As the former medical director of the Navajo Area Radiation Exposure Screening & Education Program (Navajo Area Indian Health Service), I would like to add several points to the generally excellent articles by Laura Paskus, "Navajo Windfall" and "Navajos pay for industry’s mistakes."

Having worked for four years examining patients applying for compensation under the Radiation Exposure Compen-sation Act (RECA) of 1990 and the 2000 amendments, my assessment is that RECA remains fundamentally flawed. While Congress has admitted responsibility and apologized for not ensuring that more aggressive regulatory measures were taken to protect the health of former Cold War uranium workers, the "worker’s compensation approach" of requiring documentation of objective disability or impairment as the criteria for receiving a "compassionate payment" fails to recognize the basic harm suffered by those workers. Under the last 15 years of the current law, fewer than 25 percent of those eligible for RECA have been compensated.

The federal government has yet to formally respond to the National Research Council April 2005 "Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program." The authors, nationally recognized radiation science experts, recommended that the eligibility criteria for downwinders of the Nevada Test Site be changed from a politically derived geographic area to a more objective dose-calculator model. This would allow any American exposed to Cold War-era Nevada Test Site radiation potentially to meet RECA criteria for compensation.

Bruce Baird Struminger, MD
Northern Navajo Medical Center Indian Health Service
Shiprock, New Mexico