additional state-licensed3 conventional uranium milling facilities and in situ leaching facilities that are not shown on Table 1.2.4

Figures 1.1a and 1.1b show the locations of currently operating nuclear plants and USNRC-licensed fuel-cycle facilities in the United States. Applications for 24 additional nuclear reactors were under active review by the USNRC while the present study was in progress.5


In the late 1980s, the National Cancer Institute (NCI) initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States (Jablon et al., 1990). The investigation compared cancer mortality rates in “study” counties (i.e., counties that contained nuclear facilities) with rates in “control” counties (i.e., counties that were similar to the study counties in terms of population size, income, education, and other socioeconomic factors but did not contain nuclear facilities). The NCI investigation also compared cancer registration (i.e., cancer incidence) rates in study and control counties in two states: Connecticut and Iowa. No differences in cancer mortality or incidence rates were observed between study and control counties. The authors of the study concluded that “if nuclear facilities posed a risk to neighboring populations, the risk was too small to be detected by a survey such as this one” (Jablon et al., 1991).

The USNRC has been using the results of this NCI investigation as a primary resource for communicating with the public about cancer risks near the nuclear facilities that it regulates. However, this study is now over 20 years old. There have been substantial demographic shifts in populations around some of these facilities, and the facility inventory itself has changed; some facilities have shut down and new facilities have started up. Additionally, at least one facility that was not included in the NCI investigation (Nuclear Fuel Services in Tennessee) has become a focus of public interest.

The NCI investigation had several limitations: The investigation utilized county-level mortality and, when available, incidence data. The use

3 Section 274 of the Atomic Energy Act of 1954 authorizes the USNRC to enter into agree ments with state governors to discontinue the Commission’s regulatory authority for byproduct materials (radioisotopes), source materials (uranium and thorium), and certain quantities of special nuclear materials. States that have assumed regulatory authority for these materials are referred to as agreement states.

4 A listing of these facilities as of 2010 can be found at

5 See

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