The local health impact of atmospheric nuclear weapons testing: cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan
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| Main Author: | |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Frankfurt am Main [u.a.]
Lang
2006
|
| Series: | European university studies
Ser. 7 : Sect. D, General Medicine ; 33 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Item Description: | Zugl.: Bielefeld, Univ., Diss., 2004 |
| Physical Description: | 233 S. graph. Darst., Kt. |
| ISBN: | 0820477052 3631537301 |
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| 245 | 1 | 0 | |a The local health impact of atmospheric nuclear weapons testing |b cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |c Susanne Bauer |
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| adam_text | TABLE OF CONTENTS
1 INTRODUCTION 13
1.1 Background 13
1.1.1 The Health Impact of Nuclear Testing 13
1.1.2 Radiation Epidemiology in the Former Soviet Union 14
1.2 The Semipalatinsk Nuclear Test Site 16
1.3 Scientific Background and Objectives 19
1.4 Institutional Context 21
1.5 Chapter Overview 22
2 IONISING RADIATION AND CANCER:
THE PERSPECTIVE OF EPIDEMIOLOGY 23
2.1 Ionising Radiation and Biological Effects 23
2.1.1 The Physics of Ionising Radiation and Characteristics of Nuclear Test Fallout 23
2.1.2 The Interaction of Ionising Radiation with Tissue 25
2.1.2.1 High and Low-LET Radiation 25
2.1.2.2 Physical Effects of Low-LET Radiation in Tissue 25
2.1.2.3 Physical Effects ofHigh-LET Radiation in Tissue 26
2.1.2.4 Chemical Processes Following the Physical Interaction 26
2.1.3 The Quantification of Radiation Dose 28
2.1.3.1 Background Exposure 28
2.1.3.2 Dosimetric Quantities 28
2.1.3.3 Radiation Weighting Factors 29
2.1.3.4 Weighting Factors for Tissue 31
2.1.3.5 Further Dosimetric Quantities 32
2.1.4 Biological Effects of Radiation: Deterministic and Stochastic effects 32
2.2 Cancer Aetiology and Radiation-Induced Carcinogenesis 36
2.2.1 Aetiologic Concepts and Cancer Induction 36
2.2.2 The Role of Radiation in the Carcinogenic Process 36
2.3 The Approach of Radiation Epidemiology 38
2.3.1 On the History of Radiation Epidemiology 38
2.3.1.1 Radiation Exposures before 1945 38
2.3.1.2 Radiation Epidemiology after 1945: The Role of the Life Span Study 39
2.3.2 Current Features of Radiation Epidemiology 40
2.4 Methods of Radiation Epidemiology 42
2.4.1 Radiation Risk Assessment 42
2.4.2 Retrospective Exposure Assessment 43
2.4.2.1 Dose Reconstruction 43
2.4.2.2 Selected Validation Techniques 45
2.4.3 Health Data 46
2.4.3.1 Incidence and Mortality Data 46
2.4.3.2 Soviet Cancer Data 47
7
2.4.4 The Epidemiologic Linkage of Exposure and Health 46
2.4.4.1 Cohort Studies 46
2.4.4.2 Case-Control Studies 47
2.4.4.3 Ratio and Difference Measures 48
2.4.5 Sources of Error 48
2.4.5.1 Random Error and Precision 48
2.4.5.2 Systematic Error (Bias) 49
2.4.6 Effect Modification of Radiation Risk 50
2.4.7 Transfer of Risk Estimates between Populations 51
2.5 Radiation Risk Estimates for Specific Cancer Sites 52
2.5.1 Leukaemia 53
2.5.2 Oesophagus 54
2.5.3 Stomach 55
2.5.4 Liver 56
2.5.5 Lung 56
2.5.6 Female Breast 57
3 A HISTORY OF NUCLEAR WEAPONS TESTING AND HEALTH
RESEARCH AT THE SEMIPALATINSK NUCLEAR TEST SITE 59
3.1 Nuclear Test Programmes in International Comparison 59
