The Danish ban on the Atlantic slave trade and Denmark's African colonial ambitions, 1787-1807

On 16 March 1792, King Christian VII of Denmark, his own incompetent hand guided by that of the young Crown Prince Frederik (VI), signed decree banning both the importation of slaves into the Danish West Indies (now the United States Virgin Islands) and their export from the Danish establishments on the Guinea Coast, in what is now Ghana. To soften the blow to the planters of the Danish West Indies and to secure the continued production of sugar, the law was not to take effect for ten years. In the meantime, imports of slaves, and of women especially, would actually encouraged by state loans and favourable tariffs, so as, it was hoped, render the slave population capable of reproducing itself naturally thereafter.

[Self-reported dyspnea is strongly associated with psychological and cognitive symptoms. The Danish Gulf War Study]

INTRODUCTION

Danish Gulf War veterans (GWVs) have a high prevalence of mental and cognitive symptoms and self-reported dyspnoea.

METHODS

686 GWVs were included in the study and compared with 231 controls. Extensive information about the participants was obtained from a questionnaire, and they all underwent clinical and paraclinical examinations.

RESULTS

The prevalence of dyspnoea in GWVs was 29.2%, in controls 19.5%, p = 0.005. Adjusted for age, smoking and physical activity the GWVs OR for dyspnoea at light physical demand was OR = 1.55(1.1-2.3), p = 0.02. Further adjustment for cognitive and mental symptoms reduced the OR to a non significant level, OR = 1.09(0.7-1.6), p = 0.68.

CONCLUSIONS

The high prevalence of dyspnoea among GWVs could largely be attributed to their high prevalence of mental and cognitive symptoms. In general, the results emphasize the psychological component in dyspnoea.

[Infertility in ethnic groups. Etiology and treatment]

In this retrospective case control study we analysed the causes and treatments of infertility in 100 ethnic couples consecutively discharged from the Fertility Clinic in the period October 1995 to March 1999. The mean age at referral was 28 years (19-37) for ethnic women and 31 years (24-39) for Danish women. Male infertility was the most frequent cause in ethnic couples compared to Danish couples (24% vs. 16%; NS). Tubal infertility was less frequent in ethnic than in Danish couples (19% vs. 45%; p < 0.01), ovulatory defects were more frequent in ethnic couples than in Danish (13% vs. 4%; p < 0.04). Among ethnic couples 57 (118 cycles) underwent IVF and ICSI treatment vs. 85 (198 cycles) Danish couples (p < 0.01). The ongoing pregnancy rate per initiated cycle was 29.6% in ethnic couples vs. 24.2% in Danish couples (NS). Forty four percent of the ethnic couples did not complete the whole treatment program vs. 29% of Danish couples (p < 0.04). This may be due to cultural differences and difficult communication.

Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited

OBJECTIVES

Sunlight exposure of the skin is known to be the most important source of vitamin D. The aims of this study were: (i) to estimate vitamin D status amongst sunlight-deprived individuals (veiled Arab women, veiled ethnic Danish Moslem women and Danish controls); and (ii) through food intake analysis to estimate the oral intake of vitamin D necessary to keep a normal vitamin D status in sunlight-deprived individuals.

DESIGN

Cross-sectional study amongst randomly selected Moslem women of Arab origin living in Denmark. Age-matched Danish women were included as controls. To control for racial differences, a group of veiled ethnic Danish Moslem women (all Caucasians) was included.

SETTING

Primary Health Care Centre, City Vest and Department of Endocrinology and Metabolism C, University Hospital of Aarhus, Aarhus Amtssygehus, Aarhus, Denmark.

SUBJECTS

Sixty-nine Arab women (60 veiled, nine non-veiled) and 44 age-matched Danish controls were randomly selected amongst patients contacting the primary health care centre for reasons other than vitamin D deficiency. Ten ethnic Danish Moslem women were included through a direct contact with their community.

MAIN OUTCOME MEASURES

Serum levels of 25-hydroxyvitamin D were used as estimates of vitamin D status. Intact parathyroid hormone (PTH) was used to control for secondary hyperparathyroidism. Alkaline phosphatase and bone-specific alkaline phosphatase were used as markers for osteomalacic bone involvement. Oral intake of vitamin D and calcium were estimated through a historical food intake interview performed by a trained clinical dietician.

