Supplemental Table S1. Summary of revisions to the Canadian cohort of nuclear workers, 1956-1994.

No / Revision / Details / Action
1. / Missing pre-1956 exposure information / 505 workers from the original cohort thought to have been first monitored after 1956, had records of employment at the AECL facility prior to 1956. Doses obtained by these workers prior to 1956 (especially those related to the 1952 NRX accident and cleanup), were not included in either the original Canadian(Zablotska et al, 2004) or 15-country(Cardis et al, 2007) studies. / Exclude
2. / Missing zero recorded doses for 1956 to 1970 / Annual zero doses for 5,336 AECL workers monitored prior to 1971 (27,264 zero annual dose records) were not reported to the NDR.(Ashmore et al, 2010) In addition, 147 workers excluded from the original cohort because of only one annual dose record in the NDR and found to have underreported zero doses prior to 1971 in AECL dose records, were added to the revised cohort. / Add
3. / Misclassification of workers as exposed to radiation in non-nuclear facilities / 166 workers that had been classified in the NDR as workers with radiation exposures only in non-nuclear facilities and excluded from the original study were found to have been monitored at AECL before 1980. / Add
4. / Inclusion of workers with doses ≥500 mSv / The protocol of the original Canadian cohort(Zablotska et al, 2004) called for exclusion of workers with doses ≥500 mSv (N=48) and the 15-country study(Cardis et al, 2007) excluded those with annual dose records in excess of 250 mSv. / Add
5. / Computerization of SES information for OH workers / In the original Canadian study,(Zablotska et al, 2004) SES data were based on the job classification from the last (most recent) monitoring facility for workers still in employment in 2001. Employment categories for nuclear workers are thought to be sufficiently stable over time and therefore, we used available job classification at the time of hire for OH workers to restore the missing SES information. SES information was updated for 24,548 subjects (22,888 OH workers and 1,660 workers who worked in multiple facilities). / Update
6. / Missing tritium doses / NDR validation and inter-comparison studies(Gale & Doerffer, 2000; Gale, 2002; Gale, 2003) conducted in preparation for the 15-country study, found that at AECL tritium exposure data were kept in medical records and were not reported to the NDR up until ~1969. This error was not corrected in the NDR and tritium doses for about 150 workers were missing in the NDR (most were pre-1969 tritium and small). / Update

Supplemental Table S2. SMR and 95% CI for all-cause mortality by facility in the revised cohort of Canadian nuclear workers, 1956-1994.

AECL / OH, QH and NB / All Sitesa
Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI)
Entire cohort / 725 / 1238.33 / 0.59 (0.54, 0.63) / 713 / 1064.04 / 0.67 (0.62, 0.72) / 1481 / 2409.60 / 0.61 (0.58, 0.65)
Women only / 79 / 131.32 / 0.60 (0.48, 0.75) / 19 / 26.47 / 0.72 (0.43, 1.12) / 101 / 159.29 / 0.63 (0.52, 0.77)
Men only / 646 / 1107.01 / 0.58 (0.54, 0.63) / 694 / 1037.57 / 0.67 (0.62, 0.72) / 1380 / 2250.32 / 0.61 (0.58, 0.65)
All workers by start of first employment
1956-1964 / 422 / 678.06 / 0.62 (0.56, 0.68) / 3 / 4.68 / 0.64 (0.13, 1.87) / 440 / 718.52 / 0.61 (0.56, 0.67)
>=1965 / 303 / 560.27 / 0.54 (0.48, 0.61) / 710 / 1059.36 / 0.67 (0.62, 0.72) / 1041 / 1691.09 / 0.62 (0.58, 0.65)
Men only by start of first employment
1956-1964 / 385 / 615.62 / 0.63 (0.56, 0.69) / 3 / 4.68 / 0.64 (0.13, 1.87) / 402 / 655.68 / 0.61 (0.55, 0.68)
>=1965 / 261 / 491.39 / 0.53 (0.47, 0.60) / 691 / 1032.89 / 0.67 (0.62, 0.72) / 978 / 1594.64 / 0.61 (0.58, 0.65)
Women only by start of first employment
1956-1964 / 37 / 62.44 / 0.59 (0.42, 0.82) / 0 / 0.00 / 38 / 62.80 / 0.60 (0.43, 0.83)
>=1965 / 42 / 68.88 / 0.61 (0.44, 0.82) / 19 / 26.47 / 0.72 (0.43, 1.12) / 63 / 96.45 / 0.65 (0.50, 0.84)
Abbreviations: AECL=Atomic Energy of Canada Limited; CI=confidence interval; Exp=expected; HQ=Hydro-Québec; NBH=New Brunswick Hydro; Obs=observed; OH=Ontario Hydro; SMR=standardized mortality ratio.
aIncludes AECL, HQ, NBH, OH, and workers who worked at multiple facilities.

Supplemental Table S3. SMR and 95% CI for solid cancer mortality by facility in the revised cohortof Canadian nuclear workers, 1956-1994.

