Mortality from leukemia, cancer and heart disease among U.S. nuclear power plant workers, 1957–2011

References

• Agency for Toxic Substances and Disease Registry (ATSDR). 2013. Case studies in environmental medicine: asbestos toxicity. Atlanta (GA): ATSDR, Public Health Service, US Department of Health and Human Services. [accessed 2021 January 16]. https://www.atsdr.cdc.gov/csem/asbestos_2014/docs/asbestos.pdf
   Google Scholar
• Akaike H. 1974. A new look at the statistical model identification. IEEE Trans Automat Contr. 19(6):716–723.
   Web of Science ®Google Scholar
• Akiba S. 2018. The latest study of Japanese nuclear workers. J Radiol Prot. 38(2):E26–E28.
   PubMed Web of Science ®Google Scholar
• Akiba S, Mizuno S. 2012. The third analysis of cancer mortality among Japanese nuclear workers, 1991–2002: estimation of excess relative risk per radiation dose. J Radiol Prot. 32(1):73–83.
   PubMed Web of Science ®Google Scholar
• Albitar M, Manshouri T, Shen Y, Liu D, Beran M, Kantarjian HM, Rogers A, Jilani I, Lin CW, Pierce S, et al. 2002. Myelodysplastic syndrome is not merely “preleukemia.” Blood. 100(3):791–798.
   PubMed Web of Science ®Google Scholar
• Anderson JL, Bertke SJ, Yiin J, Kelly-Reif K, Daniels RD. 2021. Ischaemic heart and cerebrovascular disease mortality in uranium enrichment workers. Occup Environ Med. 78(2):105–111.
   PubMed Web of Science ®Google Scholar
• Anderson RT, Sorlie P, Backlund E, Johnson N, Kaplan GA. 1997. Mortality effects of community socioeconomic status. Epidemiology. 8(1):42–47.
   PubMed Web of Science ®Google Scholar
• Anzenberg V, Lewis DE, Dickson ED, Bush-Goddard SP. 2010. The U.S. Nuclear Regulatory Commission Radiation Exposure Information Reporting System (REIRS). Radiat Res. 173(2):254–255.
   PubMed Web of Science ®Google Scholar
• Azizova TV, Bannikova MV, Grigoryeva ES, Rybkina VL, Hamada N. 2020. Occupational exposure to chronic ionizing radiation increases risk of Parkinson’s disease incidence in Russian Mayak workers. Int J Epidemiol. 49(2):435–447.
   PubMed Web of Science ®Google Scholar
• Beck HL, Till JE, Grogan HA, Aanenson JW, Mohler HJ, Mohler SS, Voillequé PG. 2017. Red bone marrow and male breast doses for a cohort of atomic veterans. Radiat Res. 187(2):221–228.
   PubMed Web of Science ®Google Scholar
• Blevins MR, Andersen RL. 2011. Radiation protection at U.S. nuclear power plants – today and tomorrow. Health Phys. 100(1):35–38.
   PubMed Web of Science ®Google Scholar
• Boice JD. 2010. Uncertainties in studies of low statistical power (editorial). J Radiol Prot. 30(2):115–120.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr. 2014. The importance of radiation worker studies (editorial). J Radiol Prot. 34(3):E7–E12.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr. 2016. From Oak Ridge to Indian Point Studying workers at nuclear power plants. Health Physics News. 44:23–24. [accessed 2021 November 12]. https://ncrponline.org/wp-content/themes/ncrp/PDFs/BOICE-HPnews/45-From-Oak-Ridge-to-Indian-Point-Feb-2016.pdf
   Google Scholar
• Boice JD, Jr. 2017a. The linear nonthreshold (LNT) model as used in radiation protection: an NCRP update. Int J Radiat Biol. 93(10):1079–1092.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr. 2017b. Space: the final frontier--research relevant to Mars. Health Phys. 112(4):392–397.
   Google Scholar
• Boice JD, Jr. 2019. The Million Person Study relevance to space exploration and Mars. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2019.1589020
   Web of Science ®Google Scholar
• Boice JD, Jr, Blettner M, Kleinerman RA, Stovall M, Moloney WC, Engholm G, Austin DF, Bosch A, Cookfair DL, Krementz ET, et al. 1987. Radiation dose and leukemia risk in patients treated for cancer of the cervix. J Natl Cancer Inst. 79(6):1295–1311.
   PubMedGoogle Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Chen H, Golden AP, Beck HL, Till JE. 2020. Mortality among US military participants at eight above ground nuclear weapons test series. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2020.1787543
   Google Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Ellis ED, Cragle DL, Eckerman KF, Wallace PW, Chadda B, Sonderman JS, Wiggs LD, et al. 2014. Mortality among Mound workers exposed to polonium-210 and other sources of radiation, 1944–1979. Radiat Res. 181(2):208–228.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Ellis ED, Eckerman KF, Leggett RW, Boecker BB, Brill AB, Henderson BE. 2011. Updated mortality analysis of radiation workers at Rocketdyne (Atomics International), 1948–2008. Radiat Res. 176(2):244–258.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Ellis ED. 2019. The Million Person Study, whence it came and why. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2019.1589015
   Google Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Golden AP, Howard S, Girardi DJ, Ellis ED, Bellamy M, Dauer LT, Samuels C, et al. 2021. Mortality among workers at the Los Alamos National Laboratory, 1943–2017. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2021.1917784
   Google Scholar
• Boice JD, Jr, Cohen SS, Mumma MT, Howard SC, Yoder C, Dauer LT. 2021. Mortality among medical radiation workers in the United States, 1965–2016. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2021.1967508.
