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1993, then, if Gofman is right, 70% (or 322,000) of these deaths are attributable to X-rays and half of these (or 161,000) are radiation, "fell out of the data". Because he had decades of experience researching the causes of CHD (he has written three books on heart disease), and because he knows the radiation literature so well, Gofman was able to put two and two together: radiation induces mutations in the coronary arteries, giving rise to what he calls "dysfunctional clones" (mini-tumours) in the smooth muscle lining the arteries. Interestingly, using his "physician density" method, Gofman estimates that medical radiation caused 83% of female breast can- cer in the US in 1993. Using a completely different method, Gofman estimated in 1995 that medical radiation was responsible for 75% of US breast cancer. The two estimates, by two com- pletely different methods, are remarkably similar. unnecessary. Thus we can see that X-rays are responsible for about 150,000 + 161,000 = 311,000 unnecessary deaths each year in the US, if Gofman is right. Gofman's study takes a novel approach, avoiding certain diffi- culties inherent in all data linking medical radiation to health. Here are the difficulties. Firstly, there are no reliable estimates of the average per-capita radiation dose that the US population receives now, or has received in the past, from medical X-rays. (Gofman explains why in chapter 2.) Secondly, there are no reli- able estimates of the cancer risk per unit dose from medical X- rays because no one is sure of the precise exposures received by various groups that have been studied for cancer effects. (Again, see Gofman's chapter 2.) Avoiding these difficulties, Gofman developed a novel approach. He found disease statistics for the entire US population, broken down into nine census districts (1940 to 1990 for cancer, and 1950 to 1990 for coronary heart disease). Then he correlated these disease statistics, year by year, to the number of physicians per 100,000 population in each of the nine census districts. The density of physicians per 100,000 population provides a relative measure of the medical radiation per 100,000 population in the nine districts, year by year. Gofman has shown that cancer death rates rise in lock-step with increasing density of physicians in a census district, while non- cancer deaths decline in lock-step with increasing density of physicians per 100,000 population, except in the case of coronary heart disease (CHD) which follows the rising pattern of cancer. Thus, Gofman's hypothesis, that CHD is linked to medical MINIMISING X-RAY EXPOSURE It will not be easy to convince physicians to take special care to minimise radiation administered to their patients. Familiarity breeds contempt, and many physicians and dentists treat X-rays as if they are entirely harmless. Recently I broke a tooth. My dentist, who is first rate, needed to document the injury for insurance purposes. "I'll just snap an X-ray," he said. I asked, "Is there some other way?" He nodded and immediately scribbled a note: "I broke my tooth and I don't want an X-ray." "Sign this," he said. "The insurance company is required to accept it.". One unnecessary X-ray avoided. Next time someone says they're going to give you an X-ray, don't put them on the spot but mention that you're curious what dose of radiation you will get. If your experience is anything like mine, the person giving the X-ray will not know the answer and will tell you: "Don't worry. It's completely safe." But it's not. oo Endnotes 16. O'Neill, Dan, The Firecracker Boys, St Radiation from Medical Procedures in the 1. Caufield, Catherine, Multiple Exposures: Martin's Press, New York, 1994, ISBN 0-312- Pathogenesis of Cancer and Ischemic Heart Chronicles of the Radiation Age, Harper & Row, 13416-9. Disease, Committee for Nuclear Responsibility, New York, 1989, ISBN 0-06-015900-6, p. 7. 