From Hiroshima to Fukushima to You

Dale Dewar, Florian Oelck

• Publisher: Between the Lines
• Year: 2014
• ISBN:
  9781771131285
• Topic: Social Sciences
• Subtopic: Global Development Studies
• Index: Social Sciences

The bombing of Hiroshima on August 6, 1945, brought radiation to international attention but the exact nature of what had been unleashed was still unclear to most. The 1986 meltdown at the Chernobyl nuclear plant again made headlines with estimates of fatalities ranging from 4000 to almost a million deaths. By the time of the shocking 2011 disaster at the Fukushima nuclear plant social media meant governments and corporations no longer had a monopoly over the release of information, but transparency remains low on the agenda.

Meanwhile, few physicians give thought to the delayed health effects of radiation. It has been the bold physician who has challenged the potential overuse of chest X-rays, CT scanning, or PET scans. This book provides clear and accurate information about radiation so that we can all make informed choices. In clear language it offers answers to citizens' questions: What is radiation? Where do we encounter it? What are the benefits and risks? How do we develop a responsible future around the uses and abuses of radioactivity?

CHAPTER 1

Historical Background

Mysterious Sickness¹

AT THE SAME TIME that Columbus sailed to the “New World,” in the 1490s, silver was discovered in the Cruel Mountains, so called for their harsh winter winds, in what is now the Czech Republic. In 1516, the area was named St. Joachimsthal by its founder, Count Stephan Schlick. While mining the silver, the miners found a strange mineral that stuck to their picks. Because it usually meant the end of silver in that vein, it was given the name pechblende (“bad luck rock”; “pitchblende”) and tossed aside. Just across the border, in the German town of Schneeberg, Germans were finding the same black rock amongst the silver in their mine.

About fifteen years after the first mine shafts had been dug, miners on both sides of the border started suffering from what became known as Mountain Disease. The identifying features of the illness were a constant hacking cough and the spitting up of blood. Those affected usually died within a few months. Doctors were at a loss, trying to identify what was causing “the lungs to rot away,” as one contemporary physician described it, and there was much speculation as to the cause. Nobody suspected the bad luck rock. In any case, Mountain Disease was soon forgotten when the silver ran out and famine and war devastated the land. In 1789, German pharmacist Martin Klaproth was experimenting with pitchblende and decided that it contained an as yet unnamed and unknown element. He called it “uranium,” after a newly discovered planet, Uranus. Doctors had already speculated that Mountain Disease was caused by a gas and, when radon was isolated in 1898, it became suspect. It was not until the 1920s, however, that the mysterious, rotting-lung illness, now called Schneeberger lung disease, was identified as lung cancer.² By then it was generally accepted that it was caused by radon. Over the lifetime of the mine, up to 75 per cent of miners around St. Joachimsthal contracted lung cancer, depending upon which mine, and where in the mine, they worked.³

Discovery

In 1895, Wilhelm Röntgen (usually given the English spelling, Roentgen), using cathode rays, created x-rays, the first known form of ionizing radiation. The next year, 1896, Henri Becquerel accidentally discovered natural ionizing radiation. Becquerel was experimenting with pitchblende that glowed in the dark after exposure to sunlight (probably due to the ruthenium and some of the uranium salts in the ore). He reasoned that the same energy that caused the rock to glow in the dark would cast an image on photographic film. His experiments included exposure to light, so on a cloudy day, he was forced to postpone his experiment. Being an unusually tidy scientist, he cleaned up after himself and put the rock and a photographic plate with which he was working in a drawer. Days later, when he developed the plate, he was surprised to see the shape of the rock on the plate, exactly where it had been lying. Given that this had occurred in total darkness, it was clear to Becquerel that the process did not require sunlight, and that the minerals he was examining gave off rays by themselves.⁴

At the University of Paris, where she had registered in 1891, Marie Curie was floundering in the search for a topic for her Ph.D. thesis. Her supervisor suggested that she explore the phenomenon that Becquerel had discovered. She was the first to refer to the rays as being “radioactive.” When she isolated uranium from her samples of pitchblende, she discovered that the remaining ore was highly radioactive, even more radioactive than the uranium itself. She began the painstaking process of isolating elements and was rewarded by finding both polonium and radium in 1898.⁵

Henri Becquerel, Marie Curie, and Pierre Curie, her fellow researcher and husband, were jointly awarded the Nobel Prize in Physics in 1903, Becquerel “in recognition of the extraordinary services he has rendered by his discovery of spontaneous radioactivity,” and Pierre and Marie Curie “in recognition of the extraordinary services they have rendered by their joint researches on the radiation phenomena discovered by Professor Henri Becquerel.”⁶

