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Environmental and health effects of the nuclear industry and nuclear weapons: a current evaluation.

The nuclear weapons industry in the U.S. comprises nine major plants, supported by a network of subcontractors and grantee institutions. Weapons development progresses at the Lawrence Livermore and Los Alamos Laboratories under the auspices of the University of California. Fissionable materials and tritium are produced at the Savannah River Plant (du Pont) or at Hanford. Reprocessing of plutonium and weapons grade uranium and manufacture of components are carried out at Rocky Flats (formerly Dow, now Rockwell Int.). Large amounts of radionuclides are generated or involved in operations at most of the nine plants. Internal reports of surveillance efforts by weapons plant personnel to monitor emissions of radioactive gases and particulates have now been released by several of the plants (in one case through litigation). Those reports document major releases of radioactive gases and particulates to the environment in the past, and continuing routine releases of some importance. Few investigations have been made of effects from these potent carcinogens in local populations. There have been several preliminary reports (Rocky Flats, Los Alamos and Savannah River) and one comprehensive report [Ambio 10: 176 (1981)]. Evidence of significantly increased rates of cancer of the more radiosensitive organs has been demonstrated. Adequate cancer registry and vital statistics data are essential for the comprehensive investigations of somatic and genetic effects which should be carried out around all nuclear installations near population centres.

Environmental Exposure↗

Tear gas--harassing agent or toxic chemical weapon?

Tear gas has gained widespread acceptance as a means of controlling civilian crowds and subduing barricaded criminals. The most widely used forms of tear gas have been o-chlorobenzylidenemalononitrile and omega-chloroacetophenone. Proponents of their use claim that, if used correctly, the noxious effects of exposure are transient and of no long-term consequences. The use of tear gas in recent situations of civil unrest, however, demonstrates that exposure to the weapon is difficult to control and indiscriminate, and the weapon is often not used correctly. Severe traumatic injury from exploding tear gas bombs as well as lethal toxic injury have been documented. Moreover, available toxicological data are deficient as to the potential of tear gas agents to cause long-term pulmonary, carcinogenic, and reproductive effects. Published and recent unpublished in vitro tests have shown o-chlorobenzylidenemalononitrile to be both clastogenic and mutagenic. Sadly, the nature of its use renders analytic epidemiologic investigation of exposed persons difficult. In 1969, eighty countries voted to include tear gas agents among chemical weapons banned under the Geneva Protocol. There is an ongoing need for investigation into the full toxicological potential of tear gas chemicals and renewed debate on whether their use can be condoned under any circumstances.

Adult↗

Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense.

OBJECTIVE: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a civilian population. PARTICIPANTS: The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. EVIDENCE: MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000. CONSENSUS PROCESS: The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. CONCLUSIONS: An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.

Anti-Bacterial Agents↗

Tularemia as a biological weapon: medical and public health management.

OBJECTIVE: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if tularemia is used as a biological weapon against a civilian population. PARTICIPANTS: The working group included 25 representatives from academic medical centers, civilian and military governmental agencies, and other public health and emergency management institutions and agencies. EVIDENCE: MEDLINE databases were searched from January 1966 to October 2000, using the Medical Subject Headings Francisella tularensis, Pasteurella tularensis, biological weapon, biological terrorism, bioterrorism, biological warfare, and biowarfare. Review of these references led to identification of relevant materials published prior to 1966. In addition, participants identified other references and sources. CONSENSUS PROCESS: Three formal drafts of the statement that synthesized information obtained in the formal evidence-gathering process were reviewed by members of the working group. Consensus was achieved on the final draft. CONCLUSIONS: A weapon using airborne tularemia would likely result 3 to 5 days later in an outbreak of acute, undifferentiated febrile illness with incipient pneumonia, pleuritis, and hilar lymphadenopathy. Specific epidemiological, clinical, and microbiological findings should lead to early suspicion of intentional tularemia in an alert health system; laboratory confirmation of agent could be delayed. Without treatment, the clinical course could progress to respiratory failure, shock, and death. Prompt treatment with streptomycin, gentamicin, doxycycline, or ciprofloxacin is recommended. Prophylactic use of doxycycline or ciprofloxacin may be useful in the early postexposure period.

