Re: Cancer cases in Sweden -Situational Ethics on Radiation Risks

[farbersa@optonline.net]

Dr. Cohen:



Unfortunately, the "advantage"  of the Swedish study is that the conclusions of the authors match the preconceived notions of the average reporter's phobic treatment of issues related to radiation [from certain sources such as nuclear plants or past open air testing of nuclear weapons]  Remember that the average reporter, even those on a "science beat" have little if any technical background.  



Further, the authors of the Swedish report in question are far more effective and skilled at manipulating the media to get their questionable "conclusions" out to the public.  It is quite likely after detailed analysis of the report in question, that the recent claims by the Swedish authors will be found wanting  based  on the Sternglass & Mangano tactics of hand selecting their exposed vs. control areas and picking out only the time period where the claimed adverse effect presents itself which support their preconceived conclusions.



The problem with the media and some of the institutions supposedly responsible for protecting the public against radiation risks, is well illustrated by the interesting case history below in which I was involved.



Several years ago, I had extensive dealings with the science and health editor of the TV show 20/20 when ABC was  considering doing a story about the failure of the CDC and US government to deal with the health risks of Nasal Radium Irradiation  [NRI] documented in recent followup case-controlled epidemiological studies conducted as Ph.D thesis at Johns Hopkins.  Of some note the science and health editor for ABC TV's 20/20 had a degree in English.



A few years earlier, the President's [under Clinton] Advisory Committee on Human Experiments [ACHRE] had reviewed the likely health effects of NRI on Baltimore 3rd graders treated by Johns Hopkins Hospitals in a human radiation experiment of NRI funded by the US Government. The ACHRE determined that NRI use on children had the highest risk to health of any of the 4,000 human  radiation experiments it reviewed [dwarfing the calculated risk from Pu injections and the theoretical cancer risk calculated from testicular irradiation of "consenting" prisoners in an Oregon jail (to receive some privileges) in another experiment it reviewed].  Further, NRI use on children was the ONLY experiment that exceeded the ACHRE's preselected risk of cancer death to members of a human radiation experimental cohort [looking just at brain cancer where the mortality risk they calculated was 8.8 per 1,000 vs. their threshold for medical notice and followup of 1 per thousand].  NRI involved introdu

cing a very thinly encapsulated [0.3 mm monel wall thickness to maximize beta dose] 50 mg Ra-226 source through both nostrils to the rear of the nasopharynx, where the source was positioned at the opening of the Eustachian tube. The standard course of "therapy" to shrink enlarged adenoids involved 3 to 4 treatments [separated by a week or 2] of 10 to 12 minutes duration, repeated as necessary. Thus the young children so treated received a total Ra-226 exposure commonly referenced at the time as 1.5 to 2 gram-minutes to each Eustachian tube opening. The contact doses were about 2,000 rad, with sufficient depth dose to shrink the enlarged adenoids  and open up the Eustachian tubes.



The most recent study by Jessica Yeh [Hsin-cheh Yeh] for which she received a Ph.D in 1998  at the Johns Hopkins School of Public Health [the institution which first developed and popularized NRI during WWII in early human radiation experiments on submariners and aviators, and in experiments on Baltimore schoolchildren just after WWII]  reported a Relative Risk for combined and malignant brain tumors in the treated vs. untreated group of 30.9 [which was highly statistically significant].  There were numerous other adverse health effects reported by Yeh in the treated vs. untreated group in her thesis besides brain tumors ["a significantly increased risk of tumors of the head and neck was observed amont the radiation exposed individuals" - which included a RR for cancer of the soft palate of 13.4, and overall head and neck cancer RR over 2] and in Jessica Yeh's peer reviewed journal publication. Nevertheless, the ABC "health and science editor"  [excuse my having to put the p

hrase in quotes] asked me after seeing the 1998 thesis [Hea lth Effects after Childhood Nasopharyngeal Radium Irradiation -Degree date 1998] and journal article from 2000 clearly documenting  all the clear evidence of adverse health effects from NRI  [performed on no fewer than 560,000 US children post WWII per the CDC's low-low estimate  until the 1970s in some case locales]:



"Ok, so the [recent Yeh] thesis [and just published journal article] shows these increased risks of various health problems. What's the hook?" 



The most likely number of children treated with NRI in the US is about 800,000. The CDC's published  high estimate of NRI treated children is 2.6 million which I believe is unrealistically high by a wide margin.



