Radiation [full issue]

he magazine of the World Health Organization UKr..2 3d USA: 0.50 JANUARY 1969 adiati D radiation The cover symbolises the use of radioisotopes in medicine. (Photo by E. Mandelmann). Back cover shows the inside of a reactor, (by Paul Almasy). Contents Friend and foe . . 3 Understanding the atom 4 Atoms for health, by Nigel Calder . . . 8 The dangerous atom, by Robert Plant . . 14 In the service of all, the International Atomic Energy Agency . 19 Ris6, a constant watch on food, by Gino Levi 24 Protection 26 Books 30 This issue contains an index of World Health covering 1958-1968 0 lif +1 . 2 The bomb which burst over Hiroshima started an era. From that day man was forced to live with and try to control a new, powerful source of energy. The elements that compose the world, once seen as stable and everlasting, were now perceived to be capable of radical transformation into chemical elements man had never known before. Man has learned to manage other sources of power, but it took time. When and how he discovered fire will probably always remain unknown nor are we likely to find out who first hoisted a bit of bark in the air to let the wind push his little canoe along. Even steam was slow in being introduced —many years went by from its first use to pump water from the mines until it was put to work pulling carts loaded with coal and eventually replaced horses. The march of electricity was more rapid but again a long time was to elapse before it became a major source of energy with far-reaching implications for man's life. But atomic power literally burst into the consciousness and way of life of mankind, all of mankind. Whether a country employs nuclear power or burns logs, as long as atom bombs are exploded in the air, fallout continues to descend upon it in a steady and invisible rain. However, nuclear science, for a variety of reasons, has rapidly been pressed into peaceful service as well—on ocean-going vessels and in power plants, for tracing water sources underground, _through the living cells of plants to tell us how growth takes place and even inside the human body to furnish information available in no other way: the use and abuse of the atom are with us to stay. From the earliest discoveries of radioactive matter, man has been obliged to realize the dual nature of this force. Radiation can cure and radiation can kill. Radiation can burn and radiation can help us pierce the mysteries of our universe. Radiation can deform our biological heritage and eliminate noxious elements in the blood. Jekyll and Hyde are the same. The atom is our friend and foe. With its possibilities and dangers clearly in mind, World Health devotes this issue to radiation. Man is still learning how to live with and manipulate a new and mighty source of power. It is up to him to use it for constructive purposes and not to let it damage long lines of decendants still unborn, if not humanity altogether. friend and foe A view of the bubble chamber at the European Nuclear Re- search Organization (CERN) in Geneva. 3 / tl / I arpAw'' / // I \ ■ miintimmasownw milimmors' Making the atom radioactive I. When a neutron strikes an atom this is what happens: an accelerated neutron crashes into a stable atom consisting of three protons and three neutrons around which orbit electrons. The neutron has penetrated the atom upsetting the balance. The atom has become radioactive or "unstable". A beta particle has already left the radioactive nucleus and the atom is now stable again but it contains four protons instead of three and is surrounded by four electrons. The atom's chemical nature is now chan- ged and has become another element. Beta particle PROTON NEUTRON • Accelerated neutron understanding the As you read these lines, your body is under bombardment by streams of radia- tion pouring in from outer space -- the cosmic rays. Other forms of radiation from radioactive atoms in the earth itself add to the intensity of the attack; some of these may be emanating from the walls of the room in which you are sitting, in fact they probably are. Within your body itself, particularly in the bones, radio- radiation without any harmful conse- quences. In other words, high natural radiation provides a safety mark, showing us that we can take at least that much radiation. Radiation thus forms a permanent part of our environment, but it is only recently that we have begun to understand what it is all about. Radioactivity is a characteristic of an atom that discharges radiation. Radiation is a transfer of energy. Radiation is not necessarily radio- active in origin. Any atoms having the same num- ber of protons and electrons are isotopes. active substances are pouring out particles that penetrate the living tissue. If all these particles can be likened to bullets, then your body is being riddled with machine- gun fire from all angles at all times, day and night. Yet you are still alive, and presumably none the worse for it. Natural radioactivity has not prevented life from evolving on earth, nor man as a species from develop- ing his position of pre-eminence. From this it may be assumed that irradiation of the magnitude normally encountered in our environment cannot do us any great harm. As the scientists say, we are "in biological equilibrium" with this phenomenon. And since natural radiation in certain parts of the world is known to be several times the average without apparently causing ill effects, it is reasonable to conclude that man may expose himself to additional artificial radiation of about the same magnitude as the average background Not so wild a dream Man has been looking for a way to change the structure of things for a long time. During the Middle Ages, the fires of alchemists' stoves showed that the search to transmute metals was going on. It was never to succeed but the very failures laid the base of modern chemistry. Later inves- The three R's. The potency of radiation in all forms is measured in three ways. The röntgen gives the amount of radiation absorbed in air at a given point. The rad gives the amount of radioactive energy actually held in a gram of any material. The rem indi- cates the degree of potential danger to health, and is the rad multiplied by a given factor of potential danger. The radiation to which the average citizen is exposed is made up almost wholly of the fast-moving, highly- penetrating X-rays, gamma rays and beta rays, where rem and rad are equal. (See section on danger for tolerable levels of radiation to man.) tigations showed that there were about ninety substances that could neither be broken into simpler ones nor synthesized from others already known. They were called the elements. This meant abandon- ing the search for a philosopher's stone to change one element into another. The nineteenth century was sure that in this respect the end of the line had been reached since the unchangeable foundations of nature were known. A cluster of discoveries during the last decade of the nineteenth century were to start a revolution in knowledge which is still going on and were to lead to the alchemist's dream being realized in an unexpected way. Röntgen was the first to use X-rays in order to study bone structure that was previously invisible. As early as the first year of Röntgen-ray use, reports began to come in about "changes of the skin similar to the effects of sunburn" which later proved to be various forms of radiation damage. Thus side by side with progress, a new series of dangers was being revealed. However, the determination and selfless devotion of such people as Röntgen and the Curies, showed that radiation could be used for man's advantage. There is no doubt that the more we know about the elements which compose our world the better we will be able to use them to good purpose. The basic facts All tangible things around us—the chair we sit in, the pencil in our hands, and we ourselves—are combinations of elements; each of these has certain physical and chemical properties. The smallest particle of an element is called the "atom". The atoms themselves are not little building blocks but are more like tiny solar systems in which a nucleus consisting of neutrons and protons has a number of electrons circling round it. Each atom of the same element has the same number of Landmarks 1895: W. C. Röntgen discovered X- rays. 1896: A. H. Becquerel discovered radio-active radiations emitted by uranium compounds. 1898: Marie and Pierre Curie an- nounced the discovery of polonium and of radium. 1898: P. Villard discovered gamma rays and found them to be the same type of ray as the X-ray. 1906: H. Geiger with E. Rutherford developed an instrument to detect and count alpha particles. 1910: F. Soddy suggested the exist- ence of atoms with different atomic mass but identical chemical proper- ties; such atoms would be called isotopes. 1913: N. Bohr suggested an atom model with a central nucleus and electrons moving in certain orbits around it. 1919: E. Rutherford by bombarding nitrogen atoms with alpha particles was the first person to artificially transform one element into another, namely nitrogen into oxygen. 1932: J. Chadwick announced dis- covery of the neutron. 1940: Several hundred artificially created radioactive isotopes had been discovered. Some were used in ther- apy, others served as tracer sub- stances to trace physiologic processes. 1945: Atomic bombs were exploded on July 16 in New Mexico, August 6 in Hiroshima, and August 11 in Nagasaki. 1946: Headquarters, Manhattan Pro- ject, Washington, announced the availability of a number of tracer and therapeutic radioisotopes to scientific laboratories. protons in its nucleus and electrons in orbit; these determine the chemical pro- perties of the element. However, two atoms of the same element may have an identical number of protons and electrons but a different number of neutrons. Thus one nucleus will be heavier, that is to say contain more neutrons, than another. Doing what comes naturally When the number of protons and neu- trons becomes too great the nucleus begins to break down, or rather to unload protons and neutrons. This may be inherent in some forms of unstable matter such as uranium, or else be induced artificially. In either case, this unloading or emission of radiation in the form of a stream of particles, or rays, is known as radio- activity; the atom emitting the rays is called a radioisotope. The best known of the naturally radio- active substances are probably radium and uranium, and these are still widely used by man for his own purposes; in a similar way he harnessed other natural sources of energy, for example running water and the wind. Like the rivers and the wind, these radioactive substances are always there. They can be used, they can be diverted or obstructed to some extent, but they cannot be obliterated. Natural radiation, like many other natu- ral phenomena, is not totally harmless. The point is rather that life flourishes not- withstanding, so that the damage done to the sum of mankind is almost negligible. It has been estimated, for example, that natural radiation accounts for about 10 per cent of the incidence of leukaemia, a comparatively rare disease in which the white blood corpuscles multiply at the expense of the red (see World Health, June 1968), causing glandular trouble and The top of an atomic pile in a French nuclear centre. Below, maintenance work inside the vacuum chamber of a 600 MeV synchro-cyclotron at the European Nuclear Research Organi- zation (CERN) in Geneva. finally, in time, death. From this it is possible to calculate the likely increase in leukaemia resulting from background radiation at various levels, if one assumes that there is a simple arithmetical relation- ship between the two—double the radia- tion, double the number of cases attri- butable to this cause. This assumption is made because at present we have no means of knowing why a particular person exposed to minute doses of radioactive matter shows ill effects while tens of thousands, if not millions, of individuals in the same envi- ronment show none. For practical pur- poses we can only assume that it is a question of chance, and that the chances of a particular person being the unlucky one are remote. Therefore, the only way to safeguard the unknown individual who might be struck down some day is to pro- tect the entire community. Control of the radiation level is thus a public health responsibility if ever there was one. Apart from the way in which it is pro- duced, there is nothing really "artificial" about artificial radiation to distinguish it from natural radiation. Whereas uranium, for example, has been emitting radiation of its own accord for millions of years, man has only recently learned, through the use of electricity or by splitting the atom, to set this process going. Scientists can now upset the balance of almost all known atoms, by adding a neutron to the nucleus and so 6 An ejected proton beam (CERN) Alignment of the drift-tubes contained in the resonant cavi- ties which make up the linear accelerator. Protons enter from the ion source column at the top of the photo (CERN) causing a discharge of particles, thus making the atom radioactive. However, whether these "live" atoms are artificially triggered off or derived from naturally radioactive materials, they discharge the same radiation and for practical purposes their uses in medicine and industry are the same. What is important, therefore, is not the origin of the process but rather the type and quantity of radiation. The ABC of ABG There are three kinds of radiation known as alpha particles, beta particles and gamma rays, each of which has certain advantages and drawbacks. Some rays are more potent in their biological effects than others; alpha particles, for example, are ten times as harmful as X-rays, beta par- ticles or gamma rays. Alpha particles, luckily, have little penetrating force— generally speaking they cannot penetrate even this sheet of paper; hence they do not constitute a considerable outside health risk to the body. On the other hand, they are quite dangerous if radioactive sub- stance has entered the body (by inhalation or through a wound). Thus workers hand- ling radioactive substances in industry require suitable protection. Gamma rays are deep-penetrating radia- tions, similar