Public Health Impacts of Radiation Hormesis in a Naturally High Background Area of India

Dr. Marvin Goldman has been an active participant in nuclear activities since the era of above ground nuclear weapons testing. His 1994 Oral History, taken by the US Department of Energy, is available at https://ehss.energy.gov/ohre/roadmap/histories/0468/0468toc.html . This oral history confirms that Dr. Goldman was the first person to identify and record a plutonium hot particle held in the lung tissue of a deceased test animal. He was an active US participant in the response to the Chernobyl nuclear disaster. He was instructed in the nature of the Naturally High Background Radiation Areas of the world in his early years in the US nuclear field. Of these NHBRAs, Dr. Goldman had this to say in 1994: “This is what we were taught about places like the Massif of France, places in China, and Kerala Coast [on the Arabian Sea] in India. The geology [there] is such that the background radiation [from uranium and thorium in the ground] is ten times higher than background here. People live there and have for millennia. There [were] some really careful epidemiology studies done. They have not shown a [radiation-related] difference [in cancer rates].” Source: “Oral History of Radiation Biologist Marvin Goldman, Ph.D.” Conducted December 22, 1994 United States Department of Energy Office of Human Radiation Experiments September 1995, https://ehss.energy.gov/ohre/roadmap/histories/0468/0468toc.html .

The awareness of both hormesis and NHBRAs is quite old. It’s knowledge base has been disseminated since the 1950s, as confirmed by Goldman, above.

For a period of time of at least 60 years, the school of hormesis has held at minimum that human populations living in NHBRAs of the world at worst suffer no additional risk of disease than populations who do not live in such high background radiation areas.

Over many years the school of hormesis has also made claims of health benefits imbued to human populations resident in such naturally high background radiation areas. Health benefits including added resistance to disease. For example:

“Low-dose radiation has been shown to enhance biological responses for immune systems, enzymatic repair, physiological functions, and the removal of cellular damage, including prevention and removal of cancers and other diseases. Research on low-level radiation has also shown it to have no adverse effects. Yet, current radiation protection policy and practice fail to consider these valid data, instead relying on data that are poor, ambiguous, misrepresented, and manipulated.” Source: James Muckerheide “It’s Time to Tell the Truth About the Health Benefits of Low-Dose Radiation”, 21st Century Science and Technology Magazine, Summer 2000, extracted to https://www.21stcenturysciencetech.com/articles/nuclear.html This article documents the work of Marshall Brucer and others to spread the good news of radiation hormesis.

Muckerheide was a nuclear engineer, a State FEMA operative and “He founded and served as president of Radiation, Science and Health, an international non-profit organization of scientists advocating for corrections to the federal standards for personal radiation exposure.” Source: Obituary to James Muckerheide, The Needham Times from Dec. 2 to Dec. 9, 2014. http://www.legacy.com/obituaries/wickedlocal-needham/obituary.aspx?pid=173340119

(I have observed that nuclear engineers in the modern era commonly, but not always, share the views of Marshall Brucer, Marvin Goldman and James Muckerheide.)

In 2011 the benefits of radiation exposure was emphasized in Adelaide, South Australia as follows:

““We need radiation in our environment, just as we need vitamins and minerals. Too much is a problem, too little is a problem,” she said.” Prof. Pam Sykes, “Radiation Response a Meltdown in Reason”, Flinders News, Marketing and Communications, July 2011, Flinders University at http://blogs.flinders.edu.au/flinders-news/2011/07/14/radiation-response-a-meltdown-in-reason/

This is reflective of the basic principle of hormesis – that radiation above normal background is needed for health. The following quote further describes the view on the nature of the alleged benefit of higher than “normal” radiation exposure:

“Based on results obtained in studies on high background radiation areas of Ramsar, high levels of natural radiation may have some bio-positive effects such as enhancing radiation-resistance. More research is needed to assess if these bio-positive effects have any implication in radiation protection (Mortazavi et al. 2001). The risk from exposure to low-dose radiation has been highly politicized for a variety of reasons. This has led to a frequently exaggerated perception of the potential health effects, and to lasting public controversies.” Source: S. M. Javad Mortazavi, High Background Radiation Areas of Ramsar, Iran. Address: Ionizing and Non-ionizing Radiation Protection Research Center
(INIRPRC) Shiraz University Of Medical Sciences, source link http://www.angelfire.com/mo/radioadaptive/ramsar.html Author CV http://home.sums.ac.ir/~mmortazavi/cve.pdf

Claims of the health benefits of radiation exposure above normal background have been promoted by the school of Hormesis to the scientific and general public since the 1950s. (Brucer).

