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Legally-induced abortions in Denmark after Chernobyl
Abstract
During the months following the accident in Chernobyl, Denmark experienced an increasing rate of induced abortion, especially in regions with the largest measured increase in radiation. As the increase in radiation in Denmark was so low that almost no increased risk of birth defects was expected, the public debate and anxiety among the pregnant women and their husbands "caused" more fetal deaths in Denmark than the accident. This underlines the importance of public debate, the role of the mass media and of the way in which National Health authorities participate in this debate.
... Внимание необходимо обратить и на информационную безопасность государства, которая может оказаться под угрозой как во время «штатной работы» ядерно-энергетиче-ских комплексов, так и во время чрезвычайных ситуаций, поскольку сегодня мы живём в эпоху интернета, где случаи намеренной дезинформации -«вбросов» 1 отнюдь не редки, как и заблуждения граждан, возникающие в силу различных причин, в том числе из-за недостаточной осведомлённости о физических процессах, протекающих при ядерной реакции, и т.д. 2 При этом каждое поднаправление оказывает существенное влияние непосредственно на ядерную и радиационную безопасность страны и каждое из них носит криминологическую подоплёку. ...
... -URL: https://ria. ru/20160801/1473339352.html (дата обращения: 10.06.2021).2 Так, при строительстве Белорусской АЭС в СМИ осуществлялись информационные «вбросы» о повреждениях первого энергоблока БелАЭС в результате падения корпуса ядерного реактора, причём источником такой дезинформации являлись не только государственные, но и иностранные СМИ, в частности, литовские. ...
Ensuring nuclear and radiation safety is one of the most important components of the national security of the Russian Federation. Taking into account the increased level of risks (including criminal ones) inherent in modern society, the problem of the safe use of nuclear energy is becoming one of the main ones, not only at the national but also at the international level. The article substantiates the importance of the criminological approach in the study of this phenomenon, raises the issues of criminalization of the use of atomic energy within the framework of nuclear and radiation safety of the state, provides examples of criminal threats that arise when using the energy of atomic nuclei. Particular attention is paid to the lack of high-quality criminological research conducted in the designated area of public relations, where offenses of various properties are often committed, which directly or potentially lead or may lead to serious, and sometimes irreversible consequences, which indicates the need to pay due attention to it, despite the relatively small number of crimes committed. As a result of the conducted research and in order to improve the criminological security system when using a peaceful atom, the author concludes that it is necessary to implement an integrated approach to solving these problems and suggests those areas of activity that require increased attention, including from law enforcement agencies.
... At the time, clinicians relied on what had been learned from the populations exposed to the atomic bombs at Hiroshima and Nagasaki, which showed that damage to the fetus was most likely during the 8-25th week of gestation and on conventional wisdom derived from occupationally exposed cohorts [29][30][31]. In hindsight, some feel that misconceived fear over potential congenital malformations led to thousands of needlessly induced abortions [32,33]. ...
... Significant reproductive effects were apparent also in countries of Europe that were contaminated by the radioactive plume that drifted from the crippled reactor. For example, in Denmark, many women, alarmed over the reports of radiation reaching their countries, opted for induced abortions in the three months following the accident [32], while in Greece 23% of early pregnancies were aborted [34]. In Finland and Norway, an increase in spontaneous abortions following the accident was noted, while the rates of induced abortion and stillbirth did not reflect the trends reported in other countries in Europe [35,36]. ...
The Chernobyl accident in 1986 spread ionizing radiation over extensive areas of Belarus and Ukraine, leading to adverse health effects in exposed children. More than 30 years later, exposed children have grown and became parents themselves. This retrospective study from Israel was aimed to evaluate whether Chernobyl-exposed women are at higher risk for adverse reproductive outcomes. Exposed immigrants were identified as high or low exposure based on Caesium-137 soil contamination levels registered in the town they lived in. The exposed group was age matched with three comparison groups: non-exposed immigrant women from the Former Soviet Union (FSU) excluding Belarus and the Ukraine, immigrants from other countries (Non FSU) and Israeli-born women at a ratio of 1:10. Chernobyl-exposed women were more likely to be nulliparous and have fewer children (2.1 + 0.8 vs. 3.1 + 1.8, p < 0.001), were more likely to undergo fertility treatments (8.8% vs. 5.8%, adjusted OR = 1.8, 95%CI 1.04–3.2, p = 0.036), and were also more likely to have anemia after delivery (49.4% vs. 36.6%, OR = 1.7, 95%CI 1.2–2.3, p = 0.001), compared to women in the combined comparison groups. The overall fertility of Chernobyl-exposed women seems to be reduced as reflected by the lower number of children and their greater need for fertility treatments.
... ts are characterised by the involvement of CBRN agents, such as toxic and hazardous chemicals/materials, chemical and biological warfare agents or radiological materials. Exposure to these agents can be caused by an industrial accident (e.g. 2011 Fukushima Daiichi nuclear disaster, 1986 Chernobyl disaster, 1989 Exxon Valdez Oil spill), warfare (e.g. 1991 Gulf War, 1945 atomic bombings of Hiroshima and Nagasaki, use of mustard gas and tear gas during World War I), or terrorism (e.g. 2001 U.S. Anthrax attacks, 1995 Tokyo Sarin attacks). According to Lemyre et al. (2010b), the psychosocial impacts of CBRN agents are greater than the physical impacts. Recently, the Chernobyl Forum concluded ...
... Finally, literature suggests that specific groups of people might be at higher risk for the development of psychosocial problems than after natural disasters. Pregnant women form a risk group because of the impact on the unborn child and increased abortion rates (Auvinen et al., 2001; Bertollini et al., 1990; Knudsen, 1991; Lemyre et al., 2010a). Children are at risk because they are smaller (lower proximity to the ground) and tend to put things in their mouth which increases the likeliness of exposure to agents (Lemyre et al., 2010a ). ...
Disasters are associated with a substantial psychosocial burden for affected individuals (including first responders) and communities. Knowledge about how to address these risks and problems is valuable for societies worldwide. Decades of research into post-disaster psychosocial care has resulted in various recommendations and general guidelines. However, as CBRN (chemical, biological, radiological, nuclear) events form a distinctive theme in emergency planning and disaster preparedness, it is important to systematically explore their implications for psychosocial care. The aim of this study is to answer two questions: 1). To what extent does psychosocial care in the case of CBRN events differ from other types of events? 2). How strong is the scientific evidence for the effectiveness of psychosocial care interventions in the context of a CBRN event? A systematic literature review was conducted. Searches were performed in Medline, PsychINFO, Embase and PILOTS. Studies since January 2000 were included and evaluated by independent reviewers. The 39 included studies contain recommendations, primarily based on unsystematic literature reviews, qualitative research and expert opinions. Recommendations address: 1) public risk- and crisis communication, 2) training, education and exercise of responders, 3) support, and 4) psychosocial counselling and care to citizens and responders. Although none of the studies meet the design criteria for effectiveness research, a substantial amount of consensus exists on aspects relevant to CBRN related psychosocial care. Recommendations are similar or complementary to general post-disaster psychosocial care guidelines. Notable differences are the emphasis on risk communication and specific preparation needs. Relevant recurring topics are uncertainty about contamination and health effects, how people will overwhelm health care systems, and the possibility that professionals are less likely to respond. However, the lack of evidence on effectiveness makes it necessary to be careful with recommendations. More evaluation research is absolutely needed.