Anti-Bacterial Agents↗

[Quantity of weapon oils at the target as a function of shooting sequence and firing distance].

Five widely used gun oils were tested to see if they could be identified by gas chromatography. All oils in the test produced characteristic gas chromatograms and the test was highly sensitive in tracing the oils. Seven different weapons and various types of ammunition were used to perform firing tests involving an oil sold under the brand name of "Gun pro." The weapons were oiled and wiped dry and subsequently discharged at a cotton cloth target. Series of shots were fired from a maximal distance of 3 m, and the weapon was not cleaned between shots. Grease marks and powder-burn traces were extracted separately and the extracts, after adding an internal standard, were investigated by means of gas chromatography (gas chromatography unit by Perkin and Elmer). The largest quantities of oil were transmitted by indoor ammunition fired from a small-bore rifle. At a firing range of 20 cm, a decrease in the oil quantity could be observed up to the fourth discharge. When the firing range was varied there was a decrease in the oil quantity up to a distance of 80 cm. The first and the second discharge could be distinguished up to a firing range of 60 cm. With increasing force of the projectile and a decrease in the interior length of the gun barrel, the quantity of oil conveyed to the target also decreased. Additionally, the identifiability of the oil was investigated after firing at several layers of cloth and after storage of the samples (no losses occurred after a 1-month storage period).(ABSTRACT TRUNCATED AT 250 WORDS)

Firearms↗

Brucella as a biological weapon.

Brucella has traditionally been considered a biological weapon. It was the subject of extensive offensive research in the past, and still belongs to category B pathogens on most lists. Its propensity for airborne transmission and induction of chronic debilitating disease requiring combined antibiotic regimens for treatment, its abundance around the world and its vague clinical characteristics defying rapid clinical diagnosis are some of the characteristics that apply to the pathogen's weapons potential. Yet minimal mortality, availability of treatment options, protracted inoculation period and the emergence of new, more virulent potential weapons means that its inclusion among agents of bioterrorism is nowadays mainly of historical significance. Nevertheless, in the interest of literacy and of avoiding panic, physicians and the public both should be aware of the most common zoonosis worldwide.

Animals↗

The bane of "inhumane" weapons and overkill: an overview of increasingly lethal arms and the inadequacy of regulatory controls.

Weapons of both defense and offense have grown steadily in their effectiveness--especially since the industrial revolution. The mass destruction of humanity, by parts or in whole, became reality with the advent of toxic agents founded on chemistry and biology or nuclear weapons derived from physics. The military's new non-combat roles, combined with a quest for non-lethal weapons, may change the picture in regard to conventional defense establishments but are unlikely to deter bellicose tyrants or the new terrorists from using the unlimited potential of today's and tomorrow's arsenals. The author addresses the issues that are raised by this developing situation with the intent of seeking those ethics that will enable us to survive in a future and uncertain world.

Bioterrorism↗

Fatal firearm injuries caused by handmade weapons.

Six cases of accidental death caused by a shot from handmade or improvised firearms are described. Data were collected on incident, victim and special autopsy findings. In three cases the weapon used was a so-called 'pen gun' of small calibre (5.6 mm) and in two cases a home-made shotgun/muzzle loader with shotgun cartridge (containing 16 mm pellets) was used. In one case, the weapon was a shop-made gun with home-made ammunition. It is perhaps surprising that in the present war situation in Croatia, when all kinds of firearms are easily available, people continue to produce handmade weapons.

Journal Article↗

Ocular trauma score in deadly weapon-related open-globe injuries.

