As we are all aware low doses of radiation can cause significant problems as potentially shown in the KIKK study from Germany.
Please see the very interesting debate below:
Please see the very interesting debate below:
DECC Nuclear NGO
Forum: Panel Discussion with COMARE
18th October 2012
Summary meeting
report
Attendees
Panel members
Professor
Alex Elliott COMARE
Panel
Dr.
Ian Fairlie NGO
Panel
Dr.
Alfred Körblein NGO
Panel
Mr Ian
Robinson COMARE
Panel
Professor
Richard Wakeford COMARE Panel
Non-Governmental Organisation (NGO)
representatives
Andy
Blowers (NGO Chair) Blackwater
Against New Nuclear Group (BANNG)
Ruth
Balogh West
Cumbria and North Lakes Friends of the Earth
Frank
Boulton Medact
Jo
Brown Parents
Concerned About Hinkley (PCAH)
Nikki
Clark Stop
Hinkley
Phil
Davies Nuclear
Information Service
Rita
Holmes Ayrshire
Radiation Monitoring Group (ARM)
Peter
Lanyon Shut
Down Sizewell
David
Lowry Nuclear
Waste Advisory Associates (NWAA)
Jill
Sutcliffe Low
Level Radiation and Health Conference
Pete Wilkinson Communities Against Nuclear
Expansion (CANE)
Committee on Medical Aspects of
Radiation in the Environment (COMARE) and Dept of Health representatives
Mr
Stuart Conney Dept.
of Health
Mr.
Steve Ebdon Jackson COMARE
Dr.
Chris Mitchell COMARE
Dr. Emma Petty COMARE
Department of Energy and Climate Change
(DECC)
Hergen
Haye DECC
Jane
Cantwell DECC
Margaret
McLaren DECC
Facilitation team
Carl
Reynolds 3KQ
(facilitator)
Helen
Fisher 3KQ
(report writer)
Background
Purpose
This meeting was organised by the DECC Nuclear NGO Forum in
light of COMARE’s 14th Report. The purpose of the meeting was to:
1. Explore methodological differences and different
approaches to assessing leukaemia clusters around nuclear power plants.
2. Identify whether NGOs and DECC have other related issues
they want to discuss or put on the agenda in future.
Relevant documents
·
COMARE 14th Report: Further
consideration of the incidence of childhood leukaemia around nuclear power
plants in Great Britain.
·
COMARE statement on responses following
publication of the 14th Report.
·
Joint Paper for DECC meeting on COMARE
14th Report by Dr Ian Fairlie and Dr Alfred Körblein: October 18, 2012
·
Cancer near nuclear reactors: a
possible radiobiological explanation (Alfred Körblein).
·
Letter to International Journal of
Cancer (IJC): French geocap study confirms increased leukemia risks in young
children near nuclear power plants (Alfred Körblein/Ian Fairlie).
·
Kaatsch P, Spix C, Schulze-Rath R,
Schmiedel S, Blettner M. Leukaemia in young children living in the vicinity of
German nuclear power plants. Int J Cancer. 2008 Feb 15;122(4):721-6.
·
Bithell JF, Keegan TJ, Kroll ME, Murphy
MF, Vincent TJ. Childhood leukaemia near British nuclear installations:
methodological issues and recent results. Radiat Prot Dosimetry. 2008;132(2):191-7. Epub 2008 Oct 20. Review.
Panel
The expert panel for the meeting consisted of three members
of COMARE (Professor Alex Elliott (COMARE chair), Mr Ian Robinson, and
Professor Richard Wakeford), alongside Dr. Ian Fairlie and Dr. Alfred Körblein
for the NGO panel.
Meeting format
Carl Reynolds, the facilitator for the day, explained that
the meeting would centre on a panel discussion, alongside questions and
discussion from attendees. He suggested the meeting should be undertaken with a
spirit of enquiry rather than interrogation.
The group agreed that notes from the meeting would be
attributed, and it was confirmed there would be no audio or visual recording of
the meeting.
Discussion
The notes below provide a summary of
the key issues and responses raised throughout the meeting, in an attributed
form as agreed by all attendees. Suggestions for future research or other
activities are boxed out for ease of reference. The COMARE 14 report (http://www.comare.org.uk/press_releases/documents/COMARE14report.pdf) contains a
glossary, which helps to explain some key words and phrases.
