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Radon and prostate cancer
1292
Ascabiol includes tetraethylthiuram monosulphide which produces effects similar to those of disulphide compounds used to induce aversion to alcohol.l However, such a side-effect of acaricides has seldom been reported.2,3 It implies substantial percutaneous absorption of the drug, poorly documented so far but probably attributable to its liposolubility. Therefore, despite the apparent low frequency of this adverse reaction, patients on such treatment should be routinely advised to abstain from alcohol for at least 48 h. Dermatology Clinic, Hôpital St Jacques, 25030 Besancon Cedex, France 1.
Reynolds JEF, ed. Martindale: the Pharmaceutical Press, 1989: 1352.
TABLE II-CORRELATIONS BETWEEN LYMPHOSARCOMA OR PROSTATE CANCER INCIDENCE AND RADON, CALCULATED MINIMUM DOSE, AND ESTIMATED RADON-ASSOCIATED ALPHA-ACTIVITY AT 20BqjmJ
D. BLANC PH. DEPREZ extra
pharmacopoeia.
29th ed. London:
2. Gold S. A skinful of alcohol. Lancet 1966; ii: 1417. 3. Plouvier B, Lemoine X, De Coninck, P, et al. Effet antabuse lors de l’application d’un topique à base de monosulfirame. Nouv Presse Med 1982; 11: 3209.
Radon and prostate cancer SIR,-We have reported correlations (April 28, p 1008) between the international incidence of various cancers and radon levels in houses. In the light of the work by Gardner et all implicating occupational radiation exposure of fathers with cancer incidence in their children, we have applied the population-averaged radon values from the fourteen countries used previously to cancers of the reproductive system. The correlations are greater for male than for female organs (table I). In particular cancer of the prostate gland correlates strongly with radon (figure). TABLE I-CORRELATION COEFFICIENTS FOR CANCERS OF THE REPRODUCTIVE SYSTEM AND POPULATION-AVERAGED RADON EXPOSURE
Data from Cancer Incidence in FIve Continents Vol V except for * from vol III. t UK orily.
A no-threshold linear response model may be used to determine both the minimum alpha dose to the prostate and the minimum alpha activity, for an alpha-particle quality factor of 20. Despite the large errors in the analysis the predicted activity is much larger than would be expected from radon alone (table n). A possible interpretation is that high concentrations of radon daughters are present in the prostate. Although the alpha-activity in the prostate is unknown it is worth noting the similarity with a corresponding plot of lymphosarcoma
Cancer data from Cancer Incidents in FIve Continents vol V; countries with less than 10 cases omitted.
incidence and radon concentration. Lymphosarcoma correlates strongly with radon and the predicted alpha-activity to the critical cells is similar to that predicted for the prostate (table II). The average alpha-particle dose to the critical cells in lymphosarcoma induction is again unknown; however, work with natural long-lived alpha-emitters in tracheobronchial lymph nodes yields, by standard pathway calculations, 0- 19 mSv per year. Direct measurements in this laboratory3 indicated that activity was much greater, at 6-0 mSv annually. There seem to be very high doses from alpha-emitters in parts of the lymphatic system that are not predicted by model calculations-and long-lived alpha-emitting radionuclides may be present in the prostate in high concentrations also. If the mechanism implicated by Gardner et al is correct, naturally occurring alpha-emitters in the male reproductive organs could lead to the induction of natural childhood cancers. In radiation workers who receive internal contamination the nuclides may accumulate in the prostate. This would not be revealed by an external personal dose-meter. Workers at nuclear facilities do have high standardised mortality ratios for prostate cancer. 4-7 Accumulated radionuclides in the prostate could explain why a genetic effect is found in radiation workers but not in survivors of the Japanese atomic bombs, exposed to gamma and neutron radiation.8 H. H Wills Physics Laboratory, University of Bristol,
