Environment and Rural Affairs Monitoring & Modelling Programme ERAMMP - Report-32: National Forest in Wales - Evidence Review

This review was commissioned by Welsh Government (WG) from the Environment and Rural Affairs Monitoring and Modelling Programme (ERAMMP) to provide key evidence of potential benefits and disbenefits of woodland creation, woodland expansion and managing undermanaged woodland, to provide an evidence base to inform the development of a National Forest for Wales. During the commissioning process, WG emphasised that the evidence provided must reflect the collective views of the community by reviewing the literature in an objective way highlighting where evidence is contradictory or weak. Within the time available, evidence of causality of impacts, the likely timescales and magnitude of these impacts should be also be presented, for both positive and negative impacts of woodland expansion and management of undermanaged woodlands. This Evidence Pack should also build on the evidence put forward in the ERAMMP Sustainable Farm Scheme (SFS) (https://erammp.wales/en/resources) which included a range of assessments of the value of intervention measures which promoted trees within a landscape setting for a range of environmental, economic and social outcomes. The required rapid production of the review in four months meant an expert approach of key evidence was expected rather than a systematic review. Key topics to cover were selected, in partnership with WG, focussing on issues that could fundamentally change decision-making going forward. The final agreed list was arranged under a series of high-level subject headings, and the individual reviews published as ERAMMP Reports 33 to 38 and include; Biodiversity; Managing Undermanaged Woodland; Future-proofing our Woodland; Climate Change Mitigation; Ecosystem Services, and Economics and Natural Capital Accounting. An Integrated Assessment was also commissioned to provide a synthesis of cross-cutting themes and dependencies between topics. These ERAMMP reports are all provided as Annexes to this report

Iron-Overload–Related Disease in HFE Hereditary hemochromatosis

Background: Most persons who are homozygous for C282Y, the HFE allele most commonly asssociated with hereditary hemochromatosis, have elevated levels of serum ferritin and transferrin saturation. Diseases related to iron overload develop in some C282Y homozygotes, but the extent of the risk is controversial. Methods: We assessed HFE mutations in 31,192 persons of northern European descent between the ages of 40 and 69 years who participated in the Melbourne Collaborative Cohort Study and were followed for an average of 12 years. In a random sample of 1438 subjects stratified according to HFE genotype, including all 203 C282Y homozygotes (of whom 108 were women and 95 were men), we obtained clinical and biochemical data, including two sets of iron measurements performed 12 years apart. Disease related to iron overload was defined as documented iron overload and one or more of the following conditions: cirrhosis, liver fibrosis, hepatocellular carcinoma, elevated aminotransferase levels, physician-diagnosed symptomatic hemochromatosis, and arthropathy of the second and third metacarpophalangeal joints. Results: The proportion of C282Y homozygotes with documented iron-overload–related disease was 28.4% (95% confidence interval [CI], 18.8 to 40.2) for men and 1.2% (95% CI, 0.03 to 6.5) for women. Only one non-C282Y homozygote (a compound heterozygote) had documented iron-overload–related disease. Male C282Y homozygotes with a serum ferritin level of 1000 μg per liter or more were more likely to report fatigue, use of arthritis medicine, and a history of liver disease than were men who had the wild-type gene. Conclusions: In persons who are homozygous for the C282Y mutation, iron-overload–related disease developed in a substantial proportion of men but in a small proportion of women