This paper is based on:

An "Ockham's Razor" presentation, first broadcast on ABC Radio National on 28 December, 1997. (Ockham's Razor is produced by the ABC's Science Unit under the direction of Robyn Williams.)

An October 1997 article in Search, the official publication of the Australian and New Zealand Association for the Advancement of Science.

On September 3, 1997, the former science minister Peter McGauran announced the federal government's decision to replace Australia's ageing nuclear research reactor. This reactor, known as HIFAR, is located at Lucas Heights in southern Sydney, at which site the Government proposes to locate the new reactor. While the Government's intention is clear, the proposal to build a new reactor is open to serious question. Currently it is the focus of an assessment under the 1974 Environmental Protection Act, an inquiry by a federal Senate Committee, and much opposition from local residents and environmental and anti-nuclear groups.

The proposed new reactor was announced with a great deal of fanfare about "saving lives" with nuclear medicine. Indeed, Minister McGauran's press release began with the words: "The construction of a new research reactor at Lucas Heights will build on Australia's life-saving nuclear medicine capabilities."

But nuclear medicine is not responsible for saving many lives. Over 98% of nuclear medicine procedures are for diagnostic, not therapeutic, purposes. Moreover it is frequently acknowledged in the medical literature that data on costs and benefits are thin on the ground. Thus Dr. Patton, writing in the journal Seminars in Nuclear Medicine, notes that "Costs associated with nuclear medicine include money, time, discomfort, possible drug reactions, radiation dose, and the hypothetical risk of radiation-associated cancer." And he adds that "Much work remains to be done in forming a coherent, consistent procedure for assessing cost-effectiveness in nuclear medicine." Likewise, Professor Khafagi, a member of the ANSTO Board and a prominent nuclear medicine physician, acknowledges in the journal ANZ Nuclear Medicine that "thorough evaluation of the only meaningful end-point - patient outcome - is scanty."

The issue of iatrogenic (medicine-caused) disease also needs mention. Expert bodies such as the International Commission on Radiological Protection (ICRP) acknowledge that there is no safe dose for radiation exposure. Using the ICRP's risk estimate for fatal cancers arising from ionising radiation, a study by the Australian Radiation Laboratory concluded that of the patients subjected to diagnostic nuclear medicine scans in 1991, approximately 56 would subsequently die from cancer as a result of the radiation dose (Colmanet and Samuels). Adjusting for the growth in nuclear medicine, approximately 164 patients subjected to diagnostic nuclear medicine procedures in 1998 will subsequently die from cancer caused by the radiation exposure. ANSTO says that by the year 2007, there will be 1.5 million nuclear medicine procedures in Australia. Thus it can be calculated that approximately 495 of these patients will die from cancer caused by the radiation exposure.

Despite these qualifications and reservations, we can safely assume that nuclear medicine is a useful medical technology and that an ongoing supply of medical isotopes is needed. The crucial question is whether Australia needs a new reactor for this purpose. Alternatives to a new reactor are available; but before considering these, it is worth briefly considering some reasons why it would be preferable not to build a new reactor. These include radioactive waste problems, nuclear weapons proliferation concerns, public health and safety issues, and the financial costs.

First, radioactive waste. The Government has announced a strategy to deal with the stockpile of spent fuel rods currently stored at Lucas Heights. These highly-radioactive fuel rods have been accumulating since HIFAR first began operating in the late 1950s. Seven hundred fuel rods are to be shipped to the United States for indefinite storage. The remaining 1300 fuel rods will be shipped to Scotland for reprocessing, with the reprocessing wastes returned to Australia in 10-20 years time.

The shipment of spent fuel rods over vast distances carries with it public health and safety risks, as well as environmental ones. Where the reprocessing wastes will be stored, when they are returned from Scotland, is anyone's guess. Successive Governments have been unable to establish a long-term repository for low-level wastes in Australia, and it will surely be more difficult and time-consuming to establish a long-term repository for the long-lived intermediate-level wastes arising from reprocessing. The Government's strategy has no ethical standing; it simply shifts radioactive waste problems overseas, and from this generation of Australians to the next.

Over three quarters of the waste stored at Lucas Heights is a by-product of isotope production. ANSTO plans to substantially increase isotope production in the coming decades. As a consequence, annual production of some categories of radioactive waste will increase twelve-fold by the year 2025, while for other forms of radioactive waste a four-fold increase is projected.

Second, nuclear weapons proliferation concerns. India and Israel have both used research reactors to produce plutonium which has been used to develop arsenals of nuclear weapons. Many other countries have used research reactors, overtly or covertly, in support of nuclear weapons programs - Iraq was one recent, notorious example. While there is very little likelihood of an Australian Government pursuing a nuclear weapons program in the foreseeable future, the development and export of alternative technologies - such as cyclotrons - would represent a concrete Australian contribution to global efforts to prevent the proliferation of nuclear weapons.

