FIFTY YEARS AGO, give or take a few years, do you remember as a child being taken to a doctor's office or hospital and having rods placed in your nose?
If you do remember such an event, it's possible you were given Nasal Radium Irradiation NRI), a treatment in vogue from the late 1940s through early 1970s that was thought to prevent such conditions as middle ear problems or enlarged tonsils.
Between 1948 and 1954, under a federally-funded grant, Johns Hopkins Hospital administered this treatment to shrink the adenoids of Baltimore City school children in an experiment involving 582 third graders. The intent was to gauge the effect of the radium on long-term hearing loss.
President Clinton's Advisory Committee on Human Radiation Experiments recently released its final report and recommendations on what federal efforts should be made regarding individuals subjected to Cold War-era radiation experiments.
The Committee informed the President that the excess head and neck cancer mortality risk to these Baltimore children (whose exposure to the radium lasted 12 minutes for three bilateral-through both nostrils-irradiations) is 10 times higher than the risk incurred by military veterans similarly treated with NRI between 1944 and 1946 (whose exposure was typically between six to eight minutes for two to three bilateral treatments).
The Pentagon recently anounced that about 20,000 nasal radium-treated veterans deserved notification and medical follow-up due to potential health risks. This was the sole human experiment, from among 2,300 known human experiments performed by the Department of Defense, that was deemed worthy of follow-up.
The Interagency Working Group on Human Radiation Experiments has failed to even mention the children treated with nasal radium in Baltimore, despite the significantly higher risk they incurred.
Overall, an estimated minimum of 40,000 Marylanders and 571,000 U.S. citizens were treated with NRI, a procedure which at the time was considered "standard medical practice," according to the U.S. Centers for Disease Control.
Stewart Farber, a public health scientist and director of the Center for Atomic Radiation Studies, explains the treatment process:
"Nasal Radium Irradiation involved the insertion through each nostril of thin metal rods tipped with a sealed capsule of Radium-226 (50 milligram source strength). Each radium applicator was positioned at the rear of the nasopharynx near the opening of the eustachian tube to irradiate and shrink adenoids and nearby lymphoid tissue. A typical course of treatment involved three to four `treatments' of about 10 to 12 minutes' duration, usually about two to four weeks apart."
According to Farber, "Brain cancer mortality excess risk among NRI-treated children in any given sized group would exceed total all-site cancer mortality observed in actual study of an identical number of survivors of the atomic bombing of Hiroshima and Nagasaki." The mean dose in rad-the unit used to measure radiation exposure-of the Japanese victims was 27.2 rad to the whole body. The dose to children exposed to NRI for three 12-minute treatments ranged from 2000 rads to the nasopharynx and declined with distance from the irradiator. The thyroid gland of very young children received up to 100 rads, and the pituitary gland received from 51 to 207 rads.
The excess cancer risk was monitored in a long-term health outcome study conducted by The Johns Hopkins School of Public Health that concluded in 1979. The results caused the U.S. National Academy of Sciences to derive a cancer mortality risk factor that "equates to 8.8 excess brain cancer deaths over the lifetime of each 1,000 children" who were treated with NRI.
Farber's organization wants to get in touch with those Baltimore schoolchildren, and with any other Marylanders who were treated with NRI in any other so-called "hearing loss prevention" program conducted here from about 1943 to the 1960s. For a time, NRI treatment centers were located in Hagerstown, Easton, and Salisbury.
The nonprofit organization's Radium Experiment Assessment Project is seeking to reach out to those who were treated with NRI to alert them about the potential health risks they may have due to the NRI treatment. The project will promote medical surveillance of those treated to help identify medical problems in time for suitable treatment. It also seeks to create public awareness of the potential health risks of NRI based on current scientific knowledge, and backs "right-to-know" initiatives for patients who had the treatment.
Farber's organization recently received national media attention for its involvement in lobbying for the notification of servicemen treated with NRI. Over 7,000 Army Air Force and Navy submarine personnel were subjected to experimental nasal radiation treatments during World War II. As many as 20,000 military personnel may have had the treatment since then.
The Pentagon's notification agreement, Farber notes, while it received wide publicity when announced on August 27 initially reached only 42 individuals for whom absolute documentation has been located, according to the Department of Defense.
Farber's organization wants a much broader awareness among those treated with NRI. He points out that there are many medical conditions that may have been caused by, or exacerbated by, the exposure of high doses of radium so near the brain. He mentions thyroid and pituitary problems among the problems that are surfacing among those already in the organization's NRI patient database. Those who had NRI should know it, because the treatment could be a factor in current medical problems, Farber points out.
The ongoing NRI investigation has resulted in the revelation of startling information: in 1995 the Centers for Disease Control and Prevention increased the organizations previous estimate of 571,000 persons treated with NRI to 2.5 million. Thousands of them may be at excess risk for cancer and other diseases.
By creating a database and information exchange on NRI, Farber anticipates there may be scientific breakthroughs.
"There's no other population like this, of healthy young kids receiving such doses of radiation," he points out. "How they have fared over the years could be an important benchmark of how much radiation can safely be used in the treatment of children with cancer."