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Our own worst enemy?



Sandy Perle and RADSAFERs,

In the 1970s I was a medical and academic radiation safety officer on US NRC
broad scope byproduct materials licenses (medical and research). In some senses,
I represented the institution to the NRC, and the NRC to the institution. My
constituents included authorized users, technicians, grad students,
non-technical employees, and members of the public, including patients and their
families, public officials, and the print and broadcast media. 

I discovered that I had 3 functions:

1. Keep it safe.
2. Keep it legal.
3. Help people feel it was safe.

The first was easy.  The second was harder, requiring me to furnish a lot of
paper proof that the first had been done, and a lot of paper proof that a lot of
non-safety stuff had been done, too.  The third function was the hardest
challenge.  

I continue to believe that peace of mind is a very important aspect of radiation
safety.  In the context of beneficial radiation technologies, if a person is
"safe" in the actuarial sense, but is in a psychological state between uneasy
and terrified, then I don't think my job is done.  Of course, I know from
experience that not everyone can be reasoned with or comforted or persuaded, but
listening and responding to a person's emotional reality is the only way to deal
with the peace-of-mind issue.

Fear, whether rational (it is rational to be afraid of a sawed-off shotgun
pointed at you) or irrational (it is irrational to be afraid of 1 Bq of tritium
in a glass of water), can cause real health effects.  I have experience with
people choosing to terminate pregnancies because of needless fear of radiation.
I have experience with people losing weight, suffering severe insomnia, and
generally symptoms of extreme stress because of needless fear of radiation.  I
have experience with people quitting a job because of fear, an action that
results in loss of health insurance until another job is found.  Loss of health
insurance is well known in public health circles to result in real health
detriment.  All of these are real health effects, not putative statistical
probabilities of future harm.

These real health effects were somewhat within my power to mitigate.  Should I
declare my radiation safety job done when I have completed functions 1 and 2,
when the only real health effects were in function 3?

My choice was to put energy into function 3 when I had handled functions 1 and
2.  One doesn't bring about peace of mind by ranting and raving, engaging in
monologues, lecturing, and so on, at least for some segment of the constituency
found in the medical and academic environment. 

Most of the campus RSOs I know show compassion for their constituents by making
almost any requested measurement to help people achieve peace of mind. No news
is good news when the news is dose or intake or contamination. I have seen
people show tremendous relief when a thyroid count after a botched iodination
showed no significant intake, or when a pocket ion chamber showed that no dose
had been received in a cleanup operation. I've felt that myself. That's peace of
mind.

"Unnecessary" measurements? In the larger public health picture, taking into
account the fact that real health effects can be triggered by false fears,
anything that can be legitimately and honestly done at reasonable cost to build
or restore peace of mind is, in my opinion, a valid part of the profession of
health physics. 

Finally, in my opinion (this is all my opinion), it is not legitimate or honest
to discard the linear nonthreshold dose-response model for some cancers and
heritable ill-health.  That's not going to buy any peace of mind for most
people.  What buys peace of mind is measurements that are made in response to a
real concern, and placing those measurements in the context of natural
background, such as was suggested by another RADSAFER.  In the case of
Tokaimura, just as in the case of TMI, one probably can't make too many
measurements.

- Dan Strom

The opinions expressed above, if any, are mine alone and have not been reviewed
or approved by Battelle, the Pacific Northwest National Laboratory, or the U.S.
Department of Energy.

Daniel J. Strom, Ph.D., CHP
Risk Analysis & Health Protection Group, Environmental Technology Division,
Pacific Northwest National Laboratory
Mail Stop K3-56, PO BOX 999, Richland, Washington 99352-0999 USA
Telephone (509) 375-2626 FAX (509) 375-2019 mailto:daniel.j.strom@pnl.gov
Brief Resume: http://www.pnl.gov/bayesian/strom/strombio.htm
Pagemaster for  http://www.pnl.gov/bayesian   http://qecc.pnl.gov
http://bidug.pnl.gov
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