This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (89)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Thomas E. Hamilton, MD, PhD; Gerald van Belle, PhD; James P. LoGerfo, MD, MPH

JAMA. 1987;258(5):629-636.

Abstract
We studied the risk of thyroid neoplasia in Marshall Islanders exposed to radioiodines in nuclear fallout from the 1954 BRAVO thermonuclear test. We screened 7266 Marshall Islanders for thyroid nodules; the islanders were from 14 atolls, including several southern atolls, which were the source of the best available unexposed comparison group. Using a retrospective cohort design, we determined the prevalence of thyroid nodularity in a subgroup of 2273 persons who were alive in 1954 and who therefore were potentially exposed to fallout from the BRAVO test. For those 12 atolls previously thought to be unexposed to fallout, the prevalence of thyroid nodules ranged from 0.9% to 10.6%. Using the distance of each atoll from the test site as a proxy for the radiation dose to the thyroid gland, a weighted linear regression showed an inverse linear relationship between distance and the age-adjusted prevalence of thyroid nodules. Distance was the strongest single predictor in logistic regression analysis. A new absolute risk estimate was calculated to be 1100 excess cases/Gy/y/1 x 10⁶ persons (11.0 excess cases/rad/y/1 million persons), 33% higher than previous estimates. We conclude that an excess of thyroid nodules was not limited only to the two northern atolls but extended throughout the northern atolls; this suggests a linear dose-response relationship.

(JAMA 1987;258:629-636)

Author Affiliations
From the Departments of Medicine (Drs. Hamilton and LoGerfo) and Biostatistics (Dr van Belle), University of Washington, Seattle.

Footnotes
The opinions, conclusions, and proposals in this article are those of the authors and do not necessarily represent the views of the Robert Wood Johnson Foundation or the Marshall Islands Atomic Testing Litigation Project.

Reprint requests to Occupational Medicine Program, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (Dr Hamilton).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Cohort Study of Thyroid Cancer and Other Thyroid Diseases after the Chornobyl Accident: Dose-Response Analysis of Thyroid Follicular Adenomas Detected during First Screening in Ukraine (1998-2000)
Zablotska et al.
Am J Epidemiol 2008;167:305-312.
ABSTRACT | FULL TEXT  

Thyroid Neoplasia, Autoimmune Thyroiditis, and Hypothyroidism in Persons Exposed to Iodine 131 From the Hanford Nuclear Site
Davis et al.
JAMA 2004;292:2600-2613.
ABSTRACT | FULL TEXT  

A 64-Year-Old Woman With a Thyroid Nodule
Mandel
JAMA 2004;292:2632-2642.
FULL TEXT  

Environment and health: 5. Impact of war
Leaning
CMAJ 2000;163:1157-1161.
FULL TEXT  

A Cohort Study of Thyroid Disease in Relation to Fallout From Nuclear Weapons Testing
Kerber et al.
JAMA 1993;270:2076-2082.
ABSTRACT  

Thyroid Cancer: A Lethal Endocrine Neoplasm
Robbins et al.
ANN INTERN MED 1991;115:133-147.
ABSTRACT