SNEAK PEAK: Why do we fear radiation?

Imagine this: For all your life you’ve been told that eating an orange will give you a scary disease, if not kill you outright. This is then reinforced by your teachers at school, in films and books, and by stories told by people about relatives who might have encountered this mythical orange. One day, many years later, someone comes along, sprinkling orange juice all around you without your consent, and you might, or might not, have been exposed to a tiny amount of orange juice. Even if virtually every scientist tells you that orange juice is safe, wouldn’t it be rather strange if you didn’t become anxious or scared, after years of being taught to the contrary?

Replace oranges with radiation, and voila, you get radiophobia. Over the past half a century, we have all been told in no uncertain terms that radiation is indeed very dangerous, causes cancers and birth defects, full stop. Images of Chernobyl firefighters dying after receiving atrocious amounts of radiation, children and animals born with severe birth defects such as too many legs, no arms or ballooning heads – allegedly caused by radiation exposure – and much, much more has formed our experience with radiation at the very deepest of levels.

To anyone having followed the historical debate around nuclear energy, the spectre of radiophobia has been ever-present – perhaps not always expressed, but nevertheless, always lurking in the back of the room, like a faint shadow. The story of radiophobia comes from the depths of human anxiety about nuclear weapons, but has over the decades evolved into something much larger. It has morphed to envelop nuclear power, and it has become one of the chief calamities holding back humanity, robbing us of a better tomorrow. In our fourth article, we will be exploring where radiophobia came from and the psychological processes which nurture and maintain it.

- John Lindberg

Q3. What are the health effects of radiation?

Radiation is scary, there is no denying of it. As we’ve explored previously, one of the reasons radiation is perceived by most of us as scary is due to the imagery and the associations with its effects on our health, be it radiation sickness, cancers or birth defects. We have all seen the scary photos that claim to show birth defects after Chernobyl. Indeed, this fear is so potent sometimes that it impacts our health far beyond the impacts of any radiation exposure.

Whilst there is no doubt that getting too much radiation too quickly can be dangerous there is, however, much confusion and myths about the actual impacts of radiation on our health. Radiation is one, if not the most, well-research carcinogens, with countless of billions of dollars having been spent on understanding its health effects. How much is required to cause cancer? Will any radiation dose increase the risk of cancer? Will nuclear power and its radiation put my unborn baby in harm’s way? Let’s shed some light on this tricky issue!

Radiation sickness

When you undoubtedly watched HBO’s Chernobyl series, you will have seen the gruesome effects of Acute Radiation Syndrome (ARS), or radiation sickness as most of us know it as. Its symptoms are undoubtedly scary, almost straight of the pages of a horror novel, with hair and skin falling off, vomiting, bleeding and many, many more rather unpleasant effects. This is also how many of us think about radiation and its health effects.

However, it would take astronomical amounts of radiation before you start to develop ARS, and even more radiation before you start to exhibit the more severe symptoms of it. Only about 50 people have ever died due to ARS, 28 of them at Chernobyl, the rest have mostly been workplace accidents at laboratories.

Radiation and cancer

The association between radiation and cancers goes back a long while, and the imagery of mutating rays is deeply ingrained into our relationship with cancer. Radiation has the potential to damage our DNA – something that all life has been exposed to for billions of years – but our cells have very sophisticated repair mechanisms to counter such damage. If, however, you are exposed to a lot of radiation over a very short timeframe, the repair mechanisms might become just overwhelmed enough for misrepairs to take place.

Cancer does not appear because of a single misrepair, but would rather require a large amount of misrepairs and in certain places of the DNA. It is vastly more likely that the cell will die before the “right” misrepairs take place, which is one of the reasons why radiation does not really cause as many cancers as one would believe. In order to even increase the risk of cancer but 0.4% - against the natural cancer rate of 35-50% - you would have to be exposed to some 100mSv (40 times above global average background radiation) within mere minutes. It would take astronomical doses, like 1000mSv, to increase the risk of cancer by some 5% - but at these doses, it is mostly a question of surviving the ARS.

After the Chernobyl accident and the mishandling of it by Soviet authorities, some 8000 people developed thyroid cancers, of which 15 sadly died. The likelihood of any further cancers due to Chernobyl are extremely low, with no scientific evidence supporting it. After the Fukushima accident, hardly a single cancer case is expected, as doses were very low.

In short, radiation can cause cancers, but it is really difficult to be exposed to the doses required to even slightly increase the risk of cancer. A great number of other things are much more likely to cause cancer, be it smoking, breathing oxygen, living in a big city, and the list goes on.

