Permissible Levels of Exposure
The US National Council on Radiation Protection and Measurement
gave expression to the theoretical resolution of this human dilemma
by articulating the implicit reasoning behind subsequent radiation
protection standards
development:[20]
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A value judgment which reflects, as it were, a measure of
psychological acceptability to an individual of bearing slightly
more than a normal share of radiation-induced defective
genes.
-
A value judgment representing society's acceptance of
incremental damage to the population gene pool, when
weighted by the total of occupationally exposed persons, or
rather those of reproductive capacity as involved in Genetically
Significant Dose calculation.
-
A value judgment derived from past experience of the somatic
effects of occupational exposure, supplemented by such
biomedical and biological experimentation and theory as has
relevance.
This is now an internationally accepted approach to setting standards
for toxic substances when no safe level of the substance exists.
In
short, this elaborate philosophy recognises the fact that there is
no safe level of exposure to ionising radiation, and the search for
quantifying such a safe level is in vain. A permissible level, based on
a series of value judgments, must then be set. This is essentially a
trade-off of health for some `benefit' -- the worker receives a livelihood,
society receives the military `protection' and electrical power is
generated. Efforts to implement these permissible standards would
then logically include convincing the individual and society that the
`permissible' health effects are acceptable. This has come to mean
that the most undesirable health effects will be infrequent and in line
with health effects caused by other socially acceptable
industries. Frequently, however, the worker and/or public is given
the impression that these `worst' health effects are the only individual
health effects. A second implication of the
standards-based-on-value-judgments approach is that unwanted
scientific research resulting in public scrutiny of these value
judgments must be avoided.
The
genetic effect considered by standard setters as most
unacceptable is serious transmittable genetic disease in live-born
offspring. These severely damaged children are usually a source of
suffering for the family and an expense for society which must provide
special institutions for the mentally and physically disabled. Severely
handicapped people rarely have offspring; many die, are sterile or are
institutionalised before they are able to bear children. Workers and
the public are told that the probability of having such severely
damaged offspring after radiation exposure within permissible levels is
slight. By omission, a mildly damaged child or a miscarriage is
implied to be `acceptable'.
From a column in the Yomiuri Shinbun (19 January 1965; evening
edition)
A nineteen-year-old girl in Hiroshima committed suicide after
leaving a note: `I caused you too much trouble, so I will die as
I planned before.' She had been exposed to the atomic bomb
while yet in her mother's womb nineteen years ago. Her
mother died three years after the bombing. The daughter
suffered from radiation illness; her liver and eyes were affected
from infancy. Moreover, her father left home after the mother
died. At present there remain a grandmother, age seventy-five; an
elder sister, age twenty-two; and a younger sister,
age sixteen. The four women had eked out a living with their
own hands. The three sisters were all forced to go to work
when they completed junior high school. This girl had no time
to get adequate treatment, although she had an A-bomb
victim's health book.
As
a certified A-bomb victim, she was eligible for certain
medical allowances; but the [A-bomb victims' medical care]
system provided no assistance with living expenses so that
she could seek adequate care without excessive worry about
making ends meet. This is a blind spot in present policies for
aiding A-bomb victims. Burdened with pain and poverty, her
young life had become too exhausted for her to go on . . . .
There
is something beyond human expression in her words
`I will die as I planned before.'
Quoted in Kenzaburo Oe, Hiroshima Notes, YMCA Press Tokyo
(English translator Toshi Yonezawa; English editor David
L. Swain).
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Standard
setters judge that the most severe damage done directly to
the person exposed is a fatal radiation-induced cancer, and again, this
is a rare occurrence when exposure is within permissible levels. All
other direct damage is by omission considered `acceptable'.
In
its 1959 report recommending occupational standards for internal
radiation doses (i.e. radioactive chemicals which are permitted to
enter the body through air, water, food or an open wound), the
International Commission on Radiological Protection (ICRP) formed
the following definition:
A permissible genetic dose [to sperm and ovum], is that dose [of
ionising radiation], which if it were received yearly by each person
from conception to the average age of childbearing [taken as 30
years], would result in an acceptable burden to the whole
population.[16]
[Emphasis added.]