... In some Italian regions there was an increase of induced abortions in the first 3 months following the disaster. Lower pregnancy rates and a rise in the number of induced abortions in the year following the disaster was observed in the Scandinavian countries (Ericson & K&aum;llen, 1994;Irgens et al., 1991;Knudson, 1991). Knudson (1991) concluded on the basis of these data that the fear of radiation from the Chernobyl disaster probably caused more fetal deaths than the released radioactivity itself. ...
... Lower pregnancy rates and a rise in the number of induced abortions in the year following the disaster was observed in the Scandinavian countries (Ericson & K&aum;llen, 1994;Irgens et al., 1991;Knudson, 1991). Knudson (1991) concluded on the basis of these data that the fear of radiation from the Chernobyl disaster probably caused more fetal deaths than the released radioactivity itself. ...
Exposure to toxic substances in the environment is an ever more common event, that may cause physical as well as psychological harm. When an entire community is exposed, the term 'toxicological disaster' is used. The mere threat of such an event may be a source of stress, associated with changes in mental health, physical health, and changes in health-related behaviors. A review is presented of the literature about the effects of the stressful experience of toxicological disasters on health and health-related behaviors. Three questions are examined: (a) do toxicological disasters represent a specific type of stressor, different from other stressors?; (b) which stress-mediated health effects have been observed in the aftermath of toxicological disasters? and (c) is there evidence for a higher vulnerability in certain identifiable risk groups? On the basis of the available literature, it is concluded that toxicological disasters may have profound effects on subjective health, especially on symptom reporting, and on a number of psychophysiological parameters. Evidence for a substantial impact of disaster-related stress on either physical or psychiatric morbidity remains inconclusive. In this respect toxicological disasters do not appear to differ from other stressors. There is some evidence that toxicological disasters may have a more pronounced effect on health-related behaviors, especially on reproductive behavior (number of births and abortions). Women, and especially those who have young children to care for, appear to be more at risk for the observed health effects. The evidence for a higher vulnerability in other risk groups (e.g., former psychiatric patients remains inconclusive.
... There was an increase in the induced abortion rate in several European countries after the Chernobyl accident [92][93][94][95]. It was reasonably assumed that "the public debate and anxiety among the pregnant women and their husbands 'caused' more foetal deaths… than the accident" [96]. Biased information "repeatedly created a situation of panic, like a posttraumatic stress disorder" [97]. ...
More details are in the book: https://www.cambridgescholars.com/product/978-1-5275-5100-8
... Due to methodological issues and uncertainties, it is impossible to ascertain with complete certainty the number of abortions resulting from radiophobia. Nevertheless, it is clear that abortions did increase in Denmark (Knudsen, 1991), Italy (Spinelli and Osborn, 1991), Greece (Trichopoulos et al., 1987) and Finland (Auvinen et al., 2001). However, this phenomenon was not seen in all parts of Europefor instance, there was no statistical increase in abortions in e.g. ...
The term ‘radiophobia’ has been a cornerstone in the nuclear discourse over the past 70 years. It has been used extensively to dismiss fears of radiation as being emotional overreactions to a risk that is actuarially very low, stemming from public ignorance. Despite its longevity, little attention has been afforded to the term, its history, and the factors that underpin the extreme divergence in risk perception that the term de facto refers to, threatening to severely hamper any efforts to redress said divergence. This article will explore these factors, mostly sociopsychological in nature, and conclude that the powerful affective imagery associated with radiation, compounded by various heuristics and biases, renders public discomfort with ionising radiation from nuclear power plants rational – despite the actuarial safety record of nuclear energy globally. The article will note that, whilst its often ostracising usage towards the public should render the term obsolete, radiophobia can still be regarded as a useful concept to try and explain the extreme risk perception divergence that exists between nuclear experts and the public. However, in order for a more constructive nuclear discourse, a paradigm shift will be required, acknowledging the complex historical and sociopsychological factors that have shaped radiation into becoming a uniquely feared process. Such an acknowledgement will likely be a prerequisite for any efforts towards normalising humanity's relationship with radiation, and would require considerable changes in communication practices.
... It has been found that abortions did increase following the accident in e.g. Denmark [56], Italy [57] and Finland [58], with some estimates stating that between 10000 and 200 000 foetuses were aborted following receiving incorrect medical advice [59]. This phenomenon was not seen in all parts of Europe-for instance, there was no statistical increase in abortions in e.g. ...
As far as carcinogens are concerned, radiation is one of the best studied, having been researched for more than 100 years. Yet, radiation remains feared in many contexts as a result of its invisibility, its relationship with cancers and congenital disorders, aided by a variety of heuristics and reinforced by negative imagery. The strong socio-psychological response relating to nuclear energy has made radiation a classical case in the risk literature. This is reflected clearly following the nuclear accidents that have taken place, where the socio-psychological impacts of the clear dissonance between real and perceived health effects due to radiation exposure have caused considerable health detriment, outweighing the actual radiological impacts. Despite considerable efforts to normalise humankind's relationship with radiation, there has been little shift away from the perceived uniqueness of the health risks of radiation. One consistent issue is the failure to place radiation within its proper perspective and context, which has ensured that radiophobia has persisted. The radiation protection community must get better at placing its research within the appropriate perspective and context, something that is far too rarely the case in discussions on radiation matters outside of the scientific community. Each member of the radiation protection community has an ethical, professional and moral obligation to set the record straight, to challenge the misconceptions and factual errors that surround radiation, as well as putting it into the proper perspective and context. Failing to do so, the well-established harms of radiophobia will remain, and the many benefits of nuclear technology risk being withheld.
... There was an increase in the induced abortion rate in several countries after the Chernobyl accident, while wanted pregnancies were interrupted [84][85][86]. It was reasonably assumed that "the public debate and anxiety among the pregnant women and their husbands 'caused' more fetal deaths… than the accident" [87]. Biased information "repeatedly created a situation of panic, like a posttraumatic stress Low-dose exposure to ionizing radiation disorder" [88]. ...
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https://www.researchgate.net/publication/325120341_Male_to_female_ratio_at_birth_The_role_of_background_radiation_vs_other_factors
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... They were much more victims of radio-phobia 30 . According to the IAEA and other sources from 100,000-200,000 abortions were performed following Chernobyl throughout Europe because of fear and the advice of physicians [7][8][9][10] ; these unborn children were the ultimate victims. ...
The LNT is a scientific scandal associated with deception, fraud, hyperbole, political spin and statistical manipulation. Radio-phobia resulting from application of the LNT in the Chernobyl and Fukushima incidents have resulted in thousands of deaths in the elderly and unborn. Muller’s deception and Russell’s mistake in mutation studies with fruit flies and mice promoted the LNT which was then force-fitted into hundreds of epidemiological studies. A critical mass of radiation scientists has come together under S.A.R.I. to confront and educate.
... There was an increase in the induced abortion rate after the Chernobyl accident [55][56][57][58]. It was reasonably assumed that "the public debate and anxiety among the pregnant women and their husbands "caused" more fetal deaths… than the accident" [59]. Biased information "repeatedly created a situation of panic, like a posttraumatic stress disorder" [60]. ...