RESULTS

Veiled Arab women displayed extremely low values of 25-hydroxyvitamin D: 7.1 +/- 1.1 nmol L-1, compared with 17.5 +/- 2. 3 (P < 0.002) in ethnic Danish Moslems and 47.1 +/- 4.6 (P < 10-17) in Danish controls. PTH was increased amongst veiled Arab women: 15. 6 +/- 1.8 pmol L-1, compared with 5.7 +/- 1.4 in ethnic Danish Moslems and 2.7 +/- 0.3 (P < 10-6) in Danish controls. The vitamin D intake (including food supplementation) was very low amongst Arab women: 1.04 microg day-1, compared with 13.53 amongst ethnic Danish Moslems and 7.49 amongst Danish controls (P < 0.0005).

CONCLUSIONS

Severe vitamin D deficiency is prevalent amongst sunlight-deprived individuals living in Denmark. In veiled Arab women, vitamin D deficiency is the result of a combination of limitations in sunlight exposure and a low oral intake of vitamin D. The oral intake of vitamin D amongst veiled ethnic Danish Moslems was, however, very high, at 13.53 microgram (approximately 600 IU), but they were still vitamin D-deficient. Our results suggest that the daily oral intake of vitamin D in sunlight-deprived individuals should exceed 600 IU; most probably it should be 1000 IU day-1 to secure a normal level of 25-hydroxyvitamin D. This finding is in contrast with the commonly used RDA (recommended daily allowance) for adults in Europe: 200 IU day-1.

[Health status after serving in the Gulf war area. The Danish Gulf War Study]

Increased symptom reporting has been found in American Gulf War Veterans. The symptoms comprise headache, fatigue, impaired short-term memory, sleep disturbances, agitation, respiratory symptoms, muscle and joint pain, diseases of the skin, and intermittent fever. This cross-sectional study was performed to clarify whether a corresponding pattern existed among Danes having served in the Persian Gulf during and mainly after the Gulf War. The investigation took place during the period January 1997 to January 1998 and included 821 subjects who had been deployed in the Persian Gulf within the period August 2, 1990 until December 31, 1997. Of 686 (83.6%) subjects who participated in the study, 95% had been engaged in peace keeping operations after the war. A group consisting of randomly selected age- and gender matched controls, comprised 231 of 400 potential participants (57.7%). All participants underwent clinical and paraclinical examinations, and had an interview based on a previously completed questionnaire. Unspecific symptoms such as repeated fits of headache, fatigue, memory and concentration difficulties, sleep disturbances, agitation, dyspneoa, diseases of the skin, and intermittent fever, were significantly more frequent among Danish Gulf War Veterans (p < 0.05) than among controls; no association was found with respect to muscle and joint pain. The higher symptom prevalence among Gulf War Veterans was observed for conditions which had made their first appearance during or after the Gulf War. The prevalence of diseases and symptoms which had made their first appearance before August 2, 1990 was similar for both groups. This study demonstrated a pattern of diseases and symptoms among Danish Gulf War Veterans consistent with the findings among American Gulf War Veterans. Considering that American Gulf War Veterans were predominantly deployed during the armament phase and the brief war phase, and that Danish Gulf War Veterans were predominantly deployed after the war restoring peace, the results indicate the existence of some common risk factors independent of war action.

[Acute hemolytic anemia caused by glucose-6-phosphate dehydrogenase deficiency]

Glukose-6-phosphate dehydrogenase (G6PD) is essential in protecting the red cell from oxidative damage. We report a case of acute haemolysis in a child with G6PD deficiency. Because of the severity of the anaemia, the patient was treated with blood transfusions and recovered fully. There are two main variants of G6PD deficiency (the Mediterranean variant and variant A) with different clinical profiles. Acute haemolytic attacks are induced by certain drugs, by infections or, in the Mediterranean variant, by ingestion of fava beans (favism). Increased awareness of this condition is necessary in Denmark because of increased immigration.

