Energy and human health.

Energy use is central to human society and provides many health benefits. But each source of energy entails some health risks. This article reviews the health impacts of each major source of energy, focusing on those with major implications for the burden of disease globally. The biggest health impacts accrue to the harvesting and burning of solid fuels, coal and biomass, mainly in the form of occupational health risks and household and general ambient air pollution. Lack of access to clean fuels and electricity in the world's poor households is a particularly serious risk for health. Although energy efficiency brings many benefits, it also entails some health risks, as do renewable energy systems, if not managed carefully. We do not review health impacts of climate change itself, which are due mostly to climate-altering pollutants from energy systems, but do discuss the potential for achieving near-term health cobenefits by reducing certain climate-related emissions.

Childhood cancer near German nuclear power stations.

In 2008, the Kinderkrebs in der Umgebung von Kernkraftwerken (KiKK) study in Germany reported a 60% increase in solid cancers and a 120% increase in leukemias among children living within 5 km of all German nuclear power stations. The study has triggered debates as to the cause(s) of these increased cancers. This article reports on the findings of the KiKK study; discusses past and more recent epidemiological studies of leukemias near nuclear installations around the world, and outlines a possible biological mechanism to explain the increased cancers. This suggests that the observed high rates of infant leukemias may be a teratogenic effect from radionuclides incorporated by pregnant women living near nuclear reactors. Doses and risks from environmental emissions to embryos and fetuses may be larger than suspected. Hematopoietic tissues appear to be considerably more radiosensitive in embryos/fetuses than in newborn babies. Recommendations for advice to local residents and for further research are made.

Hypothesis to explain childhood cancer near nuclear power plants.

As reported in this journal in 2009, the 2008 KiKK study in Germany found a 60% increase in all cancers and a 120% increase in leukemias among children living within 5 km of all German nuclear power stations. The KiKK study has triggered debates as to the cause(s) of these increased cancers. This article discusses the available evidence of leukemias near nuclear installations around the world. Over 60 epidemiological studies exist, the large majority of which indicate increases in leukemia incidence. The article also outlines a possible biological mechanism to explain the increased cancers, suggesting that doses from environmental nuclear power plant emissions to embryos/ fetuses in pregnant women near the plants may be larger than suspected, and that hemopoietic tissues may be considerably more radiosensitive in embryos/ fetuses than in newborn babies. The article concludes with recommendations for further research.

Commentary: childhood cancer near nuclear power stations.

In 2008, the KiKK study in Germany reported a 1.6-fold increase in solid cancers and a 2.2-fold increase in leukemias among children living within 5 km of all German nuclear power stations. The study has triggered debates as to the cause(s) of these increased cancers. This article reports on the findings of the KiKK study; discusses past and more recent epidemiological studies of leukemias near nuclear installations around the world, and outlines a possible biological mechanism to explain the increased cancers. This suggests that the observed high rates of infant leukemias may be a teratogenic effect from incorporated radionuclides. Doses from environmental emissions from nuclear reactors to embryos and fetuses in pregnant women near nuclear power stations may be larger than suspected. Hematopoietic tissues appear to be considerably more radiosensitive in embryos/fetuses than in newborn babies. Recommendations for advice to local residents and for further research are made.

Depleted uranium: properties, military use and health risks.

This article describes uranium and depleted uranium (DU), their similar isotopic compositions, how DU arises, its use in munitions and armour-proofing, and its pathways for human exposures. Particular attention is paid to the evidence of DU's health effects from cell and animal experiments and from epidemiology studies. It is concluded that a precautionary approach should be adopted to DU and that there should be a moratorium on its use by military forces. International efforts to this end are described.

Childhood cancers near German nuclear power stations: hypothesis to explain the cancer increases.

In early 2008, the very large Kinderkrebs in der Umgebung von Kernkraftwerken [Childhood Cancer near Nuclear Power Plants] (KiKK) study in Germany reported increases in leukaemias and solid cancers among children living near all German nuclear power plants (NPPs). This study, previously described in Medicine, Conflict and Survival, has triggered debates in many countries as to the cause or causes of these increased cancers. An accompanying article reports on the recent developments on the KiKK study including the responses by German radiation agencies, and the results of recent epidemiological studies near United Kingdom and French nuclear installations. This article outlines a possible explanation for the increased cancers. In essence, doses from environmental NPP emissions to embryos/foetuses in pregnant women near NPPs may be larger than suspected, and haematopoietic tissues may be considerably more radiosensitive in embryos/foetuses than in newborn babies. The article concludes with recommendations for further research.

