Text

Motion for Submission,Under Commission Question 5,of Bl Cohen 830124 Testimony on Commission Question 1.ASLB Refused to Admit Testimony Under Question 1 But Testimony Is Relevant to Question 5.Certificate of Svc Encl
	ML20073C658
Person / Time
Site:	Indian Point
Issue date:	04/01/1983
From:	Brandenburg B, Morgan C; CONSOLIDATED EDISON CO. OF NEW YORK, INC., MORGAN ASSOCIATES, POWER AUTHORITY OF THE STATE OF NEW YORK (NEW YORK
To:	; Atomic Safety and Licensing Board Panel
References
	ISSUANCES-SP, NUDOCS 8304130249
	Download: ML20073C658 (31)
	v • d • e

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C ;g,,fn Ut!ITED STATES OF AMERICA 0

NUCLEAR REGULATORY COMMISSION e

ATOMIC SAFETY AtID LICENSIllG BOAR w

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Before Administrative Judges:

- I2,,O.*37 James P.

Gleason, Chairman Frederick J. Shon Dr. Oscar H. Paris

)

In the Matter of

)

CONSOLIDATED EDISON COMPANY

)

OF NEW YORK, INC. (Indian

)

Docket Nos. 50-247-SP Point, Unit No. 2)

)

50-286-SP

)

POWER AUTHORITY OF THE STATE

)

April 1, 1983 OF NEW YORK (Indian Point,

)

Uni t No. 3)

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)

LICENSEES' MOTION FOR SUBMISSION UNDER' COMMISSION QUESTION 5 OF " LICENSEES' TESTIMONY OF BERNARD L.

COHEN ON COMMISSION QUESTION 1"

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t ATTORNEYS FILING THIS DOCUMENT:

Brent L. Brandenburg Charles Morgan, Jr.

Paul F. Colarulli Joseph J.

Levin, Jr.

CONSOLIDATED EDISON COMPANY OF NEW YORK, INC.

MORGAN ASSOCIATES, CHARTERED 4 Irving Place 1899 L Street, N.W.

New York, New York 10003 Washington, D. C.

20036 (212) 460-4600 (202) 466-7000 8304130249 830401 gDRADOCK 05000247 M

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Consolidated Edison Company of New York, Inc.,

licensee of Indian Point, Unit No.

2, and the Power Authority of the State of New York, licensee of Indian Point, Unit No. 3

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hereby move for an order permitting submis-("the licensees")

sion under Commission Question 5 of " Licensees' Testimony of Bernard L. Cohen on Commission Question 1," dated and served January 24, 1983 (Attachment A), in light of developments under Commission Question 5.

Dr. Cohen's testimony concerns comparative risk be-tween nuclear and non-nuclear hazards by providing a frame of reference for the risks posed by the Indian Point plants.

The Board refused to admit it under Commission Que_stion 1 on the grounds that it was not applicable to that Question (tr.

p. 8476).

The testimony, however, is highly relevhnt to Commission Question 5.

1 Commission Question 1 addresses the r.isk posed by the Indian Point plants.

Commission Question 5 asks about the comparative risk of Indian Point.

A sub-issue under Commission Question 5 is NUREG-0880, containing preliminary safety goals for nuclear plants.

One such goal sets a cost /

benefit figure of S1,000 per person-rem averted.

This issue receives extended discussion in the Commission Staff's " Direct Testimony of Frank Rowsome and Roger Blond Concerning Commission Question 5," dated March 22, 1983.

Indeed, in Appendix 1 to their testimony (" Economic Evaluation of Projected Severe Accident Losses"), at p. 3, l L

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Rowsome and Blond explicitly reference an article by Dr.

Cohen entitled " Society's Valuation of Life Saving in Radiation Protection and Other Contexts," printed in 38(1) Health I

Physics 33-51 (January 1980) (Attachment B).

This is the same article upon which Dr. Cohen relies in Section V of his testi-mony, entitled " Spending Money to Reduce Risk."

Because Staff addressed precisely the. issue addressed in Dr. Cohen's testi-l mony, his insights are highly relevant in addressing the l

legitimate concern under Commission Question 5 of moneti-zation of health effect risk reduction.

Moreover, the intervenors themselves address the suf ficiency of the levels of safety af f orded by prBsent NRC regulatory requirements in "UCS/NYPIRG Testimony of Steven C.

Sholly on Commission Question Five," dated March 22, 1983,'see, l

e.g., pp. 25-28 (Attachment C).

In particular, the Sho11 testimony states that NRC safety goal standards "rbflect []

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a hiddenjudgmentthatreactorsingenerafarealreadyadequately safe."

(Id., p. 26) Dr. Cohen's testimony discusses just this topic.

4 The issues discussed in Dr. Cohen's testimony are thus relevant to Commission Question 5, and have been raised l

l by both the Staff and the intervenors under Commission Question 5.

Therefore, Dr. Cohen's testimony should be admitted in this proceeding.

Licensees believe that Dr. Cohen's testimony can be received during the remaining three weeks of hearings without prejudice or inconvenience to any party, and without l _ - -

i 6

affecting the Board's schedule for completion of this hear-ing.

Respectull'y submitted, bd $.. M la. C.C ' '

C O Nisonu, %.

c.

Brancenburg g Charles Morgan,OJr / g Brent L.

Paul F.

Colarulli Joseph J.

Levin, Jr.

CONSOLIDATED EDISON COMPANY MORGAN ASSOCIATES, CHARTERED OF NEW YORK, INC.

1899 L Street, N.W.

Licensee of Indian Point Washington, D.

C.

20036 Unit 2 (202) 466-7000 Irving Place New York, New York 10003 Stephen L. Baum (212) 460-4600 General Counsel -

Charles'M. Pratt Assistant General Counsel PONER -AUTHORITY OF THE STATE OF NEW YORK Licensee'of Indian _ Point' Unit 3 10 Columbus Cir_cle.

New York, New York 10019 (212) 397-6200 Bernard.D. Fischman Michael Curley Richard F.

Czaja David H.

Pikus SHEA & GOULD 330 Madison Avenue New York, New York 10017 (212) 370-8000 Dated:

April 1, 1983 ATTACHMENT A s

UNITED STATES OF AMERICA

'03 f"e,72 qq,.y7 NUCLEAR REGULATORY COMMISSION

. ATOMIC SAFETY AND LICENSING BOARD Before Administrative Judges:

James P. Gleason, Chairman Frederick J.

Shon Dr. Oscar H. Paris

)

In the Matter of

)

CONSOLIDATED EDISON COMPANY OF

)

Docket Nos.

NEW YORK, INC.

)

50-247 SP (Indian Point, Unit No. 2)

)

50-286 SP

)

POWER AUTHORITY OF THE STATE OF

)

NEW YORK

)

January 24, 1983

- (Indian Point, Unit No. 3)

)

l LICENSEES' TESTIMONY OF BERNARD L.

COHEN ON COMMISSION QUESTION 1 ATTORNEYS FILING THIS DOCUMENT: ~

Charles _ Morgan, Jr.

Paul F.

Colarulli Brent L. Brandenburg Joseph J.

Levin, Jr.

CCNSOLIDATED EDISON COMPANY -

MORGAN ASSOCIATES,' CHARTERED OF NEW YORK, INC.

1899 L Street, N.W.

4 Irving Place Washington, D.C.

20036 New York, New York 10003 (202) 466-7000 (212) 460-4600 A-1 r

N C1b & O

-l-

TABLE OF CONTENTS I.

Introduction.......................................

1 II.

A Catalog of Risks..................>..............

4 Table 1............................................

5 Figure 1...........................................

6 III. Risks of Nuclear Energy - In Perspective..........

11 IV.

Acceptability of Risks Posed by Indian Point......

14 v.

Spending Money to Reduce Risk.....................

16

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VI.

Conclusions.......................................

25 Table 2..............................'.............

27 l

Appendix..........................................

28

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References........................................

31 e

y pe 4

9 4

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r TESTIMONY ON RISK IN PERSPECTIVE I.

Introduction My name is Bernard L.

Cohen.

I am'atprofessor of phy-sics at the University of Pittsburgh, and have done research in the areas of nuclear physics as well as societal risks 1

and risk aversion.

A statement of my professional qualifi-cations is attached.

This testimony addresses Commission Question 1 in this proceeding which asks:

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What risk may be posed by serious acci -

dents at Indian Point 2 and 3, including accidents not considered.in the plants' design basisi pending and after any improvements described in (Commission Questions] (2) and (4)

.?

Thus, a principal objective of this proceeding is to deter-g mine the level of risk posed by the continued operation of Indian Point.

The licensees are simultaneously presenting testimony quantifying the risk using probabilistic risk assessment tools..

The meaning of the nwmbers' used to express risk pro,babilistically cah be difficult for some people to' understand.

The purpose of my testimony is to provide a frame of reference for the estimates of risk posed by Indian Point, as well as to assess the reasonableness, desirability and necessity of pursuing certain further efforts to reduce the already low risk of Indian Point as I

determined in companion testimony.

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One of the major reasons for public misunderstanding of

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the risk of Indian Point and other nuclear power plants is that the great majority of people do not* understand and quantify the risks we face.

Most of us think and act as though life should be largely free of risk.

We view taking risks as foolhardy, irrational, and assiduously to be avoided.

Training children to. avoid risk is. an all-impor-tant duty of parenthood.

Risks imposed on us by others are generally considered to be entirely unacceptable.

Unfortunately, everything we do involves risk (Ref.1).

There are dangers in every type of travel, but there are dangers in staying home -- 40 percent of all f atal accidents

' here are dangers in eating -- food occur there (Ref. 2).

T is probably the most important cause _cIf cancer and of sev-eral other diseases -- but most people e~at more than neces- -

sary.

There are dangers in breathing -- air p'olfution pro-

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bably kills many tens of thousands of kmericans each year,

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and many diseases are contracted by inhaling germs -- but hardly anyone uses filters to avoid them.

There.are dangers in working -- 12,000 Americans are killed each year in job-related accidents (Ref. 2), and probably 10 times that num-ber die from job-related illnesses (Ref. 3 ) -- but most alternatives to working are even more dangerous.

There are dangers in exercising and dangers in not getting enough exercise.

Risk is an unavoidable part of our everyday live s.

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i This does not mean that we should not try to minimize i

.our risks.

We cannot minimize our risks by simply avoiding i

l those we happen to think about.

For example, if one thinks jl about the risk of airplane travel, one might decide to go by 1

automobile instead -- an alternative which would be many times more dangerous.

The logical procedure for minimizing risks is to quantify all risks and then choose those which are smaller in preference to those which are larger.

The i

j main object of this ' testimony is to provide a framework-for that process and to apply it to nuclear power risks.

There are many ways of expressing quantified risk,.but i

here I will use just one:

the loss of life exnectancy i

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( LLE ), j.. e_., the average amount by 'which one's life is shortened by the risk under consideration.

For example, statistics indicate (Ref. 4) that an average 1 40-year-old.

d will live another 34.8 years, so if he takes a-risk having a 1

1 percent chance of immediate f atality ~(and a 99 percent chance of doing no harm), it causes an-LLE of.348 years.1 l

The methods for calculating LLE are discussed'in the Appen-t d ix.

Of course, most risks ire with.us to varying extents i

i at all ages, and the effects of these risks must be added up t

over a lifetime, which makes the calculations somewhat com-3 4

plex.

A computer program was developed to perform the cal-

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culations and to study extensively a wide variety of risks 1.

.348 years = (. 01 x 3 4. 8 ) + (.99 x 0 ).

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( Re f. 1 ).

Some of the results of this study are summarized in the next section, a listing of them is given in Table 1, and a graphical ~ representation is shown in Figure-1.

II.

A Cataloc of Risks (Ref.1)

A widely recognized risk is that of smoking cigarettes (Ref. 5).

A person who smokes one pack per day incurs an LLE of 6.4 years if a male and 2.3 years if female; in the former case this figure corresponds to an LLE of 10 minutes for each cigarette smoked.

For non-inhalers the lifetime risk from one pack per day is 4.5 years for men and 0.6 years for women, while_,for those who inhale deeply it is 8.6 years for men and 4.6 years for women._ Giving up. smoking reduces these risks; af ter 5 years th'e LLE is reduced by 1/3, and af ter 10 years it is more than cut in half.

C[ gar and pipe smoking do little harm if there is no inhalation, i

but with inhalation the LLE is 1.4 years for pipes and 3.2 years for cigars tor men.

I Another major risk over,which we have some' personal

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control is being overweight (Ref. 6) -- we lose about one' month of life expectancy for each pound our weight is above average.1 For example, the LLE for 30 pounds overweight is

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a 30 months or 2-1/2 years.

An assessment of the effect of 1.

Note that the average weight is not necessarily the optimum.

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Table 1.

Loss of Life Expectancies (LLE) 1 (From selected sources)

Activity or risk Davs LLE heart disease 2100 j

cigarettes (1 pack / day; male-female average) 1600 working as a coal miner 1100 980 cancer 1

30 lbs. overweight 900 stroke 520 450 l

15 lbs. overweight all accidents 435 400 Vietnam army duty t

living in southeastern U.S.

(SC,GA,AL,MS,LA) 350 i

mining or construction work (due to accidents only) 320 l

motor vehicle accidents 200 pneumonia, influenza 130 3

alcohol 130,

i homicide 90 74 j

occupational accidents (average) 50 small cars (vs. standard size) 40 drowning 40 speed limit 55 -> 65 mph

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39 i

falls 37 j

poison + suffocation + asphyxiation 27

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fire, burns

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- 12 4

radiation workerr age 18-65

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firearms 2

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diet drinks (one/ day throughout life).

all electric power in U.S. (nuclear) (UCS) 1 l

hurricanes, tornadoes 1

1 1

airline crashes 0.5, j

dam failures all electric power in U.S. ( nucle ar) (Govt. estimates) 0.03 0.006 spending lifetime near Indian Point 4

This number includes all Americans, even those who do not live near a nuclear power plant.

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over-eating shows that our weight increases by 7 pounds for every 100 calorie increase in average daily food intake (Ref. 7).

That is, if an overweight person changes nothing about his eating and exercise habits except for eating one extra slice of bread and butter (100 calories) each day, he will gain 7 pounds (gradually over a period of about one year) and his life expectancy will be reduced by 7 months.

This works out to a 15 minute LLE for each 100 extra calor-les eaten.

Any discussion of major risks must include the tradi-tional leader', disease, (Ref. 8) which caused life expec-

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tancy early in this century to be 20 years. less than at present.