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https://www.researchgate.net/publication/340826062_Some_aspects_of_the_Fukushima_Daiichi_nuclear_accident
https://www.researchgate.net/publication/325120341_Male_to_female_ratio_at_birth_The_role_of_background_radiation_vs_other_factors
https://www.researchgate.net/publication/308413105_Re_Atomic_bomb_testing_and_its_effects_on_global_male_to_female_ratios
https://www.researchgate.net/publication/309174166_Re_Increases_in_perinatal_mortality_in_prefectures_contaminated_by_the_Fukushima_nuclear_power_plant_accident
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... The fear that your child could be affected in the future can overshadow any personal concern (Bay and Oughton 2005). These concerns extend to pregnant women, as exemplified by the rise in voluntary abortions after Chernobyl (Knudsen 1991). This may seem irrational, since many other activities have a statistically greater probability of harming children, such as traffic or even other sources of exposure to radiation. ...
This chapter provides an overview of some of the societal and ethical factors that influence risk perception. There is a tendency to assume that public aversion or fear of radiation risks is primarily due to a misunderstanding of the probabilities of harm, but risk perception is complex and shaped by a number of issues, many of which have important ethical relevance. These include autonomy and respect for personal control; justice and the distribution of risks and benefits; and community values and societal impact. The chapter gives examples of ways in which respecting these factors can improve risk management. With respect to control, in addition to a fundamental ethical respect for dignity, there is an important psychological link between coping and stress. Hence, management practices that enable personal control and empowerment could be beneficial for exposed populations. The consideration of justice with regard to the distribution of risks and benefits include awareness of the challenges of discrimination and victimisation as well as the need for the protection of the vulnerable members of society, such as children and the elderly. Community and societal impacts extend the notion of well-being to encompass not only individual physical health but also mental health and societal well-being. This raises particular challenges and issues for health surveillance and thyroid screening initiatives. A holistic approach to radiation risk management would consider both the reduction of the risks of physical harm and measures to address psychological heath and societal recovery.
... Health-care workers are another vulnerable population. They form the front line in an often terrifying scenario caring for individuals who may in Europe not directly exposed (Knudsen, 1991 contaminate them as well. They bravely risk their own health, which many ...
Risk assessment is essential to determine and prioritize potential future vulnerabilities based on solid facts. Careful analysis will help quantify the impact of possible countermeasures on the existing risks. The process of risk assessment includes creating possible scenarios of bioterrorism using present knowledge of the organisms that may be used, the preferred targets, methods of spread, etc. This is followed by an assessment of the likelihood of different scenarios, based on both the motivation of different terrorist groups and their capabilities in terms of laboratory knowledge, pathogens held, and distribution abilities. In the risk assessment, consequences of possible scenarios can be estimated using methods of exposure assessment, data on natural epidemics, and from laboratory studies. The possible countermeasures against a bioterrorist event can be examined in the risk assessment models, and chosen accordingly.
... Specific groups of people may be more prone to immediate psychosocial problems after technical disaster than after natural disasters. [46][47][48][49][50][51] These groups included pregnant women, mothers of young children, children, and evacuees from contaminated areas. It may be helpful for first receivers to identify members of these groups for mental health assessment and intervention. ...
Abstract
This article reviews the literature pertaining to psychological impacts in the aftermath of technological disasters, focusing on the immediate psychological and mental health consequences emergency department physicians and first responders may encounter in the aftermath of such disasters. First receivers see a wide spectrum of psychological distress, including acute onset of psychiatric disorders, the exacerbation of existing psychological and psychiatric conditions, and widespread symptomatology even in the absence of a diagnosable disorder. The informal community support systems that exist after a natural disaster may not be available to communities affected by a technological disaster leading to a need for more formal mental health supportive services.
... Specific groups of people may be more prone to immediate psychosocial problems after technical disaster than after natural disasters. [46][47][48][49][50][51] These groups included pregnant women, mothers of young children, children, and evacuees from contaminated areas. It may be helpful for first receivers to identify members of these groups for mental health assessment and intervention. ...
This article reviews the literature pertaining to psychological impacts in the aftermath of technological disasters, focusing on the immediate psychological and mental health consequences emergency department physicians and first responders may encounter in the aftermath of such disasters. First receivers see a wide spectrum of psychological distress, including acute onset of psychiatric disorders, the exacerbation of existing psychological and psychiatric conditions, and widespread symptomatology even in the absence of a diagnosable disorder. The informal community support systems that exist after a natural disaster may not be available to communities affected by a technological disaster leading to a need for more formal mental health supportive services.
... • artificially terminating pregnancies (Trichopoulos et al. 1987); • performing unsafe evacuations (NAIIC 2012); • medical staff being reluctant to treat patients who were possibly contaminated (IAEA 1988;ICRP 2012;Vano et al. 2011); • demanding unwarranted medical examinations that interfere with the treatment of those who are most at risk (IAEA 1988); • pregnant women worrying about their fetuses (Gonzalez 2012;Knudsen 1991;Spinelli and Osborn 1991;Vano et al. 2011); • using inappropriate substitutes for iodine thyroid blocking agents (Vano et al. 2011); • stigmatizing those from the affected area (Gonzalez 2012;IAEA 1988IAEA , 1991; • worrying about the possibility of radiation-induced cancers (Vano et al. 2011); • rejecting products from the affected area (Gonzalez 2012); • causing economic damage to the tourism industry and implementing restrictions on agriculture (Christensen 1989;IAEA 1988); and • canceling necessary nuclear medical treatments due to fear of radiation (Kinuya 2012). ...
Experience from past nuclear and radiological emergencies shows that placing the radiological health hazard in perspective and having a definition of "safe" are required in order to prevent members of the public, those responsible for protecting the public (i.e., decision makers), and others from taking inappropriate and damaging actions that are not justified based on the radiological health hazard. The principle concerns of the public during a severe nuclear power plant or spent fuel pool emergency are "Am I safe?" and "What should I do to be safe?" However, these questions have not been answered to the satisfaction of the public, despite various protective actions being implemented to ensure their safety. Instead, calculated doses or various measured quantities (e.g., ambient dose rate or radionuclide concentrations) are used to describe the situation to the public without placing them into perspective in terms of the possible radiological health hazard, or if they have, it has been done incorrectly. This has contributed to members of the public taking actions that do more harm than good in the belief that they are protecting themselves. Based on established international guidance, this paper provides a definition of "safe" for the radiological health hazard for use in nuclear or radiological emergencies and a system for putting the radiological health hazard in perspective for quantities most commonly measured after a release resulting from a severe emergency at a light water reactor or its spent fuel pool.
... A twenty-two percent rise in induced abortions was observed as far away as in Denmark in the months following Chernobyl. Based on Danish national register data Knudsen (1991) stated that fear of radiation from Chernobyl probably caused more fetal deaths than the radioactivity itself. ...
As the 20th century ushered in the age of technology, the 21rst increasingly will cope with new challenges posed by when technology goes awry, as in the 1986 Chernobyl nuclear power plant explosion that spewed long lasting radiation well beyond the borders of the former Soviet Union. While the Chernobyl incident taught the world dire lessons about the risks of nuclear power plant malfunctioning, and inspired new safety standards worldwide, risks of nuclear disaster still remain with us. Indeed these risks may even be on the rise with increased terrorist threats. It is not only technical errors, but now hijacked airplanes crashed into nuclear facilities, or insider sabotage, that can be the cause of long lasting nuclear devastation.
In dealing with and preparing for technological disasters one must ask, what exactly is a catastrophe of this type and how do these calamities differ from other stressors and from natural disasters? Clearly it is not always possible to separate natural disasters from technological disasters, as they may be a mixture of both. For instance, some of the consequences of natural disasters may be aggravated by human error such as is the case after earthquakes. There are however, distinct aspects to the experience of a toxic disaster. Havenaar (2001) defines a technological disaster as an exposure of human beings to a hazardous substance in a defined place over a defined span of time, due to some human error or action. The exposure may or may not be known at the time it occurs, but is learned of at some point, and harmful effects are attributed, whether accurately or not, to those who have been exposed to the toxins.
