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• W4220791343 abstract "No modern war has been fought on the territory of a country with nuclear power facilities. On 24 February 2022, Russian troops entered the territory of Ukraine. This invasion will cause a substantial immediate loss of lives on both sides of the conflict and a likely downward spiral of the emerging democracy in Ukraine. It is important to be aware also of potential consequences of the invasion of interest and concern to readers of the Journal. Beginning in WWI, electricity-generating facilities have been a strategic military target. The aim is to cripple a country's ability to continue fighting and to impose a heavy burden on the civilian population, spurring demand for a cessation of hostilities. In World War II, Germans and Allies targeted such facilities with considerable success. Fortunately, damage to the facilities was localized despite widespread societal disruption. In 1985 my colleague Bennett Ramberg, a former foreign-affairs officer in the US State Department's Bureau of Political Military Affairs, wrote a prescient book: Nuclear Power Plants as Weapons for the Enemy: An Unrecognized Military Peril. For example, Israel destroyed an uncompleted nuclear reactor near Baghdad in 1981 and Iraqi aircraft attacked a partly constructed nuclear power plant in 1984. Ramberg explained how bombing a major nuclear power station or waste-storage reservation with conventional explosives could contaminate thousands of square miles and identified countries where this could occur and suggested ways to diminish this threat using physical safeguards and legal restraints. Ukraine became an independent nation in 1991, six years after Ramberg's book. At the time Ukraine was the world's third largest nuclear power (after Russia and the US). Soon thereafter Ukraine decided to denuclearize after receiving security guarantees from the US, UK and Russia in the Budapest Memorandum. Ukraine today is a country with 15 nuclear power reactors providing about 50 percent of its electricity. These facilities are tempting targets to Russian military strategists. However, such individuals may not fully realize the implications of such targeting. Six of these water–water energetic reactors (VVER 1000) are in Zaporizhzhya, only 230 km (100 miles) from Donetsk, an area claimed by the Donetsk People's Republic and easily within range of a tactical ballistic missile (conventional or nuclear). Even if there is no strategic plan to attack Ukraine's nuclear power facilities, can we count on field commanders or local artillery officers to understand the wildly different implications of attacking a nuclear power facility versus a coal or gas-fired electricity-generating facility? Russian troops have already captured Chernobyl. Are we certain they understand the importance of preserving the integrity of the new containment structure designed to prevent radioactive emissions from the destroyed reactor? There are many ways a nuclear power facility can be damaged in a war. For example, a ground- or air-launched rocket could breach the containment reactor vessel. Disabling (intentionally or not) the electrical and/or water supplies to a nuclear reactor could result in a meltdown of the nuclear fuel (as occurred in the Fukushima-Daichi nuclear power facility accident). Breach of the containment vessel would result in dispersion of radioactive materials over a wide area, perhaps a substantial part of the land mass of Ukraine. The same cautions apply to facilities storing spent nuclear fuel. What has this to do with readers of BJH? The worst scenario could be equivalent to the impact of 15 Chernobyl-size accidents. This would provoke acute radiation syndrome and long-term consequences of increased cancers, including leukaemias in massive numbers of soldiers and civilians on both sides of the conflict. Large populations might have to be evacuated with profound economic, social and psychological consequences. There are no winners in a war where nuclear power facilities are targeted, intentionally or not. What can we as haematologists do? Hope for the best, plan for the worst comes to mind. We should continue to strongly support a diplomatic solution although time for this seems over. Second, consider what resources might be needed were there mass radiation-related casualties. Are there personnel and/or equipment we might send to neighbouring countries like Poland, Romania and/or Hungary? We are facing a new dimension of war in the 21st century, something few people have thought about. For further reading I suggest a recent analysis by Prof. Ramberg1 and our article in New Engl. J. Med.2" @default.
• W4220791343 created "2022-04-03" @default.
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• W4220791343 date "2022-03-10" @default.
• W4220791343 modified "2023-10-16" @default.
• W4220791343 title "The Russian invasion of Ukraine: Implications for haematologists" @default.
• W4220791343 cites W2795324523 @default.
• W4220791343 doi "https://doi.org/10.1111/bjh.18142" @default.
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