Breast Cancer and Nuclear Sites

Do nuclear sites cause increases in cancer in those living nearby? This is the question which has always been the key to stopping the development of nuclear energy.

For if the answer is Yes, the laws would cut in; human rights would cut in. Check Mate. The nuclear industry and its supporters have always known this, just as the cigarette companies and the asbestos makers recognised their own specific nemesis.

You can argue about the economics of nuclear till you are blue in the face, but they can always move the goalposts, global warming, future security of supply, special new safe thorium reactors and so forth. But killing people with your radioactive discharges: that’s it. The End.

This week saw the publication in a peer-reviewed journal – Jacobs Journal of Epidemiology and Preventive Medicine – of a study which I carried out in 2003 of breast cancer mortality 1995-2002 near Bradwell nuclear power station in Essex.

This is the first of a series of nuclear site cancer studies my colleagues and I have carried out in the last 15 years and which I have now decided to publish in proper scientific journals. In the same journal I wrote an editorial article about the problems of analysing cancer risk near nuclear sites.

Nuclear epidemiology – better choose common cancers, not rare ones

This question has historically been approached through analysis of childhood leukemia age 0-4, believed to be the most sensitive indicator.

But although child leukemia may be a flag for an effect, it has the disadvantages that the background rate is very low (6 per 100,000 children per year) and that nuclear sites (for obvious reasons) are built in sparsely populated areas with few children living near the source of the effect.

Therefore it is difficult to have enough statistical power to show that any effect you find is real and not due to chance, unless you study a large number of nuclear stations over a long period of time. But the German cancer registry did do this and found a doubling of risk in the children inside the 5km ring around all the plants in Germany.

Despite this, the authorities, the government departments, the radiation risk agencies like ICRP, UNSCEAR, BEIR and the UKs own NRPB (which is going through more transformations than a mayfly and is now Public Health England (PHE) after a period as Health Protection Agency (Radiological Protection (HPARP), or by the time you read this, maybe something else) are unconvinced.

The nuclear industry’s risk model does not fit the facts

The Gold Standard for these people is the Japanese life span study of the A-Bomb victims, where a quantity called ‘absorbed dose’ is correlated with the cancer or leukemia excess, and this provides a risk factor which is considered by them to be almost a Law of Physics.

This model is unable to explain the child leukemias by factors between 1,000 and 10,000. That is say, that the observed risk factors are 1,000 to 10,000 greater than the model predicts.

There are other problems with the design of the child leukemia studies (or indeed any studies around a point source of pollution). The method employed always assumes that the risk falls off equally in all directions. So concentric circles are drawn around the point source and these divide populations into radial distance bands.

The idea is that any effect will be shown by a continuous fall-off of cancer or leukemia rate as you go farther away from the plant. The problem is that these plants do not behave as light bulbs on a flat floor with the light intensity (the risk) reducing as an inverse square law.

Instead they make their aerial discharges downwind and their liquid discharges to the sea or to rivers where they accumulate. So studies should divide the populations at risk into those who live near the contamination and compare these with those who do not, and not on the basis of radial distance.

So in the Bradwell study, I took a different approach

For these reasons, the Bradwell study of breast cancer mortality is a valuable indicator that these considerations are important. Breast cancer has a much larger population at risk than children 0-4: it increases in women aged between 45 and 75. The incidence rate is 150 per 100,000 per year compared with 6 in the children.

And so studies of breast cancer near nuclear sites should show up a link, if there is one. And there certainly is. We have found such a link in Burnham on Sea downwind of Hinkley Point and on the contaminated coast; we have found it in the study we carried out of Trawsfynydd in Gwynedd. And we found it in the Bradwell study.

Bradwell nuclear power station was commissioned in 1966 and stopped generating in 2002. It is situated on the south eastern tip of the River Blackwater in Essex. The Blackwater is not really a river, but is a tidal muddy sea inlet on the East Coast which fills up and empties on the tides to leave large areas of sticky mud.

Long ago, I ran aground off Bradwell in the ten-ton gaff cutter Swift which I was delivering to Maldon for repairs. The lights of the power station indicated a brooding and creepy presence through the fog as we spent the night stuck in the mud waiting for the next tide.

