Editor's note: This story originally published on April 29, 2005.
A long-awaited report on compensation for downwinders says there is no scientific reason to add Idaho or any specific region to a federal program that pays $50,000 to cancer victims of Cold War bomb testing.
Instead, the report proposes that Congress reform the program to allow every American to apply for aid if they can prove a high probability of radiation, regardless of where they lived.
The report released Thursday, April 28, 2005, is a blow to Sen. Mike Crapo's promise to add Idaho downwinders to the Radiation Exposure Compensation Act (RECA). The law provides $50,000 compensation to people from 21 counties in the Southwest who suffer from any of 19 types of cancer.
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But Crapo vowed to pursue a major rewrite of RECA and quickly move to add all of Idaho. Sen. Larry Craig, R-Idaho, said he would co-sponsor Crapo's bill to add Idaho.
The report prompted a mixed response in Emmett, where hundreds of people mobilized to press for compensation there and in other Idaho counties hit by radiation.
"I'm stunned," said Tona Henderson, who gathered friends and cancer survivors at The Rumor Mill, a bakery she owns in Emmett, to review the report online. "I feel sorry for all the people who had hope."
But Shari Garmon, who grew up in Gem County and prompted a statewide push to add Idaho to RECA, said she sees promise in the report.
"Idahoans and our delegation are not ready to give up," Garmon said. "The justification is there -- not just because this boy got a marble and I want one, too -- but because Idaho was hit heavily. They're going to see a great many of the cases in Idaho qualify."
R. Julian Preston, chairman of the committee that prepared the report for the NAS's Board on Radiation Effects Research, said, "To be equitable, any compensation program needs to be based on scientific criteria, and similar cases must be treated alike."
Report uses Custer County as model for study
The 372-page report was prepared for Congress by the private nonprofit National Academies of Science. The NAS committee considered arguments to expand RECA in Idaho, Utah, Montana, New York and other states so people there might be compensated based on a 1997 National Cancer Institute study that showed they had higher doses of radioactive iodine-131 to the thyroid than those in the counties where compensation already has been paid.
NAS says RECA's compensation scheme is outdated. It suggests a new standard covering all 50 states and overseas territories.
The report extensively considers the case of thyroid cancer in Custer County, the second-hardest-hit county in the country with iodine-131 radiation. NAS uses the Custer County example based on how old people were when they were exposed, radiation dose, consumption of store-bought milk and a cancer diagnosis in 2000.
The U.S. government tested nuclear bombs in the Nevada desert during the Cold War. Most of the radioactive fallout occurred during 90 above-ground tests between 1951 and 1962.
Wind blew radioactive clouds north and east, and iodine-131 fell on pastures and alfalfa that fed cows and goats. Children under 5 were hit hardest, with doses three to seven times higher than average because they drink more milk and have small thyroids.
In the NAS hypothetical case, cancer sufferers born in Custer County between 1946 and 1952 would be eligible for compensation. Under a probability model used in legal claims that sets the standard at a 50 percent probability, only they would qualify for compensation because their disease was "as likely as not" caused by fallout.
Rep. Mike Simpson, R-Idaho, said Congress might decide to adopt a looser standard than 50 percent probability. "Congress could make it whatever exposure range it wanted," he said. "Maybe we'd put it at 30 percent." At 30 percent, victims from Custer County would also qualify if they were born between 1941 and 1945, under the example.
Report: Risk of radiation was generally low
NAS found that bomb-test radiation doses to sensitive tissues generally were small.
"With the exception of radiation exposure of the thyroid, the amount of radiation received from radioactive fallout was of the same magnitude or less than that received from natural background radiation over the same time period," according to a NAS press release. "Even in communities presently eligible for compensation, the risk of radiation-induced diseases is generally low.
"This and other scientific evidence led the committee to conclude that in most cases it is unlikely that exposure to radioactive fallout is a substantial contributing cause of cancer in downwinders," said NAS.
Even in the case of radiation to the thyroid, the study suggests compensation based on geography is a slippery slope leading to arguments about justice across the nation, not just in Idaho.