3.1.1 Nuclear Testing Programmes by Country 59
3.1.2 Characteristics of Exposures due to Nuclear Test Fallout 62
3.1.3 Search Strategies: Literature on Health Effects of Radiation 65
3.1.4 Studies on Health Effects of Nuclear Testing 66
3.1.5 Epidemiological Studies on Cancer Effects of Nuclear Test Related Exposures 67
3.1.5.1 Nevada Test Site and Population Exposure 67
3.1.5.2 Marshall Islands 68
3.1.5.3 Studies Among Military Test Participants 69
3.1.6 Analytical Studies of Fallout Exposures: Cohort and Case-Control Studies 74
3.2 The Soviet Nuclear Programme and the Semipalatinsk Test Site 77
3.2.1 Soviet Nuclear Tests 77
3.2.2 Atmospheric Nuclear Tests at SNTS 78
3.2.3 Underground Nuclear Testing 78
3.2.4 Accompanying Measurements and Retrospective Assessments 79
3.3 Soviet and post-Soviet Assessments 80
3.3.1 Soviet Research Programmes until 1991 80
3.3.1.1 Early Reports on Deterministic Effects and the Dispanser No.4 80
3.3.1.2 Interdepartmental Commission s Study in 1989 83
3.3.2 Current Scientific Programmes in Kazakhstan 83
3.3.3 Current Scientific Programmes in the Altai Region, Russian Federation 84
3.4 Dosimetric Studies 86
3.4.1 The Exposure Situation after Nuclear Tests at SNTS 86
3.4.2 Dose Reconstruction for the Exposed Regions in Kazakhstan 87
3.4.2.1 Raion-Based Radiation Risk Zoning 87
8
3.4.2.2 Dose Reconstruction Based on Physical Modelling 89
3.4.2.3 Validation Studies 91
3.4.3 Dose Reconstruction for the Exposed Areas in the Altai Region 93
3.4.3.1 Dose Reconstruction and Exposure Characteristics 93
3.4.3.2 Dose Reconstruction Based on Physical Modelling 94
3.4.3.3 Validation Studies 95
3.5 Epidemiological Studies in Kazakhstan 96
3.5.1 First Estimates of Exposed Population Numbers and Migration Patterns 96
3.5.2 Descriptive Epidemiology 97
3.5.2.1 Descriptive Cancer Date 97
3.5.2.2 Cancer Incidence Rates in the Semipalatinskaia Oblasf 97
3.5.2.3 SRIRME Incidence Study 98
3.5.2.4 Childhood Cancer Incidence in Four Oblasti in Kazakhstan 98
3.5.2.5 Population-Based Cancer Registry 99
3.5.3 Epidemiological Studies with Analytical Designs (On-Going) 99
3.6 Epidemiological Studies in the Altai Region (Russian Federation) 104
3.6.1 Estimates of Exposed Population Numbers and Migration Patterns 104
3.6.2 Descriptive Cancer Data 105
3.6.3 The Development of a Registry for Epidemiological Studies 105
3.6.4 First Registry-Based Epidemiological Studies 106
3.6.4.1 Cohort Studies Using Mortality Data 106
3.6.4.2 Thyroid Study 106
3.7 Brief Summary of the Data Situation and Studies Prior to This Analysis 107
4 THE SEMIPALATINSK HISTORICAL COHORT STUDY:
IMPLEMENTATION OF AN ANALYTICAL STUDY IN THE
SEMIPALATINSKAIA OBLAST IN KAZAKHSTAN 109
4.1 Description of the Cohort and Data Sources 109
4.1.1 Historical Cohort Definition 109
4.1.1.1 The Exposed Group 109
4.1.1.2 The Comparison Group HO
4.1.2 Data Sources and Follow-Up Procedures 110
4.1.2.1 Health Date 110
4.1.2.2 Follow-Up Procedures and Date Base 111
4.1.3 Status of Follow-Up 112
4.1.4 Exposure Date 114
4.1.4.1 Status of Dose Reconstruction 114
4.1.4.2 Individual Dose Estimation for the Exposed Group 114
4.2 Strategies for Data Analysis 116
4.2.1 Studied Cancer Endpoints 116
4.2.2 Statistical Methods II*
9
4.3 Results 121
4.3.1 Cohort Characteristics: Construction of Person-Years and Dose Distribution 121
