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Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2 (2006)

Chapter: Appendix B: Commetary on "Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Populations"

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Suggested Citation:"Appendix B: Commetary on "Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Populations"." National Research Council. 2006. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/11340.
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B
Commentary on “Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population”

A monograph authored by Dr. John W. Gofman and dated 1999 was submitted to the committee for its consideration. Dr. Gofman is professor emeritus of molecular and cell biology at the University of California, Berkeley.

In his monograph, Dr. Gofman uses two databases: (1) the database for age-adjusted mortality rates derived from U.S. age-adjusted mortality rates in the decade years from 1940 to approximately 1990—these data are grouped into nine census divisions—and (2) the database for physicians per 100,000 population according to census division obtained from records maintained by the American Medical Association.

Dr. Gofman argues that the number of physicians per 100,000 population may be used as a surrogate for the average dose of medical radiation to the population of each census division. However, no data are presented to support this argument.

In his analyses, Dr. Gofman regresses cause-specific mortality rates on physician population values. Three major causes of death are used: all cancers combined, ischemic heart disease, and all other causes. He demonstrates a positive association of physician population values with all cancer and ischemic heart disease and an inverse association with all other causes. He argues that this evidence “… strongly indicates that over 50% of the death-rate from cancer today, and over 60% of the death-rate from Ischemic Heart Disease today, are xray-induced as defined and explained in Part 5 of the Introduction.”

Comment

The data used by Dr. Gofman share certain limitations with the data used in the committee’s evaluation of environmental radiation and in the consideration of the existence of hormesis in relation to radiation. The primary issue is that so-called ecologic data are used, that is, data on populations rather than data on individuals.

A second limitation of the data used by Dr. Gofman is the assumption that the number of physicians per 100,000 population is a surrogate for the dose of medical radiation received by the population. It is not possible to verify the quantitative nature of this assumption.

Summary

The interpretation that medical radiation has been a major contributor to death from cancer and ischemic heart disease in the United States during the period 1940–1990 is not shared by the committee. There are insufficient data on dose and disease in individuals to lead to this conclusion.

Suggested Citation:"Appendix B: Commetary on "Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Populations"." National Research Council. 2006. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/11340.
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Page 329
Next: Appendix C: Issues Raised by the Institute for Energy and Environment Research (IEER) »
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This book is the seventh in a series of titles from the National Research Council that addresses the effects of exposure to low dose LET (Linear Energy Transfer) ionizing radiation and human health. Updating information previously presented in the 1990 publication, Health Effects of Exposure to Low Levels of Ionizing Radiation: BEIR V, this book draws upon new data in both epidemiologic and experimental research. Ionizing radiation arises from both natural and man-made sources and at very high doses can produce damaging effects in human tissue that can be evident within days after exposure. However, it is the low-dose exposures that are the focus of this book. So-called “late” effects, such as cancer, are produced many years after the initial exposure. This book is among the first of its kind to include detailed risk estimates for cancer incidence in addition to cancer mortality. BEIR VII offers a full review of the available biological, biophysical, and epidemiological literature since the last BEIR report on the subject and develops the most up-to-date and comprehensive risk estimates for cancer and other health effects from exposure to low-level ionizing radiation.

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