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April 09, 2011

TMI and Thyroid Cancer

By: Aaron Datesman

This post is about a report from the Radiation and Public Health Project about thyroid cancer. I admire the organization - especially their “Tooth Fairy Project”, which aims to track levels of strontium fallout - but I think the conclusions of their report are wrong. The alternative explanation I would like to offer relates to the Three Mile Island accident. It is a good illustration of the nature of fallout dangers, I hope, and certainly a cautionary warning (if true) about how corrosive an incorrect media narrative can be - even many years into the future. I will steal from the RPHP report to set the stage:

Thyroid cancer incidence is increasing more rapidly than any other malignancy in the U.S. (along with liver cancer), rising nearly threefold from 1980 to 2006. Improved diagnosis has been proposed as the major reason for this change by some, while others contend that other factors also account for the increase. Among U.S. states, 2001-2005 age-adjusted thyroid cancer incidence rates vary from 5.4 to 12.8 per 100,000. County-specific incidence data available for the first time document that most U.S. counties with the highest thyroid cancer incidence are in a contiguous area of eastern Pennsylvania, New Jersey, and southern New York. Exposure to radioactive iodine emissions from 16 nuclear power reactors within a 90 mile radius in this area as a potential etiological factor of thyroid cancer is explored; these emissions are likely a cause of rising incidence rates.

Uptake of radioactive Iodine-131, released from nuclear weapons tests and nuclear reactors, is accepted as a cause of thyroid cancer. (I recommend this article by Valerie Brown if you are unfamiliar with this topic.) Thyroid cancer is highly survivable, so it’s interesting to have incidence, rather than mortality, data. The table below is taken from the RPHP report. It lists the 18 U.S. counties with the highest rates of incidence of thyroid cancer. My childhood home of Lehigh County, PA, tops the list.

Thyroid chart.jpg

You’ll notice the eleven stars in the table. These are all counties clustered together in southeastern Pennsylvania, New Jersey, and downstate New York. This region contains the highest density of nuclear power plants in the country – thirteen operating reactors at seven distinct facilities.

In addition to this general argument, which you may find convincing, the report examines in greater depth incidence data for the area surrounding one reactor - Indian Point in Westchester County, NY. While Westchester County is not on the above list, the adjacent counties of Putnam, Orange, and Rockland all are. The authors find that the incidence of thyroid cancer in these four counties is more than 40% greater than in the rest of New York state. In 1976, the incidences were identical.

Aside from some discussion of other factors which may contribute (more on that in a moment), this is the conclusion to the report:

Geographic variations in mortality and incidence have been frequently used to reveal etiological factors for diseases. This report addresses the largely unexamined topic of geographic variation in U.S. thyroid cancer incidence and has identified proximity to nuclear plants as the most evident etiological factor. This finding is consistent with data in the U.S. National Cancer Institute study of cancer near nuclear plants, which documented consistent rises in thyroid cancer incidence in counties closest to nuclear plants after startup. Data in this report suggests that exposure to radioactive iodine released from nuclear plants is a factor in elevated and rapidly rising thyroid cancer rates.

This conclusion may be correct; there is probably information in the data presented which supports it. I do agree that iodine releases from operating reactors are certainly a matter of serious concern. However, the county-level data presented by RPHP support a much stronger explanation than the rather vague hypothesis regarding the regional concentration of nuclear reactors.

It’s not the fault of the authors that they overlooked this explanation. It’s the fault of the media, which for more than 30 years has failed to inform us regarding the true scope of the TMI disaster. This is from the section of the RPHP report which examines other sources.

Three Mile Island. Another source of exposure to radioactive iodine, especially in the northeast U.S. is airborne emissions from the 1979 accident at the Three Mile Island plant. Official reports estimated 14.2 curies of I-131 and particulates were released into the environment, and prevailing winds carried the radioactivity hundreds of miles to the east and northeast. But the 2001-2005 thyroid cancer rate Dauphin County PA, where the reactor is located, had a rate of 12.0, lower than many other counties in the state. Again, while 1979 Three Mile Island emissions may play a factor in subsequent thyroid cancer state and county, these data suggest it is not a major contributor.

There’s an interesting error here. The error also occurs in this article from the academic literature entitled “Incidence of thyroid cancer in residents surrounding the Three Mile Island nuclear facility.”

