- Email: [email protected]
Cancer—from raw data to readable form
1374
Residual contamination at southern Australia nuclear test sites Between 1953 and 1963 the UK conducted a series of nuclear weapons tests at Emu and Maralinga in southern Australia. Three years ago a technical assessment group set up by the British and Australian Governments began to assess the degree of contamination there and to advise on decontamination and land-use options. The assessment of potential dose exposure has been produced by the UK National Radiological Protection Board.’ The people most likely to be exposed are the aboriginal population. The dusty environment and the aboriginal lifestyle (such as sleeping near fires at night in the winter) make inhalation (for which the largest doses are predicted to be received by 10-year-olds) and ingestion of soil (by infants) the most important exposure pathways. The 5 exposure dose calculated for continuous occupancy ranged from 05 to 500 mSv per year, with the most heavily contaminated areas being the small regions surrounding the actual test sites (the dose limit for radiation workers is 50 mSv per year). The doses presented in the report will change with time but the main nuclide, 239Pu, hasa radioactive half-life of over 24 000 years. The report does point out, though, that the nomadic aborigines there are unlikely to stay in an area for long. Moreover, uncertainties in the data, to which attention is drawn throughout the report, have to be considered in interpreting the findings. The assessment group has indicated that the cheapest way of dealing with the sites-ie, to fence them off-would cost A$13 million.2 Exhuming and reburying waste in pits, and collecting and burying contaminated soil would cost A$60 million to$664 million. 1. Assessment of the potential radiological impact of residual contamination in the Maralinga and Emu areas (NRPB-R237). By S. M. Haywood and J. Smith. London: HM Stationery Office. 1990. Pp 103. £7. ISBN 0-859513289. 2. Anderson J. Australia weighs up the options on Maralinga. New Scientist 1990, Nov
24, p 18.
Head
banging
To have a child with head banging-a compulsion to rhythmically strike the head against a solid object-can be a disturbing experience for parents. Will the child be hurt or does this behaviour signify an unrecognised emotional disorder? The medical literature is sparse on this subject but has recently been reviewed by a Canadian group.! Head banging occurs in up to 15% of young children, and is commonly seen among those in the latter half of the first year of life, with a strong male predominance. Injury is rare and laboratory investigation is not required. Severe injury should arouse the suspicion of child abuse. The key differential diagnosis is temper tantrums, which usually have a precipitating event and do not last long. Treatment is largely parental reassurance that the child will outgrow the behaviour. Referral to a child psychiatrist is necessary only if head banging continues after 4 years of age or if there are family difficulties underlying this self-limiting disorder. 1.
Leung KC,
Robson WMLM. Head
banging. J Singapore
Cancer
raw
data to readable form
will be familiar with the International Agency for Research on Cancer series Cancer Incidence in Five Continents. The five volumes so far published (the first in 1966 and the fifth in 1987) are compilations of data, scrutinised for reliability, from population-based cancer registries around the world. To facilitate the appreciation of the range and pattern of incidence and to highlight interesting variations for different cancer sites, the data in volume V have been assembled in graphic form in a separate publication.’ Even so, 160 pages of histograms and pie-charts will not appeal to non-specialists wanting information on the geographical distribution of cancer. For them the IARC has, successfully, made its first attempt to produce a readable and concise book on the incidence (based largely on volume V) and
epidemiologists
fact that in some cases the effect of an agent extends to the progeny of the person exposed. Quantification of the effects of preventive measures gets fuller coverage. 1. Patterns of cancer in five continents. Edited by S. L. Whelan, D. M. Parkin, and E. Masuyer. Lyon: International Agency for Research and Cancer (IARC Scientific publication no 102). 1990. Pp 168. £25. ISBN 92 832 21028. 2. Cancer: causes, occurrence and control. Edited by L. Tomatis (with A. Aitio, N. E. Day, E. Heseltine, J. Kaldor, A. B. Miller, D. M. Parkin, and E. Riboli). Lyon: International Agency for Research on Cancer (IARC scientific publication no 100). 1990. Pp 352. £19.
