Reprinted from the Journal of the American Medica/ Association

January 13, 1984 Volume 251
Copyright 1964, American Medicai Association

Original Contributions


Cancer Incidence in an Area of Radioactive Fallout
Downwind From the Nevada Test Site
Cari J. Johnson, MD

© Exposures in southwestern Utah to radioactive fallout (1951 through
1962) from atmospheric nuclear detonations at the Nevada Test Site (NTS)
were followed by smaller exposures (1962 through 1979} from venting of
underground nuciear detonations. The cancer incidence in a 1951 cohort
(4,125) of Mormon families in southwestern Utah near the NTS was compared
with that of aii Utah Mormons (1967 through 1975). There were 109 more
cases of cancer than expected (288[observed]/17S(expected]). Leukemia
was most prominent early (1958 through 1966), with 19 cases, five times
more than expected (3.6). The excess of leukemia persisted into the iater
period (1972 through 1980), with 12 cases observed, 3.4 expected. There
was an increase in lymphoma. Excess cases of thyroid cancer appeared
early and a notable excess appeared later (14/1.7). An excess of breast
cancer was noted later (27/14). There were more cancers of the gastrointestinal tract than expected. There was an excess of melanoma (124.5), bone
cancer (8/0.7), and brain tumors (973.9). A subgroup with history of acute
fallout effects had a higher cancer incidence. That these cases can be
associated with radiation exposures is supported by a comparison between
groups of the ratio of cancers of more radiosensitive organs with ail other
types of cancer.
(JAMA 1984;25 1:230-236)

LONG-TERM worldwide effects of
nuclear weapons testing may cause
29,000 to 72,000 deaths from cancer

(whole-body exposure) and 168,000
See also p 197.
genetic effects (all generations) (Robert E. Alexander, Office of Standards
Development, Nuclear Regulatory

From the Medical Care and Research Foundation,
Presented at the annua! meeting of the American
Aseociation for the Advancement of Science, Wash-

ington, OC, Jan 5, 1982.

Reprint requests to 42 Hileide Or, Denver, CO

80218 (Dr Johneon).


Commiasion, Washington, DC, written communication, Feb 26, 1979).
There have been few studies of such
health effects in local civilian populations downwind from nuclear test
sites and subject to greater exposures
to fallout. An extensive study of can-

cer deaths in Hiroshima and Nagasa-

ki survivors assumed exposures to
direct radiation from the nuciear detonation and only minimal exposure to
radioactive fallout.’ After a peak in
leukemia deaths in the first five

years, there was a persistent increase

in other cancer deaths. In the last
five-year period (27 to 32 years after
the bombs), the excess cancer death
rate increased by 2.4 times, caused by

JAMA, Jan 13, 1984—Voi 251, No. 2

cancer of the esophagus, stomach,
colon, lung, breast, and urinary tract,
lymphoma, and multiple myeloma.’
There was an increase in cancerof the
thyroid gland and benign tumors as
Detonation of a 15-megaton hydrogen bombat the Bikini Atoll (March
1, 1954) caused radioactive fallout
arriving at Rongelap, 180-km distant,
in four to six hours and at Utirik,
440-km distant, in about 22 hours.
The Rongelap islanders received 175
rad of gamma radiation and Utirik
islanders received 14 rad before evacuation. About 90% of those exposed
had skin burns and hair loss at
Rongelap. Many had superficial skin
lesions (14/16{observed/exposed]) and
three had hair loss at Ailinginae
Atoll (75 rad), and no one had skin
lesions or hair loss on Utirik. The
Rongelapislanders received a thyroid
dose of 300 rad from '"I, “but about

4,200 additional rad in “I equiva-

lents” from the short-lived iodine
isotopes ('"I, '’I, and '%I)” Children
received a larger dose, up to 2,000 or
more rad for a l-year-old child. Estimated thyroid doses at Utirik ranged

from 30 to 90 rad.’ Primary hypothy-

roidism and thyroid nodules were

first recognized in 1964, about ten

years after exposure, and were earlier
and more severe in children. About
77% of Rongelap children younger
than 10 years at the time required
surgery later for benign and malignant thyroid nodules.’
Construction of the Nevada Test
Cancer and Radioactive Fallout—Johnaon

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