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Re: Cohen's Fallacy
>How do you explain that Iowa has one of the highest radon concentrations,
>yet one of the lower incidences of lung cancer?
Lower than average smoking rate 2o years ago.
>
>How do you explain that in all radon studies, most cases are exposed to the
>lowest concentrations of radon? Nearly all cases have less than the EPA
>actions level.
>
Log normal distribution of radon and a large percentage of lung cancer cases
have nothing to do with radon.
>I've explored how the 4 pCi/L action level was developed and regard that
>level as a "Glass Ceiling". I have little regard for studies that use ">148
>Bq/m^3". I know that the Iowa study did not and I respect that. My major
>concern with the Iowa study is smoking.
>
I highly recommend the recently published book, "Radons Deadly Daughters" -
They have a very detailed description of how it was arrived at.
>I have concerns with the retrospective radon detector (RRD) system. They
>report a 20% increase in radon levels over track etch detectors. The RRD
>results can very by 25% over a single pane of glass. Variability of RRD in
>houses with smokers is significant. I like the ingenuity of RRD, but I
>question the reliability of readings in houses with smokers because of the
>Po-210 introduced by tobacco smoke. In such instances, I think that track
>etch provides a more accurage reading than RRD because the particulates are
>filtered out.
>
There are some new papers on the glass-based detectors that show them to be
quite accurate.
>Radon is a statistical disease. The query "Where are all the dead bodies?"
>is as pertinent today as it was 25 years ago. I want to know how the EPA
>plans to demonstrate that the radon program has been and is effective in
>reducing lung cancers. From BEIR VI, it appears that IF the radon
>mitigation program were completely successful, there would be no detectable
>decrease in lung cancer statistics. That bothers me. Since lung cancer from
>radon is a statistical disease, statistics is the only way to show that the
>program is effective.
>
>My other concerns are of a nature that I will not post them on RadSafe.
>
>I look forward to the composite etiology lung cancers in never smokers, as
>you are. You and I have the same goal in mind. Reduce lung cancers. Even
>though both you and I have read through much of the same material, ou
>believe that the radon mitigation will satistically reduce the number of
>lung cancers; I, however, am skeptical.
>
Read radon's deadly daughters, it tells you where all the bodies are.
>Tom
>
>Rad health wrote:
> >
> > Mr. Mohaupt,
> >
> > They adjusted for smoking using a multi variate analyses, that is
>correct.
> > I believe the sample size in the North American pooling will be
>sufficient
> > to determine whether or not radon exposure to just never smokers is a
>risk
> > or not. My guess is it may be a greater factor since there is no
>increased
> > mucous secretions from the smoking to attenuate the alpha particles.
>The
> > hypotheses the Iowa Study was testing was whether or not prolonged
> > residential radon is a problem in females who have developed lung cancer
>and
> > have lived in the same home for at least 20 years. Perhaps they can
>perform
> > another study on never smokers down the road, but that was not the focus
>of
> > their study. I can not convince you of the strenth of multivariate
> > analyses, that is your personal view and I respect that. Most
>epidemiologist
> > (other than Howard who calls himself an epidemiologist) would disagree.
> > Plus the Iowa inverstigators performed tests for residual confounding
>and
> > did not find any.
> >
> > The German study was positive regardless of the spin you put on it.
> > Alavanja's study was not of just never smokers, but rather ex smokers
>and it
> > lacked power.
> >
> > Don
> >
> > >From: Tom Mohaupt <tom.mohaupt@wright.edu>
> > >To: Rad health <healthrad@hotmail.com>
> > >CC: RuthWeiner@AOL.COM, muckerheide@MEDIAONE.NET,
> > >radsafe@list.vanderbilt.edu
> > >Subject: Re: Cohen's Fallacy
> > >Date: Mon, 28 Jan 2002 15:36:04 -0500
> > >
> > >Mr. Rad Health,
> > >Ruth suggests that cases with smoking be subtracted from the data. You
>say
> > >that that this is what was done with the Iowa study, and I disagree.
>The
> > >cases with smokers were not subtracted, but included in the evaluation.
