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March 6, 1987

Polycythemia Vera Among Participants of a Nuclear Weapons Test

Author Affiliations

Massachusetts General Hospital Boston

Massachusetts General Hospital Boston

JAMA. 1987;257(9):1179. doi:10.1001/jama.1987.03390090050020

To the Editor.—  The report by Caldwell et al1 of excess polycythemia vera among veterans who were present at the Smoky nuclear weapons test in Nevada in 1957 notes that at least two and possibly four cases of polycythemia vera were found, whereas 0.2 cases would be expected based on the Baltimore incidence rates reported by Modan.2 The preceding letter by Sobell et al suggests that 0.82 cases would be expected based on Rochester, Minn, statistics. Thus, the SMR ranges from 2.44 to 10 for the two certain cases and from 4.88 to 20 for all four cases.The radiation doses reported by Caldwell et al averaged 271 mrem (2.71 mSv) for the two certain cases and 604 mrem (6.04 mSv) for all four cases. The doubling dose (the dose that doubles the normal incidence of a medical condition) can be readily calculated from these doses. Assuming a