The Million Person Study of Low-Dose Radiation Health Effects

This book presents original research findings of The Million Person Study of Low-Dose Radiation Health Effects (MPS), the largest and most comprehensive epidemiologic study of its kind to investigate the health effects of low-level chronic radiation exposure on American workers and veterans throughout the 20th century. Since the early 1900s, epidemiologists have studied the consequences of radiation exposures, yet the health effects of low levels received gradually over time remain unresolved. This uncertainty comes at a time when the public and workers are experiencing ever-increasing levels of radiation exposure from advances in medical radiation imaging techniques (e.g., CT scans), frequent flying at high altitudes, and environmental and occupational exposures. The MPS is providing answers by studying 30 radiation-exposed U.S. populations, including workers at nuclear power plants, radiologists, workers at former Manhattan Project sites, nuclear submariners, nuclear weapons test participants (atomic veterans), industrial radiographers, and radium dial painters. Ongoing for more than 20 years and coordinated by the National Council on Radiation Protection and Measurements, Vanderbilt University Medical Center and Memorial Sloan Kettering Cancer Center, the MPS is a national effort supported by the Department of Energy, National Aeronautics and Space Administration, U.S. Navy, Defense Threat Reduction Agency, Nuclear Regulatory Commission, Centers for Disease Control and Prevention, and the Environmental Protection Agency. Unparalleled in scope and quality, the MPS provides an understanding of low-dose health effects that is desperately needed for decision-makers and the radiation protection community as society continues to increase the uses of radiation technologies. Individual chapters were originally published in the International Journal of Radiation Biology.

John D. Boice Jr is past President of NCRP and Professor of Epidemiology at Vanderbilt University. He 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 Million Person Study of Low-Dose Health Effects. André Bouville is a leading expert on radiation dose reconstruction. He was Head of the Dosimetry Unit of the Radiation Epidemiology Branch at NCI until he retired in 2010. He chaired NCRP SC 6-9 on the dosimetry for the Million Person Study, producing NCRP Report No. 178. Lawrence T. Dauer is Attending Physicist specializing in radiation protection at Memorial Sloan Kettering Cancer Center in the Departments of Medical Physics and Radiology. He is a Council and former Board member of the NCRP, served on ICRP Committee 3, Protection in Medicine, and is Scientific Director for the Million Person Study. Ashley P. Golden is Senior Director of ORISE Health Studies at Oak Ridge Associated Universities where she conducts multidisciplinary projects in occupational epidemiology, biostatistics, radiation exposure and dosimetry, medical surveillance, and environmental assessments. Richard Wakeford is Honorary Professor in Epidemiology in the Centre for Occupational and Environmental Health at The University of Manchester, United Kingdom, where he specializes in radiation epidemiology. Professor Wakeford has served on UNSCEAR, ICRP, NCRP, UK and EU committees throughout his career.

1. Introduction to the U.S. Million Person Study of health effects from low-level exposure to radiation 2. Radiation in the workplace - an opportunity for substantial epidemiological evidence 3. The Million Person Study, whence it came and why 4. The Million Person Study relevance to space exploration and Mars 5. Historical perspective on the Department of Energy mortality studies: focus on the collection and storage of individual worker data 6. 50 Years of the Radiation Exposure Information and Reporting System and importance to the Million Person Study 7. Evaluation of statistical modeling approaches for epidemiologic studies of low-dose radiation health effects 8. Obtaining vital status and cause of death on a million persons 9. Validating the use of census data on education as a measure of socioeconomic status 10. Cohort profile - MSKCC radiation workers: a pilot sub-cohort of a multicenter medical radiation worker component of the Million Person Study of low-dose radiation health effects 11. Dosimetry and uncertainty approaches for the million-worker study of radiation workers and veterans: overview of the recommendations in NCRP Report No. 178 12. Dosimetry associated with veterans who participated in nuclear weapons testing 13. Dosimetry for the study of medical radiation workers with a focus on the mean absorbed dose to the lung, brain and other organs 14. MPS dose reconstruction for internal emitters: some site-specific issues and approaches 15. Potential improvements in brain dose estimates for internal emitters 16. Mortality from leukemia, cancer and heart disease among U.S. nuclear power plant workers, 1957-2011 17. Mortality among U.S. military participants at eight aboveground nuclear weapons test series 18. Updated mortality analysis of the Mallinckrodt uranium processing workers, 1942-2012 19. Mortality among workers at the Los Alamos National Laboratory, 1943-2017 20. Mortality among Tennessee Eastman Corporation (TEC) uranium processing workers 21. Mortality among medical radiation workers in the United States, 1965-2016. 22. Radium dial workers: back to the future 23. Sex-specific lung cancer risk among radiation workers in the Million Person Study and among TB-fluoroscopy patients 24. Asbestos exposure and mesothelioma mortality among atomic veterans 2 Mesothelioma mortality within two radiation monitored occupational cohorts 26. A million persons, a million dreams: a vision for a National Center for Radiation Epidemiology and Biology

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