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Kyozuka H, Ohhira T, Murata T, Yasuda S, Ishii K, Yasumura S, Fujimori K, Ohto H, Kamiya K. Eight-Year Trends in the Effect of the Great East Japan Earthquake on Obstetrics Outcomes: A Study from the Fukushima Health Management Survey. Life (Basel) 2023; 13:1702. [PMID: 37629559 PMCID: PMC10455406 DOI: 10.3390/life13081702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
Information regarding the longitudinal effects of natural/environmental disasters on obstetrics outcomes is limited. This study aimed to analyze the longitudinal changes in obstetrics outcomes over 8 years after the Great East Japan Earthquake and the Fukushima power plant accident. We used data from the first 8 years of the Pregnancy and Birth Survey by the Fukushima prefectural government, launched in 2011. We compared data on obstetrics outcomes by year and divided Fukushima Prefecture into six districts based on administrative districts. Longitudinal changes in the occurrence of preterm birth before 37 gestational weeks, low birth weight, and anomalies in newborns were accessed using the Mantel-Haenszel test for trends in all six districts. Overall, 57,537 participants were included. In 8 years, maternal age, conception rate after sterility treatment, and cesarean section delivery incidence increased. Although significant differences were observed in preterm birth and low birth weight occurrence among districts, there was no significant trend in the occurrence of preterm birth, low birth weight, and anomalies in newborns in all six districts of Fukushima Prefecture. The Great East Japan Earthquake and Fukushima power plant accident were associated with increased cesarean section delivery incidence but had no significant adverse effects on obstetrics outcomes.
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Affiliation(s)
- Hyo Kyozuka
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tetsuya Ohhira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Kayoko Ishii
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
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Smaller Nuclear Detonations as the New Emergency Preparedness Challenge in Disaster Medicine and Public Health. Disaster Med Public Health Prep 2022; 17:e269. [PMID: 36503646 DOI: 10.1017/dmp.2022.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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3
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Kyozuka H, Murata T, Yasuda S, Ishii K, Fujimori K, Goto A, Yasumura S, Ota M, Hata K, Suzuki K, Nakai A, Ohira T, Ohto H, Kamiya K. The Effects of the Great East Japan Earthquake on Perinatal Outcomes: Results of the Pregnancy and Birth Survey in the Fukushima Health Management Survey. J Epidemiol 2022; 32:S57-S63. [PMID: 36464301 PMCID: PMC9703925 DOI: 10.2188/jea.je20210444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
There are limited studies on the long-term effects of natural/environmental disasters, especially nuclear disasters, on obstetric outcomes. This study aimed to review the results of perinatal outcomes immediately after the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi Nuclear Power Plant accident, as well as their long-term trends over 8 years, in the Fukushima Health Management Survey. The annual population-based Pregnancy and Birth Survey is conducted as part of the Fukushima Health Management Survey. The Fukushima Prefecture government launched it to assess the health conditions of pregnant women and their neonates after the GEJE. The self-reported questionnaire was sent to 115,976 pregnant women by mail from January 2012, with 58,344 women responding to the questionnaire (50.3% response rate). Pregnancy complications, such as gestational hypertension, respiratory diseases, and mental disorders, increased in some women who were pregnant at the time of the earthquake and immediately after the earthquake. However, the direct effects on newborns, such as preterm birth, low birth weight, and congenital anomalies, were not immediately clear after the earthquake. Although there were significant differences in the occurrence of preterm birth and low birth weight among the districts, there was no change in the occurrences of preterm birth, low birth weight, or anomalies in newborns in Fukushima Prefecture from the fiscal year 2011 to the fiscal year 2018. Therefore, the long-term effects of the post-disaster radiation accident on perinatal outcomes are considered to be very small.
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Affiliation(s)
- Hyo Kyozuka
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kayoko Ishii
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Aya Goto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Misao Ota
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Midwifery and Maternal Nursing, Fukushima Medical University School of Nursing, Fukushima, Japan
| | - Kenichi Hata
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Fukushima Society of Obstetrics and Gynecology, Fukushima, Japan
| | - Kohta Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Akihito Nakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Nippon Medical School Tamanagayama Hospital, Tokyo, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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Korsakov AV, Geger EV, Lagerev DG, Pugach LI, Mousseau TA. De novo congenital malformation frequencies in children from the Bryansk region following the Chernobyl disaster (2000-2017). Heliyon 2020; 6:e04616. [PMID: 32885067 PMCID: PMC7452506 DOI: 10.1016/j.heliyon.2020.e04616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/24/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Ionizing radiation and chemical pollution can disrupt normal embryonic development and lead to congenital malformations and fetal death. We used official government statistical data for 2000-2017 to test the hypothesis that radioactive and chemical pollutants influenced the frequency of de novo congenital malformations in newborns of the Bryansk region of southwest Russia. METHODS A variety of statistical approaches were used to assess congenital malformation frequencies including the Shapiro-Wilk test, White's homoscedasticity test, Wilcoxon T-test, Spearman's rank correlation test, and the inversely proportional regression. RESULTS We found that the frequency of polydactyly, multiple congenital malformations, and the frequency of de novo congenital malformations in newborns were significantly higher (p = 0.001-0.054) in regions with elevated radioactive, chemical and combined contamination. Polydactyly, multiple congenital malformations, and the sum of all congenital malformations were 4.7-7.4 times, 2.5-6.8 times, and 3.5-4.6 times higher in contaminated regions in comparison with the control group. The combination of both radioactive and chemical pollutants led to significantly higher frequencies of multiple congenital malformations when compared to regions with only one pollutant (radiation alone: 2.2 times, p = 0.034; chemical pollutants alone: 1.9 times, p = 0.008) implying that the effects of these stressors were at minimum additive. Although there was a trend for decreasing frequencies of multiple congenital malformations during the 2000-2017 period in areas of combined pollution, the opposite was true for regions with radioactive or chemical pollutants alone. However, overall, our models suggest that the frequency of multiple congenital malformations in areas of combined pollution will significantly (p = 0.027) exceed the frequencies observed for regions containing radioactive or chemical pollutants alone by 39.6% and 45.7% respectively, by 2018-2023. CONCLUSION These findings suggest additive and potentially synergistic effects of radioactive and chemical pollutants on the frequencies of multiple congenital malformations in the Bryansk region of southwestern Russia.
