SCIENCE, HEALTH, AND COMMUNITY
Thus far, readers have had the opportunity to peruse a necessarily partial--and some would contend exceedingly, or even criminally, partial--couple of chapters; one dealing with the event itself and issues surrounding the unfolding crisis; the second examining various 'reporting' functions that the accident elicited, some official and some emanating from communities of interest or locale. The actual anniversary has now passed. Nothing in the Wall Street Journal, nothing in the Atlanta Constitution, nothing in the 'paper of record' marked this passage. Readers who want can listen to the audio archive that SERMCAP has created--the site that contains the audio shows up below--about this day that we should never forget.
Those who want to see the first installments, can look to the following links:
TMI, Ten Thousand Days Later, Part 1
TMI, Ten Thousand Days Later, Part 2
Today, we consider aspects of the Three Mile Island meltdown with which most people are likely to associate it--in a nutshell, cancer, dueling experts, and communities beset by discomfiture and disease. As with the previous entries(a word that I learned to use in place of "findings" thanks to a lesson from a didactic troll), necessity dictates a huge condensation of gigantic and complex topics. However, also as before, I make clear at least the primary competing perspectives, while I also acknowledge, in advance, my own biases--pro democracy, pro community involvement, pro openness, etc.
Before turning to substantive matters, a final point of information concerns our audio project, which accompanies this textual production. This Community Capacity Internet Audio Archive includes interviews with community members, an industry spokesman, several anti-nuclear activists. This source is a resource, if folks will listen in a proactive way, with an idea to joining or expanding community conversations about critical technical issues.
PUBLIC HEALTH AND ENVIRONMENTAL CONSEQUENCES--
In such a quick recounting as this, starting with the basic point can be helpful: no safe radiation dose exists; every bodily input of energy from ionizing radiation damages cells and puts organ systems and biological functions at risk. The presence of 'background' radiation does nothing to change this potential for human-manufactured radionucleides to induce cell damage, mutation, cancer, and functional breakdown as an irresistible effect of radioactivity in the human environment.
As the dispositive BEIR VII notes, "A comprehensive review of available biological and biophysical data support a 'linear-no-threshold'(LNT)risk model--...that the smallest dose has the potential to cause a small increase in risk to humans." Anything that industry adds to the environment will increase the likelihood of, and cause, cancer and other disease--as my mama used to say, "period, paragraph."
Naturally, the average dose from 'natural background' varies. Wikipedia cites a 240 millirem worldwide average, while the The Biological Effects of Ionizing Radiation Radiation(BEIR VII) suggests that the average U.S. exposure is more akin to 360 mrems. Moreover, in certain areas, such as South Central Pennsylvania, background levels are still higher, due to radon and other sources in rocks and soil. Radiation from all of these points of origin is carcinogenic, terragenic, mutagenic, and toxic, even though none of them will kill a person quickly under normal circumstances. Still, they react in unknown fashion--possibly synergistically, additively, or in other complicated ways--with additional doses of man-made origin.
The most recent compilations of the Biological Effects of Ionizing Radiation(BEIR VII)make this clear in no uncertain terms. Prominent life scientists have next to zero disagreement on this point. So saying, many scholars powerfully argue that such technologies as nuclear weapons and nuclear power, in contact with humanity, guarantee measurable and possibly horrific increases in birth defects, heart disease, endocrine disorders, non-lethal cancers and tumorous growths, lethal cancers, and other ominous health problems. Among the sources to consult in confirming this point, one might turn to a list such as this:
John Gofman, Epidemiologic studies of carcinogenesis by ionizing radiation
John Gofman Speaks Out
Thomas Mancuso: Radiation Exposures of Hanford Workers Dying from Cancer and Other Causes; Health Physics. 33(5):369-385, November 1977.
