The Fallout Hypothesis of lung cancer re-appeared in the comments yesterday, provoking an interesting discussion. The idea, in part, was that men got lung cancer more often than women because men spent more time outdoors under a rain of radioactive fallout than women.
Barry asked a good question about children:
Kids were generally much more engaged in outdoor activities than adults were – romping around and such.
I guess it depends what kind of childhood you had. I spent a lot (far too much) of my childhood sitting in classrooms being taught geography. And we really mostly only went outside when we were forced to play compulsory games like rugby or soccer or cricket – something that’s left me with a lifetime dislike of compulsory games. And also England is quite a cold country for much of the year, and it’s only really nice outside in summer. So while I can remember playing outside a lot in summer, I don’t remember playing outside very much in winter. So I imagine that kids spend more time outside in warm countries than they do in cold ones. So more children got lung cancer in the tropics?
Also back in the 1950s and 60s there were women called “housewives”. You can see one in my picture above. And housewives are a vanished species nowadays. Lots of women now have jobs no different than men. So if the fallout hypothesis has any substance, you’d expect to see female lung cancer rates rising to the same levels as male ones. And I believe they have been.
Another thing about the fallout hypothesis is that most of the atmospheric testing was done in the northern hemisphere, in Nevada in the USA, or in Russia. Even Bikini Atoll is 11º north of the equator. And I get the impression (perhaps false) that the northern hemisphere is a bit disconnected from the southern hemisphere, and so I’d expect to have seen much more lung cancer in the northern hemisphere where the tests were carried out.
That said, the French nuclear tests, many on Moruroa atoll (22º south), were in the southern hemisphere. There were 210 tests, 50 of them in the atmosphere, between about 1960 and 1996.
I think the fallout hypothesis is about the best explanation for the surge in lung cancer during the 20th century, bearing in mind that radioactive materials like radium first made their appearances circa 1900, and were initially treated as being harmless (you could buy radium soap, and my first wristwatch in the 1950s had very bright hands and numbers of a kind you never see today). There are lots of other hypotheses, of course: diesel engine exhausts, HPV.
So why are we always being told that Smoking (and only smoking) Causes Lung Cancer? Probably because if it came to be believed that it was actually radioactive fallout that caused these cancers, the governments responsible might have been forced to pay out enormous damages to millions of people. To prevent that from happening, it became necessary circa 1950 for governments to place the blame on something else, and keep the blame there for the next 100 years or more. And the chosen scapegoat was the recently-invented and newly-popularised cigarette: smokers were killing themselves, and they were also killing everyone around them. Governments were off the hook.
One consequence of this has been the rise of lifestyle medicine as practised by Public Health. For if you’re not killing yourself by smoking, then you’re probably killing yourself by drinking, or eating meat or fat or sugar or salt, or not getting enough exercise. These days, if you get sick and die, you have only yourself to blame. And while people can be blamed for their own sickness and death, it means that nobody else will get blamed. And everyone else can carry on exactly as they like, because they’ll never get blamed for anything.
In fact, I expect to see people being blamed for getting sick with diseases like malaria, whose causes are perfectly well understood, and have nothing to do with lifestyle. If we get malaria, we’ll be told that it’s our own fault for having visited countries in which malaria is endemic. And when we protest that we’ve never been to those countries, then we’ll be told that somebody we knew must have visited one, and it’s our fault for having disreputable friends like that.
The whole aim of Public Health is to remove blame for sickness and disease from governments, manufacturers, doctors, and other organisations, and instead load it entirely onto the ordinary people who get sick with one disease or other. And that’s why they get government and industry funding: they’re helping to protect them. And the more that government and industry are protected by Public Health, the less need they have to ensure that they do no harm, because they’ll never face the consequences in court.