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RE: TRAB and back to Re: Lung cancer mortality from radon versus....



Dear RADSAFERS, I sincerely apologize for the length of this post, but since

Don has obfuscated the discussion, I don't have much choice.



>>>>>>>>>>>>>>>>>>>>



Don, or whoever you are....



You are quite the piece of work.  What is interesting is that you not only

conveniently delete and ignore my queries which have been submitted in the

interest of an honest and professional debate of which you seem to be

incapable, ... you also continue to make personal attacks which leads me to

believe that you've run out of room on your position.



I will expend the fewest amount of electrons possible in response to your

diatribe:



------------------Original Message------------------------------



Date: Wed, 23 Jan 2002 12:18:05 +0000

From: "Rad health" <healthrad@HOTMAIL.COM>

Subject: TRAB



Michael,



First, do your views represent the Texas Radiation Advisory Board (TRAB)?



<snip>



<MSF:  No, my views represent me.  I am a member of the TRAB.  We are a

consensus organization made of 18 governor-appointed members, the remaining

17 of which are far more intelligent and capable than I.  Consensus

advisories are issued under the letter of the Chair.  The former Chair

resigned due to conflicts after becoming the Assistant to the Secretary of

Defense.  As Vice Chair, I am acting in the role of the Chair until another

is appointed by the Governor.>



<snip>It is interesting that you failed to post the Billet site for Dr.

Field's response.  Dr. Field indicated his letter had not been answered even

though he says he brought up his concerns about the letter a long while

before September 11, 2001.I think his response in the Billet more than

answered the TRABs extremely erroneous allegations.  Please post the site so

others can see his response.<snip>



<MSF: It is interesting that you failed to remember that YOU POSTED THAT

LINK, and I included it in my reply which you apparently failed to read.  I

explained why there was a delay and why we don't pump out letters ad hoc.  I

have discussed this with Dr. Field, and while disappointed with our

timeliness, I feel that he understands the situation.  We were actually

engaged in a polite, professional discussion on this very matter a few

months ago.....  What you think to be "extremely erroneous" and what you can

prove are apparently two different things.>



<snip>IAnd how long does it take to write a letter, you just did it.  The

TRAB could have easily responded before now if they felt they had a valid

response.<snip>I



<MSF: See above>



<snip>IDon

>I've made "more misstatements?"  Where?

>

>I make things up as I go along to justify my own paradigms?  Care to

>elaborate?



Unfortunately, I deleted your post right after reading it, so I no longer

remember the specifics of what you said. I will have to wait until Feb 1 to

see the archives.<snip>I



<MSF: Convenient.  HIGHLY unprofessional, but convenient.  For your

convenience, I will send you my original posting about which you made

several slanderous allegations.  I would sincerely appreciate you backing up

those allegations with specific examples as any honorable professional would

do.>



<snip>We took issue with several aspects of the study that, we felt, gave

reason to question the validity of the results.



The scientific method would be to write a letter-to-the-editor, rather than

bashing it in a letter to the governor.<snip>



<MSF: As I stated in my reply AND IF you ACTUALLY read the TRAB letter, you

would find that the IRLCS was cited as an example.  Try reading the letter.

You might learn something.>



>

>Although we acknowledge respectful disagreement with Dr. Field on this

> >matter, we will "recant" nothing



Why am I not surprised?



<MSF: An epidemiology student AND a comedian!  Why am I not surprised that

you're not surprised?>



- ---------------------------------------->

>First, the IRLCS was only able to establish ³statistical significance² by

>omitting cases that died during the study period.



If you read the paper again, you will see a statistically significant dose

response (positive finding) using the categorical analysis and ALL subjects

so you are clearly wrong.



