降低核战争的风险卫生专业人员的作用。

IF 3.3 4区 医学 Q2 HEMATOLOGY
Kamran Abbasi, Parveen Ali, Virginia Barbour, Kirsten Bibbins-Domingo, Marcel G. M. Olde Rikkert, Richard Horton, Robert Mash, Carlos Monteiro, Elena N. Naumova, Eric J. Rubin, Peush Sahni, James Tumwine, Paul Yonga, Chris Zielinski, Arun Mitra, Tilman Ruff, Andy Haines, Ira Helfand
{"title":"降低核战争的风险卫生专业人员的作用。","authors":"Kamran Abbasi,&nbsp;Parveen Ali,&nbsp;Virginia Barbour,&nbsp;Kirsten Bibbins-Domingo,&nbsp;Marcel G. M. Olde Rikkert,&nbsp;Richard Horton,&nbsp;Robert Mash,&nbsp;Carlos Monteiro,&nbsp;Elena N. Naumova,&nbsp;Eric J. Rubin,&nbsp;Peush Sahni,&nbsp;James Tumwine,&nbsp;Paul Yonga,&nbsp;Chris Zielinski,&nbsp;Arun Mitra,&nbsp;Tilman Ruff,&nbsp;Andy Haines,&nbsp;Ira Helfand","doi":"10.1002/hon.3218","DOIUrl":null,"url":null,"abstract":"<p>In January 2023, the Science and Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90 s before midnight, reflecting the growing risk of nuclear war.<span><sup>1</sup></span> In August 2022, the UN Secretary-General António Guterres warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War.<span><sup>2</sup></span> The danger has been underlined by growing tensions between many nuclear armed states.<span><sup>1, 3</sup></span> As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet—and urge action to prevent it.</p><p>Current nuclear arms control and non-proliferation efforts are inadequate to protect the world's population against the threat of nuclear war by design, error, or miscalculation. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations “to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control”.<span><sup>4</sup></span> Progress has been disappointingly slow and the most recent NPT review conference in 2022 ended without an agreed statement.<span><sup>5</sup></span> There are many examples of near disasters that have exposed the risks of depending on nuclear deterrence for the indefinite future.<span><sup>6</sup></span> Modernization of nuclear arsenals could increase risks: for example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation.</p><p>Any use of nuclear weapons would be catastrophic for humanity. Even a “limited” nuclear war involving only 250 of the 13,000 nuclear weapons in the world could kill 120 million people outright and cause global climate disruption leading to a nuclear famine, putting 2 billion people at risk.<span><sup>7, 8</sup></span> A large-scale nuclear war between the USA and Russia could kill 200 million people or more in the near term, and potentially cause a global “nuclear winter” that could kill 5–6 billion people, threatening the survival of humanity.<span><sup>7, 8</sup></span> Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly. The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem—by abolishing nuclear weapons.</p><p>The health community has had a crucial role in efforts to reduce the risk of nuclear war and must continue to do so in the future.<span><sup>9</sup></span> In the 1980s the efforts of health professionals, led by the International Physicians for the Prevention of Nuclear War (IPPNW), helped to end the Cold War arms race by educating policy makers and the public on both sides of the Iron Curtain about the medical consequences of nuclear war. This was recognised when the 1985 Nobel Peace Prize was awarded to the IPPNW.<span><sup>10</sup></span>(http://www.ippnw.org).</p><p>In 2007, the IPPNW launched the International Campaign to Abolish Nuclear Weapons, which grew into a global civil society campaign with hundreds of partner organisations. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. International medical organisations, including the International Committee of the Red Cross, the IPPNW, the World Medical Association, the World Federation of Public Health Associations, and the International Council of Nurses, had key roles in the process leading up to the negotiations, and in the negotiations themselves, presenting the scientific evidence about the catastrophic health and environmental consequences of nuclear weapons and nuclear war. They continued this important collaboration during the First Meeting of the States Parties to the Treaty on the Prohibition of Nuclear Weapons, which currently has 92 signatories, including 68 member states.