Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: In response to Dr Dhara, all exposed
individuals in our study lived in Kainchi Chhola township, facing the Union
Carbide plant toward the northeast and within 1 km of the plant—not
6 to 8 km south of the plant as he suggests. We had previously found a 43%
rate of pregnancy loss in 3270 families1 and
568 deaths in 2622 households2 in this and
in adjoining townships. Exposure to gases was ascertained by checking documents
such as family ration cards used in December 1984, reference sheets of the
survey carried out in early 1985 by the Tata Institute of Social Sciences,
and medical records mentioning exposure-related symptoms, as well as verification
by members of the local Health Committee. It was assumed that children aged
2 years or younger would have been near their mothers, and thus that postnatal
exposure of children could be inferred from their mothers' exposure.
Varma DR, Ranjan N, Sarangi S, Holleran S, Ramakrishnan R. Assessing Exposure to Toxic Gases in Bhopal—Reply. JAMA. 2004;291(4):422-423. doi:10.1001/jama.291.4.422-b