[Access to Danish health care by immigrant women. Access to hospital care among immigrant women with breast cancer compared with Danish women]

The study aim is to measure possible differences in access to health care among immigrant women with breast cancer compared with Danish women. We used tumour size at diagnosis as a proxy measure of access. The Danish Central Personal Register provided information from 1977-1996 on women between 20-75 years born in countries in which Islam is the dominating faith. These data were linked to the Danish Breast Cancer Cooperative Group, which registers data concerning tumour size. Sixty-five immigrant women with breast cancer were identified and matched with a control population of Danish women. The study showed larger tumours at diagnosis among women from ethnic minority groups compared to Danes. However, this tendency was not significant. Furthermore, mammographic screening had a significant effect on the tumour sizes of Danish women, but not on those of immigrants. The study indicates ethnic inequalities related to access to health services as measured by tumour size.

[Occurrence of tuberculosis among children in the area of Copenhagen 1984-1993]

This study was undertaken to describe the epidemiology, clinical manifestations and prognosis of childhood tuberculosis in Copenhagen, with special attention to differences between Danish children and children of foreign origin. Medical records for all children with tuberculosis cared for in the hospitals of the Copenhagen area 1984-1993 were reviewed. Sixty-six patients were identified. Sixteen of 20 Danish patients (80%) and 67% of foreign children had respiratory tuberculosis. Tuberculosis located in cervical lymph nodes was found only in children of foreign origin. Five patients had meningitis. The high incidence among foreign children reflects the incidence in their home countries, but poorer living conditions among ethnic minorities in Denmark may facilitate transmission of tuberculosis. Severe manifestations of tuberculosis still occur, even in a low incidence country.

[Tuberculosis in Denmark 1972-1996]

The present study is based on notified cases of tuberculosis (TB) in the National tbc. register 1972-1996. A decline in Tb incidence was seen from 1972 and until the mid-1980's. Subsequently the trend has reversed due to an increasing number of TB cases in foreigners. In 1996, 60% of all cases of TB in Denmark were found in foreigners reflecting the rising number of refugees and their families arriving in Denmark from highly endemic areas, mainly Somalia. Among native Danes the TB incidence fell from 14 per 100,000 in 1972 to 4 per 100,000 in the 1980's and stabilized at this very low level. The unchanged incidence in Danes covers a falling incidence in the older and a rising incidence in the younger and middle-aged adult population, mainly in the capital. Approximately half of the cases occur in high-risk groups. The TB-epidemic is close to elimination in the indigenous Danish population, but the disease is maintained at a low level probably due to increased patient and doctor delay and resulting microepidemics primarily in high-risk populations.

[Tuberculous meningitis in children]

Medical records of six children with tuberculous meningitis were reviewed. The patients were admitted to the paediatric departments in the city and country of Copenhagen between 1983 and 1997. Interpretation of cerebrospinal fluid findings, and difficulties in early recognition of tuberculous meningitis are discussed.

[Vitamin D deficiency. Easy to diagnose, often overlooked]

On the basis of five cases the typical clinical picture of patients with severe vitamin D deficiency is presented. The diagnosis can easily be mistaken and it is not uncommon that rheumatic or malignant diseases are suspected instead. By using a simple screening blood test consisting of 25-OH-vitamin D, PTH and alkaline phosphatase most cases will be diagnosed correctly. Important risk factors are reviewed, the most important being: elderly > 70 years, persons with low exposure to direct sunlight, gastrointestinal diseases and persons in anti-convulsive treatment. A treatment regimen consisting of oral supplementation of 1000-1500 mg calcium + 1000 IU vitamin D to patients with an isolated low 25-OH-vitamin D (< 20 nmol/l) is recommended. If the patient also has raised values of PTH or alkaline phosphatase an intramuscular dose of 100,000 IU ergocalciferol pr week for one month is given.

High serum coenzyme Q10, positively correlated with age, selenium and cholesterol, in Inuit of Greenland. A pilot study

Greenlanders (Eskimos) have low prevalence of ischaemic heart disease, partly explained by a lower extent of atherosclerosis and a low n-6/n-3 ratio of polyunsaturated fatty acids. As atherosclerosis is also a result of oxidative stress, the total antioxidative readiness could have a substantial impact. From a health survey we chose the subpopulation from the most remote area, where the traditional Greenlandic diet with high intake of sea mammals and fish predominates. The mean (SD) of S-CoQ10 in males was 1.495 (0.529) nmol/ml and 1.421 (0.629) nmol/ml in females, significantly higher (p < 0.001) compared to a Danish population. In a linear multiple regression model the S-CoQ10 level is significantly positively associated with age and S-selenium in males, and S-total cholesterol in females. The high level of CoQ10 in Greenlanders probably reflects diet, since no bioaccumulation takes place, and it could probably be a substantial part of the antioxidative defense.

