Nuclear Weapons: The Final Pandemic Preventing Proliferation and Achieving Abolition

1. Nuclear Weapons: The Final PandemicPreventing Proliferation and Achieving Abolition New understandings of radiation effects, and new evidence from Chernobyl Ian Fairlie Independent consultant on radiation and health

2. New Information on Radiation Risks Dr Ian FairlieConsultant on Radiation in the EnvironmentLondonUnited Kingdom

3. Radiation – a brief intro Untargeted Radiation Effects -a paradigm shift Some Chernobyl Findings

4. Radiation – in a nutshell • main sources • radiation risks • dose-response relationship • politics • uncertainties

5. Main Sources • background radiation • medical exposures • test bomb fallout from 1950s and 1960s Average dose UK = 2.6 mSv/a Average dose US = ~3.5 mSv/a (0.35 rem) (1 mSv = 0.1 rem)

6. Examples of Exposures (mSv)mean Effective Dose (whole-body) 10 mSv = 1 rem

7. Radiation Risks • difficult to determine at low levels • wide differences of view • major interests involved (eg military) • public fear of radiation = often much heat: less light

8. Feared Risks: 8 pointsafter (Meara, 2002) • invisible √ • inequitably distributed √ • difficult to avoid √ • cause hidden or irreversible damage √ • dangerous to future generations √ • cause dread illnesses, ie cancer √ • difficult to explain simply √ • differing views among scientists √ √=radiation

9. Risks at low doses

10. Dose-Response: Latest LSS Datasource: Brenner et al, 2003

11. Risks: Annual Radiation Limits (1 rem = 10 mSv) Occupational 1934 ~44 rem 1950 ~15 rem 1966 5 rem 1977 5 rem + ALARA 1990 2 rem + ALARA Public 1949 4.4 rem 1953 1.5 rem 1954 1.5 rem 1956 0.5 rem 1985 0.1 rem + exceptions 1990 0.1 rem + no exceptions

12. Radiation Risks: Politics and Science • military pressure to reduce RBE values • U mining opposition to worker limits • hormesis: radiation is good for you • Sellafield leuks: invented infective hypothesis? • denial of Alice Stewart’s studies • denial of new effects of radiation • current ICRP proposals to dilute safety limits (using background radiation as excuse)

13. Background Radiation AVERAGE DOSE (WORLDWIDE) = 2.5mSv/a *wide variation between countries (worldwide average given) sources: Thorne (2003); UNSCEAR (2000, annex B)

14. Background Radiation • HPA-RP* estimated ~ 6,000 UK cancer deaths per year (~5% of cancer deaths) • reason why women >40 years have miscarriages/spontaneous abortions • partly connected with ageing: why we are not immortal • connected)** with leukemias the reason for long latency periods? * Robb JD (1994) ** Comare, (1986)

15. Uncertainties in Doses and Risks 1. ENVIRO. MODELS - transport of nuclides 2. BIOKINETIC MODELS - nuclide distn’s in organs 3. DOSIMETRIC MODELS - absorbed doses in organs 4. wR - for different rad’n types 5. wT- to add organ doses (Sv) 6. Apply a RISK - apply cancer risks from RERF 7. DDREF- for low doses/dose rates = ICRP cancer risk estimate

16. 95% 95% 5% 5% Uncertainties in dose estimates

17. Uncertainties in Dose CoefficientsGoossens LHJ, Harper FT, Harrison JD, Hora SC, Kraan BCP, Cooke RM (1998) Probabilistic Accident Consequence Uncertainty Analysis: Uncertainty Assessment for Internal Dosimetry: Main Report. Prepared for U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, USA. And for Commission of the European Communities, DG XII and XI, B-I049 Brussels Belgium. NUREG/CR-6571 EUR 16773.

18. Untargeted Effects of Radiation:- a paradigm shift • Hall EJ and Hei TK. (2003) Genomic instability and bystander effects. Oncogene vol 22, pp 7032-7042. “Both genomic instability and the bystander effect are phenomena, discovered relatively recently, that result in a paradigm shift in our understanding of radiation biology.” • Baverstock K (2000) Radiation-induced genomic instability: a paradigm-breaking phenomenon and its relevance to environmentally induced cancer. Mutation Research 454 (2000) 89–109. • Belyakov OV et al (2005) Classical radiation biology, the bystander effect and paradigms: a reply. Hum Exp Toxicol 24(10):537–542. • Bridges BA (2001) Radiation and germline mutation at repeat sequences: Are we in the middle of a paradigm shift? Radiat Res 156 (5 Pt 2):631-41. • Matsumoto H, Hamada N, Takahashi A, Kobayashi Y, Ohnishi T. (2007) J Radiat Res (Tokyo). 48(2):97-106. Vanguards of paradigm shift in radiation biology: radiation-induced adaptive and bystander responses. • Morgan WF (2002) Genomic instability and bystander effects: a paradigm shift in radiation biology? Mil Med. 167(2 Suppl):44-5. • Waldren CA (2004) Classical radiation biology dogma, bystander effects and paradigm shifts. Hum Exp Toxicol. 23(2):95-100.

