[ RadSafe ] John Snow's Work and Medical Ethics

[Gerald Nicholls]

Howard Long wrote:

"The Taiwan "Study" (J Am Phys & Surg 9:1, pp6-11) is at least as
impressive as was John Snow's observation of more disease on one side of
a London street than the other having a different water supply.This at
least calls for a test, "taking off the pump handle", exposing another
population to 0.4 Sv over 10 years, to reproduce very low cancer and
fetal abnormality rates..
 
Are ambulance chasers like the TV lawyers soliciting anyone with or
without trouble who ever was near a brake lining (asbestos), had heart
trouble (aspirin family), etc, ready to block this science?"

It seems to me that Snow's work on the spread of cholera in 19th
century London is far more scientifically impressive than the Taiwan
study.  Snow proposed that cholera was transmitted by contaminated water
in 1849 (in conflict with the generally then held idea of inhalation of
vapors) and was able to prove his theory in 1854 during a particularly
tragic outbreak of the disease.  The authors of the Taiwan study have
documented their observations and pointed out the need for further
study, but not proved their case.  One of recommendations is to design
future experiments so that hormetic effects can be studied.  

You suggest a study in which you would give a population 0.4 Sv over 10
years. If the population exposed was 10,000, so as to achieve the 4,000
person Sv population dose estimated in the Taiwan study, and you had
10,000 matched controls, the researchers would have to track the health
and radiation doses to 20,000 people over 10 years, a difficult and
expensive proposition.  And, you don't need to envision ambulance
chasers and the like seeking to block this "science,"  you just have to
look as far as you nearest review board and its resident medical
ethicists.  

Doing the study retrospectively using available health and demographic
data might be possible.  It would also avoid the major ethical pitfalls,
probably cost less and the results would  likely be available in less
than 10 years.

 




Gerald P. Nicholls
NJ Dept. of Environmental Protection
609-633-7964
gerald.nicholl at dep.state.nj.us