A team of epidemiologists from the Columbia University School of Public Health will embark next week on a study of possible adverse health effects stemming from the near-catastrophic accident at the Three Mile Island nuclear power plant in 1979.

Their mandate, in part, stems from a citizens' health study that showed a cancer mortality incidence almost 700 percent higher than might normally be expected in the study population.

Today, after refusing to hold hearings on a variety of controversial topics, including health effects of the accident -- deeming them irrelevant -- the Nuclear Regulatory Commission is expected to authorize the Middletown, Pa., plant to restart the unit not damaged in the 1979 incident.

The new health study will be financed by a $242,000 grant from the Three Mile Island Public Health Fund, established by General Public Utilities Corp. under court supervision after the accident in settlement of a class action suit.

That this study is getting under way at all is a result, in part, of the persistence and determination of two former residents near the plant. Marjorie and Norman Aamodt formally entered the case before the NRC at the request of a group of their neighbors, mostly farmers, who had reported unusual and sometimes bizarre symptoms that began with the TMI accident. But the NRC never authorized specific hearings on the health issues because formal reports following the accident said that the radioactive emissions were too small to have caused health problems.

Nevertheless, the Aamodts continued to hear more and more anecdotal but equally bizarre stories, and two years ago undertook their own quasi-scientific survey.

"We expected to find a lot of symptoms like skin reddening, hair falling out or graying, nausea and other symptoms like the ones we were hearing about," recalls Norman Aamodt, who now lives in upstate New York.

"What we found was cancer deaths almost 700 percent above what the normal expectation might be for that population."

The Aamodts also found high rates of poor thyroid function in newborn babies, Down's syndrome, other birth defects along with a high rate of new cancer in both children and adults. There were also reports of animal deaths, animal birth defects and plant abnormalities -- including a dandelion with leaves three feet long.

An affidavit attesting to the plant abnormalities is included in the Aamodt health report on file with the NRC. A plant pathologist has filed an affidavit stating that the types of abnormalities were consistent with radiation contamination.

These findings were rejected by TMI owner General Public Utilities (GPU), the NRC and the Pennsylvania health department, which performed a survey of its own but limited its survey to a five-mile radius around the plant and did not do any specific surveys of the homes downwind from the plant.

The methodology used in the Aamodts' study is vulnerable to scientific criticism -- the survey was conducted by volunteers knocking on doors, for example. Because of this, and because measurements for the actual type and amount of radiation released from the plant during the first 15 or more hours of the accident are either nonexistent or unreliable, it was some time before reports from local doctors and individual citizens began to surface, seeming to indicate the existence of cancer clusters and birth defect clusters. A scientist at the Centers for Disease Control dismissed an incomplete version of the study he was sent by the NRC staff, because of its technical flaws.

But the Aamodts themselves, aided by citizen volunteers, began amassing evidence that they say supports a hypothesis that the initial emissions from the damaged nuclear reactor were vastly larger and contained more lethal radioactive particles -- so-called alpha-emitters -- than anyone associated with the plant has estimated.

On the basis of a report done for the Health Fund, the Aamodts were able to determine that the wind was blowing to the west-northwest, in the direction of three particular hilltop communities up to eight miles from the plant. The Aamodts -- he is an engineer, she a psychologist -- now hypothesize that the three communities where most of the cancer deaths occurred were actually enveloped by a radioactive plume -- a wind bearing the particles which moves in a particular direction just as the wind carries a plume of smoke from any smokestack.

Alpha-emitting particles do not penetrate the skin, but must be inhaled or ingested to cause cellular and chromosome damage -- but such damage is especially potent. If indeed the events happened in the manner suggested by the Aamodts, cancer deaths could occur within the first five years following the accident, according to calculations by Dr. Carl J. Johnson from the Medical Care and Research Foundation in Denver.

Finally, the very fact of the cancer deaths -- verified by state death certificates -- began to cause serious unease in the community, among politicians and among disinterested scientists.

The Union of Concerned Scientists, which is opposing the TMI restart on safety grounds, at first seemed to distance itself from the health issue. But the UCS general counsel, Ellyn Weiss, said last week that although UCS did not become involved in the issue because "we don't have anyone in a position to make a real informed judgment," she added: "In my mind there was a real question raised by those figures that seemed to be so much higher than they should. I thought the CDC response dismissing the Aamodt's report was appalling. So if the deaths aren't properly documented, go out and document them. If you don't think it's done right, you go and do it right.

"These people," she said, referring to the Aamodts, "must be immensely frustrated because they keep getting the circular answer that 'there wasn't any radiation so there can't be any health effect.' "

The health issue is one of a series of concerns that opponents of the restart feel have not been properly addressed by the NRC. The credibility of both companies has been shaken by a series of incidents, including a federal criminal indictment against Metropolitan Edison on 11 counts of falsifying safety records -- rates of leakage of radioactive water -- at the plant in the months prior to the 1979 accident. MetEd pleaded guilty or no contest to seven counts and the details never became public.

Last week, at a special NRC meeting to hear final objections to the restart, the NRC was urged by Sen. John Heinz (R-Pa.) to hold hearings on whether or not GPU knew of or condoned the falsifications of the leak rate and Ellyn Weiss observed: "If Franz Kafka had met Lewis Carroll, this tortuous proceeding might have been the result."

But what has become public in a number of newspaper reports recently is word that GPU is quietly settling out of court millions of dollars of lawsuits filed on the basis of health effects.

Routinely such settlements include a requirement of secrecy, but in February, a series of personal injury settlements totaling about $4 million became public because they involved children and therefore needed judicial approval. Among these settlements to 69 children and the estates of four adults who died since the accident was more than $1 million to a 5-year-old Down's syndrome child.

When the first settlements became public earlier this year, GPU said in a statement: "These settlements represent an economic decision arrived at by the insurance companies and do not constitute an admission of liability by the companies involved."

Several hundred similar suits are outstanding. Since February, when some of the settlements became publically known, an additional 43 plaintiffs filed suits claiming cancers, birth defects and other disorders and charging "fraudulent concealment" on the part of TMI for allegedly failing to make public the extent of radioactive emission that would have permitted the plaintiffs to link their illnesses to the accident at an earlier date.

"We have been up front and candid," said Ken McKee, GPU manager of communication. "We have provided the community around the plant and the media with the information we have when we have it."

It was against this background that the TMI Health Fund authorized the Columbia University study, under the leadership of Dr. Mervyn Susser and his assistant, epidemiologist Maureen Hatch.

In a brief interview, Hatch emphasized that this study will be independent of any positions taken before, although the Aamodt study did serve "as a spur." In any case, she said, "we said in our proposal that it is time to take a serious look" at the health situation. The Columbia group will first do a preliminary study of cancer incidence and deaths in children and adults six years before and six years after the accident. Other proposals in the works include a study of reproductive problems and, at the TMI Health Fund request, a possible study of psychosocial effects.