Richard Doll: a really dodgy scientist

Press release 23rd August 1999
(content not updated, but see this related story about the Plutonium trap)

Richard Doll is yesterday's man, quoting out of date science
LLRC challenges cancer establishment to conduct relevant research

The Low Level Radiation Campaign today publishes a response (see below) rejecting claims(1) that the cause of leukaemia has been found.

"Sir Richard Doll's attempt to deflect attention away from links between nuclear pollution and leukaemia depends on flawed and bowdlerised research and an outdated view of radiation dose", said campaigner Richard Bramhall. "His ideas are based on the false notion that internal radiation from contaminants we have inhaled or swallowed affects us in the same way as external radiation from cosmic rays.

"One of the papers he cites was purged of crucial data on plutonium in the lymphatic system. Earlier published versions of the same research showed that plutonium is retained in lymph nodes giving massive chronic doses to tissues which are vital to our immune defences. Sir Richard seems to be unaware that two other papers he cites show that children have higher leukaemia risks if their fathers are internally contaminated.

"Cancer and leukaemia are increasing steadily, and many studies show clear links with nuclear pollution, but the Government and the chancer charities do not dare to commission the vital project - a case / control study in which patients and their parents are examined for their body burden of man-made radioactive elements, compared with healthy controls.

"Last Monday's editorial is not the first time Doll has lent support to a study claimed to discredit links between radiation and leukaemia. The Nordic Leukaemia study(2), of which Sir Richard was a named author, was published shortly before the famous prosecution of BNFL by two families of Sellafield employees. Now we see him repeating the claim that doses were "far too small" to cause the undisputed Seascale cluster, using his reputation to inflate Dickinson and Parker's paper to the status of an adequate alternative explanation, and doing so at a time when BNFL is not only floating itself on the stock exchange but is also once more under attack in the Courts." In a current case in the Irish High Court four residents of Dundalk, Co. Louth are prosecuting BNFL for contaminating their bodies with artificial radioactivity.

Notes

1) Doll R. Editorial to Dickinson HO Parker L Quantifying the effect of population mixing on childhood leukaemia risk: the Seascale cluster British Journal of Cancer : Vol 81, Issue 1, September 1999 [actually published 16th August].

(2) Darby, S., Olsen, J. H., Doll, R. et al 1992 Trends in Childhood Leukaemia in the Nordic Countries in Relation to Fallout from Nuclear Weapons Testing, BMJ 304: 1005-9 Claimed to find no relationship between childhood leukaemia in nordic nations and weapons test fallout. Four pages of detailed analysis of shortcomings in Dr Chris Busby's 1995 book Wings of Death (pp124 - 128). Lectures at London School of Hygiene and Tropical Medicine have taken this paper as a case study of badly designed epidemiology, invalidated by an enormous extension of the study population mid-way through the study period.
Nevertheless the data do show an increase in the disease, contrary to the claim in the abstract.


The Seascale Cluster and population mixing: an improbable explanation
Low Level Radiation Campaign statement on the suggested effect of population mixing

18th August 1999

LLRC,
The Knoll
Montpellier Park
Llandrindod Wells Powys LD1 5LW
01597 824771
email: bramhall@llrc.org

Sir Richard Doll's editorial comments on the Newcastle University paper(1) cannot inflate Kinlen's population mixing hypothesis to the status of being "regarded as established".
The paper fails to account for all the excess risk, and the highest risk appears in the children of immigrants. This is the opposite of what was earlier expected from the population mixing hypothesis, and is even suggestive of a link with work in the nuclear industry since workers came into the area mainly to work in the industry, and no leukaemias were recorded until several years after the Windscale plant had started its military plutonium operations in the early 1950s.

Sir Richard's chain of reasoning hangs on demonstrably flawed links, starting from the belief that radiation doses to the people of Seascale were too low to account for the leukaemia cluster.

