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http://www.nap.edu/catalog/940.html We ship printed books within 1 business day; personal PDFs are available immediately. The Medical Implications of Nuclear War Fred Solomon and Robert Q. Marston, Editors; with a foreword by Lewis Thomas; Steering Committee for the Symposium on the Medical Implications of Nuclear War, Institute of Medicine ISBN: 0-309-56408-5, 640 pages, 6 x 9, (1986) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/940.html Visit the National Academies Press online, the authoritative source for all books from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council: • Download hundreds of free books in PDF • Read thousands of books online for free • Explore our innovative research tools • Sign up to be notified when new books are published • Purchase printed books and selected PDF files Thank you for downloading this PDF. 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Request reprint permission for this book. i ee hb mtot n on fra not er, c The Medical k, ev ow er bog, ho Implications of Nuclear pn al pamatti e origincific for War he tp d from etting-s es s creater type Institute of Medicine eh filot L d National Academy of Sciences Mn m Xes, a osed froding styl pa me n recoeaks, h Fredric Solomon, M.D., and Robert Q Marston, M.D. Editors eebr bd s or aw k hs, worgth n nal e le gin the original; li With a Foreword by Lewis Thomas, M.D. ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ NATIONAL ACADEMY PRESS utn ogi Washington, D.C. 1986 Abori Copyright © National Academy of Sciences. All rights reserved. ii ee hb mtot onn NATIONAL ACADEMY PRESS 2101 CONSTITUTION AVENUE, NW WASHINGTON, fra DC 20418 not er, c NOTICE: The symposium reported in these proceedings was approved by the Governing Board of ok, wev the National Research Council, whose members are drawn from the councils of the National er bog, ho Amceamdbeemrsy ooff tShcei ecnocmems, itthteee N reastipoonnasli bAlcea fdoerm thye osfy Emnpgoisnieuemri nwge, raen cdh tohsee nIn fsotirt uthtee ior fs pMeecdiailc icnoem. Tpeh-e pn tences and with regard for appropriate balance. al pamatti duresT ahpepsreo pvreodc beeyd ain Rgesp hoarvt eR beeveienw re Cvoiemwmedit tbeye ac ognrosiuspti nogth oefr mtheamn btheer sa oufth tohres Nacactioorndailn gA ctoa dpermocye -of e origincific for SrecpireenCsceoensnt,c ttlhhuoess iNoe naostfi oatnhndea l pv Arioecwgardsa ememx psypr oeosfn sEseodnr g,b itynh eeteh Ireni nasgtui,tt huaotnerd so tofh fMe pIeandpsitecirtisun teae.r eo ft hMeier doiwcinn ea.nd do not necessarily he ed from tsetting-sp ghreuesaipsltohhTen hdsoie fbm tIihleniemsty tpib ttueuobrt sebli eoco .ffa InaMnp a eptdhdrvioiscip,si rentihrea e ttweo I napthssrto eci fthfueeastderste ieaorrcanetlssd g iubonnyv tde hterhenr e emb xNoeatanmhtti itoanhnnaeadt lAi oiAtcnsac oodawfed mepnmo yiln'yisci toyciafo m tnSivgacetritee eisnnrscs ii eodpsnee atnrotlta icefinhyniailnnirsgtgte rdtiosiss tuthienes- s creater type onfo nmpeTrdohifceita ,Nl s caeatlifro-egn, oarlev sAeercanaricndhge,m mayne dmo feb dSeucrsciehanitpico ecnso. wrpaosr