Re: Taiwan, cobalt-60

["Howard Long" <hflong@pacbell.net>]

Congratulations, Jerry, on your assist with the Taiwanese presentation of

their "serendipitous experiment" in J Am Phys and Surg (my comments in

another post to radsci).



The question of age difference of apt dwellers exposed (0.4 Sv av) and

Taiwan pop (control) is partly answered by Fig 1, showing cancer /100,000

was 80 in 1983 for gen pop, 50 in 1983 for exposed, but a plunge to c23 in

1984 and to c17 in 1985 for those irradiated!



As a non-credible epidemiologist, I doubt whether we could ethically devise

a more convincing "experiment" to satisfy FDA. I believe we should NOW take

this Chen,Yuan (Taiwan cancer), Cameron (NShipyard WS) and BCohen (USA

County Radon vs Lung Mortality) studies to FDA as SUFFICIENT documentation

of LDR safety and benefit for chronic administration of 0.5 to 10 rem by MDs

and HPs with added certification.



Howard Long



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

From: <jerrycuttler@rogers.com>

To: "Jim Muckerheide" <jmuckerheide@cnts.wpi.edu>; <rad-sci-l@WPI.EDU>

Cc: <jerrycuttler@rogers.com>

Sent: Monday, March 29, 2004 10:11 AM

Subject: Taiwan, cobalt-60





> Tony Brooks indicated that the DOE might be persuaded to fund a proper

study if it was headed by a credible epidemiologist.

>

> We thought about Dan Cruzski (spelling?), so I spoke with Philippe about

this.  He will show the PBNC paper to Dan today or tomorrow and explore his

interest.

>

> Vera and I had a lovely Chinese dinner last night (at the House of Hong)

with Shu-Zheng and Jian.  Zheng mentioned that one of his former students (a

resident physician) has started to provide LDI therapy to appropriated

patients.  Two have already been treated.

>

> Jerry



> > Hi Don,

> >

> > A good article. Congratulations. It is unfortunate that you did not more

> > specifically respond to Chang's claim that the population is heavily

> > weighted to being 20-30 years old. Obviously this is the only real issue

> > here. The Chen et al. group can only question the epidemiology without

> > having access to the age-adjusted data. The only real issue for more

than 5

> > years has been the call for an actual epidemiology study!  Chang and the

> > Taiwan government and rad protection establishment have not responded to

the

> > many formal and informal requests over many years, including requests

> > through the top levels of the Taiwan government, to do that study (with

> > initial assurances that something would be done, but then a stone wall).

It

> > is reasonable to question the reasons, including/especially such claims,

> > after refusing access to the data or even to publish any age-adjusted

data.

> >

> > However, when we asked about the age distribution effects in 1999 and

later,

> > Chen and Luan et al. responded that, despite our expectations that the

new

> > owners of such new residential units would tend be young families with

> > children, they noted that, the residents seemed to reflect the Taiwanese

> > tendency to live in extended family units, i.e., including grandparents,

so

> > they felt it was reasonable to start with the assumption that the

exposed

> > groups would be close to the general Taiwanese age distribution. Your

> > article seems to accept Chang's claim without recognizing that he, nor

> > others, still provide no age-adjusted data, nor to question why Chang

and

> > the Taiwan government and rad protection establishment have prevented

such a

> > study for these many years.

> >

> > There is also a question about the claims of deaths vs. the dose

> > reconstruction data. It is not clear why the substantial and costly dose

> > reconstruction efforts that were undertaken and published over many

years

> > are simply rejected with Chang's claim that the doses were much less.

Chang

> > is an MD who has substantial funding to do continuing medical testing of

the

> > exposed residents. But Chang is an avid anti-nuclear campaigner, in

addition

> > to any bias induced to keep funding to follow the "victims" for their

> > lifetime. For example, one of the seven deaths that Chen et al. had

> > recognized from media claims as reported by the "Victim's Association"

was a

> > teenage boy that had died of leukemia. Chang was highly active in

virulent

> > claims in large headline articles (in the Taiwan English press as well

as

> > the Chinese press) to the effect that "this beautiful boy was killed by

the

> > horrible, callous, nuclear industry." At the same time, it was reported

that

> > the boy was not exposed in a contaminated residence, but that he had

> > attended one year of school (kindergarten) in a building in which the

iron

> > bars over the windows were made of cobalt-60 contaminated rebar. (It is

not

> > clear why you report a deprecating and unsupported comment from Chang

about

> > whether Chen was removed from office due to the contamination incident

to

> > question Chen's motives, but not report on Chang's activist actions and

> > potentially biased motives.

