Effectiveness of simplified dose estimation equations for triage after criticality accident-a case study of dose assessment in the JCO criticality accident.

The dosimetry for the triage of personnel encountering a criticality accident was investigated. The JCO criticality accident of 1999 was selected as a case study, and attention was paid to the identification and the segregation of severely exposed personnel. A series of Monte Carlo calculations revealed that simplified equations proposed by ANSI to estimate dose with respect to distance work well to determine the region of interest for triage.

On the value and costs of protective actions in a nuclear emergency.

This paper reviews the current orthodoxy for the prompt application of shelter and evacuation advice in the event of a nuclear emergency in the light of the reassessment of the perceived costs and benefits of these protective actions that followed the Fukushima event. In particular, it discusses the mechanisms and criteria for the withdrawal of protective action advice or their continuation for more than a few hours and their impact on public perception. It suggests that lack of thought given to this area may lead to protective actions being kept in place for longer than necessary leading to more harm than good. It also considers the language used to recommend protective actions and to modify them as the event unfolds. Would over strong language used at the start of the event to encourage compliance contribute to public concerns later? Finally, the report poses some discussion points.

Risk assessment for the optimization of the grid of a telemetric network monitoring system.

The goal of this work was to develop a methodology for risk assessment in case of an accident originating from a nuclear power plant, and consequently, to improve the relevant radiation monitoring network. In specific, the study involved risk estimation in Greece from a transboundary nuclear power plant accident. The tool employed was JRODOS (Java-based Real-time Decision Support), which is a system for off-site emergency management of radioactive material in the environment. This tool, widely used to generate and study scenarios for nuclear accidents worldwide, provides valuable insight to facilitate emergency preparedness and response. The probability of the plume arriving at numerous regions within the country was calculated, along with the maximum dose rates in case of transport. A risk assessment was performed, and geographical regions were prioritized in terms of risk-based environmental radioactivity burden. A total of 29 administrative districts were identified as low to medium-risk regions. Acquired results were used to determine the optimal spatial distribution of detectors for upgrading the existing monitoring network of environmental radioactivity.

JRODOS customization for Pakistan and assessment of the consequences of a hypothetical nuclear accident.

Since the Chernobyl disaster in 1986, decision support systems and modelling tools have been utilized in response to nuclear and radiological emergencies. The java-based real-time online decision support system (JRODOS) is a decision support tool that can be utilised in response to an emergency in managing off-site radiological consequences. This article documents the customization and use of JRODOS for Pakistan. JRODOS was tailored to the local Pakistan conditions, and a case study of a theoretical nuclear power plant accident was used to assess JRODOS's feasibility as a decision support tool. A worst-case probabilistic accident scenario was used to identify zones and areas where urgent protective actions, early protective actions and food restriction and other response actions could be required. The areas and distances identified for the implementation of protective and response actions for such a hypothetical accident were found to be in agreement with the emergency planning zones and distances suggested by the International Atomic Energy Agency (IAEA). Additionally, the implications of meteorological and source term input parameters on predicting the radiation doses to members of the public were investigated. It was identified that the output of such tools strongly depends on the availability and accuracy of the input parameters, such as radioactive release and meteorological data. Limitations and uncertainties associated with these tools need to be considered in deciding on protective and other response actions in response to a nuclear accident. As established by the IAEA, protective and other response actions need to be applied on a graded approach, taking into account the protection strategy and uncertainties and limitations in the available information and criteria, based on the conditions at the facility and off-site.

ESTIMATION OF RADIATION DOSES IN THE AREA OF THE MAIN PRODUCTION BLOCK OF THE NUCLEAR POWER PLANT AFTER A REACTOR ACCIDENT.

The aim of this work is to propose methodology for estimations the characteristics of the radiation fields (and derived quantities from the field of dosimetry and radiation protection) in knowledge of a distribution of radionuclides released into the main production unit (or just a containment) area after a nuclear reactor accident. For such task stochastic Monte Carlo method has been chosen. Because of dimensions and thick shielding (concrete) barriers in the facility, application of the variance reduction techniques has been necessary. Monte Carlo code Monaco in sequence MAVRIC (from package SCALE 6.2.3) with variance reduction techniques using CADIS methodology has been employed for designing the proposed methodology. Procedure has been tested on a simulation model of a main production unit described by inspiration from the block of a nuclear power plant with a VVER-1000 reactor (installed in the Czech Republic, Central Europe).

