MR. HAMM: I'm Ron Hamm with Vanderbilt Experiment Study. I want to see if Geoff would respond to the Committee's report which basically just gave us a back of the hand swipe away and said you guys weren't harmed. Go play in the traffic.

And Geoff, you know a little bit more about that. Would you respond to that, please?

MR. SEA: Yes. What the Committee did with Vanderbilt is a very instructive example of what they did generally. I think it's the other really good case study of the radium people. Because Vanderbilt was the clearest case that we had that harm was done. And that is, that it's one of the few cases where the AEC, for its own purposes, did its own follow-up study of the population.

These were 829 pregnant women who were fed radioactive iron between 1945 and 1947, were follow-up -- unwittingly. Were followed up in the 1960's and it was discovered then that three of the children died from cancers that were determined to be radiogenic. There was a fourth cancer, as well, which was questionable.

The AEC then stopped its follow-up and returned the records, we think -- we don't know yet, but at least according to certain claims -- returned the records to Vanderbilt, which is against all sound practice of public health.

And this is really where it stood. And the victims were never notified. Even when the follow-up study was done and the results were found, the victims were still not told that they had ever been fed radioactive iron, much less the results of the study.

And this is where it stood until the Advisory Committee began to look at the issue. The Advisory Committee -- and the Advisory Committee, as I said before, had an agenda. And the agenda was led by Henry Royal who comes from Malincrot Institute, which was the first and largest recipient of isotopes from Oak Ridge, where the Vanderbilt isotopes were produces. And Malincrot then became one of the largest, if not the largest supplier of isotopes for other laboratories throughout the country, many of which were doing these experiments.

And Henry Royal, aside from that, had done a study in which he was a co-author with Bertram Brill, who did the Vanderbilt follow-up study, which was a study designed to discredit the EPA's radon standards and show that they were too stringent, and go back to the old relaxed radon standards. And so he chaired the biomedical subcommittee of the Advisory Committee and he made it his personal mission to discredit the Vanderbilt results because this was a real -- other than the radium, it was the one case that showed that there was harm from the experiments.

So how did they discredit it? He first commissioned a, quote, independent, unquote, review of the dosimetry. Now, the dosimetry is actually irrelevant because the fact is that we know very little about the effects of radiation on fetuses. There's not much data. What we have is from Hiroshima and Nagasaki and there are all kinds of serious problems with that data. So we really don't know what the relations between dose and disease are in the case of fetal irradiation, and especially iron because it's -- you know, it's obscure. It hasn't been studied a lot.

So the dosimetry is irrelevant. But he went back and thought, well, if he can get a dosimetry report that says that the doses were so low it couldn't have caused the harm, that's the way to go. So, he chaired an independent study --

MR. SELIGMAN: Geoff, --

MR. SEA: I'll wrap up.

MR. SELIGMAN: Yes. The reason -- wrap up. The reason I'm interrupting is because I'm more interested, again, in having people focus on issues and less on some of the critique.

COL. BAILEY: Let me talk to the critique as well. We've got to bear in mind that we're not here to critique the Advisory Committee's report. Dr. Royal is not here. Some of the other people are not here to defend or address their positions. Our focus has to be, whether we like it or not, whether we like the Advisory Committee's report, is on the proposed responses from the government. We should not engage or indulge in personal attacks on somebody's work or abilities in this forum.

MR. SEA: I'll wrap up quickly.

We would have liked to have made these criticisms as part of the Advisory Committee but were denied that opportunity.

Just to wrap up quickly. The independent study that was commissioned was done by Oak Ridge. The results were -- when we found out about it, which was through back channels. We were not told. We commissioned our own study of the dosimetry which totally disproved the so-called Oak Ridge study. And the end result was that they took the whole chapter out. They removed it and consigned it to the public relations director of the Advisory Committee to make the final decision and the chapter was pulled.

That's just one example of how bankrupt the whole process was.

COL. BAILEY: Again, I've got to make a comment. And I'm not here to defend the Advisory Committee or the government. I'm impartial. I'm a soldier. Very impartial and non-political person. But again, the purpose of this workshop is for us to address those issues, whether we like it or not, the responses that the Interagency Working Group staff has proposed with your input.

