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I just came across this item that was originally
published in 1987, in the American Physical Society's newsletter, Physics and
Society. Has the situation improved over the past 13 years?
In this article, the LNT model was used to evaluate the
hazards of nuclear power. Now that the LNT model is largely discredited as
a means of calculating the actual number of cancer fatalities from low radiation
doses (not to mention the apparent beneficial effects) what can we say
about our on-going efforts to improve nuclear safety?
How many decades more must we wait before we declare
nuclear energy to be safe? (Is it really the media that's sustaining
the concern?)
J. Cuttler
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REDUCING THE HAZARDS OF NUCLEAR POWER: INSANITY IN ACTION Bernard L. Cohen, University of Pittsburgh How much money are we willing to spend to save a life?
Some might say "Sky's the limit," but we don't act that way. We don't spend
unlimited amounts on fire protection, highway and motor vehicle safety, health
care, non-smoking campaigns, etc…, although it is a simple calculation to
convert such expenditure into a cost per life saved. In this paper we consider
the question of how much our society is willing to spend to save a life in
various contexts.
There are numerous opportunities for highly cost-effective
life saving in under-developed countries. The World Health Organization (WHO)
estimates1 that over 5 million childhood deaths could be averted each
year at a cost ranging from $50 per life saved from measles in Gambia and
Cameroon to $210 per life saved by a combination of immunizations in Indonesia.
These costs are for complete programs including providing qualified doctors and
nurses, medical supplies, transportation, communication, etc. WHO also
estimates1 that about 3 million childhood deaths each year could be
averted by oral rehydration therapy (ORT) for diarrhea. This consists of feeding
a definite mixture of NaCl, KCl, NaHCO2 and glucose with water on a
definite schedule. The cost per life saved by complete programs range from $150
in Honduras to $500 in Egypt.
Other low cost approaches to life saving in the "Third
World" include malaria control ($550/life saved), improved health care ($1930),
improved water sanitation ($4030) and nutrition supplement to basic diets
($5300).
But charity begins at home. We next consider two fertile
areas for relatively cost-effective life saving in the U.S.. Table 1 lists the
cost per life saved by cancer screening programs,2 including many
situations where it is under $100.000. For example, only about 50% of sexually
active American women get PAP tests for cervical cancer. In a few localities,
there have been active programs, utilizing mail, telephone, and personal visits
that have increased this fraction to over 90%. The cost of these
programs2 is about $50.000 per life saved.
Table 1. Cost per life saved for cancer screening and
medical care programs in the United States. Costs are from Ref. 2, but
since they are given there in 1975 dollars, they have been doubled.
Item
$/life saved
Cervical cancer screening
50,000
Breast cancer screening
160,000
Lung cancer
screening
140,000
Colo-rectal cancer
Fecal blood
tests
20,000
Protoscopic
exams
60,000
Multiple
screening
52,000
Hypertension control
150,000
Kidney
dialysis
400,000
Mobile intensive care units in smaller
towns 120,000
As another example,2 a textile mill in North
Carolina started a program of multiple cancer screening tests for their
employees. After several years, they added up the cost of program and the number
of lives saved by early detection; dividing these gave $26,000 per life saved,
or corrected for inflation, the $52,000 per life saved in Table 1.
Another fertile areas is highway safety. Table 2 lists
some measures covered in the 1984 Annual Report of the U.S. Department of
Transportation, including the number of lives saved per year and the cost per
life saved. Since these measures typically have a service life of about 10
years, these measures taken in a single year will eventually save several
thousand lives at a cost of approximately $150,000 per life saved.
Table 2. Evaluation of recent projects undertaken to
improve highway safety. From U.S. Department of Transportation, "The 1984 Annual
Report on Highway Safety Improvement Programs", April 1984. We assume 1.1 deaths
per fatal accident.
Improvements
Lives saved
$ per life saved
per year
Improved traffic signs
79 $
31,000
Improved lighting
13 80,000
Upgrade guard
rails
119
101,000
Breakaway sign
supports 2
125,000
Obstacle
removal
8
160,000
Median barrier
28
163,000
Impact attenuators
6
167,000
Median strip
11
181,000
Bridge-guard rail
transition 3
260,000
Channels; turn
lanes
75
290,000
New flashing lights at
railroad 11
295,000
Permanent
grooving
6
320,000
With this background, let us consider the price we are
paying to save lives from radiation in the nuclear industry. Documents from the
Department of Energy (DOE) give the cost per life saved in radioactive waste
management activities as $300 million in the Savannah River Plant2
and $270 million at West Valley, New York3. But more important is our
commercial high level waste management program which is supported by a 0.1
cent/kWh tax on nuclear electricity, or $8.8 million/GWe-yr
(GWe=gigawatt-electric). It is estimated that random burial with simple
precautions would eventually cause 0.02 deaths/GWe-yr 4. If half of
the cost of the present program is to avert these deaths, the cost per life
saved is $4.4x106/0.05 = $220 million, similar to the Savannah River
and West Valley expenditures.
