Fifty years since the nuclear accident in Palomares (Almeria). Medical repercussions

Laynez-Bretones, F.; Lozano-Padilla, C.

doi:10.1016/j.rceng.2017.03.001

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Medical repercussions" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "263" "paginaFinal" => "266" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Laynez-Bretones, C. Lozano-Padilla" "autores" => array:2 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Laynez-Bretones" "email" => array:1 [ 0 => "franciscolaynez@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." 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The bomber carried 4 thermonuclear bombs, each of them with a power 75 times greater than that of the atomic bomb of Hiroshima.<a class="elsevierStyleCrossRefs" href="#bib0180">1,2</a> A large deployment was immediately organized by the U.S. authorities, which was called “Operation Broken Arrow” designed to locate the 4 bombs.<a class="elsevierStyleCrossRef" href="#bib0190">3</a> Palomares is a district of Cuevas del Almanzora, in the province of Almeria, which at the time had 1200 inhabitants.<a class="elsevierStyleCrossRef" href="#bib0195">4</a>Bomb 1 was intact, but 2 other bombs (2 and 3) spread approximately 9kg of plutonium-239 and other radioactive elements upon striking the ground.<a class="elsevierStyleCrossRefs" href="#bib0180">1,5</a> Bomb 4 fell into the sea and took 81 days to be recovered but did not release its radioactive content.<a class="elsevierStyleCrossRefs" href="#bib0180">1,6,7</a> There is a famous photograph of Manuel Fraga Iribarne, the then Minister of Information and Tourism, bathing on the beach of Palomares to try to demonstrate that there was no risk of radioactive contamination.<a class="elsevierStyleCrossRef" href="#bib0215">8</a>The nuclear contaminationNuclear bombs can be essentially 2 types: (1) atomic (the Hiroshima bomb), based on the fission of the radioactive nucleus into fragments, a process that releases energy; and (2) thermonuclear, H or hydrogen bombs (Nagasaki bomb), based on fission–fusion–fission. The fusion is followed by fission phenomena of the radioactive nucleus, and the energy release is far greater.<a class="elsevierStyleCrossRefs" href="#bib0200">5,9</a>There are basically 3 types of radioactive particles: alpha (which does not pass through human skin), beta (which passes through skin but not an aluminum plate) and gamma (which passes through aluminum but not a layer of concrete).<a class="elsevierStyleCrossRef" href="#bib0225">10</a> The bombs that fell on Palomares were mostly composed of plutonium.<a class="elsevierStyleCrossRef" href="#bib0180">1</a> Plutonium is an artificial radioactive substance, which does not exist in nature (it is obtained from uranium-238) and emits alpha radiation.<a class="elsevierStyleCrossRef" href="#bib0230">11</a>From the start, both the U.S. and Spanish authorities attempted to make the accident at Palomares go unnoticed. The American government considered their nuclear program top secret, and the Spanish government did not want the incipient tourism of the Spanish coast to be affected.<a class="elsevierStyleCrossRefs" href="#bib0200">5,12</a>The first decision facing the scientists who visited the accident scene was whether to evacuate the population. Ultimately, the decision was made not to evacuate so as not to create alarm.<a class="elsevierStyleCrossRef" href="#bib0240">13</a> The scientists immediately began to measure the alpha contamination of the area. They prepared an initial dosimetric map of the contaminated areas and fenced in the surrounding areas where bombs 2 and 3 fell.<a class="elsevierStyleCrossRef" href="#bib0240">13</a> The strong prevailing wind in Palomares in the days following the accident dispersed the plutonium contamination to uninhabited areas. Luckily, most of the urban center of Palomares lay outside the areas of greatest contamination.<a class="elsevierStyleCrossRefs" href="#bib0245">14,15</a>The next issue for the scientists was to determine what contamination levels were acceptable. This was no easy task because plutonium had been discovered only 26 years before the accident,<a class="elsevierStyleCrossRef" href="#bib0255">16</a> and cases of poisoning in humans were very scarce.<a class="elsevierStyleCrossRefs" href="#bib0260">17,18</a> Ultimately, the decision was made to remove the soil that showed radioactivity levels above 60,000 counts or disintegrations per minute (cpm) and the crops with concentrations above 400cpm.<a class="elsevierStyleCrossRefs" href="#bib0180">1,12</a> The contaminated soil and crops were placed in 4810 drums and transferred to the nuclear cemetery in Savannah River in South Carolina, US, where they are currently buried.