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Iodine-129 and caesium-137 in Chernobyl contaminated soil and their chemical fractionation.

Soil samples from areas in Belarus, Russia and Sweden contaminated by the Chernobyl accident were analysed for (129)I by radiochemical neutron activation analysis, as well as for 137Cs by gamma-spectrometry. The atomic ratio of (129)I/137Cs in the upper layer of the examined soil cores ranged from 0.10 to 0.30, with an average of 0.18, and no correlation between (129)I/137Cs ratio and the distance from Chernobyl reactor to sampling location was observed. It seems feasible to use the (129)I/137Cs ratio to reconstruct the deposition pattern of 131I in these areas. The association of (129)I and 137Cs in the Chernobyl soil and Irish Sea sediment was investigated by a sequential extraction method. Similar speciation of (129)I in the Chernobyl soil and Irish Sea sediment was found. Approximately 70% of (129)I is bound to oxides and organic matter, and 10-20% is in the readily available phase, while most of the 137Cs (73%) in Chernobyl soil remains in the extraction residue.

Cesium Radioisotopes↗

Analysis of the immune status in Latvian Chernobyl clean-up workers with nononcological thyroid diseases.

The aim of the present work was to characterize the immune status of 385 individuals who participated in the 1986-90 clean-up work of the after effects of the Chernobyl nuclear power plant explosion. Fifty-nine Chernobyl clean-up workers developed the most common thyroid diseases; euthyroid nodular and diffuse goiter; 47 healthy blood donors were taken as controls. The levels of immunoglobulins (IgA, IgG and IgM), the numbers of peripheral blood leukocytes, lymphocytes, monocytes, T lymphocytes and their subpopulations (CD3+, CD4+, CD8+), B lymphocytes (CD19+), natural killer (NK) cells (CD16+), classical and alternative pathway activity of complement (CH50, APH50), the C3 split product C3d, and neutrophil phagocytosis were determined in the peripheral blood. We found a significantly decreased number of CD16+ cells (natural killer), of CD4+ and CD8+ T lymphocytes, a reduced neutrophil phagocytic activity as well as a significant complement activation in Chernobyl clean-up workers with and without thyroid diseases when compared with normal levels and those in the control group. In addition, the number of CD3+ and CD4+ cells was significantly higher in patients with nodular goiter when compared with that in patients with diffuse goiter. Levels of IgG and numbers of monocytes were significantly decreased in persons who worked in Chernobyl in 1986 during the first 2 months after the accident (with maximal radiation exposure) but were without correlation to thyroid disorders. Our results clearly reflect an impaired immune system in the Chernobyl clean-up workers even 10-14 years after the nuclear accident.

Adult↗

The need for changes in ICRP policy: some examples based on the Chernobyl experience in Ukraine.

Current ICRP policy in radiological protection (ICRP Publication 60) is based on the independent restriction of exposure and sources for practice and intervention. Such subdivision of exposure and sources leads to a number of problems and contradictions in different applications. In a recent memorandum of the ICRP, published in the Journal of Radiological Protection in 2001, and ICRP Publications 81 and 82, the directions for settling some of these problems are indicated. This paper shows that in Ukraine, after the Chernobyl accident, a number of problems and contradictions occurred as the result of strictly separated limitation of the sources and exposure. These are demonstrated through four 'radiological paradoxes': (1) resettlement of inhabitants from territories radioactively contaminated after the Chernobyl accident to 'clean' ones, but with anomalous high levels of radon exposure in houses; (2) necessity of summation of the Chernobyl accidental doses and doses caused by normally operating nuclear power plant (NPP) to meet the requirements of Ukrainian law, which is based on the principle of 'social equity' of different sources of exposure; (3) the necessity to answer the question of primary importance: when will the Chernobyl accident finally end and when can exposure from contaminated territories be considered as exposure from old contamination? (4) the start of decommissioning of the Chernobyl NPP and transformation of the 'Object Shelter' (located inside the exclusion zone) are now slowed down because of the absence of a definite ideology for dose limitation of workers involved, who are exposed to several types of source simultaneously. The authors believe that the concept of controllable dose as presented by Professor Roger H Clarke on behalf of the ICRP can resolve such paradoxes. The changes to ICRP policy need to be made carefully in order to provide an orderly transition.

Dose-Response Relationship, Radiation↗

Chernobyl source term, atmospheric dispersion, and dose estimation.

