ATTACHMENT 4 The Department of Defense RESEARCH AND DEVELOPMENT BOARD COMMITTEE ON MEDICAL SCIENCES AND COMMITTEE ON ATOMIC ENERGY Washington 25, D.C. JOINT PANEL ON MEDICAL ASPECTS OF ATOMIC WARFARE Minutes of Seventh Meeting Held on 25-26 January 1951 The University of Rochester School of Medicine Rochester, New York BAW 3/7 SECRET MEMBERS AND DEPUTIES PRESENT: Dr. Joseph C. Aub, Chairman Dr. Franklin C. McLean Dr. Rocley D. Evans Dr. Robert R. Newel Dr. Louis H. Hempelmann Brig. Gen. Elbert DeCoursey, USA Lt. Col. Frank L. Bauer, NC,USA Maj. Gerald M. McDonnel, MC, USA Capt. C.F. Behrens, MC, USN Capt. V.C. Tipton, MC, USN Dr. Sidney R. Galler, ONR Dr. M.C. Fishler, NRDL Lt. Col. John M. Talbot, USAF (MC) Col. Robert H. Blount, USAF (MC) ASSOCIATE MEMBERS PRESENT: Mr. Allen W. Pond, USPHS Lt. Col. Wm. J. Brown, MC, USA, Log. Div., GS USA Dr. H.E. Pearse, Panel on Thermal Radiation, AFSWP SECRETARIAT Dr. Joseph M. Pisani Dr. Thomas B. Spencer Dr. Harry C. Ehrmantraut Lt. Col. Hal Bridges, MC,USA Cdr. Joseph P. Pollard, MN, USN Lt. Col. Charles E. Melcher, USAF (MC) THIS DOCUMENT IS DOWNGRADED TO "CONFIDENTIAL" UPON REMOVAL OF SECRET ATTACHMENT COPIED: 8/10/94 RECORD GROUP: #330 ENTRY: #341 FILE: 3/Panel on Medical Aspects and Atomic Warfare - Agenda Declassified Authority NN6813070 By NARA Date 8/20/93 THIS DOCUMENT CONTAINS INFORMATION AFFECTING THE NATIONAL DEFENSE OF THE UNITED STATES WITHIN THE MEANING OF THE ESPIONAGE LAWS, TITLE 18, U.S.C., SECTIONS 793 AND 794. ITS TRANSMISSION OR THE REVELATION OF ITS CONTENTS IN ANY MANNER TO ANY UNAUTHORIZED PERSON IS PROHIBITED BY LAW. OTHERS: Dr. Wallace O. Fann, Comte on Medical Sciences Dr. Paul Beall, RDB Mr. David Z. Beckler, Comte on Atomic Energy Mr. F. H. Quimby, ONR Dr. L. W. Tuttle, AEC 1. Minutes of the Sixth Meeting After a discursion of the implementation of the Minutes, including recommendations of the group concerning the catastrophe team project now being formulated, The Panel: Approved the Minutes of the Sixth Meeting 2. Technical Estimates, 1951 After reviewing the pertinent documents, The Panel: Prepared its Technical Estimates for 1951, BAW 13/4, Log. No. 38684, appended hereto as Attachment A. 3. Resume Reports on research progress in Technical Areas. A. Dr. McLean reported on the handling of catastrophes in the discussion of the catastrophe team project. B. Lt. Col. Talbot reported on problems important to aviation. C. Other reports were deferred until a future meeting. 4. Effects of Ionizing Radiation on Primates. In the absence of Dr. Andres, Mr. Pond reported on the status of this project for the Panel's information. The Minutes of the meeting on an Ad Hoc Panel (NIH) which considered this project and made pertinent recommendations to the National Advisory Cancer Committee. 2 BA 3/7 SECRET are appended as Attachment B for Panel Members only. No action has been taken on these recommendations, and they are appended only for informational purposes. 5. Human Experimentation. General James P. Cooney was unable to attend the Panel meeting but indicated that the following should be entered into the Minutes of the meeting: At the meeting of the Advisory Group to he Division of Biology and Medicine of the Atomic Energy Commission which occurred shortly after the Sixth Panel Meeting (31 Oct-1 Nov 1950), the three Services were represented by Admiral Geaves, General Powell and General Cooney, who were queried concerning any problems that they might have for the Advisory Panel to consider. General Cooney addressed Dr. Alan Gregg, the Chairman of the Advisory Committee by indicating that the military had a definite problem because of the fact that the atomic bomb might possibly be used as a tactical weapon. Under such conditions it is reasonable to assume that a large force might be subjected to aerial bombardment and a relatively short time later the commanding officer would confront his Medical Officer with the following: "I have 'X' thousands of men who have been subjected to various amounts of ionizing radiation from 25 to 150r or more. How many men can I take into battle? How many will be sick? When will they be sick How many replacements shall I request and when shall I ask for them?" Up to the present time the military has expressed opinions concerning answers to the above but there has been no official backing by any 3 BAW 3/7 SECRET authoritative medical group. Many individuals feel that we have sufficient data on humans to give those answers. Others feel we do not and therefore some human experimentation should be done on military volunteers to whom the effects of ionizing radiation have been explained in detail. Military medicine has the responsibility of maintaining high medical standards which the American Medical Association and other allied groups insist upon. If American medicine were satisfied with the data on the effect of ionizing radiation on humans, then military medicine would also be satisfied. If such information is not available, then it was requested that procedures be outlined to obtain same. The Advisory panel then had a long discussion on the problem of human experimentation and it was the consensus of this group that human experimentation was probably not the answer at this time due to the fact that in order to obtain statistically significant results several thousand people would have to be exposed to ionizing radiation. Dr. Shields Warren expressed his opinion that sufficient data was already at hand. Dr. Gregg then asked the representatives of the Services whether or not they would like to have him convene a panel of men who have had a large amount of experience n this field as members. The representatives from the Services welcomed this suggestion and as a result a meeting was held on 8 December 1950 in Washington. 