pe ACSIEIEA The Task Force ists revealed records of past accidents, melted fuel, radioactive contamination, and violations of safe oper- . ating procedures. Major environmental and safety vio- | lations, and evidence ofwidespread contamination, were found at almost every major DOE facility. The agency admitted that it had been “imbued with a dedication to the production of nuclear weapons withouta real sensitivity for protecting the environment.” Our concerns about the DOE’s epidemiologic studies—the bulwark of its assertions that there was no serious excess risk to nuclear weapons workers— intensified. PSR’s Physicians Task Force on the Health Risks of Nuclear Weapons Production In response to growing concerns about the DOE?’s weapons complex, Physicians for Social Responsibility formed a Task Force ofphysicians, epidemiologists and other scientists, both from within and outside PSR membership. This Task Force had three mandates: l.to examine the AEC/ERDA/DOE record of epidemiologic studies of health, safety and environmental issues in the nuclear weapons production complex, and to identify and explore problems of medical and public health concern; 2.to review DOE managementpolicies and evaluate the conduct of promised reforms; and 3. to make recommendations to the medical andscientific communities and to the general public on the management,activines, proposed reconfiguration and “cleanup” of the complex. The present report addresses the first of these objectives. epidemiologic work or prepare a report on ail the methodological, analytic and interpretive issues raised by each publication. Instead, it undertook a search for overall patterns in this research—the systematic pat- terns that might be found in its methodologies,its procedures for acquiring and tecording basic surveillance data,its inclusions or exclusionsof data,its selec- tion of problemsfor study, and its modesof inference, interpretation and emphasis in reaching conclusions. This is a search for generic or systematic strengths and faults in the way the entire process of epidemiologic investigation has been designed and conducted by the DOE and its predecessor agencies. The objective was to reach a judgment on a central issue: the adequacy of the DOE program in relation to the goals of worker and public health protection, and in relation to the development of further scientific knowledge of the effects on human health of low-level ionizing radiation. The Task Force focused on studies of workers in the nuclear weapons complex. The intended audience of its report is an informed general public. Major Findings of the Task Force Review The Task Force reviews identified five major patterns or problem areas in the AEC/ERDA/DOE epidemiologic studies ofthe nuclear weapons workforce, involving: 1. the accuracy and reliability of radiation dosimetry, the measurementand recording of exposures; 2. the coverage of the nuclear weapons workforce and of plant and laboratory sites by the studies; 3. the length of follow-up to determine the health outcomes of cohorts of nuclear workers; Methods and Objectives Over the past 30 months, the Task Force con- structed a relevant bibliography ofAEC/ERDA/DOE sponsored or contracted epidemiologic publications, developed and applied a standardized protocol for review, and critically analyzed 124 published AEC/ ERDA/DOE epidemiologic studies on nuclear weapons workers. We reviewed related scientific publications and controversies on the biologic effects of low-dose ionizing radianon and consideredtheir implications for the DOE workforce. We examined the work of earlier investigations of DOE epidemiologic research by independent committees and panels. The Task Force also assessed the adequacy of recent policy changes in the control and conduct of research. This report summarizes the Task Force’s findings and its epidemiologic and public policy recommendationsfor the future. 10 did not attempt a formal meta- analysis of the published AEC/ERDA/DOE 4. the consequences of the “healthy worker” effect, and of the focus on deaths rather than on disease incidence; and 5. the reliance on tests ofstatistical significance in the interpretation of studies necessarily involving relatively small numbers of subjects, and the resulung pattern of interpreting as benign—or dismissing— findings of excess cancer mortality. Radtation Dosimetry There appear to be major inaccuracies, and serious questions as to consistency and reliability, in the measurement and recording of the radiation exposures of nuclear weapons complex workers. Yet these are essen- tial elements on which occupational epidemiology studies depend. Methods ofcollecting and recording expo- DEAD RECKONING JUNCL Qaeeis Bigs Bunk . wi m7 oe * 2 ‘