[Congressional Record Volume 144, Number 33 (Monday, March 23, 1998)]
[Senate]
[Pages S2431-S2433]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SPECTER (for himself, Mr. Thurmond, Mr. Jeffords, Mr. 
        Murkowski, Mr. Rockefeller, Mr. Akaka, Mr. Wellstone, Mr. 
        Lieberman, and Mrs. Murray):
  S. 1822. A bill to amend title 38, United States Code, to authorize 
provision of care to veterans treated with nasopharyngeal radium 
irradiation; to the Committee on Veterans' Affairs.


                  medical care to veterans legislation

  Mr. SPECTER. Mr. President, as Chairman of the Committee on Veterans' 
Affairs, I have today introduced, at the request of the Secretary of 
Veterans Affairs, S. 1822, a proposed bill to authorize the provision 
of medical care to veterans who were treated with nasopharyngeal radium 
irradiation. The Acting Secretary of Veterans Affairs submitted this 
proposed legislation to the President of the Senate by letter dated 
August 11, 1997.
  Mr. President, it is my usual practice, as Chairman of the Committee 
on Veterans Affairs, to introduce Administration-requested legislation 
that is referred to the Committee without commenting on the substance 
of the introduced bills, without committing myself to either support or 
oppose the legislation in question, and without seeking co-sponsors. In 
this case, I have departed from my usual practice due to the unusual 
nature of this legislation, which is long overdue. I am pleased that 
Senator Jay Rockefeller, the Ranking Minority Member of the Committee 
on Veterans Affairs, has joined me as a cosponsor.
  A medical treatment known as nasopharyngeal radium irradiation --the 
inserting of a radium-tipped metal rod through the nose--began in 1924 
at the Johns Hopkins University as a means to treat middle ear 
obstructions and deafness. It was also commonly used to treat children 
with chronic ear infections. Even until the mid 1960's, medical 
textbooks recommended this treatment to shrink adenoid tissue in 
children. It is estimated that from 500,000 to 2 million persons may 
have received nasopharyngeal radium irradiation treatments over the 
years.
  During the 1940's and 1950's--and perhaps later--the military treated 
submariners and air crew members with nasopharyngeal radium irradiation 
to prevent ear injury caused by severe pressure changes encountered in 
submarine and flight duty. The Final Report of the Advisory Committee 
on Human Radiation Experiments issued in 1995 cites one case where the 
Navy in the early 1940's treated 732 submariners with nasopharyngeal 
radium irradiation to equalize middle ear pressure with a 90 percent 
success rate.
  Unfortunately, scientific research now suggests that individuals who 
received this then-accepted medical treatment may be at increased risk 
for developing head and neck cancers and other types of diseases and 
disorders. When nasopharyngeal irradiation was administered, radiation 
targeted to lymph tissue also affected the brain and other tissues in 
the head and neck, including the paranasal sinuses, salivary glands, 
thyroid and parathyroid glands.
  Mr. President, the Committee on Veterans Affairs will fully develop 
the scientific record on this legislation. I will not now, therefore, 
discuss at length the evidence to support the proposition that veterans 
who received such therapy should now be eligible for VA care to treat 
the previously unknown medical consequences of nasopharyngeal radium 
irradiation. Suffice it to say now that the quantum of radiation to 
which people were routinely exposed as a consequence of nasopharyngeal 
radium irradiation far exceeded levels that would be judged acceptable 
today. Our colleague from Connecticut, Senator Lieberman, stated it 
well when he commented in August 1994, at a hearing of the Environment 
and Public Works Subcommittee on Clean Air and Nuclear Radiation: ``. . 
. the best evidence of the danger of this radium treatment is the fact 
that no doctor in his right mind would think of performing such a 
procedure today.''
  VA has proposed that veterans who received such treatment in the past 
be deemed eligible for treatment of cancers and other diseases and 
disorders that might be associated with this well-intentioned, but 
seemingly misguided, exposure to radiation. This legislation, if 
enacted, would authorize VA to treat such veterans on the same priority 
basis as it treats veterans who may have been exposed to ionizing 
radiation during weapons testing or during the occupation of Japan 
following World War II. It would also authorize VA to examine any 
veteran who was subjected to nasopharyngeal irradiation and include any 
findings in the VA's radiation registry.
  As Chairman of the Veteran's Affairs Committee, I urge my colleagues 
in the Senate to join me in supporting this legislation.

