as showing 9,600 white blood cells with 45 per cent neutrophils, 5! per cent lymphocytes and 3 per cent monocytes and | per cent eosinophils. CASE NO. 22 Type ofInjury: Acute Monocytic Leukemia. BVA’s Decision: Denial Reversed. Date of Decision: 1966. Appellant's Allegation: The veteran's death from leukemia was a result of exposure to radiation during active service. Facts: Veteran retired in 1954 after 30 years of active service. Veteran allegedly developed acute monocytic leukemia about eight years following exposure to ionizing radiation during various atomic bomb tests. Service records indicate that the veteran was subject to possible exposure to radiation only during the period from November 1950 to November 1953 while he was assigned to an atomic experimental project from March 1951 to May 1951 and to other research and development projects for an indefinite period beginning in October 1951, for 110 days beginning in March 1952, for 120 days beginning in February 1953 and for 4 days during August 1953. At the time of the 1951 experiment, veteran assisted during actual field testing of the equipment because of a shortage of manpower; that all operations were considered routine in nature and were carried out within the safety limits with the exception of one instance when fall-out occurred; that the level of fall-out was considered to be above that normatly safe for extended periods of operation; that all personnel were requested to stay under cover shelter until the intensity of radiation subsided to a safe value; that there was no reason to believe that the veteran did not follow this request, that some 2 or 3 hours after the onset of fall-out it was declared safe to resume normal activities. Veteran's dosimetry records were found only for the year 1951 which indicated that he received during the March-May 195) operations a total of 1.75 roentgens, and for the October-November 1951 operations a total of 0.10 roentgens. On examination in January 1954 for retirement from service veteran did not complain of radiation exposure and a complete blood count was not done. Defects found following physical examination were slight impairment of hearing, myopia corrected by lenses and recurrent arthritic pains of the knees. Service medical records disclosed hematology examinations of veter..n in 1951 and 1952. Examination of the veteran’s blood in September 1951 was reported Evidence indicated that there was no history of cancer or leukemia in the veteran’s family. Outpatient treatment records received from a United States Army Hospital show that the veteran was seen a number of times from February 1956 to February 1960 for unrelated complaints. In October 1956 a complete blood count was done. This examination revealed 6,700 white blood cells with 53 per cent neutrophils, 42 per cent lymphocytes, 4 per cent monocytes and | per cent eosinophils. There is no record of outpatient treatment after February 1960 until February 1963 when he had a small keratotic lesion on his lower !ip. Later in February 1963 another lesion was noted over the left malar region. Both lesions were excised in March 1963. In May 1963 he complained of sudden onset of pedal edema the preceding day and of other symptoms of one week’s duration and he was admitted to a United States Army Hospital. On admission to the hospital it was clinically recorded that for the last few weeks he had had slightly less energy and other symptoms for a week or two and that the whole process had been very insidious. Following physical and laboratory examinations a diagnosis was made of leukemia, acute, subacute, probably myelocytic. He was discharged in May 1963 pending further pathological studies and was readmitted a few days later for treatment. He died on May 25, 1963, of a cerebral hemorrhage due to monocytic leukemia, probably myelomonocytic. Medical Evidence: The appellant submitted for the record, responses from two medical doctors containing answers to a number of theoretical questions about radiation and leukemia. One doctor stated that long term exposure to small to moderate doses of roentgen radiation can lead to the development of leukemia; that nothing definite can be said about a “safe” level of exposure but that this unquestionably will vary from one individual to another, probably due to genetic, age and environmental circumstances; that over the years the estimated “safe” level has shifted downward because of the awareness of increasing incidental and environmental exposure; that there is a definite and high incidence of correlation between radiation and the development .. jeukemia but that it cannot be said that radiation as such is causative althoughit is the only definite factor which has been associated with leukemia with some degree of regularity; that the probability of development of leukemia is increase:! individuals exposed to long periods of radiation, and that the leukemia which follows chronic radiation is usually some years in developing, usually within a period of 2 to 5 years after exposure. The second doctor stated that radiation was an established leukemogenic agent in man; that the ‘‘safe” level of radiation exposure would depend on the level of certainty desired and that from available data it was not absolutely as showing 6,900 white blood cells with 49 per cent neutrophils, 50 per cent certain that any dose of radiation, no matter how small, was safe, that the estimated “safe” limit had been reduced; that there was a definite and high correlation between leukemia and radiation and that it can be assumedthat radiation causes leukemia in some cases; that there was no other known cause 74 75 lymphocytes and 1 per cent monocytes. The study in July 1952 was reported of leukemia in man although there was increased susceptibility in certain