Somerset Health Authority papers reveal cancer cover-up

Somerset Health Authority papers reveal cancer cover-up
See below for details of the quick and dirty statistics they used
and what they really show

Public has a right to know:- a Western Daily Press Editorial
a reply from Somerset Health Authority's director of public health, Dr. Nicky Pearson
and a response from Dr. Chris Busby

April 24 2002 the Western Daily Press reported
Health leaders were last night accused of covering up shocking cancer rates near a West nuclear power station.
Officials are alleged to have exaggerated population figures to make it appear the disease was less common than it really was.
Leading radiation expert Dr. Chris Busby claims the true figures show people living near Hinkley Point in Somerset were much more likely to fall ill. He says a health authority dossier on his work shows cancer rates in Burnham-on-Sea were actually 30 per cent above the national average.
The scientist says local officials had previously claimed it was nearer 17 per cent above the national average - a number too small to be statistically significant.
Last night Dr. Busby, who sits on a Government body looking at the effects of radiation, accused health officials of deliberately misleading the public.
He said: "What angers me is that all along they have had this evidence and rather than come clean they have kept it secret."
He said 61 women were found to have suffered from breast cancer in Burnham, just four miles from Hinkley, between 1988 and 1997.
But instead of comparing this with the 1991 population figures officials used the 2001 statistics when the town was much bigger.
He says it meant the cancer rates appeared lower than they really were.
But health official Paul Courtney vehemently denied the accusations saying they were "utterly preposterous".
Mr. Courtney, spokesman for Somerset Coast primary health care trust, said there was no evidence linking Hinkley with increased cases of breast cancer.
He said: "To say public health doctors would have ulterior motives other than the health and well-being of the community is utterly preposterous."
But furious anti-nuclear campaigners are calling for a full-scale investigation and for health officials to resign.
Campaigners have linked the high number of cancer cases to low-level radioactive particles, legally released from Hinkley Point power stations on the north Somerset coast.
The nuclear industry denied this and said there was no evidence linking the two.
Somerset health authority said the report was alarmist and women should not be concerned as Dr. Busby had used poor maths in his report.
Burnham Mayor Jackie Richards said: "If his [Dr. Busby's] information is right I would be very alarmed. If there is a likelihood that there is a problem in our area caused by Hinkley then it should be brought to the fore."
No-one was available for comment from the nuclear industry last night
But the industry has repeatedly denied that evidence shows a link living near a power station and an increased risk of getting breast cancer.
South-west Euro-MP Graham Watson said: "I think it is important that we monitor these figures as accurately as possible if only to allay public concern about the dangers of living near a nuclear power station."
Extract from an undated message headed "Jacq CLARKSON - VP250101.DOC". [We take "VP" to be Dr Virginia Pearson, Director of Public Health & Strategy for Somerset Health Authority. "250101" looks like a date.]
David had a file from the CIU [Cancer Intelligence Unit] of breast cancer incidence (registrations) for 1988-97 by ward, age and sex. We do not have the population figures for the particular ward boundaries used in that file except for the most recent years. I have had a quick and dirty look at standardised rates using populations at 1/1/2001, within Somerset (ie using the overall Somerset rates as the standard and applying them to the individual ward populations to get the expected number of incident cases, then comparing them with the observed). I know the population distribution has changed since 1988 with more in the older age groups, but I don't have any evidence that Somerset as a whole will have changed in a different way to the individual wards. As I say, quick and dirty.
area Observed 1988- 97 Expected 1988- 97 Ratio
Burnham North 61 52.12 1.17
Burnham South 50 52.16 0.96
Burnham North has a slightly higher incidence rate, but it is not significantly higher than Somerset as a whole."
It is, of course, bad epidemiology to use the populations for 2001. The 1991 census sits almost in the middle of the period SHA was looking at. Using those populations the table looks like this...
area Observed 1988- 97 Expected 1988- 97 (1991 popns.) Ratio (Poisson value)
Burnham North 61 46.9 1.30 (0.013)
Burnham South 50 46.1 1.08 (ns)
Burnham combined 111 93 1.19 (0.03)
... a statistically significant excess.
Western Daily Press Editorial, 24th April 2002 Public has a right to know

The British public has shown a remarkable tolerance towards the nuclear industry given the continued question marks over its safety. What a pity then that fresh questions are being raised about whether that tolerance has been misplaced.

The latest accusations about cancer rates in Burnham North, near the Hinkley Point nuclear power stations, are serious and must not simply be dismissed. When it comes to the old saying about lies, damned lies, and statistics, people are understandably nervous about being bamboozled with science.