Mancuso, Thomas F.; Stewart, Alice; Kneale, George
The Handford Data: A Reply to Recent Criticisms
John Gofman: Radiation and Human Health
Joseph Mangano: Low Level Radiation and Immune System Damage
Ernest Sternglass: Secret Fallout
Helen Caldicott: Nuclear Madness
Pancreatic Cancer and Exposure to Ionizing Radiation
Joseph Mangano Tooth Study
Nevertheless, most, perhaps a lopsided majority of, nuclear industry and administrative overseers hold that no substantial, measurable health impact attended what they nevertheless acknowledge might have been a close call with mass death and disease at TMI. Furthermore, for the most part, these same 'establishment' sources--John D. Boice, Jr. is among the most prolific of the sorts of scholars who contend that nuclear power, nuclear weapons production, and other industrial generators of radionuclides are generally benign--contend that, throughout the world, little or no measurable impact of radiation accompanies power plants, mine wastes, fuel enrichment facilities, on site waste repositories, plutonium reprocessing facilities, or any of the multiple H-bomb production factories scattered around the planet. In particular, these investigators, many of whom are also prominent and credentialed, hold that no measurable impact occurred at Three Mile Island. Other scientists who cast their lot with Dr. Boice include these and others:
Evelyn Talbott Study
Boice Studies - multiple resources
American Nuclear Society sources
Ad Hoc Interagency Population Dose Assessment Group findings
Boice, Cohen, Mumma, Chadda, Blot: Mortality Among Residents Living Near a Uranium Mill
Little, Hoel, Molitor, etc: New Models for Evaluation of Radiation-Induced Lifetime Cancer Risk
Gonzales, Mason, Clarke, etc: Scope of Radiological Protection Control Measures
Boice, Mumma, Blot: Cancer Mortality Among Populations Residing in Counties Near the Hanford Site, 1950 - 2000
Rahu M, Rahu K, Auvinen, etc: Cancer Risk Among Chernobyl Cleanup Workers in Estonia and Lavtia, 1986 - 1998
While an Expert-'A'-versus-Expert-'B' method of arguing the issues will ultimately produce little or nothing substantive, one point is essential to understand. In noting a lack of "measurable impact," one cannot help being disingenuous--perhaps fraudulent--if one simultaneously rejects all but unobtainable forms of measurement. In evaluating Three Mile Island or the nuclear-power-and-weapons industries as a whole, the citizen would do well to keep in mind a few basic questions. If impacts are unmeasurable without directly metering real human beings and actual dosages, why don't governments insist on such data gathering?
Among a spate of recent monographs that deal with legal, policy , and scientific issues surrounding this important public health question, David Michaels' Doubt Is Their Product resonates with this humble correspondent. Michaels basically establishes a potent argument for believing that current scientific and legal dealings lead to policy processes and decisions governed overwhelmingly by corporate interests.
One reviewer summed up this line of attack.
"The Orwellian strategy of dismissing research conducted by the scientific community as 'junk science' and elevating science conducted by product defense specialists to 'sound science' status also creates confusion about the very nature of scientific inquiry and undermines the public's confidence in science's ability to address public health and environmental concerns. Such reckless practices have long existed, but Michaels argues that the Bush administration deepened the dysfunction by virtually handing over regulatory agencies to the very corporate powers whose products and behavior they are charged with overseeing."
Of course, this would be the same Bush Administration for which no higher expression of 'energetic' perfection existed than a 'new generation' of nuclear reactors.
Another question, plausibly apt: if the only way to have valid results involves long term assessment of workers or residents, then why don't established investigators receive the support to insure that such long-term follow up occurs? These questions are more than reasonable because, without fulfilling such premises as these inquiries contain, the only answer that we'll ever get, with any mathematical certainty, about the negative or negligible results of particular sources and streams of radiation will be that we can discern "no measurable impact."
As Paula Kinney, long-time Harrisburg resident and co-founder of "Concerned Mothers and Women", tells it,
After the accident Dr Takahata announced - he was the head of the health dept - he announced that he was ... going to do a study and follow us, the people within a five mile radius (of the site)... and do it for years. And I was actually so happy about that, because there's nothing we could have done (about the accident), but .. let's learn lessons, including, let's follow the people who've been exposed ... so we can help other people and see what happens with people who live near a nuclear plant, and just your daily releases,[...] I don't know of one person, not one person, who has been followed.