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Affiliation(s)
- Anton V. Korsakov
- Bryansk State Technical University, Laboratory “Human Ecology and Data Analysis in the Technosphere”, Russian Federation
| | - Emilia V. Geger
- Bryansk State Technical University, Laboratory “Human Ecology and Data Analysis in the Technosphere”, Russian Federation
| | - Dmitry G. Lagerev
- Bryansk State Technical University, Laboratory “Human Ecology and Data Analysis in the Technosphere”, Russian Federation
| | - Leonid I. Pugach
- Bryansk State Technical University, Laboratory “Human Ecology and Data Analysis in the Technosphere”, Russian Federation
| | - Timothy A. Mousseau
- University of South Carolina Columbia, Department of Biological Sciences, USA
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5
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Murase K, Murase J, Mishima A. Nationwide Increase in Complex Congenital Heart Diseases After the Fukushima Nuclear Accident. J Am Heart Assoc 2020; 8:e009486. [PMID: 30862223 PMCID: PMC6475040 DOI: 10.1161/jaha.118.009486] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background After the Chernobyl nuclear accident in 1986, an increase in the incidence of congenital heart disease ( CHD s) in the neighboring countries was reported. In 2011, Japan experienced the Great East Japan Earthquake and the nuclear accidents at Fukushima. However, a nationwide study of their effects has not been conducted yet. Methods and Results We used data covering the period between 2007 and 2014 from the annual surveys conducted by the Japanese Association for Thoracic Surgery, which included almost all of the operations pertaining to 46 types of CHD s in Japan. CHD s were divided into 2 groups based on complexity, the time of occurrence during heart development, and age at operation. We estimated the change in the number of the operations per 100 000 live births between pre- and postdisaster using a negative binomial generalized linear mixed model. Overall, a significant 14.2% (95% CI, 9.3-19.4) increase in the number of operations for complex CHD s in neonates and infants per 100 000 live births was found, whereas those performed for patients of 1 to 17 years old showed no significant change during the study period. Conclusions The number of operations for complex CHD s in neonates and infants in Japan significantly increased after the massive disaster, and its level was maintained thereafter. The number of operations for complex CHD was not equal but closely correlated to the live birth prevalence of complex CHD s. Therefore, some meaningful increase in the live birth prevalence can be assumed; however, the precise cause of the increase is unknown.
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Affiliation(s)
- Kaori Murase
- 1 Nagoya City University Graduate School of Natural Sciences Nagoya Japan
| | - Joe Murase
- 2 Goshawk Protection Fund Utsunomiya Japan
| | - Akira Mishima
- 3 Department of Cardiovascular Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
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Cwikel J, Sergienko R, Gutvirtz G, Abramovitz R, Slusky D, Quastel M, Sheiner E. Reproductive Effects of Exposure to Low-Dose Ionizing Radiation: A Long-Term Follow-Up of Immigrant Women Exposed to the Chernobyl Accident. J Clin Med 2020; 9:jcm9061786. [PMID: 32521764 PMCID: PMC7356322 DOI: 10.3390/jcm9061786] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/20/2022] Open
Abstract
The Chernobyl accident in 1986 spread ionizing radiation over extensive areas of Belarus and Ukraine, leading to adverse health effects in exposed children. More than 30 years later, exposed children have grown and became parents themselves. This retrospective study from Israel was aimed to evaluate whether Chernobyl-exposed women are at higher risk for adverse reproductive outcomes. Exposed immigrants were identified as high or low exposure based on Caesium-137 soil contamination levels registered in the town they lived in. The exposed group was age matched with three comparison groups: non-exposed immigrant women from the Former Soviet Union (FSU) excluding Belarus and the Ukraine, immigrants from other countries (Non FSU) and Israeli-born women at a ratio of 1:10. Chernobyl-exposed women were more likely to be nulliparous and have fewer children (2.1 + 0.8 vs. 3.1 + 1.8, p < 0.001), were more likely to undergo fertility treatments (8.8% vs. 5.8%, adjusted OR = 1.8, 95%CI 1.04-3.2, p = 0.036), and were also more likely to have anemia after delivery (49.4% vs. 36.6%, OR = 1.7, 95%CI 1.2-2.3, p = 0.001), compared to women in the combined comparison groups. The overall fertility of Chernobyl-exposed women seems to be reduced as reflected by the lower number of children and their greater need for fertility treatments.
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Affiliation(s)
- Julie Cwikel
- The Center for Women’s Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, Israel;
- Correspondence:
| | - Ruslan Sergienko
- Department of Epidemiology, Faculty of Health Sciences, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, Israel;
| | - Gil Gutvirtz
- OB-GYN (Women’s B ward), Soroka University Medical Center, Beer Sheva 84105, Israel; (G.G.); (E.S.)
| | - Rachel Abramovitz
- The Center for Women’s Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, Israel;
| | | | - Michael Quastel
- Nuclear Medicine, Soroka University Medical Center (retired), Beer Sheva 84105, Israel;
| | - Eyal Sheiner
- OB-GYN (Women’s B ward), Soroka University Medical Center, Beer Sheva 84105, Israel; (G.G.); (E.S.)
