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A Ray of Hope

BY THE SPRING of 1963, when the article finally appeared in Science, the levels of radioactivity in milk were reaching unprecedented heights all over the United States. Extreme concern was being voiced both by scientists and the general public regardless of the repeated reassurances by local public health officials and the AEC that no danger existed. The intensified pressure began to penetrate to the highest levels of government, and in June 1963 President John F. Kennedy announced that this country, the Soviet Union, and Great Britain had agreed to negotiate a treaty to end all atmospheric testing. He further stated that he had ordered an end to all such testing by the United States. In July the President delivered an address to the nation in which he urged the ratification of the treaty by the U.S. Senate. In this address, he referred to the threat of fallout as follows:

. . . the number of children and grandchildren with cancer in their bones, with leukemia in their blood, or with poison in their lungs might seem statistically small to some, in comparison with natural health hazards, but this is not a natural health hazard -- and it is not a statistical issue. The loss of even one human life, or the malformation of even one baby -- who may be born long after we are gone -- should be of concern to us all. Our children and grandchildren are not merely statistics toward which we can be indifferent.

It appeared that the issues involved in the question of fallout hazards were at last receiving widespread public recognition. In Congress, hearings on low-level radiation effects were being held by the Joint Committee on Atomic Energy, and for the first time citizens' groups and private scientists with no government affiliations were invited to testify on this subject. In August I received a letter from John T. Conway, executive director of the Joint Committee, requesting my presence at the hearings. Leafing through the transcript of the first half of the hearings held in June, I found a reprint of my Science article. It was followed by a lengthy critique prepared by the AEC's Division of Biology and Medicine. On examination, the AEC critique proved to be strikingly similar in wording and theme to the negative review for Science. It denied that any effects from low-level radiation had been proven to exist, stating that I had ignored the studies which showed no effects. The AEC critique, however, went further and cited figures showing an actual reduction in childhood cancer rates after the heavy atmospheric testing in 1957. But the figures were only for children who were less than two years old when they died, a peculiar restriction, since Stewart and MacMahon had specifically demonstrated that cancer caused by the irradiation of unborn children only showed up after the age of two. No figures for older children were given by the AEC.

The Joint Committee hearings opened on August 20, the same day that Dr. Edward Teller testified before the Senate against ratification of the Test-Ban Treaty. Dr. Teller, the renowned nuclear physicist who had been instrumental in the development of the hydrogen bomb, expressed in his testimony the main arguments advanced by the treaty's opponents. He raised the possibility of future military breakthroughs by the Russians, stating his conviction that in the 1961-62 test series they had acquired knowledge about missile defense that this country didn't have. "This is the main argument against the test-ban treaty," he said. "It weakens our defense, and as long as we have reason to distrust Soviet intentions, the weakness of our defense will invite attack. . . . I came to recognize many years ago that real cooperation between Russia and us in the near future is impossible." As to the possibility of danger from fallout, Teller flatly stated: "From the present levels of worldwide fallout there is no danger. The real danger is that you will frighten mothers from giving milk to their babies. By that, probably much more damage has been done than by anything else concerning this matter." Teller also stated that the treaty would endanger the program for the peaceful uses of nuclear explosions in the Project Plowshare program. He expressed his belief that such explosions could be carried out in "a very clean way," so that fifteen minutes afterward people could walk in the resulting crater "without exposing ourselves to more radiation that we have taken year in and year out in our laboratories."

At the same time as Dr. Teller was making this statement, in another part of the capital Dr. C. W. Mays of the University of Utah was testifying at the Joint Committee hearings about the thyroid doses received by children in Utah from one of the AEC's Project Plowshare explosions the year before. As measured by University of Utah scientists, the doses ranged from 10 to 60 rads -- anywhere from ten to a hundred times the government's maximum permissible yearly limit for that body organ.

The second day of the Joint Committee hearings, during which I was present, began with the testimony of Dr. Shields Warren, who represented the National Academy of Science's Advisory Committee on the Biological Effects of Radiation. Dr. Warren had been the first director of the AEC's Division of Biology and Medicine, and as such he had been responsible for all of the AEC's early research and planning relating to the health effects of fallout. He was also head of the U.S. delegation to the United Nations Scientific Committee on the Effects of Radiation. Dr. Warren began his testimony with a review of the effects of radiation on man, animals, and plants. The lowest dose listed on his chart was 0.001 rad, or 1 millirad, and this was followed by 0.01 rad, which he indicated as giving "no detectable effect." The next highest dose was 1.0 rad, again with the legend "no detectable effect." Dr. Warren evidently did not accept the evidence of Stewart and MacMahon, which indicated that 1.0 rad received during pregnancy produced something like a 50 percent increase in the rate of childhood leukemia and cancer, clearly a "detectable" effect.