<span><sup>11</sup></span></p><p>We now call on health professional associations to inform their members worldwide about the threat to human survival and to join with the IPPNW to support efforts to reduce the near-term risks of nuclear war, including three immediate steps on the part of nuclear-armed states and their Allies: first, adopt a no first use policy<span><sup>12</sup></span>; second, take their nuclear weapons off hair-trigger alert; and, third, urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts. We further ask them to work for a definitive end to the nuclear threat by supporting the urgent commencement of negotiations among the nuclear-armed states for a verifiable, timebound agreement to eliminate their nuclear weapons in accordance with commitments in the NPT, opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons.</p><p>The danger is great and growing. The nuclear armed states must eliminate their nuclear arsenals before they eliminate us. The health community played a decisive part during the Cold War and more recently in the development of the Treaty on the Prohibition of Nuclear Weapons. We must take up this challenge again as an urgent priority, working with renewed energy to reduce the risks of nuclear war and to eliminate nuclear weapons.</p><p>Ira Helfand and Andy Haines developed the idea of the editorial and led drafting along with Chris Zielinski. All other authors contributed significantly to the editorial content.</p><p>KB-D is a full-time employee of the American Medical Association, working as the Editor-in-Chief of JAMA and the JAMA Network. AH is principal investigator of the Pathfinder Initiative 2020–2025, co-investigator of Sustainable Healthy Food Systems research program 2017–2023, and co-investigator of Complex Urban Systems for Sustainability and Health 2017–2023, all funded by the Wellcome Trust, with additional funding from the Oak Foundation for the Pathfinder Initiative, and he reports royalties from Cambridge University Press for the coauthored book Planetary Health; consultancy fees paid to his institution from the Wellcome Trust for his role as Senior Advisor on Climate Change and Health in 2021; travel/meeting support from WHO and Human Frontiers Science Program; and he is a member of the Cool Roofs trial steering committee Nouna Research Center, Burkina Faso/University of Heidelberg, is Co-chair of the International Advisory Committee, NIHR Clean-Air (Africa) Global Health Research Unit, is a member of the Independent Advisory Group, Collaboration for the Establishment of an African Population Cohort Consortium, and he was Co-chair of the InterAcademy Partnership, Climate Change and Health Working Group 2019–2022 and Co-chair of the Academy of Medical Sciences/Royal Society working group on “A healthy future—tackling climate change mitigation and human health together” 2020–2021 (all unpaid). IH reports honoraria for several speaking engagements, all donated to Back from the Brink, the IPPNW, or Physicians for Social Responsibility; travel/meeting support for Nobel Peace Laureates' Summit, the World Federation of Public Health Associations World Congress, and the UN Human Rights Commission Youth Summit; and he is a member of the steering committee of Back from the Brink and the International Steering Group of the International Campaign to Abolish Nuclear Weapons, a Board member of the IPPNW and Physicians for Social Responsibility, and a Trustee of the Phillips Exeter Academy (all unpaid). MGMOR reports research grants from the Dutch Research Council, NOW (grant number COMPL.21COV.001) and from the Netherlands Organisation for Health Research ZonMw (grant number 09120012010063) and he is Chair of the Dutch guideline committee on cognitive impairments and dementia. TR reports a contract with the Institute for Energy and Environmental Research (USA) for papers addressing the health and