Radiation and birth defects

Right behind cancer, fears about birth defects due to radiation exposure are likely to follow. It is a most natural of fears, but one which has no scientific evidence to back those fears. After the Chernobyl accident in 1986, people have alleged that there was a significant increase in birth defects, due to radiation contamination. However, numerous reviews and inquires, some led by the UN, into the accident, and radiation exposure more broadly, has concluded that the doses women were exposed to as a result of the accident and the ensuring radiation contamination was far too long to have caused any birth defects. Some studies have even found that there were statistically significantly less birth defects in the high contamination areas compared with low contamination areas.

However, we have all seen the pictures, and heard the stories about children being born with birth defects in the areas surrounding Chernobyl. Unfortunately, birth defects are much more common across the world than most think – the Centre for Disease Control and Prevention estimates that birth defects affect 1 in every 33 babies born in the US. The images you find on Google that are genuine – some are clearly altered to make for scary propaganda – from the affected areas are simply part of the naturally-occurring birth defects, as the radiation levels their mothers would be exposed to are far, far too low to have any impacts whatsoever on the foetus.

- John Lindberg

Q2. When would I come in contact with radiation for medical purposes?

To many, radiation is first and foremost associated with things that make most of us quiver in our boots – be it the cancers it can cause, or the rather gruesome effects of receiving way too much radiation. However, throughout our lives, virtually all of us will at one point or another come in contact radiation, such as x-rays – be it when going to the dentist for an annual check-up or examining a potentially broken wrist. Indeed, it is perhaps counterintuitive that the most likely scenario of you being exposed to extreme amounts of radiation in your life is in a hospital setting.

It is perhaps ironic, as Hollywood has tried very hard to make radiation from nuclear reactors seem so dangerous, especially when many thousands of patients annually get doses far exceeding even the highest doses received at Chernobyl.

Diagnostics

1. X-rays

X-rays was discovered in 1895 by William Röntgen – hence the name “Röntgen” radiation in many languages – and less than a month after its discovery, x-rays were being used for medical purposes, allowing doctors to see inside the human body without operating. Nowadays, x-rays are one of the most essential tools in the doctors’ arsenal, helping to determine whether bones have been broken, detect breast cancers, or diagnose pneumonia or COVID19.

2. CT scan

At its most basic, a CT scan is nothing more than a large number of x-rays put together by a computer, providing doctors with a much more detailed picture of the patient. Thanks to the details provided by CT scans, they can be used not only to detect complex bone problems, but also help to stop cancers, show internal bleeding, and guide surgery and radiotherapy, to mention but a few. Given the amount of pictures taken for the scan, the radiation dose is higher than for a single x-ray picture.

Treatments

3. External radiotherapy

The, by far, most common type of radiation therapy to treat cancer is something called “external beam radiation”, where the affected area of your body is quite literally bombarded with radiation, trying to kill the tumour. The radiation doses are often really high, usually delivered at numerous occasions over a period of less than a month. These doses are often many times above the lethal limits, but because they are delivered to a small part of the body and spaced out, the radiation can kill the cancer, whilst saving the patient’s life.

4. Internal radiotherapy

In some cases, the most effective way to treat cancers is to irradiate the tumours from within. This can be done in several ways, such as taking iodine pills to treat thyroid cancers, the same type of iodine which caused some 6500 thyroid cancers after Chernobyl. Another widely used internal treatment is brachytherapy – don’t Google it – where a large number of small radioactive rods are used to treat e.g. prostate cancer. These rods deliver a high radiation dose over a few months, killing the cancer cells before the radioactivity naturally reduces and vanishes. Despite my warning, I am sure many are already searching for images - don’t tell me I didn’t warn you…!

Treating cancer with the knife, radiation…or chemo?

Cancer is, unfortunately, very much a part of the human experience. Most of us will one day make an acquaintance with this disease which in many ways hold a unique place in our cultures. As children, we’re taught that finding lumps or many bruises somewhere could be a sign that this malicious disease has found a foothold in our body.

Once confirmed, there are a number of ways to try and fight the cancer, such as surgery, radiation therapy and chemotherapy. Which option, or combination of options, are used depends on the cancer type. The most commonly used is chemotherapy, where different drugs are used to kill fast-diving cells – cancerous and normal – which often kills more healthy cells than cancer cells as it targets the whole body, resulting in hair loss and other nasty side effects. Radiation therapy, on the other hand, is much more targeted and have generally less severe side effects.

It is important, however, that we remember that each cancer diagnosis is unique, and that the decision of whether or not use radiation should depend entirely on the clinical picture, rather than any fear of radiation.

- John Lindberg