Ionizing Radiation and Human Health
One of the earliest comments upon the interaction between human bodies and ionizing radiation was made by the UK physicist, Ernest Rutherford in his diary. He had attended a celebratory tea at the home of Marie and Pierre Curie after she received her doctorate in 1903. Upon seeing Pierre Curie’s deformed hands, Rutherford’s note in his journal stated that they were “the typical deformations that developed by working with radiation”.
Henceforward the text will follow Dr. Rutherford’s lead and use the term “radiation” interchangeably with “ionizing radiation”.
X-rays and gamma rays have the same properties except that x-rays can be turned off. X-rays can be used as stand-ins to determine the effects of gamma rays. Although they are generally less penetrating, they are readily measured. The resulting effects will underestimate the effects of gamma rays. Pierre Curie was working with gamma rays - and alpha and beta - however the gamma rays were the likely culprit for his hands.
Thomas Edison, the US inventor of the light bulb, had worked briefly with x-rays and developed burning eyes and scaling hands. He left any further experiments to his assistant, Clarence Dally, who not only developed the same changes in his hands as Pierre but eventually widespread bone cancer (osteosarcoma). He suffered greatly and even had his hands amputated before dying in 1904.
Edison said, “Don’t speak to me of x-rays, I’m afraid of them.”
Ironically, Edison’s goal had been to develop a means to focus x-rays. Radiographers had been using their hands with the same results as those of Edison’s assistant. At that time and through to the 1930’s it was believed that exposure to radiation was safe as long as it didn’t cause skin reddening – or alternatively, if the skin reddening resolved during a period of rest from exposure.
The early fascination with radium led to its widespread advertising and use by all kinds of charlatans as a cure-all for everything from menstrual cramps and headaches to impotence and anal warts. Physicians were especially drawn into the fray through a method of kick-backs for their prescriptions.
Radium had a practical use on instrument dials and watches during and after WWI because it glowed in the dark. Someone had to put the radium on the dials and consequently young women, a few as young as 12, were recruited in droves.
For almost two decades the industry denied any health dangers and emphasized the so-called health effects in what should have been one of the largest malpractice suits in history. Even though the men in authority avoided contact with radium salts and those in company labs wore some sort of protective clothing, the nascent radioactive nuclear industry told their workers that radium was safe. They kept up with this mantra even as the young women, the dial painters, developed anemia, deformities, osteosarcomas and died.
The first nuclear bombs were built by an extensive team, referred to as the “Manhattan Project”. They paid attention to the results of the court cases that eventually ensued from the dial painters’ history. The head of their medical team made a special effort to speak to doctors and lawyers involved with the “radium girls”. Hence, they handled their products carefully Unfortunately they didn’t extend that care to the environment; they were very careless with their radioactive waste and experimental by-products.
During the Manhattan Project the first victims of very high dose exposures occurred. The victims were hospitalized and followed through to their eventual deaths. Those exposed to greater than 10,000 mSv had the same outcome no matter how quickly or how well they were treated. Death came over a period of weeks[i].
So many chemical bonds were disrupted that the victims became bags of broken molecules and ions, their cellular structures broken down. An exposure of 20,000 mSv or more resulted in coma and death within 24 hours.
In neither case was death painless.
By observing soldiers, pilots and sailors, the medical teams for the project were able to establish benchmarks for other exposures.
50 – 100 mSv changes in blood chemistry, anemia
400 – 500 mSv nausea, vomiting, poor coordination
700 mSv everyone vomits
750 mSv hair loss within two weeks
1000 mSv hemorrhage
4000 mSv death within months[ii]
But what of doses below these? What does 5 mSv do over time? 10 mSv? The nuclear industry maintains that low-dose exposure has such a low health effect that we can basically ignore it, and that we’ve had generations of exposure to background radiation so we have learned to live with it and further exposure is basically harmless. This “harmless” rhetoric is repeated by many medical personnel and dentists who request panoramic dental x-rays annually.
It is not true. The United States National Academy of Sciences has examined the question of low dose for decades and intermittently produced a document called the Biological Effects of Ionizing Radiation (BEIR). In BEIR 2007 their report concluded that every exposure has the potential to cause damage to humans.
