Ionizing Radiation and Human Health
Radiation was primordial, present since the Big Bang. Humans evolved with it. It could not be seen, felt, smelled or tasted. We didn’t even know it existed.
In November 1895, a German mechanical engineer and physicist, Wilhelm Roentgen produced and measured electromagnetic waves which, not knowing what they were, he called “x-rays”. Three months later, March 1896, a French engineer and physicist, Henri Becquerel found natural radiation that emanates from uranium salts.
The natural radiation, first thought to be x-rays, was soon parsed into alpha and beta particle radiation by Sir Ernest Rutherford and gamma rays by Paul Villard, French chemist and physicist.
The remarkable ability for x-rays to create images of bones led to widespread experimentation and medical diagnosis. The speed at which x-rays were adopted by physicians is exemplified by the opening of the first x-ray department in the Royal Infirmary in Scotland only one year later in 1896.
Radium was discovered by Madame Marie Curie when she was pursuing Becquerel’s “emanations” for her PhD thesis. It glowed in the dark by ionizing the air around it. It too enjoyed remarkable popularity and was incorporated into gels, creams, and drinking potions before its darker side was revealed.
In 1903, when Madame Curie received her degree, Sir Rutherford was visiting at a celebratory tea party. After darkness descended, Pierre brought out a sample of radium to oohs and ahs. Later that evening Sir Rutherford would refer to Pierre’s gnarled and deformed hands in his journal as “typical” of those who worked with radiation.
Most of the “typical hands” would have been those of x-ray machine operators. They used their hands to focus the x-rays of their primitive x-ray machines. To prevent this, Thomas Edison, US scientist and inventor, worked on a focussing mechanism but abandoned his work when his skin became reddened, and his eyes hurt. His assistant, Clarence Daily continued the work. Clarence’s hands became reddened, deformed, and painful and were finally amputated. By 1905 he died with bone cancer.
The turn of the century was an era of experimentation, and scientific exploration. It was also the time of rampant capitalism. New discoveries were quickly commodified for mass consumption.
Physicians x-rayed everything – the ethical were mesmerized by the sight of the insides of people’s bodies and explored the diagnostic limits of x-rays. The less ethical saw dollar signs. X-rays were focused on skin lesions and acne to remove them. The new gadget aided diagnosis and correct setting of broken bones. A physician with an x-ray machine attracted patients and, with them, their money.
Radium was Marie Curie’s pride and joy. She carried it in her pocket with a bottle containing her other discovery, polonium. At night at social gatherings, she would bring the radium out to show off its eerie pulsating blue glow made by the interaction between the ionizing radiation and the air.
People claimed that hot springs containing natural radium had healing properties. Many people boasted of miraculous cures after taking a few days off and going several times to the pool. Spas sprang up wherever there was hot water spilling out of rocks.
If radium was good on the outside, would it not be even better eaten or drank? Radium-infused drinking water was in demand. Doctors were recruited or bribed to participate in marketing schemes.
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 drawn into the fray through a method of kickbacks for their prescriptions.
The radium industry was a shill game which included miners, millworkers and even steamboat operators at Great Bear Lake in Northern Canada. The market crashed when Eben McBurney Byers, a wealthy industrialist and competitive amateur golfer developed osteosarcoma (bone cancer) after drinking a prescribed radium-laced water, “Radithor”.
Shortly before he died, having survived the surgical removal of his jaw, a lawsuit was making its way through the courts. The property of glowing in the dark had found a use in dials for airplane instruments in WWI and for civilian clocks and wristwatches. The radium was painstakingly painted onto the dials by young women who were instructed to follow a mantra of “Lip, Dip, and Paint”, using their lips to bring their brushes to a point, each time ingesting a tiny bit of radium.
Radium is an element belonging to the same family as strontium and calcium. When ingested, our bones will suck radium atoms out of the blood stream and insert them where there should be calcium atoms. Women, some of them as young as twelve years old, were assured that it was safe. That was a lie. Every atom of radium in bone fires off radioactive shrapnel to the cells around it.
