April 30, 2011
Unsafe at Any Dose
By HELEN CALDICOTT

Sydney, Australia

SIX weeks ago, when I first heard about the reactor damage at the Fukushima
Daiichi plant in Japan, I knew the prognosis: If any of the containment
vessels or fuel pools exploded, it would mean millions of new cases of
cancer in the Northern Hemisphere.

Many advocates of nuclear power would deny this. During the 25th anniversary
last week of the Chernobyl disaster, some commentators asserted that few
people died in the aftermath, and that there have been relatively few
genetic abnormalities in survivors' offspring. It's an easy leap from there
to arguments about the safety of nuclear energy compared to alternatives
like coal, and optimistic predictions about the health of the people living
near Fukushima.

But this is dangerously ill informed and short-sighted; if anyone knows
better, it's doctors like me. There's great debate about the number of
fatalities following Chernobyl; the International Atomic Energy Agency has
predicted that there will be only about 4,000 deaths from cancer, but a 2009
report published by the New York Academy of Sciences says that almost one
million people have already perished from cancer and other diseases. The
high doses of radiation caused so many miscarriages that we will never know
the number of genetically damaged fetuses that did not come to term. (And
both Belarus and Ukraine have group homes full of deformed children.)

Nuclear accidents never cease. We're decades if not generations away from
seeing the full effects of the radioactive emissions from Chernobyl.

As we know from Hiroshima and Nagasaki, it takes years to get cancer.
Leukemia takes only 5 to 10 years to emerge, but solid cancers take 15 to
60. Furthermore, most radiation-induced mutations are recessive; it can take
many generations for two recessive genes to combine to form a child with a
particular disease, like my specialty, cystic fibrosis. We can't possibly
imagine how many cancers and other diseases will be caused in the far future
by the radioactive isotopes emitted by Chernobyl and Fukushima.

Doctors understand these dangers. We work hard to try to save the life of a
child dying of leukemia. We work hard to try to save the life of a woman
dying of metastatic breast cancer. And yet the medical dictum says that for
incurable diseases, the only recourse is prevention. There's no group better
prepared than doctors to stand up to the physicists of the nuclear industry.

Still, physicists talk convincingly about "permissible doses" of radiation.
They consistently ignore internal emitters - radioactive elements from
nuclear power plants or weapons tests that are ingested or inhaled into the
body, giving very high doses to small volumes of cells. They focus instead
on generally less harmful external radiation from sources outside the body,
whether from isotopes emitted from nuclear power plants, medical X-rays,
cosmic radiation or background radiation that is naturally present in our
environment.

However, doctors know that there is no such thing as a safe dose of
radiation, and that radiation is cumulative. The mutations caused in cells
by this radiation are generally deleterious. We all carry several hundred
genes for disease: cystic fibrosis, diabetes, phenylketonuria, muscular
dystrophy. There are now more than 2,600 genetic diseases on record, any one
of which may be caused by a radiation-induced mutation, and many of which
we're bound to see more of, because we are artificially increasing
background levels of radiation.

For many years now, physicists employed by the nuclear industry have been
outperforming doctors, at least in politics and the news media. Since the
Manhattan Project in the 1940s, physicists have had easy access to Congress.
They had harnessed the energy inside the center of the sun, and later
physicists, whether lobbying for nuclear weapons or nuclear energy, had the
same power. They walk into Congress and Congress virtually prostrates
itself. Their technological advancements are there for all to see; the harm
will become apparent only decades later.

Doctors, by contrast, have fewer dates with Congress, and much less access
on nuclear issues. We don't typically go around discussing the latent period
of carcinogenesis and the amazing advances made in understanding
radiobiology. But as a result, we do an inadequate job of explaining the
long-term dangers of radiation to policymakers and the public.

When patients come to us with cancer, we deem it rude to inquire if they
lived downwind of Three Mile Island in the 1980s or might have eaten
Hershey's chocolate made with milk from cows that grazed in irradiated
pastures nearby. We tend to treat the disaster after the fact, instead of
fighting to stop it from happening in the first place. Doctors need to
confront the nuclear industry.

Nuclear power is neither clean, nor sustainable, nor an alternative to
fossil fuels - in fact, it adds substantially to global warming. Solar, wind
and geothermal energy, along with conservation, can meet our energy needs.

At the beginning, we had no sense that radiation induced cancer. Marie Curie
and her daughter didn't know that the radioactive materials they handled
would kill them. But it didn't take long for the early nuclear physicists in
the Manhattan Project to recognize the toxicity of radioactive elements. I
knew many of them quite well. They had hoped that peaceful nuclear energy
would absolve their guilt over Hiroshima and Nagasaki, but it has only
extended it.

Physicists had the knowledge to begin the nuclear age. Physicians have the
knowledge, credibility and legitimacy to end it.

Helen Caldicott, a founder of Physicians for Social Responsibility, is the
author of "Nuclear Power Is Not the Answer."

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