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The Hidden Tragedy of Hiroshima

LADE'S DATA on leukemia among the children of the Troy area, published in the expectation that it would disprove the existence of any effects from the 1953 fallout, now seemed to prove the very opposite. But there remained one major difficulty in accepting the evidence for an increase in leukemia, and that was the fact that the studies of the children conceived after the atomic explosions in Hiroshima and Nagasaki in 1945 had shown no such increase in leukemia, or in any other radiation effects, for that matter.

There had, of course, been very serious effects on the infants who were in the womb at the time of the explosions. A large fraction of these infants were lost through premature death, while among the few that survived more than a year, many suffered from congenital malformations and mental retardation. Of those unborn children who had been about one mile from the explosions and received estimated doses of 10 to 20 rads, nearly a third were found to have reduced brain size and mental retardation.

But among the many children conceived after the explosions, there appeared to be no effects, as opposed to the situation in Troy.

Late in 1966, I was given a copy of the preliminary results of a Yale University study of Hiroshima and Nagasaki carried out by Dr. S. Finch and a group of colleagues and sponsored by the Atomic Bomb Casualty Commission. The study involved an examination of the incidence of leukemia among some 17,000 children whose parents had been within 2000 meters of the explosions. Radiation doses ranged from about 3 to 30 rads, with a few as large as a hundred. These were certainly much larger than the doses from typical pelvic X-rays received by the mothers in the study by Dr. Saxon Graham, doses which increased the risk of childhood leukemia among the children conceived many years later by as much as 100 percent.

The control group used for comparison purposes in the Yale study consisted of the population in the suburbs farther than 2500 or 3500 meters from the explosion, where the radiation from the bomb was calculated to have been less than that from natural background. With such a tremendous difference in doses, there could be no question that there should be a substantial difference in effects. Furthermore, since there had been virtually no fallout in the two cities, the doses had been calculated from the instantaneous flash of the bombs alone. Such a flash was similar to the way in which the dose from diagnostic X-rays is delivered, so, if anything, the results of Dr. Graham's study should have been even more applicable to this situation than to Troy, where the fallout dose was delivered over a period of months or years.

Still another study of Hiroshima and Nagasaki had also found a similar lack of effect. This study had been conducted over a period of nearly two decades by Drs. J. V. Neel and W. J. Schull of the Department of Human Genetics at the University of Michigan. The puzzling nature of the results was emphasized by Dr. Neel himself during the course of a lecture series in 1963: "In view of the vast body of data regarding the mutagenic effects of radiation, it can scarcely be doubted that the survivors of Hiroshima and Nagasaki sustained genetic damage." To this he added: "The question is not `Is there damage?' but rather `Can the damage be detected?'"

It was clear that, unless this problem could be resolved, any evidence on the Troy incident would always be subject to this serious criticism. Accordingly, one day I decided to look up the original data on the radiation dose measurements for the two Japanese cities, collected by E. T. Arakawa of the AEC's Oak Ridge National Laboratories. And as I examined Arakawa's figures, I noticed that while there had indeed been little fallout in Hiroshima and Nagasaki proper, the fallout had drifted down on the suburbs a few miles away.

But if there had been fallout in the suburbs and beyond, and this fallout was far more damaging to the ova, the embryo, and the infant than anyone had realized when the studies were set up, then the so-called nonexposed control populations beyond about 3000 meters, the groups used for comparison purposes, had in fact also been affected by the radiation. And just as in the case of Lade's comparison of the leukemia rate in the Albany-Troy-Schenectady area with that in nearby areas of upstate New York, a search for a difference would fail to indicate any effect.

The fallout doses were by no means small. Arakawa reported that in the western suburbs of Hiroshima, namely Furue, Takasu, and Koi, about 5000 meters from the blast, the external radiation dose from the fallout in the environment alone probably amounted to several rads -- at least twenty times what Dr. Clark and his students were to estimate for the Troy population eight years later. In the case of Nagasaki, the fallout had been even heavier, giving external doses as high as 100 rads in the suburb of Nishiyama. This was a thousand times greater than in Troy. Such doses would greatly increase the leukemia rate for the children born all over the nearby regions that had been supposedly free of radiation, completely masking the effect if one looked only for a comparative difference, and not for an increase over the rate for preceding years. It seemed incredible that the possible effects of such large doses could have been overlooked in the two major studies of the effects of atomic warfare, yet they had been.

A few months later, in the spring of 1967, after I had taken up my new position as professor of radiation physics at the University of Pittsburgh School of Medicine, I came across the evidence that confirmed this conclusion. It was contained in a paper published in the New England Journal of Medicine, bringing up to date all the findings on leukemia among the survivors of the two Japanese cities. One glance at the first figure told the story. As compared to the rate for the preceding years, not only had there been a rise in leukemia incidence among those who were less than 1500 meters from the explosions, but there was a similar though somewhat smaller rise for the population beyond 10,000 meters who could not possibly have received any of the direct radiation from the flash of the bomb. Both rises followed the characteristic pattern of radiation-caused leukemia. Furthermore, there was another sharp rise in leukemia for both of these groups in 1958, four to six years after the first large series of hydrogen bomb tests in the Pacific and Siberia in 1952-54, tests that resulted in heavy fallout in Japan and in contamination of the fish used widely as a staple item in the Japanese diet. Again the delay in onset coincided exactly with the established pattern of radiation-caused leukemia.