19. Untargeted Effects 1. Genomic instability (damage in progeny of irradiated cells) 2. Bystander effects (damage to unirradiated cells) 3.Tandem repeat [minisatellite] mutations (damage to DNA without DNA being hit)

20. Classic Explanationfor Radiation’s Effects

21. Observed Effects of Genomic Instability cell death gene mutation micronucleus chromosome aberration gene mutation gene mutation mitotic failure

22. GenomicInstability • appears after 10-30 generations • induced at low doses • induced at very high frequency • in vitro and in vivo • mechanisms not known • bystander mechanisms involved

23. BystanderEffects 1.Signals via medium/plasma 2.Signals via gap junctions

24. BystanderEffects • induced at very low doses • induced at very high frequency • affects genetic and somatic cells • in vitro and in vivo • thought to be via chemical signals, eg cytokines or ROS

25. Observed Bystander Effects • cell proliferation • mutations • chromosome aberrations • changes in damage-inducible proteins • changes in reactive oxygen species • genomic instability • cell death (ie could be protective) • in vitro and in vivo

26. Bystander effect: dose responseMothersill and Seymour, 1999

27. Tandem Repeats in DNAeg “…AGGGTT…”

28. DNA Tandem Repeat Mutations • mini and micro satellites – non-coding DNA • but increasingly thought to be functional • associated with many diseases • hypermutable: very sensitive to radiation • not known how mutations are caused (ie not by direct DNA damage) • appears to be passed to future generations

29. Untargeted effects - important at low doses Risk Dose

30. Untargeted Effects increasedrisk decreasedrisk CellSurvival Inflammatory Responses Cell Death Genetic Factors Genetic Factors Genetic Factors

31. Untargeted Effects:are we underestimating radiation risks at low doses? • derive risks from classic effects at high doses • new effects occur at much lower doses • new effects are in addition to classic effects • transgenerational effects? • possible radiosensitive sub-populations? • little or no dose dependenceDDREF ≈ 1 not 2?

32. Untargeted Effects:Implications for safety? • CERRIE Committee (2004) was divided • authoritative scientists (Hall, Dubrova, Little, Wright, Prise etc) – state that perceived risks have increased • ICRP view … knowledge is insufficiently developed for RP purposes... • ie sanguine view, not precautionary

35. Chernobyl Accident (1986) • “..foremost nuclear catastrophe in human history” IAEA (1996) • “..its magnitude and scope, the size of the affected populations, and its long-term consequences make it, by far, the worst industrial disaster on record” IAEA/WHO (2005) • “..radioactivity released ~200 times that from Hiroshima or Nagasaki” WHO/IPHECA (1995)

36. Chernobyl Fallout

38. Doses from Chernobyl Falloutsources: *Cardis et al, 2005; ** TORCH (2006)

39. Chernobyl: observed health effects thyroid cancer leukaemia solid cancer non-cancer effects minisatellite mutations mental health + psychosocial

40. Epidemiology studies: care required • differing diagnostic criteria used • insufficient/poorly matched control groups • small numbers – low statistical power • confounding factors and biases • nil or poor dose estimates Only use reliable studies

41. Thyroid Cancer IncidenceJacob et al (2005)

42. Leukemias in Clean-up Workers Ivanov (1997)

43. Solid CancersOkeanov et al (2004), Pukkala et al (2006) *RRs statistically significant at 95%

44. Cardiovascular Disease Russian cleanup workers ERR/Sv = 0.54 (Ivanov et al, 2000) (is consistent with A-Bomb studies ERR/Sv = 0.17) (Pierce et al, 2003)

45. Non-cancer effects in A-bomb survivors(Preston and Pierce, 2003) all statistically significant at 95% level

46. Transgeneration Effects Dubrova et al (1996, 1997, 2002) • DNA minisatellite mutation incidence doubled in Belarus and Ukraine • mutations in fathers not mothers • passed to their children

47. Chernobyl: conclusions • terrible consequences • health effects still occurring • different health effects appearing • needs for more research + funding • need to question denials by many governments