Introduction
Hergen Haye and Andy Blowers, co-chairs of the DECC Nuclear
NGO Forum, were invited to open the meeting.
Andy Blowers reminded the group that there had been
considerable discussion about health at the main forum and that, as a result it
was felt it would be useful to try and establish a meeting with COMARE to
discuss the KiKK report and the COMARE 14 report. He hoped for a constructive
exchange and engagement, taking into account the different areas of the debate,
and moving on to more general discussion about other related issues. He also
asked that everyone participate fully and thanked the experts for attending.
Hergen
Haye added his thanks to the panel for taking part. He pointed out that nuclear
is a key part of policy for DECC, including decommissioning, operations of
existing plants and new build. He added that the NGO forum has been running for
two years and that DECC places a great deal of value on it. Finally, he added his
wish that the meeting be approached with a spirit of enquiry.
Key areas of critique for COMARE 14
Critique. Discussions began with an invitation to Ian Fairlie and
Alfred Körblein to talk about the key issues in their critique of the COMARE 14
report.
Ian Fairlie firstly congratulated the NGO forum for having
this meeting, recognising the amount of work that had gone into it. He noted
the importance of a spirit of enquiry and openness rather than confrontation,
but also the need to acknowledge points of difference. He then summarised the
key points of his joint paper with Alfred Körblein as follows:
1.
Data coverage and timescales: Failure to update the data is a key methodological concern.
After the KiKK study the Department of Health asked COMARE to get more data.
COMARE did not, saying this would have entailed a delay in the analysis. After
three years, another year would make little difference. It is understandable
that later years are difficult to analyse satisfactorily, but it is not
impossible. COMARE should have been able to overcome these difficulties and
provide a more up to date study.
2.
Nature of the statistical test: A two-sided (or two-tailed) rather than a one-sided (or
single-tailed) test was used.
3.
Addition of lymphomas: COMARE
was asked to look at leukaemia, but other forms not in the original Bithell
study, such as non-Hodgkin’s lymphomas (NHL), were introduced, making analysis
more difficult due to introduction of different end points.
4.
Categorical test: COMARE
should have carried out a categorical test.
Associations between nuclear power
plant proximity and leukaemia. Alfred
Körblein outlined four post-KiKK studies, including recent studies in France
and Switzerland, together with a German study based on the same data as the
KiKK study, and the data from COMARE 14. He stated a combined analysis of the
four studies finds a highly significant increase in the 5km zone compared to
the rest of the study region. He concluded that, although there is no commonly
accepted explanation, this shows there is in fact an increase of leukaemiasnear
nuclear power plants.
COMARE response to
critique. Alex Elliott responded to the first
issue regarding data with the following points, including some initial
background about COMARE’s work:
·
COMARE was set up as a result of the
Black Report (following a Yorkshire Television documentary in 1983 focussing on
Windscale) and its first report was produced in around seven months. It has
written a number of reports about leukaemia.
·
Earlier than the KiKK study was
COMARE’s 11th report, which was concerned with the increase of
leukaemia and other childhood cancers and looked at the pattern across the
whole of the UK. Simultaneously, COMARE was looking at the situation around
nuclear power plants through the publication of COMARE 10.
·
In light of the KiKK study, COMARE was
asked to look again and consider the KiKK report itself. This included a
request to redo the analysis for COMARE 10 using extended data, but only data
to 2004 were used as that was the last year for which reliable data existed.
·
Compared to other European Cancer
registries the UK Childhood Cancer Register is unique; it crosschecks against
at least three sources rather than just one. The early German Cancer Register
relied solely on notification from paediatric oncologists. In the UK it comes
from the National Cancer Registry, Cancer Research and individual cancer
registries, with the database being held in Oxford by the Childhood Cancer
Research Group. A confirmed diagnosis comes from multiple sources, so there is
reasonable confidence that all of the UK cases are captured. However, this
means it takes longer to get data in the UK as it is so rigorously checked.
COMARE could have waited a year to get the 2005 data crosschecked but that
would have delayed the report.
Bithell data. Ian Fairlie questioned if the Bithell study, which came out
in 2008, had data up to 2004, why COMARE 14 could not go up to 2008. Alex
Elliott clarified that the COMARE 14 was written in 2010. He also stated that
through the Department of Health COMARE has secured funding to ensure the
database is still getting updated and that data are currently up to 2010.
