Review of the Hanford Thyroid Disease Study Draft Final Report -- Copyright -- ACKNOWLEDGEMENTS -- Contents -- Public Summary -- BACKGROUND -- DESIGN OF THE HTDS -- Estimated Radiation Exposures -- Analysis of HTDS Data -- Statistical Power and the HTDS Interpretation -- Communication of HTDS Results to the Public -- Concluding Remarks -- Executive Summary -- BACKGROUND -- EPIDEMIOLOGIC AND CLINICAL METHODS AND DATA COLLECTION -- Conclusions: -- Recommendations: -- DOSIMETRY -- Conclusions: -- Recommendations: -- STATISTICAL ANALYSES -- Conclusions: -- Recommendations: -- STATISTICAL POWER AND INTERPRETATION OF THE STUDY -- Conclusions: -- Recommendations: -- COMMUNICATION OF THE STUDY RESULTS TO THE PUBLIC -- Conclusions: -- Recommendations: -- SUMMARY OF RESPONSES TO THE CDC'S QUESTIONS -- 1 Introduction -- 2 Overview of the HTDS Draft Final Report and Organization of the Committee's Report -- 3 Evaluation of Epidemiologic and Clinical Methods -- EVALUATION OF EPIDEMIOLOGIC METHODS -- MILK-CONSUMPTION ESTIMATION -- EVALUATION OF CLINICAL-DATA COLLECTION -- COMPLETENESS OF ASCERTAINMENT OF THYROID DISEASE -- SUSCEPTIBILITY FACTORS FOR THYROID DISEASE -- EVALUATION OF MORTALITY DATA -- AMERICAN INDIAN TRIBAL ISSUES -- 4 Evaluation of Dosimetric Methods and Results -- BACKGROUND -- HEDR CALCULATIONS OF ENVIRONMENTAL CONCENTRATIONS OF 131I FROM HANFORD AND RESULTING DOSES: ASSESSME... -- Source Term: -- Concentration of131I in Pasture Grass at Time of Fallout: -- Mean Time of Residence of 131I on Pasture Grass: -- Pasture Intake by Cows: -- Transfer Coefficient of 131I from Cow's Intake to Milk: -- Milk-Distribution Factor: -- Milk-Consumption Rate: -- Thyroid Dose Coefficient: -- HEDR DOSIMETRY-MODEL VALIDATION -- Thyroid Burdens -- Milk Concentrations -- Concentrations in Vegetation -- Concentrations in Air -- Conclusions.

Possible Underestimation or Overestimation of Doses -- DOSE UNCERTAINTIES -- 131I FROM THE NEVADA TEST SITE AND GLOBAL FALLOUT -- OTHER SOURCES OF RADIATION EXPOSURE -- 5 Evaluation of Statistical Data Analysis -- MODE OF PRESENTATION OF RESULTS -- TYPES OF ANALYSES AND RELATED DOSIMETRY-ERROR ISSUES -- ANALYSIS OF POTENTIAL CONFOUNDING OR EFFECT-MODIFYING VARIABLES -- ASSUMPTION OF EQUIVALENT RADIATION EFFECT FOR MALES AND FEMALES -- ANALYSES BY AGE AT EXPOSURE -- OUT-OF-AREA ANALYSES -- GEOSTRATUM VERSUS DISEASE -- GENERAL-POPULATION COMPARISON AND SCREENING ISSUES -- ANALYSES OF SOURCE OF PERSONAL-EXPOSURE INFORMATION -- 6 Statistical Power and Interpretation of the Study -- FACTORS IN STATISTICAL POWER -- SAMPLE SIZE AND ASSUMED BACKGROUND PREVALENCE OF DISEASE -- EFFECT OF DOSIMETRY ERROR ON STATISTICAL POWER -- VIOLATION OF THE BERKSON ERROR ASSUMPTION -- DOSE ERROR DUE TO UNCERTAINTIES IN INPUT DATA -- EFFECT OF ERRORS IN ASSESSING CHILDHOOD MILK CONSUMPTION -- CORRELATED DOSE ERRORS -- EFFECT OF GEOGRAPHIC VARIATION IN DISEASE RATES ON STATISTICAL POWER -- 7 Comparison with Other Studies -- CONCORDANCE WITH THE UTAH STUDY OF THYROID DISEASE FROM NEVADA TEST SITE FALLOUT -- CONCORDANCE WITH STUDIES OF EXTERNAL RADIATION TO THE THYROID -- COMPARISON WITH CHERNOBYL STUDIES -- 8 Communication of Study Results -- BACKGROUND -- ORIGINAL HTDS COMMUNICATION PLAN -- COMMUNICATION ISSUES IN THE WRITTEN MATERIALS -- Accuracy -- Appropriateness -- Contextual Information -- Readability -- Written Materials from CDC, May 1999 -- Updating the Communication Section of the HTDS Draft Final Report -- RELEASE OF THE DRAFT FINAL REPORT -- Planning Process -- Need for an Information Blackout -- Briefings -- Effect of the Leak to the New York Times -- The Message and its Effect -- Recommendations about Releasing the Final Report.

9 Summary of Responses to CDC's Questions -- HAS THE ANALYSIS BEEN CARRIED OUT APPROPRIATELY AND COMPLETELY? -- ARE THE PRESENTATION AND THE DISCUSSION OF RESULTS COMPLETE? -- ARE THE CONCLUSIONS REASONABLE? -- WAS THE MATERIAL ACCURATE AND APPROPRIATE IN PROVIDING GUIDANCE TO THE PUBLIC IN UNDERSTANDING THE... -- IF THESE MESSAGES NEED TO BE AMENDED, HOW SHOULD THE REVISED MESSAGES BEST BE COMMUNICATED TO THE PU... -- WITH REGARD TO RELEASE OF FUTURE STUDY REPORTS, HOW CAN CDC IMPROVE THE PUBLIC-COMMUNICATION PROCESS? -- 10 REFERENCES -- Appendix A Subcommittee Activities -- Appendix B Responses to Selected Comments by the Public -- APPENDIX C ESTIMATED THYROID DOSES FROM "GLOBAL" WEAPONS TEST FALLOUT IN AREAS DOWNWIND FROM HANFORD -- I. INTRODUCTION -- II. AVAILABLE DATA -- Milk: -- Deposition: -- Precipitation: -- I-131 Releases from Hanford: -- III. METHODOLOGY -- Estimated Fallout I-131 in Milk for Benton, Adams, Franklin Counties: -- Sr-89 Deposition for Benton-Adams-Franklin, Walla Walla and Stevens Counties: -- I-131/Sr-89 Deposition: -- Relative Deposition in 1954 and 1956 Versus 1958 from Gummed-Film: -- I-131 Milk Concentrations for 1954, 1956, 1957 and 1958: -- Dose Calculation: -- IV: RESULTS -- REFERENCES -- Appendix D Equation Relating to the Effect of Error in Assessing Childhood Milk-consumption -- Glossary -- Information on Committee Members.