environmental consequences of nuclear testing in multiple locations, including Australia, French Polynesia, central Pacific, and China; honorarium from The Choisun Ilbo media group in South Korea for a lecture on nuclear weapons in 2022 and for nuclear weapons presentations from Hyogo Medical Practitioners Association (Japan), Peace Boat (Japan), and the University of Sydney; he was an expert witness on radiation and health for Environmental Justice Australia acting for Mine-Free Glenaladale regarding proposed Fingerboards Mineral Sands Mine to the Victorian Government Fingerboards Inquiry and Advisory Committee; he is a member of RV3 Rotavirus Vaccine Development Scientific Advisory Board, Murdoch Children's Research Institute/Royal Children's Hospital; he is a member of the Committee of International Campaign to Abolish Nuclear Weapons Australia; he is a member of the Internet Peace Prize Award Committee (Sunfull Foundation, South Korea); he was a member of the Victorian International Humanitarian Law Advisory Committee, Australian Red Cross; he is a Board member of the Initiative for Peacebuilding, Faculty of Arts, University of Melbourne; he is an At-large Board member of the IPPNW; he was Co-president of the IPPNW 2012–23; and he is Honorary Principal Fellow, Melbourne School of Population and Global Health, University of Melbourne. PY reports grants from Atea Pharmaceuticals; honoraria for lectures, presentations, and educational events from bioMérieux and Pfizer Pharmaceuticals; fees for participation on an advisory board from Pfizer Pharmaceuticals; and he is a member of the Antimicrobial Stewardship Study Group Executive Committee (2022–2024) and the Clinical Practice Guideline Panel on Vaccinations in Immunocompromised hosts for the European Society of Clinical Microbiology and Infectious Diseases. CZ reports consulting fees for his role as senior adviser on the international journals project from the IPPNW. All the other authors declare no competing interests.</p><p>International Physicians for the Prevention of Nuclear War.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.3218","citationCount":"0","resultStr":"{\"title\":\"Reducing the risks of nuclear war—The role of health professionals\",\"authors\":\"Kamran Abbasi,&nbsp;Parveen Ali,&nbsp;Virginia Barbour,&nbsp;Kirsten Bibbins-Domingo,&nbsp;Marcel G. M. Olde Rikkert,&nbsp;Richard Horton,&nbsp;Robert Mash,&nbsp;Carlos Monteiro,&nbsp;Elena N. Naumova,&nbsp;Eric J. Rubin,&nbsp;Peush Sahni,&nbsp;James Tumwine,&nbsp;Paul Yonga,&nbsp;Chris Zielinski,&nbsp;Arun Mitra,&nbsp;Tilman Ruff,&nbsp;Andy Haines,&nbsp;Ira Helfand\",\"doi\":\"10.1002/hon.3218\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>In January 2023, the Science and Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90 s before midnight, reflecting the growing risk of nuclear war.<span><sup>1</sup></span> In August 2022, the UN Secretary-General António Guterres warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War.<span><sup>2</sup></span> The danger has been underlined by growing tensions between many nuclear armed states.<span><sup>1, 3</sup></span> As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet—and urge action to prevent it.</p><p>Current nuclear arms control and non-proliferation efforts are inadequate to protect the world's population against the threat of nuclear war by design, error, or miscalculation. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations “to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control”.<span><sup>4</sup></span> Progress has been disappointingly slow and the most recent NPT review conference in 2022 ended without an agreed statement.<span><sup>5</sup></span> There are many examples of near disasters that have exposed the risks of depending on nuclear deterrence for the indefinite future.<span><sup>6</sup></span> Modernization of nuclear arsenals could increase risks: for example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation.</p><p>Any use of nuclear weapons would be catastrophic for humanity. Even a “limited” nuclear war involving only 250 of the 13,000 nuclear weapons in the world could kill 120 million people outright and cause global climate disruption leading to a nuclear famine, putting 2 billion people at risk.<span><sup>7, 8</sup></span> A large-scale nuclear war between the USA and Russia could kill 200 million people or more in the near term, and potentially cause a global “nuclear winter” that could kill 5–6 billion people, threatening the survival of humanity.<span><sup>7, 8</sup></span> Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly. The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem—by abolishing nuclear weapons.</p><p>The health community has had a crucial role in efforts to reduce the risk of nuclear war and must continue to do so in the future.<span><sup>9</sup></span> In the 1980s the efforts of health professionals, led by the International Physicians for the Prevention of Nuclear War (IPPNW), helped to end the Cold War arms race by educating policy makers and the public on both sides of the Iron Curtain about the medical consequences of nuclear war. This was recognised when the 1985 Nobel Peace Prize was awarded to the IPPNW.<span><sup>10</sup></span>(http://www.ippnw.org).</p><p>In 2007, the IPPNW launched the International Campaign to Abolish Nuclear Weapons, which grew into a global civil society campaign with hundreds of partner organisations. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. International medical organisations, including the International Committee of the Red Cross, the IPPNW, the World Medical Association, the World Federation of Public Health Associations, and the International Council of Nurses, had key roles in the process leading up to the negotiations, and in the negotiations themselves, presenting the scientific evidence about the catastrophic health and environmental consequences of nuclear weapons and nuclear war. They continued this important collaboration during the First Meeting of the States Parties to the Treaty on the Prohibition of Nuclear Weapons, which currently has 92 signatories, including 68 member states.<span><sup>11</sup></span></p><p>We now call on health professional associations to inform their members worldwide about the threat to human survival and to join with the IPPNW to support efforts to reduce the near-term risks of nuclear war, including three immediate steps on the part of nuclear-armed states and their Allies: first, adopt a no first use policy<span><sup>12</sup></span>; second, take their nuclear weapons off hair-trigger alert; and, third, urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts. We further ask them to work for a definitive end to the nuclear threat by supporting the urgent commencement of negotiations among the nuclear-armed states for a verifiable, timebound agreement to eliminate their nuclear weapons in accordance with commitments in the NPT, opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons.</p><p>The danger is great and growing. The nuclear armed states must eliminate their nuclear arsenals before they eliminate us. The health community played a decisive part during the Cold War and more recently in the development of the Treaty on the Prohibition of Nuclear Weapons. We must take up this challenge again as an urgent priority, working with renewed energy to reduce the risks of nuclear war and to eliminate nuclear weapons.</p><p>Ira Helfand and Andy Haines developed the idea of the editorial and led drafting along with Chris Zielinski. All other authors contributed significantly to the editorial content.