> >

> > In the earlier list of 39 deaths (now 46) produced by Chang that I had

> > distributed last year, there were no doses reported. Certainly the

permanent

> > residence of each person in a population that is being medically tracked

> > (for life?) is specifically identified, and the doses in each residence

> > readily known from the massive funds the Taiwan and Taipei governments

have

> > put into surveying contaminated residences. So if Chang has data for

each

> > resident (that shows that the doses are much less then reported by the

> > enormous formal dose reconstruction studies) it is simple to provide

that

> > data. Again, Chen, Luan et al. have not gotten access to any such data.

> >

> > It is reasonable to expect that, since the exposed residents mostly have

> > relatively low doses, most of the cancer deaths are in that group.

> > Obviously, the question remains whether there is a dose-trend to any

cancer

> > deaths (or incidence).

> >

> > There is also a question of whether Chang's list of 7,271 residents are

only

> > living people in his medical follow-up testing program, or does he

include

> > all of the people that died in the resident population after taking up

> > residence in 1982-1984 before they would have been included in the

medical

> > follow-up group. Most would have been identified by 1994, but

contaminated

> > residences continued e identified into the late '90s. (For an

epidemiology

> > study, it would be reasonable to include perhaps a 6 month or 1 year lag

> > time. :-)

> >

> > Thank you.

> > Regards, Jim Muckerheide

> > Subject: Co-60 contamination in Taiwan

> >

> > Earlier this month, I circulated a draft article about the Co-60

> > contamination in Taiwan. Since then, I have received quite a lot of

comment

> > and correspondence on this subject, including more information from Dr

> > Chang, and two revised papers by Chen, Luan et al have been published.

It

> > seems that there is a lot that still needs to be resolved about this

> > situation but I have to go to press with my article in the ARPS

Newsletter.

> > This is it.

> >

> > Don Higson

> > ______________________________

> >

> > In the ARPS Newsletter No.28 (Radiation Protection in Australasia,

September

> > 2003, Vol.20, No.1), I published an article concerning 180 apartment

> > buildings in Taiwan, constructed about 20 years ago using reinforcing

bars

> > which had been accidentally contaminated with cobalt-60 (half-life = 5.3

y).

> > About 10 years had passed before this situation was recognised, and

> > residents were then progressively relocated. It had been estimated that

some

> > of them were exposed initially to dose rates greater than 0.5 Sv/y from

the

> > cobalt-60.

> >

> > A report on this incident, by W. L. Chen, Y. C. Luan and 12 others, had

been

> > presented earlier in 2003 as a poster paper at the 48th Annual Meeting

of

> > the Health Physics Society in San Diego, USA. According to the report,

> > residents who had been exposed to chronic radiation in these

contaminated

> > apartments had experienced beneficial health effects, including a

> > substantial reduction in the incidence of cancer.

> >

> > A revised peer-reviewed version of this report, entitled "Is Chronic

> > Radiation an Effective Prophylaxis Against Cancer" by Chen, Luan et al,

has

> > recently been published in the Journal of American Physicians and

Surgeons,

> > Volume 9, Number 1, 6-10, Spring 2004. A slightly different version of

the

> > revised paper, entitled "Effects of Cobalt-60 Exposure on Health of

Taiwan

> > Residents Suggest New Approach Needed in Radiation Protection" has been

> > presented at the Pacific Basin Nuclear Conference (PBNC-2004), hosted by

the

> > American Nuclear Society in Honolulu, Hawaii, March 21-25, 2004. The

> > findings reported in these two papers are similar to those in 2003,

though

> > not identical, and are as follows:

> >

> > .        Over a period of 9 to 20 years, up to 10,000 people had been

> > exposed to an average dose of about 0.4 Sv (~4,000 person-Sv) from the

> > cobalt-60, with the maximum individual dose being around 6 Sv.

> >

> > .        No harmful (deterministic) radiation sickness syndromes were

> > observed.

> >

> > .        Of the 10,000 total exposed population, about 2,000 were young

> > students, for whom the natural incidence of cancer is lower than for the

> > general public.

> >

> > .        On the basis of cancer mortality statistics for the whole

> > population of Taiwan*, about 186 cancer deaths would have been expected

> > during the study period in a population of 8,000 people who had not been

> > exposed to cobalt-60 contamination.