4.3.2 Rate Ratios-Follow-Up Period: 1960-1999 122
4.3.2.1 Exposed Versus Non-Exposed 122
4.3.2.2 Rate Ratios by Dose Categories 123
4.3.2.3 Excess Relative Risks 126
4.3.3 Age at Exposure and Time since Exposure 127
4.3.3.1 Age at Exposure 127
4.3.3.2 Time since Main Exposure 128
4.3.4 Restriction of the Follow-Up Period to 1960-1989 129
4.3.4.1 Dichotomous Comparisons 129
4.3.4.2 Rate Ratios by Dose Categories, Follow-Up 1960-1989 130
4.3.4.3 Excess Relative Risks (ERR/Sv), Follow-Up 1960-1989 132
4.4 Discussion of Findings from the Historical Cohort Study 133
4.4.1 Summary Review of Main Results 133
4.4.1.1 Age At Exposure 134
4.4.1.2 Time since Exposure 134
4.4.1.3 Restriction of Follow-Up 134
4.4.1.4 Excess Relative Risks 134
4.4.2 Follow-Up 135
4.4.3 Internal Validity 136
4.4.3.1 Sources of Bias 136
4.4.3.2 Complete Sampling Subgroup: Five Exposed Villages 137
4.4.4 Exposure Assessment 138
4.4.5 External Validity 140
4.4.6 Other Risk Factors 140
4.4.7 Conclusion 141
5 REGISTRY-BASED CASE-CONTROL STUDY OF STOMACH
CANCER IN THE ALTAI REGION 143
5.1 The IRMEP Registry as Data Source for Analytical Epidemiology 143
5.1.1 Data Sources: Health and Exposure Data from the IRMEP Registry 143
5.1.2.1 Study Base and Follow-Up in the IRMEP Registry 143
5.1.2.2 Health Data 144
5.1.2 Selection of Cases and Controls 145
5.1.3 Exposure Data: Individual Dose Estimates of External and Internal Doses 146
5.2 Strategies and Methods for Data Analysis 147
5.2.1 Analytic Strategy 147
5.2.2 Statistical Methods 147
5.3 Results 150
5.3.1 Descriptive Analyses 150
5.3.2 Overall and Gender-Specific OR (Dichotomous Exposure Variable) 151
10
5.3.3 Grouped Exposure Variable (Summary Doses, External / Internal Components).. 152
5.3.3.1 Effect Estimates for Summary Organ Absorbed Dose Estimates 152
5.3.3.2 Effect Estimates for External and Internal Stomach Dose 153
5.3.4 Overall and Gender-Specific OR (Continuous Exposure Variable) 153
5.3.5 Age at Exposure 154
5.3.6 Time since Exposure Periods 155
5.3.7 Attained Age 155
5.4 Discussion of Findings from the Case-Control Analysis 156
5.4.1 Summary of Results 156
5.4.2 Sources of Error and Internal Validity 157
5.4.2.1 Random Errors, Precision 157
5.4.2.2 Information and Selection Bias 158
5.4.2.3 Differential Levels of Cause-of-Death Ascertainment 159
5.4.3 Further Aspects of External Validity 160
5.4.4 Exposure Assessment 160
5.4.5 Other Risk Factors for Stomach Cancer 161
5.4.6 Conclusion 162
6 SUMMARY DISCUSSION AND PERSPECTIVES 163
6.1 Main Results 163
6.2 The Assessment of Radiation Risk - Comparisons with Other Studies 165
6.2.1 Comparisons with Studies Near SNTS, Other Fallout Studies and NIS Studies 165
6.2.2 Comparison with General Radiation Knowledge 167
6.3 Strengths and Limitations of the Performed Analyses 172
6.3.1 General Considerations 172
6.3.2 Kazakhstan 173
6.3.3 Altai Region 174
6.4 Recommendations for Future Epidemiological Studies near SNTS 175
6.4.1 Improving Validity by Further Follow-Up 175
6.4.2 Other Determinants of Cancer Risk and Intermediate Factors 176
6.4.3 Dose Reconstruction 178
6.5 The Public Health Impact 180
6.5.1 Compensation Programme in Kazakhstan 182
6.5.2 Compensation Programme in the Altai Region 183
6.5.3 Mitigation Programmes and International Efforts 184