to X-rays, which are electro- magnetic waves, not streams of physical particles. In industry, gamma rays are in fact often used for the same purpose as X-rays, by means of a small portable apparatus loaded with a capsule of radio- active matter. These instruments are much handier than X-ray installations—many of them are no bigger than a football—but X-rays can be switched off, while the radioactive substance in such capsules never ceases to emit potentially harmful rays, both beta and gamma. This illus- trates that the origin of the rays does not alter their effects, but the technique for producing them can be an important factor in occupational safety. ■ by Nigel Calder r ATOMS for health A critically injured man arrives at the hospital after a car smash. Among other injuries, there is damage to his left kidney, and the surgeon proposes to remove it. But wait—what about the right kidney? Is that one healthy and working normally? If not, removing the damaged kidney may be tantamount to passing a sentence of death on the patient. The surgeon might quickly look at the other kidney, but a normal appearance and feel are notoriously un- reliable signs of the true state of a kidney. If the accident victim is lucky, he has been brought to one of the few hospitals that are equipped to check, in just ten minutes, whether a kidney is working pro- perly. The medical team place a counter for detecting atomic radiation at the pa- tient's back, facing the kidney. They inject a special chemical compound containing radioactive atoms of iodine into a vein. Within one minute, the presence of radio- active material in the kidney will be registered by the counter. In a healthy kidney the radioactivity continues to rise for four minutes and then drops sharply as the kidney absorbs and disposes of the chemical. If the kidney is defective the radioactivity will neither rise so much nor fall off so quickly. Just by looking at a graph, or "renogram", of the counter read- ings as they change during ten minutes, the surgeon will decide whether the "spare" kidney can be relied upon to do its job when he removes the other. "Soon it will be as widely used as X-rays for finding out what's wrong with a pa- tient." Dr Walter Seelentag, World Health Organization authority on nuclear tech- niques in medicine, makes that forecast for the routine clinical application of minute doses of radioactivity to obtain informa- tion about the living body. Even today, it is difficult for a physician to picture what is happening behind the opaque walls of skin and bone; all too often he may fail to diagnose a serious condition until the pa- tient's life is in danger. Any technique that helps the physician in this critical phase of his work is at least as important as the development of better ways of treating the patient once the disease has been identified. In more and more hospitals, staffs are using, in addition to conventional methods, "radioisotopes"—radio-active forms of the ordinary chemical elements—to help them in diagnosis. We are concerned here with an awaken- ing to the possibilities, rather than with a wholly novel technique. Even before the Second World War, before the big deve- lopments in nuclear energy which made artificial radioisotopes much easier to obtain, some far-sighted biologists and medical research workers saw the oppor- tunities. Radioisotopes are by now nor- mal tools for research in leading medical laboratories, and important advances in physiology and medicine have depended upon them. Spying on the body Since 1945, clinical techniques, too, have developed—to the point where there are currently more than thirty different aspects of bodily condition and function judged amenable to reliable and safe investigation with radioisotopes, as a matter of routine. Dozens more are pending. But Dr Frank Barnaby, a. medical physicist of London who has made an up-to-date catalogue of these uses, also estimates that, so far, fewer than ten per cent of British hospitals are using radioisotopes. That low score, even in a country that has pioneered nuclear energy and radioisotope applications, is a measure of how much scope there is for the big and early expansion that both Seelentag and Barnaby anticipate. As a means of finding out what is going on inside the body, a radioisotope is really not more mysterious than an X-ray machine—or even a simple laboratory test. Think of the doctor getting the organs of the body to reveal what they are doing, by a kind of espionage, in much the same way as a spy with a secret radio trans- mitter can be sent to reveal the movements of an army to which he is attached. A radioisotope is such a spy. Although it is doing service as an ordinary chemical compound, it is radioactive. In chemical reactions and living processes, its atoms behave just like the ordinary, stable atoms of which the world is mainly composed. But, one by one, the atoms of the radio- isotope throw out atomic radiation— thereby revealing their positions. The radiation from medically useful radio- isotopes is usually of the types known as beta and gamma radiation, the latter being easier to exploit in diagnosis because it can penetrate right through bone and skin to detectors outside the body. Radioisotopes are usually made by bombarding ordinary stable materials with particles in a nuclear reactor or an "atom-smashing" machine. Scientists can label, with the radioisotopes, substances to be fed or injected into patients, so that the fate of those substances in the body can be traced. Radioisotopes used in this fashion are often called tracers. They can show what is happening in the blood, for example, in the liver, or even in the depths of the brain. Consider the radioisotopes most widely used in medicine, those of iodine. Ordinary iodine has an atomic mass 127 times greater than hydrogen and is therefore known as iodine-127. Its atoms last for ever. Other forms of iodine have slightly greater or lesser mass and are radioactive. Some very rapidly give off their radiation, thereby changing into other elements, in a matter of seconds or hours. Others, iodine- 125 and iodine-131, decay more slowly, in a matter of days or weeks, and are general- ly more convenient for clinical purposes. The shorter-lived radio-isotopes are some- times preferable, especially from the point of view of minimizing the radiation to which the patient is exposed. In most cases, they are available only in hospitals near a reactor or an atom-smashing machine (some have their own cyclotrons). But others are produced by the decay of a different, longer-lived radioisotope. Iodine-132 is a case in point. It decays in a few hours, so it cannot be shipped to a distant hospital. But tellurium-132, which lasts for several days, produces iodine-132 as it decays—so it serves as a transportable "cow" that can be "milked" of iodine-132 when required. Radio-iodine test for thyroid in the Research 9 Institute for Nuclear Medicine, Heidelberg. The medical team can use radioisotope tracers in two main ways. The first is to study dynamic function—the rates at which materials are absorbed, diluted, altered or lost by organs or by the body as a whole. The kidney test by radio- isotope renogram is one way. To take another similar example, some anaemic patients lose blood by bleeding into the gut, to an extent hard to determine by conventional means. If radioactive iron-59 is injected in solution into a vein, it becomes incorporated into the red pig- ment of blood, haemoglobin. In a healthy patient, the total radioactivity will fall off steadily at a predictable rate. If a patient is bleeding into the gut, he will be losing some of the iron-59 by that route, and the total radioactivity will therefore fall off more rapidly. In this case, the most conve- nient radiation detector is a whole-body counter; the patient is totally enclosed for a brief period in a box screened by 15 cm and more of iron or other shielding mate- rial from external radiation, and counters inside the box record the radiation coming from the whole of his body. Whole-body counting is a very sensitive technique and extremely small doses of the radioisotope are therefore sufficient. Radioactive gases serve in studies of the lungs in action. The radioactive form of a heavy gas, xenon-133, provides one of the means of studying the ventilation of diffe- rent regions of the lung and also the exchange of gases between the lung and the blood. For the first purpose, the patient breathes through a tube leading to a closed air circuit that removes the carbon dioxide from his breath. The air in this circuit contains xenon-133 and five minutes' breathing is ample to reveal, to counters deployed around his chest, whether the radioactivity is evenly distributed through- out the lungs or whether it is missing in some positions. For other diagnostic purposes, a saline solution of xenon-133 is injected into the vein supplying the lungs; when it reaches the lungs nearly all of it passes out of the blood into the air in the lungs. The patient holds his breath for a few seconds and the distribution of radioactivity shows whether the blood supply and the blood gas exchange is uniform throughout the lungs. Xenon-133 in solution in the blood pro- vides, in addition, a way of detecting obstructions of the blood supply to various organs. The material is simply injected into the appropriate blood-vessel—the coronary artery supplying the heart, for example, or the internal carotid artery leading into the brain. If the blood flow is normal, a counter will show the radio- isotope being quickly swept into the organ —and quickly out again. In disease, with sluggish blood flow, the tracer may linger. The second main way of using a radio- isotope in diagnosis is to see exactly where it goes in a particular organ, by scanning 10 the surface of the body, using a counter with a fine aperture. The most important purpose for the radioisotope scanning technique is in the detection of tumours. The cells of a tumour are growing and dividing more rapidly than the normal cells of the body and radio-isotopes will therefore tend to be taken into and to show up in a tumour more prominently than in surrounding tissues. In the case of a brain tumour, local damage may admit mate- rials, including radioisotopes, into regions normally protected against chemical inva- sion. In early American work in the inves- tigation of brain tumours, iodine-131 served as the tracer and the counter was simply scanned manually across the pa- tient's head. Since then, many more organs have been covered, the number of radio- isotopes used has increased, and scanning and display techniques have been greatly improved. Bone tumours may be revealed by taking up abnormal amounts of radio- active fluorine-18, while the pancreas, previously very resistant to diagnosis, can be persuaded to take up amino acids labelled with selenium-75. As for the instruments, the pioneers' manual scanning with a gamma-ray coun- ter gave way first to automatic mechanical scanners which carry a counter slowly to and fro across the body region concerned. A complete scan may take 20-30 minutes. The level of radiation detected by the counter can be used to regulate a light Whole body counter in scan- ning bed. An injection of iodine 131 to observe concentration in the kidneys. The control desk for a scin- tillation camera for viewing concentration of radioactivity seen in photos right. 11 Geography of the human body Sir Edmund Hillary, conqueror of Mount Everest goitre among the Sherpas. At right of photo below This photo, or rather compo- site of a series of photographs, shows isotopes revealing the inner geography of the body. Isotopes recorded in photogra- phic form can show where vita- mins or medicines are distri- buted or in some cases where blockage occurs. These photo- graphs were taken by a scintilla- tion camera. source directed at a photographic film. In another system, the counter readings are used to generate dots of different colours on a sheet of paper, according to the radiation intensity. Either method gives the physician a graphic picture of the accumulation of radioactivity. Scans made from different positions around the head and superimposed on corresponding X-ray plates will allow the shape, location and size of a brain tumour to be determined precisely. During the past ten years, "gamma cameras" have been developed which view the whole of the area of interest at one time, through an array of tubes "looking" at particular positions. The pictures are usually rougher than those produced by slow scanning, but they are made in a minute or two. Speed is an advantage, and not only in saving time and reducing the period for which the patient has to keep still; it allows the doctor to watch changes in the location of the radioisotope. Isotopes in the Himalayas In the isolated Himalayan village of Phortse, 14,000 feet above sea level, practically every inhabitant suffered from goitre caused by iodine deficiency. A New Zealand medical team which arrived in 1966 found that fully one-quarter of the Sherpa villagers were either classical cretins or else deaf mutes. The New Zealanders had struggled up there with equipment that included radioisotopes and detectors, in part fulfilment of a promise of a mountaineer. When, with the help of the Sherpas, Sir Edmund Hillary conquered Mount Everest, he said he would return with medical aid. Because goitre, and related diseases of the thyroid gland in the neck, are common among the Sherpas, and because iodine is a key element in the function of the thyroid, radioactive iodine tracers played a vital part in the work of this medical expedition. The setting was unusual, but the tech- nique was not. Radioisotope investigation of the thyroid is the best known and most widely performed of all nuclear techniques in medical diagnosis. If the patient swal- lows a solution of sodium iodide, label- led with a radioactive form of iodine, in normal conditions about a third of it finds its way into their thyroid glands within 24 hours. Both the scanning and dynamic techniques for using radioisotopes can be applied to diagnose thyroid disease. Thus, pictures made by the gamma-rays coming from the neck may show that one or both of the lobes of the thyroid is underactive or overactive. On the other hand, the function of the thyroid gland is to make hormones containing iodine, which are then incorporated with the proteins of blood plasma; other iodine finds its way 12 into the urine. Simply by taking blood and urine samples, therefore, and by measuring the radioactivity in them, it is possible to get a good impression of thyroid activity. Before studies with radioisotopes began, only three types of thyroid disease were normally recognized by physicians; now about ten types are distinguishable. That is a matter of more than academic interest, because the appropriate treatment is helped establish a hospital to alleviate endemic Hillary with radioisotope counting equipment. 