Third, safety issues. How safe are research reactors to those who operate them and to those who live in their vicinity? There have been at least 13 serious accidents involving research reactors around the world, and at least three of these resulted in loss of life.

As for the health effects of ionising radiation - whether from nuclear medicine, radioactive emissions from reactors, or other sources - the issues are complex and far from resolved. In recent years, at least six research institutes have found new evidence linking radiation exposure to genomic (genetic) instability which can, in turn, lead to mutations in future generations (Edwards). According to Dr. Eric Wright, a radiobiologist from the British Medical Research Council: "There is no doubt that genomic instability is a real consequence of radiation exposure." Apart from the possibility of inducing cancer in future generations, radiobiologists are concerned that radiation-induced genomic instability may cause a "scattergun effect" - small increases in a wide range of diseases including defective foetal development, and brain disorders such as Alzheimer's, Parkinson's and motor neuron diseases.

Fourth, the financial costs. The proposed new reactor will cost at least $300 million, plus hundreds of millions of dollars to operate the reactor and for storage and disposal of the radioactive waste. Yet reports in the science journal Search reveal that funding for medical research is to be cut by a massive 30% over the next two years, and cuts to scientific research over the Coalition's first two years of government total a projected 10.9% (Pockley). It is doubtful that the proposed new reactor can be justified in the context of these funding cuts. Barry Allen, Professor of Pharmacy at Sydney University and former Chief Research Scientist at ANSTO, says:

"The reactor will be a step into the past .... (It) will comprise mostly imported technology and it may well be the last of its kind ever built. More importantly, anticipated developments in functional magnetic resonance imaging may well reduce the future application of reactor-based nuclear medicine. Certainly the $300 million reactor will have little impact on cancer prognosis, the major killer of Australians today. In fact, the cost of replacing the reactor is comparable to the whole wish list that arguably could be written for research facilities by the Australian Science, Technology and Engineering Council."

Cyclotrons belong to a class of machines called particle accelerators. These are electromagnetic devices which accelerate charged particles to enormous velocities. The particles can then be directed to hit a target and thus produce isotopes.

Cyclotrons have important advantages over nuclear reactors in relation to radioactive waste and safety, and they pose no risk in relation to weapons proliferation. The underlying reason for these advantages is that cyclotrons are powered by electricity, whereas research reactors rely on a uranium fission reaction. One further advantage is that cyclotrons are far less expensive than reactors.

Cyclotron technology has advanced at a rapid pace in the past 10-20 years. Innovations have expanded the range of isotopes that can be produced, and they have enabled more efficient, reliable, and economical production.

20-25% of nuclear medicine procedures in Australia use cyclotron-produced isotopes, and this proportion has been growing steadily since the 1970s. Many of these isotopes come from the National Medical Cyclotron in Sydney. Australia also has a second, smaller cyclotron, adjacent to the Austin Hospital in Melbourne. It is likely that cyclotrons will be built in some other capital cities in Australia in the coming decade.

Cyclotrons produce a range of isotopes, including the second and third most commonly used medical isotopes, thallium-201 and gallium-67. A crucial debate is whether cyclotrons could be used to produce technetium-99m, which is used in about 70% of nuclear medicine procedures.

The largest research team investigating cyclotron production of technetium-99m is headed by Dr. Manuel Lagunas-Solar, of the University of California. On the strength of the latest research results, Dr. Lagunas-Solar tells me that he "firmly believes that this process is highly attractive, achievable, and with no major technical difficulties for its eventual commercialisation."

But ANSTO is pessimistic, pointing to technical problems concerning, for example, the purity of cyclotron-produced technetium-99m. ANSTO claims to have reviewed the latest research results from Dr. Lagunas-Solar's research team, but the thoroughness and objectivity of this review must be questioned. Indeed, Dr. Lagunas-Solar has recently written to the Australian Prime Minister, saying:

"It is my understanding that my work has been reviewed by ANSTO, without the benefit of my direct participation, and clearly using outdated and/or incomplete information. ANSTO also provided statements to Parliament based on information (also out of date) available through our internet site. Based upon a general analysis of ANSTO's review, I strongly feel that it does not provide an objective and balanced review of the actual status or the conclusions of our work. Furthermore, I have invited an on-site review of our completed work, and one such visit was being considered but is yet to materialise."

As for ANSTO's charge that some technical problems need to be resolved before large-scale cyclotron production of technetium-99m is a practical option - small wonder! Funding for this line of research has been a pittance in comparison with funding provided to ANSTO for reactor methods. Nevertheless, recent research results at the University of California have been promising, and further research is underway.