Company executives knew that it was not safe – they didn’t know how unsafe it was but they and their lab technicians both shielded and limited their contact with it. They denied compensation to the women for years. When the workers started developing anemia, bone pain and tumors, they were diagnosed by company doctors as having poor diet, neuroses or even syphilis. Even after one court case was concluded, women at another site sought compensation for their medical bills through legal means.
The widespread use of x-rays during WWI using poorly constructed and calibrated units also led to international concern about the exposure of operators and patients to their harm. In the late 1920’s, both national and international commissions occurred to pool information and to set standards for exposure. The early belief was that as long as skin reddening did not occur or resolved quickly, no actual harm was done.
The discovery of the neutron in 1932 by James Chadwick in England answered a nagging question about atomic weights. The atomic number measured the number of protons in the nucleus and the number of electrons orbiting it but the mass of the atoms was often much greater, for example: Helium has an atomic number of 2 but its atomic mass is 4, double the weight of the two protons. Neutrons, having the same weight as protons could fill the void.
Neutrons also provided scientists with uncharged “bullets” that could be fired at other atomic nuclei in cyclotrons or nuclear accelerators. Sometimes they would “stick” and the atom became another element. The alchemy of the Middle Ages was finally realized.
Then an astounding thing happened. Lobbing neutrons at uranium atoms produced smaller atoms! Physicist Otto Hahn and chemist Fritz Strassman from Germany shared their puzzlement with Lise Meitner (one of their research partners but being a Jew was in Sweden for her own safety) in 1939. Meitner and her nephew, Otto Frisch, also a physicist, worked out the math and concluded that the uranium had “fissioned”[i], had been broken into two pieces.
Lise and Frisch quickly realized the amount of energy that had been released during fission. Physicists around the world went silent. The active free-flowing sharing of information stopped. Everywhere, physicists recognized that there was the possibility to develop a bomb of almost immeasurable proportions – and that it had been discovered in Germany, a country under a leader who was threatening the stability of Europe.
The paranoia spread to Britain and the USA. An Austrian physicist, Leo Szilard lobbied Einstein to write a letter than persuaded the US president, Franklin D. Roosevelt to set in motion the “Manhattan Project” in December 1941 for the development of an atomic bomb.
After delving into the dial painters’ history, the “Manhattan Project” team handled their radioactive elements carefully, partly because the fissionable elements, uranium-235 and plutonium were in short supply but also because the project did not want to affect the health of its workers and scientists or face any lawsuits.
Security around the project was very tight. Breaking silence could be fined and was evenconsidered traitorous. Husbands could not share with their wives or wives with their husbands. Scientists, accustomed to sharing their findings, were forbidden their free and easy discussions. Everyone including secretaries and technicians worked in silos. Entire cities were constructed (Hanford, Washington, Oak Ridge, Tennessee, and Los Alamos, New Mexico) in secrecy.
During the Project the first victims of very high radioactive exposures occurred. They were immediately hospitalized and followed through to their 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 four weeks. If the exposure was doubled to 20,000 mSv as in the case of Cecil Kelley post Manhattan Project, death came within days.
In no case was death painless.
Besides secrecy around the project, lying about the side effects of ionizing radiation was necessary for the further development of the bomb project. For example, General Lesley Groves, the administrative “boss” of the Project knowingly lied when he tried to convince a Senate Committee in 1945 after the bombs had been dropped on Hiroshima and Nagasaki and Louis Slotkin had died that radiation exposure was a “pleasant way to die”[ii].
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[iii]
For comparison, one chest x-ray, two views give 0.15 mSV, an abdominal CT scan 10.0 mSv.
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 it can basically be ignored. This “harmless” rhetoric is maintained through the years by many medical personnel ordering CT scans and dentists requesting panoramic dental x-rays.