To be truly prepared for a technological disasters similar to that of the Chernobyl explosion, which we all of course hope can never be repeated, those in key positions of society must be prepared to prevent the incident itself as well as to prevent and remediate the psychological and health effects occurring in the aftermath of such a technological disaster. To this end caregivers, policy makers, public health officials, educators, emergency and health care workers and those who design and operate the technology of the future, all must educate themselves about how toxic disasters operate and pose threats to physical and psychological well being. In this vein they must be brought to understand that the harm done is often not only through the spread of deadly and contaminating toxins, but through the spread of information as well as disinformation. In that regard, this chapter examines the psychological and social mechanisms that are unique to toxic disasters and discusses means of averting and remediating the psychological distress and harmful mental health consequences that typically follow in the wake of technological disasters. It is also an attempt to provide an understanding of toxic contamination spread both actually and physically as well as communicated through information and disinformation can function as a new and challenging form of traumatic stressor.
... Even without any illness, the worry that your child could be affected in the future can overshadow any personal concern (Bay & Oughton, 2005). These concerns extend to pregnant women, as exemplified by rises in voluntary abortions after Chernobyl (Knudsen, 1991). It may seem illogical, since many other activities have a statistically greater probability of harming children, such as traffic or even other exposures to radiation. ...
... A twenty-two percent rise in induced abortions was observed as far away as in Denmark in the months following Chernobyl. Based on Danish national register data Knudsen (1991) stated that fear of radiation from Chernobyl probably caused more fetal deaths than the radioactivity itself. ...
... As the increase in radiation in Denmark was so low that almost no increased risk of birth defects was expected, the public debate and anxiety among the pregnant women and their husbands 'caused' more fatal deaths in Denmark than the accident (Knudsen, 1991). ...
The Chernobyl accident was the worst catastrophe involving radiation to humans. Since then, it has unfortunately been providing a main cause of radio‐anxiety. WHO suggested 4000 people could have died or could die in the future of emergency workers and residents of most contaminated areas while Greenpeace insisted that there would be 93,080 people in the world. Though the incidence of thyroid cancer increased at the Chernobyl area, it is not accepted by the experts because the area that was less contaminated by radiation has a greater reported incidence of thyroid cancer. So, it might be due to a screening effect. There is no convincing evidence that the incidence of leukaemia and solid cancer has been increased in the exposed populations, but it remains a controversial issue. Additionally, the apparent evidence of decreased fertility and increased hereditary effects was not observed in the general population.
... Researchers analyzing Danish national register data stated that fear of radiation after Chernobyl probably caused more fetal deaths than the radioactivity itself (Knudsen, 1991). Abortions carry with them their own potential consequences for posttraumatic stress responses, especially among women wanting the pregnancy or having already formed an attachment to the fetus (Speckhard & Rue, 1992;Mufel, Speckhard & Sivuha, 2001). ...
At times words, especially scientific words used to describe the psychological effects of ecological disasters fall short of getting to the heart of the matter. Sometimes scientific words can give no real voice to the pain felt by those who suffer when an untouched land is forever spoiled, when oil weighs heavy on the wings of struggling wildlife, when radiation threatens the health of hundreds of thousands of children, when mothers are afraid to breastfeed, or even to bear their own children for fear of toxins released into their surroundings. These are tragic events beyond words, or are they?
This chapter seeks to give voice to the experiences of real people struggling to comprehend and to come to terms with ecological disaster. It takes the insider’s point of view: from the simple villager struggling to comprehend invisible toxins to the journalist striving to retain objectivity and professionalism in the midst of chaos and danger, to the bureaucrat and healer, each laboring to make sense and find a healing journey out of the stormy eye of ecological disaster. It’s a journey that begins with the shock of recognition: the awakening comprehension that life has suddenly changed, perhaps forever. It follows real voices through their struggles with recognition, denial, fear, dread, anger and grief. It follows from dysfunction to coping, in and through the paths tread by those who suffer when ecological disaster robs them of what they hold most dear. Perhaps in these voices we too can find comprehension.
... Pregnant women are often overlooked in such situations even though pregnancy is known to often be a time fraught with worry about the health of the future child. One researcher wrote that the highest death toll from the Chernobyl disaster was not caused by direct exposure to radiation but due to the huge increase in voluntary abortion following it, even in areas in Europe not directly exposed (Knudsen, 1991). Likewise makeshift abortions were provided for many women in the direct exposure area. ...
This paper examines the challenges that governments and civil society faces in preparing for bioterrorist attacks - the challenges of reporting bioterrorism in the media, the psychological responses that are likely and how to deal with them, how terrorism may disrupt the political processes and how to respond to the needs of the population for calming and accurate information while minimizing fear states and maximizing compliance with government instructions. It examines the psychological dimensions of mass bioterrorist attacks on the civil population and government responses, working first from the normal government expectation of panic to a more modulated recognition that even when panic does occur, so too do increased attachment, cohesive, and supportive societal behaviors in response to disaster situations. Likewise, this paper addresses medical, psychiatric, psycho-social and informational needs that are likely to be encountered in the face of "invisible" threats and makes suggestions for designing risk communication strategies to address psychological contagion, acute and posttraumatic responses and to maximize resilience in the face of the increased bio-terror threats of today's world. Today's terrorists are skillful in their manipulation of mass media to amplify the effects of their attacks. In response governments must be equally prepared and ready to remain calm and truthful in their communication in times of crisis and they must not compromise the core values of democracy in taking up the defense against terrorism.
... The effects of exposure to the embryo and foetus are discussed in (ICRP 2000) and it was concluded that exposure to a dose below 100 mGy (of organ dose) is not considered as a reason for terminating a pregnancy. However, following the Chernobyl accident thousands of wanted pregnancies were terminated (Trichopoulos et al 1987, Knudsen 1991, Spinelli and Osborn 1991, most likely because of the unjustified fear of the effects of radiation exposure on the foetus, while none of these women were exposed to in excess of several tenths of millisieverts. ...
Lessons learned from responses to past events have shown that more guidance is needed for the response to radiation emergencies (in this context, a 'radiation emergency' means the same as a 'nuclear or radiological emergency') which could lead to severe deterministic effects. The International Atomic Energy Agency (IAEA) requirements for preparedness and response for a radiation emergency, inter alia, require that arrangements shall be made to prevent, to a practicable extent, severe deterministic effects and to provide the appropriate specialised treatment for these effects. These requirements apply to all exposure pathways, both internal and external, and all reasonable scenarios, to include those resulting from malicious acts (e.g. dirty bombs). This paper briefly describes the approach used to develop the basis for emergency response criteria for protective actions to prevent severe deterministic effects in the case of external exposure and intake of radioactive material.
... A study conducted in Denmark reported an increase in induced abortions following the Chernobyl accident (44). However, the overall number of abortions in 1986 was not clearly above that for 1985. ...
