The Committee For Nuclear Responsibility

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• Heart Risk due to Low Radiation Doses: Major Additional Evidence
  Sep 1, 2008
  by Egan O'Connor, editor for the late Prof. John W. Gofman, M.D., Ph.D.
   
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                Very strong evidence exists supporting the hypothesis that medical imaging by fluoroscopy and planar x-rays is an important causal co-actor in ischemic heart disease (IHD) as well as in human cancer --- an hypothesis described in Medical News Today, 29 Aug 2008 (“Heart Risk Due to Low Radiation Doses Worth Investigating Say Scientists,” by Catharine Paddock, PhD, referring to Batti, Sigurdson, & Mabuchi in Lancet Aug 30, 2008...)
                Powerful support for the hypothesis was uncovered and published in 1999 in a monograph (ISBN 0932682979) entitled Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population, by the late John W. Gofman, M.D., Ph.D....
                The complete monograph is available in PDF and its Executive Summary, table of contents, extensive reference list, and first five chapters are available in hypertext, free, online at ratical.org/radiation/CNR/RMP/execsumm.html. On the same site are the six main critiques by peer-reviewers at www.ratical.org/radiation/CNR/RMP/6critiques.html....
                As Medical News Today indicates in its title, a causal relationship between low-dose ionizing radiation and IHD is “worth investigating” further, especially since acquired mutations in the heart can accumulate with each additional radiation exposure. The growing use of fluoroscopy and CT in medicine makes it imperative to become familiar with verbatim excerpts from three major reports on the “safe-dose fallacy,” provided in Appendix B of the 1999 monograph.
  
  
  
• CT Heart Scans: Two Warnings from U.S. Medical History
  Jul 10, 2008, unabbreviated version
  By Egan O'Connor, editor for the late Prof. John W. Gofman, M.D., Ph.D.
   
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                My two major points can be summarized at the outset (details and references below), with respect to the valuable New York Times' June 29, 2008 article, "Weighing the Costs of a CT Scan's Look inside the Heart," by Alex Berenson and Reed Abelson.
                First, Coronary Artery Disease: The article overlooked evidence uncovered in 1999 (Part 1, below) that x-ray-induced mutations in the coronary arteries may well have had a major causal role in initiating and/or accelerating atherosclerosis (Part 4, below). This is called "Hypothesis-2" in the 1999 study.
                Second, Cancer: A credible warning (also based on the 1999 research described in Parts 3 and 4), is that accumulated lifetime exposures to medical x-rays --- which include CT and fluoroscopic exams --- may constitute a causal co-actor in more than 50% of current cancer mortality in the USA. This is called "Hypothesis-1" in the 1999 study.
                The "over 50%" estimate is at least as scientifically credible as the popular estimate that medical x-rays account for only 1% of American cancer (Doll and Peto 1981 p.1256, Table 20). I defend this assertion below (Part 3). Both estimates are "ballpark" estimates, meaning that the absence of appropriate data necessitates the incorporation of several important approximations and assumptions.

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John W. Gofman, 88;
medical physicist warned of the health effects of radiation
Aug 28, 2007
by Thomas H. Maugh II, Los Angeles Times Staff Writer
 
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            Dr. John W. Gofman, the medical physicist whose fight for what he considered scientific honesty in understanding the health effects of ionizing radiation made him a pariah to the nuclear power industry and the U.S. government, died of heart failure Aug. 15 at his home in San Francisco. He was 88.
            Often called the father of the antinuclear movement, Gofman and his colleague at Lawrence Livermore National Laboratory, Arthur R. Tamplin, developed data in 1969 showing that the risk from low doses of radiation was 20 times higher than stated by the government.
            Their publication of the data, despite strong efforts to censor it, led them to lose virtually all of their research funding and, eventually, their positions at the government laboratory.
            Most of their conclusions have subsequently been validated, but critics say the risks have been ignored by an electric power industry that sees nuclear energy as a pollution-free alternative to fossil fuels and by a medical industry that continues to use much larger amounts of radiation for medical tests than are required.
            "He always stood up for the integrity of science," said Charles Weiner, professor emeritus of the history of science at MIT.
            "He was really an original voice" in the debate over the risks of nuclear power, Weiner said, "someone who was an insider in nuclear weapons production who was very highly regarded by leaders in the field . . . and who brought credential, credibility and authority."

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• Comments upon the “Draft Recommendations
  of the International Commission on Radiological Protection.”
  Dec 26, 2004
  Submitted to the ICRP by John Gofman and Egan O'Connor
   
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              The Committee for Nuclear Responsibility . . . submits the following comments upon the “Draft Recommendations of the International Commission for Radiological Protection” (ICRP) concerning maximum annual radiation doses for workers and members of the public, and concerning release of radioactive contaminants into commerce (including foodstuffs) and into the environment.
              CNR’s conclusion is that the health damage from ICRP’s recommendations is seriously underestimated with respect to radiation doses accumulated year after year in the annual range from 10 cSv (10 rems) down to zero, and that the recommendation for putting little or no constraint on small individual releases of radioactive material may cause irreversible harm many-fold greater than assumed. One of our chief concerns is the unevaluated risk in the ICRP Recommendations of radiation-induced coronary artery disease. . . .
              We recommend that the ICRP and other such groups carefully consider the RMP study before issuing any radiation guidelines in 2005. The consequences of effective doses of radiation up to a few cSv (rems) each year, upon causation of such an important disease, should certainly not be excluded from the estimated “detriment.” The proposed exclusion in the ICRP 2005 Recommendations (p.34) is unacceptable and will surely end up creating a false sense of safety. . . .
              There is no doubt that the menace of dose-cohorts, unmatched for accumulated x-ray organ-doses in the ABSS [A-Bomb Survivor Study], should warn everyone to reduce the trust commonly placed in quantitative risk-estimates derived from the ABSS --- as are most of the ICRP guidelines.
              And this menace is not limited to the ABSS or to other dose-response studies of the effects from just ionizing radiation. For instance, it is a hazard in dose-response studies of any suspected causal co-actor (e.g., any mutagen, or diet, smoking, non-ionizing radiation) in mortality from coronary artery disease or cancer.

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• FDA Proposes New X-Ray Regulations: Immense Health Benefits Possible
  --- Unless Naysayers Prevail.
  X-Ray-Induced Diseases, Hormesis, and Medical Ethics.
  Mar 31, 2003.
  Testimony submitted to the FDA, by John Gofman and Egan O'Connor
   
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              This communication, with its three attachments, is offered in complete support of the U.S. Food and Drug Administration's (FDA) proposed performance standards for new x-ray fluoroscopic systems . . . Our purpose here is to contribute scientifcally strong evidence that the FDA has greatly underestimated the health benefits of its own proposals . . .
              The FDA asks an important question (FR, p.76072): With such a favorable ratio of benefits over costs, why must a federal mandate be invoked? The FDA's answer: The "market" does not respond to the ratio because the costs accrue to the profession, but the benefits accrue to the patients.
              We believe that the above dynamic does operate, but that it operates only because the medical profession has been taught for decades that the cancer hazard from medical x-rays is negligible. That same message continues to be repeated today, not only by the FDA (Part 2, above), but elsewhere with greater vigor (Part 6, below).
              In great contrast to claims of very low hazards from customary medical x-ray practices (and thus, negligible health benefits from dose-reduction), we have uncovered powerful evidence that customary x-ray practices became and remain one of the necessary causal co-actors in over half of the fatal cases of cancer and over half of the fatal cases of ischemic heart disease (coronary artery disease) in the USA (Gofman 1999). The study's method and findings are most succinctly summarized in Attachment-1 (i.e., Parts 4 and 5 of Gofman 2002). . . .
              "If you care, you measure." This axiom reflects the well-known fact in business and education that, if you are serious about achieving a goal, you establish a system to measure progress or its absence. "What you measure improves." Without seeing the improvement, or knowing of its absence, people lack guidance and motivation, and are robbed of their pride in achievement.
              It is impossible to believe that doses during fluoroscopy will be cut in half (and much more) unless the measurement of fluoroscopic x-ray dose becomes easy and automatic.