The Chernobyl source term available for long-range transport was estimated by integration of radiological measurements with atmospheric dispersion modeling and by reactor core radionuclide inventory estimation in conjunction with WASH-1400 release fractions associated with specific chemical groups. These analyses indicated that essentially all of the noble gases, 60% of the radioiodines, 40% of the radiocesium, 10% of the tellurium, and about 1% or less of the more refractory elements were released. Atmospheric dispersion modeling of the radioactive cloud over the Northern Hemisphere revealed that the cloud became segmented during the first day, with the lower section heading toward Scandinavia and the upper part heading in a southeasterly direction with subsequent transport across Asia to Japan, the North Pacific, and the west coast of North America. The inhalation doses due to direct cloud exposure were estimated to exceed 10 mGy near the Chernobyl area, to range between 0.1 and 0.001 mGy within most of Europe, and to be generally less than 0.00001 mGy within the United States. The Chernobyl source term was several orders of magnitude greater than those associated with the Windscale and TMI reactor accidents. However, the 137Cs from the Chernobyl event is about 6% of that released by the U.S. and U.S.S.R. atmospheric nuclear weapon tests, while the 131I and 90Sr released by the Chernobyl accident was only about 0.1% of that released by the weapon tests.

Accidents↗

The Chernobyl accident and the resultant long-term relocation of people.

Following the Chernobyl accident, large areas of the former USSR with populations in the millions were polluted, to varying extent, with long-lived radionuclides. Within the framework of the USSR state legislation still in force in the newly-formed independent states of Belorussia, Russia, and Ukraine, relocation of nearly one million people from these areas was prescribed to avoid exposure to low levels of irradiation; this measure was obviously groundless, both medically and socially. Additionally, four million people from the three affected states were needlessly included in post-Chernobyl legislation; their exposure did not exceed the natural background levels characteristic of many inhabited regions around the world. Finally, these millions of people were falsely identified as the major victims of the accident. This evoked worldwide concern and played an important role in limiting the development of nuclear power production in a number of countries. This article focuses on the social aspects of the Chernobyl aftermath that ordinarily escape scientific attention. In particular, it considers the public health-related realities of "pre-Chernobyl" and "post-Chernobyl, Soviet society, both political and psychological, that not only blocked implementation of proper radiation protection measures, but also put inappropriate measures into action.

Humans↗

129I, 131I and 127I in animal thyroids after the Chernobyl nuclear accident.

A small number of animal thyroids from Bad Hall, Austria; Ulm, Germany; and Steinkjer, Norway had 131I (half-life 8.06 d) measured between 21 and 72 d following the nuclear accident at Chernobyl on 26 April 1986. Nine years later 129I (half-life 1.57 x 10(7) y) fission product and natural 127I were measured in the same thyroids. The mass ratios, 129I/131I were calculated to the date of the Chernobyl accident and they ranged between 13 and 71. These ratios are compared to the expected ratios within an operating nuclear reactor during 2 y of operation, where the 129I/131I(-1) ratio never exceeded 30. The observed ratio of 129I to natural 127I in thyroids ranged from 5 to 200 times the ratio before the accident, except that the Norwegian thyroids had 129I/127I ratios which were less than the ratios of pre-Chernobyl thyroids from Ulm. These studies show the 129I and 131I from the Chernobyl accident were accumulated with natural 127I in animal thyroids but the isotope ratios, calculated to the release date, had wide ranges. The 131I radioactive exposure might be estimated from a fission product mixture by measuring 129I in thyroids long after the exposure to 131I, but the results would probably show a wide range of possibilities. The determining variables should be evaluated. We know of no previous data regarding both 131I and 129I in thyroid glands during the first 3 mo after the Chernobyl accident.

Animals↗

Thyroid consequences of the Chernobyl nuclear accident.

