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Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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Page 84
Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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Page 85
Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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Page 86
Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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Page 87
Suggested Citation:"References." Institute of Medicine. 2000. The Five Series Study: Mortality of Military Participants in U.S. Nuclear Weapons Tests. Washington, DC: The National Academies Press. doi: 10.17226/9697.
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84 THE FIVE SERIES STUDY Caldwell GO, Kelley D, Zack M, Falk H. Heath, CW Jr. Mortality and cancer frequency among military nuclear test (SMOKY) participants, 1957 through 1979. Journal of the American Medical Association 250~5~:620~24, 1983. CFR (Code of Federal Regulations). "Standards for Protection Against Radiation: Final Rule." Title 10, Pt. 20, 1991. CFR. "Claims Under the Radiation Exposure Compensation Act." Title 28, Pt 79.41, 1998a. CFR. "Diseases Subject to Presumptive Service Connection." Title 38, Pt. 3.309, 1998b. Cox DR. Regression models and lifetables twith discussion]. Journal of the Royal Statis- tical Society 34B: 187-220, 1972. Darby SC, Doll R. Gill SK, Smith PG. Long term mortality after a single treatment course with x-rays in patients treated for ankylosing spondylitis. British Journal of Cancer 55~2~:179-190, 1987. Darby SC, Kendall GM, Fell TP, Doll R. Goodill AA, Conquest AH, Jackson DA, Hay- lock ROE. Mortality and Cancer Incidence 1952-1990 in UK Participants in the UKAtmospheric Nuclear Weapon Tests and Experimental Programmes. Report No. NRPB-R266. Oxon, United Kingdom: National Radiological Protection Board, 1993a. Darby SC, Kendall GM, Fell TP, Doll R. Goodill AA, Conquest AH, Jackson DA, Hay- lock ROE. Further follow up of mortality and incidence of cancer in men from the United Kingdom who participated in the United Kingdom's atmospheric nuclear weapon tests and experimental programmer. British Medical Journal 307:1530- 1535, 1993b. Darby SC, Kendall GM, Fell TP, O'Hagan JA, Muirhead CR, Ennis JR, Ball AM, Dennis JA, Doll R. Mortality and Cancer Incidence in UK Participants in UK Atmospheric Nuclear Weapon Tests and Experimental Programm es. Report No. NPRB-R214. Oxon, United Kingdom: National Radiological Protection Board, 1988a. Darby SC, Kendall GM, Fell TP, O'Hagan JA, Muirhead CR, Ennis JR, Ball AM, Dennis JA, Doll R. A summary of mortality and incidence of cancer in men from the United Kingdom who participated in the United Kingdom's atmospheric nuclear weapon tests and experimental programmer. British Medical Journal 296:332-338, 1988b. DNA (Defense Nuclear Agency). Fact Sheet: Greenhouse Fact Sheet. Washington, D.C.: Defense Nuclear Agency, Public Affairs Office, 1981 (unpublished). DNA. Fact Sheet: Operation Upshot-Knothole. Washington, D.C.: Defense Nuclear Agency, Public Affairs Office, 1982 (unpublished). DSWA (Defense Special Weapons Agency). Letter dated 28 February 1997, with data tapes attached, from DM Schaeffer, NTPR Program Manager, Electronics and Sys- tems Directorate, Defense Special Weapons Agency to JC Johnson, Medical Follow- up Agency. DTRA (Defense Threat Reduction Agency). Radiation Exposure in U.S. Atmospheric Nuclear Weapons Testing, Nuclear Test Personnel Review Program. twww docu- ment]: http://www.dtra.mil/news/facts/ntprpre.html, 1999. Fisher SB, Weber L, Goldberg J. Davis F. Mortality ascertainment in the veteran popula- tion: Alternatives to the National Death Index. American Journal of Epidemiology 141:242-250, 1995. GAO (General Accounting Office). Mortality Study of Atmospheric Nuclear Test Partici- pants Is Flawed. Report to the Chairman, Committee on Veterans' Affairs, U.S. Senate Report No. GAO/RCED-92-182. Washington, D.C.: U.S. General Account- ing Office, August 1992.

