(e.g., to test study hypotheses) because of their ecological study design.

• The decay products of uranium (e.g., 230Th, 226Ra) provide a constant source of radiation in uranium tailings for thousands of years, substantially outlasting the current U.S. regulations for oversight of processing facility tailings.

• Radionuclides are not the only uranium mining- and processing-associated occupational exposures with potential adverse human health effects; two other notable inhalation risks are posed by silica dust and diesel exhaust. Neither of these is specific to uranium mining, but both have been prevalent historically in the uranium mining and processing industry. Of particular importance is the body of evidence from occupational studies showing that both silica and diesel exhaust exposure increase the risk of lung cancer, the main risk also associated with radon decay product exposure. To the extent that cigarette smoking poses further risk in absolute terms, there is potential for increased disease, including combined effects that are more than just additive.

• Although uranium mining-specific injury data for the United States were not available for review, work-related physical trauma risk (including electrical injury) is particularly high in the mining sector overall and this could be anticipated to also apply to uranium mining. In addition, hearing loss has been a major problem in the mining sector generally, and based on limited data from overseas studies, may also be a problem for uranium mining.

• A number of other exposures associated with uranium mining or processing, including waste management, also could carry the potential for adverse human health effects, although in many cases the detailed studies that might better elucidate such risks are not available.

• Assessing the potential risks of multiple combined exposures from uranium mining and processing activities is not possible in practical terms, even though the example of multiple potential lung carcinogen exposures in uranium mining and processing underscores that this is more than a theoretical concern.

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