The Philippine Journal of Otolaryngology Head and Neck Surgerypreviously co published two guest editorials, on “Reducing the Risks of Nuclear War— the Role of Health Professionals”¹and “Time to Treat the Climate and Nature Crisis as One Indivisible Global Health Emergency”²that addressed dual potentially catastrophic concerns that both place us “on the brink.”³

By co-publishing these guest editorials, the Philippine Journal of Otolaryngology Head and Neck Surgery joined the call for “health professional associations to inform their members worldwide about the threat to human survival and to join with the International Physicians for the Prevention of Nuclear War (IPPNW) to support efforts to reduce the near-term risks of nuclear war.”¹As enumerated in the editorial,¹we urged three immediate steps that should be taken by nuclear-armed states and their allies: 1) adopt a no first use policy;⁴2) take their nuclear weapons off hair-trigger alert; and 3) urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts.It is alarming that noprogress has been made on these measures.

Thus, on our 44th Anniversary, we join over 150 scholarly scientific journals worldwide in co-publishing another Guest Editorial on “Ending Nuclear Weapons, Before They End Us.”⁵We call on the World Health Assembly (WHA) to vote this May on re establishing a mandate for the World Health Organization (WHO) to address the consequences of nuclear weapons and war,6and urge health professionals and their associations (including otolaryngologists – head and neck surgeons, all surgeons and physicians, and the Philippine Society of Otolaryngology – Head and Neck Surgery, Philippine College of Surgeons, Philippine College of Physicians,
Philippine Academy of Family Physicians, Philippine Pediatric Society, Philippine Obstetrical and Gynecologic Society, Philippine Society of Anesthesiology, Philippine College of Radiology, Philippine Society of Pathologists, other specialty and subspecialty societies, and the Philippine Medical Association) to urge the Philippine Government to support such a mandate and support the new United Nations (UN) comprehensive study on the effects of nuclear war.⁷

war ; armed conflicts ; Nuclear Energy ; Atomic Energy ; Radiation ; Nuclear Weapons

war ; Armed Conflicts ; Nuclear Energy ; Atomic Energy ; Radiation ; Nuclear Weapons

Public health emergencies caused by infectious diseases are the greatest threat to mankind in the 21st century, and pose an even more significant threat than nuclear weapons. The first step in preparing for and responding to such public health emergencies is to conduct thorough surveillance and rapid epidemiological investigations. Especially in the case of public health emergencies, most information is not smoothly transmitted. Therefore, it is necessary to evaluate the emergency and to collect data quickly and efficiently by defining the minimum necessary data and information. In addition, these data should be analyzed and interpreted promptly, and countermeasures and strategies should be developed and utilized in preparedness and response activities. Epidemiological investigations should also be carried out promptly in accordance with the emergency situation, and in particular, if the infection source is not known, maximal measures should be taken to prevent epidemiologists from becoming infected. In order to carry out surveillance and epidemiological investigations effectively in the future in the event of a public health emergency, continuous efforts should be made to nurture professional manpower, international cooperation, and use of the latest information technology.
Communicable Diseases* ; Disease Outbreaks ; Emergencies* ; Epidemiology ; International Cooperation ; Nuclear Weapons ; Public Health*

OBJECTIVES: To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (Abomb) survivors. METHODS: To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down’s syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. RESULTS: Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. CONCLUSIONS: We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.
Accidental Falls ; Animals ; Asian Continental Ancestry Group ; Down Syndrome ; Epidemiology ; Genetic Diseases, Inborn ; Humans ; Mice ; Nuclear Weapons ; Parents ; Radiation, Ionizing ; Risk Factors ; Survivors ; United Nations

No abstract available.
Carcinoma, Squamous Cell* ; Humans ; Nuclear Weapons* ; Survivors*

In this article, we will examine the theory and practice of encounters between oral history and narrative medicine in view of storytelling. Man is a storytelling animal. Our experience is understood, reconstructed and transmitted as a story and we can find the meaning of life through a story. Oral history is a specific practice and method of research. It refers to the process of recording interviews with people who have something to say, transcribing the record and interpretating the written text to conduct the study of the past. Therefore story is a basic tool of oral history. There has been also growing interest regarding the narrative features of medicine. Especially the illness narrative is one of the most powerful tools in this context. An illness narrative is a patient's story about his illness, including the meaning of the illness in his life. Illness as a specific event of life can only be understood through a story of patient. How can we combine oral history and narrative medicine altogether? We propose two subjects, one is 'healing' and the other is 'the social'. The goal of medicine is healing of suffered people. It is well known that storytelling has a healing effect. Conducting oral history is not only 'recovery history' but also is helping people to have a well organized memory and integrate that into his whole life story. The use of oral history as a means of empowerment should be extended referring the healing effect of medicine. On the other hand, modern medicine has a tendency to reduce the problem of health and illness as an individual one. However story of illness can reveal the dominance of modern biomedicine in the contemporary and have political implications. Oral history deals with memory. Personal memory can only be understood in the context of social and cultural backgrounds. Collective memory is necessary in building community history. Medicine should learn from oral history's social dimensions. In this context, life of KIM Hyeongyul who was activist for second generation Korean Atomic Bomb Victims will be a good example of encounters between oral history and narrative medicine.
Animals ; Hand ; History, Modern 1601- ; Humans ; Memory ; Narration ; Nuclear Weapons ; Power (Psychology)

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.
Cohort Studies ; Humans ; Incidence ; Linear Energy Transfer ; Nuclear Weapons ; Positron-Emission Tomography ; Prospective Studies ; Radiation Protection ; Survivors

The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.
Alcoholic Beverages ; Breast ; Breast Neoplasms ; Contraceptive Agents ; Diethylstilbestrol ; Estrogens ; Ethylene Oxide ; Ethylenes ; Female ; Hormone Replacement Therapy ; Humans ; International Agencies ; Nuclear Weapons ; Occupational Exposure ; Risk Factors ; Smoking ; Survivors ; Work Schedule Tolerance

PURPOSE: Emergency physicians utilize multiple computed tomography (CT) scans in acute evaluation of patients with multiple traumas. By its nature, CT involves larger radiation doses than conventional X-ray films do. A significant association was reported between radiation dose and increasing risk of cancer in atomic bomb survivors and radiation workers. The object of this study was to investigate the amount (dose) of CT radiation in patients who activated the trauma team during the first 24 hours of their stay in the emergency department. METHODS: This study was designed as a retrospective analysis of radiologic and medical data. We reviewed 39 trauma patients who activated the trauma team of our emergency department between January 2008 and April 2009. Individual radiation dose reports calculated by the CT scanner were used to determine radiation dose from each CT scan. Radiation doses calculated by CT scanners were converted to effective dose by multiplying by a conversion coefficient. RESULTS: A total of 33 patients were enrolled. Among these patients, 24(72.7%) were male. The mean age was 41.88+/-16.13 years. The mean Revised Trauma Score was 6.94+/-1.16. The mean Injury severity score was 22.85+/-10.34. The mean number of total CT scans was 3.61+/-1.22. The median effective dose of the total CT scans was 68.81 mSv, with an intraquartile range of 56.30 to 88.41 mSv. CONCLUSION: Trauma patients in the emergency department following trauma team activation are exposed to clinically significant radiation doses from CT imaging during the first 24 hours of their stay.
Emergencies ; Humans ; Injury Severity Score ; Male ; Multiple Trauma ; Nuclear Weapons ; Radiation Dosage ; Retrospective Studies ; Survivors ; X-Ray Film