<a class="elsevierStyleCrossRef" href="#bib0180">1</a>Medical implications. The Indalo ProjectPlutonium is a heavy element, which is deposited in the ground.<a class="elsevierStyleCrossRef" href="#bib0195">4</a> The element can enter the body through inhalation or gastrointestinally.<a class="elsevierStyleCrossRef" href="#bib0270">19</a> Once in the body, plutonium has carcinogenic effects on the lungs, bones and liver.<a class="elsevierStyleCrossRef" href="#bib0275">20</a> Eliminating plutonium is very difficult; only 12.7% is eliminated 10 years after entering the body.<a class="elsevierStyleCrossRefs" href="#bib0260">17,18</a>Project Indalo was created immediately after the Palomares accident with two objectives: the monitoring of individuals affected by the accident and the environmental monitoring of the air, soils, vegetation and animals.<a class="elsevierStyleCrossRefs" href="#bib0200">5,21</a> In this article, we only discuss the monitoring of the individuals affected by the accident.Those responsible for Project Indalo were, on the Spanish side, the pharmacist Emilio Iranzo from the Nuclear Energy Board (Junta de Energía Nuclear, JEN) and, on the US side, Dr. Wright H. Langham, Head of the Los Alamos Biomedical Research Laboratory, New Mexico. Dr. Langham was known as “Mr. Plutonium” because he was the highest authority worldwide on the effects of this radioactive substance on living beings.<a class="elsevierStyleCrossRefs" href="#bib0260">17,18</a> His knowledge came from studies performed on humans who were injected with plutonium without their consent.<a class="elsevierStyleCrossRefs" href="#bib0200">5,22</a>A total of 1950 inhabitants of Palomares and its surroundings were analyzed, and 80 individuals with the highest levels of alpha radiation were selected.<a class="elsevierStyleCrossRef" href="#bib0240">13</a> These individuals were transferred to Madrid, where 24-h urine tests were performed to indirectly measure the quantity of plutonium stored in the body.<a class="elsevierStyleCrossRef" href="#bib0265">18</a> Forty-five of these individuals (56%) had positive results but at a level so low that it did not represent a threat to their health, according to the official version.<a class="elsevierStyleCrossRef" href="#bib0240">13</a> One year later, the analysis was repeated, and the level of positives had increased to 71%, which indicated that there was further poisoning through inhaling part of the plutonium deposited in the ground.<a class="elsevierStyleCrossRef" href="#bib0290">23</a> The American military authorities performed the same study on soldiers who intervened in Palomares. Initially, 18% of the soldiers involved resulted positive, but 1 year later all had gone to negative.<a class="elsevierStyleCrossRefs" href="#bib0295">24,25</a>From 1968, the individuals with the highest levels of radioactivity were also examined with an external body counter, a device that allows for the study of lung involvement.<a class="elsevierStyleCrossRefs" href="#bib0200">5,26</a> However, the results have never been made public. Since then, approximately 150 inhabitants of Palomares have been admitted annually to Madrid for studies,<a class="elsevierStyleCrossRef" href="#bib0310">27</a> whose results are reported in a concise manner.Since 1984, we have faced a new problem: the measurements of radioactive substances have shown increasing levels of americium. As with plutonium, americium is an artificial substance obtained from uranium-238. However, its toxicity is much greater because it is lighter and can therefore be inhaled more easily. Americium also emits gamma radiation, which penetrates the body and is more toxic.<a class="elsevierStyleCrossRefs" href="#bib0315">28–31</a> In 2009, the United States unilaterally decided to remove the subsidy for Project Indalo, thereby leading to its formal end. However, the Spanish government by means of the Center for Energy, Environmental and Technological Research (CIEMAT) continued performing studies on the inhabitants, air, lands and crops of Palomares.<a class="elsevierStyleCrossRefs" href="#bib0280">21,27</a>Due to the secrecy surrounding the nuclear accident at Palomares since it occurred, publications in scientific journals have been rare. The results of these studies have been made public in only a few conferences held by the heads of JEN and CIEMAT, almost all of which took place outside Spain.<a class="elsevierStyleCrossRef" href="#bib0235">12</a>In summary, 33 individuals were acutely exposed to plutonium during the hours following the accident. Subsequently, a total of 1077 individuals have been monitored, from whom 5029 urine samples were analyzed. Eleven percent of the monitored individuals (119) have shown plutonium contamination. However, according to CIEMAT, the results of the medical examinations have not shown any result that leads to the suspicion of morbidity specifically induced by ionizing radiation.