A Plan To Reevaluate Risks To Miners From Radiation Exposure

The federal standard for limiting exposures to miners from radon daughters was reduced from 12 working level months (WLM) per year to 4 WLM per year in 1971. However, even at that time some researchers were concerned that the new limit would eventually be shown to result in an excess risk for lung cancer mortality in miners. The National Institute for Occupational Safety and Health (NIOSH) is now engaged in a comprehensive review of this topic. As the lead agency in this project, NIOSH has developed a work plan and established a work group to implement this plan. The procedure and specific considerations are outlined in the work plan for developing a comprehensive ionizing radiation standard recommendation for all miners, underground and surface. Such a recommendation will not only include estimates of health risks at various levels of exposure, but also appropriate recommendations for medical monitoring, sampling and analytical methods, sampling strategies, posting, engineering controls, personal protective equipment and recordkeeping. The work group has twenty-four members. Eleven members are NIOSH personnel representing six divisions of the Institute. The remaining thirteen members represent other federal agencies, specifically the Bureau of Mines of the Department of the Interior, the Mine Safety and Health Administration and the Occupational Safety and Health Administration of the Department of Labor, the Office of Radiation Protection of the Environmental Protection Agency, and the Bureau of Radiological Health of the Food and Drug Administration, Department of Health and Human Services. Several factors contributed to the decision to initiate this project. First, the efficacy of the current standard was considered. An initial study group was formed in the spring of 1980 by NIOSH to identify and evaluate articles that contained information on lung cancer mortality risks at and below the present permissible exposure limit. The conclusion drawn from their evaluation was that a two-fold excess risk of lung cancer mortality at and below 120 cumulative working level months (CWLM) of exposure to radon daughters is evident. This composite indication from selected studies was of sufficient magnitude to justify further evaluation. The study group, however, recognized that other studies and information must also be considered in a quantitative risk assessment which would form the basis for recommending an acceptable and feasible permissible exposure limit. A second factor in the decision to pursue further evaluation was the gaps in the current standard that had previously been identified by the Mine Safety and Health Administration (MSHA). These included lack of medical monitoring of underground miners and absence of regulations for surface miners. The seriousness of the health hazard relative to other hazards in mining was also considered. Along with exposures to silica and asbestos fibers, radiation was judged to be one of the major health hazards in mining, These combined factors constituted the justification to develop criteria and recommendations for improved mandatory health standards. The development process begins with a survey and review of the available world-wide information on the topic, including data and information developed by NIOSH. The end product of this review is to be a document that will contain an evaluation of the collected information and support for any recommendations that are made. To develop this document, the present work group has been divided into five task groups with the following emphases: Health Effects, Medical Aspects, Monitoring, Environmental Exposures, and Engineering Controls and Work Practices. The Health Effects task group is to evaluate the evidence from epidemiologic and animal studies of adverse health effects associated with all forms of ionizing radiation encountered in mining and milling operations. The "weight-of-evidence" of the results of all relevant and useful studies will be summarized, with the reasons for emphasizing the cited studies. The critical cells or tissues and the factors that should be considered in estimating the dose to these areas from various types of radiation will be identified. An evaluation will be made of the possible impacts of smoking and exposure to diesel exhaust on the determination of health effects related to radiation. The implications of biologically redundant dose in terms of the time between tumor initiation and death will also be analyzed. The Medical Aspects task group is to review the generally-accepted and the state-of-the-art medical technology for the detection of adverse health effects from ionizing radiation exposure. An evaluation will be made of the accuracy of urine and fecal analysis, wholebody counting, chromosome analysis and nose blows, as well as their usefulness for early detection of adverse health effects. Early detection is of little utility to the affected individual unless subsequent medical care can improve the prognosis. Recommendations for screening tests will be made after carefully considering the accuracy of the diagnostic procedures and the usefulness of early detection. Required recordkeeping and transfer rights will also be addressed. The Monitoring task group is to consider the state-of-the-art technology for the monitoring of occupational radiation exposures. Instrumentation, sampling strategies and analytical procedures will be reviewed for both personal and area sampling. The implications of the associated levels of confidence for non-compliance decisions will be evaluated. The discussion will also include an evaluation of the feasibility of replacing present monitoring systems with recent technology and the impact that a possible lower permissible exposure limit would have on monitoring requirements. The Environmental Exposure task group is to investigate the field procedures and mathematical methodologies which have been used to quantitate exposure levels to the various kinds of ionizing radiation. The magnitude and direction of the possible biases in past exposure assessments will be estimated. Specific attention will be given to the controversies concerning the quantification of the biological dose equivalent and the feasibility of recommending standards for mixed radiation exposures which use "rem" as the unit of measurement. The Engineering Controls and Work Practices task group will analyze the advantages and limitations of