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?
It is called “ionizing radiation” because it causes molecules to “ionize”. Molecules are formed when atoms join together to build virtually anything, especially, biological structures – cellular walls, protein structures, enzymes, RNA and DNA. Struck by radiation, these molecules can be broken into parts called “ions”. The ions can join together in different configurations so that the enzyme may no longer work properly, or the DNA molecule may no longer transmit its genetic information correctly.
Any one of the products of radiation – alpha, beta or neutron particles, x-ray, gamma or cosmic rays – can cause this. As far as a cell is concerned, it is as though “there’s a bull loose in the China shop”. The greater the energy carried by the radiation, the greater the damage.
It is impossible to say whether any given disease or cancerous growth can be blamed upon any given exposure to radiation. We can discern the damage only through populations studies, comparing a group of people who had been exposed to a group of people who had not.
Humans have lived with natural radiation for thousands of years – has it caused damage?
There are two distinct examples of natural radiation causing cancer: radon, largely in basements, and skin cancers from cosmic rays.
Cosmic rays were discovered in 1912 by an Austrian physicist, Victor Hess. He went up in a balloon and measured the ionizing radiation as he ascended and found that it was three times higher at 5300 meters elevation than at ground. Others discovered that cosmic rays were largely made up of protons (89%) and alpha particles (10%).
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 as they leave a trail of ions in their passage but if the particles become internal (by eating or breathing) they are up to 20 times more dangerous.
When any of these particles or rays interact with anything including biological matter, they cause ions. Sometimes the damage can be repaired, sometimes it cannot, and the cell dies or replicates the damage. Sometimes the damage 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, for example, the release of radioactivity continues for as long as the tiny bit of radium is present or 16,400 years (the half-life of radium x 10). The skeletal remains of the “radium girls” will still be radioactive for 16 millennia!
In 1927, an American, Hermann Muller was able to show the effect of radiation (he used x-rays) on genetic material. He had no doubt that it produced mutations in succeeding generations and remained a staunch defender of radiation protection measures and was opposed to atmospheric nuclear tests[iv].
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.[v]
Diagram from Swiss study
Why do we know so little about radiation’s danger to health?
The nuclear industry has a singular interest in keeping populations ignorant. It continues to market nuclear energy as “safe” when no nuclear power plant can be operated without release of radiation in the form of tritiated hydrogen gas. By the time that Japan has released all its tritiated water (from Fukushima) into the Pacific Ocean, there will be no “unexposed” population with which to compare cancer rates.
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[vi]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[vii], 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 and Nobel laureate, Arthur Tamplin.
His first task as the chair of the biomedical unit was to squash a research paper[viii] 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. Gofman and five other experts reviewed the data, asked technical questions and concluded that the research was scientifically sound and ought to be published.
The Atomic Energy Commission (AEC) 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”[ix], 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 demise as a go-to person for the AEC.
In 1969, Dr. Ernest Sternglass published research papers claiming that up to three hundred thousand children might have died from radioactive fallout from atmospheric bomb testing. It received popular coverage in Esquire under the title “The Death of all Children”. 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, that is, no 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 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.[x] Not only did they conclude that the risk was high, 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. Their bosses in the AEC made a decision and started rumors. John heard that he “didn’t care about cancer at all and that he was trying to undermine national defense”[xi]. (He had already resigned his directorship of the laboratory but remained as a research associate.) Dr. Tamplin’s research staff was fired.
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, 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 research funding had dried up. The AEC restructured 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 revealed that AEC didn’t know if the cooling system for a type of reactor worked. The credibility held by the AEC became questioable.
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 Tamblin, and Harold Knapp were harassed, ridiculed, and sidelined because their research showed that radiation affected health. The industry didn’t stop there. Drs. Linus Pauling, Alice Stewart, Ernest Sternglass and Hermann Muller suffered similar fates. The US desire for nuclear arms required nuclear power plants. Nuclear radiation had to be safe.