In
England Now
For a time during the 1939-45 war I was medical registrar in an emergency hospital where the patients were largely serviceman. I was filled with youthful enthusiasm to add to medical knowledge, and so kept a record in a notebook of one thousand consecutive patients, to show their primary and secondary diagnoses. What I was hoping for I did not know, but eventually I showed the record to a statistician. He was a friendly man whose approach was more direct than some. "Certainly", he said, "I can process this easily. But-if you don’t mind my putting it this way-what will any possible result prove?" That floored me. I regretfully put the record away in a drawer and forgot all about it. Until last week, when I was looking for some old photographs and came across a notebook that was prominently labelled "Casebook". I have now gone through the diagnoses at an amateur level. I cannot claim statistical significance-partly because I do not really know what it means!-but there is an undoubted conjunction between (permute any three out of the seven) chronic bronchitis, pes planus, dental caries, seborrhoeic dermatitis, sinusitis, haemorrhoids, and the now discarded but then perfectly respectable term fibrositis. That seems to show that a goodly proportion of the young men of this nation in the 1940s came from a sociologically submerged tenth. Which, as far as I can tell, is still so. Was it then all a waste of time? No, I enjoyed making the record, I felt really important when I was doing it. And besides, it brings back more vividly than any diary what those days felt like. Terribly busy, the more so because there was only one trained nurse to a ward of forty beds. So that treatments often had to be spelled out in detail. Despite which most patients got better. And they didn’t all suffer from Submersion Syndrome. No, I see a kala-azar, a dystrophia myotonica, an abortus fever, even a GPI. It was only in those early years that I would have dared to postulate such diagnoses.
International Diary
Paediatr Soc 1990; 32:
14-17.
Cancer—from
mortality of cancer, the environmental determinants of cancer, and possible preventive measures.2 Where possible the relative risk of exposure to an environmental agent is given, but as pointed out in the introduction, quantification of risk is made difficult by the
6th European conference entitled Nutritional Sciences-New Developments of Consumer Concern will take place in Athens, on May 26-28: Conference Bureau, Sixth European Nutrition Conference, Federation of European Nutrition Societies, c/o Department of Nutrition and Biochemistry, Athens School of Public Health, 196 Alexandras Avenue,
GR-11521 Athens, Greece (301-646 1831). A congress of the International Society for Pathophysiology will be held in Moscow, on May 28-June 1: Dr V. S. Shinkarenko, Institute of General Pathology and Pathological Physiology, USSR Academy of Medical Sciences, Baltiyskaya str 8, Moscow 315, USSR. An international conference
on Stroke is to take place in Geneva, Switzerland, on May 30-June 1: Dr N. M. Bornstein, Organizing Committees, PO Box 50006, Tel Aviv, Israel 16500 (4122 732 088).
15th international symposium on Cerebral Blood Flow and Metabolism is to be held in Miami, Florida, on June 1-6: Ms Jenny Bemal, Conference Coordinator, BRAIN-91, University of Miami Conference Centre, 400 SE Second Avenue, Fourth Floor, Miami, Florida 33131, USA.
Residual contamination at southern Australia nuclear test sites Between 1953 and 1963 the UK conducted a series of nuclear weapons tests at Emu and Maralinga in southern Australia. Three years ago a technical assessment group set up by the British and Australian Governments began to assess the degree of contamination there and to advise on decontamination and land-use options. The assessment of potential dose exposure has been produced by the UK National Radiological Protection Board.’ The people most likely to be exposed are the aboriginal population. The dusty environment and the aboriginal lifestyle (such as sleeping near fires at night in the winter) make inhalation (for which the largest doses are predicted to be received by 10-year-olds) and ingestion of soil (by infants) the most important exposure pathways. The 5 exposure dose calculated for continuous occupancy ranged from 05 to 500 mSv per year, with the most heavily contaminated areas being the small regions surrounding the actual test sites (the dose limit for radiation workers is 50 mSv per year). The doses presented in the report will change with time but the main nuclide, 239Pu, hasa radioactive half-life of over 24 000 years. The report does point out, though, that the nomadic aborigines there are unlikely to stay in an area for long. Moreover, uncertainties in the data, to which attention is drawn throughout the report, have to be considered in interpreting the findings. The assessment group has indicated that the cheapest way of dealing with the sites-ie, to fence them off-would cost A$13 million.2 Exhuming and reburying waste in pits, and collecting and burying contaminated soil would cost A$60 million to$664 million. 1. Assessment of the potential radiological impact of residual contamination in the Maralinga and Emu areas (NRPB-R237). By S. M. Haywood and J. Smith. London: HM Stationery Office. 1990. Pp 103. £7. ISBN 0-859513289. 2. Anderson J. Australia weighs up the options on Maralinga. New Scientist 1990, Nov
24, p 18.
Head
banging
To have a child with head banging-a compulsion to rhythmically strike the head against a solid object-can be a disturbing experience for parents. Will the child be hurt or does this behaviour signify an unrecognised emotional disorder? The medical literature is sparse on this subject but has recently been reviewed by a Canadian group.! Head banging occurs in up to 15% of young children, and is commonly seen among those in the latter half of the first year of life, with a strong male predominance. Injury is rare and laboratory investigation is not required. Severe injury should arouse the suspicion of child abuse. The key differential diagnosis is temper tantrums, which usually have a precipitating event and do not last long. Treatment is largely parental reassurance that the child will outgrow the behaviour. Referral to a child psychiatrist is necessary only if head banging continues after 4 years of age or if there are family difficulties underlying this self-limiting disorder. 1.