Nothing very serious appeared on Dr. Warren's chart until he got to 1000 rads. At 10 rads the legend was: "Barely detectable qualitative changes in lymphocytes," while at 100 rads the chart indicated only "mild acute radiation sickness; slight diminution in blood cell counts. Possible nausea and vomiting. . . ." Yet the studies of Hiroshima had revealed a doubling or tripling of leukemia deaths among the surviving adults exposed to this dose.

Only at 1000 rads did radiation actually appear lethal: "Depression of blood cells and platelets . . . death within twenty days." This was profoundly misleading: It was common scientific knowledge that 50 percent of all individuals exposed to 400 rads to the whole body would die within a matter of weeks or months, while for 700 rads the figure was 95 percent.

For 10,000 rads, Dr. Warren's chart listed "Immediate disorientation and coma. Death within hours . . ." while "death of all living organisms" was reassuringly indicated as not occurring until 10,000,000 rads. In conclusion, Dr. Warren quoted the following passage from the United Nations 1962 report on fallout hazards, which he had helped to prepare:

It must be recognized that the human species has, in fact, always been exposed to small amounts of radiation from a variety of natural sources and that the present additional average exposure of mankind from all artificial sources is still smaller than that from natural sources.

This, then, had been the voice of the AEC's Division of Biology and Medicine, the National Academy of Sciences, and the U.S. delegation to the United Nations Scientific Commission.

When Congressman Melvin Price asked Dr. Warren what effects he would expect to observe in the 250,000 children in Utah who might have received 4.4 rads to their thyroids, as Dr. Mays had testified the day before, he replied: "I think it would be hard to find any effect, Mr. Chairman." But as Dr. Mays had suggested, if one does not look, one is not likely to find such effects, and indeed, no one had conducted the necessary studies of the children in Utah, in Albany-Troy, or, for that matter, anywhere else in the world.

The next witness was Dr. E. B. Lewis of the California Institute of Technology, whose "single-hit," linear theory of cancer causation supplied an explanation for the findings of Stewart and MacMahon. This theory had formed the basis of my argument that the cancer-causing effects of radiation were cumulative and that doses received gradually from fallout would be similar in effect to those received all at once from diagnostic X-rays. Dr. Lewis's latest evidence, based on a study of leukemia incidence among radiologists, indicated that low doses of radiation delivered over a period of many years could indeed lead to an increased incidence of leukemia, a finding that further buttressed his original theory.

There was now only one more witness scheduled to be heard before Dr. Brian MacMahon. This was Dr. Hyman Friedell, professor of radiology at Western Reserve University. The main burden of his testimony, as he stated, was to urge radiation protection agencies to set their standards on the basis of the linear theory of radiation damage, according to which there was no safe threshold of exposure.

Now Dr. MacMahon took the stand. He opened his testimony with an explanation of why certain other studies had not appeared to confirm Dr. Stewart's and his own results: "Every one of the negative studies has been based on small numbers, and in no instance do the results differ in a statistically significant degree from the expectation of a 40 percent increase in cancer risk among exposed children." Thus, in defense of his own work, Dr. MacMahon had effectively answered one of the major points in the AEC's critique of my article. He went on to summarize his results as follows:

I suggest therefore that the existing evidence is overwhelmingly indicative of an increase in cancer risk for children diagnostically exposed in utero; that this increase is seen for leukemia as well as for a variety of other individual forms of cancer; that the best estimate of this increase is that it is about 40 percent in excess of "normal" cancer mortality in the United States.

Turning next to the implications of his findings, he stated:

It seems to me that if this association is accepted, we must consider very seriously the possibility of cancer production by low doses of radiation such as encountered in X-ray diagnosis and even fallout.

As to the existence of a possible "threshold," Dr. MacMahon went on to say:

The exposure dose associated with pelvimetry [pelvic X-rays] at the time of these studies is not known, but it was probably of the order of 2 to 3 rad [for a series of X-rays] -- substantially below the 50 rad that has frequently been mentioned as a possible threshold level. If a threshold for leukemia induction exists, then it must be below 2 rads. It would be a coincidence indeed if a threshold existed just below the dosage level at which studies have been undertaken.