> > >
> > >Secondly, you espouse the virtues of a multivariate regression to
>account
> > >for smoking and I disagree that this is adequate for radon and lung
>cancer.
> > >
> > >For most cancers other than lung, smoking is not a direct insult to the
> > >organ in question, i.e., smoking tends to be another confounding
>factor. In
> > >lung cancer, smoking directly insults the lung. About 90% of the lung
> > >cancers would go away if smoking were removed. Smoking deposits hot
> > >particulates in the lung. It contains enumerable chemical carcinogins.
> > >Smoking directly changes the physiology of the respiratory system, thus
> > >hindering the lung from functioning properly. It also deposits a higher
> > >dose from alpha particles than from radon. Theory suggests that the
>alpha
> > >particles from radon induce lung cancer. The dose from smoking is much
> > >greater than radon, but it is not accounted for in the population-based
> > >radon studies. It's not a simple confounder and cannot be treated as
>such.
> > >Also, many of the radon studies of never-smokers have been negative. If
>the
> > >smoking model is correct, the results of studies including smokers and
> > >never-smokers should agree. Since they don't, I question whether the
> > >modeling for smoking is correct.
> > >Tom
> > >
> > >Rad health wrote:
> > > >
> > > > Ruth's second points:
> > > >
> > >
> > > >
> > > > >6. Look at whatever relationship exists between radon exposure and
>the
> > > > >remaining lung cancers (those that occurred in non-smokers). It
>is
> > >also
> > > > >necessary to look at the secondary smoke exposure in non-smokers,
>since
> > > > >secondary smoke is also a pretty well extablished carcinogen.
> > > >
> > > > This ignores the interaction between smoking and radon. You get
>alpha
> > > > exposure from both radon and tobacco.
> > > > This part of what Field did and this is likely what will be done in
>a
> > > > pooling.
> > > > >
> > > > >Maybe this is what Field et al did -- I will have to get their
>papers
> > >and
> > > > >see. But it seems to me that applying some kind of statistical
> > >correction
> > > > >for smoking that says, in effect, since the national risk of lung
> > >cancer
> > > > >from
> > > > >smoking is x, and the national (or statewide) fraction of smokers
>is y,
> > > > >then
> > > > >x*y *observed lung cancers are attributable to smoking and the rest
>to
> > > > >radon,
> > > > >doesn't really cut it. All that would tell you is the fraction of
> > >lung
> > > > >cancers that MIGHT be attributed to smoking.
> > > >
> > > > Regarding a smoking correction - As posted before on this list by
> > >others,
> > > > this is the most powerful way to adjust for smoking.
> > > >
> > > > Quoting Hosmer and Lemeshow's authoritative book, "Applied Logistic
> > > > Regression":
> > > >
> > > > "One generally considers a multivariate analysis for a more
> > >comprehensive
> > > > modeling of the data. One goal of such an analysis is to
>statistically
> > > > adjust the estimated effects of each variable in the model for
> > >differences
> > > > in the DISTRIBUTION of and associations among the other independent
> > > > variables. Applying this concept to a multivariate logistic
>regression
> > > > model, we may surmise that each estimated coefficient provides an
> > >estimate
> > > > of the log odds [of lung cancer] adjusting for all other variables
> > >[smoking]
> > > > included in the model."
> > > >
> > > > _________________________________________________________________
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> > > >
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> > >
> > >--
> > >Thomas Mohaupt, M.S., CHP
> > >University Radiation Safety Officer
> > >
> > >104 Health Sciences Bldg
> > >Wright State University
> > >Dayton, Ohio 45435
> > >tom.mohaupt@wright.edu
> > >(937) 775-2169
> > >(937) 775-3761 (fax)
> > >
> > >"An investment in knowledge gains the best interest." Ben Franklin
> >
> > _________________________________________________________________
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>
>--
>Thomas Mohaupt, M.S., CHP
>University Radiation Safety Officer
>
>104 Health Sciences Bldg
>Wright State University
>Dayton, Ohio 45435
>tom.mohaupt@wright.edu
>(937) 775-2169
>(937) 775-3761 (fax)
>
>"An investment in knowledge gains the best interest." Ben Franklin
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