on the shoulders of giants - lippincott williams & wilkins · 2014-12-02 · radiation biology...
TRANSCRIPT
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On the Shoulders of Giants: Radiation Protection over 50 years
…….and some anecdotes, stories and secrets
38th Lauriston S. Taylor Lecture
NCRP 50th Anniversary
Fred A. Mettler Jr, MD., MPH
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ROG
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50+ year career
• 1925 Worked at Western Electric (Bell labs)
• 1925 Formation of ICRU (age 23)
• 1927 Began at Natl. Bureau of Standards
• 1928 Formation of ICRP (age 26)
• 1965 retires from NBS after 37 years
• 1965 National Academy of Sciences
• 1972 retires to work for NCRP
• 1977 Retires from NCRP
• Honorary President of NCRP until age 102
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Early Radiation Safety NCRP Report #1
Laurie doing early “CPR”
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tube
stopwatch
batteries
70,000
volts
“Don’t move for the next
10 minutes or you will
be electrocuted”
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ROG
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“If I have seen farther than others, it is
because I was standing on the shoulders of
giants”
Isaac Newton 1642-1727
…..really Bernard of Chartres 1159
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The alternative……
“If I have not seen as far as others, it is because
giants were standing on my shoulders” Harold Abelson
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Acknowledgement
I have stood on the shoulders of many Giants and when I asked for their help, advice and wise counsel they always gave it to me.
Thanks to the many of you who provided advice and ideas to me for the content of this lecture
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As a child….. unknowingly being
influenced by radiation Giants
Harald Rossi 8 Edith Quimby
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1958 Nobel Prize winners
Introduction to mutation by radiation
George W Beadle Edward L. Tatum
X-ray mutation of mold linked one gene to one enzyme
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Director of Max Planck Institute for Biophysik
Radiation effects on cellular membranes
…and suggests I work with Alex Hollaender
and gives me a reference
1946
Boris Rajewsky
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Oak Ridge National Labs
– separate mouse macroglobulin
Suggests I work with Louis Hempelmann
and gives me a reference
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U.S. Atomic Energy Commission
Fallout measurement
John Harley 9 on roof of HASL with gummed film for
fallout dosimetry
Harold Beck
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Louis H. Hempelmann MD
Epidemiology
Oppenheimer & Hempelmann
Head of Radiological Safety (age 28 4 years out of medical school)
Elinor Pulitzer
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Jefferson Medical School
Robert Brent 30 Robert Gorson
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Residency and MGH and Boston
Medical physics
Edward Webster 16
…suggests that I go to Public Health School
and gives me a reference
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Harvard PHS
Environmental Health
Dade Moeller 32
….suggests that I should go take nuclear engineering at MIT
and gives me a reference
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Univ of Chicago and New Mexico Introduction to radiation protection
Robert D. Moseley Jr. MD
Worst paying job offer but Introduces me to NCRP and UNSCEAR
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My first NCRP meeting
A nice guy shares a room and a secret…….
for cold war fallout shelter dosimetry and survival
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The Lauriston Taylor secret cold war
ultimate dosimeter and radioprotectant
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….appropriate proportions if the quinine
actually scintillates
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Reflections over 50+ years
What were the most importance advances
and who was responsible for them ?
…and few predictions based on history
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Computer and technological advances
have been the main driver of change in
our field
Conversion of everything to digital
and …….
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…..and we must not forget the
inventor of the internet
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Some
former
and
current
Giants
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Genetics and radiation
Hermann J. Muller
1927 X-rays used as the first intentional mutagen in fruit flies
1939 Cautioned about possible hazard from diagnostic radiology doses
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Human population genetics
James V. Neel James Crow 5 Seymour Abrahamson
“The Amazon tribes” DNA in Forensics F1 Study RERF
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Effects of in-utero exposure
and future hereditary effects
• Teratology
• Atomic Bomb (CNS)
• Childhood cancer
survivor study
W. Jack Schull
John Boice 33 & Marilyn Stovall
Robert Brent 30
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Radiation Biology -major advances
Radiation track structure and linear/quadratic (Douglas
Lea)
Mammalian cell survival curves (Marcus, Puck and…..