[[Page S2432]]

  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1822

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled, That 
     except as otherwise expressly provided, whenever in this Act 
     an amendment is expressed in terms of an amendment to a 
     section or other provision, the reference shall be considered 
     to be made to a section or other provision of title 38, 
     United States Code.
       Sec. 2. (a) The Secretary may examine, and include in the 
     Department's Ionizing Radiation Registry Program, any veteran 
     who received nasopharyngeal radium irradiation treatments 
     while serving in the active military, naval, or air service.
       (b) Section 1710 is amended--
       (1) in subsection (a)(2)(F), by inserting ``or who received 
     nasopharyngeal radium irradiation treatments,'' after 
     ``environmental hazard,''; and
       (2) in subsection (e)(1)(B) by inserting ``, or a veteran 
     who received nasopharyngeal radium irradiation treatments 
     while serving in the active military, naval, or air 
     service,'' after ``radiation-exposed veteran''.

  Mr. ROCKEFELLER. Mr. President, I am pleased to cosponsor legislation 
that will authorize provision of care to veterans treated with 
nasopharyngeal radium irradiation. This bill, requested by the 
Department of Veterans Affairs, will provide priority health care to a 
group of veterans that have so far been excluded from access to VA 
services. I urge all of my colleagues to support this bill.
  Let me take you back over 40 years, to the 1940's and 50's, when 
thousands of military personnel (primarily Navy submariners and Army 
Air Corps pilots) received nasopharyngeal radium treatments to treat 
and prevent inner ear problems that developed due to the inadequate 
pressurization of their respective vessels. These treatments were 
considered the standard in the medical community at the time for 
children with severe middle ear obstructions and infections, often with 
accompanying deafness. To adapt the treatments to healthy adults, the 
Navy and Army conducted experiments on small groups of submariners and 
pilots. Subsequently, between 8,000 and 12,000 servicemen were 
irradiated for military purposes. The treatments were halted in the 
early 1960's as a result of two developments: pressurized planes and 
submarines became available (thus obviating the need for the 
treatments), and the clinical dangers associated with radiation were 
becoming apparent.
  Looking back, we now know just how dangerous these treatments can be. 
The Centers for Disease Control and Prevention estimate that tissues at 
the exact site of radium placement were exposed to 2000 rem of 
radiation. That is 400 times greater than the maximum ``safe'' level of 
radiation exposure established by the Atomic Energy Commission many 
years ago. Parts of the brain received 24 rem, five times the accepted 
limit of exposure. Studies that have analyzed the health effects of 
external irradiation of the head and neck conclude that there is an 
increased risk of tumors of the brain, and of the thyroid, salivary, 
and parathyroid glands. One study done on individuals who had received 
nasopharyngeal radium treatments concluded there was an increased risk 
of developing head and neck tumors associated with the childhood 
treatments.
  Unfortunately, the health effects of the treatments that were given 
to our veterans is unknown. Careful scientific studies cannot be done 
because the records documenting the treatments are incomplete or 
nonexistent. However, when such high levels of exposure are sustained, 
we must be concerned about long-term health effects, and thus, we have 
a responsibility to ensure access to health care by these veterans. 
Simply put, it is the right thing to do.
  This legislation is a step in the right direction in helping these 
individuals. As Ranking Minority Member of the Senate Committee on 
Veterans' Affairs, I am well acquainted with the difficulties 
experienced by veterans who were exposed to radiation during service to 
their country and later sought help from the VA. The willingness of the 
VA to include this group of veterans is clearly demonstrated by the 
fact that VA initiated this legislation, and that is good.
  In summary, this legislation grants veterans who received 
nasopharyngeal radium treatments the same status as other atomic 
veterans who served in the occupational forces in Nagasaki and 
Hiroshima, or who were present at the atmospheric test sites in Nevada 
and the Pacific. These veterans will now be able to enroll in the 
ionizing radiation registry, which entitles them to a full and complete 
physical examination. They will also gain access to medical care, to 
treat cancerous conditions detected during this examination that are 