OBJECTIVES/HYPOTHESIS: On March 28, 1979, the worst nuclear exposure incident in U.S. history occurred near Harrisburg, PA. Small quantities of xenon and iodine radioisotopes were released into the environment from the Three Mile Island (TMI) nuclear power plant. The Pennsylvania Department of Health (PDoH) implemented a TMI Population Registry, including 32,135 individuals within a 5-mile radius of TMI, to track possible health effects to the local population. Although no increase in cancer mortality has been noted in this cohort, cancer incidence has not been tracked. Given the long latency period for the development of thyroid cancer after exposure to low-level radiation exposure, it is plausible that an increase in thyroid cancer incidence might just now be occurring…..

CONCLUSIONS: Thyroid cancer incidence has not increased in Dauphin County, the county in which TMI is located. York County demonstrated a trend toward increasing thyroid cancer incidence beginning in 1995, approximately 15 years after the TMI accident. Lancaster County showed a significant increase in thyroid cancer incidence beginning in 1990. These findings, however, do not provide a causal link to the TMI accident.

Three Mile Island lies at the extreme southern tip of Dauphin County, adjacent to both York and Lancaster Counties. Since fallout dispersion patterns are determined by the wind, it’s suspicious to base an argument about fallout and fallout effects in Dauphin County on TMI’s location in Dauphin County. When I got the idea in my head that the authors of these papers may not have examined the geography very carefully, I graphed it out myself. You may want to compare the map below to the map in this post about the article in Science (Wahlen et al.) discussing TMI fallout measured in Albany.

TMI fallout map v2.jpg

The counties are labeled according to their rank in the incidence chart. (I grew up in the county labeled “1”.) I don’t see much evidence here that the regional concentration of nuclear power plants is related to the incidence of thyroid cancer. Of the seven regional nuclear facilities, only Peach Bottom in Delta, PA, is located in one of the counties highlighted in red. Although I believe the argument that TMI fallout might not land in Dauphin County, I don’t believe that all nuclear plants by necessity are sited on county boundaries. (I may be wrong about this. If somebody would care to look this up, I would appreciate the favor.)

There are not any nuclear power facilities in Lehigh(1), Northampton(3), and Bucks(14) Counties, although it is true that none of those locations is very far away from the Limerick power station in Montgomery County (which is not itself in the top 18). However, if routine (and even permitted) emissions of radioactive iodine are the fundamental cause, it’s very hard to explain why Lehigh County(1) and Lancaster County(18) both have high rates, while Berks County between them does not.

A much likelier explanation is a single, large emission of radioactive iodine which, due to geographical variations in the weather, resulted in an inhomogeneous pattern of fallout. In short, on the day of the Three Mile Island accident, there was scattered rain in southeastern Pennsylvania and downstate New York. You’ll notice that the three clusters (7/18, 1/3/14, and 4/5/8) of red lie quite well along a track parallel to the weather track for 28 March 1979 described in the previous post.

That’s one error based upon careful analysis of geography. (It’s perhaps something only a hometown boy would think of.) There’s possibly a second error, also. What if the estimate of the emissions of Iodine-131 due to the Three Mile Island accident were wrong – by a factor of more than 50,000?

For example, the official story is that the TMI incident released only 13 to 17 curies of dangerous iodine into the outside environment, a tiny fraction of the 13 million curies of less dangerous radioactive gases officials say were released, primarily xenon. Such a number would seem small compared with, for example, the 1986 nuclear accident at Chernobyl, which released anywhere from 13 million to 40 million curies of iodine and is linked to 50,000 cases of thyroid cancer, according to World Health Organization estimates.

But the Thompsons and Bear point out that the commission's own Technical Assessment Task Force, in a separate volume, had concluded that iodine accounted for 8 to 12 percent of the total radioactive gases leaked from Three Mile Island. Conservatively assuming the 13 million curie figure was the total amount of radioactive gases released rather than just the xenon portion, and then using the Task Force's own 8 to 12 percent estimate of the proportion that was iodine, they point out that "the actual figure for Iodine release would be over 1 million curies" - a much more substantial public health threat.