aetsitoanb lfiosrh ethde i nfu 1rt8h6e3r abnyc eA ocft socf iCenocneg arensds taesc han porliovgayte,, eh filot required to advise the federal government upon request within its fields of competence. Under its L d corporate charter the Academy established the National Research Council in 1916, the National Mn m Xes, a ALicbardaermyy o of fC Eonnggirneesesr iCnga tianl o1g9i6n4g,- ainn-dP tuhbe lIincasttiitounte D oaf tMaedicine in 1970. posed froading styl Ttohne, DmBIn.eaCcdsl.eiu,c ddSa eole spni mit np. pda2lpe0icxe-a2r.st2i o,p n1res9s 8oe5nf tnaenuddc al eot aragr sawynamizr.pedo suiunmde rh ethlde aatu sthpeic Nesa toifo nthael AIncsatidteumtey o of fM Secdieicnicnees., Washing- n recomeaks, he CPsoyncgh1ro.elsNosgeusicc.l ae3la. raN swpuaecrclfetasar—re —wCaoHrnfyaggrreiee—snsieEcs n.a v5sip.r eoNcnutmsc—leenaCtrao lwn agasrrpfeeascrsetes—s—. 2SC. ooEcnmigaelr eragsssepenescc.y t4s m—. NeCduoiccnlaegla rrse ewsrsvaeirscf.ae Irs.e— S—olomon, eebr Fredric. II. Marston, Robert Q., 1923- . III. Institute of Medicine (U.S.) bd [DNLM: 1. Nuclear Warfare—congresses. 2. Radiation Injuries—congresses. 3. Radioactive Fallout s or —adverse effects—congresses. WN 610 M4865 1985] aw k hs, RA648.3.M445 1986 363.3'498 86-18134 worgth ISBN 0-309-03692-5 n nal e le ISBN 0-309-03636-4 (pbk.) gin Copyright © 1986 by the National Academy of Sciences the original; li Nino t hpea rfto ormf t hoifs a b pohookn mogarya bpeh irce prercoodrudciendg ,b nyo arn my amye ict hbaen sictoarle, dp hino tao greratrpihevica,l osry estleemctr, otrnainc spmroitcteesds o, ror ofori otherwise copied for public or private use, without written permission from the publisher, except for on he the purposes of official use by the United States government. atio t Cover photo: Nagasaki, 10 August 1945, 11 A.M. The heavy overcast of smoke from fires cut off the presente true t sNCuaintgylia agsnhadtk. iNT Rhaaegi alnwsaaarkryio SCwtai tptyia.o tRnh.,e (paPrloihnnotgteo dwg brhayic pphhe trbhmye i Yswsöoisouunnk deoe fY dBa aamrsaeic hb aBetioano.g)k Csc,ao Irpnrycier.,id gP houtnb ©slit sr1he9etc8rh1s.e brys, Hleiarodssh tioma alreks ar AM evdidiceiontea,p Oe fdfiigcee sot fo Ifn sfyomrmpaotsiiounm, a ht i2g1h0li1g hCtso niss taitvuatiiloanb lAe.v Feonru ein, fNoWrm,a Wtioans,h winrgitteo nth, eD ICn s2t0it4u1te8 .of gitea Printed in the United States of America dibr First Printing, September 1986 ew ge Second Printing, September 1988 na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. iii ee hb mtot n on fra not er, c Institute of Medicine k, ev ow per bong, ho Steering ComImmipttleicea ftoiorn tsh oe fS Nymucpleoasiru Wm aorn the Medical al pamatti e origincific for ROBUEnRivTe rsQit.y oMf AFlRorSiTdaO, NG,a inMes.Dvi.l le(IOM), Chairman, President Emeritus, he HERBERT L. ABRAMS, M.D. (IOM), Visiting Professor, Department of tp d from etting-s DStiaangfnoorsdt iCc enRteard fioorlo Ignyte, rnSattaionnfoarl dS eUcunriivtye rasnitdy ASrmchso Cool ntorfo lMedicine, and s createer types WILPHLsIayArcvMhair adt rMRy.,e dCiBhcEailldA SrRecnDh'osS oLHlEoEsp, itaMl .MDe.,d icCalli nCiceanlt erD, airnedc