<a class="elsevierStyleCrossRefs" href="#bib0310">27,32</a>As surprising as it seems, solvent epidemiological studies have not been performed in the area. Only Dr. Martínez Pinilla has performed a study of cancer deaths in Palomares (1945–2005), a study with many limitations. The author concluded that there is no association at all between being an inhabitant of Palomares and the cancer deaths in this population. The study has not been published in scientific journals, although it is accessible by Internet.<a class="elsevierStyleCrossRef" href="#bib0340">33</a>Current situationAt this time, it is estimated that there are still approximately 500g of the 9kg of plutonium released by the fall of the bombs in Palomares. The amount of americium in the area will progressively increase as the plutonium degrades, and the maximum activity will occur approximately 73 years after the purification of the nuclear fuel, between 2030 and 2033.<a class="elsevierStyleCrossRef" href="#bib0335">32</a>In October 2015, John Kerry (the US Secretary of State) signed an agreement with the Spanish government by which the US is committed to removing the residues in the surroundings of Palomares “in the shortest period possible”, without indicating any date.<a class="elsevierStyleCrossRef" href="#bib0345">34</a> At this point, we would like to quote Juan Antonio Rubio, director of CIEMAT between 2004 and 2010, “The analyses have not shown a greater incidence of cancer, but I believe that the best course of action is to remove the radioactive material and forget about Palomares.”<a class="elsevierStyleCrossRef" href="#bib0350">35</a>Conflicts of interestThe authors declare that they have no conflicts of interest." 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One of them carried thermonuclear bombs, which released plutonium and other radioactive materials upon striking the ground.The most contaminated earth and plants were immediately removed. The Indalo Project was launched to study the effects of nuclear material on the inhabitants and environment of Palomares. A total of 1077 inhabitants have been monitored since then, and the official version is that the ionizing radiation has not been related to any type of disease. However, secrecy has surrounded much of the investigations, and no trustworthy epidemiological study has been conducted in the area.Approximately 500g of plutonium and americium remains in Palomares. Although the risk for the population appears to be low, this radioactive material should be removed as soon as possible." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "En enero de 1966, 2 aviones de guerra norteamericanos colisionaron sobre el cielo de Palomares (Almería). Uno de ellos transportaba bombas termonucleares que, al impactar con el suelo, liberaron plutonio y otros materiales radiactivos.Inmediatamente se retiraron las tierras y vegetales más contaminados, y se puso en marcha el Proyecto Indalo destinado a estudiar los efectos del material nuclear sobre los habitantes y el entorno de Palomares. Un total de 1.077 habitantes han sido controlados desde entonces, y la versión oficial es que las radiaciones ionizantes no se han relacionado con ningún tipo de enfermedad. Sin embargo, el secretismo ha rodeado gran parte de las investigaciones, y no se ha realizado ningún estudio epidemiológico solvente en la zona.Actualmente quedan en Palomares unos 500g de plutonio y americio. A pesar de que el riesgo para la población parece ser bajo, este material radiactivo debería retirarse lo antes posible." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Laynez-Bretones F, Lozano-Padilla C. 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but 2 other bombs &#40;2 and 3&#41; spread approximately 9<span class="elsevierStyleHsp" style=""></span>kg of plutonium-239 and other radioactive elements upon striking the ground&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;5</span></a> Bomb 4 fell into the sea and took 81 days to be recovered but did not release its radioactive content&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;6&#44;7</span></a> There is a famous photograph of Manuel Fraga Iribarne&#44; the then Minister of Information and Tourism&#44; bathing on the beach of Palomares to try to demonstrate that there was no risk of radioactive contamination&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">8</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">The nuclear contamination</span><p id="par0015" class="elsevierStylePara elsevierViewall">Nuclear bombs can be essentially 2 types&#58; &#40;1&#41; atomic &#40;the