Re: dose-effect estimates vs privacy

[avest@magnus.acs.ohio-state.edu (Albert Lee Vest)]

Jim Muckerheide brings up an issue that's been nagging me -

>also think this role plays into the issue of professional ethics. How do you
>morally justify making a maintenance job cost $100,000s when it could be done
>for $10,000 often at the equivalent "cost" of a few x-rays to a 5-person crew, 
>or even a few rem each to a work crew, when the actual data on rad health
>effects is unambiguous about the lack of adverse effect (even benefit from,
>eg, the Nuclear Shipyard Worker Study?!) of such exposure. 

As has been noted, the shape of the dose-response curve is "j"-like (with
maybe a slight dip in the bottom of the "j"), not linear.  But I think we
must interpret the independent variable on this curve to apply to the total
dose a person receives, not just to the dose they may be getting from doing
a particular task.  Taking this into consideration, I as an HP won't feel
comfortable deciding that these "few x-rays" would be harmless or beneficial
unless I am sure where the worker is on this j-curve (due to prior
exposures) before he starts to work on the task.

In order to be sure of this, one would need access to the most current dose
history data on the workers (and alternates, in case one calls in sick),
more extensive - and more quickly accessible - than the dosimetry data we
keep on file today.  One would not only need records of occupational
radiation dose, but also medical dose, and estimated dose from natural
origins.  Currently we don't have (or want) access to such data - but we'd
need it, wouldn't we?

Would we require the entire work force to wear personnel dosimetry at all
times?  If so, might it be better to have a government agency do all
dosimetry, rather than having each employer provide their own, to assure
uniformity (fairness)?  The data could be made available to all persons
responsible for Radiation Protection (or, rather, Radiation Optimization?)
by a log-in computer system, or some other fast response system (central
telephone switchboard).

If I'm not sure of a person's prior radiation dose, I would think it prudent
to assume the worker is up on the spine of the "j", where the slope
(marginal increase in presumed risk) is greatest, and prescribe precautions
to minimize risk accordingly.  Which puts us back to "seeking zero".

This information could come in handy at hiring time.  HP could advise
Personnel which candidates would be best suited for work entailing exposure.
Guess what - job-discrimination lawsuits would be inevitable!

The idea-football is in play.  Kick it around, folks, please!



Albert Lee Vest           The Ohio State University
Health Physicist    Room 103 1314 Kinnear Road Bldg
(614)292-1284                     1314 Kinnear Road
avest@magnus.acs.ohio-state.edu   Columbus OH 43212
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