   Google Scholar
• Boice JD, Jr, Dauer LT. 2021. Million Person study of low-dose radiation health effects. Trans Am Nucl Soc. (in press)
   Google Scholar
• Boice JD, Jr, Ellis ED, Golden AP, Zablotska LB, Mumma MT, Cohen SS. 2019. Sex-specific lung cancer risk among radiation workers in the Million-Person Study and among TB-fluoroscopy patients. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1547441
   Google Scholar
• Boice JD, Held KD, Shore RE. 2019. Radiation epidemiology and health effects following low-level radiation exposure. J Radiol Prot. 39(4):S14–S27.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr, Leggett RW, Ellis ED, Wallace PW, Mumma M, Cohen SS, Brill AB, Chadda B, Boecker BB, Yoder RC, et al. 2006. A comprehensive dose reconstruction methodology for former Rocketdyne/Atomics International radiation workers. Health Phys. 90(5):409–430.
   PubMed Web of Science ®Google Scholar
• Boice JD, Jr, Quinn B, Al-Nabulsi I, Ansari A, Blake PK, Blattnig SR, Caffrey EA, Cohen SS, Golden AP, Held KD, et al. 2021. A million persons, a million dreams: a vision for a National Center of Radiation Epidemiology and Biology. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2021.1988183.
   Google Scholar
• Bouville A, Toohey RE, Boice JD, Jr, Beck HL, Dauer LT, Eckerman KF, Hagemeyer D, Leggett RW, Mumma MT, Napier B, et al. 2015. Dose reconstruction for the million worker study: status and guidelines. Health Phys. 108(2):206–220.
   PubMed Web of Science ®Google Scholar
• Buckley JP, Keil AP, McGrath LJ, Edwards JK. 2015. Evolving methods for inference in the presence of healthy worker survivor bias. Epidemiology. 26(2):204–212.
   PubMed Web of Science ®Google Scholar
• Caldwell GG, Zack MM, Mumma MT, Falk H, Heath CW, Till JE, Chen H, Boice JD. 2016. Mortality among military participants at the 1957 PLUMBBOB nuclear weapons test series and from leukemia among participants at the SMOKY test. J Radiol Prot. 36(3):474–489.
   PubMed Web of Science ®Google Scholar
• Campbell KM, Deck D, Krupski A. 2008. Record linkage software in the public domain: a comparison of Link Plus, The Link King, and a ‘basic’ deterministic algorithm. Health Informatics J. 14(1):5–15.
   PubMedGoogle Scholar
• Cardis E, Gilbert ES, Carpenter L, Howe G, Kato I, Armstrong BK, Beral V, Cowper G, Douglas A, Fix J. 1995. Effects of low doses and low dose rates of external ionizing radiation: cancer mortality among nuclear industry workers in three countries. Radiat Res. 142(2):117–132.
   PubMed Web of Science ®Google Scholar
• Cardis E, Vrijheid M, Blettner M, Gilbert E, Hakama M, Hill C, Howe G, Kaldor J, Muirhead CR, Schubauer-Berigan M, et al. 2005. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ. 331(7508):77. DOI:https://doi.org/10.1136/bmj.38499.599861.E0
   PubMed Web of Science ®Google Scholar
• Cardis E, Vrijheid M, Blettner M, Gilbert E, Hakama M, Hill C, Howe G, Kaldor J, Muirhead CR, Schubauer-Berigan M, et al. 2007. The 15-country collaborative study of cancer risk among radiation workers in the nuclear industry: estimates of radiation-related cancer risks. Radiat Res. 167(4):396–416.
   PubMed Web of Science ®Google Scholar
• Charpentier P, Ostfeld AM, Hadjimichael OC, Hester R. 1993. The mortality of US nuclear submariners, 1969–1982. J Occup Med. 35(5):501–509.
   PubMedGoogle Scholar
• Checkoway H, Pearce N, Crawford-Brown DJ. 1989. Research Methods in Occupational Epidemiology. New York (NY): Oxford University Press.
   Google Scholar
• Cohen SS, Mumma MT, Ellis ED, Boice JD, Jr. 2018. Validating the use of census data on education as a measure of socioeconomic status in an occupational cohort. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1549758
   Google Scholar
• Cologne J, Kim J, Sugiyama H, French B, Cullings HM, Preston DL, Mabuchi K, Ozasa K. 2019. Effect of heterogeneity in background incidence on inference about the solid-cancer radiation dose response in atomic bomb survivors. Radiat Res. 192(4):388–398.
