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To fully appreciate the controversy that has arisen over the Life Span Study, it is necessary to revisit the horrific events of Hiroshima and its aftermath. At 8:16:02 AM on the morning of August 6, 1945, the “Little Boy” atomic bomb exploded over Hiroshima. At the moment of detonation, a flash of gamma radiation and neutrons showered the target area and irradiated the entire population. In a microsecond, a thermal pulse baked the city and ignited a conflagration, and a pressure wave smashed most structures to smithereens. Exact casualty figures are not known. Perhaps 100,000 people died from combined injuries from the direct effects of the blast: immense quantities of irradiation, burns, and a vast array of trauma injuries. It is estimated that by the end of 1945, total casualties had climbed to 140,000 people. By 1950, the death toll had reached over 200,000. What had once been Hiroshima was left in radioactive ruin. Radiation contaminated the soil and the water. This created an environment where internal contamination became possible for all who entered the area for years afterward. In the immediate aftermath of the bombing, people who had either lived outside the city or who had left the city center prior to the detonation reentered the city looking for family and friends. These people, not exposed to the detonation, subsequently became contaminated by internal emitters. Nevertheless, they were later included in the control group of the Life Span Study representing people who were not exposed to radiation.
This brief portrait provides all the information the reader needs in order to understand the overwhelming number of errors inherent in the atomic bomb survivor study. Never lose sight of the fact that, in the hands of the ICRP, this study provides the foundation for current models of the risks to health from radiation exposure, and via extrapolation, the hazards of low-dose exposure to internally emitting radionuclides. At a meeting of the European Parliament in February 1998, a number of attendees expressed criticism of the ICRP and the Hiroshima data on radiation effects. These were summarized in the first publication of the European Committee on Radiation Risk [1].
1) Professor Alice Stewart faulted the Hiroshima research on the grounds that the study and control groups were not representative of a normal population. Those included in the study were survivors of the stresses of war who had endured an overwhelming atrocity. Between the end of the war and the establishment of the Life Span Study, as many as 100,000 people succumbed as a result of blast injuries, irradiation, conventional illnesses, and internal contamination from fallout and tainted food and water. As a consequence, the study omits tens of thousands of radiation-induced deaths that took place in the first seven years after the dropping of the bomb. Thus, any results of the LSS will inevitably underestimate the hazards of radiation exposure. Due to the multiple stressors of the bombing and its aftermath, a natural selection process was set in motion whereby unfit people, the physically and psychologically weak, succumbed and were weeded out of the study population. A “healthy survivor effect” thus biased the study. By the time the Life Span Study got underway, those studied made up an atypical population that could not adequately represent the delayed effects of radiation exposure for the entirety of mankind.
2) Several participants at the meeting of the European Parliament criticized the ICRP for failing to adequately address the subject of internal contamination. The surviving Hiroshima population was modeled on the basis of everyone receiving an instantaneous barrage of gamma and neutron irradiation at the moment of detonation of the bomb. Completely ignored by the study is the fact that the surviving population was exposed to fallout that compounded external radiation from beta and gamma emitters. Further, soil and water were contaminated by radionuclides creating the opportunity for the ongoing accumulation of internal emitters through the diet. As a consequence, dose estimates, upon which the whole study rests, are meaningless. To make matters worse, when those outside the city during the time of the bombing entered the city to see what had happened and to look for families and friends, they likely received internal contamination. Thus, the “control” population was also contaminated with radioactivity. What effect does this have on the Life Span Study if both the study population and the control population were exposed to radiation? It will make the incidence of cancer among the study population appear much lower than if a valid comparison were made between those exposed and another suitable control population totally unexposed. By basing the study on an inappropriate control population, radiation is made to appear less hazardous than it actually is.
3) Dr. Chris Busby argued, as has been revealed previously in this chapter, that the model used by the ICRP to model the physiological impact of high levels of external radiation is totally inappropriate for accurately predicting the effects of internal contamination delivered in low doses at a low dose rate. And yet, this is exactly how the Japanese data is used to estimate health risks and derive permissible levels of exposure from internal emitters. According to Busby, by relying on faulty models to assess the risk of internal emitters, the ICRP has failed to accurately determine the true hazards of internal contamination.