Different molecular events result in low protein levels of mannan-binding lectin in populations from southeast Africa and South America

Previous studies have shown that three point mutations in exon 1 and a particular promoter haplotype of the mannan-binding lectin (MBL) gene lead to a dramatic decrease in the serum concentration of MBL. In this study, MBL genotypes and serum concentrations were determined in unrelated individuals in a population from Mozambique (n = 154) and in two native Indian tribes from Argentina (i.e., the Chiriguanos (n = 43) and the Mapuches (n = 25)). In both populations, the MBL concentrations were low compared with those found in Eskimo, Asian, and European populations. In Africans, the low serum concentrations were due to a high allele frequency (0.24) of the codon 57 (C) variant, which resulted in a high frequency of individuals with MBL deficiency (0.06), and were also due to the effect of a relatively high frequency (0.13) of low-producing promoter haplotypes. The low concentrations in the South American populations were primarily due to an extremely high allele frequency of the codon 54 (B) variant in both the Chiriguanos (0.42) and the Mapuches (0.46), resulting in high frequencies of individuals with MBL deficiency (0.14 and 0.16, respectively). In the search for additional genetic variants, we found five new promoter mutations that might help to elucidate the evolution of the MBL gene. Taken together, the results of this study show that different molecular mechanisms are the basis for low MBL levels on the two continents.

[Tropical pyomyositis]

Tropical pyomyositis is rarely observed among permanent residents of temperate or cold climates and is, to our knowledge, not described among Norwegians. It is a clinical entity comprising general symptoms of infection and abscesses in skeletal muscles. We present one case of tropical pyomyositis acquired in the Dominican Republic. The patient, a female, had an insidious progression of the disease with fever, chills, and general malaise. On admission she had also developed multiple abscesses affecting muscles of the extremities. She required surgical drainage in addition to antibiotics. Cultures from purulent material revealed Staphylococcus aureus.

[Domestic violence]

The purpose of this study was to analyze the development in the incidence of violence against women committed by husband/spouse and violence against children committed by parents. This study is based on a prospective registration during a one year period (1993-94) of women and children who attended the casualty wards and/or the Department of Forensic Medicine because of exposure to violence. The results were compared with similar studies from 1981-82 and 1987-88. The incidence of domestic violence within the age group of 25-34 years (the major group) was in 1993-94 1.9 per 1000 per year, in 1981-82 1.7 and in 1987-88 2.9. Twelve percent of the women had been exposed to violence characterized as severe. Twenty (6.6%) women were registered more than once. Thirty-eight percent of Danish women and 25.8% of foreign women reported the incident to the police. The incidence of violence against children remained unchanged at 0.3 per 1000 per year during the three registration periods.

Elements in autopsy liver tissue samples from Greenlandic Inuit and Danes. I. Sulphur, chlorine, potassium and bromine measured by X-ray fluorescence spectrometry

The purpose of this study was to measure the content of the elements Sulphur (S), Chlorine (C1), Potassium (K) and Bromine (Br) in normal liver tissue samples from Greenlandic Inuit using X-ray fluorescence spectrometry, and compare the results with those obtained in normal liver tissue samples from Danes. Liver tissue sample were obtained at autopsy from 50 Greenlandic Inuit (27 men, 23 women) with a median age of 61 years (range 20-83) and from 74 Danes (44 men, 30 women) with a median age of 52 years (range 15-87). In Inuit, the content of elements given as median and (5-95 percentile) was: sulphur, 108.07 mmol/kg dry liver (86.78 - 169.44); chlorine, 92.16 mmol/kg dry liver (45.39-128.42); potassium, 181.66 mmol/kg dry liver (146.41-236.35); bromine, 0.0901 mmol/kg dry liver (0.0563-0.1589). In Danes, the corresponding values were: sulphur, 147.58 mmol/kg dry liver (70.41-236.81); chlorine, 96.95 mmol/kg dry liver (54.01-162.52); potassium, 198.40 mmol/kg dry liver (150.68-256.37); bromine, 0.1101 mmol/kg dry liver (0.0701 - 0.4203). None of the elements displayed any significant gender difference, neither in Inuit nor in Danes. Inuit had a lower liver content of sulphur (p < 0.0001), potassium (p < 0.008) and bromine (p < 0.002) as compared with Danes.

