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RECENT INQUIRY REGARDING HORMESIS



               RESPONSE TO EARLIER INQUIRY ON 
                   RADSAFE BULLETIN BOARD,
           "DO YOU BELIEVE IN RADIATION HORMESIS?"
       
                       David S. Gooden
       
       
          Like several others who have responded to this inquiry,
       I suggest T.L. Luckey's book.  Also the 1994 UNSCEAR
       Report to the General Assembly, with Scientific Annex B,
       "Adaptive Responses to Radiation in Cells and Organisms," is
       very informative.  The entire May, 1987, issue of the Health
       Physics Journal is devoted to hormesis.  The report from the
       Proceedings of the International Conference on Low Dose
       Irradiation and Biological Defense Mechanisms, Kyoto, Japan,
       is recommended and the Journal of Biological Effects of Low
       Level Exposure (BELLE) from the University of Massachusetts
       (School of Public Health)  is valuable.  There is a lot of good
       literature on hormesis.  Like all scientific writing, these
       materials represent observations and opinions.  Presentation of
       data may include personal biases.  All materials must be
       interpreted and assimilated based on one's personal experience
       and knowledge, and a knowledge of the authors agenda.  
       
       PERSONAL OBSERVATIONS REGARDING HORMESIS
       AND RELATED ISSUES:  
       
          In my more than 30 years of experience in medical
       physics and health physics I have seen much that suggests
       hormesis may be true and much that suggests the linear no-
       threshold model may be improper.  Conversely, I personally
       have not seen anything in practice or in the literature that
       indicates that the linear no-threshold model accurately describes
       late toxic injury (including ionizing radiation) at low level
       exposures or that hormesis is unlikely.  As a scientist, it is
       important for me to have the courage to describe my
       observations and to state my conclusions even though they may
       differ from observations and conclusions of other respective
       colleagues.  Similarly, it is important for me and all of us, as
       scientists, to remain open-minded regarding this issue.  My
       responsibility to my profession is to share my observations with
       fellow scientists and to attentively listen to the opinions and
       interpretations of others.  
       
          I perceive that controversy within our community
       regarding issues like hormesis (and the linear no-threshold
       model of radiation injury) may result from our inability to
       separate "science policy" from science.  "Science policy" is a
       value judgement system, not science.  Science policy, in its
       most wholesome form, allows reasonable activities and
       reasonable health and safety regulation in areas where scientific
       certainty is lacking.  Value judgements are not inherently less
       good than science, but it is very wrong to present science policy
       as science fact.  Today, we, as a profession, are questioning
       science policy based on what we know to be science fact (see
       Gen. Roessler's editorial, HP Newsletter, April, 1995).  I think
       this is important and proper.  The science policy that has
       evolved regarding late radiation injury in humans appears to
       include the following:  
       
          1.   If radiation causes hereditary injury in any species
                      at any dose level, it causes hereditary injury in
                      humans, even if no hereditary injury has ever been
                      identified in humans;
       
          2.   Differences among species in mechanisms of injury
                      and repair are not taken into account when
                      extrapolating data from one species to another,
                      even if great differences are scientifically identified
                      between the responses in different species and the
                      response in one species may not even occur in
                      other species; 
       
          3.   If radiogenic cancer exits at any dose level, failure
                      to demonstrate radiogenic cancer at much lower
                      doses is not indicative of safety at low levels and
                      negative findings cannot be used to quantify risk,
                      even if this results in ignoring valid scientific data;
                      
          4.   A carcinogen by one route of exposure is a
                      carcinogen by any other route of exposure, even if
                      this is known not to be the case; 
       
          5.   There is no threshold dose below which an
                      increased risk of carcinogenic or genetic injury
                      occur, even if significant data indicate a threshold
                      for cancer induction and hereditary injury in
                      humans has never been identified; and 
       
          6.   The dose-response model is linear at low doses,
                      even if no toxin has ever been shown to have a
                      linear response as to biological effect at low level
                      exposure. 
       
          The primary problem with the concept of hormesis is that
       it suggests to some an intentional exposure to radiation (at some
       yet to be identified level) may be good for optimal health. 
       Even Luckey suggests this.  One of the early respondees to this
       Radsafe inquiry facetiously suggested that, if hormesis is fact,
       health physicists of the future may be required to go around and
       make sure that employees have received their monthly quota of
       radiation exposure.  Based on my personal experience and what
       I perceive to be the present state of scientific knowledge, I think
       this concept distracts from meaningful scientific discussion
       regarding this important issue.  I encourage each of us not to
       promote the notion that there may be an optimal radiation
       exposure for health.  We must "crawl" regarding our knowledge
       of the effects of low level radiation exposure in humans before
       we attempt to "walk" or "run."  
       
          Exposures to low levels of radiation of humans must have
       one of three effects:  1) no effect, 2) detrimental effects, or 3)
       positive effects.  The same is true of exposure to all toxins. 
       Can you think of any toxin or trauma (be it radiation or
       whatever) that causes an identifiable injury (or observable
       effects) in an organism at low level exposure?  Some may point
       to chromosome aberrations or mutagenesis (DNA events) as
       observable effects in humans (observable at about 100-250 mSv
       acute exposure; not very low level by some regulatory
       standards).  As health physicists we are interested in injury to
       organisms not cells.  Do chromosome aberrations or DNA
       events cause identifiable injury in humans?  The science appears
       to point toward a "no" answer.  D. Billen (Rad. Research 124,
       242-245; 1990) says that there are about 70,000,000 naturally
       occurring DNA events per cell per year in humans.  An annual
       exposure of 5 mSv adds about another 50 events/cell/year. 
       Identifiable injury in the organism must be related more to
       "failures to repair" than to DNA events themselves.  
       
          Hormesis is not a difficult concept for me.  I don't
       understand why it is difficult for other scientists.  Our present
       state of knowledge allows humans to harness some beneficial
       effects of exposure to low level biological toxins such as
       measles, polio and chicken pox viruses through immunization. 
       Some seek the positive effects of injecting small amounts of
       snake toxins into their body to protect against snake bite.  We
       know that many of our "infections" become resistant (through
       adaptive responses) to antibiotics.  Insects develop enhanced
       tolerances to pesticides.  The mechanism causing the
       "beneficial" effects of exposure to low levels of these toxins
       may be different from those of radiation hormesis, but these
       type of effects, never-the-less, speaks to the plausibility and
       reasonableness of hormesis.   
       
          Today I believe that no scientific knowledge suggests (or
       even points toward concepts of) intentional exposure of humans
       to chemical and/or radiation toxins based on known, positive
       adaptive behavior in cells and organisms.  However, it is
       important to use today's evidence regarding hormesis to assist
       in evaluating and developing proper radiation injury models and
       in formulating reasonable "science policy."  Understanding
       mechanism of radiation hormesis may be very valuable in
       assessing human responses to exposure to all toxins.