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Polycythemia and Nuclear 'Exposure'-Reply
Glyn C. Caldwell, MD;
Delle B. Kelley;
Clark W. Heath, Jr, MD;
Matthew Zack, MD
Centers for Disease Control Atlanta
JAMA. 1985;253(10):1391.
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In Reply.—
In reporting an apparent excess of polycythemia vera among participants of a nuclear weapons test, we did not consider it "unscientific" to conclude that "the small individual whole-body doses of radiation reported for these four participants makes the association with ionizing radiation tenuous, although this was the only unusual risk factor." Such a conclusion is only prudent because we lacked information on potential confounding factors (eg, race, religion, marital status, and other radiation exposures) that might explain the observed excess.
We never stated that the exposure potentially received from inhaled or ingested radionuclides absorbed by these participants was minimal, only that no data were available for measuring such exposure. If such data were available, we might or might not have found that the reported patients had a higher total exposure than anyone else. Without such data, we still believe it important to have alerted the medical community by
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