When, as is indisputably the case in the United States, the same forces and sources that swear that radiation has 'no measurable health impact' are also the gatekeepers who withhold information, falsify data, and generally fight tooth and nail to preclude systematic measurement, then the citizen has to recognize that hypocrisy, or something worse, is at least a part of what is happening. So saying, the ensuing list of materials offer insights and ideas about how to contemplate what happened 10,000 days ago near the capitol of the great State of Pennsylvania.
Joe Mangano: Three Mile Island, Health Study Meltdown
Nuclear Accident Report Faulted, by Travis Dunn
Killing Our Own: Did People Die on Three Mile Island?
Science for Sale: TMI and the University of Pittsburgh, by Eric Epstein
Three Mile Island Epidemiologic Radiation Revisited, by R William Field
Three Mile Island at 29: Reactors and Infant Health
Three Mile Island: The People's Testament, by Aileen M Smith
PENNSYLVANIA CANCER REGISTRY--
One indirectly positive result of TMI was the creation of this data bank about cancer. Of course, the fact that it has neither done much or any dosage review nor has it attempted to reconstruct amounts of radiation received severely undermines its utility to determine the effects of either the accident or routine emissions since. Association and correlation are easy to demonstrate, but never causation, which of course is perfect for the industrial and administrative sorts who want nuclear options to remain open without review.
Nevertheless, virtually all studies show some increases in cancer rates in the counties surrounding the plant, though most of them do not discern any 'statistically significant' measure of "relative risk" or deviation from "standardized mortaility ratios." At least a few investigations have taken advantage of the Cancer Registry's compilations, whatever deficiencies these collections have manifested. For example, the following study, by Penn State's Otolaryngology and surgery professor, Roger Levin, studied the "Incidence of Thyroid Cancer in Residents Surrounding the Three Mile Island Nuclear Facility." He noted that
the Pennsylvania Department of Health (PDoH) implemented a TMI Population Registry, including 32,135 individuals within a 5-mile radius of TMI, to track possible health effects to the local population. Although no increase in cancer mortality has been noted in this cohort, cancer incidence has not been tracked. Given the long latency period for the development of thyroid cancer after exposure to low-level radiation exposure, it is plausible that an increase in thyroid cancer incidence might just now be occurring.
The work covered an eighteen year period, long after the Registry itself had ceased any examination of the information that it generated. Dr. Levin's results are as follows:
In the first year available for evaluation (1985), there were 11 new thyroid cancer cases in each of the at-risk counties (Dauphin, York, Lancaster). By 2002, the incidence had increased to 29 in Dauphin County, 81 in Lancaster County, and 69 in York County. The increase in thyroid cancer in Dauphin County is not above what would be expected for both the local population growth and the increase in thyroid cancer incidence in the U.S. population in general. Thyroid cancer incidence was greater than expected in York County for all but 1 year between 1995 and 2002. Lancaster demonstrated a marked increase in thyroid cancer incidence over expected norms throughout the study period. An increase greater than 50% was noted in certain years. No discernible elevation in rates occurred in Daupin County, while Daupin County's increased rate of incidence was statistically significant. York County had noticeably higher rates that lacked statistical signficance.
The conclusion that Dr. Levin reaches is to an extent foreordained, again because the data necessary to prove causation is absent. "These findings, however, do not provide a causal link to the TMI accident."
Again, the Registry itself stopped making assessments in the mid 1980's, though their data have helped researchers to make various assessments, most of which have found slight or negligible impacts that were not statistically significant. On the other hand, a few folks have found substantial and significant elevations of lung cancers, breast cancer, and leukemia in children. In all cases, however, the rub has been to demonstrate causality, which, in the absence of accurate initial measurement and an ongoing commitment to monitoring or ferreting out evidence of exposure is close to a hopeless undertaking.
A brief comment in Public Health Reports illustrated both the promise and the paradox of this post-disaster response.
