• Criteria. Compensation rules should be drawn carefully because of the uncertainties in estimating exposure. "The challenge Congress faces would be to decide if it is best to define criteria that avoid rewarding compensation in cases in which there is very low risk, but the uncertainties associated with its PC/AS is very large, because the connection of these cancers with radiation is not well-established or the estimated doses are not well known."

• Completing dose estimates. The Centers for Disease Control and Prevention, the National Cancer Institute or other agencies should complete estimates for all significant radionuclides in fallout from American weapons tests, not just the radioactive iodine that has received most attention so far.

• Dosage. An updated dose calculator should be developed for figuring how much radiation particular parts of a person's body may have received.

• Diseases covered. No additional diseases should be added to those already cited for compensation: some leukemias; lymphomas other than Hodgkin's disease; lung, thyroid, breast, esophagus, stomach, pharynx, small intestine, pancreatic, bile ducts, gall bladder and liver cancers. Also, some nonmalignant diseases are covered. Many have provisos, such as that the person could not be a heavy smoker or heavy drinker.

• Tailings. An agency should review data on radioactive radon in areas near piles of uranium mill tailings from the U.S. nuclear program, determining if people nearby should be compensated. Homes built with uranium mine or mill tailings should be examined to determine if residents should be eligible for compensation.

• Health checks. Medical screening should be carried out on people not showing symptoms only if there is "robust scientific evidence that such screening improves health outcomes and that its benefits outweigh its risks."

But uranium miners, millers and ore transporters should be screened for diseases affecting others in mining settings. Also, uranium millers and ore transporters should be screened for chronic renal disease.

Once a person is shown to be eligible for compensation, medical screenings should be offered such as those used for the population at large.

Any screening "should be preceded by detailed counseling and informed consent that reflects an understanding and sensitivity to the culture of the potential screenee."

The report adds that screeners may wish to check the person for depression.

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E-mail: bau@desnews.com