[ RadSafe ] Re: Incidence vs death question, was: Exposed " -had lower incidences of all cancers - "

[Keith Welch]

Thanks Floyd.  Just a clarification.  I didn't mean that workers were 
removed from employment at the yard after being diagnosed; just removed 
from rad-worker status, and therefore possibly excluded from making it 
into the exposed cohort.  I used to work at a shipyard also, and I knew 
one or two folks who were cancer patients while employed there.  My 
recollection is that the first thing that happened in that event was to 
"take them off badge".  What I'm wondering is how that might (if at all) 
have affected the probability of that person being included in the 
"exposed" cohort.  I wonder what the selection criteria were.  I was 
also told anecdotally of people who were excluded from nuclear worker 
status by pre-screening for family history.

Keith

Flanigan, Floyd wrote:
> Granted, I cannot claim to speak from personal experience when it comes
> to Shipyards, but I have had the pleasure of knowing and working with
> many people from that sector. To the best of my recollection, none of
> them ever related anything about either the selection process for
> workers involving any kind of family cancer history screening for
> screening applicants, nor did any relate anything about workers being
> removed from the "yards" after being diagnosed with cancer. I have
> personally worked with several cancer patients, some who died while
> working nuke. Mostly in the D.O.E. world. None of them were asked to
> leave their positions post diagnosis. So, from what I can relate, no.
> The two selection/exclusion factors from your post are not, in my
> experience, true.
>
> Floyd W. Flanigan B.S.Nuc.H.P.
>
> -----Original Message-----
> From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
> Behalf Of Keith Welch
> Sent: Thursday, January 25, 2007 1:01 PM
> To: radsafe at radlab.nl
> Subject: [ RadSafe ] Incidence vs death question, was: Exposed " -had
> lower incidences of all cancers - "
>
> Folks,
> I am not an epidemiologist and have no experience in that field.  But 
> recently, partly due to the posts here, I have been wondering about 
> this.  Maybe I just haven't thought it through well enough.  It seems on
>
> its face that using cancer incidence rates would be preferable to 
> mortality, due in part to the issue of changes over time in cure rates, 
> but also because it would seem to help correct for the healthy worker 
> effect (incidence rate is not as affected by the availability of health 
> insurance or treatment as mortality rate) - and possibly the "rich 
> victim effect", which I have not heard many people talk about, but 
> assume must be confounding; the difference in cure rates in different 
> socio-economic classes.  I would suppose that could probably be dealt 
> with by careful cohort selection.  At any rate, I've heard that the 
> shipyard worker study was flawed due to the following: (1) screening for
>
> nuclear workers at the shipyards disqualified people with family history
>
> of cancer, and (2) removal of people from nuclear worker status (and 
> therefore, presumably from candidacy for the study?) in the event they 
> were diagnosed with cancer during employment.  Are either of these based
>
> in fact?
>
> Keith Welch
> Jefferson Lab
>
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