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ZERO POPULATION GROWTH-FOR WHOM?
824 mosomal abnormalities were detected in only 139 of the 279 patients who were included. In confirmation of previous findings, patients with cytogenetically normal bone-marrow cells at diagnosis proved to have a better prognosis than those with only abnormal karyotypes. Correlations between karyotype and survival were most significant for patients whose leukaemia was classified as M2. As expected from published observations,’-9 although many of the chromosomal abnormalities were unique, some of them occurred in several patients. These non-random abnormalities included an extra number 8 chromosome (16%), a missing number 7 chromosome (14%), translocation between chromosomes numbers 8 and 21 (8%), and translocation between chromosomes number 15 and 17 (6%). Seemingly, non-random abnormalities of the translocation type were less common above than below 60 years of age. The translocation t(15q+; 17q-) was found in 9 out of 17 patients with acute promyelocytic leukaemia (M3), confirming the
specificity of this translocation.11 Despite the difficulties in combining clinical information from different centres because of lack of homogeneity in patient management, pooling of data was useful: it revealed, for example, that patients with the translocation (8q-; 21q+) have a good prognosis. Although only a minority of cases showed specific abnormalities, the non-random nature of these changes is of great importance in relation to the aetiology of the leukxmias. The participants in the workshop appreciated the difficulties of obtaining precise banded karyotypes of leukaemic cells and suggestions were offered for the quality control of future work. Further studies, directed towards correlation between cytogenetics and particular types of leuksemia, must include information on the surface markers and enzymology of the leukaemic cells. A careful history of the possibility of environmental exposures is also important.12 Cytogenetic investigations may be useful in diagnosis and in evaluation of prognosis. Study of a few cases in depth may also help in the elucidation of some aspects of leukxmogenesis in man.
ZERO POPULATION GROWTH-FOR WHOM? FERTILITY rates in the Western World have been fall-
ing. In a paper from the Population Reference Bureau in Washington, Lincoln H. Day’ examines the situation in those 26 countries with fertility rates at or near replacement level in early 1978. He asks, "What will a Z.P.G. society be like?" In fact the question may be premature since birth-rates which have fallen dramatically since the early 1960s may rebound just as quickly. The British figures for 1978 up to Sept. 8, from the Office of Population Censuses and Surveys,2show births in England and Wales 2-6% up on those for 1977, with
8.
Oshimura, M., Hayata, I., Kakati, S., Sandberg, A. A. Cancer, 1976, 38,
748. 9. Rowley, J. D., Potter, D. Blood, 1976, 47, 705. 10. Sakurai, M., Sandberg, A. A. Cancer, 1974, 33, 1548. 11. Golomb, H. M., Vardiman, J., Rowley, J. D. Blood, 1976, 48, 9. 12. Brandt, L., Nilsson, P. G., Mitelman, F. Lancet, 1977, ii, 1074. 1. Day, L. H. Popn Bull. 1978, 33, no. 3. 2. Registrar General’s Weekly Return for England and Wales, week-ended
Sept. 8, 1978.
a considerably greater increase over the past two months. However, birth-rates in the West are lower than they were and the age structure of society is changing. Day demonstrates convincingly the advantages of a
roughly stable demographic
structure.
Unemployment,
crime, and juvenile delinquency in particular, and the provision of good housing and health and welfare services, should become less challenging if population remains stable. (Observers of the British education scene will not need convincing of the disruptive effects of rapid changes in birth-rates.) Many who recognise these factors are still apprehensive that falling birth-rates will cause society to become top-heavy, with not enough productive young workers to support an increasing proportion of elderly citizens, though projections from the O.P.C.S.3 suggest that the dependency ratio may not change drastically from one of roughly three workers for every two dependants (children and the retired). However, the distressingly high unemployment figures throughout the West show that the major employment problem in the foreseeable future will not be a shortage of workers but an increasing army of unemployed, and a moderate decrease in the number of young people reaching working age can only ameliorate this situation. Day argues that a society with an increased middle-aged and elderly component is likely, as well as being less violent and more law-abiding than a younger one, to be at least as tolerant, liberal, and hard-working. He reckons that in most fields of skilled endeavour much of the most responsible and creative work is done by those of at least middle age, and older workers are likely to be more experienced and skilled as well as having more "economically useful" attitudes. The Western demographic situation can be a worthy object for study, but it must be viewed also against the global background. The 26 countries nearing replacement level include the United States, Canada, the Soviet Union, Japan, most of the nations of Europe, as well as Australia and Singapore. Except for the last two, all are situated in the more prosperous northern half of the world and correspond roughly to what has been called the Rich Man’s Club-that minority of the human race which has access to a disproportionately large share of the world’s resources. The situation for the remaining three-quarters of the world’s population is very different. Birth-rates, although lower than in the 1960s, remain dangerously high-mainland China excepted. World population has doubled in less than a human lifetime and is still increasing by some 70 million each year. The relentless pressure of this increase in numbers, now mainly confined to the poorer countries of the world, compounds enormously the tasks they face. The gains that should have accrued from the "green revolution" have been very largely lost due to population increase. Possibly 80% of the children in developing countries have some degree of malnutrition. Millions will spend their lives ill-fed, uneducated, unemployed, ill-housed, and without access to the most elementary health, welfare, or sanitary services, and unchecked population increase is a major causal factor. Zero population growth in the richest part of the world, though welcome, is not enough. ’
