198 



( 1 ) Organize, in Hiroshima, Nagasaki, 

 and a control area or areas, a modified 

 system of pregnancy registration, this to 

 include the irradiation history of the 

 parents. 



(2) Obtain as complete information as 

 possible on the outcome of each regis- 

 tered pregnancy. 



(3) Follow up each report of an ab- 

 normal termination of pregnancy or a 

 congenital malformation with detailed 

 family studies. 



(4) Develop a system of checking on 

 the completeness and accuracy of regis- 

 tration of births and deaths, such as re- 

 quiring at intervals dual registration by 

 both the family and the obstetrician or 

 midwife. 



(5) Conduct these studies on a suffi- 

 ciently large scale that the results will 

 have statistical significance. 



(6) Integrate this program with a sys- 

 tem of periodic examination of the off- 

 spring of irradiated persons and with 

 careful death certification, so that genetic 

 effects not apparent at birth but detected 

 subsequently may be recorded. In partic- 

 ular, causes of infant mortality should be 

 accurately recorded. 



(7) Place this program in competent 

 Japanese hands, through the Japanese 

 Government, with only enough Ameri- 

 can supervision and cooperation, includ- 

 ing supplies, to facilitate a successful 

 program. 



This program must extend over a 

 period of 10-20 years before a signifi- 

 cant amount of data can be accumu- 

 lated, and quite possibly an even 

 longer period of study, extending to 

 the second and subsequent generations, 

 will be indicated. 



Certain practical limitations of the 

 program may be considered at this 

 point. The most difficult problem will 

 be to obtain the necessary complete- 

 ness of reporting. This will require 

 constant effort, a wide educational 

 program, and frequent cross-checks. 

 Congenital malformations occurring 

 within Japanese families may some- 

 times not be reported. This is perhaps 



GENETICS CONFERENCE 



more likely to occur in Japan than in 

 this country, because probably less 

 than 10 per cent of Japanese births 

 occur in hospitals as these are defined 

 in the United States. To what extent 

 stillbirths and malformations occurring 

 outside a hospital will be recorded de- 

 pends on the vigor with which the 

 problem is pursued. It will be difficult 

 to get evenly matched teams of inves- 

 tigators for bombed and control areas. 

 Furthermore, once people living in 

 Hiroshima and Nagasaki learn that 

 stillbirths and malformations may pos- 

 sibly be attributed to the effects of the 

 bomb, they will probably lose some of 

 their reluctance to report such matters, 

 whereas this will not be the case in 

 a control area. 



Japan is now a defeated and oc- 

 cupied country, under severe postwar 

 stress, whose people have a very dif- 

 ferent psychology from our own. A 

 program such as that under considera- 

 tion will proceed much more slowly 

 there than it would in this country. 



In order to reduce the possibility 

 that a negative result of the investiga- 

 tion on Japanese material be inter- 

 preted by the medical and lay public 

 as meaning that important genetic 

 effects were not produced, it is essen- 

 tial that a comparable effort be ex- 

 pended in experimentation on other 

 mammalian material, in which genetic 

 effects of different kinds can much 

 more readily be brought to light. In 

 this way it should be possible to throw 

 light upon the proportion of the total 

 genetic effects produced by the radia- 

 tion that would have been detectable 

 by the methods used in the investiga- 

 tion on the human material, and the 

 serious danger of misinterpretation of 

 the latter results would be minimized. 



Recognizing the difficulties briefly 

 touched upon in the foregoing para- 

 graphs, the Conference on Genetics 

 voted unanimously to record the fol- 