JONATHAN P. EATOUGH
Bristol BS8 1TL, UK
DENIS L. HENSHAW
1. Gardner MJ, Snee MP, Hall AJ, Powell CA, Downes S, Terrell JD. Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria. Br Med J 1990; 300: 423-34. 2. Committee on Medical Aspects of Radiation in the Environment (COMARE). Second report. London: HM Stationery Office, 1988. 3 Henshaw DL, Fews AP, Maharaj R, Shepherd L. Autopsy studies of the microdistribution of alpha-active nuclides in lung tissue Ann Occup Hyg 1988; 32: 1081-94. 4. Beral V, Inskip H, Fraser P, et al. Mortality of employees of the United Kingdom Atomic Energy Authonty, 1946-1979. Br Med J 1985; 29: 440-47. 5. Beral V, Fraser P, Carpenter L, Booth M, Brown A, Rose G. Mortality of employees at the Atomic Weapons Establishment Energy Authority, 1951-82. Br Med J 1988; 19: 757-70. 6. Smith PG, Douglas AJ. Mortality of workers at the Sellafield plant of British Nuclear Fuels. Br Med J 1986; 293: 845-52. 7. Checkoway H, Matthew RM, Shy CM, et al. Radiation, work experience, and cause specific mortality among workers at an energy research laboratory. Br J Ind Med 1985; 42: 525-33 8. Ishimaru T, Ishimaru M, Mikami M. Leukaemia incidence among individuals exposed m utero, children of atomic bomb survivors and their controls, Hiroshima and Nagasaki, 1945-79. Hiroshima: Radiation Effects Research Foundation, 1981.
CORRECTION
Incidence (per 100 000 per year).
Effects of coronary risk reduction on mortality.-In this letter by Dr N. Spritz (April 14, p 923) the end of the first paragraph should have read "... predict substantial decreases in deaths from all causes for men in whom cholesterol concentrations are lowered by 10 or 20%. This extrapolation is not supported by data from interventional studies in which cholesterol lowering has been achieved and in which a favourable effect on mortality has not been demonstrated". The last sentence of the third paragraph was omitted and should have read, "This, at least, indicates that the decision to include no time-lag between cholesterol lowering and diminished mortality is incorrect, and that at neither 5 nor 10 years after cholesterol lowering could improvement in overall mortality be predicted".
Ascabiol includes tetraethylthiuram monosulphide which produces effects similar to those of disulphide compounds used to induce aversion to alcohol.l However, such a side-effect of acaricides has seldom been reported.2,3 It implies substantial percutaneous absorption of the drug, poorly documented so far but probably attributable to its liposolubility. Therefore, despite the apparent low frequency of this adverse reaction, patients on such treatment should be routinely advised to abstain from alcohol for at least 48 h. Dermatology Clinic, Hôpital St Jacques, 25030 Besancon Cedex, France 1.
Reynolds JEF, ed. Martindale: the Pharmaceutical Press, 1989: 1352.
TABLE II-CORRELATIONS BETWEEN LYMPHOSARCOMA OR PROSTATE CANCER INCIDENCE AND RADON, CALCULATED MINIMUM DOSE, AND ESTIMATED RADON-ASSOCIATED ALPHA-ACTIVITY AT 20BqjmJ
D. BLANC PH. DEPREZ extra
pharmacopoeia.
29th ed. London:
2. Gold S. A skinful of alcohol. Lancet 1966; ii: 1417. 3. Plouvier B, Lemoine X, De Coninck, P, et al. Effet antabuse lors de l’application d’un topique à base de monosulfirame. Nouv Presse Med 1982; 11: 3209.
Radon and prostate cancer SIR,-We have reported correlations (April 28, p 1008) between the international incidence of various cancers and radon levels in houses. In the light of the work by Gardner et all implicating occupational radiation exposure of fathers with cancer incidence in their children, we have applied the population-averaged radon values from the fourteen countries used previously to cancers of the reproductive system. The correlations are greater for male than for female organs (table I). In particular cancer of the prostate gland correlates strongly with radon (figure). TABLE I-CORRELATION COEFFICIENTS FOR CANCERS OF THE REPRODUCTIVE SYSTEM AND POPULATION-AVERAGED RADON EXPOSURE
Data from Cancer Incidence in FIve Continents Vol V except for * from vol III. t UK orily.