The ways in which scientists can be harassed might be subtle, for example, their research doesn’t get published or their funding is cut off. It can also be blatant as in public ridicule, not merely their research but also their person. A mighty industry highly subsidized by government and the fascination with big bombs not unsurprisingly had control of much of the media. Scientists could spend inordinate amounts of time defending their positions in industry or in colleges and universities but, in fact, many cannot afford to dissent or even publish critical material.
Dr. Ernest Sternglass defended his research before a US Senate hearing in favour of a ban on atmospheric nuclear bomb tests. The “300,000 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 started to occur, the number of one-year-olds decreases. It flat lines until the first limited voluntary Test Ban Treaty occurs in 1958 when the healthy trend is resumed. After a brief flurry – including the headlines in Esquire magazine "The Death of All Babies" – his work was mothballed.
Insert Sternglass’s graph
Dr. Linus Pauling received a Nobel Prize for much of the same results. And then there is the little known exchange between Dr. Kathyrn Behnke who saw an increase in newborn deaths in August 1945 after the Trinity atomic bomb test and the project physician Dr. Warren Spafford who denied her findings, his assistant saying, “we can find no pertinent data concerning infant deaths”[xii] Furthermore, he “wanted to assure you that the safety and health of the people at large is not in any way endangered.”
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 [controls and leukaemia patients][xiii], it was there”.
In the USA, Dr. Rosalie Bertell, an epidemiologist working on the Tri-State Leukemia Survey – a project founded to determine why a rare disease in children was suddenly becoming more common. The researchers had 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 these children continued to show increased leukemias throughout their lives.
The medical profession and the nuclear industry desperately wanted to believe otherwise. A third study published in 1962 out of Harvard done by a male epidemiologist, Dr. Brian McMahon, found the same results.
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, they strongly emphasized that x-rays are not gamma rays. A naive public accepted their explanation.
It was only a decade later, in my medical class in 1976 at the U of Saskatchewan, the obstetrics professor taught us how to do pelvimetry, the art of calculating the size of a pregnant woman’s pelvis with x-rays, but also said without explaining why, that the practice was “now frowned upon”.
In 1979, Dr. Bertell had become obsessed with radiation and the human body. 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. At a show of hands, every single man present had the same complaint. Rosalie says, “Out of a hundred workers, a hundred had experienced gross blood in the urine.”[xiv]
She tried to get blood samples 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, the union leaders were jailed and the men forced back to work.
This small seemingly inconsequential Catholic nun was not to be deterred and kept trying to proceed with a health study of workers at Rocky Flats, Colorado and at Paducah, Kentucky. Officials who supported her were fired or departments “reorganized”. The industry was not about to risk real statistics.
Sometimes, however, 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[xv] concluding that there were almost double the cancer deaths among miners than among a cohort of non-miners. They also found, not surprisingly that the higher the exposure to radioactivity, the greater the risk of lung cancer.
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 accept their findings. The industry found fault, legitimate or otherwise, 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 research panel 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. In their conclusion, the researchers said that they didn’t know why.[xvi]
Closer examination reveals what happens. Nuclear power plants average their releases of radioactive gasses over three months although they are actually released intermittently as “puffs” of gasses. What looks like a steady low dose release of tritium is actually a bunch of radioactive puffs of tritium.
In 1976, a professor in the College of Medicine, Dr. Sylvia Fedoruk tossed a well-protected glass vial at me, “Catch” she said. I caught it at which she announced that it contained radioactive iodine. I was hugely pregnant. As I returned the vial, she said, “See, it didn’t hurt you.”[1]
Dr. Fedoruk was deeply invested in developing nuclear medicine. The incident whetted my interest. I wanted to know why there was such aggressive interest in promoting the safety of radioactivity.
The 1962 physics professor’s question had stayed with me, “What about the nuclear waste?”. I was unclear about health risks. I became a member of the International Physicians for Prevention of Nuclear War (IPPNW). Its early iteration 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.