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7
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Nembhard WN, McElfish PA, Ayers B, Collins RT, Shan X, Rabie NZ, Zarate YA, Maity S, Cen R, Robbins JA. Nuclear radiation and prevalence of structural birth defects among infants born to women from the Marshall Islands. Birth Defects Res 2019; 111:1192-1204. [PMID: 31313527 DOI: 10.1002/bdr2.1551] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/13/2019] [Accepted: 07/01/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND With their unique history of exposure to extensive nuclear testing between 1946 and 1958, descendants of Marshall Island residents may have underappreciated genetic abnormalities, increasing their risk of birth defects. METHODS We conducted a retrospective cohort study of resident women with at least one singleton live birth between 1997 and 2013 in northwest Arkansas using state birth certificate data linked to data from the Arkansas Reproductive Health Monitoring System, a statewide birth defects registry. We calculated unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) from modified Poisson regression analyses for non-Hispanic (NH) whites, NH-blacks, Hispanics and Marshallese, using NH-whites as the reference group. RESULTS Of the 91,662 singleton births during the study period, 2,488 were to Marshallese women. Due to the relatively small number of Marshallese births, we could not calculate prevalence estimates for some defects. Marshallese infants had higher rates of congenital cataracts (PR = 9.3; 95% CI: 3.1, 27.9). Although the number of defects was low, Marshallese infants also had higher rates of truncus arteriosus (PR = 44.0; 95% CI: 2.2, 896.1). CONCLUSIONS Marshallese infants may have increased risk of specific birth defects, but estimates are unstable because of small sample size so results are inconclusive. Larger population-based studies would allow for further investigation of this potential risk among Marshallese infants.
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Affiliation(s)
- Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Science, Fayetteville, Arkansas
| | - Britni Ayers
- College of Medicine, University of Arkansas for Medical Science, Fayetteville, Arkansas
| | - R Thomas Collins
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Xiaoyi Shan
- Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Nader Z Rabie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii
| | - Yuri A Zarate
- Section of Genetics and Metabolism, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Suman Maity
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - Ruiqi Cen
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - James A Robbins
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas.,Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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8
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Development and Implementation of an Internet Survey to Assess Community Health in the Face of a Health Crisis: Data from the Pregnancy and Birth Survey of the Fukushima Health Management Survey, 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111946. [PMID: 31159365 PMCID: PMC6603910 DOI: 10.3390/ijerph16111946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/27/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
The Pregnancy and Birth Survey of the Fukushima Health Management Survey is a questionnaire survey that has been conducted annually since 2011 in Fukushima Prefecture. Since 2016, the survey has been available online as well as in paper form. This study aimed to determine whether making the survey available online improved response rates and to identify the characteristics of paper and online survey respondents and their results. Using LimeSurvey, we constructed an online survey environment that enabled responses via computer or mobile device. Respondents could choose whether to respond on paper or online. The response rate for the 2016 survey was 51.8%, an increase of 3.5% over the previous year. Of these responses, 15.8% were made online. Online respondents were mostly primiparous. Further, while there was no difference in the percentage of respondents who provided free responses, the amount written was higher in paper surveys than in online surveys. The combination of paper and online surveys increased convenience for respondents and contributed to improved response rates. In addition, paper surveys were superior in terms of allowing respondents to express their feelings and opinions.
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9
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Craenen K, Verslegers M, Buset J, Baatout S, Moons L, Benotmane MA. A detailed characterization of congenital defects and mortality following moderate X-ray doses during neurulation. Birth Defects Res 2017; 110:467-482. [PMID: 29193908 DOI: 10.1002/bdr2.1161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Both epidemiological and animal studies have previously indicated a link between in utero radiation exposure and birth defects such as microphthalmos, anophthalmos, and exencephaly. However, detailed knowledge on embryonic radiosensitivity during different stages of neurulation is limited, especially in terms of neural tube defect and eye defect development. METHODS To assess the most radiosensitive stage during neurulation, pregnant C57BL6/J mice were X-irradiated (0.5 Gy or 1.0 Gy) at embryonic days (E)7, E7.5, E8, E8.5, or E9. Next, the fetuses were scored macroscopically for various defects and prenatal resorptions/deaths were counted. In addition, cranial skeletal development was ascertained using the alcian-alizarin method. Furthermore, postnatal/young adult survival was followed until 5 weeks (W5) of age, after X-irradiation at E7.5 (0.1 Gy, 0.5 Gy, or 1.0 Gy). In addition, body and brain weights were registered at adult age (W10) following X-ray exposure at E7.5 (0.1 Gy, 0.5 Gy). RESULTS Several malformations, including microphthalmos and exencephaly, were most evident after irradiation at E7.5, with significance starting respectively at 0.5 Gy and 1.0 Gy. Prenatal mortality and weight were significantly affected in all irradiated groups. Long-term follow-up of E7.5 irradiated animals revealed a reduction in survival at 5 weeks of age after high dose exposure (1.0 Gy), while lower doses (0.5 Gy, 0.1 Gy) did not affect brain and body weight at postnatal week 10. CONCLUSIONS With this study, we gained more insight in radiosensitivity throughout neurulation, and offered a better defined model to further study radiation-induced malformations and the underlying mechanisms.
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Affiliation(s)
- Kai Craenen
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre SCK•CEN, Boeretang 200, Mol 2400, Belgium.,Laboratory of Neural Circuit Development and Regeneration, Animal Physiology and Neurobiology section, Department of Biology, Faculty of Science, KU Leuven, Naamsestraat 61 bus 2464, Leuven 3000, Belgium
| | - Mieke Verslegers
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre SCK•CEN, Boeretang 200, Mol 2400, Belgium
| | - Jasmine Buset
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre SCK•CEN, Boeretang 200, Mol 2400, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre SCK•CEN, Boeretang 200, Mol 2400, Belgium
| | - Lieve Moons
- Laboratory of Neural Circuit Development and Regeneration, Animal Physiology and Neurobiology section, Department of Biology, Faculty of Science, KU Leuven, Naamsestraat 61 bus 2464, Leuven 3000, Belgium
| | - Mohammed Abderrafi Benotmane
- Radiobiology Unit, Interdisciplinary Biosciences, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre SCK•CEN, Boeretang 200, Mol 2400, Belgium
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10
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Leppold C, Nomura S, Sawano T, Ozaki A, Tsubokura M, Hill S, Kanazawa Y, Anbe H. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050542. [PMID: 28534840 PMCID: PMC5451992 DOI: 10.3390/ijerph14050542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/08/2017] [Accepted: 05/16/2017] [Indexed: 12/19/2022]
Abstract
Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (<2500 g at birth) and preterm births (<37 weeks gestation at birth) were compared pre- and post-disaster, and regression models were conducted to assess for associations between these outcomes and evacuation and food avoidance. A total of 1101 live singleton births were included. There were no increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI): 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21). No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health.