PURPOSE: To assess prognostic value of the ocular trauma score (OTS) in deadly weapon-related open-globe injuries. DESIGN: Retrospective, interventional case series. METHODS: In 82 patients (88 eyes) with deadly weapon-related open-globe injuries, certain numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, afferent pupillary defect) at presentation were summated and converted into OTS categories. The likelihood of the final visual acuities in the OTS categories were calculated and compared with those in the OTS study. RESULTS: The likelihood of the final visual acuities (no light perception NLP, light perception LP/hand motion HM, 1/200 to 19/200, 20/200 to 20/50, and > or = 20/40) in the OTS categories (1 through 5) in this group were similar to those in the OTS study group except for LP/HM in the category-2 (53% vs 26%, P < .001). No study eye was in the category-5 (the best prognosis). CONCLUSIONS: OTS calculated at initial examination may provide prognostic information in deadly weapon-related open-globe injuries.

Adolescent↗

Injury pattern of the Flash-Ball, a less-lethal weapon used for law enforcement: report of two cases and review of the literature.

Less-lethal weapons are used in law enforcement to neutralize combative individuals and to disperse riot crowds. Local police recently used such an impact weapon, the Flash-Ball, in two different situations. This gun fires large rubber bullets with kinetic energies around 200 J. Although it is designed to avoid skin penetration, impacts at such energies may still create major trauma with associated severe injuries to internal organs. This is a report of 2 patients shot with the Flash-Ball who required medical attention. One could be discharged quickly, but the other required hospitalization for heart and lung contusion. Both patients required advanced investigations including computed tomography (CT) scan. The medical literature on injuries induced by less-lethal impact weapons is reviewed. Impacts from the Flash-Ball can cause significant injury to internal organs, even without penetration. Investigations as for other high-energy blunt traumas are called for in these cases.

Adult↗

Endophthalmitis after deadly-weapon-related open-globe injuries: risk factors, value of prophylactic antibiotics, and visual outcomes.

PURPOSE: To identify clinical and microbiologic factors influencing the prevalence and visual outcomes in endophthalmitis after deadly-weapon-related open-globe injuries. METHODS: In a retrospective study of 228 eyes of 212 patients with deadly-weapon-related open-globe injuries, clinical and microbiologic factors influencing the prevalence and visual outcome in endophthalmitis were analyzed in detail. RESULTS: Twenty-nine eyes enucleated for irreparable damages at presentation were excluded. Nineteen eyes (18 patients) of 199 (186 patients) were associated with culture-proven endophthalmitis. Presence of grade 4 injury, a variable of Ocular Trauma Classification System, and lens disruption at presentation were the significant risk factors for development of endophthalmitis (P =.001; odds ratio = 15.9 [2.0 to 122.1]), and ([P <.001; odds ratio = 17.7 [2.3 to 136.3]), respectively. Favorable outcome (visual acuity of 5/200 or better) was achieved in only four eyes (21%). Five eyes (26.3%) were phthisical, and five eyes (26.3%) were enucleated or eviscerated. All eyes were under the coverage of prophylactic intravenous antibiotics when culture positivity was obtained. Except two eyes with Acinetobactersp., all were infected by gram-positive micro-organisms (89.5%), the most common of which (42%) was Staphylococcus epidermidis. None of the clinical characteristics and treatment modalities affected final visual outcome. Favorable outcome was associated with infection by the less virulent micro-organism S. epidermidis (P =.018; odds ratio = 0.50 [0.25 to 1.00]). CONCLUSIONS: Endophthalmitis after deadly-weapon-related open-globe injuries has a dismal visual prognosis. Severity of injury and lens disruption are significant risk factors for development of endophthalmitis. Infection with a less virulent microbe is the only factor associated with favorable outcome.

Adult↗

The distribution and history of nuclear weapons related contamination in sediments from the Ob River, Siberia as determined by isotopic ratios of plutonium and neptunium.

