The Lancet, Volume 349, Issue 9044, Page 64, 4 January 1997
Copyright © 1997 Elsevier Ltd All rights reserved.
Increased mortality in US nuclear test veterans
Sue Rabbitt Roff a
50 years after the first nuclear tests in the Pacific, the Medical Follow-up Agency of the US Institute of Medicine has released its study of mortality of military veterans who were involved in the CROSSROADS nuclear test programme.1 The study wisely rejects the use of standardised mortality ratios as inappropriate for veterans’ studies because of the influence of the healthy soldier effect; specifically, it comments that Robinette and colleagues’ studies2 of Nevada nuclear veterans have been withdrawn from discussion. The CROSSROADS study also repeatedly rejects the use of the nuclear test personnel review (NTPR) dose estimates based on the repudiation of this post facto database by the Committee to Study the Mortality of Military Personnel Present at Atmospheric Tests of Nuclear Weapons in its letter to the US Defense Nuclear Agency dated May 15, 1995.
Having rejected the two central principles of all previous official studies of nuclear and atomic veterans’ mortality and morbidity, the present study then takes as its control group a similar number of similarly stratified non-participant veterans of the armed forces (ie, men who did not participate in the CROSSROADS series). Most people in both participant and non-participant cohorts were navy veterans. The use of the term participant does not in fact coincide with the term on-site participation, as cited by the report from the Federal Register, but with the operational period as defined in the same source (ie, July 1, 1946, to Aug 31, 1946). The report notes: “To maintain clarity of cohort definition, this study does not include so-called ‘post-CROSSROADS’ participants, those military personnel who arrived in the designated area after the formal cutoff date of the operation but within the 6-month period 1 September 1946 through 28 February 1947.” Thus, men who participated in Operation CROSS-ROADS in the clean-up and decontamination periods could well have been listed among the controls.
Despite these and other limitations, the study did detect a 4·6% increased mortality among the navy veterans of Operations CROSSROADS. The data-base created by the study over 10 years would provide an excellent compare-son—especially of the long-term, latent effects—with that held by the UK’s National Radiological Protection Board of more than 20 000 veterans of British tests in Australia and the Pacific. However, this UK database is due to be dismantled in March, 1997, “for lack of funds” according to the board.
1 Mortality of veteran participants in the CROSSROADS nuclear test.. Medical Follow-up Agency, Institute of Medicine. Washington DC: National Academy Press, 1996.
2 Robinette CD, Jablon S, Preston TL. Studies of participants in nuclear tests. National Research Council, Washington DC: National Academy Press, 1985.
a Centre for Medical Education, University of Dundee, Dundee DD2 1LR, UK