Risks to Uranium Process Workers

Originally published on the website of the British Medical Journal.

In her review of the risks of depleted uranium to occupational groups, Dr. Mc Diarmid concludes that "Fifty years' study of occupational exposure provides little evidence of cancer." Curiously, McDiarmid does not mention a special and very prominent review of Department of Energy occupational epidemiological studies undertaken at the request of the President in July 1999. (National Economic Council, Interagency Working Group No. 1, January, 2000). This review made a special effort to search out published and unpublished papers, which were not readily available in the literature. Over the years, several important papers sponsored by the DOE that reported significant risks associated with workplace exposures at U.S. nuclear weapons sites were not published and remained buried. The IOM study apparently could not perform the kind of literature review relative to occupational epidemiologic studies of uranium process workers that was done for the White House in early 2000. Had they done so, perhaps they may have come to different conclusions.

A careful review of the interagency report would have revealed significant findings relative to uranium-exposed workers. For instance:

Oak Ridge Y-12 weapons Plant, Tennessee. Total mortality was low as expected for this group, indicating a "healthy worker effect." The study also found elevated death rates for brain cancer, several lymphopoetic (immune system) cancers, as well as cancers of the prostate, kidney and pancreas. Excess death from breast cancer among women was found. The authors found excess lung cancer as their main finding and urged that this disease warrants continued surveillance An earlier study found similar risks, with a marginal dose-response trend for lung cancer only. (Dana P. Loomis and Susanne H. Wolfe, Mortality of Workers at a Nuclear Materials Production Plant at Oak Ridge, Tennessee, 1947-1990, American Journal of Medicine, 1996, 29:131-141,Harvey Checkoway, Neil Pierce, Douglas J. Crawford-Brown, and Donna Cragle, Radiation Doses and Cause-Specific Mortality Among Workers at a Nuclear Materials Fabrication Plant, American Journal of Epidemiology, 1998,127:2:255-266.)

The K-25 Gaseous Diffusion Plant, Tennessee. Excess risks of dying from all causes were found for white males when compared to general population rates. Other statistically significant increases among white males were for cancers of the respiratory system, bone cancer, mental disorders and all respiratory diseases including pneumonia. Generally the excess deaths from diseases among females were similar to males. Upon further analysis, increased risks of dying from kidney cancer and chronic nephritis (kidney disease) were found. The latter condition was more than 600 percent higher when

deaths from the last decade of follow up was observed.(Elizabeth A. Dupree, Susan M. Wells, Janice P. Watkins, Phillip W. Wallace, Nancy C. Davis, Mortality Among Workers Employed between 1945 and 1984 at a Uranium Gaseous Diffusion Facility, Draft Report, Oak Ridge Institute for Science and Education. (no date)).

Fernald Uranium Processing Plant, Ohio. Significant increased risks of dying from stomach cancer were found among salaried workers (261 percent higher than expected). For hourly workers statistically significant increased death risks were found for all cancers (21 percent higher) and lung cancer (26 percent higher). The authors concluded that there is evidence of a radiation-dose relationship for both nonmalignant respiratory diseases and lung cancer. (Donna L. Cragle, Janice P. Watkins, J. Nicholas Ingle, Kathryn Robertson-Demers, William G.Tankersley, Charles M. West, Mortality Among a Cohort of White Male Workers at a Uranium Processing Plant: Fernald Feed Materials Production Center [FMPC], Oak Ridge Associated Universities.)

Linde Air Products Co., NY. Statistically significant increased risks of dying from all causes (18 percent higher), laryngeal cancer (447 percent higher), all circulatory diseases (18 percent higher), arteriosclerotic heart disease (19 percent higher), all respiratory diseases (52 percent higher) and pneumonia (217 percent higher) were found among workers who processed uranium at this facility between 1943 and 1949. (Elizabeth A. DuPree, Donna Cragle, Richard, W. McLain, Douglas Crawford-Brown, M. Jane Teta, Mortality among workers at a uranium processing facility, the Linde Air Products Company Ceramics Plant, 1943- 49, Scandinavian Journal of Worker and Environmental Health, 1987, 13:100- 107.)

Mallinkrodt Chemical Works, Missouri. Workers who processed uranium between 1942 and 1966 were found to have a significant increased death rate from all cancers (10 percent higher). Respiratory diseases, chronic nephritis/kidney disease (218 percent higher) and lymphatic cancers were significantly elevated. In particular, significant increased risks were found for cancers of the esophagus(40 percent higher), rectum (45 percent higher), pancreas (31 percent higher), larynx (36 percent higher) kidney (34 percent higher) and multiple myeloma/bone marrow (33 percent higher). Kidney cancer showed a significant positive dose-response association with external radiation. (E. DuPree Ellis, J.P. Watkins, J.N. Ingle, J.A. Phillips, External Radiation Exposure and Mortality Among a Cohort of Uranium Processing Workers, Oak Ridge Associated Universities, Oak Ridge TN, (unpublished report).

It is remarkable that this White House review was not mentioned by McDiarmid since it received widespread attention. It prompted the Department of Energy to officially concede on January 29, 2000 that it's nuclear weapons workers were placed at risk of increased disease and death. This Presidential review also served as an underpinning for the recent creation of a major worker compensation entitlement program by the U.S. Congress -- which specifically grants a non-rebuttable presumption for 22 listed cancers to uranium process workers exposed to recycled uranium, contaminated with isotopes such as plutonium-239, neptunium-237, and Technetium 99, which now are being found in depleted uranium on the battlefields of the Balkans and the Persian Gulf.

Robert Alvarez (Senior Policy Advisor, U.S. Secretary of Energy 1993-1999)