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The Cold War (as we once knew it) may be over, but its legacy remains quite hot—hot and deadly. A little noticed investigation from 2002 spells out the grim toll. Radioactive fallout from nuclear weapons testing has killed more than 15,000 Americans and caused at least 80,000 cancers. Ominously, the report concluded that decades of open air nuclear blasts have exposed to radiation nearly everyone who has resided in the United States since 1952.

The report, conducted by the National Cancer Institute and Centers for Disease Control, is remarkable for several reasons, not least because it represented the first time the US government released an assessment of the spread and consequences to human health of radioactive fallout from nuclear weapons testing. It was also the first time that the government owned up to the fact that a substantial number of cancer deaths have been caused by nuclear testing. Previously, the federal government had only admitted to adverse health consequences to downwinders, residents in communities near the Nevada Test Site.

The report was commissioned by Congress in 1998 following the public uproar over a 1997 study by the National Cancer Institute that investigated the fallout from only one radionuclide, iodine-131, and its link to thyroid cancers. That study mainly looked at the so-called “milk pathway” to exposure. Iodine-131 dropped as fallout across dairy country, where it was consumed by cows and goats. The toxic iodine then showed up in concentrated form in cow, and especially, goat milk.

The 2002 investigation of global fallout was much broader, tracking, among other things, exposure to cesium-137. In addition to charting fallout from the Nevada Test Site, the National Cancer Institute study also probed fallout from US nuclear tests in the Marshall Islands and Johnston Atoll, British nuclear explosions on the Christmas Islands and Soviet testing at Semiplatinsk and Novaya Zemlya.

The irradiation of the global environment has been a uniquely cooperative endeavor, with all of the world’s nuclear superpowers contributing to the toll. The US has carried out 1,030 nuclear weapons tests (the last on September 23, 1993); the former Soviet Union conducted 715 explosions; France 210 tests; China 47 tests and Britain 45 tests.

The body count from radioactive fallout is insidious, largely hidden in the slow but relentless accumulation of cancers, such as thyroid (2,500 deaths), leukemia (550 deaths), radiogenic cancers from external exposure (11,000 deaths) and radiogenic cancers from internal doses of tritium and cesium-137 (3,000 deaths).

“This report and other official data show that hot spots of radiation occurred thousands of miles away from the test sites,” said Dr. Arjun Makhijani, president of the Institute for Energy and Environmental Research. “Hot spots due to testing in Nevada occurred as far away as New York and Maine. Hot spots from US Pacific area testing and also from Soviet testing were scattered across the United States from California, Oregon, Washington in the West to New Hampshire, Vermont and North Carolina in the East.”

Even so the conclusions from this report are far from comprehensive. The CDC/NCI study only examined tests conducted from 1951 to 1962. That means it excluded Chinese tests, most French atmospheric testing in the Pacific, pre-1951 testing in the Marshall Islands, the 1945 New Mexico tests, the Hiroshima and Nagasaki bombings and ventings from underground tests by the US and the Soviet Union.

In addition, the NCI/CDC report did not include calculations for Alaska and Hawai’i, which experienced heavy fallout from the Novaya Zemlya and Marshall Islands tests respectively.

And this only tells a small part of the story. The fallout statistics don’t account for the illnesses and death of other civilians, including uranium miners, nuclear plant workers, and people who live near nuclear sites such as Hanford and Rocky Flats.

The NCI/CDC report gathered dust for more than six months, as the Bush administration and congress tussled over how to control the reaction to its horrifying conclusions. Even in the 1950s, the Pentagon and the old Atomic Energy Commission knew that radioactive fallout from explosions at the Nevada Test Site was spreading across the American West and into Canada and Mexico.

Yet, the government largely to chose to hide this information from the public. Although the United States has been grievously tardy in owning up to inflicting this horror on its own people, it is ahead of other nuclear testing nations, which have largely remained morbidly silent on the subject.

This essay is adapted from a chapter in Been Brown So Long It Looked Like Green to Me.