   PubMed Web of Science ®Google Scholar
• Cox DR. 1972. Regression models and life-tables. J R Stat Soc B. 34(2):187–220.
   Google Scholar
• Curtis RE, Boice JD, Jr, Stovall M, Bernstein L, Holowaty E, Karjalainen S, Langmark F, Nasca PC, Schwartz AG, Schymura MJ. 1994. Relationship of leukemia risk to radiation dose following cancer of the uterine corpus. J Natl Cancer Inst. 86(17):1315–1324.
   PubMedGoogle Scholar
• Daniels RD, Bertke S, Waters KM, Schubauer-Berigan MK. 2013. Risk of leukaemia mortality from exposure to ionising radiation in US nuclear workers: a pooled case-control study. Occup Environ Med. 70(1):41–48.
   PubMed Web of Science ®Google Scholar
• Daniels RD, Bertke SJ, Richardson DB, Cardis E, Gillies M, O’Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonnier M, et al. 2017. Examining temporal effects on cancer risk in the international nuclear workers' study. Int J Cancer. 140(6):1260–1269.
   PubMed Web of Science ®Google Scholar
• Daniels RD, Schubauer-Berigan MK. 2011. A meta-analysis of leukaemia risk from protracted exposure to low-dose gamma radiation. Occup Environ Med. 68(6):457–464.
   PubMed Web of Science ®Google Scholar
• Dauer LT, Bouville A, Toohey RE, Boice JD, Jr, Beck HL, Eckerman KF, Hagemeyer D, Leggett RW, Mumma MT, Napier B, et al. 2018. Dosimetry and uncertainty approaches for the million-person study of low-dose radiation health effects: overview of the recommendations in NCRP Report No. 178. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1536299
   Google Scholar
• de Vocht F, Hidajat M, Martin RM, Agius R, Wakeford R. 2020. Ischemic heart disease mortality and occupational radiation exposure in a nested matched case-control study of British nuclear fuel cycle workers: investigation of confounding by lifestyle, physiological traits and occupational exposures. Radiat Res. 194(4):431–444.
   PubMed Web of Science ®Google Scholar
• Diez Roux AV, Merkin SS, Arnett D, Chambless L, Massing M, Nieto FJ, Sorlie P, Szklo M, Tyroler HA, Watson RL. 2001. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 345(2):99–106.
   PubMed Web of Science ®Google Scholar
• Douglas AJ, Omar RZ, Smith PG. 1994. Cancer mortality and morbidity among workers at the Sellafield plant of British Nuclear Fuels. Br J Cancer. 70(6):1232–1243.
   PubMed Web of Science ®Google Scholar
• Electric Power Research Institute (EPRI). 2020. Cardiovascular risks from low dose radiation exposure: review and scientific appraisal of the literature. 3002018408. Palo Alto (CA): EPRI. [accessed 2021 January 12]. https://www.epri.com/research/products/000000003002018408
   Google Scholar
• Ellis ED, Boice JD, Golden AP, Girardi DJ, Cohen SS, Mumma MT, Shore RE, Leggett RW, Kerr GD. 2018. Dosimetry is key to good epidemiology: workers at Mallinckrodt Chemical Works had seven different source exposures. Health Phys. 114(4):386–397.
   PubMed Web of Science ®Google Scholar
• Ellis ED, Girardi D, Golden AP, Wallace PW, Phillips J, Cragle DL. 2018. Historical perspective on the Department of Energy mortality studies: focus on the collection and storage of individual worker data. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1547851
   Google Scholar
• Friedman-Jimenez G, Kato I, Factor-Litvak P, Shore R. 2021. Mortality of enlisted men who served on nuclear-powered submarines in the United States Navy. J Occup Environ Med. DOI: https://doi.org/10.1097/JOM.0000000000002364.
   Google Scholar
• Gilbert ES. 1998. Accounting for errors in dose estimates used in studies of workers exposed to external radiation. Health Phys. 74(1):22–29.
   PubMed Web of Science ®Google Scholar
• Gilbert ES, Cragle DL, Wiggs LD. 1993. Updated analyses of combined mortality data for workers at the Hanford Site, Oak Ridge National Laboratory, and Rocky Flats Weapons Plant. Radiat Res. 136(3):408–421.
   PubMed Web of Science ®Google Scholar
• Gilbert ES, Little MP, Preston DL, Stram DO. 2020. Issues in interpreting epidemiologic studies of populations exposed to low-dose, high-energy photon radiation. J Natl Cancer Inst Monogr. 2020(56):176-187.
   Google Scholar
• Gillies M, Haylock R, Hunter N, Zhang W. 2019. Risk of leukemia associated with protracted low-dose radiation exposure: updated results from the National Registry for Radiation Workers Study. Radiat Res. 192(5):527–537.
   PubMed Web of Science ®Google Scholar
• Gillies M, Haylock R. 2014. The cancer mortality and incidence experience of workers at British Nuclear Fuels plc, 1946–2005. J Radiol Prot. 34(3):595–623.