Possible effects of Chernobyl fallout on outcome of pregnancy in Finland were evaluated in a nationwide follow-up study. The outcomes were the rate of live births and stillbirths, pregnancy loss, and induced abortions by municipality. Exposure was assessed based on nationwide surveys of radiation dose rate from the Chernobyl fallout, from both external and internal exposures. Using these measurements, we estimated the monthly dose rate for each of the 455 Finnish municipalities. On average, the dose rate from Chernobyl fallout reached 50 microSv per month in May 1986--a doubling of the natural background radiation. In the most heavily affected area, 4 times the normal background dose rates were recorded. Given the underlying regional differences in live birth, stillbirth, and abortion rates, we used longitudinal analysis comparing changes over time within municipalities. A temporary decline in the live birth rate had already begun before 1986, with no clear relationship to the level of fallout. A statistically significant increase in spontaneous abortions with dose of radiation was observed. No marked changes in induced abortions or stillbirths were observed. The decrease in the live birth rate is probably not a biological effect of radiation, but more likely related to public concerns of the fallout. The effect on spontaneous abortions should be interpreted with caution, because of potential bias or confounding. Further, there is little support in the epidemiologic literature on effects of very low doses of radiation on pregnancy outcome.
... In addition to increased demands for health care after a CBN attack, immediate changes in reproductive behavior may occur. Following the Chernobyl radiation disaster there was a decrease in the birth rate across Western Europe and an increase in induced abortions (Bertollini et al. 1990;Knudsen 1991). More recently, abortions and delayed pregnancy became an issue in the Balkans during aerial bombing of chemical plants (Fineman 1999). ...
The possibility of terrorists employing chemical, biological, or nuclear/ radiological (CBN) materials has been a concern since 1995 when sarin gas was dispersed in a Tokyo subway. Contingency planning almost exclusively involved detection. containment, and emergency health care for mass casualties. However, it is clear that even small-scale CBN incidents--like the recent spread of anthrax spores through the mail--can cause widespread confusion, fear, and psychological stress that have lasting effects on the health of affected communities and on a nation's sense of well-being. More emphasis therefore needs to be placed on indirect effects and on the medical, social, economic, and legal consequences that follow months to years afterward. To respond effectively to CBN attacks, a comprehensive strategy needs to be developed that includes not only emergency response, but also long-term health care, risk communication, research, and economic assistance. Organizing an effective response challenges government institutions because the issues involved--eligibility for health care, the effects of low-level exposure to toxic agents. stress-related illnesses, unlicensed therapeutics. financial compensation--are complex and controversial.
... Therefore, after a large release of radionuclides, the critical situation encountered must be evaluated as realistically as possible, in order to take appropriate countermeasures and to avoid harmful over-reactions both by authorities and the public. The importance of this issue became evident from the results of a survey on the number of induced abortions following the Chernobyl accident 13 . ...
An extensive dataset on individual food consumption was analysed in order to study all pairwise correlations between the consumption rates of 11 major food groups. Additionally, the project aimed to examine and quantify the accuracy of a recently proposed estimator of total food consumption to be used for the estimation of radiation exposure by food. Such an inquiry seems justified, because the proposed estimator implicitly presumes an essentially positive correlation structure in food consumption rates.
Statistical analysis using representative data gathered in Germany in a nation-wide food consumption survey.
Germany.
Individuals aged between 4 and 94 years namely 10,901 males and 12,308 females.
The consumption rates of 11 major food categories showed several significantly positive, but also a number of significantly negative, correlations. Negative associations between cereal and potato products persisted consistently over all age groups, independent of sex. Other significantly negative correlations were limited to certain age groups. Reflecting these negative correlations, a subsequent analysis of relative ranks of consumption revealed that no person in the sample had the highest consumption rates in all food groups simultaneously. Based on representative samples, overestimations of 34 to 53% were obtained if--as recently suggested in the context of radiation exposure prediction--the 95th percentiles of total food consumption were determined as sums of the corresponding percentiles of the food groups.
The complex correlation structure of food group consumption rates, as identified in this study, bears important implications for various health-related issues. Ignoring them could lead to overly conservative estimations of radiation exposure due to food ingestion or to confounding effects in epidemiological studies on nutritional risk factors of diseases. The results also indicate that a distinction into different dietary patterns might be useful in characterising different consumption habits.
... Although we can avoid underestimating the effects of ionizing radiation by assuming a linear dose-response relationship without any threshold, overestimating of the effects can also have negative implications. It was pointed out that a number of induced abortions were performed in Denmark after the Chernobyl accident and that most, if not all, of these abortions were unnecessary as the increase in radiation was so low that there was almost no excess risk of birth defects [10]. Similarly, an increase in the rate of induced abortions in Italy [11] and Sweden [12] was also reported during the same period. ...
The dose-response relationship of ionizing radiation and its stochastic effects has been thought to be linear without any thresholds. The basic data for this model were obtained from mutational assays in the male germ cells of the fruit fly Drosophila melanogaster. However, it is more appropriate to examine carcinogenic activity in somatic cells than in germ cells. Here the dose-response relationship of X irradiation and somatic mutation was examined in Drosophila. A threshold at approximately 1 Gy was observed in DNA repair-proficient flies. In the repair-deficient siblings, the threshold was smaller and the inclination of the dose-response curve was much steeper. These results suggest that the dose-response relationship between X irradiation and somatic mutation has a threshold and that the DNA repair function contributes to its formation.
... This lack of predetermined criteria during past emergencies has led decision makers and the public to take actions that would be difficult to justify from a strictly radiation protection point of view. One example was that thousands of abortions were performed throughout Europe due to fear of radiation induced effects (Knudsen 1991;Spinelli and Osborn 1991); however, none of the women involved were exposed at levels above which informed decisions should be made based upon individual circumstances (ICRP 2000a;UNSCEAR 2000). ...
In the past 25 years, nuclear and radiological emergencies have occurred that cover much of the range of causes and types that had been anticipated by experts. Experience from response to these emergencies has clearly demonstrated the importance of an efficient response system that includes, among other components, emergency plans, procedures, and internally consistent operational criteria. An analysis of lessons identified from recent responses has shown that a lack of crucial components in the emergency response system could result in major radiological and nonradiological consequences at the national level. A rigorous examination of the response to past emergencies has shown that there is a need for additional consistent international guidance on taking protective and other response actions and for placing the guidance in a context that is both comprehensive for the decision makers and can be explained to the public. This paper briefly describes the lessons learned from past radiation emergencies and how these lessons are used by the International Atomic Energy Agency in developing the international guidance in the area of emergency preparedness and response. In particular, the paper discusses the proposed extended framework of emergency response criteria. The framework is composed of two fundamental parts: (1) generic reference levels and (2) a plain language explanation for each generic reference level to assist the decisions makers and the public in making informed decisions on the actions they should take when this level is reached. The system of generic reference levels covers the full range of potential and actual exposures, from those levels that can result in severe deterministic health effects down to those that allow for a return to normality.
A 71-year-old man presented with a one-week history of persistent loss of appetite and vomiting. An abdominal computed tomography (CT) scan revealed a right renal cyst (measuring 14 × 13 cm) that had compressed the descending portion of the duodenum, as well as marked gastric dilation. As a result, the patient was diagnosed with duodenal obstruction caused by a giant renal cyst. Percutaneous cyst drainage and sclerotherapy consisting of intracystic injection of 200 mg minocycline hydrochloride (MINO) were performed. Subsequent abdominal CT scan performed on hospital day 7 revealed marked shrinkage of the cyst and amelioration of the compression to the descending portion of the duodenum. There was no recurrence of the intestinal obstruction after completion of the treatment, and the patient was discharged from our hospital on postoperative day 10. Patients with renal cysts are often asymptomatic and are therefore rarely treated, but treatment may be considered in symptomatic patients. Moreover, intestinal obstruction is extremely rare among symptomatic patients, and such cases have rarely been reported to date. Here, we report a case of duodenal obstruction due to a giant renal cyst that was successfully treated by percutaneous cyst drainage and sclerotherapy.