Childhood cancers near German nuclear power stations: the ongoing debate.

In late 2007, the significant KiKK study (Kinderkrebs in der Umgebung von KernKraftwerken = Childhood Cancer in the Vicinity of Nuclear Power Plants) in Germany reported a 1.6-fold increase in all cancers and a 2.2-fold increase in leukaemias, among children living within 5 km of all German nuclear power stations. The KiKK study by Kaatsch et al. was extensively described in a recent edition of Medicine Conflict and Survival. It has triggered much discussion as to the cause(s) of these increased cancers. This article reports on recent developments on the KiKK study, including responses by German radiation agencies, and recent epidemiological studies near United Kingdom and French nuclear installations. It reflects the current debate and concludes with advice to policy-makers on radiation risks on the relative merits of the KiKK study. An accompanying article outlines a possible explanation for the increased cancers and makes recommendations for future research.

The hazards of tritium--revisited.

Tritium (3H) is the radioactive isotope of hydrogen, with a half-life of 12.3 years. It is created naturally in the atmosphere, and in higher annual rates in nuclear reactors and in nuclear weapon tests. This article surveys the properties of tritium, its biokinetics and its biological effectiveness. The safety levels of tritium have been a subject of dispute for many years, as many scientists consider that its doses and risks, as promulgated by the International Commission on Radiological Protection are, too low and should be at least doubled. Recent reports and evidence of increased cancer risks near nuclear installations that release tritium are discussed; these are of interest in view of new proposals to expand civil nuclear power.

Dispersal, deposition and collective doses after the Chernobyl disaster.

This article discusses the dispersal, deposition and collective doses of the radioactive fallout from the Chernobyl accident. It explains that, although Belarus, Ukraine and Russia were heavily contaminated by the Chernobyl fallout, more than half of the fallout was deposited outside these countries, particularly in Western Europe. Indeed, about 40 per cent of the surface area of Europe was contaminated. Collective doses are predicted to result in 30,000 to 60,000 excess cancer deaths throughout the northern hemisphere, mostly in western Europe. The article also estimates that the caesium-137 source term was about a third higher than official figures.

Uncertainties in doses and risks from internal radiation.

Many uncertainties exist in current estimates of radiation doses and risks: larger uncertainties exist with internal radiation. These arise mainly from the many steps used to derive doses, and partly from lack of statistical precision in deriving risks from epidemiology studies. The size of these uncertainties has been estimated by a number of expert dosimetrists: for some nuclides these are very large. The recent report by the CERRIE committee recommended that uncertainties should be acknowledged and dealt with by the government. Its parent committee, COMARE, backed these findings. A number of practical recommendations are suggested for government action in the light of the CERRIE report.

A hypothesis to explain childhood cancers near nuclear power plants.

Over 60 epidemiological studies world-wide have examined cancer incidences in children near nuclear power plants (NPPs): most of them indicate leukemia increases. These include the 2008 KiKK study commissioned by the German Government which found relative risks (RR) of 1.6 in total cancers and 2.2 in leukemias among infants living within 5 km of all German NPPs. The KiKK study has retriggered the debate as to the cause(s) of these increased cancers. A suggested hypothesis is that the increased cancers arise from radiation exposures to pregnant women near NPPs. However any theory has to account for the >10,000 fold discrepancy between official dose estimates from NPP emissions and observed increased risks. An explanation may be that doses from spikes in NPP radionuclide emissions are significantly larger than those estimated by official models which are diluted through the use of annual averages. In addition, risks to embryos/fetuses are greater than those to adults and haematopoietic tissues appear more radiosensitive in embryos/fetuses than in newborn babies. The product of possible increased doses and possible increased risks per dose may provide an explanation.

RBE and w(R) values of Auger emitters and low-range beta emitters with particular reference to tritium.

An apparent disparity exists between RBE (relative biological effectiveness) values for low-range beta and Auger emitters, and the current value for their radiation weighting factor (w(R)). This paper presents evidence that the current w(R) value of unity for these nuclides is inconsistent with most RBE evidence and should be increased by a factor of two to three. It recommends that the ICRP should clearly state that the most appropriate RBE value for these nuclides, and not the w(R) value, should be used in specific dose calculations, retrospective dose estimations and epidemiological studies. The ICRP should also publish guidance as to the methods and data sources that could be used for these RBE values.