   PubMed Web of Science ®Google Scholar
• Gillies M, Kuznetsova I, Sokolnikov M, Haylock R, O’Hagan J, Tsareva Y, Labutina E. 2017. Lung cancer risk from plutonium: a pooled analysis of the Mayak and Sellafield worker cohorts. Radiat Res. 188(6):645–660.
   PubMed Web of Science ®Google Scholar
• Golden AP, Cohen SS, Chen H, Ellis ED, Boice JD, Jr. 2018. Evaluation of statistical modeling approaches for epidemiologic studies of low dose radiation health effects. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1554924
   Google Scholar
• Golden AP, Ellis ED, Cohen SS, Mumma MT, Leggett RW, Wallace PW, Girardi DJ, Watkins JP, Shore RE, Boice JD, Jr. 2019. Updated mortality analysis of the Mallinckrodt uranium processing workers, 1942–2012. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2019.1569773
   Google Scholar
• Goldsmith R, Boice JD, Jr, Hrubec Z, Hurwitz PE, Goff TE, Wilson J. 1989. Mortality and career radiation doses for workers at a commercial nuclear power plant: feasibility study. Health Phys. 56(2):139–150.
   PubMed Web of Science ®Google Scholar
• Grant EJ, Ozasa K, Ban N, de González AB, Cologne J, Cullings HM, Doi K, Furukawa K, Imaoka T, Kodama K, et al. 2015. A report from the 2013 international symposium: the evaluation of the effects of low-dose radiation exposure in the life span study of atomic bomb survivors and other similar studies. Health Phys. 108(5):551–556.
   PubMed Web of Science ®Google Scholar
• Hagemeyer D, Nichols G, Mumma MT, Boice JD, Brock TA. 2018. 50 Years of the Radiation exposure information and reporting system. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1540896
   Google Scholar
• Hamra GB, Richardson DB, Cardis E, Daniels RD, Gillies M, O’Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonnier M, et al. 2016. Cohort profile: the International Nuclear Workers Study (INWORKS). Int J Epidemiol. 45(3):693–699.
   PubMed Web of Science ®Google Scholar
• Hauptmann M, Daniels RD, Cardis E, Cullings HM, Kendall G, Laurier D, Linet MS, Little MP, Lubin JH, Preston DL, et al. 2020. Epidemiological studies of low-dose ionizing radiation and cancer: summary bias assessment and meta-analysis. J Natl Cancer Inst Monogr. 2020(56):188–200.
   PubMedGoogle Scholar
• Haylock RGE, Gillies M, Hunter N, Zhang W, Phillipson M. 2018. Cancer mortality and incidence following external occupational radiation exposure: an update of the 3rd analysis of the UK National Registry for Radiation Workers. Br J Cancer. 119(5):631–637.
   PubMed Web of Science ®Google Scholar
• Howe GR, Chiarelli AM, Lindsay JP. 1988. Components and modifiers of the healthy worker effect: evidence from three occupational cohorts and implications for industrial compensation. Am J Epidemiol. 128(6):1364–1375.
   PubMed Web of Science ®Google Scholar
• Howe GR, Zablotska LB, Fix JJ, Egel J, Buchanan J. 2004. Analysis of the mortality experience amongst U.S. nuclear power industry workers after chronic low-dose exposure to ionizing radiation. Radiat Res. 162(5):517–526.
   PubMed Web of Science ®Google Scholar
• Hsu WL, Preston DL, Soda M, Sugiyama H, Funamoto S, Kodama K, Kimura A, Kamada N, Dohy H, Tomonaga M, et al. 2013. The incidence of leukemia, lymphoma and multiple myeloma among atomic bomb survivors: 1950–2001. Radiat Res. 179(3):361–382.
   PubMed Web of Science ®Google Scholar
• International Commission on Radiological Protection (ICRP). 2010. Conversion coefficients for radiological protection quantities for external radiation exposures. ICRP Publication 116. Ann ICRP. 40(2–5):1–257.
   Google Scholar
• Iwanaga M, Hsu WL, Soda M, Takasaki Y, Tawara M, Joh T, Amenomori T, Yamamura M, Yoshida Y, Koba T, et al. 2011. Risk of myelodysplastic syndromes in people exposed to ionizing radiation: a retrospective cohort study of Nagasaki atomic bomb survivors. J Clin Oncol. 29(4):428–434.
   PubMed Web of Science ®Google Scholar
• Jablon S, Boice JD, Jr. 1993. Mortality among workers at a nuclear power plant in the United States. Cancer Causes Control. 4(5):427–430.
   PubMed Web of Science ®Google Scholar
• Komrokji RS, Padron E, List AF. 2019. Chapter 106: Myelodysplastic syndromes. In: DeVita VT, Lawrence TS, Rosenberg SA, editors. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia (PA): Wolters Kluwer; p. 1802–1817.
   Google Scholar
• Krestinina L, Preston DL, Davis FG, Epifanova S, Ostroumova E, Ron E, Akleyev A. 2010. Leukemia incidence among people exposed to chronic radiation from the contaminated Techa River, 1953–2005. Radiat Environ Biophys. 49(2):195–201.