I included on the map historical weather data for Allentown, PA (in the county labeled “1”) and Poughkeepsie, NY (a bit north of county “8”). The information that there were scattered showers in New York and Pennsylvania on 29 and 30 March 1979 is significant because rainfall is the principal means by which radioactive fallout actually falls to earth. The below is excerpted from a report by the National Cancer Institute titled Whatever It Looked Like, We Didn't Drop Bombs on You: So Why Worry? Oh, no. I mean, titled Estimated Exposures and Thyroid Doses Received by the American People from Iodine-131 in Fallout Following Nevada Atmospheric Nuclear Bomb Tests .

Precipitation, hereafter used interchangeably with the words rain or rainfall, efficiently scavenges particles suspended in the atmosphere and can result in much greater deposition than that due to dry processes such as sedimentation, impaction, and diffusion. However, although a substantial fraction of the amount of radioactive materials present in the air may be scavenged by rainfall at particular locations, the fraction of the whole radioactive cloud so removed during one day is small.

Nuclear weapons were detonated when dry weather was predicted so that the deposition of radioactive materials onto the ground in the vicinity of the NTS would be as low as possible. However, because dry conditions were seldom maintained over the entire U.S. for several days after each shot, rainfall represents the primary means by which 131-I was deposited east of the Rocky Mountains.

The report makes very disturbing reading. Of course, so does this testimony belonging to Robert and Lena Zeigler of York Haven, PA, found on the Three Mile Island Alert web site:

ROBERT: And another thing I want to tell you. This patio out here. The very second day it rained. I never in my life seen it before. Where that rained on that patio, it was as purple as that towel there.

LENA: A reddish brown.

ROBERT: Just like you took maybe a spoonful of blood and dumped maybe a quart of water in it. And that went on there for a year or so, wasn’t it. It was the same thing every time. You could see it as soon as it rained. It’s still not clean. See what I mean. Now here, I had a lifetime roof put on here. It’s a sixty pound weight tin. The man told me it was a lifetime guarantee. I could go up there a month after this [accident] happened and just punch holes in my roof. It just ate that roof right up.

York Haven is in York County(7), very near to Three Mile Island. You are no doubt aware of what color water takes on when iodine compounds are dissolved in it. I will only add that, although we add it to salt, iodine is quite toxic (a lethal dose is 4 grams) and highly corrosive to metal.

It’s very plausible that the high rates of incidence for thyroid cancer in southeastern Pennsylvania and downstate New York identified by the Radiation and Public Health Project are due to fallout from Three Mile Island. As one final piece of supporting evidence, I offer this summary of the weather conditions around TMI on the day of the accident, March 28, 1979. This is taken from the Science article “Radioactive Plume from the Three Mile Island Accident: Xenon-133 in Air at a Distance of 375 Kilometers”:

For the first release period on 28 March, the meteorological conditions at Middletown were rather stagnant, with medium- to low-speed winds gradually shifting from northwesterly to northeasterly to easterly and finally to southeasterly. From 29 to 31 March, southwesterly winds prevailed at increased speed.

Following that description, a release from Three Mile Island on 28 March would have been blown over York(7) and Lancaster(18) Counties before assuming a track toward the northeast. I believe that is the story the map above tells as well.

(Full disclosure: the piece of this I can’t figure out is why the scientists in Albany didn’t detect any Iodine-131. If anyone can puzzle this out, please let me know.)

— Aaron Datesman

Posted at April 9, 2011 12:28 AM

Although your TMI reflections are informative and well researched, it pains me that you force yourself to haggle over these details when bigger sins of the nuclear industry loom large.

Hit-up this video at the 10:45 mark. Hazardous nuclear testing within U.S. borders is not new so the claim that thirty-seven states are contaminated by nuclear fallout doesn't seem all that unlikely. For those who still have doubts, this is what you're supporting when you use nuclear power. Wonder weapons like "DU" wouldn't have much widespread use if nuclear waste wasn't so cheap and plentiful.

Of course, Americans at least were lucky enough to be spared having nuclear munitions detonated in their population centers, but that's another story.

Posted by: Nikolay Levin at April 9, 2011 06:10 AM

I don’t see much evidence here that the regional concentration of nuclear power plants is related to the incidence of thyroid cancer. Of the seven regional nuclear facilities, only Peach Bottom in Limerick, PA, is located in one of the counties highlighted in red.

