HTDS- A HANFORD DOWNWINDER RESPONDS

February 3, l999

I.  REALITY:

l.  My name is Trisha Pritikin.  I was born (in late l950) and raised in
Richland, Washington, the community immediately adjacent to the Hanford
Nuclear Weapons facility in Washington State, where my father was a
nuclear engineer.

2.  Hanford released 740,000+ curies of radioiodine (I-131) between
l944-60 across wide areas of Washington State, Oregon, Idaho, Montana
and into Canada.  I-131 is taken up by the thyroid.  I-131 is not the
only radionuclides released by Hanford.

3.  Three years ago today my father died of metastatic thyroid cancer.

4.  Two days ago, on Monday 2/1/99 my mother was diagnosed with
inoperable, terminal metastatic cancer.

5.  I have severe thyroid disease (hypothyroidism)
 

II.  HANFORD THYROID DISEASE STUDY:

(all page cites are from the "Summary Final Report of the Hanford
Thyroid Disease Study," and "Executive Summary, HTDS," January, l999)

l.  "The HTDS found that the occurrence of thyroid cancer among study
participants was not related to the radiation dose to the thyroid they
received from Hanford." (Summary Final Report, at page 13)

2.  "The HTDS found that the occurrence of hypothyroidism among study
participants was not related to the radiation dose to the thyroid they
received from Hanford." (Summary Final Report, at page 17)

3.  "...the study found no evidence that persons exposed as young
children and adolescents to Hanford I-131 are at an increased risk of
developing hypothyroidism as a result of their exposure." (Summary Final
Report, at page 17)

4.  "The HTDS found that the occurrence of autoimmune thyroiditis among
the study participants was not related to the radiation dose to the
thyroid they received from Hanford." (Summary Final Report, at page 19)

5.  "...these results provide rather strong evidence that exposure at
these levels to I-131 do not increase the risk of thyroid disease or
hyperparathyroidism.  These results should consequently provide a
substantial degree of reassurance to the population exposed to Hanford
radiation that the exposures are not likely to have affected their
thyroid or parathyroid health." (quotation from Summary Comments,
Executive Summary, HTDS)
 

III. APPLICATION OF LOGIC

Applying logic:  SOMETHING IS WRONG WITH THIS PICTURE
 

That's all I have to say.

Trisha Pritikin
  Hanford Downwinder

I participated in a citizens' briefing today by CDC and Fred Hutchinson
researchers who conducted the Hanford Thyroid Disease Study.  By the
time of this briefing, it seemed that everyone else in the world,
including multiple media outlets, knew of the results of the study.
Everyone but the exposed people ourselves.

The headlines thus far reporting the HTDS results (e.g."Hanford Study
sees no thyroid harm"- New York Times)- are misleading.  What the HTDS
really found was a lack of dose response- that is, that lower doses
amongst the cohort did not result in lesser health outcomes than the
higher doses.

What this study DID do is look at an exposed cohort of 3,441 people, all
exposed as children to Hanford's radio iodine.  There is a real question
here as to whether the size of the cohort of this study supports the
statistical conclusions made by its authors. Usually, epidemiological
investigations of cohorts where radiogenic thyroid disease is of interest
will number in the tens of thousands of subjects.  The HTDS was just a
few thousand. Therefore, this study had very limited statistical power.
The statistical power of this study was further limited by the large
uncertainty of individual doses.

What the study DIDN'T do (and in my humble opinion SHOULD have done) is
compare the health outcomes of this exposed cohort to an unexposed
cohort (or as unexposed as possible, considering global fallout).

And, what the study DID find, and what you do not see in the misleading
headlines, is (and these are the exact words of one of the
researchers, during the conference call): "The levels of thyroid outcomes
found were high."

I found the content of the briefing today (by conference call) to be
very interesting.  The researchers did not voluntarily bring up
incidence of disease found among the cohort.  On the contrary, I had to
raise this subject before it was addressed.  Rather, the generic point
which it seemed was to be made by those conducting this conference call
was "there was no evidence of a relationship between thyroid radiation
dose from Hanford and the cumulative incidence of any of the 13 primary
outcomes."

Note again that this conclusion refers to dose response, not to the
overall health outcomes seen in this exposed group.  This is an
important distinction.

Here are the numbers that were given during the conference call.  They
vary somewhat from the numbers that appear in the write up of HTDS which
can be taken off the net:

249/3441 had benign thyroid nodules of 1.5cm or greater.  Note that
these are BIG nodules- the Hanford Med. Mon. Protocol will provide FNAs on
nodules of l cm or bigger.  Then, in the Russian studies, the size of
the nodule which causes FNA is .5 cm.  So, i do not think that nodules
of less than l.5 cm are included in this nodules total provided by HTDS

267/3441 had hypothyroidism

648/3441 had Hashimoto's thyroiditis

20/3441 had thyroid cancer and were still living (note that 541 people
from the original intended cohort had died by time of this study- and
cause of death is not always indicated correctly on death certificates-
also, around 40 of these death certificates were not locatable, so cause
of death was not known for those people, and remember that methods of
detection of organ of origin of cancers a few decades ago was not as
sophisticated as it is now- such that, cancer organs of origin may well
have been misdescribed.

SO, as one can see by adding these numbers, a very significant
percentage of this small group had thyroid health outcomes.

Note too that the reconstructed doses are subject to uncertainties in
dose estimates due to the fact that all of these reconstructed doses are
based on computer models used by the Hanford Environmental Dose
Reconstruction Project.  The large uncertainties in HEDR dose estimates
(that were not corrected or reduced in HTDS) compromises the ability of
HTDS to estimate a "significant" dose-response from their
epidemiological findings.

And, remember the teachings of Burdens of Proof, an amazing work by one
of my true heroes, Tim Connor, that just because an epidemiological
study is 'statistically weak' in its findings does not mean that risk is
not present.  It is well established that thyroid exposure to radiation
causes thyroid cancer.  In fact, according to EPA, radiation is the only
known thyroid carcinogen.

The HTDS did not show "no thyroid harm."  Rather, it gave us the numbers
for those so injured within a very narrowly defined group.  It did not
look at those of us born in the late l940s and early 50s, during the
Green Run, an intentional massive release of I-131 from Hanford, and did
not study those of us in infancy in l951 when the filters were removed
from the stacks at hanford and massive I-131 emissions resulted.

This harm done by these exposures to this small cohort and to those of
us who were born outside of study eligibility years is very real, as are
the substantial and disabling injuries suffered by those significantly
exposed to radio iodine and other radionuclides to which they were
involuntarily exposed from Nevada Test Site bomb tests and from other
DOE facilities.

Trisha Pritikin
Hanford Downwinder

(p.s. there was a piece on NPR's All Things Considered on HTDS today- it
will be run again tonight)
 
 

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