Nuclear
Weapons Illegality the Public Health Case Nicholas Wilson,
FAFPHM, DIH, MPH*; Michael Baker, FAFPHM, DipObs** Abstract
Under existing international law there are four rules of war that have a particular
bearing on the use of nuclear weapons. The unique effects of nuclear weapons that
relate to such rules include: I) the disproportionate magnitude of the health
effects of nuclear weapons; 2) the non localised health effects of nuclear weapons
and hence their effect on civilians, non-belligerents, and neutral countries;
3) the long-term nature of the health effects of nuclear weapons and hence their
effect on future generations; 4) the specific health effects of radiation; and
5) the health effects of the development and production of nuclear weapons. Given
these factors, it would appear that the use of nuclear weapons should be considered
illegal under existing international law. Such an approach would be consistent
with the reasons that have led to biological and chemical weapons being declared
illegal.
This review specifically examines health issues relating
to the legality of the use of nuclear weapons. This issue is important, because
the International Court of Justice (World Court) has asked all member states of
the World Health Organization (WHO) for submissions on the legal status of these
weapons. In a resolution passed in 1993 [1], the World Court asked: In
view of the health and environmental effects, would the use of nuclear weapons
by a State in war or other armed conflict be a breach of its obligations under
international law including the WHO Constitution? One step towards a treaty
to eliminate nuclear weapons would be to declare the use of these weapons illegal
under international law. Such a move may delegitimise the ownership of nuclear
weapons and provide stronger international pressure for nuclear disarmament and
for control of nuclear proliferation [2]. The health issues relating to the following
international rules of war, as discussed in the recent text by Grief on the World
Court Project, form the basis of this review [3]: - Rule 1: It is prohibited
to use weapons or tactics that cause unnecessary or aggravated devastation or
suffering.
- Rule 2: It is prohibited to use weapons or tactics that cause
indiscriminate harm between combatants and non-combatants, and military and civilian
personnel. This also relates to the duty to discriminate between belligerent and
neutral countries.
- Rule 5: It is prohibited to use weapons or tactics
that cause widespread, long-term, and severe damage to the natural environment.
- Rule 6: It is prohibited to effect reprisals that are disproportionate
to the antecedent provocation, or disrespectful of persons, institutions, or resources
protected by the laws of war.
The Disproportionate
Magnitude of the Health Effects of Nuclear Weapons There is no doubt that
"conventional" weapons have wrought great destruction, such as the use of incendiary
bombs against Tokyo and Dresden in World War II. The multiple use of nuclear weapons,
however, is capable of vastly greater devastation. The overwhelming magnitude
of the potential effects of nuclear weapons relates to all the four rules of war
described above. It is particularly relevant, however, to rule six, which deals
with the issue of disproportionality of response. Particular components of the
destructive impact of nuclear weapons include: - The potential for climatic
disturbances and mass starvation: Exchanges of nuclear weapons pose the threat
of large injections of soot and dust into the atmosphere. This effect could cause
climate change at a global and regional level. Although the risk of a superpower
war in the near future is very low, a nuclear war in the Middle East or between
India and Pakistan could possibly produce climatic effects at a regional level.
Burning oil wells in the Middle East would greatly add to the soot generated by
burning cities. The effects of regional climate change on agriculture after such
nuclear conflicts could result in widespread crop failures and massive starvation
(l) [4,5].
- The potential for complete social disintegration: The explosive
power of nuclear weapons combined with the effects of radiation has the capacity
to devastate a nation. For example, a nuclear attack on Egypt by Israel with 50
nuclear weapons, would kill much of Egypt's urban population (2) [6]. Radioactive
fallout would also kill a significant proportion of the rural population (3) [7].
Concerns about fallout exposure and disease risks would hinder the massive overseas
aid that would be necessary to prevent widespread starvation (as Egypt is highly
dependent on imported food).
Developed nations are even more vulnerable
to nuclear explosions, because their infrastructure is more centralized, their
populations are more urbanised, and they are highly dependent on electronic systems
that are readily destroyed by the electromagnetic effects of nuclear weapons.