</p><p>KB-D is a full-time employee of the American Medical Association, working as the Editor-in-Chief of JAMA and the JAMA Network. AH is principal investigator of the Pathfinder Initiative 2020–2025, co-investigator of Sustainable Healthy Food Systems research program 2017–2023, and co-investigator of Complex Urban Systems for Sustainability and Health 2017–2023, all funded by the Wellcome Trust, with additional funding from the Oak Foundation for the Pathfinder Initiative, and he reports royalties from Cambridge University Press for the coauthored book Planetary Health; consultancy fees paid to his institution from the Wellcome Trust for his role as Senior Advisor on Climate Change and Health in 2021; travel/meeting support from WHO and Human Frontiers Science Program; and he is a member of the Cool Roofs trial steering committee Nouna Research Center, Burkina Faso/University of Heidelberg, is Co-chair of the International Advisory Committee, NIHR Clean-Air (Africa) Global Health Research Unit, is a member of the Independent Advisory Group, Collaboration for the Establishment of an African Population Cohort Consortium, and he was Co-chair of the InterAcademy Partnership, Climate Change and Health Working Group 2019–2022 and Co-chair of the Academy of Medical Sciences/Royal Society working group on “A healthy future—tackling climate change mitigation and human health together” 2020–2021 (all unpaid). IH reports honoraria for several speaking engagements, all donated to Back from the Brink, the IPPNW, or Physicians for Social Responsibility; travel/meeting support for Nobel Peace Laureates' Summit, the World Federation of Public Health Associations World Congress, and the UN Human Rights Commission Youth Summit; and he is a member of the steering committee of Back from the Brink and the International Steering Group of the International Campaign to Abolish Nuclear Weapons, a Board member of the IPPNW and Physicians for Social Responsibility, and a Trustee of the Phillips Exeter Academy (all unpaid). MGMOR reports research grants from the Dutch Research Council, NOW (grant number COMPL.21COV.001) and from the Netherlands Organisation for Health Research ZonMw (grant number 09120012010063) and he is Chair of the Dutch guideline committee on cognitive impairments and dementia. TR reports a contract with the Institute for Energy and Environmental Research (USA) for papers addressing the health and environmental consequences of nuclear testing in multiple locations, including Australia, French Polynesia, central Pacific, and China; honorarium from The Choisun Ilbo media group in South Korea for a lecture on nuclear weapons in 2022 and for nuclear weapons presentations from Hyogo Medical Practitioners Association (Japan), Peace Boat (Japan), and the University of Sydney; he was an expert witness on radiation and health for Environmental Justice Australia acting for Mine-Free Glenaladale regarding proposed Fingerboards Mineral Sands Mine to the Victorian Government Fingerboards Inquiry and Advisory Committee; he is a member of RV3 Rotavirus Vaccine Development Scientific Advisory Board, Murdoch Children's Research Institute/Royal Children's Hospital; he is a member of the Committee of International Campaign to Abolish Nuclear Weapons Australia; he is a member of the Internet Peace Prize Award Committee (Sunfull Foundation, South Korea); he was a member of the Victorian International Humanitarian Law Advisory Committee, Australian Red Cross; he is a Board member of the Initiative for Peacebuilding, Faculty of Arts, University of Melbourne; he is an At-large Board member of the IPPNW; he was Co-president of the IPPNW 2012–23; and he is Honorary Principal Fellow, Melbourne School of Population and Global Health, University of Melbourne. PY reports grants from Atea Pharmaceuticals; honoraria for lectures, presentations, and educational events from bioMérieux and Pfizer Pharmaceuticals; fees for participation on an advisory board from Pfizer Pharmaceuticals; and he is a member of the Antimicrobial Stewardship Study Group Executive Committee (2022–2024) and the Clinical Practice Guideline Panel on Vaccinations in Immunocompromised hosts for the European Society of Clinical Microbiology and Infectious Diseases. CZ reports consulting fees for his role as senior adviser on the international journals project from the IPPNW. All the other authors declare no competing interests.</p><p>International Physicians for the Prevention of Nuclear War.</p>\",\"PeriodicalId\":12882,\"journal\":{\"name\":\"Hematological Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2023-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.3218\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematological Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hon.3218\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematological Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hon.3218","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