One would think that the health benefits claimed for radiation hormesis would be very clearly documented by now. One would think that disease rates in NHBRAs of the world would be lower than areas in which general populations were exposed to lower levels of radiation, natural or imposed by industry. Surely if humans did in fact need radiation in the same manner in which we need vitamins and minerals (Sykes, above), then one would expect those benefiting from more vitamin R (radiation) than others in their natural environment, then the enriched population would be doing much better than the relatively deprived populations. This is in fact the promise of Hormesis. A promise of health benefit. An improved resistance to disease, less disease, because of a radiation enhance vitality and resistance to challenges to the human system.

These claims have been spread around the world by many advocates of hormesis. I have been aware of them since the early 1970s. At that time I was trained to functionally relevant level in radiological safety in the context of my job at that time. My employer was the Australian Army. Hormesis was discussed as view point. It was not considered a worthy replacement to ALARA as the basis for a safety regime at that time.

However, Hormesis is well known to the aware members of the general public in Australia. It is now a commonly held view. Surely the populations countries and regions promoted as being “living proofs” of the validity of Hormesis are also well aware of the theory of Hormesis. Surely, for the last 60 years, populations living in high background areas of India, Iran, Brazil, China and other places, have heard the reports of their radiation endowed resistance to disease. Their claimed superior vitality and health. If so, how have ordinary people living in the NHBRAs of the world responded to the claims of Hormesis? Have they been encouraged to maintain healthy lifestyles to ensure health or have they, to the contrary, concluded that, being protected by heightened radiation exposures, and so disease resistant, they are free to engage in pleasurable but high risk habits (such as smoking and chewing tobacco, drinking more than moderate amounts of alcohol etc.) because they are free to seek more pleasure?

Has the theory of Hormesis reinforced local public health campaigns and research in HBRAs or has Hormesis caused – either directly or indirectly – periods of official complacency and historically poor record keeping in the public health arenas of the NHBRAs?  If one feels perfectly safe, and endowed with good health and resistance to disease, would a high risk habit, such as smoking and alcohol drinking, be misjudged to be  pleasurable and low risk habits and pass times?  Does spending more time rolling in the radium sands of Kerala prevent cancers? If so how potent is the alleged protection?

The school of Hormesis is very unclear on precisely what the benefits to increased radiation exposure will actually consist of. It is a claim of general radiation imbued improved resistance to disease. Improved resistance to cancer is one such claim by Hormesis advocates. Sykes et. al propose that routine and repeated low dose radiation exposure to perfectly healthy males would lower prostate cancer incidence. (Sykes, 2011). Volunteers have not yet, apparently, been called for. I would expect trouble with the University Ethics Committee on that one should the proposal progress that far. Healthy males, no diagnosis of disease, additional repeated medical radiation exposure. There might be benefit, there might be harm. The proposed “preventative treatment” is actually an experiment.

The Current Cancer “Crisis” Discovered in the NHBRA of Kerala, India.

In late 2013 and early 2014, media reports from India broke the story of the apparently high rate of cancer cases being being diagnosed and reported to the central Indian governments at state and national levels. For example:

“Thiruvananthapuram, Kerala: In a shocking revelation, Kerala Chief Minister Oommen Chandy today informed the state Assembly that the state has the highest number of cancer patients in the country.

Out of every one lakh males, 133 persons suffer from the disease while in the case of females, it is 123 for every one lakh females, he said while replying to a calling attention motion on the necessity to set up a cancer institute in Kochi.

As per statistics, nearly 50 per cent of cancer cases could be cured if the disease was identified in the initial stage itself and treatment started, Chandy said.

On the demand for a Cancer Institute, he said the cabinet had already decided to set up a Cancer Research Institute at the campus of Kochi Medical College hospital, which was taken over by the government from the co-operative sector.

Union Health Minister Ghulam Nabi Azad had, during his recent visit to the state, also sanctioned Rs. 25 crore to set up the institute at Kochi. This amount would be utilised for the proposed project, he added.

Taking up the issue, S Sarma (CPI-M) said doubts have arisen in the minds of public on the proposed project as no funds had been earmarked for it in the current year’s budget.

Sarma demanded that government clarify its position on the matter and speed up the work of the institute.

Eminent personalities of various walks of life, including jurist V R Krishna Iyer have launched a campaign in Kochi in support of the institute.” Source: Press Trust of India | Updated: January 27, 2014 20:04 IST, http://www.ndtv.com/south/highest-rate-of-cancer-cases-in-kerala-chief-minister-oommen-chandy-549016

It is my perception that the media and public awareness of this cancer crisis came out of the blue, presenting a shock to the society, its population and its medical and civil/politcal leadership. I do not live in Kerala and my perception may be in error. I have no idea what the ordinary people of Kerala knew and felt about the presence and risk of illness in their communities.