After the discovery of the new elements radium and polonium became known, Marie Curie was awarded the Nobel Prize in Chemistry in 1911. The award was notable in that she became the first person to receive it twice (only three other people have done so)⁷ and because she was recognized for both the “isolation of radium” and the “study of the nature and compounds of this remarkable element.”⁸

Early Effects on Health

Doctors eagerly adopted the new diagnostic and treatment possibilities that x-rays offered. As a result of their overenthusiasm, the earliest reported damage attributed directly to radiation was caused by x-rays and was evident within months of their discovery.⁹ In 1896, an Austrian doctor reported he had severely burned his patient’s back after treating a mole with x-rays.¹⁰

Thomas Edison, the US inventor of the light bulb, was also initially enthusiastic about x-rays and worked on the development of an x-ray focus tube. He lost his enthusiasm when one of his scientists, Clarence Dally, suffered radiation skin disease, which at first expressed itself as a dermatitis. This reddened and scaly skin damage progressed to skin cancer, which eventually spread (metastasized), resulting in his painful death in 1904. Edison himself suffered from sore eyes and skin rashes after experimenting with x-rays and later said, “Don’t talk to me about x-rays, I am afraid of them.”¹¹ Clearly, x-rays were not to be taken lightly, a fact reinforced when, years later, in 1926, H.J. Muller, a US geneticist, showed that x-ray damage to cells was hereditary in fruit flies.¹² This discovery would win him a Nobel Prize in 1946.

While x-rays were coming under scrutiny, natural sources of ionizing radiation fascinated the public. A vibrant industry grew up around the marketing of radium. It glowed in the dark and was known to have mysterious rays with equally mysterious powers. Unlike x-rays, it didn’t cause immediate, visible damage.¹³ In fact, radium was sold as beneficial to one’s health in both Europe and the United States and radium-laced products were sold for health improvement, in cosmetics, and, ironically, for cancer prevention.¹⁴

During the mid-1920s, while in its heyday, slowly developing and sad events occurred that would bring this industry to a halt. The tragic story of the “radium girls” began to make headlines. Grace Fryer was one of the radium girls. She had begun working in a New Jersey radium dial factory in 1917. At the factory, the women used brushes dipped in a radium solution for painting glow-in-the-dark dials on clock faces. They were instructed to use their lips to form the brush to a point. Fryer wondered why her handkerchief glowed in the dark after she blew her nose, but she didn’t worry about it. In fact, she and her co-workers—reassured that the material with which they were working was safe—had routinely painted their teeth and nails with radium to surprise their boyfriends at night.

Grace Fryer left the factory three years later, in 1920, to work at a bank, feeling young and healthy. Two years later, in 1922, she had excruciating pain in her mouth. Her teeth began falling out and x-rays showed that her jawbone was deteriorating (osteonecrosis). Initially thought to be “phossy jaw,” previously identified in match girls and due to phosphorus, Dr. Theodor Blum, a dentist, called it “radium jaw.” Years of denial and media manipulation ensued as U.S. Radium Corporation moved to protect its financial interests.

In 1927, Fryer and four former co-workers sued the corporation for $250,000 each. By this point, she had lost all her teeth, could not walk, and was unable to sit up without a back brace. In fact, it was clear to observers that the women were dying. U.S. Radium paid each woman a sum of $10,000 and $600 annually for as long as the woman lived. In addition, it agreed to cover all medical bills, past and future. It was a very cheap settlement even by 1920s standards; by the early 1930s, all five were dead. In the aftermath, it was discovered that the laboratory technicians and supervisors at the corporation’s factory site had known about the dangers of radium and had used protective gloves and aprons to shield themselves.¹⁵

Radiation Protection Measures

As the mystery of radioactivity and its effects on human health unfolded, it left a trail of increasingly stringent regulations and protective guidelines and an entire alphabet soup of regulatory and scientific organizations. A short timeline of events can be drawn from the discovery of x-rays to the making of regulations: Roentgen discovered x-rays in 1895 and physicians immediately started using them. A year later, in 1896, x-ray dermatitis, a reddening of the skin with peeling, was described in medical literature in the United States and Europe. Radiation-caused dermatitis was puzzling because it was different from other rashes; it is very difficult or even impossible to heal because the basal cells, the cells in the skin that regenerate new skin, have been killed by the radiation. By 1900, US electrical engineer, Wolfram Fuchs, himself a martyr to the damaging effects of radiology, established the three principles that have become the tenets of radiation safety, principles of time, distance, and shielding for x-ray exposure and treatments. Patients were told to keep the exposure as short as possible, not to stand within twelve inches (30 cm) of the tube, and to coat their skin with Vaseline.¹⁶