4) Dr. David Sumner criticized the ICRP for utilizing the Sievert (equivalent to 100 rem) as a unit of measure. According to his argument, the quality factors introduced into equations to account for differences in the physiological impact of different types of radiation are value judgments and not physical units. To say, for instance, that alpha radiation produces ten times as much biological effect as electromagnetic radiation is not sufficiently rigorous to be used to evaluate the risk from different types of exposure.
5) Dr. Rosalie Bertell challenged the very legitimacy of the ICRP to represent before all mankind the hazards to health of ionizing radiation. “The ICRP is profoundly undemocratic and unprofessionally constituted. It is self-appointed and self-perpetuated” [2]. Since its inception with some original members drawn from the Manhattan Project, the ICRP has been filled with people who are biased in favor of the nuclear establishment. “ICRP is organized by its By-Laws to include only users and national regulators (usually coming from the ranks of users) of radiation” [2]. Membership has remained balanced between 50% physicists and 50% medical doctors. About 25% of the doctors have been medical administrators in countries possessing nuclear weapons who set radiation protection standards in their respective countries and another 15% have been radiologists. The remaining 10% of doctors has consisted of one pathologist, two geneticists, and a biophysicist. Women have been completely excluded. The rules of the main committee responsible for making decisions explicitly exclude participation of an epidemiologist, occupational health specialist, public health specialist, oncologist or pediatrician. According to their own mandate, the job of the ICRP is not to protect workers or public health. Rather, their self-appointed purpose is solely to make recommendations as to what represents a sensible — i.e., “permissible” — tradeoff between the benefits and risks to society of pursuing technologies that result in people receiving exposure to ionizing radiation. Thus, the standards set by the ICRP for what constitutes acceptable exposure are infused with value judgments made by a select few with ties to nuclear weapons and other nuclear technologies.
"In terms of its own claims, ICRP does not offer recommendations of exposure limits based on worker and public health criteria. Rather, it offers its own risk/benefit tradeoff suggestion, containing value judgments with respect to the “acceptability” of risk estimates, and decisions as to what is “acceptable” to the individual and to society, for what it sees as the “benefits” of the activities. Since the thirteen members of the Main Committee of ICRP, the decision makers, are either users of ionizing radiation in their employment, or are government regulators, primarily from countries with nuclear weapon programs, the vested interests are clear. In the entire history of the radiologist association formed in 1928, and ICRP, formed when the physicists were added in 1952, this organization has never taken a public stand on behalf of the public health. It never even protested atmospheric nuclear weapon testing, the deliberate exposure of atomic soldiers, the lack of ventilation in uranium mines, or unnecessary uses of medical X-ray" [2].
"The ICRP assumes no responsibility for the consequences attributable to a country following its recommendations. They stress that the Regulations are made and adopted by each National Regulatory Agency, and it merely recommends. However, on the National level, governments say they cannot afford to do the research to set radiation regulations, therefore they accept the ICRP recommendations. In the real world, this makes no one responsible for the deaths and disabilities caused!" [2].
In reference to the Hiroshima research, Dr. Bertell made similar observations as the other presenters to the European Parliament:
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"It [the LSS] has focused on cancer deaths, is uncorrected for healthy survivor effect, and is not inclusive of all of the radiation exposures of cases and controls (dose calculations omit fallout, residual ground radiation, contamination of the food and water, and individual medical X-ray), and fails to include all relevant biological mechanisms and endpoints of concern" [2].
