National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

Mortality of Veteran Participants in the CROSSROADS Nuclear Test

Medical Follow-up Agency

INSTITUTE OF MEDICINE by

J. Christopher Johnson

Susan Thaul

William F. Page

Harriet Crawford with oversight from the

Institute of Medicine

Committee on the CROSSROADS Nuclear Test

NATIONAL ACADEMY PRESS
Washington, D.C.
1996

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

National Academy Press
2101 Constitution Avenue, N.W. Washington, DC 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Support for this project was provided by the U.S. Department of Veterans Affairs contract nos.V101(93)P1431 and V101(93)P1165), cofunded by the Defense Special Weapons Agency (formerly, Defense Nuclear Agency). This support does not constitute an endorsement of the views expressed in this report.

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Copyright 1996 by the National Academy of Sciences. All rights reserved.

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

COMMITTEE ON THE CROSSROADS NUCLEAR TEST

RICHARD B. SETLOW, Chair, Associate Director for Life Sciences and Senior Biophysicist,

Biology Department, Brookhaven National Laboratory, Upton, New York

GILBERT W. BEEBE, Statistician,

Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland

RICHARD L. BOYLAN, Senior Military Reference Archivist,

National Archives and Records Administration, College Park, Maryland

DANIEL H. FREEMAN, JR., Professor,

Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas

ETHEL S. GILBERT, Senior Staff Scientist and Statistician,

Pacific Northwest Division, Battelle Memorial Institute, Richland, Washington

DENNIS F. HOEFFLER, Medical Director,

General Electric Lighting, Cleveland, Ohio

BARBARA S. HULKA, Professor,

Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina

KEITH J. SCHIAGER, Director Emeritus,

Radiological Health Department, University of Utah, Salt Lake City, Utah

SEYMOUR JABLON,

Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland (through 1/93)

Study Staff

J. CHRISTOPHER JOHNSON, Study Director

HARRIET CRAWFORD, Operations Team Leader

WILLIAM F. PAGE, Biostatistician

PAMELA C. RAMEY-McCRAY, Project Assistant

SUSAN THAUL, Epidemiologist

DENNIS ROBINETTE (through 12/91)

YOUN SHIM (6/94–1/95)

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

BOARD OF THE MEDICAL FOLLOW-UP AGENCY

NORMAN BRESLOW, Chair, Professor of Biostatistics,

University of Washington, Seattle

JOHN C. BAILAR, III, Professor,

Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada

DAN G. BLAZER, J.P. Gibbons Professor of Psychiatry, Dean of Medical Education,

Duke University Medical Center, Durham, North Carolina

DONALD L. CUSTIS, Senior Medical Advisor,

Paralyzed Veterans of America

DAVID G. HOEL, Chairman,

Department of Biometry and Epidemiology, Medical University of South Carolina, Charleston

MICHEL M. IBRAHIM, Dean,

School of Public Health, Department of Epidemiology, University of North Carolina, Chapel Hill

BERNARD T. MITTEMEYER, Executive Vice President and Provost,

Texas Tech University Health Sciences Center, Lubbock

H. ELDON SUTTON, Professor of Zoology, Director,

The Genetics Institute, The University of Texas at Austin

MARIE G. SWANSON, Professor,

Cancer Center at Michigan State University, East Lansing

MYRNA M. WEISSMAN, Professor of Psychiatry and Epidemiology,

Columbia University, College of Physicians and Surgeons, New York

Staff

RICHARD N. MILLER, Director,

Medical Follow-up Agency

CARLISS PARKER-SMITH, Administrative Assistant

NANCY DIENER, Financial Associate

Operations Team

HARRIET CRAWFORD, Operations Team Leader and Senior Programmer/Analyst

CHIQUITA BENSON, Programmer/Analyst

JIHAD DAGHMASH, Programmer/Analyst

NOAH DROPKIN, Coder/Abstractor

MARY JUMAN, Senior Program Assistant

SYLVIA MCKINNIS, Manager,

St. Louis Office

NICK FINDLAY, Records Assistant (7/95–6/96)

ALEXANDER SAENGER, Programmer/Analyst (9/93–7/95)

