The United States Navy and Employees with Cancer: The Time for Change Is Now

The US Navy, including the US Marine Corps and Naval Nuclear Propulsion Program (NNPP), has a robust radiological protection and monitoring program meeting (and typically exceeding, in the name of conservatism) federal law requirements. The program covers the variety of ways in which the Navy produces and uses ionizing radiation and radioactive sources: in medicine, nuclear ship propulsion and repair, industrial and aircraft radiography, and myriad other unique uses in carrying out its vital mission. In executing these programs, thousands of people across the world are employed as active-duty Sailors and Marines, government civilians, and government contractors. These workers include physicians, reactor operators, radiation safety officers, and nuclear repair workers, to name but a few. The health protection standards for these workers are promulgated in the publicly available Navy Medicine P-5055 Radiation Health Protection Manual (NAVMED P-5055), published February 2011 with Change 2 published December 2022, and are applicable to Navy and Marine Corps and NNPP radiation protection programs. The NAVMED P-5055 outlines the individual medical requirements for those qualified and able to receive exposure to ionizing radiation as part of their duties and requires that "Radiation workers receive focused medical examinations to establish whether or not cancer is present which would medically disqualify a person from receiving occupational radiation exposure." Additionally, without scientific or medical basis, the NAVMED P-5055 requires disqualifying those employees who have a history of cancer, cancer therapy, radiation therapy including radiopharmaceuticals received for therapeutic purposes, or bone marrow suppression from drawing dosimetry, entering radiation areas, or handling radioactive material. This policy, which exists regardless of lifetime occupational radiation dose or projected future radiation dose, applies to all cancers except adequately treated basal cell carcinoma. The policy is not supported by relevant scientific and medical literature; does not align with reasonable professional ethical standards; does not conform to US Navy radiological training, which stipulates the assumed increased risk of developing cancer from Navy and Marine Corps and NNPP occupational radiation exposure is small; and removes critical leadership and mentoring capability from the workforce unnecessarily. This article discusses in detail (1) this policy and its ramifications to the Navy and Marine Corps and NNPP workforce and (2) recommendations, benefits, and impacts for the Navy and Marine Corps and NNPP to remove this policy and still maintain a robust radiation protection program.