Among individual maladies, heart disease with LLE-5.8 years, cancer with LLE-2.7 years, and stroke with LLE-1.1 years for men and 1.7 years for women are rated one, two,andthree,respectively,followedbypneubonaand influenza with LLE-4-1/2 months, and cirrhosis of the liver and diabetes with LLEs slightly over 3 months each, the former occurring'more in men and the latter occurring more in women by approximately 3 to 2 ratios.

The most highly publicized risks are those of being killed in accidents (Ref. 2), although the actual danger is well below that of the risks discussed above.

Th.e LLE from all accidents combined is 435 days (1.2 years).

Almost 1/2 involve motor vehicles which render an LLE of 207 days, 170 days while riding and 37 days as pedestrians.

Using small A-9

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cars rather than standard size cars increases one's LLE by 50 days, and changing from standard size to large cars re-e duces it by an equal amount.

Before the -national-speed lbnit was reduced from 65 to 55 miles per hour, the total LLE 'was 40 days higher.

On the average,-riding one mile in 3

an automobile and crossing a street each have an LLE of 0.4 minutes, making them as dangerous as one puff on a cigarette j

(assuming 25 puffs to a cigarette), or an overweight person eating 3 extra calories.

Accidental death rates vary greatly with geography (Ref. 9); they are 4 times higher in Wyoming than in New York State, the two extremes; the North _ east is generally the safest area while the Rocky Mountain region is generally the most dangerous.

We spend most of our time at home and at work, so that is where most of our non-travel-connect,ed accidents occur (Ref. 2).

The LLE for accidents in the home is 95 days, and for occupational accidents it is 74 days.

The latter number varies considerably frem industry to industry, from about 300 days in mining, quarrying and construction to 30 days in trade.

Nearly 1/2 of all workers are in manufacturing and service industries for which the LLE is 45 days.

Some showmanship activities are widely adver.tised as having very high accident potential, but judging from sta-tistical experience, these dangers are exaggerated in the public mind.

For example, (Ref. 10) professional aerialists l

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(tight-rope walkers, trapeze artists, aerial acrobats, and 1

high pole balancers) receive an LLE of 5 days per year of participation, or 100 days from a 20-year.. career.

.The risk is similar for automobile and motorcycle. racers of various j

sorts, so the risk of accidental death in these professions i

j is less than in ordinary mining and construction work.

The most dangerous profession involving thousands of partici-f pants is deep-sea diving with an LLE of 40 days per year of i

i participation.

In addition to accidents, occupational exposure causes many diseases which affect a worker's life span, and in most cases these are much more important than accidents.

Coal miners generally live three 3 years less than the average a

l man with the same socioeconomic status, and statistics are similarly unfavorable for truckers, fishermen, ship workers, steel erectors, riggers, actors and musicians (perhaps due J

to irregular hours), policemen, and firemen.

On the other hand, there are occupational groups in which men live 1 year or more longer than average for their socioeconomic stand-ing, like postal workers, government officials, university j

professors, and gardeners.

Clearly one's choice of occupat-

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tending it several years, t

The media have publici=ed the dangers of various indi-l vidual substances.

Coffee is believed to cause bladder l

cancer, with an LLE of 6 days for regular users (Ref. 11).

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i There is some evidence that saccharin may cause bladder a

cancer (Ref. 12); the LLE from one diet soft drink every day, j

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of one's life is 2 days, but the weight gain from-one extra non-diet sof t drink per day causes an LLE-of 200 days.

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j Birth control pills can cause phlebitis (Ref. 11) wnich 4

j gives their users an LLE of 5 days.

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Even very tiny risks of ten receive extensive public-i i

ity.

Perhaps the best example was the impending f all of the orbiting Sky-Lab, which gave us an LLE of.002 seconds (Ref.

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13).

The Three Mile Island nuclear power plant accident l

gave the average Harrisburg area resident an LLE of' l.5 minutes (.001 days).1 _The risk of'being struck by lightning i

(Ref. 15) gives us an LLE of 20 hours2.314815e-4 days <br />0.00556 hours <br />3.306878e-5 weeks <br />7.61e-6 months <br />.

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~~ Mass scale (Catastrophe) Risks one may think that large catastrophes pose an important threat to us, but this is hardly the case (Ref. 15).

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canes and tornadoes combined give the average.American an f

LLE of 1 day, as do airline grash.es.

Major fires and explo-

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sions (those with 8 or more fatalities) give us an LLE of 0.7 days, and our LLE from massive chemical releases is only i

0.1' day.

The LLE from being sent to Vietnam during the war l

1.

The r-'erage exposure to people in that area was 1.2 mrem (Re f. 14 ).

The LLE for 1 mrem of radiation exposure is 1.2 minutes (see Appendix).

Thus, the LLE for 1.2 mrem is (1.2 x 1.2) % 1.5 minutes.

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j was 2.0 years in the Marines, 1.1 years in the Army, 0.5 f

years in the Navy, and 0.28 years in the Air Force.

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Some people say that risks which kil-1 one person or a

't f ew people are not important, but only large catastrophes i

are worthy of consideration and must be avoided at all costs.

Media coverage is certai.nly focused upon catastro-phes or " potential" catastrophes.

Therefore, some people i

attribute great importance to the possibility of a reactor i

The meltdown accident.

This argument is highly distorted.

cancers from a hypothetical severe meltdown accident at Indian Point would increase the cancer rate of those exposed by.02 percent whereas _the national average cancer rate is 8

.approximately 20 percent.

Testimony presented in -this pro-i ceeding by licensees demonstrates that-the risk of_ an acci-dent at Indian Point increasingthiscancerrate}isvery small.

III.

Risks of Nuclear Enerev -- In Persoective With the benefit of the. perspective provid'ed' by quanti-fying the risk of day-to-day life, I now turn to Indian Point and other nuclear steam electric power plants and will evaluate them under the assumption that all the electricity now used in the United States were to be generated from nuclear power.

The calculations are simple and are explained in the Appendix, but here I will only quote the results.

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e The mortality risk of living near the Indian Point plants has recently been calculated to be 1.2 x 10~8/ year.1 This is equivalent to an LLE of 0.006 days (9 minutes) from spending a lifetime in that area.2 According to the Reactor Safety (Rasmussen) Study (WASH 1400) (NUREG-75/014), the risk of nuclear reactor accidents would reduce the life expectancy for the average American by

.012 days or 18 minutes,3 whereas the estimate based upon the Union of Concerned Scientists' (UCS') assess'ed risk is 1.5 days (Ref. 16).

Because our LLE from being killed in accidents. is now 435 days", it would be increased by.003 percent according to Ra,smussen, or by 0 3 percent according to UCS.

If the risks of a meltdown are 20 times those given

'in the Rasmussen Study, the LLE is (20 x 18 minutes) =6 hours, and the LLE from accidents is increased by-0.6 per-cent.

This makes nuclear accidents thousands of tbnes less dangerous than moving from the Northeast to the Wes t (where accident rates are much higher), an action taken in the last few decades by millions of Americans with littib considerat-1.

Draft testimony to be submitted by licensees under Commission Question 5, subject to confirmation.

8 x 10~3 The lifetime risk is 1.2 x 10~ /yr x 72 years = 8.6 The average victim loses about 20 years of life ex-pectancy (7300 days), so the average person loses (8.6 x 10-' x 7300) = 0.00 6 days or 9 minutes.

3.

See Appendix for an explanation of the derivation of these numbers.

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l ion given to the added risk.

Yet nuclear accidents are what.

I a great many people are worrying about.

If we compare these risks with some of those-listed in Table 1, we see that were all electricity in this country generated by nuclear power plants, under the assumption that meltdown risks are 20 t Lmes higher than those given by.

Rasmussen, nuclear power would present the same added health risk (UCS estimates in brackets) as a regular smoker indulg-ing in 1 extra cigarette every 9 months (every 3 months], or as an overweight person increasing his weight by.24 ounces

(.8 ounces), or as raising the U.S. highway speed limit from 55 miles per hour to 55.1 [55.4] miles._per hour, and it is 100 times (30 times] less of a danger _than -switching from standard size to small cars.

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Indian Point and nuclear power generally arej being opposed because they are viewed as being too risky, but the best way for the parties to this proceeding to understand a risk is to compare it with other risks with which they are familiar.

These comparis.ons, are.also -the best wa'y for mem-bers of the general public to understand the risks of nuclear power.

The comparisons set forth in this testimony are the all-important bottom line in. evaluating Commission Question 1 relating to the risk posed by the Indian Point plants.

These comparisons show that the risk of nuclear power plants in general, and Indian Point in particular, is A-15

_ 14 _

extremely small compared to the everyday risks to which the

.public is exposed.

IV.

Acceptability of Risks Posed by Indian Point The purpose of the discussion presented above is to '

make the risks of the Indian Point nuclear power plants understandable.

Risks'are best understood when compared to other risks with which we are familiar.

But, what is not generally discussed is the question of whether they are acceptable.

Acceptability includes factors other than the magnitude of risks.

For example, many-people are more -willing to accept voluntary risks like skiing, auto yacing, and m'untain o

c' limbing than i'nvoluntary risks, and ' ant _i-nuclear. activists are quick to point out that nudlear power pres,en(s an invol-untary risk to the public.

On the other hand, many other risks 'are involuntary, or at least have an important invol-a person's untary component.

In many if not most cases r occupation is determined more by. circumstances than by vol-untary choice.

Riding in automobiles is hardly voluntary for most people, as they have no other way to get to work, to purchase food, and to participate in other normal activi-ties of life; even if you avoid riding in automobiles, you are still subject to accidents to pedestrians which account for 20 percent of deaths from motor vehicle accidents.

Most other accidents are largely due to involuntary activities.

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Most drownings occur to children, but a parent cannot pre-vent his child from going swimming without risking psycho-i

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logical damage.

An appreciable fraction of drownings result i

from taking baths.

Deaths from fires, burns, f alls, poison-ings, suffocation, and asphyxiation are also not usually due I

to voluntary risk taking.

Some people are more willing to accept natural risks

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than man-made risks, but nearly all of the risks considered in this testimony are man-made.

Living with man-made risks

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is the price we pay for the benefits of civilization and, in a

my opinion, these benefits grossly outweigh the risks.

An appreciable number of early fatalities is expected I,

in less than 1 percent of all meltdowns' (Ref.15).

A comp-arable disaster has already occurred "from air poliQtion --

I an episode in London in 1952 in which there were}3500 extra There are d'm failure accidents deaths within a f ew days.

a (Ref. 15) which could kill 200,000 people within a few hours, and they are estimated to be far more. probable than a severe nuclear meltdown accident.

1 There are many potential causes of large loss of life l

anywhere large numbers of people congregate.

A collapse of the upper tier of a sports stadium, a fire in a crowded theater, and a poison gas entering the ventilation system of l

a large building (some buildings house 50,000 people) are a few examples.

The idea that a potential reactor meltdown 4

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f accident is uniquely or even unusually catastrophic is grossly erroneous.

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I have a deeper objecti.on to the idea that a.catas-trophic accident is more important than a. larger number of people dying unnoticeably.

In choosing between technologies on the basis of health impacts, the total number of deaths should be the overriding consideration.

Anyone who does not agree should attempt to explain to the survivors of the victims that their loved ones had to die because people consider only large catastrophes important.

I am=certain that their explanation would gain little accepta'nce.

^

What risks are' acceptable is not a scientific question; therefore, I as a scientist cannot claim expertise in th_is area.

I have merely presented the risks as they are, hope-

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fully in understandable terms.

If any citizen feelslthat the tens of billions of dollars worth of electricity pro-duced by nuclear power plants is not worth the risk of a regular smoker smoking 1 extra cigarette every 9 months, or of an overweight' person adding 1/4 ounce to his weight, or of raising the national speed limit from 55 to' 55.1 miles per hour, he is entitled to that opinion.

I do not share i t. -

V.

Soending Money to Reduce Risk (Ref. 17)

Another aspect of understanding risk is to consider what society is doing -- or deciding not to do -- to reduce A-18

j 1

l our risks.

It is unreasonable to spend a lot of money to reduce one risk, such as -attempting to reduce the risk at l

Indian Point through the retrofitting of a filtered vented 1

i containment system (FVCS) or some other device, if we can i

i reduce a greater risk much more cheaply but do not.

I respectfully submit that it would be inappropriate for this f

Board to recommend Indian Point retrofits unless the cost j

per fatality averted data (see below) available to the Board fully justifies such a course.

It may seem immoral and inhumane even to consider the 1

monetary cost of saving lives, but the fact is that a great many of our risks can be reduced by spending money.

A few 4

years ago, air bags were of fered as op.tional safety equip-1 i

i ment on several types of automobiles,' but they are no longer I

offeredbecausenotenoughpeoplewerewillingto] buy J

them.

They were proven to be effective and safe -- an esti-t mated 15,000 lives per year would be saved and the average j

American's life expectancy would be increased by 15 days if l

they were installed in all cars (Ref.18 ).

There is no i

disccmfort or inconvenience associated with them.

They have only one drawback -- they cost money.

Apparently Americans i

did not feel that it was worth the money to reduce their risk of being killed or injured in an automobile accident.

There is a long list of other automobile safety fea-4 1

tures we can buy -- premium tires, improved lights, and rear window de-icers., to name a f ew.

We can spend money on fre-k A-19 l

quent medical examinations, we can use only the best and most experienced doctors, we can buy elaborate fire protec-tion equipment for our homes, we can fly _and rent.a car at our destination rather than drive on long. trips, we can move i

1 to safer neighborhoods, the list is endless.

Each of these alternatives also costs money.

In this section we consider i

how much it costs to save a life by spending money in vari-ous ways.

In some cases, when personal effort and time are i

i also required, a reasonable monetary compensation will be added to the cost.

J j

For example, obtaining a Pap smear to test for cervical ~

i i

cancer requires making an appointment and spending a few minutes at the doctor's. office, but most women would be willing to do equivalent chores for a-payment of _5 dol-j lars.

A Pap test costs about 10 dollars, so we add the 5

~

dollars for time and effort and arrive at a total cost of 15 dollars.

Each annual Pap test has one. chance in 3,000 of saving a woman's life (Ref. 19) so for every 3,000 tests,

(

1 costing (3000 x 15 dollars) = 45,000 dollars, a life is saved.

The average cost per life saved is then 45,000 f

dollars.

The above example is taken fran' a study (Ref.17) com-1 pleted a few years ago in which all costs are given in 1975 i

dollars.

Other details of calculation are given in the j

Appendix, but here I will quote some of the other results of that study.