Dr Chris Busby, the man behind the latest claims that breast cancer is a worrying 30 per cent higher than previously thought, is not a crank, otherwise he would not be on a Government body looking at the effects of radiation.

There would be little point in his making his claims unless he was pretty convinced he was right. He would risk professional humiliation. Dr Busby says that Somerset Health Authority compiled its statistics based on the wrong population figures. If he is wrong then it should be very easy to prove.

If he is right, then serious questions arise, like how such a mistake occurred, or whether it was a mistake at all, and not just a more convenient basis from which to compile statistics.

There may well be other contributing factors behind the breast cancer rates, and if those questions have been asked the public has a right to know the answers. If they have not been asked the public has a right to know why not.

Dr Busby has also asked the health authority to publish statistics on people with a current diagnosis of cancer because he believes this is a more accurate way of pinpointing a potential problem than mere mortality rates. Most people would feel that is perfectly reasonable, and be suspicious about the reasons for refusing his request.

The nuclear industry wants a third reactor at Hinkley. Its go-ahead should be conditional on public satisfaction about responses to the latest questions.

26th April 2002 Figures that don't tell the full story - a response from Dr. Nicky Pearson, director of public health at Dorset & Somerset Health Authority.

This week Dr. Chris Busby, a "leading radiation expert", claimed he had found breast cancer was 30 per cent higher than the national average in the seaside town of Burnham.

Anti-nuclear campaigners also suggested that Dr. Busby found above average deaths from breast cancer around the Hinkley Point nuclear power station.

Dr. Busby's conclusions and their association with Hinkley Point were reached after he scrutinised data from Somerset health authority.

And he said that the authority's experts got its sums wrong in estimating that the cancer rate was only 17 per cent higher than average.

He claims that health authority experts used the wrong population data. And even more preposterous is Dr. Busby's suggestion that public health doctors had this evidence but kept it secret.

The health authority did provide Dr. Busby with extensive information about breast cancer in Burnham.

Figures were supplied showing the actual deaths from breast cancer - 23 between 1995 and 1999 - and figures for the registered incidence of breast cancer based on the most up- to-date information available (The LLRC site manager cannot refrain from commenting that this is a lie - Busby's reply is far too restrained on this point.)

Lets have a look at the facts (site manager's emphasis!) behind the figures.

Cancer, including breast cancer, can take many years to develop.

Burnham is a popular retirement area for older citizens, some of whom have lived most of their lives in other parts of the country before moving to the area. In the light of this most recent publicity the authority's analysts have again revisited the data.

But again we maintain that our calculations from official records still show that Burnham North has 17 per cent more breast cancer cases than the county average. Burnham South has four per cent fewer.

The authority has never concealed or refuted this.

The figure is higher than we would have expected, but not so high as to indicate that there is a significant health problem in this community.

When calculations are extrapolated from the average incidence of a disease there will always be some communities showing higher or lower than average figures.

When a large number of comparisons are made with an average, by the nature of statistics it is not unusual for a few of them to appear extreme.

In fact there are other areas of Somerset, nowhere near the Hinkley Point power station or its outflow, that have higher cancer death rates than the national average.

Health experts have also seen no scientific evidence to support a hypothesis that an increase in reported cases of breast cancer could be attributable to radioactive discharges from the station.

The health authority's experts have never attempted to hide or play down health statistics.

The authority's analysts do not know what precise mathematical calculations Dr. Busby has used to reach his conclusions but believe he might have made calculations based on flawed assumptions.

A mathematical calculation of the expected incidence of breast cancer in Burnham and other areas in Somerset is extrapolated from countrywide recorded figures, based on the age distribution in the specific population.

This is then compared with the number actually recorded.

The figures given to Dr. Busby for breast cancer cases were 61 at Burnham North between 1988 and 1997 when 52.12 would have been expected, and 50 in Burnham South when 52.16 was the projected figure.

The expected, 52, and those observed - 61, which is 17 per cent above expected - are accurate.

Dr. Busby is wrong when he asserts that health authority experts used newer population data based on the 2001 census instead of the 1991 census in an attempt to make the statistical incidence of the disease appear smaller.

What possible motive could doctors, with statutory responsibility for the health of the community, have for doing this?

The Cancer Intelligence Unit gave us information on the incidence of breast cancer based on the patient's council ward, as defined by boundaries in 1996.

We do not have accurate population distribution figures for these 1996 wards, for the early years of the time period.

Hence we used the earliest accurate population distribution figures that we had. In 1991 population figures were gathered by parish. But in 1996 new ward boundaries were drawn up.

