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January 28, 2004

Assessing Exposure to Toxic Gases in Bhopal—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(4):422-423. doi:10.1001/jama.291.4.422-b

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.

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