I don't know what a "regional nuclear facility" is, but we shouldn't ignore the Susquehanna facility which is on the western edge of Luzerne County (on the Susquehanna between Columbia and Luzerne counties). That seems as relevant as Peach Bottom (between York and Lancaster counties).

Posted by: Junius Ponds at April 9, 2011 10:33 AM

@Junius Ponds -

If you click through to the report, you'll find a chart which lists the facilities. Susquehanna is one of them. It is located in Berwick, PA, which is in Columbia County. I was not aware of its location on the border between Columbia and about that!

Given that the plants are often sited on rivers, and rivers are often county boundaries, I guess it's not surprising. It's just another wrinkle to consider when analyzing the geographical data.

Posted by: Aaron Datesman at April 9, 2011 10:50 AM


Very intersting and timely again. Keep up the good work.

I have absolutely no idea what the answer is to your question--I can only tell you how I'd get someone with the knowledge to answer it go through that process of trying to find the answer, and I'm betting you already have done that. Nonetheless, do Xe-133 and Iodine-131 have to travel together? For example, could Iodine-131 dissipate faster, move differently on the wind, be washed out by rain along the way, etc.?

Apart from that, what's the reliability of the Albany data? How precise are the measurements? How possible is misreporting or confusion of one isotope with another etc.

Posted by: N E at April 9, 2011 01:04 PM

NE - Thank you for the compliment!

Actually, as I was lying in bed last night after posting this, I came up with a possible answer: different release times. The vent processes for Xe and I are mechanically separate and were probably initiated at different times under different weather conditions. In fact, there is some anecdotal evidence that the accident began a few days earlier than the 28th. If that's the case, that could confound the Albany conclusions as well.

I could probably verify or refute this hypothesis by carefully reading the commission report on the accident. Maybe I will do that someday. However, before I do that, I owe you some OZONE, I believe. And actually I want to wrap up this series, because there is a point to the whole thing....

You're very polite for a computer posing as a human, by the way.

Posted by: Aaron Datesman at April 9, 2011 01:23 PM

How can you get your hands on cancer incidence data as a layperson? This has piqued my interest as to the effect the Rocky Flats nuclear weapon production facility has had on the Denver metro population.

Posted by: Gordon at April 9, 2011 03:38 PM

And as it turns out, the effects are pretty bad. This study linked emissions (before some of the worst accidents even occurred) to an increase in incidence of various cancers of 25% over the rest of the state. So, now I'm paranoid, thanks.

Posted by: Gordon at April 9, 2011 03:44 PM

Gordon -

Hey, welcome to my world! I didn't know most of the stuff I've written about until I got curious enough to start digging. And once you start digging, if you have a little technical background, oh boy - there's a lot of scary stuff.

And all because - to share a personal detail - I happened to remember a stupid story about the Home Shopping Network.

By the way, the example you mentioned in a previous post about the stress-strain model: were you thinking about the recent result with carbon nanotubes in a PDMS matrix, or something else?

Posted by: Aaron Datesman at April 9, 2011 05:08 PM

Aaron, as you've recently cited the NYAS report estimation of nearly 1 million Chernobyl deaths approvingly in regards to George Monbiot saying there are only 43 confirmed cases, I was wondering if you would be able to give your opinion of Monbiot's latest salvo on this issue, here.

I bring this up not to challenge you, but because I recently was arguing with a pro-nuclear power acquaintance, cited the NYAS numbers, and was referred the Monbiot response. To my untrained eye, Monbiot seems to be successfully discrediting the numbers in the NYAS report. The best I could manage was just to point out that the Union of Concerned Scientists estimates 35,000 Chernobyl cancer deaths.

Of course, even if it's "just" 43, it's still people dying pointlessly. The ultimate morality of the situation remains unchanged. But nonetheless, it would be good know just what numbers I can safely use without getting trounced in debate.

Posted by: Quin at April 9, 2011 09:16 PM

Mx. Quin:

Even with "just" 43 deaths the morality remains quite vague. It's always a question of alternatives and while discussing any options in isolation is valuable there are always trade offs both good and bad. Sometimes a person is faced with the position of choosing to advocate for a nuclear plant, a coal plant, or no plant. Nuclear power generation does kill people as well as does coal power generation and everything I know leads me to believe that coal kills more people even considering that a million people died at Chernobyl. So the question then becomes is the power generation from the nuclear plant worth it if it is the best option to get that electricity? This isn't clear cut when the electricity generation would help save lives as when it helps to power a hospital or a fire station.