toArs, sisDtaenpta rPtmroefenst soor,f eh filot K. SUNE D. BERGSTROM, M.D., Ph.D. (IOM, NAS), Professor of L d m XMes, an THOCMhAemSi sCtr.y ,C KHaAroLlMinsEkRa SIn, sMtit.uDte. (IOM), Distinguished Service Professor of posed froading styl DAVMNIDeewd i cSYi.no erGk, PRCrEietEysiRde, ntM a.nDd. D(eIaOnM E)m, eDrietuasn, Tohfe MMeoduincti nSei naain dM ePdriocafel sCsoern teorf, me n recoeaks, h ALECXoAmNmDuEnRity HLeEaAltFh,, BMro.wDn. U(nIOivMers, ityNAS), Ridley Watts Professor of eebr Preventive Medicine, Harvard Medical School, and Chairman, Department s bord of Preventive Medicine and Epidemiology, Massachusetts General Hospital work hagths, w JENNCIoFmEmRu nLityE AHNeaIlNthG P, lanM.D., Chief of Emergency Services, Harvard n GILBERT S. OMENN, M.D., Ph.D. (IOM), Dean, School of Public Health and nal e le Community Health, and Professor of Medicine and Environmental Health, gin the original; li JEANUNniEv ePrsEiTtyE oRfS WOaNs,h Uinngittoend Nations Office of Population ofori CHESTER M. PIERCE, M.D. (IOM), Professor of Education and Psychiatry in on he the Faculty of Medicine, the Graduate School of Education, and the Faculty atio t of Public Health, Harvard University presente true t THEIOntDerOnRatEio nAal. SePcOurSitTyO aLn,d APrhm.Ds .C, oSnctrioenlce Fellow, Stanford Center for alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn IOM, Member of the Institute of Medicine ogi Abori NAS, Member of the National Academy of Sciences Copyright © National Academy of Sciences. All rights reserved. iv ee hb mtot onn FREDERICK C. ROBBINS, M.D. (IOM, NAS), ex officio President, Institute fra k, not ever, c oEfp ideMmeidoilcoignye and(1 B98io0s-t1a9ti8s5ti)c,s , CUanseiv Werseisttye rn PRreosfeersvseo rS, choDoel poafr tMmeednitc ineof ow ARTHUR C. UPTON, M.D. (IOM), Professor and Chairman, Department of er bog, ho Environmental Medicine, New York University School of Medicine pn FRANK VON HIPPEL, Ph.D., Professor, Woodrow Wilson School of Public al pamatti and International Affairs, and Center for Energy and Environmental e origincific for Studies, Princeton University he Institute of Medicine tp d from etting-s es President s creater type SAMUEL O. THIER, M.D. eh filot L d Mn Project Staff m Xes, a FREDRIC SOLOMON, M.D. (Project Director), Director, Division of Mental osed froding styl MARHCe alMthE aSnSdI BNeGh a(vDioerpaul tMy ePdriocijnecet, IDnsitrietuctteo ro)f, MSteadfifc iCneonsultant, Institute of mpea Medicine n recoeaks, h NANCY WINCHESTER, Editor, National Academy Press eebr bd s or aw k hs, worgth n nal e le gin the original; li ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. CONTENTS v ee hb mtot n on fra not er, c CONTENTS k, ev ow er bog, ho pn al pamatti e origincific for he d from tetting-sp ForLeewwoisr dThomas, M.D. ix es s creater type PreRfoabceert Q. Marston, M.D., and Fredric Solomon, M.D. xiii eh filot ML nd Understanding and Preventing Nuclear War: The Expand- 1 m Xes, a ing Role of the Scientific Community osed froding styl Part I NuDclaevaird W A.a Hr awmitbhu rMg,o Mde.rDn. Weapons: Physical Effects and pa n recomeaks, he EPonsAvsiitrbtoalecn