41111 different for the various types. In one form of thyroid malignancy, thyroid-type tissue can find its way into other parts of the body, for example the lungs, and there take over some of the functions of the thyroid. Such "metastatic" thyroid tissue can be detected by its marked uptake of iodine radioisotopes. The last test has to be done in special centres, but the simpler checks for goitre now provide the principal use for radio- isotopes in medical diagnosis for the developing countries. It would be foolish to exaggerate the importance of other applications in countries where mal- nutrition and infectious disease shorten life. Human needs as well as public health priorities at present make attention to cancer, or to the subtler metabolic diseases that figure in other radioisotope applica- tions, less urgent. In any case, the supply of radioisotopes may be relatively difficult to arrange. Yet medical research done with radioisotopes may be highly relevant to the needs of developing countries—for example in studies of protein malnutrition, or mechanisms of parasitic diseases. In the industrialized countries, three great barriers have stood in the way of Sherpa undergoing examination. widespread adoption of this new aid by the medical profession. All three are now crumbling. First, and psychologically most important, is the all too well-founded fear of radioactivity and the possible injury it can cause to an individual or his off- spring. In a world that has learned to oppose casual exposure to radiation and the scattering of radio-activity by explo- sions of nuclear weapons, the idea of feeding radioactivity to a patient "merely" for diagnosis seems at first hearing detest- able to the medical mind. There is a fair analogy with diagnostic X-ray pictures. In principle, X-rays can be dangerous to health; in practice, at low exposures and in the hands of skilled radio- logists and their radiographers, the risks may be very small compared with the benefit to the patient's health that come from accurate diagnosis. It takes time and ample records of successful experience to persuade the profession, however, that many of the radioisotope techniques can make do with very small doses of radio- activity and that there is no sign of harm to patients observed over long periods. In other cases, there may be good reason for questioning the clinical application of radioisotopes when the required doses may be judged potentially harmful to the patient. As in the case of X-rays, radio- isotopes are not given to pregnant women and very young children unless deemed essential. The ordinary physician does not know a great deal of physics and he may be puzzled by the procedures and instruments used in the radioisotope applications. Here is a second barrier. It is not enough to say that a hospital physicist can make whatever technical judgements are neces- sary and assist in interpreting the results. Unless the physician is familiar with the fundamental ideas of the radioisotope techniques, he will often prefer to rely on more conventional means of diagnosis. A world-wide shortage of hospital physi- cists and technicians does not make the conversion process easier. It is therefore imperative to train more staff—technicians and physicians, as well as auxiliary per- sonnel—in the skilful use of radioistotopes, together with modern equipment. Thirdly, the physician's misgivings about the complexity of the equipment and pro- cedures have been to some extent justified. The cost of the equipment has deterred hospital authorities, even in prosperous countries. Recent improvements in instru- ments make them cheaper, or quicker and easier to use in clinical conditions. Also, they often mean that even smaller doses of radio-isotopes can be used than before. Thus technical progress is helping to remove the barriers to more general use of radioisotopes in diagnosis, and opening the way to fulfilment of Dr Seelentag's prediction. ■ 13

Arlo oo *-Noi, by Robert Plant Medical men divide the ill effects of radiation into three categories. First, there is the evident risk of more or less imme- diate injury, the somatic or bodily effects. Second, there are the delayed effects, in extreme cases not discernible for as long as 50 years after exposure; these might be termed the delayed somatic effects. Finally, there are the genetic effects, which do not affect us directly but appear in our pro- geny. In the main, the somatic effects are those which persons expoed in medicine and industry may suffer. Localized somatic symptoms were observed as early as 1896, one year after the discovery of X-rays —reddening of the exposed areas, wounds looking like burns, ulceration of the skin. Later, general symptoms, such as lassitude, nausea and general weakness were noticed. By 1903, it had been demonstrated experi- mentally on animals that radiation retard- ed bone growth, and by 1905 that it affected the blood. A case where a human foetus was exposed by mistake during X-ray examination of the mother showed that the whole growth and development of a child could be greatly handicapped. The risk of injury is particularly serious to the more delicate tissues of the body, such as the eyes, the genitals, the bloodforming organs and growing glands, and the female breast. The somatic symptoms may not appear for some time. The normal latent period is a matter of weeks, but the damage be- gins with radiation and may take time to build up to a clinical condition. A malignant growth, for example, that does not become manifest for perhaps five years after the exposure, should not be confused with a delayed somatic injury, in which the deterio- ration does not, as far as can be deter- mined, make a start until long after the event. For somatic injury a certain minimum dose seems to be req.uired. a threshold which may be approached but not passed with safety. A dose of 25 to 50 rcentgens to the whole body was found to affect the white blood corpuscles and to produce mild lassitude and softening of the mus- cles. The evidence of radiation accidents over the years has shown that 400 to 500 rcentgens on the whole body are fatal in about 50 per cent of cases, and 600 to 700 in practically every case. This know- ledge makes it relatively simple, in prin- ciple, to protect the citizen from the risk of somatic radiation injury—such injury can only be the result of negligence, ignor- ance or accident. The maximum permitted dose in the ILO code for radiation wor- kers, averaged out for several years, amounts to about 100 millirems per week. More mysterious Delayed somatic injury is a more myste- rious phenomenon. Years after the bomb- ing of Hiroshima and Nagasaki, it was found that the number of leukaemia cases reported in those areas was in proportion to population five to ten times larger than in other parts of Japan. It is always difficult to show a measurable relationship between injury and radiation in delayed somatic cases, because of the long time lag and because other causes may have been at work, but it is now fairly well established that delayed effects are mainly of three kinds: leukaemia, malignant tumours and shortening of life. In animals, delayed malignant tumours have been induced by comparatively heavy doses, 100 rcentgens and more. A direct arithmetical relationship has also been demonstrated between the amount of radiation received by mice and their length of life. This, too, was established by experi- ments involving fairly high doses, 50 rcent- gens and over. To obtain reliable informa- tion using smaller doses would require testing more animals than is practicable, but if the effects are directly proportional to the amount of radiation received, down to the lowest levels—in other words, if there is no threshold—then it can be cal- culated that a dose of one roentgen on the whole body would reduce the average expectation of a man's life by about three days. From this it is not difficult to work out the length of time by which the life would be shortened of, say, an industrial worker exposed regularly to the maximum dose permitted by the ILO code. This being on average 5 rems per year, he might lose 15 days of life for every year he worked. A radiologist receiving the maxi- mum permitted dose in hospitals—which is at the same level of about 5 rems per year over a working career of 40 years might lose one-and-a-half years of life. Nobody is likely to be exposed to the maximum permitted dose many years of his working life, and the assumptions on which these calculations are made are of course speculative, to say the least. They are, however, the assumptions on which we have to work at the present time. What is certain is that radiation exposure can shorten life, and does so appreciably. This has nothing to do with discernible injury. We just don't live as long. Mutations Genetic effects should not be confused with injury to the sex organs or injury to an unborn baby; strictly speaking, these are somatic effects. Genetic effects proper are revealed only in future generations. They are the result of damage to the chro- mosomes. Every human cell contains 46 chromosomes, 23 inherited from the An artist's interpretation of an atomic explosion. 15 Doses of rads Man most vulnerable Vulnerability to radioactivity is illustrated in the table below giving approximate orders of magnitude. Doses of 600 to 700 rads are usually fatal for man, one of the most vulnerable of living organisms. Plant germination can be stopped by doses of about 10,000 rads. To destroy insects, higher doses are usually necessary and insects can sometimes survive doses of as much as 40,000 rads. There is some overlapping between the upper limits of radio- activity sufficient to stop plant germination and the lower limits sufficient to kill insects. Destruction of moulds results from doses that may vary between 100,000 and 1,000,000 rads. The range between which various forms of mould can resist the destructive effects of radioactivity is considerable. mother and 23 from the father, and each chromosome contains hundreds of thou- sands of genes, by which the characteristics of the species and indeed of different indi- viduals are transmitted to the offspring. Radiation injury can take two forms, named by medical men chromosome muta- tions and point mutations. The former involve damage to the whole chromosome and can be detected by a microscope; the latter leave the chromosome alive but touch the genes. Chromosome mutations require a cer- tain minimum dose—in other words, there is a threshold—and the chromosomes occasionally recover. Generally, they entail the death of the cell to which they belong. If that cell finds its way into the reproduc- tive process, obviously the possibilities of fertilization are reduced. Hence there is a connection between chromosome muta- tion and sterility. It is a matter of chance, and of pretty remote chance in the average individual, but in a population of millions somebody will be unlucky in the draw. To the layman, the most sinister of all radiation effects is point mutation. The cell is not killed, life can still be transmitted, but the offspring may be malformed in ways we cannot foresee. Here there is appa- rently no threshold; a single "hit" by a radioactive ray can cause the damage, which of itself is too slight even to be visi- ble under the microscope. The only com- fort is that the probabilities involved are remote. First, there is the chance of a parti- cular person sustaining the injury. Then there is the chance of the cell containing the chromosome with the damaged genes finding its way into the reproductive pro- cess. Finally, it is necessary for both parents to have sustained the injury for the mutation to be passed on. So high are the odds against, that we are not likely to see the consequences in our lifetime. Pro- fessor Walter Seelentag of WHO says: "With certain qualifications, an increase in the mutation rate after irradiation will probably be manifest only after many generations." At first, this seems rather consoling, but only at first. The thought that by our complacent acceptance of the benefits of radiation we may be causing some child to be born malformed, long after we have lived out our natural lives and are resting in our graves, must surely appall any per- son of imagination and conscience. One is forced to echo Shakespeare's Hamlet, speaking four centuries ago : "The dread of something after death . . . must give us pause." The burden today Cosmic rays are weakened as they pass through the atmosphere, but at ordinary living altitudes their impact is about 35 millirems a year. Terrestrial radiation, emanating from the earth's crust, varies greatly: in Kerala, in India, for example, where there are rock formations contain- ing uranium, it can be as high as 1000 mil- lirads a year. At the other extreme, parts of Germany with mainly basalt formations have recorded as little as 14 millirads a year and parts of England where limestone predominates, 26 millirads. The average is about 50. Natural radiations from other sources, such as the air around us, add another 20 or so. This radiation originates in the earth but hits us at second hand, so to speak. Internal radiation, from radio- active matter in the body, is thought to inflict about 25 millirads a year on the body as a whole but may be as high as 70 or 80 in the bone marrow. All in all, it is estimated that the total natural radiation to which the average person is subjected comes to about 175 millirems a year. On balance, the protection afforded by buildings is offset by radiation from the structure itself. Most materials act as par- tial shields, but they also contain