One other major issue remained to be discussed, and that was the evidence for an increase in cancer risk with an increase in dose -- termed the "dose-response" relationship. To this point, MacMahon now addressed himself as follows:

Furthermore, there is some indication in both Stewart's and our own data that a dose-response relationship exists even within the low-dose range that is being considered.

Thus, MacMahon, together with all the other nongovernment scientists who testified in this part of the hearings, presented evidence in conflict with the AEC's claims for the existence of a safe threshold.

Inevitably, Dr. MacMahon was asked his opinion of the use to which I put his data in my Science paper. He summarized his reply as follows: ". . . the argument used by Dr. Sternglass does not convince me personally, but, on the other hand, I cannot deny that ultimately his point of view may be correct." He further stated, however, that he agreed with all the comments in the AEC critique. This seemed puzzling, since I felt he had just answered the most serious points in his own testimony. It became clear that I would have to amass much stronger evidence before my hypothesis could gain the public support of many scientists.

After a brief recess, Dr. Eric Reiss was called to the witness stand. Dr. Reiss was a St. Louis physician and a co-founder, with Dr. Barry Commoner, of the St. Louis Committee for Nuclear Information. In his presentation on behalf of the St. Louis group, he concentrated on the subject of local fallout incidents resulting from the AEC's tests in Nevada. Referring to the many reports on local fallout prepared by the AEC, he pointed out that the general conclusion in all these official reports had been that "the test program has been carried out without any discernible threat to the safety of the local population."

"In contrast," Dr. Reiss went on to say, "our analysis of the same monitoring data published by the AEC shows that as a result of nuclear tests at the Nevada Test Site, in the period 1951-62, a number of local populations, especially in Nevada, Utah, and Idaho and probably other communities scattered throughout the continental United States, have been exposed to fallout so intense as to represent a medically unacceptable hazard to children who may drink fresh locally produced milk." He explained that the discrepancy between the AEC's conclusions and those of the St. Louis group arose out of the fact that the AEC only measured the external dose from the fallout in the environment, while his group also measured the internal dose from the fallout particles concentrated inside the body, as Dr. Lapp had done in the case of Troy.

Dr. Reiss proceeded to present figures indicating that for 10 rads to the thyroid approximately one in 2860 children might be expected to develop thyroid cancer. Because of the long latent period for this disease, he explained, the damage would not show up for many years. Possibly ten to twenty. He then cited estimated thyroid doses of 3 to 18 rads for the large population of Salt Lake City, Utah, as a result of fallout on May 7, 1952, and 5 to 40 rads for Albany-Troy on April 26, 1953 (this did not even include the much heavier fallout in June). Such hazardous doses, Dr. Reiss pointed out, arose not only from atmospheric tests but also from certain underground tests: "Venting [leaking of radioactivity] has been reported for at least seven underground nuclear tests," said Dr. Reiss, adding that his group was able to calculate, for example, that "fallout from the underground `Gnome' shot delivered sufficient fallout to the vicinity of Carlsbad, New Mexico, to cause thyroid dose levels of from 7 to 55 rads to children."

And then Dr. Reiss turned to an astonishing aspect of the whole problem: If the dangerous internal doses had been estimated at the time, "simple preventive measures could have been taken to avoid exposure." It would only have been necessary to warn the inhabitants of the area to avoid drinking fresh milk produced locally until the iodine levels died down. "We know of no instance," said Dr. Reiss, " in which such a warning was issued until the summer of 1962, when high iodine 131 levels observed in commercial milk supplied in Utah led state health officials to divert current milk from the market." And finally, Dr. Reiss noted that correct estimates of internal doses should have been possible by as early as 1954 on the basis of the then-available scientific theory.

The questioning of Dr. Reiss was nearing its end when John Conway asked him why his group had made only theoretical calculations of the thyroid doses without benefit of any direct measurements of the iodine levels in the milk. "I am delighted you brought that up," Reiss answered, "because it is the nub of the problem. If measurements were available, we would obviously have used them. The question is, why were no measurements made or reported publicly by those who had been charged with the protection of our health and safety?"