Isotopic ratios of Pu and Np measured in sediment cores from 5 locations in the Ob River drainage basin show clear evidence of input from sources other than global fallout (non-fallout sources). Historical contaminant records obtained by combining isotopic ratio information with chronological information indicate that non-fallout inputs are from several sources that have varied significantly over the past 50 years. Unique isotopic signatures observed in sediments from tributaries that drain areas containing known or suspected sources of non-fallout contamination are used to identify the source of materials in sediments collected at downstream locations. These data can lead to a better understanding of the transport behavior, fate, and relative importance of particle reactive, weapons related contaminants originating from the nuclear facilities Mayak. Tomsk-7, and Semipalitinsk, which lie within the drainage basin. From our work to date, we draw the following conclusions: (1) Persistent non-fallout contamination is observed in the Ob River above its confluence with the Irtysh River, indicating contamination from the Tomsk-7 facility. (2) Non-fallout contamination in the Tobol River above its confluence with the Irtysh River indicates contamination from the Mayak facility. (3) Non-fallout contamination in the Irtysh River above its confluence with the Tobol River indicates contamination from the Semipalitinsk weapons test site. (4) The occurrence of isotopic ratios in Ob Delta sediments that are similar to those observed in source tributaries suggests that contamination from at least two sources has been transported along the length of the river system. (5) Global fallout, a result of high-yield atmospheric weapons tests conducted by the FSU and USA primarily, is the dominant source of Pu and Np to the region; however, there have been brief periods when inputs from non-fallout sources exceeded those from global fallout.

Environmental Monitoring↗

An analysis of the environmental mobility of radiostrontium from weapons testing and Chernobyl in Finnish river catchments.

The mobility of radiostrontium within the Arctic environment and surrounding area has been studied by analysing the mobility of 90Sr in river catchments that are within Finland. The environmental mobility of 90Sr deposited by both nuclear weapons testing and the Chernobyl accident has been investigated in five Finnish river catchments. Different models assessing the time-dependent mobility of 90Sr have been evaluated. No significant differences were found between the mobility of 90Sr from nuclear weapons tests and from the Chernobyl accident. Model parameters obtained by fitting to the measurements of the deposition and runoff rates of the nuclear weapons test fallout gave predictions which were consistent with the mid- and long-term contamination by the Chernobyl fallout. A comparison of 90Sr with 137Cs showed that they had similar mobility on deposition but, as time passed, the relative mobility of 90Sr increased with respect to 137Cs over a period of 5-8 years. Once the relative migration of 90Sr with respect to 137Cs reached equilibrium, its runoff rate was, on average, approximately an order of magnitude greater than 137Cs.

Arctic Regions↗

A weapon-related injury surveillance system in New York City.

CONTEXT: Assault injuries and deaths are a major public health problem in New York City but they are poorly understood because there is a dearth of information concerning them. OBJECTIVE: Develop and implement a low-cost, efficient, permanent weapon-related injury surveillance system (WRISS) for the city. DESIGN: WRISS was established, using a hierarchical exclusionary model, to capture all weapon-related (gunshot, stab, blunt instrument trauma) mortality and morbidity. SETTING: The five boroughs of New York City: The Bronx, Brooklyn, Manhattan, Queens, and Staten Island. PARTICIPANTS: NYC Vital Statistics Office, New York State hospital discharge database, Statewide Planning and Research Cooperative Systems (SPARCS), hospital emergency departments, and the police department. MAIN OUTCOME MEASURES: Surveillance system simplicity, acceptability, flexibility, cost. RESULTS: NYC WRISS is a simple surveillance system depending on both existing data sources and active data collection, and is therefore acceptable to providers. It is flexible and has allowed assault injuries without weapons to be added to better reflect domestic assaults. The cost is low, less than $60,000 per year. CONCLUSIONS: NYC WRISS is an efficient, cost-effective surveillance system, particularly suited to big cities with many assault injuries. Its low cost and obvious importance as a public health tool have allowed for its institutionalization, reflected by a permanent health department position, and annual reports alongside the more traditional public health surveillance systems. Analyses of data from 1990 to 1996 have lent new understanding to the decrease in homicides and assaults in New York City during that period.

Adolescent↗

Massachusetts Weapon-Related Injury Surveillance System.

