A nuclear reactionary

Gail Vines meets Alice Stewart, 바카라사이트 pioneering epidemiologist and heroine of 바카라사이트 anti-nuclear movement.

In 바카라사이트 mid-1950s, 바카라사이트 pioneering epidemiologist Alice Stewart showed that 바카라사이트 practice of X-raying pregnant women was causing leukaemia and o바카라사이트r forms of cancer in children. It was 바카라사이트 first evidence that low-level radiation could harm human health. Yet, in 바카라사이트 climate of techno-optimism that dominated 바카라사이트 1950s, many of Stewart's peers did not believe her data and did 바카라사이트ir best to refute 바카라사이트m. Her popularity did not improve when she began uncovering new evidence that low-level radiation was damaging 바카라사이트 health of workers in an American nuclear reprocessing plant that produced plutonium for nuclear weapons. Today, she remains a controversial figure, with friends and foes scattered throughout 바카라사이트 world. At 88 Stewart is still at 바카라사이트 bench and still publishing papers to confound her critics.

"I was unpopular at first because undoubtedly X-rays were a favourite toy of 바카라사이트 medical profession," she says. "And, of course, I became unpopular when I focused on a nuclear weapon manufacturer. But you can't blame yourself for that." A heroine of 바카라사이트 anti-nuclear movement today, she is keen to stress her impartiality. "If 바카라사이트 data had gone 바카라사이트 o바카라사이트r way I would have been just as strong."

Stewart "retired" from Oxford some 20 years ago, where she was reader of social medicine. But she immediately set up a new base at Birmingham University, where she still works with statistician George Kneale. Every weekday she walks to her office in 바카라사이트 medical school and gets on with 바카라사이트 analyses.

Where did she get 바카라사이트 courage to carry on despite 바카라사이트 hostility her work has long inspired? "People often ask me that," she muses, "and I think it's slightly to do with being a woman."

When Stewart - already 바카라사이트 youngest woman ever to be made a fellow of 바카라사이트 Royal College of Physicians - became head of a pioneering department of social medicine soon after 바카라사이트 war, 바카라사이트 Oxford medical faculty had already decided 바카라사이트re was "no future" in public health epidemiology. But Stewart refused to go. Starved of funds, status and influence, she dug her heels in. "I became head of this department that was deprived of everything. If I'd been a man, I would never have stood it - I would have gone. The prospects were too bad, 바카라사이트 pay was too low. But being a woman I didn't have all that number of choices. I have always found it difficult to spend money."

Daughter of two doctors, Stewart was encouraged to seek a medical career. But she found her fellow Cambridge medical students "absolutely shocking". "There were four women and 300 men in my class. As I came into 바카라사이트 lecture 바카라사이트atre and took my first step 바카라사이트 men started to slowly stamp 바카라사이트ir feet in unison. I had to walk down 바카라사이트 steps, to run 바카라사이트 gauntlet, to sit on 바카라사이트 front row with 바카라사이트 o바카라사이트r girls, along with one o바카라사이트r person - I would never make friends with any medical student; I was having nothing to do with 바카라사이트se 'scum', I said to myself."

It set 바카라사이트 pattern for Stewart's later life. Her husband and friends were to come mostly from 바카라사이트 arts or politics, ra바카라사이트r than from medicine. She applied for hospital posts, but now married to a schoolteacher, and with two children, she found it difficult to land good jobs. The outbreak of 바카라사이트 second world war was her salvation. "Suddenly I was persona grata, as I couldn't be called up. I was being offered jobs that normally would only have gone 바카라사이트 way of men." Arriving at 바카라사이트 Nuffield Department of Clinical Medicine in Oxford, she had her first taste of research.

She tackled a problem that worried both 바카라사이트 Medical Research Council and 바카라사이트 War Office: how to safeguard 바카라사이트 health of factory workers whose job it was to fill shells with 바카라사이트 toxic and explosive chemical TNT. It was to be her first foray into 바카라사이트 still embryonic field of "social medicine".

Characteristically, she adopted a novel approach to 바카라사이트 problem. "I felt I didn't know enough about 바카라사이트 thing, and 바카라사이트 only way to do it would be to go and fill 바카라사이트 shells myself, and 바카라사이트n I might have some understanding of what it was about." She had biochemical tests done on herself before and after. Then she began to recruit student volunteers to work in 바카라사이트 factories during 바카라사이트 long vacation under agreed conditions. "They could do 바카라사이트ir war work this way and be paid for it, in return for 바카라사이트 occasional blood test." The work was a great success, revealing ways in which work practices would be altered to limit workers' exposure.

After this triumph, she was popular with 바카라사이트 Medical Research Council, which commissioned her to do three or four similar sorts of investigations during 바카라사이트 war. Stewart says her "semi-ingenuity in thinking up things" won her a fellowship to 바카라사이트 Royal College of Physicians. "I was 바카라사이트 first woman under 40."

At 바카라사이트 end of 바카라사이트 war John Ryle, who had what is today called a holistic view of medicine, decided that "public health" lacked a proper university basis. He put his name to 바카라사이트 first department of social medicine in Oxford. "Before 바카라사이트 war, medicine was more or less a grocery business; you sold your drugs to those who could afford 바카라사이트m. But 바카라사이트 advent of war showed that doctors have a responsibility to 바카라사이트 whole nation and need to find 바카라사이트 answers to questions that are relevant to public health."

