Blood pressure, stroke, and coronary heart disease: Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias

NOTE The report of the Committee without its annexes appears as Official Records of the General Assembly, Sixty-third Session, Supplement No. 46. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The country names used in this document are, in most cases, those that were in use at the time the data were collected or the text prepared. In other cases, however, the names have been updated, where this was possible and appropriate, to reflect political changes. Scientific Annexes Annex A. Medical radiation exposures Annex B. Exposures of the public and workers from various sources of radiation INTROdUCTION 1. In the course of the research and development for and the application of atomic energy and nuclear technologies, a number of radiation accidents have occurred. Some of these accidents have resulted in significant health effects and occasionally in fatal outcomes. The application of technologies that make use of radiation is increasingly widespread around the world. Millions of people have occupations related to the use of radiation, and hundreds of millions of individuals benefit from these uses. Facilities using intense radiation sources for energy production and for purposes such as radiotherapy, sterilization of products, preservation of foodstuffs and gamma radiography require special care in the design and operation of equipment to avoid radiation injury to workers or to the public. Experience has shown that such technology is generally used safely, but on occasion controls have been circumvented and serious radiation accidents have ensued. 2. Reviews of radiation exposures from accidents have been presented in previous UNSCEAR reports. The last report containing an exclusive chapter on exposures from accidents was the UNSCEAR 1993 Report [U6]. 3. This annex is aimed at providing a sound basis for conclusions regarding the number of significant radiation accidents that have occurred, the corresponding levels of radiation exposures and numbers of deaths and injuries, and the general trends for various practices. Its conclusions are to be seen in the context of the Committee's overall evaluations of the levels and effects of exposure to ionizing radiation. 4. The Committee's evaluations of public, occupational and medical diagnostic exposures are mostly concerned with chronic exposures of …

sources and effects of ionizing radiation

Wine, alcohol, platelets, and the French paradox for coronary heart disease

MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial.

This two-part article provides an overview of the global burden of atherothrombotic cardiovascular disease. Part I initially discusses the epidemiologic transition which has resulted in a decrease in deaths in childhood due to infections, with a concomitant increase in cardiovascular and other chronic diseases; and then provides estimates of the burden of cardiovascular (CV) diseases with specific focus on the developing countries. Next, we summarize key information on risk factors for cardiovascular disease (CVD) and indicate that their importance may have been underestimated. Then, we describe overarching factors influencing variations in CVD by ethnicity and region and the influence of urbanization. Part II of this article describes the burden of CV disease by specific region or ethnic group, the risk factors of importance, and possible strategies for prevention.

Global Burden of Cardiovascular Diseases Part I: General Considerations, the Epidemiologic Transition, Risk Factors, and Impact of Urbanization

Gastric carcinoma in a fixed population

A measurement of indoor radon ({sup 222}Rn) concentrations in Hiroshima and Nagasaki was carried out to assess the variability of exposure expected among atomic bomb survivors. Two hundred dwellings, mostly belonging to members of the fixed cohort of atomic bomb survivors under study by the Radiation Effects Research Foundations, were selected for this measurement. The geometric mean values of the radon concentrations for 100 dwellings in Hiroshima and 99 dwellings in Nagasaki measured by Track-Etcho Type SF detectors were 56.8 Bq m{sup {minus}3} and 28.5 Bq m{sup {minus}3}, respectively. No statistically significant difference was observed between lung cancer mortalities in the low-dose range in the two cities. However, apparent values of the mortality rate for low dose range in Hiroshima are consistently greater than those in Nagasaki. The exposure to radon and its progeny and the atomic bomb radiation effect might have some cooperative effects on the lung cancer incidence.

Radon concentrations in residential housing in Hiroshima and Nagasaki.

Blood pressure is a powerful predictor of the occurrence of coronary heart disease (CHD). Within a population, the measurement of an individual’s blood pressure is perhaps the single most accurate guide to that individual’s risk of subsequently developing CHD. This ‘within-population’ accuracy of prediction does not extend to comparisons between populations. In the United States, for example, blacks have higher mean blood pressures than whites, but not higher rates of CHD[1]. In the West Indies, average blood pressure levels are high, but not the rate of occurrence of CHD [2]. Similarly, blood pressure levels in Japan are comparable to those in western countries [3, 4], but the rate of occurrence of CHD in Japan is much lower than in western countries [5, 6].

Hypertension and Heart Disease in the Ni-Hon-San Study

Data on Hiroshima and Nagasaki A-bomb survivors are used to investigate, for each city, possible circular asymmetry in cancer mortality around the hypocenter. Using the Cox regression method and controlling for age ATB, sex, followup year, distance from the hypocenter, and type of shielding, it is found that in Hiroshima cancer mortality was significantly higher in the westerly direction from the hypocenter. Mortality from stomach cancer, leukemia, and colon cancer were higher in the westerly direction. In Nagasaki, only lung cancer exhibited circular asymmetry, and was significantly higher in the westerly direction. For various reasons, the results tend to support the possibility of an asymmetry in radiation dose in Hiroshima, but not in Nagasaki. Also, possible asymmetry in nondose variables associated with cancer is suggested in both cities, particularly in variables associated with lung cancer. Indications for future work and implications for future dose-mortality investigations are discussed.

Investigation of circular asymmetry in cancer mortality of Hiroshima and Nagasaki A-bomb survivors.

This presentation summarizes the recent re-evaluations of the dose and risk of cancer among survivors of the atomic bombing of Hiroshima and Nagasaki. It addresses briefly their limitations, and describes some of their implications for the lifetime projection of the risk of a fatal cancer following exposure to ionizing radiation.

Hiroo Kato

Papers

Gastric carcinoma in a fixed population

Radon concentrations in residential housing in Hiroshima and Nagasaki.

Hypertension and Heart Disease in the Ni-Hon-San Study

Investigation of circular asymmetry in cancer mortality of Hiroshima and Nagasaki A-bomb survivors.

Hiroshima and Nagasaki: new doses, risks, and their implications.