I read with great interest the recent article by Krestinina et al. (1), which reported the results of a cohort mortality study of the extended Techa River cohort. I was especially intrigued by the authors' conclusion that this study provided “strong evidence of long-term carcinogenic effects of protracted low-dose-rate exposures”. If this claim were borne out, it would set this study apart from the numerous other studies of such exposures that have failed to detect carcinogenic effects. I would like to submit two observations for the authors' and readers' consideration.

First, the authors attribute the apparent increase in cancer mortality they observed solely to radiation exposure. However, it is at least possible, if not probable, that the liquid effluents discharged into the Techa River from the Mayak complex contained other nonradioactive, toxic and/ or carcinogenic chemical components. If so, this would present a...

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