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Boice, Jr., John D.

Publications and source records attributed to Boice, Jr., John D..

5 records
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DOE OSTI2024

A Million Person Study Innovation: Evaluating Cognitive Impairment and other Morbidity Outcomes from Chronic Radiation Exposure Through Linkages with the Centers for Medicaid and Medicare Services Assessment and Claims Data

Here, the study of One Million U.S. Radiation Workers and Veterans, the Million Person Study (MPS), examines the health consequences, both cancer and non-cancer, of exposure to ionizing radiation received gradually over time. Recently the MPS has focused on mortality patterns from neurological and behavioral conditions, e.g., Parkinson's disease, Alzheimer's disease, dementia, and motor neuron disease such as amyotrophic lateral sclerosis. A fuller picture of radiation-related late effects comes from studying both mortality and the occurrence (incidence) of conditions not leading to death. Accordingly, the MPS is identifying neurocognitive diagnoses from fee-for-service insurance claims from the Centers for Medicare and Medicaid Services (CMS), among Medicare beneficiaries beginning in 1999 (the earliest date claims data are available). Linkages to date have identified ∼540,000 workers with available health information. Such linkages provide individual information on important co-factor and confounding variables such as smoking, alcohol consumption, blood pressure, obesity, diabetes and many other health and demographic characteristics. The total person-level set of time-dependent variables, outcomes, organ-specific dose measures, co-factors, and demographics will be massive and much too large to be evaluated with standard software. Thus, development of specialized open-source software designed for large datasets (Colossus) is nearly complete. The wealth of information available from CMS claims data, coupled with individual dose reconstructions, will thus greatly enhance the quality and precision of health evaluations for this new field of low-dose radiation and neurocognitive effects.

Dauer, Lawrence T.↗
DOE OSTI2022

Methods of improving brain dose estimates for internally deposited radionuclides *

The US National Council on Radiation Protection and Measurements (NCRP) convened Scientific Committee 6–12 (SC 6–12) to examine methods for improving dose estimates for brain tissue for internally deposited radionuclides, with emphasis on alpha emitters. This Memorandum summarises the main findings of SC 6–12 described in the recently published NCRP Commentary No. 31, ‘Development of Kinetic and Anatomical Models for Brain Dosimetry for Internally Deposited Radionuclides’. The Commentary examines the extent to which dose estimates for the brain could be improved through increased realism in the biokinetic and dosimetric models currently used in radiation protection and epidemiology. A limitation of most of the current element-specific systemic biokinetic models is the absence of brain as an explicitly identified source region with its unique rate(s) of exchange of the element with blood. The brain is usually included in a large source region called Other that contains all tissues not considered major repositories for the element. In effect, all tissues in Other are assigned a common set of exchange rates with blood. A limitation of current dosimetric models for internal emitters is that activity in the brain is treated as a well-mixed pool, although more sophisticated models allowing consideration of different activity concentrations in different regions of the brain have been proposed. Here case studies for 18 internal emitters indicate that brain dose estimates using current dosimetric models may change substantially (by a factor of 5 or more), or may change only modestly, by addition of a sub-model of the brain in the biokinetic model, with transfer rates based on results of published biokinetic studies and autopsy data for the element of interest. As a starting place for improving brain dose estimates, development of biokinetic models with explicit sub-models of the brain (when sufficient biokinetic data are available) is underway for radionuclides frequently encountered in radiation epidemiology. A longer-term goal is development of coordinated biokinetic and dosimetric models that address the distribution of major radioelements among radiosensitive brain tissues.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2022

Mortality among Tennessee Eastman Corporation (TEC) uranium processing workers, 1943–2019