<MSF: We merely used Dr. Fields et al own words.  If I am "clearly wrong,"

why did the authors go to such great lengths to explain why they did what

they did.  AND if there's no difference, why explain anything at all?  Let

the study stand on its own.>



<snip>You said, they only found significance by excluding cases that died

during the study.  They did NOT exclude any subjects that died during the

study. SO you are obviously wrong again.  HOWEVER, they did a sub analysis

of subjects who did not fill out a questionnaire themselves because they

were deceased prior to contact, not during the study.<snip>



<MSF: Field et al state, "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."  What did I

miss?  I think you're trying to split frog hairs here.  How could they be a

"subject" if they weren't part of the study?>



<snip>  The percent of live cases in the Iowa Study is extremely impressive

and is the highest of any radon case control study I know of.  They said

they used rapid reporting to get out to the subjects as soon as possible

since 50% of lung cancer subjects died the first year after diagnosis.<snip>



<MSF: And the fact that you're extremely impressed means what exactly?  That

we're justified in spending a trillion dollars on radon?  Try citing fact.

Also, if 50% of the lung cancer subjects died after the first year of

diagnosis, then the numbers are wrong for the "cases/controls" in the

"Alive" analysis stated in Table 4 on page 1098.  I can send you a copy if

you'd like.>



<snip>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?



Michael wrong again, read the paper.  Are you really serious going out to

that many decimal places?  I'll tell you - that looks pretty darn even to

me. It says in the paper that they a priori decided they needed 15% of the

subjects in the highest exposure category to allow a sufficient number for

statistical analysis.  After they did that they broke the categories up into

equal categories.  I don't really think it is relevant how many places you

carry it out to since it would not make any difference in the findings.



<MSF: Perhaps Dr. Field would like to step in here?  The intervals were

taken directly from the paper that I have with Dr. Field's card stapled to

it.  (Table 4, page 1098 and Table 6, page 1099)  Apparently, the IRLCS

authors were serious in going to that many decimal places.  HINT:  Take a

few moments and read the study yourself before you type out a rejoinder.

Finally, juggling the intervals would CERTAINLY make a difference in the

findings.  Again, why 4.23 WLM intervals?>

- ----------------------------



<snip>

>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.



Michael wrong again, The modeling they did for smoking was very well done

and in fact it you read the paper they even tested for residual confounding

from smoking.



As Dr. Field has said, you can not match completely on smoking smoking.  How

do you match, pack-year rate, numbers of packs per lifetime, year started,

year ended, etc?  If you pick one, then the other variables will not be

matched.  It is obvious you do not understand the process of adjusting for

smoking in a mutivariate analysis.<snip>



<MSF: Excuse me?  Did you say "modeling"?  And that model was validated by

whom?  Models are great, except that most of the time they're incorrect and

they cannot reproduce nature.  I did not contend that there had to be

complete matching for smoking, merely that there should have been a better

attempt to match.  Other studies have done much better work in this area,

and I cited an example to prove it.  Again, you CANNOT "model away" the

influence of the number one cause of lung cancer when the number two cause

is way down in the weeds.>



Dr Field has already wrote a letter to the Billet and has not had a response

from you or the TRAB in the Billet. If you have the time to post this

response you have the time to respond to the Billet.  It may not be a

response from the TRAB to his letter, but it is better than no response at

all.



<MSF: Again, in a effort to defend my former Chair, I provided the response

to your unprofessional slap.  I have no desire to involve Dr. Field and his

cohorts in your mud slinging.  I am certain that they are all honorable

individuals and the utmost of professionals.  I am also certain that they

feel strongly about the outcome of their studies, otherwise they would not

have published them.  I speak only for myself when I say that "I" disagree

with the significance of the IRLCS based on the comments discussed within

this forum.  I still do not agree that it strengthens the case for radon as

a public health hazard, based on a review of the facts.  Further, I maintain

that a trillion dollars is better spent on finding different crops for

tobacco farmers, solving the problems of water-borne pathogens in

communities throughout the US, and securing our water resources from

attack.>



<snip>Don<snip>



Have a Great Day!



Michael

--------------------------------------------

Michael S. Ford, CHP

Texas Radiation Advisory Board

Amarillo, Texas  USA

--------------------------------------------





<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<



Date: Tue, 22 Jan 2002 21:26:32 -0600

From: Michael Ford <michaelford@cox-internet.com>

Subject: 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

- --------------------------------------------



> 

> 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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