       1) The reason for COMARE's failure to ascribe any cluster of leukaemia to low levels of radioactive pollution is that the scientific model they use is crude and inadequate. It is based entirely on studies of acute high dose-rate external gamma irradiation and is silent on internal contamination, whereas people who are exposed to environmental pollution suffer chronic internal irradiation from alpha and beta emitters at very low dose and low dose rates. Many workers now agree that the pivotal concept of "absorbed dose" is inapplicable at these low levels. The biological mechanisms of radiation damage at low dose are largely unknown, but radiation remains the only known cause of leukaemia. The only dispute concerns the methods of estimating the dose needed to induce the disease.

      2) Sir Richard claims that Popplewell et al's 1988 paper (2) supports the assertion that doses to the Seascale leukaemia victims were too small to cause the disease:

" ... measurements of Pu and Cs-137 in the bodies of exposed people .. showed that the models that had been used to estimate the doses people received had, for the most part, over estimated them."
However, examination of the 1988 Popplewell paper shows that the data on tracheo-bronchial lymph nodes (TBLNs) has been removed, although earlier published versions(3) of the same research include them.

The Irish Sea is heavily contaminated with insoluble particles of plutonium and uranium from Sellafield which have been detected far inland. These particles are retained in the lymph nodes after inhalation. Plutonium in tracheo-bronchial lymph nodes has been measured in post mortem analyses at very high concentrations.

In one US subject the lungs contained 67,000mBq/g, but the TBLNs (a tiny organ) contained 2,612,000 mBq/g - 17.5% of all the plutonium in the body. This was a nuclear industry worker(4).
In three UK radiation workers in the Popplewell study a comparison of the lung burden with the TBLNs shows:

Lung (mBq/kg) TBLNs (mBq/kg)
120 1600
1140 73300
450 4100
In a sample of non-occupationally exposed people the concentration values ranged as follows:
Lung (range)(mBq/kg) TBLNs (range)(mBq/kg)
1.6 - 17 10 - 145
We can thus see that while occupational exposure clearly brings higher burdens, even in the general public the lymph nodes concentrate plutonium quite extremely. The omission of the lymph nodes data from a study which Sir Richard relies on is fatal to his argument.

The lymphatic system is vital to the competence of the immune system. Hot particles deliver chronic irradiation many times higher than natural background rates. Depression of the immune system increases susceptibility to infections, so maybe here we can see an explanation of Professor Kinlen's findings.

       3) Even without the airbrushing of data from Popplewell's research, recent correspondence between COMARE and independent researchers at Green Audit about high rates of cancer and leukaemia along the Welsh coast of the Irish Sea has revealed that NRPB's modelling of dose to lymphatic tissue(5) from particles of plutonium and uranium oxide contains serious averaging errors. Intake of plutonium to the age of 25 years has been underestimated by basing it on the lung capacity of an infant aged 0 - 1 year which is then multiplied by 24, while the consequent radiation dose to the lymphatic system has been diluted by modelling the lymphatic system as ‘liver, lung, kidney, spleen, pancreas, uterus, intestines, etc.’ , presumably to provide the largest possible mass in which to dilute the dose to the tiny, 1 gram, lymph nodes.

       4) Doll relies further on two papers which show associations between internal contamination and increased cancer risks: 4.1) the Record Linkage study of Draper Little et al 1997 (6). This showed a 1.8-fold increased risk of leukaemia in children of male nuclear industry workers, rising to 2.9-fold risk where fathers were monitored for internal contamination. The paper's authors however ignored the obvious - their abstract and media coverage concentrated on the fact that the lowest risk was for children whose fathers had the highest external dose (i.e. measured by film badge, which gives no information on doses from internal contamination). The authors speculated that "observed associations may be due to chance findings or result from ... infective or other agents." But the findings were 95% certain of not being due to chance, and no infective agent for leukaemia has ever been identified. 4.2) Cancer in the children of nuclear industry workers -Roman et al 1999(7). The authors claim Overall the incidence of all cancers and of leukaemia was similar to that expected in the general population Their methodology was however completely inappropriate. When reanalysed with a simpler and more suitable model (as Green Audit has done, soon to be published in Radioactive Times) a risk of 4.4 times the national average appears.

