The incidence of coronary heart disease among Palestinians and Israelis in Jerusalem.

BACKGROUND: Lifestyle factors relevant to coronary risk factors differ between Palestinians and Israelis. Both have been exposed, albeit differently, to the stressors of the long-term conflict. We determined the incidence of coronary heart disease, previously unreported in Palestinians, in these Mediterranean populations and made international comparisons with the MONICA Programme. METHODS: We applied the rigorous World Health Organization MONICA protocol, which enables standardized international population-based comparisons, to determine all acute myocardial infarction events and coronary deaths among Palestinians and Israelis aged 25-74, residents of the Jerusalem district in 1997. RESULTS: We confirmed a total of 265 coronary events among 76,200 Arabs and 698 among 226,500 Jews. Rates among Arabs were substantially higher than in Jews, particularly so in women. Age-adjusted rate ratios (RRs) for coronary events were 1.58 [95% confidence interval (95% CI) 1.34-1.87] among men and 2.37 (95% CI 1.81-3.10) among women. When restricted to coronary deaths, Arab: Jewish RRs were 2.79 (95% CI 2.09-3.73) in men and 2.66 (95% CI 1.77-4.00) in women. Compared with MONICA populations in 20 countries, Arabs ranked first in total coronary event rates and first in non-fatal myocardial infarction rates, exceeded populations in Finland, Scotland, and Northern Ireland, and showed striking differences from the participating Mediterranean centres. CONCLUSIONS: Coronary risk appears to be particularly high in Palestinian Arabs. Determinants of these unexpected findings should be sought and prevention programmes initiated.

Myocardial infarction occurrence in Jerusalem: a Mediterranean anomaly.

BACKGROUND: The Jewish population of Israel consumes a diet rich in polyunsaturated fatty acids with a relatively low proportion of saturated fat, has a small alcohol intake and a lipid profile characterized by low HDL-cholesterol and high lipoprotein(a) (Lp(a)). It is therefore of interest to compare occurrence rates of coronary heart disease (CHD) with those elsewhere. METHODS: The community-based event rate of CHD [comprising acute myocardial infarction (AMI) and CHD death] and case-fatality was determined in 1995-1997 by active surveillance among Jewish residents of the Jerusalem District aged 25-64 according to standardized WHO-MONICA criteria. We compared our findings with rates among MONICA populations in 21 countries. Twelve hundred and six events occurred in Jerusalem during approximately 399,000 [correction] person-years (930 non-fatal AMI and 276 CHD deaths). RESULTS: The age-adjusted incidence of CHD ranked high compared with the 21 countries (men third highest, women eighth highest), far exceeding the Mediterranean countries. In contrast, the pre-hospital mortality rate was low, similar to countries in the Mediterranean basin, and the 28-day case fatality was remarkably low, far lower than for any MONICA population in men, and second lowest in women. Correspondingly, the incidence of non-fatal AMI ranked extraordinarily high (men first, women third). The low case-fatality ranking persisted upon adjustment for treatment differences between populations. CONCLUSIONS: We report an unusual combination of a high incidence of CHD among Jewish residents of Jerusalem accompanied by extraordinarily low case fatality, the latter suggesting reduced susceptibility to lethal arrhythmias. Determinants of this anomaly require clarification.

Natural and Chernobyl-caused radioactivity in mushrooms, mosses and soil-samples of defined biotops in SW Bavaria.

Different mushrooms, mosses and corresponding soil samples have been collected mainly from two sites in the alpine region of southwestern Bavaria. At the end of the growthseason, September 1986, gamma spectroscopic analysis showed that the moss-, mould, and needle-layer contained considerably more 134Cs and 137Cs activity per unit fresh weight than eight different species of mushroom. These two isotopes were carried into the biotop mainly as a consequence of the Chernobyl accident. 131J could not be found any more in the samples ca. 5-6 months after the catastrophe. The activity of the cesium isotopes decreased with increasing soil depth. In the mushrooms the activity was relatively high in Xerocomus badius and surprisingly low in Boletus edulis; samples of the latter and of Cantharellus cibarius collected in September 1985 (before the accident) and kept deep frozen contained almost identical amounts of 137Cs as those collected from August to October 1986. Mushrooms contained considerably more of the natural isotope 40K than the needlelayers and the soil samples in the neighbourhood. In all mushrooms except Xerocomus badius the activity of 40K was generally higher than the 137Cs activity. The results indicate that except Xerocomus badius the analyzed mushrooms do not actively take up Cs from the soil, in contrast to K.

Radioactivity in mushrooms, mosses and soil samples of defined biotops in SW Bavaria-two years after "Chernobyl".

Mushrooms, the moos/grass layer and soil samples have been collected in autumn 1987 from two sites in SW-Bavaria in continuation of a former investigation (Elstner et al. 1987). There were still relatively high amounts of 137Cs and 134Cs in all samples. The ratio 137Cs/134Cs changed according to the different half-life times of the two radioisotopes, indicating in nearly all cases the Chernobyl accident as source. The distribution of the radioisotopes within the mushroom populations shows considerable variation, even within the same species and location. Besides 137Cs, 134Cs and 40K no other radioisotopes were detected.