RSH -- Table of Contents - Data 1.0

"Admittedly, radiation at low dose rates does seem to be remarkably ineffective as a complete pancarcinogen, or even as a complete carcinogen of any sort. But it could well be a pan-co-carcinogen, precisely as envisioned by the multiplicative model.

"If this were the case, one would predict a fair increase of malignant mortality with increasing background, and this prediction has been made quite explicit by the model’s authors, (Gofman 1971; Tamplin 1971) e.g., from 1% to 30% increase at 170 mrem/yr, depending on various assumptions of latency, plateau, and doubling dose. (Gofman 1971; Tamplin 1971; BEIR 1972)

"With this in mind it was intriguing to note, ...the resolute insistence on dwelling in regions of high background that seemed to characterize the low mortality groups. At r = 0.03 and 0.003 only six groups were at the 170 mrem/yr national average, none were below the average, and at least 40 were above 180 mrem/yr. At first we thought this might only be a secondary association with the well-known urban trend of U. S. cancer mortality. (MacDonald 1967; Grahn 1971) Tests failed to substantiate this, however. A white female resident of Dallas, for example (140 mrem/yr), simply seems to be about twice as likely to contract leukemia as her counterpart in Denver (290 mrem/yr). Since we doubted that anyone was prepared to ascribe oncolytic properties to the radiation background, we felt obliged to search for some other association. Surely there must be some sort of mortality increase with increasing background. (Gofman 1971; Tamplin 1971; BEIR 72)

"However, plots of U. S. rates for white, malignant mortality (Burbank 1971) against natural background for the 50 states showed, if anything, the reverse e.g., Figure 1. Now, were it not for the insistence of the hypothesis (Gofman 1971; Tamplin 1971) that there must be a correlation between malignant mortality and background, we would be inclined to dismiss Figure 1 as an example of simple noncorrelation. (Neyman 1972). However, of the 14 states above 140 mrem/yr, 12 were very significantly (P<0.01) below the U. S. average, one insignificantly lower, and only one slightly, but significantly, higher. The probability of this occurring by pure chance proved to be <0.001. Similar results were obtained with an independent estimate of natural backgrounds. (Oakley 1972).

"Several features of Figure 1 might be worth noting. First of all, some states at common background had rates identical to the third significant figure, so that some of the single points actually represent pairs.

"Secondly, no error bars are shown because the standard errors are less than the size of the points. The data base is, literally, enormous . Each point represents an average of about 105 deaths, and a coefficient of variability, V, of about 0.3%.... it is evident that the vertical dispersion displayed is not "scatter", at least not in the usual sense. Rather, it reflects the operation of the genetic, cultural, socioeconomic and other environmental factors so well known in the epidemiology of malignancy. [multiple references]"

"Finally, in addition to the seeming negative correlation of rate with background, the ten lowest states in the U. S. all lay at backgrounds >135 mrem/yr. Thus, there seemed to be some real, if hidden, association between high backgrounds and low malignant mortalities. Although a similar and even more dramatic effect was noted in the non-white population, we confined ourselves to the white population because of its greater homogeneity, better statistics, the better availability of socioeconomic data, etc. ( Vital Statistics 1950-1968; Statistical Abstracts 1950-1972)

"For purposes of further comparison, we discriminated three groups: A, the seven states of natural background above 165 mrem/yr; B, the fourteen states of natural background above 140 mrem/yr; C, the fourteen states with the lowest backgrounds. These were compared with all 50 U. S. states, (Vital statistics 1950-1968; Statistical Abstracts 1950-1972).

"We first analyzed the 50 states for each of the 56 (Mn) types to see if the low mortalities of groups A and B could be due to particularly low rates for a few types. These two groups, however, proved to be lower in all categories than the U. S. average, and this premise had to be discarded. A summary is presented in lines 3-7 of Table 4. The rates for all categories, in fact, tended to decrease with increasing background."

