Healthy Worker Effect

["TED S. BOHN" <BST@inel.gov>]

      Radiological Engineering (bst@inel.gov)
      6-1279  MS 4138  FAX 6-8959  Pager 5841
I haven't followed the entire string of this subject, but are there studies
that establish that an UNHEALTHY person is more likely to contract cancer
due to radiation exposure than a HEALTHY person?  I can see this in bacterial
and virial caused diseases but not cancer.  Maybe the "Healthy Worker" types
are assumed not to be in contact with carcinogens as regularly as the
"Unhealthy Worker" types. I thought that radiation caused cancer however,is not
discriminatory and even the healthiest worker has an equal opportunity.

*** Reply to note of 03/21/96 08:35
To: RADSAFE --INELMAIL RADSAFE

Subject: Healthy Worker Effect
Hi Al,

> Why can't the observed data derived from epidemiological studies of persons
> exposed to ionizing radiation that demonstrate cancer incidence or cancer
> mortality lower than that for the controls be interpreted as a hormetic
> effect?  Why is it always interpreted as a "healthy worker effect?"  Any
> comments?  Al Tschaeche xat@inel.gov

Disinformation; rationalization.

The "rationalization" is obvious. Workers do not include people who can't work
due to medical problems, and workers get better health care, and some less
significant (unquantified!) factors. But, for carcinogenesis, for radiation
effects, how does that 20 or 30 year-old worker get more or less cancer than
the general population (that does not already have cancer). "Public health"
advocates would otherwise have us believe that the industrial workplace is a
cesspool of INCREASED cancer. These people can have it both ways in their
political rhetoric justifying "concern" (and funds).

Consider for radiation specifically:  Many studies with internal controls
confirm no such effect exists. See eg, the Nuclear Shipyard Worker Study
(NSWS), the best worker study in the history of the planet re dosimetry and
confounding factors and the size of the population (publication suppressed;
now at least ref'd in UNSCEAR 94). The non-nuclear workers SMR vs aged
adjusted general population is 1.00 (+- 0.03).

It is not plausible. The "healthy worker effect" comes from the general public
that includes people not well enough to work. This works for general illness
and disease. It can not apply to long-term cancer.  (Ie, no data or
plausibility supports that rationale that selecting a healthy worker today,
and even good health care, can affect comparisons to cancers that appear
later, with a 5, 10 or 15 year lag.)

Even more disingenuous is that the "public health establishment" in other
forums considers the industrial workplace to be a SOURCE of cancer. If there
were anything to that, there should be an "unhealthy worker effect" _for
cancer_ in industrial occupations exposed to industrial chemicals and other
physiological damage, in addition to radiation.

Requests to produce data confirming the existence, and quantifying, the effect
to the proponents of this rationalization (which is easy to do
epidemiologically, as in the NSWS, and which can/should be done in many
non-nuclear occupational populations) has never gotten anyone to demonstrate
and confirm/quantify the effect. (From specific challenges over the years, the
knowledgeable science defenders of the justification and consequences of the
linear _hypothesis_ know this well.)

Thanks.

Regards, Jim Muckerheide
jmuckerheide@delphi.com
Radiation, Science, and Health