Saturday, August 23, 2008

The Health Situation in Libya: Part I cancer

"Every single time they called or I called [Libya] they told me of someone who just died or who is dying. The cause of death is either a car accident or cancer." Laments Sereeb.

For a country of less than 6 million people this statement should raise a thousand red flags!

Sereeb was not the first one to notice this anomaly related to chronic diseases, I pointed out in my previous post that "I have lost six friends to cancer, while another five are in various stages of survival/remission. I have also lost one to a heart attack, and two to car accidents and I have one friend recovering from a stroke." This means at least 11 of my friends have cancer; I have not brought up the neighbours, work colleagues, family members, acquaintances and their families, neighbours etc…thinking exponentially and factoring in the funerals I have attended I would say it is a national disaster.

Before you proceed to my report below please ensure you read and understand this disclaimer: the following is not a research done by scientific methods. I have no hard numbers or statistics to give but only my own personal observations- so please do not use it as a weapon against me or Libyans.

OK – with this out of the way we can move on…

My first observation that something was amiss was when the number of miscarriages in Libya spiraled alarmingly in the mid 80s. From that time up to now I can confidently say that the majority of Libyan married women have had at least one miscarriage during their first year of marriage and before the birth of their first child. This is NOT NORMAL. Notice I said majority – not all! For those who did not have a miscarriage then we need to dig a bit deeper and of course there are always exceptions to the rule. I noticed this first with my aunts who began founding families in the mid 80s. I also noticed that this phenomenon began in the mid 80s onward roughly when the following international issues were unfolding.

o Eldorado Canyon
o The Chernobyl disaster (the fires did last for 10 days)
o The Aozou strip border conflict
o Desert Storm

For the sake of objectivity I would like to add the following factors:
o Social upheaval
o Environmental Pollution

I've read many articles, papers and books and I understand that my story could be criticised as unsubstantiated, but I'm simply searching for a cause not conspiracy theories or a scapegoat.

Two essential things I've noted during the last decades:

(1) Fertility has decreased in Libya, families now average 3-5 kids, whereas before it used to be 6-10. Increasingly IVF pregnancies are sought in Jordan (for the sake of discretion as this is a sensitive topic) Meanwhile Libyan women are showing a range of gynae/obstetric complaints. The UNICEF report gives us the following figures for total fertility rate in Libya: 2006 = 2.8, in 1990 = 4.8 and in 1970= 7.6. Not sure what that means. [ref]

It could be socially related such as marrying later in life of course but not if it is chronic-diseases-related.

(2) Cancer in all forms is widespread but particularly, breast, ovarian and uterine cancer in women, prostate cancer for men and leukemia and cancer of the stomach in both genders. I don't think it is due to improved screening process because we don't have that kind of attitude and culture established yet. Ex: Libyan women in their 30s do not automatically have mammograms or even breast self examination at home.

Basically when Libyans go to the doctor it means it is serious.

Surveillance of non-communicable diseases in Libya and particularly cancer may not yet have been underway. But in 2003 there was apparently a first attempt at collecting such data in Benghazi. The population in eastern Libya is 1.6 million; cancer cases registered in 2003 were 997.[ref]

The annual report from the Secretariat of Health and Environment for 2007 is finally out and it apparently contains a survey of cancer cases registered from both Western and Eastern regions of Libya, but the electronic full copy has still not been loaded to the official website.

A- Social/cultural causes:

National authorities have reported that 13% of the mortality in Libya is attributed to cancer as a result of social and lifestyle changes ( ex : change in smoking pattern and prevalence).

B. Environmental issues possibly due to modernization, sanctions and military ambitions

(1) Water pollution:
"The combined impact of sewage, oil byproducts, and industrial waste threatens the nation's coast and the Mediterranean Sea generally. Libya has 0.8 cu km of renewable water resources with 87% used in farming activity and 4% for industrial purposes. Only about 68% of the people living in rural areas have pure drinking water. The nation's cities produce about0.6 million tons of solid waste per year. [ref]

Potential hazards are detailed here as well.[ref]

(2) Carbon Emission:
Libya has the highest CO2 emissions per capita in Africa on a par with Japan and UK. [ref]

The ILSA act of 1996 most probably had some kind of detrimental impact on these results by preventing investment in the oil sector that could have helped purchase equipment and material to curb this environmental disaster.