Shortly after... March 28, 1979, the Pennsylvania Department of Health, in conjunction with the Centers for Disease Control and the U.S. Bureau of the Census, conducted a census of the 35,930 persons residing within 5 miles of the plant. With the help of 150 enumerators, demographic and health-related information was collected on each person to provide baseline data for future short- and long-term epidemiologic studies of the effects of the accident. Individual radiation doses were estimated on the basis of residential location and the amount of time each person spent in the 5-mile area during the 10 days after the accident. Health and behavioral resurveys of the population will be conducted approximately every 5 years. Population-mobility, morbidity, and mortality will be studied yearly by matching the TMI Population Registry with postal records, cancer registry records, and death certificate data. Because the radiation dose from TMI was extremely small, any increase in morbidity or mortality attributable to the accident would be so small as not to be measurable by present methods; however, adverse health effects as a result of psychological stress may occur. Also, a temporary increase in reporting of disease could occur.
This work, our interviews with residents show, was something that most people greeted with relief and enthusiasm.
Eric Epstein and others make clear, however, that the bias apparent in the account above--relying on estimates of releases from the company that had fostered a criminal conspiracy, then asserting such 'low' doses that attendant effects would be so small as "not to be measurable"--soon alienated much community good will for the Registry's work. Law suits were already under way, and sickness that people could count and see was increasing, whether the scientific probity of these observations would ever be demonstrable. And because people are not likely to accede easily the nonexistence of what they can so easily note in front of them, they took further action. Finally, inasmuch as the promises of follow-up and attention went largely unfulfilled, this grassroots uprising was the only course for the afflicted to follow.
THREE MILE ISLAND PUBLIC HEALTH FUND--
Though different sources offer alternate dates for the inception of this adversarial offshoot of the accident, all reports accept that a legal settlement was the source of the multi-million dollar seed money. Dickinson University's note is likely correct, since TMI Alert also backs this chronology. "The Three Mile Island Public Health Fund was established in 1981 to provide remedies to businesses and individuals affected by the accident at the Three Mile Island facility on March 29, 1979. Funding was established as the result of a successful lawsuit against GPU, the TMI plant operator. The Fund is administered by the law firm of Berger & Montague, P.C. All disbursements from the Fund have been approved by the Honorable Sylvia Rambo, Middle Pennsylvania Federal Court.". One charge of the fund has been the furtherance of radiation research, which has happenstancially highlighted the hypocrisy and duplicity of established authorities.
As a 1989 science piece from the New York Times points out,
The TMI Public Health Fund... has spent the last three years in legal battles trying to get the D.O.E. to release records it compiled on 300,000 workers at the nation's principal weapons facilities; many of them are believed to have been exposed to radiation. Dr. Thomas F. Mancuso was hired by the Government in 1964 to study the radiation exposure of 225,000 workers at nuclear-weapons plants; he collected most of the data the T.M.I. fund is requesting. His 15-year study concluded that ''low-level'' exposures significantly increased the chance of developing cancer, and that industry standards for safe levels of exposure were at least 10 times too high. When Mancuso published his findings, the Government fired him and denied him access to his data.
The Mancuso epic is full of sinister twists, apropos for another story perhaps. The upshot is that the TMIFund, after Mancuso had been fighting on his own behalf for years, continuing his work by using up his retirement fund, provided additional support and helped him to hack a path through the courts to achieve simple justice and at least the potential for scientific integrity in the matter. The observer has to note that the Department of Energy, the Nuclear Regulatory Commission, and the utility industry, still seem not to have taken to heart Mancuso's call for openness and honesty. http://www.americanhealthstudies.org...
The conjunction of Mancuso and Alice Stewart, another stalwart scientific backer of the contention that the ill effects of low doses of radiation are insidious, and who had worked as an expert witness in some of the settled TMI lawsuits, ironically resulted from TMI's meltdown. Their work, which government and pro-nuclear investigators labeled "junk science" with religious fervor, is now the BEIR VII gold standard. Moreover, the citizen-initiated data gathering that TMIFund supported also fit with this model that posited measurable health consequences from small exposures to radionuclides, not that this commonsensical, common man acuity has done much to dent the arrogant certainty of so-called mainstream scholarship. One can still find bland assertions that 'no measurable harm' occurred, that exposure to radiation was minimal, and that the only damage was psychosomatic.