How does ionizing radiation harm human cells?
By now most people know that when we speak of “ionizing radiation” we speak about the release of particles and rays. The particles are alpha particles – relatively large in the atomic world, made up of two protons and two neutrons, the size of a helium nucleus – and beta particles, tiny electrons. The rays are gamma rays and x-rays, x-rays being the only artificially produced radiation that can be turned off and on with a switch. They are all energetic with different degrees of penetration – alpha particles are stopped by skin; beta particles pass just through the skin and x-rays and gamma rays pass completely through a human body.
This would make x-ray and gamma rays seem to be the most dangerous, but they are more like bullets from a high-powered rifle, only causing damage if they hit something. Alpha and beta particles are up to 20 times more dangerous when they are internal (by eating or breathing). Instead of a bullet, they are more like hand grenades, exploding randomly.
When any of these particles or rays interact with any substances and especially biological matter, they cause ions. They oxidize enzymes, proteins, genetic material – any molecules with which they come in contact. Sometimes the damage can be repaired, sometimes it cannot, and the cell replicates the damage or dies. Sometimes the damage affects the way a cell replicates itself and sometimes it affects the very process of replication itself.
Diagram from text.
This is what happens when a tumour is formed. A cell “goes wild” and doesn’t know when to turn off its growth.
If radioactive dust is inspired or eaten, the release of radioactivity occurs in the body. If it is radium dust, the release of radioactivity continues for as long as the tiny bit of radium is present or 1640 (the half-life of radium) x 10 = 16,400 years.
It is called ionizing radiation because that is exactly what it does, It ionizes what it comes into contact with.
To answer the question, how dangerous is the radiation that we call “background” radiation, the radiation that we cannot avoid? Some European researchers compared the incidence of cancers in children who lived in areas with low background radiation (0.70 mSv) to those who lived in areas with higher background radiation (2.3 mSv). Every tumour marker studied was higher in the children with the higher background radiation.[iii]
Diagram from Swiss study
What is the evidence for radiation’s health effects?
In 1962 Dr. John Gofman was recruited by the US Atomic Energy Commission to head a biomedical unit. He was told that “the AEC was on the hot seat because a series [of atmospheric atomic bomb tests] had clobbered the Utah milkshed[iv]with radioiodine. And they have been getting a lot of flak. They think that maybe if we had a biology group working with the weaponeers at Livermore[v], such things could be averted.”
The recruitment came with a very generous budget – 3 million dollars (almost three trillion dollars in 2020 dollars). John surrounded himself with scientists and technicians along with an outstanding colleague, Arthur Tamplin.
The AEC sent him for his first task as the chair of the biomedical unit to squash a research paper[vi] by Dr. Harold Knapp, that concluded a one hundred fold increase in the amount of radiation received from fallout by the people who lived in the downwind areas. He and five other experts reviewed the data, asked a couple of technical questions and concluded that the research was scientifically sound and ought to be published.
The Atomic Energy Commission balked, “we’ve told these people [in the fallout zone] all along that it’s safe and we can’t change our story now.”
Gofman’s committee remained firm.
It was clear that Gofman was not a lapdog hireling. When his department could not support the “Plowshares Project”[vii], the use of atomic bombs for “good”, they became known as the “enemy within”. Gofman thought that they were being teased and it was all in fun, but this was the beginning of his hazing.
In 1969, Dr. Ernest Sternglass published some research papers claiming that up to four hundred thousand children might have died from radioactive fallout from bomb testing. It received popular coverage in Esquire under the title “The Death of all Children”. In response to the AEC’s request, John’s colleague Arthur Tamplin re-calculated the data and his result was an estimation of four thousand. Unfortunately, the AEC was still deeply displeased. The only answer they wanted was zero, zero children affected.
The Atomic Energy Commission had been promoting a “safe threshold” of radiation below which no health effects could be detected. A safe threshold was important to the industry. It made it possible to expose servicemen to atomic bomb tests, for workers in nuclear power plants to receive yearly doses of radiation and for people living near nuclear power plants to receive regular discharges of radiation. Drs Gofman and Tamplin estimated that the cancer risk from radiation was twenty times as bad as the most pessimistic estimate previously made.[viii] Not only did they conclude that the risk was high, but they also concluded that there was no safe amount of radiation and that it could be assumed that there was some risk all the way down to zero.” They presented their research at the Institute for Electrical, Electronic Engineers (IEEE) meeting in October 1969. A month later, John was invited to give the same paper to hearings convened by Senator Muskie.