(3) The quest for chemical, biological and nuclear arsenals:
Various attempts were exerted since the 80s with Rabta, Sebha and Tarhuna plants being among the most famous along with the Tajoura nuclear research reactor as Dr Joshua Sinai kindly mentions in this now old (1997) but relevant analysis.

Anyway as we know these efforts all culminated in Libya's now famous dismantling of its WMD programme in 2004. However, we can only guess whether these activities have released toxins into the environment. There are no studies to my knowledge.

(4) Agriculture and Aquaculture:
Libya is on the Mediterranean and Tuna is a staple Libyan diet a study in 1997 reveals that the metal levels found in it are not considered toxic. [ref]
I don't understand those results but maybe blogger Maya M can. I'm sure someone did a more current survey.

As for crops, I fear there is indiscriminate and uncontrolled use of pesticides, but that is only my hunch. I've also noted too many plastic houses in farms. As for cattle and poultry I think that businesses are abusing the public trust with the imported cattle feed but then greed and corruption is universal.

For some at a glance statistics which I don't understand, look here,

C. The Aozou Strip:

This "long stretch of desolate land located in the middle of the Sahara Desert [has been a] zone of contention among the colonial powers of Africa, and […] between the now independent and sovereign countries of Chad and Libya". Libya captured it in 1973. "It remained in Libyan hands until a Chadian offensive in the late 1980s. In 1990, the two countries finally agreed to take their dispute to the International Court of Justice, which ruled in early 1994 that the Aozou Strip belonged to Chad." [ref]

We won't dwell on the casualties or the historical ownership for this land which was stupidly given up/left in limbo in the 50s (another story), but the salient question is
"Why would two countries engage in hostilities over a stretch of desert? According to rumors, the Aozou Strip contains rich deposits of uranium." [ref]

This is related to pursuit of military advantage mentioned in paragraph B(3) earlier. On the other hand although the common understanding is that uranium has not been mined yet, but in the proverbial fog of war we have no idea what happened, but what we can be certain of is that uranium is radioactive and toxic.

D. Chernobyl:

Photo source [ref].

Information states that " there is no evidence nor any likelihood of an increase attributable to Chernobyl in birth defects, adverse pregnancy outcomes, decreased fertility or any other radiation-induced disease in the general population either in the contaminated areas or further afield." But it also states that "the lighter material [released] was carried by wind over the Ukraine, Belarus, Russia and to some extent over Scandinavia and Europe." [ref]

Yet crops, flora, fauna, milk, water bodies and fish have been contaminated in Europe [ref]

A recent study in 2007 maintains that kids were affected in Sweden because their mental development was impaired in utero. [ref]

Apparently the radiation cloud from the Chernobyl accident was "eventually detected all over the world. Events, such as volcano eruptions and nuclear bomb testings, result in major effluent emission that also can be detected with very sensitive equipment.[…] on the other hand the occurrence of chronic affects may never be validated because such relatively small increments are statistically indistinguishable in the face of the great variability of spontaneous cancer rates." [ref]

D. Desert Storm (the Gulf War):

That's very close in the Near East and what is interesting to know is this bit: " The third and largest phase of the air campaign ostensibly targeted military targets throughout Iraq and Kuwait: Scud missile launchers, weapons of mass destruction sites, weapons research facilities and naval forces.[...]Allied bombing raids were successful in destroying Iraqi civilian infrastructure. 11 of Iraq's 20 major power stations and 119 substations were totally destroyed, while a further six major power stations were damaged.[28][29] At the end of the war, electricity production was at four percent of its pre-war levels. Bombs destroyed the utility of all major dams, most major pumping stations and many sewage treatment plants, turning Iraq from one of the most advanced Arab countries into one of the most backward. Telecommunications equipment, port facilities, oil refineries and distribution, railroads and bridges were also destroyed." [ref]

While destruction of enemy infrastructure maybe a standard procedure in war I am left to wonder what sort of toxic material was released from all this and particularly how much. From Iraq to the region needs only a short leap of imagination.

That was before even hearing about the depleted uranium. " They were told depleted uranium was not hazardous. Now 23 years after a US arms plant closed, workers and residents have cancer " [ref].

In a 2003 article in CS Monitor, I read with shock and awe that " depleted-uranium bullets are made of low-level radioactive nuclear-waste material, left over from the making of nuclear fuel and weapons. It is 1.7 times as dense as lead, and burns its way easily through armor. But it is controversial because it leaves a trail of contamination that has half-life of 4.5 billion years - the age of our solar system."

