related to radiation risks from the recent disaster in Japan (North Carolina, Massachusetts). Health concerns resulting from 1979 TMI incident were reported by the Pennsylvania Department of Health. Following that incident, the Department received state funding to conduct multidecadal health-related studies.

The number of concerns received by the public health departments may not be an accurate estimate of overall community concerns. For example, although the Tennessee Department of Public Health reported that it has been contacted by only two members of the public in 2009 and 2010 with concerns about the Nuclear Fuel Services facility located in Erwin, Tennessee, the study committee is aware that a group of citizens in Erwin have filed a class-action lawsuit against Nuclear Fuel Services, claiming that releases from the facility are to blame for high rates of cancer. The Health Department of Georgia reported that it has not received any relevant health reports; however, members of the public voiced health-related concerns during the committee meeting in Atlanta, Georgia. It is possible that some members of the public are unaware of state health department reporting systems, or they lack confidence to report concerns or that their concerns will be investigated.

Some states, such as Kentucky and Oregon, noted that they do not have a formal database for tracking complaints. Instead, public complaints are addressed individually and followed up as deemed appropriate by the specific departments devoted to radiation health. It is possible (as stated by the New York Department of Health) that the records and recollections from staff are incomplete.

Finally, one state department of public health may receive public requests about facilities in neighboring states if the facility is close to the state border. For example, health departments in Massachusetts and Connecticut have received concerns about facilities in Vermont (Vermont Yankee) and New York (Indian Point), respectively.


The committee judges that public engagement will be an import element of any Phase 2 study. Engagement needs to be designed to address the needs of the broad public population, which may not be coincident with the population that is targeted by the epidemiologic study. Although there is no checklist for sucessful engagement, previous National Research Council (NRC) reports can be used to identify important plan elements. Such reports include Improving Risk Communication (NRC, 1989), Science and Judgment in Risk Assessment (NRC, 1994), Understanding Risk (NRC, 1996), and the more recent Science and Decisions (NRC, 2009). The

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