4 BAW 3/7 SECRET (The results of this meeting are contained in the letter, appended as Attachment C, BAW 10/3, which was distributed at the Panel. The subject letter was addressed to Mr. Robert LeBaron, Chairman of the Military Liaison Committee by Mr. Boyer of the Atomic Energy Commission. The Military Liaison Committee disseminated this letter to the Chief of Staff of the Army, the Chief of Staff of the Air Force and the Chief of Naval Operations, who in turn have disseminated this information widely to the individual Services.) Those opinions, since they are based upon impressions rather than experimental data, do not negate the necessity for human experimentation at some future date. It is felt, however, that the acute need for this human experimentation has been somewhat relieved and therefore diligent efforts for the establishment of this program may be temporarily curtailed. Implications and impression never replace facts. 6. Report on Ventilation Systems of Airplanes. Radiation Hazards in Air Force Operations. In connection with the question of fission product contamination of the cabin atmosphere and surfaces of aircraft flying through a radioactively contaminated atmosphere, calculations suggest that the inhalation hazard for crew members in anticipated AW situations is negligible but that the likelihood of extremely serious external gamma ray exposure is a real one. Col. Blount requested the Panel opinion on the need for filtering cabin pressurizing and ventilating. 5 BAW 3/7 SECRET SECRET DEPARTMENT OF DEFENSE RESEARCH AND DEVELOPMENT BOARD COMMITTEE ON MEDICAL SCIENCES AND COMMITTEE ON ATOMIC ENERGY WASHINGTON 25, D.C. 26 January 1951 BAW 13/4 Log No. 38684 Copy No. 88 JOINT PANEL ON MEDICAL ASPECTS OF ATOMIC WARFARE TECHNICAL ESTIMATES, 1951 The Joint Panel on Medical Aspects of Atomic Warfare submits the following technical estimates pertaining to its interest in AW-5 and AW-6: 1. Biological Effects of radiation. Of the many effects of radiation upon biological systems the chief concern of this panel is with the dosages of external radiation (chiefly gamma rays) and of internal radiation (chiefly alpha and beta emitters) which are of immediate military significance in that they will reduce the effectiveness of troops, produce casualties, or compel the evaluation of occupied areas. Long term effects, such as reduction in fertility, increase in the number of mutations, and reduction in the ultimate life span of exposed individuals, will be the concern of military planners, but will hardly affect the decision of commanders in the field. External gamma radiation. Tentative figures for doses of total body gamma radiation, acceptable as military risks, have been adopted by competent authority, and these figures are available for the guidance of planners and commanders until they are corrected on the basis of experience. Such experience can be gained by observation of human volunteers, or under actual combat conditions. Further light may also be thrown on the subject by additional animal experimentation, such as the exposures of large animals planned at Oak Ridge, and the observations on primates now proposed under the joint auspices of the National Institutes of Health and the Atomic Energy Commission. In the meantime, the influence of other factors, such as time-intensity, depth-dose, and concurrent injury (burns, etc.) upon the effects of external radiation, is under study by means of animal experimentation. (This document contains information affecting the national defense of the United States within the meaning of the Espionage Law, Title 18, U.S.C., Sections 793 and 794. The transmission or the revelation of its contents in any manner to an unauthorized person is prohibited by law.) "Depository Furnished Copy 2-15-51" Attachment A to BAW 3/1 SECRET Internal Radiation. (Chiefly inhalation of alpha and beta emitters). The assessment of the hazard from possible inhalation of radioactive material is complicated by the time of burst, the variety of materials, their solubilities and their local and systemic deposition and effects after inhalation. Further developments in instrumentation are also required to assess the hazard under any given conditions. At the present rate of progress, a reasonably satisfactory understanding of the many variables involved in the hazard from inhalation of alpha and beta emitters should be available by 1956. 