Site-specific
analysis. Alex Elliott also confirmed that COMARE
is currently working on further analysis around the Dounreay and Sellafield
sites. In response to a question from Rita Holmes (ARM), he also confirmed that
this work would include analysis of the Dounreay cluster from the 1980s
retrospectively based on validated cases.
Ruth
Balogh (West Cumbria and North Lakes Friends of the Earth) asked why it has
taken so long for the analysis of Dounreay and Sellafield data to be
undertaken, given that it is a long gap between 1987 and 2012. In response to
this, Alex Elliott agreed and outlined that there had been difficulties with
the Data Protection Act. Specifically, discussions are underway with the
National Information Governance Board and the Information Commissioner’s Office
over use of data from the 1987 Seascale school cohort study.
Do additional data matter? On the wider issue of extra data, Alfred Körblein suggested
that whether or not more data were included would not change the main result,
given the small number of additional cases. When asked why this had been one of
the criticisms of the COMARE report if it would not make a difference, he
responded that it would increase the power of the study but not the result. He
added that practically all nuclear power plants in the UK are on the coast so
only a semicircle of population can be investigated, whereas in Germany they
tend to be inland, which gives more powerful results, so that in the UK you
don’t need to see the data to know that you would not get such significant
results.
Why not delay the
report? David Lowry (NWAA) noted that COMARE
were asked to extend the time period but that COMARE says it “was judged that
delay was undesirable”. He asked whether the Secretary of State for Health was
satisfied that time periods were not extended, and from who’s point of view was
the delay “undesirable”?
Alex
Elliott clarified that COMARE was not asked to extend the time, rather to
extend the analysis of COMARE 10, which they did. He confirmed that the
Department of Health was very happy with the report technically, but that the
objective was to provide a report to the Department of Health in the shortest
possible time, so COMARE used the data available rather than waiting another
year. Stuart Conney (Department of Health) added that the Department was keen
to understand if the KiKK study would be reflected in the UK.
Addition of lymphomas
COMARE response to critique. In response to this element of the critique, Alex Elliott
pointed towards COMARE 14, which states that in earlier reports there were a
couple of cases that turned out not to be leukaemia. He said that clinical
diagnosis of leukaemia has changed over the years and that in COMARE 14 early
cases of non-Hodgkin’s lymphomas were sometimes classed as leukaemia, which
means uncertainty over whether early cases were leukaemia or non-Hodgkin’s
lymphomas. In response to this COMARE undertook a combined analysis and also
sub-divided the categories out in order to be more consistent, after receiving
advice from two independent epidemiologists not connected to COMARE. This was
consistent with COMARE 10.
Nature of the statistical test
COMARE response to
critique. Richard Wakeford responded to the
criticism that COMARE 14 should have used a one- rather than two-sided
statistical test as follows:
·
The equivalent to a one-sided test is a
95% confidence interval and two sided would be a 90% confidence interval, but
people are tending to move away from tests of statistical significance and
confidence intervals.
·
It depends on the view you have of the
test you are carrying out before you carry it out. If you were looking for an
increase you would go for a one-sided test. If you were looking for a
difference in either direction you would go for a two-sided test. But this
should not make any material difference to any conclusion of substance.
Statistical
confidence or public confidence? There
followed a discussion between Nikki Clark (Stop Hinkley) and Richard Wakeford
about the relative importance of statistical confidence and public confidence.
Namely, the concern that health issues (particularly ones like this) arguably
require a higher level of confidence and thus a tighter statistical test
because of the potential implications, contrasted with the argument that
statistical tests only give an indication of whether something is going on and
that becoming more confident statistically does not necessarily mean there is
really something going on.
Richard
Wakeford acknowledged the point that public confidence is based on the data you
put out, but also suggested this was only one aspect of judging confidence; for
example data may have very high levels of confidence but the study itself may
be flawed.