For any reader who would like just a small additional taste of the Dr. Mancuso drama and its impact on and intersection with the evolution of the Three Mile Island community, a New York Times Magazine article is quickly accessible. It delves further into the case, beginning with early weapons-program radiation fatalities and injuries for which the government generally and the AEC specifically also sought to avoid any liability. "The Hidden Files: America's Radiation Victims," by Clifford Honicker, does not dig deeply into issues of power plant radiation, but a day of reckoning may be close at hand, even though past mortality and illness has already transpired, and new deaths and sicknesses are now likely unavoidable. As Eric Epstein acknowledges,
"we've got to be adults about it and admit that nuclear is a bridge fuel, but we've also got to insist that the industry and the government live up to their promises"
and make a real effort to look as good in practice as they do on paper.
THE HATCH REPORT--
Respected epidemiologists and other health scientists from Columbia University contributed two major journal posts as the 1990's began. Maureen Hatch led each group, and their work has the imprimatur of being the academically accepted standard for this matter. This humble correspondent excerpts parts of their abstracts below, before commenting briefly on issues of interpretation and approach.
AmJEpid.,1990,vol132, pp397-412 "Cancer Near the Three Mile Island Nuclear Plant: Radiation Emissions"As a public charge, cancers among the 159,684 residents living within a 10-mile (16-km) radius of the Three Mile Island nuclear plant were studied relative to releases of radiation during the March 28, 1979, accident as well as to routine plant emissions. ... Estimates of the emissions delivered to small geographic study tracts were derived from mathematical dispersion models which accounted for modifying factors such as wind and terrain; the model of accident emissions was validated by readings from off-site dosimeters. ... For accident emissions, the authors failed to find definite effects of exposure on the cancer types and population subgroups thought to be most susceptible to radiation. ... Trends for two types of cancer ran counter to expectation. Non-Hodgkin's lymphoma showed raised risks relative to both accident and routine emissions; lung cancer (adjusted only indirectly for smoking) showed raised risks relative to accident emissions, routine emissions, and background gamma radiation. Overall, the pattern of results does not provide convincing evidence that radiation releases from the Three Mile Island nuclear facility influenced cancer risk during the limited period of follow-up.
Cancer Rates..." Am.J.PublHealth; vol 81, pp719-24BACKGROUND: In the light of a possible link between stress and cancer promotion or progression, and of previously reported distress in residents near the Three Mile Island (TMI) nuclear power plant, we attempted to evaluate the impact of the March 1979 accident on community cancer rates. ... A modest association was found between postaccident cancer rates and proximity (OR = 1.4; 95% CI = 1.3, 1.6). After adjusting for a gradient in cancer risk prior to the accident, the odds ratio contrasting those closest to the plant with those living farther out was 1.2 (95% CI = 1.0, 1.4). A postaccident increase in cancer rates near the Three Mile Island plant was notable in 1982, persisted for another year, and then declined. Radiation emissions, as modeled mathematically, did not account for the observed increase.
Both Talbott's numerous studies at the University of Pittsburgh, noted below, and two studies led by Maureen Hatch of Columbia University, "began with the assumption that the maximum possible radiation risk doses from the accident were well below average annual background radiation levels," as Steve Wing and many others consistently point out. Moreover, the assumption of accurate dosimetry from the accident is a matter of dispute. Perhaps most critical are the choices, or necessities, of both studies to 'model mathematically' radiation and received dosages among the population.
An entirely different issue was the decision to study a large population which, as Eric Epstein notes, included a likely majority that had not even been present in 1979. Whatever the pertinence and power of these critiques, Dr. Hatch and her estimable cohorts are on the record as indicating that increased cancers have no demonstrable causal connection to the presence of a nuclear reactor admittedly responsible for the release of a minimum of ten million curies of radioactivity in the early Spring of 1979. Of course, related releases, and emissions from the crippled reactor's sister plant, have continued to this day.
