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Both Young and Old

MEANWHILE, I continued my search, for the investigation of infant mortality had revealed still another possible dimension of the effects from fallout. As Dr. I. M. Moriyama put it in the introduction to his 1964 report entitled "The Change in Mortality Trend in the United States":

The same kind of change in trend observed for infants appears to be taking place in the death rates for other ages.

Regarding the overall trend, he added:

The failure to experience a decline in mortality during this period is unexpected in view of the intensified attack on medical problems in the postwar years . . . there has been a growth in the volume and scope of health services in prevention, diagnosis, medical and surgical therapy, and rehabilitation, and also an improvement in their quality. The rapid growth of health insurance plans has made high quality medical care readily accessible to ever-increasing numbers of people. The rising level of living has resulted in improvement of work and home environment, quality and variety of food, educational attainment, and facilities of recreation. Developments in medicine arising from the exigencies of a global war have become readily available for application to civilian health problems. At no time in the history of the country have conditions appeared so favorable for health progress.

In this setting, it would seem reasonable to expect further reductions in mortality. On the other hand, the possible adverse effects on mortality of radioactive fallout, air pollution, and other manmade hazards cannot be completely ignored.

In the School of Public Health library, page after page of data showed the same dramatic upward changes for chronic diseases as had occurred for childhood leukemia and fetal and infant mortality. Deaths from all types of noninfectious respiratory diseases such as lung cancer, emphysema, and bronchitis had increased especially dramatically among all age groups, as had deaths from certain other types of cancer. The overall life expectancy, particularly for adult males, had begun to level off and then actually declined again after decades of steady rise in this country and in northern Europe.

Most significant of all were the death rates due to all types of childhood cancers in the U.S. For young people of both sexes, white and nonwhite alike, there were sudden, steplike jumps in the cancer rate between 1948 and 1951. For the white children, the rate doubled during these three years. The rate for the nonwhite children, which had held basically steady between 1930 and 1948, tripled during the same three-year period. This was to be expected if fallout was the cause, since by far the largest portion of the nation's nonwhite population lived in the regions where the fallout from the early tests came down.

When had this overall trend begun? Dr. Moriyama's report indicated that deaths from respiratory diseases and childhood cancers either declined steadily or held level throughout the 1930s and most of the 1940s, the period of rising air pollution and the tripling of cigarette consumption. Between about 1948 and 1950, three to five years after the detonation of the first bombs in New Mexico and Japan and the onset of atomic testing in the Pacific, the death rates from these diseases suddenly began to shoot up. For example, the annual death rate among white males seventy-five to eighty-four years old from respiratory diseases (not including influenza and pneumonia) was close to 110 per 100,000 per year in 1934. By 1948 it had declined to an all-time low of about 70. But after this it shot up to 190 by 1960.

The sharp upward changes in the rates for these types of chronic diseases were reflected in an overall leveling in the decline of death rates for the United States as a whole. But this effect was particularly serious in certain states, where the death rates actually rose again after decades of steady decline. As Moriyama pointed out: "In twelve states and the District of Columbia there appears to be a marked rise in the crude death rate during the past five to ten years as represented by the trend for North Carolina." The list of the states showed that they were all either southern states to the east of New Mexico and Nevada, or states directly to the northeast of the Nevada test site. The states were Alabama, Arkansas, the District of Columbia, Louisiana, Missouri, North Carolina, South Carolina, Tennessee, and West Virginia in the South, and Nevada, Colorado, South Dakota, and Wyoming in the West. None of these states was heavily industrialized or noted for its air pollution. In fact, the opposite was true.

The number of excess deaths in the U.S. resulting from these upward changes in the death rates was calculated by Dr. Moriyama as being 300,000 during 1956-60. This was the period of heavy Nevada testing. The fallout and the excess deaths continued as testing resumed in 1961. According to Moriyama, "The estimated excess deaths is about 85,000 deaths for 1961, and 131,000 deaths for 1962." The "excess deaths" had jumped from an average of 60,000 per year during the earlier period of testing to 85,000 in 1961, the year that the Russians detonated the largest megaton weapons ever exploded. In the following year, when nearly 70 megatons of fission energy were detonated by the U.S. and the Soviet Union -- the highest megatonnage ever exploded in a single year -- the excess deaths in the United States alone reached 131,000.

The same trends were also evident in other parts of the world. A detailed report on changes in mortality trends for England and Wales by Hubert Campbell at the Welsh National School of Medicine showed that in those countries the mortality rates for the very young and the very old followed exactly the same pattern as in the U.S. Beginning about 1953-55 the total death rates for 1- to 4-year-olds suddenly refused to decline further. For the 5- to 9-year age groups, which the studies of Stewart and MacMahon had shown to reflect most strongly the cancer-causing effect of irradiation during early development, the mortality rate actually started to climb again. Beginning the year after the first Nevada tests, there was also the same sudden halt in the rapid decline of maternal mortality associated with complications of pregnancy and childbirth as in the U.S. These rates actually turned sharply upward in 1960-61 for the youngest group of women (15 to 24 years of age) for the first time in modern history. And there was the same sharp rise in cancer deaths of all types for the age group 5 to 14 years, following some three to five years after the New Mexico test and the detonations in Japan in 1945. Both male and female death rates jumped in a steplike fashion: from about 30 per million per year to about 60 for boys, and from 25 to about 50 for girls, all between 1948 and 1951, exactly as in the United States. That these rises could not be due to changes in statistical or classificational methods was emphasized by Campbell: "There has been no important change in the classification of these diseases during this period. . . ."