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摘要

2023年1月,《原子科学家公报》科学与安全委员会将世界末日时钟的指针调快至午夜前90秒,反映出核战争的风险日益增加2022年8月,联合国秘书长António古特雷斯警告说,世界正处于“冷战高峰以来从未见过的核危险时期”。许多拥有核武器的国家之间日益紧张的局势凸显了这种危险。1,3作为世界各地卫生和医学期刊的编辑,我们呼吁卫生专业人员提醒公众和我们的领导人注意这一对公共卫生和地球基本生命支持系统的重大危险,并敦促采取行动加以预防。目前的核军备控制和不扩散努力不足以保护世界人民免受蓄意、错误或误判造成的核战争威胁。3 .《不扩散核武器条约》(不扩散条约)要求190个参加国中的每一个国家“真诚地就早日停止核军备竞赛和核裁军的有效措施以及就一项在严格和有效国际监督下的全面彻底裁军条约进行谈判”进展缓慢得令人失望,2022年举行的最近一次《不扩散核武器条约》审议会议没有达成一致声明有许多近乎灾难的例子暴露了在不确定的未来依赖核威慑的危险核武库的现代化可能会增加风险:例如,高超音速导弹减少了区分攻击和虚假警报的时间,增加了迅速升级的可能性。任何核武器的使用对人类来说都是灾难性的。即使是一场“有限的”核战争,只涉及世界上13000枚核武器中的250枚,也可能彻底杀死1.2亿人,并导致全球气候破坏,导致核饥荒,使20亿人处于危险之中。美国和俄罗斯之间的大规模核战争可能会在短期内杀死2亿人或更多,并可能导致全球“核冬天”,可能会杀死50 - 60亿人,威胁到人类的生存。一旦核武器被引爆,就可能迅速升级为全面核战争。因此,防止使用核武器是一项紧迫的公共卫生优先事项,还必须采取根本步骤,通过废除核武器来解决问题的根源。卫生界在减少核战争风险的努力中发挥了至关重要的作用,今后必须继续这样做20世纪80年代,在国际防止核战争医师协会(IPPNW)的领导下,卫生专业人员通过教育铁幕两侧的决策者和公众了解核战争的医疗后果,帮助结束了冷战军备竞赛。1985年诺贝尔和平奖授予IPPNW.10(http://www.ippnw.org).In 2007年,IPPNW发起了国际废除核武器运动,该运动发展成为一项拥有数百个伙伴组织的全球公民社会运动。2017年《禁止核武器条约》的通过为废除核武器开辟了一条道路,国际废除核武器运动因此获得2017年诺贝尔和平奖。国际医疗组织,包括红十字国际委员会、IPPNW、世界医学协会、世界公共卫生协会联合会和国际护士理事会,在谈判的过程中发挥了关键作用,并在谈判本身中提出了关于核武器和核战争对健康和环境造成灾难性后果的科学证据。两国在《禁止核武器条约》缔约国第一次会议期间继续开展这一重要合作。《禁止核武器条约》目前有92个签署国,其中包括68个成员国。11 .我们现在呼吁卫生专业协会向其世界各地的成员通报这一对人类生存的威胁,并与IPPNW一道支持减少核战争近期风险的努力,包括有核国家及其盟国立即采取三个步骤:首先,采取不首先使用核武器的政策12;第二,解除核武器一触即发的戒备状态;第三,敦促所有卷入当前冲突的国家公开和毫不含糊地保证不在这些冲突中使用核武器。 我们进一步要求他们为彻底结束核威胁而努力,支持有核国家之间紧急开始谈判,以便根据《不扩散核武器条约》中的承诺达成一项可核查的、有时限的消除其核武器的协议,为所有国家加入《禁止核武器条约》开辟道路。危险是巨大的,而且还在增长。拥有核武器的国家必须在消灭我们之前消灭它们的核武库。卫生界在冷战期间以及最近在制定《禁止核武器条约》方面发挥了决定性作用。我们必须再次把这一挑战作为一项紧迫的优先事项,以新的精力减少核战争的危险并消除核武器。Ira Helfand和Andy Haines提出了社论的想法,并与Chris Zielinski一起负责起草。所有其他作者都对编辑内容做出了重大贡献。KB-D是美国医学协会的全职员工,担任JAMA和JAMA网络的主编。AH是“探路者计划2020-2025”的首席研究员,“可持续健康食品系统研究计划2017-2023”的联合研究员,“可持续发展与健康复杂城市系统2017-2023”的联合研究员,所有这些都由威康信托基金资助,并由橡树基金会为探路者计划提供额外资金,他报告剑桥大学出版社合著的《行星健康》一书的版税;Wellcome Trust为他在2021年担任气候变化与健康高级顾问而支付给他所在机构的咨询费;世卫组织和人类前沿科学规划提供的旅行/会议支持;他是凉爽屋顶试验指导委员会的成员布基纳法索/海德堡大学Nouna研究中心的成员,是国家卫生研究院清洁空气(非洲)全球卫生研究组国际咨询委员会的联合主席,是建立非洲人口队列联盟合作独立咨询小组的成员,他是国际科学院伙伴关系的联合主席,2019-2022年气候变化与健康工作组,2020-2021年医学科学院/皇家学会“健康的未来——共同应对气候变化减缓和人类健康”工作组联合主席(无薪)。IH报告了几次演讲的酬金,所有这些都捐赠给了Back from the Brink, IPPNW或社会责任医生;为诺贝尔和平奖得主峰会、世界公共卫生协会联合会世界大会和联合国人权委员会青年峰会提供旅行/会议支持;他是Back from the Brink指导委员会和国际废除核武器运动国际指导小组的成员,IPPNW和社会责任医生的董事会成员,以及菲利普斯埃克塞特学院的受托人(全部无偿)。MGMOR报告了荷兰研究理事会,NOW(资助号:comp . 21cov .001)和荷兰卫生研究组织ZonMw(资助号:09120012010063)的研究资助,他是荷兰认知障碍和痴呆指导委员会主席。TR报告了与能源和环境研究所(美国)签订的合同,内容是关于在澳大利亚、法属波利尼西亚、中太平洋和中国等多个地点进行核试验的健康和环境后果;韩国《Choisun Ilbo》媒体集团举办的2022年核武器讲座和兵库县医师协会(日本)、和平之船(日本)、悉尼大学有关核武器的演讲的酬金;他是澳大利亚环境正义组织关于辐射和健康问题的专家证人,代表无矿格伦达拉代尔向维多利亚州政府手指板调查和咨询委员会提出手指板矿砂矿的建议;他是RV3轮状病毒疫苗开发科学顾问委员会成员,默多克儿童研究所/皇家儿童医院;他是澳大利亚废除核武器国际运动委员会的成员;他是互联网和平奖委员会(韩国Sunfull基金会)的成员;他是澳大利亚红十字会维多利亚国际人道主义法咨询委员会的成员;他是墨尔本大学文学院建设和平倡议的董事会成员;他是IPPNW的普通董事会成员;2012-23年,他是IPPNW的联合主席;他是墨尔本大学墨尔本人口与全球健康学院名誉首席研究员。 PY报告来自Atea制药公司的资助;biomsamrieux和辉瑞制药公司的讲座、演讲和教育活动的酬金;参加辉瑞制药公司顾问委员会的费用;他是抗菌药物管理研究小组执行委员会(2022-2024)和欧洲临床微生物学和传染病学会免疫功能低下宿主疫苗接种临床实践指南小组的成员。作为国际期刊项目的高级顾问,CZ向IPPNW报告了咨询费。所有其他作者声明没有竞争利益。国际防止核战争医师协会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing the risks of nuclear war—The role of health professionals

In January 2023, the Science and Security Board of the Bulletin of the Atomic Scientists moved the hands of the Doomsday Clock forward to 90 s before midnight, reflecting the growing risk of nuclear war.1 In August 2022, the UN Secretary-General António Guterres warned that the world is now in “a time of nuclear danger not seen since the height of the Cold War.2 The danger has been underlined by growing tensions between many nuclear armed states.1, 3 As editors of health and medical journals worldwide, we call on health professionals to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet—and urge action to prevent it.