Leo Szilard feeder cells 1954)
Re-discovery that hypoxia is a problem in tumors
(Thomlinson and Gray 1955)
Leo Szilard Philip Marcus
Single cell
colonies
Feeder
cells
“Permeable”
divider
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The “new” biologists
Kathryn Held Amy Kronenberg
DNA sequencing and genomics, gene expression
and epigenetics are likely the future
David Brenner
Joel Bedford Ann Kennedy Sally Amundson Edward Azzam
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Radiation Units, Doses and Limits
By 1953 rad and rem in use
Genetically significant dose gone
No progress on Sv vs Sv
20 mSv vs 1 mSv limits are a problem
SI Units (NCRP Report 1985)
Randy Caswell
Harold Wyckoff 4
“You are young enough to learn..”
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Dosimetry advances
• Models- Lung, GI tract
• Monte Carlo simulations
• Voxel CT scan based phantoms
• Computer power essential
Voxel phantoms Keith Eckerman
Rich Leggett
John Auxier Wesley Bolch
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Dose reconstruction advances
• Hiroshima/Nagasaki
• Veterans and workers
• Releases (Nevada testing, Hanford etc)
• US facilities (Apollo, Rocketdyne, Rocky Flats
• Techa River, Chernobyl, Fukushima
Bruce Napier Dan Strom Rear Admiral John Till (ret)
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Environment and radiation
Their own families often don’t
know they are Giants
Merril Eisenbud 7
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Environmental effects become a public concern
• Chernobyl
• Efforts to protect
plants/animals (ICRP)
Red Forest wikipedia
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Fukushima
Ward Whicker
Chernobyl
Most ecology populations
appear unaffected if
individual humans are
protected
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Health Physics coming into its own
• HPS founded in 1956
• ABHP in 1960
• “Ask the Experts”
Herbert Parker
Taylor lecturer #1
Elda Anderson J. Newell Stannard 14
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John Cameron
TLD QA and DEXA
Ken Mossman John Frazier
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Radon major advances
• Miner data
• Smoking and radon
• Residential radon
Jay Lubin et.al. Naomi Harley
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Simplicity in Statistics
Charlie Land 34
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Epidemiology
• Site specific cancer estimates
• Meta analyses (good or bad ?)
e.g Nuclear worker studies
• Practical lower limit ?
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The Pope
visits Brazil
1 million
people
WSJ
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Risk assessment
Probabilistic risk assessment
WASH-1400
Risk-informed decision making
Risk-managed decision making
“Adoption of LNT was a turning
point in risk management”
Norman Rasmussen (Red Sox)
Chris Whipple David Hoel
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The linear non-threshold (LNT) hypothesis
• May be true or not. “No conclusive
evidence to reject the assumption”
NCRP 136
• Not a comforting concept to the public.
• Has caused lots of angst and ? Expense
• Laurie Taylor was not a fan of LNT
Arthur Upton 13
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Probability of causation (POC) has come
with good and bad
• Radioepidemiological tables
• Suggested use of POC by WHO, IAEA, ILO, NAS, NCRP
• IREP & RADRAT were logical steps forward
• Political issues have distorted science
• Compensation programs confusion continues
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Tackling uncertainty about risks
……..and other things
P.S. Owen Hoffman is not really Dilbert
Owen Hoffman was a National Park Ranger
How deep is Crater Lake
…..Really ?
592 m vs
594 m
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“All risk estimates are
probably within a factor
of 3 of the truth”
W. Sinclair
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Risk communication and psychological issues
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One of the most important issues
with least public progress
• Risk Perception, Acceptability,
Amplification
• TMI > Chernobyl > Fukushima
Paul Slovic
Evelyn Bromet Steve Becker Paul Locke Susan Wiltshire
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Nuclear weapon issues diminish and then
come back again
1960-1985
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Terrorism
• Decorporation of
wounds and internally deposited
radionuclides
• Research on radioprotective methods
Judith Bader, Norm Coleman
• Rapid personal dosimetry
William Blakely
Bryce Breitenstein Pat Durbin 31
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There has not been use of a nuclear
weapon for > 65 years
My prediction: There will be use of a nuclear
weapon in the next 50 years (…or sooner)
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30 years ago a nuclear uptick was projected..
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Radioactive waste and Yucca Mountain
Issues
President Obama
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Reactor spent fuel continues to remain a
problem
Dick Meserve Dry cask storage is “interim”
solution for spent fuel rods
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Legacy waste
56 million gallons 177 tanks 60 leaking.