Returning Home after Decontamination? Applying the Protective Action Decision Model to a Nuclear Accident Scenario.

Studies of the aftermath of nuclear power plant accidents show that affected citizens assess higher risks and adopt more risk-avoidant behaviors than authorities expect. This results in differences between the planned recovery and actual outcomes. Based on this knowledge, this study examined the factors that affect citizens' preference to continue living in a decontaminated area. Testing the key aspects of the protective action decision model (PADM), this study analyzed Swedish survey data (N = 2291) regarding such an accident scenario. Several aspects of the PADM, from the layperson's view of threats and protective actions, to stakeholders and situational factors, were strongly supported. The most influential variables affecting settlement choices are perceptions of radiation risk, perceptions of decontamination effectiveness, government information, living with certain restrictions, and attachment to an area because of one's work. A novel contribution of this study is that it ranked the significance of such effects on behavioral intentions in an emergency scenario. Regarding the policy recommendations, this study concluded that a recovery program must facilitate most aspects of people's lives and provide trustworthy information on decontamination efficiency. As some people will avoid potential health risks and leave a decontaminated area, planning to implement one solution for everyone would likely not be optimal.

Assessment of radiological consequence of a hypothetical accident at the Ghana Research Reactor-1 facility based on terrorist attack.

The International Atomic Energy Agency defines a nuclear and radiation accident as an occurrence that leads to the release of radiation causing significant consequences to people, the environment, or the facility. During such an event involving a nuclear reactor, the reactor core is a critical component which when damaged, will lead to the release of significant amounts of radionuclides. Assessment of the radiation effect that emanates from reactor accidents is very paramount when it comes to the safety of people and the environment; whether or not the released radiation causes an exposure rate above the recommended threshold nuclear reactor safety. During safety analysis in the nuclear industry, radiological accident analyses are usually carried out based on hypothetical scenarios. Such assessments mostly define the effect associated with the accident and when and how to apply the appropriate safety measures. In this study, a typical radiological assessment was carried out on the Ghana Research Reactor-1. The study considered the available reactor core inventory, released radionuclides, radiation doses and detailed process of achieving all the aforementioned parameters. Oak Ridge isotope generation-2 was used for core inventory calculations and Hotspot 3.01 was also used to model radionuclides dispersion trajectory and calculate the released doses. Some of the radionuclides that were considered include I-131, Sr-90, Cs-137, and Xe-137. Total effective doses equivalent to released radionuclides, the ground deposition activity and the respiratory time-integrated air concentration were estimated. The maximum total effective doses equivalent value of 5.6 × 10-9 Sv was estimated to occur at 0.1 km from the point of release. The maximum ground deposition activity was estimated to be 2.5 × 10-3 kBq/m3 at a distance of 0.1 km from the release point. All the estimated values were found to be far below the annual regulatory limits of 1 mSv for the general public as stated in IAEA BSS GSR part 3.

Scientific research and product development in the United States to address injuries from a radiation public health emergency.

The USA has experienced one large-scale nuclear incident in its history. Lessons learned during the Three-Mile Island nuclear accident provided government planners with insight into property damage resulting from a low-level release of radiation, and an awareness concerning how to prepare for future occurrences. However, if there is an incident resulting from detonation of an improvised nuclear device or state-sponsored device/weapon, resulting casualties and the need for medical treatment could overwhelm the nation's public health system. After the Cold War ended, government investments in radiation preparedness declined; however, the attacks on 9/11 led to re-establishment of research programs to plan for the possibility of a nuclear incident. Funding began in earnest in 2004, to address unmet research needs for radiation biomarkers, devices and products to triage and treat potentially large numbers of injured civilians. There are many biodosimetry approaches and medical countermeasures (MCMs) under study and in advanced development, including those to address radiation-induced injuries to organ systems including bone marrow, the gastrointestinal (GI) tract, lungs, skin, vasculature and kidneys. Biomarkers of interest in determining level of radiation exposure and susceptibility of injury include cytogenetic changes, 'omics' technologies and other approaches. Four drugs have been approved by the US Food and Drug Administration (FDA) for the treatment of acute radiation syndrome (ARS), with other licensures being sought; however, there are still no cleared devices to identify radiation-exposed individuals in need of treatment. Although many breakthroughs have been made in the efforts to expand availability of medical products, there is still work to be done.