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• What Are the Main Critiques of the 1999 Study by Gofman,
  after Three Years of Peer-Review?
  Six Critiques of Radiation from Medical Procedures
  in the Causation of Cancer and Ischemic Heart Disease (IHD), Nov 2002
   
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              The study's two principal conclusions are 1) Medical radiation, introduced into medicine in 1896, became and remains a necessary causal co-actor in over half of the fatal cases of cancer in the USA, and 2) became and remains a necessary causal co-actor also in over half of the fatal cases of ischemic heart disease (coronary artery disease) in the USA. . . .
              The conclusions above are obviously so important for human health that they demand thoughtful, independent scrutiny, i.e., peer-review.
              How have our conclusions held up under peer-review? Has someone shown a reason to discard them, to ignore them, or to modify them? Not so far. . . .
              Why, then, are the findings not yet treated as one of the major medical breakthroughs of the past decade? Experience shows that it always takes time for humans to discard mistaken beliefs, especially when the beliefs are so comforting (e.g., "The harm from medical x-rays is trivial"). Still, patience may be no virtue when very many premature deaths could be prevented by a little speed (Gofman 1999 pp.17-20). We agree with the author, Kenneth Graham, who has observed:
              "The strongest human instinct is to impart information, and the second strongest is to resist it."
• The following is a publication of
   
  XaHP: The X-rays and Health Project

  ---

  An educational project of
  the Committee for Nuclear Responsibility
   
  • Making Personal Decisions about X-ray Screening Tests,
    Such as Mammography and CT of the Lung,
    Colon, Heart, or the Entire Body, May 2002
     
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      The fact that some people do benefit from various x-ray screening tests certainly does not guarantee that individuals who consent to (or insist upon) getting screened are likely to receive more personal benefit than personal harm.
                The older you are, the more abnormalities you have accumulated. When they are detected by x-ray screening, you are very likely to face a host of additional procedures which are not risk-free (e.g., more x-rays, biopsies, surgeries, etc.) --- quite possibly to care for abnormalities which would never have caused you any trouble.
                Responsible health professionals are finally asking: Do some sorts of screening policies cause more harm than good? Because the potential benefits have been so widely promoted, this document concentrates on providing more information about the likelihood of harms.

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• The following are publications of
   
  XaHP: The X-rays and Health Project

  ---

  An educational project of
  the Committee for Nuclear Responsibility
   
  • Links to Professional Societies, Current to 12 Oct 2001
     
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      In this document, the X-rays and Health Project (XaHP) offers links and addresses to six professional societies whose leaders and members have either the authority or expertise to reduce x-ray dose per x-ray imaging procedure.
                Short messages of encouragement from non-members can intensify professional attention to dose-reduction . . . When you contact the leaders of these societies, you could express your confidence that they have the skills to achieve a better benefit-risk ratio for patients by reducing x-ray doses . . .
                The societies fall into three categories: (1) Radiologists, (2) Radiologic Technologists, (3) Health Physicists. In addition, we have listed a route of easy access to the radiation divisions of Health Departments in every state.
    
    
    
  • Who Says that Usual X-Ray Doses Can Be Much Lower?, Oct 2001
     
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      To help educate health professionals and the public about x-ray dose-levels, the X-Rays and Health Project has assembled some excerpts from the peer-reviewed radiology journal American Journal of Roentgenology. (Roentgen ray is another name for x-ray.) The AJR is edited by Lee F. Rogers, M.D. and published by the American Roentgen Ray Society (www.arrs.org), which was founded in 1900 -- the nation's first radiology society.
    
    
    
  • X-Radiation and Gamma Radiation:
    Comments on Their Nomination as Known Human Carcinogens
    for the Eleventh Report on Carcinogens (RoC), Sep 11, 2001
     
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      These comments apply primarily to x-ray exposure received during medical imaging procedures (during diagnosis, during surgery, during placement of catheters, needles). These comments do not address x-rays and gamma rays used at very high doses for cancer therapy because the Report on Carcinogens (RoC) lists causes of cancer, not potential treatments. . . .
                The mistaken assumption, that x-ray exposure from medical imaging is negligible, has been very widely embraced. Although the NTP Reports on Carcinogens explicitly exclude any risk-assessments, the NTP has the responsibility to evaluate whether or not exposure to a nominated carcinogen is literally negligible. . . .
                There is a vast literature on human cell-studies which demonstrates that x-rays and gamma rays are a potent cause of structural chromosomal mutations of every sort, including re-arrangements, acentric fragments, and deletions ranging in size from multiple genes probably down to single nucleotides. (The deletion of a single nucleotide is no small matter, since it can scramble the genetic code by causing a frame-shift.)
    
    
    
  • Computed Tomography (CT) X-Ray Exams:
    Estimated Doses to Patients, Sep 2001
     
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      CT doses below are merely "ballpark" values. Entrance doses during CT scans are almost never measured. Actual doses --- even from the same equipment for the same patient --- can vary many-fold according to the settings selected for kVp, mAs, pitch, filtration, slice-width, and some other variables.
                Real doses in centi-Gray units (cGy) are distinctly different entities from "effective" doses in centi-Sievert units (cSv). Real doses quantify energy per gram of tissue delivered by an x-ray exam to the irradiated sections of the body, whereas "effective" doses are artificial values based on assumptions about risk ("detriment").
    
    
    
  • Breast Cancer: Why Do We Permit So Many Preventable Cases?, Jun 2001
     
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      A guaranteed way to reduce future breast cancer is to reduce x-ray dose per x-ray imaging procedure. And if we are serious about achieving good images with the least possible x-ray doses, x-ray measurements are the key. If we care, we measure -- because otherwise we do not know if we are succeeding or failing. "What you measure improves," is an appropriate motto here.
                I am unaware of any other aspect of medicine where we use a potentially lethal agent without measuring the dose and making every effort to reduce the risk. It is not good enough, morally, that the benefit exceeds the risk. The moral imperative includes making the risk as small as possible.
                Naysayers will deny that patients commonly receive much higher x-ray doses than necessary. Such denials would be wrong according to recent articles right in the medical literature (see references in The X-rays and Health Project). Techniques to reduce x-ray doses are already known and demonstrated, and await application. . . .
                Where will we find the "Heroes for Breast Health?" There are three professional groups, present in large hospitals, who are outstanding candidates for this honor: The radiologists, radiologic technologists, and health physicists. Together they have the expertise to do what is needed to reduce x-ray dose per x-ray imaging procedure. Links to their main professional societies are provided here.
                When these three groups decide to accept this responsibility, they will change the entire landscape in the breast-cancer field. Local chapters could contribute successful models which other localities could duplicate. By leading a relentless program to reduce doses during x-ray imaging, these professionals can say "NO!" to permitting a great many preventable cases of future breast cancer, and they would deserve every honor of the realm, absolutely! Will they rise to the occasion? How soon?
    
    
    
  • How the Cold War Caused Millions of American Deaths
    Through Medical Practice:
    A Story of Intended and Unintended Consequences, Apr, 2001
     
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                The key point is that peacetime nuclear activities (military and civilian) expose the general public to low doses of ionizing radiation.
                The government's solution to quelling public fear of "radiation" was to have its agents assert --- for decades after it was no longer true --- that evidence of human harm from ionizing radiation comes exclusively from exposure to high doses, and that evidence of human harm from low doses does not exist. . . . What the government and its agents failed to point out in the 1950s and early 1960s was that no studies capable of producing evidence about low doses had ever been completed. . . .
                Fifty years of ridiculing the fear of low-dose ionizing radiation ("radio-phobia") have had a tragic unintended consequence: Two or three generations of practicing physicians and their professors at medical schools have mistakenly believed that danger from x-ray imaging procedures was either absent or trivial. . . .
                The evidence in my 1999 monograph (Ref.4), which no one has refuted, indicates that about 250,000 persons each year in the USA are dying prematurely from cancer and coronary heart disease due to the unnecessary half of the x-ray doses which they accumulated earlier in life, during x-ray imaging procedures. This has been going on for 50 years, and continues. . . .
                The Cold War propaganda has left the medical professions unaware of the premature, preventable, x-ray-induced deaths which they have been causing, by using higher x-ray doses than needed during imaging.
                The era of unawareness should end --- forever. Ethical responsibility for current and future x-ray practice rests now with the medical professions, and especially with the gatekeepers to their education: The medical school professors, the medical journal editors, and the members of the radiological professional societies. How will they respond?
    
    
    
  • X-Ray Dose-Measuring Service for Physicians and Dentists,
    Jan 21, 2001
     
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                The entrance dose of x-rays is the dose received at the body's surface, where the x-ray beam enters. The exit dose, which is what results in an image, is very much lower. The body absorbs the difference between the entrance and exit doses.
                TLDs (ThermoLuminescent Dosimeters) can measure the x-ray entrance dose received by any patient during an x-ray imaging procedure. . . . X-ray practitioners can obtain TLDs the instructions, and the reading service by mail from an accredited laboratory at the University of Wisconsin.
  
