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Decades after the blasts, the survivors experienced an unexpected increase in heart disease risk and a general shortening of their life spans. By the early 1960s, that study showed excess lung cancer. Because all uranium was mined for the Atomic Energy Commission through 1971, the US government had jurisdiction for protecting the miners' health but did not do enough. Nuclear fallout spread globally from testing by the United States and five other countries. [...]nuclear weapons have harmed the health of diverse groups in the United States: the \"atomic veterans,\" the downwinders, the Atomic Energy Commission and later Department of Energy workers, and uranium miners and millers.

Wildfires are increasingly common and projected to worsen with climate change. Health consequences include burns and mental health effects, as well as risks from air pollutants in smoke. Cutting carbon emissions to limit the global temperature increase to 2.0°C or 1.5°C above the preindustrial level would markedly reduce wildfire risks.

The development of environmental health policies is grounded in evidence related to agent characteristics, exposures, and associated risks to human and ecological health. Methods to assemble evidence to support decision making have evolved greatly over the last two decades, moving from reviews based on expert judgment to transparent and systematic approaches to gathering, evaluating, synthesizing, and integrating research findings. For example, 15 years ago, the U.S. Environmental Protection Agency replaced the encyclopedic, but not integrative, listings of its criteria documents with the Integrated Science Assessment (ISA), a systematically assembled and evaluated compilation of evidence following a systematic review approach, when considering revisions of the National Ambient Air Quality Standards. Responding to guidance from a 2011 report of the U.S. National Academies, the agency also introduced systematic review into its Integrated Risk Information System (IRIS) assessments, which provide hazard assessments and dose-response relationships for cancer and non-cancer health outcomes.

In this issue of AJPH, a distinguished group of tobacco control researchers and practitioners call for a more balanced look at e-cigarettes for reducing the enormous and persistent burden of smoking-caused morbidity and premature mortality-a worthy goal. The article is built around the artifice of a controversy between \"fervent opponents\" of harm reduction who emphasize risk to young people and \"enthusiastic supporters\" who want to facilitate smoking cessation and reduce harm with e-cigarettes. This \"controversy\" exists because we lack evidence on the long-term consequences of policies that promote the use of e-cigarettes for harm reduction, both for the smoking adults who switch to them and for the youths who start using them. Of course, we cannot see or model far enough into the future to have credible projections of the impact of regulatory decisions made now, decisions that will undoubtedly have long-term, generational repercussions.

Nerve injury in children is important to recognize early given the greater chance for recovery. Both children and adults have better outcomes the sooner nerve injuries are recognized and repaired. Children have even better functional results after surgical repair, thought to be related to their neural plasticity. Ultrasound is a powerful diagnostic tool for grading and mapping peripheral nerve injury and is complementary to electromyography and nerve conduction studies. Nerve injuries can be classified into low and high grade with ultrasound adding essential prognostic information and aiding in patient management. High-grade nerve injuries likely require surgical intervention. This article will review nerve anatomy and injury grading systems that radiologists can learn quickly in order to accurately communicate with their clinical partners. A practical approach to describe the sonographic appearance of nerve injury will be discussed. This article will show radiologists how the added value of ultrasound for peripheral nerve injury can directly affect clinical management.

Abstract Implications: This commentary addresses the state of the evidence on tobacco products, nicotine, and COVID-19. The evidence of the effects of smoking on respiratory infections and the immune system in general are examined and the current understanding of tobacco products and risk for SARS-CoV-2 infection and the course of COVID-19 is addressed.

Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI) based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women) died. Compared to those without sleep-disordered breathing (AHI: <5 events/h), the fully adjusted hazard ratios for all-cause mortality in those with mild (AHI: 5.0-14.9 events/h), moderate (AHI: 15.0-29.9 events/h), and severe (AHI: >or=30.0 events/h) sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08), 1.17 (95% CI: 0.97-1.42), and 1.46 (95% CI: 1.14-1.86), respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33). Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality. Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the article for the Editors' Summary.

Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up. Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4–14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5–<25·0 kg/m2. All-cause mortality was minimal at 20·0–25·0 kg/m2 (HR 1·00, 95% CI 0·98–1·02 for BMI 20·0–<22·5 kg/m2; 1·00, 0·99–1·01 for BMI 22·5–<25·0 kg/m2), and increased significantly both just below this range (1·13, 1·09–1·17 for BMI 18·5–<20·0 kg/m2; 1·51, 1·43–1·59 for BMI 15·0–<18·5) and throughout the overweight range (1·07, 1·07–1·08 for BMI 25·0–<27·5 kg/m2; 1·20, 1·18–1·22 for BMI 27·5–<30·0 kg/m2). The HR for obesity grade 1 (BMI 30·0–<35·0 kg/m2) was 1·45, 95% CI 1·41–1·48; the HR for obesity grade 2 (35·0–<40·0 kg/m2) was 1·94, 1·87–2·01; and the HR for obesity grade 3 (40·0–<60·0 kg/m2) was 2·76, 2·60–2·92. For BMI over 25·0 kg/m2, mortality increased approximately log-linearly with BMI; the HR per 5 kg/m2 units higher BMI was 1·39 (1·34–1·43) in Europe, 1·29 (1·26–1·32) in North America, 1·39 (1·34–1·44) in east Asia, and 1·31 (1·27–1·35) in Australia and New Zealand. This HR per 5 kg/m2 units higher BMI (for BMI over 25 kg/m2) was greater in younger than older people (1·52, 95% CI 1·47–1·56, for BMI measured at 35–49 years vs 1·21, 1·17–1·25, for BMI measured at 70–89 years; pheterogeneity<0·0001), greater in men than women (1·51, 1·46–1·56, vs 1·30, 1·26–1·33; pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI. The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations. UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health.