Assessment of an Emergency Medicine System for Radiation Accidents in Korea: A State Survey of the Workers Involved the Medical Response to Radiation Accidents.

Radiation emergency medicine systems are operated around the world to provide special care for the injured that require immediate medical attention in accidents. The objective of this survey was to evaluate people's perception of those who design the emergency medical plan for radiation accidents and those who supervise it in Korea. A questionnaire survey was conducted on the people involved in a regulatory system for medical response in a radiation emergency. Of 150 survey recipients, 133 (88.7%) completed the survey, including 92 workers and 41 inspectors. The respondents expressed the view that the national emergency medical plan is prepared above the average level using a Likert-style scale of 1 to 5 (mean = 3.55, SD = 0.74). Interestingly, using the Mann-Whitney U test, it could be shown that inspectors evaluated the emergency medical system for radiation accidents more strictly in all of the questions than the licensee workers, especially on radiation medical emergency preparedness (p = 0.004) and the governmental regulatory policy for radiation safety (p = 0.007). For a more efficient system of radiation emergency medicine, licensee workers prioritized the workforce, whereas inspectors favored laws and regulations for safety. The survey results show different perspectives between inspectors and licensee workers, which stem from the actual properties of each occupational role in the regulatory system for radiation medical emergency. These data could be utilized for communication and interaction with relevant people to improve the medical response preparedness against radiation accidents.

Simulation study on radiation exposure of emergency medical responders from radioactively contaminated patients.

Emergency medical responders (EMRs) who treat victims during a radiation emergency are at risk of radiation exposure. In this study, the exposure dose to EMRs treating hypothetically contaminated patients was estimated using a Monte Carlo simulation, and the findings may be useful for educating EMRs and reducing their anxiety. The Monte Carlo simulation estimated radiation doses for adult computational phantoms based on radioactive contamination conditions and radiation dosages from previous studies. At contamination conditions below the typical upper limit of general Geiger-Müller survey meters, the radiation doses to EMRs were estimated to be less than 1 µSv per hour. In cases with greater contamination due to mishandling of an intense radioactive source (hundreds of GBq), the radiation doses to EMRs could reach approximately 100 mSv per hour. These results imply that a radiological accident with a highly radioactive source could expose EMR to significant radiation that exceeds their dose limit. Thus, authorities and other parties should ensure that EMRs receive appropriate education and training regarding measures that can be taken to protect themselves from the possibility of excessive radiation exposure. The results of this study may provide EMRs with information to take appropriate protective measures, although it is also important that they not hesitate to perform lifesaving measures because of concerns regarding radiation.

The secondary sex ratio in Italy over the past eighty years (1940 to 2019) and potential impact of radiological contamination after atmospheric nuclear testing and after Chernobyl: Temporal change-point analysis using Markov Chain Monte Carlo.

In Europe, the male to female ratio at birth (secondary sex ratio: SSR; sex odds: SO) is 1.04-1.06, is influenced by many factors and is declining in industrialized countries. This study was carried out to identify possible impacts of fallout by atomic bomb tests or by the Chernobyl event on SSR in Italy. Italy is a country without commercial nuclear power generation for the last four decades and thus nearly free of radiological confounders. Counts of annual male and female live births in Italy are provided by the World Health Organization (WHO) and by the Italian Istituto Nazionale di Statistica (ISTAT). This study included 57.7 million live births (1940-2019) with overall SSR 1.05829. The Italian SSR trend was modelled with linear and non-linear logistic regression. Trend changes, i.e., periods with level shifts were estimated with Markov Chain Monte Carlo (MCMC). Two distinct idealized level shifts were identified superimposed on a uniform secular downward trend. The first one is seen towards the end of the 1960s with a jump sex odds ratio (SOR) 1.00681, p < 0.0001. The second one occurred in 1987 with SOR 1.00474, p < 0.0001. In each of the 3 periods separated by the two jumps, SSR uniformly decreased with trend SOR per 100 years of 0.98549, p < 0.0001. In conclusion, the secular trend in the Italian SSR showed two marked level shifts, at the end of the 1960s and from 1987 onward. These follow the release of radioactivity by atmospheric atomic bomb tests during the 1960s and by Chernobyl in 1986 and corroborate the hypothesis that ionizing radiation increases SSR.

