later he descended into the bomb crater and spent a limited period, perhaps half an hour, there. It is not stated whether he wore his film badge at that time or if so, what the reading of the film badge was. It would be my guess that the residual radioactivity of the crater was not fully appreciated at that time... . CASE NO.29 Type ofInjury: Acute Granulocytic Leukemia. BVA's Decision: Denial Reversed. Date of Decision: 1969. . ee eee. i at ee Appellant’s Allegation: That veteran’s condition was caused by exposure to radiation received while in the service. Facts: The veteran had active service from August 1942 to November 1945. He was assigned to security duty from January 1944 to November 1945. During this period he was assigned as a driver at the Trinity Atomic Test Site in New Mexico (during and after the detonation of the first nuclear bomb in July 1945). Acute granulocytic leukemia was diagnosed during 1967 at which time veteran had a history of fatigabitity. Veteran testified that he did not believe the official record that he had been exposed to 2 roentgens of radiation represented even a fraction of the exposure he had received, but only related to one incident. He testified he had been exposed to radiation on many other occasions. Medical Evidence: The Board of Veterans Appeals referred the veteran’s case and records for the opinion of an independent medicalspecialist on the effects of atomic radiation. This opinion, issued in November 1968, is as follows: [Veteran] is clearly suffering from acute granulocytic leukemia, and it is established that acute granulocytic leukemia as well as other forms of leukemia maybe related to earlier exposure to ionizing radiation. Not all those so exposed develop leukemia even though the exposure might be very high (up to several hundred R), but those individuals exposed to jonizing radiation have an appreciably higher probability of developing leukemia than do those persons not thus exposed... . The veteran, from the records of his fitm badges, is stated to have received an aggregate of about 2 R. This would have been minimal. In the early days of the Manhattan Project particularly, knowledge in radiation health physics had not yet developed as to the wave length dependency of the photographic emulsions used in film badges. Consequently, determinations made from these emulsions tended at times to be lower than the actual exposures. Hence, we must regard the recorded exposure as minimal rather than maximal. It is clearly established in the record that [veteran} as... chauffeur was present at the Trinity test explosion in 1945 and that also approximately 30 days 92 Calculation of dosimetry in this instance is difficult. Radioactive iron would probably have been the most troublesome radioactive component of the elements activated by neutrons in the soi! of the crater. Assuming a reasonable concentration of iron in the soil and only a moderate amount of residual iron present from the structure of the test tower at one month after the detonation, [veteran] might well have received radiation totaling less than IOOR.... In addition, [veteran| acted as a courier in transporting radioactive materials. These probably were adequately shielded, as the Manhattan District handled its shipments carefully. However,it is quite possible that there might have been some minor additive exposures occurring in the course of this work. Considering the nature of his work, the fact that he had access to restricted areas at Los Alamos, that he transported radioactive material, that he was present at the test explosion, the evidence that he was present, though at an adequate distance, and apparently in the open air at the time of the Trinity test, the fact that he entered the bomb crater at Point Zero a month later, combine to present a strong probability that he had received much more than the minimal 2 R of radiation recorded by his film badges. From all the available evidence it would seem probable that the veteran might have received radiation totaling as much as 100 R in the course of his various opportunities for exposure. Such an amount of radiation would clearly be in the leukemogenic range. The time interval between exposure and disease is not excessive. | know in my personal medical experience of one case where the exposure to radiation was received in 1906 and 1907, and leukemia did not appear until 25 years later. There are many cases where damage from occupational exposure to radiation has been late (over 15 years) in developing. Hence, the remoteness in time of the development of the disease from the time of exposure does not militate against the probability of a causal relationship. On the basis of all the evidence presented, research in the literature and my own experience, | am convinced of the following: 1. Exposure to ionizing radiation on the order of 100 R or more predisposes to the development of leukemia. The veteran may well have received radiation in this range. 2. The type of leukemia that he has developed—acute granulocytic—is known to appear with considerable frequency among those exposed to large doses of ionizing radiation. 3. The time elapsed between exposure to radiation and onset of 93