[ RadSafe ] Any comment on the latest paper in The BMJ

[parthasarathy k s]

Friends,
I am happy to read your comments on the paper. We must send rapid responses to The BMJ, the way Mohan and Bobby Scot did. You may recall that The BMJ is a very well respected peer reviewed journal widely read by the public.Open criticism of the frailties of the paper will be very useful to generate discussion.I recall that a similar discussion in NATURE another popular journal led to substantial comments on the original paper.Immediately after publication such comments are also read by the readers
Not all epidemiological studies need have a control. If risk versus dose is proved the subjects themselves will be the controls.
"LNT" is only a convenient hypothesis.Issues of a robust threshold dose and a well  defined dose response curve in the region below 100 mSv are needed to resolve the low dose problem.Some diehard enthusiasts believe that the truth will emerge if the mechanistic intricacies at low dose levels are resolved. Low dose research funded by DOE did not help, though it revealed details of some of the cellular response mechanisms.
The big issue is whether the repair of radiation insult will be totally error free.
I would like to invite the attention of the group to a similar issue which was attracting the attention of researchers. It is a problem in physical sciences mercifully it does not involve the variability of biological phenomena.
Mercury is toxic.It is present in a few traditionally prepared Ayurvedic drugs.It became controversial because the Ayrvedic physicians assert that if mercury is added to drugs as prescribed in Ayurvedic "scriptures", mercury will be in such a form with minimum bioavailablity.It appears that in the final form every atom of mercury will form a compound with sulphur.Mercuric sulphide has extremely low bio-availability.The issue here is not the efficiency of the drug to cure!
How can we prove that each and every atom of mercury in the drug is converted into mercuric sulphide.Scientists in the Bhabha Atomic Research Centre, Bombay used synchrotron radiation to prove it. Based on the paper published in the Journal of Synchrotron Radiation I wrote an article on the issue.
The link: http://www.thehindu.com/sci-tech/why-rasasindura-is-not-toxic/article7619239.ece
Will it ever be possible to prove that the "microscopic", "nanoscopic" or "picoscopic" damage due to radiation insult in every cell in a lump of living tissue is fully repaired? Till that is understood cancer induction, hormesis etc at the lowest level will remain enigmatic mysteries
Warm regardsParthasarathy
 


     On Monday, 2 November 2015, 23:11, "Brennan, Mike (DOH)" <Mike.Brennan at DOH.WA.GOV> wrote:
   

 I have several comments that I posted earlier, but upon further reflection there are three that I believe point out major issues with the paper and its conclusions:

(1)  There needs to be a control group, demographically matched to the radiation workers.  The study claims to show increased cancer with increased cumulative dose among radiation workers, but does not compare this to a population exposed only to "background" radiation.  If the cancer rate among any portion of the radiation worker population is lower than in the control, that would present a problem with the current paper, but an interesting topic for a future paper.  Also, this would go some way toward dealing with the medical radiation exposure Mohan correctly points out as an issue.

(2)  Of particular concern is the strong likelihood that cumulative dose maps very well on increasing age (it makes sense; the longer someone is a radiation worker the more radiation they've been exposed to, and the older they are).  I believe that the connection between age and the chances of developing cancer is fairly well established.  What if the driver for the graph in the paper is not cumulative radiation dose, but cumulative years?

(3)  At least for the US radiation workers, a non-trivial percentage started their careers in the Navy, and in some cases received much higher dose than they likely did as civilian rad workers.  This does not appear to be captured.  

-----Original Message-----
From: radsafe-bounces at health.phys.iit.edu [mailto:radsafe-bounces at health.phys.iit.edu] On Behalf Of Doss, Mohan
Sent: Sunday, November 01, 2015 6:18 PM
To: The International Radiation Protection (Health Physics) Mailing List
Subject: Re: [ RadSafe ] Any comment on the latest paper in The BMJ

Dear Parthasarathy,
    You can read my rapid response criticizing the design of this study at http://www.bmj.com/content/351/bmj.h5359/rr .  There are two other rapid responses critical of the article also.  In my opinion, there is good reason to ignore this paper.
    If there are any new publications that claim increased cancer risk from low-dose radiation, you can probably assume that they have major flaws negating their conclusions, since that has been the pathetic record of such publications todate.  Such authors have cried wolf too many times. 
    With best regards,
                              Mohan

-----Original Message-----
From: radsafe-bounces at agni.phys.iit.edu [mailto:radsafe-bounces at agni.phys.iit.edu] On Behalf Of parthasarathy k s
Sent: Sunday, November 01, 2015 8:09 PM
To: The International Radiation Protection (Health Physics) Mailing List
Subject: [ RadSafe ] Any comment on the latest paper in The BMJ

Our newsgroup has apparently ignored tha following paper published in The BMJ
http://www.bmj.com/content/351/bmj.h5359

Under what this study adds are the following comments:
"The study provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality. Although high dose rate exposures are thought to be more dangerous than low dose rate exposures, the risk per unit of radiation dose for cancer among radiation workers was similar to estimates derived from studies of Japanese atomic bomb survivors. Quantifying the cancer risks associated with protracted radiation exposures can help strengthen the foundation for radiation protection standards". 

Warm regardsParthasarathy
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