WEST VIRGINIA UNIVERSITY
			   SCHOOL OF MEDICINE


TO:	  Duncan Thomas, Ph.D.

FROM:     Alan Ducatman, MD

DATE:	  February 22, 1995


	I am sorry I could not respond earlier to the R. Neuman memo of
Aug 1994 to F. W. Webster which you faxed earlier.  Our funded mission
needed urgent attention.  Here are my comments.

	First, I agree emphatically with Dr. Neumann that there is no
convincing evidence of excess cancer in the exposed population.  There
is also no good evidence for the null hypothesis.  To be really clear,
there is just no good study at this dose.  That is why we do studies,
especially at physiological plausible exposure levels such as this one.

	Second, I think it a bit irrelevant to expend effort shooting
down Stu Farber's strawmen.  It must be clear by now that Stu is not
an epidemiologist.  The issue here whether or why Stu thinks the 
Sandler study is definitive, for example.  The issue is whether there
are interesting and unanswered questions raised by available scanty 
data, including the Sandler study.

	The discussion of more people versus larger dose (Part B.
paragraph 2) is buffling in the context of not wanting to do a 
study.  Does a population study of 250:  at a third of the relevant
dose provide an answer?  More importantly, a study of >50,000 at
the dose of interest would be enough.

	There is some obfuscation concerning cancer excess. 
Meninpomas are among the excess cancers now reported in A bomb
survivors.  I am not an expert in these data, and do not know what
other head/neck outcomes may be important in Japan.  This is not
really the issue, however.  The mode and size of local exposure
dose is not exactly parallel in the comparison between A bomb
survivors and nasopharyngeal radium patients.  I am afraid that 
this is yet another issue where the focus on Faber statements has
got in the way of sound population [ILLEGIBLE) design thinking.


	The penultimate paragraph in the memo states that basic
effects of radiation on human subjects were well understood in 
the 1940's.  I leave the significance of this belief to you, but
suggest that wide distribution of this statement would be
inappropriate for your needs.

	Finally, I agree emphatically with Neumann's conclusion 
that Faber's projections are naive.  (After Farber made them in 
the Senate hearing.  I corrected the impression immediately.
This is recorded on C-Span).  None of this detracts from the 
clear need for a study, which is the essential point about which
Farber is right.  I suspect and hope that support for a study is 
the point of Neuman's memo to E. W. Webster.


	 Institute of Occupational and Environmental Health