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Radon and Smoking (individual vs aggregate)
Dr. Cohen wrote, "If you don't understand that the BEIR
Reports use a liinear relationship between lung cancer and radiation
exposure, there is no point in discussing these matters with you. What do
you think the LNT debate is all about?"
Dr. Cohen,
If you get a chance, could you respond this the last post.
I agree, it makes little sense to continue when we are in disagreement
over basic facts about BEIR VI. However, rather than conveying my
interpretation of BEIR VI, let me quote:
"Miner data clearly indicate that the relationship of
lung-cancer occurrence in a person, to cumulative exposure, is not simply
linear, and that the joint relationship of radon and smoking is not
additive" (Page 376 BEIR VI).
Relative risks for cumulative radon exposure and lung cancer have
dependencies on other factors other then smoking and radon. There
are vectors of covariates that affect background lung cancer rates and
other vectors that modify the exposure response relationship.
Let's take just one example, if you hope to test the LNT theory using an
ecologic study, you must know the joint distribution of radon exposure
and smoking in EACH county (Guthrie's paper I faxed you goes into detail
on how to possibly get at this information). Nonetheless, you state
by using "rigorous mathematics" in your 1995 paper you prove
you can test the LNT theory using an ecologic study. You may have
used math, but you needed an assumption that all smokers have the same
smoking duration and intensity to obtain the Cohen derived formula.
This faulty assumption invalidates your derived equation. This
faulty assumption can not be later verified or treated by after the fact
stratifications using more averaged smoking data especially without
knowing the joint distribution of the covariates. In fact, you have
even previously stated, your analysis only, "crudely
introduces the pack-year concept." Dr. Gilbert has already
provided evidence that your results are confounded by smoking, because
other smoking related cancers are also negatively associated with your
county radon data (Perhaps Jim has a mechanism that shows alpha
irradiation to the lung decreases the cancer rates in other organs - if
so please share it). So when you say, the LNT fails, what you are
really proving is that the Cohen derived LNT formula that used faulty
assumptions failed. While I am not a loyal LNT supporter, I find
myself in agreement with Dr. Piantadosi who said in 1994, your findings
do, "more to discredit the analysis than the theory." I
would not expect you to be able to explain your inverse findings by using
your "treatments" as you call, since the Cohen derived formula
used to test the LNT suffers from faulty assumptions.
Regards, Bill Field
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