Pervasive #Arctic #lead #pollution suggests substantial #growth in #medieval #silver production modulated by #plague, #climate, and #conflict (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

Pervasive Arctic lead pollution suggests substantial growth in medieval silver production modulated by plague, climate, and conflict

Joseph R. McConnell, Nathan J. Chellman, Andrew I. Wilson, Andreas Stohl, Monica M. Arienzo, Sabine Eckhardt, Diedrich Fritzsche, Sepp Kipfstuhl, Thomas Opel, Philip F. Place, and Jørgen Peder Steffensen

PNAS first published July 8, 2019 / DOI:

Edited by Eric W. Wolff, University of Cambridge, Cambridge, United Kingdom, and accepted by Editorial Board Member A. R. Ravishankara June 13, 2019 (received for review March 15, 2019)



Detailed lead pollution measurements in an array of 13 ice cores spanning nearly half the Arctic showed surprisingly similar temporal variability during the past 2 millennia until the Industrial Revolution. Lead pollution increased by 250- to 300-fold from the Early Middle Ages to the 1970s industrial peak, reflecting large-scale emissions changes from ancient European silver production, recent fossil fuel burning, and other industrial activities. Pronounced decadal-scale increases coincided with exploitation of new mining districts, technology development, and periods of economic prosperity, while decreases coincided with climate disruptions, famines, major wars, and plagues. Despite midlatitude pollution abatement policies that reduced Arctic lead pollution by >80% since the 1970s, recent levels remain 60-fold higher than at the start of the Middle Ages.



Lead pollution in Arctic ice reflects large-scale historical changes in midlatitude industrial activities such as ancient lead/silver production and recent fossil fuel burning. Here we used measurements in a broad array of 13 accurately dated ice cores from Greenland and Severnaya Zemlya to document spatial and temporal changes in Arctic lead pollution from 200 BCE to 2010 CE, with interpretation focused on 500 to 2010 CE. Atmospheric transport modeling indicates that Arctic lead pollution was primarily from European emissions before the 19th-century Industrial Revolution. Temporal variability was surprisingly similar across the large swath of the Arctic represented by the array, with 250- to 300-fold increases in lead pollution observed from the Early Middle Ages to the 1970s industrial peak. Superimposed on these exponential changes were pronounced, multiannual to multidecadal variations, marked by increases coincident with exploitation of new mining regions, improved technologies, and periods of economic prosperity; and decreases coincident with climate disruptions, famines, major wars, and plagues. Results suggest substantial overall growth in lead/silver mining and smelting emissions—and so silver production—from the Early through High Middle Ages, particularly in northern Europe, with lower growth during the Late Middle Ages into the Early Modern Period. Near the end of the second plague pandemic (1348 to ∼1700 CE), lead pollution increased sharply through the Industrial Revolution. North American and European pollution abatement policies have reduced Arctic lead pollution by >80% since the 1970s, but recent levels remain ∼60-fold higher than at the start of the Middle Ages.

ice core – lead pollution – Arctic  – plague – Middle Ages



1 To whom correspondence may be addressed. Email:

Author contributions: J.R.M. designed research; J.R.M., N.J.C., A.S., M.M.A., S.E., D.F., S.K., T.O., P.F.P., and J.P.S. performed research; J.R.M., N.J.C., A.I.W., and A.S. analyzed data; and J.R.M., N.J.C., A.I.W., and A.S. wrote the paper.

The authors declare no conflict of interest.

This article is a PNAS Direct Submission. E.W.W. is a guest editor invited by the Editorial Board.

This article contains supporting information online at

Published under the PNAS license.

Keywords: Arctic; Environmental Pollution; Middle Age; Plague; Wars.



#US #sanctions in #Venezuela: #help, hindrance, or #violation of #humanrights? (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

US sanctions in Venezuela: help, hindrance, or violation of human rights?