2. Therapy of Radiation Injury. The therapy of radiation injury is under intensive investigation in animals and present methods of treatment should be thoroughly tested by 1953 (1954). The use of antibiotics as an adjunct to general supportive therapy is still the most promising of the methods now under study. The use of antibiotics together with the improved facilities for patient care and administration of supportive therapy should decrease the number of deaths by 50%. Long range technical estimates on improvement in the treatment of radiation injuries will depend entirely upon future discoveries in the field of radiation biology and associated sciences. 3. Protection of Personnel. Protection against hazards of radiation may be obtained by various means including evasive action, whole and partial body shielding, decontamination, and the use of substances which are under investigation. At the present rate of progress in the discovery and evaluation of protective substances and technic, there will be a choice of methods by 1954 which will reduce mortalities by 50%. The means of collective and individual protection against radioactive particulates are now available. Efficient filters and masks have been developed and knowledge is adequate concerning skin protection. The successful use of these means is largely dependent upon indoctrination and discipline. 4. Thermal Burns. The problem of thermal burns in atomic warfare, from the practical standpoint of care and casualties, is by far the most important. In spite of the enormous research effort in this field, there is little prospect of markedly reducing this hazard in atomic explosions or of protecting against it beyond our present state of knowledge. It is expected that the use of protective clothing will be evaluated by 1952. In the treatment of thermal burn casualties, it is expected that between 1954-1956 (1955-1958) significant reduction (50%) in fatalities will be achieved by means of development of procedures, selection and stockpiling of essential medical materiel, and development of fundamental knowledge for indoctrination of personnel. 5. Blast. The hazards of blast effects in atomic weapons will be assessed by 1953 (1952). This is because of unavoidable difficulties and consequent delays in the construction of the blast generator. From the current and contemplated level of effort, better understanding of atomic blast injuries and a more accurate approach to 2 BAW 13/4 the general problem of blast casualties are expected. However, improvements in hazard reduction, protective measures and therapy are in the main unlikely or conjectural. 6. Decontamination of Food and Medicinals. Essential information for the decontamination of certain type of packaged foods and medicinals (as in undamaged metal waterproof containers) under some environmental conditions is now generally available but not completely evaluated. However, a choice of techniques will probably be available for application and/or refinement by 1952. Knowledge about the decontamination of animal and vegetable crops raised in contaminated land and/or water areas is not well evaluated and will not be available for application before 1954. 7. Decontamination of Water Supplies. Information necessary for the decontamination of domestic and industrial water supplies is 50% available but not completely evaluated. A choice of techniques and equipment will be ready for large scale application in 1953. Information about permissible dosages needed for producing potable water under energy field conditions from sources contaminated with short-lived radioactive materials is available for immediate use. Therefore, the beta-gamma tolerance values are most useful during periods not exceeding a month after a nuclear explosion. Permissible dosage information for the production of potable water under emergency field conditions from sources containing long-lived radioactive contaminants will be available by 1952. 8. Personnel and Equipment. Basic information needed for the external decontamination of personnel and equipment under some operating conditions is being obtained at a satisfactory rate and a choice of decontamination techniques should be available by 1952. 9. Decontamination under Extreme Environmental Conditions. The problems associated with the decontamination of personnel and equipment under extreme environmental conditions (arctic, desert or other areas where water is not readily available) have not been evaluated. Effective evaluation should be accomplished in one year after such a program is initiated. 10. Decontamination of Burned and/or Wounded Personnel. Basic information needed for the establishment of standard procedures for the decontamination of burned and/or otherwise wounded area of the skin will be approximately 50% available by 1952 and completely available by 1955. 