I can say though the school of Hormesis has, since the 1950s maintained that the naturally high background radiation areas present in the Indian state of Kerala was a benefit to the health of the people living there. (Goldman, 1994, S. M. Javad Mortazavi, 2001)

Previous Cancer Incidence Research in Kerala, India

Goldman, 1994, states the following about early studies undertaken in Kerala, India:

“This is what we were taught about places like the Massif of France, places in China, and Kerala Coast [on the Arabian Sea] in India. The geology [there] is such that the background radiation [from uranium and thorium in the ground] is ten times higher than background here. People live there and have for millennia. There [were] some really careful epidemiology studies done. They have not shown a [radiation-related] difference [in cancer rates]. ….   Source: Oral History of Dr. Marvin Goldman, US Department of Energy, 1994, https://ehss.energy.gov/ohre/roadmap/histories/0468/0468toc.html

” Lori Taylor is the former head of the National Council on Radiation [Protection]. He was the first president. He became president in 1928, when I was born, and he’s still alive and [well]. He’s an unbelievable guy. (Because low doses of radiation extend life).
(laughter).” Goldman, ibid.   Lauriston S. Taylor (Lori, as known by Goldman) died on 26 November 2004, aged 102.  There is no evidence to suggest, as Goldman implies, that the late Dr Taylor lived to 102 because of his occupational radiation exposures.  The Queen of England is rapidly approaching Dr. Taylor’s age of demise. HRH has never been a radiation worker.   I knew a Herbalist  who lived to 103.

Dr. Goldman fails to give his sources in the course of his oral history, I do not know which ‘ really careful epidemiology studies’ he is referring to.  Despite this, I have the work of Nair and others in this regard.

“A Dearth of Published Literature”

Even though Goldman keeps his cards close to his chest, his statements made in 1994 during his DOE oral history gives the impression that the school of hormesis hold a treasure trove of proves relating to the alleged health  benefits of living in Kerala, India and other placed. Benefits imparted onto human populations and individuals due to the naturally high background background (ie chronic low dose) radiation exposures of those areas.  What the “really careful epidemiology studies” are is unknown to me at this point.

However, in trying to find these early reports cited but not referenced by Goldman, I did come across the following statement: “There is a dearth of published literature on the frequency and distribution of pediatric and adolescent non-Hodgkin lymphoma (NHL) in India according to the 2001 WHO classification.” Source: Marie Therese Manipada, Sheila Nair, Auro Viswabandya, Leni Mathew, Alok Srivastava, Mammen Chandy “Non-Hodgkin lymphoma in childhood and adolescence: frequency and distribution of immunomorphological types from a tertiary care center in South India”,World Journal of Pediatrics November 2011, Volume 7, Issue 4, pp 318-325 First online: 01 June 2011 http://link.springer.com/article/10.1007%2Fs12519-011-0303-7

How the school of Hormesis has been able to make its bombastic statement that the NHBRA of the world, Kerala in this instance, that such areas imbue a health benefit and a resistance to disease upon their populations, from the 1950s until today, given the acknowledged “dearth of published literature” evident regarding relevant disease, is beyond me.  Apparently I am not allowed to point this out, as I am not a Hormesis scientist, not a scientist all, just a voter.  All these things therefore fall into my political domain.  These things are also a matter of conscience.  What is truth?

Nair et. al.

M.K. Nair has had over 4oo scientific papers related to health in India, many relating to Kerala, India, published and available via PubMed. (http://www.ncbi.nlm.nih.gov/pubmed , search Nair MK). Nair has writing and publishing on the issues since 1965.  This persistence over time provides a robust base of information from which to begin a study as to the mystery of an allegedly sudden and concerning increase in the incidence of cancer diseases recently noted in Kerala India.

“A comprehensive survey of the population exposed to high-level natural radiation is presented. The population living in Karunagappally taluk in Kerala, India, presents a unique opportunity for studies on the health effects of chronic exposure to low-level radiation. The environmental radiation emanates largely from the thorium deposited mostly along coastal areas. In certain locations on the coast, it is as high as 70 mGy/year and on average is 7.5 times the level seen in interior areas. Using portable scintillometers, radiation levels in more than 66,306 houses were measured; outside levels were also measured in the same house compound. Of the total population of 400,000, 100,000 lived in areas with high natural radiation. Information on lifestyle, socio-demographic features, occupation, housing, residence history, and tobacco and alcohol use was obtained by house-to-house visits and enumeration of every resident individual. A population cancer registry system has been established to obtain cancer incidence rates. In this preliminary analysis, there is no evidence that cancer occurrence is consistently higher because of the levels of external gamma-radiation exposure in the area. Further dosimetry-level studies are needed along with biological studies. Studies of soil, thoron-in-breath, and the radon thoron levels in houses are ongoing, and further case-control analyses are continuing.” Source: Nair MK1, Nambi KS, Amma NS, Gangadharan P, Jayalekshmi P, Jayadevan S, Cherian V, Reghuram KN.  “Population study in the high natural background area in Kerala, India”. Radiat Res. 1999 Dec;152(6 Suppl):S145-8.  http://www.ncbi.nlm.nih.gov/pubmed/10564957

