response to some postings August 8-9/00

[Rudi Nussbaum <d4rn@pdx.edu>]

1. Among several flaws in the RERF study is the fact that portions of the
"control" group at large distances DID get sizeable doses from fallout
(definitely not negligible compared to their calculated DS86 doses) that
have never been corrected for by RERF scientists. See the discussion given
in reference (1) of my 8/7/00 posting.
2.When I started learning about occupational radiation epidemiology, it
took me a while to understand the many intricacies of confounding factors,
of which selection is a major one.
Maybe, I misinterpret Sandy Perle's remark re. the healthy worker
effect. But if he implies that this is a fantasy, it might be helpful to
read (1-3) below. It is remarkable that someone can talk about
"fantasizing" when told about real, observed effects among the A-bomb
survivors, before having carefully studied the reports on the matter.Check 
my previous reference (11), in the latest issue of the Intern J Epid
(August 2000).
This does remind me of Galileo's contemporary astronomers, who refused to
look through G.'s telescope to observe that Jupiter has moons (that would
shatter the then unquestionably accepted crystal sphere on which Jupiter
was fixed according to Aristotle) while directly or indirectly implying
that G. had fabricated an optical illusion (fantasy) in his telescope.
3. By selection I mean that during the 5 years before the A-bomb survivor
cohort was assembled (1950), during which the infrastructure had to be
rebuilt from total destruction (housing,water, sewers, energy, medical
services,etc) only those with the most robust health could survive. Thousands 
of the original survivors had died from acute injuries, infections and
other diseases before the RERF cohort was assembled. Alice Stewart
presented the evidence of this "selection of the fittest" in a series of
publications. 
4. Low doses are losely defined, depending on the context. For A-bomb
survivors I would say about 50 rem, for nuclear workers below 10 rem
approximately.

REFERENCES ON HEALTHY WORKER AND OTHER CONFOUNDING FACTORS 
(1) Wilcosky T, Wing S. The healthy worker effect. Scand J Work Environ
Health 13:70-72(1987).

(2) Wilkinson, GS. Some pitfalls in studies of low-dose ionizing
radiation: The healthy dose effect, 	significance questing, and
exposure reductionism.  PSR Quarterly 2(1): 33-39(1992).

(3) Wilkinson, GS. Seven years in search of alpha: The best of times, the
worst of times. Epidemiology  	10(3):340-344(1999).

Rudi H. Nussbaum



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