Letter to L a Sagan, Subject: Program Review of the AEC Employees Study

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Division of Biology and Medicine United States Atomic Energy Commission , Medical Research Branch Thank you for giving m e the opportunity to participate i n your . program review of the .4EC employees study. A s promised, I now offer some personal opinions and impressions gained at the meeting and in-reviewing , opinions, or this letter, with Dr. Mancuso, if you wish, for I hope it will be evident that my criticism is aimed at the overall concept of such a study and not a t t h e way the study is being conducted. Nobody has had more experience than Dr. Mancuso with the practical aspects of a study such as this, and it is clear that he is pursuing this study.with energy and ability. While I disagree with Dr. Mancuso on the recommendation to continue and expand the study, I have nothing buYadmiration for the way h e h a s handled e-written rnat5rial.I I would have no objection to your sharing these In my opinion this study does not have, never did have, and never (in any practical sense) will have, any possibility or' contributing to knowledge of radiation effects in man. That, of course, is a bald statement, and one which might well heng m e in a few years time, far any study has some possibility of contributing to something - even something completely unrelated to its original purpose. What I mean, of course, is that the chances of a substantlal contribution being made are remate. They are far outweighed by the possibility of misleading information b&g derived from the operatian of unknown biases in the material, kom deb rate falsification ) or even frcm chance alone.of received d o s e (as suggested by The problem is that of the tremendous numbers of observations required for the detection of radiation effects a t the level ~i exposures involved. Dr . Mancuso an a his collezgues zre well aware of this problem and seem themselves t o recognise that little of value to rdi ation biology w i l l be developed. They seem to justify the study, ana its expansion,-

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largely in terms of "spin-off" studies of other types of exposure (lead, mercury, etc.) and of general improvement of methodology in the field of industrial epidemiology. In my view, the study, much less its expansion, can not be justified in these terms. If the objective is to study other types of exposure, there a r e other populations available *&at would b e more suitable. In the interests of logic and economy, one should seek the particular population best suited to answering a particular problem. Apart from some minor and technical matters relating t o computers s n d large-scale d a t a processing, I see no particular methodologic problem, the solution of which might have general applications, that is being tackled. I recognise that much of the motivation for s ming this study arose from the "political" need for assurance that AEC employees are not suffering harmful effects. Such assurance will derive h n t h e five-year study as already planned. One of the major conirihutions-of the study to date has been the extensive documentation of the levels of radiation exposure received in various segments of the industry. mis is a collection of information that should be of great value in assuring *ever n e e d s to be assured regarding harmful effects to employees. -Thus,?-do not believe that this "political" motivation, real though it was in the -%ginning, should carry over into a decision to continue or expand the study. 71On t h e question of synergism between radiatfan and chemical agents, the data are not yet assembled in such a way th& one can pick out opportunities for study. It may be that within t h i s tremeadous variety of experience there are specific situations that could be s t u d e d with profit. Awa ~ i c inope rhat these would be identified within the can text of the presenr data collection plans. However, such situations are likdy to be fe5a vague handwave in the direction of ''synergism" in general is not adequate grounds for continuing the whole massive eiiort . ~. Lastly, I must s a y that my respect for Dr. Mimcuso's personal ability does not extend to the staff that he has a ssem bid for the project. While the exposure-measurement aspects ' seem to be in good hands (so far as Iam able to judge), some of the remarks made by the statistical apd data processing staff give cause for concern. with Dr. Mancuso of the progress reports, Ip res ux st hz r these two ir.dividuals are his primary aides.I have serious rec irv arlon s about their campetence, particularly when they d e a l with more sophisticEted matters than the mechanics of data processing. I s ET. Mancuso gettr?,g t h e suppcrt that he might expect from his University, in the way GI' putti?% studer.rs in his path? Surely this material could pov ide the rescurce fm mnya docrcral thesis, and the project would beneiit from theBa - tic ipa tim of young and able physicians and other public health students. From their app ezra ncea s co-authors

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would therefore urge ET. Mancuso to proceed with the whole program on t h o s e parts of the industry experience that have already been abstracted (e .g. Hanford), rather than waiting until all the industry experience h a s