In 1990, decades after dozens of nuclear blasts from weapons testing shot radioactive dust into the skies above Nevada, the U.S. Congress agreed with what health activists had been arguing for years: People affected by the tests deserved compensation.
"I believe our nation has a commitment to the thousands who were victims of radiation exposure while supporting our country's national defense. We have an obligation to care for those that were injured, especially since they were not adequately warned about the potential health hazards," said Sen. Orrin Hatch (R-Utah) in 2003.
Known as the Radiation Exposure Compensation Act (RECA), the 1990 law provides lump sum payments of $50,000 for "downwinders"people who lived in a fallout zone in the 1950s and 1960s. A 2000 amendment extended the program to uranium workers (who receive up to $100,000) and added several cancer types to the list of diseases for which downwinders could file claims.
A recent National Academies panel concluded that the compensation program should better reflect the latest data on radiation exposure. Instead of simply compensating anyone who lived in a particular county during the tests, the panel recommended estimating the amount of radiation each compensation candidate received.
The report, Assessment of the Scientific Information for the Radiation Screening and Education Program, noted that ongoing research regarding fallout patterns indicated that some areas outside the compensation zone received as much or more radioactive fallout as compensated counties. Idaho and Montana were particularly affected. In fact, according to maps produced by the National Cancer Institute in the late 1990s, Montana was home to the five counties with the highest per capita exposure to fallout, but state residents were ineligible for any compensation. To further complicate matters, within-county variations in fallout density were sometimes much larger than between-county differences.
So in 2002, Congress asked the National Academies to review RECA with an eye toward expanding, or at least redefining, the geographic zones and diseases covered by the act.
R. Julian Preston, Ph.D., director of the environmental carcinogenesis division at the Environmental Protection Agency, chaired the review panel, which released its conclusions in late April. Regarding diseases eligible for compensation, Preston said the case was clear. "We didn't feel there was any information in the recent literature that suggested adding anything [to the existing list]. The doses required [to cause other diseases] would be much higher than even the highest exposure predictions."
But regarding geographic spread, the case was muddier. "Fallout doesn't have geographic boundaries," said Preston. "The original act was based upon the information available at the time and some political decisions."
Hatch spearheaded the act and had ensured that much of his state was eligible for compensation. Early estimates of prevailing wind patterns suggested that most of the fallout blew east and southeast, into much of Utah, southern Nevada, and northern Arizona, which were included in the legislation.
But that assumption was flawed. In the late 1990s, NCI researchers published maps showing that Nevada Test Site fallout spread across the nation. One relative hot spot even appeared thousands of miles east, in Vermont.
With these data in hand, Preston and the NAS panel have proposed compensation based on estimated individual exposures instead of geography. "We decided geographic areas was not the way to go. We instead recommended expanding RECA based on a scientific principle," he said, citing a hoary ethical maxim: "Like cases must be treated alike."
Calculating Odds
In this instance, "like cases" means cancers that are equally likely to be caused by radioactive fallout. Because medicine cannot yet determine whether radiation sparked a tumor, epidemiologists are left estimating. Their best guess to date, which comes from a 2001 draft report from the NCI and the Centers for Disease Control and Prevention on the consequences of global fallout, is that all nuclear tests conducted around the globe between 1951 and 1962 raised the risk of dying from cancer among U.S. residents alive at the time by 0.03%. That figure translates to an additional 11,000 cancer deaths against a background of 40 million total cancer deaths.
But in the 1970s, a vocal movement of Western state residents and environmental activists did not know this. They demanded action from Congress and filed a raft of liability lawsuits against the government. Congress began debating radiation compensation in 1979, and in 1983 they asked NCI to help sort through the claims and counter-claims.
"The idea was to give Congress and the courts something substantial to base their decisions on," said Charles Land, Ph.D., a radiation statistician at NCI. "Probability-of-causation models do that."
|
The NAS panel recommended that Congress base future RECA compensation on the tool. "The [probability-of-causation] models weren't available when RECA was established," said Preston. "But they are used in other compensation laws." In particular, the Departments of Energy and Defense compensate nuclear weapons plant workers and soldiers, respectively, who are exposed to radiation while on the job. Both DOE and DOD use the NCI probability-of-causation formulas, as does similar legislation in the United Kingdom that compensates workers exposed to radiation.
The proposed formulas for RECA would be similar, with modifications to account for the physics of above-ground atomic explosions. Although a person's location at the time of detonations is key, other factors come into play. Age at exposure is of major importance; children are more susceptible than adults. Age at diagnosis is another important factor; tumors identified within a few years of exposure are much more likely to be caused by radiation than tumors discovered decades later.
And it turns out that cow and goat milk is the fourth major factor. When an atomic bomb explodes, it shoots a radioactive rainbow of isotopes into the atmosphere. As the fallout spreads, it settles on buildings, trees, and grass. As cows and goats grazed on grass dusted with fallout, their metabolism funneled one specific isotope, iodine-131, into milk. When peoplechildren in particulardrank the contaminated milk, their thyroids, which need iodine, took up and further concentrated the isotope.
|
The NAS report recommended extending the model to the other compensable cancers and the full range of isotopes, not just 131I. "The other radionuclides were never given much attention because their significance is much lower," said Simon. "It's pretty hard to have received much exposure from them."
Nevertheless, in 2001, again at the behest of Congress, NCI and the CDC published their draft report on the feasibility of performing a detailed analysis for each isotope generated by the global sum of atomic testing between 1951 and 1962.
"We don't have a good model of how to estimate doses that came from outside the U.S.," said Simon, who helped write the draft report. "It's going to move around the Earth and [the isotopes] are decaying as they drift, so you need to take that into account." Preston, whose committee carefully considered the draft NCICDC report, said that his impression was that such models "would not take an enormous amount of work." Simon in part agreed, saying that the 131I work poured an important foundation. "Anything's doable given time, money, and effort," he said. "But no one's asking for it."
Waiting for Reaction
Although Congress mandated both the NAS report and the NCICDC report on global fallout, its interest in their findings has been low or even "nil," according to a source inside the National Academies.
After the report's release, Rep. Jim Matheson (D-Utah) said, "I'm worried that moving away from geography as a basis for expanding RECA may result in thousands of downwinders falling through the cracks."
Preston and his panel sensed this reaction when they briefed lawmakers. "Every senator and congressman would like to go back to their state and say, Hey, this is a winner. You're all going to get compensated, "Preston said. "There was a degree of realization that this was not the case and probably some degree of disappointment."
Simon was a bit more blunt. "Whether it does or does not take a lot of work [to develop the NAS-recommended models] is not the issue ... . [The legislators] didn't want something where [people possibly eligible for compensation] would have to prove their case in a difficult, technical way. That was the last thing on earth they wanted."
There also appears to be little interest in the NCICDC draft feasibility report on global fallout models. The CDC posted the draft on its Web site after its release in 2001 and then sent it to the Secretary of Health and Human Services for review. Four years later, without a final version in sight, HHS had not provided an explanation for the delay before this article went to press.
Despite these obstacles, though, Congress is moving to expand RECA. Bills introduced this spring would add much of Montana, Idaho, and all of Guam to the list of compensable geographic regions. But the legislation fails to address the NAS recommendations meant to put RECA on a more defensible scientific footing. Said Simon, "We haven't heard anything from Congress. Not a peep."
![]() |
||||
|
Oxford University Press Privacy Policy and Legal Statement |