11. The Effects of Sublethal Dose Irradiation upon Spontaneous activity. Motivation, Learning,and retention of learning, in Laboratory Animals. In rats, a good evaluation for activity and motivation will be available by 1953; for learning and retention of learning by 1954. By 1952, these investigation will have been extended to monkeys and a quantitative evaluation should be obtained by 1955. 3 BAW 13/4 SECRET ATOMIC ENERGY COMMISSION Washington 25, D.C. copy BAW 10/3 January 10, 1951 Honorable Robert LeBaron Chairman, Military Liaison Committee P.O. Box 1814 Washington 25, D. C. Dear Dr. LeBaron: As you know, one of the important problems that would confront us in the event of a war in which nuclear weapons were employed would be of external radiation from radioactive materials that military personnel could tolerate and still effectively carry out their assigned duties and missions in the Armed Forces. This problem was a principal subject of discussion at the November 10, 1950 meeting of the Atomic Energy Commission's Advisory Committee for Biology and Medicine. In attendance at this meeting were Rear Admiral F.C. Greaves and Captain C.F. Behrens of the Bureau of Medicine and Surgery, Brigadier General William H. Powell, Jr., of the Office of the Surgeon General, Air Force, and Brigadier General James P. Coney, Army Medical Corps, and Chief of the Radiology Branch, Division of Military Application, Atomic Energy Commission. It was suggested at this meeting that it would be helpful to the Armed Forces to have the opinions of an ad hoc commission, composed of physicians and radiologists whose recommendations would be recognized as authoritative, to advise the Armed services of the permissible levels of radiation to which troops could be exposed and still be expected to be effective as fighting forces. In order to obtain an accurate and authoritative answer to the question raised at this meeting, the Division of Biology and Medicine of the Atomic Energy Commission has consulted with a group of the physicians and scientists of this country whose experience in this field has been broadest and most extensive, and whose reputation for clear thinking and good judgment renders their advice and opinions of very great value. This group includes clinicians and radiologists experienced in the use of X-ray and radium in the treatment of human patients and who have had occasion to radiate the human body in such treatments; it includes physicians and scientists who were in Japan at the close of the last war and carefully studied bomb victims at Hiroshima and Nagasaki, the physician who treated the victims of the three accidents involving acute radiation injury in the history of the Manhattan Project and the Atomic Energy Commission; scientists who have conducted and are well acquainted with the results of experiments on the effects of radiation on Attachment C to BAW 3/7 BAW 10/3 various aspects of experimental animals, including the genetic effects of radiation; and physicians who were members of the Medical Board of Review which appraised the medical work of the Manhattan Engineering Division. On December 8 these men met as a group in Washington at the request of the Atomic Energy Commission. Attending and taking part in this meeting were: Dr. Alan Gregg, Director of the Division of Medical Sciences Rockefeller Foundation, and Chairman of the AEC Advisory Committee for Biology and Medicine, who acted as chairman of this meeting. Dr. Austin M. Brues, Associate Professor of Medicine, University of Chicago Medical School, and Senior Biologist and Director of the Division of Biological and Medical Research, Argonne National Laboratory of the AEC. Dr. Simeon T. cantril, Radiologist with the Tumor Institute of the Swedish Hospital, Seattle, Washington. Consultant to the Atomic Energy Commission and to General Electric Company in their operation at Hanford Works during the last war full time with the Manhattan Project. Dr. Andrew H. Dowdy, Professor of Radiology and Chairman of the Department, Medical School of the University of California at Los Angeles, formerly Professor of Radiology at the University of Rochester Medical School and head of the Atomic Energy Commission research laboratories located there. Dr. Louis H. Hemplemann, Associate Professor of Radiology at the University of Rochester Medical School, Special Assistant to the Director of the Division of Biology and Medicine Dr. Robert F. Leob, Bard Professor of Medicine, College of Physicians and Surgeons, Columbia University, Specialist in Pathology and Internal Medicine, Chairman, Medical Board of Review, Atomic Energy Commission, 1947. Dr. Curt Stern, Geneticist and Professor of Zoology, University of California, member of AEC Advisory Committee for Biology and Medicine, formerly Chairman of division of Biological Sciences, University of Rochester, and geneticist with the AEC Atomic Energy Project located there. Dr. Shields Warren, Professor of Pathology, Harvard University Medical School, Division of Biology and Medicine, Atomic Energy Commission. 