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 that generation 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.
Inadvertent research in medicine
What is less well known is that the medical profession has inadvertently conducted research on radioactivity and, after the fact of the exposures, discovered correlations of injury with radioactivity. Only a few 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, especially for Jewish children planning to immigrate to Isreal. 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 reports of somnolence (sleepiness) lasting from 4 – 14 days in 30 of 1100 children occurred. By the 1930’s side effects included atrophic changes to the scalp, epilepsy, hemiparesis, emotional changes and dilatation of the brain’s ventricles.
The absolute death knell to the practice occurred in 1966 when University Medical Center (New York) published a study showing a dramatic increase in cancers and an increased rate of psychiatric hospitalizations.
Studies continue to roll in – the latent phase for meningioma is approximately 30 years but metastatic tumours may take over 40 years to develop. No one irradiates scalps for ringworm now.[xvii]
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 finding from this study was that fractionated doses had the same risk of developing cancer as the single total dose.[xviii]
3. Irradiation of the thymus gland and subsequent breast cancer
Young children normally have large thymus glands. Until the advent of chest x-rays in the 1920’s, this large thymus was unknown so it was viewed with suspicion. Pediatricians feared that a large thymus could lead to respiratory problems. Until 1953[xix]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, researchers have become 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.[xx]
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.[xxi]
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 lower than the lifetime risk of dying in a motor vehicle accident (1 in 108).[xxii]
However, when Canadian researchers focused on 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.
Because five year follow-up is very short for the development of cancers, this is likely a underestimate by a large factor.
Specific Radioactive Elements and Their Effects
That radioactive elements cause cancer is beyond doubt. Increasing their presence in our environment does increase the incidence of cancer. It seems that these elements may cause any number of other problems – auto-immune and cardiovascular diseases, ill-health and chronic tiredness, headaches and benign tumours all have suspicious links. Lowered resistance to bacterial and viral illnesses has been seen.
Funding to do the studies that extend over years is not available.
Even an accident as large as the Three Mile Nuclear Power plant accident received funding for only nine years. When studies done by Joseph Mancuso, Alice Stewart and Geoffry Knean on Hanford workers showed a health effect not only was their funding cut but demands were made that they release all their hard data to the National Research Council. (Mancuso lost his data but Stewart and Knean had taken most of the documentation home with them, to the UK.)
That radioactivity causes chromosomal defects in fruit flies is also not questioned. To show these effects however, if they occur in humans, would require centuries.
The specific effects of some radioactive elements have been well studied:
Radon-222: Cancers caused by radon prompted the Canadian government to establish the Canadian National Radon Program using guidelines developed by the International Radiation Protection Association. Various public health offices believe that alpha radiation from radon causes up to 20% of Canadian lung cancers.
Radon is the main decay product of radium. It has a half-life of only 3.8 days so its decay chain is also of concern for health. One of its products is polonium-210, one of the most poisonous elements on earth. Cancers blamed on radon might actually be caused by polonium.
Radon has found some use as a tracer but, while found naturally, it is still considered part of uranium waste.
Uranium-238: This isotope of uranium is its most common. Forming 99.27% of natural uranium, it has a half-life of 4.5 billion years. It is the starting of a decay chain that includes radium, radon, polonium and ends with stable lead-210. This isotope, uranium-238, is popularly referred to as “depleted uranium” because its uranium-235 has been removed.
Uranium is a heavy metal and as such, its health effects resemble those of lead and mercury, kidney failure being the most common. It seems to have estrogen-mimicking properties and at least one chronic disease has found to be increased, systemic lupus erythematosus, among a cohort of uranium miners.
Areas of Iraq are steeped in uranium-238. Physicians there report increases in infant deformities and mortality.
The Eldorado uranium miners study looked specifically for lung cancer and found a doubling effect – but was it due to powdered uranium or gaseous radon (and polonium)?
