The Sputum Cytology Surveillance Program For Uranium Workers In Ontario

The Elliot Lake Centre was established in 1965 as an independent Centre for Continuing Education offering a variety of adult education services. In 1976 all retraining and community college type activities were transferred to the Sault College of Applied Arts and Technology which had opened a branch campus in Elliot Lake. Upon the completion of this transfer, the Elliot Lake Centre was then contracted in 1977 by the Canada Centre for Mineral and Energy Technology to study the feasibility of establishing a research and information institute dealing with various health and safety concerns of the uranium worker. By late 1980, a federal charter was granted for the establishment of the Canadian Institute for Radiation Safety, made possible through the cooperative efforts of the Governments of Canada and Ontario, the Ontario uranium mining and refining companies, and the Elliot Lake Centre. On 1 April 1981 the Institute officially began operations. PROGRAM DEVELOPMENT AND COORDINATION In May 1978 the Elliot Lake Centre initiated a voluntary sputum cytology program for uranium workers. This program was financed by the Ontario uranium mining companies: Agnew Lake Mines Limited near Sudbury; Madawaska Mines Limited in Bancroft, and Denison Mines Limited and Rio Algom Limited in Elliot Lake. In 1981 additional funding was granted by Eldorado Nuclear Limited for a small group of employees at the company's uranium refinery in Port Hope, Ontario. Initially in 1978, program participants were accepted according to length of employment, radiation exposure levels (calculated in working level months) and/or smoking history. These restrictions were abolished within a few months and all uranium workers were encouraged to participate. From 1978 to 1979 the sputum cytology program was medically directed by personnel from the Montreal Cancer Institute. Until 1979 all data maintenance for the program was performed manually, however the effort required to sustain the system increased significantly as the number of participants grew. In September 1979 the Division of Thoracic Surgery at the Toronto General Hospital, under the direction of Dr. F.G. Pearson, submitted a proposal to the Elliot Lake Centre to develop a data processing system to help coordinate the surveillance program. In October 1979, Dr. Pearson became the new Project Director. Director of the Cytology Program is Dr. D.W. Thompson of the University of Toronto who is responsible for all cytologic analyses. Developmental work to establish the new surveillance system was initiated in January 1980 and became fully operational at the beginning of March 1981. The following sections describe the Elliot Lake operations of the sputum cytology program now conducted by the Canadian Institute for Radiation Safety. PROGRAM PARTICIPATION As of 1 September 1981 the sputum cytology program has 518 participants enrolled. Eligibility is restricted only to a willingness to participate and the ability of an individual to produce adequate sputum samples. Each participant registers for the program at the Institute and is given personal instruction on methods of sputum collection. The majority of the participants in this program are employed by the uranium mining industry; some work for firms which are contracted by the larger companies. Many participants are either retired from the work force or receive disability pensions or workmen's compensation benefits. Other participants have been employed in the uranium mining industry and have since gone on to other employment; some work for various federal and provincial governmental agencies concerned with the mining industry. Some participants are referred to the program by their family physicians because of smoking histories and/or various respiratory conditions. A small number of these individuals have never been involved in the mining industry at all. A chart describing program participation by employment is found in Appendix 1. PROGRAM REGISTRATION In the Elliot Lake area, persons interested in registering in the program are required to go directly to the Sputum Cytology office located at the Canadian Institute for Radiation Safety. Each individual is interviewed personally by the Program Officer. For the employees of Agnew Lake Mines, Madawaska Mines and the Port Hope refinery of Eldorado Nuclear Limited, registration is possible during the Program Officer's semi-annual on-sitevisits. Participants are assigned, in chronological order, "program numbers" for easier identification. File labels are color-coded according to place of residence or, in some instances, place of employment. Each file is stamped with the date each sample bottle is distributed. A file contains: all original test results, a completed registration