Boston, MA—Living near Coldwater Creek—a Missouri River tributary north of St. Louis that was polluted by nuclear waste from the development of the first atomic bomb—in childhood in the 1940s, '50s, and '60s was associated with an elevated risk of cancer, according to a new study led by Harvard T.H. Chan School of Public Health. The researchers say the findings corroborate health concerns long held by community members.
The study will be published July 16 in JAMA Network Open. It coincides with Congress having passed an expanded version of the Radiation Exposure Compensation Act (RECA) as part of the Trump tax bill, through which Americans, including Coldwater Creek residents, can receive compensation for medical bills associated with radiation exposure.
Most studies of radiation exposure have focused on bomb survivors who have had very high levels of exposure; far less is known about the health impacts of lower levels of radiation exposure.
For this study, the researchers used a subsample of 4,209 participants from the St. Louis Baby Tooth – Later Life Health Study (SLBT), a cohort composed of many individuals who lived near Coldwater Creek as children and who donated their baby teeth beginning in 1958 to measure exposure to radiation from atmospheric nuclear testing. The participants, who lived in the Greater St. Louis area between 1958 and 1972, self-reported incidences of cancer, allowing the researchers to calculate cancer risk in accordance with childhood residence proximity to Coldwater Creek.
The findings showed a dose-response effect—those living nearest to the creek had a higher risk for most cancers than those living farther away. There were 1,009 individuals (24% of the study population) who reported having cancer. Of those, the proportion was higher for those living near the creek—30% lived less than one kilometer away, 28% between one and five kilometers away, 25% between five and 20 kilometers away, and 24% 20 kilometers or more away).
The researchers estimated that those living more than 20 kilometers away from the creek had a 24% risk of any type of cancer. Compared to this group, among those who lived less than one kilometer away from the creek, the risk of developing any type of cancer was 44% higher; solid cancers (cancers that form a mass, as opposed to blood cancers), 52% higher; radiosensitive cancers (thyroid, breast, leukemia, and basal cell), 85% higher; and non-radiosensitive cancers (all except thyroid, breast, leukemia, and basal cell), 41% higher. The risk went down among those who lived between one and 5 kilometers away from the creek, and then down a little more among those who lived 5-20 kilometers away, but was still slightly higher than those living more than 20 kilometers away.
"Our research indicates that the communities around North St. Louis appear to have had excess cancer from exposure to the contaminated Coldwater Creek," said corresponding author Marc Weisskopf, Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology. "These findings may have broader implications—as countries think about increasing nuclear power and developing more nuclear weapons, the waste from these entities could have huge impacts on people's health, even at these lower levels of exposure."
Other Harvard Chan School authors included Michael Leung, Ian Tang, Joyce Lin, Lorelei Mucci, Justin Farmer, and Kaleigh McAlaine.
The study was funded by the National Institutes of Health (R01ES031943, P42ES030990, P30ES000002 and T32ES007069).
"Cancer Incidence and Childhood Residence Near the Coldwater Creek Radioactive Waste Site," Michael Leung, Ian W. Tang, Joyce J.Y. Lin, Lorelei Mucci, Justin G. Farmer, Kaleigh McAlaine, Joseph J. Mangano, Marc. G. Weisskopf, JAMA Network Open, July 16, 2025, doi: 10.1001/jamanetworkopen.2025.21926
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