Hiroshima bomb&#41;&#44; based on the fission of the radioactive nucleus into fragments&#44; a process that releases energy&#59; and &#40;2&#41; thermonuclear&#44; H or hydrogen bombs &#40;Nagasaki bomb&#41;&#44; based on fission&#8211;fusion&#8211;fission&#46; The fusion is followed by fission phenomena of the radioactive nucleus&#44; and the energy release is far greater&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">5&#44;9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There are basically 3 types of radioactive particles&#58; alpha &#40;which does not pass through human skin&#41;&#44; beta &#40;which passes through skin but not an aluminum plate&#41; and gamma &#40;which passes through aluminum but not a layer of concrete&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">10</span></a> The bombs that fell on Palomares were mostly composed of plutonium&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a> Plutonium is an artificial radioactive substance&#44; which does not exist in nature &#40;it is obtained from uranium-238&#41; and emits alpha radiation&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">From the start&#44; both the U&#46;S&#46; and Spanish authorities attempted to make the accident at Palomares go unnoticed&#46; The American government considered their nuclear program top secret&#44; and the Spanish government did not want the incipient tourism of the Spanish coast to be affected&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">5&#44;12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The first decision facing the scientists who visited the accident scene was whether to evacuate the population&#46; Ultimately&#44; the decision was made not to evacuate so as not to create alarm&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> The scientists immediately began to measure the alpha contamination of the area&#46; They prepared an initial dosimetric map of the contaminated areas and fenced in the surrounding areas where bombs 2 and 3 fell&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> The strong prevailing wind in Palomares in the days following the accident dispersed the plutonium contamination to uninhabited areas&#46; Luckily&#44; most of the urban center of Palomares lay outside the areas of greatest contamination&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The next issue for the scientists was to determine what contamination levels were acceptable&#46; This was no easy task because plutonium had been discovered only 26 years before the accident&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">16</span></a> and cases of poisoning in humans were very scarce&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">17&#44;18</span></a> Ultimately&#44; the decision was made to remove the soil that showed radioactivity levels above 60&#44;000 counts or disintegrations per minute &#40;cpm&#41; and the crops with concentrations above 400<span class="elsevierStyleHsp" style=""></span>cpm&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;12</span></a> The contaminated soil and crops were placed in 4810 drums and transferred to the nuclear cemetery in Savannah River in South Carolina&#44; US&#44; where they are currently buried&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Medical implications&#46; The Indalo Project</span><p id="par0040" class="elsevierStylePara elsevierViewall">Plutonium is a heavy element&#44; which is deposited in the ground&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">4</span></a> The element can enter the body through inhalation or gastrointestinally&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">19</span></a> Once in the body&#44; plutonium has carcinogenic effects on the lungs&#44; bones and liver&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">20</span></a> Eliminating plutonium is very difficult&#59; only 12&#46;7&#37; is eliminated 10 years after entering the body&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Project Indalo was created immediately after the Palomares accident with two objectives&#58; the monitoring of individuals affected by the accident and the environmental monitoring of the air&#44; soils&#44; vegetation and animals&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">5&#44;21</span></a> In this article&#44; we only discuss the monitoring of the individuals affected by the accident&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Those responsible for Project Indalo were&#44; on the Spanish side&#44; the pharmacist Emilio Iranzo from the Nuclear Energy Board &#40;<span class="elsevierStyleItalic">Junta de Energ&#237;a Nuclear</span>&#44; JEN&#41; and&#44; on the US side&#44; Dr&#46; Wright H&#46; Langham&#44; Head of the Los Alamos Biomedical