Uranium-235: This isotope is fissile, the isotope desired for nuclear bombs. “Enrichment” of uranium occurs to increase the percentage of U-235 and there are various percentages required for different tasks.
Most light water nuclear reactors require a concentration of 3 – 5% U-235 to operate, to reach criticality and produce the heat to boil water. It is anticipated that the proposed small modular reactors will require HALEU (High Assay Low Enriched) uranium which contains 19.5% uranium-235.
Aside from nuclear bombs and nuclear power plant fuel, uranium has no other functions. Uranium as an ore, refined to “yellow cake” is not very radioactive.
Radium-226: The most stable isotope of radium with a half-life of 1640 years is radium 226, itself a decay product of thorium-230 in the uranium-238 decay chain. Radium is considered the most radioactive element known. It emits alpha, beta and gamma radiation. Its glowing colour is the result of ionization of the air around it.
All 34 known isotopes are radioactive. It is found in nature.
Radium’s use has evolved from the dials of watches until the 1970’s and cancer treatments until the 1990’s when it was discarded in favour of less radioactive but still effective elements. It may have been the first element used in brachytherapy where the element is encapsulated and inserted inside a tumour. It is still used for prostate cancer that has spread to bones.
Radium is a relative of calcium and strontium. When it is in the blood, bones and muscles will absorb it and use it in place of calcium. In the bones and muscles, its radiation induces bone cancers, and cancers of the bone marrow (leukemias). Hence the dial workers and the industrialist developed bone cancers, osteosarcomas.
Strontium-90: Strontium (element 38) is found ubiquitously in radioactive fallout from nuclear bombs or nuclear power plants. It is a fission product of uranium.
Natural strontium is not radioactive, nor are its four isotopes. It belongs to the same family of elements as calcium and human biology treats them very similarly, strontium is scooped out of the blood to incorporate it into bones and muscles. It is believed to have a biophysical[4] half-life of 18 years. Because it is very close to blood-forming components in the bones, it is blamed for increases in leukemia, lymphomas and bone cancers. While in situ, it initially weakens bones.
Strontium-90 decays with a half-life of 29 years to yttrium-90 which also undergoes beta decay to zirconium-90 which is stable.
Strontium-90 has no commercial value and is considered entirely an environmental pollutant.
Iodine-131: Radioactive iodine therapy increases the risk of leukemia, stomach cancer and salivary gland cancer, according to the American Cancer Society[xxiii]. On March 27, 2011, Massachusetts Department of Public Health found I-131 in low concentration in rain water, believed to originate from the Fukushima accident.
Iodine-127 is the only stable isotope of the element with 53 protons in its nucleus. Of the remaining 26 isotopes, iodine-131 is not only of greatest concern with respect to nuclear bomb testing fallout, nuclear power plant accidents and natural gas production, but of all fission-related radioisotopes, it has also found the greatest medical use. It has a half-life of about 8 days and emits an energetic electron, a beta particle. It is preferentially filtered out of the blood by the thyroid.
Because it is collected by the thyroid, it can be used in high doses to selectively kill hyperactive thyroid cells whether they are benign or malignant. Also, because it is collected by the thyroid, its action can be mitigated by taking normal oral iodine at the time of exposure.
Its short half-life means that it is an insignificant contributor to nuclear waste.
It decays to xenon-131 which is stable.
Tritium: All three hydrogen isotopes are gasses and can form water with oxygen. Hydrogen itself has one proton in its nucleus and one electron circling it. Deuterium is “heavy water” with one proton and one neutron in its nucleus. Tritium is radioactive with one proton and two neutrons in its nucleus.
While it is naturally formed by cosmic rays hitting hydrogen in the upper atmosphere, the bulk of today’s tritium is released from nuclear power plants. It is often characterized as a short-lived weakly radioactive radioisotope, but a half-life of 12.3 years is questionably “short” in human terms. The beta particle emitted by tritium is low energy but its presence inside human cells is still destructive.