Discharges from Bradwell to the Blackwater do not go away. The Blackwater is isolated from the north (the Colne) and the south (the Crouch) by extensive offshore drying sand and mud banks. So the radioactivity just sluices up and down and precipitates at slack water into the mud. The highest concentrations are at the head of tide, the town of Maldon which is at the western end of the estuary.

The rising trend of nuclear contamination in the Blackwater

The Ministry of Agriculture Fisheries and Food, MAFF provided measurements of radioactivity in the environment from 1970 and this continues today with annual RIFE reports. I have every annual report from the beginning on my shelves.

In 1970 there was 1.5Bq/kg Caesium-137 in the mud by the power station. 1976 there was 2.3Bq/kg. In 1977 it was 20Bq/kg. By 1984 it was 78Bq/kg; oysters contained Americium-241 and Plutonium-239. In 1993 there was 17Bq/kg at the pipeline, but the radioactivity had migrated up the Blackwater with 84 Bq/kg at Maldon.

NRPB calculated that the dose to the critical group, using what it believed to be the critical pathway, houseboat dwellers who ate oysters (Yes!) to be 0.01mSv or 1% of the allowed dose limit. (See MAFF 1994 Aquatic Environment Monitoring Report No 42: Radioactivity in surface and coastal water of the Briitsh Isles, 1993. Lowestoft: Directorate of Fisheries Research.)

But these dose calculations are based on the industry-standard radiation risk model of the International Commission on Radiological Protection, the ICRP.

There are persuasive reasons for concluding that this model cannot be used for internal radiation where novel radioactive elements that have a high affinity for DNA end up inside the body through inhalation or ingestion. And the same dose calculations were done for the children, and were unable to explain the leukemias also.

Recently available cancer statistics by electoral ward give much finer detail

So what did we do? Incidence data has always been impossible to get aggregated to small areas. They don’t want people like me ferreting about and turning up inconvenient results. But mortality data became available from the Office for Population Census and Surveys, OPCS beginning in 1995 after the organisation was privatised and needed money.

The Vital Statistics outputs give numbers of deaths from the main cancers, including breast cancer in the census wards of England and Wales. By 2003 I had all the annual data from 1995 and was able to add up the total deaths from breast cancer in each of the 26 wards around the Blackwater.

I also had the data for a control group – the wards along the River Crouch to the South which does not have a nuclear power station discharging into it and which is isolated by large offshore mud banks and tidal flows.

Using census data down to the same ward level I calculated the numbers of breast cancer deaths expected on the basis of the age breakdown of the population in each ward. You have to do this because cancer increases rapidly with age and you have to compare on an age-standardised basis. I also allowed for the Social Class of the women in the wards, again using data from the census. Breast cancer rates are higher in the higher Social Class for various reasons.

The Observed number divided by the Expected number gives the Standardised Mortality Ratio or SMR. This is all standard epidemiology.

More than double the cancer risk in heavily contaminated Maldon

My prior hypothesis was that the wards near the contaminated mud would have the highest breast cancer SMRs. And this was borne out in the results. The ward with the highest levels of contamination, Maldon, also had the highest SMR of 2.1

I began by conducting a statistical test comparing all the wards adjacent to the Blackwater mud with all the other wards in the area i.e. away from the mud. The result was a statistically significant 70% excess risk of dying between 1995 and 2002.

I then compared those living along the Blackwater with those living on the uncontaminated River Crouch. The result was a Relative Risk of 2.1. That is there was twice the chance of dying of breast cancer if you lived next to the Blackwater than if you lived next to the Crouch.

In case this effect was driven by an urban / rural effect I tested the town of Maldon against the town of Burnham on Crouch. The Relative Risk was again 2.1. The only explanation is that it is living close to the radioactive contamination which drives the excess risk. My prior hypothesis was confirmed.

A scientific controversy breaks out

Following our study of breast cancer mortality near Hinkley Point (which found excess risk of dying from Breast Cancer in the downwind town of Burnham on Sea) the West Mersea Residents Association contacted me and asked if I could have a look at Bradwell.

I did the initial study using data from 1995-1999 and this showed much the same effect, a doubling of risk. There was a lot of fuss when we published this from Green Audit, as there was with the Hinkley study.

The Essex Health Authority commissioned the Small Area Health Statistics Unit to come and repeat the study, paying them about £30,000 (we got £400 from the residents for ours). SAHSU found no effect at all and said Green Audit must have made a mistake.

