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10 Conclusions The committee explored in detail the feasibility of an epidemiologic study examining the association between adverse reproductive outcomes and paternal exposure to ionizing radiation. Such a study would be of great interest not only to the 210,000 veterans exposed to atomic weapons radiation but also to many other individuals who have received low doses of radiation at their places of employment or elsewhere. The committee's assessment is that it will be ex- tremely difficult, if not impossible, to find and contact a sufficiently high and representative percentage of veterans' families, to establish a good measure of dose for each veteran, to identify and accurately document reproductive prob- lems that occurred over a fifty-year interval, and to measure other factors that cause reproductive problems and therefore might confound any observed rela- tionship between radiation exposure and reproductive problems. These difficul- ties become even more acute with regard to the grandchildren of these veterans. The cohort of Atomic Veterans does not provide a practical opportunity for a scientifically adequate and epidemiologically valid test of the hypothesis that paternal exposure to ionizing radiation has increased the frequency of adverse reproductive outcomes among their children and grandchildren. The committee recognizes the real concerns of the Atomic Veterans as expressed by their repre- sentatives, but it must conclude that epidemiologic studies cannot adequately address these concerns. 79
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