Re: Leukemia in Astronauts -Reply-Other unusual radiation exposure?

[RADPROJECT@aol.com]

In a message dated 98-07-23 17:37:29 EDT, Holloway writes:

<< 
 I don't think that fuzzy incidents like the one mentioned below are at all
 meaningful.   Many people die of brain cancer who have not had any special
 exposure and in the cases that you mention, you don't even know if Deke
 Slayton or Alan Shepard had the NRI procedure.  It is a tale built on a rumor
 that is based on a speculation. 
 
 << It should also be recognized that another eartly astronaut, Deke Slayton
 died
  of brain cancer, an outcome linked to NRI. Having heard from about 1,500
  individuals treated with NRI, I'm aware of another case where a [non-
 Oriental]
  test pilot for Grummen Aircraft had NRI treatments and later developed and
  died of nasopharyngeal cancer. >>
 
  >>

The main point of my comments on Nasal Radium Irradiation's possible
contribution to health outcomes that might otherwise be presumed to be linked
to cosmic radiation was to raise awareness of possible confounders that are
commonly overlooked. All I was saying is it is quite likely many of the early
test pilots and astronauts in the early 1950s would have received NRI
treatments, and NRI has been linked to various radiation health effects. I'm
not saying that Shepard or Slayton had NRI only that they might have and this
should be documented.

The health problems linked to NRI include excess rates of  brain cancer [RR=
5.3 per BEIR-V], a near significant link to L/H malignancy, as well as high
rates of Graves disease [RR= 8.6, p=<<0.01 per Sandler, 1980] apparently due
to "intense pituitary irradiation" accourding to Sandler. Also be aware that
Deke Slayton was also scrubbed from the mission which Glenn went on to
complete, because Slayton developed a cardiac arrythymia, another common
effect of Graves disorder.

Potential confounders should not be overlooked. In several studies of cancer
mortality at defense nuclear facilities (Oak Ridge-Y12 and Los Alamos) there
have been findings and/or claims of excess brain cancer mortality which could
not be explained by the low level occupational radiation exposures received.
[Cites available in Farber, 1992, NE Journal of Med. Jan. 2,  1992 noted in my
original post on this subject but not right at hand]. Some of these
observations of brain cancer mortality at defense nuclear facilities have led
to large scale investigations and large financial expenditures to no end.
However, it is possible many workers in the defense nuclear industry may have
received NRI as children or as part of their entry to the submarine service in
the late 1940s and 1950s. Proper questions should be asked in taking health
histories or a potentially very important confounder for radiation health
effects may be missed. 

NRI was not just a simple medical use of ionizing radiation in some diagnostic
technique but represents a complete outlier and unique biomedical situation.
It involved 50 mg [50 mCi] of lightly filtered [0.3 mm wall thickness to
maximize beta dose] Ra-226 inserted up each nostril for a total of about 40
min in  a typical course of treatment [= 2 gm-min or a Ci up each nostril
positioned at the base of the brain for 2 min!]. Thyroid dose (direct gamma)
in very young children treated with NRI was as high as 100 rad with typical
thyroid doses at age 8 perhaps 10 rads. Pituiatary doses in children were in
excess of  50 rad. BEIR-V in evaluating the US treatment protocol based on
Sandler, 1982 estimates a brain dose of 15 to 40 rad.

The fact that the CDC now estimates that from 570,000 to 2.6 million children
received NRI from 1946 forward [ 1,000,000 a "best estimate" of the population
treated] and that about 15,000 military personnel (mostly Navy nuclear types
but about 7,000 Army Air Force personnel in WWII according to published
reports) highlights the scope of this issue.

Of note, the Senate Veterans Affairs Committee has recently introduced
legislation (S. 1822) to declare veterans who received NRI eligible for
priority medical care and inclusion on the VA's Ionizing Radiation Registry. 

However, the use of NRI on children continues to be ignored for political
reasons and the CDC is against even notifying this special population of about
1,000,000 individuals [now adults averaging about 50 years old]  at risk of
the need for thryoid screening on a regular basis consistent with existing
NIH/NCI consenses standards ("Irradiation Related Thyroid Cancer- Information
for Physicians" -1977) which recommend that any person who received "unusual
head and neck irradiation" as a child including NRI have an initial thyroid
exam and a follow-up exam every 2 years for the rest of their lives.


Stewart Farber, MS Public Health
Director, Radium Experiment Assessment Project
19 Stuart St.
Pawtucket, RI 02860

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