Research Laboratory&#44; New Mexico&#46; Dr&#46; Langham was known as &#8220;Mr&#46; Plutonium&#8221; because he was the highest authority worldwide on the effects of this radioactive substance on living beings&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">17&#44;18</span></a> His knowledge came from studies performed on humans who were injected with plutonium without their consent&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">5&#44;22</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 1950 inhabitants of Palomares and its surroundings were analyzed&#44; and 80 individuals with the highest levels of alpha radiation were selected&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> These individuals were transferred to Madrid&#44; where 24-h urine tests were performed to indirectly measure the quantity of plutonium stored in the body&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">18</span></a> Forty-five of these individuals &#40;56&#37;&#41; had positive results but at a level so low that it did not represent a threat to their health&#44; according to the official version&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> One year later&#44; the analysis was repeated&#44; and the level of positives had increased to 71&#37;&#44; which indicated that there was further poisoning through inhaling part of the plutonium deposited in the ground&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> The American military authorities performed the same study on soldiers who intervened in Palomares&#46; Initially&#44; 18&#37; of the soldiers involved resulted positive&#44; but 1 year later all had gone to negative&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">24&#44;25</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">From 1968&#44; the individuals with the highest levels of radioactivity were also examined with an external body counter&#44; a device that allows for the study of lung involvement&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">5&#44;26</span></a> However&#44; the results have never been made public&#46; Since then&#44; approximately 150 inhabitants of Palomares have been admitted annually to Madrid for studies&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">27</span></a> whose results are reported in a concise manner&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Since 1984&#44; we have faced a new problem&#58; the measurements of radioactive substances have shown increasing levels of americium&#46; As with plutonium&#44; americium is an artificial substance obtained from uranium-238&#46; However&#44; its toxicity is much greater because it is lighter and can therefore be inhaled more easily&#46; Americium also emits gamma radiation&#44; which penetrates the body and is more toxic&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">28&#8211;31</span></a> In 2009&#44; the United States unilaterally decided to remove the subsidy for Project Indalo&#44; thereby leading to its formal end&#46; However&#44; the Spanish government by means of the Center for Energy&#44; Environmental and Technological Research &#40;CIEMAT&#41; continued performing studies on the inhabitants&#44; air&#44; lands and crops of Palomares&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">21&#44;27</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Due to the secrecy surrounding the nuclear accident at Palomares since it occurred&#44; publications in scientific journals have been rare&#46; The results of these studies have been made public in only a few conferences held by the heads of JEN and CIEMAT&#44; almost all of which took place outside Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">12</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">In summary&#44; 33 individuals were acutely exposed to plutonium during the hours following the accident&#46; Subsequently&#44; a total of 1077 individuals have been monitored&#44; from whom 5029 urine samples were analyzed&#46; Eleven percent of the monitored individuals &#40;119&#41; have shown plutonium contamination&#46; However&#44; according to CIEMAT&#44; the results of the medical examinations have not shown any result that leads to the suspicion of morbidity specifically induced by ionizing radiation&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">27&#44;32</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">As surprising as it seems&#44; solvent epidemiological studies have not been performed in the area&#46; Only Dr&#46; Mart&#237;nez Pinilla has performed a study of cancer deaths in Palomares &#40;1945&#8211;2005&#41;&#44; a study with many limitations&#46; The author concluded that there is no association at all between being an inhabitant of Palomares and the cancer deaths in this