History of Dose, Risk, and Compensation Assessments for US Veterans of the 1966 Plutonium Cleanup in Palomares, Spain

Implications of Recent Epidemiological Studies for Compensation of Veterans Exposed to Plutonium

ABSTRACT

The objective of this paper is to compare post-2007 epidemiological results for plutonium workers to risk predicted by the software program NIOSH-IREP (IREP for short), which is used to determine the lowest dose for a US veteran to obtain cancer compensation. IREP output and methodology were used to predict excess relative risk per Gy (ERR Gy -1 ) for lung cancer at the 99 th credibility percentile, which is used for compensation decisions. Also estimated were relative biological effectiveness factors (RBE) predicted for workers using IREP methodology. IREP predictions were compared to results for Mayak and Sellafield plutonium workers, separately and pooled. Indications that IREP might underpredict 99 th -percentile lung cancer plutonium risk came from (1) comparison of worker RBEs and (2) from comparison of Sellafield results separately. When Sellafield and Mayak data were pooled, ERR Gy -1 comparisons at the 99 th percentile roughly matched epidemiological data with regression dose range restricted to < 0.05 Gy, the most relevant region to veterans, but overpredicted for the full dose range. When four plausible distributions for lung cancer risk, including both new and old data, were combined using illustrative weighting factors, compensation cutoff dose for lung cancer matched current IREP values unless regression results below 0.05 were chosen for Sellafield, producing a two-fold reduction. A 1997 claim of a dose threshold in lung cancer dose response was not confirmed in later literature. The benefit of the doubt is given to claimants when the science is unclear. The challenge for NIOSH-IREP custodians is dealing with the Sellafield results, which might best match US claimants.

The Sound of Silence: Unspoken Meaning in the Discourse of Pregnant and Breastfeeding Women on Environmental Risks and Food Safety in Spain

(1) Background: In recent years, a growing number of qualitative health research studies have performed discourse analysis of data from participants’ narratives. However, little attention has been paid to the gaps and silences within these narratives. The aim of the present study is to interpret the silences detected in the discourse of pregnant and breastfeeding women concerning environmental risks and food safety. (2) Methods: This descriptive, interpretive, observational study was conducted according to a qualitative research paradigm and from a phenomenological and ethnographic perspective. The study sample was composed of 88 intentionally selected women, among whom fifty interviews, three ethnographies and five focus groups were conducted. Data coding and analysis were performed using N-Vivo 12 software. (3) Results: The results obtained show that the women’s discourse presented silences that reflected their minimisation of perceived environmental and food risks. However, these women were wary of food produced in the proximity of contaminated areas. Nevertheless, the participants believed they were powerless to overcome environmental pollution and the potential contamination of their own bodies. (4) Conclusions: The participants’ minimisation of the environmental risks faced and their inaction in this respect are sustained by the biopolitical practices of public institutions, which have propelled these women into a situation of learned helplessness and social injustice.