“The coastal belt of Karunagappally, Kerala, India, is known for high background radiation (HBR) from thorium-containing monazite sand. In coastal panchayats, median outdoor radiation levels are more than 4 mGy y-1 and, in certain locations on the coast, it is as high as 70 mGy y-1. Although HBR has been repeatedly shown to increase the frequency of chromosome aberrations in the circulating lymphocytes of exposed persons, its carcinogenic effect is still unproven. A cohort of all 385,103 residents in Karunagappally was established in the 1990’s to evaluate health effects of HBR. Based on radiation level measurements, a radiation subcohort consisting of 173,067 residents was chosen. Cancer incidence in this subcohort aged 30-84 y (N = 69,958) was analyzed. Cumulative radiation dose for each individual was estimated based on outdoor and indoor dosimetry of each household, taking into account sex- and age-specific house occupancy factors. Following 69,958 residents for 10.5 years on average, 736,586 person-years of observation were accumulated and 1,379 cancer cases including 30 cases of leukemia were identified by the end of 2005. Poisson regression analysis of cohort data, stratified by sex, attained age, follow-up interval, socio-demographic factors and bidi smoking, showed no excess cancer risk from exposure to terrestrial gamma radiation. The excess relative risk of cancer excluding leukemia was estimated to be -0.13 Gy-1 (95% CI: -0.58, 0.46). In site-specific analysis, no cancer site was significantly related to cumulative radiation dose. Leukemia was not significantly related to HBR, either. Although the statistical power of the study might not be adequate due to the low dose, our cancer incidence study, together with previously reported cancer mortality studies in the HBR area of Yangjiang, China, suggests it is unlikely that estimates of risk at low doses are substantially greater than currently believed.”   Source: Nair RR1, Rajan B, Akiba S, Jayalekshmi P, Nair MK, Gangadharan P, Koga T, Morishima H, Nakamura S, Sugahara T.  “Background radiation and cancer incidence in Kerala, India-Karanagappally cohort study.”  Health Phys. 2009 Jan;96(1):55-66. doi: 10.1097/01.HP.0000327646.54923.11.

I do not know if current authorities in Kerala, India, have access to the cancer registry created by Nair et. al in the 1990s and used for the purpose of producing the 2009 study and paper.   The finding that conventional radio protection regimes based upon ALARA are approximately accurate is a significant finding of Nair et. al.  The age range apparently studied by Nair et. al was 30 years to 84 years, and so did not contribute, apparently to the knowledge of childhood cancers in the regions in question.  The current “dearth of information” in that regards appears to have been maintained by Nair et. al.

The scientific finding of Nair et al that “showed no excess cancer risk from exposure to terrestrial gamma radiation. ” does not address excess cancers per say. It is not clear to me from Nair whether or not the 1990s and 2009 papers by Nair etl. al. identified an excess of cancer incidence in the parts of Kerala state studied compared to other parts of the state and other parts of India.  If Nair et. al. had discovered a “cancer crisis” in Kerala or parts of Kerala, this is not mentioned in their two papers referred to above.

Yet other sources state that the current “cancer crisis” has been growing for the past 30 years, that is, since about 1986.  Surely a detailed cancer survey in 2009 might have found concerning evidence important enough to require separate reporting.    The overt reason for the reports of Nair et. al. was to report only upon the measured health impacts , if any, of living in the NHBRA of Kerala.  Surely though, an observed cancer crisis would have required immediate reportage to public health officials in Kerala.  So did Nair et al see the crisis or not? I cannot determine this one way or the other from the abstracts of the paper, which is all I have access to.

Let us say then that Nair et al found that living in the high radiation areas of Kerala did not pose a risk to health.

What then of the repeated claim of the health benefit and claimed reduced incidence of disease such areas are alleged to give their human residence?  Cancer, it seems, according to Nair et al, is present in the high radiation areas of Kerala, not due to radiation.  So where is the claimed health benefit? Is there less cancer in these areas? In regard to childhood cancer, we know there is “a dearth of published literature”. Indeed, Nair et. al. studied no one under 30 years of age. An odd omission in my lay opinion. What do we make of the statement “showed no excess cancer risk from exposure to terrestrial gamma radiation…” (Nair et. al, 2009), especially in relation to childhood disease in Kerala?