Their research was picked up by the Washington Press. Rumors started to fly in the AEC lab. John heard that he “didn’t care about cancer at all and that he was trying to undermine national defense”[ix]. (He had already resigned his directorship of the laboratory but remained as a research associate.) Dr. Tamplin was punished by the firing of his research staff.
When John was called before the Joint Committee on Atomic Energy, a Congressional committee, he and Arthur reviewed all the data they could find. They concluded that “as a matter of fact, that we’d underestimated the hazard of radiation when we’d given the Muskie testimony”. They wrote fourteen more research papers. John’s main research was now into chromosomes and their response to radiation. He applied elsewhere for funding to continue, including the Cancer Society but their research funding had dried up. The AEC had to restructure its biomedical unit; it had discovered that doctors and health researchers were hard to control.
At the same time, two scientists with the Union of Concerned Scientists had revealed that AEC didn’t know if the cooling system for a type of reactor would or wouldn’t work. On top of other bad publicity, that news ended any credibility held by the AEC.
The government abolished it and created two new agencies: ERDA (Energy Research and Development Agency) and NRC (Nuclear Regulatory Commission), the former to oversee research and the latter to regulate the industry.
Drs John Gofman, Arthur Tamplin, and Harold Knapp were harassed, ridiculed, and sidelined when their research showed that radiation affected health.
Drs. Linus Pauling, Alice Stewart and Herman Muller suffered similar fates. The US desire for nuclear arms required nuclear power plants and the nuclear industry was not about to be stopped. Opposition was futile.
To be clear, the ways in which scientists can be harassed might be subtle, for example, their research doesn’t get published or blatant as in public ridicule, not merely their research but also their person. Lies are spread. Their funding is cut off or they are called to defend their positions in industry or in colleges and universities. In fact, many cannot afford to dissent or publish material that might be deemed critical of the nuclear industry.
Dr. Ernest Sternglass defended his research before a US Senate hearing in favour of a ban on atmospheric nuclear bomb tests. His interest in infants stemmed from his own son’s death from Tay Sach’s disease[x] which led him to question the safety of the genes his father, who was a radiologist in the days when they took no precautions, would have passed on as his inheritance.
The “400,000 dead babies’ theory” was simple mathematics. Every year starting well before atmospheric atomic testing counties had public health numbers for the numbers of babies born and the numbers of babies that reached their first birthday. As health care, vaccinations and antibiotics became widespread and better food became available, there were more children reaching their first birthday. Then suddenly when atmospheric testing starts to occur, the number of one-year-olds flat-lines.
Dr. Sternglass had simply looked at the birth registries in the counties around the nuclear testing site and compared them to the number of one-year olds. From the mid-1930’s the number of children making it to their first birthday was steadily increasing. Then the testing starts and the number of those making it to their first birthday flat-lines until the first Test Ban Treaty occurs in 1958. The numbers then returned to the previous healthy trend. After a brief flurry – including headlines in Time magazine – his work was mothballed.
Dr. Linus Pauling received a Nobel Prize for much of the same research results. And then there is the little known paper published by a public health nurse in one of the counties who saw this decrease in one-year-olds after the Trinity test in July 1945.
Several other studies claiming the role of radiation in disease occurred in quick succession. Dr. Alice Stewart in the UK had uncovered a link between x-rays in the mothers and leukemia in the offspring. She found such a strong link that she says, “by the time we reached 32 pairs[xi] [of controls and leukemia victims], it was there”.
In the USA, Dr. Rosalie Bertell, an epidemiologist working on a project – the Tri-State Leukemia Survey – one of the goals of which was to determine why a rare disease in children was suddenly becoming more common. The researchers found that the use of x-rays on the mothers in their pregnancies was associated with a two-fold increase in leukemias in the so-exposed offspring. What was surprising was that they showed increased leukemias throughout their lives.