48. References • Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, Lubing JH, Preston DL, Preston JR, Puskin JS, Ron E, Sachs RK, Samet JM, Setlow RB and Zaider M (2003) Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. (2003) PNAS Nov 25, 2003, vol. 100 no. 24 13761–13766 • Cardis E (2005) Cancer effects of the Chernobyl accident (presentation at IAEA/WHO Conference ‘Environmental and Health Consequences of the Chernobyl Accident’) • CERRIE (2004) Report of the Committee Examining Radiation Risks of Internal Emitters London, October 2004 www.cerrie.org (accessed February 12, 2006) • Day R, Gorin MB and Eller AW (1995) Prevalence of lens changes in Ukrainian children residing around Chernobyl Health Physics 68 632-42 • Dubrova YE, Grant G, Chumak AA, Stezhka VA, Karakasian AN (2002) Elevated minisatellite mutation rate in the post-Chernobyl families from Ukraine. Am J Human Genet 71:801-809 • Dubrova YE, Nesterov VN, Krouchinsky NG, Ostapenko VA, Neumann R, Neil DL and Jeffreys AJ (1996) Human minisatellite mutation rate after the Chernobyl accident. Nature 380 683-686 • Dubrova YE, Nesterov VN, Krouchinsky NG, Ostapenko VA, Vergnaud G, Giraudeau, Buard J and Jeffreys AJ (1997) Further evidence for elevated human minisatellite mutation rate in Belarus eight years after the Chernobyl accident. Mutat. Res. 381, 267-278 • European Commission (1998) Atlas of Caesium Deposition on Europe after the Chernobyl Accident. European Commission. EUR 19810 EN RU. Brussels • Goossens LHJ, Harper FT, Harrison JD, Hora SC, Kraan BCP, Cooke RM (1998) Probabilistic Accident Consequence Uncertainty Analysis: Uncertainty Assessment for Internal Dosimetry: Main Report. Prepared for U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, USA. And for Commission of the European Communities, DG XII and XI, B-I049 Brussels Belgium. NUREG/CR-6571 EUR 16773. • IAEA/WHO (2005a) Health Effects of the Chernobyl Accident and Special Health Care Programmes. Report of the UN Chernobyl Forum Expert Group “Health” (EGH) Working draft. July 26 2005 • IAEA/WHO (2005b) Environmental Consequences of the Chernobyl Accident and their Remediation. Report of the UN Chernobyl Forum Expert Group “Environment” (EGE) Working draft. August 2005 • IAEA/WHO/EC (1996) One Decade After Chernobyl: Summing up the Consequences of the Accident. • Ivanov VK et al (2000) Radiation-epidemiology analysis of incidence of non-cancer diseases among the Chernobyl liquidators. Health Physics 78, 495-501 • Ivanov VK, Tsyb AF, Gorsky AI, et al (1997) Thyroid cancer among "liquidators" of the Chernobyl accident. Br J Radiol 70: 937-41 • Jacob P, Meckbach R, Ulanovski A, Schotola C and Pröhl G (2005) Thyroid exposure of Belarusian and Ukrainian children due to the Chernobyl accident and resulting thyroid cancer risk. GSF-Bericht 01/05, Neuherberg: GSF-Forschungszentrum mbH, 72S.; mit Anhang • Meara J (2002) Getting the Message Across: Is Communicating the Risk Worth it? J of Radiation Protection Vol 22 pp 79-85 • Okeanov AE, Sosnovskaya EY, Priatkina OP (2004) A national cancer registry to assess trends after the Chernobyl accident. Swiss Med Wkly 134:645-9 • Preston DL, Shimuzu Y, Pierce DA, Suyama A and Mabuchhi K (2003) Studies of mortality of Atomic Bomb survivors. Report 13: Solid Cancer and Non-cancer Disease Mortality: 1950-1997 Radiation Research 160, 381-407 • Pukkala E, Poliakov S, Ryzhov A, Kesminiene A, Drozdovich V, Kovgan L, Kyyrönen P, Malakhova I V, Gulak L and Cardis E Breast cancer in Belarus and Ukraine after the Chernobyl Accident. (2006) International Journal of Cancer, in press • Robb JD (1994) Estimates of Radiation Detriment in a UK Population. NRPB Report R-260 National Radiological Protection Board, Chilton, Oxon • Thorne MC (2003) Background radiation: natural and man-made. J Radiol Prot vol 23(1) pp 29-42 • UNSCEAR (2000) United Nations Scientific Committee on the Effects of Atomic Radiation Report to the General Assembly, with Scientific Annexes.(New York:UN) Annex B • US DoE (1987) Report of Interlaboratory Task Group. Health and Environmental Consequences of the Chernobyl Nuclear Power Plant Accident. US Department of Energy DOE/ER-0332 NTIS Springfield VA 22161 • WHO/IPHECA (1995) Health Consequences of the Chernobyl Accident, Results of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA). Summary Report. World Health Organisation.

49. Reading List Books • Caufield C (1990) Multiple Exposures: Chronicles of the Radiation Age. Penguin Books. London UK • Greene G (1999) The Woman Who Knew Too Much. University of Michigan Press. Ann Arbor, MI, US • Proctor RN (1995) Cancer Wars: How Politics Shapes What We Know and Don’t Know about Radiation. Basic Books. New York, NY, US Articles • Greenberg M (1991) The Evolution of Attitudes to the Human Hazards of Ionising Radiation and to its Investigators. Am J of Industrial Medicine Vol 20 pp 717-721 • Rose G (1991) Environmental Health: Problems and Prospects. J of Royal College of Physicians of London Vol 25 No 1, pp 48-52 • Stewart AM (1991) Evaluation of Delayed Effects of Ionising Radiation: an Historical Perspective. Am J of Industrial Medicine Vol 20 pp 805-810

50. My grateful thanks to Dr David Sumner Dr Keith Baverstock Professor Eric Wright (any errors remain the author’s responsibility)