EXPOSURE OF THE AMERICAN POPULATION TO RADIOACTIVE FALLOUT FROM NUCLEAR WEAPONS TESTS

A Review of the CDC-NCI Draft Report on a Feasibility Study of the Health Consequences to the American Population from Nuclear Weapons Tests Conducted by the United States and Other Nations

Committee to Review the CDC-NCI Feasibility Study of the Health Consequences from Nuclear Weapons Tests

Board on Radiation Effects Research

Division on Earth and Life Studies

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests EXPOSURE OF THE AMERICAN POPULATION TO RADIOACTIVE FALLOUT FROM NUCLEAR WEAPONS TESTS A Review of the CDC-NCI Draft Report on a Feasibility Study of the Health Consequences to the American Population from Nuclear Weapons Tests Conducted by the United States and Other Nations Committee to Review the CDC-NCI Feasibility Study of the Health Consequences from Nuclear Weapons Tests Board on Radiation Effects Research Division on Earth and Life Studies NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by DHHS contract 200-2000-00629, TO#5 between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-08713-9 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624–6242 or (202) 334–3313 (in the Washington metropolitan area); Internet, http://www.nap.edu Copyright 2003 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm.A.Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V.Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. Wm.A.Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests COMMITTEE TO REVIEW THE CDC-NCI FEASIBILITY STUDY OF THE HEALTH CONSEQUENCES FROM NUCLEAR WEAPONS TESTS WILLIAM J.SCHULL (Chair), Professor Emeritus, School of Public Health, University of Texas, Houston, TX BRUCE B.BOECKER, Scientist Emeritus, Lovelace Respiratory Research Institute, Albuquerque, NM A.BERTRAND BRILL, Vanderbilt University Medical School, Nashville, TN MELVIN W.CARTER, Neely Professor Emeritus, Dunwoody, GA SUE B.CLARK, Washington State University, Pullman, WA EDMUND A.C.CROUCH, Cambridge Environmental Inc., Cambridge, MA SHARON M.FRIEDMAN, Lehigh University, Bethlehem, PA KATHRYN A.HIGLEY, Oregon State University, Corvallis, OR SUSAN E.LEDERER, Yale University School of Medicine, New Haven, CT MILTON LEVENSON, Menlo Park, CA HERWIG G.PARETZKE, GSF-Institute of Radiation Protection, Neuherberg, Germany BOBBY R.SCOTT, Lovelace Respiratory Research Institute, Albuquerque, NM ROY E.SHORE, New York University School of Medicine, New York, NY DANIEL O.STRAM, University of Southern California, Los Angeles, CA NATIONAL RESEARCH COUNCIL STAFF ISAF AL-NABULSI, Study Director DIANNE STARE, Research Assistant DORIS E.TAYLOR, Staff Assistant NORMAN GROSSBLATT, Senior Editor SPONSOR’S PROJECT OFFICER JAMES SMITH, Centers for Disease Control and Prevention

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests BOARD ON RADIATION EFFECTS RESEARCH S.JAMES ADELSTEIN (Chair), Harvard Medical School, Boston, MA R.J.MICHAEL FRY (Chair until 6/30/02), Indianapolis, IN JOEL S.BEDFORD, Colorado State University, Fort Collins, CO VALERIE BERAL, University of Oxford, Oxford, England JAMES E.CLEAVER, University of California Cancer Center, San Francisco, CA SARAH S.DONALDSON, Stanford University Medical Center, Stanford, CA SHARON L.DUNWOODY, University of Wisconsin, Madison, WI EDWARD R.EPP, Professor Emeritus, Harvard University, Boston, MA HELEN H.EVANS (Member until 6/30/02), Case Western Reserve University, Cleveland, OH DANIEL KREWSKI, University of Ottawa, Ottawa, Canada WILLIAM F.MORGAN, University of Maryland, Baltimore, MD THEODORE L.PHILLIPS, University of California, San Francisco, CA FRANKLYN G.PRENDERGAST, Mayo Clinic Cancer Center, Rochester, MN ANDREW M.SESSLER, Lawrence Berkeley National Laboratory, Berkeley, CA DANIEL O.STRAM, University of Southern California, Los Angeles, CA PAUL L.ZEIMER, Purdue University, West Lafayette, IN NATIONAL RESEARCH COUNCIL STAFF EVAN B.DOUPLE, Director, Board on Radiation Effects Research RICK JOSTES, Senior Program Officer ISAF AL-NABULSI, Senior Program Officer CATHERINE S.BERKLEY, Administrative Associate TAJUANA CLAYTON, Project Assistant BENJAMIN HAMLIN, Research Assistant (until 12/13/02) DIANNE STARE, Research Assistant DORIS E.TAYLOR, Staff Assistant