Why the Sudden awareness of the elevated disease rates in Kerala if the school of homesis, as claimed by Goldman and others, had already proven the lack of harm and had indeed shown proof of benefit, to living in the HBRAs of Kerala and other places?

Excuse me for my lay rationality and common sense, which I know is not science. If there is a dearth of literature, as has been shown to exist,  regarding the disease incidence of the most vulnerable (children) which coincides with the finding that “Although HBR has been repeatedly shown to increase the frequency of chromosome aberrations in the circulating lymphocytes of exposed persons, its carcinogenic effect is still unproven.” (Nair et all, 2009), how could Nair et. al. or anyone else hope to explain the mystery by an exclusion of the young from the age ranges studied?

Do children tell us things we do not wish to hear?

How long have some scientists seen a “cancer crisis” in Kerala and not separately reported on it to public health officials as a matter of urgency, regards of any view as to the actual cause of it?

A Thirty Year Long “Cancer Crisis”

If I l had been and raised in a NHBRA of the world I would have a common sense attitude about my place, and of the people who were part of my community and state or province. I would not expect to see mass deaths from any cause in the normal course of events. Infections, starvation, drought, war, all being exceptions to my common experience. Lucky am I. Much of the world is not so lucky.

I would not even be aware of the indigenous radiation exposure experienced in my hypothetical home place.  Most people in Adelaide, including myself, have no current knowledge of our individual annual exposures. I could look it up. I haven’t.  I know I will probably live longer in Adelaide than I would in say Damascus or elsewhere.  Then again I might not.

It is generally true that most people in any age range do not die of cancer. Generally, in the West, it is a set of diseases which are of old age.  This may be changing, I am not sure.

It is probably very true to say that most people who live in Kerala do not suffer cancer. It is true to say, on the basis of recent reports, that the incidence of cancer has suddenly been identified as being the highest in all India. This fact says nothing about causes. This fact raises questions about the claim of the existence of a “beneficial dose”, whether that radiation dose does exist, whether it conveys health benefit and whether that benefit includes resistance to disease.  I have always been dubious of the claims of hormesis. They say they have thoroughly studied the relevant populations.  Surely if they had, there would not be a “dearth” of relevant data, and surely, were the disease trends in Kerala thoroughly understood since the 1950s, as claimed by Goldman, there would have been shock and surprise and concern among the population, the doctors, the politicians, the media of Kerala State and India as a whole.

It is all very dubious, these claims made by Hormesis.  That school which abides no opposition and which implores ordinary people to believe it without question. Where it is questioned, the school of hormesis complains that ordinary people must not cite science or scientific reports, must not search the net for answers.  Hormesis takes whatever academic merit it has as an entitlement to be the only point of  view accepted by governments and populations. As I have experienced Hormesis in South Australia. Bombastic and arrogant and anti-democratic.  Hormesis must be flourishing in Communist China.  And it probably is.

No lay person is in a position to verify experimentally the assertion of science.  In the end the lay person, to one degree or another must choose, especially in the case of contested science, who to believe.  From there one may move on to try to learn more for oneself, remaining, all the while, academically, a lay person. And hence inadmissible to science. But not to politicians. We can vote.  I have been reading radiation safety and disease texts privately since I was trained as a trainer in basic military radiological safety in the 1970s.

While not a scientist, as a Layman I am entitled to my point of view and it deviates from that of hormesis. I see no benefit to the allegedly beneficial dose.  I am not setting out here to prove harm instead. No. If I were living in Kerala, I would continue to live there. It would be my home. And that perspective deserves respect.  Even though it was in the 1950s that nuclear industry in search of a PR platform, turned such populations into happy test populations, used to promote the benefits of higher than normal chronic (long term) exposures.

In short, I have no knowledge as a scientist, for  I am not one. I possess a very minor military qualification to work as a radiac soldier that is now 4 decades old. I have my own readings of current material at each era since the 1970s and which continues. What I know now as a layman informs my beliefs as an enfranchised person in a democracy, as much as that may upset Goldman and the rest of the school of hormesis. (Goldman, 1994)