17. Metzger, ibid., p. 236. San Francisco, 1999, ISBN 0-932682-98-7 2. ibid., p. 4. 18. ibid., p. 237. [available for $27.00 from Citizens for Nuclear 3. ibid., p. 15. 19. Morgan and Peterson, ibid., p. 33. Responsibility, telephone/fax +1 (415) 776 8299, 4. ibid., p. 28. 20. Morgan, Karl Z., "Changes in International e-mail crnl123@webtv.net]. 5. Robbins, Jim, "Camping Out in the Merry Radiation Protection Standards", American 35. Gofman, John W., Radiation and Human Widow Mine", High Country News, vol. 26,no. Journal of Industrial Medicine, vol. 25, 1994, pp. Health, Sierra Club Books, San Francisco, 1981, 12, June 27, 1994 (pp. unknown). See 301-307. ISBN 0-87156-275-8. http:/www.hen.org/1994/jun27/dir/reporters. 21. Modan, Baruch and others, "Radiation- 36. Gofman, John W. and Egan O'Connor, X- html. Also see Induced Head and Neck Tumours", Lancer, 23 Rays: Health Effects of Common Exams, Sierra http://www.roadsideamerica.com/attract/MTBAS — February 1974, pp. 277-279. Club Books, San Francisco, 1985, ISBN 0- radon.html. 22. Mancuso, Thomas F. and others, "Radiation 37156-838-1. 6. Makhijani, Arjun and Scott Saleska, The Exposures of Hanford Workers Dying from 37. Gofman, John W., Radiation-induced Nuclear Power Deception: US Nuclear Cancer and Other Causes", Health Physics, vol. Cancer from Low-Dose Exposure: An Mythology from Electricity "Too Cheap to Meter" 33, November 1977, pp. 369-385. Independent Analysis, Committee for Nuclear to "Inherently Safe" Reactors, The Apex Press, 23. Morgan and Peterson, ibid., p. 112. Responsibility, San Francisco, 1990, ISBN New York, 1999, ISBN 0-945257-75-9. 24. ibid., p. 113. 0-932682-89-8. 7. Metzger, H. Peter, The Atomic Establishment, 25. March, H.C., "Leukemia in radiologists ina 3g. Gofman, John W. (edited by Egan Simon & Schuster, New York, 1972, ISBN 671- _ twenty-year period", American Journal of O'Connor), Preventing Breast Cancer, 21351-2. Medical Science, vol. 220, 1950, pp. 282-286. Committee for Nuclear Responsibility, San 8. D'Antonio, Atomic Harvest, Crown 26. Stewart, Alice and others, "Preliminary Francisco, 1995, 1996 (2nd edition), ISBN Publishers, New York, 1993, ISBN 0-517-58981- | Communication: Malignant disease in child- 0-932682-96-0.. ; 8; and Ward, Chip, Canaries on the Rim: Living _ hood and diagnostic radiation in utero", Lancet, 39. Gofman, John W., 1999, ibid. Downwind in the West, Verso, New York, 1999, 1956, pp. 447-448. 40. ibid. ° —_— ISBN 1-8598-4750-1. 27. Morgan and Peterson, ibid. 9. Morgan, Karl Z. and Ken M. Peterson, The 28. Morgan, 1994, ibid. se Angry Genie: One Man's Walk Through the 29. ibid. Editor's Note: Nuclear Age, University of Oklahoma Press, 30. Morgan, Karl Z., "Medical X-Ray Peter Montague's article was first published in Norman, Oklahoma, 1999, ISBN 0-8061- Exposures", Industrial Hygiene Journal, three parts in Rachel's Environment & Health 3122-5, p. 96. November/December 1963, pp. 588-599. Weekly, nos. 691, 692, 693, March 16, April 13, 10. ibid., p. 101. 31. Morgan, Karl Z., "You can drastically cut X- April 20, 2000; published by Environmental 11. ibid. ray exposure below today's levels", Consultant, Research Foundation, PO Box 5036, Annapolis, 12. Metzger, ibid., p. 204. March/April 1970, p. 16. Maryland 21403, USA, tel +1 (410) 263 1584, 13. ibid., p. 227. 32. Morgan and Peterson, ibid., p. 121. 1-888-2RACHEL (toll-free in North America), fax 14. ibid. 33. ibid. +1 (410) 263 8944, e-mail erf@rachel.org, web- 15. ibid., p. 231. 34. Gofman, John (edited by Egan O'Connor), site www.monitor.net/ rachel/. 38 - NEXUS AUGUST - SEPTEMBER 2000