The Committee on Medical Aspects of Radiation in the Environment, COMARE had a look. Yes, we had made a mistake. There were some wrong numbers where a few wards had become mixed up.

But COMARE also found that SAHSU had also made mistakes, leaving out the Maldon wards altogether. When the corrections were made, SAHSU found that we were right and they were wrong: indeed the effect we found got larger (worse).

The concentric circle comparison, the one that is normally used in the children studies, showed nothing. Relative risk was 1.04, there was no difference in rates in the inner and outer circles. If you look at Figure 1 it is obvious why. The estuary, where the radioactivity is, is in both the distance bands, inner and outer.

Wolves of water

This issue of Breast cancer around Bradwell was one of the key questions to be decided by the Committee Examining Radiation Risks from Internal Emitters, CERRIE as it was set up in 2001.

The Environment Minister, Michael Meacher required that CERRIE carry out three key epidemiological studies to determine whether the ICRP model was correct for internal radionuclide exposures.

This was one of the three and was to be studied by me, by Richard Wakeford of BNFL (now an ‘independent’ scientist on the ICRP and advisor on radiation and leukemia to the Children with Cancer charity) and Colin Muirhead of the NRPB.

There were several epidemiology sub-committee meetings to agree the study area, and indeed the study area was agreed to be the one presented here. But before the study was carried out (and probably because it was by then clear what it would show), Meacher was sacked by Blair in 2004, and replaced by Elliott Morley.

Morley, who later went to jail for fiddling expenses, shut down the CERRIE committee and the Chair, Dudley Goodhead, shut down the epidemiological co-studies. Goodhead got an OBE.

The shenanigans associated with these antics, including some interesting email exchanges I obtained under the Freedom of Information act, are discussed in my book Wolves of Water.

My duty to make these facts known

Why has this only now been published? Good question. The answer is that after CERRIE I became involved with Depleted Uranium. I am essentially lazy, and the effort required to fight my way through the referees of the journals was too much. I had another research area to invest energy in, Uranium photoelectrons and Iraq.

But now I am increasingly being asked for papers, and as I am getting old and may fall down dead suddenly, or even be pushed over a cliff by the bad guys, I have decided to get all my research papers out into peer review.

So what can we conclude? First, that studies of adult cancer around nuclear sites should focus on common cancers like breast cancer, or indeed multiple cancers. There is more statistical power.

Second, in such ‘ecological studies’ (where a region is taken as a surrogate for an exposure) the groups must be chosen as a result of determining where the radioactivity ends up, and not through some primitive circle drawing exercise.

This is an important message to the US Nuclear Regulatory Commission (NRC) who have been mulling over protocols for examining risk near US nuclear sites for several years now since they were bounced into it by pressure brought to bear on Congress by those people living near the nuclear sites, who can see what is happening to them and their friends.

Writing of which, I leave the last word to a Blackwater local, the Secretary of the Maldon Oyster Fishermans’ Association, Mr B J R Wright, who wrote to the Maldon Standard in April 2001 after our first results came out and were being dismissed by earlier versions of nuclear advocate George Monbiot:

“Trust the experts – what a joke. I find it more than a coincidence that in the last seven years four commercial fishermen who spent years working on the mud flats and fishing outside Bradwell have all had bone cancer. Three have died and I myself have only survived owing to the brilliant staff at Broomfield hospital. I have also been told that commercial barge skippers who regularly plied our river are affected by bone cancer.”

In the same newspaper a few weeks later the headline was:

“Council crackdown on breast cancer; residents urged to take up healthy eating and stop smoking.”

Dr Chris Busby is the Scientific Secretary of the European Committee on Radiation Riskand the author of Uranium and Health – The Health Effects of Exposure to Uranium and Uranium Weapons Fallout (Documents of the ECRR 2010 No 2, Brussels, 2010). For details and current CV see chrisbusbyexposed.org. For accounts of his work see greenaudit.orgllrc.org and nuclearjustice.org.

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Dr Chris Busby is the Scientific Secretary of the European Committee on Radiation Riskand the author of Uranium and Health – The Health Effects of Exposure to Uranium and Uranium Weapons Fallout (Documents of the ECRR 2010 No 2, Brussels, 2010). For details and current CV see chrisbusbyexposed.org. For accounts of his work see greenaudit.orgllrc.org and nuclearjustice.org.

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