Forrow L, Blair B G, Helfand I, Lewis G, Postol T, Sidel V, Levy B S, Abrams H, Cassel C
Division of General Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
N Engl J Med. 1998 Apr 30;338(18):1326-31. doi: 10.1056/NEJM199804303381824.
In the 1980s, many medical organizations identified the prevention of nuclear war as one of the medical profession's most important goals. An assessment of the current danger is warranted given the radically changed context of the post-Cold War era.
We reviewed the recent literature on the status of nuclear arsenals and the risk of nuclear war. We then estimated the likely medical effects of a scenario identified by leading experts as posing a serious danger: an accidental launch of nuclear weapons. We assessed possible measures to reduce the risk of such an event.
U.S. and Russian nuclear-weapons systems remain on a high-level alert status. This fact, combined with the aging of Russian technical systems, has recently increased the risk of an accidental nuclear attack. As a conservative estimate, an accidental intermediate-sized launch of weapons from a single Russian submarine would result in the deaths of 6,838,000 persons from firestorms in eight U.S. cities. Millions of other people would probably be exposed to potentially lethal radiation from fallout. An agreement to remove all nuclear missiles from high-level alert status and eliminate the capability of a rapid launch would put an end to this threat.
The risk of an accidental nuclear attack has increased in recent years, threatening a public health disaster of unprecedented scale. Physicians and medical organizations should work actively to help build support for the policy changes that would prevent such a disaster.
20世纪80年代，许多医学组织将防止核战争确定为医学专业最重要的目标之一。鉴于冷战后时代背景发生了根本性变化，有必要对当前的危险进行评估。
我们查阅了近期有关核武库状况和核战争风险的文献。然后，我们估计了一个被顶尖专家认定为构成严重危险的情景——核武器意外发射——可能产生的医学影响。我们评估了降低此类事件风险的可能措施。
美国和俄罗斯的核武器系统仍处于高度戒备状态。这一事实，再加上俄罗斯技术系统的老化，最近增加了意外核攻击的风险。据保守估计，俄罗斯一艘潜艇意外进行一次中等规模的武器发射，将导致美国八个城市因火灾风暴造成683.8万人死亡。数百万其他人可能会受到沉降物中潜在致命辐射的影响。达成一项将所有核导弹从高度戒备状态移除并消除快速发射能力的协议，将消除这一威胁。
近年来，意外核攻击的风险有所增加，威胁到一场规模空前的公共卫生灾难。医生和医学组织应积极努力，帮助为防止此类灾难的政策变革争取支持。
