1. Slide 1 Upgrading the United States Transuranium and Uranium Registries’ Pathology Database Stacey L. McCord, MS USTUR Project Associate smccord@tricity.wsu.edu 54 th Annual Meeting of the Health Physics Society July 13, 2009, Minneapolis, MN “Learning from Plutonium and Uranium Workers”

2. Slide 2 United States Transuranium and Uranium Registries

3. Slide 3 USTUR: Registrant Status As of June 15 th, 2009 Total Active (Living) and Deceased Registrants:423 Living Registrants:93 Potential Partial-body Donors:73 Potential Whole-body Donors:13 Special Studies:7 Deceased Registrants:330 Partial-body Donations:289 Whole-body Donations:36 Special Studies:5

4. Slide 4 Professional Nosologist Contracted to Code Causes of Death All deceased registrant cases were coded using the International Statistical Classification of Diseases and Health Related Problems (ICD).  Provides codes to classify diseases.  Used worldwide for morbidity and mortality statistics. ICD Coding CompletedSept. 2008 Deceased Registrants330 ICD-9-CM and ICD-10 Coded325 not enough data to ICD code5

5. Slide 5 Professional Nosologist Contracted to Code Deceased Registrant Cases ICD data provided by Carolyn Watkins:  Underlying Cause of Death coded using ICD-9-CM and ICD-10 codes.  Up to seven Contributing Causes of Death coded using ICD-9-CM and ICD-10 codes.  The contributing causes of death are ranked in order of Severity. 1 = Most Severe 7 = Least Severe  A Source Code is reported for each coded cause of death. D = Death Certificate A = Autopsy Report

6. Slide 6 Quality Assurance Data is reported to the USTUR in an ready-to- import Excel file. Import rejects and flags invalid ICD codes. Visual inspection of ICD codes.

7. Slide 7 Pathology – Main Page

8. Slide 8 Pathology – Main Page

9. Slide 9 Pathology – Main Page

10. Slide 10 Pathology – Main Page

11. Slide 11 Search by Case Number, ICD code, or Keyword

12. Slide 12 Search by Case Number, ICD code, or Keyword Results: Eight mesotheliomas observed

13. Slide 13 Search by Case Number, ICD code, or Keyword Seven mesotheliomas are the underlying cause of death

14. Slide 14 Search by Case Number, ICD code, or Keyword ICD-9-CM codes

15. Slide 15 Search by Case Number, ICD code, or Keyword ICD-10 codes are more specific

16. Slide 16 Search by Case Number, ICD code, or Keyword D = Death Certificate Source of A = Autopsy Report ICD data

17. Slide 17 USTUR Pathology Database – Now on the Web (April 6 th, 2009)!

18. Slide 18 Looking Forward Provide pathology data in an interactive, web- based format. Link pathology data to:  Radiochemistry  Health physics  Tissue dose and dose-rate estimates (long term project goal).

19. Slide 19 Disclaimer: “This presentation was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, makes any warranty, expressed or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof.”