Tanya L Zakrison, Carles Muntaner

Published: June 13, 2019 / DOI:


We read with interest the Review about Venezuela’s public health crisis1 and could not agree more emphatically with the authors. However, the root causes of this economic crisis, specifically, the impact of the US economic sanctions, deserve further inquiry. Since 2014, 43 unilateral, coercive measures have been applied against Venezuela by the US Administration. These have effectively paralysed the economy, blocked oil exportation globally, and frozen Venezuelan financial assets abroad while denying access to international financial systems. This loss in oil revenue and assets has amounted to a shortfall worth billions of US dollars, prohibiting the importation of essential, lifesaving products.



We declare no competing interests.

Keywords: Public Health; Venezuela; USA; Wars; Politics; Society; Poverty.


The Ongoing #Ebola #Epidemic in the #DRC, 2018–2019 (N Engl J Med., abstract)

[Source: The New England Journal of Medicine, full page: (LINK). Abstract, edited.]

The Ongoing Ebola Epidemic in the Democratic Republic of Congo, 2018–2019

Oly Ilunga Kalenga, M.D., Ph.D., Matshidiso Moeti, M.D., Annie Sparrow, M.B., B.S., M.D., M.P.H., Vinh-Kim Nguyen, M.D., Ph.D., Daniel Lucey, M.D., M.P.H., and Tedros A. Ghebreyesus, Ph.D.



The international response to the evolving Ebola epidemic in eastern Democratic Republic of Congo (DRC) has had interim successes while facing ongoing difficulties. The outbreak has occurred in an area of intractable conflict among multiple armed groups at a time of contentious national elections. Despite porous international borders and considerable population movement, however, transmission has been confined to North Kivu and Ituri provinces. Factors potentially contributing to this containment include conduct of about 55 million screenings, surveillance of contacts (12,591 under surveillance currently), testing of 280 samples per day, provision of safe and dignified burials for most deaths, vaccination of high-risk people (112,485 vaccinated as of May 7, 2019), and medical treatment including four investigational therapies. Major challenges remain. Since late February 2019, a sharp rise in cases and increased transmission have been observed. These coincide with organized attacks by armed groups targeting response teams, deteriorating security, and the population’s increasing distrust of the response effort. The risk of local and regional spread remains high given the high proportion of deaths occurring outside treatment facilities, relatively low proportions of new patients who were known contacts, ongoing nosocomial transmission, and persistent delays in detection and reporting. Stopping this epidemic will require the alignment of the principal political and armed groups in eastern DRC in support of the response.

Keywords: Ebola; DRC; Society; Poverty; War.


#Water and #Sanitation #Deficits Take a Toll in Armed #Conflict Regions (JAMA, summary)

[Source: Journal of American Medical Association, full page: (LINK). Summary, edited.]

Global Health / May 21, 2019

Water and Sanitation Deficits Take a Toll in Armed Conflict Regions

M.J. Friedrich

JAMA. 2019;321(19):1861. doi:10.1001/jama.2019.6186


Diarrheal diseases resulting from scarce clean water and sanitation in countries with protracted armed conflicts take more children’s lives than the violence itself, according to a recent United Nations Children’s Fund (UNICEF) report.


Keywords: Society; Poverty; Public Health; Wars.


Administrative #Military #Discharge and #Suicidal #Ideation Among Post–9/11 #Veterans (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Administrative Military Discharge and Suicidal Ideation Among Post–9/11 Veterans

Claire A. Hoffmire, PhD1,2, , Lindsey L. Monteith, PhD1,3, Ryan Holliday, PhD1,3, Crystal L. Park, PhD4, Lisa A. Brenner, PhD1,2,3, Rani A. Hoff, PhD5,6


Published online: March 19, 2019




From 2005 to 2016, the Veteran suicide rate increased 25.9%. Reducing this rate is a top priority for the Department of Veterans Affairs. In 2017, a policy change expanded emergent mental health services to include previously ineligible Veterans discharged under other than honorable conditions. To date, research examining the relationship between military discharge type and suicide risk has been limited.


This study aimed to examine the association between discharge type (honorable versus administrative) and active suicide ideation among Veterans participating in the Survey of Experiences of Returning Veterans (N=850, data collection 2012–2015 and data analysis 2017–2018) using logistic regression. Stratified analyses explored whether gender, time since military separation, or recent mental health service use moderated this relationship.