Current nuclear arms control and non-proliferation efforts are inadequate to protect the world's population against the threat of nuclear war by design, error, or miscalculation. The Treaty on the Non-Proliferation of Nuclear Weapons (NPT) commits each of the 190 participating nations “to pursue negotiations in good faith on effective measures relating to cessation of the nuclear arms race at an early date and to nuclear disarmament, and on a treaty on general and complete disarmament under strict and effective international control”.4 Progress has been disappointingly slow and the most recent NPT review conference in 2022 ended without an agreed statement.5 There are many examples of near disasters that have exposed the risks of depending on nuclear deterrence for the indefinite future.6 Modernization of nuclear arsenals could increase risks: for example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation.

Any use of nuclear weapons would be catastrophic for humanity. Even a “limited” nuclear war involving only 250 of the 13,000 nuclear weapons in the world could kill 120 million people outright and cause global climate disruption leading to a nuclear famine, putting 2 billion people at risk.7, 8 A large-scale nuclear war between the USA and Russia could kill 200 million people or more in the near term, and potentially cause a global “nuclear winter” that could kill 5–6 billion people, threatening the survival of humanity.7, 8 Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly. The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem—by abolishing nuclear weapons.

The health community has had a crucial role in efforts to reduce the risk of nuclear war and must continue to do so in the future.9 In the 1980s the efforts of health professionals, led by the International Physicians for the Prevention of Nuclear War (IPPNW), helped to end the Cold War arms race by educating policy makers and the public on both sides of the Iron Curtain about the medical consequences of nuclear war. This was recognised when the 1985 Nobel Peace Prize was awarded to the IPPNW.10(http://www.ippnw.org).

In 2007, the IPPNW launched the International Campaign to Abolish Nuclear Weapons, which grew into a global civil society campaign with hundreds of partner organisations. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. International medical organisations, including the International Committee of the Red Cross, the IPPNW, the World Medical Association, the World Federation of Public Health Associations, and the International Council of Nurses, had key roles in the process leading up to the negotiations, and in the negotiations themselves, presenting the scientific evidence about the catastrophic health and environmental consequences of nuclear weapons and nuclear war. They continued this important collaboration during the First Meeting of the States Parties to the Treaty on the Prohibition of Nuclear Weapons, which currently has 92 signatories, including 68 member states.11

We now call on health professional associations to inform their members worldwide about the threat to human survival and to join with the IPPNW to support efforts to reduce the near-term risks of nuclear war, including three immediate steps on the part of nuclear-armed states and their Allies: first, adopt a no first use policy12; second, take their nuclear weapons off hair-trigger alert; and, third, urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts. We further ask them to work for a definitive end to the nuclear threat by supporting the urgent commencement of negotiations among the nuclear-armed states for a verifiable, timebound agreement to eliminate their nuclear weapons in accordance with commitments in the NPT, opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons.

The danger is great and growing. The nuclear armed states must eliminate their nuclear arsenals before they eliminate us. The health community played a decisive part during the Cold War and more recently in the development of the Treaty on the Prohibition of Nuclear Weapons. We must take up this challenge again as an urgent priority, working with renewed energy to reduce the risks of nuclear war and to eliminate nuclear weapons.

Ira Helfand and Andy Haines developed the idea of the editorial and led drafting along with Chris Zielinski. All other authors contributed significantly to the editorial content.