A-20

., l l

l There is in fact a compelling reason for risk-reducing decisionmaking to be guided by " cost of saving lives" think-ing: society's resources are only finite.-

Because unlimited sums cannot be spent on reducing risks in all areas, were we to spend money on risk-reducing measures unwisely from the standpoint of how effective they would be, other more needy and deserving alternatives will be passed over.

If there were a smoke alarm in every home, it is esti-mated that 2,000 fewer people would die each year in fires (Ref. 20).

Even with a generous allowance for costs of installation and maintenance', this works out to a life saved for every 60,000 dollars spent, but only 20 percent of Americae homes now have smoke alarms. _

~

on the other hand, a great many ' Americans purchase.

premium tires to avert the danger of blowouts.,

I* everyone d id, this would cost an aggregate of about 5 billion dollars per year and could avert nearly all of',the 1,800 fatalities per year which result from blowouts, a cost of nearly 3 mil-lion dollars per life saved., Many Americans buy larger cars than they need in order to achieve greater safety, although this decision costs approximately 6 million dollars per life saved (Ref. 17).

There are millions of Americans who purchased premium tires with their new cars but did not order air bags, even though the air bags are 10 times more cost-ef fective.

The problem is that the American consumer does not calculate A-21

c -.

cost-effectiveness.

His actions are governed by advertising i

campaigns, salesmanship, peer group pressures, and a host of other psychological and sociological factors.

i Measures could be taken to increase the percentages of l

women who receive annual Pap smears, this has been done in a I

f ew cities including Louisville, Toledo, ostfold (Norway),

t Aberdeen (Scotland), and Manchecter (England), and approxi-mately 90 percent participation in these cities was achieved by such measures as sending personal letters of' reminder or 1

I visits by public health nurses.

These measures involve j

~

j added costs, but tests are cheaper when done in a large-1 scale program (Ref. 19)- -- a Mayo Clinic program conducted them for $3.50 in the 2960s and a British program. conducted them for S2 in 1970 -- so thousands of. lives could be' saved

}

I each year at a cost below 50,000 dollars each.

i There are several other cancer-screening programs which s

could be implemented.

Fecal blood tests can detect cancer of the colon or rectum for as little as 10,000 dollars per I

life saved (Ref.'21).

Many more of these cancers could be detected in men aged 50 to 65 by annual proctoscopic exam-1 inations (Ref. 22), saving a life for every 30,000 dollars j

spent, but only one in 8 men this age now receive such exam-l inations.

4 Testing for high blood pressure has almost beccme a fad in this country, but the problem goes beyond detection, f

Treatment is quite effective but because the condition is A-22 i

l-i i

immediately life threatening, many people ignore it.

A i

not i

i.

well-organized treatment program would save a life for every I

75,000 dollars invested (Ref. 23), with 1/2 of that cost i

i compensating patients for their inconvenience, but such 1

programs have not been developed.

1 i

An especially effective approach to saving lives with medical care is the use' of mobile intensive care units i,

(MICU) (Ref. 24), well-equipped ambulances carrying trained paramedics ready to respond rapidly to a call for help.

1 i

Experience in large cities has shown that MICUs save lives at an average cost of approximately 12,000 dollars, and consequently every large city has them.

However, for smal-f le'r towns the cost increases, and when it reaches-30,000 t

f dollars per life saved, the cost for 'a town with a popula-4 tion of 40,000, it is often considered too expens}ive l

(Re f. 2,5 ).

Ef fectively, it is decided that. saving a life is not worth more than 30,000 dollars.

To summarize these medical examples, there are several available programs which could save la'rge numbers of lives for costs below 50,000 dollars each, and many more for costs up to 100,000 dollars per life saved.

These are, of course, i

American lives which may be our own.

Saving lives overseas i

is much cheaper.

Sending food to underdeveloped -countries (Ref. 26) like India cculd effectively save one life for I

every 5,000 dollars spent, and there is an immunization program in Indonesia which can save 300,000 lives at a cost A-23,

i 1'

i I

of 30 million dollars, or 100 dollars per life saved I

j (Re f. 27).

1 Health care is not our only means of spending money to i

l save lives.

Over 35,000 Americans die inside automobiles 9

j each year as a result of collisions, and over one million i

are seriously injured even though there are many ways in 1

which this toll could be reduced by investing money in high-1 i

way or automobile safety devices.

1 To some extent these improvements have been made.

A

~

number of new safety devices in automobiles were mandated by 1

law between 1956 and 1974, and a study' by th'e U.S. General i,

Accounting Office (Ref_. 28) indicates that they have saved one life for every 140,000 dollars spent. -Unfortun'tely the a

program has ended.

In 1970-73 alone,~16 new safety measures

(

in automobiles were mandated, but hardly any have. been added i

I i

since that time.

As noted previously,_an air bag. require-i ment which would cost 300,000 dollars per life saved has not 1

j been implemented.

t i

There are many highway constructi'on measures' which l

could save lives.

For example, about 6,000 Americans die a

I each year in collisions with guardrails, and there are j

guardrail construction techniques which could save most of j

them (Ref. 29).

The " National Highway Safety Needs Report" l

(Ref. 30), published in 1976, represented a federal govern-ment effort to estimate the cost-effectiveness of various j

highway safety measures.

It found that guardrail improve-i s

A-24

23 -

1, J

ments in selected locations could save over 300 lives per I

year at a cost of 34,000 dollars each.

Improvements in speed limit and hazard warning signs would save even more l

lives at a similar unit cost.

Other measures which would i

each save hundreds.of lives per year at costs below 50,000 t

dollars per life include construction techniques to improve h

i skid resistance and better designed bridge rails and para-f pets.

The use of standard techniques to avoid wrong way j

entrance onto freeways would save about 30 lives per year at 1

i that cost.

1 If we were willing to pay 100,000 dollars per life, we-

~

could save 680 lives per year with impa_ct-absorbing devices J

at critical roadside points, and 325 lives -per year by use-ing breakaway sign and lighting supports rather.than rigid i

supports on high-speed roadways.

f It is estimated (Ref. 31) that high school courses in f

driver education avert approximately 6,000 f atalities per year and they cost less than 100,000 dollars.per life saved, S

even if we include, a 50 dollar payment-to each "st'udent for lf J

his time and trouble.

Yet, there are recent indications

\\

that these programs are being cut to save costs.

Before leaving the area of traffic safety it should be pointed out that there are 40 serious injuries for every fatality in traffic accidents (Ref. 2), and the measures discussed would reduce the former as well as the latter.

I have erred on the high side in charging all of the costs-to i

A-25 1

lifesaving, so the costs per life saved are lower than given in the above discussion.

We have -seen that some of our governmental. agencies are forgoing opportunities for saving lives at costs below 50,000 dollars, and they are rarely willing to spend over 200,000 dollars.

But when radiation is, involved, they has-ten to spend much more.. The Environmental Protection Agency is now requiring that in cases in which' the radium content is abnormally high in drinking water, special' measures must be taken to remove a portion of it.

This measure, it esti-mates, corresponds to spending 2.5 million dollars per life saved (Ref. 32).

a UCS/NYPIRG has suggested that a FVCS b_e installed at both Indian Point units.

They estimate the cost _ of such a device to be " tens of millions of dollars," which.they acknowledge does not include research and development, down-time or other related costs, and thus is an understatement of the true full cost.

UCS/NYPIRG Testimony of Gordon R.

Thompson and Steven C. Sholly on Commission Question Two, Contentions 2.1(a) and 2.1(d) at 19 (Dec. 28, 1982).

For purposes of my analysis here, I have assumed the total cost of designing and installing a FVCS at Indian Point would be 50 million dollars for each unit.

The UCS/NYPIRG witnesses further estimate that the reduction in cancer deaths from this device would be approximately.90.

Id. at 16.

A-26 l

1

Using the above estimates and the expected latent f atalities of 1.7 x 10-1/ reactor-year for Indian Point Unit i

~

2 and 3.3 x 10-2/ reactor-year for Indian Point Unit 3 as determined in the Indian Point Probabilistic Safety Study

( Re f. 3 3 ), I have calculated a cost per fatality averted

~

associated with the installation of a FVCS.

For Indian Point Unit 2, the cost 'per f atality averted is 10.9 million dollars, and for Indian Point Unit 3, the cost per fatality averted is 56.1 million dollars.

A summary of the costs per life saved developed here, plus others from Ref. 17, is shown in Table 2.

Clearly, there are enormous wastes of money. and-of lives resulting from the illogical inconsistency 'in our spending -for life-s a'ving.

Thousands of Americans die needlessly each year for lack of money spent on medical programs and tr,affic safety, while the money which could save them $is spent to save a single life from radiation hazards.

VI.

Conclusions Based upon the foregoing, I have shown that the risk from nuclear power, specifically Indian Point, is small compared to the everyday risks with which people are faced.

I have also shown that many more lives could be saved by taking the money which would be spent on nuclear l

power plant modifications such as proposed by UCS/NYPIRG to this Licensing Board and using it to upgrade other areas, A-27

--,y-,

,y

,,r-

e

.-m., -. -. -.,

4-

26 -

l l

such as traffic safety and medical care, when the same j

expenditures would unquestionably result in a much greater saving of American lives.

G 9

+

pur m

m e

g 4

.e 4

9 e

O 9

e 9

=

9 I

i A-28 9

y Table 2.

Cost per fatality averted (1975 dollars) implied l

by varicus societal activities (Ref.17)

S per fatalief Item

- averted 4

4 Further W 4e-=1 u ni m and care for 4

Cervical cancer 25,000 i

Breast cancer 80,000 2

Lung cancer 70,000 i

Ccicrectal cancer i

Fecal blood tests 10,000 Pm W 30,000

{

Multiple h wiing 26,000 i

Hypertensicri centrol 75,000

)

Kidney dialysis 200,000 j

Mcbile intensive care units 30,000 Traffic safety 130,000 Auto safeef equipnent - 1966-70 100,000 Steering column iem-eit Air bags (driver only) 320,000 -

Tire inspection 400,000 Rescue helicopters

_65,000 Passive 3 point harness 250,000 Passive torse belt-knee bar 110,000 _

Criver education 90,000 -

Eighway construe.-maint. practice 20,000_.

Regulatory and warning signs 34,000 -

Guardrail 1,w ents 34,000 Skid resistance 42,000 -

Bridge rails ard parapets 46,000 j

Wrong way entry' avoidance 50,000 I= pact acscrbing readside dev.

108,000 Breakaway sign, lighting pcsts 116,000 Median barrier improvement

~

228,000.

284,000 Clear readside recovery area Miscellaneaas ncn-radiation:

further ex::enditures for

~

i I.W-=tien in Inhia 100 i

Fced for overseas relief 5300 i

Smcke alarms in hcmes 60,000 Higher pay for risky jobs 260,000 Coal mine safedf 22,000,000 Cther mine safeef 34,000,000 3

Ccke fune standards 4,500,000 Air Force pilot safeef 2,000,000 Civilian aircraft (France) 1,200,000 l

Radiatien-related activities Efforts to reduce radium in drinkirs water 2,500,000 i

Lwed :nedical X-ray equipnent 3600

}

IC3P recanmendaticns (Ref. 34) 320,000 Better radwaste practice--general 10,000,000 WCS (at IP-2) 10,900,000 A-29' i

WCS (at IP-3) 56,100,000

Appendix For those persons who are interested, I demonstrate

~

here how to calculate some of the result 5 quoted' in this testimony.

~

First, calculate the LLE from reactor accidents accord-ing to the Rasmussen Study (Ref. 9), which estimates one meltdown per 20,000 reactor-years of operation, and an aver-age of 400 fatalities per meltdown.

If all United States electricity were derived from nuclear power plants, approxi-mately 250 such plants would be required and we would have 250 reactor-years of operation each year.

We would expect an average of one meltdown every (20,000/250) 80 years.

=

The average f atality rate is then (400/80) ~= 5 per year.

If the U.S. were to maintain its present populatiori 'for a long time there would be a total of approximately 3_million deaths from all causes each year, and h5/3 million) = 1.7 of every million deaths would be due to nuclear accidents.

Victims of nuclear accidents lose an average of 20 years of life expectancy (cancers from radiatich usually develop 15 to 50 years after exposure), giving the average American an LLE = 1.7 x 10-6 x 20 = 34 x 10-6 years; multiplying this by 365 days /yr x 24 hrs / day x 60 minutes / hour gives LLE = 18 minutes as quoted previously for the Rasmussen -Study.

The UCS estimates (Ref. 16) are one meltdown every 2000 reactor-years, with an average of 5000 deaths per melt-down.

These numbers are 10 -and 12.5 times higher, respec-A-30

tively, than the Rasmussen estimates, so the LLE is larger by a f actor of 10 x 12.5 = 125.

Multiplying this number by

~

18 minutes yields 2250 minutes or 1.5 days.

Alternatively,

^

one could perform the entire calculation explained in the previous paragraph.

For major risks such as disease, smoking, and motor.

vehicle accidents, a " life table" calculation must be per-formed.

(A computer program prepared for that purpose was used in all calculations from Ref. 1.)

The correct way to calculate life expectancy is to devise a table with one line for each year of age.

Starting with a cohort of.1000 people at age 0, and introducing the average risk of death between i

age 0 and I, the number dying in that -age range and the number surviving to age 1 is calculate'd..

From 'th'e risk of death between ages 1 and 2, the number of these dying in that age range and the number surviving to age 2 is calcu-lated.

This procedure is followed for-all ages until all of the cohort has died.

The number dying at each age is multi-plied by the number of years-lived ( e_.h., those dying be-tween ages 35 and 36 are construed as having lived 35.5 years), and the results are added to yield the total number of years lived by the original cohort of 1000 people.

Their life expectancy is this total divided by 1000.

To calculate the LLE from cancer, for example, the risk of death from cancer at each age is subtracted from the total risk of death at that age, and the above life table A-31

j calculation is repeated with these decreased risks.

This 4

j yields a life expectancy if there were no deaths from can-cer.

The difference between this result and the previous j

one is the LLE from cancer.

l The comparisons of risks are based upon the ratio of LLE.

For example, if one pound of added. weight gives an 1

overweight person an LLE of 30 days while the UCS estimate gives an LLE from reactor accidents of-1.5 days, gaining one

\\

l pound is 30 t 1.5 = 20 times more dangerous, or. gaining 1/20 1

i of one pound must be equally dangerous.

Multiplying by 16 I

ounces per pound gives 0.8 ounces as the weight gain result-ing in an equivalent risk.

