Re: Cancers defined as "radiogenic diseases"

["Michael P. Grissom" <mikeg@SLAC.Stanford.EDU>]

Radsafers,

The VA, of course, has been under tremendous political
pressure to open the doors as wide as possible regarding
possible radiogenic causation (the agent orange/dioxin
issue is intertwined in this causation process as well) in
order to settle veterans' claims on as timely a basis as
possible, within the administrative procedures constraints
of the US bureaucracy (I believe the Australian/UK in 
general/French administrative processes have been tested 
as well).  I suppose as a veteran that I should be happy 
since, if enacted, all the normal cancers expected for an 
aging veteran population will now (possibly!) be covered.

However, as noted in BEIR V (and III), not all cancers have
been demonstrated to have a "radiation association".  Whether
in fact any exposures at occupational levels have caused any
cancers has, I suspect, never been definitively demonstrated.
I will note that the dosimetric evidence for most veterans
(those participating in atmospheric nuclear testing are the
majority of the population, although more recent nuclear
propulsion and nuclear weapons workers' claims have arisen) 
argues against any radiogenic causation.  However, demonstrating
the adequacy of the dosimetric data available, the uncertainty
of dose reconstruction methodologies, the adequacy of old
radiation safety programs (going back to and including
the Manhattan District and Hiroshima/Nagasaki occupation
forces), and incomplete historical records of individual veteran's
activities (how well do you remember what you did 50 years ago?) 
have led the VA to its present course of compensation (within 
limits) for most claims.  It is somewhat analogous to companies 
settling lawsuits that have no or little merit and could be 
easily defeated in court simply because settlement is still less 
costly than the full blown court action (and enough scientific
uncertainty helps make a positive outcome less likely)!

I would hope that the terminology used in the proposed modified
VA adjudication procedure statement:

>Sec. 3.311 Claims based on exposure to ionizing radiation.
>
> * * * * *
>
>     (b) * * *
>     (2) * * *
>     (xxiii) Prostate cancer; and
>     (xxiv) Any other cancer.
>
> * * * * *

is an accommodation to the adjudication process, is probably no
more outlandish than the use of the probability of causation
tables (which at least attempted to merge SEER data and BEIR
radiogenic associations into some "probability of causation"
for a given type of cancer, at a certain age of exposure, and 
most likely dose), and is NOT a positive assertion that any
cancer is radiogenic at occupational exposure levels (prostate
or any other gland/organ/system).

It does, of course, open the administrative process door a
bit more...

Again, an opinion...

MikeG.


At 07:36 AM 10/22/96 -0500, you wrote:
>Dr. Kenneth Mossman had a very interesting lecture this past summer at the
>1996 HPS Summer School, "Applications of New Technology: External
>Dosimetry."  In Dr. Mossman's section of the textbook and in the lecture, he
>mentioned several cancers that apparently could NOT be induced by radiation.
>Note, he does not say low sensitivity, but NO sensitivity.  They are:
>chronic lymphatic leukemia, Hodgkin's disease, and cancers of the prostate,
>uterus, cervix, testis, mesothelium, mesentary.  He also indicated with
>humor (but I'm sure he was right) that whoever could identify the reason for
>these tissues' apparent total lack of radiosensitivity could win a Nobel.
>
>If Dr. Mossman is on this list, maybe he can expound a little.  And perhaps
>he could lend a hand to the VA (not that I'm volunteering him).
>
>Scott O. Schwahn, CHP
>Jefferson Lab, M.S. 12A1
>12000 Jefferson Avenue
>Newport News, VA 23606
>(757)269-7551 (w)
>(757)269-7363 (fax)
>schwahn@jlab.org

-----------------------
Michael P. Grissom
Special Assistant, SLAC
mikeg@slac.stanford.edu
Phone:  (415) 926-2346
Fax:    (415) 926-3030