Choosing which
test to use. In order to provide an example of why
the KiKK study tested one- not two-sided, Alfred Körblein pointed towards a
German study. An initial study, covering 1980-1990, found a significant effect:
a threefold increase in leukaemia rates in under-fives in the 5km zone. This
triggered a second study, which included five more years to 1995 but had no
significant result (p-value was 0.06) as it used a two-sided not a one-sided
test. If it was one-sided it would have been significant (p-value 0.03). Richard Wakeford challenged the idea
that it makes a difference if the p-value is 0.03 or 0.06, pointing out that
the KiKK study gives the same result whether you do a one sided or two sided
test, but that there are more fundamental issues with the KiKK study than this.
Ian
Fairlie recalled a number of incidents where the choice of test has lead to a conclusion
of ‘no increase’ when the conclusion should have been ‘there is an increase but
there is a less than 5% chance it is significant’. He added that he hoped after
today that a one-tailed test would be used as a standard in future studies.
Richard Wakeford again challenged this, stating that it depends on the question
to be answered and that if a conclusion depends on whether a test is one-sided
or two-sided there should not be much weight put on that conclusion.
Causal relationships
A large part of the day was spent discussing the issue of
causal relationships – i.e. whether an association between nuclear power plants
and increased leukaemia could be shown to have a causal relationship or not.
Visitor data. Jo Brown (PCAH) asked whether studies took into account, for
example, the high numbers of visitors to Somerset each year and the potential
for this to have a causal link with the high incidence of leukaemia in one part
of Birmingham. Richard Wakeford responded that these are very intensive studies
to conduct but that you can do them in theory. Jo Brown added that, in order to
pick up on latency issues in cancer incidences, DNA tests to pick up heritable
genetic mutations could be undertaken on everybody.
SUGGESTION:
Consider looking at visitor data and its relationship to leukaemia incidence.
Causality or random distribution? Chris Mitchell (COMARE) recalled that, in over 30 years
looking after children with leukaemia, many parents have asked about clusters.
He suggested that clusters do occur randomly from time to time, but equally
that if you threw a handful of rice onto a checked tablecloth you would be
surprised to see one grain in each square. He stated that the reliability of
the UK data made it difficult to compare it with that of other countries.
Nuclear power plant as cause or
coincidence? Andy Blowers summarised the issue by
stating that, although everyone in the room knew there was an association
between nuclear power plant location and occurrence of leukaemia, the issue was
whether we could rule out the nuclear power plant as a cause of these
clusters. He pointed out the range of
variables that needed to be taken into account, e.g. plant size, emission type/
timing, weather patterns, coastal locations of UK sites, population movements,
and so on.
Emission spikes. Ian Fairlie talked attendees through the possibility that
emission spikes from nuclear power plants could be a cause of increased
leukaemia, summarising:
·
None of the current theories on
increased leukaemia cases near nuclear power plants have really addressed the
central evidence of the KiKK study and other studies, that this has something
to do with nuclear power plants.
·
The main source of radiation from these
plants is from the radioactive discharges. Recently released information in
Bavaria shows that, contrary to previous thoughts that discharges were even,
there were rather large spikes of emissions from nuclear power plants, for
example up to half of annual discharge due to a refuelling episode.
·
In Britain the National Dose Assessment
Working Group prepared a guidance on this and their estimation was that doses
from these spikes would increase by a factor of about 20 over ‘normal’ doses
(other German studies show up to factor of 100), although this depends on a
number of things such as weather and population patterns.
·
Ian Fairlie’s article in the Journal of
International Journal on Occupational and Environmental Health hypothesises
these leukaemias arise before the child is born from in utero exposures. This
stems from the work of Alice Stewart; in a survey of childhood cancers she
found women exposed to abdominal x-rays have a risk of childhood leukaemia when
born.
Dose response
curve. Alfred Körblein outlined his theory
relating to the dose response curve, with key points as follows:
·
When comparing the effects of radiation
emitted from nuclear power plants to background radiation we think that the
average dose reported by utilities is distributed evenly across the year. They
usually report total annual emissions.
·
Real data show spikes during refuelling
up to 500 times the routine emissions, for example one third of the total
annual emissions in only two days from one site.
·
If the dose response curve were linear,
it wouldn’t matter if the doses were emitted in short periods of time or not.
But if the dose response curve is non-linear or superlinear you cannot average
that and you have to look at the emission pattern. That’s the question – is
dose response known or not known?