Generally I would prefer solar, hydroelectric, or wind to nuclear power generation despite the deaths inherent in those options but it is always a choice of alternatives and the number of deaths inherent in each of the available options does change the morality. As accidents are unavoidable in any industrial process, including nuclear power generation, accurate death tolls from these accidents must be generated to help evaluate the alternatives.

I'm sure the public consensus on information regarding all of these options are better then the truth but with everything I know I still tend to prefer nuclear over coal and going without electric power. In situations when something else isn't an option, I would be willing to accept the horrors of nuclear power as opposed to the horrors coal power or the horrors of risking frequent blackouts to my local fire station.

Posted by: Benjamin Arthur Schwab at April 9, 2011 10:40 PM

This was the study I was referring to:
I was flipping through a Scientific American that I thought was new, but was actually published in 2003, so maybe not as cutting-edge as I originally thought, but I think the principle stands. After a little digging into Rocky Flats (pretty interesting case study), I've discovered that my childhood creeks and lakes were contaminated with tritium and plutonium just a few years before I was born. So, thanks again technical knowledge, for helping me understand exactly why that is so unbelievably horrifying.

Posted by: Gordon at April 9, 2011 11:02 PM

Gordon, you're welcome. I feel the same way about my childhood fields and woods in Coopersburg, Pennsylvania. I wonder whether the fireflies looked extra-sparkly due to radiation.

Quin - thanks for asking that question. I will eventually have to write more about it, which probably means I'll have to shell out the $150 for the NYAS report. But, in short, I'll give you a couple of reasons why I believe Caldicott.

1. You had to be in that car with me to understand the anguish I caused by asking that question. 43 deaths in an industrial accident does not equate to anguish in Ukraine.

2. There's this article:

3. Then, go ahead and look up the longevity statistics in Belarus. In this country, we roll our eyes and say, man, those people, they smoke and drink too much. But I think there are other explanations, as there are other explanations to the illness in the county where I grew up.

But basically, look, it's like this - have you ever gotten sick when you were stressed out or not sleeping well? If one's body is busy all the time keeping cancer in check, it's weaker and more vulnerable overall. Therefore large-scale epidemiological studies are the only way to really capture the harm overall.

What most studies do, however, is define an exposure threshold below which no harm is assumed to be possible. It's a stacked deck. It's disgraceful that a guy with Monbiot's record fails to acknowledge or understand this.

I'll keep the Monbiot piece in mind and compose more of a response in future. Frankly I'm more out to educate anyone who cares to read HOW to think about these issues, than in telling them what to think. Although the Monbiot claim boils my blood more than a little.....

Appreciate the question. Thanks.

Posted by: Aaron Datesman at April 9, 2011 11:16 PM

Interesting. Cache, UT; Bonneville ID; and Yellowstone MT are all within reasonable proximity to the notorious DOE Nuclear facility in S. Idaho.

Posted by: kgb999 at April 9, 2011 11:32 PM

Mx. Quin:

In addition to Mr. Aaron's reasons there is an additional reason to trust Caldicot over Monboit: There is a lot of money at stake in convincing people nuclear power generation isn't as harmful as it is while there is a lot less money at stake in admitting the true scope of any of these disasters (including the, as of yet talked about here, Kyshtym disaster: ). A rational person who ignores this fact and its impact will conclude that the scope of the disasters is less then it is. There is assuredly more then 43 deaths if that is the official total.

Posted by: Benjamin Arthur Schwab at April 10, 2011 12:09 AM

Aaron, thanks for your response, and I appreciate the link. It's an important point, if overall health has been measurably diminished even outside any uptick in cancer rates.

But what Monbiot writes also sounds very reasonable. He writes that none of the sources for any of the most shocking statistics (including the NYAS report) are peer reviewed; he puts the burden of proof on Helen Caldicott when she makes the claim that the UN Scientific Committee and WHO are part of a massive cover-up. If you can indeed show people like me "how to think" when it comes to evaluating this information, I will be very grateful. On its surface, I find what he writes very hard to dispute. If he's right that the NYAS report isn't peer-reviewed, what qualities about it make its numbers worth trusting in over conservative numbers which are peer-reviewed? And if Caldicott's right that there is a cover-up going on, should she not be able to provide at least some kind of documentary support on this score?