3. O.P C.S. Popn Trends, 1978, no. 11, p. 45; see Lancet, 1978, i, 783.
specificity of this translocation.11 Despite the difficulties in combining clinical information from different centres because of lack of homogeneity in patient management, pooling of data was useful: it revealed, for example, that patients with the translocation (8q-; 21q+) have a good prognosis. Although only a minority of cases showed specific abnormalities, the non-random nature of these changes is of great importance in relation to the aetiology of the leukxmias. The participants in the workshop appreciated the difficulties of obtaining precise banded karyotypes of leukaemic cells and suggestions were offered for the quality control of future work. Further studies, directed towards correlation between cytogenetics and particular types of leuksemia, must include information on the surface markers and enzymology of the leukaemic cells. A careful history of the possibility of environmental exposures is also important.12 Cytogenetic investigations may be useful in diagnosis and in evaluation of prognosis. Study of a few cases in depth may also help in the elucidation of some aspects of leukxmogenesis in man.
ZERO POPULATION GROWTH-FOR WHOM? FERTILITY rates in the Western World have been fall-
ing. In a paper from the Population Reference Bureau in Washington, Lincoln H. Day’ examines the situation in those 26 countries with fertility rates at or near replacement level in early 1978. He asks, "What will a Z.P.G. society be like?" In fact the question may be premature since birth-rates which have fallen dramatically since the early 1960s may rebound just as quickly. The British figures for 1978 up to Sept. 8, from the Office of Population Censuses and Surveys,2show births in England and Wales 2-6% up on those for 1977, with
8.
Oshimura, M., Hayata, I., Kakati, S., Sandberg, A. A. Cancer, 1976, 38,
748. 9. Rowley, J. D., Potter, D. Blood, 1976, 47, 705. 10. Sakurai, M., Sandberg, A. A. Cancer, 1974, 33, 1548. 11. Golomb, H. M., Vardiman, J., Rowley, J. D. Blood, 1976, 48, 9. 12. Brandt, L., Nilsson, P. G., Mitelman, F. Lancet, 1977, ii, 1074. 1. Day, L. H. Popn Bull. 1978, 33, no. 3. 2. Registrar General’s Weekly Return for England and Wales, week-ended
Sept. 8, 1978.
a considerably greater increase over the past two months. However, birth-rates in the West are lower than they were and the age structure of society is changing. Day demonstrates convincingly the advantages of a
roughly stable demographic
structure.
Unemployment,
crime, and juvenile delinquency in particular, and the provision of good housing and health and welfare services, should become less challenging if population remains stable. (Observers of the British education scene will not need convincing of the disruptive effects of rapid changes in birth-rates.) Many who recognise these factors are still apprehensive that falling birth-rates will cause society to become top-heavy, with not enough productive young workers to support an increasing proportion of elderly citizens, though projections from the O.P.C.S.3 suggest that the dependency ratio may not change drastically from one of roughly three workers for every two dependants (children and the retired). However, the distressingly high unemployment figures throughout the West show that the major employment problem in the foreseeable future will not be a shortage of workers but an increasing army of unemployed, and a moderate decrease in the number of young people reaching working age can only ameliorate this situation. Day argues that a society with an increased middle-aged and elderly component is likely, as well as being less violent and more law-abiding than a younger one, to be at least as tolerant, liberal, and hard-working. He reckons that in most fields of skilled endeavour much of the most responsible and creative work is done by those of at least middle age, and older workers are likely to be more experienced and skilled as well as having more "economically useful" attitudes. The Western demographic situation can be a worthy object for study, but it must be viewed also against the global background. The 26 countries nearing replacement level include the United States, Canada, the Soviet Union, Japan, most of the nations of Europe, as well as Australia and Singapore. Except for the last two, all are situated in the more prosperous northern half of the world and correspond roughly to what has been called the Rich Man’s Club-that minority of the human race which has access to a disproportionately large share of the world’s resources. The situation for the remaining three-quarters of the world’s population is very different. Birth-rates, although lower than in the 1960s, remain dangerously high-mainland China excepted. World population has doubled in less than a human lifetime and is still increasing by some 70 million each year. The relentless pressure of this increase in numbers, now mainly confined to the poorer countries of the world, compounds enormously the tasks they face. The gains that should have accrued from the "green revolution" have been very largely lost due to population increase. Possibly 80% of the children in developing countries have some degree of malnutrition. Millions will spend their lives ill-fed, uneducated, unemployed, ill-housed, and without access to the most elementary health, welfare, or sanitary services, and unchecked population increase is a major causal factor. Zero population growth in the richest part of the world, though welcome, is not enough. ’
3. O.P C.S. Popn Trends, 1978, no. 11, p. 45; see Lancet, 1978, i, 783.