       5) Unborn children are at risk from internal contamination; early results of current research(8) shows that radio-nuclides cross the placenta easily and accumulate in foetal tissues to higher levels than in the mother.

       6) The main thrust of official efforts to determine whether there is an association between cancer and environmental levels of man-made radioactivity is directed towards geographical aspects. This is a matter of serious concern, because the generalised dispersion of anthropogenic radioactive substances means that all populations are to some extent contaminated. The Department of Health is funding a project entitled "Geographical variations in childhood cancer incidence generally and in relation to nuclear installations", covering all cases of childhood cancer in Great Britain between 1969 and 1993. The study will be looking at variations in incidence rate in relation to socio- demographic factors, clustering, population mixing, nuclear installations and parental preconceptual irradiation. LLRC has asked DoH for detail of the protocols of the studies, but (in common with other such applications to DoH) no detail has been disclosed. It is known, however, that a large element will be supplied by the Leukaemia Research Fund's Childhood Cancer Study, whose director is Professor R.A. Cartwright. In a letter to LLRC dated 3rd August 1998 Professor Cartwright wrote:

"The United Kingdom Childhood Cancer Study will have data on exposure to various kinds of ionising radiation which will include radioisotopes from medical sources, as well as other medical X-rays and the like and also from environmental radon and gamma, which are, after all, by far the greatest and most variable exposures in this area. The study has made no attempt whatsoever to ascertain exposure from the trivial levels of artificial radioisotopes consequential on atmospheric and aqueous discharges." (our emphasis)
DoH has said that when the work is complete and published COMARE will be ask to give its opinion. LLRC has ascertained that this opinion will come from COMARE's Geographical Assessments Subcommittee. The Chairman of GAS is Professor R A Cartwright.

       7) Irrespective of such biases in design and review, the question of a link between nuclear pollution and cancer will not be resolved by geographical studies. There is, rather, a compelling need for a case / control study in which cancer and leukaemia patients and their parents are examined for their body burden of man-made radioactive elements, compared with healthy controls. This is the experiment the cancer establishment dares not commission.


References

1) Doll R. Editorial to Dickinson HO Parker L Quantifying the effect of population mixing on childhood leukaemia risk: the Seascale cluster British Journal of Cancer : Vol 81, Issue 1, September 1999.

2) Popplewell DS Ham GJ Dodd NJ Shuttler SD Plutonium and Cs-137 in Autopsy tissues in Great Britain Science of the Total Environment 70 (1988) 321 - 334

3) Popplewell DS Ham GJ Johnson TE, Barry SF Plutonium in Autopsy tissues in Great Britain Radiol. Prot. Bulletin No. 74 10 - 12 and Health Physics 49 no. 2 304-309 Aug.1985 [Note: the earlier published data including TBLNs can be seen in Wendy McLeod-Gilford's report on the LLRC website at www.llrc.org/plutonium_pollution.htm]

4) McKinroy, J. F. Kathren, R.L. Voelz, G.L. Swint, M. J. 1991 U. S Transuranium Registry Report on the 239 Pu distribution in a human body Health Physics, Vol. 60 No. 3 307-333 March 1991 [Note: the units have been converted to mBq/kg to allow comparison with data from Popplewell et al.]

5) NRPB Report #276

6) Draper, G. J. Little, M. P. Sorahan, T, Kinlen, L. J. et al. 1997 Cancer in the offspring of radiation workers: a record linkage study. British Medical Journal Vol. 315 p.1181; 8 Nov 1997

7) Eve Roman, Pat Doyle, Noreen Maconochie, Graham Davies, Peter G Smith, and Valerie Beral Cancer in children of nuclear industry employees: report on children aged under 25 years from nuclear industry family study. BMJ 1999; 318: 1443-1450. 29th May 1999

8) DoH Radiation Protection Research Programme project no. RRX 30: Fetal radiation dose from environmental radionuclides. Palmer AM Preece AW


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