traces of radioactive elements : they parry and thrust at the same time. Research in Sweden, for example, revealed that radiation inside wooden houses was 50 millirads a year, inside brick houses 104 millirads and inside slate concrete houses 171 millirads, while in the streets of Stockholm 85 millirads a year was recorded. Some everyday appliances are radio- active. Television tubes emit X-rays, but these are too feeble to travel far and are almost completely absorbed in the set. Shoe fitting fluoroscopes were found to impose a considerable load, in one case as high as 10 roentgens a year on a child's foot through repeated use, but these instru- The inside of a reactor at a French nuclear centre. ments are now employed with greater cau- tion and the effect is slight. Until a few years ago, in a European country where research was conducted, luminous wrist- watches were found to be inflicting a local dose to the skin ranging from 1.3 to 30 roentgens a year. This weakened as it travelled through the body, but the genetic exposure—the irradiation of the sex or- gans—still worked out at an average per person over the whole population of 2.5 millirads a year. The radium formerly used to luminize the dials of watches and clocks has now been superseded by less dangerous substances, from which the dose to the body as a whole is negligible. In general it may be said that radiation from everyday appliances is at present too small to be important. But, like all the uses of radia- tion, it is growing. Medical uses of radiation amounted in 1963 in a typical industrialized country, Germany (F.R.), to an average of 23.5 mil- lirems for every member of the population, of which 22 millirems were received by the patients and 1.5 by the staff. Of course these are average figures meaning that doses received may be much higher or lower per person according to the case. Staff in industry and research, in this coun- try, accounted for less than a millirem —0.7 to be exact per member of the population, and various other sources added 2.5 millirems. Fallout amounted to 33 millirems per capita bringing the total for 1963 to almost 60 millirems. A need for better technique At this point, the reader may protest that the dose received by many individuals, particularly those working in medicine and industry, must have been very much higher than the average, and this of course is true. The necessity of safeguarding persons where there is a high risk of exposure is everywhere recognized. Techniques for limiting the exposure of hospital patients to the practical minimum and avoiding irradiation of the sex glands are also ob- viously important and can in many cases be improved. The figures show that in Britain, for example, a country with gen- erally high standards, the factor the experts call the "genetically significant dose" would be reduced by 80 per cent if techni- ques in all hospitals were raised to the level of the best. The situation in other coun- tries is doubtless similar. It is largely a matter of directing the rays carefully to the areas under examination and, if necessary, of shielding the vital parts. To assess the radiation load on the people as a whole, however, which is the public health author- ity's concern, these local concentrations have to be worked into the national aver- age. Only in this way can some measure- ment be attempted of the overall danger, particularly where casualties may be a matter of chance. The urgent thing for the public health expert is to keep within bounds—if he can the total volume of irradiation in the community. The burden from radioactive fallout is really in a category by itself. Being man made, it is certainly artificial radiation, but it is not produced voluntarily by most of the communities on which it descends. It consists of radioactive particles released into the atmosphere by an atomic explo- sion, floating down to earth for some years afterwards. Because of the height to which the particles are driven and the effect of air currents, it is distributed fairly evenly over the whole human race. It is falling on you now. It subsides in time, but, so long as above-ground tests of nuclear weapons continue, the supply is replenished. Meas- urements made in 1963 in Germany (F.R.), a country where there had been no explo- sions, showed that a dose of 33 millirems per person was received from this source —representing more than half of the 60 millirems attributed to all artificial radio- activity and radiation. Fallout is indeed practically the only man-made background radiation to which the man in the street is exposed at present. Medical and industrial radiation, after all, are kept in their place. Only the beginning... Very broadly, it may be said that artifi- cial radiation from all sources does not yet exceed the natural product. So far, not too bad. But we are only at the beginning. Scientists and industrialists, if not sol- diers, are bound to make increasing use of this extraordinary force which they can now manipulate but not control. Many of the artificial uses of ionizing rays benefit man, and under proper conditions add only small doses of radioactivity to our environment. These doses add up, how- ever; each use is developed without refer- ence to the others, the total grows . . . How far dare we let this process go? The ordinary man knows that he must accept the dangers of his natural environ- ment, but he sees no reason why he should endure hazards created by the human will, unless the benefit greatly exceeds the harm. He is at the mercy of a danger that is at the same time universal and insidious : it respects no frontiers, and man has no natural sense by which to know its pre- sence. He cannot see it, he cannot smell it, he cannot taste it, he cannot hear it, he cannot touch it. He only knows it is always there, the invisible peril. He is an innocent in the hands of the experts. Surely he is entitled to ask that the pro- cess be brought under control before it is too late. He asks this, moreover, not only in his own name. He asks it on behalf of a child without a name, not to be born per- haps for a hundred years, who may be the victim of his indifference. ■ 18 Laboratory of the Agency, near Vienna. The International Atomic Energy Agency is the youngest of the agencies of the United Nations. There are a number of reasons for this. Immediately following the Second World War the idea of such an agency was almost inconceivable. One country held a monopoly of the secrets of the atom, and world opinion, disturbed by the staggering examples of nuclear destruction, was far from imagining what peaceful uses atomic energy might have. In 1953, atomic monopoly ended and the mood changed. President Eisenhower proposed to the United Nations that an international organization be created allowing the technically developed coun- tries to devote a portion of their resources to this new source of energy for the good of mankind rather than for its destruction. The following year, the UN General Assembly unanimously adopted a resolu- tion on the peaceful uses of the atom and expressed the desire to create, as soon as possible, an international atomic energy agency. A conference in October 1956, at which 81 states were represented, unanimously approved the establishment of such an agency; on 29 July, 1957, less than a year later, 26 countries had ratified the relevant agreement and the Interna- tional Atomic Energy Agency was born. Today it has 98 member states. Its head- quarters are in Vienna. Underlying all the activities of the agency is the twin desire to promote the peaceful uses of atomic energy and to assure that these uses do not imperil peace or health. Today, the work of the Atomic Agency has grown considerably: 3,000 scholar- ships have been granted, 120 professors were sent out on mission, hundreds of conferences and seminars have taken place attended by 15,000 scientists. Beyond these figures, however, it is the Agency's field work that is making its real contri- bution to human well-being. In the field of medicine, the Agency has been carrying out research on goitre in the Andes and the Himalayas, as well as in certain islands of Japan. It is also cooper- ating with WHO in studying anaemia, mal- nutrition and the effects of parasitic diseases in man. It has furnished material 19 The National Institute of Ra- diation Breeding at Ohmiya, Ibaraki-Ken, Japan, operates a gamma field for the purpose of inducing plant mutations, espe- cially in rice. The photo shows the radiation tower and the entrance. A programme of rice research organized by the IAEA involves experiments around the world. This picture, taken in Vienna, shows Dr Kiyoshi Tensho (Ja- pan) measuring the amounts of oxygen taken by plants with their leaf shoots removed in comparison with the intake by those with normal shoots. Not a paint box, this set con- tains radioactive standards, here calibrated gamma sources. Standardized radiation sources are essential for the effective and safe use of radioisotopes. 20 In many areas of the world, the Mediterranean fruit fly destroys millions of dollars worth of fruit every year. To supplement chemical pesti- cides, IAEA and FAO and WHO are developing the "ste- rile male" technique. This in- volves the release of millions of flies after sterilizing them with gamma irradiation. The sterile males mate with females and steadily reduce the birth rate. At the Seibersdorf Labo- ratory, near Vienna, the prob- lems of rearing the enormous numbers necessary, of devising cheaper means of feeding them, and of releasing them from aeroplanes are being investi- gated. Lower photograph shows Medi- terranean fruit flies. for the radiological treatment of cancer to seven countries. Methods and techniques for medical diagnosis and treatment using isotopes have been developed and stan- dardized. A programme to use irradiated serum for snake bites has been started and it may be possible by this means to save the lives of some 3,000 persons a year. The steriliza- tion of bandages and dressings, cat-gut as well as surgical instruments, by ionizing radiation has already considerably reduced the risk of infection. In agriculture, research pursued jointly by several countries has led to increased production of rice and maize through a more effective use of fertilizer. Mutations induced by radiation have led to the im- provement of rice, wheat and barley. Gamma rays have been effectively used for the sterilization of harmful insects. Atomic techniques can present a means of conservation of foodstuffs, allow data to be gathered about how water contained in the soil can best be used, and is of importance in producing animal vaccines. The World Meteorological Organization (wMo) and the Atomic Agency are carrying out a world study on hydrogen tritium (radioactive isotopes) in order to follow the water cycle on the planet and solve a number of water problems in twenty countries. A similar study concerned with water courses was undertaken by the Atomic Agency in collaboration with UNESCO. As regards industry, the Agency helped to make known radioisotope methods for improving the quality of manufactured products: checking on defects in the homo- geneity of certain metals; finding where machinery begins to show strain; deter- mining two or more types of oil flowing through pipes, etc. New horizons are opening for the Atomic Agency. Electric energy from nuclear power stations will soon be indis- pensable if our needs are to be satisfied. Through the Atomic Agency, experts are advising on the possibilities of establishing nuclear plants on the regional, national and international level. As nuclear energy continues to grow, so, too, will the Agency's responsibilities as a world co- ordinator of the atom in the service of man and in cooperation with wHo for his health and well-being. ■ The Oceanographic Museum of Mona- co, hewn within the solid rock on which stands the palace of the Prince, plays a key role in the study of marine radioactivity. Since 1961, the International Atomic Energy Agency has been running an inde- pendant laboratory at the Museum in order to measure the radioactivity of the water as of the fauna and flora of the ocean, and to predict the effects of man- made radiation. This calls for detailed research into the chemistry of sea-water at the surface as well as in depth, and into the habits of its living organisms and their environmental responses; the effects of tides, wind and currents, and a multitude of other factors which make up the science of oceanography have to be taken into account. Under an agreement between the Ocea- nographic Museum, the Monaco Govern- ment and the IAEA, the last-named dele- gated a scientist to take charge of research and provided staff and funds for equipping and operating the laboratory. The Monaco Government for its part is making an annual contribution towards research and for additional scientific, administrative and technical staff, while the Oceano- graphic Museum has agreed to place its scientific equipment at the disposal of the IAEA as far as the Museum's own research programme allows. The investigations come under four main headings. First is the physical prob- lem of transport and dissemination of radioactive materials in space and time. Conditions obviously vary between the tidal currents of the North Sea and the winds of the Mediterranean or the great ocean currents such as the Gulf Stream in the Atlanic. 