Within six years of the discovery of x-rays, the link between x-rays and cancer had been established. At the time, radiologists would use their hands to focus the beam of the x-ray machine. They developed skin cancer at such an alarming rate that the connection between the two was obvious. The Röntgen Museum in Remscheid, Germany, retains the preserved and gruesome radiation-affected hand of radiologist Paul Drause as a reminder of the deleterious effects of ionizing radiation from x-rays on bone and skin.¹⁷

By using radiation experimentally for therapy for practically everything, it was likely that eventually radiation would be found useful for something. In fact, in 1896, basing his treatment on the already described skin changes, Emil Grubbe, a medical student in Chicago, used x-rays to treat a recurrent cancer of the breast.¹⁸ By 1899, researchers in Sweden reported that cancer patients were being cured with the use of radioactivity.¹⁹ The term radiotherapy was coined to refer to the use of radioactivity as a treatment.

At the turn of the twentieth century, both electricity and radiation were still novelties. Both technologies seemed to show promise for medical applications. Consequently, in 1902 an International Congress of Medical Electrology and Radiology was held in Switzerland to bring together people with direct and indirect experience with the new technologies. They discussed the injuries resulting from the use of x-rays, particularly acute and chronic dermatitis. They also discussed what could and could not be seen using x-rays; its use in diagnosing broken bones was obvious, but determining what could be seen in soft tissue, such as the lungs, was less straightforward.²⁰

Acknowledging the usefulness of x-rays but interested in decreasing injuries, a dentist, William H. Rollins, after burning his hands while using x-rays for jaw and facial surgery, began experimenting with guinea pigs in 1904, eventually publishing a series of papers. He confirmed that the immediate ill effects of radiation from x-rays could be minimized by keeping the x-ray tube a certain distance from the patient’s body, but he also advocated the wearing of lead-shielding for the parts of the body not involved in the x-ray and the use of protective clothing for the technician. With the exception of ending the practice of holding the x-ray tube against the patient’s body, his research and resulting recommendations were ignored for decades.²¹

The problems of x-ray-related injuries plagued their use during the First World War, when an alarming increase in x-ray-related injuries resulted from the use of primitive, mobile, x-ray equipment in battlefield surgical units. Radiologists were forced to admit that the measurement of doses and exposure levels was inconsistent and poorly performed. To address this problem, the British Institute of Radiology invited radiologists from around the world to the first International Congress on Radiology (ICR) in London in 1925. It was at this first meeting of over five hundred medical radiation specialists—as much as one can be a “specialist” in newly discovered technology—that the International Commission on Radiation Units and Measurements (ICRU) was founded.²²

A second ICR was held in Stockholm in 1928. Although the roentgen, a measurement of radiation, had been used to describe exposure for two decades, it was at this congress that it became the official measurement. The International X-Ray and Radium Protection Committee (IXRPC) was also founded to propose guidelines on radiation protection. By 1929, these guidelines forced the American Medical Society to officially condemn the use of x-rays for hair removal.²³ After that, in the early 1930s, following the death of a famous New York sports personality and industrialist, Eben McBurney Byers, and the radium girls court settlement, the United States Food and Drug Administration (FDA) began cracking down on health and beauty products containing radium.

In 1934, the IXRPC established what it called a tolerance dose, a level of external radiation exposure considered “harmless.” It was based upon levels of radiation that caused erythema (reddening of the skin).²⁴ Although the connection between radiation and cancer had been established in 1902, scientists assumed that the cancer effect was just a progression from the localized effect—if exposure stayed below levels causing erythema, it would not cause cancer. “Tolerance” described immediate, not long-term, effects.²⁵ Hence, because the long-term side effects of radiation exposure were unknown (and unsuspected), the tolerance dose was set at a level twenty-five times today’s accepted occupational exposure level.²⁶

A monument was erected in Hamburg, Germany, in 1936 to commemorate all those who had perished due to x-ray exposure. The medical profession wanted a symbolic way of parting with the unregulated, pioneering days of diagnostic x-rays and x-ray treatment by acknowledging the countless patients who unwittingly suffered the results of early experimentation. Several hundred medical workers who died from radiation damage are named on the monument as well.²⁷

In 1946, in the United States, responding to scientists who had worked on the development of the atomic bomb and had experienced first hand some serious radiation effects (some had actually died), the National Committee ...