Began 20 yrs ago
? End by 2047 Total Cost ~ at least $300 billion.
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Pipe scale (NORM) waste issues
aka…..the plaintiff lawyers 401k plan
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Waste will remain a serious issue for the next century
AP February 20, 2014
AP February 20, 2014
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Understanding radium, plutonium and
uranium metabolism and effects
Radium
(R. Evans, O. Raabe)
Plutonium
(Wright Langham, G. Voelz)
Uranium facility
epidemiology
(J.Boice et.al.) George Voelz
“I didn’t know how famous Dad was …..”
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Changes in
U. S. medical radiation exposure
Natural
2.4
CT scanning 1.5 mSv
Radiography 0.3 mSv
Nuclear medicine 0.8 mSv
All other ?? mSv
Medical ~3.0 mSv
Total ~ 5.4
Medical 0.54 mSv
Total 3.0 mSv per capita
Natural 2.4 mSv
U.S. 1980 U.S. 2006
Interventional 0.4 mSv All other
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Who are the these “Giants” who were indirectly
responsible for a Nobel Prize and the CT scanner ?
?? Amish farmers
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Sir Godfrey Houndsfield
Nobel Prize in Medicine 1979
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1971
Now
CT MRI
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Diagnostic Radiology (CT)
Kimberly Applegate Don Frush Julie Timins
Dave Brenner
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Some of the physics team…..
Cynthia McCollough
Larry Dauer Terry Yoshizumi
Walter Huda
Mahesh Mahadevappa
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Fluoroscopy injuries continue
despite intensive efforts
Louis Wagner Steve Balter Don Miller
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Mammography.. A success story
• Direct film > low dose > digital
• FDA and ACR accreditation including
continuing education and experience
Edward Sickles Lawrence Rothenberg Stephen Feig
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Nuclear Medicine
• Gamma Camera (1956)
• Use of technetium-99m in 1960’s
• PET scanner
James Adelstein 24
Gordon Brownell
Hal Anger
Mike Stabin
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Incredible progress in NM imaging
Rectilinear 1950-1965
Gamma camera 1965-2000
PET/CT 2000-present
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Radiation Oncology over 50 years
• Radium and Cobalt-60 gone
Replaced by linear accelerators etc
• Computerized treatment planning
• Hybrid diagnostic and therapeutic
equipment
• Patient and tumor specific biology
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Effects of Radiotherapy
• Understanding radiopathology
• Response to fractionation – differential response
normal tissue vs tumor and early vs late changes
• Issues with children
Phil Rubin
Can I have my book ? Sandy Constine H Rodney Withers
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Rare,but major accidents in radiotherapy
continue
• Spain 1990 human error
• Costa Rica 1996 human error
• Panama 2000 human error
• Poland 2001 machine failure
• France 2005 human error
• Accidents will continue as long as humans are
around and machines get more complex
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Medical treatment of severe acute radiation
syndrome—breakthroughs and lessons
10 Gy
5 Gy
0-1 0.5-1.5 4-15
Months
GI etc
Bone
Marrow
Respiratory
About 100 % Lethality
Other
organ
failure
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Chernobyl and Belarus accidents
90 days-
pulmonary failure death 24 hours post exposure
Angelina Guskova MD
8 Gy ~ 12-15 Gy
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Tokaimura criticality accident
Kaz Maekawa MD
Worker A ~17 Gy
survived 82 days
Worker B ~10 Gy
survived 210 days
Long term survival will remain unlikely after > 12 Gy
Unless multi- system failure is solved
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Lost and stolen radioactive sources continue
to be a problem
SY Chen
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Non-ionizing radiation
• Ultrasound
• Radiofrequency
Wesley Nyborg 25
Marvin Ziskin
Gary Zeman
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Space facts and the future
• 12 people have walked on the moon
• 535 astronauts have been in space (37 countries)
including Malaysia, Syria, Mongolia, Cuba (> 119 PY)
• Virgin Galactic now selling trips to the public
• Mars trips
Francis Cuccinota
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Which former or current NCRP director
qualified for astronaut training ?