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Affiliation(s)
- Claire Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, George Square, Edinburgh EH8 9LD, UK.
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Akihiko Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Masaharu Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Sarah Hill
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Yukio Kanazawa
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Hiroshi Anbe
- Department of Obstetrics and Gynecology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
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11
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Ishii K, Goto A, Ota M, Yasumura S, Fujimori K. Pregnancy and Birth Survey of the Fukushima Health Management Survey. Asia Pac J Public Health 2017; 29:56S-62S. [DOI: 10.1177/1010539516684534] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Pregnancy and Birth Survey was started by Fukushima Medical University as part of the Fukushima Health Management Survey in 2011 in order to assess the physical and mental health of mothers and provide parenting support (telephone counseling) for those in need. The present study reviewed the major findings from 4 annual surveys conducted from 2011 to 2014. Overall proportions of preterm deliveries, low birth weight infants, and congenital anomalies in the first year were almost the same as those in national surveillance data. The prevalence of depressive symptoms among the mothers held steady at about 25% over the 4 years. Regarding the content of parenting counseling, the proportion of mothers who voiced concerns about radiation decreased each year. This survey should be continued to provide support to mothers in Fukushima.
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Affiliation(s)
- Kayoko Ishii
- Fukushima Medical University, Fukushima City, Japan
| | - Aya Goto
- Fukushima Medical University, Fukushima City, Japan
| | - Misao Ota
- Fukushima Medical University, Fukushima City, Japan
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Wertelecki W, Chambers CD, Yevtushok L, Zymak-Zakutnya N, Sosyniuk Z, Lapchenko S, Ievtushok B, Akhmedzhanova D, Komov O. Chornobyl 30 years later: Radiation, pregnancies, and developmental anomalies in Rivne, Ukraine. Eur J Med Genet 2017; 60:2-11. [DOI: 10.1016/j.ejmg.2016.09.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 09/29/2016] [Indexed: 11/24/2022]
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13
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Machatkova M, Brouckova M, Matejckova M, Krebsova A, Sperling K, Vorsanova S, Kutsev S, Zerova T, Arbuzova S, Krejci R, Petersen M, Macek M. QF-PCR Examination of Parental and Meiotic Origin of Trisomy 21 in Central and Eastern Europe. J Histochem Cytochem 2016; 53:371-3. [PMID: 15750023 DOI: 10.1369/jhc.4b6510.2005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Study of parental/meiotic origin of free trisomy 21 in nuclear families from Russia (70 cases), Ukraine (32 cases), and 22 from Germany revealed maternal nondisjunction in 77.3% (Germany), 93.8% (Ukraine), and 91.4% (Russia), paternal origin in 13.6%, 6.2%, and 8.6%, respectively. Maternal meiosis I errors were found in 84.4% (Ukraine), 77.1% (Russia), paternal origin in 3.1% (Ukraine), 2.9% (Russia). Maternal meiosis II errors occurred in 9.4% and 14.3% and paternal in 3.1% and 5.7% in Ukraine and Russia, respectively. No significant differences were found in maternal/paternal origin among Ukraine, Russia, Germany, and published data from other European regions.
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Affiliation(s)
- Marina Machatkova
- University Hospital Motol, Institute of Biology and Medical Genetics, Laboratory of Assisted Reproduction and Reproductive Genetics, V Uvalu 84, Prague-5, 150 06, Czech Republic
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14
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Wertelecki W, Koerblein A, Ievtushok B, Zymak-Zakutnia N, Komov O, Kuznietsov I, Lapchenko S, Sosyniuk Z. Elevated congenital anomaly rates and incorporated cesium-137 in the Polissia region of Ukraine. ACTA ACUST UNITED AC 2016; 106:194-200. [PMID: 26871487 DOI: 10.1002/bdra.23476] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 11/20/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Investigations soon after the 1986 Chornobyl (Chernobyl in Russian) accident of exposed populations residing elsewhere in Europe led government and international agencies to conclude that exposures to cesium-137 (Cs-137) were not teratogenic. Our observations of elevated population rates of neural tube defects (NTDs) and microcephaly and microphthalmia (M/M) in the Rivne Province in Ukraine, which were among the highest in Europe, prompted this follow-up investigation inclusive of whole-body counts (WBCs) of Cs-137 among ambulatory patients and pregnant women residing in Polissia, the most polluted region in Rivne. METHODS Yearly (2000-2012) population rates of NTDs and M/M and WBC patterns of ambulatory patients (2001-2010) and pregnant women (2011-2013) in Polissia and non-Polissia regions of Rivne were analyzed. RESULTS The NTD and M/M population rates in Rivne remain elevated and are statistically significantly higher in Polissia than in non-Polissia. The WBCs among residents in Polissia are statistically significantly higher than among those from non-Polissia. CONCLUSION NTD and M/M rates are highest in the Polissia region of Rivne and are among the highest in Europe. In Polissia, the WBCs of Cs-137 are above officially set permissible upper limits. The results are based on aggregate data of NTDs and M/Ms and average WBC values. Further investigations of causality of the high rates of NTDs and M/Ms are needed and urgent strengthening policies and implementations to reduce exposures to teratogens, in particular radioactive nuclides and alcohol, and consumption of folic acid supplements are indicated.
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Affiliation(s)
| | - Alfred Koerblein
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine
| | - Bogdana Ievtushok
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.,Rivne Province Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Nataliya Zymak-Zakutnia
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.,Khmelnytsky City Perinatal Center, Khmelnytsky, Ukraine
| | - Oleksandr Komov
- Rivne Province State Sanitary-and-Epidemiologic Service, Rivne, Ukraine
| | - Illia Kuznietsov
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.,Human and Animal Physiology Department, Eastern-European University, Lutsk, Volyn, Ukraine
| | - Serhiy Lapchenko
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine
| | - Zoriana Sosyniuk
- OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.,Rivne Province Regional Medical Diagnostic Center, Rivne, Ukraine
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15
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Schmitz-Feuerhake I, Busby C, Pflugbeil S. Genetic radiation risks: a neglected topic in the low dose debate. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2016; 31:e2016001. [PMID: 26791091 PMCID: PMC4870760 DOI: 10.5620/eht.e2016001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 01/20/2016] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (Abomb) survivors. METHODS To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down's syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. RESULTS Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. CONCLUSIONS We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.