22 Second comes the chemistry of the sea, i.e. chemical action on matter which enters the sea and what this means biologically. Knowledge of the chemical effects on some of the main metallic elements found in radioactive waste is gradually being in- creased. Iron, for example, is easily preci- pitated but manganese and cobalt stay in solution for a long time; zinc, chromium and cerium occupy an intermediate posi- tion. Experiments concern both organic and inorganic aspects, and involve the chemistry of sediments and sea-water as well as the distribution of elements in marine organisms. Despite the complexi- ties, it will probably soon be possible to predict what amount of radioactive mate- rial from a given quantity of waste may be found in a tunafish—or any other marine unit. Fish and sea animals are the third sub- ject of study since radioactivity becomes concentrated in them and may then repre- sent a danger for man. The concentration of radioisotopes depends on chemical pro- cesses within the fish. If it could be estab- lished that certain chemicals were not assimilated by fish, security would be greatly enhanced. An additional topic is the examination of the movement of radioisotopes in the sea bed, and the influence of water masses and different kinds of sediment. The aim is to be able to forecast accurately the pattern of radioactivity in all circum- stances, whether radioactivity arises from the steady disposal of waste or from an unexpected occurrence such as the burst- ing of a waste container or an accident to a nuclear vessel. Such in outline is the research being pursued in Monaco. The means so far are modest, but there is hope that with the acquisition of a research vessel and the improvement of cooperation between in- terested national and international bodies, knowledge of radioactivity in the oceans and the related ecology of marine forms of life will be rapidly increased. ■ Fish can live in a contaminated environment. Experiments are being conducted to find out how fast they accumulate radioactivity and how dangerous they are for human consumption. Above, equipment used for collecting plankton to check on radioactivity. 23 a constant watch on food DENMAR I by Gino Levi 0 n the poetic Roskilde Fjord, a few kilometres from the town of Roskilde, capital of Denmark in the 12th century, stands the Riso Research Establishment of the Danish Atomic Energy Com- mission. Here 700 men and women are engaged in a constant search for ways and means of harnessing atomic energy to make the world a better and healthier place to live in. On the central approach road, flanked by rows of grey poplars, is the guard house where visitors to Riso are checked in. In co-operation with the Danish Nation- al Health Service, the health physics department at the centre is engaged in fall-out studies as part of routine health protection activities. Regular monitoring of land, air and sea at Riso has not at any time revealed an increase in levels of radio- activity, nor has plant and personnel con- trol shown any exposure of staff members in excess of the acceptable doses for occu- pational exposure. This environmental monitoring includes the study of sea-water, seaweed, soil, grass and milk from cows and it now covers the whole of Denmark, Greenland and the Faroe Islands. Twice a year, inspectors go out to buy a typical Danish diet on the markets (including milk, eggs, bread and butter) and the col- lected material is analysed for traces of Strontium 90 and Caesium 137, radio- active products resulting from nuclear fis- sion that are dangerous for living organ- isms. A laboratory team of eleven headed by a scientist study the samples collected in the environment. Nuclear power stations are scheduled to be operative in Denmark some time be- tween 1975 and 1980, and the planning of such stations calls for close co-operation between all concerned, including the Health Service, in order to ensure control of the environment and to protect personnel. Electron irradiation Another point of contact between scien- tists at Riso and the health workers is the electron accelerator. This piece of equip- ment can be used for electron irradiation experiments, but also for the radio-sterili- zation of medical equipment including hypodermic syringes, infusion and trans- fusion sets, artificial lungs, disposable hypodermic needles, intra-uterine devices (the loop), drainage bottles and so forth. As products treated by radio-sterilization receive comparatively small doses of energy (less than 10 MeV) no radioactivity is induced. There often is a definite eco- nomic advantage in being able to use dis- posable equipment. Danish firms have, in fact, built up an industry based on this technique. Riso also serves medical science by the production of radioisotopes in two of the three reactors. These isotopes are chiefly used by Danish hospitals, which also make use of Riso's newly-established activation analysis service. Here, for example, blood samples can be analyzed by neutron techniques for the presence of minute quantities of various elements such as arsenic. A further use of irradiation in medicine is the prototype cobalt-60 plant which was developed at Riso in collaboration with the National Hospital, Copenhagen. The plant produces apparatus that has a nomi- 24 Measuring the radioac- tivity of the human body (right). Below: a microphoto- graph of a number of wheat cells some of which are in the process of divi- sion showing their chro- mosome structure. Below right: basic ele- ments in the Danish diet• nal source of strength of 1000 curies and is used for extra-corporal irradiation of blood (ECI), of importance in the treat- ment of various blood diseases and in transplantations. As a result of close co-operation be- tween physicists and physicians the plant combines large flexibility with simplicity of operation so that specially trained per- sonnel is not required. Dwarf trees The Riso Agricultural Research Depart- ment performs irradiation experiments with plants and seeds. These long-term studies are aimed at inducing higher yield, earlier harvesting of crops, and disease- resistance. It is estimated that an average of 15 years would be required to market any new plants. Barley is the most import- ant Danish crop since it accounts for about one third of the country's total production. Studies are aimed at genetic mutations that may, for instance, induce straw stiff- ness. With more fertilizer and genetic improvements, bigger yields can be ob- tained. Certain mutants showing resistance to mildew fungus have been arrived at but are not yet marketed because further trials are required at experimental agricultural stations. Other experiments include gamma irra- diation of fruit tree grafts in order to arrive at dwarf or compact trees for easier, more economic picking. Studies in this field have been going on for some years with apple and cherry trees. However, another ten years at least are required for final results. Radioactive isotopes are also used to check the effects of various substances on the growth of plants. Selenium, an element of the sulphur group, for instance, is of great importance to livestock. It was for- merly thought to be completely poisonous but in recent years evidence has accumu- lated proving that some amount of this element is essential in animal nutrition. Since the margin between selenium defi- ciency and toxicity is now known to lie extremely small, highly sensitive modern techniques are needed to tell at what point this element ceases to become a friend of the animal and begins to be a danger. ■ 25

1, 11 PROTECTION 41111111.0 Usually we associate protection with distance from danger. Indeed the distance between our planet and the sun allows some re- lative protection against ionizing rays. But distance alone isn't enough. In the case of cosmic rays, the atmosphere around the earth provides valuable protection. But for practical shielding against man- made sources of radiation, materials which have a high density, such as lead, are used. The higher the density of the material employed, the thinner the necessary shielding. The amount of rays absorbed is propor- tional to the amount of mass they are forced to penetrate and the density of the material used. Radioactive substances are manipulated behind protective screens at some distance. If it is a case, however, of rays which have a short range, such as soft beta rays, gloves and special clothing are sufficient. But there are other dangers besides those of radiation from outside, most parti- cularly pollution. So as to prevent inhal- ation of microscopic radioactive particles in nuclear installations, effective ventilation systems must be installed. The disposal of radioactive wastes is an increasing problem. Until recently, wastes were small in quantity and were usually sunk in the sea. At first it seemed as if the huge mass of the sea would provide sufficient protection against an increase in radioactivity. However, recent events such as the Torrey Canyon accident in 1967 showed how easily pollution might be concentrated in limited areas. One of the important facts about sea pollution is that plankton and fish have a particular affinity for strontium 90. Com- pared to the sea around them, plankton has a strontium content 50,000 times greater than average, that of the flesh of fish 200 times and their eggs 100,000 times. Furthermore, strontium 90 has radioactive effects which extend over scores of years. The International Atomic Energy Agency is carrying on extensive studies of these questions in its Monaco laboratory (see page 22). Thanks to the precautions taken ever since the beginning of the atomic era, accidents in laboratories or nuclear instal- lations have been extremely rare. Security rules are rigid as the following examples illustrate. When the discharge of radioactive wastes into the sea from the Windscale works in the U.K. was being considered, it was discovered that a food product known as "laver bread" was made from a type of seaweed harvested in the region. Laver bread is eaten by a relatively small group of people living 200 miles away, but since the seaweed tends to absorb radioactive ruthenium, the amount of radioactivity in the discharge had to be set low enough not to affect those consumers. When determing permitted discharges from the Bradwell nuclear power plant in the U.K., it was the fact that oysters might absorb radioactive zinc that influenced the decisions. At the Hanford plant in the U.S.A., a survey revealed that local inhabitants who fished intensively in the local river were in the habit of eating the bones as well as the flesh of the fish. Fish tend to absorb radioactive phosphorus in their bones, and since some of this material was included in the discharges of waste, it was consi- Decontaminating a working surface. 27 ars ',lb ..111 ■11111111111111 . 11111 ; siro, Ci1110 1111111/91.11.1.11111111101.1111 - Plant for the treatment of radioactive waste. After being sealed into containers and placed in concrete, radioactive waste may be stored underground or underwater. A "glove box" in the plant for handling radioactive waste. Men working in contaminated areas must wear protective clothing such as this frogman suit. Manipulating radioactive material. dered necessary not only to reduce the rate of discharge of this element but to re- design the effluent treatment plant. Protection means vigilance but it also means research. The use of certain fuels results in the formation of radioactive krypton gas. If protection measures are not rapidly devised this could have incalculable genetic consequences by the end of the century. Moreover, as atomic power plants will increasingly take over the role of providing energy formerly produced by coal and oil, problems are likely to increase in magni- tude. Furthermore, new applications of nuclear energy continue to appear— meteorological buoys for seaports, radio- active material in consumer goods, atomic ships. These are only beginning but will soon be multiplied and the accompanying effects may present a danger. Quite rightly, WHO and the IAEA remain fully conscious of the need for permanent vigilance. ■ Brief Bibliography Nimmo, R.R., Atomic Energy, Chap- man & Hall Ltd., London, 1949 Brondsted, H.V., The Atomic Age and Our Biological Future, Philo- sophical Library, New York, 1957 Lindell, Bo and Lowry Dobson, R., Ionizing Radiation and Health, WHO Public Health Papers, No. 6, 1961 Glasser, 0., Quimby, E. H., Taylor, L. S., and Weatherwax, J. L., Physical Foundations of Radiology, Cassell & Co. Ltd., London, 1952 Glasstone, S., Sourcebook on Atomic Energy, D. Van Nostrand Co. Ltd., New York, 1950 Seelentag, W., On the importance of the radiation burden of a population with special reference to the gene- tically significant dose from appli- cation of radiation in medicine, in Progress in nuclear energy, Perga- mon Press, London, 1968 Pellerin, P., Moroni, J. P., Remy, M.-L., Premiers resultats d'une etude systematique des contamina- tions internes consecutives aux retombees radioactives, Revue d'Hygiene et de Medecine Sociale, Paris, janvier-fevrier, 1965. 29 Lady Allen of Hurtwood, Planning for Play, Thames & Hudson, 140 pages, 176 photographs and plans, 42s. The importance of play in the physical and psychological development of children of all ages is now undisputed. At the same time, opportunities for the young to exer- cise their bodies and their imaginations are decreasing all over the world as people throng to already congested cities or are packed into high-density housing estates. Lady Allen of Hurtwood, a landscape architect by profession and a champion of children by vocation, has long played an influential role in helping to alleviate this situation. With her new book, Planning for Play, in which she has assembled a wide variety of playground ideas, her influence should extend even further, for she has shown how to provide possibilities for the spontaneous, creative activity that all children need while avoiding expensive mistakes of the past. Books The level stretch of asphalt with fixed equipment is quickly discarded as the "prison" period of playground construc- tion. Lady Allen is scarcely more impres- sed with the other extreme where a painted steam roller, concrete pipes and ingenious play sculpture are to be found, usually installed at great expense. Her inspira- tion is the so-called adventure playground where, in essence, waste materials and equipment are assembled and children can do what they like with them, construc- tively or destructively. They may be allowed to use tools, mix cement, dig holes, make gardens, keep animals, collect insects, practise arts and crafts, and light fires to cook food. The satisfaction these play- grounds give children is in direct propor- tion to the pain they cause tidy-minded architects, planners and neighbours. This book is designed to show that children can be given the liberating experience of such a playground without creating eye- sores. The case is well made with the qualification that any playground needs a mature adult to bring it to life. This is particularly the case in the adventure play- ground where the person in charge must be interested and helpful without thwart- ing initiative. The successful organizers have included actors, carpenters, night watchmen, plumbers and ex-seamen but rarely conventionally trained leaders. Many types of playground are described and useful chapters are devoted to play opportunities for children in hospitals and for handicapped, subnormal and mal- adjusted children. There are well-illustrated examples from a number of countries. Dimensions and costs are often given and down-to-earth problems such as suitable surfacing materials are treated in detail. The architect who cares more for the well- being of children than the tailored elegance of ordered landscape or of paved parking places will find this a useful source book. As such it would have been improved by a good index and perhaps by a more disciplined layout. Most important of all however is the international point of view of this book which is applicable to every country where increasing urbanization is undermining the rights of children. Medical and Biological Studies of Weight- lessness, in Russian, edited by Academi- cian V. Parine and Professor I. Kasian, with contributions by numerous authors. Medicina, Moscow, 1968, - 2.5 roubles. This recent study brings together the latest findings of Soviet specialists and scientists in the field of space medicine and biology. The experimental data obtained through study of man and animals in flight is given in detail, as well as research findings on the problem of weightlessness, its peculiar- ities, ways and means of producing it, and its effect on the animal and human organ- ism, particularly the cardiovascular and respiratory system. The authors go over the results of the physiological studies carried out during the flights of Vostok and Voshkod, and give particular emphasis to the problem of man's work capacity under conditions 30 Order form Please enter my subscription to World Health: 1 year .