As an example of calculating the cost per life saved, j

consider the use of air bags.

According to Allstate Insur-l ance Co. (Ref. 18) an air bag reduces.the drivers _' mortiliqr J.

rate by 1.4 deaths per hundred million. miles driven.

A car driven 50,000 miles has a probability of saving a life of

~

l 1.4 x (50,000/100,000,000) = 1/1500, one chance in 1500, i

i This air bag would cost approximately 200 dollars, so the j

j cost per life saved is 200 dollars divided by 1/1500, or 300,000 dollars.

For every 1500 cars equipped with an air I

bag, an average of one life would be saved; the cost would then be 1500 x 200 dollars = 300,000 dollars to save one life.

i 1

l l

A-32 r

y.,

RE FERENCES 1.

B.L.

Cohen and I.S. Lee, A.

Catalog of Risks, Health Physics 3 6, 707 (1979).

2.

National Safety Council, " Accident Facts," Chicago, IL (published annually).

~

3.

B.L. Cohen, Perspective on Occupational Mortality Risks, Health Physics 40, 703 (1981).

~4.

U.S. Bureau of Census, Vital Statistics of the Unite'd States (published annually).

5.

H.A. Kahn, "The Dorn Study of Smoking and Mortality Among U.S. Veterans," in National Cancer' Ins.titute Monograph 19 (Edited by W. Haenszel), U.S. Department of Health, Education and Welfare (1966).

9 E.C. Hammond, " Smoking in Relation to the Death Rates of One Million Men and Women," in National Cancer Institute Monograph 19 (Edited by W. Haenszel), U.S.

Department of Health, Education and Welfare (1966).

~

PHS (U.S. Public Health Service), "The Health Consequences of Smoking -- A Public Health Servic'e Review -- 1967" (1967).

6.

MetropolitanLifeInsuranceCompany,"Statis[tical Bulletin," Society of Actuaries, Build and Blood Pressure Study (1959).

7.

B.L. Cohen, Body Weight as an Application of Energy Conservation, Am. Jour. Phys. 45, 867 (1977).

~l 8.

U.S.

Bureau of Census, " Statistical Abstract.of the United States -- 1975" fl9 7 5-).

9.

NCES (National Center for Health Statistics), " State Life Tables, 1969-71," DHEW Publication No. (HRA) 75-1151 (1975).

10.

Metropolitan Life Insurance Company, " Statistical Bulletin," Hazardous Occupations and Avocations (Mar.

1974).

Metropolitan Life Insurance Company, " Statistical Bulletin," Fatalities in Motor Vehicle Racing (Dec.

1976).

A-33 7..

c g.

-,.,.9 w.-g

. ~

4 11.

NSF (National Science Foundation) Science and Technology Policy Of fice Report, " Chemicals and Health" (1973).

12.

FDA ( U. S. Food and Drug Administration), in 4 2 Federal Register 20,001 ( Apr.15,1977 ); also press release.

Unpublished calculations by author. '

i 13.

14.

Nuclear Regulatory Commission Special Inquiry Group, M.

Rogovin (Director), "Three Mile Island: A Report to the

~

Commissioners and to the Public" (1980).

15.

NRC (U.S. Nuclear Regulatory Commission), Reactor Safety Study, WASH-1400, NUREG-75/014 (1975).

16.

Union of Concerned Scientists, "The Risks of Nuclear Power Reactors," H.W. Kendall (Director) Cambridge, MA (1977).

~

17.

B.L. Cohen, Society's Valuation of Life Saving in Radiation Protection and Other Contexts, Health Physics 28, 33 (1980).

18.

A.R. Karr, " Saga of the Air Bag," The Wall Street Journal, Reprinted in Insurance Ihst. for Highway Safety, Status Report 11, 18 (Nov. 30,1976)

L.M. Patrick, "P.assive and Active-Restraint-Systems --

Performance and Benefit-Cost Comparison,"- Soc.

Automotive Eng. Transactions, Paper 750389 (1975).

W. Stork, "The Cost Ef fectiveness -of International Vehicle Regulations," Automotive Engineering (Mar.

1973, p.32).

19.

L.

Dickinson, " Evaluation of the Ef fectiveness of Cytologic Screening for' Cervical Cancer," Mayo Clinic Proc. 47, 550 (Aug. 1972).

J. B. Thorn, J.E. Macgregor, E.M. Russell, and K.

Swanson, " Costs of Detecting and Treating Cancer of the Uterine Cervix in North East Scotland in 1971," Lancet (Mar. 22,1975, p.674).

~

R.J. Walton, " Cervical Cancer Screening Programs:

The Walton Report," Canadian Med. Assn. Jr.114, No.11, (June 5, 1976).

R.N. Grosse, " Cost-Benefit Analysis of Health Service,"

Ann. Am. Acad. 399, 89,(1972).

A A

~

).

JEC (Joint Economic Committee), U.S.

Congress, "The Analysis and Evaluation of Public Expenditure:

The PPB System" (1969).

S.E. Rhoads, "How Much Should We Spind to S'a've Lives?,"

The Public Interest (Spring 1978, p.74).

20.

J.P. Ruchinskas, Private communications giving generally accepted value, General Electric Co.,

Housewares Div. Bridgeport, CT (1978).

I 21.

M. Kristein, " Economic Issues in Prevention," Prev.

j Med. 6, 252 (1977).

22.

R.J. Bolt, " Sigmoidoscopy in Detection and Diagnosis of the Asymptomatic Individual," Cancer 28, 121 (1971).

2 j

V.A. Gilbertson, " Proctosigmoidoscopy and Polypectomy

{

in Reducing the Incidence of Rectal Cancer," Cancer 34, j

No. 3 Su'pplement, p.936 (1974).

i l

R.N. Grosse, " Cost-Benefit Analysis of Health Service,"

Ann. Am,. Acad. 399, 89 (1972).

23.

J. Stamler, R.

Stanler, W.F. Riedlinger, G. Algera, and

~

R.H. Roberts, " Hypertension Screening of Onei Million Americans," J. AMA 235, 2299 (1976).

4 J.

Stokes and D.C. Carmichael, " A Cost-Bene [it Analysis of Modern Hypertension Control," National Heart and Lung Institute, National Institutes of Health, Bethesda, MD (1975).

f 24.

R. Zeckhauser and D. Shepard, "Where Now for Saving Lives," Law and Contemporary Problems 40, No. 5, p.5 (1976).

i J.P. Acton, " Evaluating Public Programs to Save Lives:

i The Case of Heart Attacks," Rand Corp. Report R-950-RC, i

Los Angeles., CA (1973).

i i

2 5..

J. Riordan, Private communication, Health Services Adm., Washington, DC (1979).

26.

B. Ward, Paper presented at UNICEF New World Food Conference, Rome (1974).

4 i

i A-35

q '

E. Egan, Private communication, Catholic Relief Services, New York (1977).

17 x 2.3 x 106,2936

trial in New York City involving 31,000 513.300.

N 9 y]

women aged 40-64 invited for screening of it is difficult to reconcile the wide variations whom 20.000 responded. and 31.000 u n-we have found hereJbut the actual cost is not 1,j screened controls. In a 5-yr period, there were the important point for our purpose; we are y[

40 deaths from breast cancer among those in-interested in the costis perceived by those in vited vs 63 among the controls, which may be a position to iristitute screening programs.

interpreted as saving 23 lives. The cost was Since.the Kristein analysis is rather recent, we 540, examination, which with our inflation and must conclude that screening programs were

'n inconvenience factor becomes

560, or not widely instituted when the perceived cost 20.000 x 560/23 = 552.000 life saved. This was in the range below 580.000. life saved. In 9

price could hase been substantially reduced by a 1977 Gallup, poll (Ga77). 51*, of women

,- j limiting the service to those above age 50.

above age 18 said that they had had some type

.)

Kristein (Kr77) gives breast cancer, incidence of breast examination during the previous year.

f among females of age $5-64 as 2 x 10", so (3) Lung cancer screening. Lung cancer is the among 1 million women there would be 2000 largest cancer killer by far among U.S. males.

cases year of whom 42",, would normally die with a rate approaching 50 x 10-5/yer.r and 20', of these (169) would be saved (this among all mal'es and several times higher than is half the save rate in Sh72). He gives the cost this for heavy cigarette smokers. Early detec-as 540. examination which remains approxi-tion is facilitated by X-ray and sputum cyto-mately unchanged when corrected for inflation logy studies, and early detection is the key to and inconvenience. The cost per life sased is sursival. although even at best the chance of then 40 x 10" 169 = S240.000. However, he survival is small.

estimates that the radiation from the X-rays The most optimistic screening information would cause 67 deaths (this seems high for comes from two studies in 1.ondon (Na68:

women of that age) which increases the cost life Br69) insolsing about 30.000 subjects each.

~

sased to 40 x 10" 102 = S400.000. He con-plus an equal number of controls. They report sider, this to be obsiously cost ineffectise.

costs as low as 5350 cancer found and cured B-5

,.s

__ J.7 -..

_, - e -. -

.% e.

s--, w s.m.v-sc u T w p.N.w.;.:

7.smi mLv a '

I

!ij $ f$

d IMI p 38 SOCIETY'S VAllJATION OF LIFE SAVING IN RADIATION PROTECTION g

gj among heavy smokers, but I)oucot and Weiss perception of those in a position to institute p

(Bo73a)' estimate that their costs for X-ray film programs, lives could be saved by lung cancer l

h; alone should have been 512,500/ survivor, and screening at a cost of 570,000 each. The 1977 with inconvenience and other costs and a cor-Gallup poll (Ga77) indicated that 26?; of adult L

Y rection for inflation, the cost would be in-men and women have lung X rays each year.

B__..

about 520.000jlife saved.

creased to perhaps 530,000/ life saved.

(4) Screeningfor cancer of colon and rectum.

l Colley(Co74) estimates the costs of the Lon-Cancer of the colon and rectum causes an don projects as $1300 per case found and cured annual mortality rate in the U.S. of 20 x 10-5 and concludes that the programs should be for males and 15 x 10-5 for females: the rates phased out! With our inflation and incon-are much higher for ages above 45. A simple venience factors, the cost would be raised to screening technique involves fecal blood tests.

and a more elaborate procedure is visual exam-

'- - N Boucot and Weiss (Bo73). working in Phila-ination by proctosigmoidoscopy.

delphia. examined 10,000 men at 6-month in-Kristein (Kr77) gives the mortality rate for tervals for 3 yr, for a total cost of $250,000 and all people over 55 asi3 x 10-3/ year and esti-found and cured three lung cancers, a cost of mates that 20!; of these could be saved by S83,000/ life saved. They conclude It is ques-early detection with fecal _ blood tests at a cost

a m yf tionable whether the community could afford of 52 each. We add another 52 as an incon-i I

the price With our inflation and incon-venience~ cost as this requires only turning in venience factors, the cost would be increased a fecal sample with no office time. For a pro-to about S200,000flife saved.

' gram' involving 106 people. there would then The Mayo Lung Project (Fo75) detected 25 be 3000 cases of which 600 would be saved lung cancers (plus two cancers of the upper at a cost of 54 x 10^. The~ cost per life saved respiratory tract and one cancer of the tongue) would then be S6700.

in thcir first examinations of 3900 participants.

Bolt (Bo71) estimates thitt by screening 9000_,,

Folle.ing pulmonary resections, the prognosis people above age 45 by proctosigmoidoscopy.

was good in 12 of these cases. If three of these one can~ expect to find 20 colorectal cancers prove to be cured, and the cost of an examin-and cure 17 of them whereas only 10 of them ation is taken to be S50 (including incon-venience), a single examination will have saved would be-cured without screening, a net saving

)

of seven lives. He estimates the cost to be i

three lives at a cost of S195,000 or 565.000. life 512/ scan, which gives a costflife saved =

saved. This takes no credit for the three other 512 x 9000/7 = 516.000. He argues that this cancers found and cured.

-price is too high to be practical: With our cor-Actually, the Mayo project was designed to rections for inflation and inconvenience. the provide examinations at 4-month intervals in cost per life saved is raised to S27.000.

I order to detect newly-developing cancers which Gilbertson (Gi?41 estimates that screening of

{

they estimate to be 507, curable. In the early 400.000 people would detect 1300 cases of work they found (Fo75) six cases in 3000 which SS" would survive vs 50*, without this follow-up examinations, which hopefully corre-early detection, a saving of (0.8S-0.50) x sponds to one curell000 examinations or 1300 = 494 lises. He estimates the cost at 550.000 life saved. Recent experience (Fo7S). Si!.73 examination. but adding our inflation

~

has detected 4.5 cancers /yr-1000 people which, factor and inconvenience charge this becomes with three examinations l year at 550 each S20. The cost life sased is then 20 x 400.000-l and a 50?; cure rate correspond to 494 = S16.000.

j 150,2.3 x 10-3 = 565.000 per life sased.

Grosse (Gr72: JEC69) estimates the cost of j

in siew of the abose. it seems reasonably an examination at S20.10 which. corrected for conservative to conclude that, at least in the inflation and the inconvenience. becomes S35.

I j;3, i

B-6 i

q

{

% gmmmme

m j

Oi' l'

t j

BERNARD L COHEN 39 i

I nstitute He estimates one case fo'und per 496 examm-above 95 (St76). In this study, 28"; of these L[

cancer ations, with an additional 22?; cured z a result caso had been previously undetected.11!; had

. a le 1977 of the early detection. The cost per life saved been detected but untreated. and 17"; had been J

l i

)f adult is then 535 x 496/0.22 - 579,000.

treated but uncontrolled. so fully 55* of the l

l 1 year.

Since Grosse's work is rather old, we give 257;. or 13;; of those screened. obtained im-rectum.

it less weight and conclude that lises can be portant information. Since blood pressure t

1 i lses t.n saved by proctosigmoidoscopy screening at a measurement is an extremely simple and cheap

! ! $l; x 10- 8 cost of S30.000 each, and a screening program procedure, this suggests that the cost-benefit le rates in fecal blood tests could save lives at a cost ratio would be very favorable, although it is g j simple of perhaps S10.000 each. According to the 1977 not easy to quantify because hypertension is H Jp ;

d tests, Gallup poll (Ga77). only 8;; of all men and not ordinarily a direct cause of death. How-Q exam-12;; of those aged 50 and above had procto-ever, an analysis by Kristein (Kr77) indicates y [i H,

scopic examinations in the previous year.

that such screening is cost effective even from u

ate for (5) Miscellaneous cancer screening and com. the standpoint of money loss from missing I j.

