Government Promises Help
When Mike Krabach told friend Stewart Farber 15 years ago that a Connecticut doctor had placed radioactive radium rods up his nose, he had no idea how this would trouble his friend.

His story unleashed Farber, an unassuming 51-year-old radiation health physicist and independent consultant in Pawtucket, R.I.

Farber has taken on the military, the government, the medical community and academic health professionals over what he believes is the most serious human-radiation experiment.

Krabach is one of as many as 2 million Americans who underwent nasal pharyngeal irradiation treatment during or after World War II. Certified in military experiments, it saw widespread use by civilian doctors after the war.

Medical studies, which Farber brought to public attention, suggest that those treated back then could be at a greater risk for getting cancer today.

At least three federal agencies have been trying to figure out what to do for thousands, and perhaps millions, of people who received the treatment.

Neither Farber nor Krabach believes those efforts have adequately addressed the serious nature of the exposure or the risk to those exposed.

For years, Farber has argued that the exposures represent a public health crisis, primarily because of the numbers involved, but also because those exposed may not know they are at risk. He says, too, that the medical establishment itself is poorly informed about the potential risk.

In an Albuquerque visit, Krabach recalled how his casual, coffee-break conversation with Farber launched his friend on a one-man crusade that has exposed nasal radium and forced government officials to examine it.

Krabach, who lives a few miles from Farber in Cumberland, R.I., said he remembers talking with his friend about the field of epidemiology, the study of disease in populations. They were on a break at Yankee Power Co. in Bolton, Mass., where both worked.

Farber's work dealt with assessing the radiation environment for the company and ensuring it was within federal rules. Their talk centered on radiation health studies, exposures, background radiation everyone receives and strict nuclear regulations that limit worker and public exposures.

Krabach remembers blurting out, ''Hey, you want to hear something really strange?''

He then described the nasal-radium treatments he got in New London, Conn., from the late Dr. Henry L. Haines. He was referred to Haines, who told him the practice was common and had been done safely on thousands of people.

\Farber was stunned, and the more he heard the more concerned he became. Krabach told him he had undergone a series of the treatments in 1965 to help him handle changes in water pressure while doing scuba diving for a ship-builder.

The treatments helped. But Krabach said that as radiation-exposure concerns grew over the years, he occasionally wondered whether nasal radium would someday haunt him. He felt fine, so he put it out of mind.

But the conversation with Farber jogged his memory. Farber realized that many more people probably had had the same exposure his friend had. In fact, Farber would discover other friends and acquaintances who had it.

The treatment involved placing thin rods tipped with a capsule of radioactive radium up each nostril for several minutes, in effect to shrink or burn away the adenoids and clear the nasal passages.

The treatment was effective in combating chronic nasal and ear infections, mild deafness and the inability to clear the ears, that is, to equalize atmospheric pressure at high altitudes or in deep water.

After his conversation with Krabach, Farber would discover through library research that physicians had ignored warnings of potential long-term health effects.

He learned that the treatment had been developed at Johns Hopkins Medical Center in Baltimore and that the center had conducted a follow-up study that had found problems. People treated as children had a significantly increased risk of head and neck cancers and thyroid disease as adults.

Unlike Krabach, who was treated as an adult, most people were treated as children when experts believed a growing body is most susceptible to long-term damage from radiation.

When confronted by Farber, some in the modern medical establishment initially doubted such a treatment even existed.

Later, faced with Farber's mounting research and evidence, they suggested it was probably impossible to do anything about it anyway, for two reasons: lack of patient records on procedures done decades ago; and, the inability to do anything medically for those who might develop brain cancers.

During the last five years, Farber has insisted that based on two independent medical studies, the risks are quantifiable for head and neck cancers and thyroid disease and ought to move the government to action.

Krabach told Farber that Dr. Haines had reassured him prior to the treatments that he had successfully treated hundreds of Navy submariners over many years.

''You're kidding,'' Farber said he told Krabach. When Krabach didn't smile, an astonished Farber pumped him for details, enough to propel him on an initial research trip to nearby Brown University Library, his alma matter. There he searched old medical periodicals for leads and clues.