6.5.4 Epidemiology, Public Health and Participation 185
6.6 Conclusion 187
REFERENCES 189
LIST OF TABLES 216
LIST OF FIGURES 218
APPENDIX 219
11
|
| adam_txt |
TABLE OF CONTENTS
1 INTRODUCTION 13
1.1 Background 13
1.1.1 The Health Impact of Nuclear Testing 13
1.1.2 Radiation Epidemiology in the Former Soviet Union 14
1.2 The Semipalatinsk Nuclear Test Site 16
1.3 Scientific Background and Objectives 19
1.4 Institutional Context 21
1.5 Chapter Overview 22
2 IONISING RADIATION AND CANCER:
THE PERSPECTIVE OF EPIDEMIOLOGY 23
2.1 Ionising Radiation and Biological Effects 23
2.1.1 The Physics of Ionising Radiation and Characteristics of Nuclear Test Fallout 23
2.1.2 The Interaction of Ionising Radiation with Tissue 25
2.1.2.1 High and Low-LET Radiation 25
2.1.2.2 Physical Effects of Low-LET Radiation in Tissue 25
2.1.2.3 Physical Effects ofHigh-LET Radiation in Tissue 26
2.1.2.4 Chemical Processes Following the Physical Interaction 26
2.1.3 The Quantification of Radiation Dose 28
2.1.3.1 Background Exposure 28
2.1.3.2 Dosimetric Quantities 28
2.1.3.3 Radiation Weighting Factors 29
2.1.3.4 Weighting Factors for Tissue 31
2.1.3.5 Further Dosimetric Quantities 32
2.1.4 Biological Effects of Radiation: Deterministic and Stochastic effects 32
2.2 Cancer Aetiology and Radiation-Induced Carcinogenesis 36
2.2.1 Aetiologic Concepts and Cancer Induction 36
2.2.2 The Role of Radiation in the Carcinogenic Process 36
2.3 The Approach of Radiation Epidemiology 38
2.3.1 On the History of Radiation Epidemiology 38
2.3.1.1 Radiation Exposures before 1945 38
2.3.1.2 Radiation Epidemiology after 1945: The Role of the Life Span Study 39
2.3.2 Current Features of Radiation Epidemiology 40
2.4 Methods of Radiation Epidemiology 42
2.4.1 Radiation Risk Assessment 42
2.4.2 Retrospective Exposure Assessment 43
2.4.2.1 Dose Reconstruction 43
2.4.2.2 Selected Validation Techniques 45
2.4.3 Health Data 46
2.4.3.1 Incidence and Mortality Data 46
2.4.3.2 Soviet Cancer Data 47
7
2.4.4 The Epidemiologic Linkage of Exposure and Health 46
2.4.4.1 Cohort Studies 46
2.4.4.2 Case-Control Studies 47
2.4.4.3 Ratio and Difference Measures 48
2.4.5 Sources of Error 48
2.4.5.1 Random Error and Precision 48
2.4.5.2 Systematic Error (Bias) 49
2.4.6 Effect Modification of Radiation Risk 50
2.4.7 Transfer of Risk Estimates between Populations 51
2.5 Radiation Risk Estimates for Specific Cancer Sites 52
2.5.1 Leukaemia 53
2.5.2 Oesophagus 54
2.5.3 Stomach 55
2.5.4 Liver 56
2.5.5 Lung 56
2.5.6 Female Breast 57
3 A HISTORY OF NUCLEAR WEAPONS TESTING AND HEALTH
RESEARCH AT THE SEMIPALATINSK NUCLEAR TEST SITE 59
3.1 Nuclear Test Programmes in International Comparison 59
3.1.1 Nuclear Testing Programmes by Country 59
3.1.2 Characteristics of Exposures due to Nuclear Test Fallout 62
3.1.3 Search Strategies: Literature on Health Effects of Radiation 65
3.1.4 Studies on Health Effects of Nuclear Testing 66
3.1.5 Epidemiological Studies on Cancer Effects of Nuclear Test Related Exposures 67
3.1.5.1 Nevada Test Site and Population Exposure 67
3.1.5.2 Marshall Islands 68
3.1.5.3 Studies Among Military Test Participants 69
3.1.6 Analytical Studies of Fallout Exposures: Cohort and Case-Control Studies 74
3.2 The Soviet Nuclear Programme and the Semipalatinsk Test Site 77
3.2.1 Soviet Nuclear Tests 77
3.2.2 Atmospheric Nuclear Tests at SNTS 78
