Health Physics

WASHINGTON, D.C. — The American Nuclear Society (ANS), a nonprofit representing over 12,000 professionals in the fields of nuclear science and technology, issues the following response to "National Analysis of Cancer Mortality and Proximity to Nuclear Power Plants in the United States," by Yazan Alwadi, Petros Koutrakis, et al., published February 23, 2026, in Nature Communications (doi: 10.1038/s41467-026-69285-4):

Experts with ANS, including health physicists and radiation protection specialists, have reviewed the study published in Nature Communications purporting to show associations between residential proximity to nuclear power plants and elevated cancer mortality rates across U.S. counties from 2000 to 2018. This study contains fundamental methodological shortcomings, acknowledged by the authors themselves, that prevent it from supporting any credible scientific conclusions.

The Bottom Line:

This flawed ecological study does not advance our understanding of radiological risk. The authors themselves state that their findings "cannot establish causality" and that their study "does not include dosimetry," admissions that undermine the study's central premise and that ANS urges journalists and policymakers to weigh carefully.

One of the more pivotal issues in facilitating the use of radiation sources—including nuclear power—in the United States (and most of the Western world) is concern about the health effects of low levels of radiation. The current regulatory assumption is that every additional increment of radiation linearly increases the risk of cancer.

Chris Wagner has more than 40 years of experience in nuclear medicine, beginning as a clinical practitioner before moving into leadership roles at companies like Mallinckrodt (now Curium) and Nordion. His knowledge of both the clinical and the manufacturing sides of nuclear medicine laid the groundwork for helping to found Eden Radioisotopes, a start-up venture that intends to make diagnostic and therapeutic raw material medical isotopes like molybdenum-99 and lutetium-177.

Mauritius Hiller

The nuclear industry is being pushed forward by a global tailwind that includes plans for more conventional nuclear plants and an exciting trend toward developing small modular reactors. These include advanced safety features and novel reactor designs, often powered by new types of fuel.

This new technology must meet existing stringent safety and security demands and must be safe for the environment, workers, and general population. Wide acceptance of international standards, as well as standardization of designs and plant concepts, will help in the long run.

Radiation protection (RP) professionals play a key role from the very start of the design phase. There is rapid and continuous development in the field of RP. Improved computational tools enable better modeling and understanding of radiation shielding, detection, and effects. Nuclear safeguards and nuclear criticality safety are increasingly important.

Kathryn Higley

For nearly a century, the National Council on Radiation Protection and Measurements has served as the United States’ leading authority on radiation protection. Established in 1929 as the Advisory Committee on X-ray and Radium Protection, the NCRP was created in response to growing concerns about the health risks of radiation exposure following the discoveries of X-rays and radioactivity.

It was formally chartered by Congress in 1964 through Public Law 88-376, also known as the National Council on Radiation Protection and Measurements Charter Act. The NCRP has provided science-­based guidance for the public, workers, and the environment. Its work spans a wide range of topics, including protecting patients and workers in medical, industrial, and environmental settings; supporting emergency preparedness; developing risk models for low-dose exposures; guiding safe practices for new technologies such as advanced nuclear reactors; and providing information on wireless communication devices.

Radiation protection specialists agree that clear communication of radiation risks remains a vexing challenge that cannot be solved solely by finding new ways to convey technical information.

Earlier this year, an article in Nuclear News described a new radiation risk communication tool, known as the Radiation Index, or, RAIN (“Let it RAIN: A new approach to radiation communication,” NN, Jan. 2025, p. 36). The authors of the article created the RAIN scale to improve radiation risk communication to the general public who are not well-versed in important aspects of radiation exposures, including radiation dose quantities, units, and values; associated health consequences; and the benefits derived from radiation exposures.

In commercial nuclear power, there has always been a deliberate tension between the regulator and the utility owner. The regulator fundamentally exists to protect the worker, and the utility, to make a profit. It is a win-win balance.

From the U.S. nuclear industry has emerged a brilliantly successful occupational nuclear safety record—largely the result of an ALARA (as low as reasonably achievable) process that has driven exposure rates down to what only a decade ago would have been considered unthinkable. In the U.S. nuclear industry, the system has accomplished an excellent, nearly seamless process that succeeds to the benefit of both employee and utility owner.

Craig Piercy
cpiercy@ans.org

So, President Trump has just kicked the low-dose radiation hornets’ nest.

Specifically, his recently signed executive order “Ordering the Reform of the Nuclear Regulatory Commission” calls for the NRC to “reconsider reliance” on the linear no-threshold (LNT) theory and the ALARA (as low as reasonably achievable) standard for radiation protection.

This directive will certainly reignite a vociferous debate within the radiation research community over the continued efficacy of using LNT as the basis for protecting the public and the environment, a community that has been wracked with controversy on this matter for the last few years.

I must admit that whenever the low-dose issue comes up, my first thoughts always go to Sayre’s Law.

Dewji

Bahadori

Caffrey

Three authorities on health physics have written a response to President Trump’s Executive Order 14300, “Ordering the Reform of the Nuclear Regulatory Commission.”

Published June 27 on Substack, “Radiation Protection Policy in a Nuclear Era: Recommendations from Health Physicists in Response to EO 14300” was written by Emily A. Caffrey, assistant professor and director of the Health Physics Program at the University of Alabama–Birmingham; Amir A. Bahadori, associate professor at Kansas State University; and Shaheen A. Dewji, assistant professor at the Georgia Institute of Technology.

There is a critical knowledge gap regarding the health consequences of exposure to radiation received gradually over time. While there is a plethora of studies on the risks of adverse outcomes from both acute and high-dose exposures, including the landmark study of atomic bomb survivors, these are not characteristic of the chronic exposure to low-dose radiation encountered in occupational and public settings. In addition, smaller cohorts have limited numbers leading to reduced statistical power.