The medical profession and the nuclear industry desperately wanted to believe otherwise. A third study out of Harvard done by Dr. Brian MacMahone, epidemiologist, found the same results[xii].
The nuclear industry, if it acknowledged Drs Pauling and Sternglass’s findings, did so dismissively stating that more research must be done. With respect to Drs Stewart, McMahon and Bertell, the industry made the most of the fact that x-rays are not gamma rays (the naïve public accepted this fraudulent distinction.
It was only a decade later, in the medical class (my class) in 1976 at the U of Saskatchewan, the obstetrics professor told us how to do pelvimetry, calculating the size of a pregnant woman’s pelvis with x-rays but also said that the practice was “now frowned upon”. He was opaque about why.
In 1979, Dr. Bertell had become obsessed with determining how radiation affected the human body. She had been surprised at how far a single x-ray could affect cells and became interested in chromosomal breakage. She turned her research towards nuclear energy because it was also ionizing radiation.
She was invited to meet with workers at Erwin, Tennessee who were striking – not for higher wages but for the right to retire at age 55 and collect a pension. They didn’t believe that they would live to age 65.
One man asked her what was meant by blood in his urine. Every single man present had the same complaint. Rosalie says, “Out of a hundred
workers, a hundred had experienced gross blood in the urine.”
The social pressures on them were great, they were being accused of being “unpatriotic.” They were striking against the Navy. The Cold War was in full swing and the Navy needed the fuel rods that they made. Because they’re asking for retirement at age fifty-five, their demands seemed unreasonable to the ordinary American worker. In addition, there was a personal risk. Because of their long history of working with radioactive material, they are unemployable elsewhere. Although the industry was continuing to deny the health effects of their work, public knowledge was such that no other employer would assume liability for a worker who had worked that long with radioactive materials. They couldn’t retire under the present system. They didn’t feel physically fit to continue.
Rosalie said, in 1970’s slang, “This is heavy, this whole thing is heavy.”[xiii]
She tried to get blood samples in order to do a limited survey of several workers but the union doctors failed to get the sample or deliver them promptly. After Rosalie contacted the doctors, union leaders were jailed and the men forced back to work.
When the Erwin plant was closed because of an unexplained loss of plutonium, the workers were dispersed and silent about their experience. Dialogue that Rosalie had with workers at the Rocky Flats, Colorado plutonium plant and the enrichment plant in Paducah, Kentucky convinced her that there were real worker problems. However, she kept running into stonewalls when she tried to do any worker follow-up. At the West Valley plant, she hit a legal blockade and a most suspicious “reorganization” of the Erie county Departments with dissolution of the Environmental Health section. The official who was supportive of a study was fired. The nuclear Industry had deep pockets and a broad net of influence. They were not about to risk real statistics.
Sometimes they had to accept real statistics. In Canada, a study of uranium miners in Northern Saskatchewan established a connection between uranium mining and lung cancer. The original Eldorado study (named for the mining company) was published in 1986. It counted lung cancer deaths among miners from 1948 to 1980 who had been working at Beaverlodge and Port Radium mines.[xiv]
There were almost twice as many cancer deaths among miners than among a cohort of non-miners. They also found, perhaps not surprisingly that the higher the dose of radioactivity, the greater the risk of lung cancer.
There are many more tales of how research into the connection between human health and radioactivity is blocked, ignored, or simply not performed. Witness the silence in North America of the National Cancer Associations. In order to do research, the funding, the subjects, the equipment and the researchers must all be in synch. The industry can sabotage any step.
Kikk Study
Although several English and French studies had shown a link between radioactive emissions and children’s leukemia (a cancer of the blood), there was huge resistance to accepting their findings. The industry found fault with all of them.
However, enough people in Germany were concerned about the increase in leukemia in children living close to nuclear power plants that they endeavoured to do the “definitive study”.
The researchers included people of every political bent and various backgrounds with respect to nuclear power – they tried to create a research board that could not be criticized as “biased”. They chose children living within different distances, 5, 10, up to 25 km from the plant and paired them with children outside of those areas.
They used the data from the nuclear power plants to calculate the average amount of radiation that each child likely received.