  
  
• Solving Energy Shortages without Nuclear Power:
  Three Easy Rules, Apr 2001
   
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              The three main arguments against nuclear electricity are even stronger now than they were 30 years ago, when CNR began putting them forth. This very short summary, with some updated resources, will be handy during the new effort to revive nuke-power. . . .
              The hydrogen economy, with the hydrogen provided by various types of solar technologies, can liberate the planet both from production of more radioactive poisons by nuke-plants and from the greenhouse gases and other pollutants produced by fossil fuels. The USA could commit itself to the hydrogen economy now, for the sake of health, the environment, national security, and abolition of wars over oil. The fuel of responsible civilizations will be renewable solar-generated hydrogen gas.
    . . . Claims, that "advanced" nuke-plants are inherently safe, merit no credence until their proponents show that they believe their own claims. If they do, they would openly beg Congress to exempt every "advanced" nuke-plant from the law (the Price-Anderson Act) which protects the nuke industry from full liability for catastrophic radioactive releases.
              In any case, sudden catastrophic releases are a threat limited to a few decades of operation. The real problem endures for over 1,000 years. About 400 nuke-plants now operate worldwide (100 in the USA). Permission to operate a few additional nuke-plants might appear like a minor issue. But if ten new nuke-plants each operate for at least 30 years, they would commit posterity to isolating (containing) additional radioactive poisons equivalent to the long-lived poisons produced by exploding 300,000 Hiroshima-bombs: 1,000 bombs/year per plant * 10 plants * 30 years. The poison generated by just ten plants would be about 20 times more than all the long-lived radioactive fallout from all the atmospheric nuclear bomb-tests conducted by the US, UK, and USSR combined . . .
              Each additional nuke-plant of any design inevitably increases the legacy of radioactive poison --- to threaten posterity for at least 40 generations. This fact was and remains enough to make nuke-plants unacceptable --- the ultimate selfishness. Ethics aside, it is clear that nuke-plants were not necessary in the past, and will not be necessary in the future. Case closed.
  
  
  
• The Causes of Cancer: Is There "Too Much Emphasis on Genes, and Not Enough on the Environment?" How to Avoid Some Mistakes, Apr 2001
   
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              Genetic abnormalities can be divided into two classes: Inherited and acquired. . . . Unlucky individuals inherit genetic abnormalities which can predispose every cell to become malignant, but the full set of genetic abnormalites required for malignancy is very rarely (if ever) inherited. Instead, the full set is accumulated in a particular cell over time. And the probability of accumulation in the same cell is determined by the cell's "environment" --- by its exposure to agents which can cause alterations in that cell's genetic molecules. Because the importance of acquired genetic abnormalities, in causing cancer, is very widely acknowledged, no discontinuity really exists between "genetic causes" and "environmental causes" of cancer.
  
  
  
• Key Facts Justifying Opposition to Nuclear Pollution at Any Level:
  A Brief Letter of Concern, Feb 6, 2001
   
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              The topic of this letter is the fact that there exists no threshold dose of ionizing radiation below which natural repair, of radiation damage to the genetic molecules, always occurs perfectly. . . .
              In short, a single x-ray photon or the radioactive decay of a single atom is physically capable of causing permanent and consequential mutations --- including mutations which cause cancer. The chance that this will occur is proportional to dose, right down to zero dose. . . .
              It follows from the absence of any safe dose that citizens everywhere have a strong scientific basis for opposing activities which can cause radioactive pollution at any level. The fact that humans cannot escape exposure to ionizing radiation, from various natural sources, is no reason to let human activities increase the exposure. Moreover, the record of governments and their licensed agents has often been horrible regarding containment of radioactive poisons. This record argues strongly against confidence in any promises of future containment.

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• The following are publications of
   
  XaHP: The X-rays and Health Project

  ---

  An educational project of
  the Committee for Nuclear Responsibility
   
  • Eight Key Points: Your Stake in
    the Patients' Right-to-Know about X-Rays, Dec 7, 2000
     
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              3    My recent study (Radiation from Medical Procedures, 699 pages) provides the first powerful evidence that the U.S. population's accumulated exposure to medical x-rays is a necessary co-actor in causing over half the deaths from cancer, and over half the deaths also from ischemic (coronary) heartdisease. Since the study's publication in November 1999, no one has shown that it overestimates the impact of x-rays in causing cancer and coronary heart disease. Some people say "it must be an overestimate," but they have never shown how. Some of the critics have never even looked at the study.
              8    The right time to start action on the "Doses Down Now" policy is today, because achievements in your locality can benefit your family and your community within 18-24 months, without waiting for statewide or nationwide success. Any locality can get its x-ray doses down, regardless of how slowly other regions might make progress. The "Doses Down Now" policy is a proven way to prevent some of the cancer problem, not a "maybe." So please invite people on your E-mail address book to join the "Patients' Right-to-Know" effort.
     
  • A Proposal for Radiologists:
    How a Specific Consultation Can Become a Major
    Asset for the Practice and for the Community, Oct 2000
     
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      Radiologists in Toronto invited a team of medical physicists to observe their actual x-ray imaging practices, to measure doses, to teach low-dose techniques, to tune-up existing equipment, and to ensure proper processing of exposed films. . . . The consultation demonstrated that --- without loss of image-quality --- average dose could be reduced "by a factor of at least 3 with little work and by a factor of 10 or more if all conditions are optimized" (Taylor 1983, p.557). These achievements were obtained without purchases of major new equipment.
     
  • Mammography and XaHP (the X-Rays and Health Project):
    Is There Any Conflict? Four Brief Comments, Oct 2000
     
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      If there is a war on cancer, but no group or agency is devoted to reducing exposure to a PROVEN cause of every major type of cancer --- namely, x-rays --- then the decision to neglect x-rays really CAUSES the future xray-induced cancers (and heart attacks) which could have been prevented. This logic creates the moral obligation to succeed at what is demonstrably feasible: Obtaining all the benefits of medical and dental x-rays, at lower doses per procedure. An imaginary conflict, between this goal and mammography, would be tragic for nearly everyone.
     
  • Do X-Ray Practitioners Give Enough Attention
    to Minimizing the Patients' X-Ray Dosage?
    Some Opinions, Some Facts, Sep 2000
     
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      The personal comments of the radiologist's wife seem to be consistent with the published comments of Joel E. Gray, Ph.D., professor and medical physicist at the Mayo Clinic until his recent retirement to become a consultant. Dr. Gray is a world-class expert in obtaining high-quality x-ray images while minimizing x-ray dosage to patients and staff. . . .
                "If your exposures have not been measured recently, you cannot be sure what exposures you are using. And if you don't know what your exposures are, you don't know if you are doing a good job" (Gray 1998a, p.61). Dr. Gray stresses that dose-reduction techniques not only reduce the risk of causing cancer, but they can sometimes produce better images.
     
  • How X-Ray Doses Vary From One X-Ray Practitioner to Another:
    Nationwide Surveys, Sep 2000
     
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      An assumption, widely held among physicians and patients alike, is that x-ray practitioners in general already give x-ray doses which are as low as technically possible, consistent with obtaining good images.
                That assumption is demonstrably false, as illustrated by the table below, which is based on nationwide surveys of about 300 facilities (CRCPD 1989 + CRCPD 1994). . . .
                Joel E. Gray, Ph.D. --- using the CRCPD data plus his own vast experience as a professor and medical physicist at the Mayo Clinic (and currently as a private consultant) --- has published two articles which further demolish the assumption that doses received during x-ray imaging are already as low as technically possible (Gray 1998a+b).
                Helpfully, Dr. Gray's articles also describe "relatively simple, inexpensive, and easily applied" techniques which, combined, can reduce dose in various circumstances to one-fifth the amount given if such measures are not used. Unfortunately, the two articles are very hard to obtain, and they probably have been seen by almost no one in medicine and certainly not by the public.
     
    Fear, and the Patients' Right-to-Know:
    The Viewpoint of an Influential Radiologist,
    Deserving a Public Response, Sep 2000
     
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      The goal of the X-Rays and Health Project (XaHP) is to reduce the x-ray dose per x-ray procedure, to the minimum level consistent with obtaining the medical and dental benefits. The reason for dose-reduction is that x-rays increase the risk of consequential mutations, even when each x-ray exposure occurs at low doses. . . .
                In our opinion, a medical degree confers an especially strong duty to examine evidence bearing on life and death very carefully, before urging anyone to ignore it.
                Imagine that persons with such a degree hear about a new study whose conclusion is that millions of future cases of cancer and coronary heart disease could be prevented by reducing x-ray dosage per x-ray procedure. Such a benefit would hardly be trivial! Without examining and refuting the new evidence, can physicians ethically urge anyone to ignore it? What about the very great harm that such advice may cause?
                Our viewpoint is that the best outcome for health, with respect to x-rays, will occur only if both patients and physicians are aware of the full range of informed medical opinion. Our informed opinion is that reducing x-ray dosage per x-ray procedure will prevent significant shares of future cases of cancer and coronary heart disease. That would be an immense health benefit. The evidence is so strong that we would feel ashamed if we did nothing about it.
     