Comparative assessment of impact analysis methods applied to large commercial aircraft crash on reinforced concrete containment.

The precise evaluation of the potential damage caused by large commercial aircraft crash into civil structures, especially nuclear power plants (NPPs), has become essential design consideration. In this study, impact of Boeing 767 against rigid wall and outer containment building (reinforced concrete) of an NPP are simulated in ANSYS/LS-DYNA by using both force time history and missile target interaction methods with impact velocities ranging from 100 m/s to 150 m/s. The results show that impact loads, displacements, stresses for concrete and steel reinforcement, and damaged elements are higher in case of force time history method than missile target interaction method, making the former relatively conservative. It is observed that no perforation or scabbing takes place in case of 100 m/s impact speed, thus preventing any potential leakage. With full mass of Boeing 767 and impact velocity slightly above 100 m/s, the outer containment building can prevent local failure modes. At impact velocity higher than 120 m/s, scabbing and perforations are dominant. This concludes that in design and assessment of NPP structures against aircraft loadings, sufficient thickness or consideration of steel plates are essential to account for local failure modes and overall structural integrity. Furthermore, validation and application of detail 3D finite element and material models to full-scale impact analysis have been carried out to expand the existing database. In rigid wall impact analysis, the impact forces and impulses from FE analysis and Riera's method correspond well, which satisfies the recommendations of relevant standards and further ensure the accuracy of results in full-scale impact analysis. The methodology presented in this paper is extremely effective in simulating structural evaluation of full-scale aircraft impact on important facilities such as NPPs.

Radioactive Games? Radiation Hazard Assessment of the Tokyo Olympic Summer Games.

We conducted a comprehensive radiation hazard assessment of the Tokyo Olympic Games (Tokyo 2020, postponed to 2021). Our combined experimental and literature study focused on both external and internal exposure to ionizing radiation for athletes and visitors of the Games. The effective dose for a visit of 2 weeks ranges from 57 to 310 µSv (including flight dose). The main contributors to the dose are cosmic radiation during the flights (approximately 10-81%), inhalation of natural radon (approximately 9-47%), and external exposure (approximately 8-42%). In this complex exposure, anthropogenic radionuclides from the Fukushima nuclear accident (2011) always play a minor role and have not caused a significant increase of the radiological risk compared to pre-Fukushima Japan. Significantly elevated air dose rates were not measured at any of the Tokyo Olympic venues. The average air dose rates at the Tokyo 2020 sites were below the average air dose rates at the sites of previous Olympic Games. The level of radiological safety of foods and water is very high in Japan, even for athletes with increased water and caloric demands, respectively.

OFF-SITE RADIOLOGICAL DOSE ASSESSMENT IN A SEVERE NUCLEAR ACCIDENT OF APR1400.

Shin Kori unit 3 of Korea Hydro and Nuclear Power Co. is the pressurized water reactor of advanced power reactor 1400 (APR1400) in the Republic of Korea. A hypothetical accident was assumed for Shin Kori unit 3 to perform the time-dependent dose calculations along with the release rates of radionuclides to the environment. In order to assess the accident scenarios, Radiological Assessment System for Consequence Analysis code was used, which is a set of tools for emergency response applications developed by US Nuclear Regulatory Commission. A straight-line Gaussian model was used for the near-field atmospheric calculations and a Lagrangian Gaussian puff model was used for the far-field simulations where released radioactive materials to the environment were transported, dispersed and deposited. In this study, long-term station blackout in spring, summer, autumn and winter season was considered in 2016-2018 based on reactor condition and seasonal effects. It was found that the worst season is the spring and the worst scenario found during the evening time of spring in 2017. The calculated maximum values of total effective dose equivalent (TEDE) and thyroid committed dose equivalent (CDE) are 22 mSv and 390 mSv, respectively, around 5 km of precautionary action zone (PAZ) in 2 days after the accident. According to Korean regulations on urgent public protective actions, for indoor sheltering, the criteria are 10 mSv in 2 days. For public evacuation 50 mSv in 1 week and iodine prophylaxis should be introduced if thyroid protection level is 100 mSv. Calculated values of TEDE are more than double and thyroid CDE is almost four times in the PAZ compared with Korean regulations; hence, it was found that indoor sheltering and supply of iodine prophylaxis should be executed for short/mid-term protective measures. In this situation, indoor sheltering should be decided by off-site emergency management center, which was accountable for emergency decision-making process in nuclear accident under nuclear safety and security commission in Korea.

