Australia's nuclear bureaucrats and scientists have convinced many in the Federal Government that we must build a new nuclear reactor at Lucas Heights in Sydney at a cost of over $320 million (plus $12 million per annum running costs).

Unfazed by concerns about accidental or deliberate radioactive contamination and accumulating waste, they hold before us the image of a sick child. We need, they insist, a new reactor of our own, to produce the radioisotopes that ensure Australians' access to the best of medical care.

In my practice on Victoria's Surfcoast, isotope issues arise at times: take fracture of the scaphoid bone in the wrist, for example, which is often not evident on initial X-rays. Failure to pick scaphoid fracture early, and treat it appropriately, can lead to lifelong disability, so a prompt and definitive test is highly valuable.

When I started medical school twenty-five years ago, the only investigative option was to subject patients to a nuclear bone scan - injecting them intravenously with a radioisotope called technetium-99, irradiating the whole body, but hopefully identifying a "hot-spot' if there was a fracture. Unfortunately, isotopes like technetium emit high-energy particles, which damage DNA, predisposing the subject to cancer and genetic disruption.

By the time I entered general practice in 1986, C.T. scanning (or computerised axial tomography) had edged out nuclear scans as the best test for this sort of injury. CT avoided whole body irradiation, but still subjects patients to ionising rays. With the passage of time and more detailed studies, scientists recognised that even tiny doses of ionising radiation are potentially harmful, so best practice means absolute minimisation of exposure. Today, the investigation of first choice is magnetic resonance imaging (MRI), which provides a better image and involves no ionising radiation at all.

This is not to say that nuclear medicine is obsolete: tests and treatments using radioisotopes are still an important part of modern medicine. And there are certainly promising areas of research, particularly in the area of certain cancer therapies.

The real question is, however: do we actually need a nuclear reactor of our own to provide these isotopes?

In fact, many of the isotopes are already produced in non-reactor facilities, like the cyclotron at Royal Prince Alfred Hospital in Sydney or the one proposed for Sir Charles Gairdner Hospital in Perth.

On the other hand, the "work-horse" isotope of nuclear medicine is technetium, which accounts for about 80% of services in Australia. Currently technetium is only produced in reactors and we make about 80% of our requirement in the old HIFAR reactor at Lucas Heights, which is destined for the scrap heap. We import the remaining 20%, through the well-established international isotope market, as do many nations - including the US, UK and Japan.

It's worth noting that from February to May 2000, while the HIFAR reactor was shutdown for maintenance, we simply imported all our technetium, without any reported adverse patient outcomes.

At a time when so many research and development projects are dying on the domestic vine or moving offshore because of government indifference or inadequate funding, the proposed replacement reactor will be Australia's largest ever capital expenditure on science or technology.

We simply don't need this expensive, dangerous facility located on two identified earthquake fault lines in a growth corridor of our nation's largest city, generating radioactive waste for which we have no satisfactory management plan and representing an attractive target for terrorists and saboteurs.

Importation of technetium is a satisfactory medium-term alternative, because there is a highly attractive long-term potential for non-reactor technetium production using particle accelerators. This exciting prospect has been extensively investigated in the U.S. and is technically feasible, with the major advantages of minimal radioactive waste generation and costs in the realm of tens, not hundreds, of millions.

A recent authoritative assessment showed that development and commercialisation of this technology would require two years effort involving a small team of able scientists.

Australia would thereby develop and possess valuable expertise in the production of the world's most popular medical isotope.

That is the answer for the clever country!

Guest on this program:

Dr Bill Williams

Public Representative
Radiation Health Committee
Australian Radiation Protection And Nuclear Safety Agency (ARPANSA)

Member: Medical Association for the Prevention of War

Further information: Medical Association for the Prevention of War http://www.mapw.org.au