In sum, cyclotrons are producing a growing proportion of medical isotopes and they may, in time, be able to produce most or all of the isotopes used in nuclear medicine. As the Medical Association for the Prevention of War has said, a new reactor may well turn out to be an expensive white elephant given the advances in cyclotron technology.

Another alternative to building a new reactor in Australia is greater reliance on imported isotopes.

Several multinational companies have invested tens of millions of dollars in reactors and isotope processing facilities in recent years. These multinationals have the production capacity to supply world demand several times over. The Canadian company Nordion supplies isotopes to over 100 countries and the UK-based company Amersham International supplies over 150 countries. More than three quarters of all nuclear medicine procedures carried out around the world use imported isotopes. Countries largely reliant on imported isotopes include advanced industrial countries such as America, the UK, and Japan.

On the strength of the international situation, it is difficult to see why a greater reliance on imported isotopes could not substitute for a new reactor in Australia. Indeed, 20-30% of the medical isotopes used in Australia are already imported, primarily by Amersham and Mallinckrodt; and this despite competing against heavily-subsidised products from ANSTO.

ANSTO argues that importation would diminish reliability of supply. There are conflicting claims on this issue. Former science minister Peter McGauran said that when the HIFAR reactor is shut down for routine maintenance, one third of imported shipments arrive late. ANSTO has made similar claims. However the main supplier during HIFAR shut downs, the South African Atomic Energy Corporation, claims that only one in two hundred of its overseas shipments arrives late. It is difficult to see how these claims can be reconciled with one another. I have written to ANSTO five times in recent months, asking for the evidence which substantiates its claim. I have yet to receive a response. If the evidence exists, what possible reason could ANSTO have for refusing to supply it?

Even if we accept the dubious proposition that supply from the major overseas producers - in South Africa, Europe and North America - is too unreliable, this is of no great concern because it is very likely that supply can be obtained from more proximate sources. There are numerous possible suppliers in the Asia Pacific region, including South Korea, Indonesia, and Thailand.

ANSTO claims that technetium-99m cannot be imported because it has a short radioactive half life of 6 hours. This is misleading scare-mongering. As ANSTO is well aware, technetium-99m has a longer-lived parent isotope, molybdenum-99, which is widely transported all around the world. I have asked ANSTO's Executive Director, Prof. Helen Garnett, if she cares to defend ANSTO against my charge of misleading scare-mongering. Prof. Garnett has not responded.

Perhaps the biggest problem with greater reliance on imported isotopes concerns the ethics of relying on other countries to operate reactors and to deal with the attendant problems such as radioactive waste. In the long term, it would be preferable to rely completely on advanced isotope sources, such as cyclotrons, rather than domestic or overseas reactors. In the meantime, however, a good case can be made for partial reliance on imported isotopes.

In conclusion, a fortunate combination of events has emerged in recent years - rapid advances in cyclotron technology, and good prospects for reliance on imported isotopes.

These developments present Australia with an ideal opportunity to move away from reactor technology. In the short to medium-term, imports plus domestic cyclotrons will suffice. This should be combined with a robust program of research and development to further improve cyclotron technology, with a view to sharply reducing demand for imported isotopes.

Greater emphasis on cyclotron technology could create as many - or more - jobs as the reactor option. In addition, the strategy I propose tackles the problems associated with radioactive waste. It would be in keeping with the following recommendation of the 1996 Senate Select Committee on the Dangers of Radioactive Waste: "The Commonwealth Government should promote research into alternative technologies in both industry and medicine which will lead to the avoidance or reduction of radioactive waste materials."

Building a new reactor is the worst of the options. Among other problems, it will perpetuate radioactive waste problems, and it will curtail development of cleaner, safer production technologies.

Allen, Barry, "Benefits of Nuclear Reactor Still Unclear", Search, Vol.28(9), 1997, p.259.

Colmanet, Silvano F., and Samuels, David L., "Diagnostic Radiopharmaceutical Dose Estimate to the Australian Population", Health Physics, Vol.64(4), 1993.

Edwards, Rob, "Radiation Roulette", New Scientist, 11 October, 1997, pp.37-40

Khafagi, F.A., "Economic Evaluation in Nuclear Medicine", ANZ Nuclear Medicine, June, 1992, pp.16-19.

Medical Association for the Prevention of War, Submission to the Research Reactor Review, 1993.

Patton, Dennis D., "Cost-Effectiveness in Nuclear Medicine", Seminars in Nuclear Medicine, Vol.XXIII(1), 1993, pp.9-30.

Pockley, Peter, "Research cuts emerge after Budget hoopla", Search, Vol.28(5), 1997, pp.131-132.

Pockley, Peter, "Doherty Attacks Drop in Research Funding", Search, Vol.28(9), 1997, p.264.