Why Dose Reconstruction? Epidemiology seldom provides quick answers. When epidemiologists make mistakes in classifying individuals' exposures, then the study often gets biased toward "no effect." Mixing up a few "high" and "low" exposure individuals can cancel out any dose-response gradient. The highest form of scientific proof in environmental epidemiology is to prove that the response (or disease) in a population increases with dose. This is very hard to do when the effect is cancer and the relevant exposures occurred many years ago.
Many people in environmental health, myself included, believe dose reconstruction is the solution to this problem of misclassifying individuals' exposures. If we could only assign people correctly into exposure groups of high, medium and low, then we'd be able to design studies that more accurately measure the health effects of low level environmental radiation.
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The recent, surprising negative findings in the Hanford Thyroid Disease Study offer a stunning reminder of just how harsh a taskmaster epidemiology can be. If the best dose reconstruction money can buy didn't yield results satisfactory to citizens at Hanford, then it would be wise for residents of Northern New Mexico to go into this process with modest expectations.
Thyroid Disease. The prospects for linking the Los Alamos thyroid cancer cases of 1988-1993 to historical emissions of radioiodine would appear to have dimmed due to the Hanford findings. Yet it may be possible to show a close relationship in time between radioiodine releases from LANL and thyroid disease in children, because childhood thyroid cancer is so rare (and historically so high in Los Alamos) and the latent period may be as short as five years. There are many stones left unturned (e.g., Questions #14, 16, 20, 29, 30, 34, 36, 39) from previous studies to justify CDC's prompt attention to potential historical sources of radioiodine around LANL. A closer examination of external radiation exposures and thyroid disease is also overdue.
Brain Cancer. Similarly, the brain cancer cluster of the late 1980's cries out for attention to past exposures. At LANL, the Western Area's proximity to CMR Building (Question # 26) entices one to think "plutonium." It should be noted that Dr. Gregg Wilkinson and colleagues found increased rates of brain cancer in workers at Rocky Flats, but a dose-response gradient was evident only for external radiation -- not for plutonium. Sources of external radiation at LANL (Question #38) also deserve a closer look.
Off the Hill. Perhaps of greatest value will be CDC's estimates of radiation releases that caused exposure to populations "off the hill." If exposures were tiny, then it may not be necessary for epidemiologists to study health problems on the Pueblos. On the other hand, if serious contamination is present then tribal governments will have their hands full modeling exposures from traditional practices . Similarly, residents of Espanola may be able to breathe a sigh of relief; or they may choose to get more involved with the workplace issues NIOSH seeks to address.
Other Historical Concerns. Epidemiology aside, in Northern New Mexico there are many, many compelling reasons for moving ahead aggressively on historical documents discovery at LANL. The nagging issue of "background" plutonium in Northern New Mexico is long overdue for independent assessment. A never-published internal 1990 LANL analysis suggested that plutonium stack emissions from TA-21 (DP West) were much greater than officially reported (Question #4). Irregularities in historical monitoring reports (Questions #7, #12) lend support to the undercurrent of public skepticism toward LANL assurances regarding past emissions. Longstanding problems with DOE and LANL information access practices (Questions #2 and #5) have only heightened suspicions.
Priority Issues. Health Division Monthly Progress Reports provide a revealing narrative of day-to-day historical health and safety concerns at Los Alamos. Installments in this series later than 1964 have not yet been released to the public (Question #15). Curiously, this is right around the time that the wattage of Omega West Reactor was increased from 5 to 8 MW for "national security" purposes (Questions #17 and #18), against the wishes of AEC safety personnel in Washington, D.C.. In 1969 in the months after the fire at Rocky Flats, strange things were going on at DP West (Question #11; Cover). Declassification of the Health Division Monthly Progress Reports after 1964 should be a priority for CDC.
Role of Citizens. CDC and its badged contractors can carry the public's concerns and hunches into the Archives, the Classified Reports Collection and every nook and cranny of the LANL paperwork kingdom. Whether they emerge with anything of lasting value to Northern New Mexico depends upon the willingness of citizens to support and participate in their efforts.
NIOSH and the CDC Radiation Studies Branch do serious work under difficult circumstances. They get thoughtful oversight from the federal Advisory Committee on Energy Related Epidemiologic Research (ACERER), and its feisty Community Working Group. ACERER is a formal federal advisory committee which meets four times per year to oversee health studies at DOE sites. But like all government agencies, CDC and NIOSH are only as good as the participation and demands they get from affected citizens.
Origin of These Documents. All of these documents were obtained without a security clearance, using time- honored methods of scholarship such as looking up footnotes; long hours in reading rooms, microfiche and archival collections; interviews with retirees; collegial exchanges with groups like CCNS; and targeted use of the Freedom of Information Act (FOIA). Thank you to CCNS, especially Jay Coghlan and Colin King, for agreeing to distribute some of the historical questions I have accumulated in the course of my dissertation work at Boston University School of Public Health. CCNS and other watchdog groups provide an essential function. Intellectuals can lose sight of difference between objectivity and neutrality. It's good to remain objective. But it's also good to come to a few value judgments. No matter what we do for a living, we're all "citizens."
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