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests Preface The years since World War II have seen the testing of hundreds of nuclear weapons. Many of those tests have led to the injection into the atmosphere of substantial amounts of radioactive material, some of which has fallen to Earth. As public awareness and concern mounted over the possible health hazards associated with exposure to this “fallout,” studies were initiated to assess the extent of the hazard. The studies failed to allay public concern, and further studies were begun in the 1980s to reevaluate the radiation exposures of the population after the weapons tests in Nevada. In 1983, Public Law 97–414, Section 7(a) directed the secretary of health and human services to conduct research into and develop estimates of the thyroid doses received by the American people from 131I (iodine-131) in fallout from the Nevada atmospheric tests. To that end, in 1983, the National Cancer Institute (NCI) established a task group to assist it in a program of technical and scientific work. The work of the task group was centered on 131I and the fallout arising from the weapons tests conducted by the United States. Its findings appeared as an NCI report titled Estimated Exposures and Thyroid Doses Received by the American People from Iodine-131 in Fallout Following Nevada Atmospheric Nuclear Bomb Tests (NCI, 1997). That publication did not address the risks associated with other radionuclides found in fallout or the contribution to exposures of global fallout stemming from weapons testing outside the US by the US and other nations, and these omissions became a matter of public concern. In 1998, scientists at the Centers for Disease Control and Prevention (CDC) and the NCI were asked by the US Congress to assess the feasibility and public health implications of a detailed study of the health consequences for the American people of radioactive fallout from aboveground nuclear-weapons tests conducted in 1951–1962 by the United States and other nations. In March 2002, the National Research Council’s Committee on An Assessment of the Centers for Disease Control and Prevention Radiation Studies from DOE Contractor Sites was called on to review a two-volume draft technical report of CDC-NCI titled A Feasibility Study of the Health Consequences to the American Population from Nuclear Weapons Tests Conducted by the United States and Other Nations. The draft report presents preliminary estimates of radiation doses of a set of important radionuclides received by the American people in the coterminous 48 states as a result of atmospheric nuclear-weapons tests. Because the purpose of

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests the project was to determine only the feasibility of a more-detailed study that might be carried out, those dose estimates are based on an initial review of the open literature and available dose-assessment methods. The Research Council committee examined all the technical aspects of the CDC-NCI draft report, but, at the request of CDC, it focused its attention on the following four questions: Are the methods and sources of information used in the technical report to estimate radiation doses and health effects from fallout appropriate for this study? Are the methods and results clearly presented in the main text of the technical report? Are the findings presented in the report supported by the data and analyses provided? Do the Options for Future Work presented in Chapter 6 represent an appropriate range of options for public health activities that could be pursued as a result of this study?” The present report sets forth in detail the committee’s response to its general charge and to the four questions specified above. We deeply appreciate the dedication and hard work of the study director, Isaf Al-Nabulsi, and the administrative assistance of Dianne Stare and Doris Taylor. We also appreciate the contributions of members of CDC and NCI—specifically, André Bouville, Ethel Gilbert, Charles Miller, and Steve Simon—to the committee’s understanding of some aspects of the feasibility study. Finally, we acknowledge our indebtedness to Lynn Anspaugh and Harold Beck, who as consultants to the feasibility study, constituted a source of information for the NRC committee. William J. Schull Chair

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests Acknowledgments This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their participation in the review of this report: Harry M.Cullings, Hiroshima, Japan John M.Flack, Detroit, MI R.J.Michael Fry, Indianapolis, IN F.Owen Hoffman, Oak Ridge, TN Shawki Amin Ibrahim, Fort Collins, CO Kenneth J.Kopecky, Seattle, WA Michael T.Ryan, Charleston, SC Joseph V.Smith, Chicago, IL Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by David G.Hoel, Medical University of South Carolina and Maureen M.Henderson, University of Washington (Professor Emeritus) appointed by the National Research Council. They were responsible for making certain that an independent examination of the report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of the report rests entirely with the authoring committee and the NRC.

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Exposure of the American Population to Radioactive Fallout from Nuclear Weapons Tests Contents     EXECUTIVE SUMMARY   1     INTRODUCTION   9     BACKGROUND AND CONTEXT   9     THE CONGRESSIONALLY REQUESTED FEASIBILITY STUDY   13     THE NATIONAL RESEARCH COUNCIL’S INVOLVEMENT   13     THE COMMITTEE’S REVIEW   15     TECHNICAL APPROACH AND CONTENTS OF THE DRAFT REPORT   15     ASSESSMENT OF THE DOSE RECONSTRUCTION   16     Deposition Density of Nevada Test Site Fallout Radionuclides   17     External Doses from Nevada Test Site Fallout   18     Internal Doses from Nevada Test Site Fallout   19     Deposition Density of Global Fallout Radionuclides   19     External Doses from Global Fallout   20     Internal Doses from Global Fallout   20     DOCUMENT LOCATION AND RETRIEVAL   21     ASSESSMENT OF THE ESTIMATES OF CANCER RISK   22     THE VALUE OF FURTHER REFINEMENTS OF THE 131I NEVADA TEST SITE CALCULATIONS AND UNCERTAINTY ANALYSIS   26     Dosimetric Refinements   26     Epidemiologic Refinements   27     COMMUNICATION WITH THE PUBLIC ABOUT EXPOSURE AND CANCER RISK   29     Overview of the Proposed Communication Plan   30     The 131I/Nevada Test Site Communication Plan   30     Would Adapting the 131I/Nevada Test Site Communication Plan Work for the Feasibility Study?   31     Communication Issues for Option 1   31     COMMENTS ON THE OPTIONS FOR FUTURE WORK   32     COMMITTEE RECOMMENDATIONS   35     REFERENCES   38 APPENDIX A:   SPECIFIC COMMENTS   41 APPENDIX B:   COMMITTEE ACTIVITIES   50     GLOSSARY   53     COMMITTEE BIOGRAPHIES   65

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