image 寫:等十月調漲電價 台灣今年整年的用電會是負成長呢?
back to the beginning, 根據基本經濟學原理 (我最常做的不務正業)
A 需求不變的狀況下, 供給減少 -> 價格上升 -> 壓抑需求, 卻刺激供給
B 需求下降 -> 供給過剩 -> 價格開始反轉
C 最終, 下降的價格, 會降低供應商的供給意願 -> 壓抑供給, 卻刺激需求 -> 回A
經濟循環就像赫爾蒙feedback機制一樣週而復始.
電價也是如此. 沒什麼好賭的.
我不認同的是台灣數十年低電價, 然後民眾又口口聲聲喊浪費,
畢竟人民每次漲價就在抗議, 等於要政府介入價格變因, 民眾缺乏自主以及被動制衡機制, 卻又要供需平衡,
天下哪有那麼好康的事情, 政府不倒閉才怪.
台灣與其他開發中國家一樣, 它需要的是在停留在上述的成長期,
而不是開始斤斤計較, 甚至negative feedback的階段.
而反正, 真要談論電力成長消耗, 工程安不安全, 什麼的, 說實話 not my specialty
我也不打算再回這些
我最關心的
回到原題, 我從最開始, 就po出WHO報告中文翻譯, 我下的標題是 "醫師更應該閱讀WHO報告"我在意的, 就是任何宣稱都要有科學根據,
輻射有傷害大家都知道; 但劑量多少, 傷了多少人, 還有多少潛在傷害, 不是憑空喊價
死亡人數是不是被反核者誇大, 或者擁核者低估... 這些都要有scientific evidence,
畢竟我們都沒治療過radiation syndrome病人, 而WHO, UN數千位國際頂尖學者已經幫我們做review與report
要不要蓋, 大家怕不怕, 最終都是怕傷害健康或者死亡, 不是嗎?
一般民眾很容易被誤導,
如果錯誤的觀念造成恐慌, 甚至死亡, 那就更令人惋惜;
會讓我想到, 諸多被人云亦云觀念害死或者殘的 多少病人 (ex.謠言正統醫療很多副作用, 不敢就醫等)
江湖郎中賣藥的, 往往就是藉由攻擊醫師有利益瓜葛, 達到他們的目的, 不是嗎?
醫師擁有閱讀 科學文獻, 尤其是健康醫學文獻 的能力, 難道不應該多看看, 甚至查閱原文,
而不是人云亦云.
錯的要導正, 正確的要推廣... "health effect", 我在意的就是這個而已.
最後, 我再送上NEJM June 2011福島事件後, 有人寫的輻射線review
2011 June才事發後三個月, WHO完整評估都尚未出來,
NEJM內容還有核反應爐原理等... 我僅翻譯健康效應, 有興趣的可以自行看原文.
June 2011. NEJM: Health Risks of Accidents at Nuclear Power Plants
http://www.nejm.org/doi/full/10.1056/NEJMra1103676
Types of Radiation Exposure
Human radiation exposure as a result of reactor accidents is generally characterized in three ways三種輻射暴露方法: total or partial body 因靠近輻射源而局部或全身暴露exposure as a result of close proximity to a radiation source, external contamination外污染, and internal contamination內污染. All three types can affect a given person in a radiation accident. Total or partial body exposure occurs when an external source irradiates the body either superficially to the skin or deeply into internal organs, with the depth depending on the type and energy of the radiation involved. For example, beta radiation travels only a short distance in tissue, depending on its energy, and can be a significant source of dose to skin. High-energy gamma radiation, however, can penetrate deeply. In previous reactor accidents, only plant workers and emergency personnel who were involved in the aftermath had substantial total or partial body exposure. Persons who have had total or partial body exposure but no contamination are not radioactive and therefore cannot expose their caregivers to radiation. External contamination occurs when the fission products settle on human beings, thereby exposing skin or internal organs. Populations living near a reactor accident may be advised to remain indoors for a period to minimize the risk of external contamination. Internal contamination occurs when fission products are ingested or inhaled or enter the body through open wounds. This is the primary mechanism through which large populations around a reactor accident can be exposed to radiation. After Chernobyl, approximately 5 million people in the region may have had excess radiation exposure, primarily through internal contamination.
Reactor accidents can release a variety of radioisotopes into the environment. Table 1 lists the radioisotopes that were released during the Chernobyl accident. The health threat from each radioisotope depends on an assortment of factors同位素對健康的威脅由許多因素決定. Radioisotopes with a very short half-life (e.g., 67 hours for molybdenum-99) or a very long half-life (e.g., 24,400 years for plutonium-239鈽)半衰期長短, those that are gaseous氣體 (e.g., xenon-133氙), and those that are not released in substantial quantities 量不大(e.g., plutonium-238鈽) do not cause substantial internal or external contamination in reactor accidents. In contrast相對來說, iodine-131 can be an important source of morbidity because of its prevalence in reactor 碘131由於它的量大也常見於反應爐, 傾向沉積在地面, 可是一個很大的影響健康因素. discharges and its tendency to settle on the ground. When iodine-131 is released, it can be inhaled or consumed after it enters the food chain可以被吸入或者從食物進入食物鏈, primarily through contaminated fruits, vegetables, milk, and groundwater. Once it enters the body, iodine-131 rapidly accumulates in the thyroid gland, where it can be a source of substantial doses of beta radiation.