Leung KC,
Robson WMLM. Head
banging. J Singapore
Cancer
raw
data to readable form
will be familiar with the International Agency for Research on Cancer series Cancer Incidence in Five Continents. The five volumes so far published (the first in 1966 and the fifth in 1987) are compilations of data, scrutinised for reliability, from population-based cancer registries around the world. To facilitate the appreciation of the range and pattern of incidence and to highlight interesting variations for different cancer sites, the data in volume V have been assembled in graphic form in a separate publication.’ Even so, 160 pages of histograms and pie-charts will not appeal to non-specialists wanting information on the geographical distribution of cancer. For them the IARC has, successfully, made its first attempt to produce a readable and concise book on the incidence (based largely on volume V) and
epidemiologists
fact that in some cases the effect of an agent extends to the progeny of the person exposed. Quantification of the effects of preventive measures gets fuller coverage. 1. Patterns of cancer in five continents. Edited by S. L. Whelan, D. M. Parkin, and E. Masuyer. Lyon: International Agency for Research and Cancer (IARC Scientific publication no 102). 1990. Pp 168. £25. ISBN 92 832 21028. 2. Cancer: causes, occurrence and control. Edited by L. Tomatis (with A. Aitio, N. E. Day, E. Heseltine, J. Kaldor, A. B. Miller, D. M. Parkin, and E. Riboli). Lyon: International Agency for Research on Cancer (IARC scientific publication no 100). 1990. Pp 352. £19.
In
England Now
For a time during the 1939-45 war I was medical registrar in an emergency hospital where the patients were largely serviceman. I was filled with youthful enthusiasm to add to medical knowledge, and so kept a record in a notebook of one thousand consecutive patients, to show their primary and secondary diagnoses. What I was hoping for I did not know, but eventually I showed the record to a statistician. He was a friendly man whose approach was more direct than some. "Certainly", he said, "I can process this easily. But-if you don’t mind my putting it this way-what will any possible result prove?" That floored me. I regretfully put the record away in a drawer and forgot all about it. Until last week, when I was looking for some old photographs and came across a notebook that was prominently labelled "Casebook". I have now gone through the diagnoses at an amateur level. I cannot claim statistical significance-partly because I do not really know what it means!-but there is an undoubted conjunction between (permute any three out of the seven) chronic bronchitis, pes planus, dental caries, seborrhoeic dermatitis, sinusitis, haemorrhoids, and the now discarded but then perfectly respectable term fibrositis. That seems to show that a goodly proportion of the young men of this nation in the 1940s came from a sociologically submerged tenth. Which, as far as I can tell, is still so. Was it then all a waste of time? No, I enjoyed making the record, I felt really important when I was doing it. And besides, it brings back more vividly than any diary what those days felt like. Terribly busy, the more so because there was only one trained nurse to a ward of forty beds. So that treatments often had to be spelled out in detail. Despite which most patients got better. And they didn’t all suffer from Submersion Syndrome. No, I see a kala-azar, a dystrophia myotonica, an abortus fever, even a GPI. It was only in those early years that I would have dared to postulate such diagnoses.
International Diary
Paediatr Soc 1990; 32:
14-17.
Cancer—from
mortality of cancer, the environmental determinants of cancer, and possible preventive measures.2 Where possible the relative risk of exposure to an environmental agent is given, but as pointed out in the introduction, quantification of risk is made difficult by the
6th European conference entitled Nutritional Sciences-New Developments of Consumer Concern will take place in Athens, on May 26-28: Conference Bureau, Sixth European Nutrition Conference, Federation of European Nutrition Societies, c/o Department of Nutrition and Biochemistry, Athens School of Public Health, 196 Alexandras Avenue,
GR-11521 Athens, Greece (301-646 1831). A congress of the International Society for Pathophysiology will be held in Moscow, on May 28-June 1: Dr V. S. Shinkarenko, Institute of General Pathology and Pathological Physiology, USSR Academy of Medical Sciences, Baltiyskaya str 8, Moscow 315, USSR. An international conference
on Stroke is to take place in Geneva, Switzerland, on May 30-June 1: Dr N. M. Bornstein, Organizing Committees, PO Box 50006, Tel Aviv, Israel 16500 (4122 732 088).
15th international symposium on Cerebral Blood Flow and Metabolism is to be held in Miami, Florida, on June 1-6: Ms Jenny Bemal, Conference Coordinator, BRAIN-91, University of Miami Conference Centre, 400 SE Second Avenue, Fourth Floor, Miami, Florida 33131, USA.