   PubMed Web of Science ®Google Scholar
• Kuznetsova IS, Labutina EV, Hunter N. 2016. Radiation risks of leukemia, lymphoma and multiple myeloma incidence in the Mayak cohort: 1948–2004. PLoS One. 11(9):e0162710.
   PubMed Web of Science ®Google Scholar
• Laurier D, Richardson DB, Cardis E, Daniels RD, Gillies M, O'Hagan J, Hamra GB, Haylock R, Leuraud K, Moissonnier M, et al. 2017. The International Nuclear Workers Study (Inworks): a collaborative epidemiological study to improve knowledge about health effects of protracted low-dose exposure. Radiat Prot Dosimetry. 173(1–3):21–25.
   PubMed Web of Science ®Google Scholar
• Leggett RW, Eckerman KF, Bellamy M. 2018. MPS dose reconstruction for internal emitters: some site-specific issues and approaches. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1558302
   Google Scholar
• Leuraud K, Richardson DB, Cardis E, Daniels RD, Gillies M, O'Hagan JA, Hamra GB, Haylock R, Laurier D, Moissonnier M, et al. 2015. Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study. Lancet Haematol. 2(7):e276–e281.
   PubMed Web of Science ®Google Scholar
• Linet MS, Little MP, Kitahara CM, Cahoon EK, Doody MM, Simon SL, Alexander BH, Preston DL. 2020. Occupational radiation and haematopoietic malignancy mortality in the retrospective cohort study of US radiologic technologists, 1983–2012. Occup Environ Med. 77(12):822–831.
   PubMed Web of Science ®Google Scholar
• Little MP, Weiss HA, Boice JD, Jr, Darby SC, Day NE, Muirhead CR. 1999. Risks of leukemia in Japanese atomic bomb survivors, in women treated for cervical cancer, and in patients treated for ankylosing spondylitis. Radiat Res. 152(3):280–292.
   PubMed Web of Science ®Google Scholar
• Mabuchi K, Preston DL, Brenner AV, Sugiyama H, Utada M, Sakata R, Sadakane A, Grant EJ, French B, Cahoon EK, et al. 2021. Risk of prostate cancer incidence among atomic bomb survivors: 1958–2009. Radiat Res. 195(1):60–65.
   PubMed Web of Science ®Google Scholar
• Mahoney MC, Wilkinson GS. 1987. Smoking patterns among Los Alamos National Laboratory employees. Report LA-10650. Los Alamos (NM): Los Alamos National Laboratory. [accessed 2021 July 16]. https://www.osti.gov/biblio/6403953-smoking-patterns-among-los-alamos-national-laboratory-employees
   Google Scholar
• Matanoski GM, Seltser R, Sartwell PE, Diamond EL, Elliott EA. 1975. The current mortality rates of radiologists and other physician specialists: specific causes of death. Am J Epidemiol. 101(3):199–210.
   PubMed Web of Science ®Google Scholar
• McLean AR, Adlen EK, Cardis E, Elliott A, Goodhead DT, Harms-Ringdahl M, Hendry JH, Hoskin P, Jeggo PA, Mackay DJC, et al. 2017. A restatement of the natural science evidence base concerning the health effects of low-level ionizing radiation. Proc Biol Sci. 284(1862):20171070.
   PubMed Web of Science ®Google Scholar
• Metz-Flamant C, Laurent O, Samson E, Caër-Lorho S, Acker A, Hubert E, Richardson DB, Laurier D. 2013. Mortality associated with chronic external radiation exposure in the French combined cohort of nuclear workers. Occup Environ Med. 70(9):630–638.
   PubMed Web of Science ®Google Scholar
• Monson RR. 1986. Observations on the healthy worker effect. J Occup Med. 28(6):425–433.
   PubMedGoogle Scholar
• Mueller TJ, Weishar TM, Hallworth JM, Draper DA. 2020. Occupational radiation exposure from U.S. Naval nuclear plants and their support facilities. NT-20-2. Washington (DC): Naval Nuclear Propulsion Program. [accessed 2021 January 18]. https://www.energy.gov/sites/prod/files/2020/07/f77/NT-20-2.pdf
   Google Scholar
• Muirhead CR, Boice JD, Jr, Raddatz CT, Yoder RC. 1996. Comparison of dose histories for U.S. nuclear power plant workers, based on records held by a major dosimetry service company and on the NRC REIRS database. Health Phys. 70(5):645–650.
   PubMed Web of Science ®Google Scholar
• Muirhead CR, O’Hagan JA, Haylock RG, Phillipson MA, Willcock T, Berridge GL, Zhang W. 2009. Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers. Br J Cancer. 100(1):206–212.