Now as far as the side issues, the critique of the Advisory Committee's report, that is beyond our charter. And I understand your concern. I understand your emotions. But we've got to keep our eye on the ball.

MR. EGILMAN: Let me say something about that. We can't just give -- I can't as a physician give you a recommendation without analyzing the data. I'm sorry about that. But I like to look at the data.

I understand that the President's Committee wanted to make up their own and didn't like to look at the data. So it's very important for us to analyze what they actually did, what the data was, when we give you our recommendations about what we think you should do. Because our recommendations are based on the data.

We didn't come with conclusions that people should be monitored for fun, willy-nilly, to do things that nobody ever proposed. Biopsies. That's ridiculous. No one ever suggested biopsies of anything for anyone, Dr. Galson. And you know that that's never been proposed for any kind of a monitoring program. That's an effort to come up with a bizarre example.

He's here to defend himself. Let him try.

MR. SELIGMAN: Shall we go on?

MR. BIBEAU: I have one comment to Dr. Galson at this time. When you're trying to respond -- when you're trying to figure out how to respond to Recommendation Number 4, all the people that I have had personal contact with would appreciate not only being notified but finding out what their risks are. And rather than worrying about if medical treatment will be harmful or if there is medical treatment, they would like to have the option themselves to make that choice. They don't want to have the Advisory Committee say, well, just because we think it's one in 1,000 and I have figures that dispute that one in 1,000 which I shared with them, we would like to have that option.

Where's Phil Harrison?

MR. HARRISON: My name is Phil Harrison. I'm with the Navajo Uranium Miners, too, and I'd like to kind of add a little to what Tim's question was.

I've been involved with Navajo Uranium Miners and millers and other miners in the Four Corners area for the last 16 years and there was never a time to where I was approached by these victims that they had received follow-up on the studies, them being part of the studies.

There's not a thing from any of these miners that was mentioned that they're being studied by NIOSH. And my position at this time right now is I assume that the NIOSH people are still studying the miners, let alone without being warned that we're sent into those mines and they were studied without their consent.

So this to me is a serious violation of civil and constitutional rights. But like I said, every day I'm involved with these miners and these are never brought out. These are never brought out.

Some of these miners, there's medical information that are being withheld from them. These are not disclosed by Indian Health Service doctors at our hospitals in the local area.

This is a question for the gentleman from NIOSH.

MR. SCHULTE: No. I hear your concern. As I earlier, we did the study because we were obliged to do those kinds of studies because that's what our job is. And we've tried to respond by informing people of the results of the study.

Now, I know that along the way there were a lot of groups in the Public Health Service doing studies with the Navajo miners and maybe all have not disclosed all of the findings. I can only speak to what NIOSH has done and why we did it.

MR. BIBEAU: Okay. The next question for the panel is from Sandra Reid.

MS. REID: I've got a couple of comments and a question. To the gentleman from NIOSH, in the studies that were -- Sandra Reid.

The studies that one is talking about with regard to this, how many of them were actual clinical analysis where competent physicians with the training in say internal medicine came in and actually examined these patients and then continued their medical analysis evaluating the whole patient and analyzing what other symptomology one might have been observing?

MR. SCHULTE: Are you referring to the studies that I have --

MS. REID: Any that you've been involved with. Particularly, I'm talking to the uranium miners and the Navajo nation and then the people from Laguna.

Has there ever been a time that there was a consistent medical ongoing clinical evaluation of these people?

MR. SCHULTE: Generally, the studies that I described were record linkage studies, epidemiologic studies that looked at where a person worked and then how the people in that group died, what they died from. It was not a medical follow-up study, per se. It was a record linkage type of study. So the answer is generally no.

MS. REID: And I think that that is an important issue to present to people because often -- I'm in the health care profession. It took me a while to understand how limited one's ability is to analyze some of the impacts of these pollutants, the effects of these illnesses without having that kinds of hands-on analysis.

Perhaps that would be a recommendation to put forward that one starts with small pilot programs at some of these sites. You've got these people who have got three and four generations that believe they've been affected by these contaminants. To go in and listen to not only their elders, to hear what the historical past diseases are, but what are they seeing now within the communities. Not use cancer as an end point but look at the immunological impairment. We are able to do that now in medicine.