population&#46; The study has not been published in scientific journals&#44; although it is accessible by Internet&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Current situation</span><p id="par0085" class="elsevierStylePara elsevierViewall">At this time&#44; it is estimated that there are still approximately 500<span class="elsevierStyleHsp" style=""></span>g of the 9<span class="elsevierStyleHsp" style=""></span>kg of plutonium released by the fall of the bombs in Palomares&#46; The amount of americium in the area will progressively increase as the plutonium degrades&#44; and the maximum activity will occur approximately 73 years after the purification of the nuclear fuel&#44; between 2030 and 2033&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In October 2015&#44; John Kerry &#40;the US Secretary of State&#41; signed an agreement with the Spanish government by which the US is committed to removing the residues in the surroundings of Palomares &#8220;in the shortest period possible&#8221;&#44; without indicating any date&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> At this point&#44; we would like to quote Juan Antonio Rubio&#44; director of CIEMAT between 2004 and 2010&#44; &#8220;The analyses have not shown a greater incidence of cancer&#44; but I believe that the best course of action is to remove the radioactive material and forget about Palomares&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In January 1966&#44; 2 US military aircraft collided over the skies of Palomares &#40;Almeria&#41;&#46; One of them carried thermonuclear bombs&#44; which released plutonium and other radioactive materials upon striking the ground&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The most contaminated earth and plants were immediately removed&#46; The Indalo Project was launched to study the effects of nuclear material on the inhabitants and environment of Palomares&#46; A total of 1077 inhabitants have been monitored since then&#44; and the official version is that the ionizing radiation has not been related to any type of disease&#46; However&#44; secrecy has surrounded much of the investigations&#44; and no trustworthy epidemiological study has been conducted in the area&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Approximately 500<span class="elsevierStyleHsp" style=""></span>g of plutonium and americium remains in Palomares&#46; Although the risk for the population appears to be low&#44; this radioactive material should be removed as soon as possible&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En enero de 1966&#44; 2 aviones de guerra norteamericanos colisionaron sobre el cielo de Palomares &#40;Almer&#237;a&#41;&#46; Uno de ellos transportaba bombas termonucleares que&#44; al impactar con el suelo&#44; liberaron plutonio y otros materiales radiactivos&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Inmediatamente se retiraron las tierras y vegetales m&#225;s contaminados&#44; y se puso en marcha el Proyecto Indalo destinado a estudiar los efectos del material nuclear sobre los habitantes y el entorno de Palomares&#46; Un total de 1&#46;077 habitantes han sido controlados desde entonces&#44; y la versi&#243;n oficial es que las radiaciones ionizantes no se han relacionado con ning&#250;n tipo de enfermedad&#46; Sin embargo&#44; el secretismo ha rodeado gran parte de las investigaciones&#44; y no se ha realizado ning&#250;n estudio epidemiol&#243;gico solvente en la zona&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Actualmente quedan en Palomares unos 500<span class="elsevierStyleHsp" style=""></span>g de plutonio y americio&#46; A pesar de que el riesgo para la poblaci&#243;n parece ser bajo&#44; este material radiactivo deber&#237;a retirarse lo antes posible&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Laynez-Bretones F&#44; Lozano-Padilla C&#46; Cincuenta a&#241;os del accidente nuclear de Palomares &#40;Almer&#237;a&#41;&#46; Repercusiones m&#233;dicas&#46; Rev Clin Esp&#46; 2017&#59;217&#58;263&#8211;266&#46;</p>"
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                        "titulo" => "Operaci&#243;n Flecha Rota&#46; Accidente nuclear en Palomares &#40;Almer&#237;a&#41;"
                        "serieFecha" => "2003"
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                      "titulo" => "Componentes estrat&#233;gicos de la seguridad y defensa&#46; Proliferaci&#243;n nuclear&#58; la energ&#237;a y su relaci&#243;n con la seguridad y la defensa"
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                          "etal" => false
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                  ]
                  "host" => array:1 [
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