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Langlois PH, Lee M, Lupo PJ, Rahbar MH, Cortez RK. Residential radon and birth defects: A population-based assessment. BIRTH DEFECTS RESEARCH. PART A, CLINICAL AND MOLECULAR TERATOLOGY 2016; 106:5-15. [PMID: 25846606 PMCID: PMC4595158 DOI: 10.1002/bdra.23369] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 02/12/2015] [Accepted: 02/18/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Associations have been reported between maternal radiation exposure and birth defects. No such studies were found on radon. Our objective was to determine if there is an association between living in areas with higher radon levels and birth defects. METHODS The Texas Birth Defects Registry provided data on all birth defects from 1999 to 2009 from the entire state. Mean radon levels by geologic region came from the Texas Indoor Radon Survey. The association between radon and birth defects was estimated using multilevel mixed effect Poisson regression. RESULTS Birth defects overall were not associated with residential radon levels. Of the 100 other birth defect groups with at least 500 cases, 14 were significantly elevated in areas with high mean radon level in crude analyses, and 9 after adjustment for confounders. Cleft lip with/without cleft palate had an adjusted prevalence ratio of 1.16 per 1 picoCurie/liter (pCi/L) increase in exposure to region mean radon, 95% confidence interval, 1.08-1.26. Cystic hygroma / lymphangioma had an adjusted prevalence ratio of 1.22 per 1 pCi/L increase, 95% confidence interval, 1.02-1.46. Other associations were suggested but not as consistent: three skeletal defects, Down syndrome, other specified anomalies of the brain, and other specified anomalies of the bladder and urethra. CONCLUSION In the first study of residential radon and birth defects, we found associations with cleft lip w/wo cleft palate and cystic hygroma / lymphangioma. Other associations were suggested. The ecological nature of this study and multiple comparisons suggest that our results be interpreted with caution.
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Affiliation(s)
- Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, Medical School, and Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas
| | - Mohammad H Rahbar
- Division of Clinical and Translational Sciences, Department of Internal Medicine, Medical School, Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, and Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ruben K Cortez
- Radiation Branch, Texas Department of State Health Services, Austin, Texas
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Hayashi M, Fujimori K, Yasumura S, Goto A, Nakai A. Obstetric Outcomes in Women in Fukushima Prefecture during and after the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident: The Fukushima Health Management Survey. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojog.2016.612088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mangano J, Sherman JD. Changes in Congenital Anomaly Incidence in West Coast and Pacific States (USA) after Arrival of Fukushima Fallout. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojped.2015.51013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Wertelecki W, Yevtushok L, Zymak-Zakutnia N, Wang B, Sosyniuk Z, Lapchenko S, Hobart HH. Blastopathies and microcephaly in a Chornobyl impacted region of Ukraine. Congenit Anom (Kyoto) 2014; 54:125-49. [PMID: 24666273 PMCID: PMC4233949 DOI: 10.1111/cga.12051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/05/2014] [Indexed: 12/17/2022]
Abstract
This population-based descriptive epidemiology study demonstrates that rates of conjoined twins, teratomas, neural tube defects, microcephaly, and microphthalmia in the Rivne province of Ukraine are among the highest in Europe. The province is 200 km distant from the Chornobyl site and its northern half, a region known as Polissia, is significantly polluted by ionizing radiation. The rates of neural tube defects, microcephaly and microphthalmia in Polissia are statistically significantly higher than in the rest of the province. A survey of at-birth head size showed that values were statistically smaller in males and females born in one Polissia county than among neonates born in the capital city. These observations provide clues for confirmatory and cause-effect prospective investigations. The strength of this study stems from a reliance on international standards prevalent in Europe and a decade-long population-based surveillance of congenital malformations in two distinct large populations. The limitations of this study, as those of other descriptive epidemiology investigations, is that identified cause-effect associations require further assessment by specific prospective investigations designed to address specific teratogenic factors.
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Affiliation(s)
- Wladimir Wertelecki
- Department of Medical Genetics, College of Medicine, University of South AlabamaMobile, Alabama, USA
- OMNI-Net for Children International Charitable FundRivne, Rivne Province, Ukraine
| | - Lyubov Yevtushok
- OMNI-Net for Children International Charitable FundRivne, Rivne Province, Ukraine
- Rivne Regional Medical Diagnostic CenterRivne, Rivne Province, Ukraine
| | - Natalia Zymak-Zakutnia
- OMNI-Net for Children International Charitable FundRivne, Rivne Province, Ukraine
- Khmelnytsky Perinatal CenterKhmelnytsky, Khmelnytsky Province, Ukraine
| | - Bin Wang
- Department of Mathematics and Statisitcs, University of South AlabamaMobile, Alabama, USA
| | - Zoriana Sosyniuk
- OMNI-Net for Children International Charitable FundRivne, Rivne Province, Ukraine
- Rivne Regional Medical Diagnostic CenterRivne, Rivne Province, Ukraine
| | - Serhiy Lapchenko
- OMNI-Net for Children International Charitable FundRivne, Rivne Province, Ukraine
| | - Holly H Hobart
- Cyto-Genetics Laboratory, Department of Pathology, University of Mississippi Medical CenterJackson, Mississippi, USA
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Fujimori K, Kyozuka H, Yasuda S, Goto A, Yasumura S, Ota M, Ohtsuru A, Nomura Y, Hata K, Suzuki K, Nakai A, Sato M, Matsui S, Nakano K, Abe M. Pregnancy and birth survey after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident in Fukushima prefecture. Fukushima J Med Sci 2014; 60:75-81. [PMID: 25030719 DOI: 10.5387/fms.2014-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND On 11 March 2011, the Great East Japan Earthquake followed by a powerful tsunami hit the Pacific Coast of Northeast Japan and damaged Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant, causing a radiation hazard in Fukushima Prefecture. The objective of this report is to describe some results of a questionnaire-based pregnancy and birth survey conducted by the Radiation Medical Science Center for the Fukushima Health Management Survey. MATERIALS AND METHODS Questionnaires were sent to women who received maternal and child health handbooks from municipal officers in Fukushima Prefecture between 1 August 2010 and 31 July 2011, with the aim of reaching those who were pregnant at the time of the disaster. Mailing began 18 January 2012. Data were analyzed separately for six geographic areas in Fukushima Prefecture. RESULTS The total number of women meeting survey criteria was 15,972. The number of responses received to date is 9,298 (58.2%). Data from 8602 respondents were analyzed after excluding 634 invalid responses and 5 induced and 57 spontaneous abortions (less than 22 gestational weeks). The incidences of stillbirth (over 22 completed gestational weeks), preterm birth, low birth weight and congenital anomalies were 0.25%, 4.4%, 8.7% and 2.72%, respectively. These incidences are similar to recent averages elsewhere in Japan. CONCLUSION Considering the pregnancy and birth survey data in aggregate, our disaster seemed to provoke no significant adverse outcomes over the whole of Fukushima prefecture. But post-disaster prenatal care and support intended for patients' safety and security should be coupled with ongoing surveillance and rigorous data analysis.