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

Preface

In November of 1983 the Congress of the United States passed Public Law 98–160 that directed the Veterans Administration (VA) to provide for the conduct of epidemiological studies of the long-term adverse health effects of exposure to ionizing radiation from detonation of nuclear devices. In response, the Medical Follow-up Agency (MFUA), then in the Commission on Life Sciences, National Academy of Sciences (NAS), proposed to compare the mortality experience of veteran participants in the CROSSROADS nuclear test to a similar group of nonparticipants. Operation CROSSROADS involved approximately 40,000 military personnel, mostly Navy, and occurred in July of 1946 at the Bikini Atoll in the Marshall Islands.

The VA convened an ad hoc scientific committee to review the NAS proposal which they recommended should be funded to "enlarge the growing body of information relating to the effects of low levels of radiation on human populations." The study was begun in September of 1986 and in 1988, a committee of the Institute of Medicine was organized to provide guidance and advice to the MFUA staff on the conduct of the study. The study was interrupted by the untimely death of the principal investigator, Dr. Dennis Robinette, in 1992. Both the Committee and MFUA staff wish to acknowledge their debt of gratitude to Dr. Robinette who laid the ground work for this study and assembled the comparison cohort. We regret he was not able to see the fruits of his labors in the publication of this report.

The Committee to Study the Crossroads Nuclear Test has met periodically since 1988 to review and guide the work of the MFUA staff as they have conducted the study. As with all research, resources are not boundless, and decisions must be made to apply them where the potential for gain is the

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

greatest. This study is no exception. While servicemen from all services participated in Operation CROSSROADS about 91 percent were from the Navy and the rest were distributed among the Marine Corps and the Army, which then included the Air Force. We chose to concentrate on the Navy cohort, and the reader will find that the conclusions are based on that group alone. Detailed investigation of the remaining branches of service are left to other ongoing and future studies in which the populations of Army, Air Force and Marines are much larger.

Since this is a congressionally mandated study, we expect that these results will be of interest to a wide range of readers from epidemiologists and scientists, to policy makers, veterans, and interested but possibly nontechnical readers. To make the report useful to such a wide audience has been a challenge. Hopefully, the scientists will find the detail and rigor they are accustomed to seeing in a technical report, while the interested readers with training outside the sciences will find sufficient background material to enable them to follow the technical discussion and understand the findings in the context of standard epidemiologic methods.

RICHARD B. SETLOW, CHAIR

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

Acknowledgments

The Committee and the authors wish to express their appreciation to the veterans, too numerous to thank individually, who have provided us with information on their participation in CROSSROADS and to the veterans' groups that represent them. We are particularly indebted to Mr. Boley Caldwell of the National Association of Atomic Veterans (NAAV), who gave us the list of CROSSROADS veterans that we used as one source in verifying our participant list; Dr. Oscar Rosen for his perspective on Operation CROSSROADS as a participant and Director of NAAV; Mr. Robert Campbell, for the relevant information and documents he has provided over the course of the study; and Mrs. Pat Broudy, for her insights on the legislative aspects of atomic veteran compensation programs.

We have performed this study under Department of Veterans Affairs (VA) contracts (V101(93)P1431 and V101(93)P1165) which were cofunded by the Defense Special Weapons Agency (DSWA). We are appreciative of their support. The DSWA also provided indispensable information about the participants in Operation CROSSROADS study from their Nuclear Test Personnel Review (NTPR) database. In addition to funding, the VA has provided support in ascertaining the mortality of the cohort.

We are also in the debt of the National Archives and particularly the National Personnel Records Center, St. Louis MO, and their staffs, who provided us with necessary individual, mortality and unit data. Dr. Eric Gunderson and Dr. Frank Garland of the Naval Health Research Center, San Diego, gave us much useful information on the classification of both ships and personnel within the Navy.

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Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
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We particularly acknowledge the contributions of the Operations Team of the MFUA, for their untiring, behind-the-scenes work to compile, edit, endlessly query and maintain the files of nearly 80,000 veterans whose records make up the database for this study. Without their expertise and experience in building military study cohorts of this type, the CROSSROADS investigation would not have been possible. Finally, we thank Dr. Richard Miller, director MFUA for his assistance and encouragement, Mrs. Pamela Ramey-McCray for her administrative support, Ms. Nancy Diener for budgetary guidance, and Mr. Peter Slavin for his editorial review.

