The Problem with NAS/IOM Reviews of Gulf War Illness

November 17, 2009 (VeteransToday) Spent the day deep in research and as we all know there is a problem in River City this time it is the Potomac River ie DC.  Over and over again Gulf War Veterans have identified a central problem with the NAS/IOM [National Academy of Science / Institute of Medicine] studies that is Huge and Gaping!  The NAS/IOM only is allowed to review published peer reviewed journal articles of research.  As anyone knows a great deal of research is never published in peer reviewed journals!  Below is a critique of the problem with DU studies and items missed.

"Curiously, [VA's Dr. Melissa] McDiarmid does not mention a special and very prominent review of Department of Energy occupational epidemiological studies undertaken at the request of the President in July 1999 (National Economic Council,Interagency Working Group No. 1, January, 2000). This review made a special effort to search out published and unpublished papers, which were not readily available in the literature. Over the years, several important papers sponsored by the DOE that reported significant risks associated with workplace exposures at U.S. nuclear weapons sites were not published and remained buried.

The IOM study apparently could not perform the kind of literature review relative to occupational epidemiologic studies of uranium process workers that was done for the White House in early 2000. Had they done so, perhaps they may have come to different conclusions. "  Are the veterans of the Gulf War(1990-91) not entitled to have an agency that finds even the unpublished research studies and other government reports that might give answers to their health problems.  This is what happens when you have the science, politics, hidden agendas of corporations, and the economics and cost factor interfere with the truth.  Our Veterans deserve the very best regardless of interfering factors! 

In her review of the risks of depleted uranium to occupational groups, Dr. Mc Diarmid concludes that "Fifty years' study of occupational exposure provides little evidence of cancer." Curiously, McDiarmid does not mention a special and very prominent review of Department of Energy occupational epidemiological studies undertaken at the request of the President in July 1999. ( National Economic Council,Interagency Working Group No. 1, January, 2000). This review made a special effort to search out published and unpublished papers, which were not readily available in the literature. Over the years, several important papers sponsored by the DOE that reported significant risks associated with workplace exposures at U.S. nuclear weapons sites were not published and remained buried. The IOM study apparently could not perform the kind of literature review relative to occupational epidemiologic studies of uranium process workers that was done for the White House in early 2000. Had they done so, perhaps they may have come to different conclusions.

A careful review of the interagency report would have revealed significant findings relative to uranium-exposed workers. For instance:

Oak Ridge Y-12 weapons Plant, Tennessee. Total mortality was low as expected for this group, indicating a "healthy worker effect." The study also found elevated death rates for brain cancer, several lymphopoetic (immune system) cancers, as well as cancers of the prostate, kidney and pancreas. Excess death from breast cancer among women was found. The authors found excess lung cancer as their main finding and urged that this disease warrants continued surveillance An earlier study found similar risks, with a marginal dose-response trend for lung cancer only. (Dana P. Loomis and Susanne H. Wolfe, Mortality of Workers at a Nuclear Materials Production Plant at Oak Ridge, Tennessee, 1947-1990, American Journal of Medicine, 1996, 29:131-141,Harvey Checkoway, Neil Pierce, Douglas J. Crawford-Brown, and Donna Cragle, Radiation Doses and Cause-Specific Mortality Among Workers at a Nuclear Materials Fabrication Plant, American Journal of Epidemiology, 1998, 127:2:255-266.)

The K-25 Gaseous Diffusion Plant, Tennessee. Excess risks of dying from all causes were found for white males when compared to general population rates. Other statistically significant increases among white males were for cancers of the respiratory system, bone cancer, mental disorders and all respiratory diseases including pneumonia. Generally the excess deaths from diseases among females were similar to males. Upon further analysis, increased risks of dying from kidney cancer and chronic nephritis (kidney disease) was found. The latter condition was more than 600 percent higher when deaths from the last decade of followup was observed.(Elizabeth A. Dupree, Susan M. Wells, Janice P. Watkins, Phillip W. Wallace, Nancy C. Davis, Mortality Among Workers Employed between 1945 and 1984 at a Uranium Gaseous Diffusion Facility, Draft Report, Oak Ridge Institute for Science and Education. ( no date))

Fernald Uranium Processing Plant, Ohio. Significant increased risks of dying from stomach cancer were found among salaried workers (261 percent higher than expected). For hourly workers statistically significant increased death risks were found for all cancers (21 percent higher) and lung cancer (26 percent higher). The authors concluded that there is evidence of a radiation-dose relationship for both nonmalignant respiratory diseases and lung cancer. (Donna L. Cragle, Janice P. Watkins, J. Nicholas Ingle, Kathryn Robertson-Demers, William G.. Tankersley, Charles M. West, Mortality Among a Cohort of White Male Workers at a Uranium Processing Plant: Fernald Feed Materials Production Center [FMPC], Radiation Research ( not sure if it is published))

Linde Air Products Co., NY. Statistically significant increased risks of dying from all causes (18 percent higher), laryngeal cancer (447 percent higher), all circulatory diseases (18 percent higher), arteriosclerotic heart disease (19 percent higher), all respiratory diseases (52 percent higher) and pneumonia (217 percent higher) were found among workers who processed uranium at this facility between 1943 and 1949. (Elizabeth A. DuPree, Donna Cragle, Richard, W. McLain, Douglas Crawford-Brown, M. Jane Teta, Mortality among workers at a uranium processing facility, the Linde Air Products Company Ceramics Plant, 1943- 49, Scandinavian Journal of Worker and Environmental Health, 1987, 13:100- 107.)

Mallinkrodt Chemical Works, Missouri. Workers who processed uranium between 1942 and 1966 were found to have a significant increased death rate from all cancers (10 percent higher). Respiratory diseases, chronic nephritis/kidney disease (218 percent higher) and lymphatic cancers were significantly elevated. In particular, significant increased risks were found for cancers of the esophagus (40 percent higher), rectum (45 percent higher), pancreas (31 percent higher), larynx (36 percent higher) kidney (34 percent higher) and multiple myeloma/bone marrow (33 percent higher). Kidney cancer showed a significant positive dose-response association with external radiation. (E. DuPree Ellis, J.P. Watkins, J.N. Ingle, J.A. Phillips, External Radiation Exposure and Mortality Among a Cohort of Uranium Processing Workers, Oak Ridge Associated Universities, Oak Ridge TN, (unpublished report).

It is remarkable that this White House review was not mentioned by McDiarmid since it recieved widespread attention as it prompted the Department of Energy to officially concede on January 29, 2000 that it's nuclear weapons workers were placed at risk of increased disease and death. This Presidential review also served as an underpinning for the recent creation of a major worker compensation entitlement program by the U.S. Congress -- which specifically grants a non-rebuttable presumption for 22 listed cancer to uranium process workers exposed to recycled uranium,(contaminated with isotopes such as plutonium-239, neptunium-237, and Tectnicium 99) which now apparently has been measured in depleted uranium found on the battlefields of the Balkans and the Persian Gulf.

Written by Robert Alvarez