Mortality of Veteran Participants in the CROSSROADS Nuclear Test (1996) / Chapter Skim
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Characterization of the Cohorts and Analysis Plan
Characterization of the Cohorts and Analysis Plan
Pages 49-61
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From page 49... ...
Chapters 6 and 7 describe who is in the analysis, while Chapters 8 and 9 discuss what data items are used and in what manner. DATA DECISIONS TAKEN BEFORE ANALYSIS Restricting Data Elements or Sample Definition In the overall attempt to balance the validity, precision, understandability, and usefulness of the analyses in this report, we made the following decisions, based mostly on issues of data availability: 49
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From page 50... ...
· For VA claims folders that did not contain a date of death from VA records or an acquired death certificate and that had been transferred from VA to a Federal Archives Record Center (FARC) , use date of folder transfer to calculate an estimated date of death (see Chapter 9~.
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Tables 10-1 through 10-3 show the numerical balance between participant and control cohorts for age, rank (or rating) , and occupational specialty, respectively, for Navy personnel.
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From page 52... ...
% No. % Ei Junior Enlisted12 0.010 0.0 E2 Junior Enlisted10,624 27.59,773 27.9 E3 Junior Enlisted7,321 18.96,616 18.9 E4 Midlevel Enlisted5,377 13.94,881 13.9 E5 Midlevel Enlisted4,917 12.74,225 12.1 E6 Senior Enlisted4,316 11.23,752 10.7 E7 Senior Enlisted2,718 7.02,330 6.7 W1 (Warrant)
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From page 53... ...
38,668 100 35,036 100 See Chapter 8 for discussion of boarder variable. MISSING DATA Imputation of Fact and Date of Death Because we classified approximately 500 individuals as "Dead" solely because their VA claims folder had been transferred to a Federal Archive Records Center (FARC)
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Imputation of Date of Birth For 1,448 otherwise complete Navy records, date of birth was missing. Since the proportional hazards and standardized mortality analyses we used require age information, we devised a date-of-birth imputation procedure.
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Under this null hypothesis there would be no significant trend observed across boarding party participants (more exposure surrogate) , non-boarding-party participants (less exposure surrogate)
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From page 56... ...
It is a semiparametric model that "measures the relative risk of death or disease in (infinitesimally) small time intervals under the assumption that the relative risk is constant over the followup period (Ingram and Makuc 1994~." We used the Cox model with survival time as the response variable; vital status as the censoring variable;22 and age, participant status, paygrade, Engineering & Hull status, and boarder status as explanatory variables.
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From page 57... ...
Vital status 1 = Dead; 0 = Not Known Dead Age at shot Continuous variable calculated by date of shot minus date of birth Survival time Continuous variable calculated by date of death minus date of shot Participant status 1 = Participant; 0 = Control Boarder status 3-Level set of indicator variables representing boarding participants, nonboarding participants, and nonparticipant controls. Paygrade Paygrades summarized in four levels (junior enlisted, E1-E3; mid level enlisted, E4-E5; senior enlisted, E - E7; and Officers (commissioned and warrant, 01-010 and W1-W4~.
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From page 58... ...
58 CROSSROADS TABLE 10-9. ICD9 Mortality Codes Used as Case Definitions for Analyses Case definitions ICD9 mortality codes All causes All malignancies Buccal cancer Digestive cancer Esophagal cancer Stomach cancer Large intestine cancer Rectal cancer Liver cancer Pancreatic cancer Respiratory cancer Lung cancer Bone cancer Skin cancer Prostate cancer Testicular cancer Bladder cancer Kidney cancer Eye cancer Brain and other CNS cancer Thyroid cancer All lymphopoietic cancer Lympho sarcoma and reticula sarcoma Hodgkin's disease Leukemiab and aleukemia Other lymphatic tissue cancer Multiple myeloma Benign neoplasms Circulatory system disease Respiratory disease Digestive system disease All external causes of death All accidents Motor vehicle accidents Suicide Infectious and parasitic diseases Endocrine, nutritional, and metabolic diseases and immunity disorders 0010-9999 1400-2021, 2024, 2027-2089, 2384, 2386, 2898 1400-1499 1500-1590, 1592-1599 1500-1509 1510-1519 1530-1539, 1590 1540-1542, 1544-1549 1550-1551, 1553-1569 1570-1579 1600-1639, 1642, 1643, 1648, 1649, 1650-1659 1620-1629 1700-1709 1720-1739 1850-1859 1860-1876, 1878-1879 1880-1886, 1888-1889 1890-1899, 1887 1900-1909 1910-1929 1930-1939 2000-2021, 2024, 2027 2089, 2384, 2386, 2898 20002009 2010-2019 204~2089, 2024, 2031 2020-2021, 2027-2030, 2032-2039, 2384, 2386, 2071, 2053, 1591 2030, 2386 2100-2376, 2378-2383, 2388-2399 3900-4599 4600-5199 5200-5799 8000-9989 8000-9499 8100-8299 9500-9599 001-139 240-279
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From page 59... ...
In fact, an earlier National Research Council mortality study of atmospheric nuclear tests and mortality (Robinette et al.
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From page 60... ...
As a result of these factors, we chose to: analyze the Army and the Marine data for differences in all-cause, allcancer, and leukemia mortality using the proportional hazards model developed for the Navy without the occupational specialty variables, and · compute SMRs on the Army and Marines only for all-cause, all-cancer, and leukemia mortality. We do these analyses with some hesitation, given the limitations in the Army data and the small number of Marines, and we present the results solely for completeness.
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From page 61... ...
Areas of inquiry into which we have not delved in this study but for which we could imagine a study design include: e exposure-outcome analyses based on exact dosimetry estimates calculated for a subset of the overall study population, fuller examination of cause of death, looking beyond the underlying cause to all associated or contributory causes listed on the death certificate; and · detailed analysis of the participants who served in the Marines and Anny (including the Army Air Corps) in CROSSROADS and their controls.
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