Use of A-bomb survivor studies as a basis for nuclear worker compensation. (Correspondence).
Epidemiologic studies depend on accurate exposure classification for valid dose-response estimation. In addition to selective survival in a population subjected to nuclear attack and subsequent devastation of public health infrastructure, radiation-cancer dose-response estimates from A-bomb studies are further affected by a lack of individual dose measurements and the use of dose reconstruction based on interviews conducted in an occupied nation by a scientific team funded and directed by the U.S. government (Wing et al. 1999). The ability to elicit accurate information on location, position, and shielding was affected not only by traumatization of the survivors and their domestic stigmatization but by their distrust of medical teams working under occupation forces (Lindee 1994).
As Parascandola (2002) noted, we believe that findings from carefully conducted epidemiologic studies of badge-monitored nuclear workers exposed to chronic, low-level ionizing radiation should be considered in implementation of the Energy Employees Occupational Illness Compensation Program Act. Medical practices regarding exposures of pregnant women to diagnostic X rays were changed decades ago on the basis of low-dose studies, even though their findings were not predicted from studies of A-bomb survivors. The question today is, will A-bomb studies continue to dictate estimates of cancer risks in adulthood, despite evidence of bias and the availability of alternative epidemiologic data? The large number of highly exposed survivors in the study, cited as a major strength, may actually be a weakness if it encourages scientists and policy makers to confuse statistical precision with valid dose--response estimates that depend on an absence of selective survival and correct exposure classification.
Steve Wing David Richardson Department of Epidemiology School of Public Health University of North Carolina E-mail: email@example.com
Doll R, Wakeford R. 1997. Risk of childhood cancer from fetal irradiation. Br J Radiol 70:130-139.
Lindee MS. 1994. Suffering Made Real: American Science and the Survivors at Hiroshima. Chicago:University of Chicago Press.
McMahon B. 1962. Prenatal X-ray exposure and childhood cancer. J Natl Cancer Inst 28:1173.
Parascandola M 2002. Compensating for cold war cancers. Environ Health Perspect 110:A405-A407.
Richardson DB, Wing S, Hoffmann W. 2001. Cancer risk from low level ionizing radiation: the role of age at exposure. Occup Med 16:191-218.
Stewart A. 1985. Detection of late effects of ionizing radiation: why deaths of A-bomb survivors are so misleading. Int J Epidemiol 14:52-56.
--. 1997. A-bomb data: detection of bias in the Life Span Study cohort. Environ Health Perspect 105(suppl 6):1519-1521.
--. 2000, The role of epidemiology in the detection of harmful effects of radiation. Environ Health Perspect 108:93-98.
Stewart AM, Webb J, Giles D, Hewitt D. 1958. Malignant diseases in childhood and diagnostic irradiation in utero. Lancet 2:447.
Wing S. 2000. The influence of age at exposure to radiation on cancer risk in humans. Radiat Res 154:732-733.
Wing S, Richardson DB, Stewart A. 1999. The relevance of occupational epidemiology to radiation protection standards. New Solutions 9:133-151.
|Printer friendly Cite/link Email Feedback|
|Publication:||Environmental Health Perspectives|
|Date:||Dec 1, 2002|
|Previous Article:||"Bioassay bashing is bad science": MacDonald's response. (Correspondence).|
|Next Article:||Rice and rice blast: new bases for comparison. (Agriculture).|