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Affiliation(s)
- Keiya Fujimori
- Radiation Medical Science Center for the Fukushima Health Management Survey
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Dallas CE. Medical lessons learned from chernobyl relative to nuclear detonations and failed nuclear reactors. Disaster Med Public Health Prep 2013; 6:330-4. [PMID: 23241462 DOI: 10.1001/dmp.2012.72] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The Chernobyl disaster in 1986 involved the largest airborne release of radioactivity in history, more than 100 times as much radioactivity as the Hiroshima and Nagasaki atomic bombs together. The resulting emergency response, administrative blunders, and subsequent patient outcomes from this large-scale radiological disaster provide a wealth of information and valuable lessons for those who may find themselves having to deal with the staggering consequences of nuclear war. Research findings, administrative strategies (successful and otherwise), and resulting clinical procedures from the Chernobyl experience are reviewed to determine a current utility in addressing the appropriate protocols for a medical response to nuclear war. As various myths are still widely associated with radiation exposure, attention is given to the realities of a mass casualty medical response as it would occur with a nuclear detonation.
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Affiliation(s)
- Cham E Dallas
- Institute for Health Management and Mass Destruction Defense College of Public Health, University of Georgia, Athens, GA 30602, USA
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Alaani S, Al-Fallouji MAR, Busby C, Hamdan M. Pilot study of congenital anomaly rates at birth in fallujah, iraq, 2010. THE JOURNAL OF IMA 2012; 44:jima-44-1-10463. [PMID: 23864991 PMCID: PMC3708634 DOI: 10.5915/44-1-10463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 09/09/2012] [Indexed: 01/17/2023]
Abstract
Objectives To examine numbers of congenital anomaly (CA) at birth overall and by class in one clinic in Fallujah General Hospital, Fallujah, Iraq. Study Design: All congenital anomaly birth referrals to one pediatric clinician at Fallujah General Hospital for an eleven month period beginning November 1, 2009 were recorded. This clinic was one of three clinics to which cases would be referred. Results: There were 291 CA cases registered at birth in the period at the study’s clinic. The total number of births recorded in the hospital over the period was 6049. The CAs included 113 heart and circulatory system cases, 72 nervous system cases, 40 digestive system cases, 9 genitourinary cases, 6 ear, face and neck cases, 7 respiratory cases and 30 Down syndrome cases. Conclusion: Owing to difficulties establishing the exact number of births from which these cases were drawn, the exact rates cannot be precisely determined. Nevertheless, on the basis of reasonable assumptions relating to the activity of the clinic involved, these results support earlier epidemiological findings. On the basis of work reported elsewhere, the higher rates of congenital anomalies are believed to be caused by exposure to some genotoxic agent, possibly uranium.
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Affiliation(s)
- Samira Alaani
- Fallujah General Hospital, Althubbadh, Fallujah, Iraq
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Sperling K, Neitzel H, Scherb H. Evidence for an increase in trisomy 21 (Down syndrome) in Europe after the Chernobyl reactor accident. Genet Epidemiol 2011; 36:48-55. [DOI: 10.1002/gepi.20662] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 09/06/2011] [Accepted: 09/29/2011] [Indexed: 01/18/2023]
Affiliation(s)
- Karl Sperling
- Institute of Medical and Human Genetics; Charité - Universitaetsmedizin Berlin; Germany
| | - Heidemarie Neitzel
- Institute of Medical and Human Genetics; Charité - Universitaetsmedizin Berlin; Germany
| | - Hagen Scherb
- Institute of Biomathematics and Biometry; Helmholtz Zentrum München-German Research Centre for Environmental Health; Neuherberg; Germany
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Abstract
BACKGROUND The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. METHODS A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birth weight, congenital anomalies), mental health, and child development. A total of 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. RESULTS Studies addressing the World Trade Center disaster of September 11 and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, although there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. After a disaster, mental health of the mother may more strongly influence on child development than any direct effect of disaster-related prenatal stress. CONCLUSIONS There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly exposed women. Future research should focus on understudied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. TARGET AUDIENCE Obstetricians & Gynecologists. LEARNING OBJECTIVES After completion of this educational activity, the obstetrician/gynecologist should be better able to compare and contrast the effects of different types of disasters (hurricanes, earthquakes, chemical spills) on pregnant and postpartum women in order to prepare for patient care in the aftermath of such disasters; differentiate the birth outcomes likely to be affected by disaster, in order to identify patients likely to be at high risk; and assess the extent to which pregnant and postpartum women are a uniquely vulnerable population after disaster, to assist in organizing care under such circumstances.
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Affiliation(s)
- Emily Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans LA 70012-2715, USA.