They concluded that there was a distinctive increase in leukemia that also increased the closer the child was to the nuclear power plant. When they wrote up their conclusions, the scientists said that they didn’t know why.[xv]
Critical examination revealed what happens. Nuclear power plants release tritium (and other gasses) intermittently, like puffs, but they average the emissions over three months. What looks like a steady low dose release of tritium is actually a bunch of higher dose radioactive puffs.
Why is this not more widely known? When people know a case of leukemia, they quickly become concerned but if they have never had such a case in their friends, neighbours or co-workers, it is like it never happens. Leukemia is a rare disease. So rare that many physicians, including myself, may never had made the diagnosis. To find an increase in incidence should be an alarm bell that really clangs.
The entire history of ionizing radiation has been damaging to human beings. It is amazing that something (radium) that could be shown to cause deformations in the very hands that held it would hold such public fascination. From radium-painted watch dials to cancer treatments, the fascination remains unabated.
In 1976, a professor, Dr. Fedoruk tossed a well-protected glass vial at me, “catch” she said. I caught it at which moment she announced that it contained radioactive iodine. I was visibly pregnant, and she might have chosen me for her little demonstration because as I returned the vial, she said, “See, it didn’t hurt you.”[1]
The incident spurred me to research which entailed many visits to the university library with two children in tow. My husband had a summer job working in Northern Saskatchewan, so he was mostly not home. The literature was fairly light on radiation, the subject of my fascination.
The question that my 1962 physics professor asked had stayed with me, “have they discovered a way to deal with nuclear waste”? I was certainly unclear about health risks. I became a member of the International Physicians for Prevention of Nuclear War (IPPNW). In its early iteration, it did not oppose nuclear power.
Committing to activism in the 1970’s was hardly in the cards. I was in my final year of medical college, mother of two children, partner to someone who was already an activist, - I didn’t have any extra time or energy.
But now it is 2023, and I no longer have babies but I do have a grandchild. I am appalled that we are still spewing ionizing radiation into their atmosphere. And pretending that it is ok. Maybe they will be fine but what of the next?
As Dr. Gordon Edwards says, “Who is speaking for our grandchildren?”
Are we still questioning the safety of ionizing radiation? Nuclear industry leaders are delighted to remind me that physicians are the leading causes of the radioactive “burden” that most people carry.
What is less well known is that the medical profession has inadvertently conducted research on children, and on women. There are hundreds of incidences of which only a few examples are listed here:
1. Radiation-Induced Meningiomas:
In the early 1900’s until after the discovery of topical anti-fungals[2] in the late 1950’s, the treatment of choice for fungal or yeast infections of the scalp was irradiation. The technique exposed the scalp to 5 – 8 Gy to the scalp, and 1.4 – 1.5 Gy to the surface of the brain. Initially it seemed like a safe thing to do.
But then a report of somnolence (sleepiness) lasting from 4 – 14 days in 30 of 1100 children occurred. By the 1930’s delayed side effects included atrophic changes to the scalp, epilepsy, hemiparesis, emotional changes and dilatation of the brain’s ventricles.
The death knell to the practice occurred in a New York University Medical Center which compared 1908 people treated with irradiation to 1801 patients who had not been irradiated. Those exposed to radiation had nine cancers vs only one in the non-radiated. A report ensued that pointed to increased rates of psychiatric hospitalizations.
Studies continue to roll in – the latent phase for meningioma is approximately 30 years but the metastatic tumours may take over 40 years to develop. No one irradiates scalps for ringworm anymore.[xvi]
2. Treatment of tuberculosis using chest fluoroscopy:
Between 1925 and 1954, one of the therapies for tuberculosis was collapse of the lung followed by x-Ray fluoroscopy. More than 2500 of these patients were followed for 30 years. Increases in the rate of cancer of the breast was not seen until about 10 to 15 years after first exposure[3]. There were 147 breast cancers in the treated cohort compared to 113.6 in tuberculosis patients that were not treated with fluoroscopy. The researchers concluded that younger women were more likely to develop cancer and that the risk of developing cancer remained high for their entire lives.
