dose was 6 mGy (maximum 108 mGy). Internal cohort dose–response analyses provided no evidence for increasing trends with radiation dose for leukemia (excluding chronic lymphocytic leukemia (CLL)) [ERR (95% CI) per 100 mGy −0.37 (−1.08, 0.33); n = 710], CLL, myelodysplastic syndrome, multiple myeloma, ischemic heart disease, or cancers of the lung, prostate, breast, and brain.

Conclusion

No statistically significant radiation associations were observed among 114,270 nuclear weapons test participants followed for up to 65 years. The 95% confidence limits were narrow and excluded mortality risks per unit dose that are two to four times higher than those reported in other investigations. Significantly elevated SMRs were seen for mesothelioma and asbestosis, attributed to asbestos exposure aboard ships.

Keywords:

• Atomic veterans
• nuclear weapons tests
• radiation epidemiology
• Million Person Study
• cancer
• suicide

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This research was supported in part by contracts and grants from the National Cancer Institute [Grant No. U01 CA137026]; the U.S. Department of Energy [Grant No. DE-SC0008944 awarded to the National Council on Radiation Protection and Measurements], which included interagency support from the U.S. Nuclear Regulatory Commission, the U.S. Environmental Protection Agency and the National Aeronautics and Space Administration; and a Discovery Grant from the Vanderbilt-Ingram Cancer Center (Center No. 404-357-9682). The biodosimetry work was supported by the NCI Intramural Research Program through an interagency agreement with the Radiation Nuclear Countermeasures Program of the National Institute of Allergy and Infectious Diseases (NIAID) under NIAID agreement #Y2-Al-5077 and NCI agreement #Y3-CO-5117. We acknowledge Dr. Paul Blake, Chief, Nuclear Test Personnel Review, Defense Threat Reduction Agency, U.S. Department of Defense and his staff for their technical support of the project, and Hanson Gaugler at L-3 Services for his critical contributions to our accessing and interpreting the comprehensive data sources necessary for study conduct. Similarly, Han Kang and Tim Bullman, Environmental Epidemiology Service, U.S. Department of Veterans Affairs, were instrumental in providing support and assistance throughout the conduct of the Eight Series Study of atomic veterans. We also are indebted to: the Department of Energy (Nimi Rao), the Nuclear Regulatory Commission (Doris Lewis), Oak Ridge Associated Universities (Derek A. Hagemeyer), Landauer, Inc. (Craig Yoder, PhD), the U.S. Army Dosimetry Center (William S. Harris, Jr., CHP), the U.S. Air Force Radiation Dosimetry Laboratory (Ms. Linda Wilson), and the Naval Dosimetry Center (CDR Anthony Williams and Lt Selena Hayes) for facilitating linkages with their respective dosimetry files. The findings and conclusions in this paper are those of the authors. Its publication does not necessarily represent the official position of or imply endorsement by the National Council on Radiation Protection and Measurements, Oak Ridge Associated Universities, Vanderbilt University, or any of the acknowledged agencies.

Notes on contributors

John D. Boice

John Boice is past President of the National Council on Radiation Protection and Measurements and Professor of Medicine at Vanderbilt University. He is an international authority on radiation effects and served on the Main Commission of the International Commission on Radiological Protection and on the United Nations Scientific Committee on the Effects of Atomic Radiation. He directs the MPS of Low-Dose Health Effects.

Sarah S. Cohen

Sarah Cohen is a Senior Managing Epidemiologist at EpidStrategies, a division of ToxStrategies, where she directs observational research studies in the areas of pharmacoepidemiology, nutritional epidemiology, and occupational epidemiology as well as leads large data management projects and statistical analyses. She is also an Adjunct Assistant Research Professor of Medicine in the Department of Medicine at Vanderbilt University School of Medicine. She has been a collaborator on the MPS of Low-Dose Health Effects for nearly twenty years, providing analytic support as well as coauthoring numerous publications.

Michael T. Mumma

Michael Mumma is the Director of Information Technology at the International Epidemiology Institute and the International Epidemiology Field Station for Vanderbilt University Medical Center. He has over 20 years of experience in data analysis and conducting epidemiologic investigations.

Heidi Chen

Heidi Chen is a Research Assistant Professor of Biostatistics in the Vanderbilt Center for Quantitative Sciences. Her Ph.D. is in biomathematics from North Carolina State University and her research focuses on applying mathematical, statistical and computational methods to fit models for biological systems. Since joining the Department of Biostatistics, Vanderbilt University Medical Center in 2003, her research has involved identifying biomarkers and building models to predict disease progression and clinical outcome for cancer patients. Heidi has been a statistical collaborator on the Million Person Study since 2013.

Ashley P. Golden

Ashley P. Golden is a biostatistician and project manager at Oak Ridge Associated Universities where she conducts multidisciplinary projects in occupational epidemiology, radiation exposure and dosimetry, medical surveillance, and environmental assessments. She has been a collaborator on the Million Person Study of Low-Dose Health Effects for six years.

Harold L. Beck

Harold L. Beck is a leading expert on radiation dose reconstruction with more than 50 years of experience in radiation dosimetry, radiation metrology, and dose reconstruction uncertainty. He served for over 36 years in various scientific and management positions in the Department of Energy Environmental Measurements Laboratory.

John E. Till

John E. Till is the founder and President of Risk Assessment Corporation with more than 40 years of experience in environmental dosimetry. He received the E.O Lawrence award from the Department of Energy in 1995 and delivered the L.S. Taylor lecture for the National Council on Radiation Protection and Measurements in 2013. He also served in the U.S. Navy Nuclear Submarine Program, retiring as a Rear Admiral in the U.S. Naval Reserve in 1999.