* 2 years * 3 years I enclose cheque/postal order in the amount of Name: Street : City • Country • * Subscriptions are entered for the calendar year Please complete, detach and mail this order form to the agent for WHO publications in your country. of weightlessness when working outside the capsule in space. Soviet research and experience show that weightlessness produces a number of more or less serious changes in the organ- ism according to the individual. However, in the case of specially chosen and trained cosmonauts, adaptation to spatial activ- ities is quite satisfactory. Their health and general physical and mental condition do not seem to be seriously affected. This book will be of interest to doctors, biologists and engineers but, because of its clear style, it is also accessible to the general public. The conquest of space has fascinated people in all walks of life around the world. This study is published by Medicina Editions, which puts out a great number of medical books, manuals and treatises of all sorts, as well as sixty-eight medical reviews including the monthly Zdorovie, a magazine with a circulation of eight million. During the fifty years of its existence Medicina Editions has put out sixteen thousand books with a circulation of more than four hundred million copies. Medicina makes WHO publications avail- able in Russian. ■ Photo credits: E. MANDELMANN: Cover, pp. 25, 28, 29, 30 (wHo) P. ALMASY: Cover (back), pp. 8, 10/11, 12 (WHO) CERN: pp. 3, 4, 7 P. JAHAN/CERN: pp. 6, 7, 23 IAEA: pp. 21, 22, 23 J. TAIT/IAEA: pp. 12, 13 SKREIN/IAEA: pp. 19, 20 GOLDBERGER/IAEA: p. 20 NOVOSTI : p. 31 J. BIAUGEAUD/CENTRE SACLAY: p. 17 inc Atomic Energy Authority: p. 26, 27 World Health where to subscribe Afghanistan: See India, WHO Regional Office. Argentina: Editorial Sudamerica S.A., Humberto 1. 545, Buenos Aires. Australia: Hunter Publications, 23 McKillop Street, Melbourne C. 1; United Nations Association of Australia, Victoria Division, 364 Lonsdale Street, Melbourne, Victoria 3000. Austria: Gerold & Co., I. Graben 31, Vienna 1. Belgium: Office international de Librairie, 30 ay. Marnix, Brussels. Burma: See India, WHO Regional Office. Cambodia: The WHO Representative, P.O. Box 111, Phnom-Penh. Canada: The Queen's Printer, Ottawa. Ceylon: See India, WHO Regional Office. China: The WHO Representative, 5 Chungshan Road South, Taipeh, Taiwan; The World Book Co., Ltd, 99 Chungking South Road, Section 1, Taipeh, Taiwan. Colombia: Distrilibros Ltd, Pio Alfonso Garcia, Carrera 4a, Nos 36-119, Cartagena. Congo: Librairie congolaise, 12 avenue des Aviateurs, Kinshasa. Costa Rica: Imprenta y Libreria Trejos S.A., Apartado 1313, San Jose. Cyprus: MAM, P.O. Box 1722, Nicosia. Denmark: Ejnar Munksgaard, Ltd, Norregade 6, Copenhagen. Ecuador: Libreria Cientifica S.A., P.O. Box 362, Luque 223, Guayaquil. Fiji: The WHO Representative, P.O. Box 113, Suva. Finland: Akateeminen Kirjakauppa, Keskuskatu 2, Helsinki. France: Librairie Arnette, 2 rue Casimir-Delavigne, Paris 6 0 . Germany: Govi-Verlag GmbH, Beethovenplatz 1-3, Frankfurt A. M. 6; W. E. Saarbach, Postfach 1510, Follerstrasse 2, Cologne I; Alex. Horn, Spiegelgasse 9, Wiesbaden. Greece: G.C. Eleftheroukadis S.A., Librairie internationale, rue Nikis 4, Athens (T.126). Haiti: Max Bouchereau. Librairie " A la Caravelle ", Boite postale 111-B, Port-au- Prince. Hungary: Kultura, P.O.B. 149 Budapest 62, Akademiai Konyvesbolt, Vaciutca 22, Budapest V. Iceland: Snaebjdrn Jonsson & Co., P.O. Box 1131, Hafnarstraeti 9, Reykjavik. India: WHO Regional Office for South- East Asia, World Health House, Indraprastha Estate, Ring Road, New Delhi 1 - Oxford Book & Stationery Co., Scindia House, New Delhi; 17 Park Street, Calcutta 16 (Sub-agent). Indonesia: WHO Regional Office for South- East Asia, World Health House, Indraprastha Estate, Ring Road, New Delhi I, India - Indira Ltd, 37 Dj. Dr Sam Ratulangi, Jakarta (Sub-agent). Iran: Mebso Bookstore, Naderi Avenue (Arbab-Guiv Building), Teheran. Ireland: The Stationery Office, Dublin. Israel: Heiliger & Co., 3 Nathan Strauss Street, Jerusalem. Italy: Edizioni Minerva Medica, Corso Bramante 83-85, Turin; Via Lamarmora 3, Milan. Japan: Maruzen Company, Ltd, 6 Tori-Nichome Nihonbashi, Tokyo. Kenya: The Caxton Press Ltd, Head Office: Gathani House, Huddersfield Road, P.O. Box 1742, Nairobi. Korea: The WHO Country Liaison Officer, Central P.O. Box 540, Seoul. Laos: The WHO Country Liaison Officer, P.O. Box 343, Vientiane. Lebanon: Librairie Au Papyrus, Immeuble Abdel Baki, rue Cinema Colisee, Hamra, Beirut. Luxembourg: Librairie Trausch-Schummer, place du Theatre, Luxem- bourg. Malaysia: The WHO Representative P.O. Box 2550, Kuala Lumpur; Jubilee (Book) Store Ltd, 97 Batu Road, Kuala Lumpur. Mexico: La Prensa Medica Mexicana, Ediciones Cientificas, Paseo de las Facultades, 26, Mexico City 20, D.F. Mongolia: See India, WHO Regional Office. Morocco: Editions La Porte, 281 avenue Mohamed V, Rabat. Nepal: See India, WHO Regional Office. Netherlands: N.V. Martinus Nijhoff's Boekhandel en Uitgevers Maatschappij, Lange Voorhout 9, The Hague. New Zealand: Government Printing Office, Govern- ment Bookshops at State Advances Building, Rutland Street (P.O Box 5344), Auckland; 20 Molesworth Street (Private Bag), Wellington; 112 Gloucester Street (P.O Box 1721), Christchurch; Stock Exchange Building, Princes Street (P.O. Box 1104), Dunedin - R. Hill & Son Ltd, Ideal House, Cnr. Gilles - Avenue & Eden St., Newmarket, Auckland S.E. I. Nigeria: University Bookshop Nigeria, Ltd, University of lbadan, Ibadan. Norway: Johan Grundt Tanum Forlag, Karl Johangst. 41, Oslo. Pakistan: Ferozons' Publishers, Mc Leod Road, Karachi; 365 Circular Road, Lahore; 35 The Mall, Peshawar - Mirza Book Agency, 65 The Mall, Lahore 3; Mirza Book Agency, 65 Shahrah Quaid-E. Azam, P.O. Box 729, Lahore 3 - Shilpa Niketan, 29 D.1.T. Super Market Mymensingh Road, Dacca 2. Paraguay: Agenda de Librerias Nizza S.A., Estrella No. 721, Asunci6n. Peru: Distribuidora Inca S.A., Apartado 3115, Emilio Althaus 470, Lima. Philippines: World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, Manila; Alemar's, 769 Rizal Avenue, Manila. Poland: Skladnica Ksiegarska, ul. Mazowieka 9, Warsaw (except periodicals) -- BKWZ Ruch, u. Wronia 23, Warsaw (periodicals only). Portugal: Livraria Rodrigues, 186 Rua Aurea, Lisbon. Singapore: City Book Store, Ltd, Winchester House, Collyer Quay. South Africa: Van Schaik's Bookstore (Pty) Ltd, P.O. Box 724, Pretoria. Spain: Comercial Atheneum S.A., Consejo de ciento 130-136, Barcelona; Vergara 9, Madrid; Libreria Diaz de Santos, Lagasca 38, Madrid I. Sweden: Aktiebolaget C.E. Fritzes Kungl. Hovbokhandel, Fredsgatan 2, Stockholm 16. Switzerland: Medizinischer Verlag Hans Huber, Marktgasse 9, Berne. Thailand: See India, WHO Regional Office. Tunisia: Societe Tunisienne de Diffusion, 5 avenue de Carthage, Tunis. Turkey: Librairie Hachette, 469 ay. de l'Independance, Istanbul. Uganda: See address under Kenya. United Kindgom: H.M Stationery Office: High Holborn, London, W.C.1; 13a Castle Street, Edinburgh 2; 109 St Mary Street, Cardiff, CFI, IJW; 7-11 Linenhall Street, Belfast BT2, 8AY; Brazennose Street, Manchester 2; 258-259 Broad Street, Birmingham 1; 50 Fairfax Street, Bristol. All postal orders should be sent to P.O. Box 569, London S.E.1. United Rep. of Tanzania: See address under Kenya. United States of America: The American Public Health Association, Inc. 1740 Broadway, New York, N.Y. 10019. USSR: For readers in the USSR requiring Russian editions: Komsomolskij prospekt 18, Medicinskaja Kniga, Moscow - For readers outside the USSR requiring Russian editions: Kuznetskij most 18, Mezdunarodnaja Kniga, Moscow G-200. Venezuela: The University Society Venezolana C.A., Apartado 10786, Caracas - Libreria del Este, Av. Francisco de Miranda 52, Edificio Galipan, Caracas. Viet-Nam: The WHO Repre- tative, P.O. Box 242, Saigon. Yugoslavia: Dr2avno Preduzede Jugoslovenska Knigja, Terazije 27/11, Belgrade. Articles and photos not copyrighted may be reproduced provided the credit line reads " World Health". Please address enquiries to the Editor, WHO, Avenue Appia, Geneva, Switzerland. UK UK UK 4.0 0.0 £2.12.0 Switzerland Switzerland Switzerland 12.- 22.- 30.- One year USA $ 5.00 Two years USA $ 8.00 Three years USA $10.00 ri es R eu n ie s S .A . WORLD HEALTH 1958-1968 A ACCIDENTS: Special issue, Mar.-Apr. 1961- Children: May-June 1960, 17-21 ; Nov.-Dec. 1961, 23 - Home: Prevention in Great Britain, Mar.-Apr. 1961, 10-11 ; Special issue, June 1967 - Road: Research in, Mar.- Apr. 1961, 15-21 ; Cause and prevention of, Jan.-Feb. 1962, 24-29 ; How to avoid, May 1963, 24-26. ADOPTION: Alternative (others • foster home, institu- tion) for children without family, Nov.-Dec. 1961, 30. AFGHANISTAN: Insecticide against typhus, Jan.- Fey. 1960, 38 - Training nurse midwives, Jan.-Feb. 1961, 14-15 - Public Health Institute, May 1967, 26-27 - Public Health Institute, Aug.-Sept. 1967, 32-39. AFRICA: Special issue, Nov.-Dec. 1959 - Urbanization, Meeting in Brazzaville, Jan.-Feb. 1960, 38 - Experiences among the blind (John Wilson), Jan. 1964, 18-21 - Special issue, Apr. 1964 - Special issue, Jan. 1967 - Special issue, July 1968; See also individual countries. AIR POLLUTION: May-June 1961, 3-8; Feb. 1963, 12- 13 - Institute for, Chile, Dec. 1968, 8-13. ALCOHOL AND ALCOHOLISM: Campaign against alcoholism in France, Jan.-Feb. 1960, 9-10 - Life and death of an alcoholic, June 1963, 7-13 - Special issue, Jan. 1966. AMERICAS: Special issue, Sept.-Oct. 1961 - Special issue, Dec. 1968 - Health problems, interview D' A. Horwitz, Dec. 1968, 3-7. See also : Latin America, individual countries and foot-and-mouth disease. ANDRIC, IVO: The Bridge on the Drina" (excerpts), Dec. 1962, 24-31. ANKYLOSTOMIASIS: Eastern Mediterranean region, Jan.-Feb. 1960, 37. ANIMALS: Preventing dog bites, July-Aug. 1960, 13 - Diseases of, that can be transmitted to man (chart ; applied to the Americas), Sept.-Oct. 1961, 30-31 - Lessons for human medicine, Apr. 1965 - Special issue, May 1968; See also individual zoonoses, "rabies", etc. ARTHROPOD-BORNE VIRUSES: Studied in WHO reference centre, May 1965, 7. ATOMIC ENERGY: First international conference on peaceful uses of, influence on WHO programme, May-June 1958, 28 - Exhibition on peaceful uses, 2nd U.N. conference, Jan.-Feb. 1959. AUSTRALIA: Health service to the outback (flying doctor), May-June 1960, 34-36 - New surveying tech- nique, May 1963, 7. AUXILIARY HEALTH OFFICERS: Ethiopia, May-June 1958, 14; July-Aug. 1962, 20-23. B BACTERIAL ENTERIC INFECTIONS: WHO refer- ence centres, May 1965, 11. BERI-BERI: Mar. 1963, 9, 24. BERNARD, PROF. JEAN: Haematologist (profile), May-June 1964, 38-42. BIOLOGICAL STANDARDIZATION : What are stand- ards? Nov. 1962, 22 - WHO laboratories for, May 1965, 25. BILHARZIASIS (Schistosomiasis) May-June 1962, 8 - Irony of irrigation, July-Aug. 1963, 24-25 - WHO snail identification centre, May 1965, 18 - Drugs for treat- ment, poison for snails, May 1966, 11. BIOLOGICAL CONTROL: Against mosquitos, Apr. 1968, 30-31. BLIND: Training, Mar.-Apr. 1962, 27-33 - In Africa, Jan. 1964, 18-21 - Rural training school in India, Oct.-Nov. 1968, 28-31. BLOOD: Anaemias, WHO reference centres, May 1965, 22 - Groups, international reference laboratory, May 1965, 24- Groups, Aug .-Sept. 1966, 30-31 - Special issue, June 1968. BORNEO: Changes in living conditions, Mar. 1963, 26. BOTSWANA: Trypanosomiasis (African sleeping sickness), July 1968, 18-27. BOXING: Yes or no, Sept. 1968, 16-17. BRAZIL: Introduction and eradication of yellow fever, May 1963, 10 - Indians of the Upper Xingu, Sept.- Oct. 1963, 14-22, 39-41 - Rural nurse, Dec. 1963, 18-22. BRUCELLOSIS: May 1965, 15; May 1968, 8, 23. BULGARIA: Rural living conditions, Sept.-Oct. 1960, 7-8 - Life in the village of Perushtitsa, Nov. 1963, 24-31 - School nurse, Dec. 1963, 7-9. BURMA: Training medical assistants, Jan.-Feb. 1961, 17. C CAMBODIA: Smallpox, May-June 1961, 19. CANADA: Eskimos, health services for, July-Aug. 1959, 18-23; Sept.-Oct. 1961, 14-17. CANCER: Progress report, Jan.-Feb. 1960, 6-8 - Re- search developments, Sept.-Oct. 1960, 23-24 - Epi- demiology, Nov.1962, 24-28-Control (Expert Committee Meeting), Feb. 1963, 20-21 - Smoking and, July-Aug. 1963, 7-8 - Special issue, Sept. 1964 - WHO refer- ence centres, May 1965, 27 - USSR, Oct. 1967, 30. CARDIOVASCULAR DISEASES: Coronary throm- bosis, May-June 1960, 24-27 - Arteriosclerosis and hypertension, July-Aug. 1960, 30-33 - And mental health, July-Aug. 1960, 32-33 - Research in, Sept.