·
Looking at data of perinatal mortality
in Germany after the Chernobyl accident, a non-linear dose response was found –
a steep increase with dose with approximately a power of dose of three. Also
data of congenital malformations from Bavaria following Chernobyl showed a
strongly upward curved dose response relationship.
·
If the dose response rate is
curvilinear then that could explain the observed increases. Dose estimates have
a high uncertainty and there may be certain systematic underestimating of dose.
Allowing for a systematic underestimation of dose by a factor of say 10 and
allowing for a lognormal distribution for the form of the dose response, this
would explain observed increases.
COMARE’s remit and
wider causative mechanisms. Alex
Elliott suggested that all incidences of leukaemia rather than just those
around nuclear power plants needed to be considered when looking at causes,
pointing towards clusters of leukaemia nowhere near nuclear power plants across
the world (for example in Nevada) or at sites where a nuclear power plant was
planned but never built. He referenced the Gardner study, which also found
associations with farming and the iron/steel industry, as well as other
theories about infection, population mixing and so on. He stressed the need for
COMARE to retain an open mind on causative mechanisms and pointed out that
COMARE is currently continuing to study ionising radiation but that its remit
is also extending to look at other potential causes. He also confirmed that
COMARE has opened discussions with colleagues in France and Germany and will
take forward a tri-national study.
Ian Fairlie argued that a clear association between nuclear
power plants and leukaemia is beyond reasonable doubt, questioning why COMARE
is not ready to accept this view. However Alex Elliott reiterated that COMARE
has an open mind and is taking forward work on ionising radiation as well as
considering non-radiation factors.
Concern about COMARE’s extended remit was expressed by Nikki
Clark (Stop Hinkley). Although not disagreeing that leukaemia needs to be
studied as a disease, she was concerned about COMARE taking this on, suggesting
that other work should be conducted by the Department of Health or other
bodies. She also expressed concerned that COMARE’s position seemed to be
defending the industry and that by deflecting the critiques of hypotheses put
forward COMARE was not inspiring confidence in its own work.
Alex
Elliott again stated that COMARE’s primary remit is indeed to look at radiation
and that they would not divert from that task, but that it could also expand to
look at other aspects. It was confirmed that the Department of Health or the
devolved administrations determine COMARE’s work programme, with COMARE
deciding only how to deliver it.
Views on causative
mechanisms and dose response from COMARE. In
response to discussions so far, Richard Wakeford talked about current evidence
and the need to continue looking at the bigger picture. His key points were as
follows:
·
The Oxford Survey of Childhood Cancers
data is an important set of data. Examining this and similar data from around
the world is important in showing us that we aren’t getting things drastically
wrong in terms of dose and response.
·
For example, atmospheric nuclear
weapons testing put enormous quantities of radionuclides into the environment –
much greater than Fukushima or Chernobyl. Studies of low level exposure to
radiation – CT scans, natural background radiation – are coming out with risk
per unit dose estimates compatible with Hiroshima and Chernobyl. If the bomb
tests were in some way responsible for a high risk of childhood leukaemia you
would expect to see a large signal of that in late 1960s – you do not.
·
This evidence has been assessed by a
lot of sceptical scientists over around 30 years and it is difficult to see how
this can be put at the door of ionising radiation exposure, although Körblein
and Fairlie’s letter in the International Journal of Cancer is important.
·
The bigger picture also needs to be
borne in mind. The amount of evidence that infection is involved in child
leukaemia is substantial. Deep genome sequencing is progressing, and a number
of groups are looking for specific viruses in children with leukaemia. Looking
at ionising radiation is important but we should not lose sight of other
potential causes as this risks missing a large part of the causes.
Jo
Brown (PCAH) commented that she was concerned incidences in perinatal mortality
had not been taken into account.
Looking for a point source. Alfred Körblein pointed out that many hypotheses do not
consider the fact that this effect is concentrated on the 5km zone and is not
found beyond the 5km zone, which suggests the effects of a point source.
How much evidence
is needed? Peter Lanyon (Shut Down Sizewell)
questioned what evidence COMARE would need before the precautionary principle
required it to declare that nuclear power plants were an issue. Alex Elliott
responded that more evidence than COMARE currently has would be needed, and
also mentioned the dangers of HARKING (hypothesising after the results are
known). He confirmed COMARE would be looking for a study with more power than
those currently undertaken.