Also, the populations in these countries are more aware of the hazards of radiation
and, therefore, are more likely to panic and flee from their homes if they believe
they are being exposed to a plume of radioactive fallout. Two other uniquely
destructive effects of nuclear explosions could add to the complete social disintegration
of an attacked nation. First, there is the capacity of one high altitude nuclear
explosion to severely damage electronic systems over huge areas (e.g., as large
as the land mass of the continental United States [8]). Such an "electromagnetic
pulse" from a nuclear explosion over a key economic area such as Tokyo could trigger
a global financial crisis. Second, only nuclear explosions have the capacity
to readily destroy and disperse the radioactive contents of land-based nuclear
reactors. In this way, one nuclear explosion can greatly magnify its destructive
capacity in terms of radiation effects [9]. Magnitude of
the psychosocial effects The psychological and social effects of being
a nuclear bomb survivor are another component of the overwhelming magnitude of
the use of this type of weapon. Hiroshima survivors (the hibakusha) continue to
suffer a psychological burden and stigmatisation decades after the atomic bombing
[10]. Research indicates that Hiroshima was different from other disasters in
that it plunged the survivors into an interminable and unresolvable encounter
with death [11]. Complete inadequacy of any medical response
The complete inability of any health service to cope with the injured, even after
only one nuclear explosion, has been known since the l960s. In one U.S. study,
the injured-to physician ratio was projected to be more than 1,000 to 1 [12].
Injuries from nuclear explosions are also likely to be much more complex than
those arising from other weapons, as they may involve a mixture of the following:
blast injuries, burns, radiation injury, temporary blindness (from the nuclear
flash), the psychological effects associated with complete devastation of the
individual's community, and fear of the consequences of radiation. There are few
cities in the world that could cope with more than 20 new cases of severe burns
or radiation sickness all at once. Non-localised health
effects of nuclear weapons "Non-localised effects" on human health are
summarized below. These issues relate particularly to rules of war numbers one
and two. - Potential for climatic disturbances over large areas: As
described above, this effect could produce starvation in non-combatant countries.
Nuclear explosions could also thin the ozone layer over a large part of the hemisphere.
This could potentially increase the risks for skin cancer and cataracts for millions
of people [4].
- Dispersal of radiation: As clearly demonstrated by the
Chernobyl nuclear accident, radiation is readily dispersed by the wind and deposited
over large parts of the planet [13]. The radiation from as little as a five megaton
nuclear war in the Middle East could cause thousands of cancer deaths regionally
in the long-term. Depending on wind patterns, radiation from such a war could
be dispersed over Europe, Asia, and Africa. High altitude nuclear explosions in
the Middle East could result in radioactive fallout distributed over the mid latitudes
of the northern hemisphere (4) [14].
Radiation is a specific hazard
of nuclear weapons regardless of their size. Therefore, even if "micronukes" or
"mininukes" are produced [15], these weapons will continue to produce the non-localised
and long-term health effects associated with radiation. In any case, to continue
the production of small nuclear weapons necessarily means maintaining the ability
to produce large ones with their more devastating potential. - The
risk of massive communicable disease outbreaks following nuclear attack: The devastation
of urban centres from nuclear weapons, would lead to complete social and economic
breakdown. Such breakdown combined with the debilitating effects of injuries from
blast, thermal, and radiation effects associated with these weapons would increase
the risk of disease outbreaks [16]. Outbreaks of communicable diseases could spread
far outside areas directly involved in the conflict.
The
long term nature of the health effects of nuclear explosions All types
of weapons can produce psycho logical and physical disabilities that last the
lifetime of the individuals affected. Nuclear weapons, however, have effects that
go beyond the generation directly exposed as detailed below: - Long-term
health effects from environmental destruction: Human health is completely dependent
on the "health" of ecosystems. The destructive potential of nuclear war, however,
is such that ecosystems could be damaged for generations. Fires from nuclear explosions,
combined with climatic disruptions, radiation effects, toxins released by fires,
and increased ultraviolet light from ozone layer damage, could all act together
to damage ecosystems severely [5]. This damage would diminish ecosystem services
to humans, (i.e., food supply, water and soil conservation, and preservation of
biodiversity). Nuclear-war-induced fires, for example, could accelerate soil erosion
in the affected areas and, therefore, decrease local food production and increase
the risk of floods.
- Radiation induced genetic diseases: By increasing
the mutation rate in exposed humans, nuclear weapon use may increase the long-term
burden of genetic disease in the exposed populations [17].
- Effects from
ongoing radiation exposure: The use of nuclear weapons would produce radiation
that would continue to expose populations for generations. In the case of airburst
nuclear explosions, as at Hiroshima, radiation is distributed in the upper atmosphere
and falls out around the world over many years. In groundburst explosions, the
effects would tend to be more localised. Some of these radioactive hotspots could
be rendered uninhabitable for many decades [13]. This would particularly be the
case in areas contaminated by the radioactive contents of bombed nuclear reactors
or from the results of terrorist use of "radiation bombs."
The
specific health effects of radiation The fact that radiation from nuclear
weapons can be spread over enormous areas and can produce intergenerational health
effects has been discussed above. Another particular aspect of radiation as a
weapon is that it is invisible in the absence of appropriate sensing equipment.
This can increase the fear associated with radiation for non-combatants and civilians.