associated with exposure to ionizing radiation.
  It is especially important to provide physical examinations and 
health care to these veterans because documentation of the 
nasopharyngeal radium treatments was poorly done, if it was done at 
all. Thus, the relevant clinical information is not in their civilian 
or military medical records to alert a physician to potential problems. 
The appalling lack of documentation has proved to be a constant problem 
in ongoing efforts to grant benefits to atomic veterans of all types, 
and continues to plague us in this effort as well.
  We will continue to study the plight of all atomic veterans, but this 
legislation offers eligible health care to a group of atomic veterans 
that have up to now been closed out of the VA. It is reasonable, 
compassionate, and long overdue.
  Mr. LIEBERMAN. Mr. President, I am very pleased today to join with my 
colleagues, including Senators Specter and Rockefeller, the Chairman 
and Ranking Member of the Veterans Affairs Committee, and the Chairman 
of the Armed Services Committee, Senator Thurmond, as an original 
cosponsor of this legislation which would authorize access to priority 
medical care for veterans treated with nasopharyngeal radium 
irradiation. Enactment of this legislation would be a major step 
forward for our veterans who received this treatment for inner-air 
problems between l940 and l960. I applaud the Clinton Administration 
for submitting this legislation.
  Mr. President, nasal radium irradiation was the largest scale 
radiation experiment in the United States and the consequences of 
exposing so many people to ionizing radiation has not been adequately 
addressed. It was used to alleviate pressure changes associated with 
submarine and flying duties for our soldiers and to treat children with 
inner ear problems. We have a moral obligation to do everything we can 
to help these veterans and civilians. This legislation is especially 
important to me because veterans who received this treatment included 
Navy submariners trained in Connecticut. I've been working for the last 
four years to get similar legislation enacted.
  Under this bill, veterans who received nasopharyngeal radium 
treatments will receive the same status as other atomic veterans who 
served in the occupational forces in Nagasaki and Hiroshima or were 
present at the test sites in Nevada and the Pacific. What this means is 
that these veterans will be able to enroll in the ionizing radiation 
registry which entitles them to a full and complete physical 
examination. They will also gain access to medical care to treat 
cancerous conditions detected during this examination that are 
associated with exposure to ionizing radiation.
  Studies that have analyzed the health effects of external irradiation 
of the head and neck indicate that there is an increased risk of 
tumours of the brain and of the thyroid, salivary and parathyroid 
glands.
  Mr. President, I've been working on many aspects of this problem for 
a number of years. I've been very concerned about notifying veterans 
who received this treatment so that they are aware of the concerns 
about the long term effects of such treatment and can take appropriate 
actions. Last September, the Veterans Administration agreed to provide 
such notification where they had the information available. The 
Veterans Administration is also considering performing a health 
surveillance involving about 400 veterans whose names were discovered 
in a logbook in April l996 at the Submarine School Museum in 
Connecticut. This would also be a significant step forward.
  I also remain very concerned about our civilians who have been 
exposed to this treatment. The Center for Disease

[[Page S2433]]

 Control and Prevention estimates that between 500,000 and two million 
civilians received this treatment between 1945 and l960. I was very 
pleased that CDC hosted a video conference on the treatment at Yale in 
September l995 and has published notices in medical bulletins about the 
treatment, including fact sheets for the general public.
  My number one priority on the civilian side now is attempting to 
ensure that civilians who received the treatment are notified. I have 
written to Secretary Shalala asking her to undertake a feasibility 
study about providing notice. People need to know that they had this 
treatment so that they can determine appropriate next steps, and our 
government should do everything possible to ensure that notice is 
provided.
  Mr. President, many challenges remain as the government seeks to 
fulfill its moral obligation to our veterans. But enactment of this 
legislation would be an extremely important step forward.

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