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Ionizing radiation had a positive image up to the mid-1950s: prior to World War II, advertisements hailed mineral waters or beauty creams for their richness in radioactive nuclides and the development of nuclear energy initially met with public favor. However, since 1953, an increasing "radiophobia" has taken hold in all the industrialized countries. This evolution can be explained by sociological factors, notably the mistrust of science and progress. But the role of campaigns must be underlined because they insist on the risks of ionizing radiation and the idea that all doses, no matter how low, carry a cancer risk. The use of the linear no threshold hypothesis in the estimation of the carcinogenic effects of low doses has crystallized these fears. Conversely, the most recent epidemiological and biological data indicate that doses lower than a few mSv, equivalent to those delivered by natural background irradiation to which all living organisms are exposed, have an insignificant effect. Doses received by the population from nuclear energy are about 0.02 mSv and those in France from the Chernobyl fallout are lower than variations in natural irradiation in France (1.5 to 6 mSv/year). On the other hand, doses higher than 100 mSv in children and 200 mSv in adults may induce cancers. It is therefore legitimate to reduce as much as possible the dimension of irradiated healthy tissues during radiotherapy and to avoid the multiplication of unwarranted radiological examinations (in particular CT scans of children and young adults). In order to counteract fear of radiation and unnecessary irradiation, the public must be informed and physicians should be given training in this field. Radiobiological effects and radiation are no longer a mystery and are well understood today. They should be taught on a regular basis since physicians are at the origin of the largest amount of human irradiation (imaging and radiotherapy).
From the perspective of peace psychology, the role of abortion in acts of violence against women is explored, with a focus on violence-prevention strategies. Setting aside the political debate, this task force report takes the conflict-transformation approach of considering all perspectives that have concern for the right of women to avoid being victims of violence. The evidence that victims of Intimate Partner Violence are disproportionately represented in women presenting for abortion suggests a need for screening at clinics. Coerced abortion is a form of violence and has occurred by government policy in China and as a result of other violence against women: sex trafficking and war situations. Sex-selection abortion of female fetuses, referred to as "gendercide," has reached pandemic proportions and caused a gender imbalance in some countries. Psychology, through empirical research, can make unique contributions to understanding the relationship between abortion and violence and in developing prevention strategies.
The possibility of terrorists employing chemical, biological, or nuclear/ radiological (CBN) materials has been a concern since 1995 when sarin gas was dis- persed in a Tokyo subway. Contingency planning almost exclusively involved detec- tion, containment, and emergency health care for mass casualties. However, it is clear that even small-scale CBN incidents — like the recent spread of anthrax spores through the mail —c an cause widespread confusion, fear, and psychological stress that have lasting effects on the health of affected communities and on a nation's sense of well-being. More emphasis therefore needs to be placed on indirect effects and on the medical, social, economic, and legal consequences that follow months to years afterward. To respond effectively to CBN attacks, a comprehensive strategy needs to be developed that includes not only emergency response, but also long-term health care, risk communication, research, and economic assistance. Organizing an effec- tive response challenges government institutions because the issues involved — eligi- bility for health care, the effects of low-level exposure to toxic agents, stress-related illnesses, unlicensed therapeutics, financial compensation — are complex and con- troversial.
Low dose radiation has been defined as doses in the range under 100 mSv of low linear energy transfer (low-LET) radiation. There are two sources of ionizing radiation: natural and artificial radiation. Medical radiation exposure is the most common artificial radiation exposure. The frequency and volume of medical radiation exposure has markedly increased because of recent developments in medical technology. Radiation protection is now a concern due to the increasing use of computed tomography (CT) scans and diagnostic X-rays. This article introduced several models and hypotheses regarding the possible carcinogenic risks associated with low-LET radiation. Although opinions vary on the health effects of low level radiation exposure, current studies of medical radiation rely on exposure information collected prospectively, including cohort studies such as atomic bomb survivor studies. Although there are differences in perspective, the majority of studies have supported 'linear-no-threshold model without threshold' between low-LET radiation and the incidence of cancer risk. There is a need for further studies on medical radiation exposure including CT and positron emission tomography in order to understand the health effects of low-LET radiation, including the cancer incidence.
ABSTRACT This study examined the knowledge, attitudes, and behaviors of radiation workers to radiation safety management (RSM) using survey questionnaires. Radiation workers are those who handle radiation generators, radioactive isotopes, and other radioactive materials for industrial uses. The survey was distributed to 861 radiation workers between 1 August to 5 September 2011. A knowledge of, awareness of, attitude toward, and behaviors related to RSM were analyzed by comparing the means and standard deviations. Both the knowledge and awareness of RSM among radiation workers were high. Although all questions about the awareness of RSM were answered correctly, there were also many negative responses. All questions regarding the attitude of radiation workers toward RSM were answered correctly, and their attitude toward and awareness of RSM were high. Overall, the results demonstrated that safety management is not taken seriously in many cases, highlighting the need for proper education in the future to raise awareness among radiation workers. Furthermore, it is important to establish a foundation for the efficient use of radiation based on the continuous management of radiation workers.
Last year marked the 10th anniversary of Operation Desert Storm, the start of the Persian Gulf War. The facts are clear. Iraq
occupied Kuwait on August 2, 1990. Shortly after, Coalition Forces, led by the United States, began a military deployment
known as Operation Desert Shield. On January 17, 1991, an active air campaign began against Iraq, Operation Desert Storm,
and on February 24 a ground war began, lasting only four days. For the Coalition it was a military success. Iraqi forces were
beaten in the field and expelled from Kuwait. The main contributor to the Coalition was the United States, with 697,000 personnel.
Substantial contributions also came from the United Kingdom (53,000), Saudi Arabia, Egypt, Oman, France, Syria, Kuwait, Pakistan,
Canada, Bahrain, Morocco, and Qatar. Twenty-five other countries also contributed smaller numbers.
The Chernobyl disaster in 1986 involved the largest airborne release of radioactivity in history, more than 100 times as much radioactivity as the Hiroshima and Nagasaki atomic bombs together. The resulting emergency response, administrative blunders, and subsequent patient outcomes from this large-scale radiological disaster provide a wealth of information and valuable lessons for those who may find themselves having to deal with the staggering consequences of nuclear war. Research findings, administrative strategies (successful and otherwise), and resulting clinical procedures from the Chernobyl experience are reviewed to determine a current utility in addressing the appropriate protocols for a medical response to nuclear war. As various myths are still widely associated with radiation exposure, attention is given to the realities of a mass casualty medical response as it would occur with a nuclear detonation.
( Disaster Med Public Health Preparedness . 2012;6:330-334)
Objective . To study the impact of marital status, age and parity on the decision regarding pregnancy termination over time among pregnant Norwegian women.
Design . National surveillance data of induced abortions and births.
Material . All women terminating their pregnancies (n = 174,590) as registered in the Abortion File in the Central Bureau of Statistics and all women giving birth (n = 639,551) as registered in the Medical Birth Registry of Norway between January 1, 1979 and December 31, 1990 were eligible for the study. Included in the analysis of pregnancy outcome were records with complete information on marital status, age and parity, which comprise 93.8% (n= 163,826) of all women having had an induced abortion and 99.0% (n = 633,542) of all women giving birth during the time period.