ZME Science
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ZME Science
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Giants sometimes come in twos
Naomi23 and John Harley9
Both Taylor Lecturers
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Mega mouse genetic experiments
Liane Russell William (Bill) Russell
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Radiation Biology and Medicine
Shirley and Michael Fry18
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Health Physics
Genevieve and Charles Roessler
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Giants sometimes leave us too early
Elaine Ron Goeff Howe
Shaggy dog story
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A young giant getting
fatherly advice
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But still….in our field even giants have
to pump their own gas
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Who will turn out to be a Giant
can be difficult to recognize……… Would you give this kid a Q clearance and $25 million for
radiation research ?
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John Boice Jr 33
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Some Giants impart knowledge through
books
Eric Hall 22
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The “study guide” of the
Essential Physics of Medical Imaging
is in progress
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Editors are giants too..
Richard Vetter Gen Roessler Mike Ryan
Michael Fry
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Are there certain spots where
Giants historically hang out ?
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Particular Universities
• Columbia
• Wisconsin
• Univ of Rochester
• UC Berkeley
• Univ of Chicago
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RERF
• S. Shigematsu
• D. Hoel
• J. Neel
• G. Beebe
• W. Schull
• S. Jablon
• D. Preston
• R. Shore
• Evan Douple
• R. Ullrich
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Lovelace ITRI
• Bruce Boecker
• Fletcher Hahn
• Joe Mauderly
• Ray Guilmette
• Bruce Muggenberg
• Roger McClellan
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Hanford - PNNL
• Bill Bair21
• Ron Kathren
• Dan Strom
• Bruce Napier
• Bill Morgan
• Tony Brooks
• Bill Morgan
• Les Braby
• Kathryn Pryor
Can’t they get
better office
paneling ?
First PhD in Rad Biol.
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Oak Ridge
• Clarence Lushbaugh
• The Frys
• Robert Ricks
• Ron Goans
• Al Wiley
• Dick Toohey
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NCI Radiation Epidemiology
• Gil Beebe
• Bob Miller
• John Boice33
• Andre Bouville
• Elaine Ron
• Kiyohiko Mabuchi
• Jay Lubin
• Ruth Kleinerman
• Martha Linet
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U.S. Government
• U.S. FDA (CDRH)
John Villforth
Don Miller
John McCrohan
Orhan Suleiman
• US NRC
Don Cool
Vince Holahan
• EPA DOE
Julian Preston Stephen Musolino
Mary Clark
Michael Boyd
• State
Jill Lipoti
James Yusko
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ICRP Giants
• Lauriston Taylor
• Rolf Sievert
• Dan Beninson
• Sir Edward Pochin
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Sir Edward Pochin 2 (ICRP Weighting factors)
visits Albuquerque
or “a knight comes to dinner at the Mettler’s”
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Fighting anti-nuclear dragons
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My UNSCEAR Giants
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Philanthropic Giant- Yohei Sasakawa
Has given tens
of $ millions
for radiation
related
disasters
How do you get cash after a tsunami ?
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Then there are “NCRP” Giants
Who are they ?????
I reviewed all reports 1-174 1931-thru
2013
1354 persons: chairs and committee
members
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6 NCRP Committees
• C. Meinhold 6 (3)
• R. Roesch 6 (3)
• H. Rossi 6 (3)
• H. Parker 6 (2)
• R. Gorson 6 (1)
• W. Bair 6 (1)
• L. Marinelli 6
• P. Durbin 6
• H. Wyckoff 6
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7-9 Committees
W. Sinclair 9 (3) K. Kase 8 (3)
L. Taylor 9 (2) S. Feitelberg 8
K. Miller 9 (2) M. Fry 7 (3)
G. Failla 9 (1) C. Braestrup 7 (3)
R. Shore 9 D. Moeller 7 (2)
R. Newell 9 J. Boice 7
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The NCRP Super Giants of all time
• Edith Quimby 12 (4)
• John Poston 12 (2)
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To do more work and get on the
next NCRP Giant list…..
• More committees are becoming available but
space is limited…………
• Limited bookings for 2015 and 2016
• Make your reservation now
• Call John Boice at any time day or night
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NCRP Past Presidents
2002-2012
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The Giants who really keep the other Giants
from making silly mistakes
• W. Roger Ney T. Fearon
• W. Beckner J. Spahn
• D. Schauer M. Rosenstein
• E. I. White C. Maletskos
Otha Linton
Laura Atwell Cindy O’Brien
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My personal Giants
Radiation protection is a time-limited career.
…….. Family is forever
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So many Giants……
…...so little time
A gathering of Giants this morning
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RHJ
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Thank you