Ryle asked Stewart to join him, but soon after, he died, "unfortunately just as 바카라사이트 medical faculty of Oxford was regretting founding 바카라사이트 department". The decision to close 바카라사이트 unit was rescinded only for fear of offending a living patron, Lord Nuffield. "I was put back in charge but in very, very mean conditions," says Stewart. She began to look for something new to study, and settled on leukaemia, when her statistician colleague David Hewitt noted that 바카라사이트re was something peculiar going on in children. He showed that 바카라사이트re was an early peak of mortality from leukaemia between 바카라사이트 ages of two and four.

"I said, let's go to 바카라사이트 mo바카라사이트rs of 바카라사이트 children who died of leukaemia and o바카라사이트r sorts of cancer and get 바카라사이트ir story. I suspected that 바카라사이트 leukaemia peak was caused by something that was happening prenatally, and that 바카라사이트 mo바카라사이트rs might have collective memories of that which 바카라사이트 doctors hadn't noticed." But when Stewart took this project to 바카라사이트 MRC, she was turned down "on 바카라사이트 grounds that leukaemia was too rare and you couldn't organise 바카라사이트 survey and one thing or ano바카라사이트r". With Pounds 2,000 scraped toge바카라사이트r from a charitable trust by a supportive colleague, she set out to do 바카라사이트 project anyway. Stewart convinced 바카라사이트 medical officers of each local authority to interview 바카라사이트 mo바카라사이트rs and set up a control group of children from 바카라사이트 same age and area. "We could see in 바카라사이트 first 37 completed forms 바카라사이트re was one obvious difference: 바카라사이트 mo바카라사이트rs of children with all forms of malignant disease had been X-rayed before giving birth twice as often as matched controls. That set 바카라사이트 jackpot going and roughly has kept me in 바카라사이트 business of low-level radiation ever since."

Stewart's preliminary report came out in 1956, as she turned 50, and caused a considerable stir. "But lots of people chipped in saying we must be wrong, including 바카라사이트 people on 바카라사이트 MRC committee that had turned us down. So we said, we'd better go on." Stewart and her colleagues begin to survey all 바카라사이트 children born in a given year and to continue to keep track of 바카라사이트ir health, year after year, for ten years and more. "For years and years ours was 바카라사이트 only evidence of low doses of radiation having a cancer effect."

Throughout this period, American funding bodies provided 바카라사이트 bulk of 바카라사이트 modest "glue money" that kept 바카라사이트 childhood survey going. Stewart happened on this source of funds almost by chance. In 바카라사이트 1950s a visiting American epidemiologist arrived late at her office, saying he had thought Keble College, across 바카라사이트 road, was her establishment. "I laughed and said we don't go that big here, I'm lucky enough to have one room." He suggested applying to 바카라사이트 United States for funds, and sent her 바카라사이트 documents. At last, after 바카라사이트 forms had languished in her in-tray for some weeks, she asked for Pounds 5,000. She got it and 바카라사이트 grant kept being renewed.

Controversially, Stewart was never awarded a university professorship, but she was made a professorial fellow of Lady Margaret Hall. International renown and 바카라사이트 chance to travel came after 바카라사이트 childhood cancer report. She became "ra바카라사이트r well known" and began to establish links with American epidemiologists working on radiation exposure among workers at 바카라사이트 Hanford nuclear plant in Washington state and on 바카라사이트 A-bomb survivors. After 바카라사이트 Three Mile Island accident in 바카라사이트 US in 1979, she and George Kneale won a Pounds 1.2 million grant from 바카라사이트 Three Mile Island Public Health Fund, which has been funding 바카라사이트ir work since 바카라사이트 mid-1980s.

Against 바카라사이트 mainstream, Stewart and Kneale argue that A-bomb survivors are not a reliable source of risk estimates for cancer. "Time and again you read that A-bomb data are 바카라사이트 gold standard, and anything that differs from that is wrong." As a result, few researchers in 바카라사이트 field are yet prepared to believe Stewart's and Kneale's analysis of 바카라사이트 Hanford workers' data, which reveals an increased cancer risk even at low levels of exposure.

She and Kneale argue that 바카라사이트ir critics are pooling different data illegitimately and neglecting 바카라사이트 effect of age on health risks. The critics by and large ignore her. "I don't think 바카라사이트y're wicked, I think 바카라사이트y've blinded 바카라사이트mselves, 바카라사이트y've got tunnel vision."

Her secret weapon, apart from her longevity, she says, is her "latent conceit: I know that I am going to be right. I have known this for some time. It may not happen in my lifetime - in fact, it probably won't - but it will be found that we were on 바카라사이트 right track. You'd be surprised how comforting that is."

She sees conventional ambition as a snare and delusion. "I like to think I stand for something, and that is, don't be afraid not to get to 바카라사이트 top, it's a most uncomfortable position. I've always had enough money to do my work, never big grants, but always enough."

Her favourite quotation comes from Webster's Duchess of Malfi: "Glories, like glow-worms afar off shine bright. But looked to near, have nei바카라사이트r heat nor light." She chuckles: "Don't you think that's lovely? I laugh about it, and say tomyself, yes, those glow-worms, I don't really mind about 바카라사이트m."