Getting into human cells is pretty easy for a hydrogen isotope because, combined with oxygen, it forms tritiated water and water enters every cell of every biological being. It is very difficult to link specific exposures to cancers and chronic disease but using population studies, researchers can link the health of populations around nuclear power plants with case-matched[5]populations that are not exposed to tritium releases from power plants.
Tritium has had commercial use as the energy source in radio luminescent lights for watches, gun sights, numerous instruments and tools, and even novelty items such as self-illuminating key chains[xxiv]. It is used in a medical and scientific setting as a radioactive tracer. The past use in exit signs was discontinued because of breakage.
Conclusion:
Does ionizing radiation cause cancer? Cancer seems to be at least one consequence of exposure. While it is difficult to determine whether a person has developed cancer because he/she worked in a uranium mine, had a high amount of radon in their home, got struck by cosmic rays, or had too much glyphosate or benzo(a)pyrene[6] in their diet, wherever the more difficult comparison of populations has been done, those affected by the higher ionizing radiation regardless of the element, show increased incidences of cancer.
We can also say with certainty is that ionizing radiation causes ions. When it enters human cells, it can pass straight through or, like a home invader, wreak havoc on the cell’s internal structure.
Ionizing radiation can break up chromosomes, the things in cells that tell the cell what it is. If it is a skin cell, the chromosome will tell the cell to make more skin cells. If the chromosome has been damaged, it may not be able to tell the cell how to make normal skin cells.
To say that ionizing radiation is safe is fraudulent.
What can you do to limit your exposure to ionizing radiation?
Whenever you or a child or someone under your care is asked to have an x-ray, ask the person ordering it how the x-ray result will change or otherwise affect treatment. Often the answer will be that they simply want to assess your progress. If you feel good (or better), you already know your progress.
Make sure that you are getting the right imaging for the problem you are facing. When a CT scan was suggested for one of my patients, I realized that he would be better served by an MRI.
Don’t succumb to the doctor or other care provider’s “curiosity” or desire to know. Ask questions.
My patient, call him “John”, told me this story. At 79 years of age, he had Chronic Myelogenous Lymphoma and was told by his specialist to have a biannual CT scan. He was feeling quite well. When he asked the doctor, “What are you looking for?” He was told that the physician was looking for “changes”. John considered - he already had a cancer diagnosis, he expected changes but he currently felt well. He told the specialist he would return if his health changed.
There is almost no excuse for “routine x-rays”. At one time everyone who entered a hospital was submitted to chest x-rays.
To these choices that affect you personally, there is another action that we should be taking:
Oppose development of nuclear weapons and nuclear power. One will not exist without the other. Medical radioisotopes don’t need nuclear power reactors for their use and development but nuclear bombs cannot be built or serviced without nuclear power.
[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 came in pill form.
[3] Some women were treated as many as 88 times.
[4] Length of time that it is in the body: in this case, half of the strontium-90 will have discarded by 18 years.
[5] “Case-matched”: the researchers choose individuals whose habits are similar to match those in the studied populations. If a member of the studied population smoked, a smoker of the same gender would be selected from the other population. If one was 65 years of age, it would be matched. And so on.
[6] Contaminates from herbicides and coal products respectively.
[i] Alan Chodos, Editor, This Month in Physics History, December 1938: Discovery of Nuclear Fission, December 2007 (Volume 16, Number 11) APS News
[ii] William King, A weapon too far: The British radiological warfare experience, 1940–1955, Sage Journals, Volume 29, Issue , January 11, 2021, https://doi.org/10.1177/0968344520922565 Accessed 28.12.23
[iii] United States Environmental Protection Agency, www.epa.gov/rpdweboo/understand/health-effectshtml#est_health_effects
[iv] Elof Axel Carlson, Genes, Radiation, and Society: The Life and Work of H.J. Muller (Ithaca: Cornell University Press, 1981), 2016.