3.2.3 Underground Nuclear Testing 78
3.2.4 Accompanying Measurements and Retrospective Assessments 79
3.3 Soviet and post-Soviet Assessments 80
3.3.1 Soviet Research Programmes until 1991 80
3.3.1.1 Early Reports on Deterministic Effects and the Dispanser No.4 80
3.3.1.2 Interdepartmental Commission's Study in 1989 83
3.3.2 Current Scientific Programmes in Kazakhstan 83
3.3.3 Current Scientific Programmes in the Altai Region, Russian Federation 84
3.4 Dosimetric Studies 86
3.4.1 The Exposure Situation after Nuclear Tests at SNTS 86
3.4.2 Dose Reconstruction for the Exposed Regions in Kazakhstan 87
3.4.2.1 Raion-Based 'Radiation Risk Zoning" 87
8
3.4.2.2 Dose Reconstruction Based on Physical Modelling 89
3.4.2.3 Validation Studies 91
3.4.3 Dose Reconstruction for the Exposed Areas in the Altai Region 93
3.4.3.1 Dose Reconstruction and Exposure Characteristics 93
3.4.3.2 Dose Reconstruction Based on Physical Modelling 94
3.4.3.3 Validation Studies 95
3.5 Epidemiological Studies in Kazakhstan 96
3.5.1 First Estimates of Exposed Population Numbers and Migration Patterns 96
3.5.2 Descriptive Epidemiology 97
3.5.2.1 Descriptive Cancer Date 97
3.5.2.2 Cancer Incidence Rates in the Semipalatinskaia Oblasf 97
3.5.2.3 SRIRME Incidence Study 98
3.5.2.4 Childhood Cancer Incidence in Four Oblasti in Kazakhstan 98
3.5.2.5 Population-Based Cancer Registry 99
3.5.3 Epidemiological Studies with Analytical Designs (On-Going) 99
3.6 Epidemiological Studies in the Altai Region (Russian Federation) 104
3.6.1 Estimates of Exposed Population Numbers and Migration Patterns 104
3.6.2 Descriptive Cancer Data 105
3.6.3 The Development of a Registry for Epidemiological Studies 105
3.6.4 First Registry-Based Epidemiological Studies 106
3.6.4.1 Cohort Studies Using Mortality Data 106
3.6.4.2 Thyroid Study 106
3.7 Brief Summary of the Data Situation and Studies Prior to This Analysis 107
4 THE SEMIPALATINSK HISTORICAL COHORT STUDY:
IMPLEMENTATION OF AN ANALYTICAL STUDY IN THE
SEMIPALATINSKAIA OBLAST IN KAZAKHSTAN 109
4.1 Description of the Cohort and Data Sources 109
4.1.1 Historical Cohort Definition 109
4.1.1.1 The Exposed Group 109
4.1.1.2 The Comparison Group HO
4.1.2 Data Sources and Follow-Up Procedures 110
4.1.2.1 Health Date 110
4.1.2.2 Follow-Up Procedures and Date Base 111
4.1.3 Status of Follow-Up 112
4.1.4 Exposure Date 114
4.1.4.1 Status of Dose Reconstruction 114
4.1.4.2 Individual Dose Estimation for the Exposed Group 114
4.2 Strategies for Data Analysis 116
4.2.1 Studied Cancer Endpoints 116
4.2.2 Statistical Methods II*
9
4.3 Results 121
4.3.1 Cohort Characteristics: Construction of Person-Years and Dose Distribution 121
4.3.2 Rate Ratios-Follow-Up Period: 1960-1999 122
4.3.2.1 Exposed Versus Non-Exposed 122
4.3.2.2 Rate Ratios by Dose Categories 123
4.3.2.3 Excess Relative Risks 126
4.3.3 Age at Exposure and Time since Exposure 127
4.3.3.1 Age at Exposure 127
4.3.3.2 Time since Main Exposure 128
4.3.4 Restriction of the Follow-Up Period to 1960-1989 129
4.3.4.1 Dichotomous Comparisons 129
4.3.4.2 Rate Ratios by Dose Categories, Follow-Up 1960-1989 130
4.3.4.3 Excess Relative Risks (ERR/Sv), Follow-Up 1960-1989 132
4.4 Discussion of Findings from the Historical Cohort Study 133
4.4.1 Summary Review of Main Results 133
4.4.1.1 Age At Exposure 134
4.4.1.2 Time since Exposure 134