For all age groups in England and Wales, Campbell's report showed tremendous rises in leukemia for both men and women, beginning suddenly between 1947 and 1951, with the sharpest changes for the very young and the very old. Thus, whereas the leukemia death rate had remained fairly steady for men 75 to 84 years old during the fifteen years between 1931 and 1946, ranging from 50 to 80 deaths per million individuals each year, by 1954 the rate had increased to about 200. It reached 350 by 1959, an increase of about 500 percent. During the same period, the leukemia rate remained unchanged for the middle-aged group 45 to 54 years old, but it increased some 50 percent for boys 5 to 14 years of age. This was the rise that had prompted Dr. Stewart's study.

The data for Japan, prepared by a group of public health physicians and statisticians from the Japanese Institute of Public Health, was particularly significant, since Japan was not only exposed to the fallout from the Hiroshima and Nagasaki bombs, but also received the radioactive debris from the U.S. Pacific and Soviet Siberian tests.

The report showed that three to five years after the fallout from Hiroshima and Nagasaki descended in 1945 the cancer rate for the 10- to 14-year-old children all over Japan tripled from 10 to 30 cases per million population, gradually climbing further to 40 cases by 1955 and to 50 by 1963, a fivefold increase during the period of heavy testing. For the youngest children zero to 4 years old, the increase was less, once again confirming the hypothesis that radiation was the causative factor as in the case of Troy. Again, the rates for the middle-aged group remained level, while the rate for those over 80 went up as elsewhere, in the case of Japan from about 3000 to 8000 per year per million individuals.

Here then was the confirmation of why the studies of the Hiroshima and Nagasaki survivors had not revealed any effects on their children. Everywhere in Japan, mortality rates had gone up due to the fallout, so that there was little or no difference between those survivors exposed to the direct flash and those who received the fallout in their diet over the years that followed.

And after the large hydrogen bomb tests, deaths due to noninfectious lung diseases such as emphysema and bronchitis suddenly stopped declining in Japan after 1955. This was the year after the Pacific and Siberian tests filled the air all over the world with radioactivity. In the next two years, deaths due to bronchitis, which had been dropping rapidly from 150 per million population in 1950 to a low of 40 by 1955, actually began to rise again. Thus, in the period from 1945 to 1955, when industrial growth and the accompanying smog and chemical pollution had been very great, these respiratory diseases had been declining. As in the United States, they rose only after the enormous increase of atmospheric radioactivity.

If the major factor was fallout and not the pollution produced by industry and the automobile, then Chile provided an excellent chance to test this hypothesis in a country of low industrialization, as it was the only South American country for which detailed mortality-trend data was available. Since Chile was located on the west coast of South America, facing the prevailing winds from the South Pacific that release their moisture on the steeply rising slopes of the Andes, there should be upward changes in mortality following the first two series of Pacific A-bomb tests in 1946 and 1948. And these increases should be even more noticeable for the heavy series of tests beginning in 1952, involving the "dirty," uranium-clad hydrogen bombs that had produced such massive amounts of fission products.

The Chile mortality graphs instantly confirmed this prediction, especially the plot of mortality for the infants dying between the ages of one month and one year, which showed an initial rise between 1947 and 1949 after the first Bikini and Eniwetok tests. Far more serious was the sudden and complete reversal of the overall infant mortality trend, from a steady decline to a continuous rise beginning in 1954 and persisting until 1960, the last year for which data were available.

And the same change had taken place in the total mortality rate for all ages combined. There had been a steady decline after 1933, except for small rises during the second half of the 1940s, but then between 1953 and 1955 there was a sudden and complete end to the decline for both men and women, continuing for as long as the data had been plotted.

In the words of the report's authors, a group of Chilean public health specialists:

The significance of this trend is evident if the mortality for 1960 is estimated on the basis of regression for 1933-53. The expected rate was 8.6 and the observed rate was 12.3, which means that 28,024 of the total 93,265 deaths registered in 1960 would not have taken place if the previously described trend had continued.

This did not mean that cigarettes or air pollution were not significant factors in chronic lung disease, or that heavy metals, pesticides, food additives, and other pollutants were not adversely affecting worldwide health. The phenomenon of synergism, in which combinations of two or more biological agents have a much greater effect than one alone, is well known to modern science. For instance, it has long been known that uranium miners have ten times the normal rate of lung cancers because of their breathing of radioactive gas in the mines. But those who smoked died of lung cancer at one hundred times the normal rate.

However, statistics from all over the world kept indicating that radiation was the dominant factor in these worldwide changes of mortality trends. It made no difference what the social or economic system was, nor how much medical care was available, as in the very different cases of the Netherlands versus Chile. It made no difference whether infant mortality was high or low to begin with, as in Mississippi versus Sweden. It did not matter whether there was any air pollution, or what the genetic, cultural, or dietary differences were. There was only one way to explain these worldwide, synchronous, and totally unexpected changes that did not stop at any national boundaries nor at the edges of the seas. Only the introduction of some new and enormously powerful biological agent on a worldwide scale could produce such sudden rises in death rates that could almost be termed epidemics. And this new agent clearly seemed to be the fallout that had been released into the atmosphere in quantities equivalent to tens of millions of pounds of radium, the most powerful biological poisons yet created by man, circling the world in a matter of a few weeks and attacking mainly the weakest in every living species -- the developing young and the very old.

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