[v] Swiss study on background radiation
[vi] The area of
[vii] 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.
[viii] 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
[ix] 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.
[x] Leslie J Freeman, Nuclear Witnesses: Insiders Speak Out, W.W. Norton & Company, New York, 1981, p. 95
[xi] Ibid. p. 97
[xii] Bulletin of the Atomic Scientists Trinity: “The most significant hazard of the entire Manhattan Project”
By Kathleen M. Tucker, Robert Alvarez | July 15, 2019
[xiii] Matched pairs of children, one with leukemia and one of a similar background without leukemia.
[xiv] Nuclear Witnesses, p30.
[xv] 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.
[xvi] Kinderkrebs in der umgebung von Kernkraftwerken (Kikk study)
[xvii] M. Necmettin Pamir, MD, Peter M. Black, MD, PhD, and Rudolf Fahlbusch, MD, Meningiomas, 2010
[xviii] 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
[xix] (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.
[xx] Risks of leukemia, intracranial tumours and lymphomas in childhood and early adulthood after pediatric radiation exposure from computed tomography”
[xxi] 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.
[xxii] Felix G. Melnel, John W. Nance, Jr, Brett S. Harris, Carlo N. De Cecco, Philip Costello, U. Joseph Schoepf, “Radiation Risks From Cardiovascular Imaging Tests”, CMAJ, 29 Jul 2014
[xxiii] www.cancer.org, Accessed 21.12.23
[xxiv] https://nuclearsafety.gc.ca/eng/pdfs/fact_sheets/january-2013-fact-sheet-tritium_e.pdf. Accessed 31.12.23
[1] Alan Chodos, Editor, This Month in Physics History, December 1938: Discovery of Nuclear Fission, December 2007 (Volume 16, Number 11) APS News
[1] William King, A weapon too far: The British radiological warfare experience, 1940–1955, Sage Journals, Volume 29, Issue , January 11, 2021, https://doi.org/10.1177/0968344520922565 Accessed 28.12.23
[1] United States Environmental Protection Agency, www.epa.gov/rpdweboo/understand/health-effectshtml#est_health_effects
[1] Elof Axel Carlson, Genes, Radiation, and Society: The Life and Work of H.J. Muller (Ithaca: Cornell University Press, 1981), 2016.
[1] Swiss study on background radiation
[1] The area of
[1] 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.
[1] 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
[1] 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.
[1] Leslie J Freeman, Nuclear Witnesses: Insiders Speak Out, W.W. Norton & Company, New York, 1981, p. 95
[1] Ibid. p. 97
[1] Bulletin of the Atomic Scientists Trinity: “The most significant hazard of the entire Manhattan Project”
By Kathleen M. Tucker, Robert Alvarez | July 15, 2019
[1] Matched pairs of children, one with leukemia and one of a similar background without leukemia.
[1] Nuclear Witnesses, p30.
[1] 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.
[1] Kinderkrebs in der umgebung von Kernkraftwerken (Kikk study)
[1] M. Necmettin Pamir, MD, Peter M. Black, MD, PhD, and Rudolf Fahlbusch, MD, Meningiomas, 2010
[1] 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
[1] (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.
[1] Risks of leukemia, intracranial tumours and lymphomas in childhood and early adulthood after pediatric radiation exposure from computed tomography”
[1] 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.
[1] Felix G. Melnel, John W. Nance, Jr, Brett S. Harris, Carlo N. De Cecco, Philip Costello, U. Joseph Schoepf, “Radiation Risks From Cardiovascular Imaging Tests”, CMAJ, 29 Jul 2014
[1] www.cancer.org, Accessed 21.12.23
[1] https://nuclearsafety.gc.ca/eng/pdfs/fact_sheets/january-2013-fact-sheet-tritium_e.pdf. Accessed 31.12.23