4 esti-ments. Grosse (Gr72; JEC69) estimates that work.

I d

ed by screening for cancers of the head and neck We derive an estimate of cost / life saved from j ]j,

a cost could save lives'a't aYou of 5%*.000 each. With fmdin5 and controlling blood pressure as fol.

J ;i

'I$l for males 55' 64 years old, the ncon-corrections for inflation and inconvenience lows (St75):

ing in charge. this becomes 575.000. -

annual mortality risk can be reduced from

h a pro-Cannon Mills, a large textile manufacturing 219 x 10-* to l_79 x 10-' by reducing diasto-I then corporation. runs a program of medical screen-lie blood pressure from 97 to S7 mm-Hg. a fly

g!

saved ing of its employees for colorectal(fecal blood); reduction of 40 x 10-'qear. at a cost of i

sased cervical, and breast cancer blood pressure, and S150 year for medicine and care plus,perhaps h

diabetes. The examinations cost 58 for men an equal amount for inconvenience. This corre-

'9000 and 512 for women. or an average of about sponds to S300:40 x.10-' = S75.000. life M

' copy.

59, but it would seem that only about 57 of saved. Similarly male mortality rates in this age h,

incers this should be charged to cancer screening. In range can be reduced by 60 x 10-' by reduc-them 11,000 examinations. 23 cancers were found ing blood pressure from 102 to 87 mrn-Hg.

.aving (He77). If three additional cures are obtained which costs about 5240. year for medicine and h,

to be as a result of this early detection, the cost treatment plus a somewhat lesser amount for h

ed =

would be 7 x 11.000'3 = S26.000. This item is inconvenience, which corresponds to about

%p:

0.

i this entered as " multiple cancer screening" in Table S450 60 x 10-' = 575.000. fatality averted.

r cor-l 1.

. For fem ~ ales and males in adjacent age ranges.

M Jil the i

The Lancer ran an extensise series on cancer the reduced mortality is 3-5 times smaller so screening and. in summary papers on the the cost per fatality averted would co up to 57j Eg of series. Randall (Ra74) favored screening for S300.000. but this does not change the abose M.

s of cervical cancer but recommended caution on value for $5-64-year-old males which is listed Ih-t this all others. while Holland (Ho74a) concluded in Table 1.

Y

!0)x that no type of cancer screening is worth the It may be noted that we have not mentioned k'

st at cost!

the costs of screening here: actually they are

$1 h

ation (6) Hypertension screenimi and control. included but they contribute a small amount omes Hypertension thigh blood pressurel is a con-to the abose co' ts.

p s

1000-tributory factor in about one-third of all fatali-(7) Kidney dialysis. About 6000 Americans j

ties from heart-disease and stroke. It is also need kidney dialysis treatment on a regular H.

a fairly common condition:in one large screen-basis, but only S50 were receising it in 1968 h

51 of 1 for ing actiuty insohing 1 million Americans. 25",,

while the rest were condemned to early death.

.h 535.

had diastolic pressure abose 90 and 12". were (Gosernment in Sweden was committed to I

l

'S' I

-fi 5-7

.i, x

-L-M' I

l 40 SOCIETY'S VALUATION OF LIFE SAVING IN RADIATION PROTECTION provide treatment for all.) A person on dialysis Alternativel[an MCCU could save 15 lives has a life expecta'ncy of about 9yr (Kl6S) and at a cost of 542.000 plus 578,000 in spill-over the cost is about 510,000iyear, whence the costs or 58000/ life saved.

average cost to avert early death is about When the. effectiveness of this type of service 590.000. A recent cost estimate (Rh78) is was recognized, programs were implemented in 530.000 year which gives a cost per death alllarge cities (Br79: Ri79). It was soon found averted of 5270.000. In Table I we list an inter-that efficiency could be improved if the para-polated value for 1975 of about 5200.000. If medic was trained and the ambulance was we standardize to 20 years of life expectancy, equipped for handling sesere burns, trauma.

this is increased to 5440.000.

and other injuries, and these units are now R

higher than those of other medical items. This It may be noted that the costs here are much known as Mobile Intensive Care Units (MICU). In areas served by them there is typi-seems reasonable in view of the fact that the cally one unit for each 100.000 people, hand-person at risk is readily identifiable in advance, ling an average of about 10 calls per day. We and it is much more difficult to condemn a assume that the costs aje those from the above particular person to certain death than to con-discussion about $12,000 per life sased.

demn large numbers of people to a slightly in.

In order to determine an implicit valuation crased risk. The kidney dialysis item is there-of life saving. one can obIerve how small a fore less applicable to effects of_ radiation than community does not have such a service. It is are the other items.

estimated (Ri79) that the great majority of

18) Mobile intensire care imits. About one-communities with more than-75.000 population

$/g third of all deaths in the United States are from either base or are considering obtaining. this

,9 heart attacks. and 30?; of these are in people service. On the other eitreme it is estimated r

~. +

less than 65 years old.Two-thirds of the deaths that such a ' service would. be highly unusual occur before the patient reaches a hospital, so in a community ofless than 25.000. We assume

^

many lives could be sased by providing more then that_it is not generally considered cost prompt care.

efTective in communities of less than 40.000.

J Zeckhauser and Shepard (Ze76) estimated and we further assume that the cost per life y

3 y

that a mobile coronary care unit (MCCU) saved is inversely pr'oportional to the popula-which involves an ambulance with a trained tion serviced below 100.000. This sields a cost D

paramedic and coronary monitoring and defi-at which the service is only partially imple.

brillation equipment could save a life in S,, mented t'o be S12.000 x.(100.000 40.000) =

A y

of all heart attacks treducing " dead on arriyal~ 530.000 per hie sased. This estimate is consert.

at hospitals from 22", to 14" ) at a cost of atise in that it ignores benefits from servicing e

5400 attack. This represents a cost of conditions other than heart attacks.

[

400 0.0S = 55000, life saved. Additional treat-ment at the hospital costs 53500 and follow up care costs 5400, year for the S yr of remain- (B) Tragic wfery meawre3 i.

3s ing life expectancy, which adds up to Over 35.000 Americans die from accidents 512.000 life saved.

inside automobiles cach year, so it seems E

Acton IAc73) estimated that for a com-reasonable to seek technological methods for munity of 100.000 a special ambulance pro-protecting them. Congress passed the National gram would sase 11 lises year at a cost of Tratlic and Motor Vehicle Safety Act of 1966.

S24.000 plus spill-oser costs of about 568.000 setting up a National Highway Tratlic Safety for subsequent hospital care (including ruling Administration to attack the problem and out heart attack as the diagnosis in most cases) since that time there has been a great deal of for a total of 592.000, or SS4tio life sined. actisity in this area. We resiew some of the B-8 f

i

%,,g m ycw w r.m m m:m w uxm m <--~ ~---'-----

1 O l h,

[l BERNARD L COHEN 41 g

5 lises

~

cost-benefit information that has developed since they save lives and cost nothing but t

ill-over from i't.'

money, but they are not being used because g

Most of the items to be discussed have bene-of their cost (there have been allegations that f

service fits in averting injuries as well as deaths. For they do not function as expected, but these g

nted in every traffic fatality there are 40 injuries (Na75) have been proven to be false (In76)).

(

p i found resulting in disability extending beyond the day According to Allstate Insurance Company, j

para-of the accident and many of them have lifelong an air bag reduces a driver's mortality risk 6 g

e was serious effects. As a general average it would from 2.7 x 10- 8 to 1.3 x 10-8 per mile R

g

rauma, probably be reasonable to assign only half of (Ka76). The cost of an air bag as an option d

G e now the costs to averting fatalities. Since we do not was S315 in 1976, although this would be h

Units do this, there is approximately a factor of 2 greatly reduced to perhaps 5100 ifit were stan-f q

is typi-conservatism in all figures. Traffic fatalities dard equipment (Ka76): We take the cost to j ].

hand-differ from most medical problems in preferen-be S200 and assume that it gives protection l}

i ty. W e tially affecting the younger segment of the at this cost for 50,000 milescThe cost / life saved e

above population, so about 40 yr of life expectancy is then 200/l.4 x 101 x 50,000 = S290,000.

f h

are lost in an average traffic fatality. This is Patrick (Pa75) estimates that equipping p

p uation reflected in the right-hand column of Table 1.

essentially all automobiles with airbags to pro-j E

g[

nall a Many of the measures taken require an tect the driver over a 10-yr period would cost p

Itis appreciable effort by the people protected so S18.5 billion and would save 46.400 lives. This yfj q

ity of the dollar cost is not the entire cost. For corresponds to S400,000 per life saved.

lation example, seat belts are tremendously cost effec-Stork (St73) estimates that using four air hr j$

r, this tive, but are generally not used because of the bags in a car would cost S77/ year. and that fi 9

mated effort involved. Rather than trying to assign if all cars were equipped, fatalities would be 3 j! F iusual dollar values to this efTort, we will ignore cut in half.' This corresponds. to a ' cost of

.d ! $

ssume measures of this type and confine our attention S77 x 108 to equip al1 U.S. automobiles and

'd

~

I cost to passive meas 'res.

it would save 17,000 lises, a cost / life saved of 0.000.

(1) A uto sq, cry imprarements, 1966-70. 5430000. Protecting four passengers is only h b rr life According to an analysis by the General about half as cost-effective as protecting the IF y spula-Accounting Office (Ge761. the efTects up driver (the average car carries 'l.5 people); with h 2 2 cost through 1974 of safety improsements intro-a correction for inflation, this gives rf:}

mple-duced in 1966-70 model cars were: amortized S250,000, life saved by protecting the driver

-E

30) =

costs,53 billion; lives. saved,28,200. This gives only.

k }t iserv-a cost ' life saved = S106.000. Correction for Ascraging our three estimates gises S320.000 j

R

, icing inflation increases this to S130.000. The GAO per life saved.

( 7 y Report found little benefit up to 1974 from (3) Automobile rire inspection. Most states

/

g items introduced in 1971-74 models. Their have inspection requirements on automobile dii S

amortized cost was $205 million; if this is in-tires, and in many places it is illegal to drise (il

'i cluded the above number is raised to S140.000. on worn tires. The rationale for this is that

(

lents One item introduced during this reriod was worn tires hase a better chance of a blow-out

]p.gq eems the energy-absorbing steering column. It is esti-which can cause an accident.

s for mated (Ge76) that it cost $153 million and,

About 4*, of all fatal traffic accidents in th.

...[ 7 mnal would asoid 1800 fatalities (plus an equal U.S. are caused by blow-outs, which amounts

'(l

!966, number of injuries). This corresponds to to 1800 fatalities per year. Roughly we assurne M i afety S83.000 per life sased; corrected for inflation that this number would be doubled without f

and it becomes S100.000.

the inspection and legal requirements. There d!

d of (2) Air ham. Air bags are an especially clean are 180 million passenger car tires sold cach

][,y the example of society's esaluation of life sasing year in the U.S., and we crudely estimate that

.ii ?

~.aq b[

B-9 y7

?

E xw n:21m a u m m m m m s w ~

~

-we~ ~ ~ "'

42 SOCIETY'S VAI.UATION OF LIFE SAVING IN RADIATION PROTECTION 30 million of these would not be purchased would cost $13.5 billion ar$d sase 55.000 lives, without the above requirements. If an average a cost of S250.000. life saved.

tire costs $25. this is $25 x 30 x 106/1800 -

He similarly estimates that a passive torso 5400.000 per life saved. It is evident from the belt-knee bar restraint combination would cost quality of these inputs that this estimate is 55 billion and would save 46,000 lises, a cost particularly crude. ~

of 5110.000flife saved.

It is interesting here to consider the costs From the entries on auto safety in Table 1, some people are willing to pay to protect their it is apparent that many lives can be saved own lives and those of their loved ones by buy-at costs in the 5300.000 range or less. However, ing tires that will not blow out. These cost at the auto safety program has all but ground to least an additional 530, so if all automobiles a halt (In76a); in 1970-73,16 new standards were so equipped this woald represent a cost were issued. but only one new standard was of S30 x 180 x 106/1800 = S3 million per life issued in 1974-75.

sa ved.

(6) Drirer educarimr. Kaywood (Ka76) has (4) Use of small cars es standard si:c. The estimated that a hig.i school course in Driver I

risk of being killed while riding in a small car Education for all students would reduce traffic is about 25% higher per mile of travel than fatalities by 10-15*;. It would therefore pre-in a standard size car (Co76). The average sumably save about 5800 lives per year. Such a

American's risk of being killed in an auto-courses insolve time and effort expenditure by

' *h" mobile is 1.6 x 10-*/ year, whence use of the the students, so a dollar cost must include 7

heavier car aserts a risk of 4 x 10-5 per year. compensation for these. A brief opinion survey The added cost of a heavier car, including indicated that a paymint of 550 would be operadng and maintenance costs is perhaps ample inducement for t'he great majority of stu-5500 year. Since an average car carries two dents. Instruction costs average aboUt 575 per

~

g people. the cost per fatality averted is then student (Na78L but there are probably hidden 5500'2 x 4 x 10-5 = 56 million. Of course costs (e.g. automobiles are often donatedl to this applies only if added safety is the sole bring the total cost to S150l student. For reason for purchase of the larger car. This item 3.5 x 10* students year. the cost. life saved'is is not included in Table 1 because society has S150 x 3.5 x 10*/5S00 = 590.000.

e

%m made no move to ban the use of small cars Drise'r education courses are now taken by (5) Miscellaneous auto safety derices and 81", of all high school students (Na78L so it

~

]

conunents. Stork (St73) estimates that in West is perhaps unfair to itselu.de this option as not Germany, a fleet of 50 rescue helicopters could fully implemented. However 20*,, of all high 1

sate 400 lives per year at a cost of 524.4 million schools, including many large ones. do not which. with a small correction for inflation. is offer courses. and there have been many recent l

565.000 life saved. He also estimates that a fleet indications that programs are being cut back g

of 150 rescue cars in urban areas could save (Ka76al.

l 2

350 lises year at a cost of 573.5 million which.

(7) Highway construction improrements.