The fluoroscopic and x-ray doses were known. Another interesting finding from this study was that fractionated doses[4] had the same risk of developing cancer as the single total dose.[xvii]
3. Irradiation of the thymus gland and subsequent breast cancer
Young children normally have large thymus glands. With the advent of chest x-rays in the 1920’s, this large thymus was viewed with suspicion of abnormalcy. Pediatricians feared that a large thymus could lead to respiratory problems. Until 1953[xviii] irradiation of the thymus was done to decrease its size.
The rate of breast cancer among woman who were so treated as children was three times that of those that were not treated. The cancers occurred when women were in their early 30’s, more than 25 years after irradiation.
Since the amount of radiation given to the thymus was quite low, the researchers became concerned about the rising tendency for CT scans of the chest either for diagnosis or treatment. Their results “underscored the importance of limiting radiation exposure in the youngest children as much as possible.”
4. CT scans of children’s heads following injuries.
Like many physicians wishing to comfort parents whose child had a concussion, I was pleased to be able to refer the child to a CT scanner when one became available in 1996. We all slept better at night thinking that a normal CT meant that the kid’s brain was ok.
Maybe we should not have.
A Canadian study of children receiving CTs to the head indicated that as few as four CT scans before the age of six could result in doubling the risk of leukemias, lymphomas and intracranial tumours starting about ten years later.[xix]
5. Secondary cancers resulting from radiation treatment for cancer
Until recently second primary cancers were neither given serious thought nor studied. Most patients receiving radiation did not live long enough, the 15 to 20 years after their treatment, to display the side effects of ionizing radiation.
One of the first studies on this population indicated that the number of second cancers caused by radiation was as high as one person in five.
There are many criticisms of this study not the least of which is that the size of their sample was small and, at ten years, the length of time for the development of solid cancers was short, but the researchers still concluded that “an effort toward a reduction in their incidence is mandatory. In parallel, radiation therapy philosophy must evolve, and the aim of treatment should be to deliver the minimal effective radiation therapy rather than the maximal tolerable dose.[xx]”
Arising from their work were estimations of dose associated with harm. They concluded that the incidence increased with the dose even though thyroid and breast cancers were observed following doses as low as 100 mGy and adults developed cancers following treatment doses as little 500 mGy. The risk of developing sarcoma (bone cancer) was 30.6 times higher for doses of more than 44 Gray than for doses of less than 15 Gray.
6. Side effects of ionizing radiation tracers and heart disease.
Research has shown that the lifetime risk of developing fatal cancer from the use of a radioactive tracer as in a PET or MIBI scan is 1 in 2000, in other words, it is much lower than the lifetime risk of dying in a motor vehicle accident (1 in 108).[xxi]
However, when Canadian researchers focused on their 82,861 patients who had heart attacks, they found that 77% underwent at least one cardiac imaging or therapeutic procedure involving low dose ionizing radiation. By comparing populations, they found that for every 10 mSv of radiation there was a 3% increase in the risk of age- and sex-adjusted cancer over a follow-up period of five years.
This is, of course, an underestimate of radiation-induced cancers because five years is very short for solid cancers.
What can you do to limit your exposure to ionizing radiation?
1. Whenever you are asked to have an x-ray, ask the person ordering it how the x-ray results will change or otherwise affect your treatment. If they have already prescribed a treatment, this should always be asked. Often the answer will be that they simply want to assess your progress.
2. Make sure that you are getting the right imaging for whatever problem you are facing. Often the physician will order a CT scan when an MRI is more appropriate – wait for the MRI.
My patient, John, told me this story. At 79 years of age, he has Chronic Myelogenous Lymphoma and was told by his specialist that he should have biannual CT scans. He could've asked how these CT scans would influence his health or his prognosis but instead he asked the doctor, “What are you looking for?” He was told that the physician was looking for “changes”. John knew there would be "changes" because that's the nature of his disease and he felt well so he agreed to return when he thought further investigations would be useful.
3. There is almost no excuse for “routine x-rays”. At one time everyone who entered a hospital had to have admission chest x-rays; "routine x-rays" rarely show any surprises.
Conclusion:
Does ionizing radiation cause cancer? The World Health Organization ranks radiation as a carcinogen of the highest degree. Cancer is at least one consequence of exposure but it is very difficult to determine whether a person has developed cancer because he/she worked in a uranium mine or had a high amount of radon in their home or got struck by a cosmic ray at the wrong time.