KB-D is a full-time employee of the American Medical Association, working as the Editor-in-Chief of JAMA and the JAMA Network. AH is principal investigator of the Pathfinder Initiative 2020–2025, co-investigator of Sustainable Healthy Food Systems research program 2017–2023, and co-investigator of Complex Urban Systems for Sustainability and Health 2017–2023, all funded by the Wellcome Trust, with additional funding from the Oak Foundation for the Pathfinder Initiative, and he reports royalties from Cambridge University Press for the coauthored book Planetary Health; consultancy fees paid to his institution from the Wellcome Trust for his role as Senior Advisor on Climate Change and Health in 2021; travel/meeting support from WHO and Human Frontiers Science Program; and he is a member of the Cool Roofs trial steering committee Nouna Research Center, Burkina Faso/University of Heidelberg, is Co-chair of the International Advisory Committee, NIHR Clean-Air (Africa) Global Health Research Unit, is a member of the Independent Advisory Group, Collaboration for the Establishment of an African Population Cohort Consortium, and he was Co-chair of the InterAcademy Partnership, Climate Change and Health Working Group 2019–2022 and Co-chair of the Academy of Medical Sciences/Royal Society working group on “A healthy future—tackling climate change mitigation and human health together” 2020–2021 (all unpaid). IH reports honoraria for several speaking engagements, all donated to Back from the Brink, the IPPNW, or Physicians for Social Responsibility; travel/meeting support for Nobel Peace Laureates' Summit, the World Federation of Public Health Associations World Congress, and the UN Human Rights Commission Youth Summit; and he is a member of the steering committee of Back from the Brink and the International Steering Group of the International Campaign to Abolish Nuclear Weapons, a Board member of the IPPNW and Physicians for Social Responsibility, and a Trustee of the Phillips Exeter Academy (all unpaid). MGMOR reports research grants from the Dutch Research Council, NOW (grant number COMPL.21COV.001) and from the Netherlands Organisation for Health Research ZonMw (grant number 09120012010063) and he is Chair of the Dutch guideline committee on cognitive impairments and dementia. TR reports a contract with the Institute for Energy and Environmental Research (USA) for papers addressing the health and environmental consequences of nuclear testing in multiple locations, including Australia, French Polynesia, central Pacific, and China; honorarium from The Choisun Ilbo media group in South Korea for a lecture on nuclear weapons in 2022 and for nuclear weapons presentations from Hyogo Medical Practitioners Association (Japan), Peace Boat (Japan), and the University of Sydney; he was an expert witness on radiation and health for Environmental Justice Australia acting for Mine-Free Glenaladale regarding proposed Fingerboards Mineral Sands Mine to the Victorian Government Fingerboards Inquiry and Advisory Committee; he is a member of RV3 Rotavirus Vaccine Development Scientific Advisory Board, Murdoch Children's Research Institute/Royal Children's Hospital; he is a member of the Committee of International Campaign to Abolish Nuclear Weapons Australia; he is a member of the Internet Peace Prize Award Committee (Sunfull Foundation, South Korea); he was a member of the Victorian International Humanitarian Law Advisory Committee, Australian Red Cross; he is a Board member of the Initiative for Peacebuilding, Faculty of Arts, University of Melbourne; he is an At-large Board member of the IPPNW; he was Co-president of the IPPNW 2012–23; and he is Honorary Principal Fellow, Melbourne School of Population and Global Health, University of Melbourne. PY reports grants from Atea Pharmaceuticals; honoraria for lectures, presentations, and educational events from bioMérieux and Pfizer Pharmaceuticals; fees for participation on an advisory board from Pfizer Pharmaceuticals; and he is a member of the Antimicrobial Stewardship Study Group Executive Committee (2022–2024) and the Clinical Practice Guideline Panel on Vaccinations in Immunocompromised hosts for the European Society of Clinical Microbiology and Infectious Diseases. CZ reports consulting fees for his role as senior adviser on the international journals project from the IPPNW. All the other authors declare no competing interests.

International Physicians for the Prevention of Nuclear War.

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来源期刊
Hematological Oncology
Hematological Oncology 医学-血液学
CiteScore
4.20
自引率
6.10%
发文量
147
审稿时长
>12 weeks
期刊介绍: Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged: -Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders -Diagnostic investigations, including imaging and laboratory assays -Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases -Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies -Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems. Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.
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