In fact, for all of Japan, leukemia rates rose sharply by 50 percent between 1946 and the early 1950s, just as Dr. Stewart's statistician, David Hewitt, had originally observed for England and the United States. This was followed by another sharp rise as of 1959. And just as the rates had turned down again in Hiroshima and Troy, they declined again throughout Japan to half their peak intensities four to six years after the temporary moratorium of 1958-61, proving that these rises had not been due to such factors as improved diagnostic methods or increased use of medical X-rays, as some had suggested.

The last major argument against the connection between the 1953 rainouts and the rise in leukemia in Albany-Troy had disappeared. By now, some three years had elapsed since my last attempt to get additional data on the Albany-Troy-Schenectady area from the New York Health Department. I sent another letter to Dr. Lade in a final effort to obtain more detailed and up-to-date information. Within a few weeks, the following reply arrived:

Doctor Sternglass, Sir:

I would be most willing to provide you with the data you request in respect to the occurrence of leukemia in children in the Albany-Troy-Schenectady area if there were any reason to suppose that they had sustained a significant exposure to fallout radiation. In my letter to the editor of Science, 141, 1109 (13 September 1963), I pointed out that children on a milk diet in this area at the time of 1953 could not have had a significant exposure. I fail to see, therefore, how further data could be "valuable for our understanding of low dose rate effects."

Reluctantly, I began the preparation of a final paper for Science, based on the incomplete data from Lade's brief letter of 1964.

It appeared unlikely that Science would publish the Albany-Troy paper in the near future, so I decided to present my findings at the forthcoming annual meeting of the Health Physics Society, to be held in Denver, Colorado, in June of 1968. This professional society had been founded in 1955 by Dr. Karl Z. Morgan and a few other physicists who, since the early years of atomic energy, had been concerned with the health aspects of this technology. The society was officially dedicated to "the protection of man and his environment from unwarranted radiation exposure." Over the years it had acquired many members who were professionally engaged in safety planning for nuclear weapons tests and nuclear industry activities.

Dr. Morgan, one of the most widely respected individuals in the health physics field, had himself become a controversial figure in recent years, due to his outspokenness regarding the widespread use of inadequate medical X-ray equipment and procedures. Long convinced that there existed no evidence for a completely safe "threshold" of radiation exposure, Dr. Morgan had incurred heavy criticism from radiologists' associations and others for his estimates that thousands of additional deaths of unborn children were being caused each year by unnecessary overexposure to medical X-rays. Prior to the June meeting, I sent Dr. Morgan a copy of the paper I had just submitted to Science and received a letter from him expressing deep concern about the seriousness of the evidence, as well as indignation about the refusal of the New York State Health Department to provide the additional data.

At the annual meeting in Denver, the press was well represented, word having gotten around about the nature of my findings. I presented the evidence and concluded by urging that much more detailed studies be made of other areas known to have received heavy fallout. During the discussion period that followed, many of the questions dealt with the inadequacies of Lade's data -- for example, the lack of such facts as the birthplace of each case and the particular type of leukemia involved. I could only point out that this information was not available to me.

Reports of the Troy findings were carried widely by the press both in the U.S. and around the world. Among the many phone calls that came during the aftermath was one from an Associated Press reporter in Detroit, who informed me that the New York State Health Department had just issued a news release stating that "there is no evidence to support a Pittsburgh professor's report that radioactive fallout over the Albany-Troy, N.Y., area in 1953 has increased the incidence of childhood leukemia." The subsequent AP dispatch based on this release added that "Sternglass had consulted the department earlier and had been told the department's opinion." This "consultation," of course, had consisted only of requests for information that were repeatedly denied, while "the department's opinion" consisted of the arguments advanced by Lade in his correspondence to minimize the significance of the data. But it appeared likely that newspaper readers would gain quite a different impression.

It later developed that segments of the Health Physics Society were also displeased by the publicity. In a letter to the society's board members a month after the annual meeting, R. E. Alexander, chairman of the society's public relations committee, stated that some board members had complained that "the publicity about the paper of E. J. Sternglass . . . was damaging to the nuclear industry." After defining the "basic publicity objective" of the society, namely, "to let the public know that due to a frankly acknowledged need, we have a new technology, health physics, which will permit them to enjoy the benefits of nuclear energy safely," Alexander went on to say that "while we try to avoid publicizing papers that do not contribute to our basic objective, there is no way to prevent such publicity absolutely." (Emphasis added.)

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