- Oct. 1960, 24-25; Nov. 1962, 29-31 - Special issue, June-July 1965 - USSR, Oct. 1967, 26-28 - Care and research, Aug. 1968, 16-23. CARIBBEAN (Barbados, Guyana, Jamaica, Trinidad and Tabago): Health in the, Dec. 1968, 30-35. CATARACT: Mar.-Apr. 1962, 20. CEYLON: Health situation in 1960, Jan.-Feb. 1961, 36-38 - Malaria eradication in, "Extra issue" (1962), 30-35. CHAGAS' DISEASE: July-Aug. 1959, 14-15. CHILDREN: Beginning school, July-Aug. 1960, 3-7 - Special issue (The rights of the child), Nov.-Dec. 1961 - Bringing up, United States of America, Feb. 1963, 29-31 - USSR, May 1963, 29-31 - Japan, June 1963, 29-30, 35 - Norway, July-Aug. 1963, 29-30, 35 - Seen by a city schoolmistress, Oct. 1964, 4-17 - Seen by a school doctor, Oct. 1964, 18-31 - Medical care for, USSR, Oct. 1967, 24-25 - Premature babies (France), Dec. 1967, 32-39 - Child is born, Mar. 1968, 18-23 - Acquisition of language, Oct.-Nov. 1968, 36-39. CHILDREN, accidents of May-June 1960, 17-21. CHILDREN, handicapped : Rehabilitation of, May-June 1958, 32-35 - Importance of early detection, Nov .- Dec. 1961, 26 - Situation of, Oct.-Nov. 1968, 7-11 - Outing for, Oct.-Nov. 1968, 32-35. CHILDREN, mental health : Copenhagen consultations, May-June 1958, 15- Screening in Switzerland (Valais), May-June 1959, 22-23 - Importance of, July-Aug. 1961, 20-22; Nov.-Dec. 1961, 8-9 - Education of mentally disturbed, May-June 1961, 9-11 - Retarded, Oct.-Nov. 1968, 10, 12-27. CHILE: Institute for Industrial Health and Air Pollu- tion, Dec. 1968, 8-13. CHOLERA: Bangkok, Jan.-Feb. 1959, 22-24 - In Man- churia (China), 1930-1941, Mar.-Apr. 1959, 13 - India (pilgrimages), Jan.-Feb. 1961, 20-25 - Pakistan, May- June 1962, 16-17 - Heading off a big epidemic, May 1966, 9-10. 2 CITIES: See Urbanization. CLONORCHIASIS AND PARAGONIMIASIS: In Korea, July-Aug. 1960, 26-27. COLD: Life in cold climates, Jan. 1963, 21-25; See also : Eskimos. COMMUNICATIONS AND COMMUNICATIONS SCIENCE: Importance in emergencies, Jan.-Feb., 1965, 24-48 - Techniques applied to medicine, Jan.- Feb. 1965, 49-55 - Techniques in teaching, Jan.-Feb. 1965, 56-61 - In medicine, May 1967, 8-10 - Computers applied to medicine, Mar. 1968, 31-38 - Science and technology, Mar. 1968, 50-55 - Computers at bedside, Aug. 1968, 8-15 - Use in Czechoslovakia, Aug. 1968, 24-27. COMPARATIVE MEDICINE: Animals as natural labo- ratory, April 1965, May 1968, 34-35. COMPUTERS: See Communications and communica- tions science. CONGO: Independence and emergency medical organ- ization, Nov.-Dec. 1960, 2-31 - First Congolese Doctors, Jan.-Feb. 1962, 8-13. CORONARY THROMBOSIS: Description, May-June 1960, 24-27 - Unit, Edinburgh Royal Infirmary, Aug. 1968, 16-20. CUBA: Medical care, Dec. 1968, 14-17. CYBERNETICS: Electronic tortoise, July-Aug. 1961, 14. CZECHOSLOVAKIA: Health services organization (ex. Kromeriz), Feb. 1963, 22-25 - Studies and compu- ters, Aug. 1968, 24-27. D DEATH: Principal causes in 14 developed countries, Jan.-Feb. 1960, 2-5. DEBRE, PROF. ROBERT: Paediatrician (profile), May- June 1964, 10-14. DELAY, PROF. JEAN: Psychiatrist (profile), May- June 1964, 34-37. DENMARK: Child mental health, May-June 1958, 15 - Healthy country, July-Aug. 1959, 26-31. DENTAL HEALTH: Children, Nov.-Dec. 1961, 24-25 - Special issue, Nov. 1966. DEVELOPMENT: U.N. Conference on, May 1963, 4-15. "DISEASES OF CIVILIZATION": What are, Sept.- Oct. 1960, 19-25. DOCTORS: Illustrated history of, Sept.-Oct. 1959, 6-19 - USSR: 1 for 450 inhabitants, May-June 1960, 4-5 - Need for, Feb.-Mar. 1967, 4-7 - African doctor in Europe, July 1968, 24-26 - Country doctors in Africa, July 1968, 32-34. DOCTORS, general practice: France, Sept.-Oct. 1958, 25-31 - Flying (Australia), May-June 1960, 34-36 - Bel- gium, Sept.-Oct. 1960, 32-35 - Scotland (Hebrides), Jan.-Feb. 1962, 30-35. DUBOS, PROF. RENE: Scientific dreams of man, July-Aug. 1963, 12-15. DURRELL, GERALD: Zoos and conservation, May 1968, 36-47. DRUGS: Self-medication, Mar.-Apr. 1959, 20-25 - Antimalarial, Mar.-Apr. 1960, 35-36 - Control of, especially new, Feb. 1963, 5-7 - Antibiotics, WHO Centre of Information on, May 1965, 23 - Pharma- ceuticals, WHO Reference Centre for Chemical Substances, May 1965, 26 - Doping in sport, Sept. 1968, 18-20 ; See also : Narcotics. E EASTERN MEDITERRANEAN REGION: Ankylosto- miasis, Jan.-Feb. 1960, 37 - Special issue, May-June 1962; See also : individual countries. ENTOMOLOGY: Fungus vs. mosquitos (Tokelau Islands), May-June 1961, 12-15 - Research on mos- quito behaviour, Nov. 1962, 20 - Fish against mos- quitos, Apr. 1968, 30-31. EPIDEMIOLOGY: Need for inclusion of accidents, Mar.-Apr. 1961, 2-5 - Serological testing, May 1967, 5-8; See also : Research, individual diseases. ERNI, HANS: "Victory of mankind over disease and early death"; mural painting, Sept.-Oct. 1958, 16-17. ESKIMOS: Resurrection of, July-Aug. 1959, 18-23 - Health services, Canada, Sept.-Oct. 1961, 14-17 - Adaptation to climate (International Biological Pro- gramme), Dec. 1968, 27-28. ETHIOPIA: Auxiliary health officers training, May- June 1958, 14 - Coptic manuscript, St Mary seccou- ring, Jan.-Feb. 1959, 15-17 - Malaria epidemic, May- June 1960, 39 - Father Aba Weldatensae Ghizan treats hysteria, July-Aug. 1960, 26- Health assistants, May-June 1962, 9 - Gondar Health Centre, July-Aug. 1962, 20-23. EUROPE: Over-eating: nutritional problem, May-June 1960, 38 - Special issue, Sept.-Oct. 1960 - Special issue, Aug. 1968. EXPLORERS: Demythification of, June 1963, 22-24. EYESIGHT: Special issue, Mar.-Apr. 1962. F FARMS: Accidents on, Mar.-Apr. 1961, 22-23. FEAR: Disease of the atomic age, Jan.-Feb. 1959, 4-5. FILMS: Film catalogue WHO, Jan.-Feb. 1968, 24. See also : Nurses, Mental Health, Narcotics, Trachoma. FISH: Weapon against mosquitos, Apr. 1968, 30-31. FOOD: Poisoning ; Air travel (WHO Manual), Sept.- Oct. 1958, 21 ; 10,000 poisoned by adulterated oil (Meknes, Morocco), Sept.-Oct. 1960, 38-39; Nov.-Dec. 1960, 34-38. - Additives: WHO interest in, May 1967, 12-14. FOOT AND MOUTH DISEASE: Primary and secon- dary effects, May 1968, 30-31 - In South America, Dec. 1968, 18-23. FRANCE: A country doctor, Sept.-Oct. 1958, 25-31 - Poison centre (Paris), Jan.-Feb. 1962, 14-16 - Psy- chiatric nurse (male), Dec. 1963, 13-17 - Doctors in (special issue), May-June 1964 - Modern psychiatric hospital (La Verriere), Apr. 1966 - Centre for prema- ture babies, Dec. 1967, 32-39. FROMENT, PROF. ROGER: Cardiologist (profile), May-June 1964, 30-33. G GABON: Health situation, Jan. 1967, 13-23 passim. GENETICS: Special issue, Aug.-Sept. 1966 - WHO courses for teachers of, May 1967, 24 ; See also : Blood. GERBIL: Real reservoir of plague? May-June 1958, 13. GERIATRICS: Oxford (England) Geriatrics Unit, Sept.- Oct. 1960, 17-18 - USSR, Oct. 1967, 35-39; See also : Mental health of the aged. GHANA: Kwashiorkor, May 1963, 6-7. GLAUCOMA: Mar.-Apr. 1962, 15. GOITRE: Sept.-Oct. 1958, 21 ; July-Aug. 1960, 22-23. GREECE: Rural health service in Thessaly, July-Aug. 1963, 16-23; See also : Rehabilitation. GUIANA, FRENCH: Oayana Tribe, Feb. 1963, 26-28. 3 H HAEMATOLOGY: See Blood. HAITI: Recuperation centre for undernourished chil- dren, May 1967, 25-26. HAMBURGER, PROF. JEAN: Urologist (profile), May- June 1964, 43-46. HAEMORRHAGIC FEVER (mosquito-borne) : Increa- sing, May 1966, 7-8. HEALTH WORKERS: Need for, Feb.-Mar. 1967, 4-7 - Who makes up the health team? Feb.-Mar. 1967, 18-23. HEART: Special issue, June-July 1965 - Operations, USSR, Oct. 1967, 26-27; See also : Cardiovascular diseases. HISTORY OF MEDICINE: The doctor, from Mesopo- tamia to (British) National Health Service, Sept.- Oct. 1959, 6-19 - 500 years in European medicine, Sept.-Oct. 1960, 20-22 - Islamic Medicine, May-June 1962, 18-24 - Fathers of French medicine, May-June 1964, 21-29 - First International Sanitary Conference (1851), Mar. 1968, 3-5. HONG KONG: Housing, Mar. 1963, 22; Aug. 1965, 10-17. HOSPITALS: Sweden, Karolinska, Jan.-Feb. 1960, 10 15; - Europe: Hospital Administration, July-Aug. 1962, 14; See also : Children, Mental Health, nurses. HUMAN RIGHTS, UNIVERSAL DECLARATION OF: 15th anniversary, Sept.-Oct. 1963, 3-13 - 20th anniver- sary, special issue, Oct.-Nov. 1968 - Editorial on, Ph. Noel-Baker, Oct.-Nov. 1968, 3-5. HYDATIDOSIS: Yugoslavia, Sept.-Oct. 1958, 22; May 1968, 22. IMMUNOLOGY: Antibodies, July-Aug. 1960, 10-11 - Interview with Drs Salk, Sabin and Miles, Nov. 1962, 6-9 - Work of WHO reference centres, May 1965, 27. INCAPARINA: Vegetable food for proteins, May- June 1960, 37. INDIA: Village community schemes, Jan.-Feb. 1961, 4-11 - Water for Calcutta, Jan.-Feb. 1961, 30-35 - Nutrition, children's gardens, May 1963, 8 - Medical education, May 1963, 9 - Kyasanur Forest disease, Nov. 1962, 19; June 1963, 25-28 - Nurse-midwife, Dec. 1963, 10-13 - Chandigarh, Jan. 1964, 22-27. INDIA, TUBERCULOSIS: Statistics, Sept.-Oct. 1958. 21 - Home care for patients (Madras research project), Jan.-Feb. 1966, 29-32 ; Jan.-Feb. 1961, 10; May 1963, 11-12. INDONESIA: Yaws ship, May-June 1960, 38; Jan.-Feb. 1961, 18-19 - Development after yaws eradication, Mar. 1963, 18. INDUSTRIAL AND OCCUPATIONAL HEALTH: Rehabilitation of injured workers, Sept.-Oct. 1958, 22-23 - Italy, Sept.-Oct. 1960, 10-11 - SAFETY, Mar.- Apr. 1961, 24 - USSR, Oct. 1967, 12-15 - Seafarers, Jan.-Feb. 1968, 30-47 - Institute for, Chile, Dec. 1968, 8-13. INFLUENZA: May 1965, 4 - Where it stands, May 1966, 6-7 - And pigs, May 1968, 28. INSECTICIDES: Resistance to, in mosquitos, Mar.- Apr. 1960, 30-34; See also : Malaria eradication. INTERNATIONAL BIOLOGICAL PROGRAMME: In the Americas, Dec. 1968, 24-29. INTERNATIONAL QUARANTINE: See Quarantine. IRAQ (Kurdistan): Malaria eradication campaign, May- June 1958, 22-25; May-June 1961, 10-12. IRAN: End of opium culture, Sept.-Oct. 1958, 20 - Malaria eradication in and around Shiraz, Mar.-Apr. 1960, 22-25. ISRAEL: Life in a young country, May 1963, 16-23. ITALY: Worker in Naples, Sept.-Oct. 1960, 10-11 - Sardinia after malaria eradication, Apr. 1968, 12-25. J JAPAN: Seishi Ryogo En Hospital for Crippled Children, May-June 1958, 32-35 - Bringing up children, June 1963, 29-30, 35 - Public health nurse, Dec. 1963, 3-6 - Tokyo, Aug. 1965, 4-9. JUVENILE DELINQUENCY: Teddy boys, blousons noirs & Co., May-June 1960, 28-33. K KALA AZAR: See Leishmaniasis. KENYA: District Medical Officer of Health, July 1968, 27-31. KOREA: Paragonimiasis and clonorchiasis, July-Aug. 1960, 26-27. KURU: Among Fore tribesmen (New Guinea), Jan. 1963, 5-9. KUWAIT: Oil money used for food and health, Jan. 1963, 14-19. KWASHIORKOR: Mar. 1963, 8 ; May 1963, 6-7. KYASANUR FOREST DISEASE: How it is spread, Nov. 1962, 19 - Investigation of, June 1963, 25-28. L LAOS: See Rehabilitation. LATIN AMERICA: Special issue, Sept.-Oct. 1965 - Foot and mouth disease, Dec. 1968, 18-23; See also : individual countries. LEGAL MEDICINE: Blood in, June 1968, 37-39. LEISHMANIASIS: WHO Reference Centre, May 1965, 19. LEPROSY: Nigeria, May-June 1958, 6-8 - Thailand (from L. to priesthood), Jan.-Feb. 1961, 28 - Progress against, in South-east Asia, Jan.-Feb. 1961, 29 - Eastern Mediterranean region, May-June 1962, 17 - Endemic disease service in West Africa, Apr. 1964, 22-25 - Research primordial for control, May 1966, 10-11 - World Leprosy Day, Jan. 1968, 28-29. LEPTOSPIROSIS: FAO/WHO and WHO reference laboratories, May 1965, 16 - And rats, Apr. 1967, 15; May 1968, 23. LEUKAEMIA: Jan. 1963, 10-11 ; June 1968, 32-33. M MAKEEVA, Dr OLGA: Farewell of Indian women to, Sept.-Oct. 1958, 20-21. MALARIA: Special issues: Mar.-Apr. 1960; "Extra issue" 1962; Apr. 1968 - Epidemic in Ethiopia, May-June 1960, 39 - WHO reference centres, May 1965, 17. MALARIA ERADICATION: Mexico, May-June 1958, 16-21 - Iraq, May-June 1958, 22-25 - Insecticide resist- ance, Mar.-Apr. 1960, 30-34; May-June 1961, 10-12 South-east Asia, Jan.-Feb. 1961, 12 - Danger at Aswan Dam, July-Aug. 1960, 25 - Need for experi- enced workers, July-Aug. 1960, 24 - Eastern Mediter- ranean, May-June 1962, 12-13 - Surveillance worker (India), Jan. 1963, 4 - Progress report, May 1966, 3-4 - Africa, Jan. 1967, 8-9, 11-13 - Situation in 1966, May 1967, 14-15 - Mauritius, May 1967, 22-23. MALAYSIA: Effects of industrialization in rural areas, Nov. 1964, 4-9. 4 MALI: Smallpox, July 1968, 14-17. MALTA: Mental health, water, waste disposal, Aug. 1968, 28-35. MASCULINITY: Hooliganism as an affirmation of, May-June 1960, 31. MAURITIUS: Malaria eradication, May 1967, 22-23. MEDICAL APPARATUS: New machines and mate- rials, Feb.-Mar. 1967, 24-31. MEDICAL ASSISTANTS: Training in South-east Asia (esp. Burma), Jan.-Feb. 1961, 16-17; See also : Auxiliary health officers. MEDICAL EDUCATION: Leyden (Netherlands), Sept.- Oct. 1959, 20-31 - Public health (Latin America), Sept.- Oct. 1961, 32-34 - Edinburgh (Scotland), Feb.-Mar. 1967, 8-17- WHO fellowships in 1966, May 1967, 18-19 - WHO travelling professors, May 1967, 20 - USSR, Oct. 1967, 10-11 - Long-term planning necessary, Mar. 1968, 56-59 - Baroda (India), Mar. 1968, 60-63 - Dar- es-Salaam (Tanzania), July 1968, 22-23. MENINGITIS, CEREBROSP INAL: Niger, Apr. 1964, 16-21. MENTAL HEALTH: Special issues: May-June 1959; July-Aug. 1961 - "Head against the wall" (film), Mar.-Apr. 1959, 2-9 - Aged and ageing, Jan.-Feb. 1960, 16-17 - Ethiopian priest treats hysteria, July- Aug. 1960, 26 - Research necessary, Sept.-Oct. 1960, 25 - South-east Asia in 1960, Jan.-Feb. 1961, 26-27, - Electroencephalograph in research, July-Aug. 1961, 11 - Part of total health (Dr P. V. Lemkan), Sept.-Oct. 1961, 37-38 - Primordial role of the family, Dec. 1962, 11-16 - Place of leisure, Dec. 1962, 17-23 - Among refugees, Apr. 1964, 26-30 - Malta, Aug. 1968, 28-32. MENTAL HELTH, CHILDREN: Copenhagen (Den- mark) consultations, May-June 1958, 15 - Sreening in Switzerland, May-June 1959, 22-23 - Education, May-June 1961, 9-11 - Importance, July-Aug. 1961, 20, 22 ; Nov.-Dec. 1961, 8-9. MENTAL HEALTH, STUDENTS: In Europe, Sept.- Oct. 1960, 13. MENTAL HEALTH, PSYCHIATRIC HOSPITALS: Open-door policy, Sept.-Oct. 1958, 22 - National Mental Hospital, Manila (Philippines), May-June 1959, 8-15 - Europe and America, May-June 1959, 18-26 - La Verriere, (France), July-Aug. 1960, 34-39; Apr. 1966. MEXICO: Malaria eradication campaign, May-June 1958, 16-21 - Military planning against malaria, A pr. 1968, 32-39. MIDWIFERY: Syrian training for traditional midwives, May-June 1961, 17; See also : Nurse-midwives. MIGRATION: Spanish emigrants to Argentina, Dec. 1965. MONGOLISM: Chromosome abnormality, July-Aug. 1961, 12. MOROCCO: Treatment for 10,000 paralysed by adul- terated oil (Meknes), Sept.