Radiation exposure in Taiwan, JPandS correspondence posted

["Jaro" <jaro-10kbq@sympatico.ca>]

FYI, forwarded from another listserver.....



 Jaro

http://www.cns-snc.ca/branches/quebec/quebec.html



^^^^^^^^^^^^^^^^^^^^^



Sent: Sunday, May 30, 2004 9:45 AM

Subject: Radiation exposure in Taiwan, JPandS correspondence posted



[....] correspondence in the Journal of American Physicians and Surgeons

that has just been posted at:

http://www.jpands.org/vol9no2/correspondence.pdf [see text pasted below]



It relates to the article that appeared in the Spring 2004 issue, available

at:  http://www.jpands.org/vol9no1/chen.pdf



<END QUOTE>



http://www.jpands.org/vol9no2/correspondence.pdf

Journal of American Physicians and Surgeons

Volume 9 Number 2 Summer 2004



Radiation Exposure in Taiwan.



I read with some amazement the article by Chen et al that appeared in the

Spring 2004 issue of the Journal. The authors reported remarkably low rates

of cancer mortality among individuals, and congenital malformations among

their

offspring, following inadvertent exposure to radiation from Co contaminated

steel that had been accidentally used in the

construction of apartment blocks in Taiwan during 1982-84. Large numbers of

residents were exposed before the

discovery of the contamination in 1992.



Chen et al suggest that their findings support the notion that chronic

irradiation may be protective against cancer. There are, however, severe

shortcomings in this paper that lead one to question the conclusions.

Chen et al found just seven cancer deaths among 10,000 exposed residents,

and three congenital malformations among their offspring, against expected

numbers of 232 deaths and 46 malformations calculated from Taiwanese

national rates.

Two primary questions immediately follow: how were the residents and their

children unambiguously and accurately

identified, and how have the cancer deaths and congenital malformations in

these groups been comprehensively and

accurately traced? Unless these fundamental requirements of an

epidemiological cohort study such as this can be

unequivocally demonstrated, no reliance can be placed upon the results

because serious biases could be present. The correct identification of

several thousand individuals, and then establishing their vital status and

causes of death over many years, is a major exercise. It is astonishing,

therefore, that effectively no information is presented in the paper to

address these allimportant issues. The reader is left with no idea how the

basic data for this study were assembled. Under these circumstances, the

most realistic conclusion is that the great majority of cases were missed.



There are many other problems with this paper. For example, the expected

number of cancer deaths should have been adjusted to take into account the

age structure of the exposed residents, which might differ from that of

Taiwan as a whole. Further, it is most unlikely that the average dose for

the highdose category, where most of the epidemiological information will

reside, has been calculated correctly. The calculation appears to assume a

uniform distribution of

individual doses between the lower dose bound for the category and the

highest dose received by a resident, which almost certainly seriously

overestimates the average dose and hence the predicted number of

radiation-induced health effects. Overall, the paper contains a surprisingly

large number of fundamental errors.



The primary purpose of peer review is to maintain a minimum standard of

papers published in the scientific literature. If this fails, then the

scientific community is liable to be overwhelmed by findings from unreliable

studies. The paper of Chen et al. should have been subjected to more

rigorous peer review prior to being accepted for publication.



RichardWakeford, Ph.D.

Principal Research Scientist

British Nuclear Fuels plc

1100 Daresbury Park

Daresbury

Warrington

WA4 4GB

United Kingdom

e-mail: R.Wakeford@bnfl.com



1. Chen WL, Luan YC, Shieh MC, Chen ST, Kung HT, Soong KL, Yeh YC, Chou TS,

Mong SH, Wu JT, Sun CP, Deng WP, Wu MF, Shen ML.

Is chronic radiation an effective prophylaxis against cancer?

J AmPhys Surg  2004;9:6-10.





In Reply :



As explained in the article, this incident was a "serendipitous experiment,"

not a carefully planned and executed clinical trial. The AEC of Taiwan

conducted an intensive research program to measure the radiation levels in

approximately 1,700 apartments and to study and document the health of the

residents who lived in these homes, especially the 1,600 people who lived in

apartments that were highly and moderately radioactive. Identifying the

people who died of cancer and the children with congenital malformations was

the prime interest and concern, not only of the AEC scientists, but also of

the Department of Health; the Victims Association; the Nuclear, Biological

and Chemical (NBC) Protection Society; the Nuclear Science and

TechnologyAssociation (NUSTA); and the free press.



The number of cancer deaths and the number of congenital malformations in

this article are the numbers reported in the official AEC technical reports

that are referenced. We agree that a proper epidemiological study should be

carried

out, and we advocate this in the abstract and in the recommendations. We

recognize that it would be a major exercise; however, we disagree with Dr.

Wakeford that "no reliance can be placed upon the results."

The scientists who conducted the AEC research program saw no evidence of

serious bias, such as age or income

distribution. There was no conflict of interest or incentive for bias in

collecting the data. So, although we are strongly in

favor of an extensive epidemiological study, there is no evidence to suggest

that the current data are biased in any way.

Postulating a bias toward young adults would also imply a greater number of

children and an increase in the expected and predicted congenital

malformations.



Thus, the authors have provided information, references, and discussion on

the "all-important issues" that Dr.Wakeford

cites. And, although Dr. Wakeford apparently questions the expertise and

abilities of Taiwanese AEC scientists to

correctly identify and study the affected population, he presents no

evidence to support his opinion. Dr. Wakeford also

presents no evidence to support his "realistic conclusion" that "the great

majority of [cancer] cases were missed."



Dr.Wakeford also questions the method of average dose calculation. The

article explains the calculations and points out that they are crude, but

adequate. In predicting health effects, accurate dose calculations are

important only if the LNT hypothesis is employed. But the LNT hypothesis is

fundamentally incorrect, and most radiation biologists acknowledge this.

There is considerable scientific evidence that living organisms respond in a

nonlinear manner when they receive a low radiation dose or a low dose rate.

There is even evidence that a very small conditioning dose - only 1 mGy of

gamma radiation - is all that is needed to cause a strong adaptive response.

Significant biopositive effects appear when radiation levels increase above

ambient. This evidence is being ignored because of antinuclear political

activity by prominent scientists and other nonscientific considerations.

This is unfortunate because low doses of radiation can be used to treat a

host of very serious illnesses by stimulating our damage control biosystem.

The potential for helping many patients is enormous.



Two competent physicians subjected the article to double-blind peer review,

and every comment and question was addressed to their satisfaction.

Subject-matter specialists carried out additional reviews, and their

comments were also incorporated into the final article.



W.L. Chen, Ph.D.

Director

Dept. of Medical Radiation Technology

National Yang-Ming University

155 Li-Nong St., Sec. 2, Pei-tou,

112 Taipei

Taiwan



Y-C. Luan

Senior Scientist and Manager

Radiation Protection Division

Nuclear Science & Technology Association

8F, 182 Beisin Rd., Sec. 2, Sindian

Taiwan



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Available at: http://cnts.wpi.edu/RSH/Docs/Mitchel.html. Accessed May 3,

2004.



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