   PubMed Web of Science ®Google Scholar
• Mumma MT, Cohen SS, Sirko SS, Ellis ED, Boice JD, Jr. 2018. Obtaining vital status and cause of death on a million persons. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2018.1539884
   Google Scholar
• Mumma MT, Sirko JL, Boice JD, Blot WJ. 2019. Mesothelioma mortality within two radiation monitored occupational cohorts. Int J Radiat Biol. DOI:https://doi.org/10.1080/09553002.2019.1642540
   Google Scholar
• National Academies of Sciences, Engineering, and Medicine (NASEM). 2019. The future of low dose radiation research in the United States. Proceedings of a Symposium. Washington (DC): National Academies Press. https://doi.org/https://doi.org/10.17226/25578
   Google Scholar
• National Academies of Sciences, Engineering, and Medicine (NASEM). 2021a. Space radiation and astronaut health: managing and communicating cancer risks. Washington (DC): The National Academies Press. https://doi.org/https://doi.org/10.17226/26155
   Google Scholar
• National Academies of Sciences, Engineering, and Medicine (NASEM). 2021b. Developing a long-term strategy for low-dose radiation research in the United States. https://www.nationalacademies.org/our-work/developing-a-long-term-strategy-for-low-dose-radiation-research-in-the-united-states
   Google Scholar
• National Academies/National Research Council (NA/NRC). 2006. Health risks from exposure to low levels of ionizing radiation (BEIR VII phase 2). Washington (DC): National Academies Press.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2008. Uncertainties in the measurement and dosimetry of external radiation. NCRP Report No. 158. Bethesda (MD): NCRP.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2012. Uncertainties in the estimation of radiation risks and probability of disease causation. NCRP Report No. 171. Bethesda (MD): NCRP.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2014. Radiation protection for space activities: supplement to previous recommendations. NCRP Commentary No. 23. Bethesda (MD): NCRP.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2018a. Deriving organ doses and their uncertainty for epidemiologic studies (with a focus on the one million U.S. workers and veterans study of low-dose radiation health effects). NCRP Report 178. Bethesda (MD): NCRP.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2018b. Implications of recent epidemiologic studies for the linear-nonthreshold model and radiation protection. NCRP Commentary 27. Bethesda (MD): NCRP.
   Google Scholar
• National Council on Radiation Protection and Measurements (NCRP). 2020. Dosimetry guidance for medical radiation workers with a focus on lung dose reconstruction. NCRP Commentary 30. Bethesda (MD): NCRP.
   Google Scholar
• Naval Dosimetry Center (NDC). 2021. Lifetime exposure history repository for the U.S. Navy's nuclear-powered fleet personnel. [accessed 2021 January 12]. https://www.cnic.navy.mil/regions/ndw/installations/nsa_bethesda/about/tenant_orgs/ndc.html
   Google Scholar
• Oak Ridge Institute for Science and Education (ORISE). 2011. Establishing a U.S. Nuclear Regulatory Commission worker registry for epidemiologic investigations. A feasibility study using the Radiation Exposure Information and Reporting System. Submitted to the Nuclear Regulatory Commission. [accessed 2021 January 12]. http://www.anewstudy.org/2012NovNPP/REIRS%20Feasibility%20Study-FINAL_01142011%20%282%29.pdf
   Google Scholar
• Ozasa K, Shimizu Y, Suyama A, Kasagi F, Soda M, Grant EJ, Sakata R, Sugiyama H, Kodama K. 2012. Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: an overview of cancer and noncancer diseases. Radiat Res. 177(3):229–243.
   PubMed Web of Science ®Google Scholar
• Ozasa K, Takahashi I, Grant EJ, Kodama K. 2017. Cardiovascular disease among atomic bomb survivors. Int J Radiat Biol. 93(10):1145–1150.
   PubMed Web of Science ®Google Scholar
• Petersen GR, Gilbert ES, Buchanan JA, Stevens RG. 1990. A case-cohort study of lung cancer, ionizing radiation, and tobacco smoking among males at the Hanford Site. Health Phys. 58(1):3–11.
   PubMed Web of Science ®Google Scholar
• Preston DL, Lubin J, Pierce D, McConney M, Shilnikova N. 2015. Epicure risk regression and person-year computation software: command summary and user guide. Ottawa (CA): Risk Sciences International.
   Google Scholar
• Preston DL, Sokolnikov ME, Krestinina LY, Stram DO. 2017. Estimates of radiation effects on cancer risks in the Mayak Worker, Techa River and atomic bomb survivor studies. Radiat Prot Dosimetry. 173(1–3):26–31.
   PubMed Web of Science ®Google Scholar
• Richardson DB, Abalo K, Bernier MO, Rage E, Leuraud K, Laurier D, Keil AP, Little MP. 2020. Meta-analysis of published excess relative risk estimates. Radiat Environ Biophys. 59(4):631–641.
   PubMed Web of Science ®Google Scholar
• Richardson DB, Cardis E, Daniels RD, Gillies M, Haylock R, Leuraud K, Laurier D, Moissonnier M, Schubauer-Berigan MK, Thierry-Chef I, et al. 2018. Site-specific solid cancer mortality after exposure to ionizing radiation: a cohort study of workers (INWORKS). Epidemiology. 29(1):31–40.
   PubMed Web of Science ®Google Scholar
• Richardson DB, Cardis E, Daniels RD, Gillies M, O’Hagan JA, Hamra GB, Haylock R, Laurier D, Leuraud K, Moissonnier M, et al. 2015. Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS). BMJ. 351:h5359.
