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Brian Vastag

JAMA. 2002;287:3070.

The US Department of Health and Human Services has issued final rules under which federal workers exposed to radiation will be compensated for job-related cancer. Since the late 1940s, hundreds of thousands of government employees and contractors may have received harmful doses of radiation at nuclear weapons test sites and manufacturing plants.

Because the rules cover the early Cold War through the 21st century, the true number encompassed by the law is impossible to calculate, said Larry Elliott, MPH, director of the Office of Compensation Analysis and Support at the Centers for Disease Control and Prevention (CDC). "Six hundred thousand is probably a low estimate," he said. Given that roughly 25% of the US population receives a diagnosis of cancer at some time, more than 150 000 former employees and their families could eventually qualify, he said.

That huge figure has Elliott's office preparing for an onslaught. He is hiring health physicists to help reconstruct radiation exposure histories for each claimant. While simple cases may take just a few days, Elliott said complicated cases could take 6 months or more. The estimated exposure figures are then fed into computer models that predict the probability that radiation caused the cancer. Any federal employee with cancer for whom there is at least a 50% chance that the disease was caused by workplace radiation will qualify for compensation—$150 000 plus coverage of future medical bills.

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