Hormesis has not presented me with a sudden crisis in its sudden manifestation in Adelaide from 2o11 (Sykes).  For I have been reading about it since 1972. I rejected it then and I reject now on the basis of the evidence.   Nair et al is a case in point in the context of the allegedly sudden rise of the “cancer crisis” in Kerala India.  Where is the promised hormetic benefit, the benefit of the higher radiation areas as revealed in the health stats? IT IS NOT THERE.  And in pointing this is out I am not saying natural radiation caused the cancer crisis. I do not know the cause.   Neither, apparently do the scientists.  The last sort of scientist to ask about this it seems to me would be the scientists who believe hormesis.  For they have, prima facie, excluded at least one possible cause (radiation) from their consideration.  It’s a bit like Goldman in 1992 being the last person alive to claim that there was no excess thyroid cancer caused in Belarus due to Chernobyl. He didn’t look like Galileo than, he merely looked ridiculous. As he does so now.  Where are these so-called very careful surveys of Kerala, dating from the 1950s on,  Goldman, and why did not you not warn the public health system of the facts in order to  forewarn that society?  Or were you happy in the belief of yours that radiation in the place would save the people from cooking smoke, tobacco, alcohol and 1960s hair dyes and the consequent cancer crisis which has only just been realized.   Seems to me there is no risk of Goldman being confined to his by the church he elects to believe in. Not at all like Galileo.  And I disagree with him.  Easy answer from church, tolled out its bell – Langley is a radiophobe and must not be heard if he speaks.  More Hormetic bullshit.

The Cancer Crisis in Kerala, India, has been Growing for 30 Years!

The work of the PhD student Abin Thomas is invaluable to anyone seeking to understand the discrepancy between the claims of hormesis and the actual experience of relevant disease in Kerala, India.

An interview with Mr Thomas is located here: http://www.ia-forum.org/Content/ViewInternalDocument.cfm?ContentID=8215

One of Mr Thomas’ papers is here: http://www.cppr.in/wp-content/uploads/2014/06/Cancer-care-policy-Abin.pdf

The paper is entitled:

“Kerala’s public policy crisis in fighting Cancer”
By Abin Thomas, PhD Scholar Student, King’s India Institute, London
The following text and graphic is taken from this paper by Mr. Thomas for study purposes. Please read the whole paper at the above link:
“A renewed anxiety on the matter has been on the rise since 2014 January 27. Shri. Oommen Chandy, the Chief Minister of Kerala, informed the public that
the state of Kerala has thehighest number of cancer patients all over India.
In Kerala, out of every one lakh males, 133 persons suffer from the disease while in the case of females, it is 123 for every one lakh females. At national level, according to the former Union Minister for Health and Family Welfare Ghulam Nabi Azad there were 2,934,314 cases in 2013 based on the study of the Indian Council of Medical Research, ICMR.
To give a historical picture of cancer spread in the state over the last 33 years from its
inception, the Regional Cancer Centre in Trivandrum registered the trends within cancer
treatment and management in the Hospital Based Cancer Registry and its
Consolidated Report 1982-2011.
A general trend in Cancer care based on the Consolidated Report
shows the graphical representation of annual number of patient’s attendance at the RCC every year till 2011.” Source: Abin Thomas, “Kerala’s public policy crisis in fighting Cancer”, undated, circa 2014, http://www.cppr.in/wp-content/uploads/2014/06/Cancer-care-policy-Abin.pdf

The graph included in the paper by Mr. Thomas shows a constant increase from about 3,690 people treated in 1982 to 14,018 people treated in 2011. This is a large and continuous increase in people being treated for cancer at a major hospital in Kerala.

It is clear that hospital staff in Kerala were well aware of the increasing incidence of cancers in the State of Kerala from 1982 on.  It is equally clear, from the constant publications of the school of hormesis that this increase in cancer incidence was willfully ignored by that school, dedicated as it  ostensibly is to public health and safety matters, even as it promoted the idea of the beneficial dose as a means of reducing cancer incidence world wide.

My original question remains my main question here: Given the 3o year old cancer crisis in Kerala, India, and given the apparent failure of the theory of the protective and beneficial radiation dose, given the alleged constancy of research in NHBRAs by the school of hormesis since the 1950s until now, why is there a cancer crisis in Kerala, and why is anyone surprised by it?

To what extent were the people of Kerala rendered more (significantly more) vulnerable to cancers than other populations living in India?  To what extent did the ordinary people of Kerala believe strongly in the claim of hormesis which states, falsely I believe, that living in an area of enhanced background rates of radiation exposure imparts protection or benefit against disease, that a health benefit exists and that everyone, no matter what, can expect to live longer in a NHBRA of the world and be relatively free of disease?

In both the NHBRAs of Iran and India, the claims made by hormesis are revealed to be false. To what extent do people living on those areas engage in smoking, drinking and running two stroke motors in the belief that the activities impose only attenuated and low risks upon them?  Do the people hold this false belief because they have been inculcated to so believe by the authority of the school of hormesis?

I fear so.   Having experienced the nature of the school of hormesis – its dictate that we should believe it with no dissent, no admittance of contrary facts – because, we the lay people are not scientists and so should not read science (Annesley, 2016) because we are, allegedly too radiophobic and too ignorant to know what we do.

