The Effects Of Low-Dose Radiation

Abstract

Book Review Health AffairsVol. 19, No. 2 The Effects Of Low-Dose RadiationLynn H. Ehrle AffiliationsLynn Ehrle is a freelance medical writer and health policy analyst, based in Plymouth, Michigan.PUBLISHED:March/April 2000Free Accesshttps://doi.org/10.1377/hlthaff.19.2.269AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSCancerMortality ratesMedical practiceCoronary heart disease Seldom does a book appear with the potential to alter medical practice, reduce mortality rates, and change health care policy, but Radiation from Medical Procedures is a rare exception. Author John Gofman has had a long and distinguished career, first as a graduate student in nuclear/physical chemistry at the University of California, Berkeley, where he worked on the Manhattan Project. He then earned a medical degree and won several awards for discovering evidence that high blood levels of LDL, IDL, and VLDL lipoproteins are risk factors for coronary heart disease. In 1963 Gofman was appointed associate director of the Lawrence Livermore National Laboratory, where he began his work on the health effects of radiation. His groundbreaking book, Radiation and Human Health (Sierra Club, 1981), set the standard for radiation effects research. This latest book, skillfully edited by Egan O'Connor, represents the culmination of Gofman's thirty-year effort to convince the nuclear power industry and the cancer establishment that low-dose ionizing radiation is a necessary co-actor in deaths from cancer and coronary heart disease. Gofman matched the aggregate number of physicians per 100,000 population (“PhysPop,” as a surrogate for xray exams) with U.S. age-adjusted cancer mortality rates. His analysis showed a strong positive dose-response correlation between PhysPop and cancer and a negative relationship to all noncancer mortality, with one glaring exception—ischemic heart disease (IHD).Gofman uses 760 (my count) charts and graphs to connect the raw data with the conclusions. He builds his case upon the following concepts. (1) Ionizing radiation is a powerful mutagen, capable of inducing every known kind of mutation, which, quite unlike routine DNA damage from endogenous free radicals, often eludes repair. (2) There is no safe dose. (3) Ionizing radiation is a necessary co-actor in a majority of cancer and IHD deaths. (4) X-rays are more potent than gamma rays, per dose-unit. (5) Humans receive lifelong exposure to ionizing radiation from natural sources. (6) Most kinds of human cancer are inducible by ionizing radiation. (7) Ionizing radiation is a proven cause of genomic instability, a feature of the most aggressive cancers.The 127-page appendices provide much-needed balance to current medical thinking on radiation and cite reports that should put to rest the Hormesis thesis (that high doses of radiation may be fatal, but small doses have a therapeutic effect). Gofman's book challenges clinicians and policymakers to first, do no harm, and to accept the U.K. protection board's “precautionary principle,” that x-ray dosage could be reduced by about half without any reduction in diagnostic information.Gofman points out that cancer and IHD accounted for 45 percent of all deaths during the 1990s. At this rate, we can expect over one million cancer/IHD deaths this year, a devastating and costly burden on millions of families and the U.S. health care budget. An aggressive education and x-ray reduction campaign, with x-ray exposures noted as part of each person's medical record, could bring about a significant reduction in the future mortality rates from these twin killers. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 March 2000 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.PDF download