CONGENITAL heart disease is responsible for one-half of all deaths from congenital malformations in Oregon. Improvement in diagnosis and treatment over the past decade, including spectacular and costly surgical ad¬ vances, has developed. These advances raise many economic and sociologic questions which may be answered through an epidemiologic study. The only populations readily avail¬ able for a study of congenital malforma¬ tions were those of single institutions, and these were not representative of the population of the entire State. Thus, the birth and death certifi¬ cates identifying congenital malformations were selected as the starting point in developing a population for study representative of the State as a whole. Fetal death certificates were not used because autopsies of fetuses were seldom performed, and "prematurity" was recorded most frequently as the cause of fetal death, a term giving no information about congenital malformations. The epidemiologic investigation of congenital heart disease was started as a retrospective and descriptive study for the years 1957-61. The period was selected because in 1956 specific space Dr. Osterud is associate professor, department of public health and preventive medicine, and Dr. Menashe is associate professor of pediatrics, crippled children s division, University of Oregon Medical School, Portland. Miss Martin is State

In a recent paper published in the journal (1), we reported results of an ecological multifactorial study showing that the growing incidence of prostate cancer in Martinique and Guadeloupe is probably caused by environmental factors, and have hypothesized in a second paper that among factors, spray of organochlorine pesticides might be causally involved (2). Table I indicates the different carcinogenic, mutagenic and/or reprotoxic (CMR) or presumed CMR pesticides used since 1955 in the two islands. Unlike that indicated in our first paper (1), aldrin and dieldrin are not rated as 2B carcinogens but instead as group 3 in the IARC classification. Moreover, although our paper clearly showed an excess of prostate cancer in the South East part of Martinique (Fig. 1), unfortunately in the text, this area was mentioned as corresponding to the South-West of the island. These two necessary precisions do not change the basic conclusions of our paper, and the importance of its scientific message, since it clearly establishes for the first time that prostate cancer may be an environmental disease.