• The Health Effects of Climate Change in the United Kingdom
  
• Assessment of disposal of very low level radioactive waste in landfill sites
  
• New WHO online tool to improve clinical trial transparency

   

The Health Effects of Climate Change in the United Kingdom

The Department of Health (DH) and the Health Protection Agency have published an update to a report on the Health Effects of Climate Change in the United Kingdom [1] originally published in 2002 [2]. The new report takes into account up-to-date information and current predictions about climate change in the UK.

New information provided by the report shows that the UK population is adapting well to the increasing temperatures experienced since the 1970s, but heatwaves still pose a serious problem to health and they will become more frequent.

The main findings of the report include:

• By 2012 there is a 1 in 40 chance that South Eastern England will have experienced a serious heatwave.
• Periods of very cold weather will become less common, while periods of very hot weather will become more common.
• Winter deaths will continue to decline as the climate warms.
  Flooding is an increasing risk.
• Tick-borne diseases are likely to become more common in the UK , but this is more likely to be due to changes in land-use and leisure activities, than to climate change.
• Increased exposure to sunshine and to ultraviolet light will lead to an increase in skin cancers.
• The UK population seems to be adapting to increasingly warm conditions.

The report has been placed the DH website for comment for a period of six weeks. Comments will be taken into account and a final version published in July. It can also be accessed via the HPA website at
<http://www.hpa.org.uk/chemicals/publications/chapd_consultation_docs/climate_change_report.htm

References
1. Department of Health and Health Protection Agency. Health Effects of Climate Change in the UK (Draft for comment). (An update of the Department of Health report 2001/2000). London: DH/HPA, 2007. Available at <http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_074439>.

2. Health effects of climate change in the UK. London: Department of Health, 2007. Available at <http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/
DH_4007935 >.

Assessment of disposal of very low level radioactive waste in landfill sites

The Health Protection Agency has carried out an assessment of the potential radiological impact of the disposal of large quantities of very low level solid radioactive waste (VLLW) from the nuclear industry in sites built to conventional landfill site standards [1].

This work was funded by the Department for Environment, Food, and Rural Affairs (Defra) and the Environment Agency to provide the United Kingdom government with information on potential radiation doses from the disposal of large quantities of VLLW, to assist policy development in this area. Although primarily for government and environment agencies, the report may be useful to organisations considering options for the disposal of large quantities of waste with very low levels of radioactivity.

The report considers the implications of a proposed change in the definition of VLLW to include large quantities of waste with very low levels of radioactivity, such as slightly contaminated concrete rubble from the decommissioning of a nuclear power station. It also considers three different types of landfill site and assesses a number of potential exposure scenarios including the exposure of workers, the direct disposal of water from the discharge management system at the landfill site to a nearby river, and the potential radiological impact to members of the public after closure of the landfill site.

Based on the dose criteria used in this study, disposal of a million tonnes of waste with very low levels of radioactivity in a site built to current landfill site standards was estimated to be acceptable, in terms of the radiological assessment, for six out of 11 of the radionuclides considered. For five radionuclides (Carbon-14, Cobalt-60, Caesium-137, Radium-226 and Thorium-232) it would be necessary to consider the exact characteristics of the site to determine the quantity which could be disposed of.

The study provided a basis for the inclusion of disposal of large quantities of VLLW waste in sites similar to landfill sites in the revised government policy [2] as High Volume VLLW, and controls will be specified on the total volumes of this waste which can be disposed of to a specific site. Under the previous Low Level Waste policy small quantities of very low level radioactive waste could be disposed of, with ordinary waste, to landfill sites under a generic authorisation.

References
1. QQ Chen, R Kowe, SF Mobbs, KA Jones. Radiological assessment of disposal of large quantities of very low level waste in landfill sites. Chilton: HPA, 2007.
Available at <http://www.hpa.org.uk/radiation/publications/hpa_rpd_reports/2007/hpa_rpd_020.htm>.

2. Defra, DTI and the Devolved Administrations. Policy for the long term management of solid low level radioactive waste in the United Kingdom. London: Defra, 2007. Available at <http://www.defra.gov.uk/environment/radioactivity/waste/pdf/llw-policystatement070326.pdf>.

New WHO online tool to improve clinical trial transparency

On 4 May 2007, the World Health Organization (WHO) launched a new web site that will enable researchers, health practitioners, consumers, journal editors, and reporters to search more easily and quickly for information on clinical trials. The site works as an entry point or portal into multiple, high quality, clinical trial registers with a global search function.

Clinical trial registers have now become widely accepted as an essential part of an overall strategy for improving health outcomes. The challenge now facing those wanting to identify clinical trials research is knowing how to navigate their way through the ever increasing number of registers that now exist, and knowing which registers provide information that is accurate and reliable.

For a doctor or a patient, identifying all clinical trials relevant to a decision to receive a specific treatment option is a difficult task, made easier if the results have been reported in the published literature. A significant proportion of research is never published and, even if it is published, it is possible that only part of the story is told in the publication. Relying on information provided only by published trial research is therefore unreliable and leads to inadequately informed treatment decisions.

The only way to ensure the availability of complete and accurate information about clinical trials is for all trials to be registered before any participants are recruited. WHO believes that the registration of clinical trials is a scientific, ethical, and moral responsibility.

The quality of information accessible through the WHO portal is assured, as registers providing data to the search portal are all collaborators in the WHO Network of Collaborating Clinical Trial registers. The network will provide a forum for registers to exchange information and work together to establish best practice for clinical trial registration. Registers in the network that contribute data to the search portal have agreed to prospectively register trials, are able to collect all 20 items in the WHO Trial Registration Data Set and have mechanisms in place to ensure the optimal quality of the data provided. They are also required to publicly disclose their ownership, governance structure, and for-profit status. Details of registers meeting the required standards are available on the web site.

The portal is accessible at <http://www.who.int/trialsearch>.