November 11, 2003 By ANDY NEWMAN Joseph J. Mangano does not even notice the smell anymore. It hits you the moment you walk into his tiny, tidy apartment in Park Slope, Brooklyn, something musty and a little acrid, though not entirely unpleasant. It is the smell of 3,000 human baby teeth and the crumbling 50-year-old envelopes that hold them, each one scribbled with a few bits of information: cuspid or molar, intact or rootless, milk-fed or breast. The teeth - some split or brown-streaked, some improbably pearly - sit in boxes inside boxes atop his bookshelf, waiting for the next phase of research to see if they contain life-threatening amounts of nuclear fallout. Mr. Mangano runs the Radiation and Public Health Project Inc., a shoestring organization with offices mostly on his kitchen table, that has spent the last 18 years questioning the safety of nuclear power. In 2001, the group acquired custody of thousands of baby teeth collected from America's young mostly during the 1950's and 60's for a study of the effects of atom bomb tests. The original survey, known as the Tooth Fairy study, found many teeth with elevated levels of strontium 90, a radioactive and carcinogenic yellowish metal isotope that bonds to tooth and bone. Mr. Mangano's group is looking to track down donors and find out if levels of strontium 90 correlate with cancer in later life. But that is only half of the Radiation and Public Health Project's mission - the less provocative half. They are also measuring strontium 90 in the teeth of modern-day children, sick and healthy, to determine the relative levels in children born or reared near nuclear power plants. Mr. Mangano's group thinks the dual effort might show something that few people want to hear: that the nation's 100-plus nuclear power reactors, when operated under normal conditions, are giving people cancer. They say they have already found signs: disproportionate drops in infant mortality after reactors close; parallel trends in childhood cancer rates and strontium 90 levels. "We're not trying to scare anyone," Mr. Mangano said last Friday. "We're trying to inform people." The group's work is, to say the very least, controversial. Though members of the group have published a handful of articles in peer-reviewed journals, including Archives of Environmental Health, their credibility with the scientific establishment hovers near zero. Detractors say they obsess over amounts of radiation that are insignificant compared with the dose humans receive each day from cosmic rays, soil and other natural sources. And their few government contracts have left a short trail of dissatisfied local officials sharply critical of their methods, their scientific objectivity and their results. "What they do is what's popularly referred to as junk science," said Dr. Joshua Lipsman, the health commissioner in Westchester County, home of the embattled Indian Point nuclear power plant and, according to the Radiation and Public Health Project, children with the highest strontium 90 readings in the region. "We found a number of scientific errors both in measurement and process in their proposals." Mr. Mangano, 47, who has a master's degree in public health, defends the group's work. He is not surprised to meet resistance from the military-industrial-energy-pharmaceutical-governmental complex. "It's something that government does not do, measure radiation levels in the bodies of people living near reactors," he said. A 1991 National Cancer Institute study of disease patterns found no general increased risk of death from cancer for people living near 62 reactors. But Mr. Mangano said the study, while comprehensive, focused on disease patterns, which can have causes other than radiation, and that in any case the most recent data used in it is now 20 years old and needs to be updated. Zdenek Hrubec, a biostatistician who worked on the 1991 study, said that while the study had its limits, it was difficult to imagine a case where reactors caused an increase in cancer that was hidden in the statistics. "You'd have to postulate that there was a deficit of smokers or industrial pollutants in the same places where there were nuclear reactors," he said. The Radiation and Public Health Project keeps trying, and with the help of its friends, including left-leaning celebrities like Alec Baldwin and Susan Sarandon, it is surviving. Tomorrow at Hackensack University Medical Center in New Jersey, the group will announce the receipt of a $25,000 state grant to collect and analyze 50 teeth from children with cancer and compare them with the teeth of healthy children. Gov. James E. McGreevey is scheduled to speak. Almost more encouraging, Mr. Mangano said, is that a state finance official told him on Friday that the first check was in the mail. "By Tuesday I'll know if he's telling the truth," Mr. Mangano said. The original Tooth Fairy study goes back to the height of the Red Menace, when scientists began to complain that the government was regularly exploding atomic bombs over domestic soil - more than 100 nuclear tests were eventually done - without knowing their effects on people. In 1959, researchers at Washington University in St. Louis, including Barry Commoner, one of the founders of environmentalism, started a campaign to collect baby teeth. Each donor received a button saying "I gave my tooth to science." Strontium 90 was chosen as a proxy for the dozens of slow-decaying radioactive compounds in nuclear fallout because it was relatively easy to test for. The researchers determined that from 1945 to 1965, strontium 90 levels in baby teeth had risen 50-fold, a finding used in the successful push for a nuclear test ban. But no one followed up on the health of the donors, and the program was discontinued in 1970. The Radiation and Public Health Project was founded in 1985 by Jay M. Gould, a retired statistician. The group's first tooth study, done in Suffolk County in 1999, found that strontium 90 levels had dropped steadily in the first 20 years after the nuclear test ban but had been creeping up since the mid-1980's, a finding that Mr. Mangano said has been repeated in every study they've done since then, across several states. In 2001, a cache of 85,000 old teeth turned up in an old munitions bunker in, believe it or not, Eureka, Mo. Dr. Commoner recommended that they be given to Mr. Mangano's group for analysis. Mr. Mangano said it would cost about $50,000 to track down and study the health of 400 of the old donors. (The 82,000 teeth not in Mr. Mangano's living room are being stored upstate.) The Radiation and Public Health Project has its teeth tested at a radiochemistry laboratory in Ontario. There they are washed, dried, ground, dissolved in nitric acid and treated with chemicals that help locate the strontium. But John Matuszek, a retired director of the New York State Health Department's radiological sciences laboratory who was hired by Suffolk County to evaluate the Radiation and Public Health Project's research proposal there, said he found that the proposal had a host of basic scientific flaws. Dr. Matuszek said that the proposed sample sizes - a single tooth, as opposed to the 90-tooth batches used in the St. Louis study - were too small to yield detectable amounts of strontium 90. And that the detectors they used were incapable of differentiating between strontium 90 and some naturally occurring radioactive compounds, and that the error margins they claimed were implausible. The conclusions the group drew, Dr. Matuszek said, "have nothing to do with cancer cases." Hari Sharma, the radiochemist the group uses, said the precautions he had taken were more than adequate to screen out false positives and other errors. Mr. Mangano said Dr. Matuszek had been enlisted by health officials in Suffolk County who "were determined that we not receive those funds and test those teeth." The group has its defenders. Samuel Epstein, chairman of the Cancer Prevention Coalition and a professor of environmental and occupational medicine at the University of Illinois, has reviewed some of Mr. Mangano's papers for journals. He called the group's research "good, careful work." "While they were somewhat overexuberant in their initial stuff," Dr. Epstein said, "they've calmed down and I think they are producing solid scientific work that stands critical peer review." In the eyes of Mr. Mangano's group, it is the government that has the proven credibility problem. For decades, he said, officials lied or withheld the truth about the extent of civilian exposure to nuclear tests and its health consequences. In 1997, for example, the government belatedly acknowledged that radioactive iodine from nuclear fallout caused thyroid cancer in 10,000 to 75,000 Americans. "National security considerations are sometimes placed before health concerns," Mr. Mangano said. "These are very inflammatory comments but that's the way it is." Matt Ahearn, the Green Party assemblyman from Bergen County who shepherded the group's $25,000 appropriation through the budget process, said the debate over their work did not bother him. "There's corporate junk science and the people's junk science," he said. "Take your pick." Copyright 2003 The New York Times Company