This book is the story of people’s encounters with radiation, and of how mankind has been transformed by the experience. The story is, therefore, told with an emphasis on the human aspects, and it is told from a health-centric perspective. The goal is to integrate the technological aspects of radiation with the human experience and thereby remove some of the mystery and misunderstanding that surround radiation.
PART ONE: RADIATION 101: THE BASICS
Part One (chapters 2–4) tells the story of how radiation was discovered, and how society immediately put that discovery to practical use. You’ll learn how a chance observation of a glowing fluorescent screen in a laboratory in Wurzburg, Germany, saved a man’s leg from amputation in Montreal, Canada, just a few weeks later. You’ll learn about Thomas Edison’s initial enthusiasm for x-ray tubes, why he soon became afraid of them, and the heavy price his assistant paid for acting carelessly. You’ll also learn how a cloudy day in Paris resulted in the discovery of radioactivity. Along the way, you will be introduced to a few physics concepts that are important to understanding how radiation affects health. Ideas about radiation and its relevant physics are introduced progressively and systematically, while the health aspects of radiation make cameo appearances in the form of anecdotes about problems suffered by the early scientific pioneers of radiation research. A comparison is made to electricity, as an example of an earlier technology that was originally regarded by the public with even greater suspicion.
1. Nuclear Jaguars
2. Now You See It: Radiation Revealed
Radiation is simply energy on the move, be it through solid matter or free space. For the most part, it is invisible to us and can only be detected with instruments. But there is one type of radiation that can be seen with the naked eye. This visible radiation is called light.
On December 22, 1895, Roentgen took a trusted friend—his wife—into his confidence. He called her down from their apartment to his laboratory. He demonstrated his discovery with the glowing screen, and then he took a “photograph” of her hand. In a short while, he developed the film and showed it to her. She was both astounded and frightened by what she saw.
It should be kept in mind that this was a time when skeletal bones were only seen after a person died and their flesh had decayed away; an image of a skeleton was then the universal depiction of death. In fact, when Roentgen showed his wife the image of the bones in her hand, she is said to have exclaimed, “I have seen my own death!”
3. Seek and You Shall Find: Radioactivity Everywhere
4. Splitting Hairs: Atomic Particles and Nuclear Fission
PART TWO: THE HEALTH EFFECTS OF RADIATION
Part Two (chapters 5–11) introduces the effects of radiation on human health. It begins with the story of miners in Germany who unknowingly suffered from a radiation-related illness before radiation had even been discovered. You’ll find out what their illness had to do with the mysterious deaths of women who painted watch dials in the United States. And you’ll learn how it was discovered that radiation can cure cancer. You’ll also learn about radiation sickness and why most medical doctors have never seen a case of it. And you’ll find out why you shouldn’t be drinking milk after a nuclear power plant accident. Evolving notions about how human cells and tissues react to radiation are introduced, with a focus on how radiation’s health effects are measured, culminating in what we now know about their underlying causes. The radiation biology related to health issues, rather than the radiation physics, is dealt with systematically, and the concept of equating “safety” with “low risk” is introduced anecdotally. This is done as a prelude to Part Three, where the role of risk/benefit analysis in making decisions regarding radiation use is explored.
5. Painted into a Corner: Radiation and Occupational Illness
It is a sad truism of public health practice that the first indication of toxicity from any hazardous agent will always appear among those who are occupationally exposed. This is because workers are typically exposed to higher levels for longer periods of time than the general public, and higher and longer exposures often shorten the time to onset of disease and increase the severity of symptoms.
A classic example is mercury poisoning among hat workers. Mercury solutions were used in the hat-making industry during the nineteenth century to preserve the animal pelts used in hat production (e.g., beaver-fur top hats). Workers, called hatters, breathed the fumes, and the mercury accumulated in their bodies. They developed a wide range of neurological symptoms that were misunderstood as signs of insanity. It soon became generally known that hatters often suffered mental difficulties, and this developed into the colloquialism “mad as a hatter” to describe anyone who seemed a little daft. We now know that the hatters’ apparent madness was due to the neurotoxicity resulting from their mercury exposure, and we have since adopted strict regulation limiting the general public’s exposure to mercury.
Mercury was by no means the only chemical to cause a particular illness in workers. As early as the eighteenth century, doctors were well aware of other occupational diseases, such as painter’s colic (lead in paint), brass founder’s ague (metal oxide fumes), and miner’s asthma (rock dust).