Yet, for thirty years the researchers of the school of hormesis, if we are to believe its claim of intimate and current knowledge of the health status of the NHBRAs, failed to report the Kerala cancer crisis.

Why?  Is hormesis an impartial science or not?

Radiation Safety Measures in a Radiological Workplace

I was trained that one must not smoke tobacco or anything else in a workplace in which radioactive particles may be present. This routine is due to the fact that the static charge held by the particles in smoke attract the radioactive particles.   The radioactive clumps of material which form around the smoke impart higher skin and internal doses than would otherwise be the case.

I would advise the people of Kerala to reduce or terminate their smoking habits, to reduce or terminate their consumption of alcohol.

Had I been aware of this in 1982 in the context of the cancer crisis in Kerala, as the school of hormesis and its experts have been, I would have advised these precautions as worthy ones, even if I had or have no idea as to the cause of the cancer crisis. I have no idea of the actual cause or causes.   Hormesis as it may have been broadcast in the NHBRA of Kerala India has, in my view, merely rendered the population of that state vulnerable to a cancer crisis.  This view is supported by current knowledge.

One wonders when the school of Hormesis will abolish itself. On the basis of its grave technical errors. On the basis that it sees the ethics and mores of democratic societies as a threat to its existence.   To be polite, it should move its headquarters from Los Alamos and Flinders University, Adelaide, to somewhere in North Korea.

In my opinion.

Last Word

“Although, a Division Bench of the Kerala High Court on July 12, 1999 banned smoking in public places across the state, a recent study conducted by National
Drug Dependence Treatment Centre and the All India Institute of
Medical Sciences shows Seventy-four per cent children in Kerala use tobacco (27
th February, 2014, The Hindu).
Smoking tobacco is not the only reason. ‘Unlike many other parts of the
world, smokeless tobacco is very common in India. Tobacco or tobacco-containing products are chewed orsucked as a quid, applied to gums, or inhaled. The practice of keeping the quid in the mouth between the cheek and gum causes most cancers of the buccal mucosa, which is the most common mouth cancer in India’according to the Lancet (
Lancet Onco 2014 (15): 227) Also, the research paper projected the tobacco-related mortality in India to rise to 1.5 million people by 2020, ‘which represents 13% of total mortality and an increase of 320% within22 years’ (Lancet Oncol2014 (15): 228). It is against this appalling crisis, Kerala’s young population is inching towards dying every day with the consumption of tobacco-related products. While the draft health policy of the state aims to establish tobacco free homes, schools and workplaces, an imminent comprehensive cancer care policy is required with the

changing epidemiological demography of the state.”

“Kerala’s public policy crisis in fighting Cancer” By Abin Thomas, PhD Scholar Student, King’s India Institute, London  http://www.cppr.in/wp-content/uploads/2014/06/Cancer-care-policy-Abin.pdf
One does not have engage in science fiction to see what needs to be removed from the state Kerala in order to reduce cancer.
One can see that any researcher with a primary focus on the welfare of people would have reported the increasing cancer incidence in Kerala as soon as they were able.
As usual the school of hormesis, for all its “careful” studies, remains to call out caution in this or any other similar matter.
There is no benefit to the school of hormesis in Kerala, India. There is no reduction in disease. However, there may be an  increase in disease because in the NHBRA of the Kerala state may have believed the assurance made repeatedly by hormesis – that their home soil, by virtue of its characteristics will keep them well.
This is patently wrong. Cancer incidence has gone up in Kerala in a proportion to the increasing stridency of Hormesis in the modern world.
If you want to live a long time, don’t smoke, don’t drink much alcohol and don’t believe the claims of hormesis.

Hormesis claims to know all there is to know about health in Kerala (Goldman). Yet it didn’t report the cancer crisis. If it did not know about the cancer crisis, its claim to expert status is inappropriate. If it knew about the cancer crisis, it did nothing to warn local authorities or the people. Hormesis has never varied its claim that the naturally high radiation radiation areas of the world, including those in Kerala do nothing other than impart health benefit and disease resistance.

No, they do not. There is a cancer crisis in Kerala. Very likely, being a mere 30 years old, it has nothing to do with the natural environment of Kerala and everything to do with the false beliefs of human beings. It has more to do with PR and advertising, with what is known and what is believed and how those two human factors interact.

Noone is free from cancer risk. Perhaps in a NHBRA, people should be more careful about their bad habits, not less so.

And this directly confronts the position of everyone from Brucer, to Goldman, to Scott, to Sykes and Baht in their hormetic claims to the contrary.

Subtle Realities

Despite the rising from cancers in Kerala, India, that state retains its title as the place in India with the highest life expectancy. Cancer in any population, even in the perceived “crisis” seen in Kerala, afflicts a minority of the population in any place in time.

