Personnel safety is a priority when decommissioning obsolete nuclear facilities. The study was aimed to develop the methodological basis for the medical and sanitary support of the nuclear industry enterprise personnel radiation safety during the nuclear legacy elimination on the example of Siberian Chemical Plant (SCP, Seversk). The study involved the data of the SCP employees' medical and dosimetric register containing information about all cases of death (with an indication of the cause) of former and current employees of the enterprise. The study results were used to justify selection of the area for development of scientific and methodological support of activities in the field of medical and sanitary support of radiation safety during the nuclear legacy elimination. Death rates and the risk of dying from cancer of certain localizations (trachea, bronchi, lung, skin, stomach, colon, lymphoid, hematopoietic and related tissues, breast and prostate glands) in the nuclear industry enterprise employees were assessed. The directions for improving the medical support of the nuclear enterprise employees and the population of the surveillance zones during the nuclear legacy elimination were defined. The findings will make it possible to adjust the medical support of the nuclear industry enterprise employees in order to extend their working longevity, as well as to reduce the adverse radiation-induced health effects in people engaged in the nuclear legacy elimination.