DOSE HYSTERIA
Wednesday, March 17, 2010 at 03:00AM March 2010 Vol. XXVIII, No. 2
A 90-year-old man approached me at a social event because of a New York Times article about the radiation danger of medical imaging. He had anxiously searched his medical records and found that he had had a CT scan. How much should he worry?
A patient with terminal pancreatic cancer reportedly refused a CT scan ordered by his oncologist because he was worried about radiation (Diagnostic Imaging 2/16/10).
Numerous articles in the medical literature list the doses delivered in various imaging procedures, and calculate a large number of potential future radiation-induced cancers. There are no actual excess cancers–in fact it would be too soon to see them. All calculations are based on the implicit, unquestioned assumption of the linear no-threshold hypothesis (LNT), and completely neglect the possibility of hormesis (search www.ddponline.org for past discussions of these subjects).
Radiation doses received by Japanese atomic bomb survivors–1% of whom developed leukemia, cancer, or life-shortening–were tens of thousands to hundreds of thousands times higher than we receive from natural background or medical procedures, notes Martin Sturman, M.D., of Mathemedics (Second Opinions Newsletter 3/31/10).
Dose hysteria may prevent the approval of new medical procedures and expanded use of advanced noninvasive imaging. It could impede an urgently needed renaissance in nuclear energy. And it could cause fatal panic in the event of a nuclear detonation.
About 70 million CT (computed tomographic) scans are performed in the U.S. each year. The FDA is stalling on approval of CT colonoscopy (Gardiner Harris, NYT 3/28/10).
Hot-tub size 25 MW nuclear reactors costing $30-$50 million, capable of powering 20,000 homes, could be available by 2013. They could produce electricity for about 10 cents/KWH. There are no moving parts, and no operators would be needed. The Union of Concerned Scientists, however, warns that they could be targets for terrorism–although buried 15 feet underground (Fortune 3/22/10).
During World War I, the use of poison gas was announced in advance, so that the troops' fear reaction would cause them to breathe faster, thus increasing the effectiveness of the gas, writes Stephen Jones. During the Cold War, preventing panic was the core of American civil defense strategy. Now, however, Americans have been taught to dread even tiny doses of radiation, he states. Radiation science has been eliminated from public education for two generations. “Why is this?” Jones asks.
The Chernobyl accident, the worst possible catastrophe of a nuclear power station, continues to have an enormous political, economic, and social impact, largely because of dose hysteria resulting from the LNT. A complete core meltdown and 10 days of free emission of radionuclides into the atmosphere resulted in the early death of only 31 persons. That is 0.86 death/GWe-year of Chernobyl's electricity generation, 47 times lower than for hydroelectric stations (40/GWe-year). While thousands of late cancer deaths were predicted, a 15% to 30% deficit of solid cancer deaths was actually observed in Russian emergency workers, and a 5% decreased cancer incidence in the most heavily contaminated areas. The registration of excess thyroid cancers is almost certainly the effect of intensive screening, as occult thyroid cancers (“incidentalomas”) are very common. Thyroid cancers decreased with higher doses (http://www.dx.doi.org/10.2203/dose-response.09-029.Jaworowski).
Figure on p 2: www.nuclear.utah.edu/class_notes/shared/dose_ranges_aug05.pdf.
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