That evening the Washington Post gave prominent coverage to Reiss's testimony, as well as to the testimony given at the Senate's test-ban ratification hearings. At those hearings, Dr. John S. Foster, Jr., the new director of the AEC's Livermore Laboratory, where the hydrogen bomb had been developed, had offered his opinion on fallout hazards:

You are asking for a quantitative answer which involves the understanding of an effect, namely the effect on the human being that is so small compared with his [radiation exposure from] background that we have not been able to measure it. One way to look at it would be to say that the fallout from all past tests affecting man for the next 50 to 100 years would be something like the same thing as deciding to live a few hundred feet higher up, higher above sea level; that is what it means.

Senator Robert Byrd of West Virginia then asked Dr. Foster what importance should be attached to the public's fears of fallout. Byrd phrased his question as follows: "If I may pose a hypothetical question, are you saying, in essence, that if you were a senator with the knowledge that you possess in the scientific field . . . you would disregard entirely this factor [public opinion] in your reaching a decision?"

To which Foster replied: "That is correct, sir, although it would be a very difficult position for me to put myself into. . . ."

The third day of the Joint Committee's low-level radiation hearings opened with my testimony. I reviewed all the evidence regarding low-level radiation effects on unborn children, presented my arguments as to the probable similarity in effects of X-rays and fallout radiation, and gave estimates of the increase in childhood cancer that might be expected from nuclear testing. Then the questioning period began.

Congressman Craig Hosmer asked me how there could be any evidence in Stewart's and MacMahon's studies for a dose-response relationship when the radiation dose from hospital X-ray machines was known to differ widely from hospital to hospital, due to variations in the adjustment and quality of the machines. Such differences would mean that some mothers might have received the same or greater dose from a single X-ray as others received from two or even three. Therefore, the finding of Stewart and MacMahon that there was an increase in cancer risk with the number of X-rays taken might not indicate a dose-response relationship. I explained that it was also true, however, that in the case of any one machine, the mothers who received two X-rays from it would definitely have received twice as much radiation as those who were X-rayed only once. Since the ratio of single pictures to double or treble pictures taken was generally the same for each X-ray machine, there could be no question that, on the average, the mothers who received two X-rays had received twice as much radiation as those who received only one.

Congressman Hosmer next asked why one couldn't test the validity of the dose-response relationship simply by examining the statistics for leukemia in children after the test series in the early 1950s. I pointed out that this was precisely what Lapp, Mays, Reiss, myself, and others had urged the government to do without success.

The next question involved the principal argument used by the AEC to minimize the possible effects of fallout. Congressman Holifield asked whether I was aware that testimony had been presented by government scientists that fallout from all past testing had raised background radiation by only some 10 percent. Since the typical background dose was 100 millirads per year, this seemed to be only 10 millirads additional radiation, much less than the 200 millirads received from a modern pelvic X-ray, or than the dose of 200 to 400 millirads that I had calculated for the recent test series.

What the spokesmen for the AEC and the Federal Radiation Council had done was to take the total radiation dose from all the bombs detonated so far -- some 700 millirads -- and average it out as if it were received uniformly over a seventy-year life span at a rate of 10 millirads per year. But in fact, most of the dose comes from the short-lived isotopes that predominate in fallout, and is thus delivered in the first few months after the tests. To illustrate this, I cited figures published just a few months before by the AEC's Brookhaven National Laboratory, located on Long Island, not far from New York City. According to these figures, during the first six months of 1963, the average radiation exposure on Long Island had risen to 4.7 millirads per week, as compared with a normal background rate of only 1.7 millirads per week. This meant that in only half a year the dose received by individuals in this area would be about 122 millirads as compared with a normal dose of only 44 millirads. Thus, instead of the negligibly small 10 percent increase which the AEC's seventy-year averaging procedure would give, the actual exposure to an infant in the womb would have been nearly triple the background rate. And this dose did not even include the effects of internal concentration. This, then, was the reasoning behind the reassuring statements of the world's radiation protection agencies that doses from atmospheric testing were negligible compared with all the sources of radiation in man's natural environment.

Congressman Hosmer next raised the point that the greater background radiation due to cosmic rays in an area of high altitude such as Denver as opposed to that in an area at sea level such as Long Island should lead to a higher leukemia rate in Denver. But in point of fact, as I stated, the difference in total background radiation between these two areas is actually quite small because most background radiation comes from sources other than cosmic rays. Cosmic rays contribute only about 30 millirads at sea level, compared to 50 millirads from the rocks and soil and 20 millirads from traces of natural radioactive substances in our body. Going to an altitude of 5000 feet increases the cosmic ray dose by only 40 percent, or a total of 12 millirads. Since place-to-place differences of 20 or 30 millirads in the radioactivity of rocks are common, the small difference due to altitude is easily masked by this factor alone. Furthermore, cosmic rays do not concentrate in critical body organs as does fallout.