  • A Patient's Guide, When X-Rays Are Proposed, Sep 2000
     
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      The U.S. Food and Drug Administration makes this estimate on its website, March 2000: Seven out of 10 Americans will get a medical or dental x-ray "picture" this year. . . . Sooner or later, you or a family member is very likely to contemplate an x-ray, due to a medical or dental problem or due to an accident.
                Two types of x-ray imaging procedures which generally (not always) deliver the highest x-ray doses are fluoroscopy and CT exams (XaHP Doc.102). The American Cancer Society has stated, "Fluoroscopy delivers larger doses of x-ray than that used in standard films. If there is an alternative means of making a diagnosis, fluoroscopy should be avoided". . . .
                There is no mystery about how to reduce doses, technically. What is lacking is leadership. If just a few thousand American radiologists would openly endorse the goal, their leadership (in our opinion) could reduce the average dose-level administered by other radiologists virtually overnight. Other kinds of x-ray practitioners would follow suit.
     
  • Making the Bay Area a Model for California and the Nation:
    A Guaranteed Way to Reduce Future Cancer-Rates, Fall 2000
     
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      A dose-reduction program requires no one to give up any of the benefits of x-ray images. The fact is that the benefits of x-ray images can be obtained from lower doses. Only 25% of x-ray practitioners are using the lowest doses technically possible. The other 75% are giving patients higher doses than the doses needed for high-quality images --- in some cases, 5-times, 10-times, 15-times more dose than needed. . . .
                We suggest that the goal in the Bay Area, and in every county of the nation, should be that all x-ray practitioners give patients the lowest x-ray doses technically possible, consistent with obtaining good images. No patient deserves to receive an unnecessary x-ray-induced death later on, due to uselessly high x-ray exposure. . . .
                If the two goals of the Policy Statement had been adopted 30 years ago, when it was first clear that x-rays are a cause of Cancer in adults, countless cases of misery would have been prevented. It is a moral imperative to do now what could have been done ago. The Bay Area can lead the way, as a model for the rest of California and the nation.
     
  • X-Rays: The Fallacy of the "Day in the Sun" Comparison, Feb 28, 2000
     
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      Usually, when exposure to x-rays is compared with "a day in the sun" or "a day at the beach," the mistaken assumption is that the ultraviolet light from the sun is comparable to the penetrating photons of x-rays and gamma rays. . . . When the "day in the sun" analogy is meant to compare x-ray exposure to exposure by one day of natural background radiation, the comparison is still mistaken, even though natural background radiation has access to the body's internal organs.
     

    ---

• A New, Low-Cost Way to Shake a Mistaken Mindset, Apr 2, 2000
   
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    Now, there is a new, low-cost way to challenge [the] harmful mindset ... that ionizing radiation makes only a small contribution to our rate of Cancer (and no contribution at all to our rate of Coronary Heart Disease). People can readily distribute the 32-page Executive Summary of "Radiation from Medical Procedures" to members of pollution advisory panels, enivronmental groups, local cancer-action groups, local physicians, local chapters of professional groups, local college faculties, local consumer protection groups, local holistic medical groups, local media and columnists, etc. The "trickle-up" from a million copies would do a lot to undermine the mistaken mindset. That's one way that "alternative" medicine became "mainstream."
  
  
• Preventing an Exercise in Self-Defeat:
  The Relevance of Medical Radiation to Nuclear Pollution, Apr 2000
   
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              Because all types of ionizing radiation do their damage in the same way (Part 3, above), insights gained from the study of people exposed to one type of ionizing radiation apply also to the other types of radiation (with minor modifications).
              So, it would be scientific lunacy for persons working on nuclear pollution to reject the knowledge gained from studying the health-harm from medical xrays. For example, some of the most important insights in the whole scientific effort have been based on medical xrays:
              Medical xrays provided Alice Stewart's evidence, in 1956-1958, that pre-birth exposure to ionizing radiation increases the risk of childhood Cancers and Leukemia.
              Exposure to medical xrays, in therapy of the painful spinal disease "Ankylosing Spondylitis," provided the first evidence in the 1960s that nearly all kinds of human Cancer would probably turn out to be inducible by ionizing radiation. This early warning was correct.
              Human exposure to medical xrays provided the type of evidence which made it possible in 1990 for us to prove, by any reasonable standard of biomedical proof, that there is no safe (risk-free) dose-level or dose-rate of ionizing radiation with respect to causing Cancer. And much of the same evidence was subsequently used in 1995 by the British National Radiological Protection Board, to conclude that "the weight of the evidence falls decisively" against any threshold (safe dose).
              Now, in 1999, data from human exposure to medical xrays provides the first powerful evidence that exposure to ionizing radiation is a cause of Coronary Heart Disease. This discovery is clearly as important as the discovery that exposure to ionizing radiation is a cause of Cancer.
              How could anyone assume that all the discoveries above have no relevance to exposure by nuclear pollutants? Such an assumption would be an irrational denial of the essential feature of ionizing radiation. Everyone concerned about nuclear pollution has a huge stake in knowledge gained from studies of medical xrays.
  
  
• Additional Materials Related to Radiation from Medical Procedures :
   
  • One Easy and Important Step You Can Take
    Toward Avoiding Cancer and Coronary Heart Disease:
    An Affordable Summary of New Evidence about X-Rays, 2/00
     
  • Are X-Ray Procedures Equivalent, in Extra Radiation Dose,
    To Taking an Airplane Trip?, 2/28/00
     
  • What Is an "Entrance Dose" of X-Rays?, 2/00
     
  • RAMP Addition-1: "Expectations", 2/19/00
    
    Demonstration, for All-Cancers-Combined:
    The Findings in RAMP Are in Line with Reasonable Scientific Expectations.
    A Response to Claims that the Findings Are not in Line with Reasonable Expectations.

     
  • RAMP Addition-2: "Causation", 2/25/00
    
    A Response to the Comment, "Very Impressive Dose-Responses ---
    But Dose-Responses Do Not Prove Causation by Radiation Because
    They Do Not Rule Out Some Other Cause of the Observed Relationships."

     
  • RAMP Addition-3: "Atherogenic Mutations", 3/9/00
    
    The Unified Model of Atherogenesis and Acute IHD Death:
    Additional Evidence Related to Monoclonality, and to Acquired Mutations.

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• Letter of Concern, regarding the biological effects of ionizing radiation, May 11, 1999
   
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• Cancer in the Family: Does Each Case Require More Than One Cause?
  The Likelihood of Co-Action, Apr 1999
   
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              Contrary to popular belief, [terms such as "radiation-induced Cancer"] do not necessarily mean that radiation acts alone to cause a case of Cancer, or that smoking acts alone to cause a case of Cancer, or that a workplace carcinogen acts alone to cause a case of Cancer, . . . . Indeed, the "general wisdom" is that they do not act alone (Part 3).
    . . . To allow for the likelihood that a case of Cancer requires more than one cause, one should think of "radiation-induced Cancers" as cases which would be absent (prevented) in the absence of radiation exposure (Parts 7 + 8). . . .
              One of the interesting implications of co-action is this: Reducing exposure to a single carcinogen reduces the power of all of its partners in causing Cancer. If one can identify a single carcinogen which is a necessary co-actor in many common types of Cancer (which means, the carcinogen will have a high Fractional Causation), then one can make real progress in preventing Cancer by reducing exposure to that single cause.
              This year, the Committee will publish strong new evidence that ionizing radiation is such a carcinogen.

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• CNR Renewal Request, Fall 1998
   
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              One of the most overlooked dangers from nuclear pollution, and from other sources of irradiation, is the problem of inherited afflictions when the exposed persons subsequently conceive children. This topic belongs at the top of the list of importance, with respect to nuclear power and nuclear pollution. . . .
              The enclosed article supports the scientifically credible warning that at least one-fourth --- and maybe more than half --- of the inherited tendencies are probably due to the very low-dose radiation which humans have been receiving (generation after generation) from natural background sources.
  