AECL / OH, QH and NB / All Sitesa
Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI)
Entire cohort / 234 / 350.76 / 0.67 (0.58, 0.76) / 238 / 302.11 / 0.79 (0.69, 0.72) / 490 / 682.05 / 0.72 (0.66, 0.78)
Women only / 38 / 54.23 / 0.70 (0.50, 0.96) / 13 / 10.50 / 1.24 (0.66, 2.12) / 54 / 65.32 / 0.83 (0.62, 1.08)
Men only / 196 / 296.53 / 0.66 (0.57, 0.76) / 225 / 291.61 / 0.77 (0.67, 0.88) / 436 / 616.73 / 0.71 (0.64, 0.78)
All workers by start of first employment
1956-1964 / 130 / 199.01 / 0.65 (0.55, 0.78) / 0 / 1.45 / 137 / 211.06 / 0.65 (0.54, 0.77)
>=1965 / 104 / 151.76 / 0.69 (0.56, 0.83) / 238 / 300.66 / 0.79 (0.69, 0.90) / 353 / 470.99 / 0.75 (0.67, 0.83)
Men only by start of first employment
1956-1964 / 114 / 172.53 / 0.66 (0.55, 0.79) / 0 / 1.45 / 120 / 184.41 / 0.65 (0.54, 0.78)
>=1965 / 82 / 124.00 / 0.66 (0.53, 0.82) / 225 / 290.16 / 0.78 (0.68, 0.88) / 316 / 432.32 / 0.73 (0.65, 0.82)
Women only by start of first employment
1956-1964 / 16 / 26.48 / 0.60 (0.35, 0.98) / 0 / 0.00 / 17 / 26.70 / 0.64 (0.37, 1.02)
>=1965 / 22 / 27.76 / 0.79 (0.50, 1.20) / 13 / 10.50 / 1.24 (0.66, 2.12) / 37 / 38.67 / 0.96 (0.67, 1.32)
Abbreviations: AECL=Atomic Energy of Canada Limited; CI=confidence interval; Exp=expected; HQ=Hydro-Québec; NBH=New Brunswick Hydro; Obs=observed; OH=Ontario Hydro; SMR=standardized mortality ratio.
aIncludes AECL, HQ, NBH, OH, and workers who worked at multiple facilities.

Supplemental Table S4. SMR and 95% CI for leukemia and other hematologic cancers mortality by facility in the revised cohortof Canadian nuclear workers, 1956-1994.

AECL / OH, QH and NB / All Sitesa
Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI) / Obs / Exp / SMR (95%CI)
All leukemia
Entire cohort / 11 / 12.51 / 0.88 (0.44, 1.57) / 10 / 11.56 / 0.87 (0.41, 1.59) / 21 / 25.19 / 0.83 (0.52, 1.27)
All workers by start of first employment
1956-1964 / 8 / 6.13 / 1.30 (0.56, 2.57) / 0 / 0.04 / 8 / 6.51 / 1.23 (0.53, 2.42)
>=1965 / 3 / 6.38 / 0.47 (0.10, 1.37) / 10 / 11.51 / 0.87 (0.42, 1.60) / 13 / 18.67 / 0.70 (0.37, 1.19)
Leukemia excluding CLL
Entire cohort / 8 / 10.88 / 0.74 (0.32, 1.45) / 9 / 9.96 / 0.90 (0.41, 1.72) / 17 / 21.82 / 0.78 (0.45, 1.25)
All workers by start of first employment
1956-1964 / 5 / 5.15 / 0.97 (0.32, 2.27) / 0 / 0.04 / 5 / 5.47 / 0.91 (0.30, 2.13)
>=1965 / 3 / 5.73 / 0.52 (0.11, 1.53) / 9 / 9.92 / 0.91 (0.41, 1.72) / 12 / 16.35 / 0.73 (0.38, 1.28)
Non-Hodgkin lymphoma
Entire cohort / 7 / 12.58 / 0.56 (0.22, 1.15) / 10 / 12.01 / 0.83 (0.40, 1.53) / 17 / 25.75 / 0.66 (0.38, 1.06)
All workers by start of first employment
1956-1964 / 3 / 6.45 / 0.47 (0.10, 1.36) / 0 / 0.05 / 3 / 6.88 / 0.44 (0.09, 1.28)
>=1965 / 4 / 6.13 / 0.65 (0.18, 1.67) / 10 / 11.96 / 0.84 (0.40, 1.54) / 14 / 18.88 / 0.74 (0.41, 1.24)
Abbreviations: AECL=Atomic Energy of Canada Limited; CI=confidence interval; CLL=chronic lymphocytic leukemia; Exp=expected; HQ=Hydro-Québec; NBH=New Brunswick Hydro; Obs=observed; OH=Ontario Hydro; SMR=standardized mortality ratio.
aIncludes AECL, HQ, NBH, OH, and workers who worked at multiple facilities.