The most vulnerable are afflicted first. The most resistant are afflicted, if at all, last.

“In males, in Thiruvananthapuram district some of the highest incidence rate in the world of cancer of the mouth was seen. There also seems to be a belt of Thyroid cancer in females in the coastal districts of Kerala, extending along the west coast on to Karnataka and Goa.” Source:
“Development of an Atlas of Cancer in India”, Chapter five, “Patterns of Cancer in Selected Districts – Kerala State”, National Cancer Registry Programme, (Indian Council of Medical Research), http://www.ncrpindia.org/CAI/PDF/Ch5_Kerala.pdf

One cannot say, given the 30 years during which the hospitals of Kerala have treated the diseases, that this is new knowledge.

So why is it still maintained by the school of Hormesis that the NHBRA areas of India have a low rate of disease?
This pattern of “world’s worst” rates also occurs in males living in the NHBRA of Iran.

There is an urgent need for better stats everywhere, not just in the exhausting and dedicated hospitals of Kerala, that Indian state with the best public health system in all India (thus explaining the long life expectancy of the people of Kerala.)

There is an urgent for the school of Hormesis, if it is to gain any credibility at all with me, and people like me (ie the millions and millions of people who disagree with it.) to come clean about what it has actually known about the cancer crises in an relevant places in Iran and India and other places. It has only ever stated that NHBRA are a health benefit.

Where, pray tell, Pam, is the benefit? And why are people such as you giving the people in NHBRA feelings of falsely invincibility in regard to their alleged resistance to disease.

Look at the graphs of diseases in those areas and there is not benefit to be seen. Hormesis does not do any good, and I believe in the cases mentioned above, it does harm by the inculcation of a false belief among ordinary people in vulnerable societies.

In my opinion, Paul Langley.

 

kerala

Above: Figure 5(J) : Map of Kerala State highlighting the
districts with MAAR above 36.2 per 100,000   ”

Eight of the fourteen districts of this state provided data for which detailed description of leading sites is given. These eight districts highlighted in the map and in the descending order of MAAR were: Kollam, Thrissur, Thiruvananthapuram, Palakkad, Kasaragod, Pathanamthitta, Kannur and Ernakulam” Source: “Development of an Atlas of Cancer in India”, Chapter five, “Patterns of Cancer in Selected Districts – Kerala State”, National Cancer Registry Programme, (Indian Council of Medical Research), http://www.ncrpindia.org/CAI/PDF/Ch5_Kerala.pdf

 

journal.pone.0050468.g001

Above: Figure 1. Map showing sample locations in the high background radiation area (HBRA) Chavara, Puthenthura and Neendakara in Kollam District, Kerala, India. Source:

Radionuclides and Radiation Indices of High Background Radiation Area in Chavara-Neendakara Placer Deposits (Kerala, India)

PLOS

 

If an authority tells a population it is imbues with a health benefit and that disease rates are low,  that population must be forgiven for believing such an authority.  However, when contrary facts reveal the authority, the afflicted population must also be forgiven for severely questioning the integrity and honesty of the authority which promised the non-existent benefit.

Since the 1950s the school of hormesis have promised the entire planet a health benefit from increased radiation exposure.  Particularly the populations of NHBRAs have been cited as proofs of this benefit. In the two areas I have read of, Iran and Kerala India, to the contrary of the promise, both places reveal higher rates of relevant diseases than in other parts of the two nations. And in both places, incidents of specific cancers in male cohorts are so high as to either lead the world or be among the highest incidence in the world.

The promises of hormesis are revealed for what they are – worth little, by the sufferings of lay people who, unable to duplicate the experiments of scientists, have no option but to believe or disbelieve.

It is my opinion that such people would have been better off if the promises of hormesis had never been made. For the afflicted people at the very least, the promises are false.

The long expectancy in Kerala India is due, according to multiple references, to the highly advanced state of public health in Kerala.

How the life expectancy in such places changes over time remains to be seen.  Certainly there is evidence that the relative lack of starvation, malnutrition and infectious disease in Kerala are the drivers for the long life expectancy compared to other parts of India.

Lastly the reported high rate of chromosomal abnormality reported by Nair et al 1999, 2009, for India’s NHBRA needs to be investigated in the light of current Indian and world knowledge. The abnormalities should not be studies by the school of hormesis alone.  For it will, as it normally does, find what it will and demand, at the end of its research paper, for authorities to lower radiation protection standards in Kerala, India.  There is no doubt of this. This is manner in which Sykes et al end their papers.

 

“you can prove anything with a rodent”. Goldman, 1994.

 

 

 

 

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