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

Glossary and Acronyms

A

ABLE.

Military code name of 1 July 1946 nuclear detonation in Operation CROSSROADS.

AMFIT.

A statistical modeling program (in the Epicure software package) used to compute standardized mortality ratios (SMRs).

B

background radiation.

Detected disintegration events not emanating from the sample. Natural background is that radiation that is a natural part of a person's environment, primarily terrestrial radioactivity and cosmic rays.

BAKER.

Military code name of 25 July 1946 nuclear detonation in Operation CROSSROADS.

BEIR.

Biological Effects of Ionizing Radiation: A series of reports by committees of the National Academy of Sciences.

BEIR IV.

Biological Effects of Ionizing Radiation, 1988 Report IV (see References).

BEIR V.

Biological Effects of Ionizing Radiation, 1990 Report V (see References).

BIRLS.

Beneficiary Identification and Records Locator Subsystem, Department of Veterans Affairs.

BRER.

Board on Radiation Effects Research, National Research Council.

C

CDC.

Centers for Disease Control and Prevention, DHHS.

CFR.

Code of Federal Regulations.

CI.

Confidence interval (epidemiology/statistics).

CJTF-1.

Commander, Joint Task Force One.

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

CLL.

Chronic lymphocytic leukemia, a form of leukemia that has not been found in studies to be radiogenic.

CNS.

Central nervous system.

cohort study.

An epidemiologic investigation or follow-up of a group of individuals who are known to have had an exposure or a disease and whose health status is followed over time. Can usually provide a basis for calculating risk or disease outcome.

confounder.

A variable that is causally related to the disease under study and is associated with exposure in the study population, but is not a consequence of this exposure.

CROSSROADS.

Military code name of atmospheric test of nuclear weapons, July 1946, Bikini Atoll, Marshall Islands.

D

DD-214.

Military service discharge form.

DHHS.

Department of Health and Human Services, USA.

DNA.

Defense Nuclear Agency. The name was changed to Defense Special Weapons Agency (DSWA) in June 1996.

DoD.

Department of Defense, USA.

dose.

The amount of absorbed radiation energy.

DSWA.

Defense Special Weapons Agency (new name for DNA as of June 1996).

E

E1-E7.

Enlisted personnel paygrades.

exposure (radiation).

A term describing the amount of ionizing radiation that is incident upon living or inanimate material.

F

FARC.

Federal Archives Records Center.

film badge.

Photographic film shielded from light; worn by an individual to measure radiation exposure.

G

gamma ray.

Radiation emitted from the nucleus having a wavelength range of 10-9–10-12 centimeters.

GAO.

General Accounting Office, USA.

H

HCFA.

Health Care Financing Administration, DHHS.

I

ICD9.

International Classification of Diseases, 9th revision. (See References, World Health Organization, 1995)

ICRP.

International Commission on Radiological Protection.

incidence.

The number of persons who have developed a disease in a given period of time divided by the total population at risk.

IOM.

Institute of Medicine.

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

ionizing radiation.

Radiation that produces ion pairs along its path through a substance.

irradiation.

Exposure to radiation.

J

JTF.

Joint task force.

L

LTFU.

Lost to follow-up.

M

MFUA.

Medical Follow-up Agency, Institute of Medicine.

mrem.

Millirem, one-thousandth of a rem.

MSN.

Military service number.

mSv.

Millisievert, one-thousandth of a Sv.

N

NAAV.

National Association of Atomic Veterans.

NARA.

National Archives and Records Administration.

NAS.

National Academy of Sciences.

NCRP.

National Council on Radiation Protection and Measurements.

NDI.

National Death Index, maintained by the National Center for Health Statistics, CDC, DHHS.

NPRC.

National Personnel Records Center.

NRC.

National Research Council.

NRC

Nuclear Regulatory Commission. United States government agency regulating by-product material.

NRPB.

National Radiological Protection Board, U.K.

NTPR.

Nuclear Test Personnel Review, DNA.