  
• "Asleep at the Wheel": The Special Menace
  of Inherited Afflictions from Ionizing Radiation, Fall 1998
   
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              The topic which consumes Parts 5,6,7 of this article is the famous failure to detect (at a statistically significant level) any extra frequency of inherited afflictions, in the Japanese children of the Atomic Bomb Survivors.
              The main importance of the "famous failure" has been its power to render much of the environmental and medical communities "asleep at the wheel," with respect to the menace of inherited afflictions caused by ionizing radiation. Some environmentalists even talk about "giving nuclear power a second chance." And some people in medicine are so relaxed, about low-dose radiation, that their customers have to fight in order to obtain shielding of their ovaries and testes from xray beams.
              We suspect that hardly one-percent of environmentalists and medical professionals know (a) that when the A-Bomb Genetics Program was initiated, it was already acknowledged that, in all probability, it would be inherently incapable of producing statistically significant results (see Para.5b), and (b) that very few inherited effects were even explored in that Program (see Part 6). One purpose of this article is to document statements (a) and (b).
              The other purpose of this article is to set forth a scientifically credible warning that ionizing radiation is probably the single most menacing mutagen to which people everywhere are exposed --- and by itself is probably the mutagen which accounts for one-quarter or more of humanity's inherited afflictions (Para.2b). This warning is tied to three types of relevant human evidence (Parts 9,10,11). . . .
              The very low doubling-dose for radiation-induced chromosomal mutations, and confirmation of the importance of such mutations in inherited disorders, combine almost to scream at humanity: "Do not permit increases in nuclear pollution. At enormous expense, you can recapture only a small part of what you let loose. Irrevocable nuclear pollution inevitably increases humanity's rate of inherited afflictions."
  
  
• The Fission-Product Equivalence
  between Nuclear Reactors and Nuclear Weapons, Fall 1998
  Adapted from Vol.117, No. 105, Jul 8, 1971, of the Congressional Record
   
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              The calculations below establish that one large nuclear power plant, during one year of operation, produces as much long-lived radioactive poison (fission products) as produced by the explosion of about 1,000 Hiroshima bombs. . . .
              What is desired here is a determination which compares production of long-lived fission products (for example, strontium-90 or cesium-137) by nuclear power reactors, with such production by nuclear weapons. In particular, we shall determine what Kilotonnage of atomic fission bombs (the Hiroshima bomb was a fission bomb) is required to produce an inventory of long-lived fission products equivalent to the inventory within a 1000 Megawatt (electrical) nuclear generating station which has operated for one year.
  
  
• Comments on Extremely Low Frequency Electric and Magnetic Fields, 10/2/98
   
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              I have received the full 500-page "Working Group Report" on identifying (not quantifying) potential health hazards from exposure to power-line frequency EMFs (NIH Pub. 98-3981). You invite comments, especially about the group's vote (by 19 out of 30 members) to classify ELF EMFs as "possibly carcinogenic to humans" (p.396), according to IARC criteria. . . .
              4.   In the absence of conclusive evidence about adverse health effects from EMFs, there is a troubling ethical issue which NIEHS and Congress should not overlook. People are getting exposed without their consent to an agent of unknown toxicity. The fact, that this is true also for most chemical pollutants, does not make it morally defensible. The doctrine, that there is a right to expose people unless they (or their government) can prove harm, amounts to enrolling the population in a giant biological experiment without consent. And after harm is established, the cost-benefit doctrine of pollution takes over, and this doctrine still assumes a polluter's right to expose people without their consent, as long as the majority of 535 members of Congress decree that the economic benefit to society (and possibly to certain Congressmen and polluters) is "worth it." . . .
              9.   Indeed, because of the potential conflict of interest in such research, I urge NIEHS to adopt a policy --- starting with a website addendum to this report --- of requiring every member of a Working Group, Task Force, Advisory Panel, etc. to disclose the source and amount of his/her past and current funding, and if at a university, any benefactors of his or her department. If judges, non-profit board members, lawyers, security analysts, and many other high-status professionals routinely disclose their sources of funding --- without claiming that such disclosure impugns their integrity --- then scientists deserve no exemption. As you know, journals routinely ask for such disclosure from scientists. But I find no clue about past and current funding of the various experts named on pages 1-4. Nor do I find any discussion of the "interests" of those who picked the 30 Working Group members, and the criteria for selecting Dr. X instead of Dr. Y for a slot.
  
  
• Mammography: An Individual's Estimated Risk that the Examination Itself
  Will Cause Radiation-Induced Breast Cancer, 6/9/98
   
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    This is a distillation of pp.172-181 of the 1996 book Preventing Breast Cancer, by John W. Gofman, M.D., Ph.D. Adapted for this table by Dr. Gofman.
  
  
• Confirmation that Ionizing Radiation Can Induce Genomic Instability:
  What is Genomic Instability, and Why Is It So Important?, Spring 1998
   
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              Genomic instability --- also called "genetic instability" and "chromosomal instability" --- refers to abnormally high rates (possibly accelerating rates) of genetic change occurring serially and spontaneously in cell-populations, as they descend from the same ancestral cell. By contrast, normal cells maintain genomic stability by operation of elaborate systems which ensure accurate duplication and distribution of DNA to progeny-cells, and which prevent duplication of genetically abnormal cells. . . .
              Why is genomic instability so important? Many (not all) cancer biologists now believe that genomic instability "not only initiates carcinogenesis, but also allows the tumor cell to become metastatic and evade drug toxicity" . . ., and "The loss of stability of the genome is becoming accepted as one of the most important aspects of carcinogenesis" . . ., and "One of the hallmarks of the cancer cell is the inherent instability of its genome". . . .
              In view of all the five facts above, it would be inappropriate to doubt the menace of low-dose ionizing radiation.
              And in view of all the five facts, it is strange --- in studies which attempt to explain a difference in cancer-rates between two groups --- that the question is so seldom asked: How do the radiation histories differ between the groups? In view of the five facts above, it should be the first question.

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• Reject the Policy of Putting Radioactive Scrap-Metal into Commerce,
  Dec 1, 1997
  If You Ever Take an Xray, Fly, or Live at High Altitude, Are You Silly to
  Reject the Policy of Putting Radioactive Scrap-Metal into Commerce?
   
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              Like every other "Below Regulatory Concern" (BRC) practice, commercial use of radioactive scrap-metal amounts to permission to commit premeditated random murder --- as does every "permissible dose" of nuclear pollution. These BRC and "permissible" doctrines violate human rights in a profound way. . . . The morally bankrupt aspect of radioactive scrap and nuclear pollution is that these practices force unwilling and unsuspecting people to take extra radiation exposure. These practices amount to deadly trespass.
  
  
• Cassini Fly-By, An Open Inquiry to NASA and DOE, Oct 23, 1997
  Will the "Ceramic" Plutonium Still Be a Cohesive Solid,
  or Will Its Self-Irradiation Have Made It Very Fragile?
   
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              NASA and DOE have issued public assurances that, during the fly-by of Cassini on route to Saturn, even a burn-up accident would cause no health-hazard on Earth. Reason: The plutonium-dioxide on board is said to be a cohesive solid ("ceramic") which would never be able to fall-out as small inhalable particles of the size (less than 10 microns in diameter) which could deposit themselves in human lungs and cause lung cancer.
              Below are the calculations which indicate that, as a result of self-irradiation, every plutonium atom on the mission will have been subjected on the average to about 800 high-energy events, per year of decay before the fly-by.
              I do not know the evidence that Cassini's pellets of "ceramic" plutonium-dioxide will still be a cohesive solid after all that internal bombardment. . . . If the results go in the direction of fine powder rather than "ceramic" cohesion, such results would seriously undermine current claims that a fly-by accident would have no health consequences on Earth.
    See Also: Dr. Gofman in a PBS NewsHour Forum on "Is the Cassini Mission Safe?"
  
  
• The Following 3 Pieces Together Comprise The Fall '97 mailing:
  
  
  1. Need for "Adversary Science" -- the Cassini Example
      
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                 A key lesson about Cassini, in our opinion, is that society should finally stop the repeated lunacy of depending on risk-estimates provided by the enthusiasts of any enterprise --- in this case, NASA, the Jet Propulsion Lab, and others. . . .
                 What do we mean by Adversary Science? We mean financial support for competing teams of experts assigned to find out, and to tell the public, about any hazards which the enthusiasts of a project may have failed to report, or even to "see."
                 This early-warning function would be a research and publicity effort, not a regulatory effort. . . . The world automatically funds plenty of Promotion Science (by governments, some industries, some foundations). For a more balanced public debate, humanity needs a system also to fund automatically some Adversary Science. Certainly not to give Adversary Scientists a veto. Just to provide a more balanced debate.
       See Also: Dr. Gofman in a PBS NewsHour Forum on "Is the Cassini Mission Safe?"
     