A no-threshold linear response model may be used to determine both the minimum alpha dose to the prostate and the minimum alpha activity, for an alpha-particle quality factor of 20. Despite the large errors in the analysis the predicted activity is much larger than would be expected from radon alone (table n). A possible interpretation is that high concentrations of radon daughters are present in the prostate. Although the alpha-activity in the prostate is unknown it is worth noting the similarity with a corresponding plot of lymphosarcoma
Cancer data from Cancer Incidents in FIve Continents vol V; countries with less than 10 cases omitted.
incidence and radon concentration. Lymphosarcoma correlates strongly with radon and the predicted alpha-activity to the critical cells is similar to that predicted for the prostate (table II). The average alpha-particle dose to the critical cells in lymphosarcoma induction is again unknown; however, work with natural long-lived alpha-emitters in tracheobronchial lymph nodes yields, by standard pathway calculations, 0- 19 mSv per year. Direct measurements in this laboratory3 indicated that activity was much greater, at 6-0 mSv annually. There seem to be very high doses from alpha-emitters in parts of the lymphatic system that are not predicted by model calculations-and long-lived alpha-emitting radionuclides may be present in the prostate in high concentrations also. If the mechanism implicated by Gardner et al is correct, naturally occurring alpha-emitters in the male reproductive organs could lead to the induction of natural childhood cancers. In radiation workers who receive internal contamination the nuclides may accumulate in the prostate. This would not be revealed by an external personal dose-meter. Workers at nuclear facilities do have high standardised mortality ratios for prostate cancer. 4-7 Accumulated radionuclides in the prostate could explain why a genetic effect is found in radiation workers but not in survivors of the Japanese atomic bombs, exposed to gamma and neutron radiation.8 H. H Wills Physics Laboratory, University of Bristol,
JONATHAN P. EATOUGH
Bristol BS8 1TL, UK
DENIS L. HENSHAW
1. Gardner MJ, Snee MP, Hall AJ, Powell CA, Downes S, Terrell JD. Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria. Br Med J 1990; 300: 423-34. 2. Committee on Medical Aspects of Radiation in the Environment (COMARE). Second report. London: HM Stationery Office, 1988. 3 Henshaw DL, Fews AP, Maharaj R, Shepherd L. Autopsy studies of the microdistribution of alpha-active nuclides in lung tissue Ann Occup Hyg 1988; 32: 1081-94. 4. Beral V, Inskip H, Fraser P, et al. Mortality of employees of the United Kingdom Atomic Energy Authonty, 1946-1979. Br Med J 1985; 29: 440-47. 5. Beral V, Fraser P, Carpenter L, Booth M, Brown A, Rose G. Mortality of employees at the Atomic Weapons Establishment Energy Authority, 1951-82. Br Med J 1988; 19: 757-70. 6. Smith PG, Douglas AJ. Mortality of workers at the Sellafield plant of British Nuclear Fuels. Br Med J 1986; 293: 845-52. 7. Checkoway H, Matthew RM, Shy CM, et al. Radiation, work experience, and cause specific mortality among workers at an energy research laboratory. Br J Ind Med 1985; 42: 525-33 8. Ishimaru T, Ishimaru M, Mikami M. Leukaemia incidence among individuals exposed m utero, children of atomic bomb survivors and their controls, Hiroshima and Nagasaki, 1945-79. Hiroshima: Radiation Effects Research Foundation, 1981.
CORRECTION
Incidence (per 100 000 per year).
Effects of coronary risk reduction on mortality.-In this letter by Dr N. Spritz (April 14, p 923) the end of the first paragraph should have read "... predict substantial decreases in deaths from all causes for men in whom cholesterol concentrations are lowered by 10 or 20%. This extrapolation is not supported by data from interventional studies in which cholesterol lowering has been achieved and in which a favourable effect on mortality has not been demonstrated". The last sentence of the third paragraph was omitted and should have read, "This, at least, indicates that the decision to include no time-lag between cholesterol lowering and diminished mortality is incorrect, and that at neither 5 nor 10 years after cholesterol lowering could improvement in overall mortality be predicted".