The prevalence of suicide ideation was significantly higher (p<0.01) among Veterans reporting administrative discharge (23.1%, 95% CI=12.8, 33.3 vs 10.6%, 95% CI=8.4, 12.8). However, after accounting for lifetime suicide attempt history, combat experiences, posttraumatic stress disorder symptoms, depression, and drug dependence, discharge was no longer associated with suicide ideation. Recent mental health service use and time since separation significantly modified this relationship. The relationship was only significant among Veterans not using mental health services (OR=4.8, 95% CI=1.3, 18.2) and among transitioning Veterans <2years from separation (OR=3.6, 95% CI=1.4, 9.2).


These findings suggest that recognized risk factors for suicide, such as a history of mental health conditions, account for the increased prevalence of suicide ideation among Veterans with administrative discharges and that mental health services may have the potential to mitigate such risk in this high-risk Veteran population.

Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Keywords: USA; Society; Wars; Psychiatry.


#Venezuela’s #publichealth #crisis: a regional #emergency (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Venezuela’s public health crisis: a regional emergency

Kathleen R Page, MD, Shannon Doocy, PhD, Feliciano Reyna Ganteaume, BArch, Prof Julio S Castro, MD, Paul Spiegel, MD, Prof Chris Beyrer, MD

Published: March 11, 2019 / DOI:



The economic crisis in Venezuela has eroded the country’s health-care infrastructure and threatened the public health of its people. Shortages in medications, health supplies, interruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led to a progressive decline in the operational capacity of health care. The effect of the crisis on public health has been difficult to quantify since the Venezuelan Ministry of Health stopped publishing crucial public health statistics in 2016. We prepared a synthesis of health information, beyond what is available from other sources, and scholarly discussion of engagement strategies for the international community. Data were identified through searches in MEDLINE, PubMed, and the grey literature, through references from relevant articles, and governmental and non-governmental reports, and publicly available databases. Articles published in English and Spanish until Dec 1, 2018, were included. Over the past decade, public health measures in Venezuela have substantially declined. From 2012 to 2016, infant deaths increased by 63% and maternal mortality more than doubled. Since 2016, outbreaks of the vaccine-preventable diseases measles and diphtheria have spread throughout the region. From 2016 to 2017, Venezuela had the largest rate of increase of malaria in the world, and in 2015, tuberculosis rates were the highest in the country in 40 years. Between 2017 and 2018, most patients who were infected with HIV interrupted therapy because of a lack of medications. The Venezuelan economic crisis has shattered the health-care system and resulted in rising morbidity and mortality. Outbreaks and expanding epidemics of infectious diseases associated with declines in basic public health services are threatening the health of the country and the region.

Keywords: Public Health; Venezuela; Wars; Society; Poverty.


An #Epidemic of #Suspicion — #Ebola and #Violence in the #DRC (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]


An Epidemic of Suspicion — Ebola and Violence in the DRC

Vinh-Kim Nguyen, M.D.


Until the 2014 Ebola epidemic in West Africa, Ebola outbreaks had been sporadic, small, and largely confined to isolated rural villages in Central Africa. But the 2014 epidemic broke all the rules and killed more than 15,000 people; since then, more outbreaks have been reaching larger urban centers, sometimes resulting in uncontrolled spread. The current epidemic in the Democratic Republic of Congo (DRC) has triggered a massive international response, which has been met by violence, culminating in attacks at the end of February that partially destroyed Ebola treatment units in the regional hub of Butembo and its township, Katwa. This area is the epicenter of the epidemic, which is likely to be fueled by any breakdown of isolation and treatment efforts.



Disclosure forms provided by the author are available at

The views expressed in this article are those of the author and do not necessarily reflect those of Médecins sans Frontières.

This article was published on March 6, 2019, at

Author Affiliations: From Médecins sans Frontières, Democratic Republic of Congo.

Keywords: Ebola; Society; Global Health; Wars.