ABC decided in 2000 not to air a story on the effects of NRI on the no fewer than 560,000 US children who received the treatment as "standard medical practice" despite the important role such a story would have played in ensuring that people who were so treated would realize they were in a "special population at risk" and should receive a periodic good, basic head and neck exam with their physicians having a "heightened index of suspicion". The quoted phrases in the preceding sentence were those contained in a Public Health Advisory issued by the State of Massachusetts Public Health Department to all 27,000 physicians in Massachusetts after my lengthly interactions with an Advisory Committee to the Massachusetts Governor on Radiation Issues.  Of note, the CDC actively opposed the Massachusetts DPH advisory despite the solid epidemiological evidence of harm. The CDC falsely maintained [and totally ignored all the science!!]  that there was no evidence of "adverse malignant or

 non-malignant health effects" from NRI despite a 1979 Ph.D thesis by Dr. Dale Sandler showing a doubling of head and neck cancer, and the followup study by the 1998 Yeh thesis on the same cohort showing additonal late health effects  [since the Yeh thesis brought forward  in time the same cohort studied by Sandler to see what health effects showed up after longer periods of followup]. T he CDC was aware of this clear evidence of harm when it fought the Massachusetts' Public Health Advisory in 1998. Also of key note, a special committee of the NIH [National Institutes of Health] and NCI [National Cancer Institute]  reviewed the potential health risks of "unusual head and neck irradiation"   [which included NRI, but also x-ray treatment for acne and tinea capitis, and irradiation of infant thymus] and  looked narrowly at potential thyroid cancer in the late 1970s. The NIH/NCI recommended that such children subject to "unusual head and neck irradiation"  be "recalled" by the in

stitution or doctor which administered the treatment, and that treated children receive a thorough head and neck exam initially and for every one to two years for the rest of their lives. The NIH/NCI wrote in its "Recommendations for Physicians" on "Irradiation Related Thyroid Cancer" in 1977 that if institutions or physicians did not have records on their treated patients due to the  passage of time, that there should be a "broad public information campaign" to reach this population with a "non-inflammatory" message of the need for regular head and neck exams of the treated individuals. These earlier recommendations of NIH/NCI regarding NRI have been completely ignored by CDC despite the accumulation of a great deal of additional epidemiological evidence of the excess risk from NRI on large numbers of individuals treated as young children and now from 45 to 70 years old in published epidemiological case-controlled studies.



Obviously, radiation risks and actions by government and the media are clearly situational depending on whose ox is getting gored. The CDC up to the present has been actively involved in not wanting the medical profession to have to deal honestly with a radiation risk stemming from the medical profession's earlier actions in widely using  NRI, an unfortunate, ill-advised procedure, on hundreds of thousands of young children. Some might even be so bold as to suggest the CDC is actively involved in a medical scandal and cover-up by ignoring an issue of such clear excess radiation risk. Interestingly, the CDC has gone on record to willingly embrace the potential risks of radiation releases from various defense nuclear facilities, and has willingly accepted countless millions of dollars to "study" thyroid cancer risks to downwinders and residents around these facilities, which are a minute fraction of the radiation dose to the thyroid resulting from NRI treatments documented in 

solid case-controlled epidemiological studies of NRI.  Hmmm. It just gets curioser and curioser. One can't help thinking that when it comes to radiation risks, and what gets "addressed" and what gets "ingored",  we've all fallen down the rabbit hole..



NRI was criticized widely by some top ENT's in the late 1940s, with nationally respected medical specialists saying at a national conference on the rapidly expanding use of NRI in general medical practicie and potential risks held at the Univ. of Chicago:



"The use of nasal radium irradiation has reached the racket stage."



I guess it comes down to the fact that many "scientists" in academia and government have their own racket going.  Situational ethics? You decide.  



I once recall seeing a definition of discretion:



"Discretion - the fine art of knowing on which side one's bread is buttered."



Wishing everyone a great Thanksgiving and hopefully all our problems will be solved by massive ingestion of tryptophan by the entire US population after consuming too much turkey. 



 Stewart Farber, MSPH



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



From: Bernard Cohen

Date: Tuesday, November 23, 2004 10:21 am Subject: Re: Chernobyl disaster caused cancer cases in Sweden > This discussion of low levels of radiation causing higher > cancer > rates in some areas of Sweden makes me wonder why my studies > showing > lower lung cancer rates in U.S. counties with high radon exposure > do not > completely convince everyone that this Swedish data is misleading. > My > studies have far more data, far better statistics, far more > extensive > analysis including consideration of over 500 potential confounding > factors, and have withstood a very wide exposure to critics, > Can anyone suggest any possible advantage this Swedish study > might > have over mine? ************************************************************************ You are currently subscribed to the Radsafe mailing list. To unsubscribe, send an e-mail to Majordomo@list.vanderbilt.edu Put the text "unsubscribe radsafe" (no quote marks) in the body of the e-mail, with no subject line. You can view the Radsafe archives at http://www.vanderbilt.edu/radsafe/