Assessment of probable scenarios of radiological emergency and their consequences.

PURPOSE: Despite the vast amount of literature on radiological emergencies, to the best of our knowledge there is no systematic review of probable scenarios and their consequences. This work aimed for compiling such review. MATERIALS AND METHODS: The authors comprised a Red Team - that is, simulated best efforts to inflict maximal damage to the society by various means of radiological attacks. Nuclear warfare including improvised nuclear devices is beyond the scope of this work. RESULTS: The direct radiogenic health consequences of any conceivable radiological accident, natural or man-made, are much less dangerous than those which are usually perceived. In each scenario, direct health effects are only a small part of the damage caused by fear and over-reaction; the damage is somewhat independent of the small health effect predicted for most of the scenarios. The reason is that nuclear radiation has become perceptually connected with nuclear apocalypses. This connection has caused the emotional description of radiological emergencies to frequently substitute quantitative considerations. For example, Chernobyl and Fukushima became major humanitarian disasters not because of the radiation itself but because of the over-reaction of both the authorities and the public, that led to the unjustified relocation of hundreds of thousands of people. In Fukushima, the evacuation was not justified at all and in Chernobyl the evacuated zone should have been re-populated after 1 month. CONCLUSIONS: It is vital to educate decision makers, first responders and the public about the factual extent of possible radiological consequences, as well as about the very real danger of over-reaction. Since the extent of the countermeasures deployed is unavoidably connected, in the eye of the public, with the extent of the danger, we suggest launching educational campaigns that explain the factual extent of the radiation risk, followed by easing regulations and narrowing safety margins. Such measures will probably be the most efficient method of countering radiological terrorism: by depriving any adversary of the most important ability which is to cause an over-reaction.

Consequences of a large-scale nuclear accident and guidelines for evacuation: a cost-effectiveness analysis.

PURPOSE: We aimed for a quantitative evaluation that justifies guidelines for evacuation which take into consideration both the human and economic costs. To the best of our knowledge, such an evaluation has not been performed yet. The present guidelines published by the International Atomic Energy Agency (IAEA) are probably based on averting radiation risk only; IAEA did not cite any quantitative estimation of the human cost of evacuation. MATERIALS AND METHODS: Quantitative estimation of the human and monetary costs of evacuation and, alternatively, the human and monetary costs of radiation exposure (non-evacuation). Associating human life with monetary value is psychologically difficult and somewhat challenging ethically; however, there is no escape from such an association (cost-effectiveness analysis) when making decisions regarding public health and safety, since extraneous public expenditures lead to a statistical life shortening. Estimating worst-case health consequences of irradiation, we used the conservative linear no-threshold (LNT) model because this model is widely used in spite of its controversy. In our estimation of the human cost of evacuation, we considered three factors: (a) direct loss of life (after Fukushima, 1% of the evacuees died within 2 years due to causes directly related to their evacuation), (b) loss of quality of life, and (c) loss of wealth leading to loss of life. The connection of economic loss with loss of life was performed according to the median cost-effectiveness threshold of 50-100 thousand USD per quality-adjusted life year. RESULTS: Even according to mortality calculations based on LNT, the overall loss of life due to evacuation is higher than the loss of life due to irradiation if the population-averaged first-year radiation dose is 500 mSv or less. CONCLUSIONS: Based on the performed analysis, we suggest avoiding evacuation if the projected first-year dose is below 500 mSv. This suggested action level is about five-fold higher than the action level presently recommended by the IAEA (100 mSv per year).

Nuclear power plant: state of knowledge of the population living in the area of the Cattenom special intervention plan. A cross-sectional study.