2 Brigadier General James P. Cooney for the Army, Admiral Thomas C. Anderson and Dr. Robert Flynn for the National Security Resources Board, and Major Gerrit L. Hakuis for the Air Force. The last-mentioned group attended this meeting for the purpose of presenting to the group in further detail the problems in this field already raised by the armed forces and to obtain personally the conclusions and recommendations of this committee on the subjects of importance to the harmed forces and civilian defense agencies. Members of the Division of Biology and Medicine of the AEC noted as staff to this committee in collecting and summarizing pertinent available research data and clinical information and presenting it to the committee for their consideration. As a supplement to information gained personally by armed force and civilian defense representatives at this meeting, the committee has asked me to write this letter summarizing their views on the pertinent questions asked them. This letter was submitted to each of them for any suggestions or corrections they cared to make, and I can now tell you that the members of this committee were in unanimous agreement that what follows is a correct summary of their joint conclusions. Question 1: Assume that troops are acutely exposed to penetrating ionizing radiation (gamma rays). At what dosage level will they become ineffective as troops? Answer of the Committee: Uniform dosage of 50r to a group of armed force personnel will not appreciable affect their efficiency as a fighting unit. Uniform acute dosage of 100r will produce in occasional individuals nausea and vomiting, but not to an extent that will render armed force personnel at any time ineffective as fighting units. Troops receiving an acute radiation dose of 100r and above ought to be given, as soon as feasible (within a week, if possible), a period for rest and individual evaluation. Uniform acute dosage approximately 150r or greater can be expected rapidly (in a few hours) to render armed force personnel as a group ineffective as troops through a substantial incidence of nausea, vomiting, weakness and prostration. Mortality produced by an acute dose of 150r will be very low and eventual recovery of physical fitness usually may be expected. Field officers should therefore assume that if substantial numbers of their men receive acute radiation doses substantially above 100r, there is grave risk that their commands will rapidly become ineffective as fighting units. Question 2: What dosage will render an air crew inefficient, that is, unable to complete a mission, during a flight of one to three hours, four to twelve hours, twelve to forty-eight hours? Answer of the Committee: In all three cases if radiation damage to flight crew members is held below 75r, radiation exposure will be unimportant in determining the success or failure of a mission provided the crew members had not previously received an appreciable amount of radiation. In all three cases radiation doses substantially above 75r, combined with human stresses associated with military aviation missions in wartime, are considered to very seriously reduce the odds for successful completion of a mission. Question 3: How often may an aircraft crew accept an exposure of 25r per mission and still be a reasonable risk for subsequent missions? Answer of the Committee: It is probable that at least eight missions can be carried out at weekly or longer intervals, with exposure of 25r per mission, before the chance of mission failure becomes large due either to illness during the mission or significant general deterioration in health and ability. More missions may be feasible, but personnel should be carefully checked and evaluated before each mission and particularly before a decision to permit grater exposure than 200r total in these divided doses is made. The possibility should not be ignored that cumulative radiation doses to the entire body above 200r may substantially reduce the life expectancy of the irradiated individual. Question : A submarine crew are receiving 25r permission. How many missions should they be allowed to make? Answer of the Committee: The answer is substantially the same as to question 3. It is probable that a least eight missions can be carried out. Personnel ought to be carefully checked and evaluated after each mission. The possibility of substantial reduction in life expectancy by radiation doses totally over 200r should not be ignored. As indicated earlier, in arriving at these conclusions the Committee took into account the results of extensive animal experiments, the response of patients treated for disease by X-ray and radium, observations on the effect of radiation from the atom bomb detonated over the Japanese cities of Hiroshima and Nagasaki, and accidental radiation exposures within the Manhattan Project and the Atomic Energy Commission. I believe you can accept these values as realistic appraisals that can be used in planning with the convictions that their predictions will be closely fulfilled in practice. We are sending copies of this letter to the Chief of the Bureau o of Medicine and Surgery, Department of the Navy, and the Surgeons General of the Army and Air Force. Sincerely yours, Marion W. Boyer General Manager