   PubMed Web of Science ®Google Scholar
• Ron E, Hoffman O. 1999. Uncertainties in radiation dosimetry and their impact on dose-response analyses. Publication No. 99-4541. Bethesda (MD): National Cancer Institute.
   Google Scholar
• Rushton L. 1994. Use of multiple causes of death in the analysis of occupational cohorts-an example from the oil industry. Occup Environ Med. 51(11):722–729.
   PubMed Web of Science ®Google Scholar
• Schafer DW, Gilbert ES. 2006. Some statistical implications of dose uncertainty in radiation dose-response analyses. Radiat Res. 166(1 Pt 2):303–312.
   PubMed Web of Science ®Google Scholar
• Schubauer-Berigan MK, Daniels RD, Bertke SJ, Tseng CY, Richardson DB. 2015. Cancer mortality through 2005 among a pooled cohort of U.S. nuclear workers exposed to external ionizing radiation. Radiat Res. 183(6):620–631.
   PubMed Web of Science ®Google Scholar
• Schubauer-Berigan MK, Daniels RD, Fleming DA, Markey AM, Couch JR, Ahrenholz SH, Burphy JS, Anderson JL, Tseng CY. 2007. Chronic lymphocytic leukaemia and radiation: findings among workers at five US nuclear facilities and a review of the recent literature. Br J Haematol. 139(5):799–808.
   PubMed Web of Science ®Google Scholar
• Steenland K, Henley J, Calle E, Thun M. 2004. Individual- and area-level socioeconomic status variables as predictors of mortality in a cohort of 179,383 persons. Am J Epidemiol. 159(11):1047–1056.
   PubMed Web of Science ®Google Scholar
• Steenland K, Nowlin S, Ryan B, Adams S. 1992. Use of multiple-cause mortality data in epidemiologic analyses: US rate and proportion files developed by the National Institute for Occupational Safety and Health and the National Cancer Institute. Am J Epidemiol. 136(7):855–862.
   PubMed Web of Science ®Google Scholar
• Stram DO, Preston DL, Sokolnikov M, Napier B, Kopecky KJ, Boice J, Beck H, Till J, Bouville A. 2015. Shared dosimetry error in epidemiological dose-response analyses. PLOS One. 10(3):e0119418.
   PubMed Web of Science ®Google Scholar
• Takahashi I, Shimizu Y, Grant EJ, Cologne J, Ozasa K, Kodama K. 2017. Heart disease mortality in the life span study, 1950–2008. Radiat Res. 187(3):319–332.
   PubMed Web of Science ®Google Scholar
• Tapio S, Little MP, Kaiser JC, Impens N, Hamada N, Georgakilas AG, Simar D, Salomaa S. 2021. Ionizing radiation-induced circulatory and metabolic diseases. Environ Int. 146:106235.
   PubMed Web of Science ®Google Scholar
• Thierry-Chef I, Richardson DB, Daniels RD, Gillies M, Hamra GB, Haylock R, Kesminiene A, Laurier D, Leuraud K, Moissonnier M, et al. 2015. Dose estimation for a study of nuclear workers in France, the United Kingdom and the United States of America: methods for the International Nuclear Workers Study (INWORKS). Radiat Res. 183(6):632–642.
   PubMed Web of Science ®Google Scholar
• Till JE, Beck HL, Aanenson JW, Grogan HA, Mohler HJ, Mohler SS, Voillequé PG. 2014. Military participants at U.S. atmospheric nuclear weapons testing-methodology for estimating dose and uncertainty. Radiat Res. 181(5):471–484.
   PubMed Web of Science ®Google Scholar
• Till JE, Beck HL, Boice JD, Jr, Mohler HJ, Mumma MT, Aanenson JW, Grogan HA. 2018. Asbestos exposure and mesothelioma mortality among atomic veterans. Int J Rad Biol. DOI:https://doi.org/10.1080/09553002.2018.1551641.
   Google Scholar
• Tran V, Zablotska LB, Brenner AV, Little MP. 2017. Radiation-associated circulatory disease mortality in a pooled analysis of 77,275 patients from the Massachusetts and Canadian tuberculosis fluoroscopy cohorts. Sci Rep. 7(1):44147.
   PubMed Web of Science ®Google Scholar
• Tucker JD, Tawn EJ, Holdsworth D, Morris S, Langlois R, Ramsey MJ, Kato P, Boice JD, Jr, Tarone RE, Jensen RH. 1997. Biological dosimetry of radiation workers at the Sellafield nuclear facility. Radiat Res. 148(3):216–226.
   PubMed Web of Science ®Google Scholar
• U.S. Department of Energy (DOE). 2021. DOE 2019 Occupational radiation exposure. Washington (DC): US Department of Energy, Office of Environment, Health, Safety and Security, The Radiation Exposure Monitoring System (REMS). [accessed 2021 April 29]. http://energy.gov/ehss/occupational-radiation-exposure
   Google Scholar
• U.S. Department of Health and Human Services (USDHHS). 2010. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services.