kmFsa eitnna ltoiatril e nCse ofarnro sUmeqr bSuauenpn eAcrefrsieraess Following Nuclear 15 eebr bd Theodore A. Postol, Ph.D. as wor A Review of the Physics of Large Urban Fires 73 k hs, H.L. Brode, Ph.D., and R.D. Small, Ph.D. worgth n nal e le gin the original; li ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. CONTENTS vi ee hb mtot onn Recent Assessments of the Environmental Consequences 96 fra k, not ever, c oRfi cNhuacrdle Par. WTuarrco, Ph.D. ow Nuclear Famine: The Indirect Effects of Nuclear War 117 er bog, ho Mark A. Harwell, Ph.D., and Christine C. Harwell, J.D. pn Nuclear Winter: The State of the Science 136 al pamatti George F. Carrier, Ph.D. e origincific for AtmRoosbpehrte rCic. MPearltounrbea, tPiohn.Ds .of Large-Scale Nuclear War 141 he Possible Toxic Environments Following a Nuclear War 155 tp d from etting-s RadJioohanc tWiv.e B Fiarkllso,u Pth.D., and Sherry L. Stephens 167 es Charles S. Shapiro, Ph.D., Ted F. Harvey, Ph.D., and s creater type Kendall R. Peterson, M.S. eh filot Part II Health Consequences of Nuclear War L d m XMes, an Casfuroamlti eVsa Driuoeu st oH tyhpeo Bthleatsitc, aHl eNaut,c alenadr RAattdaicokasc otinv eth Feallout 207 posed froading styl UWvoninlil tiHeadimp S pDtealat,eu Psghh.eDrt.y, Barbara Levi, Ph.D., and Frank me n recoeaks, h AcuJotes eRpahd Riaotitobnla Mt, oPrhta.Dli.ty in a Nuclear War 233 eebr Burn and Blast Casualties: Triage in Nuclear War 251 s bord Jennifer Leaning, M.D. work hagths, w FooAdl eaxnadn dNeurt rLiteiaofn, Min. Dth.e Aftermath of Nuclear War 284 n nal e le gin the original; li ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. CONTENTS vii ee hb mtot onn Psychological Consequences of Disaster: Analogies for the 290 fra k, not ever, c NJaumcelesa Tr hCoamsepson, Ph.D. ow The Immunological Impact of Nuclear Warfare 317 er bog, ho David S. Greer, M.D., and Lawrence S. Rifkin pn Expected Incidence of Cancer Following Nuclear War 329 al pamatti Nikolai P. Bochkov, M.D., and Per Oftedal, Ph.D. e origincific for GenPeetri cO Cftoendsaelq, uPehn.Dce.s of Nuclear War 337 he tp d from etting-s Part III MeNduiccalle aRre Wsouarrce Needs and Availability Following s createer types MTheeHd Ciecroabnle sSreutq pLup.e lAnycb aernsa dmo fDs ,Ne Mmuc.aDlne.dar i nW aa rP:o Astn-N Euccolneoamr-Wic aarn Wd orld 334891 eh filot Social Perspective L d m XMes, an Hal Cochrane, Ph.D., and Dennis Mileti, Ph.D. posed froading styl Part IV ImtCaigvheeilssd arennd's R ainsdk sA odfo Nleusccelenatsr' WPearcre: pPtisoyncsh oofs othceia Tl hPreerastp oefc- 413 me n recoeaks, h NWuilcllieaamr WR. aBr:e aImrdpslliecea,t iMon.Ds .of Recent Studies eebr Scandinavian Youth View the Future: A Preliminary 435 s bord Report of a Large Questionnaire Survey work hagths, w AdMulta Bgneeli eRfasu, nFdeaellienng, sP, ha.nDd. ,A acntdio Onsl eR Jeoghaardni nFgin Nnouyclear 444 n War: Evidence from Surveys and Experiments nal e le Susan T. Fiske, Ph.D. gin the original; li ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. CONTENTS viii ee hb mtot onn Hope and the Denial of Stress in the Nuclear Age 467 k, not frever, ca