No comment!

E. Eldorado Canyon
This was an aerial bombing of Libyan cities in 1986 (you can read my rant here).

I'm wondering what was the ammunition; what 'shit' did the bombs that fell on us from the sky contain? this site though interesting and lengthy provided no concrete information [ref]

From the Chernobyl cloud it is clear that meteorological patterns were a contributing factor in the spread of toxic pollutants to Europe, it is therefore easy to believe some material may have been carried from Europe to North Africa or to the Middle East. From space photographs the zone affected is wider than thought. I remember vividly that day in April 1986 as it came not too long after the US bombing over Libya; and the sky on that day was grey and murky even though we had not heard about Chernobyl immediately.

Blogger Shlemazl who grew up in the USSR and is coincidently a nuclear physicist (I think) could be able to help me understand.

Right on the thread of weather and climate, I would like to add that Libya has famous sandstorms whereby "dust from the Sahara Desert can be transported over thousands of kilometres by convection currents, which also cause other meteorological conditions, such as thunderstorms. Because the Sahara, where sandstorms are very common, is a major source of mineral dust, large concentrations of the dust can be found in the tropical Atlantic and the Caribbean." [ref]

Hence looking at photos I have no problem imagining what can be carried in these particles whether from the desert or back from Europe. If you look at my photos here from 2006 you will have an idea [ref]

Since military hostilities and industrial accidents (as we know) do have an effect on the environment and this can be compounded by the weather peculiarities and since we are an oil producing country, Highlander became curious about pollution indices in Libya. I could not find much except for a study on the Gulf of Sirte area for levels of radiation. I'm sure it is fine but again I'm not qualified enough to decipher it. Volunteers are welcome.

In conclusion cancer alone in Libya is of epic proportion. I would venture to say it is the number 3 killer and I'm not sure such a large number of cases is normal. I tried to think of all the possible causes but as a layperson and someone not in the field of medicine or research I understand my limitations and accept that I could be wrong but at least maybe it can inspire some thoughts. What I am sure about though is that too many Libyans are dying of cancer.

I believe that Libya's biggest concerns are chronic diseases, with cardiovascular, cancer and diabetes topping the list, while the no. 2 killer are road traffic accidents (RTAs) which are not a 'disease' but which if not fatal can result in debilitating injuries. I will devote a special post to RTAs, meanwhile the next post will discuss Libya's health system and will not be limited to cancer.

Let me know what you think…


WEDA said...

that's it i talked too about that.....really what';s up for libyans 2 fall in the circle of cancer to this degree,,,,,,,really as u said we all need an answer is it food or drugs or what......

Maya M said...

Thank you for referring to me, though I don't think I can be very useful because I am neither a doctor nor a cancer researcher (Benghazi Citizen, Enlightened Spirit and Weda could make much better contributions). Still, I'll try my best. I thought about it while reading in your previous post about your friends lost to cancer - it sounded to me scary, quite like Hiroshima in the 1950s.
I was somewhat puzzled and saddened by your disclaimer - are there really people who would use what you write on such a serious subject as a weapon against you or your people? I hope not.

About miscarriages - today's science considers their "normal" rate to be about 10%, that is, one in ten pregnancies to be aborted spontaneously. The prevalence is lower in younger women and increased after 35, due to chormonal changes and increasing prevalence of numerical chromosomal abnormalities in the fetus. Other risk factors are shock, weight-lifting and overwork. In fact, the decreased feeling of well-being during the 1st trimester is a strong indicator that the organism needs rest. Alas, employers and husbands are often reluctant to relieve pregnant women.
Because most women in my circles create families in their 30s, I know of more miscarriages than successful pregnancies. I've myself had one between my two births. When the fetus has a wrong number of chromosomes, usually the pregnancy cannot be saved, even if the parents want it. So my advice: If possible, try to have your children before your late 30s.
A single spontaneous abortion is not considered a reason for examination. However, when a couple has had 2 (or more) miscarriages, it is recommended to check for hormonal or anatomical abnormalities in the woman and for chromosome abnormalities in both parents.
"Total fertility rate", as far as I know, is the number of children per woman in a given population. To my opinion, the data cited by you point not to decrease of "fertility" in the medical sense but rather to ongoing demographic transition in Libya (families having fewer children due to parental choice). This, however, doesn't exclude fertility and gynaecological problems due to environmental factors. Some common pollutants such as DDT are suspected to have estrogen-like properties and, as a result, to interfere with the reproduction of humans (and other animals). Moreover, the same is suspected for soya; the following article is not from a scientific journal but nevertheless contains food for thought:
I personally know about a breeding facility where wild animals are fed soya-rich food and have fertility problems. An anecdote with no proof of causation, but still... be careful with the soya!

