Yet the world continues to need such scientists. Studies following the Chernobyl accident illustrate how an oversight may occur from incomplete knowledge of the literature. In their study of intrauterine effects, the Soviets concentrated on severe mental retardation, which had been the focus in the recent medical literature. I was a member of a U.S. delegation on nuclear safety that visited the Soviet Union following the Chernobyl accident. During a briefing at the Ministry of Health for the Ukraine, we learned that the Soviets had noted no differences between exposed and unexposed newborns. We also discovered that although they had made body measurements of the newborn infants, they apparently had not analyzed head size in relation to exposure dose. In Japan, small head circumference in newborns occurred at lower doses and, over the full dose range, was four to six times more common than was severe mental retardation among those who had been exposed to atomic bomb radiation under 18 weeks of gestational age. After exposure to 10-19 rad in the air, 11 percent of this group developed small head size; after 20-29 rad, 25 percent were affected.
From the discussion that followed our question about small head size, we sensed that the Soviets would make such an evaluation. (A small head remains small throughout life and therefore can easily be measured at any age.) The episode illustrates, however, how opportunities for learning about the effects of radiation can be delayed or even lost.
U.S. physicians who trained in radiation biology in the postwar years were sponsored in several ways. In the 1950s the Atomic Energy Commission (AEC) trained a number of physicians who remained in the field for years or even decades. The purpose was to educate quickly a group of physicians who could serve in civilian or military positions as the use of isotopes and other forms of ionizing radiation increased. No government agency today could be expected to provide funds for that purpose. The program combined six months of classroom training at a university with six months of laboratory research at an AEC installation.
Foundations have also helped in the past. For 10 years, the Rockefeller Foundation, for example, funded academic programs at schools of public health at Harvard, Johns Hopkins and the University of Pennsylvania that trained experts in the management of radiation health problems. The number of physicians entering these programs has dwindled, however, and foundations are unlikely to give high priority to repeating this effort. At the same time, the military sponsored trainees for its own ranks, and departments of radiology generated a few specialists in late radiation effects, but they, too, are nearing retirement age.
The best hope for the future appears to be in departments of radiology, where a few physicians training in the traditional aspects of radiologic diagnosis and therapy could undertake additional study of delayed radiation effects. These physicians could then serve as experts on radiation effects on humans whenever accidents occur, as at Three Mile Island or Chernobyl.
These matters are currently being discussed by the Committee on Environmental Hazards of the American Academy of Pediatrics. Even closer to the issue are societies for radiologists. The American College of Radiology, for example, should evaluate the need and prospects for training a reasonable number of specialists to take care of the continuing flow of nationally important problems concerning the late effects of ionizing radiation on human health.