TheS hNloumcloea Br rAezrmnistz R, Pache.D a.nd the Psychology of Power 474 ow Jerome D. Frank, M.D., Ph.D. er bog, ho Managerial Demands of Modem Weapons Systems 485 pn John D. Steinbruner, Ph.D. al pamatti Sources of Human Instability in the Handling of Nuclear 490 e origincific for WHeerabpeornt sL. Abrams, M.D. he The Impact of Crisis-Induced Stress on Decision Making 529 tp d from etting-s Alexander L. George, Ph.D. s createer types Part V LonfVrgioe-mTwe NIrmuc Cleoanr sWeqaure:n Tcewso o Vf aienwds Prospects for Recovery 555 eh filot Carl Sagan, Ph.D. L d m XMes, an VieLwy nInI R. Anspaugh, Ph.D. 566 posed froading styl CoSnuclmumdianrgy Ranedm Paerrksspective: With Some Observations on 583 me n recoeaks, h IHneforbrmeret dL C. Aobnrsaenmts, M.D. eebr s bord Glossary 589 aw work hgths, Biographies of Contributors 599 n nal e le Index 607 gin the original; li ofori n e oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved. FOREWORD ix ee hb mtot n on fra not er, c FOREWORD k, ev ow er bog, ho pn al pamatti e origincific for I was in Europe at the time of the Institute of Medicine's symposium, and I he ed from tsetting-sp rBaenranidtoi suthhn ecn eeamwccesonputa pnwetasr sso .t fhB atahtn ean enmru echeleteiaandrg lwi nianer s t,wh leeo auhdled as ctdoalriuniseeess ,A forIfoD ntSht .ep aFgreesn cehv,e rGyewrhmearne., Tanhde s creater type deficiNenoc my aatste ar tchoant stehqeu reenacle A fIoDr Sth ies scuaruvsievdo rbsy o af vrairduisa.t iTohne, mcoanlncueptrti toiof ni,m bmuumnse, eh filot grief, and other assaults of nuclear bombardment was compelling. ML nd It was as though the problem of hydrogen bombs had suddenly turned into m Xes, a something the writers could lay hands on. Something to sit down and think osed froding styl austbnootrhuieitns, k,a acnbodln ect ionmmuaeptdtoe soresn .a i Tnfsoroi dnbete p psaauggreees ,s, ttgohirevyri ena gbw osueortm;e seso onmmeweet h elisinntgiem sd aiaftefte srt hoenef tt bhfroeo tntmoum mal blo etfrh sot hoseef pa n recomeaks, he phtheeeao lp"thlne u cctaolre eab rse y wsktiienllmteed rd" oosiucntegrni gaahnrityo tb.h yBin ubgtl aeisvt te wnaa nmsd aAbrIguDimnSas l,tl hytha ute s ceuaftuutegl,rh ati nmtdhp eso osamsttieben ilmtiitoeynn toiofof n at nhoyef eebr bd press, AIDS that made the story. as wor When I got back to New York a few days later, the whole story had k hs, vanished from the papers, but I found clippings from most of the earlier reports worgth that had appeared in the national papers and news magazines. Same story: AIDS. n nal e le And then that was the end of the matter. No more stories in the days and ofthe origioriginal; lin wthoue nengkorsry m thfaoalrt: ftteohlleel ovswitsueiocdnk, , n itonhtce o atnbacolkluu tso itfvh een emGwee dtnaielcvkaasl, ctaaorlnmkssse, qctuohenen tcrhoealsr atoanflg knusu,e cstlr eebaayrt yws vtaairto.e lsBamtaioecnnk n e talks, editorials saying that neither side can trust the other or ever oh atio t presente true t alreks ar gitea dibr w e eg na his s. P Te file: ng fil DF etti Pes this al typ utn ogi Abori Copyright © National Academy of Sciences. All rights reserved.