DR. STEVE WING'S WORK--
Steve Wing measures his effectiveness by the accusations of "junk science" from those who refuse to see the contradiction in their methodology. "You just can't ignore the fact that if you don't take measurements," if in other words requisite and biologically viable data-gathering is not a sine qua non of the nuclear industry, "you will never discover any measurable impact." Such approaches would be laughable were they not the province of 'experts' so dismissive and cocksure that the death and disease that clusters in downwind communities were the product of conspiracy theories. Some such vicious and vituperative know-it-alls have dared to state that Occam's Razor is their rationale; here's a clue: cancer causing radiation is a much simpler explanation for cancer than is a combination of labeling people psychotic or delusional and then positing other, unnamed sources that have, in unknown and unexamined fashion, elevated incidences of death and disease.
When Wing shares the experiences that he has had with the nuclear establishment, one might find the temptation powerful to think that such things don't happen in America. Then one recalls Karen Silkwood, Thomas Mancuso, and the casually murderous attitude of nuclear hit-men out to destroy credibility and sow doubt about folks who are competent, even brilliant, for no other reason than that their work collides with inflexible bigotry of atomic ideology.
Like Mancuso, the Department of Energy hired Wing to evaluate Oak Ridge workers' incidence of cancer, fully anticipating that this young professor from the University of North Carolina would prove to be a team player and deliver the 'correct' results that the study sponsors made clear that they expected in advance. When, on the contrary, the initial findings indicated a substantial rise in cancer and other disorders because of exposure to low level radiation,
I got a phone call and a ticket to Washington telling me that I had an urgent conference with the project director.
What follows is bizarre and chilling. At the end of a four hour grilling that failed to shake Dr. Wing's confidence in his evaluation, he stated flatly: "the numbers are clear; they don't lie."
His boss was equally dead-pan:
Well you just head on back home then until you come up with better numbers.
As with the pillorying of Stewart, Gofman, Mancuso, and others before him, he had met head-on the duplicity of convenience characteristic of both the nuclear industry and its 'overseers' in government. Wing did not waver from the uncomfortable path of scientific integrity, though it cost him this grant and was his first encounter with the cottage industry of character assassination that is the standard operating procedure of the atomic establishment. Luckily for those of us who care about humanity and the human condition, Steve Wing has also played a prominent part in the Three Mile Island waltz of weirdness.
"Objectivity and Ethics in Environmental Health Science" appeared in Environmental Health Perspectives six years ago. Wing expands on the conundrums of seeking a ticket to testify in court when one cannot state a definite conclusion, but only likelihoods and strong possibilities, noting the restrictive requirements of the "Daubert Standard," which will be a part of the next section of this retrospective set of essays. He argues that "strong objectivity" requires an attention to social responsibilities and the political and economic context of scientific work and knowledge. His abstract proffers that
During the past several decades, philosophers of science and scientists themselves have become increasingly aware of the complex ways in which scientific knowledge is shaped by its social context. This awareness has called into question traditional notions of objectivity. Working scientists need an understanding of their own practice that avoids the naïve myth that science can become objective by avoiding social influences as well as the reductionist view that its content is determined simply by economic interests. A nuanced perspective on this process can improve research ethics and increase the capacity of science to contribute to equitable public policy, especially in areas such as environmental and occupational health, which have direct implications for profits, regulation, legal responsibility, and social justice. I discuss research into health effects of the 1979 accident at Three Mile Island near Harrisburg, Pennsylvania, USA, as an example of how scientific explanations are shaped by social concepts, norms, and preconceptions. I describe how a scientific practice that developed under the influence of medical and nuclear physics interacted with observations made by exposed community members to affect research questions, the interpretation of evidence, inferences about biological mechanisms in disease causation, and the use of evidence in litigation. By considering the history and philosophy of their disciplines, practicing researchers can increase the rigor, objectivity, and social responsibility of environmental health science.
Dr. Wing also published the reanalysis of the Hatch Report that was the most powerful basis for victory in the ultimately unsuccessful class action law suit that took twenty years after Three Mile Island to resolve. Having criticized the assumptions and methodological problems of Ms. Hatch's team's work, Dr. Wing and his colleagues produced "A reevaluation of cancer incidence near the Three Mile Island nuclear plant: the collision of evidence and assumptions" for the 1997 EHP. An abstract and an excerpt follow.
