Public Perception of Radiation: The Leading Issue in Health Physics Today

Kenneth L. Mossman, Ph.D. Department of Radiation Medicine Georgetown University Medical Center

EDITORS NOTE: This article appears here as an encore presentation, due to the considerable interest this topic has garnered recently. In readying the article for reprint, I am struck by the timelessness of the pieceDr. Mossmans comments are as appropriate today as when they were first written in 1985!

ORIGINAL EDITORS NOTE: In the pages of Radiation Protection Management, we often take a myopic view of the health physics profession. We dont bury our heads in the sand, but we do tend to keep them down and focus only on the tasks at hand. Meanwhile, we may be oblivious to some important trends that are developing outside our little world of applied radiation protection. In this commentary, Dr. Mossman encourages us to look up for a moment and notice that those who are not part of our profession have some very real fears about nuclear power and radiation. When it comes to understanding radiation risks, we are in the minority - those who do not understand are the majority. I welcome Dr. Mossmans comments, and I encourage RPMs readers to take a moment to think about the full implications of what he has to say. The 1980s have provided and will continue to provide exciting challenges in health physics. The demand for health physicists continues to increase. The Atomic Industrial Forum

estimates that 1,000 to 2,000 new jobs will be created in health physics and related areas in nuclear power alone by 1991.[1] Radiological risk assessment and waste disposal are just two of many challenging practical problems for todays health physicists, and within the academic community, attracting outstanding students to the profession continues to be an issue of concern. However, in my opinion, the leading issue in health physics today is the perception of radiation risk by the general public. I think most health physicists would agree that radiation has a bad name. When the word radiation is mentioned, many people conjure up images of Hiroshima and Nagasaki, nuclear war, cancer, deformed children, etc. The public is confused about radiation and its risks. I suggest that health physicists should make a concerted effort to clarify the concepts of risk, to inform the public about the benefits and risks of radiation, and to dispel existing myths and misconceptions about radiation.

PUBLIC PERCEPTIONS OF RISK Perceptions of the severity of risk by ordinary people are usually quite different from the risks actually measured or calculated for many hazards and activities. Paul Slovic and his colleagues conducted a survey among various groups to determine how risks were perceived.[2] Individuals were asked to rank 30 activities in order of most hazardous to least hazardous. Analysis of the data indicated that how people perceive risks bears no relation to

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the actual hazards ranking of the activities. Further studies by Slovics group suggest that the following characteristics of risks influence the publics perception: voluntariness, controllability, degree of knowledge of the risk, catastrophic LJ potential, delay of conesquences, familiarity, tendency to kill rather than injure, threat to future generations, and number of people exposed.[2] Therefore, developing messages that incorporate discussions of these various factors, may reduce the riskiness of radiation as perceived by the public.

power plant.[5] The public is obviously poorly informed on this matter since such explosions are impossible. Myths and misconceptions about things nuclear also haunt the medical community. In a recent meeting, the Commission on Magnetic Resonance of the American College of Radiology suggested dropping the word nuclear from nuclear magnetic resonance imaging in order to dissociate this new, exciting modality from any negative connotations that might be associated with nuclear power plants and nuclear bombs.[6] Misconceptions about radiation continue to persist because of the massive media coverage afforded nuclear power, especially in the days and months following the Three Mile Island accident in 1979. The news media failed to convey some of the most basic facts the public needs in order to make informed judgments about it [nuclear power].[5] The Time magazine cover story of February 13, 1984, Nuclear Power - Bombing Out, is an example of the tendency of the press to use misleading sensationalism. The bombing out really referred to the financial difficulties of the nuclear industry, but the casual reader might erroneously associate nuclear bombs with nuclear power based on the headline.[5] Myths and misconceptions can create obstacles to appropriate behavior. Unwarranted fears and misunderstandings about radiation may prevent people from getting appropriate diagnostic tests or therapy, thus compromising their medical care. Misconceptions about the possibility of bomb-like explosions of nuclear power plants have a major influence on support for the nuclear option. Sixty percent of those members of the public that think an explosion is likely in a nuclear power plant oppose further development of such plants.[5] Among those aware that a nuclear explosion is impossible, 88% support nuclear power and 12% oppose it.[5]