This fear can contribute to the causation of various psychological illnesses and
possibly even cancer, according to a study on the population around the Three
Mile Island nuclear reactor [18,19]. Therefore, even populations exposed to very
small doses of radiation downwind of a nuclear explosion might be expected to
suffer adverse health effects. The public fear of radiation makes nuclear
weapons more attractive for terrorists who might attempt to obtain a nuclear weapon
or weapons-grade materials (e.g., enriched uranium or plutonium). This may not
be that unlikely in the long term, given that there are still tens of thousands
of nuclear weapons in the world and that they are stored in at least 13 different
countries. If terrorists could not obtain a proper nuclear bomb, they could produce
a "radiation bomb" using nuclear materials and a conventional explosives [20].
Apart from these points, there is also a case that nuclear weapons should be prohibited
under the Geneva Chemical Weapons Convention (1925), since radioactive fallout
is a kind of poison that can be absorbed through the skin, inhaled, or eaten. The
health effects of the development and production of nuclear weapons - Health
effects of testing nuclear weapons: Many populations have been exposed to radiation
from nuclear testing, including indigenous peoples such as Aborigines, Marshall
Islanders, and the peoples of French Polynesia. Many of the Marshall Islanders
have radiation-induced thyroid disease and have also suffered displacement from
their traditional islands. Thousands of soldiers in the military forces of the
U.S., UK, Australia, and the former Soviet Union were also either deliberately
or recklessly exposed to nuclear tests during the 1950s and 1960s. One recent
estimate is that there have been 430,000 deaths from cancer up to the year 2000,
caused by military testing of more than 1,800 nuclear weapons [21].
- Health
effects of assembling nuclear weapons: Assembling nuclear weapons has damaged
the health of -- and even killed -- civilian workers. Accidents have included
occasions where plutonium has undergone "accidental criticality" and where plutonium
induced fires have occurred [20]. Moreover, even though parts of dismantled nuclear
weapons can be turned into fuel for reactors, the long-term requirement to store
plutonium and bomb components is likely to impose health threats for many generations
[22].
- The opportunity costs of nuclear weapons development on health:
The maintenance of nuclear weapons costs many billions of dollars per year. For
the U.S. alone it currently costs $31 billion per year to buy, operate, and maintain
the country's nuclear weapons and weapon delivery systems [23]. This expenditure
limits the capacity of the global community to respond to critical social and
environmental threats to health facing the world today, including the potential
effects of global warming and overpopulation [24]. For example, providing access
to family planning services to 100 million couples in developing countries who
request such services could cost $6 billion -- the approximate cost of three nuclear-armed
submarines [25]. This opportunity cost of nuclear weapons can therefore be considered
an indirect adverse health effect of such weapons on civilian populations.
Summary
This review has highlighted five key aspects of the unique health effects of nuclear
weapons that are particularly relevant to the international rules of war:
- The disproportionate magnitude of the health effects of nuclear weapons;
- The
non-localised health effects of nuclear weapons and hence their effect on civilians,
non-belligerents, and neutral countries;
- The long-term nature of the
health effects of nuclear weapons and hence their effect on future generations;
- The specific health effects of radiation;
- The health effects
of the development and production of nuclear weapons. Given these factors, it
would appear that the use of nuclear weapons should be considered illegal under
existing international law. Indeed, the argument for the illegality of nuclear
weapons use is consistent with the reasons that have lead to biological and chemical
weapons being declared illegal.
Acknowledgments
The authors would like to thank Dr. Erich Geiringer and Dr. Ian Prior for helpful
comments on the manuscript. Footnotes
1. While most modelling of climatic effects of nuclear war relate to superpower
conflicts, these models do not exclude significant atmospheric and agricultural
effects from smaller regional nuclear wars.
2. This is estimated from the
more detailed studies on the effects of nuclear attacks on American cities. Important
variables are whether airburst or groundburst explosions are used and if several
explosions on one city will trigger a "superfire." [See 5]
3. For example,
a 100 kiloton Israeli nuclear weapon exploded at ground level would contaminate
more than 100 square kilometres of land with a dose of radiation expected to kill
half the population. [See 6]
4. One conservative estimate for the long term
effects of global fallout from airburst explosions is 1,000 deaths per megaton.
[See 14]
5. Radiation bombs are weapons that disperse radiation by means
of a conventional explosion. Certain types of radiation bombs could convert metallic
plutonium into fine particles for dispersal. [See 19] References
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* At the time of publication NW was a Public Health Medicine Specialist in Wellington,
New Zealand; ** MB was Public Health Medicine Specialist, ESR: Health Communicable
Disease Center, Porirua, New Zealand. Medicine & Global
Survival 1995:115-121 Copyright 1995 Medicine and Global
Survival |
