Stillbirths and male irradiation

Little (1999) recently reviewed the evidence that paternal preconception irradiation in the Sellafield workforce (Parker et al 1999) and among Japanese atomic bomb survivors (Otake et al 1990) might be associated with an increased risk of stillbirth. He concluded that the association reported for radiation workers was statistically incompatible with the absence of an association seen among the exposed Japanese parents. These studies and analyses illustrate the considerable difficulty in assessing stillbirths conceived by men exposed to ionising radiation at work. For example, occupational doses may not be sufficiently large to result in a detectable effect and maternal factors that are associated with stillbirths and important to adjust for may not be available. These papers also bring to focus a relevant but not well-studied public health issue, namely, what are the reproductive risks for men and women exposed to potential mutagens? We wish to emphasise here the theoretical and practical advantages of addressing this issue in persons not with low dose occupational or acute atomic bomb exposures, but with higher dose medical experiences; in particular, in survivors of cancers of childhood, adolescents, and young adulthood (Blatt 1999, Bryne et al 1998, Sankila et al 1998, Green et al 1997, Hawkins and Stevens 1996). Letter-to-the-editor