The Radiation Exposure Compensation Act (RECA) was set up by Congress in 1990 to compensate people who have been diagnosed with specified cancers and chronic diseases that could have resulted from exposure to nuclear-weapons tests at various U.S. test sites. Eligible claimants include civilian onsite participants, downwinders who lived in areas currently designated by RECA, and uranium workers and ore transporters who meet specified residence or exposure criteria. The Health Resources and Services Administration (HRSA), which oversees the screening, education, and referral services program for RECA populations, asked the National Academies to review its program and assess whether new scientific information could be used to improve its program and determine if additional populations or geographic areas should be covered under RECA. The report recommends Congress should establish a new science-based process using a method called "probability of causation/assigned share" (PC/AS) to determine eligibility for compensation. Because fallout may have been higher for people outside RECA-designated areas, the new PC/AS process should apply to all residents of the continental US, Alaska, Hawaii, and overseas US territories who have been diagnosed with specific RECA-compensable diseases and who may have been exposed, even in utero, to radiation from U.S. nuclear-weapons testing fallout. However, because the risks of radiation-induced disease are generally low at the exposure levels of concern in RECA populations, in most cases it is unlikely that exposure to radioactive fallout was a substantial contributing cause of cancer.

During the 18-year program of atmospheric testing of nuclear weapons (1945-1962), some of the 225,000 participants were exposed to radiation. Many of these participants have been experiencing sicknesses that may be test-related. Currently, test participants who had served in military units have pending over 6,000 claims for compensation at the Department of Veterans Affairs. This study presents improved methods for calculating the radiation doses to which these individuals were exposed, and are intended to be useful in the adjudication of their claims.

More than 200,000 U.S. military personnel participated in atmospheric nuclear weapons tests between 1945 and the 1963 Limited Nuclear Test Ban Treaty. Questions persist, such as whether that test participation is associated with the timing and causes of death among those individuals. This is the report of a mortality study of the approximately 70,000 soldiers, sailors, and airmen who participated in at least one of five selected U.S. nuclear weapons test series1 in the 1950s and nearly 65,000 comparable nonparticipants, the referents. The investigation described in this report, based on more than 5 million person-years of mortality follow-up, represents one of the largest cohort studies of military veterans ever conducted.

In 1986, officials of the US Department of Energy revealed that the Hanford Atomic Products Operations in Richland, Washington, had been releasing radioactive material, in particular iodine-131, into the environment over a period of years. This information, which confirmed the suspicions of some people in the Pacific Northwest about what they called the Hanford Reservation or just Hanford, created quite a stir. Both the US Congress and citizens of the Northwest became keenly interested in knowing whether these radiation releases had caused human health effects. They were particularly concerned about whether Hanford releases of iodine-131 had led to an increase in thyroid disease among the population of the area. In 1988, Congress ordered a study of the human health effects of exposure to the iodine-131 released from Hanford. Funded by the Centers for Disease Control and Prevention (CDC), the study was carried out by the Seattle-based Fred Hutchinson Cancer Research Center over the last decade. The study examined estimate of exposure of the thyroid and rates of thyroid disease because iodine-131 concentrates in the thyroid and that organ would be the best indicator of radiation damage in the population. The Centers for Disease Control and Prevention (CDC) asked the National Academy of Sciences-National Research Council (NAS-NRC) to give an independent appraisal of the study methodology, results, and interpretation and of the communication of the study results to the public. Review of the Hanford Thyroid Disease Study Draft Final Report constitutes the response of the NRC subcommittee to that request. To respond to the charge, the NRC subcommittee felt that it needed to go beyond the specific questions addressed to it by CDC and develop a broad understanding and critique of the HTDS and the Draft Final Report. As part of those activities, the subcommittee solicited comments from outside experts and members of the public primarily in a public meeting held in Spokane, Washington, in June 1999, where 14 scientists and members of the public made formal presentations to the subcommittee about various aspects of the Draft Final Report. Other members of the public also spoke during four open-comment sessions at the meeting. In addition, efforts were made to evaluate all information materials prepared for the public and additional CDC communication plans. Information was gathered through interviews with journalists, members of concerned citizen groups in the Hanford region, members of the CDC scientific and media staff in Atlanta, and the HTDS investigators. In this summary, the main points follow the structure of our report and are presented under several headings: epidemiologic and clinical methods and data collection, dosimetry, statistical analyses, statistical power and interpretation of the study, and communication of the study results to the public. We then provide a brief synopsis of our response to the questions raised by CDC.

Exposures at low doses of radiation, generally taken to mean doses below 100 millisieverts, are of primary interest for setting standards for protecting individuals against the adverse effects of ionizing radiation. However, there are considerable uncertainties associated with current best estimates of risks and gaps in knowledge on critical scientific issues that relate to low dose radiation. The Nuclear and Radiation Studies Board of the National Academies hosted the symposium on The Future of Low Dose Radiation Research in the United States on May 8 and 9, 2019. The goal of the symposium was to provide an open forum for a national discussion on the need for a long-term strategy to guide a low dose radiation research program in the United States. The symposium featured presentations on low dose radiation programs around the world, panel discussions with representatives from governmental and nongovernmental organizations about the need for a low dose radiation research program, reviews of low dose radiation research in epidemiology and radiation biology including new directions, and lessons to be learned from setting up large research programs in non-radiation research fields. This publication summarizes the presentation and discussion of the symposium.

This book is the seventh in a series of titles from the National Research Council that addresses the effects of exposure to low dose LET (Linear Energy Transfer) ionizing radiation and human health. Updating information previously presented in the 1990 publication, Health Effects of Exposure to Low Levels of Ionizing Radiation: BEIR V, this book draws upon new data in both epidemiologic and experimental research. Ionizing radiation arises from both natural and man-made sources and at very high doses can produce damaging effects in human tissue that can be evident within days after exposure. However, it is the low-dose exposures that are the focus of this book. So-called “late” effects, such as cancer, are produced many years after the initial exposure. This book is among the first of its kind to include detailed risk estimates for cancer incidence in addition to cancer mortality. BEIR VII offers a full review of the available biological, biophysical, and epidemiological literature since the last BEIR report on the subject and develops the most up-to-date and comprehensive risk estimates for cancer and other health effects from exposure to low-level ionizing radiation.