O

O1–O10.

Commissioned officer paygrades.

odds ratio (OR).

Used as an estimation of relative risk. Primarily used for case-control studies and is calculated from the odds of exposure among the cases to that among controls.

OTA.

Office of Technology Assessment, U.S. Congress.

P

p.

Probability (epidemiology/statistics, e.g., p = .05).

PHREG.

Proportional hazards regression program, SAS.

R

radiation.

Energy propagated through space or matter as waves (gamma rays, ultraviolet light) or as particles (alpha or beta rays). External radiation is from a source outside the body, whereas internal radiation is from a source inside the body (e.g., radionuclides deposited in tissues).

RADSAFE.

Radiation safety monitor units, or personnel.

relative risk—RR.

The ratio of the incidence of a condition in the exposed population divided by the incidence in the nonexposed population. If there is no difference as a result of exposure, the RR is 1.0.

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

rem.

A unit of radiation dose equivalent; replaced by the sievert.

Roentgen (R).

Quantity of x-or gamma radiation that produces one electrostatic unit of charge per cubic centimeter of air; a unit of exposure.

S

SAS.

Originally ''Statistical Analysis System,'' proprietary software package.

shield (shielding).

A body of material used to reduce the intensity of radiation.

SI.

International System of Units (as instituted in 1960).

sievert (Sv).

A unit of effective or equivalent dose. Equivalent dose incorporates an adjustment for the fact that different types of radiation (alpha, beta, gamma, neutron) differ in their ability to do biologic damage. Effective dose also incorporates adjustments for the relative sensitivity of different organ systems. The sievert is the SI unit that replaced the rem.

SMR.

Standardized mortality ratio.

SSN.

Social Security Number.

Sv.

sievert.

U

UNSCEAR.

United Nations Scientific Committee on the Effects of Atomic Radiation. A committee of the U.N. General Assembly.

US.

United States.

USS.

United States Ship, Navy.

V

VA.

Department of Veterans Affairs.

VAMI.

Veterans Affairs (was Veterans Administration) Master Index.

VARO.

Veterans Affairs Regional Office.

W

W1-W4.

Warrant officer paygrades.

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Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
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Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×
   

Exclusion of "Post-Crossroads" Participants,

 

29

   

Crossroads Participants Who Participated in Other Nuclear Tests,

 

29

   

Primary Analysis—Navy Personnel Only,

 

30

   

Exclusivity of Participant and Comparison Cohorts,

 

30

7

 

The Comparison Cohort

 

31

   

Comparison Cohort Selection,

 

31

   

Navy and Shipboard Marines,

 

31

   

Army and Army Air Corps,

 

33

   

Military Personnel Records,

 

33

   

Additional Controls,

 

34

8

 

Exposure Definition, Measurement, and Verification

 

35

   

Introduction,

 

35

   

Dosimetry Background,

 

36

   

Definition of Potential Surrogate Dose Groups,

 

36

   

DNA-Provided Dose Estimates,

 

37

   

Participant versus Nonparticipant Cohorts as an Exposure Surrogate,

 

38

   

Boarders versus Nonboarding Participants versus Nonparticipants as Exposure Surrogates,

 

39

   

Engineering & Hull versus Other Specialty Status as an Exposure Surrogate,

 

39

   

Relationships of Surrogates with DNA Dose Data,

 

42

   

Decisions for the Analyses in this Report,

 

43

9

 

Mortality Ascertainment

 

44

   

Procedure,

 

45

   

Vital Status Ascertainment,

 

45

   

Cause and Date-of-Death Ascertainment,

 

46

   

Summary of Mortality Ascertainment Quality and Its Potential Effects on Valid Interpretation of the Findings,

 

46

10

 

Characterization of the Cohorts and Analysis Plan

 

49

   

Data Decisions Taken Before Analysis,

 

49

   

Restricting Data Elements or Sample Definition,

 

49

   

Data Cleaning and Variable Development,

 

50

   

Univariate Descriptions of Study Population,

 

51

   

Missing Data,

 

53

   

Imputation of Fact and Date of Death,

 

53

   

Imputation of Date of Birth,

 

54

   