[Multiresistant tuberculosis in Denmark 1993-1996]

Infections with multiresistant tubercle bacilli have also become a problem in the rich part of the world. The reasons are lack of compliance in patients with life style problems and ineffectiveness of the health system due to lack of fundings. During a four year period, 1993-1996 ten patients were seen in Denmark with tuberculosis due to multiresistant Mycobacterium tuberculosis. Nine were infected abroad, one developed MDR-TB during treatment in Denmark. It is possible to cure these patients, but it is expensive and takes a long time. In the future more cases created within Denmark are likely to be seen due to lack of funding for the tuberculosis programme and, depending on immigration, further cases created abroad are expected.

[Children from ethnic minorities in hospital in Aarhus. Why there--how long--because of what?]

We analysed the proportion of hospitalization, duration of hospitalization and diagnoses for children from ethnic minorities (both parents did not come from Nordic countries, EU, North America, New Zealand or Australia) compared to other ("western") children in a follow-up study. The study included all 47,987 children < 15 years in the municipality of Aarhus. All hospitalizations during March and April 1996 were recorded. The proportion of children from ethnic minorities who were hospitalized was 0.012, the corresponding proportion being 0.007 for the other children, showing a hospitalization-proportion-rate of 1.7 for the ethnic minorities. The median hospitalization time was two days and independent of ethnic group. In the group of ethnic minorities there were more children with psychological problems and with thalassaemia, and there were language problems in a third of the hospitalizations. The study showed a need for special health promotion activities for children from ethnic minorities.

Cancer risk in a cohort of Danes working in Greenland

Greenland is a high-incidence area for certain virus-associated cancers. The long term cancer risk in a cohort of 7,761 Danish employees who had been working for some time (median 19.7 months) in Greenland during the period 1955-1978 was studied. During a total of 162,300 person-years (average 20.9 years) of follow-up ending on December 31, 1992, the number of cancers observed was 732 vs. 669 expected (relative risk (RR) = 1.09, 95% confidence interval (CI) 1.02-1.18). Whereas the men did not experience any unusual cancer incidence at any cancer site, the women were at elevated risk of developing breast cancer (RR = 1.5, 95% CI 1.2-1.8 (n = 96)); malignant melanoma (RR = 1.8, 95% CI 1.0-2.9 (n = 16)); and lymphatic and hematopoietic malignancies (RR = 1.7, 95% CI 1.0-2.8 (n = 16)). Exposure during adulthood to a high-incidence area for cervical cancer, nasopharyngeal carcinoma and tumors of the major salivary glands did not confer any measurable increase in the risk for these virus-associated cancers. Postponement of childbearing might explain part of the elevated breast cancer risk. Intensive exposure to ultraviolet light, that is likely to explain the increased risk of malignant melanoma among the women, might also be involved in the excess incidence of lymphatic and hematopoietic malignancies observed in these women. However, why the men did not experience similar alterations in the risk of melanoma and cancers of the immune system is enigmatic.

[Contributing causes of malaria among Danish travellers]

A retrospective evaluation of contributing causes of malaria among Danish travellers, based on patient files and telephone interviews, is presented. Four centres participated, and 33% of all malaria cases reported to the Danish authorities in 1993 and 1994 were included (in total 82 patients). Ten out of 52 patients with falciparum malaria had not taken any chemoprophylaxis at all. Among the 42 patients who had, only 14 were both correctly advised and fully compliant. Within the remaining 28 patients, lack of compliance concerning the chemoprophylaxis was reported in 16, inadequate chemoprophylaxis was prescribed to 12 patients, and a further eight (19%) were underdosed. Only four out of 30 patients with vivax, ovale or malariae malaria had not used chemoprophylaxis. The distribution of contributing causes of chemoprophylaxis failure was similar to that of falciparum malaria, although noncompliance was more predominant in patients developing vivax, ovale or malariae malaria (58% compared to 38% in falciparum malaria).

The validity of a short food frequency questionnaire and its ability to measure changes in food intake: a longitudinal study

BACKGROUND

In studies of health behaviour exploring factors associated with differences and changes in eating patterns of populations, diet is often measured with short food frequency questionnaires (FFQ). This study examines the validity of a short FFQ by comparing frequencies of food intake from the FFQ to information on food intake obtained by a diet history interview.