"It is normally claimed that the biological basis of the cancer death risk estimates used by ICRP is the atomic bomb studies. However, these studies are not studies of radiation health effects, but of the effects of an atomic bomb. For example, the radiation dose received by the Hiroshima and Nagasaki survivors from fallout, contamination of food, water and air, has never even been calculated. Only the initial bomb blast, modified by personal shielding, is included in the US Oak Ridge National Laboratory assigned “dose.” This methodology is carried to an extreme. For example, one survivor I know lived within the three kilometer radius of the hypocenter, but was just beyond the three kilometer zone, at work, when the bomb dropped. As soon as she could, she returned home after the bombing and found her parents and brother dead. Then she stayed in her family home for the three following days, not knowing where to go and filled with grief. Although she suffered radiation sickness and many subsequent forms of ill health, she is counted as an “unexposed control” in the atomic bomb data base. By using the “not in the city” population which entered after the bombing as “controls”, many of the cancers attributable to the radiation exposure in both cases and controls are eliminated from the outcomes considered related to the bomb" [2].
Testifying before the United States Senate Committee on Veterans’ Affairs in 1998, Dr. Bertell dropped a bombshell. The team that had assigned dosages in 1986 to Japanese survivors assigned a dose of ZERO to anyone with a calculated dose less than 10 mGy (1 rad). This represented a total of 34,043 participants in the study: 37.3 percent. These people, purely by definition, were assigned to the “not exposed” control group. This decision effectively destroyed the possibility of any detection of heightened incidences of illnesses from those who actually received low-level exposure. Further, by lumping those exposed into the unexposed control group, the LSS is weighted to underestimate the health effects of radiation due to an unsuitable control population. These irreparable errors invalidate any possible conclusions of the LSS as they pertain to low-level exposure. Radiation protection standards are grounded on the research from Japan. What is thought to be the effects of low doses of radiation are extrapolated mathematically from the observed high dose effects discovered by the Life Span Study. As a result of Dr. Bertell’s revelation, however, it is clear that the Atomic Bomb research can have no relevance to any discussion about the health effects of low doses of radiation. Those who supposedly received low doses had their exposure nullified. If honesty prevailed, this fact alone would shake the radiation protection community. A cornerstone of current approaches to radiation safety holds that the hazards posed by low doses of radiation can be inferred from the effects observed in Japan from high doses.
"The atomic bomb researchers assumed (but did not demonstrate or prove) that below 1 rem exposure from the original bomb blast no radiation related cancer deaths would occur. Therefore this data base can tell us nothing about such low-dose exposures because the researchers assumed their exposure was “safe” and did not test for an effect. In philosophy, we call this “begging the question” and it results in an invalid 'proof'" [2].
There is other evidence available in the public domain that seriously questions the structure of the Life Span Study in regards to the assignment of dosages received by Japanese survivors:
"Detection of radiation risks depends upon the ability of an epidemiological study to classify persons according to their exposure levels. A-bomb survivors were not wearing radiation badges, therefore their exposures had to be estimated by asking survivors about their locations and shielding at the time of detonation. In addition to the typical types of recall bias that occur in surveys, stigmatization of survivors made some reluctant to admit their proximity [3]. Acute radiation injuries such as hair loss and burns among survivors who reported they were at great distances from the blasts [4,5] suggests the magnitude of these errors, which would lead to underestimation of radiation risks" [6].
Bibliography
[1] European Committee on Radiation Risk (ECRR). Recommendations of the European Committee on Radiation Risk: the Health Effects of Ionising Radiation Exposure at Low Doses for Radiation Protection Purposes. Regulators' Edition. Brussels; 2003. www.euradcom.org.
[2] Bertell R. Limitations of the ICRP Recommendations for Worker and Public Protection from Ionizing Radiation. For Presentation at the STOA Workshop: Survey and Evaluation of Criticism of Basic Safety Standards for the Protection of Workers and the Public against Ionizing Radiation. Brussels: European Parliament, February 5, 1998a. http://ccnr.org/radiation_standards.html
[3] Lindee M.S. Suffering Made Real: American Science and the Survivors at Hiroshima. Chicago: University of Chicago Press; 1994.
[5] Neriishi K., Wong F.L., Nakashima E., Otake M., Kodama K., Choshi K. Relationship Between Cataracts and Epilation in Atomic Bomb Survivors. Radiation Research. 1995; 144:107-113.
[6] Wing S. Statement to the Subcommittee on Energy and Environment of the Committee on Science. United States House of Representatives. July 18, 2000. http://www.mothersalert.org/healtheffects.html