Previous studies concluded that there was no evidence that the 1979 nuclear accident at Three Mile Island (TMI) affected cancer incidence in the surrounding area; however, there were logical and methodological problems in earlier reports that led us to reconsider data previously collected. A 10-mile area around TMI was divided into 69 study tracts, which were assigned radiation dose estimates based on radiation reading and models of atmospheric dispersion. Incident cancers from 1975 to 1985 were ascertained from hospital records and assigned to study tracts. Associations between accident doses and incidence rates of leukemia, lung cancer, and all cancer were assessed using relative dose estimates calculated by the earlier investigators. Adjustments were made for age, sex, socioeconomic characteristics, and preaccident variation in incidence. Considering a 2-year latency, the estimated percent increase per dose unit +/- standard error was 0.020 +/- 0.012 for all cancer, 0.082 +/- 0.032 for lung cancer, and 0.116 +/- 0.067 for leukemia. Adjustment for socioeconomic variables increased the estimates to 0.034 +/- 0.013, 0.103 +/- 0.035, and 0.139 +/- 0.073 for all cancer, lung cancer, and leukemia, respectively. Associations were generally larger considering a 5-year latency, but were based on smaller numbers of cases. Results support the hypothesis that radiation doses are related to increased cancer incidence around TMI. The analysis avoids medical detection bias, but suffers from inaccurate dose classification; therefore, results may underestimate the magnitude of the association between radiation and cancer incidence. These associations would not be expected, based on previous estimates of near-background levels of radiation exposure following the accident.
Not only does this study find a significant relationship between TMI radiation releases and cancer incidence, but it also suggests that understating the corrrelation is quite plausible.
Rather than engage in a my-expert-is-better-than-yours pissing contest, this humble correspondent merely asks that readers, who are in fact capable of reflecting honestly about such complex and controversial matters if they so choose, consider the reasoning and good sense that Dr. Wing displays. Changing minds is not the point; listening and thinking is.
We reanalyzed the TMI cancer incidence data for two reasons. First, some of the symptoms reported at the time of the accident are consistent with acute responses to high dose radiation, and recently reported cytogenetic studies of persons reporting such symptoms suggest accident doses of 600-900 mGy [8,9]. Because the authors of the previous study did not consider the possibility of serious underestimation of doses, there was a logical inconsistency between the hypothesis they addressed,"that risks of specified cancers may have been raised by exposure to radiation emanating from the Three Mile Island nuclear power plant" [5, p. 398], and the assumption that doses were too low to cause cancer. This assumption led the authors to conclude that associations which were demonstrated as evidence relevant to the study hypothesis did not support the hypothesis.
Second, the original study suffered from a number of methodological difficulties [5]. Only rare cancers with presumably shorter latency were considered as primary outcomes, greatly limiting statistical power, despite the fact that ionizing radiation is a general mutagen and immune suppressant that can induce most types of cancer [3,4]. It is important to note that increases in cancer incidence following radiation-induced immune system suppression begin months to a few years after exposure [4], well within the time frame of this study. The sensitivity of analyses of one primary outcome, childhood cancers, was reduced by failure to consider birth cohorts in the analysis [5]. Finally, although the investigators collected both pre- and post-accident cancer incidence data, they did not use those data to correct estimates of accident effect for pre-accident geographic variation in cancer incidence.Our re-analysis addresses these logical and methodological problems by (1) considering associations between cancer incidence and relative dose as an indication of the coincidence of cancer increases with plume travel, which allows the epidemiological analysis to be interpretable as an indicator of higher doses; (2) focusing on types of cancers that occur with sufficient frequency to increase the statistical power of the analysis; (3) using an analytical model to correct cancer-accident dose associations for pre-accident variation in cancer incidence; and (4) correcting for errors in data used for the previous analyses. We also interpret the results in the context of the strengths and limitations of the design of the study.
When one looks abroad, as eventually this humble correspondent will do for folks, one can find--in Spain, in Germany, in England, and in France--a much more developed methodology and government mandate for radiation studies. Only one such thinker appears here, a Russian instrumental in that country's management of the only nuclear accident in history worse than three Mile Island.