-Oct. 1960, 38-39,; Nov.-Dec. 1960, 34-38 - Ten years of health planning, Dec. 1967, 26-31. MOSQUITO LEGEND: South Viet-Nam, Mar.-Apr. 1960, 20-21. N NARCOTICS: Eradication of opium culture, Iran, Sept.-Oct. 1958, 20 - Portrait of a hashish smoker, Jan.-Feb. 1960, 24-25 - Opium, Jan.-Feb. 1962, 18-23 - Special issue, July 1967 - "False Friends" (film) July 1967, 19-21. NEPAL: Malaria eradication, Mar.-Apr. 1960, 14-19; Jan.-Feb. 1961, 12-13. NETHERLANDS: Leyden University Medical School, Sept.-Oct. 1959, 20-31. NEW GUINEA: Kuru among Fore tribe, Jan. 1963, 5-9 - Life in the Moiree tribe, July-Aug. 1963, 26-28. NEW HEBRIDES ISLANDS: Aug. 1965, 24-33. NEW YORK CITY: Department of Health, Sept.-Oct. 1958, 6-15. NIGER: Epidemic of cerebrospinal meningitis, Apr. 1964, 16-21 ; Health situation, Jan. 1967, 13-23, passim. NIGERIA: Leprosy, May-June 1958, 6-8 - Yaws, Sept.- Oct. 1958, 22-23. NILE RIVER: July-Aug. 1964, 20-27. NOMADS: Malaria eradication campaign among Kurds, May-June 1958, 22-25 - Trying to prevent transport of diseases by, May-June 1962, 24-27 - Somalia, May-June 1961, 16. NORWAY: Bringing up children, July-Aug. 1963, 29-30, 35. NURSES: Career of WHO nurse-tutor, May-June 1958, 26-27 -"People like Maria" (film), Jan.-Feb. 1959, 25-31 - Student nurses abroad, May-June 1961, 18-19 - Special issue: Nursing in the world today, Dec. 1963 - More responsibilities, May 1967, 10-12. NURSE-MIDWIVES: Training, Afghanistan, Jan.-Feb. 1961, 14-15 - India, Dec. 1963, 10-13, NUTRITION: Development of Incaparina, May-June 1960, 37 - Over-eating in Europe, May-June 1960, 38 - Latin America, Sept.-Oct. 1961 ; 26-30 - Waste, worst enemy of good, Nov.-Dec. 1961, 11-12 - Special issue, Mar. 1963 - Diseases of hunger, Mar. 1963, 8-10 - Panama and Haiti, May 1967, 24-26 - Children, Africa, July 1968, 13 - Adaptation to environment, Dec. 1968, 27-28. 0 OCCUPATIONAL HEALTH: See Industrial and occupa- tional health. OLYMPIC MEDICAL ARCHIVES: Sept. 1968, 9. O'NYONG NYONG FEVER: A new disease? May 1963, 27-28. ONCHOCERCIASIS: Mar.-Apr. 1962, 16-17. OPIUM: See Narcotics. PAINTING: Psychiatric patients', May-June 1959, 2, 16-17. PAKISTAN: Smallpox, cholera, leprosy, May-June 1962, 15-17 - Modern fishing harbour at Karachi, May 1963, 8-9. PALESTINE: Refugees, Nov. 1963, 2-23. PAMPANA, Dr EMILIO: Memoirs of 40 years against malaria, Mar.-Apr. 1960, 26-29. PANAMA: Applied nutrition programme, May 1967, 24. PAN AMERICAN HEALTH ORGANIZATION: History, Sept.-Oct. 1961, 4-6 - Border Field Office (USA- Mexico), Jan. 1963, 26-29. PARAGONIMIASIS: Public health problem in Korea, July-Aug. 1960, 26-27. PARAGUAY: Water for Asuncion, July-Aug. 1960, 27. PARISOT, PROF. JACQUES : Public health specialist (profile), May-June 1964, 3-9. PELLAGRA: Mar. 1963, 10. PHILIPPINES: Rice-growing, Mar. 1963, 20. PHILIPPINES, (health): Rural health, May-June 1958, 30-31 - National Mental Hospital, May-June 1959, 5 8-15 - Mental Health services, May-June 1960, 38 - Health in countryside, Aug. 1965, 34-43. PHYSICAL FITNESS: Tests for women proposed by YWCA (letter), July-Aug. 1963, 2. PLAGUE: Effect on a village in Uttar Pradesh, India, May-June 1958, 12-13 - China, 1920-1941, Mar.-Apr. 1959, 12-13 - Search for the reservoir, July-Aug. 1963, 9 - History of, on map, July-Aug. 1963, 10-11 - Rats, Apr. 1967, 7-14. POISON: Paris centre for, Jan.-Feb. 1962, 14-17. POLAND: Health care for children, Sept.-Oct. 1960, 3-4. POLIO: Rehabilitation of Japanese child, May-June 1958, 32-35-History of, May-June 1961, 29-34- Increas- ing in warm climates, May 1966, 8-9. POLLITZER, Dr ROBERT: Biography: Typhus, plague, cholera, Mar.-Apr. 1959, 10-13. POPULATION: Second U.N. Conference on (Bel- grade), Nov. 1965 - Life-span, Mar. 1968, 11-17 - Rela- ted to food: 2000 A.D., Mar. 1968, 24-30. PROFESSIONAL TRAINING: See Medical assistants, medical education, nurses, etc. PSYCHIATRIC NURSING: France, Dec. 1963, 14-17. PSYCHIATRY, relationship to medicine as a whole : "Letter to a young doctor", Sept.-Oct. 1959, 26-27. PUBLIC HEALTH: Survey of Europe, Sept.-Oct. 1960, 28-31 - Sanitary and epidemiological station (SANE- PID) USSR, Sept.-Oct. 1960, 27 ; Oct. 1967, 7-9 - Work of Medical Officer of Health for Liverpool, Sept.- Oct. 1963, 46-47; See also various countries. Q QUARANTINE: Mecca Pilgrimage, special regula- tions, Jan.-Feb. 1959, 18-19 - History of, Jan.-Feb. 1959, 19-21 - 1961 Mecca Pilgrimage free of quaranti- nable diseases, May-June 1962, 37-39 - Border cross- ing, USA-Mexico, Jan. 1963, 26-29 - WHO role in, May 1963, 2-3 - Report for 1966, May 1967, 16-17 - Medical aspects of Mecca Pilgrimage, Aug.-Sept. 1967, 10-13. R RABIES: What it is, Sept.-Oct. 1958, 3-5 - Dangers of dogs, July-Aug. 1960, 12-13 - Five-year programme in Ceylon, Jan.-Feb. 1961, 38 - Increasing, May 1968, 32. RADIATION: WHO interest in, May-June 1958, 28 - Quantities rising, Jan.-Feb. 1962, 4-7 - Effects on parts of body, Nov. 1962, 34-35. RADIATION MEDICINE: Basic vocabulary, Sept.- Oct. 1959, 28-29. RADIOACTIVE WASTES: Disposal, Jan.-Feb. 1959, 10-11. RADIOISOTOPES: Tritium, use in medicine, Jan.- Feb. 1959, 13-14. RATS: Special issue, Apr. 1967. RED CROSS: 100 years: history and work, Apr. 1963. REFUGEES: Palestinian, Nov. 1963, 2-23 - Mental health problems among, Apr. 1964, 26-30 - U.N. High Commission for, Oct. 1966, 18-31. REHABILITATION: Of injured workers, Sept.-Oct. 1958, 22-23 - Greece, Sept.-Oct. 1960, 5-6 - Laos, Oct.-Nov. 1963, 40-43. REPORT ON THE WORLD HEALTH SITUATION, FIRST: Photo essay, Nov.-Dec. 1958. RESEARCH, MEDICAL: WHO Advisory Committee, Jan.-Feb. 1960, 33; Nov. 1962, 5 - Views on (Dr Ber- nardo Houssay interview), Sept.-Oct. 1961, 36 - Special issue, Nov. 1962 - WHO Reference centres, May 1965 - USA National Institutes of Health, Jan.- Fev. 1968, 14-27. RESPIRATORY VIRUSES (other than influenza): May 1965, 5. RHINE RIVER: Life along the, June 1963, 16-21. RICKETTSIAL DISEASES: Studied in WHO refe- rence Centre, May 1965, 9. RINDERPEST: Menace to protein supplies, May 1968, 33. RIVOLIER, Dr JEAN: The anatomy of adventure, June 1963, 22-24. ROAD ACCIDENTS: See Accidents. ROMANIA: Health in, Nov. 1964, 10-33. RURAL LIFE: Bulgaria, Sept.-Oct. 1960, 7-8; Nov. 1963, 24-31 - Nurse, Brazil, Dec. 1963, 18-22 - Village doctor, USSR, Oct. 1967, 16-21. S SAUDI ARABIA: Medical aspects of Mecca Pilgri- mage, Aug.-Sept. 1967, 10-13; See also : Quarantine. SCHISTOSOMIASIS: See Bilharziasis. SCHOOLS: Sports in, Sept. 1968, 28-31. SCIENCE: Essay on the scientific dreams of man (R. Dubos), July-Aug. 1963, 12-15. SCOTLAND: Doctor in the Hebrides, Jan.-Feb. 1962, 30-35 - Edinburgh University School of Medicine, Feb.-Mar. 1967, 8-17 - Coronary Care Unit, Edinburgh Royal Infirmary, Aug. 1968, 16-20. SCURVY: Mar. 1963, 9-10. SEAFARERS: Health services, esp. Norwegian, Sept.- Oct. 1960, 12 - Life and health of, Jan.-Feb. 1968, 30-47. SERUM BANKS: Where, what, why ? May 1965, 10. SHIPWRECK: What to do in case of, Jan. 1963, 12-13. SINGAPORE: Life in, Aug. 1965, 18-23. SLEEPING SICKNESS (African) : See Trypanosomiasis. SMALLPDX: Eradication given priority South-east Asia, Jan.-Feb. 1960, 38 - World situation 1959, May- June 1960, 37 - South-east Asia, Jan.-Feb. 1961, 25 - Eastern Mediterranean, May-June 1962, 15-16 - Special issue, Mar. 1965 - Still exists, Jan.-Feb. 1968, 2-13; Voir : Cambodia, Mali, Sweden. SOMALIA: Nomads and malaria, May-June 1961, 16-17. SOMALILAND: Malaria eradication excites opposi- tion, May-June 1960, 39. SOUTH-EAST ASIA, WHO region: Special issue, Jan.-Feb. 1961 ; See also : individual countries. SNAKES: Snake bite and serum, June 1963, 14-15. SPACE MEDICINE: Physiology and postulates, Jan. 1964, 3-17 - Boris Egorov, doctor-cosmonaut, Feb.- Mar. 1967, 32-39 - And biology, Oct. 1967, 34. SPORTS: Accident prevention (mountaineering, motor racing, motor-cycle racing, parachuting), Mar.-Apr. 1961, 33-37 - And exercice, USSR, Oct. 1967, 32-33 - Special issue, medical aspects, Sept. 1968. STAMPS, POSTAGE: History of WHO in, Jan.-Feb. 1960, 18-23 - Malaria, the world united against, "Extra issue", 1962, 30; Mar.-Apr. 1962, 2-3 - WHO nurses on Yemenite, Jan. 1963, 4 - Bilharziasis illustrated, June 1963, 2. STAPHYLOCOCCAL INFECTIONS: WHO Centre for, May 1965, 12. STUDENTS: Mental health (Europe), Sept.-Oct. 1960, 13. SUDAN: Venereal disease among Murle tribe, Sept.- Oct. 1959, 2-5 - Gezira irrigation scheme, May-June 6 1962, 6-8 - Khartoum Nursing College, Dec. 1963, 36-39. SWEDEN: Karolinska Hospital (Stockholm), Jan.-Feb. 1960,10-15; Smallpox epidemic, Sept.-Oct. 1963,58-61 - Nurses, Dec. 1963, 30-35 - Computers for patient care and health administration, Aug. 1968, 8-15. SWITZERLAND: Screening children for psycholo- gical problems (Valais), May-June 1959, 22-23. SYPHILIS: Why has it returned ? Nov. 1964, 34-37; See also : Venereal diseases. SYRIA: Midwife training, May-June 1961, 17. T TANZANIA: Dar-es-Salaam Faculty of Medicine, July 1968, 22-23. TATERA INDICA: Reservoir of plague? May-June 1958, 13. TEACHERS AND TEACHING: City schoolmistress, Oct. 1964, 4-17 - Communications techniques in teaching, Jan.-Feb. 1965, 56-61 ; See also : Medical education. THAILAND: Cholera epidemic (summer 1958), Jan.- Feb. 1959, 22-24 - Beri-beri in, Mar. 1963, 24. THALIDOMID: See: Drugs, Control of. TOKELAU ISLANDS: Fighting mosquitos with fun- gus, May-June 1961, 12-15. TOGO: Malaria eradication, Apr. 1968, 26-29. TONGA: Water, July-Aug. 1964, 38-41 - Water system working, May 1967, 28-29. TRACHOMA: May-June 1958, 9-11 - "Open your eyes" (film), July-Aug. 1959, 24-25 - Studied in WHO Refe- rence Centre, May 1965, 8 - Increasing, May 1966, 9. TRANSPORT: Imagination needed to solve pro- blems, May 1963, 10-11 ; See also : Urbanization. TRAVEL AND TOURISM: WHO Manuel ou Air Travel (Sanitation), Sept.-Oct. 1958, 20; Aug.-Sept. 1967, 3-31. TREPONEMATOSES: WHO reference centres, May 1965, 15; See also : Venereal diseases. TRICHINOSIS: And rats, Apr. 1967, 14-15. TRITIUM: Use in medicine, Jan.-Feb. 1959, 13-14. TRYPANOSOMIASIS: American (Chagas' disease), July-Aug. 1959, 14-15 - African (sleeping sickness), Jan. 1967, 13- Botswana, July 1968, 18-21. TUBERCULOSIS: Birth of BCG vaccine, Jan.-Feb. 1960, 26-28 - Eastern Mediterranean region, May-June 1962, 36 - Special issue, Mar. 1964 - WHO Reference Laboratory, May 1965, 13 - Progress report, May 1966, 4-5 - Communications science in epidemiology, May 1967, 10; See also : India. TUNISIA: Campaign against trachoma, May-June 1962, 35-36 - War on tuberculosis, Mar. 1964, 22-25 - Uni- versity of Tunis Medical School, 27-28. TURKEY: Maternal and child health centres, Sept.- Oct. 1960, 6-7 - Water for Istanbul, Mar. 1968, 46-49. TYPHUS: In WWI prisoner-of-war camps, Mar.-Apr. 1959, 11-12 - Insecticide campaign in Afghanistan, Jan.-Feb. 1960, 38 - Murine, Apr. 1967, 15. U UNDULANT FEVER: See Brucellosis. UNESCO: The first 20 years, Dec. 1966. UNICEF: 20 years of co-operation with WHO, Dec. 1967, 3-25. URBANIZATION: In Africa, Jan.-Feb. 1960, 38 - Pro- blems, seen by a doctor, Dec. 1962, 3-9 - Evoked by No Andric, Dec. 1962, 24-31 - In Hong Kong, Mar. 1963, 22 - Life in Chandigarh (India), Jan. 1964, 22-27 - Cities tomorrow, Dec. 1964 - Man and his cities, special issue, Feb.-Mar. 1966 - For tomorrow, Mar. 1968, 39-45. URBANIZATION, MENTAL HEALTH: City office workers, Sept.-Oct. 1960, 14-16 - Responsibilities of social psychiatry, Jan. 1964, 28-31. UNITED STATES OF AMERICA: New York City Department of Health, Sept.-Oct. 1958, 6-15 - Bring- ing up children, Feb. 1963, 29-31 - National Insti- tutes of Health, Jan.-Feb. 1968, 14-27. USSR: Health services, Jan.-Feb. 1960, 34-37; May- June 1960, 2-16 - Bringing up children, May 1963, 29-31 - Campaign against cancer, Sept. 1964, 30-37 - Health 50 years after the Revolution, Oct. 1967. V VECTORS: Diseases of, WHO Reference Centre, May 1965, 20; See also : Entomology, Malaria. VENEREAL DISEASES: Warning against over-opti- mism, Sept.-Oct. 1958, 18-19 - Sudan, Murle Tribe, Sept.-Oct. 1959, 2-5 - Rates rising among teenagers, May-June 1960, 32 - Return of syphilis, Nov. 1964, 34-37 - Relationship between syphilis and yaws, May 1966, 5-6. VERNEJOUL, ROBERT DE: Surgeon (profile), May- June 1964, 18-20. VIET-NAM: The mosquito legend, Mar.-Apr. 1960, 20-21. VIRUS: What are viruses? Sept.-Oct. 1960, 22 - Dis- eases, May 1967, 4-5. w WATER: Launching of WHO spear-head programme, May-June 1960, 22-23- Calcutta, Jan.-Feb. 1961, 30-35 - How to get more, e.g. Latin America, Sept.-Oct. 1961, 19-21 - In Asuncion, Paraguay, July-Aug. 1960, 27 - Special issue, July-Aug. 1964 - Tonga, May 1967, 28-29 - Istanbul, Mar. 1968, 46-49 - Malta, Aug. 1968, 34. WESTERN PACIFIC REGION: Special issue, Aug. 1965. WHO: Its work in 1961, July-Aug. 1962- Place in U.N. family, Jan. 1963, 2-3 - Organization, Feb. 1963, 2-3 - History, Mar. 1963, 2-3 - Work in international qua- rantine, May 1963, 2-3 - Day to day, June 1963, 3-6 - 800 projects in 1963, special issue, Feb. 1964 - Work in 1966, May 1967- Fellowships in 1966, May 1967, 18-19. WHO, Voluntary Fund for Health Promotion ; Sept.-Oct. 1963, 42-45 ; Dec. 1968, 18-19. WHO, field personnel ; Who they are, July-Aug. 1959, 3-13. - World map, Nov.-Dec. 1960, 32-33 - Nurses, Dec. 1963, 24-29 - Map, Feb. 1964, 10-11. WHO, history in stamps: Jan.-Feb. 1960, 18-23. WHO, new headquarters building: Jan.-Feb.1965, 62-64 - Moving in, May 1966, 13-31 - Photo album, June- July 1966. WHO, 10th and 20th anniversary: The world is healthier, May-June 1958, 4-5 - 1968 calendar, Nov. 1967 - Special issue, Mar. 1968. WOMEN: Emergence of in Eastern Mediterranean Region, Mar.-Apr. 1959, 14-19 - Status of, in Eastern Mediterranean region, May-June 1962, 28-34 - And sports, Sept. 1968, 22-27. Y YAWS: Nigeria, Sept.-Oct. 1958, 22-23 - Ship used for eradication in Indonesia, May-June 1960, 38; Jan.- Feb. 1961, 18-19 - Situation in 1964, Nov. 1964, 38-41 - Surveillance studies, May 1967, 5-7. YUGOSLAVIA; Hydatidosis, Sept.-Oct. 1958, 22. z ZOONOSES: See : Animals. ZOOS: Gerald Durrell's, May 1968, 36-47. 7 WORLD HEALTH ORGANIZATION Geneva, Switzerland Printed in Switzerland