REFERENCES 85 Gelband H. A Discussion of Questions About the 1985 NAS Report "Mortality of Nuclear Weapons Test Participants." Washington, D.C.: Office of Technology Assessment, August 1992. Gladeck F. Johnson A. For the Record: A History of the Nuclear Test Personnel Review Program, 1978-1993. DNA-6041F. Washington, D.C.: Defense Nuclear Agency, 1996. Hall P. Mattson A, and Boice ID Jr. Thyroid cancer diagnostic administration of iodine- 131.RadiationResearch 145:86-92, 1996. Harris P. Lowery C, Nelson A, Obermiller S. Ozeroff W. Weary S. Plumbbob Series, 1957. Washington, D.C.: Defense Nuclear Agency, l98l. ICRP (International Commission on Radiological Protection). Nonstochastic effects of ionizing radiation. ICRP Publication 41. Annals of the ICRP 14~3), 1984. ICRP. 1990 recommendations of the International Commission on Radiological Protec- tion. ICRP Publication 60. Annals of the ICRP 21~1-3), 1991. IOM (Institute of Medicine). A Review of the Dosimetry Data Available in the Nuclear Test Personnel Review (NTPRJ Program. An Interim Letter Report of the Commit- tee to Study the Mortality of Military Personnel Present at Atmospheric Tests of Nuclear Weapons to the Defense Nuclear Agency. Washington, D.C.: Institute of Medicine, 1995. IOM. Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications. Washington, D.C.: National Academy Press, 1999. JAYCOR. 5 Series Cohort Unit Selection Methodology Report for the National Academy of Sciences. Provided by DM Schaeffer, Defense Nuclear Agency, June 1995 (un- published document). JAYCOR. Participant Identification Methodology Report for the National Academy of Sciences. Provided by DM Schaeffer, Defense Nuclear Agency, June 1997 (unpub- lished document). Johnson AA, Goetz JL, McRaney WK. For the Record: A History of the Nuclear Test Personnel Review Program, 1978-1986. DNA-6041F. Washington, D.C.: Defense Nuclear Agency, 1986. Johnson JC, Thaul S. Page WE, Crawford H. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, D.C.: National Academy Press, 1996. Kang HK, Bullman TA. Mortality among U.S. veterans of the Persian Gulf War. New England Journal of Medicine 335:1498-1504, 1996. Korn EL, Graubard BI, Midthune D. Time-to-event analysis of longitudinal follow-up of a survey: Choice of the time scale. American Journal of Epidemiology 145~1~:72- 80, 1997. Land CE. Studies of cancer and radiation dose among atomic bomb survivors: The exam- ple of breast cancer. Journal of the American Medical Association 274~5~:402-407, 1995. Last JM. A Dictionary of Epidemiology, 3rd edition. New York: Oxford University Press, 1995. Mabuchi K, Soda M, Ron E, Tokunaga M, Ochikubo S. Sugimoto S. Ikeda T. Terasaki M, Preston DL, Thompson DE. Cancer incidence in atomic bomb survivors. Part I: Use of the tumor registries in Hiroshima and Nagasaki for incidence studies. Radia- tion Research. 137(Suppl.~: S US 16, 1994. Marsh GM, Youk AO, Stone RA, Sefcik S. Alcorn C. OCMAP-PLUS: A program for the comprehensive analysis of occupational cohort data. Journal of Occupational and Environmental Medicine 40:351-362, 1998.