CONTEXT: Surveillance data on nonfatal weapon-related injuries--particularly those treated only in the emergency department (ED)--have been largely unavailable. OBJECTIVE: To develop a surveillance system for fatal and nonfatal gunshot wounds and sharp instrument assaults. DESIGN: The Massachusetts Department of Public Health (DPH) developed an ED-based reporting system for weapon-related injuries. Inpatient discharges and mortality data were linked to ED data, and police data sources were evaluated. SETTING: Statewide. PARTICIPANTS: All 84 acute care hospital emergency departments. Uniform Hospital Discharge Data Set (UHDDS), mortality, and police data were obtained from existing systems. MAIN OUTCOME MEASURES: System sensitivity, predictive value positive (PVP), representativeness, flexibility, usefulness, acceptability, and sustainability. RESULTS: The ED reporting system captured 82% of firearm-related injuries and 74% of reportable sharp instrument wounds from 1994 to 1996. Case reporting by demographic characteristics of the victim was representative and largely complete. Reporting by characteristics of the incident (e.g., type of gun) was less reliable. Police data were used to augment the system. From 1994 to 1996, ED-treated gunshot wounds dropped 41%, from 662 in 1994 to 393 in 1996. Unintentional and self-inflicted gunshot wounds showed no declines. For every firearm-related homicide, 4.7 nonfatal firearm assaults were treated; 85% of self-inflicted gunshot wounds were fatal. CONCLUSIONS: The system has proven timely (1996 ED data were available for release in March 1997), flexible (the reporting form has been revised several times), useful (DPH responds to 150 weapon injury data requests annually), acceptable (reporting is voluntary and no hospital declined participation), and sustainable (state funding is currently supporting the ED reporting system).

Adolescent↗

Strengthening the biological weapons convention and implications on the pharmaceutical and biotechnology industry.

The development, production, stockpiling, and use of biological weapons are banned by the 1972 Biological Weapons Convention (BWC). Reflecting the realities of the Cold War era in which it was negotiated, the BWC lacks means for compliance verification or enforcement. International efforts to remedy this deficiency are accelerating in the face of evidence that covert biological weapon programs are proliferating at the national and subnational levels.

Bacterial Infections↗

Use of army weapons and private firearms for suicide and homicide in the region of Basel, Switzerland.

OBJECTIVES: Switzerland has one of the highest rates of firearm suicides in the world. International studies show a positive correlation between the rate of households with guns and femicides with guns. Because its defense system requires a militia to keep personal firearms at home, Switzerland has a high rate of households with a gun. METHODS: Records of suicides in the region of Basel between 1992 and 1996 were reviewed. Suicides with either army weapons or private firearms and suicides by other means were compared. Methods and types of homicides that occurred in the region at the same time were also analyzed. FINDINGS: Firearm suicides were clearly the most frequent means of suicide. They were also used in 30.0% of domestic homicides, although other means were used at similar rates. Firearms for suicide were mainly used by men, especially army weapons. These men were younger, professionally better qualified, and fewer had ever been treated in one of the local state psychiatric services. DISCUSSION: The use of firearms for suicide, rather than homicide, and particularly of army weapons by young, well-educated men, requires more attention in debates and informed policy regarding access to firearms and suicide prevention in Switzerland.

Adult↗

Comparison of the uptake of radiocaesium from soil to grass after nuclear weapons tests and the Chernobyl accident.

In order to compare the transfer factors of 137Cs deposited after the fallout from the Chernobyl accident with 137Cs from nuclear weapons testing, soil and vegetation samples have been collected from a semi-natural ecosystem in western Norway. For the 137Cs from Chernobyl, 85% is found in the upper 5 cm of soil, whereas most of the nuclear weapons test 137Cs is found between 3 and 12 cm in the soil profile. The transfer factors from soil to vegetation are calculated to be 0.41 +/- 0.07 m2 kg-1 for the nuclear weapons test 137Cs and 0.40 +/- 0.22 m2 kg-1 for Chernobyl 137Cs. Hence, the results show no significant difference between the two fallouts. The effective ecological half-life of 137Cs for this ecosystem is estimated to be between 10 and 20 years. Wash-out and binding effects seem to be of minor importance for the uptake.

Accidents↗