     
  2. Solar-Energy Update: Good News about Solar Energy & Energy-Efficiency
      
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                 In May 1997, a wonderful book about progress in solar energy and energy-efficiency was published: Charging Ahead: The Business of Renewable Energy and What It Means for America, by John J. Berger, Ph.D. (398 pages; Holt & Co.;   $30; <www.charging-ahead.com>. It can be bought directly from 1-800-288-2131 or 1-800-544-4565). . . .
       . . . The mystery: What slows up adoption of these popular, proven, renewable technologies? This book explains --- and could empower the public to remove those obstacles. Dr. Berger has done a monumental public service. His book (selected for listing by Science News Books) belongs in the hands of every owner of a home or building, every person who dislikes smog and oil-wars and nuclear pollution, and in every college, high school, and public library.
     
     
  3. Corrections of Frontline's "Nuclear Reaction"
      
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                 A "Frontline" PBS broadcast named "Nuclear Reaction" resembles, in our opinion, a promotional film for nuclear electricity. Like other Frontlines, Nuclear Reaction is likely to be broadcast repeatedly. After writing PBS about one of the program's many factual errors, we also acquired the program's verbatim transscript. Below, we select a few of the Frontline errors for correction.
  
  
• The Free-Radical Fallacy about Ionizing Radiation:
  Demonstration That a Popular Claim Is Senseless, Sep 1997
   
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              In some peer-review journals and various interviews in the media, what we call the Free-Radical¹ Fallacy has been employed in an effort to deny the menace of low-dose ionizing radiation. Here, we will demonstrate why it is a fallacy and explain how to demolish the false claim that ionizing radiation "must" be a negligible health menace, because it adds so few free-radicals to the large number which are present anyway in each of our cells. Our demonstration, which uses only simple arithmetic, disposes of the Free-Radical Fallacy in an objective way, and describes a unique feature of ionizing radiation which is not in dispute. Our demonstration is suitable for students, teachers, science writers, physicians, and concerned medical patients.
              Its last paragraph (4e) states the broader fact-based theme at the very heart of the Committee's mission:

    Because of its unique property, ionizing radiation is a unique menace to our DNA and chromosomes. This fact needs wide recognition, as mankind learns that far more health problems are mutation-based than anyone could prove 15 years ago.

  
  
• A Wake-Up Call for Everyone Who Dislikes Cancer
  and Inherited Afflictions, Spring 1997
   
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              Various media generally refer to "Gofman, long-time opponent of nuclear power," but they almost never label people who deny harm from low-dose radiation as "long-time advocates of nuclear-power" (or mammography, etc.) or as people who have a personal conflict of interest because their grants or livelihoods come from interests who irradiate people. . . .
              In our own view, it is quite possible that a permanent doubling of the "background" dose of ionizing radiation, worldwide, would very gradually double mankind's burden of inherited afflictions --- from mental handicaps to predispositions to emotional disorders, cardio-vascular diseases, cancers, immune-system disorders, and so forth. Such a doubling would be the greatest imaginable crime against humanity. . . .
              At the very time when more and more dreadful afflictions (not only cancer) are discovered to be gene-based, one might expect a very loud consensus in favor of immediate reduction of exposure to ionizing radiation. Instead, we see the opposite: A growing effort to belittle the menace of this particular mutagen. It takes our breath away.
  
  
• Letter of Protest to KQED President re:
  broadcasting Frontline's "Nuclear Reaction", Apr 25, 1997
   
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              For about a week prior to the broadcast of the FRONTLINE program on nuclear power, KQED incessantly ran an ad showing that a piece of paper would stop the alpha particle radiation from a piece of plutonium. The context was, of course, suggesting that plutonium is not all that dangerous as a toxic material --- "even a piece of paper stops all the radiation."
              This is an absolute violation of your privilege to use the airwaves. It is not appropriate for you to air materiel which can have major harmful consequences for life for your listeners. In this case, the horrendous blunder on plutonium can in time add to the death toll which will result from population exposure to plutonium.
  
  
• Supporting files to the Preventing Breast Cancer book:
   
  Breast-Cancer Study
   
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    New Study* Identifies Past Medical Irradiation As Major Cause Of The Breast-Cancer Problem
   
  • Some Reviews and Comments on the Book
     
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  • Breast Cancer-Free Zones: Why Not? An Effective Way to Begin
     
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  • Resistance To New Ideas: A Relevant Story from the Past
     
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• Answers to Frequently-Asked-Questions about "Radiation", Fall 1996
   
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    Xrays and gamma rays, which are a type of electro-magnetic radiation, are far more energetic per photon than visible light, and immensely more energetic per photon than microwaves and radiowaves. Nonetheless, xrays and gamma rays do their biological damage via particles, especially electrons. . . . Regardless of their origin, as high-speed particles slow down, they transfer unnaturally large amounts of energy at irregular intervals to various cells. These transfers of too much energy are unlike the smaller energy-transfers in routine body-chemistry, and the bigger transfers can cause complex, non-repairable damage to a cell's library of genetic instructions --- the chromosomes and DNA. Some types of permanent injury kill the cell, but other types do not.
  
  
• Letters To the Editor -- Unsafe in any dose, Sep 19, 1996
   
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              Citizens of California would be crazy not to insist, even belatedly, on credible proof that the radioactive and "mixed" inventory at LBNL will remain contained -- not only during routine operations, but also through earthquakes, mud slides, and especially fire such as the terrible conflagration which might have consumed the lab just a few years ago. Can a good hot fire and its wind lift and then drop the radioactive and chemical poisons as "fallout"? I am astonished to be told that this question seems not to have been answered in a straightforward, persuasive manner yet.
  
  
• Chernobyl's 10th: Cancer and Nuclear-Age Peace -- Don't Be Deceived,
  Mar 9, 1996
   
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    The monolithic nuclear/radiation "community" cannot afford to provide a meaningful analysis of the radiation consequences. Life, for this monolith, requires the lowest possible death consequences of Chernobyl. . . . Those enterprises (military or civilian) which deliver ionizing radiation to people, anywhere in the world, share the common goal of underestimating the health-hazard of ionizing radiation. Thus, the military enterprises, the nuclear power enterprises, and the medical radiation enterprises (x-rays and "nuclear medicine") share a common endeavor.

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• What Is Factually Wrong with This Belief:
  "Harm from Low-Dose Radiation Is Just Hypothetical
  --- Not Proven", Fall 1995
   
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    Advances in identifying the causes of cancer and inherited afflictions receive much attention in the media because people care very much about preventing these miseries. The mistake we address here is the claim that harm from ionizing radiation, a proven carcinogen and mutagen, is "only hypothetical" at low dose-levels. This misinformation is routinely treated as credible and is disseminated widely . . . The purpose of this communication is to show you, in abbreviated fashion, the factual basis for rejecting the claim that no harm has yet been proven from low-dose radiation. . . .
  
  
• Seven Comments on Proposed Radiation "Standards"
  for the Yucca Mountain Rad-Waste Repository: Oct 26, 1995
   
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    The concept of irreversible rad-waste burial represents an assault against current and future generations. Virtually no one believes it will all stay contained and out of the biosphere.
              Indeed, when the U.S. Government seeks advice from the National Research Council on setting "standards" (so-called permissible limits) for future radiation exposure from Yucca Mountain and other rad-waste burial sites, the government is conceding that some of the poison will probably get into the biosphere. In response, the YMS Committee concedes that rad-waste burial at Yucca Mountain is possible only if people are convinced that "very low radiation doses pose a negligibly small risk" (p.7).
              How can any level of premeditated random murder be presented by policy-makers as "negligible"? Is this really happening in the USA? Can anyone in the National Research Council or the Environmental Protection Agency possibly endorse a right to inflict radiation-induced cancers and inherited afflictions on current and future generations? These are criminal acts. . . .
              People can not justify exposing other people to extra ionizing radiation via nuclear pollution by speculating, contrary to the evidence, that maybe a safe dose exists. The people who advocate such a position are accomplices to premeditated massive experimentation on their fellow humans --- even into future generations. Experimentation on other humans without their individual consent is a crime identified by the Nuremberg Tribunals.

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• The Bonds of Trust vs. Deceit by DOE:
  Some Enduring Measures for Your Health and Safety, Spring 1994
   
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    If crooks make a database, even Einstein would get false answers from it. . . .
              Our government controls all the important radiation health databases in this country, and some abroad (list in Part 8). It's as if the tobacco industry controlled all the databases about the health effects of tobacco (see Part 5).
              The obvious conflict of interest in the control of radiation databases is something which editors of our leading biomedical journals and professors of epidemiology, in our medical schools and schools of public health, should have protested long ago --- even if they knew nothing of specific problems with these databases.