Criteria needed to establish compensation
The report says people who lived in areas currently ineligible for compensation, including Idaho, Utah, Montana, Arizona, Nebraska, Indiana, Tennessee, New York and Vermont, would have a claim to compensation under the current RECA exposure standard. An imaginary male born Jan. 1, 1948, would have received doses exceeding radiation in some RECA-eligible counties.
But recommending expansion based on geography "might well include counties throughout much of the United States," said the NAS. That "would not be equitable" because it would fail to compensate high-risk people in ineligible areas, such as newborns, but pay low-risk people, such as those exposed at an advanced age.
Risk of radiation-induced cancer depends on diet, age at exposure and age at diagnosis in addition to dose. Therefore, the committee recommended a risk assessment applied across the country to determine if "an identified cancer was caused by radiation rather than by other agents."
The report bluntly downplays prospects of widespread compensation, saying, "...it is unlikely that a very large number of individuals with cancer, even thyroid cancer, would be newly eligible for compensation. The actual number will depend on the threshold criteria established by Congress."
Idaho lawmakers have not reached consensus
Crapo acknowledged the need for Congress to consider amending RECA to reflect current science and said the report "does not offer the immediate relief sought by Idahoans."
But because RECA is based on geography, Crapo plans to introduce legislation in the next few weeks expanding compensation to all of Idaho. "We have the current paradigm which is in the law. The question is whether Idaho should be included or not. And I think the answer is yes."
Crapo, Craig and Reps. Simpson and C.L. "Butch" Otter were briefed Wednesday by study chairman Preston, director of the Environmental Carcinogenesis Division at the U.S. Environmental Protection Agency. Four other members of the 10-member committee that wrote the report, Thomas Borak of Colorado State University, Dr. A. Bertrand Brill of Vanderbilt University, Thomas Buhl of the Los Alamos National Laboratory and Patricia Fleming of Creighton University, attended the private briefing.
"We recommended expanding the program in an equitable way," Preston told The Idaho Statesman. "Fallout doesn't follow geographical boundaries. I would tell people in Idaho they are indeed included. We don't just address their concerns, we address the concerns of all people who may have been exposed."
Craig praised the report. "The report affirms my contention that winds know no political boundaries," he said in a statement. "Limiting eligibility to certain counties is unwise -- Idahoans deserve an opportunity to be considered for compensation. So I will support Sen. Crapo in an effort to assist Idahoans who were harmed by the fallout from nuclear weapons testing."
Simpson said the model Congress adopted in 1990 is outmoded and that he's inclined to adopt the report's strategy for a national compensation plan.
"How do you justify going forward with an unfair program?" Simpson said in an interview. "We need a science-based approach to this and it ought to be nationwide."
He said practical politics mean Crapo's plan to add Idaho probably can't pass Congress. "The report makes it very unlikely that Congress would expand the program to include Idaho or (parts of) Utah or any other area based on geography."
Simpson said the delegation discussed the issue after the briefing but has not reached a consensus on what to do next. He didn't rule out supporting Crapo's bill to add Idaho to RECA but said he fears giving Idahoans "false hope."
Otter said in a statement that government must account for any damages to citizens, but that the "report provides some hard scientific realities about the basis for compensation in Idaho and nationwide."
"While those realities may be difficult for Idahoans to accept, I'm grateful for the work that's been done to establish the facts and give voice to the concerns of our people," he said. "Idahoans who believe they were hurt as a result of our government's actions continue to deserve our advocacy in this process, and I appreciate Sen. Crapo's leadership in that regard."
Otter's spokesman declined to say whether Otter would support Crapo's bill adding Idaho.
How we got here
RECA was co-authored by Sen. Orrin Hatch, R-Utah, in 1990 and expanded with Hatch's leadership in 2000. Hatch, responding to calls to further expand RECA, helped secure funding in 2002 for the $1 million NAS study released Thursday. He has urged expansion to at least four more counties in Utah.