86 THE FIVE SERIES STUDY Martin E, Rowland R. Castle Series, 1954. DNA 6035 F. Washington, D.C.: Defense Nuclear Agency, 1982. Mettler FA, Upton AC. Medical Effects of Ionizing Radiation, 2nd ed. Philadelphia: W.B. Saunders, 1995. Nagataki S. Shibata Y. Inoue S. Yokoyama N. Izumi M, Shimaoka K. Thyroid diseases among atomic bomb survivors in Nagasaki. Journal of the American Medical Asso- ciation 272~5~:364 370, 1994. NCRP (National Council on Radiation Protection and Measurements). Ionizing Radiation Exposure of the Population of the United States. NCRP Report. No. 93. Bethesda, Md.: National Council on Radiation Protection and Measurements, 1987. National Research Council. Committee on the Biological Effects of Ionizing Radiation (BEIR V). Health Effects of Exposure to Low Levels of Ionizing Radiation. Wash- ington, D.C.: National Academy Press, 1990. Page WF. VA mortality reporting for World War II Army veterans [letter]. American Journal of Public Health 82~1~: 12~125, 1992. Page WF. Evaluation of Vietnam Veteran Mortality Ascertainment by Department of Veterans Affairs Files, Final report to the Veterans Administration under contract V101~93)P-1316. Washington, D.C., March 1993 (unpublished manuscript). Page WF, Braun MM, Caporaso NE. Ascertainment of mortality in the U.S. veteran population: World War II veteran twins. Military Medicine 160~7~:351-355, 1995. Page WF, Mahan CM, Kang HK. Vital status ascertainment through the files of the De- partment of Veterans Affairs and the Social Security Administration. Annals of Epi- demiology 6~2~: 102-109, 1996. Pearce N. Mortality and Cancer Incidence in New Zealand Participants in United King- dom Nuclear Weapons Tests in the Pacif c: Supplementary Report. Wellington, New Zealand: Wellington School of Medicine, 1996. Pearce N. Winkelmann R. Kennedy J. Lewis S. Purdie G. Slater T. Prior I, Fraser J. Fur- ther follow-up of New Zealand participants in United Kingdom atmospheric nuclear weapons tests in the Pacific. Cancer Causes and Control 8:139-145, 1997. Pierce DA, Shimizu Y. Preston DL, Vaeth M, Mabuchi K. Studies of the mortality of A- bomb survivors. Report 12, Part I. Cancer: 1950-1990. Radiation Research 146:1- 27, 1996. Ponton J. Massie J. Maag C, Shepanel R. Rohrer S. Operation Upshot-Knothole, 1953. Washington, D.C.: Defense Nuclear Agency, 1982. Preston DL, Kusumi S. Tomonaga M, Izumi S. Ron E, Kuramoto A, Kamada N. Dohy H. Matsui T. Nonaka H. Thompson DE, Soda M, Mabuchi K. Cancer incidence in atomic bomb survivors. Part III: Leukemia, lymphoma and multiple myeloma, 1950-1987. Radiation Research 137(Suppl.~: S68-S97, 1994. Robinette CD, Jablon S. Preston TL. Mortality of Nuclear Weapons Test Participants. Washington, D.C.: National Research Council, 1985. Ron E. Ionizing radiation and cancer risk: Evidence from epidemiology. Radiation Re- search 150(Suppl.~:S3~S41, 1998. Ron E, Preston DL, Mabuchi K, Thompson DE, Soda M. Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality. Radiation Research 137(Suppl.~:S98-S112, 1994. Rothman KJ and Greenland S. Modern Epidemiology. 2nd edition. Philadelphia: Lippin- cott-Raven, 1998. SAS Institute, Inc. SAS/STAT Software: Changes and Enhancements Through Release 6.11. Cary, N.C.: SAS Institute, Inc., 1996.

REFERENCES 87 Schull WJ. Effects of Atomic Radiation: A Half-Century of Studies from Hiroshima and Nagasaki. New York: Wiley-Liss, 1995. Seltzer CC, Jablon S. Effects of selection on mortality. American Journal of Epidemio- 10gy 100:367-372, 1974. Seltzer CC, Jablon S. Army rank and subsequent mortality by cause: 23-year follow-up. American Journal of Epidemiology 105 :559-566, 1977. Sherman GJ, Howe GR, Miller AB, Rosenstein M. Organ dose per unit exposure result- ing from fluoroscope for artificial pneumothorax. Health Physics 35:259-269, 1978. Shore RE, Hildreth N. Woodward E, Dvoretsky P. Hempelmann L, Pasternack B. Breast cancer among women given x-ray therapy for acute postpartum mastitis. Journal of the National Cancer Institute 77~34:689-696, 1986. Singleton RA, Straits BC, Straits MM. Approaches to Social Research. 2n~ edition. New York: Oxford University Press, 1993. Thomas, TL, Kang HK, Dalager NA. Mortality among women Vietnam veterans, 1973- 1987. American Journal of Epidemiology 134:973-980, 1991. Thompson DE, Mabuchi K, Ron E, Soda M, Tokunaga M, Ochobuko S. Sugimoto S. Ikeda T. Terasaki M, Izumi S. et al. Cancer incidence in atomic bomb survivors. Part II: Solid tumors. Radiation Research 137(Suppl.~:S17-S67, 1994. UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation). Sources and Effects of Ionizing Radiation. UNSCEAR 1994 Report to the General Assembly with Scientific Annexes. New York: United Nations, 1994. USDHHS (U.S. Department of Health and Human Services). Postservice mortality among Vietnam veterans (The Centers for Disease Control Vietnam Experience Study). Journal of the American Medical Association 257~6~:790-795, 1987. USDHHS. The International Class.ification of Diseases, Ninth Revision, Clinical Mod.ifi- cation, 4th edition. DHHS Publication No. (PHS) 91-1260), 1991. Watanabe KK, Kang HK. Military service in Vietnam and the risk of death from trauma and selected cancers. Annals of Epidemiology 5:407-412, 1995. Watanabe KK, Kang HK, Dalager NA. Cancer mortality risk among military participants of a 1958 atmospheric nuclear weapons test. American Journal of Public Health 85:523, 1995.

