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Re: Lung cancer mortality from radon versus mortality from other<plus> Radon Health Risks
Whoa Cowboy!!
How did we get off track from our discussion of the facts? I've merely
asked for your view of our public health priorities and you respond with a
left-turn, ignore-the-current-discourse slap. There's something very
telling in that approach.
Have you run out of arguments and merely want to shout down the person
you're having a debate with? Is that what they teach grad students at your
school these days?
I've made "more misstatements?" Where?
I make things up as I go along to justify my own paradigms? Care to
elaborate?
My friend, you make some rather serious (read: slanderous) allegations that
you had better back up. I'll wait for your examples.
As for your reference to the letter to then-GOVERNOR Bush, I have had
discussions with Dr. Field regarding the Texas Radiation Advisory Board
Chair's response to his letter. I informed Dr. Field that a response would
be forthcoming; however, the TRAB has been preoccupied with the security of
radioactive materials within our state for some months following 9/11.
Since you've broadcast your inflammatory statements to the RADSAFE
community, I feel obliged to respond as the Vice Chair in defense of the
former Chair:
The letter you've referenced :
http://www.tdh.state.tx.us/ech/rad/PDFFILES/radonltr.PDF
was sent to then-Governor Bush by the TRAB as a "heads-up" to the EPA's
planned changes to the Safe Drinking Water Act regarding radon. You are
welcome to read it. As governor-appointed officials, one of the TRAB's
responsibilities is to advise the governor and other state government
officials and agencies on matters involving public health policy as it
intersects with radiation and radioactive materials.
I think you'll find that we are consistent in our position that
"hypothesized" hazards should not divert limited public monies from real,
demonstrable, public health hazards. Which is what the EPA radon program
seeks to do.
The Iowa study was cited in the letter because of its recent publication and
the fact that it was being waved about by the EPA as the "bloody shirt" for
radon. We took issue with several aspects of the study that, we felt, gave
reason to question the validity of the results.
Although we acknowledge respectful disagreement with Dr. Field on this
matter, we will "recant" nothing regarding the statements made in that
letter concerning the Iowa study; there were three:
First, the IRLCS was only able to establish ³statistical significance² by
omitting cases that died during the study period. Dr. Field disagrees with
this contention and stated his case in his letter to the Billet (linked
above). In reply, I offer the following direct quote from the IRLCS
website: http://www.cheec.uiowa.edu/misc/radon.html#questions
"9. Why were analyses performed that excluded deceased cases?
Deceased subjects were excluded in some analyses to minimize the biases and
exposure misclassification that might be associated with the second-hand
information from relatives. We included all subjects in one analysis and
"live" subjects in another. The "all" analysis showed a significant positive
trend for categorical analysis, while the "live" subset analyses were
statistically significant for both the continuous and categorical methods"
In order to achieve "statistical significance" for the continuous method,
31% of the total cases (130 deceased of 413 total) were "omitted" for the
"Alive" scenario. If there was no difference in statistical significance
between the All and Alive cases, I believe that Dr. Field would have stated
as such. Otherwise, why go to such lengths to explain something that is not
an issue.
Second, the data set was "carved up into non-uniform intervals. Again, Dr.
Field disagrees with this. This may be a fine point, but they are not
uniform. If the authors chose to define the intervals down to the
"common-place" (or not) 4.23 WLM, they did not succeed. The intervals were
4.23, 4.23, 4.22, 4.23 and >16.95. They may have made an a priori decision
on what the intervals would be, but the decision to break down the intervals
to the 23/100 of a WLM is not well-described and for no apparent reason.
Why?
Third, the disparities in smoking histories between subjects and controls
were "poorly corrected." Perhaps "corrected" was not the best word to use
in this instance. A more appropriate term would have been "controlled" (or
"poorly controlled"). Again, Dr. Field disagrees.
This specific issue has been discussed at length within this forum over the
last few weeks. As many have stated, you cannot merely hand wave and say
statistical procedures will address these discrepancies. To have 86.4% of
cases and 32.6% of controls be "ever-smokers" shows poor matching of cases
and controls. Period.
It is unthinkable that such poor control of the number one cause of lung
cancer would be done in a study of a *hypothesized* number two cause of lung
cancer when the numbers for the number one cause (smoking) are so
overwhelming in comparison.
As a point of comparison, the "Residential Radon and Lung Cancer among
Never-Smokers in Sweden," Lagarde, et al, Epidemiology, July 2001, Vol. 12
No. 4, presents cases and controls as follows:
Time since last exposure, years:
Cases (%) Controls(%)
Less than 3 7.4 6.8
3-15 10.9 10.7
15 or more 18.6 16.6
Unknown 1.9 1.8
Unexposed 60.1 62.8
Unknown 1.2 1.2
Reasonably good matching .... Whereas the IRLCS cites the Former smokers
(25% of cases; 21% of controls) as follows:
Years since cessation of smoking
Cases (%) Controls(%)
<10 70.5 29.8
10-19 17.3 21.9
20-29 7.1 20.5
>=30 5.1 27.8
No apparent effort made to match cases and controls in the critical area of
smoking. Perhaps Dr. Field can prepare his reply to this post, we can send
both versions to the Billet and end the matter.
As a matter of public health policy and ALARA (as you have raised, Don), I
will submit that it is not only UNreasonable to spend TRILLIONS of dollars
on the radon industry, it is also unethical and immoral. Unethical because
we are diverting monies from areas that could show a demonstrable public
health benefit (e.g., smoking cessation and water-borne pathogen control).
Immoral because we fabricate a public health crisis and bilk a trusting
public out of the money to support it.
When I get back to my office, I will provide the references for radon
hospital studies in the former USSR that show the beneficial use of radon
and response in a clinical environment. This should be better than your
need for case-control studies.
Finally, the holy-grail pooling exercise won't be able to statistically
massage out all of the inconsistencies between the various and sundry study
methods. As for the Texas Radiation Advisory Board, don't expect a
recommendation to support voodoo-science EPA initiatives to redirect limited
public monies away from critical, quantifiable public health hazards to
support hypothesized hazards (radon).
v/r
Michael
--------------------------------------------
Michael S. Ford, CHP
Texas Radiation Advisory Board
Amarillo, Texas USA
--------------------------------------------
on 1/22/02 9:50 AM, Rad health at healthrad@HOTMAIL.COM wrote:
>
> MICHAEL,
>
> You never recanted your clearly erroneous statements concerning the Iowa
> study that you sent to President Bush. These errors were pointed out in a
> letter in the Billet (http://www.stc-hps.org/billet.htm). Perhaps you should
> respond to that before you make more misstatements. It appears you make
> things up as you go to justify your own paradigms.
>
>
> I noticed you didn't cite any of the
>> studies that found negative associations
>
> Michael, Which case controls were negative? The only one I know about is
> the China cave study that had a lot of problems with indoor cooking and
> failure to account for gamma radiation in their eperms.
>
>
> Here's my beef with the radon
>> studies, Don's: Does the wealth of data that you cite justify spending a
>> trillion dollars? If so, what health initiatives would you say we should
>> divert that money from?
>
> Michael,
>
> I think we should first focus on reducing smoking via increased sales tax on
> cigarettes and state smoking ordinances. Secondly, we should try to reduce
> exposure as possible to all lung carcinogens including radon.
>
>
>> <MSF: Then it apparently did not disabuse you of the notion of their
>> significance. Try reading some of the studies from the Russian radon
>> hospitals.>
>>
>
> Do you have references for these studies?
>
>
> Don
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