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A partial response to Professor Nussbaum
Professor Nussbaum wrote:
-----Original Message-----
Date: Mon, 7 Aug 2000 20:15:02 -0700 (PDT)
From: Rudi Nussbaum <d4rn@pdx.edu>
To: Multiple recipients of list <radsafe@romulus.ehs.uiuc.edu>
Subject: Response to previous postings
<snip>
My suspicions about the scientific reliability of most
of the radiation health studies (practically all sponsored by DOE or other
federal agencies with interests in the promotion of nuclear technology)
found confirmation in several extensively documented reports, a few of
which are listed below. (2-7).(This does not mean acceptance of all
conclusions by these authors.)
<snip>
My doubts, as well as those expressed by a group of independent scientists
(12) about published interpretations of DOE-sponsored nuclear worker
studies, were recently supported by 15 public health scientists from 12
federal agencies (13).
REFERENCES:
1. Nussbaum RH, Koehnlein W. Inconsistencies and Open Questions Regarding
Low-Dose Health Effects of Ionizing Radiation. Environ Health
Perspect 102(8): 656-667 (1994).
2.Wasserman H, Solomon N. Killing Our Own. New York:Dell Publishing
Co. 1982.
3. Caufield C. Multiple Exposures. Chicago:The University of Chicago
Press, 1990.
4. Gallagher C. American Ground Zero:The secret nuclear
war. Cambridge: MIT Press, 1993.
5. Morgan KZ,Peterson KM. The Angry Genie: One Mans Walk Through the
Nuclear Age. Norman. University of Oklahoma Press, 1999.
6. Greene G. The Woman Who Knew Too Much: Alice Stewart and the secrets of
radiation. Ann Arbor. Michigan University Press, 1999.
7. Alvarez R. Energy in Decay: After decades of out-of control behavior,
the Energy Department's Nuclear Age balloon mortgage comes due. Bull
Atomic Scientists, May/June 2000.
<snip>
12. Geiger HJ, Rush D, Michaels D, Baker DB, Cobb J, Fischer E, Goldstein
A, Kahn HS, Kirsch JL, Landrigan, PJ, Mauss E, McLean DE. Dead
Reckoning: A critical review of the department of energy's
epidemiological research. Washington DC: Physicians for Social
Responsibility 1992.
13. National Economic Council: The Link Between Exposure to Occupational
Hazards and Illnesses in the Department of Energy Contractor
Workforce. Washington, DC (2000).
Web:http://tis.eh.doe.gov/benefits/nec/necreport1.pdf
<snip>
--
Dr. Rudi Nussbaum
Please note my new email address
d4rn@odin.pdx.edu or d4rn@pdx.edu
=============
Jim Dukelow responds:
It has become popular of late with those who believe as Professor Nussbaum does
to cite the NEC review of epi studies of DOE weapons complex workers as
supporting the position that radiation exposures are a significant occupation
risk.
The actual report does not support this conclusion. I am reposting an analysis
of the report that I posted on RADSAFE a few months ago, as a booster shot
against this fallacious conclusion.
------------------------------
Date: Mon, 24 Apr 2000 00:26:54 -0700
From: "Dukelow, James S Jr" <jim.dukelow@pnl.gov>
To: "'riskanal@lyris.pnl.gov'" <riskanal@lyris.pnl.gov>,
Subject: Some thing you may have wanted to know about the NEC study of DOE
Bottom line first. The "final" report of the National Economic Council
on _The Link Between Exposure to Occupational Hazards and Illnesses in
the Department of Energy Contract Workforce_ is an enormous improvement
over the piece-of-trash Preliminary Draft Report that was leaked to the
NY Times in January. As it turns out, as the quality of the report has
improved, it offers less support for the Department of Energy's decision
to compensate workers assumed to have been sickened by their employment
at AEC/ERDA/DOE weapons' complex facilities.
Quoting from the report:
The question of cancer risk for chronic low dose levels or periodic
higher levels of ionizing radiation exposure (e.g., such as may occur
in certain occupational settings at DOE facilities) has not yet been
completely studied.
<snip>
The panel did not evaluate information on non-DOE populations, such as
atomic bomb survivors or populations with occupational exposures such
as shipyard workers and medical personnel. Determining the causal
links between an exposure and an illness was not considered to be
within the mandate of this panel.
<snip>
For certain facilities and for certain subgroups of workers within
these facilities, some evidence suggests a strong association between
employment and adverse health outcomes. Some studies indicate an
increased risk of adverse health outcomes with increased risk of
exposure to ionizing radiation.
<snip>
JSD Note: Note the "... certain facilities ... certain subgroups ...
some evidence suggests ... Some studies indicate ...". This is the key
to the major failing of the NEC report and many of the epi studies on
which it is based.
The identificaton of excesses of some types of cancers at some
facilities and other types of cancers at other facilities is not
surprising given the differences in past and present production
processes, levels of exposure, and types of radiation and chemical
hazards at these DOE facilities.
<snip>
Although data from other radiation exposed cohorts, most notably
nuclear shipyard workers, were discussed by the panel members, the
results of these studies are not included in this report due primarily
to the limited focus and charge of this panel.
<snip>
JSD Note: It might be noted here that the epi studies of the nuclear
shipyard workers do not seem to support the idea that low-dose radiation
exposures are harmful.
JSD Note: The graph on page 4 of the report shows average deep dose
equivalent exposure per monitored worker for 1947 to 1997. For 1947-54,
the average was 150 mrem. In 1959, it spiked to 210 mrem, returned to
150 mrem for 1950 through 1974, dropped to 110 to 90 mrem from 1975
through 1986, declined to approximately 10-20 mrem by 1990, at which
level it has remained.