6. The Hippocratic Paradox: Radiation Cures Cancer
Grubbe believed that x-ray exposures caused high levels of irritation to the tumor, which, in turn, resulted in an increase in its blood volume. The increased blood then brought large number of leukocytes (white blood cells) that then choked circulation through the tumor. Deprived of circulatory nutrition, the tumor starved to death. Remarkably, this explanation, based on an irritation hypothesis, is reminiscent of the mechanism for cancer causation proposed by Virchow. You may recall Virchow’s hypothesis was that tissues suffering prolonged irritation were at risk of becoming cancerous. Thus, according to Grubbe, irritation was supposedly the underlying mechanism for both the cause and cure of cancer. Although this was a unifying mechanistic hypothesis, it still didn’t adequately explain how radiation could produce two opposite biological effects. That explanation would be a long time coming.
7. Location, Location, Location: Radiation Sickness
The first radiation syndrome was hardest to recognize because it was mixed with the severe physical trauma and skin burns experienced by those closest to ground zero. Nevertheless, against the background of physical injuries, there was a characteristic combination of nausea, vomiting, and headache. Patients with these symptoms expired within the first three days. The exact cause of death was hard to determine because it usually was the result of a combination of both trauma and radiation injury. Still, there were surely some who, one way or another, escaped trauma and burns yet still died within hours or days of the blast. These patients were likely killed exclusively by internal radiation damage. Their location within some building at the time of the blast protected them from flying debris and burns, but only the strongest stone, brick, or concrete buildings could have shielded someone from the penetrating radiation, and few of Hiroshima’s buildings were constructed of those materials.
This first radiation syndrome occurred among those who were closest to the blast and who thus received the highest radiation doses (greater than 20,000 mSv).When a human body experiences whole-body radiation doses at this level, all of the body’s cells, including the brain’s nerve cells (neurons), begin to die. Ironically, neurons are among the most radiation resistant of human cells because they never divide; yet, when doses get high enough for even neurons to succumb, it is these resistant cells that precipitate the victim’s rapid death. This is because the brain is critical in controlling all of the body’s physiological functions. As the brain’s neurons begin to die, the brain swells, and coma and death cannot be far behind, as all systems begin to shut down. This first syndrome, found exclusively among the very highly dosed victims, is known as the central nervous system (CNS) syndrome. It is a type of radiation sickness from which none recover, and death comes mercifully soon.
After the GI syndrome patients had all passed away, Sasaki noticed another lull in deaths that lasted a couple of weeks. But then at around thirty days after the bombing, some of the surviving patients had a nearly complete loss of all types of blood cells (pancytopenia) and started to die from all of the medical complications associated with this condition. Sasaki and his colleagues soon learned that two important factors were critical to the prognosis of these patients. Either a very high and sustained fever, or a white-blood-cell count that dropped below 1,000 per microliter of blood, was bad news. One of these two symptoms meant death was highly likely, but having both spelled certain demise.
8. Snow Warning: Radioactive Fallout
9. After the Dust Settles: Measuring the Cancer Risk of Radiation
Biological and chemical weapons have never proved to be effective weapons of mass destruction largely because they are hard to control. Once biological and chemical weapons are unleashed, environmental conditions can throw the weaponized agents back in the faces of their users. Such was the case during the Battle of Loos, France, in World War I, when shifting wind blew chlorine gas released on German soldiers back into the trenches of the British soldiers. If a weapon’s lethality can’t be controlled, it isn’t of much military use. In that regard, radioactive fallout presents a similar military problem; it can come back and get you. After seeing how fallout-contaminated battleships were as incapacitated by radioactivity as had they been sunk, Admiral William H. P. Blandy (1890–1954), the first commander of the Bikini Atoll nuclear bomb tests, remarked, “This is a form of poison warfare.”
Uncontrollable fallout is a major obstacle to effective use of nuclear weapons. But if unwanted atmospheric fallout were minimized, while radioactivity in the targeted blast area were maximized, it might provide yet another means of making nuclear weapons more lethal to enemy combatants. Furthermore, the targeted radioactivity could make the enemy’s lands uninhabitable, thus thwarting recovery and deterring them from future aggression. This concept is reminiscent of the idea of the Roman general, Scipio Aemilianus (185–129 BC), who allegedly salted the earth of defeated Carthage at the end of the Third Punic War (146 BC) in order to avert a Fourth Punic War
10. Breeding Season: Genetic Effects
The question that needed to be answered back in 1927 was whether radiation could produce inheritable mutations. An inheritable mutation is a permanent change to a gene that causes it to transmit an altered trait (i.e., a new trait, not found in the parents) to the offspring.Muller showed that radiation could and did produce inheritable mutations, at least in his biological model, the common fruit fly (Drosophila melanogaster).