There is no way to map information for any given postcode area from the old parishes to the new wards.

We assumed that the relative differences in population across the county did not change much in the years 1988 to 1997.

Public health experts with Somerset health authority - now Dorset & Somerset health authority - have previously advised Dr. Busby that we would investigate any new information or statistics which suggested there was a significantly higher risk to the health of women in Burnham.

The same offer would apply to any robust scientific evidence that showed a likely link with increased breast cancer and radioactive emissions from Hinkley Point power station. To date we have seen no such evidence.

A response from Dr. Chris Busby (26th April 2002)
Among other points he rather gently pins down Dr Pearson's untruth about what data have been given to him.

My concerns lead to two sets of questions, the first about the behaviour of the Health Authority, and the second about the effects of Hinkley Point emissions on the health of local people.

As far as the Health Authority are concerned, Dr, Nicky Pearson's article does not reassure me. In my original paper, I drew attention to a significant excess breast cancer mortality in Burnham North from 1995-1999. The Health Authority and the nuclear industry accused me of poor statistics and of using the wrong populations, i.e. the 1991 census data. I asked for, and they supplied me with what they said were correct populations for 1995-1999. I applied these and found that there was still almost a 100% increase in breast cancer mortality. I added in the year 2000 data and this increased the effect.

At this point the Health Authority changed their ground: they conceded that there was indeed a significant excess mortality in Burnham North, but changed their attack, now saying that there was no evidence that it could be caused by Hinkley emissions. They made no apology for having rubbished my earlier figures. I suggested that they let me have the incidence data for ten years, but they said that this was not available as it was confidential, and the cancer registry also refused to release it.

However, when, invoking the Data Protection Act, I paid 10 pounds and asked for the release of any data the Health Authority was holding about me, behold, I discovered that they had the incidence data all along, and that it showed a 17% excess over the whole period 1988-97 according to their use of 2001 populations, and a 30% excess when I used the 1991 census populations. It also shows an excess in Sedgemoor.

Their use of 2001 populations is wrong because it would diminish the relative size of the discrepancy between Burnham North and the average for England. This is because the population has aged from 1988 to 2001. There are far more old people in 2001 than in 1988, so we would expect more cancer. In addition, the 2001 populations are estimates - probably wrong. More accurate ward populations exist for 1991 a year which falls near the centre of the period 1988-97 and would be the most accurate population available. Their point about ward boundaries is unclear: they could have determined the correct populations for the boundaries they believe the data is for from the 1991 census data. It seems that they did not do this. Why? I believe that the answer is that they couldn't be bothered, because they thought I was wrong. Dr. Pearson asks what possible motive they could have for such shenanigans? I believe the answer is that there is a culture of complacency in the Health Authority. We know that there were studies which showed a significant excess of leukaemia in the area around Hinkley Point. Has this situation been monitored since then?

What infuriates me is that these people are paid to look after the health of the local population: when some evidence is brought forward that the local nuclear power station might be killing people (not the first evidence, since there was the earlier leukaemia report), they panic and attack the author. They cover up the data that shows the there is an excess. Dr Nicky Pearson says the health authority did provide Dr Busby with extensive information about breast cancer in Burnham ... Figures were supplied. . . . The Health Authority gave me nothing but the revised population data which was posted to me on a disk from Reading in Berkshire. They have been as obstructive and vituperative as possible.

It is time they arranged to meet with me and with local representatives and give me the data I need to conduct a complete survey of the area so that trends in incidence can be correlated with distance from the radioactive contamination, rather than just looking at Burnham on Sea. We can agree the wards, the populations and the numbers and do the study together. Why are they so afraid to do this?

The second point is about the health effect of low-dose radiation. The nuclear industry and the Health Authority say that there is no evidence that the releases are harming anyone. This is because they are assuming that the risk models for radiation are correct. The UK government have now conceded that there is a large question mark over these models for internal radiation, the kind that gets inside the body, and there is a new committee (CERRIE) investigating these risks. There is overwhelming evidence now that the models are incorrect by a large factor, and that those exposed to internal radiation from atmospheric weapons fallout, nuclear power releases, Chernobyl, Sellafield etc. are at considerable risk of developing cancer. All my studies of populations near coastal contamination show this to be the case - in the Irish Sea, near Hinkley, near the Severn Estuary, near Cardiff and near Bradwell. It is time the health authorities took their heads out of the sand and tried to examine the causes and spatial and temporal trends in cancer.

Chris Busby, 26th April 2002

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