Outcome measure . The proportion of pregnancies terminated as induced abortions and the relative risk of pregnant women choosing abortion in strata of marital status, age and parity.
Statistical methods . Trend analysis of the proportion of pregnancies terminated as induced abortions in different time periods in categories of marital status, age and parity.
Results and conclusion . From the first three‐year period 1979‐81 to the last three‐year period 1988‐90 there was a decreasing tendency to choose abortion among unmarried pregnant women above 20 years of age and married women with two or more children. In the other strata of marital status, age and parity there were no changes over the time period, except for married women 20‐24 years of age which was the only group that showed an increasing abortion tendency over the time period.
The prospect of single parenthood was the strongest determinant for choosing abortion independent of age and parity. Within all age groups of married women the abortion tendency increased more with parity than age. Cohabiting women chose abortion significantly more often than married women did. However, the true estimate of choosing abortion among cohabiting women was closer to married women than to single women. In order to find out the importance of other social factors and attitudes in the decision making process regarding pregnancy outcome, adjustments must be made for marital status, age and parity.
The impact on Western Europe of the Chernobyl accidents is assessed. In particular an evaluation of the contamination of air, soil, seawater and food with special reference to geographical and orographical situations. A simple and reliable method to evaluate the levels of Cs-134, Cs-137 and Sr-90 in green vegetables, hay and milk on the basis of the soil deposition only is described and experimental results are given. The model appears to be rather conservative and to overestimate the contamination. The situation prior to Chernobyl with respect to regulations of radiation protection against the consequences of a major accident is considered. The development of the recommendations and regulations issued by the Commission of the European Communities for the Maximum Permitted Levels of different groups of radionuclides in foodstuffs is reviewed. The different reactions to the accident are examined and some data on the average individual effective dose equivalents estimated in a number of countries are also reported. Also the consequences of the countermeasures are discussed. Some main problems concerning the information of the public and the preparedness for possible future accidents are summarised. Finally the present status of radioecology in the Mediterranean Area is described pointing out the unjustified reduction of the efforts on the monitoring and research with a special reference to the radiation protection problems in emergency situations.
The impact of the environment (air, water, food pollution) on health is a major concern in contemporary society. Unfortunately, there are relatively few objective epidemiological data on this subject and their accuracy is limited. Risks are often not quantified, whereas in public health the quantitative assessment of the various risks and benefits must provide the bases for a global strategy. Actual risks should be distinguished from putative risks and, when the risks are putative, an effort should be made to ascertain the upper and lower limits of the risk. The validity of a linear no threshold relationship for assessing putative risks should be discussed and, whenever appropriate, other relationships should be considered. Since emotional reactions often pervade environmental issues, which in turn are exploited for political or commercial reasons, it is not surprising that any statement or action may provoke violent debate. It is serious to underestimate the importance of a risk, since appropriate measures may not be put in place. However, it is equally serious to overestimate it because this can provoke unjustified fears, a pervasive unease, and a rejection of certain technologies, even to the point of discrediting science. It can lead therefore to a questioning of progress by instilling fears about any innovation, as well as facilitating the manipulation of public opinion for financial or ideological reasons, and finally to distortions in budget allocations and public health actions. Confronted with this situation, the Academy’s role should be threefold. a) Whenever necessary, point out the need for an increase in appropriate fundamental research. When epidemiological data are uncertain, analyse the cause of these uncertainties and advocate appropriate development in statistical methodologies and epidemiological research, which could ascertain the upper limit of the putative risk. The lack of knowledge often results in public anxiety; this reaction should be investigated and psychosociological research must be encouraged and supported. b) Inform the scientific community and the public; fight against misinformation and sensationalism in the news, and take advantage of the Internet to this end. Encourage openness and transparency in the preparation of scientific reports and dialogue with the stakeholders. c) Better define the role and the place of experts, ensure their independence, monitor their competence and make sure they represent the various fields involved. When reports are conflicting, the Academy should be ready to organize a forum for analysing the roots of these disagreements and to delineate the limits of the uncertainties.RésuméL’impact de l’environnement sur la santé constitue une préoccupation majeure dans le monde contemporain. Malheureusement les données objectives, épidémiologiques sur ce sujet sont relativement peu nombreuses et leur précision est limitée. Étant donné les réactions émotives qui entourent ces problèmes et l’exploitation qui en est souvent faite pour des raisons commerciales ou politiques, il n’est pas surprenant que tout résultat et toute action suscitent des polémiques parfois violentes. Or il est aussi grave de sous-estimer l’importance d’un risque, puisque l’on ne met pas en œuvre les mesures nécessaires, que de le surestimer, ce qui peut d’une part provoquer des craintes injustifiées, une atmosphère d’inquiétude, un rejet de certaines technologies, voire un discrédit de la science, une remise en question du progrès et la crainte de toute innovation, et d’autre part faciliter les manipulations de l’opinion pour des raisons financières ou idéologiques et entraîner des distorsions dans les allocations budgétaires et les actions de santé publique. Devant cette situation, le rôle des Académies devrait être triple : a) Accroître les connaissances fondamentales, développer des méthodologies statistiques et épidémiologiques, soutenir les recherches psychosociologiques sur les risques. b) Informer la communauté scientifique et le public, lutter contre la désinformation et la sensationalisation des nouvelles. c) Mieux définir le rôle et la place des experts, assurer leur indépendance, veiller à leur compétence et à leur représentativité.
Background: Whereas the effects of various socio-demographic determinants on a woman’s risk of having an abortion are relatively well-documented, less attention has been given to the effect of previous abortions and births. Objective: To study the effect of previous abortions and births on Danish women’s risk of an abortion, in addition to a number of demographic and personal characteristics. Data and methods: From the Fertility of Women and Couples Dataset we obtained data on the number of live births and induced abortions by year (1981-2001), age (16-39), county of residence and marital status. Logistic regression analysis was used to estimate the influence of the explanatory variables on the probability of having an abortion in a relevant year. Main findings and conclusion: A woman’s risk of having an abortion increases with the number of previous births and previous abortions. Some interactions were was found in the way a woman’s risk of abortion varies with calendar year, age and parity. The risk of an abortion for women with no children decreases while the risk of an abortion for women with children increases over time. Furthermore, the risk of an abortion decreases with age, but relatively more so for women with children compared to childless women. Trends for teenagers are discussed in a separate section.
