The Five Series Study Mortality of Military Participants in U.S. Nuclear Weapons Tests (2000) / Chapter Skim
Currently Skimming:
12 Discussion
12 Discussion
Pages 73-82
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 73... ...
in light of the limitations and strengths of these data and the findings that others have reported in studies of atomic veterans. LIMITATIONS Fact-of-Death and Cause-of-Death Ascertainment Death rates for both the participant and the referent cohorts were generally lower than those for the U.S.
|
From page 74... ...
Similar calculations yield estimates for adjusted hazard ratios of 1.094 for leukemia minus CLL and 2.232 for thyroid cancer. The effect of this adjustment is always to reduce the size of the original hazard ratios.
|
From page 75... ...
For example, the coding for cause of death on death certificates is not necessarily uniform across geographic regions or time periods, or across the various groups of personnel responsible for choosing which cause, among the overlapping possibilities, to formalize on a death certificate. Statistical Power Veteran concern about radiogenic cancer was a major impetus for this research.
|
From page 76... ...
, it also concluded that carefully done custom dose reconstructions performed anew for selected participants using consistent methods could provide usable dose data. Such custom dose reconstructions, however, would be prohibitively expensive to carry out for the entire cohort of participants.
|
From page 77... ...
Neither information about the nuclear tests nor current understanding of radiobiology helps us to explain this observed higher risk. Similar estimates of excess mortality due to external causes, however, have been found in the study of British nuclear test participants (relative risk 1.06 for the initial follow-up through 1983 and 1.03 for 1984 through 1990; Darby et al., 1993b)
|
From page 78... ...
Although the data are far from definitive, our findings are broadly consistent with a radiogenic basis for the excess leukemia deaths observed. The relative risks for leukemia deaths were highest for two acute leukemia subtypeslymphoid leukemia excluding chronic lymphoid leukemia and myeloid leukemia excluding chronic myeloid leukemia (Table 11-4~.
|
From page 79... ...
fatality rate, a few additional found cases could influence the study findings. Neither the Darby nor Pearce team found an increased risk of death due to thyroid cancer; Watanabe et al.
|
From page 80... ...
Specifically, participant concerns about the possibility of cancer being caused by their participation may have led to more intensive follow-up, with a concomitant increase in prostate cancer discovered, and subsequently, in reported deaths due to prostate cancer. CONCLUDING COMMENTS Having described the difficulties faced in carrying out this study most of which are shared by other studies involving insufficiently recorded exposure and endpoint information, we here recapitulate some of its general advantages.
|
From page 81... ...
The size, length of follow-up, and persistence of data collection efforts involved in this Five Series Study have helped to assure us that the findings we report are valid. The weak associations observed and the varied consistency with other studies, however, make interpreting these findings difficult.
|
From page 82... ...
It is unlikely that another cohort study of this type and magnitude would provide more precise answers than this, because any atomic veteran study of this kind would face the same methodologic problems namely, inadequate exposure data and imperfect mortality ascertainment-that we encountered in this Five Series Study. Other research strategies, using better-defined dosimetry data, might be those that focus on specific diseases and more detailed individual-level exposure information.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.