METHODS

Food intake was measured at two separate occasions in the same 329 individuals, first in 1987-1988 and 6 years later in 1993-1994.

RESULTS

In 1987-1988 the Spearman correlation coefficients were around r = 0.50 for most foods, with white and dark ryebread and light bread as extremes on the one hand (r = 0.10, r = 0.23 and r = 0.27, respectively) and coarse bread, fruit and cakes as extremes on the other (r = 0.61, r = 0.60, r = 0.60, respectively). In general, the correlations were higher at the second data collection in 1993-1994. At both data collections, the mean food intake from the diet history interview increased with increasing frequency category, indicating that the questionnaire was able to identify levels of food intake correctly. In general, when individual changes in food intake were assessed during the study period, those who reported a less frequent intake by the FFQ in 1993-1994 compared with 1987-1988 also had a lower mean daily intake according to the diet history information.

CONCLUSION

The short FFQ can quantify food intakes and, is also responsive to changes in food intake over time. Thus the short FFQ can be used to monitor changes in food patterns at a group level.

Effects of smoking and marine diet on birthweight in Greenland

The associations of maternal smoking and blood mercury concentration on birthweight were studied in 1106 liveborn singletons from Greenland with a gestational period of 37+ weeks. After control for population group, smoking was significantly associated with low birthweight while consumption of marine mammals, maternal or cord blood mercury concentration were not. Only in West Greenlanders a week association was found between mercury and low birthweight. The Greenlandic diet of marine mammals has high concentrations of mercury and organochlorines which may reduce birthweight, and it is rich in n-3 fatty acids which have been shown to prolong pregnancy and thereby increase birthweight. In the present study neither previous reports of a negative influence of marine diet on birthweight due to methylmercury or previous reports of a positive influence of marine diet on birthweight due to n-3 fatty acids were supported.

Hysterectomy in a Danish cohort. Prevalence, incidence and socio-demographic characteristics

BACKGROUND

The aim has been to assess the frequency of hysterectomy in relation to sociodemographic characteristics.

MATERIALS AND METHODS

A cross-sectional survey of 2,403 women selected at random from the population in the western part of Copenhagen County. One thousand seven hundred and sixty-five Danish women (77%) filled in the questionnaire and took part in the interview. The cohort was followed for eight years through central registers to assess the incidence of hysterectomy. Logistic and Cox regression were used as main statistics.

RESULTS

Life time prevalence of hysterectomy was 10.4%. In the prevalence study, hysterectomy on benign diagnoses (85%) was related to short schooling, lack of vocational education, and low social status personally as well as regards the family. In the multivariate analyses school education, vocational education, and ascending social status by marriage were independent explanatory variables. In the incidence study, the crude rate of hysterectomy on benign diagnoses was 3.4 pr. 1000 years, with the 40-year-old women having the highest rate (7.8 pr. 1000 years). Risk factors as regards hysterectomy due to bleeding disorders and uterine fibroids at ages <50 (premenopausal) were unemployment and lack of vocational education, only the latter reached significant level in the multivariate analysis.

CONCLUSION

There are social inequalities regarding premenopausal hysterectomy on benign diagnoses, but the social-demographic indicators of interest have changed through the last decades. Short schooling and lack of social mobility by marriage were only associated with the hysterectomies performed before 1982, whereas lack of vocational education was related to hysterectomy independent of the calendar period involved. A woman without education has a relative risk of 2.2 (1.1-4.4) for hysterectomy compared to an educated woman.

Reduced fertility after the crash of a U.S. bomber carrying nuclear weapons? A register-based study on male fertility

A register-based study was performed to elucidate whether workers employed on the Thule air base in the clean-up period after the crash of a U.S. B-52 bomber carrying nuclear bombs had reduced fertility, as measured by the numbers of liveborn children. The highest birth rates were among 25-34-year olds with 1-3 years of employment on the base, but who had not worked at the base the year before, who already had one child, with a 2-5-year interval since the birth of the last child. No difference was seen between the group of men who had worked at the base during the clean-up period after the crash--the possibly exposed group--and those people who had worked at the base only outside the clean-up period. Because of the massive media coverage and possible claims for damages a register-based study is the only practicable way of elucidating statements about infertility. The main conclusion is that the accident has not reduced fertility.