Work package 2.1. Non-cancer morbidity and mortality among Mayak workers
Task 2.1.1 Identification of the cohort of workers first employed during 1948-1982 (SUBI, HPA)
The cohort of Mayak PA workers first employed at one of the main plants during 1948-1958 using the Mayak-Doses-2005dosimetry system was identified within the SOUL contract and will be used to analyse the risks of morbidity and mortality risks respiratory diseases under (b) above. The cohort that will be used to compare circulatory disease findings underMayak-Doses-2005 and Mayak-Doses-2008, ie. first employed at one of the main plants during 1948-1972, under (a) above was also identified under the SOUL contract
Task 2.1.2 Improvement (adjustment, verification, expansion) of the medical and dosimetry database on Mayak PA workers (SUBI, with input on procedures from HPA)
The “Clinic” database will be improved as follows:
Task 2.1.3 Quality control of the medical-dosimetry database (SUBI, HPA)
Routine quality control checks of the primary data and data entered into the “Clinic” medical-dosimetry database will be performed throughout the full period of compilation. Quality control of data will be based on techniques for error assessment developed and agreed upon in the process of establishing the database and developed further during the SOUL project, including checks for any errors in cohort identification, dosimetry (including occupational exposures in work other than at Mayak PA), vital status, residence status, non-radiation risk factors and errors in the identification/specification of diseases. Checks with other sources of data (e.g. on morbidity) will be undertaken.
Task 2.1.4 Analyses of mortality and morbidity risks due to circulatory and respiratory diseases among Mayak PA workers, including those first employed during 1948-1982 (SUBI, HPA)
Based on the outcomes of the preceding tasks, concerning the identification of the main cohort of Mayak PA workers first employed during 1948-1982 using new Mayak-Doses-2008 dosimetry system (Task 2.1.1), the collection and improvement of data (Task 2.1.2), and quality control checks (Task 2.1.3), an assessment will be made of the feasibility of conducting an analysis of mortality and morbidity risks for respiratory diseases in this cohort of Mayak PA workers followed-up to 31 December 2008 (by month 36). Subject to a satisfactory outcome of this feasibility phase, this analysis will be conducted (by month 48).
The preceding work will also allow an analysis to be performed of morbidity and mortality risks due to circulatory diseases in the cohort of Mayak PA workers first employed during 1948-1982 and followed to 31 December 2008 using the Mayak-Doses-2008 dosimetry system (by month 42).
Work package 2.2. Cancer incidence among Mayak workers
Task 2.2.1 Maintenance of the Medical-Dosimetry Register (SUBI)
The task implies continued maintenance of the Medical-Dosimetry Register, which comprises workers employed at the reactor, radiochemical and plutonium production facilities of Mayak PA in 1948-1982, verification of their vital status, accounting for all malignant neoplasms diagnosed while the cohort members were living in the city (including the post-mortem diagnoses), quality control of the data, verification of the histological type of a malignancy, and extension of the dosimetry data for those who are still working.
Task 2.2.2 Collection, verification and coding of information on cases with malignant neoplasms in MWC with follow-up of 2005-2008 (SUBI)
Cases with malignant neoplasms diagnosed in the study cohort during 2005-2008 will be collected, verified and coded into ICD-O. A report on the number of cases and information sources for verification is to be prepared by month 18. These data will be included in the preliminary analyses of WP3.4.
Task 2.2.3 Assessment of cancer morbidity risk in organs of plutonium main deposition: the lung, liver, skeleton (SUBI, HPA)
Cancer risk will be analysed in the cohort of Mayak PA workers first employed during 1948-1982 with the follow-up 31.12.2004 in the specified organs with regard to doses from external gamma-rays and internal alpha-radiation (usingMayak-Doses-2008). The report and a manuscript are to be prepared by month 12, and the paper will be submitted for publication by month 18.
Task 2.2.4 Assessment of morbidity risk for other solid cancers, except for the lung, liver, skeleton (SUBI, HPA)
The risk of all solid cancers combined, except for the lung, liver and skeleton, will be analysed in the cohort of Mayak PA workers first employed during 1948-1982 with the follow-up 31.12.2004 with regard to doses from external gamma-rays and internal alpha-radiation (using Mayak-Doses-2008). The report and a manuscript are to be prepared by month 24, and the paper will be submitted for publication by month 30.
Task 2.2.5 Assessment of hemolymphoblastosis morbidity risk (SUBI, HPA)
Cancer risk of specific sites, including leukaemia (except for CLL), CLL and multiple myeloma, will be analysed in the cohort of Mayak PA workers first employed during 1948-1982 with the follow-up 31.12.2004 with regard to doses from external gamma-rays and internal alpha-radiation (using Mayak-Doses-2008). The report and manuscripts are to be prepared by month 36, and the papers will be submitted for publication by month 42.
Task 2.2.6 Preparation of the final report on cancer risk in MWC (SUBI, HPA)
The final report on cancer risk based on the morbidity rates in the study cohort 1948-1982 with the follow-up 31.12.2008 and Mayak Doses-2008 is to be prepared by month 48.
Work package 2.3. Cause-of-death register Ozyorsk
The principal objective of WP2.3 is an extension of the cause-of-death register of Ozyorsk for the time period from 2006 to 2010, with continued monitoring of high data quality.
Task 2.3.1 Extension of the cause-of-death register for Ozyorsk population and maintenance of the primary data archive (SUBI)
Extension of the cause-of-death register consists of two phases:
Information on causes of death will be compiled on the paper files from medical certificates of the Civil Registry Office. Death causes will be double-coded in accordance with the 9th revision of International Classification of Diseases (ICD-9) by two independent coders at SUBI. All the primary data will be entered into the computer database of the cause-of-death register. The number of Ozyorsk residents expected to die in 2006-2010 is approximately 7000 individuals.
Task 2.3.2 Quality control checks of the cause-of-death register database of Ozyorsk population (SUBI, DCS)
It is very important to verify the validity and reliability of the information on causes of death to be entered into the database. Quality control checks will be based on error assessment techniques developed and agreed upon in the process of the database establishment, accounting for errors in identification/classification of diseases.
Task 2.3.3 Inter-laboratory comparison of the quality of death cause coding using ICD-9 (SUBI, DCS)
One of the most prominent objectives of the proposed work is ensuring that the applicable mortality data comply with the up-to-date requirements, reliable and comparable with the current international procedures of cause-of-death coding.
Task 2.3.4 Analysis of the mortality structure of Ozyorsk population (SUBI, DCS)
The mortality structure of the Ozyorsk population will be analyzed. Mortality rates of all death causes and the most significant ones (e.g. circulatory diseases, ICD-9 VII class; cancer diseases, ICD-9 II class; respiratory diseases, ICD-9 VIII class, and etc.) will be estimated with regard to the distributions by age, gender and workplace. Mortality rates will be compared for the Mayak workers and Ozyorsk population, and national rates in the Russian Federation.