What we can say with certainty is that ionizing radiation causes ions. It enters human cells and, like a cyclone, wrecks things. It causes proteins and enzymes to break up – and it breaks up chromosomes.
Chromosomes are the things in cells that tell the cell what it is. If it is a skin cell, it has the responsibility to make more skin cells. If the chromosome has been damaged, it may not be able to make normal skin cells.
[1] In 1976, I was quite neutral about nuclear power even as I was staunchly opposed to nuclear bombs.
[2] Creams and ointments that could be applied on the outside of the skin and attack the fungus. Later some of these became pills.
[3] Some women were treated as many as 88 times.
[4] Doses delivered in a fraction of the total. If the therapeutic dose was considered to be 10 units, it might be delivered in two exposures of 5 units. This is still a method of delivering radiation in oncology.
[i] Harry Daghlian died the fall of 1945 and Louis Slotkin died the summer of 1946.
[ii] United States Environmental Protection Agency, www.epa.gov/rpdweboo/understand/health-effectshtml#est_health_effects
[iii] Swiss study on background radiation
[iv] The area of
[v] Livermore Laboratory: in the 1950’s there had been a controversial decision to set up a second weapons laboratory in the United States. Los Alamos in New Mexico was the first; the Livermore Laboratory was set up about 50 miles East of the Berkeley Campus of the University of California. A radiation laboratory already existed there.
[vi] Dr. Harold Knapp as described by Anne Fadiman, “The Downwind People: A Thousand Americans Sue for Damage Brought on by Atomic Fall,” Life, June 1980, p.39
[vii] A series of projects using the power of the atomic bomb for “good” – a rerouting of the Panama Canal and creating natural gas caverns were two of them.
[viii] Leslie J Freeman, Nuclear Witnesses: Insiders Speak Out, W.W. Norton & Company, New York, 1981, p. 95
[ix] Ibid. p. 97
[x] Tay Sach’s Disease:
[xi] Matched pairs of children, one with leukemia and one of a similar background without leukemia.
[xii] Brian MacMahon, M.D.
JNCI: Journal of the National Cancer Institute, Volume 28, Issue 5, May 1962, Pages 1173–1191, https://doi.org/10.1093/jnci/28.5.1173
[xiii] Nuclear Witnesses, p30.
[xiv] G.R.Howe, RC Nair, HB Newcombe, A B Miller, J. D. Abbatt: “Lung cancer mortality (1950 – 80) in relation to radon daughter exposure in a cohort of workers at the Eldorado Beaverlodge uranium mine”, Natl Cancer Inst 1986, Aug: 77(2):357-62.
[xv] Kinderkrebs in der umgebung von Kernkraftwerken (Kikk study)
[xvi] M. Necmettin Pamir, MD, Peter M. Black, MD, PhD, and Rudolf Fahlbusch, MD, Meningiomas, 2010
[xvii] J.D. Boice, D. Preston, F. G. Davis, R.R. Monson, “Frequent chest X-ray fluoroscopy and breast cancer incidence among tuberculosis patients in Massachusetts”, Radiat Res 1991, Feb. 125(2):214-22
[xviii] (Michael) Jacob Adams, MD, MPH,1 Ann Dozier, PhD,1 Roy E. Shore, PhD,2 Steven E. Lipshultz, MD,3Ronald G. Schwartz, MD, MS,4 Louis S. Constine, MD,5 Thomas A. Pearson, MD, MPH, PhD,1 Marilyn Stovall, PhD,6Paul Winters,1 and Susan G. Fisher, PhD Breast Cancer Risk 55+ Years after Irradiation for an Enlarged Thymus and Its Implications for Early Childhood Medical Irradiation Today. Cancer Epidemiol Biomarkers Prev. 2010 Jan; 19(1): 48–58.
[xix] Risks of leukemia, intracranial tumours and lymphomas in childhood and early adulthood after pediatric radiation exposure from computed tomography”
[xx] Maurice Tubiana “Can we reduce the incidence of second primary malignancies occurring after radiotherapy? A critical review” Radiother Oncol. 2009 Apr;91(1):4-15; discussion 1-3.
doi: 10.1016/j.radonc.2008.12.016. Epub 2009 Feb 5.