But perhaps peer-review is not the only useful rubrik by which to judge scientific data. And maybe the notion of a cover-up should be more self-evident. Or maybe there's something else I'm missing. In any case, if Monbiot is wrong in a way which should be clear to me, I do need to learn how to think a bit more about these issues, yes. If we're going to shift the debate on nuclear energy away from the current consensus (I live in Japan, and you would be shocked at how many people I know here who are still keeping pro-nuclear as their default stance, even in light of current events) then the necessary tools to convince fence sitters need to become more easily accessible to sympathetic non-scientists who want to join in. Like me!

Posted by: Quin at April 10, 2011 02:40 AM

The ratio per 100,000 seems way off

Posted by: sfsmskater at April 10, 2011 11:24 AM

Is it possible the solubility differential between Iodine and Xenon could impact how far one would travel as opposed to the other? There are rain incidents throughout the period between TMI and Albany. If the "red rain" that has been described was caused by iodine, it would follow that at least some quantity of the substance was dissolved and precipitated (aside: silver iodide is used in cloud seeding). Would Xenon interact with water in the same way?

In Richland and other down-winder communities this neck of the woods, much of the impact from Iodine exposure was attributed to meat/dairy through farm animals having eaten contaminated grass - and to a lesser extent through direct consumption of produce (we tend to wash things better than cows do). Direct exposure is only one piece of the puzzle impacting negative health impacts.

As for Monboit ... those clowns are a dime a dozen. Back in Vegas when they were trying to ram through Yucca, the industry used to trot out this guy for the TVs who would swear up and down that radiation has not even been absolutely determined harmful - I forget his affiliation, but he was well-credentialed with a full-on high ranking position. Happened just about the time they "scientifically" decided Las Vegas citizens could absorb 5x the radiation as is legally considered safe anywhere else in the nation (sun makes the skin more "leathery" dontcha know - reflects gamma radiation or some shit).

Posted by: kgb999 at April 10, 2011 04:14 PM

I found this link to be non-technical and very interesting:

It is about Chernobyl.

Posted by: Susan at April 10, 2011 07:02 PM

You throw that line "although we add it to salt, iodine is quite toxic" as a little aside. However I wonder WHEN iodine was added to all (food) salt, and what the salt consumption levels are in these various counties, and wonder whether there might be an ancillary correlation between this and thyroid cancer rates.

Some people (not I as I don't know enough information) do find a correlation between iodized food salt consumption and thyroid cancers.

Posted by: Soj at April 10, 2011 11:32 PM

Greetings everybody. It has been determined that homo sapiens truly are biomachines with certain programs. See - Catalog of human population (chp)

Posted by: humanoid at April 10, 2011 11:36 PM

Monbiot should watch this documentary:

Posted by: Jenny at April 11, 2011 12:12 AM

I think that "photobook" that Susan posted a link to is fascinating. It certainly has a more emotional impact for me than data.

Posted by: N E at April 11, 2011 05:31 PM

NE - I agree! Susan, thank you for sharing that. It's incredibly, incredibly powerful. And it explains my friends' emotions for me much more deeply than I had understood.

Posted by: Aaron Datesman at April 11, 2011 10:08 PM

You are welcome. I am not sure when I was first alerted to that website, but I have looked at it several times... it is fascinating.

The movie "Chernobyl Heart" is also moving - it is about the children in the area who are born with birth defects, and how a group of westerns are trying to get them medical care. There is a shitload of these children, and they are still being born (I think). They made up the term "Chernobyl Heart" because of a particular heart defect a lot of them are born with.

Posted by: Susan at April 12, 2011 02:38 AM

another photo essay on the after effects of Chernobyl...

very upsetting

Posted by: Susan at April 12, 2011 01:43 PM

Hello friends. As per the Catalog of human population (chp) any human is a biomachine and has a program along with three manipulation modes. This allows to get complete power over a human being without dependence from his / her will, simply because translation of adjustment modes won't get registered by intellect and consciousness of this individual.

Posted by: bio-robot at April 12, 2011 11:58 PM