This
might be paraphrased to say that the general public
(governments) may be willing to accept the number of blind, deaf,
congenitally deformed, mentally retarded and severely diseased
children resulting from the permissible exposure level. Defined this
way, the problem becomes primarily an economic one, since society
needs to estimate the cost of providing services for the severely
disabled. Once reduced to an economic problem, some nations may
choose to promote early detection of foetal damage during pregnancy
and induced abortion when serious handicap is suspected. When a
foetus is aborted prior to sixteen weeks' gestation the event may not
need to be reported and included in vital statistics. It becomes a
non-happening, and the nation appears to be in `good health', having
reduced the number of defective births.
Mild
mutations, such as asthma and allergies, are ordinarily not
even counted as a `cost' of pollution. The economic burdens, `health
costs', fall more on the individual and family than on the
government. Their pain and grief do not appear in the risk/benefit
equation. Parents and children are unaware of the `acceptable
burden' philosophy.
The
prediction of the magnitude of the burden of severe genetic
ills on an exposed population is essential to this philosophy. However,
the data accumulated at Hiroshima and Nagasaki did not give clear
answers. Either through ineptitude or loss of survivors of the bombing,
who died before their story was told, the researchers failed to find
any severe genetic ills clearly attributable to the parental exposure to
radiation at low doses.[21]
Probably the more fragile individuals in the population died from the blast,
fire and trauma of the bombs, the women not surviving long enough to become
pregnant.[22]
Governments
could not use the research on genetic damage in
children of medical radiologists,[23]
although this damage was measurable, because, in the early days,
radiation exposure to physicians was not measured. No quantitative
dose/response estimates could be derived.
Animal
studies of radiation-related genetic damage abounded, and
the recommending body, ICRP, used (and still uses) mouse studies as
a basis of its official predictions of the severe genetic effects of
ionising radiation in humans.
As
late as 1980, a US National Academy of Science publication
from its committee on the Biological Effects of Ionising
Radiation[24]
stated:
New data on induced, transmissible genetic damage expressed in
first generation progeny of irradiated male mice now allow direct
estimation of first generation consequences of gene mutations on
humans . . . As with BEIR I, a major obstacle continues to be the
almost complete absence of information on radiation-induced
genetic effects in humans. Hence, we still rely almost exclusively
on experimental data, to the extent possible from studies involving
mammalian species [i.e. mice].
These
mouse studies are used as the basis of prediction, and
permissible doses are set so that the expected number of severe
transmittable genetic effects in children of those exposed could be
presumed to be an acceptable burden for governments choosing a
nuclear strategy.
The
introductory section of ICRP Publication 2, 1959, states:
The permissible dose for an individual is that dose, accumulated
over a long period of time or resulting from a single exposure,
which, in the light of present knowledge carries a negligible
probability of severe somatic [damage to the individual] or genetic
[damage to the offspring] injuries, furthermore, it is such a dose that
any effects that ensue more frequently are limited to those of a
minor nature that would not be considered unacceptable by the
exposed individual and by competent medical authorities. Section
30.[16]
[Emphasis added.]
Mild
mutations are notably happenings of a minor nature, normally
neither reported nor monitored in the population. They are likely to be
statistically hidden by normal biological variations and unconnected
in the mind of the individual or his/her physician with the exposure. The
publication continues:
The permissible doses can therefore be expected to produce effects
[illnesses] that could be detectable only by statistical methods
applied to large groups. Section
31.[16]
[Emphasis added.]
In
spite of this clarity, no such statistical audit of all health effects
including chronic diseases in exposed people and mild mutations in
their offspring has ever been done. More than 25 years have expired
since this document was published and the world is more than 35
years into the nuclear age.
As
late as 1965, ICRP Publication
9[25]
stated:
The commission believes that this level [5 rems radiation exposure
per 30 years for the general public] provides reasonable latitude for
the expansion of atomic energy programs in the foreseeable future. It
should be emphasised that the limit may not in fact represent a
proper balance between possible harm and probable benefit because
of the uncertainty in assessing the risks and benefits that would
justify the exposure. [Emphasis added.]