MYTHS AND MISCONCEPTIONS ABOUT RADIATION Risk estimates by the public may be seriously distorted by judgmental limitations based on media coverage and misleading experiences and feedback. For instance, in a recent survey conducted by the Office of Cancer Communications of the National Cancer Institute, 64% of the population surveyed thought radiation was a significant cause of cancer in this country.[3] In fact, radiation is responsible for only a small portion of the cancer burden in the United States - about 1%of all cancer deaths may be attributable to radiation exposure.[4] The primary factors contributing to cancer are dietary habits and tobacco consumption, which together account for about 65% of all cancers.[4] One of the more obvious examples of myths and misconceptions about radiation occurs in the nuclear power industry. The nuclear bombings of Hiroshima and Nagasaki may have effectively ended World War II, but they have caused nothing but grief for the nuclear power industry. Anything labeled nuclear is automatically associated with atomic bombs. The majority of the public does not have a clear idea of the distinction between nuclear power plants and atomic bombs. . . and tends to view nuclear accidents as potential Hiroshima-like explosions.[5] Eighty-four percent of Americans think that an atomic bomb-like explosion is possible in a nuclear
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WHAT CAN WE DO? Obviously one way health physicists can reduce the publics confusion about radiation is to increase public knowledge. To do this we must: 1. define the concepts of risk in lay terms; 2. use a simple vocabulary to explain radiation, what it is, and what it is not; and 3. educate the public and the media about radiation and its benefits and risks. We need to inform the public about the progress we have made in understanding radiation, how it interacts with matter, and the impressive safety record of the various radiation technologies. For example, we should tell the public that we know quite a bit about radiation bioeffects, and, although we do not have all of the answers, certainly our level of knowledge about the bioeffects of low levels of radiation is far superior to our knowledge of the effects of other potentially harmful environmental agents. Health physicists need to help individuals obtain realistic perspectives on radiation risks, primarily by dispelling unwarranted fears. The use of comparative risk methodologies, that is, comparing radiation risks with risks of common, everyday activities, frequently can be useful in placing radiation risks in their proper perspective.[7] I believe that a public awareness program about radiation can work. The National Cancer Institute, through their Office of Cancer Communications, has already begun such a program to increase public knowledge and improve public attitudes about cancer. They have used television and radio commercials as well as pamphlets and other literature to inform the public about cancer and how individuals can reduce their risks for cancer. Perhaps the most important segment of the public that must be educated about radiation is the media. Unfortunately, during the Three Mile Island accident, media emphasis was directed primarily at our level of uncertainty about radiation effects, especially at low doses.
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This projected confusion and uncertainty only served to amplify the publics concerns and fears about radiation. To counteract this sort of misinformation, I think it is important that health physicists work together with media groups and others responsible for relaying information to the general public. In this way distortion of facts concerning radiation can be minimized. The Baltimore/Washington Chapter of the Health Physics Society has taken an active role in the public perception issue by holding workshops on communication skills for health physicists. Clearly, developing effective communication skills is an integral part of informing the public about the benefits and risks of radiation and dispelling existing myths and misconceptions. The Chapter successfully staged three work-shops during 1983-85, with the most recent one having been held during the 30th Annual Meeting of the Health Physics Society in Chicago this past May. These workshops emphasize speaking to the public, handling audience questions and critics, confronting hostility and misconceptions, and dealing with news reporters and TV interviewers.

CONCLUSION In dealing with the public, it is important to let people know that their concerns about radiation are shared by health physicists as well. Health physicists are not immune to radiation; film badges and thermoluminescent dosimeters do not protect us. Nuclear war concerns us as do the imprudent uses of radiation in medical and dental practices. Only in this way will we be able to earn the confidence and respect of society - an absolute must if we are to educate the public about radiation, its benefits, and its true risks.

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References 1. Atomic Industrial Forum, 1982. Working with the Atom - Careers for You. Washington, DC: Atomic Industrial Forum, Inc. 2. Slovic, P., 1980. Images of Disaster: Perception and Acceptance of Risks from Nuclear Power. Perceptions of Risk, Proceedings of the Fifteenth Annual Meeting [of the NCRP], held on March 1415, 1979. Washington, DC: National Council on Radiation Protection and Measurements. 3. National Institutes of Health, 1984. Cancer Prevention Awareness Survey, NIH Publication No. 84-2677. Bethesda, MD: U.S. Department of Health and Human Services. 4. Doll, R. and R. Peto, 1981. The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today. Journal of the National Cancer Institute, 66, 1191-1308. 5. Inglehart, R., 1984. The Fear of Living Dangerously: Public Attitudes Toward Nuclear Power. Public Opinion, 7, 41-44. 6. Meaney, T.F., 1984. Magnetic Resonance Without Nuclear. Radiology, 150, 277. 7. Mossman, K.L., 1982. Analysis of Risk in Computerized Tomography and Other Diagnostic Radiology Procedures. Computerized Radiology, 6, 251.
The Author Kenneth L. Mossman is Professor of Health Physics and Director, Office of Radiation Protection at Arizona State University in Tempe, Arizona. From 1990-1992 he served as Assistant Vice President for Research at Arizona State. During the period from 1973-1990, Dr. Mossman was on the faculty at Georgetown University in Washington, DC, and was Professor and Founding Chairman of the Department of Radiation Science in Georgetowns Graduate School from 1985-1990.

Dr. Mossman served as President of the Health Physics Society from 1993-1994. During his term in office, a science teachers workshop program to promote science education and a national public affairs program were initiated. Dr. Mossmans research interests include the biological effects of low-level radiation, radiation exposure in pregnancy, health effects of environmental radon, and radiation protection and public policy. Dr. Mossman has over 100 publications in the open literature, including six books and proceedings related to radiation health issues. He has presented testimony before the U.S. House of Representatives and the U.S. Senate. In 1984, Dr. Mossman was awarded the prestigious Elda Anderson Award from the Health Physics Society and in 1994 was elected a Fellow of the Society in recognition of outstanding contributions to the field of health physics. In 1995, he received the Marie Curie Gold Medal. From 1996-1998, Dr. Mossman served as a Sigma Xi Distinguished Lecturer. Dr. Mossman earned the BS in biology from Wayne State University. He was awarded the MS and PhD degrees from the University of Tennessee in radiation biology and the MEd degree in higher education administration from the University of Maryland. Dr. Mossman and his wife currently make their home in Scottsdale, Arizona. Office of Radiation Protection Arizona State University Tempe, Arizona 85287-3501 Phone: 602/965-6140 Fax: 602/965-6609

Editors Note: The preceding biographical information is current for Dr. Mossman; when the article was written, he was a member of the Georgetown University faculty.

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