William Page's tenure as acting director reached an end in 1992 with the appointment of Chris Howson as interim director. After the ensuing search, IOM leadership recruited Dr. Richard Miller from the Walter Reed Medical Center as the new director of the program in 1993. Coming from both a medical and a military background, Miller fit many of the stipulations for a successful director set forth by the site visit group shortly after Jablon left the agency. Miller continued efforts begun under both Page and Howson. One especially notable study begun under Howson was designed to monitor the health status of Persian Gulf veterans (see Box 16). The mere fact of this study indicated that the agency fit better into the 1990s than at any time in decades. Page, Howson, and Miller would not let the opportunity presented by the Gulf War slip the way the Vietnam War had through the fingers of the MFUA staff in the early 1970s.

Miller took steps to make the agency more visible within the IOM structure, successfully arguing that the MFUA's oversight group should be a board instead

BOX 17 Studies of Participants in Atmospheric Tests of Nuclear Weapons

In 1976 the case report of a paratrooper diagnosed with acute myelocytic leukemia reached the Centers for Disease Control and Prevention (CDC). The paratrooper attributed the leukemia's occurrence to his presence at the test detonation of the nuclear device "SMOKY." Subsequent preliminary investigations by the CDC and others raised concerns about increased mortality rates due to leukemia among all participants in atmospheric nuclear weapons tests. In 1979, the Medical Follow-up Agency was commissioned to investigate mortality among individuals present at these tests. This investigation culminated in a National Research Council (NRC) report Mortality of Nuclear Weapons Test Participants , published in 1985. This report examined the records of soldiers participating in at least one of five select nuclear weapons test series between 1951 and 1957. Researchers did not identify any statistically significant increase in mortality attributed to radiation-related disease (e.g., leukemia or other malignancies) among the individuals studied, other than those leukemias previously noted among SMOKY participants. However, in 1992 the U.S. General Accounting Office distributed a report concluding that the data provided by the Defense Nuclear Agency (DNA), and used by the MFUA in the preparation of its 1985 report, contained misclassification errors that rendered the study flawed. The MFUA was asked to redo its earlier research. This study, scheduled for completion in 1999, uses a DNA-corrected and updated participant list, a comparison group of military personnel who did not participate in the atomic tests, and the addition of mortality data for 10 years since the earlier publication. Meanwhile, in 1996, the NRC published another MFUA report examining mortality among participants in atmospheric tests of nuclear weapons. This study (Johnson et al. 1996) compared the mortality of Navy personnel participating in the CROSSROADS test series with the mortality of those in a comparison group. Although the study found a small but statistically significant increase in mortality



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