We need to look at the precursors. And by evaluating that and having these people participating in that program start to design and develop preventative measures and actual treatments for what is happening with immuno-compromised patients.

And you, doctor, as an internist -- Dr. Galson -- knows that that's well within our ability to accomplish. To iron out any problems and not go into any kind of overrun with money, to do it on a small analysis utilizing some of the data we've obtained in the past.

The other thing is we don't look -- there has never been -- the end points of cancer is totally ridiculous. The early, early records even show we knew their hematological effects. We knew that the strontium and these other man-made radioactive isotopes actively attacked various organs in the body. They did not present with cancer in some cases until many years later, although some were of early onset.

Kidney damage was not addressed, and that's one of the early symptoms of this. And the people were not allowed to ask those questions.

That is why I'm coming to you from my community to say that we want to ask the question. We don't know exactly what the effects have been but we feel that this is an opportunity for medicine to be ethical and responsible. The people are asking the questions. We're asking for assistance on this. It isn't to point a finger. It's to try and evaluate what kind of management, prevention and treatment can be defined.

MR. SEA: Could I address that for one second and just say -- and this partly goes to Dr. Galson's remarks before and what I said about the President being profoundly uncreative. I thought that the President supported a national health care system.

And that may have been last year's idea, but if he does, it seems to me that the fact that there's now an ethical obligation to provide medical care and treatment for however many million experiment victims there are could be used as an important justification and political platform for calling for a national health care system. Because then the costs, these tremendous unwieldy costs of providing health care, would be absorbed in the national health care system.

Why doesn't the President use that?

MR. SELIGMAN: Should we go on?

MR. BIBEAU: Cooper Brown has a comment or a question.

MR. BROWN: Cooper Brown. Actually, I've got a couple of comments and a question.

MR. SELIGMAN: Please identify where you're from, too.

MR. BROWN: National Committee for Radiation Victims.

Initially, this is a point that's already been made by a couple of the panelists to Richard Miller, but I'd like to address this on behalf of the Taskforce, if I may. And that is that perhaps rather than looking at this issue of adequate funding -- and perhaps I could address this to the Administration, as well, as a struggle over limited resources -- that we work together to increase the pie and addressing that to the rest of the Administration.

I mean, it hasn't escaped our notice that every agency in here is under attack and wrestling with budget constraints. And actually, I think within DOE perhaps some of those who work with this issue are under the greatest attack.

And perhaps we ought to start -- I've said it before in private conversations with members of the Administration. We need to quit moving out of a position of fear, fear about what's outside there, outside of us and outside of this room and start trying to figure out what's in the mutual self-interest of all of us in this room and move from that perspective.

And I think it would be -- and I think I can safely speak for the rest of the Taskforce when I say this. That it would truly be for us a travesty of justice if in order to do the right thing by way of follow-up and medical monitoring of the experiment victims we have to raid the public health money that agencies have available to deal with other public health concerns.

That is unacceptable. We have to find another way to find the money to do the right thing.

And on doing the right thing, Mr. Benally spoke about being studied. That, too, is unacceptable in the way that it is done, because -- and I know this from my experience in the Marshall Islands. I know it from working with other indigenous people. When outsiders come in and study people who have been put at risk without including those people from the get-go in the design of the study, in the implementation of the study, there is a deep feeling that the wrong is continuing to be perpetuated. That we are having someone else from outside who have done it to us who are now going to come in and study us.

There needs to be allowance for these people who have been affected to choose doctors and scientists that they trust to work with NIOSH, to work with these others agencies in conducting studies that they feel are needed.

And finally, with all due respect to the concerns of Colonel Bailey and Dr. O'Toole about addressing side issues, we in the Taskforce look at these more as underlying issues. And those issues have to be brought forth. We have to have the -- we, all of us, yourselves included, need to be able to commit truth here because only by doing that I think are we going to be able to find a way out of this problem. And I think this issue of medical monitoring is the best example of that. Because when you understand and are willing to acknowledge the bias of those who do the health risk evaluation, that right there tell us where we need to go next.

Thank you.

DR. GALSON: Just one quick response.

