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Death before Birth

A FEW MONTHS after the Denver meeting, a letter arrived from Science flatly rejecting the Albany-Troy paper. There were two reviews enclosed, both negative. One contained references to nonpublic data available only to the New York Health Department, indicating that the reviewer was a member of that agency. Apparently unaware of the irony, this reviewer claimed that "the number of cases in the Albany-Troy area used in this study are too few to warrant the conclusion." This was, of course, the same number of cases that Lade had used in his 1964 letter to Science to prove there had been no effect from the fallout, and his conclusion had then been deemed suitable for publication by the editor. And this very same data had also been cited frequently to the same end by the AEC and the New York Health Department. Apparently these figures were only adequate to prove there was no effect.

I now became more determined than ever to pursue the effort to have the full evidence on the worldwide effects of nuclear fallout on childhood leukemia exposed to the scientific community and the public at large. The issue was far greater than the rejection of just another scientific paper. The nature of modern science depends upon the free communication of even the most disturbing ideas, since only through their widest possible examination can the essential process of the gradual correction of errors be accomplished.

And so I began the task of answering each objection raised by the reviewers. One of the points was that the increase in childhood leukemia could probably be explained simply by the increase in the number of children born in Albany-Troy-Schenectady during the postwar years. It was really quite evident that this factor could not possibly begin to explain the fourfold rise in the annual number of cases in an area where the entire population had only increased by 10.5 percent from 1950 to 1960. But now this had to be proved in detail.

I began the laborious task of going through the volumes of the U.S. Vital Statistics, extracting the figures for annual births in the three counties of upstate New York for which Lade had given the leukemia rates. While copying down the numbers, I noticed that there was also a listing for fetal deaths -- stillbirths, miscarriages, and other forms of death before birth. Remembering that an increase in fetal deaths had been looked for by J. V. Neel in his study of genetic effects on the survivors of Hiroshima and Nagasaki, I decided to note down these figures as well.

As expected, the gradual increase in annual births during the period from World War II to 1953 was far too small to account for the subsequent increase in the number of leukemia cases. The births had increased by only some 50 percent, while the leukemia cases had risen by over 300 percent.

But the figures for fetal deaths showed something quite unexpected. After steadily declining from 23.8 cases per thousand births in 1941 to a low of 14.4 in 1952, the number of fetal deaths suddenly refused to decline any further. It had only declined to 14.2 seven years later in 1960. This type of change is termed a "leveling off" in the rate of decline. In the case of fetal mortality, such a leveling off was most significant, for the original pattern of steady decline was the result of steady improvements in prenatal medical care which should have enabled the decline to continue until reaching an "irreducible minimum." This minimum had clearly not yet been reached, as was shown by the fact that the decline started again after each discontinuation of testing. More significantly, it reached an all-time low of 11.7 in 1965, two years after large-scale atmospheric testing had ended.

Could it be that this effect on fetal mortality had also been missed by Dr. Neel because his study had not taken into account the effects of fallout on the control population? Was it some kind of statistical illusion, or was it real, and therefore far more serious than even the rise in leukemia?

The library closed for the day, cutting short my investigations. But the implications were staggering. For it was widely known among statisticians that the number of fetal deaths listed in the U.S. Vital Statistics was perhaps no more than one-tenth of the total that actually occurred, since many cases, especially in the early months of pregnancy, were never reported to the authorities. Before the fallout, there had been only two or three leukemia cases per year in the Troy area, as compared with some 150 to 200 reported fetal deaths. The actual number of fetal deaths in the area would probably have ranged from 1500 to 2000. If the relative increase in fetal deaths in Albany-Troy-Schenectady after the fallout was comparable to that for leukemia, then it would involve the loss of hundreds of times as many unborn children as might die from leukemia.

If it was true that fallout caused an increase in fetal mortality, then a similar effect should have occurred not only in the Troy area but also in the rest of New York State, parts of which had been exposed to various other rainouts throughout the 1950s. The next day I returned to the library and went through the data for New York State as a whole. Exactly the same pattern existed: There was a steady decline in fetal deaths toward a minimum of 22.2 per thousand births in 1950, but then the rate actually rose again to 23.3 in 1953 instead of continuing its decline to the 20 per 1000 live births that was to be expected if the normal downward trend had continued. After a brief drop in the mid-fifties, fetal mortality rose once again following the major test series in 1957 and 1958, so that the rate exceeded the expected number by almost 50 percent in 1960. The gap widened steadily as all further improvements in living standards, diet, and maternal health care suddenly failed to have any further effect.

But when I reached 1964, I found the most extraordinary figure of all. In a single year the number of reported fetal deaths in New York State had jumped by 1500 cases. After this it declined once more -- the exact same pattern as in the Troy area. In the single year 1964, then, there must have been some ten times this number of reported cases, or, ten to fifteen thousand additional children lost by miscarriage or stillbirth in New York State alone. This tremendous steplike increase for the entire state was clearly connected with the 1961-62 test series, from which large peaks in iodine and other short-lived radioactivity resulted when the spring rains came down in 1963. Unlike the local rainouts of the 1950s, the fallout from these extremely large tests came down much more uniformly over large areas of New York State. Thus there would have been few, if any, unexposed sections, and the state as a whole would show the kind of sharp increases that earlier had been seen only in localities like Albany-Troy.

But could this extraordinary figure be the result of some statistical fluctuation, or a sudden improvement in reporting methods that happened to coincide exactly with the period of the highest fallout levels ever recorded? There was one way to check this very quickly. Unlike the number of fetal deaths, more than 95 percent of all live births are reported to the public health authorities, since nearly all of them take place in hospitals. So if there had really been an increase of some 15,000 fetal deaths in New York State in 1964, then there would have to have been a corresponding sudden drop in the number of children born live the following year. And this is exactly what happened.

For 1962, the total live births in New York State were listed as 354,152. For 1963, the number had increased to 355,760. For 1964, there was a drop to 351,602. But for 1965, there was a sudden decline to 335,628. This was a drop of 15,974 live births, or almost exactly the number of babies lost in 1964 through stillbirth or miscarriage. The rise in fetal deaths must therefore have been real.

It was imperative to make still another test. New York State in the early 1960s was more or less typical of the United States as a whole with respect to the levels of fallout in milk, food, and water. Therefore, the entire country should have shown the same effect: some ten to fifteen times as many fetal deaths in 1964, and a corresponding sharp drop in live births in 1965.

It took only a few minutes to find the figures for the children born live in the United States during these years. For 1964 the number was 4,027,000, and for 1965 it had declined to 3,760,000, a sudden drop of 267,000, the sharpest single decline in the entire history of the United States. And for the entire country the year before, fetal deaths showed a corresponding jump.

It seemed that if there had been about twenty times as many bombs detonated during the 1961-62 test series, there would probably not have been many children born live in 1965.

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