DR. VLADIMIR SHEVCHENKO--
This respected biologist from the former Soviet Union, who was a leading component of monitoring and trying to ameliorate the impacts of Chernobyl, came to Pennsylvania to testify for plaintiffs in their ultimately losing attempt to receive recompense from Metropolitan Edison, General Public Utilities, et al. Ultimately, though the court acknowledge his expertise and the validity and applicability of his findings, Judge Sylvia Rambo dismissed his right to draw a conclusion from his data, thereby eviscerating the legal effect of what he had discovered. More about this will appear in the next installment.
Dr. Shevchenko was able to show that damaged trees were indicative of relatively high radiation exposure in several locations in and around TMI, just as other experts have long tabulated animal impacts of the accident that show a much higher likely dose than ever acknowledged.
He also took blood and tissue samples from around 30 of the plaintiffs and returned to his labs in Russia, where, using protocols that Judge Rambo admitted were arguably sound, he performed cytogenetic analysis on the samples. This permits a determination about whether dicentric chromosomal abnormalities are present. Such deviation from the norm is a clear likely marker of radiation damage from significant dosages. His lab's analysis found such dicentric chromosomes in four of the first batch of blood samples that it examined. However, the good doctor was prohibited by the court from offering his expert opinion on the likely doses of radiation that must have been present to cause this damage.
An article from the University of North Carolina noted the collaboration between Dr. Wing and Dr. Shevchenko and put their efforts in perspective.
At the time of the accident, TMI-2's core was 90 percent melted. Radiation detectors at the plant went off-scale. Pennsylvania Governor Thornburgh advised pregnant women and young children to evacuate, causing over 100,000 people to flee.
In the 1980s, local activists brought TMI survivors to the Triangle to report incidents and symptoms such as illness, cancer, animal deaths and the widespread mutations of plants (dandelions with 2-foot-long leaves).
Government officials and the nuclear industry have always denied that people were exposed to any significant radiation from this major accident.
Other researchers have also found evidence of high doses of radiation from the TMI accident. Using a "radiation meter" to detect highly radiation-specific mutations (dicentric chromosomes), Russian researcher Vladmir Shevchenko analyzed human blood cells from people who lived near TMI at the time of the accident. He found evidence that radiation exposures were similar to exposure of so-called "liquidators," clean-up workers at the Chernobyl nuclear accident.
A control group of Pennsylvanians, matched for characteristics other than TMI-exposure, had levels of these mutations similar to unexposed control groups in other radiation studies.
Increases in cancer rates in communities downwind from the TMI reactor fits with Shevchenko's work. Co-author Dr. Steve Wing of UNC-CH notes that the increased occurrence of cancer in those areas "only happened after the accident."
Previous researchers blame the elevated rates on stress.
"The medical community in the USA has been mostly hostile for many years to the idea that stress can cause disease, yet when cancer is detected near nuclear power plants, suddenly they say stress is a credible explanation,"
said Wing.
"Lung cancer went up two to four times in areas directly in the pathway of plumes of radioactivity. Leukemia rates were eight to 10 or more times higher." These figures compare the most exposed areas to less-exposed areas, all within a ten mile radius of TMI.
Researchers adjusted estimates of the association between radiation doses from TMI and cancer for the baseline (pre-accident) cancer rates. A relatively simple statistical approach was used from data collected previously.
Of course, industry technicians and other acolytes of atomic shamanism rudely and crudely ridiculed this Russian American collective effort in much the same way as they blithely rejected any and all findings that dismembered their preconceived worldview and presumptions. Given the vitriol and libel with which the nuclear holy men greet brilliant scientists, the reader can assume that the next chapter, by someone as lowly as this humble correspondent will merit particular disdain among the pro-nuclear crowd.
Manana's text permits those who are following along to review the development of powerful citizen science efforts, juxtaposed to the work of Evelyn Talbott, whose studies join Dr. Hatch's work atop the accepted heap of the nuclear establishment. In any case, tomorrow's material will conclude this examination of the evidence and underlying thinking about nuclear safety and community impacts. As always, honest critique--and even the blessed attention of the trolls--is welcome.