Lauriston S. Taylor lecture: fifty years of scientific research: the importance of scholarship and the influence of politics and controversy.
Over the past 50 years our laboratory has performed and published many studies in the fields of teratology, radiation biology and radiation embryology. The early work took place when I was a research employee at the University of Rochester Manhattan Project in 1944 and where I had my introduction to embryology and genetics. Over the years our lab has provided consultations dealing with the risks of various environmental toxicant exposures during pregnancy. With the advent of the Internet, consulting has become more rapid and efficient. In the past year our pregnancy Web site of the Health Physics Society received approximately 154,000 hits, of which over a thousand contacts were still quite anxious after reading the Web site answers and requested a personal consultation. From this extensive experience we have learned that many physicians and other counselors are not prepared to counsel patients concerning radiation risks. Approximately 8% of the patient contacts who have consulted a professional have been provided with inaccurate information that would have resulted in an unnecessary interruption of a wanted pregnancy. There are five areas of radiation embryology that are considered to be controversial. 1) Can the fetus be harmed by ionizing radiation if the fetus is not directly exposed? 2) Is the production of mental retardation from radiation during pregnancy a threshold phenomenon? 3) Does fractionation and protraction of radiation decrease the magnitude of the reproductive and developmental risks? 4) Is there a period during pregnancy when radiation will result in an increased mortality but not an increase in malformations? 5) How sensitive is the fetus to the oncogenic effects of radiation? We utilize the scientific information obtained from studies in these five areas to counsel patients concerning pregnancy radiation risks. The willingness and persistence of scientists to debate the controversial aspects of this research and apply the best available scientific information to assist patients in turmoil about the risks of radiation to themselves and their offspring has saved thousand of lives and changed family histories.
Brent
Robert L
RL
Thomas Jefferson University, A.I. duPont Hospital for Children, PO Box 269, Room 308 R1A, Wilmington, DE 19899, USA. rbrent@nemours.org
D000016:Abnormalities, Radiation-Induced; D000818:Animals; D001921:Brain / Q000528:radiation effects; D003376:Counseling; D004307:Dose-Response Relationship, Radiation; D047108:Embryonic Development / Q000528:radiation effects; D005257:Fellowships and Scholarships; D005260:Female; D005333:Fetus / Q000528:radiation effects*; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D019055:No-Observed-Adverse-Effect Level; D011057:Politics; D011247:Pregnancy