The Arctic Aeromedical Laboratory's Thyroid Function Study A Radiological Risk and Ethical Analysis (1996) / Chapter Skim
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1 Introduction
1 Introduction
Pages 8-25
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Air Force. The AAL ceased operations in 1967, and its functions were transferred to Brooks Air Force Base, San Antonio, Texas.
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Based on previous research, including animal studies, researchers at the AAL had hypothesized that the thyroid might play a role in cold weather survival and designed a study to measure the effects of cold on thyroid activity by comparing Alaska Native subjects and white military personnel. To measure thyroid function, researchers used a radioactive medical tracer, the radioisotope iodine 131 (~3~.
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To conduct this study, the Committee sought to examine as much written documentation as possible, including AAL historical records, results, procedures of experunents, and case files of participants and investigators. The Committee also examined historical and current literature on the use of radioisotopes for diagnosis and therapy of thyroid dysfunction and federal and professional guidelines for the conduct of human biomedical experimentation.
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Air Force doctors and scientists, and research subjects included animals, military personnel, and Alaska Natives. One laboratory project, entitled "Human Acclimatization and Adaptation to Arctic Cold," alone included 35 separate studies (U.S.
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CONDUCT OF THE STUDY: SAMPLE SIZE AND DISTRIBUTION Alaska Natives _ The first }~3i tests took place in the coastal Inupiat villages of Wainwright and Point Lay during August 1955. The inland Inupiat village of Anaktu~ruk Pass was visited in September, and the Athabascan Indian villages of Fort Yukon and Arctic Village were visited in October 1955 (see Box 1.2~.
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Introduction ~.~ ~ ~ I: -.
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CONDUCT OF TED STUDY: SUBJECT SELECTION The U.S. Air Force did not have guidelines in place requiring written consents in human experimentation, so AAL physicians did not obtain signed consent forms.
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~ . Alaska Native subjects of the AAL thyroid Unction study by village 15 Number of Number Number Number AAL Highest Its' VILLAGE of of of Age Trips to Activity in ,uCi Subjects Men Women Range Village Wainwright 47 39 8 20-70 2 71 Point Lay 12 7 5 16-90 1 16 Anaktuvuk Pass 20 13 7 21-76 3 129 Fort Yukon 6 6 0 2140 2 58 Arctic Village 11 5 6 17-67 3 130 Point Hope 6 6 0 19-28 1 54 TOTAL 102 76 26 16-90 SOURCE: Rodahl and Bang (19571.
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Results of the experunents generally were not conveyed to the subjects, only to the scientific press and colleagues, which presumably also included the Alaska Native Service doctors. Wainwright In Wainwright, a villager who is now an elder reported that he acted as the intermediary and interpreter for the AAL doctor in the 1950s medical study.
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. The inland village of Anaktuvuk Pass was a community of 78 nomadic Inupiat Eskimos living in a collection of tents and nine houses who followed game, principally caribou, across the Brooks Range mountains and elsewhere in the interior of north central Alaska (Rodah!
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Some participants were employed at the Fort Yukon Hospital at the time; some, in fact, participated
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Two Indians had been transported to Anchorage for thyroidectomies since 1955 (Rodahl and Bang, 1957~. Arctic Village and Anakfuvuk Pass were chosen by the AAL doctors for a control test using a potassium iodide supplement to determine whether increased }~3} uptake was related to endemic goiter or might be related to thyroid stimulation from exposure to cold.
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STUDY RESULTS The AAL thyroid function study concluded there was no significant difference in thyroid uptake or urinary elimination of radioactive tracers in the Natives and whites tested. Nor was there any indication of increased thyroid stimulation as a result of exposure of the subjects to cold.
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The effort consisted of a detailed historical records search, requests for assistance from local, tribal, state, and federal agencies and governments, telephone and personal interviews, written interviews utilizing a questionnaire, and a public hearing. The Committee focused on gathering information on the conduct of the medical study and did not conduct physical examinations of the study participants nor review their medical histories, although that information was volunteered in the testunony of some participants.
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7 -- -- -- = ~-7 Interview and Public Hearing Information The written documentation available was not adequate to provide a complete picture of the AAL thyroid function study, particularly in regard to the consent process, the day-to-day functioning of the AAL at the tune, and the participants' understanding of the nature of the study (both researchers and subjects)
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, scientific and ethical concerns regarding human medical experimentation of Alaskans and military men during the period of the Cold War, and the }~31 studies in particular. Some former employees of the AAL during the period 1955-1957 were asked to speak on the working conditions and organization of lab and about the state of medical practice in local communities, the relationship between the Alaska Native Service and the staff of the AAL, methods used to get military and Native volunteers for medical studies, what guidance on informed consent may have existed in the AAL at that time, and what they could remember about the AAL studies.
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During the public session, it became clear that many of the speakers were concerned about experunents beyond the AAL thyroid function study other medical experiments conducted at other times and places. Some speakers raised concerns about unrelated, but obviously important, issues such as unresolved Arctic contamination from the military presence.
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With hindsight, the secrecy ethos of the Cold War era did much to breed mistrust of government, not just in Alaska but throughout the citizens of the nation. The Alaska Natives' strong response to learning of the AAL thyroid function study was born out of years of mistrust, a mistrust that will not be simple to rectify.
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