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A Cohort Study of Thyroid Disease in Relation to Fallout From Nuclear Weapons Testing
Richard A. Kerber, PhD;
John E. Till, PhD;
Steven L. Simon, PhD;
Joseph L. Lyon, MD, MPH;
Duncan C. Thomas, PhD;
Susan Preston-Martin, PhD;
Marvin L. Rallison, MD;
Ray D. Lloyd, PhD;
Walter Stevens, PhD
JAMA. 1993;270(17):2076-2082.
Abstract
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Objective.
—To estimate individual radiation doses and current thyroid disease status for a previously identified cohort of 4818 schoolchildren potentially exposed to fallout from detonations of nuclear devices at the Nevada Test Site between 1951 and 1958.
Design.
—Cohort analytic study.
Setting.
—Communities in southwestern Utah, southeastern Nevada, and southeastern Arizona.
Participants.
—Individuals who were still residing in the three-state area (n=3122) were reexamined in 1985 and 1986, and information on the subjects' and their mothers' milk and vegetable consumption during the fallout period was obtained by telephone interview (n=3545). After exclusions to eliminate missing data and confounding factors, 2473 subjects were available for analysis.
Main Outcome Measures.
—Individual radiation doses to the thyroid were estimated by combining consumption data with radionuclide deposition rates provided by the US Department of Energy and a survey of milk producers. Relative risk models adjusted for age, sex, and state were fitted using maximum likelihood to period prevalence data for thyroid carcinomas, neoplasms, and nodules.
Results.
—Doses ranged from 0 mGy to 4600 mGy, and averaged 170 mGy in Utah. There was a statistically significant excess of thyroid neoplasms (benign and malignant; n=19), with an increase in excess relative risk of 0.7% per milligray. A relative risk for thyroid neoplasms of 3.4 was observed among 169 subjects exposed to doses greater than 400 mGy. Positive but nonsignificant dose-response slopes were found for carcinomas and nodules.
Conclusions.
—Exposure to Nevada Test Site—generated radioiodines was associated with an excess of thyroid neoplasms. The conclusions are limited by the small number of exposed individuals and the low incidence of thyroid neoplasms.
(JAMA. 1993;270:2076-2082)
Author Affiliations
From the Department of Family and Preventive Medicine (Drs Kerber and Lyon), the Department of Pediatrics (Dr Rallison), the Department of Radiobiology (Dr Lloyd), and the Department of Anatomy (Dr Stevens), University of Utah, Salt Lake City; the Radiological Assessments Corporation, Neeses, SC (Dr Till); the Nationwide Radiological Study, Republic of the Marshall Islands (Dr Simon); and the Department of Preventive Medicine, University of Southern California, Los Angeles (Drs Thomas and Preston-Martin).
Footnotes
Reprint requests to the Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84132 (Dr Kerber).
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