Thus, it would be nearly impossible to find differences in leukemia rates as a result of altitude differences even as large as those for Denver and Long Island, considering that MacMahon had to use a study group of some 70,000 exposed children to clearly establish an effect from about 1000 millirads of X-rays. And I added that there are of course other factors beside radiation that enter into the likelihood of a child developing leukemia, making such a comparative study of the effects of slightly different background levels next to impossible.

Following up this point, Congressman Hosmer suggested that if factors other than radiation were involved in the cause of leukemia, did this not invalidate MacMahon's study? To this I replied that, in such a study, comparisons are carried out with control groups for whom all the other factors are, on the average, nearly the same as for those exposed to X-rays, thus essentially eliminating the effect of such factors on the outcome.

After some discussion of the size of the dose from fallout, the chairman indicated that the committee's counsel, John Conway, had some points he wished to raise. After a lengthy prelude, Conway led up to the fact that the Federation of American Scientists' news release based on my paper said that 100 megatons of nuclear fission energy had been released in the 1962 test series. Conway argued that since the amount released in 1962 was actually 76 million tons, then my estimate of the expected number of leukemia deaths was too high.

But it was clear from both my original paper in Science and my written testimony that the figure of 100 megatons applied to the entire test series that began in September of 1961 and ended late in 1962, not just to the amount detonated in 1962 alone. Thus, the news release, which was not even prepared by me, should have said more precisely, "1961-62 test series."

When this became clear, Chairman Price intervened to point out the simple nature of the misunderstanding, and when Conway nevertheless wanted to pursue the matter further Price thanked me for my testimony and called the next witness.

The debate over the test-ban treaty continued in Congress through most of September, and then the U.S. Senate voted overwhelmingly for ratification.

A highly revealing postscript to the entire test-ban treaty debate came to light in December, when the full proceedings of the Joint Committee hearings were published. Inserted in the record was a letter from Dr. Harold Knapp, a fallout specialist who had recently resigned from the AEC's Division of Biology and Medicine. In his letter, Dr. Knapp made reference to a 1957 incident in which a nuclear reactor in Windscale, England, had gone out of control and emitted tremendous quantities of radioactivity into the atmosphere. The contamination from iodine 131 was so great that the crops and milk for hundreds of square miles around had to be seized and dumped. According to Dr. Knapp's letter, in 1960, when he was doing fallout research for the AEC, he came to the startling conclusion that in Utah "depositions of iodine 131 per unit area at many inhabited ranches and communities must on several occasions have exceeded the maximum iodine 131 concentrations on pasturage found after the Windscale accident." (Emphasis added.)

As an example, Knapp cited an incident of relatively heavy fallout in the St. George, Utah, area on May 19, 1953. His calculations indicated that 24 hours after the explosion the iodine levels in milk must have reached 700,000 to 2,600,000 micromicrocuries per liter. He estimated that the thyroid dose for an infant who drank one liter (slightly more than a quart) of this milk each day for the three weeks following the test would be anywhere from 120 to 440 rads.

Knapp wrote a report containing these conclusions in 1960, but the AEC did not release his report for publication until August 16, 1963, just a few days before the second half of the Joint Committee hearings began, by which time it was evident that the independent scientists from Utah and St. Louis were going to make public their own similar findings. Thus, during the entire early effort to achieve a test-ban treaty, this shocking and vital information was kept from the people and political leaders of the world, while hundreds of megatons of bombs were exploded by the U.S. and Russia during 1961-62. And since Knapp's report had not even been made public by the AEC and the Joint Committee by the time of the first half of the low-level radiation hearings in June of 1963, it had still been possible for the AEC to mislead Congress and the public until just before the end. From page 225 of the proceedings of the June hearings:

REPRESENTATIVE HOLIFIELD: And the testimony before this committee has been that tolerable permission dose has not been reached by the amount of radiation that comes from manmade fallout radiation, is that not true?
DR HARLEY: Yes, Sir.

Dr. Harley was John Harley, the former colleague whom Professor Clark had telephoned at the time of the Albany-Troy incident. At that time a scientist with the AEC's Health and Safety Laboratory in New York City, Harley had since become head of the lab, which had been responsible for the classified reports on the Troy fallout during the spring of 1953.

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