MR. SELIGMAN: Steve, identify yourself.

DR. GALSON: Steve Galson, DOE.

It is standard scientific practice in this country, universities, state agencies and federal agencies across the government levels to do record based epidemiologic studies without getting consent of participants. It's happening in hundreds and hundreds of studies going on right now.

If this group finds that ethically objectionable, which I'm definitely hearing some occurrence about this, I would bring it to the National Bio-Ethics Advisory Committee. Got a couple of representatives from that group here today and bring that up.

MR. SEA: Give us a seat on it and we'll bring it to them. Give us a seat on the --

DR. GALSON: Right. I heard you.

So that's another forum. It's a huge issue which we can't address here.

MR. BROWN: Yes. Just to clarify that, Dr. Galson, I wasn't talking about record based epidemiological studies. I'm talking about things like and to site magnificent precedent by the Department of Energy in the Marshall Islands where, thanks in large part to DOE, people like Tom Bell here, they agreed several years go to conduct an environmental study of Rongelab, with scientists that Rongelab chose, working in conjunction with scientists that the government was involved in helping select. That's the type.

I'm talking about studies on real live people today.

MS. REID: Dr. Galson, Sandra Reid here. The other thing is none of us are complaining about that type of epidemiology that you've just mentioned. However, if any physician or nurse or health care professional found an abnormality under that, they are obligated to contact those people and let them know. And it's irrelevant as to how that study was done. They have to make every effort to do that.

I'm an emergency room nurse. Sometimes we could not find patients that came back with abnormal labs. In the real world, one is still obligated to do that. You warn the people that you have found something.

MR. BIBEAU: Okay. We still have four more people that have requested to address the panel.

MR. SELIGMAN: We'll give those four a chance to.

MS. GORDON: I'm Janet Gordon from Citizens Call a downwind victim organization from Utah and the National Committee for Radiation Victims.

I'd like to make a couple of comments and then ask a couple of questions. My coming here -- I had to be excused from jury duty. I think I'm a citizen. I think I can be arrested if I don't show up for jury duty. I have responsibilities as a citizen. I also have rights, I believe.

Why is there a question about notification? Are we dealing with people? Are we dealing with human being? Are we dealing with citizens? How can there possibly even be a question of whether these people are entitled to be notified?

I don't understand that. I work in grassroots politics. I'm the Vice Chair of my party in my county. I believe in the democratic process. I believe I'm a citizen. I thought I was a full-fledged honest citizen. You have made us non-citizens with non-rights, invisible.

I'm obviously not invisible. I'm quite substantial. But as far as the government is concerned, I'm invisible. I have no rights to notification. I have no rights to honesty. I have no rights to follow-up. You can conduct experiments on my people without telling us? In fact, by lying to us and telling us that what you're doing to us isn't what you're doing to us. And then you have no obligation to provide any health care for people when they suffer.

I don't understand that process. What is going on here? I'd like to ask the Interagency Working Group to address that. Are you dealing with U.S. citizens are aren't you? Determine what category you're putting us in and either treat us or human beings and full-fledged citizens or let us know that we're not so that we can take some action in the World Court.

Secondly, I would like to address the political reality check here. There are budget constraints and there are difficulties with contacting so many people. I want to know how you could conduct experiments on that many people and you could afford to do those experiments if you can't afford to follow them up. If they were difficult -- to follow up, how were they not complicated enough to do in the first place. If they were doable in the first place, they're follow-upable in the second place? How can that make any kind of sense?

And finally, I would like to like to, as Jackie did, beg -- beg the Interagency Working Group to not follow an established professional pattern which says major deity is the meaning of MD or that Ph.D. is powerful major deity. We're all human being. And just because you have an MD after your name does not mean that you're in charge of whether I'm a human being or not.

I'd care for a response.

MR. EGILMAN: Before we get cut off, can I just ask -- and I'm representing one of the substantial people here -- that we go an extra 15 minutes and have an hour and 15 minute lunch? We have three more people in the audience who requested some time, so --

MR. SELIGMAN: Yes. That's not a problem.

MR. BIBEAU: You took the words right out of my mouth, David.

MR. EGILMAN: I won't take your hotdog, though.

MR. BIBEAU: Sandra?