Maya M said...

About cancer:
While public health programs are welcome, my advice is NOT to rely on them. E.g. after today's science recommends for each woman who is sexually active OR over age 20 to check every year for cervical cancer by PAP smear, will you wait for the government to impose a mandatory program or manage it yourself with your gynaecologist?
(Yes, gynaecological equipment looks like torture equipment and feels almost so. But cancer kills.)
Now, there are also vaccines against the viruses causing uterine cancer. I know little about them because they aren't fit for me anyway, but younger women should check.
Guys are even less willing to keep an eye on their prostates, and some pay for this with their lives.
People should visit a doctor more often for prophylaxis than for treatment. A man I know recently died from colorectal cancer. This cancer develops for quite a long time in situ, so if the victim had complained to a doctor upon feeling increasing discomfort, he would be diagnosed and saved by surgery. But he waited and fooled himself for years, until it became too late.
Stomach cancer and colorectal cancer partly depend on the diet. What do Libyans eat? Generally, smoked and fried food is bad and so are pickled vegetables. Boiled and stewed food is good, fresh fruits and vegetables are even better (provided that they haven't been fertilized with too much nitrogen). Baked food is "intermediate". If the meal requires addition of oil, do not put it from the beginning but 20-30 min before the end of cooking.
People with gastritis or ulcer should be examined for infection with Helicobacter pylori and, if present, it should be treated. This bacterium is a risk factor for stomach cancer.
BTW, one of your references is about tuna fish. Some warn that is it endangered, so I think it's better not to eat it.

Maya M said...

Carbon dioxide isn't carcinogenic but some hydrocarbons are, and oil industry may contribute to cancer prevalence this way. (Savitz & Moure in 1984 review 8 studies suggesting "a positive association between oil industry activity and cancer rates, with more direct evidence provided by studies of refinery employees"). Also, asbestos may still be used in facilities with fire hazard.
Other environmental factors that should be kept in mind:
- Is older, more hazardous X-ray equipment still in use in Libya? If so, patients will be at risk, and personnel even more.
- Do Libyan doctors still order X-ray in situations when ultrasound examination would also do?
- Are there precautions to minimize X-ray exposure of pregnant women?
- Any data about cancer caused by oncogenic viruses, and the prevalence of these viruses among Libyan population? (E.g., as far as I know, hepatitis C virus may cause liver cancer.)

Maya M said...

If Chernobyl has had any effect in Libya, I think it would manifest itself primarily by transient increase in childhood thyroid cancer.
About the impact of warfare - it should be kept in mind that not all that is toxic is also carcinogenic. Uranium is known to be both. Depletion of uranium decreases its radioactivity by only about 30% and is meant to make it not "safer" but unsuitable for nuclear bomb production.
As far as I know, there are yet no good data about the influence of depleted uranium on public health. This vacuum is filled with mass phobia and hysteria of which we in Bulgaria had a full after the 1999 bombing of Serbia. While some real carcinogenic (and mutagenic) effect must exist, I, as a person with occupational exposure to depleted uranium, can classify most of the stories as unfounded. Somebody must do some serious research on the influence of depleted uranium on background radioactivity and cancer prevalence; until then, we have no useful knowledge.
In conclusion, I wish to distinguish cancer in the elderly vs. that in younger people. As medicine developed and infectious diseases subsided, cancer and cardiovascular diseases took their place as primary causes of "natural" death. This, to my opinion, isn't very alarming and while medicine can work wonders and prolong the lives of cancer patients for years, we must remember that we are mortals and must ultimately die of something. However, high prevalence of cancer in younger people is very alarming and the factor(s) causing it must be sought and controlled. Unfortunately, the authors of the 2003 report about cancer in Eastern Libya didn't specify the age pattern of patients (not in the abstract, at least).

Maya M said...

About the health effects of ionizing radiation, I would recommend this document:
Personally, I was touched most by the story of radium dial painters.

Highlander said...