4.4.1.3 Restriction of Follow-Up 134
4.4.1.4 Excess Relative Risks 134
4.4.2 Follow-Up 135
4.4.3 Internal Validity 136
4.4.3.1 Sources of Bias 136
4.4.3.2 'Complete Sampling' Subgroup: Five Exposed Villages 137
4.4.4 Exposure Assessment 138
4.4.5 External Validity 140
4.4.6 Other Risk Factors 140
4.4.7 Conclusion 141
5 REGISTRY-BASED CASE-CONTROL STUDY OF STOMACH
CANCER IN THE ALTAI REGION 143
5.1 The IRMEP Registry as Data Source for Analytical Epidemiology 143
5.1.1 Data Sources: Health and Exposure Data from the IRMEP Registry 143
5.1.2.1 Study Base and Follow-Up in the IRMEP Registry 143
5.1.2.2 Health Data 144
5.1.2 Selection of Cases and Controls 145
5.1.3 Exposure Data: Individual Dose Estimates of External and Internal Doses 146
5.2 Strategies and Methods for Data Analysis 147
5.2.1 Analytic Strategy 147
5.2.2 Statistical Methods 147
5.3 Results 150
5.3.1 Descriptive Analyses 150
5.3.2 Overall and Gender-Specific OR (Dichotomous Exposure Variable) 151
10
5.3.3 Grouped Exposure Variable (Summary Doses, External / Internal Components). 152
5.3.3.1 Effect Estimates for Summary Organ Absorbed Dose Estimates 152
5.3.3.2 Effect Estimates for External and Internal Stomach Dose 153
5.3.4 Overall and Gender-Specific OR (Continuous Exposure Variable) 153
5.3.5 Age at Exposure 154
5.3.6 Time since Exposure Periods 155
5.3.7 Attained Age 155
5.4 Discussion of Findings from the Case-Control Analysis 156
5.4.1 Summary of Results 156
5.4.2 Sources of Error and Internal Validity 157
5.4.2.1 Random Errors, Precision 157
5.4.2.2 Information and Selection Bias 158
5.4.2.3 Differential Levels of Cause-of-Death Ascertainment 159
5.4.3 Further Aspects of External Validity 160
5.4.4 Exposure Assessment 160
5.4.5 Other Risk Factors for Stomach Cancer 161
5.4.6 Conclusion 162
6 SUMMARY DISCUSSION AND PERSPECTIVES 163
6.1 Main Results 163
6.2 The Assessment of Radiation Risk - Comparisons with Other Studies 165
6.2.1 Comparisons with Studies Near SNTS, Other Fallout Studies and NIS Studies 165
6.2.2 Comparison with General Radiation Knowledge 167
6.3 Strengths and Limitations of the Performed Analyses 172
6.3.1 General Considerations 172
6.3.2 Kazakhstan 173
6.3.3 Altai Region 174
6.4 Recommendations for Future Epidemiological Studies near SNTS 175
6.4.1 Improving Validity by Further Follow-Up 175
6.4.2 Other Determinants of Cancer Risk and Intermediate Factors 176
6.4.3 Dose Reconstruction 178
6.5 The Public Health Impact 180
6.5.1 Compensation Programme in Kazakhstan 182
6.5.2 Compensation Programme in the Altai Region 183
6.5.3 Mitigation Programmes and International Efforts 184
6.5.4 Epidemiology, Public Health and Participation 185
6.6 Conclusion 187
REFERENCES 189
LIST OF TABLES 216
LIST OF FIGURES 218
APPENDIX 219
11 |
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| genre | (DE-588)4113937-9 Hochschulschrift gnd-content |
| genre_facet | Hochschulschrift |
| geographic | Semei (DE-588)6075653-6 gnd |
| geographic_facet | Semei |
| id | DE-604.BV022261457 |
| illustrated | Illustrated |
| index_date | 2024-07-02T16:42:58Z |
| indexdate | 2024-07-09T20:53:36Z |
| institution | BVB |
| isbn | 0820477052 3631537301 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-015472095 |
| oclc_num | 72437084 |
| open_access_boolean | |
| owner | DE-12 |