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26
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Les fentes labiopalatines et l’environnement en Russie. ACTA ACUST UNITED AC 2010; 111:177-9. [DOI: 10.1016/j.stomax.2009.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Revised: 04/07/2009] [Accepted: 04/22/2009] [Indexed: 11/17/2022]
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Frecuencia y tendencia temporal de los defectos congénitos en Asturias. La necesidad de la vigilancia clinicoepidemiológica. GACETA SANITARIA 2009; 23:300-5. [DOI: 10.1016/j.gaceta.2008.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Accepted: 06/03/2008] [Indexed: 11/21/2022]
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Holland A, Whittington J, Cohen O, Curfs L, Delahaye F, Dudley O, Horsthemke B, Lindgren AC, Nourissier C, Sharma N, Vogels A. The European Prader-Willi Syndrome Clinical Research Database: an aid in the investigation of a rare genetically determined neurodevelopmental disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:538-547. [PMID: 19457156 DOI: 10.1111/j.1365-2788.2009.01172.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Prader-Willi Syndrome (PWS) is a rare genetically determined neurodevelopmental disorder with a complex phenotype that changes with age. The rarity of the syndrome and the need to control for different variables such as genetic sub-type, age and gender limits clinical studies of sufficient size in any one country. A clinical research database has been established to structure data collection and to enable multinational investigations into the development of children and adults with PWS. METHODS As part of a joint basic science and clinical study of PWS funded through Framework 6 of the European Union (EU), an expert multidisciplinary group was established that included clinicians involved in PWS research and clinical practice, expert database software developers, and representatives from two national PWS Associations. This group identified the key issues that required resolution and the data fields necessary for a comprehensive database to support PWS research. RESULTS The database consists of six 'index' entry points and branching panels and sub-panels and over 1200 data 'fields'. It is Internet-based and designed to support multi-site clinical research in PWS. An algorithm ensures that participant data are anonymous. Access to data is controlled in a manner that is compatible with EU and national laws. The database determines the assessments to be used to collect data thereby enabling the combining of data from different groups under specifically agreed conditions. The data collected at any one time will be determined by individual research groups, who retain control of the data. Over time the database will accumulate data on participants with PWS that will support future research by avoiding the need for repeat data collection of fixed data and it will also enable longitudinal studies and treatment trials. CONCLUSION The development of the database has proved to be complex with various administrative and ethical issues to be addressed. At an early stage, it was important to clarify the exact function of the database. It was agreed that it was primarily to support grant-funded research rather than clinical practice. The most complex issues that had to be addressed were concerned with data ownership and establishing the rules for data entry, retrieval and sharing that are compatible with data protection laws, and which are likely to be acceptable to participants and their families and to individual research groups.
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Affiliation(s)
- A Holland
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Busby C, Lengfelder E, Pflugbeil S, Schmitz-Feuerhake I. The evidence of radiation effects in embryos and fetuses exposed to Chernobyl fallout and the question of dose response. Med Confl Surviv 2009; 25:20-40. [PMID: 19413155 DOI: 10.1080/13623690802568954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Current legal frameworks for radiation exposure limits are based on the risk models of the International Commission on Radiological Protection (ICRP). In Publication 90 (2003), ICRP presents a safe (threshold) dose range of up to 100 mSv for radiogenic effects resulting from in utero exposure and bases this conclusion on the findings in Hiroshima and Nagasaki. However, a variety of observations of congenital malformations, fetal loss, stillbirths and infant deaths, as well as of Down's syndrome and other health defects in children after the Chernobyl accident exposures suggest that the A-bomb survivor data are incomplete. The Chernobyl findings are generally marginalized or even denied because of the low values of the estimated human exposures and the inconsistency of the results with the accepted risk models. One explanation for the observations is that physical dosimetric models have underestimated the effective exposure. This possibility is supported by biological dosimetry in the contaminated regions. The assumptions about effects after in utero exposure by incorporated radionuclides need to be revised.
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Affiliation(s)
- Chris Busby
- Green Audit and Department of Molecular Biosciences, University of Ulster, UK
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Jenkins KJ, Correa A, Feinstein JA, Botto L, Britt AE, Daniels SR, Elixson M, Warnes CA, Webb CL. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation 2007; 115:2995-3014. [PMID: 17519397 DOI: 10.1161/circulationaha.106.183216] [Citation(s) in RCA: 532] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prevention of congenital cardiovascular defects has been hampered by a lack of information about modifiable risk factors for abnormalities in cardiac development. Over the past decade, there have been major breakthroughs in the understanding of inherited causes of congenital heart disease, including the identification of specific genetic abnormalities for some types of malformations. Although relatively less information has been available on noninherited modifiable factors that may have an adverse effect on the fetal heart, there is a growing body of epidemiological literature on this topic. This statement summarizes the currently available literature on potential fetal exposures that might alter risk for cardiovascular defects. Information is summarized for periconceptional multivitamin or folic acid intake, which may reduce the risk of cardiac disease in the fetus, and for additional types of potential exposures that may increase the risk, including maternal illnesses, maternal therapeutic and nontherapeutic drug exposures, environmental exposures, and paternal exposures. Information is highlighted regarding definitive risk factors such as maternal rubella; phenylketonuria; pregestational diabetes; exposure to thalidomide, vitamin A cogeners, or retinoids; and indomethacin tocolysis. Caveats regarding interpretation of possible exposure-outcome relationships from case-control studies are given because this type of study has provided most of the available information. Guidelines for prospective parents that could reduce the likelihood that their child will have a major cardiac malformation are given. Issues related to pregnancy monitoring are discussed. Knowledge gaps and future sources of new information on risk factors are described.
