Mortality of Veteran Participants in the CROSSROADS Nuclear Test

Author: Crawford, Harriet; Page, William F.; Thaul, Susan; Johnson, J. Christopher
Publisher: National Academies Press
ISBN: 9780309055963
eISBN Pdf: 9780309589772
eISBN Epub: 9780309175173
Place of publication: United States
Year of digital publication: 1996
Month: November
Pages: 160
DDC: 350
Language: English

Caption

In 1946, approximately 40,000 U.S. military personnel participated in Operation CROSSROADS, an atmospheric nuclear test that took place at Bikini Atoll in the Marshall Islands. Congress passed a law directing the Veterans Administration to determine whether there were any long-term adverse health effects associated with exposure to ionizing radiation from the detonation of nuclear devices. This book contains the results of an extensive epidemiological study of the mortality of participants compared with a similar group of nonparticipants. Topics of discussion include a breakdown of the study rationale; an overview of other studies of veteran participants in nuclear tests; and descriptions of Operation CROSSROADS, data sources for the study, participant and comparison cohorts, exposure details, mortality ascertainment, and findings and conclusions.

Mortality of Veteran Participants in the Crossroads Nuclear Test
Copyright
Preface
Acknowledgments
Glossary and Acronyms
Contents
Summary
1 Study Rationale and Overview
- RATIONALE
- OVERVIEW
2 Other Studies of the Human Health Effects of Radiation Exposure
3 Epidemiology Primer
- CHOICE OF COMPARISON GROUP
- FINE TUNING OF EXPOSED GROUP
- CONFOUNDERS
- DATA COLLECTION
- INTERPRETING DATA FINDINGS
- EPIDEMIOLOGY SUMMARY RELATED TO THIS STUDY
4 Description of Operation Crossroads
5 Data Sources for the Crossroads Study
6 The Participant Cohort
- INDEPENDENT VERIFICATION OF PARTICIPANT COHORT
- EXCLUSION OF "POST-CROSSROADS" PARTICIPANTS
- CROSSROADS PARTICIPANTS WHO PARTICIPATED IN OTHER NUCLEAR TESTS
- PRIMARY ANALYSIS—NAVY PERSONNEL ONLY
- EXCLUSIVITY OF PARTICIPANT AND COMPARISON COHORTS
7 The Comparison Cohort
- COMPARISON COHORT SELECTION
  - Navy and Shipboard Marines
  - Army and Army Air Corps
- MILITARY PERSONNEL RECORDS
- ADDITIONAL CONTROLS
8 Exposure Definition, Measurement, and Verification
- INTRODUCTION
- DOSIMETRY BACKGROUND
  - Definition of Potential Surrogate Dose Groups
  - DNA-Provided Dose Estimates
    - Overall
    - Alternatives
- PARTICIPANT VERSUS NONPARTICIPANT COHORTS AS AN EXPOSURE SURROGATE
- BOARDERS VERSUS NONBOARDING PARTICIPANTS VERSUS NONPARTICIPANTS AS EXPOSURE SURROGATES
- ENGINEERING & HULL VERSUS OTHER SPECIALTY STATUS AS AN EXPOSURE SURROGATE
- RELATIONSHIPS OF SURROGATES WITH DNA DOSE DATA
- DECISIONS FOR THE ANALYSES IN THIS REPORT
9 Mortality Ascertainment
- PROCEDURE
  - Vital Status Ascertainment
  - Cause and Date-of-Death Ascertainment
- SUMMARY OF MORTALITY ASCERTAINMENT QUALITY AND ITS POTENTIAL EFFECTS ON VALID INTERPRETATION OF THE...
10 Characterization of the Cohorts and Analysis Plan
- DATA DECISIONS TAKEN BEFORE ANALYSIS
  - Restricting Data Elements or Sample Definition
  - Data Cleaning and Variable Development
- UNIVARIATE DESCRIPTIONS OF STUDY POPULATION
- MISSING DATA
  - Imputation of Fact and Date of Death
  - Imputation of Date of Birth
  - Summary
  - COMPLETENESS OF VITAL STATUS ASCERTAINMENT
- MORTALITY COMPARISONS
- MULTIVARIATE ANALYSES
  - Cox Proportional Hazards Model
  - Standardized Mortality Ratios
- ANALYSIS OF ARMY (INCLUDING ARMY AIR CORPS) AND MARINE DATA
- NOT THE SUBJECT OF ANALYSIS IN THIS REPORT
11 Findings and Discussion
- ORGANIZATION
- FINDINGS: DISPLAYED IN TABLES
- NARRATIVE SUMMARY OF FINDINGS
  - Participant Status
  - Boarder Status/Hypothesized Exposure Gradient
  - Engineering & Hull Status/Hypothesized Exposure Surrogate
- FINDINGS FOR MARINES AND ARMY (INCLUDING ARMY AIR CORPS) PERSONNEL
- DISCUSSION
  - Boarders
  - Engineering & Hull
  - Discussion of Other Findings
  - Other Models and Parameters Considered During Analysis
- STANDARDIZED MORTALITY RATIOS
- DISCUSSION RRELATING THESE FINDINGS TO THOSE OF SIMILAR STUDIES
  - Findings in Other Studies of Atomic Veterans
  - Selection Bias as an Explanation for Increased Participant All-Cause Mortality
- AVENUES OF FURTHER EXPLORATION
12 Conclusions
- SUMMARY OF FINDINGS
References
A National Association of Atomic Veterans (NAAV) Medical Survey
B Participant Description (DNA Memorandum dated July 11, 1994)
- EXPLANATORY MEMORANDUM
  - Background
  - Operational Period and Operational Area
- SOURCES OF PARTICIPANT INFORMATION
- TRACKING OF PARTICIPANTS
- REFINEMENT OF THE INITIAL DATA BASE
- PARTICIPATION DATES AND DOSE RECONSTRUCTING
- DOSE RECONSTRUCTION
- ENGINEER RATINGS
- SOURCE CODES
- PARTICIPATING UNIT/PERMANENT UNIT DATA
- COMMANDER JOINT TASK FORCE (CJTF-1) MEDICAL RESEARCH PERSONNEL, BOARDING TEAM AND RADSAFE TEAMS
C Standardized Mortality Ratios
D Radiation Doses for CROSSROADS Participants and Exposure Surrogate Groups
E Verification of Completeness and Accuracy of the Participant Roster
- INTRODUCTION
- METHODOLOGY
  - Comparison to Previous Versions of the Participant Roster
  - Comparison of Participant Roster to National Association of Atomic Veterans (NAAV) Mortality Study List
  - Comparison of DNA Participant Roster to a List of Participants Solicited through Veterans' Journals
  - Individual Follow-Up on Putative Participants of Uncertain Status
- RESULTS
  - Comparison with an Earlier Version of the Participant Roster
  - Comparison with the NAAV Medical Survey
  - Comparison with the Write-in List
  - Follow-Up on Putative Participants of Uncertain Status
- DISCUSSION
- CONCLUSION
F Verification of Completeness and Accuracy of Mortality Ascertainment
- ASSESSMENT OF COMPLETENESS
  - Completeness of Mortality Follow-Up
- ASSESSMENT OF VALIDITY
  - Mortality Ascertainment
    - HCFA
    - NDI
- EXTERNAL VALIDATION DISCUSSION
  - Mortality Information
  - Cause-of-Death Information

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