D with an inflation correction. is $230.000 life There are many practices in highway construe.

hM a!

saved. The helicopters are the more cost-tion and operation that could be improved to effectise option so only it is included in sase lises at a cost of. money alone. For j

Table 1.

example, it is estimated (Ta76) that moving Patrick (Pa75) estimates that a S135 passise light posts 30ft back from the edge of high-

_;Q three. point harness. a seat belt-shoulder har-ways would save 500 lises per year. About 6000 ness that closes oser the driver without his in-people per year are killed in collisions 'with

f; tersention. uould asert 30",, of all fatalities. guardrails, and there are guardrail construction Equipping all U.S. cars oser a 10-yr period techniques that could sase' ~most of tficm. A c::

-2 B-10 l

L

I 1

I BERNARD L COHEN 41 X)0 lives, ~

recent paper (Sp77) stated that there are many using these at critical roadside points where local highway improvements that could be im-removal of fixed object hazards and yield-on-l yetorso plemented in Oklahoma that would save a life impact techniques are not feasible; this would i

fuld cost for every 543,000 spent.

save 678 lives / year at a cost of 5108,000 per y a cost The National Highway Safety Needs Report life saved. Breakaway sign and lighting sup-l I

(US76) conducted a study by polling knowl-ports involves using these rather than rigid B

Table 1.

edgeable people to determine the cost per fatal-supports along high-speed highways. with a d

psaved ity forestalled of various measures. The most program for systematic replacement; this b

pwever, cost-effective measures which involve no per-would save 325 lives / year at a cost of S116,000 i

pund to sonal effort or inconvenience are listed in Table I each. Median barriers includes use of improved M

tindards and explained below:

design on these to reduce consequences of col-

?

ird was Highway construction and maintenance lisions. and includes programs for replacing

)f practices refer to following the Manual on Uni-substandard and damaged sections; this would

76) has form Traffic Control Devices including inspec-save 53 lives / year at p cost of 5228,000 each.

k Driver tion and maintenance: this would save 46 lives / Clear roadside recosery areas includes areas k

traffic year at a cost of 120,000/ life. Regulatory and that enable vehicles which leave the travel ce pre-Warning Signs refers to upgrading and installa-lanes to return without injury; this includes 7.Such tion of signs in accordance with the aforemen-construction of gradual side slopes and remo-J;f ture by tioned manual; this would save 367 lives / year val of haiardous drainage features, trees, and j!

helude at a cost of 534,000 each. Guardrail includet. rocks for a minimum of 3.0ft from the edge i1 survey using improved designs in a program to re-of freeways. This would save 53 lives. year and h

rid be place substandard and damaged units; this would-cost S284,000 per. fatality overted.

of stu-would save 316 lives year at a similar cost.

If these numbers are credible, there are many O

75 per Skid resistance refers to locating places where ways that lives can be saved for less than dig hidden slippery conditions are contributing to high-550.000 spent on highway: improvements, and 4 i way accidents and implementing construction this general category has one of the most favor-hh ved) to t.

For techniques to improve their skid resistance; able cost-benefit ratios. However, there has

'] -

ned is this would sase 374 lives l year at a cost of been strong criticis~m that the program is floun-542.200; life saved. Bridge rails and parapets in-dering (Ge76a).

3 Len Sy cludes design and installation of these so as i f c so it to redirect vehicles which would otherwise (C) Miscellancous caregories*

as not have collisions with objects or other schicles:

(1) Foo.lfor orersects relief. Starsation is a M

11 high this would save 152 lives) ear at.a cost of -common experience in many underdeveloped j

lo not 546.000 per fatality averted. Wrong-way entry nations of the world and its effects are es-

- 1:

recent avoidance involves use of standard techniques pecially important in children. About 60 mil-

[

t back to asoid wrong-way entra'nce on to freeways: lion children are born each year in these coun.

,s i

5 this would save 78 livestyear at a cost of tries, and 25-30% of them will die before reach-l '.

'"v"'5-549.400 each. Impact-absorbing devices means ing age 5 from malnutrition and related dis-9 eases. a total of IS-IS million deaths year that

!Pd istruc-

' Note mMed in ymI: A much more cost-erTectise. could be averted by food relief. Moreover, program than any listed here has recently come to those that survive the first 5 yr sufTer through-ih r

mins bght (Ba74 Expanding the present smallpos and out life from the effects of this early starvation.

p high-BCG immunization program m Indonesia to coser a Ward (Wa74) has estimated tl'at most of d

6000 Inger population and to include immunization for with diphtheria. whooping cough, and tetanus would usert these children could be saved by S20 } car

'}F 313.0W deaths (in a 5 Scar programi at a cost of 533 worth of food, but most estimates are higher.

L.

n milhon, or $106 per life sased. It would also asert 5.5 One estimate (Eg77) is that 5120fyear would

'I

A I

million non-fatal cases of these diseases.

do thejob in Brazil. In the Rice Bowl of Asia.

I Im 3-11

]l q

A

SOCIETYS VALUATION OF LIFE SAVING IN RADIATION PROTECTION 44 S10.' year woisld supply the needed milk and that something less than 15% of all homes are

~

550! year would provide the needed extra pro-protected.

tein for adequate nutrition.

(4) Higher pay for risky jobs. Thaler and To derive an estimate, we conservatively Rosen (Th75a) carried out a correlation analy-assume that 5150 per year through the first 5 yr sis of salaries vs risk in various jobs, and con-L of life would avert half of the deaths. This cor-cluded that the higher pay for an 0.001 increase responds to a S750 expenditure per child to in mortality risk is S260! year. This corresponds increase the probability of survival by 14?;. or to an evaluation of a life at S260.000.

55300/ life saved. This is probably an overesti.

Carlson (Ca63) calculated that the flight pay mate for saving the young children, but it for a U.S. Air Force captain implies an evalu-may be compensated by the need for some ation of his. life at between S135.000 and additional food for older children.*

5980.000, depending on the type of plane flown.

(2) Air poIIntion contio!. Typical estimates If we take the mee. ;f these and apply an infla-are that sulfur dioxide (SO ) air pollution tion factor, the rejult~is about 5600,000.

2 causes about 10.000 fatalities / year in the (5) Industrial sqfety. A study of the effects

. United States (Co76). About half of the 50 of the Coal Mine Health and Safety Act of 2

comes from coal-burning power plants. and it 1969 (De78) indicated _that compliance requires is hoped that 85'; of this contribution can be the addition of 118.000 miners in U.S. coal climinated by installation of scrubbers. at least mines. The average salary of a coal miner is on newly constructed plants. This would save 514.000 year (Co77). and we assume an ad-4300 lives per year.

Our current coal generated electricity could ditional 50?; for overh'ead and fringe benefits.

which brings the total annual cost to be produced by about 150 of these plants. S14.000 x 1.5 x 11S.000 = S2.5 x.10',

The According to EPA estimates (Sc78) the cost new safety measures.have reduced the annual of SO2 scrubbers is 0.3c kW-hr which works average fatality toll in-coal mines from 260 in out to be SIS million per year for each plant. 1965-70 to 145 in 1972-75 (Co77). a saving of This therefore represents an expenditure of 115 lises' year. The cost per life saved is then 52.3 x 10' to save 4300 lives, or 5500.000 ' life S2.5 x 10'l115 = S22 million.

saved.

A similar study of the effects of the Federal (3) Smoke alarms in homes. It is estimated Metal and Non-metal Mine Safety Act of 1966 (Ru78) that smoke alarms in homu would save indicated (De78) that compliance requires 2000 lives year. We estimate that such protec-employment of 42.000 additional miners at tion could be supplied by the produ,ction and 512.000 year (Co77) which. if we assume 50',

distribution of 10 million units' year at a cost, overhead, amounts to 5750 millioniyear. This including installation, maintenance over a 10-yr average lifetime and inconvenience, of has reduced accident fatality rates (Co77) by no more than 22 per year (93 year in 1965-70

%c about 550 each. This corresponds to a cost per vs 71. year in 1973-75. but 152 in 1972L which M

life saved of 50 x 102 x 10' = S250.000.

corresponds to 534 million per life sased.

1 There are currently 10 million smoke alarms Rhoads (Rh781 reports that occupational in use in the United States (Gr79) which means safety standards for coke fumes corresponds to 1 l expenditure of 54.5 million life sased. He ques-

'Norc odded m prmf. Another potentiat oserseas tions the wisdom of this practice. but says that l

aid program is one of malaria control in Indonesid it is stroncly supported by the Union.

t

~

. (Barnum H., "An Economic Analysis of a.\\lalaria (6) Aircraft. Carlson (Ca63) estimated that u

I

(

Control Program in the Outer Islands or Indoneua", the cost of ti e ejection system on a B-58 unpublkhedL lt would sase 15.300 Ines at a cost of bomber implies a cost per life saved between j

$64 million. or $4S00 per fatality aserted.

S1.7 million and 59 million. If we take an s

4 I

7

~

B-12

,a

BERNARD L COHEN 45 bmes are average of these and apply a correction for reasonable assumption that. on an average.

ller and inflation. we get a cost of SS million life saved. gonadal and whole-body doses are equal, im-ti Carlson also estimates that the emergency proving X ray machines can save lives at a cost t

@ analy-procedures for pilots flying jet fighter planes of 0.51.8.x 10-* = S2800 each or. after a cor-

~

2nd con-imply a hfe saving cost (for recommending rection for inflation, for S3600flife saved.

d increase ejection) in excess of 5270.000. With an infla-(3) ICRP recommendations. The Internation-h

?esponds tion correction this becomes $450.000. In al Commission on Radiological Protection W

Table I we list the mean proportion between (IC73) recommends values for cost man-rem in

!]

light pay the costs for bomber and fighter pilots at 52 the range S10-5250 to be used in cost-benefit

O

nevalu-million.

analysis. The mean proportion of these is 00 and Morlat (Mo70) estimated that in France S50! man-rem. which, with the BEIR risk esti-

,1 (e flown.

about S900.000, life saved is spent o 1 additional mator of 1.8 x 10-'/ man-rem, corresponds to sn infla-civilian aircraft safety me:sures. Corrected for a cost per life saved of S280.000. With a corree-M; 0.

inflation this becomes 51.2 million.

tion for inflation this becomes S320.000 fatality J

e effects aserted.

Act of (D) Radiation-related acticities (4) OMB yuidelines. The Office of Manage-GQ requires The field of radiation protection involves a ment and Budget, in OMB Circular A-94

'.S. coal great many health protection regulations and (1972) recommends a value of 51000 man-rem

.!.h rniner is standards. and in mmy situations these can be averted-to be used as the justifiable costs in 1

v an ad-translated into a value placed on fatalities analysis of reactor safety systems. With the

-3

benefits, averted. In this section we make this trans-1.8 x ' deaths: man-tem estimator and a k

ost to lation for ceveral cases. In general. radiation-correction for inflation.,this corresponds to S7 M j[

The ir.dced cancers redece life expectancy by million per fatality averted.

~

ii annual about 20 yr, so the listings in the two columns (5) NucIcar industry._radwaste practice. In

}, )

i 2.60 in of Table 1 are identical.

seeking guidance _ for - application of the

?1 ning of (1) Radium in drinking water. The Environ-ALARA principle, the Nuclear Regulatory if80 8

is then mental Protection Agency requires that the Commission imposed interim standards (10

'f; j.

radium content in drinking water be no larger CFR 50. Appendix I) of S1000fman-rem to the Tederal than S pCiliter and that remedial action be wholeibody and to the thyroid as the in-i f sf 1966 taken where necessary to meet this standard cremental cost that must be spent for equip-

$i requires (EP76). They estimate that compliance with ment to avert an incremental population dose.

%}

ners at this standard will. require expenditure of 52.5 It was found that equipment already in place ne 50 ;

million per fatality averted.

. at all ' reactors easily conformed to these stan-y ir. This (2) Medical X-rays. A 1970 study by the U.S.

dards, and therefore this was made permanent J d 377) by Public Health Service (Ro71) indicates that un-in Regulatory Guides 1.109-1.113 (1976L f

'965-70 necessary exposures in medical X-rays can be The fact that industry practice was already 5

. which substantially reduced at a cost averaging 51000 conforming to these standards implies that the

., f(

d.

per machine by attaching more sophisticated money being spent for radwaste equipment iational collimation devices. Terrill (Te72) estimated exceeds S1000 man-rem. For whole-body radi-ands to that this would reduce gonad exposures by 330 ation this implies expenditures of more than f

e ques-man-ram year for each machine, if we assume S1000'I.8 x 10-* = S5.5 million per fatality tys that that this advantage is maintained for 6 yr, this userted. If this is easily exceeded in all plants l ;.

represents an exposure reduction of 2000 man-it is safe to conclude that the aserage expendi-d that rem for 51000, or 50c, man-rem.

tures are at least S10 million fatality averted.

i a B 58 According to the BEIR Report (NA72L The mortality risk from thyroid exposure is

'etw een I man rem of exposure to the whole body in-sery much lower than from whole-body expo-ike an duces 1.S x 10-* fatal cancers. If we make the sure. The UNSCEAR Report (USSCEAR77) u E-13 d he.

f W'

46 SOCIETYS VALUATION OF LIFE SAVING IN RADIATION PROTECTION

~ - p estimates 5-15 x 10-6/ rem. If we take 10 x future, which introduces the question of the 10-*/ rem, the expenditures for 828I emission relative value of averting a fatality now and control must be in excess of $1000!!0 x 10-6 in the distant future. This will be discussed in i

i

= S100 million per fatality averted.

the next section.

1 (6) Defense high-ierel waste. The U.S.

h Department of Energy is proposing a S2.7 bil-lion program to convert high level radioactive ME-DEt.AY CONS! DER 4TioNS Mi waste from the Savannah River Plant to a glass It is conventional in cost-benefit analyses to and store it in a deep geologic repository discount money that will be spent or needed (Oe78). One alternative plan is to leave the in the future at rates varying between 5% and gl waste in its present liquid form and set up a 10% per year. For example if 5% discounting i

o.,

I WR37 trust fund to maintain it, at a cost of $500 mil-is used in the es'timates of the economic value gg lion. It is estimated (En77) that this would of a life from the standpoint of earnings (dis-cause an additional 500 man-rem of radiation cussed in the introductioni. 510.000 earned exposure. The more elaborate program there-20 yr from now is counted as having a present i

fore represents an additio'nal expenditure of value of 55000. This discounting is in addition S2.2 x 10'/500 = S4.4 x 10*/ man-rem averted. to inflation.

Dividing this by 1.8 x 10-' fatalities' man-rem Considerations of thlt type have a tremen-4 gives 525 billion fatality averted.

. dous importance when considering the cost To some extent the decision not to maintain effectiveness of managing radioactive waste

-e the present system is based on the fact that which may cause fatalities far in the future.