| owner_facet | DE-12 |
| physical | 233 S. graph. Darst., Kt. |
| publishDate | 2006 |
| publishDateSearch | 2006 |
| publishDateSort | 2006 |
| publisher | Lang |
| record_format | marc |
| series | European university studies |
| series2 | European university studies : Ser. 7 : Sect. D, General Medicine |
| spelling | Bauer, Susanne 197X- Verfasser (DE-588)1057789658 aut The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan Susanne Bauer Frankfurt am Main [u.a.] Lang 2006 233 S. graph. Darst., Kt. txt rdacontent n rdamedia nc rdacarrier European university studies : Ser. 7 : Sect. D, General Medicine 33 Zugl.: Bielefeld, Univ., Diss., 2004 Radiation carcinogenesis Kazakhstan Semeĭ Krebs Medizin (DE-588)4073781-0 gnd rswk-swf Epidemiologie (DE-588)4015016-1 gnd rswk-swf Kernwaffentest (DE-588)4139467-7 gnd rswk-swf Strahlenbelastung (DE-588)4057817-3 gnd rswk-swf Semei (DE-588)6075653-6 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content Semei (DE-588)6075653-6 g Kernwaffentest (DE-588)4139467-7 s Strahlenbelastung (DE-588)4057817-3 s Krebs Medizin (DE-588)4073781-0 s Epidemiologie (DE-588)4015016-1 s DE-604 European university studies Ser. 7 : Sect. D, General Medicine ; 33 (DE-604)BV002788547 33 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015472095&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Bauer, Susanne 197X- The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan European university studies Radiation carcinogenesis Kazakhstan Semeĭ Krebs Medizin (DE-588)4073781-0 gnd Epidemiologie (DE-588)4015016-1 gnd Kernwaffentest (DE-588)4139467-7 gnd Strahlenbelastung (DE-588)4057817-3 gnd |
| subject_GND | (DE-588)4073781-0 (DE-588)4015016-1 (DE-588)4139467-7 (DE-588)4057817-3 (DE-588)6075653-6 (DE-588)4113937-9 |
| title | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |
| title_auth | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |
| title_exact_search | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |
| title_exact_search_txtP | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |
| title_full | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan Susanne Bauer |
| title_fullStr | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan Susanne Bauer |
| title_full_unstemmed | The local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan Susanne Bauer |
| title_short | The local health impact of atmospheric nuclear weapons testing |
| title_sort | the local health impact of atmospheric nuclear weapons testing cancer epidemiology in areas adjacent to the semipalatinsk test site kazakhstan |
| title_sub | cancer epidemiology in areas adjacent to the Semipalatinsk test site, Kazakhstan |
| topic | Radiation carcinogenesis Kazakhstan Semeĭ Krebs Medizin (DE-588)4073781-0 gnd Epidemiologie (DE-588)4015016-1 gnd Kernwaffentest (DE-588)4139467-7 gnd Strahlenbelastung (DE-588)4057817-3 gnd |
| topic_facet | Radiation carcinogenesis Kazakhstan Semeĭ Krebs Medizin Epidemiologie Kernwaffentest Strahlenbelastung Semei Hochschulschrift |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015472095&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV002788547 |
| work_keys_str_mv | AT bauersusanne thelocalhealthimpactofatmosphericnuclearweaponstestingcancerepidemiologyinareasadjacenttothesemipalatinsktestsitekazakhstan |