Weda, thanks yes we need an answer and I was hoping you the Libyan doctors can help us find some answers. Are any of you doing research, can you point me to some place where I can find answers ?

Highlander said...

Hi Maya, thanks for helping brainstorm with me.

First of all I do trust your judgment or let's say your analytical process when it comes to hard science and chemistry which is why I referred to you. Especially as an outsider you would not be plagued by bias.

You say I was somewhat puzzled and saddened by your disclaimer - are there really people who would use what you write on such a serious subject as a weapon against you or your people? I hope not.

You would be surprised Maya, if I had not put that disclaimer, the first thing any commenter would have done would be to jump at my throat and say 'this is a load of rubbish, you have no proof'or 'you Libyans deserve all this because of such and such policies and you health system is rotten or whatever' which would have been besides the topic and we would never have gotten out of the blame game instead of trying to think possible graspable causes or even reaching a cause that this may all be very normal and I'm just an alarmist :P

As for miscarriage, I do agree that today's science considers their "normal" rate to be about 10%, that is, one in ten pregnancies to be aborted spontaneously. The prevalence is lower in younger women and increased after 35, due to chormonal changes and increasing prevalence of numerical chromosomal abnormalities in the fetus, but I'm alarmed because the miscarriages in Libya are not discriminating between 17 to 50 years old women, I would venture so far to say that young brides have at least 1-2 miscarriages before bringing a full fetus to term and then they may even have miscarriages between each live birth. Though I have not seen birth defects in the libe births no idea about the aborted fetuses though.Very weird stuff.

As far as the fertility rate, yes I did admit in my post that the decrease in number of children could be a reflection of social demographics rather than a fertility decrease. You also mentioned DDT I would venture to say that DDT or some other form of agricultural pesticide have been used abusively in the last 10 years ( at least) by corrupt greedy 'farmers'! It is very scary and I used to be proud of our fresh produce now I'm not sure anymore...
Soya is not really part of our diet here in Libya but I'm wondering at all the hidden soya products in imported alimentary goods that are now available to Libyans widely in supermarket. We still are not careful enough in reading labels ( I admit I don't do that myself). I know that the food and drugs agency is carrying out a lot of testing and stuff but I also know there is endemic corruption in many places so it is a scary world. Again this sentence of mine should not be used to bash Libyans as a whole.

With regards to state cancer programmes no I was not going to rely on that, but I was hoping some straplines to communicated in the media at least in lieu of some mandatory tests.

With regards to colorectal and stomach cancer and its relevance to diet, Libyans eat a Mediterranean diet, which again if many of the ingredients are imported with proper quality control whilst local produce can be polluted by toxins then God help us.

About CO2 yes one of my readers did point out to me in email that it was not carcinogenic, as for the oil industry I will have an upcoming post about that as well.

Asbestos is something I am totally freaked out but I'd venture to say that we don't use it in construction of our homes in Libya which are not insulated at all ( but maybe for the roofs ? not sure ) so perhaps it is used only in the government buildings adn factories ? We would need the input of a Libyan engineer to tell us about asbestos.

X-ray equipment, hmmm old and ultramodern equipment are both used but I also think that ultrasound echography is used highly as well instead of x-ray however I'm no longer sure about safety practices

I have no idea about oncogenic viruses as for HCV that's in the coming posts too.

I also agree that the high prevalence of cancer and chronic disease could be the result of better access to medicine which I made sure to note in my post, my alarm is that these diseases are not discriminating between young and old. I expect an older person to have cancer or cardiac disease but I do not expect someone who does not fit the profile to have any of that.

Thanks Maya for all the links you provided also. I'm glad that you are OK despite access to DU and my personal concern about uranium and other such hazardous stuff maybe amplified due to lack of having a full picture of risks in Libya. Ignorance is a plague !

Now let's hope Shlemazl can help here too :)

Maya M said...