As a point of reference, members of the general U.S. population
receive an average annual effective dose equivalent of 3.6 mSv (0.36
rem) from natural, enhanced natural and man-made sources of ionizing
radiation.
<snip>
JSD Note: The report has a table describing different components of the
360 mrem U.S. average background radiation. A footnote notes that
smoking provides an estimated effective dose equivalent to a segment of
the bronchial epithelium of 16 rem.
It has been estimated that more than 40,000 different chemical are
present throughout the DOE complex, and some, such as solvents and
egreasers, are used in vast quantities. Most of these chemicals are
not unique to DOE sites and are found in other industries. However,
little is known about actual levels of worker exposure to thes
materials. DOE does not maintain a centralized repository of
industrial hygiene information on exposures to individual chemicals.
To further complicate matters, exposures are often mixtures of
substances, making a risk assessment based on the known toxicological
profiles of these materials nearly impossible.
While chemical hazards have not been either well documented or studied
at DOE, a number of reports suggest, either directly or indirectly,
that chemical hazards pose a significant health risk to both current
and former DOE employees. ... These risks may even exceed those posed
by radionuclides.
<snip>
More than 40 studies of DOE contractor workers have been completed to
date; there are more than 20 additional studies underway.
<snip>
Overall, DOE production workers had significantly lower age-adjusted
death rates compared to the U.S. general population for all causes of
death combined; there were two exceptions. (Appendix 5 references
LIND87, ORK96).
<snip>
An increase in the risk of dying from specific conditions has been
associated with increased exposure to external radiation exposure in
seven corhort studies and to internal exposure in two studies.
JSD Note: For most (perhaps all) of these trends, the actual SMR
(standard mortality ratio) was less than 1.0 (that is, the subgroup
considered was healthier than the general public), but the "healthy
worker" performance of the subgroup reflected increasing disease with
increasing exposure.
Special studies of workers with brain cancer, multiple myeloma,
malignant melanoma, non-malignant respiratory diseases, and malignant
respiratory diseases were pursued. Except for non-malignant
respiratory disease among Fernald workers, the special studies did not
identify specific occupational exposures associated with the
conditions.
<snip>
End of quoting from the report.
The report includes at this point a table summarizing Statistically
Significant ELEVATED [JSD emphasis] Findings for Cancer at Department of
Energy (DOE) Sites.
Perhaps the most important thing to note about this table is that
although almost all sites had significant monitored radiation exposures
(and none had monitored chemical exposures), there is no consistent
pattern of disease over the various sites.
Appendix 3 is a textual summary of statistically significant POSITIVE
results from the (apparently) 40 studies summarized. This shares the
failing of the piece-of-trash preliminary draft that only the POSITIVE
results are reported. This allowed Matthew Wald (of the NY Times) and
other journalists to write things like (paraphrasing) "the NEC report
shows that DOE workers at 14 sites have suffered 22 different diseases
caused by their exposure to radiation and hazardous chemicals". For all
of that, the most common statement in Appendix 3 was "no cancer cause of
death was greater than expected based on the general population" or
"There were no cancer or non-cancer causes of death with rates greater
than those seen in the U.S. general population."
Finally, Appendix 4, titled Tables of Standardized Mortality Ratios for
Epidemiological Studies, includes a wealth of information missing from
the piece-of-trash Preliminary Draft Report. There are tables of rank-
ordered SMRs for all of the diseases and from all of the studies
considered by the NEC review team. The first table includes ALL SMRs,
both statistically significant and not, and both elevated and reduced.
The second and third tables have all of the statistically significant
ELEVATED SMRs and the fourth table has all statistically significant
SMRs, both ELEVATED and REDUCED.
These tables allow the reader to see what the 40 epi studies are really
saying about the DOE worker cohort.
The 40 studies calculated 2507 SMRs, considering 84 different diseases
and conditions. If the data were completely random and there were no
health effects due to the chemical and radiation exposures, you would
expect roughly 125 spurious positive and negative "statistically
significant" results from these 2507 SMRs (roughly 62.5 positive and
62.5 negative). What actually happened?
There were 78 statistically significant positive results (i.e., more
disease than the control population) and 263 statistically significant
negative results (less disease than the control population).
If you consider various cancers only, there were 32 statistically
significant positive results vs. 42.17 expected and 138 negative results
vs. 42.17 expected.
For non-cancer diseases and conditions, there were 56 statistically
significant positive results vs. 20.51 expected and 125 statistically
significant negative results vs. 20.51 expected.
"Expected" in the previous three paragraphs means the number of spurious
"statistically significant" results you would expect if there were no
actual effects of the radiation and chemical exposures.
This underlines the major failing of the collection of DOE worker epi
studies. Basically, they have been reporting their statistical noise as
significant results and downplaying the fact that, in spite of the
exposures to radiation and a myriad of ugly chemicals, DOE workers are a
"healthly worker" population.
There are some things that stand out in the accumulated data reported in
the final NEC report. There is apparently some chemical exposure at
Rocky Flats that is causing "benign and unspecified neoplasms of the
brain". Also, there are some worker populations that don't seem to
exhibit a healthy worker effect, but they are workers employed at
several facilities in 1943-45, when most able-bodied men were serving in
the armed forces.
The report is available as a PDF file from the DOE web site
<www.doe.gov>. Just follow the references to the DOE worker health
study.
Best regards.
Jim Dukelow
Pacific Northwest National Laboratory
Richland, WA
jim.dukelow@pnl.gov
These comments are mine and have not been reviewed and/or approved by my
management or by the U.S. Department of Energy.
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