In France information campaigns are periodically conducted within a 10 km radius of nuclear power plants on the protective actions to be adopted in the event of a nuclear accident. The aim of this study was to assess the knowledge of the inhabitants of the Cattenom PPI area on the recommended actions to be adopted in the event of a nuclear accident after the information campaign that took place from 2016 to 2017 and compare its results with a similar study carried out before the information campaign. We performed a cross-sectional study in the Cattenom PPI area after the 2016-2017 information campaign. We administered questionnaires in ten municipalities selected by lot. These questionnaires contained queries on the general protective actions and required approach to taking potassium iodide (KI). The results obtained were compared with the results of a study conducted before the information campaign in the same area. Out of 200 questionnaires administered, 122 people responded. Only 40% of respondents remembered the information campaign. Only 16% knew all of the recommended protective actions. 78% of households had KI and only 60% knew the objective of KI intake. Compared to the results of the study before the information campaign, KI coverage was better (69% versus 78%, p = 0.02) and the dosage was better known (16% versus 28%, p = 0.0003). This study provides an overview of the effectiveness of information campaigns on the procedure in the event of a nuclear accident. This study highlights the insufficient knowledge of people living in the Cattenom PPI area.

Estimation of External Contamination and Exposure Rates Due to Fission Product Release.

In the event of a radiological incident, the release of fission products into the surrounding environment and the ensuing external contamination present a challenge for triage assessment by emergency response personnel. Reference exposure rate and skin dose rate calibration data for emergency response personnel are currently lacking for cases where receptors are externally contaminated with fission products. Simulations were conducted to compute reference exposure rate coefficients and skin dose rate coefficients from photon-emitting fission products of radiological concern. To accomplish this task, simplified mathematical skin phantoms were created using surface area and height specifications from International Commission on Radiological Protection Publication 89. Simulations were conducted using Monte Carlo radiation transport code using newborn, 1-y-old, 5-y-old, 10-y-old, 15-y-old, and adult phantoms for 22 photon-emitting radionuclides. Exposure rate coefficient data were employed in a case study simulating the radionuclide inventory for a 17 × 17 Westinghouse pressurized water reactor, following three burn-up cycles at 14,600 MWd per metric ton of uranium. The decay times following the final cycle represent the relative activity fractions over a period of 0.5-30 d. The resulting data can be used as calibration standards for triage efforts in emergency response protocols.

Topographical classification of dose distributions: implications for control for worker exposure.

This paper deals with classification of dose distributions of nuclear workers based on antikurtosis (Q) and entropy coefficients (K) and their relationship presented in QK-diagrams. It is shown that determination of the most appropriate distribution to adopt, for a specific data set of a wide range of input data, requires building and analysing QK-diagrams for distributions of logarithms of individual doses. Actual dose distributions for emergency and occupational exposure situations were then considered, as well as doses for one day of work during clean-up and routine activities. It is shown that, in all cases, three types of distributions of logarithms of individual doses were present: normal, Weibull and Chapeau. The location of the representation point of a dose distribution reflects the degree of dose control of the group of workers whose individual doses are collectively displayed in the QK-diagram. The more the representation point of the analysed distribution of the logarithms of the individual dose of a given contingent of workers deviates from the point of the lognormal distribution, the more there was intervention in the process of individual dose accumulation. Thus, QK-diagrams could be used to develop a dose control function. It is shown that the hybrid lognormal distribution, which is widely used in the field of radiation safety, for the purpose of approximation of real dose distributions, is unable to satisfactorily describe many dose distributions arising in aftermath operations and occupational exposure.

Stakeholder participation in nuclear and radiological emergency preparedness and recovery in Spain: benefits and challenges of working together.

Emergency preparedness and response (EP&R) to radiological or nuclear accidents depends on many different stakeholder groups: nuclear and radiological regulators and authorities; institutions and ministries concerned by health, environment and consumption; first-line responders including the police, military, firefighters and health workers; as well as local authorities and nuclear industries. Stakeholders also include the general public, such as people living near NPPs8 or affected by previous nuclear or radiological accidents and incidents. Teachers and journalists, bloggers and other social media figures would play a key role in effective dissemination of knowledge and information. NGOs9 or civil associations/societies can also be involved in radiation monitoring and protection. The present study describes the role of different research institutions (such as CIEMAT10, UPM11 and ISGlobal12) and of the Spanish Society of Radiological Protection (SEPR) in bringing together the above-listed stakeholders in Spain to discuss EP&R and identify benefits and challenges of working together. Stakeholder opinions on EP&R, collected mainly in the framework of several European-funded projects, are provided. Remaining barriers and examples of good practices in radiation protection are discussed, as well as recommendations for improving nuclear and radiological emergency preparedness in Spain. The conclusions may be useful for other countries.