THE FIVE SERIES STUDY PREP UBLICATION COPY FOR PUBLIC RELEASEllAMOCTOBER20, 1999 Pearce N. Winkelmann R. Kennedy I, Lewis S. Purdie G. Slater T. Prior I, Fraser I. Further follow-up of New Zealand participants in United Kingdom atmospheric nuclear weapons tests in the Pacific. Cancer Causes and Control S: 139-145, 1997. Pierce DA, Shimizu Y. Preston DL, Vaeth M, Mabuchi K. Studies of the mortality of A- bomb survivors. Report 12, Part I. Cancer: 195~1990. Radiation Research 146:1-27, 1996. Ponton J. Massie J. Maag C, Shepanel R. Rohrer S. Operation Upshot-Knothole, 1953. Washington, D.C.: Defense Nuclear Agency, 1982. Preston DL, Kusumi S. Tomonaga M, Izumi S. Ron E, Kuramoto A, Kamada N. Dohy H. Matsui T. Nonaka H. Thompson DE, Soda M, Mabuchi K. Cancer incidence in atomic bomb survivors. Part III: Leukemia, lymphoma and multiple myeloma, 195~1987. Radiation Research 137 (Suppl.~: S68-S97, 1994. Robinette CD, Jablon S. Preston TL. Studies of Participants in Nuclear Tests. Washington, D.C.: National Research Council, 1985. Ron E. Tonizing radiation and cancer r~sk: Evidence from epidem~ology. Radiation Research 150(Suppl.~:S3~S4l, 1998. Ron E, Preston DE, Mabuchi K, Thompson DE, Soda M. Cancer incidence in atom~c bomb survivors. Part IV: Compar~son of cancer incidence and mortality. Radiation Research. 137 (Suppl.~: S98-S!12, 1994. Rothman KT and Greeniand S. Modern Epidemiology. 2nd edition. Philadelphia: Lippincott-Raven, 1998. SAS Institute, Inc. SAS/STAT Software: Changes and Enhancements Through Release 6.~. Cary, N.C.: SAS Institute, Inc., 1996. Schull WJ. Effects of Atomic Radtiation: A Half-Century of Studties from Hiroshima andt Nagasaki. New York: Wiley-Liss, 1995. Seltzer CC, lablon S. Effects of selection on mortality. American JournaZ of Epidemiology 100:367-372, 1974. Seltzer CC, lablon S. Army rank and subsequent mortality by cause: 23-year follow-up. American Journal of Epidemiology 105:559-566, 1977. Sherman G], Howe GR, Miller AB, Rosenstein M. Organ dose per unit exposure resulting from fluoroscopy for artificial pneumothorax. Health Physics 35:259-269, 1978. PP\REFERENCES 6

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More than 200,000 U.S. military personnel participated in atmospheric nuclear weapons tests between 1945 and the 1963 Limited Nuclear Test Ban Treaty. Questions persist, such as whether that test participation is associated with the timing and causes of death among those individuals. This is the report of a mortality study of the approximately 70,000 soldiers, sailors, and airmen who participated in at least one of five selected U.S. nuclear weapons test series1 in the 1950s and nearly 65,000 comparable nonparticipants, the referents. The investigation described in this report, based on more than 5 million person-years of mortality follow-up, represents one of the largest cohort studies of military veterans ever conducted.

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