BBC interview on leukaemia near Cap de la Hague

Six-fold leukaemia excess near Cap de la Hague

Item from You and Yours (1) 29th June 2001 about a new paper (2) confirming high rates of childhood leukaemia near the French nuclear fuel reprocessing plant at Cap de la Hague.

BBC: Now we turn to to a new study of childhood leukaemia near the coast at Cherbourg which shows a higher than average incidence of the illness - a higher incidence that the researcher, Dr Derek Pheby, from the University of the West of England in Bristol, describes as small but significant. We have reported similar findings in the past, most recently at the beginning of May the British scientist Dr Chris Busby discovered a new cluster of childhood leukaemias within the town of Chepstow. But are the nuclear power plants the cause? Dr Busby and Dr Pheby both joined me and I asked Dr Pheby whether he puts his findings in France directly down to the proximity of the nuclear plant.

DP: It's difficult to know. Obviously radiation is a possible cause of childhood leukaemia, so one cannot discount that, but there are other hypotheses as well; there's the suggestion that population mixing might have something to do with it.

BBC: Can you just explain to me what you mean by population mixing?

DP: It's to do with bringing a lot of people into an isolated rural area for a major development like, for example, building a nuclear plant. The incomers may be from a fairly cosmopolitan background and have therefore been exposed to a lot of viruses, and they come into an area with an isolated and stable community where people haven't had that kind of exposure to viruses. The theory is that if childhood leukaemia was caused by a virus there may be carriers among the incoming population who are immune themselves but who can pass on the virus to people in the local population who aren't immune, who can then develop cancer or leukaemia; or their children can develop leukaemia.

BBC: Dr Busby, you have done research of this sort yourself in the past and you seem to be rather more convinced that there could be a direct link.

CB: This is a very interesting result. It confirms earlier work by Professor Jean- Francois Viel and it does show that there's an approximately six-fold excess of childhood leukaemia of this type in the 5 - 9 year olds, but also an excess in the overall 0 - 25 year olds and also in the 0 - 4s. So this is roughly similar to what we have found at other reprocessing sites like Sellafield and Dounreay and similar to the effects that we have also found in Wales close to radioactive sediment.
Now the only thing that I'm concerned about is that Dr Pheby's method is one in which he draws circles round the plant and then circles further away and so on and he tests the inner circle against the outer circle. Now what we've been finding in this kind of work is that actually what drives the effect is proximity to the coast, and I think that Professor Viel found this too - in a case control study he found a linkage with children playing on the beach.

DP: The study by Professor Viel that Dr Busby referred to is a rather different kind of study - it was a case control study. We [on the other hand] were looking at incidence within the population as a whole. Professor Viel did a similar [incidence] sort of study which produced a result which also showed a result for childhood leukaemia but in a rather different location - in a area 20 to 30 kilometres away from the plant and to the south of the plant which is not in the direction of the prevailing winds - which is rather odd...
CB: But you could have looked close to the sea, couldn't you?
DP: Well yes, you could but the population base is quite small ..
CB: Yes, sure ...
DP: ...and to do this kind of study, once you get into the very very small areas there's an awful lot of random fluctuation and noise anyway ...
CB: Yes, sure ...
DP: ... which is very difficult to interpret.

CB: Yes he's right; it's difficult looking at such small numbers, which makes us think we should look at adults. In 1996 I was asked to go to Alderney to look at cancer mortality in adults and we certainly found an effect there - we found an approximate doubling in cancer mortality if we tested the later period of the operation of the plant against the earlier period. We found a significant excess of cancer mortality and this what we also found in Wales, and close to Hinkley Point, and Oldbury and various other nuclear sites, so I think this concentration on children could probably now be extended to other cancers in adults.

DP: The problem is that people don't stay put in the same place, which is what they really ought to do if they wanted to make life easy for epidemiologists, but they don't. I think one of the problems would be that a lot of the cancers we've been looking at in adults [have] a much longer lead time, [so there is] a massive dilution effect. The thing about childhood leukaemia is that by definition there's a short lead time between exposure [and expression]; otherwise the patient is no longer a child. That's why we have to concentrate on something [a disease] where the lead time is relatively short and I think that is why there has been this concentration on childhood leukaemia in relation to these plants.

BBC: Can I just come back to the cause? - the conclusions that you've drawn, Dr Pheby? You've said that you do think there could be other reasons for this effect. Dr Busby, do you think that population movements could account for it?

CB: I certainly think population mixing can account for a very small excess in leukaemia and this has been shown, but there are all sorts of other reasons for this and certainly population mixing could not account for the very large excess of leukaemia near Sellafield. I think you would have to look at the population mixing parameters themselves around this particular plant [Cap de la Hague] to see whether it could account for part of the excess but this six-fold excess is far too large, I feel, to be accounted for [by population mixing] and it seems to me that this [the radiation] explanation has only been discounted because the risk model doesn't predict that there should be such an excess. Now this seems a rather crazy way of looking at it, because if you find an effect around all the nuclear sites then it seems the cause is most likely to be radiation unless there's some persuasive evidence to the contrary.

BBC: Wouldn't you agree with that, Dr Pheby?

DP: Not entirely. We know that radiation can be a cause of childhood leukaemia - of course no-one disputes that - but this hypothesis of population mixing has been carried out in other contexts, looking at major civil engineering projects which don't involve the nuclear industry. This study was not intending to pinpoint causes .. merely to try to document the facts of the situation so that further research might be undertaken hopefully to identify what causes might be at work. Obviously it's a matter of importance that this work should be done because clearly it's a matter of considerable public health importance.

References

1 You and Yours is a BBC Radio 4 consumer affairs and investigative programme broadcast 12 noon to 1 pm weekdays in the UK.

2The incidence of childhood leukaemia around the La Hague nuclear waste reprocessing plant (France): a survey for the years 1978-1998. A-V Guizard, O Boutou, D Pottier, X Troussard, D Pheby, G Launoy, R Slama, A Spira, and ARKM J Epidemiol Community Health 2001; 55: 469-474


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