Appendix A

Dissenting Opinion from the Human Health Committee Report of the ACERP

Jane M. Orient, M.D.

The ACERP report contains much useful data and some important observations. However, this member of the Committee disagrees with the fundamental methodology.

The report does make note of some very serious risks, but as an aside. The final ranking focuses on risks that in everyday language would be called "small," "insignificant," "trivial," "minuscule," or "unproved."

The number of deaths or cancers is calculated, in most cases. That is, the number is hypothetical, not real. The report should clearly state that the calculation gives an upper limit that is deliberately overstated, often by several orders of magnitude. A more correct table would give ranges, say from 0 to 200 deaths, with a note that the most probable number is, in most instances, at the low end of the scale if not actually zero.

The cancer calculations are based on a controversial assumption, which I believe to be incorrect: the no-threshold linear hypothesis. This is the equivalent of saying that if 100% of people die from falling from a height of 100 feet, then 1/100 as many (1%) will die from falling from a height of 1 foot. By this method, one can show that people are at higher risk of dying from an asteroid impact than from most of the items on our list. Asteroids, however, are not in the set of "environmental" issues. The definition of "environmental" was not determined by the Committee; I believe it was dictated by regulatory concerns.

A few of the numbers that the Committee considered are actual deaths from a proved cause: for example, microorganisms. In this instance, the committee deviated from its convention of using an upper limit. In fact, under some scenarios, the upper limit for victims of epidemic disease would be extremely high, perhaps the entire population.

My chapter on microorganisms and allergens was deleted from the final report, even though no one refuted my contention that these are numerically far more significant than the risks that were included. This chapter challenged the Committee's operating assumptions and attempted to place risks in perspective. I believe it was omitted for political reasons.

Another high risk that was defined to be outside the scope of our Committee was the human cost of misdirected regulation. For example, the Committee considered the potential risk of chemicals seeping into the water table from leaking underground storage tanks, but refused to consider the tradeoff (fires and explosions from aboveground fuel tanks or traumatic deaths due to making huge excavations for "clean-up"). The idea that regulators should do risk/benefit and cost/benefit analysis is, of course, an explosive one that is now being debated in Congress.

On the whole, this report accomplishes what appears to me to be its purpose: to place an expert Committee imprimatur on a regulatory agenda, much of which was predetermined. Those who are spending taxpayer dollars on a toll-free "SOS- RADON" line can point to our report for justification. (The report - at least in its draft form - gives an incorrect definition for "hormesis" rather than stating that household levels of radon may actually have a protective effect even though very high levels cause lung cancer.)

The Committee deserves commendation for placing some caveats, albeit diluted ones, in the Executive Summary. However, I object to the deletion of the referenced elaboration on those caveats that I prepared in my report.

As I see it, an account of many months of work must be viewed as incomplete when it excludes the minority report, either on the individual issues or the overall direction of the project. It should be viewed as the work of those who signed off on the components, with acknowledgment of the input from those who did not.