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From the April 10, 1998 edition of the Bulletin Refinements
to Roster, Protocols Delay Worker Cancer Assessment
The assessment
that the U.S. Department of Energy (DOE) has initiated with the New York
State Cancer Registry to look at the incidence of cancer among BNL
employees, past and present, is on target for completion by the end of
the summer. Cliff Strader,
an epidemiologist in DOE’s Office of Epidemiologic Studies (OES), came
to BNL last January 29, to participate in employee briefings about the
assessment. In devising the protocols for the assessment, OES staffers
conferred with Laboratory and DOE personnel at Brookhaven. Strader also
worked with BNL’s Human Resources (HR) Division to create a
computerized database of all of BNL’s current and former employees,
who number over 21,200. Although the
original plan was to forward the roster to the Cancer Registry shortly
after the meetings and to have results of the assessment early this
summer, Strader now expects to send the roster to the Cancer Registry in
May. He explained
that three factors have contributed to the delay. First, at the January
meetings, some employees expressed concern about their names’ being
included on the roster. So, the submittal was delayed at least two weeks
to give employees who wished to have their names removed from the roster
time to follow through. One employee
did not want to participate, Strader said, and that individual’s
record will be removed from the roster before it is sent to the Cancer
Registry. During this
period, Strader also began a quality review of the roster, which was the
second contributing factor to the delay. “I found a number of possible
typos and logic errors, that needed to be double-checked,” he said.
For example, Strader noticed what seemed like an unusually high number
of employees born in the 1800s. He included that as one of the queries
that he has sent to HR, but it turned out that no error had been made:
When BNL started up in 1947, many of the new hires were in their 50s
and60s, and so would have been born at the end of the previous century.
Some of Strader’s other concerns, however, require more work on HR’s
part. But Strader says the double-checking is important because,
“before we send the roster to the Registry, we want it to be as free
from errors as we can make it.” The third
factor contributing to the delay arose from concerns about the
assessment’s protocol that were raised by two outside organizations.
On March 4, DOE’s on-site Brookhaven Group received a letter from
Standing for Truth About Radiation (STAR) asking for an independent
review of the protocol. DOE agreed to delay the beginning of the
assessment until March 31, to permit the review. By March 31,
DOE had received two sets of comments, one from STAR and one from the
Community Alliance for Laboratory Accountability (CALA), an umbrella
group of 28 local organizations, including STAR, which was formed in
January. “Their
reviews of the protocol seem to reflect the desire for a full study,”
Strader said, “and this protocol was clearly not designed to be a full
analytical study. That’s because, while DOE can choose to conduct
limited, short-term rate assessments on its own, major epidemiologic
studies of the DOE work force are selected and conducted independently
by the Centers for Disease Control (CDC) and Prevention’s National
Institute for Occupational Safety and Health [NIOSH] to ensure the
independence of the studies and their results.” To this end,
he explained, DOE has a memorandum of understanding with CDC and funds
CDC to conduct full epidemiologic studies of exposures and health
outcomes at DOE sites. Thus, Strader
said, “a study such as the one recommended by STAR and CALA would be
performed by our counterparts at NIOSH or by a grantee or contractor
selected by them as part of its overall health research program at DOE
sites conducted under the memorandum of understanding. Should NIOSH
undertake a full study, DOE will cooperate fully to facilitate the
research and provide any assistance it can to ensure that workers, the
community and other stakeholders are provided with the study results in
a timely manner.” As to the
recommendations made by CALA and STAR, Strader acknowledged, “Some of
their recommendations are feasible for the cancer rate assessment so we
are incorporating them into the protocol.” For example, the protocol
is being revised to have the Cancer Registry look at the relationship
between cancer rates and duration of employment; compare cancer rates at
BNL separately with Suffolk and Nassau Counties, rather than combining
both counties for the comparison; and explicitly incorporate additional
cancer types for analysis As to that
last point, Strader said, “Some confusion may have arisen because we
presented a recommended minimum list of cancers that have been
identified as strongly associated with radiation exposure, but we fully
expect the analysis to examine all cancer types if there are enough
cases to permit analysis. That determination will have to be made by
Cancer Registry staff based on their direct experience with identifying
cases from their computerized database.” |
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