Chris
Mitchell (COMARE) added that the numbers show there were 20 cases of leukaemia
in children under 5 around nuclear power plants in 1969 to 2004 – six above expected
numbers – and in the same time period 6500 children in the rest of the UK had
leukaemia. He commented that there are plenty of reasons for these cases other
than radiation and, whilst it is important for COMARE to look at radiation,
maintaining a sense of balance is also important.
Wider health
detriment. Jo Brown (PCAH) raised the issue of
wider health impacts of ionising radiation (for example immune system effects)
and pointed out that the Justification and National Policy Statement (NPS)
accept that nuclear power plants have a causal link to reduced health. Hergen
Haye clarified that the National Policy Statement does not deal with this issue
at all as it is a planning statement, but that the regulatory justification
indeed looks at possible health detriment versus other benefits. He confirmed
that the Secretary of State has taken the decision based on all the current
evidence known confirming that the benefits outweighed any know health
detriments which are effectively regulated.
Other
participants commented that the consultation on Justification had focused on
the heath detriments which were assessed to be outweighed by the assumed
benefits arising from nuclear energy, Andy Blowers recalled that the challenge
BANNG put to the consultation was to look more critically at the benefits,
which he believed to be minimal or non-existent. He agreed there was not a denial that
there are health detriments, but suggested that if there are no benefits the
justification should go the other way.
Further COMARE
response on health detriment and earlier hypotheses. Ian Robinson confirmed that the International Standards for
Radiological Protection and the UN Committee on the Effects of Radiation
associate a dose of radiation with a detriment.
In
response to the suggestion that emissions could be up to 500 times the average
annual dose, he pointed out the differences between UK and German nuclear power
plants: in Germany liquid discharges have to be restricted as plants tend to be
inland so they choose to put more as aerial effluent; in the UK plants tend to
be coastal so there is a big dilution of what goes into the sea and aerial
discharges are far less than on the continent. In addition he pointed out
refuelling spikes in the UK are minute. In response to this Jo Brown (PCAH)
suggested that the RIFE 16 report recorded huge increases.
Further work
Follow-up contact with Ian Fairlie and
Alfred Körblein. Ian Fairlie pointed out that both he
and Alfred Körblein had PowerPoint presentations on their various theories
about the causation of increased leukaemia, which they would be happy to
provide for the report of the meeting, confirming that they would both be happy
to be contacted with any questions.
Further debate of nuclear power plant
proximity as a cause. Ian Fairlie went
on to outline some outcomes that he and Alfred Körblein hoped would come out of
the meeting:
1.
An acknowledgement that the
preponderance of evidence shows that there are increased leukaemias near
nuclear power plants.
2.
The preparation of a report which looks
at radionuclide discharges as being a causative effect and publishing a report
saying that.
He then suggested this may be too big an ask given the UK
government is going ahead with building new nuclear power stations, quoting Dr
Gordon Thompson at the Institute for Resource and Security Studies as saying
that “political pressures from economic interests too often influence policy
approaches to low-dose radiation”. He suggested that this was happening in the
UK, and that it was inevitable to some extent but that we should try to look
hard at where the evidence leads. He finished by saying he hoped COMARE would
undertake work to look at possible causes, and that looking at nuclear power
plant proximity as a cause would be the obvious thing to do. There was vocal
opposition from one attendee about this.
SUGGESTION: Consider radionuclide discharge as a causative
effect.
Further data. Ian Fairlie went on to reference other studies coming out
possibly in Belgium and Sweden about increased leukaemia near nuclear
facilities, which he said would provide more evidence. He also looked forward
to the publication of COMARE 15 looking at incidences of childhood leukaemia
near Sellafield and Dounreay and asked for an indication of when the extended
CCRG data would be available.
Richard
Wakeford responded that he would fully expect the Childhood Cancer Research
Group (CCRG) in Oxford to update these studies on a relatively regular basis,
but that the accumulation of data is relatively low frequency so it would not
be sensible to do that every year. He pointed out that the Bithell published
paper was not an exercise on behalf of COMARE or the Department of Health but
was a CCRG initiative and is the most recent in a series of studies by the
CCRG, with a much wider area than just radiation. He suggested that, provided
the CCRG continued to exist, he had no reason to believe they would not
continue with that series of studies.