   Google Scholar
• U.S. Government Accountability Office (USGAO). 2017. Low-dose radiation: interagency collaboration on planning research could improve information on health effects. GAO-17-546. Washington (DC): GAO. [accessed 2021 January 12]. https://www.gao.gov/products/GAO-17-546
   Google Scholar
• U.S. Nuclear Regulatory Commission (USNRC). 1994. Voluntary reporting of additional occupational radiation of exposure data (generic letter 94-04). [accessed 2021 January 12]. https://www.nrc.gov/docs/ML1204/ML12047A243.pdf
   Google Scholar
• U.S. Nuclear Regulatory Commission (USNRC). 2021. Radiation exposure information and reporting system (REIRS). [accessed 2021 January 19]. https://www.reirs.com/ and http://www.nrc.gov/reading-rm/doc-collections/gils/rad-exp.html
   Google Scholar
• United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). 2008. Effects of ionizing radiation. UNSCEAR 2006 report. Report to the general assembly. Volume 1. Scientific annex A. Epidemiological studies of radiation and cancer. Publication E.08.IX.6. New York (NY): United Nations.
   Google Scholar
• United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). 2014. UNSCEAR 2012 Report to the General Assembly with Scientific Annexes. Scientific annex B. Uncertainties in risk estimates for radiation-induced cancer. New York (NY): United Nations.
   Google Scholar
• United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). 2018. UNSCEAR 2017 report. Principles and criteria for ensuring the quality of the committee’s reviews of epidemiological studies of radiation exposure. Scientific annex A. New York (NY): United Nations. [accessed 2021 January 15]. https://www.unscear.org/docs/publications/2017/UNSCEAR_2017_Annex-A.pdf
   Google Scholar
• United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). 2020. Sources, effects and risks of ionizing radiation. UNSCEAR 2019 Report to the General Assembly. Scientific Annex A: evaluation of selected health effects and inference of risk due to radiation exposure. New York (NY): UNSCEAR. [accessed 2021 April 29]. https://www.unscear.org/docs/publications/2019/UNSCEAR_2019_Annex-A.pdf
   Google Scholar
• Velazquez-Kronen R, Gilbert ES, Linet MS, Moysich KB, Freudenheim JL, Wactawski-Wende J, Simon SL, Cahoon EK, Alexander BH, Doody MM, et al. 2020. Lung cancer mortality associated with protracted low-dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983–2012. Int J Cancer. 147(11):3130–3138.
   PubMed Web of Science ®Google Scholar
• Villoing D, Borrego D, Preston DL, Alexander BH, Rose A, Salasky M, Linet MS, Lee C, Kitahara CM. 2021. Trends in occupational radiation doses for U.S. radiologic technologists performing general radiologic and nuclear medicine procedures, 1980-2015. Radiology. 300(3):605–612.
   Web of Science ®Google Scholar
• Vrijheid M, Cardis E, Ashmore P, Auvinen A, Gilbert E, Habib RR, Malker H, Muirhead CR, Richardson DB, Rogel A, et al. 2008. Ionizing radiation and risk of chronic lymphocytic leukemia in the 15-country study of nuclear industry workers. Radiat Res. 170(5):661–665.
   PubMed Web of Science ®Google Scholar
• Waitzman NJ, Smith KR. 1998. Phantom of the area: poverty-area residence and mortality in the United States. Am J Public Health. 88(6):973–976.
   PubMed Web of Science ®Google Scholar
• Wakeford R. 2019. Does low-level exposure to ionizing radiation increase the risk of cardiovascular disease? Hypertension. 73(6):1170–1171.
   PubMed Web of Science ®Google Scholar
• Yen IH, Kaplan GA. 1999. Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study. Am J Epidemiol. 149(10):898–907.
   PubMed Web of Science ®Google Scholar
• Yoder RC, Balter S, Boice JD, Jr, Grogan H, Mumma M, Rothenberg L, Passmore C, Vetter R, Dauer L. 2021. Using personal monitoring data to derive organ doses for medical radiation workers in the Million Person Study – considerations regarding NCRP Commentary No. 30. J Radiol Prot. DOI:https://doi.org/10.1088/1361-6498/abcfcb
   Google Scholar
• Zablotska LB, Bazyka D, Lubin JH, Gudzenko N, Little MP, Hatch M, Finch S, Dyagil I, Reiss RF, Chumak VV, et al. 2013. Radiation and the risk of chronic lymphocytic and other leukemias among Chornobyl cleanup workers. Environ Health Perspect. 121(1):59–65.
   PubMed Web of Science ®Google Scholar
• Zablotska LB, Lane RS, Thompson PA. 2014. A reanalysis of cancer mortality in Canadian nuclear workers (1956–1994) based on revised exposure and cohort data. Br J Cancer. 110(1):214–223.
   PubMed Web of Science ®Google Scholar
• Zeidan AM, Shallis RM, Wang R, Davidoff A, Ma X. 2019. Epidemiology of myelodysplastic syndromes: why characterizing the beast is a prerequisite to taming it. Blood Rev. 34:1–15.
   PubMed Web of Science ®Google Scholar