Appendix I. Complete Inventory of All Documents in the Archive

Appendix II. List of Documents Selected at Primary Review Stage

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CHAPTER I. CONCLUSIONS AND RECOMMENDATIONS

A. INTRODUCTION

The search of the files of the Public Health Service (PHS), instituted at the direction of the Secretary of HEW in January of 1979, resulted in the creation of an Archive containing more than 11,000 documents. Only a small proportion of these, about five percent, met the Panel's criteria for critical review, i.e., inclusion of substantive material and relevant background information relating to radiation exposure from weapons testing or the health impact of such radiation in a six-state offsite area: Colorado, Wyoming, Utah, Nevada, New Mexico, and Arizona. Most of the Archive consisted of documents which were not reviewed by the Panel because they dealt with issues unrelated to the Charge of the Panel, including such issues as worldwide fallout, nuclear reactors, medical uses of radioactivity, background radioactivity, and various administrative affairs.

The Panel had no way to assess the completeness of the Archive since it had no part in its assembly. Furthermore, the numerous reorganizations of the PHS during the last several decades, and existing policies regarding the destruction of inactive government files after 10 years of storage, suggest the probability that many documents have been lost. It should be noted that the Archive does not include any files from the Department of Defense, the Department of Energy (DOE), or other Federal agencies which may bear on the Charge to the Panel.

In the course of reviewing the Archive, the Panel came across documents describing other sources of radiation exposure to the general population besides nuclear weapons fallout; these included natural background, nuclear industries, and the practice of medicine. A review of these other topics was not germane to the Charge of the Panel, but to leave them unmentioned might be misleading. It seems reasonable that governmental concern with the health hazards of radiation should focus on those sources which contribute large proportions of that radiation received by the population, and on those sources

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background and medical use accounted for far more radiation to the average member of the population than did either nuclear fallout or industry. With the ban on atmospheric nuclear tests already in effect in most countries with nuclear capability, medical and industrial uses of radiation are the sources which can be modified. Therefore, the Panel suggests that any future work resulting from the present report on fallout in no way diminish efforts to improve health by investigation and action directed at medical and industrial uses of radiation.

B. CONCLUSIONS

While the PHS had been involved with the Atomic Energy Commission (AEC) after 1949 in surveillance and monitoring of environmental contamination by ionizing radiation, it was not until 1954 that it assumed well-defined responsibilities in this regard around the Nevada Test Site (NTS) where the nuclear weapons tests in the continental area of the United States (U.S.) were conducted. The Archive, however, contains documents relating to environmental surveillance and monitoring primarily after 1958, i.e. after the weapons tests of the early 1950s.

Documents in the Archive reveal extensive activities by the PHS to measure contamination of food, water, milk, and air by fallout from weapons testing. The Archive indicates that radioactivity in milk and food was not generally different in the states surrounding the NTS than in other states during the period observed. However, an incident of excess radioactivity in milk supplied in and around Salt Lake City in 1962 is reported in the Archive. This incident required initiation of a series of actions to protect the population from excess exposure.

The Archive contains few documents which provide data useful in assessing individual external radiation exposure, although there is evidence that as many as 2,000 offsite volunteers wore film badges at one time or another in the area around the NTS. Somewhat more information is available in the Archive regarding internal radionuclide contamination from strontium-90 in the form of data from a bone sampling program during the years 1959-1963 and reports of other theoretical and observational studies. From these sources it may be concluded that theoretical calculations of bone levels of strontium-90 agreed well with actual measurements, that bone concentration in children

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living in areas thought to have received particularly large amounts of fallout (Washington and Iron Counties, Utah) were no different from the levels in bone samples from children of comparable age in other areas. Bone concentrations in several children dying of leukemia in Washington and Iron Counties were no different from the rest of their age group. With respect to thyroid gland exposure from internally metabolized iodine-131, the Archive contains a number of documents referring to estimates based on various theoretical models for the passage of radionuclides through the food chain to the thyroid gland. were limited by inadequacies of the available exposure data. Thus, the exposures reported in Archival documents varied greatly, although there appears to be general agreement among the authors of the documents that children in the fallout areas proximal to the NTS received more exposure than those more distant.

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The Archive contained a number of documents consisting of reports by Drs. E. Sternglass, J. Tamplin, and J. Gofman and critiques of their papers. In general, they were critical of radiation protection standards. These papers and others by the same authors have been extensively reported, reviewed, and critiqued mainly in full public view. The Panel did not feel that further analysis of these documents would resolve these issues more satisfactorily than has already been accomplished. A great deal of data concerning environmental monitoring and surveillance as well as body burden measurements were made available to the public in a publication of the Bureau of Radiological Health (BRH) entitled, Radiological Health Data. The Panel did not review or evaluate this resource because it was not part of the Archive.

Ionizing radiation produces both genetic and somatic effects. Genetic effects are those resulting from alteration of germ cells and lead to mutations which may show up in any subsequent generation. Somatic effects are direct results of exposure of biological tissues and occur in the same generation. Developing tissues in the embryo or fetus are particularly sensitive to radiation damage. Somatic effects may be acute and occur shortly after exposure or they may be delayed in appearance by months or years. The Archive contains documents bearing on all of these possible outcomes, except that information on acute effects is minimal.

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mutations or may be induced by direct effects of radiation on the developing organism. By making assumptions regarding the proportion of birth defects. attributable to natural background radiation, and extrapolating from the results of animal experiments, it is possible to make rough estimates of the additional cases which may be expected as a result of nuclear weapons testing fallout. The Archival documents provide such estimates together with projections of embryonic and neonatal deaths attributable to ionizing radiation from fallout. For both types of outcome (birth defects and embryonic and neonatal deaths) the proportion expected to be added to those occurring under "natural" circumstances is relatively small and therefore hard to detect less than

0.1 percent of the total number in each category. The actual total number of defects nevertheless would be sizable. Thus, if the total number of birth defects in the U.S. in one generation were two million, the number contributed by exposure to weapons testing fallout through 1961 would be approximately 1,500.

Efforts were made to assess possible changes in the occurrence of spontaneous abortions (miscarriages), stillbirths, and congenital mal formations in Utah and other states in the fallout area. However, the data in the Archive are fragmentary and essentially uncontrolled, and therefore inconclusive.

The most important delayed somatic effect of ionizing radiation is the causation of various neoplastic diseases. Studies of the carcinogenic effects of radiation are difficult since radiation-related tumors have varying latent periods ranging from a few years to several decades. Although the PHS assumed responsibility in 1954 for the offsite monitoring of possible adverse health consequences of fallout, the Archive contains no documents describing the investigation of leukemia, cancer, or thyroid diseases until 1961. In 1963, a coordinated program of surveillance and special investigations was established by the Division of Radiological Health (DRH), the State Health Departments of Utah, Nevada, and Arizona, and the University of Utah. The Archive contains no documents related to this coordinated effort after 1971.

The thyroid gland is particularly liable to be affected by fallout because of its ability to concentrate iodine-131, a fission product making up an important part of weapons testing fallout and likely to gain access to the human body, particularly in children, through contamination of cattle fodder and subsequent incorporation into the milk supply. Two major studies of