Epidemiologic analysis of warfare: a historical review

Article Abstract:

The hazards of warfare are so extremely obvious that it may seem odd that relatively few comparative data have been tabulated on the health effects of war. The collection and examination of these data reveal some expected trends, one of which is that the improvements in weaponry and the increasing scale of conflict has resulted in increasing numbers of deaths. However, it was not until the second World War that the number of soldiers killed in action was greater than the number of soldiers who succumbed to disease. In World War I, soldiers who died of disease slightly outnumbered the soldiers killed in battle or those who died of their wounds. In the US Civil War, disease claimed twice as many soldiers as did battlefield action. While the total number of deaths has risen dramatically in recent times, the number of deaths out of the total number of soldiers has not. The number of wounds per soldier has declined, which is partly due to the fact that in modern warfare the percentage of soldiers actually exposed to battle has declined. Furthermore, improvements in medical treatment have significantly reduced the number of wounded soldiers who die of their wounds. During World War II, the US suffered 408,000 deaths, accounting for about 0.3 percent of the population. Germany lost 6.2 million people. Conservative estimates place Soviet losses in World War II at about 15 million people, 10 percent of its total population. With the development of new weapons, new strategies are also needed to prevent or minimize war-related deaths, especially among civilian populations. Other health-related causalities of war that need to be considered include the psychological impact of combat and the destruction of the environment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, War, Warfare, Conventional, Conventional warfare, Combat, Casualties, War casualties, Battle casualties

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Poor survival of treatment-related acute nonlymphocytic leukemia

Article Abstract:

One side effect of chemotherapy or radiotherapy for cancer is the possibility that the treatment itself will induce a cancer, such as leukemia. It has been thought that when leukemia occurs as a result of chemotherapy, the condition is particularly virulent and survival times are extremely short. The present statistical study examined data from more than 1 million patients registered in the Surveillance, Epidemiology and End-Results program of the National Cancer Institute. The database yielded 6,271 patients who developed acute nonlymphocytic leukemia which was not a result of treatment (de novo) and 107 patients who developed leukemia as the result of either chemotherapy or radiotherapy for cancer. An additional group of 118 cases of acute nonlymphocytic leukemia patients were also studied; these patients had a solid tumor, but were not treated with either chemotherapy or radiotherapy. The survival rate of the three groups was compared and analyzed. Patients with de novo leukemia and those with a previous tumor, but did not receive therapy, had a survival time at 12 months of 30 and 36 percent, respectively. Patients in whom leukemia occurred secondary to therapy had a 12-month survival time of only 10 percent. On the basis of these data, it appears that acute nonlymphocytic leukemia following radiation or chemotherapy is biologically distinct and either more aggressive or less responsive to treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Radiotherapy, Chemotherapy

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Environmental exposures in cytogenetically defined subsets of acute nonlymphocytic leukemia

Article Abstract:

The relationship between environmental exposure to mutagenic agents and the presence of clonal abnormalities in patients with acute nonlymphocytic leukemia (ANLL) is examined. The case control study group included 126 patients with abnormal karyotypes and 109 with no clonal abnormalities. Mutagenic factors considered included prior cytotoxic therapy for other conditions, cigarette smoking and alcohol use. Patients with clonal abnormalities reported a higher exposure to environmental mutagenic factors. Certain clonal abnormalities were associated with specific types of exposure while others were not associated with specific agents.

Case studies, Abnormalities, Leukemia, Chromosome abnormalities, Karyotypes, Environmentally induced diseases, Environmental illness

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