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It has been noted for years that there is anexcess of mesothelioma deaths among the Registrants of the U.S. Transuranium and
Uranium Registries (USTUR). The latest statistics shows that there are 9 mesothelioma cases among 341 (2.6%) deceased
USTUR Registrants, compared with less than 1 expected mesothelioma death (0.16%) for the U.S. general population adjusted
for age, gender, race, and calendar year.A matched case control analysis wasused to evaluate the cluster of mesothelioma cases
in association with cumulative external radiation exposures. First, all causes of USTUR Registrants� deaths were classified
into 4 groups: mesothelioma (Meso), lung cancers (LC), other cancers (OC), and non-cancers (NC). Second, for each case
of mesothelioma, controls were identified in the LC (2 ~ 3 controls per case), OC (2 ~ 5 controls per case), and NC (2 ~ 5
controls per case) groups matching gender (male), race (white), years of employment (�±2.5 years), first hire (�±5 years), birth
year (�±5), and age at death (�±5 years). Third, a paired t-test (one sided) was used to examine whether there were statistically
significant differences in cumulative external radiation doses between cases and respective controls in LC, OC, and NC groups.
In practice, a permutation paired t-test (PPTT) was developed to run the significance tests based on a large number of paired
t-tests. For each paired t-test, one control for each case was randomly selected from multiple (2 ~5controls per case) matching
controls for the case. This procedure was repeated many times, and the percentage of statistically significant (p � 0.05) paired
t-tests were counted. Inference was reached based on whether or not 5% or more of PPTTs were statistically significant. PPTTs
were not significant for Meso vs. LC and Meso vs. OC; PPTTs were significant, however, for Meso vs. NC with larger than 9.0%
of significant paired t-tests. A follow up conditional logistic regression for the Meso and NC groups showed a non-statistically
significant odd ratio (OR) of 1.001 (95% CI: 0.997 ~ 1.006) between cumulative external radiation doses and mesothelioma.
The matched case control analysis suggested that the excess of mesothelioma deaths among USTUR Registrants was not
associated with cumulative external radiation exposures.