The Times -Obituaries, June 27, 2002
Original address: http://www.timesonline.co.uk/printFriendly/0,,1-45-339101,00.html
Epidemiologist who proved links between exposure to
radiation and cancer, and forced the authorities into greater openness.
For more than 40 years the epidemiologist Alice
Stewart challenged official estimates of the risks of radiation. Her
research in 1956 and 1958 alerted the medical profession to the link
between foetal X-rays and childhood cancer. Two decades later, in her
seventies, she again called for a change in working practices when she
published a study showing that workers at nuclear weapons plants are
at greater health risk than international safety standards admit.
She was born Alice Mary Naish in Sheffield in 1906. Her parents were
both physicians and widely known for their dedication to childrens
welfare. Alice took a medical degree at Cambridge, where she formed
an intense relationship with the literary critic William Empson. Their
friendship ended only with his death in 1984. But in 1933 she married
Ludovick Stewart. They had a son and a daughter, but divorced in the
During the war she studied the health risks of industrial chemicals
in factories and among miners, and in 1946 she was one of the founders
of the British Journal of Industrial Medicine. This first stage of her
career culminated with her election as a Fellow of the Royal College
of Physicians, the youngest woman to achieve this distinction. She already
had a reputation as a brilliant teacher and clinician.
Shortly after the war, she accepted a position under Professor John
Ryle, at the new department of social medicine at Oxford, and became
a Fellow of Lady Margaret Hall. Ryle hoped to direct the attention of
the medical profession towards public health, and his ideals greatly
appealed to Stewart, but with his death in 1949 social medicine at Oxford
was demoted, and although she was kept on as a reader, she was left
with barely enough to light a gas fire.
Then, with a grant of £1,000, she launched her landmark study
of the causes of childhood cancer. Beginning from a hunch that mothers
might remember something that the doctors had forgotten, she devised
a questionnaire for women whose children had died of any form of cancer
between 1953 and 1955. By the time a mere 35 questionnaires had been
returned, the answer was clear: a single diagnostic X-ray, well within
the exposure considered safe, was enough almost to double the risk of
This news was a surprise to Stewart and was not welcome in the scientific
community. Enthusiasm for nuclear technology was at a high point in
the 1950s, and radiography was being used for everything from treating
acne and menstrual disorders to ascertaining shoe fit. X-rays, as Stewart
put it, were the favourite toy of the medical profession.
The British and American Governments were investing heavily in the arms
race and promoting nuclear energy, and there was little willingness
to recognise that radiation was as dangerous as Stewart claimed. She
never again received a major grant in England.
For the next two decades, however, she and her statistician, George
Kneale, extended, elaborated and refined their database at what became
the Oxford Survey of Childhood Cancer, until in the 1970s major medical
bodies recommended that pregnant women should not be X-rayed, and the
The Oxford Survey had collected information on hundreds of thousands
of children across Britain over a 30-year period. Stewart and Kneale
had demonstrated that children incubating cancer have greatly increased
susceptibility to infections, and turned up a connection between inoculations
and resistance to cancer which suggests links between cancer and the
immune system. They also had theories about ultrasound and sudden infant
death syndrome that they would have liked to test but such funding
as they had was cut off.
In 1974, having officially retired and moved from Oxford to Birmingham,
where she had accepted a research appointment, the 68-year-old Stewart
received an unexpected phone call from America. Dr Thomas Mancuso, who
had been at work on a government study of the health of nuclear workers
at Hanford, the weapons complex that produced plutonium for the Manhattan
Project, wanted her to take a closer look at his data.
Mancusos study had been going on for more than a decade, and
was not expected to turn up anything troubling, since workers
exposure at Hanford, the oldest and largest nuclear weapons facility
in the world, was well within the safety limits set by international
guidelines. But Stewart and Kneale found that the cancer risk to the
workers was about 20 times higher than was being claimed, a discovery
that put them at odds with the multimillion-dollar Hiroshima and Nagasaki
studies on which international safety guidelines are based.
The American Department of Energy dismissed Mancuso and attempted to
seize the data. But Stewart and Kneale took their work back to England
and, together with Mancuso, published a series of studies which continued
to corroborate a cancer effect considerably higher than the Hiroshima
studies indicated. The Energy Department denied the scientists further
access to the workers records and kept research under strict government
control. Although the statistical methods of the study were criticised
by the Oxford epidemiologist Richard Doll (who had been one of the first
to prove the link between smoking and cancer), the Mancuso findings
attracted public attention and provoked congressional investigations
in 1978 and 1979.
The accidents at Three Mile Island in 1979 and Chernobyl in 1986, while
the British and American Governments were trying to expand nuclear facilities
and weapons production, brought the anti-nuclear movement back to life,
and Stewart became one of its heroes. She found herself much in demand,
called on as an expert witness to testify against the siting of nuclear
facilities and dumps and to testify in compensation cases by veterans
and victims who had lived downwind of various plants.
In 1986, when she was 80, she received the Right Livelihood Award,
the alternative Nobel as it is called, which is awarded
in the Swedish Parliament the day before the Nobel Prize to honour those
who have made contributions to the betterment of society. The British
Embassy, however, refused even to send a car to the airport to pick
her up. In 1992 she was awarded the Ramazzini Prize for epidemiology.
Even in the years when Stewart was making dozens of public appearances
on behalf of activists in Britain and America, she always insisted that
she was a scientist, not an activist, and that she did not have a political
programme. She published more than 400 papers in scientific journals.
However, although she could deliver her findings in person with exceptional
clarity, her publications were often very hard to decipher.
Also in 1986, Stewart received a $1.4 million grant to study the effects
of low-dose radiation. This came not from a government agency or academic
institute, but from activists, and derived from a fine imposed upon
the Three Mile Island facility. To undertake the study, Stewart needed
access to the nuclear workers records, but the American Government
refused to release them. It took several years and several freedom of
information suits to get at them. When in 1992 Stewart was finally granted
access to the records of one third of all workers in nuclear weapons
facilities in the US, the front page of The New York Times called it
a blow for scientific freedom.
Stewart continued to publish and present papers into her nineties.
She was a charismatic speaker and a person of great warmth and generosity.
She did not have an easy time as a lone woman in male-dominated fields,
and she suffered keenly from the loss of funding and her isolation as
a result of taking unpopular stances, but she maintained that obscurity
had its advantages, since it allowed her to take risks that other scientists
Truth is the daughter of time, she was fond of saying;
and It helps in this field to be long-lived since
in such a political area truth is slow in coming out. She lived long
enough to see radiation science move in her direction, with each official
estimate of radiation risk acknowledging greater danger than previous
She also lived to see her efforts help to break the American Department
of Energys hold on radiation health research. She had the satisfaction
of seeing one Secretary of Energy in 1993 open the record of the Governments
management of nuclear operations during the Cold War, including the
records of human experimentation, and then seeing another in 2000 recommending
compensation for nuclear workers suffering from cancers that may have
been incurred at work.
A biography of her, The Woman Who Knew Too Much by Gayle Green, was
published in England and America in 1999.
Alice Stewart is survived by her daughter.
Alice Stewart, epidemiologist, was born on October 4, 1906. She died
on June 23, 2002, aged 95.