Enclosure 5 LETTER TO EXAMINING PHYSICIAN SUBJECT: Medical Evaluation of Nuclear Weapons Test Participants TO: 1. Medical Officer Performing Examination The Department of Defense (DoD), with the cooperation of the Veterans Administration (VA), has undertaken an extensive personnel data collection program called the Nuclear Test Personne]. Review (NTPR) -— a program encompassing all DoN-affiliated individuals who participated in the atmospheric nuclear weapons test program, 1962. 1945- This population group consists of past and present uniformed military personnel, civil servants, and contractor employees. 2. Our records show that the bearer of this letter is a veteran and a nuclear weapons test participant. He has been offered the availability of a current medical examination through the resources of your facility. Authorities for you to administer the examination are (a) VA-DMS Cir 10-78-69 of Apr 7, 1978, subject: Nuclear Tests and Ionizing Radiation, (b) DMS Cir 10-79-82 of Apr 12, 1979, subject: Extension of DMS Cir 10-78-69, (c) DMS Cir 10-79-2150 of July 10, 1979, subject: Medical Examinations, Nuclear Test Participants, and (d) a recent DMS hot line notification concerning test participants with annual exposures in excess of 5 rem to be followed shortly by a new DMS circular similar to (c). . 3. This extensive effort is being undertaken in an attempt to ascertain whether there are long-term medical effects of low-level exposure to ionizing radiation. Data from the NIPR program, to include radiation exposure levels, and, in selected cases, medical examination data, will be made available to the Center for Disease Control and the National Academy of Sciences. These organization will evaluate information obtained from the NTPR population and compare it with a comparable control population to ascertain if there are alterations in the frequency of specific diseases in the test participants compared to the controls. If there is a statistically significant increase in the incidence of a group of diseases, an epidemiological investigation will be initiated to attempt to establish an etiologic vector. 4. In reviewing the patient's history prior to or subsequent to his nuclear weapons test participation, particular attention should be directed to additional occupational or medical radiation exposures. Alterations in the individual's health pattern should be noted chrono- ud