> >

> > .        *The mean cancer mortality in Taiwan during 1983-2002 was

reported

> > to be 116 deaths/100,000 person-years. [This figure is quite low

compared,

> > for example, with 174 for Australia in 1986. DJH]

> >

> > .        According to the ICRP-recommended risk model, the estimate of

186

> > cancer deaths would have been increased to 242 by the exposure to

radiation.

> >

> > .        However, the actual, total number of cancer deaths among the

> > exposed group was reported to be only 7, five of these being among the

8,000

> > mixed population and two among the 2,000 students.

> >

> > .        Similarly, about 46 hereditary defects would have been expected

> > naturally, with an estimated increase to 64 due to the radiation. The

actual

> > number among the exposed group was reported to be only 3.

> >

> > The authors of the study have claimed that the above figures suggest

> > strongly that chronic irradiation has beneficial effects on the exposed

> > individuals, consistent with the radiation hormesis model reported by

> > others, and that it may thus be an effective prophylaxis against cancer.

> > These beneficial effects were reported to have appeared in the residents

> > immediately upon moving into the contaminated apartments, unlike the

> > negative health effects associated with acute radiation exposures which

have

> > long latency periods.

> >

> > As the findings of this study are such a departure from those expected

from

> > ICRP criteria, its authors recommend that their findings should be

reviewed

> > by other, independent organisations. Population data not available to

them

> > should be provided so that a proper epidemiological analysis can be

made.

> > The authors also recommend -

> >

> > .        that radiation protection authorities should change their

policies

> > and standards to reflect the actual benefits as well as the hazards of

> > exposure to radiation; and

> >

> > .        that radiation biologists and medical scientists should in

future

> > pay close attention to evidence of radiation hormesis.

> >

> > My previous article (from the ARPS Newsletter No.28, September 2003) was

> > circulated and reprinted elsewhere, and has prompted considerable

interest.

> > The reported size of the beneficial health effect has prompted

scepticism

> > even amongst some of those who accept that radiation hormesis occurs.

> >

> > I have also been contacted by two professors of the National Yang-Ming

> > University in Taiwan (Dr. J. J. Hwang, Dept. of Radiation Technology &

> > Institute of Radiological Sciences; and Dr. W. P. Chang, Institute of

> > Environmental Health Sciences) who have been involved in another study

of

> > this matter. They have presented a very different view of the

consequences.

> > Their following conclusions are quoted, with their permission, from

e-mail

> > correspondence that I have had with them. These conclusions have not yet

> > been fully published.

> >

> > One of their primary concerns has been with dosimetry. Their estimates

of

> > the cumulative exposures are significantly less than those made by Chen,

> > Luan et al. However, in my view, it is the differences in the reported

> > health effects of exposure which are the most important: Dr Chang has

told

> > me that 131 cases of cancer, including 46 cancer fatalities, were

observed

> > over 18 years amongst 7,271 persons registered, via the National Cancer

> > Registry Program in Taiwan, as the exposed population. He suggests that

this

> > may be greater than the number of cancer cases in a similar population

that

> > had not been exposed to the radiation - particularly hemato-lymphoid

> > malignancies and all types of leukemia in men, and thyroid cancers in

women.

> >

> > On the basis of the cancer mortality statistics cited by Chen, Luan et

al

> > (see * above), about 152 cancer deaths would have been expected over 18

> > years in a population of 7,271 people who had not been exposed to

cobalt-60

> > contamination. The significantly lower figure of 46 cancer deaths has

been

> > explained to me by Dr Chang as being because most of the exposed

population

> > were aged in the range 20-30 years, which is information apparently not

> > available to Chen, Luan et al.

> >

> > Furthermore, if most of these residents were aged 20-30 years, a greater

> > number of children would have been expected to be born in this cohort

than

> > in the average Taiwan population. The number of predicted congenital

> > malformations should therefore be higher than the 64 mentioned above,

> > although only 3 were reported. Official statistics on the age

distribution

> > of the exposed population would be helpful in this respect.

> >

> > It seems, even at this stage, that full and complete information on the

> > consequences of this potentially most important incident is not freely

> > available. Dr Chang has also told me of another aspect of this matter

that

> > may be considered significant, viz: that Dr W L Chen (one of the

principal

> > authors of the HPS 2003 paper), who was the director of radiation

protection

> > of the Atomic Energy Council (Taiwan's nuclear regulatory agency), was

> > forced to leave his position due to the cobalt-60 contamination issue.

> Jerry Cuttler DSc, PEng

> Cuttler & Associates Inc.

>

>





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