title: Mortality and ionising radiation exposures among workers employed at the Fernald Feed Materials Production Center (1951-1985).
abstract: OBJECTIVE
  To examine mortality patterns and dose-response relations between ionising radiation and mortality outcomes of a priori interest in 6409 uranium workers employed for at least 30 days (1951-1985), and followed through 2004.
  
  
  METHODS
  Cohort mortality was evaluated through standardised mortality ratios (SMR). Linear excess relative risk (ERR) regression models examined associations between cause-specific mortality and exposures to internal ionising radiation from uranium deposition, external gamma and x-ray radiation, and radon decay products, while adjusting for non-radiologic covariates.
  
  
  RESULTS
  Person-years at risk totalled 236 568 (mean follow-up 37 years), and 43% of the cohort had died. All-cause mortality was below expectation only in salaried workers. Cancer mortality was significantly elevated in hourly males, primarily from excess lung cancer (SMR=1.25, 95% CI 1.09 to 1.42). Cancer mortality in salaried males was near expectation, but lymphohaematopoietic malignancies were significantly elevated (SMR=1.52, 95% CI 1.06 to 2.12). A positive dose-response relation was observed for intestinal cancer, with a significant elevation in the highest internal organ dose category and a significant dose-response with organ dose from internal uranium deposition (ERR=1.5 per 100 μGy, 95% CI 0.12 to 4.1).
  
  
  CONCLUSIONS
  A healthy worker effect was observed only in salaried workers. Hourly workers had excess cancer mortality compared with the US population, although there was little evidence of a dose-response trend for any cancer evaluated except intestinal cancer. The association between non-malignant respiratory disease and radiation dose observed in previous studies was not apparent, possibly due to improved exposure assessment, different outcome groupings, and extended follow-up.
authors: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA. zre4@cdc.gov
authors: Sharon R
authors: SR
authors: Silver
authors: Stephen J
authors: SJ
authors: Bertke
authors: Misty Jena
authors: MJ
authors: Hein
authors: Robert D
authors: RD
authors: Daniels
authors: Donald A
authors: DA
authors: Fleming
authors: Jeri L
authors: JL
authors: Anderson
authors: Susan M
authors: SM
authors: Pinney
authors: Richard W
authors: RW
authors: Hornung
authors: Chih-Yu
authors: CY
authors: Tseng
mesh_terms: D000328:Adult; D002423:Cause of Death; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D015989:Healthy Worker Effect; D006801:Humans; D007221:Industry; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D009820:Ohio / Q000453:epidemiology; D016016:Proportional Hazards Models; D011839:Radiation, Ionizing; D017678:Sex Distribution; D014501:Uranium; D055815:Young Adult
chemical_list: D014501:Uranium