The
committee protected itself against accusations of wrongdoing
but failed to protect the public from its possible error. It defines its
role as recommending, with the responsibility of action to protect
worker and public health resting with individual national
governments. Governments in turn tend to rely on ICRP
recommendations as the best thought of internationally respected experts.
In
spite of this uncertainty about responsibility and safety levels for
exposure of the public, 5 rem per year, rather than per 30 years, was
permitted for workers in the nuclear industry. The 5 rem per 30 years
was set as the average dose to a population, with a maximum of 0.5
rem per year (15 rem per 30 years) for any individual member of the
public.
For
twenty years, between 1945 and 1965, health research on the
effects of ionising radiation exposure has focused on estimating (not
measuring) the number of excess radiation-induced fatal cancers and
excess severe genetic diseases to be expected in a population (i.e. a
whole country) given the average estimated exposure to radiation for
the country. Disputes among scientists usually have to do with the
magnitude of these numbers. Omitted from this research are other
radiation-related human tragedies such as earlier occurrence of
cancers which should have been deferred to old age or even might not
have occurred at all because the individual would have died naturally
before the tumour became life-threatening. These are not excess
cancers, they are accelerated cancers. This
approach also omits other physiological disorders such as
malfunctioning thyroid glands, cardio-vascular diseases, rashes and
allergies, inability to fight off contagious diseases, chronic respiratory
diseases and mildly damaged or diseased offspring. The implications
of such `mild' health effects on species survival seem to have either
escaped the planners of military and energy technology, or to have
been deliberately not articulated. Other obvious limitations of this
national averaging approach include the failure to deal with global
distribution of air and water with the result that deaths and the
cumulative damage to future generations are not limited to one
country.
The
usual procedure for setting the standard for a toxic substance or
environmental hazard is to decide the relevant medical symptoms of
toxicity and determine a dose level below which these symptoms do
not occur in a normal healthy adult. This cut-off point is sometimes
called the tolerance level and it represents a sort of guide to the
human ability to compensate for the presence of the toxic substance
and maintain normal health. The tolerance level for a substance, if
one can be determined, is then divided by a factor (usually 10) to
give a safe level. This allows for human variability with respect to the
tolerance level and also for biological damage which may occur
below the level at which there are visible signs of toxicity,
i.e. sub-clinical toxicity.
Human
experience with ionising radiation had been recorded for
more than fifty years prior to the nuclear age, the early history of
handling radioactive material having been fraught with tragedy. The
discoverer of the X-ray, W. K. Roentgen, died of bone cancer in 1923,
and the two pioneers in its medical use, Madame Marie Curie and her
daughter, Irene, both died of aplastic anaemia at ages 67 and 59
respectively. At that time, bone marrow studies were rarely done, and
it was difficult, using blood alone, to distinguish aplastic anaemia
from leukaemia. Both diseases are known to be radiation-related. Stories
of early radiologists who had to have fingers or arms
amputated abound. There were major epidemics among radiation
workers, such as that among the women who painted the radium dials
of watches to make them glow in the dark. Finally, there were the
horrifying nuclear blasts in Hiroshima and Nagasaki.
The
painful period of growth in understanding the harmful effects of
ionising radiation on the human body was marked by periodic
lowering of the level of radiation exposures permitted to workers in
radiation-related occupations. For example, permissible occupational
exposure to ionising radiation in the United States was set at 52
roentgen (X-ray) per year in
1925,[26]
36 roentgen per year in
1934,[27]
15 rem per year in
1949[28]
and 5 to 12 rem per year from 1959 (depending on
average per year over age 18) to the
present.[29]
Recently there has been an effort to increase permissible doses of
ionising radiation to certain organs such as thyroid and bone
marrow[30] in
spite of research showing the radiosensitivity of these
tissues. This newer trend probably reflects economic rather than
physiological pressures, especially given the lack of an acceptable
audit of physiological cost.
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