"Certain possibilities, for example, were ruled out by the nature of the observed mortality pattern. Thus, if the decedent populations of groups A or B above were to contain significantly large numbers of immigrants from other parts of the U.S., (i.e. , the decedents had not been exposed to the high backgrounds until late in life), one would have expected the rates in groups A and B to be higher than those of the remaining states. This because the Mn rates of the remaining states are much higher than those of A or B, e.g., 150.4 for the U.S.-minus-A, and 151.6 for the U.S.-minus-B. Instead, the reverse was true. Accordingly, if short-term residents are a factor, the true rates for the long-term residents must be even lower than those given in Table 4."

No.	Characteristic	A	B	C	D
1	Natural background, mrem/yr	210	170	130	118
2	White population, thousands	5735	16,897	158,051	59,683
3	r, Mn 140-159	42.9	45.6	52.4	50.3
4	r, Mn 160-164	15.8	16.9	22.3	23.4
5	r, Mn 170-181	36.8	38.2	41.5	40.1
6	r, Mn 190-205	30.8	31.5	33.3	33.0
7	r, All malignancies	126.3	132.2	149.5	146.8
8	Residence altitude, ft	4510	2650	900	730
9	Urbanization, %	63	57	69	74
10	Per capita personal income,$	2021	1922	2215	2255
11	Median family income, $	5600	5400	5660	5650
12	Physicians/1000 population	1.27	1.25	1.49	1.49
13	Hospital beds/1000 population	8.24	8.82	9.49	8.70
14	Median years of school completed	11.8	11.7	10.9	10.8
15	Poor diet households, %	16.5	21.2	19.1	19.1
16	Population on Fed. Food Assist, %	2.6	3.2	3.2	2.5
17	Unemployment, %	4.3	3.9	3.9	3.3
18	Accepted, Military Selective Svc	65	63	56	53
19	Life expectancy, male	67.7	67.7	67.6	67.5
20	Life expectancy, female	74.5	74.7	74.2	74.3
21	Urban air, particulates, ugm/m3	129	119	115	116
22	Urban air, benzene sol., ugm/mJ	10.1	9.3	9.5	9.6
23	Urban air, radioactiv., pCi/m3	8.5	7.7	6.8	6.3
24	Urban air, beta, pCi/m3	5.5	5.2	4.4	4.2
25	r, Mn 140-205, age 0-9	8.11	8.31	8.54	8.31
26	r, Mn 140-205, age 10-19	6.80	6.61	6.82	6.72
27	r, Mn 140-205, age 20-29	10.46	10.73	11.09	11.19
28	r, Mn 140-205, age 30-39	27.61	28.39	31.45	32.27
29	Mortality rate, all causes	892.0	893.2	928.5	903.9
30	U. S-group, all causes	36.5	35.2	-	24.6
31	U. S-group, malignancy	23.2	17.3	-	2.7
32	r, Stomach, 151	11.7	11.6	11.8	11.0
33	r, All G. Z., 150-159	40.7	43.0	49.0	46.7
34	r, Lung, 163-164	14.5	15.5	20.4	21.5
35	r, Breast, female, 170	21.5	22.6	25.3	24.4
36	r, Thyroid, 194	0.055	0.054	0.057	0.054
37	r, Bone, 196	0.92	1.03	1.12	1.07
38	r, Leukemia, 204	7.03	7.23	7.13	6.91

Editor’s Note: An analysis of "competing risks", longevity and age, radiographic exposures, radiation rate, are then considered, with no effect on the primary relationships and conclusions.]

"Regardless of which of the suggested values (Gofman 1971; Tamplin 1971; BEIR 1972) we used for D or DD, V invariably increased, i.e., the results were always the opposite of what would have been expected if the model represented a real factor in U. S. malignant mortality. Furthermore, this increase in V was found to hold for essentially all U.S. malignancies, even for leukemia, the classic of radiogenic malignancies Thus we seemed to be left without statistical support for a multiplicative model, either for all malignancies (pancarcinogenesis), or even for specific ones."