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De Vigan C, Khoshnood B, Lhomme A, Vodovar V, Goujard J, Goffinet F. [Prevalence and prenatal diagnosis of congenital malformations in the Parisian population: twenty years of surveillance by the Paris Registry of congenital malformations]. ACTA ACUST UNITED AC 2005; 34:8-16. [PMID: 15767912 DOI: 10.1016/s0368-2315(05)82665-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess overall and malformation-specific trends in the prevalence, prenatal diagnosis and pregnancy termination of congenital malformations in the Parisian population. METHODS We used data from the Paris Registry of Congenital Malformations, which includes all births and pregnancy terminations with structural birth defects or chromosomal anomalies. Data on total and live birth prevalence were available for the period 1981-2000 and for prenatal diagnosis and pregnancy terminations for 1983-2000. Twenty malformations were selected for malformation-specific analyses due to their higher frequency and consistent definitions in different classification systems. RESULTS For the period 1981-2000, the overall total prevalence of malformations was 3.2%. Prenatal diagnosis rates consistently increased from 16.2% (95% CI, 13.8-18.6) of cases with malformation in 1983 to 69.1% (95% CI, 66.7-71.5) in 2000. Pregnancy terminations increased from 8.8% (95% CI, 7.0-10.8) of cases with malformation in 1983 to 30.1% (95% CI, 27.7-32.6) in 2000. CONCLUSION Registries of congenital malformations provide population-based data on the prevalence of malformations and their associations with other anomalies. Registry-based data can also be used to evaluate the impact of prenatal testing policies for congenital malformations.
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Affiliation(s)
- C De Vigan
- Registre des malformations congénitales de Paris, INSERM U 149, Recherches épidémiologiques en santé périnatale et santé des femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif Cedex.
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Abstract
The surveillance of congenital anomalies serves two main purposes: to facilitate the identification of teratogenic (malformation causing) exposures and to assess the impact of primary prevention and prenatal screening policy and practice at a population level. EUROCAT, the European network of population based registers for the epidemiological surveillance of congenital anomalies, now covers 1.2 million births per year, a quarter of births in Europe. The added value of European collaboration is particularly great for congenital anomalies, coming from the opportunity to pool data, to compare data between regions and countries, to give a common response to European public health questions, and to share expertise and resources, including computing tools. EUROCAT provides essential epidemiological information on congenital anomalies in Europe, facilitates the early warning of teratogenic exposures, evaluates the effectiveness of primary prevention, assesses the impact of developments in prenatal screening, acts as an information and resource centre regarding clusters, provides a ready collaborative network and infrastructure for research, and acts as a catalyst for the setting up of registries throughout Europe.
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Affiliation(s)
- H Dolk
- Epidemiology and Health Services Research, University of Ulster at Jordanstown, Shore Rd, Newtownabbey BT37 OQB, UK.
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Dubrova YE. Long-term genetic effects of radiation exposure. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2003; 544:433-9. [PMID: 14644346 DOI: 10.1016/j.mrrev.2003.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To date, there has been little experimental knowledge on the genetic risks of human exposure to ionising radiation for humans. Recent data suggest that hypervariable tandem repeat minisatellite loci provide a useful and sensitive experimental approach for monitoring radiation-induced germline mutation in humans. Here, I review the results of studies on minisatellite mutation rates in human populations exposed to radioactive fallout after the Chernobyl accident and nuclear weapon tests in Kazakhstan.
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Affiliation(s)
- Yuri E Dubrova
- Department of Genetics, University of Leicester, University Road, Leicester LE1 7RH, UK.
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Dean G, Nevin NC, Mikkelsen M, Karadima G, Petersen MB, Kelly M, O'Sullivan J. Investigation of a cluster of children with Down's syndrome born to mothers who had attended a school in Dundalk, Ireland. Occup Environ Med 2000; 57:793-804. [PMID: 11077007 PMCID: PMC1739900 DOI: 10.1136/oem.57.12.793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To investigate a reported cluster of Down's syndrome in offspring of former pupils of a girls' school in Ireland, to establish the prevalence of Down's syndrome among live births in the area around the school, and to review the literature on the possible causes of reported clusters of Down's syndrome. METHODS Questionnaire survey of obstetric and personal histories of women who had attended the girls' school at Dundalk, County Louth, Republic of Ireland, at some time during 1956-7, and also of women who had attended another, nearby, girls' school during the same period. Comparison of observed numbers of cases of Down's syndrome identified by these surveys with maternal age adjusted expected numbers for the reported live births. Laboratory tests were conducted to verify and characterise the cases of Down's syndrome constituting the cluster. Retrospective collection and collation of data on Down's syndrome occurring among live births, and the compilation of maternal age specific incidences, in County Louth and in Newry and Mourne District in neighbouring Northern Ireland, during 1961-80. These rates were compared with reference rates and rates for other areas of Ireland. RESULTS Six children with Down's syndrome were confirmed among 387 reported live births to women who had been pupils at the girls' school in Dundalk during 1956-7, compared with 0.69 expected (nominal p<10(-4)). Five of the affected births were to mothers under 30 years of age, against 0.15 expected (nominal p<10(-6)), although only four of these mothers were attending the school at any one time. The origin of the non-disjunction was found to be maternal first meiotic in four children, mitotic after fertilisation in another (with the youngest mother), and in the remaining one could not be determined. The marked excess of Down's syndrome in births to young mothers did not extend to offspring of former pupils of the other Dundalk girls' school surveyed, or to live births in County Louth generally or in adjacent Newry and Mourne District. CONCLUSION A striking, highly localised, excess of Down's syndrome in births to young mothers who had attended a girls' school in Dundalk during 1956-57 has been confirmed. However, not all of the mothers of the affected children attended the school concurrently and the origin of non-disjunction in one child was an error occurring after conception. Some exposure essentially confined to girls attending the school at this time is a possible, although unlikely, explanation, but a review of potential risk factors does not suggest what this could be. Previous suggestions that an influenza epidemic or contamination from the Windscale nuclear reactor fire might be implicated, both of which occurred in October 1957, can be effectively dismissed because three of the women with affected offspring had left the school by then and had moved away from Dundalk, and Down's syndrome in the child of another mother originated in an error after fertilisation. Owing to the retrospective nature of the investigation and the characteristics of the cases, chance is the most likely explanation for the cluster.
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Affiliation(s)
- G Dean
- Medico-Social Research Board (now The Health Research Board), 73 Lower Baggot Street, Dublin 2, Ireland
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