4 it relies on future generations maintaining re-One dollar now at even 1*; annual real interest I

sponsibility, although the costs for this are pro-(i.e. discounting inflation) becomes S20.000 vided. An alternative plan which does not after 1000 yr 5400 million after 2000 yr, S8 tril-E depend on such reliance would be to simply lion after 3000 yr, etc. At 5 or 10*, interest the pump the unprocessed waste as a slurry into time before these values are reached is reduced local bedrock. This involves an integrated by a factor of 5 or 10. Based on this reasoning e

exposure of 61.000 man-rem above the option it is completely cost ineffective to spend any chosen, and would cost 5500 million. ThQs the money now to save lives a thousand or perhaps option chosen represents a straight trade-off even a few hundred years in the future. It

.1 of 52.2 x 10' for 61.000 man-rem, or would be far better for those living then if we a

536.000fman-rem which corresponds to S200 would instead set up.a modest trust fund which million life sased. This is the number entered will give them copious supplies of money to in Table 1. Similar projects are planned for the sase lives by methods whose value they will Hanford and Idaho Falls Waste.

be in a better position to judge than we are (7) Cirillan high-lcrcl radioacrire waste. It is now. For example. a simple cure may be found

'i estimated (Co79) that dumping high-level for cancer, or it may be determined that low-radioactive waste in the ocean will eventually lesel radiation is harmless. in either of which q

cause 0.17 esentual fatality.GWe yr without case our money would be wasted.

j doing harm to ocean life, but this is considered This line of reasoning would not be applic-j too dangerous. The present plans are to spend able if our actions now could cause large-scale

.I about 53 million GWe-yr for geologic disposal killing in the distant future, but this is clearly j

as a safer option. This represents a cost of not the case. It would be extremely difficult s-S3 x 10' 0.17 = SIS million per fatality to construct a credible scenario in which a aserted.

M release of deeply buried radioactive waste It should be noted here that the fatalities could cause a detectable number of excess being aserted are seseral thousand years in the cancers at any future date.

s 1

1 i

I m

f

.f.

B-14 I

[^s

.4

'M'.____.______..-______-___-_____._

L' m

~~

N I

BERNARD L. COHEN 47 c

a of the -

Perhaps the concept of a trust fund extend-does not depend on th'e ' articulars of the costs E

p iow and ing over many hundreds of years is unrealistic we assume-with any assumed costs we will ussed in since it assumes that capital will continue to esentually save more lises with medical attract real interest, or that capital can be in-research than with medical care expenditures.

Q, vested to generate more wealth than its ori-But our society does not behave that way-we ginal value. But there are more subtle ways spend far more money on medical care, and y

in which we can invest money for the benefit even our research expenditures are targeted at g

lyses to of our progeny even more effectively. For short term pay-offs. Congress was willing to J

needed example, money invested in research now bene-spend vast sums on cancer research when it i

5% and fits all future generations, paying a high rate believed that it would develop a cure for cancer l {

ounting of compound interest if we can judge by past in our lifetime. Ifit were informed that the cure 1 ;

ic value performance. The high standard of living we would not come for f00yr, the money would j

.j igs(dis-enjoy today is largely the product of small all but dry up instantly, although the number earned amounts of money and effort invested in of lives that would be_ saved over the next

,h.

present research over the past two centuries.

several thousand years would be essentially the 7

iddition Another way of arriving at a similar conclu-same.

1/i sion is to recognize that our attempts to spend If we accept the idea that the value of lives

.) ]

tremen-money now to save lives in the distant future saved far in the future-should be discounted i

1e cost represents what some consider our moral obli-at 1*yyear, the final entry of Table I represents waste gation to leave each segme6t of the environ-a rough estimate of the cost / life saved by not fh future.

ment to our progeny in at least as gocJ a con-dumping nuclear waste in the oceans.

.jg ;

interest dition as we found it. This is an intuitively

-q.

$20.000 appealing goal, but it is wholly unrealistic.

rounc SS tril-Anything we can do in this regard is com-Another approach to determining public 7 ag;i est the pletely overshadowed by the horrible legacy we attitudes toward the v'alue of saving a life is g

educed leave our progeny when we consume all of the by polling samples of the public on questions

~

Q@

isoning earth's rich mineral resources. What we can do whose answers depend only on that evaluation.

J ad any is make enough positive contributions to turn ActonlAc73) used this approach to determine ail $

<rhaps the world over to our progeny in better orcrall how much people were willing to spend for ure. It condition that we found it. It seems obvious service'by a mobile coronary care unit, and dp 2ifwe that with this goal in mind, it would be better depending on how the question was phrased rh which to spend money on research than to spend mil-the equivalent value of life saving was 528.000

!?

ney to lions of dollars to save the life of some person or 543.000. This is~in ' reasonable agreement

.- t

y will living in the distant future.

with the value in Table 1.

[I ne are But since this paper deals with society's We prewnted the same set of questiors to (W

found valuations, we must point out that society does classes of about 100 students in a course on

] low-not value future lives equivalently with lives of Energy and Environment at the University of which those now living. For example with such a phil. Pittsburgh in two successive years. and essen-

' f.]

osophy we would spend nearly all our money tially the same average results were obtained.

rpplic-on medical research rather than on medical We present a few examples, all of which the i

-scale care. According to Table I we can save a life class was told are realistic:

L

learly now for every 550.000 or so that we spend on (1) If control equipment could be added in Rcult medical care, and let us say that with medical a nearby nuclear power plant to reduce your

';;'i ich a research we can save one lifetyear for every mortality risk from I in a million to 1 in 2 caste SS million dollars spent;if our concerns extend million. how much extra would you be willing

.xcess to 1000 yr, we sase 10 times as many lives with to pay for electricity in order to add them?

the research. It is obvious that this argument The average answer was $25 which gives a

-I d I l l' l.

B-15 I

- mw.~.5" m.-_ _ _ _ _. _ -

48 S7CIETTS VALUATION OF LIFE SAVING IN RADIATION PROTECTION value of life saving at 525/5 x 10-' = S50 It is cicar from the discrepancies in valuation million.

implied by the various answers that these (2) If control equipment could be added in values ar~e not calculated even subconsciously, a nearby coal-fired power plant to reduce your at least by an average university student. This mortality risk from 1 in 1000 to 1 in 2000, seems especially clear from No. (1) and No.

how much extra would you be willing to pay (2) where the wording was almost identical and for electricity in order to add them? The aver-the numerical probabilities were given expli-age answer was 560. which gives a value of life citly. The best interpretation we could devise saving at 560/5 x 10" = S120.000, is that a few tens of dollars sounds like a (3) How much money would you be willing reasonable amount to spend for a risk reduc-to have the government spend on a health pro-tion or a little less on a single day trip. S170 gram that would save 1000 lives? The average is a reasonable extra cost when buying a car.

answer was 52.5 billion, which corresponds to 50c extra seems reasonable for a pack of cigar-52.5 million per life saved.

ettes, and a few bijlion dollars is about right (4) If having an air bag in your car does no for a government program; in each case, the harm other than adding to the cost, and if it reduces your mortality risk from I in 1500 to I expenditure is enough to be meaningful, but not enough to make a big difference, in 3000, how much would you be willing to pay for the air bag? The average answer was S170 msetssios which corresponds to S110fi/3000) = S500.000 value for life saving.

The wide variatic ns in the values in Table 1 (5) (For cigarette smokers onlyt if a new-would seem 'to be worthy of extensive discus-type cigarette came out that was in every way sion. Some of them can be justified. The low the same as your present brand except that it value on food for overseas relief r.epresents a was guaranteed to avoid bad health effects, common' human attitude that charity begins at how much extra would you be willing to pay home, and the higil expenditures for protecting for it? The average answer was 50c/ pack. A miners and coke workers may be justifiable as I pack' day smoker buys 20.000 packs in a life-the price they demand of us for their services time, so at 50e/ pack he pays $10,000. A man (ahhough they should perhaps be offered the 4

loses 6.5yr of life expectancy and a woman alternative of having some of the costs now loses 2.6 years from this habit (Co79a). and spent in protecting them added to their wages instead).

since boys were a majority the average is 5 yr.

But aside from these few cases. it seems diffi-If we assume that' an average early death in-volves 20 yr loss of life expectanby. a'l-pack? cult to justify the differences morally, indeed.

day smoker has one chance in four of being one could argue that it is highly immoral for such a victim. This gives a valuation of life 5100 million in funds obtained from the gen-saving at $10.000 (1/4) = S40.000.

eral citizenry to be spent in saving one life from (6) If you were going on a 500-mile trip and 83'l emissions when that same money could had your choice between a bus and an auto-save 2000 lives if it were spent on medical or traffic safety programs which are being held mobile. and if all aspects of the two choices back for lack of money.

were equal except for the added safety of the bus, how much extra would you be willing to Sociologists and economists usually try to pay to go by bus. Many answers were zero, explain rather than tojustify discrepancies like but the average was S13. The risk is about those in Table 1 (Fi76: Li78a: S17St Human fears are not necessarily correlated with actual.

1 x 10"/ mile (for thruway 'trasel) x 500 dangers. and government agencies are more

= 5 x 10 ", so the valuation implicit is g

513/5 x 10 S2.6 million.

concerned with allaying fears then with avert-b ing dangers. This could be interpreted as a B-16 h

A

^

J l

i l

BERNARD L. COHEN 49 i

valuation -

cynical disregard for human welfare, but on the De78 Denison E. F,1978. " Effects of Selected 1

hat these other hand it could be viewed as participatory Changes in the Institutional and Human Environ-

'nscious! -h democracy functioning properly by being re-ment on-Output per Unit ofInput", Survey of Cur-N r.

rent Business. January 1978.

dent. This sponsive to the desires of the etttzenry. In any Di72 Dickir. son L,1972. " Evaluation of the Effec-l and No.

case, it explains the large values in Table I tiveness of Cytologic Screening for Cenical plical and for radiation-related activities-with the excep-Cancer", Afa.m Clinic Proc. 47, $50 (August 1972).

o en expli-tion of medical X-rays which the public does Eg77 Egan E 1977, Private communication. Catho-l

I

[ld devise not view as radiation, and the ICRP recom, ye R lief Serv c New Yo k.

}

ps like a mendations which are not made (or used) by (ERDAk 1977," Alternatives for Long-Term hian-

! l rik reduc-government agencies. The only solution to this agement of Defense High-Level Radioactive h

Irip, S170 dilemma would seem to be education, and it Waste", ERDA-77-42/1.

hgacar is clear from Table I that the radiation protec. EP76 EPA (Environmenta! Protection Agencyk j

Report EPA-570 9-400. Washington. DC.

}! l, j of cigar-tion community has done a particularly poor Fi76 Fischhoff B, Slouc P. and Lichtenstein S, but right job of educatine the pubh.c.

1976. "How Safe. is Safe Enough'" Decision case, the Research Report 741. Eugene. Oregon.

T[y sful, but REFERE3cEs Fi77 Fischhoff B.,19'77. " Cost-Benefit Analysis and d.

Ac73 Acton J. P,1973. " Evaluating Public Pro-the Art of hiotorcycle hiaintenance", Policy i

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M,j.

Rand Corp. Report R-950-RC. Los Angeles. CA.

Fo75 Fontana R. S, Sanderson D. R, Woolner Ba78 Barnum H 1978. "An Economic Analysis of L. B.; h1 iller W. E, Bernatz P. E Payne W. S.

t discus-sia", unpublished.

Chest 67,511.

{Jb Table I an Expanded Program of Immunization in Indone-and Taylor W. F,1975."The Ntayo Lung Project".

.jif the low Bo71 Bolt R. J 1971. " Sigmoidoscopy in Detection Fo78 Fontana R. S,1978. Private communication, i p}

{#5#nts a and Diagnosis of the Asymptomatic Individual".

Mayo Cimic. Rochester h1N.

, {E Cancer 28,121.

Fr65 Fromm G,1965. " Civil Asiation Expendi-

~

>egins at Bo73 Boucot K. R. and Weiss W,1973. "Is Curable tures",in: Afrasuring the Benefits of Gorernment In-i stecting Cancer Detected by Semi-annual Screening?" J.

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Washington. DC. "

(i,1 services Bo73a Boucot K. R. and Weiss W,1973," Screening Ga77 Gallup Organization. Princeton. NJ., January rred the I r Lung Cancer". J. A Af A 227.566.

1977- (Survey sponsored by National Cancer d.h Br69 Brett G. Z,1969. " Earlier Diagnosis and Sur-Society.)

k.'

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darus for Protection of Passenger Car Occupants",

s.

ns diffi.

Ca63 Carlson J. W.,1963. " Valuation of Life Sas-Washington, DC'.

Indeed, ing". Harvard Unhersity Thesis.

Ge76a. General Accounting Office.1976. "htanage-

' [, y Co74 Colley J. R. T 1974 " Diseases of the Lung",

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!ical or Co76a Conley B. C,1976. "The Value of Human 936.

lh Life in the Demand for Safety". Am. Econ. Rcr.

Gr72 Crosse R. N,1972. " Cost-Benefit Analysis of g held

~

[.

66.45.

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Co77 Commerce. Dept. of.

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National Safety Council. Chicaco. IL.

es like Co79 Cohen B. L 1979. " Ocean Dumpmg of High He77 Heyden. S 1977 ~ Prisate communication fumcn Lesel Waste". Niul. TM. in press, dated October 3.1977. Duke Unnersity hiedical Co79a Cohen B. L,1979. "A Catalog of Risks".

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Cytology in the Dedining Morbidity and Mort.nlity Ho74a Holland. W. W.,1974. "Takine Stock". Lan.

as a of Cerucal Cancer" Cancer 34,20lS.

cer 1974.ii, p.1494 i

4 8-B-17 M.R m.:rA m. mum %. w m-,=. w r..c m w, m-m.m_.. m _ _,

M

So SOCIETY'S VALUATION OF LIFE SAVING IN RADIATION PROTECTION IC73

~ -

t

. ICRP (International Commission on Radiolo-. Na78 National Safety Council,1978 " Driver Edu-gical Protection) Publication No. 22.1973, "Impli-cation Status Report" Chicago IL cations of Commission Recommendations that Oe78 Oertel G,1978. Talk presented at NRC Doses Be Kept as Low as Reasonably Achievable" Workshop on High-Lesel Radioactise Waste (New York: Pergamon Press).

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In?6 Insurance Institute for Highway Safety,1976, Pa75 Patrick L. M,1975, " Passive and Actise Re-Status Report, ll,17, November 2,1976, p. 4.

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c r1-a Ka76 Ka r A. R,1976. " Saga of the Air Bag". The Ri79 Riordan J, 1979. Private communication.