In enacting RECA, Congress apologized to victims and provided for "compassionate payments" because they were "involuntarily subjected to increased risk of injury and disease to serve the national security interests of the United States."
Payments of more than $444 million have been authorized to 8,900 cancer victims and their survivors who lived in 21 counties in Nevada, Utah and Arizona downwind from the Nevada test site. To get $50,000, they must have been there between 1951 and 1962.
NAS recommends scuttling RECA's eligibility rules and requiring any new claim meet a probability test linking cancer to radiation.
The report also rejects the standard adopted by Congress in 2000 when it expanded RECA to add counties and more types of cancer. President Clinton objected to adding counties and cancers because science didn't justify it. But Congress was persuaded by the emotional stories of victims.
"To ignore the written and personal testimonies of the hundreds of victims themselves or survivors concerning their illnesses is unwarranted," wrote the House Judiciary Committee. "The strong evidence they have supplied is sufficient to provide relief."
Hundreds of Idahoans have spoken out with stories
Since the downwinders story exploded in Idaho in August 2004, more than 500 Idahoans have written NAS to detail their stories. Their names appear in the report. Pressured by the Idaho congressional delegation, NAS agreed to hold a hearing in November in Boise. Hundreds showed up at Boise State's Taco Bell Arena, and 75 people testified, many of them wracked by cancer.
The NAS committee took pains in the report to say it sympathized with those stories. But the report says: "The scientific evidence indicates that in most cases it is unlikely that exposure to radiation from fallout was a substantial contributing cause to developing cancer."
"Moreover, scientifically based changes that Congress may make in the eligibility criteria for compensation in response to this report are likely to result in few successful claims. The committee is aware that such conclusions will be disappointing, but they have been reached in accordance with the committee's charge to base its conclusions on the results of best available scientific information."
Screening will speed the claims process
The report acknowledges that establishing new criteria will take time, but it says pre-screening populations for diseases, geographic areas and population groups in those areas would help "ensure that claims are processed efficiently and rapidly."
The report says screening would discourage claims unlikely to succeed.
"Citizens' concern to achieve equity occupied much of the committee's deliberations," says the report. But the panel said its charge was to follow science and defer to congressional policy questions about whom to compensate.
"The decision rests with Congress," wrote the panel. Any change requires an act of Congress.
MANY AMERICANS WERE EXPOSED to harmful radiation, which did not follow county lines, though compensation did go only to those from 21 counties.
WHAT'S NEXT? Sen. Mike Crapo vowed Thursday to introduce a bill expanding federal payments to downwinders across Idaho. "I would hope we would be able to do it within a matter of weeks," Crapo said.
The Radiation Exposure Compensation Act provides $50,000 to victims and their survivors presumed to have been injured by nuclear-bomb testing in Nevada, principally by above-ground blasts between 1951 and 1962.
People in 21 southwestern counties who contract one of 19 diseases are covered: leukemia (other than chronic lymphocytic leukemia), multiple myeloma, lymphomas (other than Hodgkin's disease), and primary cancer of the thyroid, male or female breast, esophagus, stomach, pharynx, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary bladder, brain, colon, ovary, or liver (except if cirrhosis or hepatitis B is indicated), or lung.
The 21 covered counties
Utah: Beaver, Garfield, Iron, Kane, Millard, Piute, San Juan, Sevier, Washington, Wayne.
Nevada: Clark (rural portion), Eureka, Lander, Lincoln, Nye, White Pine.
Arizona: Apache, Coconino, Gila, Navajo, Yavapai.
About the report
Congress commissioned a $1 million report on downwinders in 2002. The report was prepared by the Board on Radiation Effects Research (BRER), an arm of the National Academy of Sciences. NAS is a private, non-profit society of scholars chartered by Congress in 1863. It is required to advise the federal government on science and technology. NAS was hired by the U.S. Health Resources and Services Administration to complete the report. HRSA is a branch of the Department of Health and Human Services.
BRER's 10-member panel of scientists first met in November 2002 and subsequently met 13 more times. Public meetings were held in St. George, Utah, Window Rock, Ariz., Salt Lake City and Boise.