Radiophobia is natural and, to my opinion, reasonable because radioactivity is a hazard that cannot be detected by our senses, only by equipment unaccessible to most people. I work with uranium occasionally when I prepare cells for electron microscopy. Electrons are pushy and you need heavy nuclei to stop them and produce an image, so uranyl acetate is used. This compound is soluble and thought to leave the body soon even if inhaled/ingested (not that it's advisable). Uranium in weapons, as far as I know, is in a less soluble form and more difficult to remove if inhaled.
US military claims to have used DU weapons for the first time in 1991; if true, then the bombs dropped over Tripoli and Benghazi mustn't have contained it, but as you said, winds may bring some quantity used in another place.
BTW are there any data on the natural "background" radioactivity of the environment in Libya? We have some quite radioactive mineral springs; and some rocks are so radioactive that 2 weeks in a house built with them is reported to be equivalent to an X-ray.
A chemical carcinogen present in food which I forgot to mention is aflatoxin:
In Bulgaria, people like to eat nuts such as peanuts, almonds and hazelnuts but don't like their prices. So traders offer nuts remained from the previous year - they are much cheaper. And also enriched with aflatoxin because of moulds grown during the additional year of storage. This substance causes liver cancer.
What you write about miscarriages is very worrying. Does anybody have any idea about the causes? It is good that ultrasound equipment is widely available. I think that, as soon as a woman discovers that she is pregnant, she must go and have an ultrasound examination just to check whether it is in the uterus. And then one every month till the end of the pregnancy, to know how the fetus is developing. Plus of course an urgent ultrasound if bleeding appears.
Do pregnant women in Libya take proper folic acid supplements? Low levels of this vitamin are a risk factors for misscarriage (and birth defects). In fact, such supplements are recommended for all women trying to conceive, because folic acid is needed even before the woman knows about her pregnancy.
Marriages within big families or small villages are best avoided. As an extreme example, take Tutankhamun: at age 18, he and his wife had 2 miscarriages, 0 live births.
Parents and community should push doctors to do some research and hopefully find out what is going on.

Maya M said...

Miscarriage may also be due to an infection, the two most important are:
- rubella - are today's Libyan women of childbearing age vaccinated against it? It can, however, induce only 1 miscarriage per woman.
- toxoplasmosis - as far as I know, no vaccine is available, so pregnant women should avoid contact with cats, especially ones that go outdoors.

PH said...

Ramadan Mubarak to you and all your family .

ibeebarbie said...

Salam Highlander,

Ramdan Kareem to you and all of your family. May Allah bless you dearly.

Anglo-Libyan said...

Ramadan Mubarak to you and your family.

The Lost Libyano said...

Ramadan Mubarak

Highlander said...

Maya M thanks again for your input, I'm not sure there is any data on background radiation. I tried to look up some studies about pollution etc.. in general and could not find any but maybe they are not online.

As for aflatoxin, I hope the guys at the FDA are doing their their job well and we are not flooded with imported preserved last year 's nuts that would be sad as we use nuts a lot.

Folic acid is commonly taken by pregnant women in Libya so I don't worry about that.

As for vaccinations yes rubella is done. But we have a whole bunch of Libyan bloggers it seems and I wish they would give us some information.

Ss for toxoplasmosis: for women in Libya it is important to :) so you will be sure they are going to avoid cats like the plague as soon as they are married. Although doing the battery of tests to check for antibodies of such potential immnunological diseases is not routine and is only taken into consideration after miscarriage number one from my observations.

Highlander said...

Thank you PH, Ibee, Anglo and The Lost Libyano for your Ramadan greetings and I wish you blessed tidings to you and your families.

shlemazl said...

A couple of points about things that shine:

1. When the earth crust was created it was made to be radioactive. There is natural activity all around you. You are radioactive. Muscles contain a lot of K-40. Beware of hugging men with muscles.

2. Depleted uranium does not pose any risk in terms of radiation that is worth mentioning. The fact that it decays as slowly as you say means that it does not irradiate your body. However I wouldn't recommend licking it or inhaling dust. As all heavy metals, such as lead, depleted U poses conventional chemotoxic hazards.

3. Chernobyl cloud travelled around the world and you could measure the impact almost everywhere. Outside USSR places that were most affected were in Skandinavia. Even there there was no measurable impact in terms of statistically significant health effects. As Maya said, the only impact was thyroid cancer in children in the Ukraine and Belarus due to inhalation of radioactive iodine. Iodine decays quickly and all the damage was done in the immediate aftermaths of the accident.

4. Oil/gas production and fertilizer production (phosphoric acid manufacture) do generate singificant quantity of concentrated "natural" radioactivity. In recent years these industries released way more radioactivity in the environment than the nuclear industry. North African countries are heavily involved in both industries.

Highlander said...

Thanks Shlemazl, as I said in my post I have my doubts about many things including pollution in Libya due to hydrocarbon exploitation, I just don't know enough and don't even know how to start looking for facts.
Your input was indeed very helpful.