Background: There are few occupational studies of women exposed to ionizing radiation. During World War II, the Tennessee Eastman Corporation (TEC) operated an electromagnetic field separation facility of 1152 calutrons to obtain enriched uranium (235U) used for the Hiroshima atomic bomb. Thousands of women were involved in these operations. Materials and methods: We report a new study was conducted of 13,951 women and 12,699 men employed at TEC between 1943 and 1947 for at least 90 days. Comprehensive dose reconstruction techniques were used to estimate lung doses from the inhalation of uranium dust based on airborne measurements. Vital status through 2018/2019 was obtained from the National Death Index, Social Security Death Index, Tennessee death records and online public record databases. Analyses included standardized mortality ratios (SMRs) and Cox proportional hazards models. Results: Most workers were hourly (77.7%), white (95.6%), born before 1920 (58.3%), worked in dusty environments (57.0%), and had died (94.9%). Vital status was confirmed for 97.4% of the workers. Women were younger than men when first employed: mean ages 25.0 years and 33.0 years, respectively. The estimated mean absorbed dose to the lung was 32.7 mGy (max 1048 mGy) for women and 18.9 mGy (max 501 mGy) for men. The mean dose to thoracic lymph nodes (TLNs) was 127 mGy. Statistically significant SMRs were observed for lung cancer (SMR 1.25; 95% CI 1.19, 1.31; n = 1654), nonmalignant respiratory diseases (NMRDs) (1.23; 95% CI 1.19, 1.28; n = 2585), and cerebrovascular disease (CeVD) (1.13; 95% CI 1.08, 1.18; n = 1945). For lung cancer, the excess relative rate (ERR) at 100 mGy (95% CI) was 0.01 (–0.10, 0.12; n = 652) among women, and –0.15 (–0.38, 0.07; n = 1002) among men based on a preferred model for men with lung doses <300 mGy. NMRD and non-Hodgkin lymphoma were not associated with estimated absorbed dose to the lung or TLN. Conclusions: There was little evidence that radiation increased the risk of lung cancer, suggesting that inhalation of uranium dust and the associated high-LET alpha particle exposure to lung tissue experienced over a few years is less effective in causing lung cancer than other types of exposures. There was no statistically significant difference in the lung cancer risk estimates between men and women. The elevation of certain causes of death such as CeVD is unexplained and will require additional scrutiny of workplace or lifestyle factors given that radiation is an unlikely contributor since only the lung and lymph nodes received appreciable dose.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗
DOE OSTI2020

Million Worker Study

Radiation health issues have been an important aspect of DOE's Worker Safety and Health programs. The goal is to ensure that workers are adequately protected from the various radiological hazards associated with DOE sites and operations. Since the early 1940’s DOE has supported the conduct of epidemiologic studies of practically every DOE (AEC) facility and collected these data, now managed by the Oak Ridge Associated Universities (ORAU), in remarkable detail. In the early 2000s, the Office of Health, Safety and Security authorized access to specific DOE worker datasets. Shortly thereafter, the DOE Office of Science provided funds for a pilot study that confirmed the feasibility of the Million Worker Study (MWS), and then additional resources were provided (with other agencies) to extend the follow-up of many populations, not just DOE workers, but also atomic veterans, industrial radiographers, nuclear power plant workers and medical radiation workers (the Million Persons Study (MPS)). This proposal was a continuation of support provided by DOE, specifically to extend the follow-up of the worker populations at the Mallinckrodt Chemical Works (MCW) and Los Alamos National Laboratory (LANL). The work addresses DOE’s interest in clarifying the health risks of their workers as well as contributing knowledge on radiation risks that is relevant today with regard to compensation schemes. The findings are also important for the US public in light of the increased population exposure to medical imaging, environmental circumstances such as hydraulic fracturing, increased exposures during high altitude flights, and with regard to nuclear accidents such as Fukushima and possible terrorist events. Furthermore, it is important to consider reducing the uncertainty in current risk estimates by developing risk coefficients based on healthy American workers who are more representative of U.S. workers and the general public than 1945 Japanese survivors of the atomic bombs living in a war-torn country which experienced deprivation, malnourishment, and increased rates of infections and other diseases. But more importantly, it is important to learn whether radiation exposures received gradually over time (e.g., years) are more or less effective in causing health effects, cancer in particular, than if the radiation dose is received all at once in a fraction of a second as experienced by the Japanese atomic bomb survivors. Finally, the ability to evaluate and combine large populations with intakes of radionuclides such as uranium, radium, plutonium, americium and polonium will provide new quantitative knowledge on human health effects that hitherto has not been possible. This cost-efficient study has built on the investments made and foundations laid by investigators and government agencies, including DOE, over the past 30-40 years, which have established early worker cohorts that can now provide answers to questions on the lifetime human health risks associated with low-level radiation exposures. Collaborating institutions included: International Epidemiology Institute, Oak Ridge Associated Universities, Oak Ridge National Laboratory, Los Alamos National Laboratory, Landauer, Inc., and Vanderbilt University. Follow-up of these two populations and the integration of them with the many other cohorts (now a total of 31) in the MPS continues under a separate DOE grant (DE-AU0000046).

61 RADIATION PROTECTION AND DOSIMETRY↗