COMARE comment on
research recommendations. Richard Wakeford
commented that there had been a whole series of recommendations by COMARE and
others in recent years. He suggested looking at the nature and amount of
research recommended and asking whether COMARE had left anything uncovered or
overlooked something as far as childhood leukaemia as a whole is concerned. He
went on to say that it was time to ask whether COMARE had really missed
something big as far as radiation is concerned or whether it was time to look
at childhood leukaemia as a whole now.
He
pointed out this was being taken on by the European Commission as a whole (for
example the Melodi Programmes being considered) and that, in his view, it would
be myopic to just focus on radiation unless COMARE has missed something. He
stated that he sensed we were on the verge of a lot of progress as far as the
big picture is concerned.
COMARE 15. Alex Elliott confirmed that what had been referenced earlier
as COMARE 15 (further work on incidences of childhood leukaemia near Sellafield
and Dounreay) may end up being COMARE 16 as the Department of Health has asked
COMARE urgently to look at use of CT scanning in the UK. But either way the
expectation is to complete the work on Sellafield and Dounreay by the end of
2014.
Site data for the
UK. In reference to an earlier comment from
COMARE about there being no radiation spikes in UK, Alfred Körblein asked
whether these data were available for independent scientists to look at. Ian
Robinson responded that he did not know about the availability of data, that
there are data to some extent in the Radioactivity in Food and Environment
report, but that he was not sure whether sites would release it. He suggested
the Environment Agency may be able to help.
Pete
Wilkinson (CANE) added that Sizewell Site Stakeholder Group sent a letter to
EDF some time ago to ask for the outage data to see if they could replicate the
spike from the German plant. After
nearly two years EDF finally provided the data, but it is not broken down into
hourly or half hourly chunks, instead showing the average across the year.
Further data
analysis: risks at variable distances. Alfred
Körblein brought up another area of potential research, referencing some work
he had done with German data:
·
Normal modelling of risk with distance
in the KiKK study (and COMARE/Bithell) assumes infinite risk at no distance.
This is not reasonable as, with fallout, the risk is not highest nearest the
plant, but is estimated at 2-4km depending on dispersion concentration, wind
speed, stack height etc.
·
Looking at the KiKK data, the cancer
risk below 3km was lower than in the 3-5km zone. So this points to a decrease
of risk from the 3-5 km zone towards the site.
He suggested that similar data are available in the UK, and
that such an analysis could be undertaken in order to find out whether there is
increased risk at 3-5 km, which would support the idea that increased leukaemia
incidence has to do with emissions. If the data are there he suggested this
would be easy to do.
SUGGESTION: Analysis of risk at variable distances from
nuclear power plants in the UK.
In addition, he stated that a study of leukaemia near the La
Hague reprocessing plant in France found a significantly increased risk for
young males under 10 years but not for females, leading to the possibility that
radiosensitivity of males may be higher than for females. He suggested that
COMARE could also look at the data for a difference between males and females.
SUGGESTION:
Consideration of possible variable impacts on males and females.
COMARE response to
further data analysis. Richard Wakeford
questioned whether doing the sort of modelling suggested with the sparseness of
the data available would be useful, pointing out there would be a need to test
again with an independent but equally sparse data set, and that data would only
be available in wards rather than the degree of resolution required. He
suggested it would be better to look for certain radionuclides like tritium and
carbon-14 in the environment or even in people. He referenced a study on
childhood leukaemia clusters for Seascale and Dounreay, which looked at the
plutonium levels in them, siblings, relatives and children in Glasgow; the
results showed background levels only. He suggested that by doing that sort of
measurement you can look at whether certain radionuclides are being grossly
underestimated.
Ian
Fairlie agreed with the comments on radionuclide measurements but suggested
that he and Alfred Körblein could do the analysis suggested if they could be
given the data, and that data at ward level would be good enough.
Communications and working together
Giving communities
a clearer message. Pete Wilkinson (CANE) related concerns
over the feeling of disrespect between participants in the meeting to the wider
issue of communities around nuclear power plants and how they are communicated
with, specifically the lack of clear, consistent information on topics such as
this.
He
suggested that the panel is united by the recognition of an association between
nuclear power plants and leukaemia incidence, and that what was needed was a
way to bring the two sides of the debate together and look towards a joint
funded piece of work, rather than a polarised debate that leaves communities in
the dark.