In 1941, as a consequence of Muller’s 1927 findings with fruit flies and the concerns it raised, the Chicago Health Division of the Manhattan Project received a new secret assignment: to determine how much radiation a man could absorb daily, without increasing his chances of having abnormal children. What they found was not reassuring. The lowest dose tested was 130 mSv. The results showed that offspring of male mice that had been irradiated to 130 mSv and bred with unirradiated females had mutation rates approximately three times the natural background mutation rate. At the highest dose tested (2,380 mSv) there were nearly nine times as many radiation-induced mutations as background mutations. It was not possible to push doses much higher than this, because higher doses produced sterility. Ninefold was high, but it wasn’t nearly the 150-fold increase in mutations that Muller had seen at doses that nearly produced sterility in fruit flies.
11. Crystal Clear: The Target for Radiation Damage
WEIGHING THE RISKS AND BENEFITS OF RADIATION
Part Three (chapters 12–17) is a collection of chapters narrowly focused on radiation topics of popular interest. To mention just a few, you’ll learn how dangerous the radon in your basement is, how hazardous it is to eat food contaminated with radioactivity, and how risky it is to live next to a nuclear power plant. Although you may be tempted to cherry-pick these chapters, and read only those of particular interest, you should resist that temptation. Embedded within each chapter is an illustration of a specific risk assessment concept, and the chapters are ordered so that they progressively reveal the value of considering both risks and benefits when making health decisions, as well as the importance of weighing alternative risks. Also included is systematic discussion of how uncertainty affects the validity of our radiation decisions. It is possible to read the chapters in this part out of numerical order without any loss of narrative continuity, but the developing story of risk assessment and its relationship to safety will be garbled, so a nonsequential approach is not recommended.
12. Silent Spring: Radon in Homes
13. A Tale of Two Cities: Diagnostic Radiography
There are many diagnostic radiography procedures out there and we can’t review them all. Nevertheless, the three procedures highlighted here—arm x-ray, mammography screening, and spiral whole-body CT screening—like all other diagnostic radiography procedures, fall into one of two categories of use: (1) finding disease in patients that present with clinical symptoms of disease; or (2) screening for disease in people who have no symptoms.
In the first category, the benefits nearly always far outweigh the risks, as long as the chosen procedure is appropriate for the clinical condition. This is because the penalty for not finding the underlying cause of the disease can be severe—a nonfunctioning arm or death from cancer—and the risks of partial body radiography procedures are quite low.
In the second category, regarding the screening of the worried well, we should take pause. Do the real benefits meet the claims? How does the NNT compare to the NNH? And what are the added perils apart from the radiation? All these things need to be considered in consultation with a knowledgeable physician before making any decisions.
14. Sorry, Wrong Number: Cell Phones
“If cell phones are truly killing us with brain cancer, where are the bodies?
..the beauty of cell phones is that the means to control your personal risk is literally in the palm of your hand. If you’re uncomfortable with this risk level, you can virtually eliminate your risk while still retaining the benefits. As we’ve already mentioned, it’s the phones themselves and not the cell phone towers that are giving us the dose, and it’s our heads that are taking the brunt of it. Even using hands-free Bluetooth audio devices will largely eliminate the alleged threat because Bluetooth signals are notably weaker than the cell phone signals themselves. So just use headphones or Bluetooth and keep talking on your cell phone without worrying about cancer.
15. Hot Tuna: Radioactivity in Food
Madigan collected steaks from 15 different bluefin. He then contacted fellow scientist Nick Fisher, an expert on marine radioactivity at the School of Marine and Atmospheric Sciences at Stony Brook University in New York State. Would Fisher test the fish for radioactivity? Fisher told Madigan that he would, but really didn’t expect to find anything. Soon the results were in and, to Fisher’s surprise, all 15 fish were contaminated with manmade radioactivity. But not just any radioactivity. They were all contaminated with cesium-134 and cesium-137 radioactivity, a signature of recent nuclear power plant waste. The implication was clear. The tuna were contaminated with radioactivity they had likely picked up that spring in the waters off Fukushima, Japan, the site of a major nuclear reactor meltdown.
16. Blue Moon: Nuclear Power Plant Accidents
There were 340,000 people displaced by the 2011 Fukushima disaster. Will it ever be safe for them to go back home? Will things ever return to normal in the Fukushima Prefecture? Good questions.
The radioactivity levels in the Fukushima Prefecture will never drop down to their prior levels within any of the survivors’ lifetimes. The area is too contaminated with radioactive fission products for that to occur. The reality is that, although radioactivity will decay away and dissipate with time, it will always be elevated compared with other areas of Japan. This is an unfortunate fact.
17. The Things They Carried: Geopolitical Radiation Threats
I loved this book and its 120+ pages of just references and research material. I’ve learned loads and I’ve even shared this with my radiologist friends and they loved it too! So well documented and so well annotated, with all of the data displayed to you, the normal reader with no scientific background, in an easy to understand format. I mean there’s even a Jon Snow reference for all you Game of Thrones people!