Summary,

 

54

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×
  

Mortality Comparisons,

 

55

  

Multivariate Analyses,

 

56

  

Cox Proportional Hazards Model,

 

56

  

Standardized Mortality Ratios,

 

59

  

Analysis of Army (including Army Air Corps) and Marine Data,

 

60

  

Not the Subject of Analysis in this Report,

 

60

11

 

Findings and Discussion

 

62

  

Organization,

 

62

  

Findings: Displayed in Tables,

 

64

  

Narrative Summary of Findings,

 

72

  

Participant Status,

 

72

  

Boarder Status/Hypothesized Exposure Gradient,

 

73

  

Engineering & Hull Status/Hypothesized Exposure Surrogate,

 

74

  

Findings for Marines and Army (including Army Air Corps) Personnel,

 

74

  

Discussion,

 

76

  

Boarders,

 

76

  

Engineering & Hull,

 

77

  

Discussion of Other Findings,

 

78

  

Other Models and Parameters Considered During Analysis,

 

79

  

Standardized Mortality Ratios,

 

81

  

Discussion Relating These Findings to Those of Similar Studies,

 

81

  

Findings in Other Studies of Atomic Veterans,

 

81

  

Selection Bias as an Explanation for Increased Participant All-Cause Mortality,

 

82

  

Avenues of Further Exploration,

 

84

12

 

Conclusions

 

86

  

Summary of Findings,

 

86

 

References

 

89

 

Appendixes

 

A

 

National Association of Atomic Veterans (NAAV) Medical Survey,

 

93

B

 

Participant Description (DNA memorandum dated July 11, 1994),

 

99

C

 

Standardized Mortality Ratios,

 

105

D

 

Radiation Doses for CROSSROADS Participants and Exposure Surrogate Groups,

 

110

E

 

Verification of Completeness and Accuracy of the Participant Roster,

 

114

F

 

Verification of Completeness and Accuracy of Mortality Ascertainment,

 

128

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
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List of Tables

TABLE 6-1.

 

Distribution of Participation in Nuclear Test Series

 

30

TABLE 8-1.

 

Broad Occupational Specialty Groupings of Navy Enlisted Ratings Developed from "Navy Career Paths" (1949)

 

40

TABLE 8-2.

 

General Rank/Rating and Occupational Specialty Categories for Navy Personnel

 

41

TABLE 10-1.

 

Age-at-Shot Distribution of Navy Participants and Controls

 

51

TABLE 10-2.

 

Distribution of Ranks and Ratings Among Navy Participants and Controls

 

52

TABLE 10-3.

 

Distribution of Occupational Specialties Among Navy Participants and Controls

 

53

TABLE 10-4.

 

Distribution of Boarders in the Study Cohort

 

53

TABLE 10-5.

 

Number and Percent of Records with Missing Needed Data Item

 

54

TABLE 10-6.

 

Vital Status on Follow-Up

 

55

TABLE 10-7.

 

Information Available on Deaths

 

55

TABLE 10-8.

 

Definitions of Analysis Variables

 

57

TABLE 10-9.

 

ICD9 Mortality Codes Used as Case Definitions for Analyses

 

58

TABLE 11-1.

 

Rate Ratios of Major Mortality Endpoints for Exposed to Not Exposed Personnel

 

65

TABLE 11-2.

 

Mortality Rate Ratios from Six Selected Major Cause-of-Death Categories (subset of Table 11-1)

 

66

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Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
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TABLE 11-3.

 

Mortality Rate Ratios from Remaining Major Cause-of-Death Categories (subset of Table 11-1)

 

67

TABLE 11-4.

 

Mortality Rate Ratios from Selected Cancer Sites within All Malignancies (Table 11-2)

 

68

TABLE 11-5.

 

Mortality Rate Ratios for Selected Cancer Sites within Digestive, Respiratory, and Lymphopoietic Cancers (subset of Table 11-4)

 

69

TABLE 11-6.

 

Mortality Rate Ratio for Selected Subset of Other Lymphatic Tissue (subset of Table 11-5)

 

69

TABLE 11-7.

 

Mortality Rate Ratios for Subset of External Causes (subset of Table 11-2)

 

70

TABLE 11-8.

