individuals with a higher baseline risk of disease, because of inherited variation, also have higher excess risks from exposure. Similarly, genes found to confer sensitivity to high-dose radiation exposures, such as those now being evaluated in studies of second cancers following radiation therapy, should also be studied in people with protracted exposure to radiation at low-dose rates. The committee recommends that:
As these questions surface in the future, NIOSH and DOE explore the possibility of addressing them through studies that utilize DNA from DOE workers diagnosed with cancer and from controls. To facilitate these future studies DOE and NIOSH should consider the following:
Establishment of a database of workers with appropriate data to facilitate follow-up and to evaluate potential confounders (e.g., see recommendation 2);
Development of valid methods to identify non-cancer health outcomes including the use of periodic questionnaires, and specific diagnostic tests (e.g., pulmonary function); and
Support for the continuance of biorepositories such as that funded by ATSDR (Gunter 1997; NRC 2006b) that archive specimens such as blood and DNA to support future studies.
NIOSH provided independently (NIOSH 2005), and also in response to committee requests, information detailing the DOE-funded output of the NIOSH OERP program. In addition, the committee accessed the NIOSH OERP website,17 which is periodically updated with new publications that cite OERP funding. These sources also identified the material as intramural and extramural. That information was updated during the committee’s 10-month study period and is included in Table 2A-1 that follows. The table is based on information received from NIOSH May 9, 2006. NIOSH noted in responding to a committee information request that: “… the bibliography has been revised and updated to include all known publications that acknowledge whole or partial funding by DOE through the NIOSH Occupational Energy Research Program. This includes those studies funded directly by DOE between 1991 and 1993 but overseen by NIOSH under the OERP. Studies and literature that may relate to the OERP but did not acknowledge either DOE or NIOSH funding were not included. The committee should be aware that, for grants, there is no requirement that grantees report publications to NIOSH; therefore, we have identified many of these publications