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To the Editor: In their Research Letter about exposure to toxic fumes from the Union Carbide pesticide plant in Bhopal, India, Mr Ranjan and colleagues¹ found selective growth retardation in boys, but not in girls, who were either directly exposed or born to exposed parents. The assignment of exposure appears to be have been performed on an ecological rather than an individual basis, thus leading to the probability that some individuals (depending on their location on the night of the incident) might not necessarily have been exposed.

A study reported by the International Medical Commission on Bhopal (IMCB) found that some individuals living 6 to 8 km south of the plant who reported being exposed were, in fact, unexposed.² These authors were able to develop a quantitative individual exposure index for individuals exposed to gas on the basis of duration of exposure, location, and physical activity, and demonstrated associations between . . . [Full Text of this Article]

V. Ramana Dhara, MD, ScD, MPH
International Medical Commission on Bhopal
Snellville, Ga

RELATED LETTER

Methyl Isocyanate Exposure and Growth Patterns of Adolescents in Bhopal
Nishant Ranjan, Satinath Sarangi, V. T. Padmanabhan, Steve Holleran, Rajasekhar Ramakrishnan, and Daya R. Varma
JAMA. 2003;290(14):1856-1857.
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RELATED ARTICLE

Assessing Exposure to Toxic Gases in Bhopal—Reply
Daya R. Varma, Nishant Ranjan, Satinath Sarangi, Steve Holleran, and Rajasekhar Ramakrishnan
JAMA. 2004;291(4):422-423.
EXTRACT | FULL TEXT