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No significantly increased SIRs were observed for all cancers or site-specific cancers except bone cancer; of these, there were four cases, three of which occurred in the first year. The SIR for all bone cancers was 600 (95% CI, 160-1,530); if the first year was excluded, it was 170 (95% CI, 0-1,010).

Sumanovic-Glamuzina et al., 2003

During the Bosnian War, civilians were potentially exposed to environmental contaminants that might have resulted in increases in malignant diseases and other adverse health effects. However, the magnitude of exposure and the resulting health outcomes remained unclear. In 2000, researchers sought to assess the prevalence of major congenital malformations in two 1-year cohorts of neonates born immediately after the war (in 1995) and in 2000, 5 years after military activities. The study population included all live-born neonates and stillborn fetuses in the maternity ward of the Mostar University Hospital in western Herzegovina. Malformations were documented by using the EUROCAT Protocol during physical examination of live-born and stillborn neonates. Autopsies were not performed on the stillborn. For the 1995 cohort, data on prenatal and perinatal complications were collected from medical records and interviews with the mothers. Interviews were not conducted for the 2000 cohort. Prevalence was analyzed with consideration of the relevant organ systems, sex, and gestational age, and chi-square tests were conducted. Aborted fetuses were not included in the analysis.

In 1995, 40 of 1,853 neonates had major malformation, a prevalence of 2.16% (95% CI, 1.49-2.82%). In 2000, 33 of 1,463 (2.26%) had major malformations (95% CI, 1.50-3.01%). Anomalies of the cardiovascular and central nervous systems were significantly higher in the 2000 cohort than in the 1995 cohort.

ENVIRONMENTAL-EXPOSURE STUDIES

The studies reviewed below examine health outcomes in persons who lived near uranium-processing facilities or in households in Finland where well water with high uranium content was the primary source of drinking water. The studies are summarized in Table 7-3.

Residential Studies

Bithell and Draper, 1999

Greenham Common US Air Force base in Berkshire in the UK was the site of a B-47 jet fire in 1958. Residents living around the base expressed concern that depleted-uranium contamination from the fire might have resulted in an increased incidence of cancer, particularly leukemia, in the area. In a 1961 declassified document, excess concentrations of plutonium and uranium were modeled on a



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