Haines, Farber discovered, had published extensive articles about the procedure and his military experiments. Nasal radium had blossomed medically after Haines conducted the experiments in 1945 and 1946 for the Navy, at the Naval Base at Groton, Conn., Farber found.

Air Force doctors also had used the procedure on pilots, Farber learned, who insisted against military claims to the contrary that veteran medical records could be used to identify those exposed.

After years of denying it existed or that there was any realistic hope of ever locating those involved in the original experiments, the Navy last summer found Haines' experimental log book in Groton.

It contains the names of more than 1,700 submarine students treated by Haines, including their military serial numbers.

While some medical experts had argued that nasal radium was an accepted medical practice of the time, military officials acknowledged that the Navy log book is unequivocal evidence that at least the initial use on the submariners was clearly experimental.

To Farber, this made nasal radium the most far-reaching human-radiation experiment in human health terms.

He said it represents an important experiment beyond Haines' original intent: a controlled means for studying internal radiation effects in a large group of people. They were exposed to the same radiation doses at roughly the same point in time and now may be at risk of cancer.

Learning what happened to them could have an impact on hundreds of thousands, perhaps millions, of civilians who later had the radium treatments.

Farber's research suggests some 20,000 Navy submariners or Army Air Force pilots or crew members ultimately received the treatment over several decades of military use. He contends the military experiments led to the treatment's broad civilian use between 1946 and the early 1970s.

Farber says the government has dragged its feet, and he continues to warn in any forum he can that nasal radium could cause serious disorders and death.

For example, late last year Farber traveled to Washington, D.C., to state his case at the American Nuclear Society's national scientific meeting and again to staff members of key members of Congress.

In December, he discovered that a Dutch study of nasal radium that had reported negative results had been revised. Previously it had shown no ill effects and had been cited by U.S. government authorities as evidence that nasal radium was harmless.

The study now suggests that nasal-radium patients have twice the overall risk of getting cancers compared to those who didn't have the treatment.

The new finding is significant, Farber and others say, because Europeans who had the treatment actually received a significantly smaller radioactive dose than most Americans who got it. That's because the individual treatments administered in America typically lasted longer.

Farber was outraged that government scientists weren't aware of the new data in the study, even though it came out of their own conference sponsored by the government.

Krabach says such tenacity is the only reason the nasal-radium issue is still percolating with the government.

Virtually alone, Farber has forced the government to examine nasal radium over the last four years and he considers it unconscionable that no one has assumed responsibility for it.

He believes there is a professional silence that is preventing people at risk from being alerted to the potential health implications.

''If we wait long enough, it won't matter,'' Farber mused. ''They'll all be dead or dying.''

The exposures, as well as the unprecedented numbers of those exposed, justify a major government-backed medical study, he says.

Originally, Farber was criticized for estimating that 20,000 military personnel got the treatment and that in the decades after World War II, perhaps 200,000 to 400,000 civilian patients had radium rods shoved up their noses.

Recently, however, the Centers for Disease Control and Prevention in Atlanta acknowledged his work and indicated his ''ballpark'' figures probably are conservative.

The center's estimate: Between 500,000 and 2 million Americans likely were exposed to radium rods, most while they were children and most susceptible to tissue damage.

The CDC has sponsored two medical conferences to explore nasal radium. But otherwise, Farber feels, government agencies have been looking for excuses not to do anything.

Only after years of researching and trying to get various experts interested in it did Farber get professional notice. The New England Journal of Medicine published his extensive letter on the defunct practice in 1992, nearly three years after it had been submitted.

Finally, Farber got some encouragement. The White House announced this spring that it will propose legislation to make World War II veterans who received the treatment eligible for Veterans Affairs health services.

The administration also announced that it is considering conducting a study of the servicemen who were treated to definitely determine the health impacts of the treatments.

Long frustrated by unfulfilled promises of various government bureaucrats, Farber's response was cautious.

''That's a start,'' he said. ''It's certainly the most I heard to date from the government. We'll see.''

(Lawrence Spohn writes for The Albuquerque Tribune in Albuquerque, N.M.)