Methods
Study design and participants
The INWORKS cohort consists of nuclear workers from three of the major partners included in the previously published 15-country study of cancer among workers in the nuclear industry:17 France,14 the UK,15 and the USA.16 Less than 20% of deaths from leukaemia were contributed by the other 12 countries.18 These cohorts have been updated since the 15-country study. INWORKS includes fewer partners than the earlier 15-country study because of the limited resources and the consequent need for efficiency in project coordination.
The study includes workers employed by the French Atomic Energy Commission, AREVA Nuclear Cycle, and Electricité de France, workers employed by the British Atomic Weapons Establishment, British Nuclear Fuels, the UK Atomic Energy Authority, British Energy Generation, the UK Ministry of Defence, and other organisations providing data to the National Registry for Radiation Workers, and workers employed by the US Department of Energy’s Hanford Site, Savannah River Site, Oak Ridge National Laboratory, Idaho National Laboratory, and the Portsmouth Naval Shipyard. Workers who were employed in the nuclear industry for less than 1 year were excluded. In France, workers were given the opportunity to refuse participation, which is required by the French Data Protection Authority; however, none did. In the USA, worker information was taken from existing records, with no direct contact with any participants; because there is minimal risk to participants, the National Institute for Occupational Safety and Health institutional review board waived requirements for informed consent. UK workers can refuse to participate in the National Registry for Radiation Workers and associated studies; less than 1% did.
MethodsStudy design and participantsThe INWORKS cohort consists of nuclear workers from three of the major partners included in the previously published 15-country study of cancer among workers in the nuclear industry:17 France,14 the UK,15 and the USA.16 Less than 20% of deaths from leukaemia were contributed by the other 12 countries.18 These cohorts have been updated since the 15-country study. INWORKS includes fewer partners than the earlier 15-country study because of the limited resources and the consequent need for efficiency in project coordination.The study includes workers employed by the French Atomic Energy Commission, AREVA Nuclear Cycle, and Electricité de France, workers employed by the British Atomic Weapons Establishment, British Nuclear Fuels, the UK Atomic Energy Authority, British Energy Generation, the UK Ministry of Defence, and other organisations providing data to the National Registry for Radiation Workers, and workers employed by the US Department of Energy’s Hanford Site, Savannah River Site, Oak Ridge National Laboratory, Idaho National Laboratory, and the Portsmouth Naval Shipyard. Workers who were employed in the nuclear industry for less than 1 year were excluded. In France, workers were given the opportunity to refuse participation, which is required by the French Data Protection Authority; however, none did. In the USA, worker information was taken from existing records, with no direct contact with any participants; because there is minimal risk to participants, the National Institute for Occupational Safety and Health institutional review board waived requirements for informed consent. UK workers can refuse to participate in the National Registry for Radiation Workers and associated studies; less than 1% did.
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