There are some strange aspects to these large waste
management expenditures. In the first place, the lives saved are those of people
living many thousands of years in the future, who bear no closer relationship to
us than those now living in under-developed countries whose lives we disdain to
save at one-millionth of these costs. In the second place, there is an excellent
chance that a cure for cancer will be found in the next few thousand years, in
which case these deaths will never materialize and the money will be wasted. In
the third place, if only a tiny fraction of this money were invested even at
minimal interest, it could provide enormous benefits to these future potential
victims, including the saving of tremendous numbers of lives. Equivalents of
such an investment are spending the money on biomedical research, or simply
using it to reduce the national debt and thereby making more money available to
later generations to spend on themselves.
With any reasonable consideration of these matters, we are
spending the equivalent of innumerable billions of dollars per life saved in our
radioactive waste management programs.
As another example from the nuclear industry, consider
reactor safety. Since the mid-1970’s, the Nuclear Regulatory Commission (NRC)
has been tightening regulations to reduce the risks of reactor accidents. This
program of "regulatory ratcheting" has increased the cost of a nuclear power
plant by a factor of 4-5 over and above inflation, an increased cost per plant
of well over $2 billion. How many lives does NRC hope to save at this cost?
According to its own studies5, plants built prior to this regulatory
ratcheting could be expected to cause an average of 0.8 deaths over their
operating life. Thus, according to their own calculations, NRC is knowingly
spending $2 billion/0.8 = $2.5 billion per life saved.
An ironic aspect of these NRC reactor safety-upgrading
activities is that the cost increases they have caused have forced utilities to
build coal burning power plants instead of nuclear plants. A typical
estimate5 is that the air pollution from 1 GWe of coal burning plants
kills 25 people per year, or about 1000 people over its operating lifetime.
Considering the fact that the nuclear plant is expected to kill 0.8 according to
NRC5 (or 100 according to the anti-nuclear activist organization,
Union of Concerned Scientists7), that means that every time a coal
burning plant is built instead of a nuclear plant, something like 1000 extra
people are condemned to an early death.
As a result of this NRC program of regulatory ratcheting,
about 100 GWe of coal burning plants will eventually be built instead of nuclear
plants, causing about 100,000 needless deaths. The 60+ nuclear plants in the USA
that will eventually be completed have cost an average of at least $1.6 billion
extra each, for a total cost of 100 billion in an effort to save these 60x0.8 =
50 lives. If this money were spent, instead, on cancer screening and highway
safety measures, it could have saved something approaching a million
lives.
There are additional indirect consequences of this NRC
regulatory ratcheting. Essentially the same nuclear power plant costs about 2
1/2 times as much in the United States as in France and since projected costs
for coal-burning electricity and nuclear electricity in the United States are
about equal, this means that electricity will probably be twice as expensive in
the United States as in Western Europe and Japan. This puts a direct bite on our
standard of living. But more important, many economists believe that a large
part of the reason for past U.S. economic success has been our relatively low
cost of energy, so it is not unlikely that the reversal of that advantage will
contribute substantially to our unemployment problems. It is
estimated8 that a 1% increase in unemployment in the United States
causes an extra 37,000 deaths per year, including about 20,000 from
cardiovascular failures, 900 suicides, 650 homicides, and 500 deaths from
alcohol-related cirrhosis of the liver. In addition to the deaths, it causes
4200 admissions to mental hospitals, and 3300 admissions to state
prisons.
Returning to our principal theme, we see that our society
is spending $2x109/life saved from nuclear hazards while it could
save a life for each $2x105 spent on cancer screening or highway
safety. This policy is clearly causing the needless loss of thousands of lives
and the waste of billions of dollars every year. Why is this insanity taking
place? It's easy to find out. Just ask the government officials who make these
decisions. They tell you that the primary responsibility of a government
official is to be responsive to public concern. In a democracy, that is the way
it should be. We want our government to be responsive to our concerns. The
problem is that public concern is driven by media coverage rather than by
rational scientific analysis. The media have driven the public insane over the
fear of radiation and of nuclear power accidents.
Why do the media do this? They are basically in the
entertainment business. One point in the Nielsen rating for network evening news
brings $11 million per year in increased advertising revenue. They must
therefore do everything possible to attract an audience, and discussing hazards
is much more useful for that purpose than discussing good, smooth, routine
operation.
The entire problem can be viewed as one of natural
selection, survival of those who adapt best to their environment. A TV producer
who would value presenting problems in the proper perspective rather than
emphasizing dangers to attract an audience would not survive, and a government
official who would value doing what is right rather than being responsive to
public concern would not survive. Laws of natural selection are hard to beat.
But when the results lead to the needless deaths of many thousands of Americans
every year, and to the impoverishment of our nation, we must do everything we
can to try to beat them.
Bernard L. Cohen, Pittsburgh University, USA
http://www.phyast.pitt.edu/faculty/cohen.htm
____________________________________________________
SOURCE: This article was initially published by "Physics
and Society", Vol. 16, N° 3, July 1987.
Available on the Internet:
http://www.ecolo.org/DOCS.WORD/cost_of_lives_saved.eng.doc
French translation by Michel Noraz/EFN, 1999:
http://www.ecolo.org/DOCS.WORD/cout_des_vies_sauvees.fr.doc
REFERENCES AND NOTES Physics and Society, Vol. 16, N° 3,
July 1987
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