Joint working. There followed some discussion of the difficulties and
considerations of joint working, with reference to various participants’
previous experience with the European Committee on Radiation Risk (ECRR) and
the Committee Examining Radiation Risks of Internal Emitters (CERRIE). The need
to assimilate critical voices into the process was contrasted with the
difficulty of reconciling polarised views.
SUGGESTION:
Joint working, involving critical voices, on the degree to which there is or is
not a causal link between nuclear power plants and leukaemia incidence.
Public communications.
Frank Boulton (Medact) commented on the
fact that radiation and leukaemia were both difficult to understand for the
general public.
Jill Sutcliffe (Low Level Radiation and Health Conference)
made the point that there are people on the ground who have a different and
more direct experience of this topic but who don’t want to follow this level of
debate. She stressed the need to be careful at the end of these scientific
exchanges that people on the ground understand why certain things are done in certain
ways, perhaps through the development of a knowledge transfer interface to
improve public understanding. She suggested that scientists are too quick to
respond saying there is no problem and that this does not fill people with
confidence.
SUGGESTION:
Development of a common knowledge transfer interface to enable members of the
public to keep up to speed with the debate in a non-technical manner.
Ongoing dialogue. A few participants express the desire to continue
discussing this issue, perhaps through further meetings similar to this one.
Ian Fairlie suggested that, whilst it may be unrealistic to expect COMARE to
meet with the Forum regularly, there could be the option of sending out a draft
report for comment in future.
SUGGESTION:
Further meetings on this topic/of this type.
SUGGESTION: Drafts of COMARE reports for external review
prior to publication.
Wider topics and further work
Risk models and
sex ratios. Jo Brown (PCAH) suggested the relative
merits of the risk models would be a useful topic for further discussion, as
would consideration of possible sex ratio impacts of radiation
SUGGESTION:
Future discussion of the relative merits of different risk models.
SUGGESTION:
Investigation of possible sex ratio effects in communities close to nuclear
power plants.
Risk estimates. Phil Davies (Nuclear Information Service) suggested that it
might be useful to consider another paper written by Ian Fairlie looking at
genomic instability. Ian Fairlie confirmed that this was a large study looking
at a new range of effects of radiation called non-targetted effects, and that
the jury is still out as to the overall significance of these effects. He
suggested there is still a lot of research happening in this area.
Considering the
range of hypotheses. Nikki Clark (Stop Hinkley) asked
whether the range different hypotheses put forward could be tested by COMARE.
The process for COMARE’s work was confirmed by Alex Elliott as follows:
·
The first step is always to do the
literature review. Anything in the literature will automatically go into
consideration including hypotheses.
·
A sub group is set up for each
individual report, including people outside of COMARE (for example Ian Robinson
was brought in for COMARE14). The sub group will decide the broad bones of the
report then that will be taken forward.
Closing words
The co-chairs of the DECC / NGO Forum closed the meeting.
Both thanked the panel for their input.
In addition Andy Blowers reflected on the aim to have a
constructive debate founded on the science of the issues in an atmosphere of
mutual respect, feeling that this had only been partially achieved. Although on
the whole reasonably constructive, he felt the meeting had, at times fallen
below the standard of mutual respect. He called for these kinds of discussions
to be restrained, sceptical, and rational as far as possible, within the norms
of what would be regarded as reasonable scientific discussion. He pointed out
the need to be clear about the agenda and to try to avoid incoherence. Having
said that, he felt it has been an interesting and invigorating discussion and
expressed hope that discussions of this kind could be continued, ending with
the challenge of how the work of committees like COMARE is communicated
externally.
Hergen Haye followed this by saying that this had been an
interesting discussion and that he had some sympathy regarding the question of
how these issues can be coherently communicated to the wider public. He suggested that if
there is the possibility of consensus we should strive for that but also
recognise that it may not always be possible. A wider issue, he suggested, was
that if people in one way or another are set on one particular outcome, the
question of whether dialogue is possible is raised, nuclear issues being very
challenging in that respect. He suggested that sometimes long standing
convictions can stand in the way of enquiry and that all parties have to be
willing to look for solutions or perhaps even be willing to move from what they
believe, in order to ultimately have a successful outcome and one which is
evidence-based.
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