Malignant melanoma at a scientific laboratory

The general consensus of the seven reviewers is that occupational exposures at Lawrence Livermore National Laboratory have not been established as a causal factor for the observed excess of malignant melanoma. Several observations support the impression that some or all of the observed melanoma excess may be attributable to intense surveillance and enhanced detection of early stage melanoma lesions. Since the incidence of melanomas among Laboratory employees has not diminished, an early harvesting effect is unlikely. This suggests the distinct possibility that localized, in situ melanomas that would normally not be detected are being reported, and that in the absence of this enhanced detection, many of these early stage lesions would show little or no clinical progression. This phenomenon would explain the continued high incidence of melanomas in the absence of a physical or chemical inciting cause. A key point in this reasoning is the issue of the rate of growth of early stage melanomas, and this point remains a key question for study. Even if the observed excess cannot be explained by detection bias, the reviewers agree that the Austin and Reynolds' study does not make a convincing case for occupational factors being a cause of the high melanoma incidence. 6 refs

A Mortality Study Of Employees Of The Nuclear Industry In Oak Ridge, Tennessee

An analysis was conducted of 27,982 deaths among 106,020 persons employed at four Federal nuclear plants in Oak Ridge, Tennessee between 1943 and 1984. The main objectives were to extend the evaluation of the health effects of employment in the nuclear industry in Oak Ridge to include most workers who were omitted from earlier studies; to compare the mortality experience among the facilities; to address methodological problems that occur when individuals employed at more than one facility are included in the analysis; and to conduct dose-response analyses for those individuals with potential exposure to external radiation. All cause mortality and all cancer mortality were in close agreement with national rates. The only notable excesses occurred for white males for lung cancer---standardized mortality ratio (SMR) = 1.18, 1849 deaths--- and nonmalignant respiratory disease (SMR = 1.12, 1568 deaths). A more detailed analysis revealed substantial differences in death rates among workers a..