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Health Services Adm. Washington. DC.

5,.?.

g for Highway Safety. Status Report, 11. 18, Ro71 Roney P. L, If 71. " Preliminary Estimates T,<

November 30.1976, p.1.

from the USPHS 1970 X-ray Exposure Study",

g,,

{;

Ka76a Kaywood R.,1976, "The Stakes are High",

U.S. Public Health Service. Washington, DC.

J. Traf. Safety Ed July 1976, p. 5.

Ru?8 Ruchinskas J. P,1978, Private communica-

,o

.r.

K168 Klarman H. E., Frances J. O. and Rosenthal tions giving generally accepted value. General Elec-hh$

G. D 1968, " Cost Effectneness Analysis Applied tric Co Housewares Din Bridgeport. CI'.

to the Treatment of Chronic Rehal Disease", Afedi-Sc68 Schelling, T. in: Problems in Public Expenditure cal Care 6. 48.

(Edited by Chase S. B.L Brookings Inst Washing-Kr77 Kristein M,1977, " Economic issues in Pre-ton. DC.

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Sc78.Schwing R. C,1973, " Expenditures to Reduce Kr77a Kristein M.

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Li78a Linnerooth J,1978, "The Value of Human January 1977, p. 30.

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1976, p. 39.

~

q,,; e M

any B-18 sk

MW MR s

BERNARD L COHEN SI

'Driser Edu-Te72 Terrill J. G,1972. -Cost-Benefit Estimates for Effects of-Ionizing Radiation-(New York: United Major Sources of Radiation Exposure", Am. J. Pub.

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!['

Th75a Thaler R. and Rosen S,1975. 'The Value Assn. Jr.114. No.11. June 5.1976.

"l kreening by of Saving a Life", in: Household Production and Ze75 Zeckhauser R,1975. -Procedures for Valumg e

Con:umption. National Bureau of Economic Res, Lives". Public Policy 23,419 (Fall 1975k l.

i Should We New York NY.

Ze76 Zeckhauser R. and Shepard D 1976. -Where II I

crest. Spring UNSCEAR77 United Nations Scientific Committee Now for Saving Lives". Law and Contemporary on Effects of Atomic Radiation.1977. " Sources and Problems 40, No. 5, p. 5.

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ATTACmiENT C

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"Ec f:.r tne plani.s being mn;2 area ma:3 t be carefully examined to ascertain the sources of the uncertainties and their impact on the validity of the comparisons being attempted.

Q.25 Is a comparison of the Indian Point results With the Cotnmission's Safety Goals germane to answering Commission Question _ Five?

A.25 Not in my view.

The principal reason for this view is that what the Commission ultimately seeks to assess through this proceeding is the acceptability of the risks. posed by operation of Indian Point Units 2 and 3 Comparisons of. risk estimates with the safety goals does not accomplish this goal for two principal reasons.

First, the safety goals are incomplete estimators of ' risk.

As noted by the Risk Assessment Review Group report (NUREG/CR-0400, page ix], there are many accident consequences associated with risk.

The safety goals focus on early fatality, latent cancer, and core melt risks.

Other

~

consequences which can be important risk considerations are land contamination, financial impacts, and non-fatal injuries and disease.

Second, the safety goals are intended as assessment toois, not'as " speed

~

limits" [Bernero, page 7].

A given plant' may exceed s. safety goal and still not represent an unacceptable risk; by the same token, a given plant might meet all of the safety goals, and still represent an unaccaptable risk.

Moreover, the safety' goals are s'ubject to change after the two-year evaluation period which the Commission has adopted (Safety Goal Policy Statement, pages 2, 4, and 8].,

j

~

It should also be noted th'at during' the two-year evaluat1on' period. the Commission has stated that the safety goals and quantitative design

(

objectives should not be used in the licensing process, and are not to e

be litigated in NRC hearings.

The Commission has explicitly limited the use of the safety goals during the evaluation period to:

(c) examiriation of proposed and existing regulatory requirements; (b) establishment of research priorities; (c) resolution of generic safety issues; and (d) definition of the relative importance of issues as they arise (Safety Goal Policy Statement, page 7],

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26-Q.26 Are there any conclusions regardin6 the risk r.f Indtan Foir.t rehtive t?

the " range of risks" that can be drawn on the basis of information, now available?

Q.26 Yes.

On a site basis, and considering the actual power level of the

~

Indian Point reactors, it is clear that the Indian. Point site is an outlier with respect to other plants.

The only sites which approach the conditional mean consequences (based on an SST-1 release) for Indian Point are Zion and Limerick. These two sites'are also outliers.

Considering design / operation risk characteristics. valid comparisons are not feasible at present.

There are a limited number of PRA studies available, the typicality of the reactors upon which the studies have been performed has yet to be established.

Furthermore, the existing PRA studies vary significantly with regards to completeness, asstanptions, methodology, data base, and degree of conservatism employed in the analyses.

It would be premature to attempt to rank reactors according to absolute risk because of these factors. _

implications do these conclusions have regarding ~ the desirability Q.27 What

~

of accident mitigation systems?

A.27 Serious consideration of such mitigation systems for Indian Point should be undertaken.

It will be a period of several year's (ht best) before it will be reasonable to attempt relative risk rankings based on aboslute risk projections.

Waiting for such r,esults, if they are indeed available in a few years, poses an uncertain risk to the population surrounding Indian Point.

It is clear 'that the risk associated with

~

site risk characteristics is -high compared to other sites.

The risk associated with design / operation risk characteristics is highly uncertain, but provides no firm basis for delaying in-depth consideration of accident mitigative measures.

pt Q.28 Does consideration of mitigative measures using a.value of $1,000 per person-rem averted provide a reasonably comple'te view of the value of mitigation systems?

A.28 No.

Use of the $1,000 per person-rem averted standard reflects a hidden It would judgment that reactors in gen,eral are already adequately safe.

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/

r.:qo t r e a very ru g h ccre melt pr..bability e cmb i w! wi n a

rg-l conditional probability of a large release to make even the most modest l

l add-on mitigation system " cost-effective" under the $1,000 per person-rem averted standard.

Moreover, the standard does not reflect the degree to which fatalities, injuries, and offsite property damage is caused by the person-rem exposure.

This is especially true with respect to consequences whose magnitude is determined on a threshold basis, since the number of persons suffering the early consequence _s is strongly determined by population magnitude and distribution near the plant site.

Using the CRAC2 results from the Sandia siting study, D.R.

Strip of Sandia National Laboratories has examined this issue by ranking the number of sites versus the number of early fatalities, early injuries, latent I

cancer fatalities, and offsite property damage per thousand person-rem of exposure for an SST-1 release.

The results for early fatalities per J

thousand person-rem span more than a factor of 1,000.

The results for

)

early injuries span a factor of about 70.

The results for offsite property damage span about a factor of 10.

The results for latent cancer fatalities span a range of less than__a factor of 2

(NUREG/CR-2899, page 6].

Thus, the results of applying the 1,000 per person-rem averted will not be consistent ^from site-to-site.

In addition, with regard to latent cancers, the present use of the

$1,000 per person-rem standard involve's two problems.

First, the reevaluation of the atomic-bomb casualty data is ongoing; Radford asserts that this reevaluation will support the linear hypothesis for 1

cancer risk coefficients, rather than the present model which is based on a liner-quadratic formulation [ Rad ford, page 143.

Second, the present consequences model calculates only fatal cancers; there would also be a large number of non-fatal cancers whose costs would not be assessed under the $1,000 per person-rem standard.

In addition, the costs associated with treatment of early injuries would not be assessed as the standard is presently designed.

The value of a mitigation system for Indian Point should also be

.C-3

or l y :4hu*,elown o!'

20n.it :erett 1.

5:c.tj ;;c:', u:.n wi t h, c 0rit. ? :; t. ! it., !. +. !'c t'

-s t r -

the reactors.

The costs of an early shutdown of Indian Point Units 2 and 3 will be addressed in testimony by Vince Taylor, to be filed under Comission Question Six in this proceeding.,,

0.29 Does this conclude your testimony?

A.29 Yes.

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C.-4

UNITED STATED OF AMERICA a

NUCLEAR REGULATORY COMMISSION ATOMIC SAFETY AND LICENSING BOARD Before Administrative Judges:

James P.

Gleason, Chairman Dr. Oscar H.

Paris Frederick J. Shon.

_--__-__-_-----_-----_____--_____x CONSOLIDATED EDISON COMPANY OF Docket Nos. 50-247-SP NEW YORK, INC. (Indian Point, 50-286-SP Unit No. 2)

POWER AUTHORITY OF THE STATE OF NEW YORK, (Indian Point, Unit No. 3)

April 1, 1983

x CERTIFICATE OF SERVICE -

I certify that I have served copies of-

~

Licensees ' Motion for Submission Under Commission Question 5 of " Licensees' Testimony of Bernard L. Cohen'on Commission Question 1" by deposit in the United ' States mail, first class postage prepaid this #irst day of Apr_il,.1983 Docketing and Service Branch Mr. Frederick J.

Shon Of fice of the Secretary Administrative Judge U.S. Nuclear Regulatory Atomic Safety and Licensing Commission

~

Board Washington, D.C.

20555 U.S. Nuglear Regulatory Commission James P.

Gleason, Esq., Chairman Washington, D.C.

20555 Administrative Judge 513 Gilmoure Drive James A. Laurenson Silver Springs, Maryland 20901

' Administrative Judge Atomic Safety and Licensing Dr. Oscar H.

Paris Board Administrative Judge U.S. Nuclear Regulatory Atomic Safety and Licensing Commission Board Washington, D.C.

20555 U.S.

Nuclear Regulatory Commission Washington, D.C.

20555

Paul F. Colarulli, Esq.

Charles J.

Maikish, Esq.

Joseph J.

Levin, Jr., Esq.

Litigation Division Pamela S. Horowitz, Esq.

The Port Authority of.

Charles Morgan, Jr., Esq.

New York and New Jersey Morgan Associates, Chartered one World Trade Center 1899 L Street, N.W.

New York, New York 10048 Washington, D.C.

20036 Ez ra I. Bialik, Esq.

Charles M.

Pratt, Esq.

Steve Leipsiz, Esq.

Stephen L.

Baum New York State Attorney Power Authority of the State General's Office of New York Two World Trade Center 10 Columbus Circle New York, New York 10047 New York, New York 10019 andrew P. O'o.ourke Ellyn R.

Weiss, Esq..

Westchester County Executive William S. Jordan, III, Esq.

_ 148 Martine Avenue Harmon & Weiss White Plains, New York 10601 1725 I Street, N.W.,

Suite 506 Washington, D.C.

20006 Renee Schwartz, Esq.

Paul Chessin, Esq.

Joan Holt, Project Director Laurens R.

Schwartz, Esq.

Indian Point Project Botein, Hays, Sklar & Herzberg New York Public Interest 200 Park Avenue Research Group New York, New York 10166 9 Murray Street New York, New York -10007 Stanley B.

Klimberg New York State Energy Melvin Goldberg

- 2 Rockefel'ler State Plaza Staff Attorney Albany,.New York 12223 New York Public Interest Research Group Ruth Messinger 9 Murray Street Member _of;the Council of the New York, New York 10007 City of New York

- District #4 Jeffrey M.

Blum City Hall New York University Law School

. New York, New York 10007 423 Vanderbilt Hall Washington Square South

- Marc L.

Parris, Esq.

New York, New York 10012

. County Attorney County of Rockland Donald Davidoff, Dirtetor 11 New Hempstead Road Radiological Preparedness New City, New York 10010 Group Empire State Plaza Craig Kaplan, Esq.

Tower Building - Room 1750 National Emergency Civil Albany, New York 12237 Liberties Committee 175 Fifth Avenue - Suite 712 New York,-New York 10010 i

Joan Miles A-lan Latnan, Esq.

Indian Point Coordinator 44 Sunset Drive New York City Audubon Society Croton-on-Hudson, New York 1052:

71 W.

23rd Street, Suite 1323 New York, New York 10010 Richard M..Hartzman, Esq.

Lorna Salzman Greater New York Council on Friends of the Earth, Inc.

Energy 208 West.13th Street c/o Dean R. Corren, Director New York, New York 10011 New York University Fleisher t

26 Stuyvesant Street Zipporah S.

New York, New York 10003 West Branch Conservation 443 Buena Vista Road Atomic Safety and Licensing New York, New York 10956 Board Panel U.S.

Nuclear Regulatory Mayor F. Webster Pierce Commission Village of Buchanan Washington, D.C.

20555

~ 236 Tate. Avenue Buchanan, New York 10511 Atomic Safety and Licensing Judith Kessler, Coordinator Appeal Board Panel Rockland Citizens for Safe U.S.

Nuclear Regulatory Energy Commission 300 New Hempstead Road Washington, D.C.

20555 New City, New York 10956 Richard L. Brodsky -

- David H.

Pikus, Esq.

Member of the County Legislature Richard F.

Czaja, Esq.

Westchester County

- 330 Madison Avenue County Office Building New York, New York 10017 White Plains, New York 10601

~

Phyllis Rodriguez, Spokesperson Amanda.Po_tterfield, Esq.

Parents Concerned About New York Public Interest Indian Point

- Research Group, Inc.

P.O. Box 125 9 Murray Street, 3rd Floor Croton-on-Hudson, New York 10520

. New York, New York 10007 Charles A.

Scheiner Janice Moore, Esq.

Co-Chairperson Office of,the Execitive Westchester People's Action Legal Director Coalition, Inc.

U.S. Nuclear Regulatory P.O.

Box 488 Commission White Plains, New York 10602 Washington, D.C.

20555 Stewart M. Glass Regional Counsel, Room 1347 Federal Emergency Management Agency 26 Federal Plaza

~

New York, New York 10278 S

S

Jonathan D.

Feinberg 3

New York State Public Service Commission David 3.

Duboff Three Empire State Plaza Westchester People's Albany, New York 12223 Action Coalition 255 Grove Street Steven C. Sholly White Plains, New York 10601 Union of Concerned Scientists Sper.ce W.

Perry 1346 Connecticut Avenue, N.W.

Office of General Counsel Suite 1101 Federal Emergency Washington, D.C.

20036 Management Agency 500 C Street Southwest David Lewis, Esq.

Washington, D.C.

'20472 Atomic Safety and Licensing Board Panel Andrew S. Roffe, Esq.

U.S. Nuclear Regulatory

_ New York State Assembly Commission Albany, New York 12248 Washington, D.C.

20555 Datedr April 1, 1983 New York, New York

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