The release of radioactive water into the sea at the Fukushima plant has resulted in an additional route whereby the food chain may be affected, through contaminated seafood.福島受污染的水也可從海產進入食物鏈, 形成另外一種路徑. Although the radioactivity in seawater close to the plant may be transiently higher than usual by several orders of magnitude雖然電廠附近的海水可能好幾個月內短暫的幾十倍高於正常, it diffuses rapidly with distance and decays over time, according to half-life, both before and after ingestion by marine life. 無論被海中生物食入前後, 它都被迅速的稀釋, 隨著時間與距離衰退.
Clinical Consequences of Radiation Exposure 輻射暴露臨床效應
Type of Radiation and Dose Rates 輻射種類與劑量
分子生物的層次... (略)...
急性暴露 (大劑量, 一次性的暴露) 不常見於核電廠事故, 所以掠過. 直接跳到:
Increased Long-Term Cancer Risks 增加的長期癌症風險
In the region around Chernobyl車諾比區域, more than 5 million people may have been exposed to excess radiation超過五百萬人接觸過量輻射, mainly through contamination by iodine-131 and cesium isotopes主要經過碘131以銫同味素. Although exposure to nuclear-reactor fallout does not cause acute illness, it may elevate long-term cancer risks雖然輻射塵不會造成急性症狀, 它可能增加長期癌症風險. Studies of the Japanese atomic-bomb survivors showed clearly elevated rates of leukemia and solid cancers, even at relatively low total body doses.日本原子彈生存者也清楚顯現即使低全身劑量也, 會增加白血病與實體腫瘤. However, there are important differences 然而, 核電廠與原子彈有很重要的不同 between the type of radiation 輻射種類 and dose rate 還有劑量 associated with atomic-bomb exposure and those associated with a reactor accident. These differences may explain why studies evaluating leukemia and nonthyroid solid cancers0 have not shown consistently elevated risks in the regions around Chernobyl. 這些差別或可解釋, 為何車諾比區域, 白血病或者非甲狀腺癌, 並沒有明顯的增加. Alternatively, small increases in the risks of leukemia and nonthyroid solid cancers may become more apparent with improved cancer registries or longer follow-up. 再者, 白血病, 以及非甲狀腺癌症機率可能因為居民註冊的數量增加, 而導致輕微比例增加. In the population around Three Mile Island, there was a notable temporary increase in cancer diagnoses in the years immediately after the accident在三浬島附近, 事發數年內即有短暫的增加癌症診斷機率, but this increase may have been the result of intensified cancer screening in the area是因為對這區域居民密集的癌症篩檢的結果. Long-term follow-up has shown no increases in cancer mortality. 長期追蹤並沒有發現增加癌症死亡率.
However, there is strong evidence of an increased rate of secondary thyroid cancers among children who have ingested iodine-131然而, 有明顯證據顯示兒童的甲狀腺癌因為食用碘131而增加. Careful studies of children living near the Chernobyl plant (which included estimates of the thyroid radiation dose) suggest that the risk of thyroid cancer increased by a factor of 2 to 5 per 1 Gy of thyroid dose.車諾比附近的研究顯示甲狀腺劑量每增加1Gy, 風險會增加2-5. Although this relative increase in incidence is large雖然相對增加比例看似很大, the baseline incidence of thyroid cancer in children is low 但是年輕人甲狀腺癌基期太低 (<1 case per 100,000 children十萬人裡少於一人). Factors that increase the carcinogenic effect of iodine-131 include a young age and iodine deficiency at the time of exposure會增加甲狀腺癌的危險因子包括年紀輕, 以及暴露時候有碘缺乏. Among children in regions with endemic iodine deficiency, the risk of thyroid cancer per 1 Gy of thyroid dose was two to three times that among children in regions in which iodine intake was normal. Moreover, the risk of thyroid cancer among children who were given stable iodine after the Chernobyl accident was one third that among children who did not receive iodine.車諾比事件後, 有持續給予兒童食用碘的族群, 發病機率是沒有給食用碘 (碘缺乏) 的1/3倍. Studies of the effect of thyroid exposure to radiation in utero and in adulthood have been inconclusive. 研究顯示胎兒暴露放射線碘的影響是尚未有結論的.
In accidents in which iodine-131 is released, persons in affected areas should attempt to minimize their consumption of locally grown produce and groundwater災區應該盡量減少飲用地下水以及當地食物. However, since the half-life of iodine-131 is only 8 days, these local resources should not contain substantial amounts of iodine-131 after 2 to 3 months. 因為碘131半衰期只有8天, 大約2-3個月後當地食水應該就不太含碘了. On the advice of public health officials, area residents may take potassium iodide to block the uptake of iodine-131 in the thyroid還有食用碘化鉀來防止吸收放射碘. To be most effective, prophylactic administration of potassium iodide should occur before or within a few hours after iodine-131 exposure. The administration of the drug more than a day after exposure probably has limited effect, unless additional or continuing exposure is expected. Although potassium iodide can have toxic effects, the Polish experience with en masse administration of the drug after Chernobyl was reassuring. More than 10 million children and adolescents in Poland were given a single dose of prophylactic potassium iodide, with very limited morbidity波蘭超過一千萬的成人及小孩食用預防性碘化鉀, 幾乎沒有什麼副作用. The Food and Drug Administration has issued guidelines for the administration of potassium iodide according to age and expected radiation exposure.