Over the past 50 years, our laboratory has provided consultations dealing with the risks of various environmental toxicant exposures during pregnancy. These contacts were primarily by telephone or written communications. Since the year 2000, the primary source of consultations has been via the internet. In 2007, the pregnancy website of the Health Physics Society received 1,299,672 visits. The contacts who downloaded information totaled 620,035. After reading the website information, 1442 individuals who were still concerned contacted me directly. Unfortunately, we have learned that many physicians and other counselors are not prepared to counsel patients concerning radiation risks. Approximately, 8% of the website contacts, who had consulted a professional, were provided inaccurate information that could have resulted in an unnecessary interruption of a wanted pregnancy. Research from our and other investigators' laboratories has provided radiation risk data that are the basis for properly counseling contacts with radiation exposures. Mammalian animal research has been an important source of information that improves the quality and accuracy of estimating the reproductive and developmental risks of ionizing radiation in humans. What are the reproductive and developmental risks of in utero ionizing radiation exposure? 1. Birth defects, mental retardation, and other neurobehavioral effects, growth retardation, and embryonic death are deterministic effects (threshold effects). This indicates that these effects have a no adverse effect level (NOAEL). Almost all diagnostic radiological procedures provide exposures that are below the NOAEL for these developmental effects. 2. For the embryo to be deleteriously affected by ionizing radiation when the mother is exposed to a diagnostic study, the embryo has to be exposed above the NOAEL to increase the risk of deterministic effects. This rarely happens when the pregnant women have x-ray studies of the head, neck, chest or extremities. 3. During the preimplantation and preorganogenesis stages of embryonic development, the embryo is least likely to be malformed by the effects of ionizing radiation because the cells of the very young embryo are omnipotential and can replace adjacent cells that have been deleteriously affected. This early period of development has been designated as "the all-or-none period." 4. Protraction and fractionation of exposures of ionizing radiation to the embryo decrease the magnitude of the deleterious effects of deterministic effects. 5. The increased risk of cancer following high exposures to ionizing radiation exposure to adult populations has been demonstrated in the atomic bomb survivor population. Radiation-induced carcinogenesis is assumed to be a stochastic effect (nonthreshold effect) so that there is theoretically a risk at low exposures. Whereas there is no question that high exposures of ionizing radiation can increase the risk of cancer, the magnitude of the risk of cancer from embryonic exposures following diagnostic radiological procedures is very controversial. Recent publications and analyses indicate that the risk is lower for the irradiated embryo than the irradiated child, which surprised many scientists interested in this subject, and that there may be no increased carcinogenic risk from diagnostic radiological studies. Examples of appropriate and inappropriate counseling will be presented to demonstrate how counseling can save lives and change family histories. The reader is referred to the Health Physics Society website to obtain many examples of the answers to questions posed by women and men who have been exposed to radiation (www.hps.org). Then click on ATE (ask the expert).
Comparison with other risks helps to put a radiation risk into perspective and facilitates communication of radiation risk to the public. Twelve recommendations for risk comparisons are given, and some guidelines for risk communication are discussed.
The subject of the reproductive toxicity of various forms of radiation can be anxiety provoking to the public on two accounts, since reproductive failure engenders an unusual level of guilt and anger in the affected families, and radiation effects are misunderstood and feared by the public. Reproductive problems include an array of genetic and acquired diseases affecting parents and their offspring. Many of these problems are associated with the risk of being induced by preconception and/or postconception exposures to environmental agents. For the various forms of radiation, namely, ionizing radiation, ultrasound, low-frequency electromagnetic fields (EMF), and microwaves, the potential for producing reproductive effects varies considerably with the form of "radiation" and, of course, the dose. Whether the exposure occurs preconceptionally or postconceptionally is another major consideration. In evaluating the actual reproductive risks, we rely on accurate dosimetry and information obtained in epidemiological studies and animal studies. Epidemiological studies must demonstrate consistency of the reproductive finding, and animal studies should be designed to add to the findings of the epidemiological studies. Most importantly, the conclusions must not contradict the basic principles of teratology, genetics, and reproductive biology, and they should be biologically plausible. But frequently important basic science principles are ignored in the evaluation process. Yet developmental basic science principles can be instrumental in refuting or supporting the concern about possible risks. Although there is some overlap with regard to the preconception and intrauterine effects of ionizing radiation, there are significant differences. Preconception effects are mainly stochastic effects, while intrauterine effects are mainly deterministic effects. The stochastic genetic risks are lower than the deterministic risks at equivalent exposures. Thus, it is frequently difficult to demonstrate the occurrence of stochastic effects in populations that have received low preconception exposures to ionizing radiation. The reproductive effects from preconception and intrauterine exposures to electromagnetic fields (low-frequency EMF, video display terminals, microwaves) and ultrasound represent much different problems, since the main effects of microwaves and ultrasound occur because of their hyperthermic effects at high exposures. Low-frequency EMF does not have the capacity to produce hyperthermia, and none of these forms of nonionizing radiation has the specificity to damage the DNA comparable to the specificity of ionizing radiation. Not only do they not have targeted mutagenic effects at the usual exposures that populations receive, they are not cytotoxic at these exposure levels as well. From the viewpoint of biological plausibility, these other forms of radiation are much less likely to have the potential for producing reproductive toxicity at the usual population exposures.
The 1986 nuclear reactor accident at Chernobyl caused nonuniform radiocontamination of air and land, primarily within regions of the former Soviet Union and Western Europe. Major exposure groups included the reactor workers, villagers evacuated from within 30 km of the accident, the "liquidators" who decontaminated the evacuation zone afterward, those in radiocontaminated villages not evacuated, and "others" not in the latter categories. The possibility of being exposed to radiation caused considerable anxiety, especially among pregnant women. Were teratogenic levels of radiation (> or = 0.1 Gy) exposure attained? To date there is no consistent proof that this level of radiation exposure was received. Nevertheless, thousands of induced abortions were performed. Radioiodine (I-131) caused thyroid cancer in young children in portions of Belarus, the Ukraine, and Russia. It is not known but very possible that I-131 fetal thyroid exposure contributed to this observation. The relationship between mental retardation and radiation exposure has not been confirmed. Leukemia and other cancers, while predicted for the liquidators (mainly males), has not been found in the other exposure groups at this time. Investigations of aborted fetuses and newborns in Belarus showed an increase in the frequency of both congenital and fetal abnormalities in high and low Cs-137 contaminated regions. This study is unreliable due to detection and selection biases. Accident and environmental factors unrelated to radiation doses may have contributed to these observations. Occasional positive teratogenic studies in less contaminated regions of Western Europe are suspect because of the low radiation doses received. There is no substantive proof regarding radiation-induced teratogenic effects from the Chernobyl accident.
The impact of the environment (air, water, food pollution) on health is a major concern in contemporary society. Unfortunately, there are relatively few objective epidemiological data on this subject and their accuracy is limited. Risks are often not quantified, whereas in public health the quantitative assessment of the various risks and benefits must provide the bases for a global strategy. Actual risks should be distinguished from putative risks and, when the risks are putative, an effort should be made to ascertain the upper and lower limits of the risk. The validity of a linear no threshold relationship for assessing putative risks should be discussed and, whenever appropriate, other relationships should be considered. Since emotional reactions often pervade environmental issues, which in turn are exploited for political or commercial reasons, it is not surprising that any statement or action may provoke violent debate. It is serious to underestimate the importance of a risk, since appropriate measures may not be put in place. However, it is equally serious to overestimate it because this can provoke unjustified fears, a pervasive unease, and a rejection of certain technologies, even to the point of discrediting science. It can lead therefore to a questioning of progress by instilling fears about any innovation, as well as facilitating the manipulation of public opinion for financial or ideological reasons, and finally to distortions in budget allocations and public health actions. Confronted with this situation, the Academy's role should be threefold. a) Whenever necessary, point out the need for an increase in appropriate fundamental research. When epidemiological data are uncertain, analyse the cause of these uncertainties and advocate appropriate development in statistical methodologies and epidemiological research, which could ascertain the upper limit of the putative risk. The lack of knowledge often results in public anxiety; this reaction should be investigated and psychosociological research must be encouraged and supported. b) Inform the scientific community and the public; fight against misinformation and sensationalism in the news, and take advantage of the Internet to this end. Encourage openness and transparency in the preparation of scientific reports and dialogue with the stakeholders. c) Better define the role and the place of experts, ensure their independence, monitor their competence and make sure they represent the various fields involved. When reports are conflicting, the Academy should be ready to organize a forum for analysing the roots of these disagreements and to delineate the limits of the uncertainties.