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• Reflections on "Mission Impossible"
  for the 30th Anniversary of LLNL, Biology Programs, Nov 22, 1993
   
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              I am sure that there are objective, DOE-sponsored experts who are very sad about DOE's lack of credibility, which taints their own work. So a solution would be in your interest as well as the public's. I do not believe the Laboratory and DOE can ever achieve credibility on the issue of health effects of radiation (or other pollutants) unless you establish some powerful counter-measures to the obvious conflict of interest.
              One such measure could be a permanent policy of setting aside a segment of the health effects budget --- say 5 or 10 % --- to be administered by independent, non-governmental, citizen-based groups who would sponsor on-site experts of their own choosing. The daily on-site presence of potential whistle-blowers would do a lot to liberate DOE-sponsored analysts from any humiliating pressures, and would give their own work some real credibility.
              I can not guarantee that this would work. But I do guarantee that more than powerless "citizen advisors" are needed to give DOE-sponsored health studies some public credibility. Without a serious plan to cope with conflict of interest, the bio-medical programs will remain -- with respect to public respect -- on a Mission Impossible.
  
  
• What Is Humanity's Most Harmful Law?
  The Law of Concentrated Benefit over Diffuse Injury, Nov 1993
   
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              The law of Concentrated Benefit over Diffuse Injury can be stated as follows:

    A small, determined group, working energetically for its own narrow interests, can almost always impose an injustice upon a vastly larger group, provided that the larger group believes that the injury is "hypothetical," or distant-in-the-future, or real-but-small relative to the real-and-large cost of preventing it.

              Many scholars have written about this extremely important axiom before -- it is not original with us. The fact that narrow special interests are always at work for their own benefit at the expense of others is not at all surprising, given human nature. And it is not surprising that the victims select what appears to be the strategy of least cost to themselves.
              The surprising aspect is the failure of so many victims -- especially in peaceful democracies -- to appreciate the aggregate consequences which inevitably accrue, when each small injustice has such a high chance of prevailing.
• Beware the Data Diddlers, by Dr. John Gofman,
  The Bulletin of the Atomic Scientists, May 1993
   
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              Although there is ample evidence that nuclear pollution presents health risks, how can we properly assess the degree of risk when the governments that have unleashed the poisons also sponsor virtually all the health research concerning nuclear radiation?
              That conflict-of-interest problem has a common-sense solution. We -- and "we" refers mainly to individuals and nongovernmental organizations -- must insist that independent "watchdog authorities" be established to monitor the work of those who may have a vested interest in underestimating the health risks that may be attributed to nuclear radiation. . . .
              My work on the risks of low-dose radiation has been controversial. Some scientists say they agree with me. Many say they do not. But whether I'm right or wrong about the low-dose question is irrelevant in evaluating the watchdog proposal. The watchdog idea serves the interests of objective, scientific inquiry. It does not promote the interest of any particular point of view regarding the possible outcomes of specific studies. . . .
              The sponsors of current research on radiation and other types of pollution may fight vigorously behind the scenes to kill the watchdog idea. And after the watchdog proposal is accepted -- soon, I hope -- people must still remain vigilant. They must insure that independent experts are not -- or do not become -- sheep who wear a watchdog costume. In the end, we are all watchdogs. We owe future generations at least that much.
  
  
• Radio-Iodine: From Hanford To Chernobyl . . . And Beyond?, Spring 1993
   
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              In 1989, a group of radiation experts who were sent to the Chernobyl area by the World Health Organization (WHO) denied that any of the health problems were related to radiation. In May 1991, a report by the International Atomic Energy Agency (IAEA) produced the same denial. Neither report denied health problems. Rather, the reports denied any connection between the problems and radiation. Both sets of experts claimed that the Chernobyl populations which they visited suffered from exaggerated fears about their radiation exposures.
              We think that the explanation for some of the health problems may be radiation-induced hypo-thyroidism from radio-iodine --- rather than "radio-phobia." This essay explains why.

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• The Right Livelihood Award, 1992, John Gofman (USA),
  for his pioneering work in exposing the health effects of low-level radiation.
  
   
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    To counter such scientifically questionable practices Gofman has called for an independent `Watchdog Authority' to oversee the next generation of Chernobyl studies, and particularly to enforce nine essential rules (many of which were broken by the IAEA and WHO studies mentioned earlier) of good scientific practice: comparable groups, a real difference of dose, a sufficiently big difference of dose, careful reconstruction of dose, `blinding' of dose analysts, `blinding' of diagnostic analysts, no changes after results are known, no excessive sub-division of data and no prejudgements.
  
  
• Bio-Medical "Un-Knowledge" And Nuclear Pollution: A Common-Sense Proposal,
  On the occasion of the Right Livelihood Award, Stockholm, Dec 9, 1992.
   
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    "Bio-medical un-knowledge" is an abbreviation for all the findings which are the opposite of what is true about health and disease.
    . . . How can humanity have even the remotest chance of protecting its own health, when an agent of poisoning the population is also the sponsor of virtually all the health research concerning the pollutant? . . .
              If the database itself is false -- either from careless work or from intentional bias -- it poisons every conclusion which emerges from it. A false database causes innocent analysts of such data to fill the medical journals and textbooks with un-knowledge. It renders all its users into agents of possibly deadly mis-information. . .
  
  
• No One Escapes Harm: The Essential Story of In-Utero Irradiation, Nov 1992
   
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              Injury is a certainty rather than a risk during the 8-25 week period [of gestation of the human fetus]. No one who is thus irradiated in-utero completely escapes some loss of mental function. These are reasonable conclusions from the only existing human evidence, but of course, they might someday be modified by additional human evidence. . . .
              The really huge aggregate injury arises because evidence and logic combine to indicate that everyone who receives extra in-utero radiation during the 8-25 week period loses some mental function, in proportion to the extra dose. Those who are not pushed over the arbitrary dividing line into full-blown mental retardation are injured too. At each dose-level, those who were destined to be mentally retarded anyway become more retarded, those who were destined for average function become below-average, and those who were destined for brilliant mental function become less brilliant.
  
  
• Radiation-Inducible Chromosome Injuries:
  Some Recent Evidence on Health Consequences -- Major Consequences, Spring 1992
   
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              Chromosomes are the structures, in the nuclei of our cells, which are composed of helical, double-stranded DNA and associated proteins. The DNA molecules encode our human and individual genetic heritage. Two types of genetic injury which are readily caused by ionizing radiation at very low doses and low dose-rates are chromosomal deletions and translocations.
              Recent evidence links a great variety of chromosomal deletions and translocations with devastating birth defects and mental handicaps. Nonetheless, pressure to "forgive" more nuclear pollution --- and thus "forgive" more involuntary exposures to ionizing radiation --- is reviving in a big way. One consequence of additional exposure would be additional injury of the population's chromosomes, our library of genetic information.
              The chromosome story is a classic example of how "permissible" levels of radiation and other pollutants are recklessly established under the "prove harm" doctrine before technologies even exist for proving which agents can be the cause of dreadful health effects.
              This CNR paper describes the evidence which links chromosomal deletions and translocations with mental handicap and structural defects of the heart, kidneys, digestive tract, skeleton, and genitalia, and it also describes the limits of technology which have delayed this evidence for so long.

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• "HOLOCAUST" versus "NOTHING HAPPENED" :
  Tales from a Distant Place . . . with a Problem Very Close to All of Us, Fall 1991
   
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              Who will control what information becomes the new "textbook wisdom" about Chernobyl's radiation consequences? Obviously it makes a huge difference. . . .
              [O]ver decades and centuries, science has established important barriers against bias -- rules which are widely disregarded today in radiation research. Adherence to these rules will not be demanded by the public, press, and other professions unless they are aware of them. Some of the basic principles will be listed in Part 5 . . .
              If the world allows the truth about Chernobyl to become distorted by bias in the direction of underestimating its radiation consequences, it would be a warning that the truth about every chemical pollutant is also in danger of comparable distortion.
              And if all these hazards are systematically distorted by conflicts of interest in the research, humanity everywhere will face not only a vast harvest of radiation-induced misery from "permissible" nuclear pollution, but additional giant harvests from "permissible" chemical pollution of every type. And "mysteriously rising" rates of illness can occur even while the average length of life is growing.
              Therefore, one of the most vital activities in the field of citizen action and preventive medicine -- today, tomorrow, and forever -- is the fiercest possible defense of objective, untainted databases.
              There can be no activity more important for human health, for if the databases cannot be trusted and relied upon, then medical science can be turned on its head by mis-information, which can persist as textbook wisdom even for centuries.