 

Mortality Rate Ratio for Subset of All Accidents (subset of Table 11-7)

 

71

TABLE 11-9.

 

Rate Ratios for All-Cause Mortality of Engineering & Hull to Non-Engineering & Hull Groups by Status as Participants or Controls

 

71

TABLE 11-10.

 

Mortality Rate Ratios of Participants Relative to Controls (Marines, n = 1,137)

 

75

TABLE 11-11.

 

Mortality Rate Ratios of Participants Relative to Controls (Army, including Army Air Corps, n = 6,482)

 

75

TABLE 11-12.

 

Nonsignificant Risk Estimates from Tables 11-4 and 11-5 that Indicate at Least a 40 Percent Excess or Deficit in Mortality

 

80

TABLE 11-13.

 

All-Cause Mortality Rate Ratios, Including and Excluding Records with Imputed Dates of Birth

 

80

TABLE C-1.

 

Standardized Mortality Ratios for All Causes of Death in Navy Participants and Controls

 

107

TABLE C-2.

 

Standardized Mortality Ratios for All-Malignancy Deaths in Navy Participants and Controls

 

108

TABLE C-3.

 

Standardized Mortality Ratios (SMR) for Leukemia (including CLL) for Navy Enlisted Personnel (n = 66,831)

 

109

TABLE C-4.

 

Standardized Mortality Ratios (SMR) for Army (including Army Air Corps, n = 6,482)

 

109

TABLE C-5.

 

Standardized Mortality Ratios (SMR) for Marines (n = 1,137)

 

109

TABLE D-1.

 

Tabulation of DNA Assigned Total Doses (rem [cSv]) by Study Grouping and Status as a Boarder or Nonboarder

 

113

TABLE E-1.

 

Resolution of 617 Apparent Participant Deletions Between 1986 and 1994

 

119

TABLE E-2.

 

Summary of Completeness of the NTPR Participant List as Indicated by Veteran Responses to MFUA Solicitations Published in Veterans' Publications

 

121

TABLE E-3.

 

Disposition of 103 Records of Putative Participants in CROSS-ROADS Whose Status Was Uncertain

 

122

Suggested Citation:"Front Matter." Institute of Medicine. 1996. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, DC: The National Academies Press. doi: 10.17226/5428.
×

TABLE E-4.

 

Disposition of 89 Discrepant Records from the NAAV Medical Survey List,

 

123

TABLE E-5.

 

Summary of Completeness of the NTPR Participant List According to Write-in Data (includes verification of 17 discrepancies by personnel record searches at DNA),

 

123

TABLE F-1.

 

Procedural Steps and Success Rates for Determination of Vital Status Information,

 

129

TABLE F-2.

 

Vital Status for Navy Personnel,

 

130

TABLE F-3.

 

Completeness of Mortality Information,

 

130

TABLE F-4.

 

Summary of Vital Status for Study Records Submitted to HCFA,

 

131

TABLE F-5.

 

Comparison of VA and HCFA Vital Status for Operation CROSS-ROADS Participants and Controls,

 

133

TABLE F-6.

 

Number of Potential Matches for Each Record Submitted to NDI,

 

135

TABLE F-7.

 

Comparison of NDI and MFUA Mortality Information,

 

136

TABLE F-8.

 

NDI and HCFA Comparisons,

 

137

TABLE F-9.

 

Distribution of Causes of Death for 641 Death Certificates Sent for Recoding,

 

138

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In 1946, approximately 40,000 U.S. military personnel participated in Operation CROSSROADS, an atmospheric nuclear test that took place at Bikini Atoll in the Marshall Islands. Congress passed a law directing the Veterans Administration to determine whether there were any long-term adverse health effects associated with exposure to ionizing radiation from the detonation of nuclear devices. This book contains the results of an extensive epidemiological study of the mortality of participants compared with a similar group of nonparticipants. Topics of discussion include a breakdown of the study rationale; an overview of other studies of veteran participants in nuclear tests; and descriptions of Operation CROSSROADS, data sources for the study, participant and comparison cohorts, exposure details, mortality ascertainment, and findings and conclusions.

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