[en] To determine whether a strong association between leukemia incidence between 1978 and 1986 and potential for exposure to radiation emitted from the Pilgrim 1 nuclear power plant in Plymouth, Massachusetts was a spurious finding resulting from either (1) failure to account for temporal variation in the level of radioactivity released from the plant or (2) inattention to certain potentially confounding factors, additional age/sex-matched case-control analyses controlled for the effects of socioeconomic status (SES), work history, and cigarette smoking were performed with data collected in the Southeastern Massachusetts Health Investigation -- a study of leukemia among residents aged 13 and older of 22 southeastern Massachusetts towns. None of the additional analyses, including incorporation of emissions data into the exposure-assessment scheme and crude attempts to control for (1) medical-radiation exposure, (2) potential for exposure to pesticides sprayed on cranberry bogs, or (3) workplace exposure to radiation, chemical solvents, dust, or fumes, altered the finding of a statistically significant dose-response relationship between leukemia incidence and potential for exposure to radioactive emissions. The trend in the association over time was not entirely consistent, however, with the hypothesis that unusually large amounts of radioactivity reportedly released from the plant during the mid-1970s were responsible for the observed effects. Recommendations were made for further study of the Plymouth-area population for studies of this problem elsewhere