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• The Greening of Nuclear Power and The De-Regulating of Nuclear Waste:
  Four Key Facts Which Need Attention, Nov 1990
   
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              The conflict of interest in radiation research cannot be denied. Professions, industries, and governments which expose people to radiation are the funders of research about the health hazards. This reminds us of a vampire guarding the blood bank. It should surprise no one if the result is an artificial consensus of scientists on one side of the hazard-issue, and an extreme shortage of scientists willing and able to challenge them. . .
         - USEFUL PUBLIC PERCEPTION in the "greening" effort: Nuclear pollution is a trivial issue.
         - REALITY: A de-regulation campaign is underway which can drastically increase levels of nuclear pollution to unpredictable levels. Moreover, validation of the "pie-chart" dose estimate for nuclear power is non-existent. Nuclear utilities are the source for data on how much radioactive pollution is released at their power plants. Until more citizen-groups achieve their own monitoring and measuring networks, there can never be an independent check on any figures or claims about the doses from nuclear power.

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• "For Want of a Nail . . . The Rider Was Lost" :
  A Big Flag of Warning from the Radiation Issue, Nov 1989
   
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              In the absence of the no-dumping principle, the "prove harm" rule dominates, worldwide. Therefore, it is highly important to consider the potential consequences for human health of continuing under that rule. (If we are unwilling to protect human health, then other species will fare even worse.) The nuclear energy issue illustrates in classic fashion what actually happens. . . .
              . . . under the "prove harm" rule, it turns out that proof of harm is not good enough anyway. Then the argument begins, over how much harm is too much. In the case of a million extra cancers from Chernobyl, for instance, it is true that they will occur gradually over 75 years or so, and they will not be detectable in the Vital Statistics. Under the "prove harm" ethic, any health-effect which fails to show up conclusively in the Vital Statistics can be debated as "inconsequential." In my world, it is impossible to regard giving cancer to a million people as a negligible crime. But that is where the "prove harm" rule leads. . . .
              The repeated statement, that 14,000 to 75,000 [Chernobyl] cancer-deaths constitute a very small increment in the natural cancer-mortality, is another great big warning from the radiation controversy to the environmental movement in general. If you prove harm, you will end up arguing endlessly over how much killing can be inflicted with impunity. Once premeditated random murder by polluters receives legal approval, and is also accepted as an ethical norm by the environmental movement, more than the physical health of humans is in peril.

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• What About Reviving Nuclear Power?, Oct 1988
   
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              The no-dumping principle simply means no one has any right to dump anything into the world's common supply of air and water. Wastes have to be detoxified, recycled, contained, or not produced at all. . .
              [T]here is all the difference in the world between adopting a good principle gradually, versus denying the principle, which is what we do now. Today people are claiming polluters have a right to kill some people, at random, for the economic benefit of some others. Only the exact number is debated. It's called the "benefit-risk" doctrine. I call it premeditated random murder. . . .
              The radioactive half-life of thorium-230 is 80,000 years, and the average life is therefore 115,400 years. In my 1981 book, I have shown that fueling 1,000 plants would release enough radon to cause 450,000 fatal lung cancers for each year that those 1,000 plants operate. Those deaths would not be imposed on ourselves. They would occur over many thousands of years among our descendants. Nice legacy. . . .
              Fission-products get out in the endless series of small leaks, burps, and spills which we hear about. Nuclear pollution requires nothing spectacular. Just the commonplace: Leaky pipes, mistakenly open valves, faulty O-rings, cracked cement, stuck needles in a dial, human carlessness, and even people literally asleep at the switch.
              Fission products are also getting out by intention: The so called "permissible" releases. . . .
              I participated in the first Earth Day, 1970, and proposed some strategies for stopping the nuclear power juggernaut. There were 1,000 nuclear plants planned then for the U.S. alone! I proposed a 5-year moratorium on any new licenses, so that independent people could evaluate the dangers. For several years, many environmental groups said the proposal was too extreme. Imagine. It was so mild.

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• Assessing Chernobyl's Cancer Consequences:
  Application of Four "Laws" of Radiation Carcinogenesis
  The American Chemical Society Symposium On Low-Level Radiation,
  Division of Chemical Health and Safety, Sep 9, 1986
   
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• The Top 10 Pronuclear Arguments . . . Answered
  The Mother Earth News, 1981
   
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    [W]e spent some time seeking out the strongest and most commonly used pronuclear statements we could find. Then we sent the arguments off to Dr. John Gofman, chairman of the Committee for Nuclear Responsibility and one of our country's most prominent opponents of nuclear power. The following, then, are ten of the arguments most often used by proponents of nuclear power . . . and Dr. Gofman's replies.

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• Some Medical Causes and Consequences of Nuclear War: How Physicians Might Help to Prevent Nuclear War

  This address was delivered at the 2-day symposium,
  “The Medical Consequences of Nuclear Weapons and Nuclear War”.
  September 27 and 28, 1980,
  at the Hunter College Assembly Hall, New York City.
  Sponsored by:
  Albert Einstein College of Medicine, and Columbia University College of Physicians and Surgeons.
  Organized by:
  Physicians for Social Responsibility, and the Council for a Livable World (Education Fund).
   
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    It is my opinion that there may well be a medical cause of the nuclear arms race, and of the likely occurrence of nuclear war. Fur- ther, it is my opinion that the way in which the medical profession treats the issue of the health effects of ionizing radiation may well make the difference between nuclear war and no nuclear war. Let me explain both points of view.

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• Nuclear Power: A Suggestion For Insuring The Uninsurable...
  A New Kind of “Direct Action”,
  Sep 23, 1979
   
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• A Small Affidavit with Big Implications
  Jun 5, 1978
   
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• CNR Publication List: Sep 1978
   
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• Testimony by John W. Gofman for the NRC GESMO Hearings
  addresses the considerations of the toxicity of plutonium
  Feb 21, 1977
   
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• Letter to James Schlesinger
  on National Energy Policy Recommendations
  Mar 17, 1977
   
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• Gross Energy Available through Light Water Reactors
  C.N.R. Report 1977-2
  May 1977
   
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• Jimmy Carter's Energy Plan: Myths vs. Realities
  by John W. Gofman and Egan O'Connor

  • Part I: Solar Energy (PDF, TEXT),
    CNR Report 1977-3, June 6, 1977
  • Part II: Energy Conservation (PDF, TEXT),
    CNR Report 1977-4, June 6, 1977
  • Part III: Nuclear Fission (PDF, TEXT),
    CNR Report 1977-5, June 6, 1977

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• The Cancer Hazard from Inhaled Plutonium,
  CNR Report 1975-1 - R,
  May 14, 1975
   
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• Estimated Production of Human Lung Cancers
  by Plutonium from Worldwide Fallout,
  CNR Report 1975-2,
  Jul 10, 1975
   
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• Some Important Unexamined Questions Concerning
  The Barnwell Nuclear Fuel Reprocessing Plant
  Testimony Before The Nuclear Study Committee,
  The Legislature of the State oF South Carolina,
  Jan 7, 1972
   
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• Reacting to reactors -- The "peaceful atom": Time for a moratorium
  Environmental Action, Nov 25, 1972
   
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              There is no significant technical controversy that can be resolved by a debate on the merits of specific gadgets in the nuclear power industry. What is really at issue is a moral question -- the right of one generation of humans to take upon itself the arrogance of possibly compromising the earth as an habitable place for this and essentially all future generations. Nuclear power generation carries with it the prospect of visiting increased cancer upon this and a thousand generations to come. Additionally, nuclear power generation carries with it the prospect of genetic deterioration of humans that will insure an increase in most of the common causes of death in future generations. . . .
              The only way we will achieve clean synthetic gas from coal in large quantities and a full solar energy economy in the early future is via an immediate rejection of nuclear fission power as an acceptable option. Such rejection would be meaningful through a national moratorium on the operation or construction of any nuclear fission power plants. The resources, both public and private, freed by a moratorium on nuclear fission power will be enormous. The acceptable alternatives will move rapidly toward realization once these resources are available.
              The energy industry has no place in its ledgers marked "health and welfare of future generations." Therefore, the task of accomplishing a moratorium and providing a sane energy economy cannot be entrusted to that industry. But individuals in society do have a moral obligation to avoid recklessness and extremism in dealing with the future of living creatures on earth. Given the nature of the real problem of nuclear power, a problem admitted by proponents and opponents of nuclear power, it is difficult to understand the position of anyone who is not insistent upon an immediate moratorium on all nuclear fission power generation.

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• Epidemiologic Studies of Carcinogenesis By Ionizing Radiation,
  by John W. Gofman and Arthur R. Tamplin,
  Proceedings of the Sixth Berkeley Symposium on
  Mathematical Statistics and Probability, Jul 20, 1971
   
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• Curriculum Vitae of Dr. John W. Gofman, M.D., Ph.D.
  from 3 pages of "About The Author" in Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of this Disease
   
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• See also: "CHAPTER 4, John W. Gofman, Medical Physicist" from Leslie Freeman's book, Nuclear Witnesses, Insiders Speak Out