It is well recognized that the use of external irradiation of the head and neck to treat patients with various non-thyroid disorders increases their risk of developing papillary thyroid carcinoma years after radiation exposure. An increased risk of thyroid cancer has also been reported in survivors of the atomic bombs in Japan, as well as in Marshall Island residents exposed to radiation during the testing of hydrogen bombs. More recently, exposure to radioactive fallout as a result of the Chernobyl nuclear reactor accident has clearly caused an enormous increase in the incidence of childhood thyroid carcinoma in Belarus, Ukraine, and, to a lesser extent, in the Russian Federation, starting in 1990. When clinical and epidemiological features of thyroid carcinomas diagnosed in Belarus after the Chernobyl accident are compared with those of naturally occurring thyroid carcinomas in patients of the same age group in Italy and France, it becomes apparent that the post-Chernobyl thyroid carcinomas were much less influenced by gender, virtually always papillary (solid and follicular variants), more aggressive at presentation and more frequently associated with thyroid autoimmunity. Gene mutations involving the RET proto-oncogene, and less frequently TRK, have been shown to be causative events specific for papillary cancer. RET activation was found in nearly 70% of the patients who developed papillary thyroid carcinomas following the Chernobyl accident. In addition to thyroid cancer, radiation-induced thyroid diseases include benign thyroid nodules, hypothyroidism and autoimmune thyroiditis, with or without thyroid insufficiency, as observed in populations after environmental exposure to radioisotopes of iodine and in the survivors of atomic bomb explosions. On this basis, the authors evaluated thyroid autoimmune phenomena in normal children exposed to radiation after the Chernobyl accident. The results demonstrated an increased prevalence of circulating thyroid antibodies not associated with significant thyroid dysfunction. This finding is consistent with the short period of follow-up, but it is highly likely that these children will develop clinical thyroid autoimmune diseases in the future. Therefore, screening programmes for this at-risk population should focus, not only on the detection of thyroid nodules and cancer, but also on the development of thyroid autoimmune diseases.

Autoimmunity↗

BRAF mutations are not a major event in post-Chernobyl childhood thyroid carcinomas.

The BRAF gene has been shown to be a major target for mutations in papillary thyroid carcinoma (PTC) (36-69%), which forms almost all of the over 2000 cases of thyroid carcinoma that have occurred in Chernobyl. BRAF is activated by point mutation, and were it to occur at a high frequency in Chernobyl-related tumors, it would challenge the dominant role of double-strand breaks in radiation-induced PTC. In a previous study, we detected the BRAF V600E mutation in 46% (23 of 50) of sporadic adult PTC. Using the same methodology, we have analyzed 34 post-Chernobyl PTC and detected RET/PTC rearrangements in 14 (41%) and BRAF mutations (V600E) in four (12%). These two alterations did not coexist in any PTCs. The mean age at exposure of patients with PTC showing BRAF mutation was higher than that of patients with tumors without BRAF mutation irrespective of their RET status. We have also analyzed 17 sporadic cases of childhood PTC and found that only one (6%) harbored the BRAF V600E mutation. We conclude that the frequency of BRAF mutations is significantly lower (P = 0.0008) in post-Chernobyl PTC than in adult sporadic PTC, whereas no significant difference was found between post-Chernobyl and sporadic childhood PTCs.

Carcinoma, Papillary↗

Thyroid consequences of the Chernobyl nuclear power station accident on the Turkish population.

OBJECTIVE: The Chernobyl accident caused widespread effects across Europe and huge areas were radiocontaminated. The major impact of the accident on human health was a sharp increase in childhood thyroid carcinoma and autoimmune thyroid diseases in exposed populations. The thyroidal effects of the Chernobyl accident have been investigated in most European countries, except Turkey. The aim of the current study was therefore to determine the thyroidal consequences of the Chernobyl nuclear power station accident in a selected Turkish population. DESIGN: This study was designed as a sectional, area study, between October 2000 and March 2001, in two different regions of Turkey. According to the data of the Turkish Atomic Energy Authority, the eastern part of the Black Sea region was the most radiocontaminated area in Turkey at the time of Chernobyl accident, while Middle Anatolia was not seriously affected. Thus, Rize city, which is located in the eastern Black Sea region, served as a study area, and 970 adolescents, living in this region, comprised our study group (group R). On the other hand, Beypazari, which is located in Middle Anatolia, was chosen as the control region, and 710 adolescents living in this location were enrolled into the study as controls (group B). METHODS: During the study, thyroid ultrasounds were performed in all subjects and thyroid volumes were calculated. World Health Organization and International Council for Control of Iodine Deficiency Disorders criteria were used for the determination of goiter. Thyroid fine-needle aspiration biopsy with ultrasound guidance was performed when a nodule was detected. Blood samples for thyroid function tests and thyroid autoantibodies, and urine samples for urinary iodine excretion were collected from all subjects. RESULTS: Thyroid function tests were similar in both groups, but thyroid volumes were found to be higher in group B (13.93+/-5.04 vs 17.66+/-5.58 ml; P<0.001). The prevalence of goiter was found to be 28.25% in group R and 61.95% in group B (P<0.001). Thyroid nodules were determined in 6.28% of subjects in group R and 4.22% of subjects in group B (P=0.065). No malignant lesions were found in either of the regions. Although the percentage of autoantibody-positive subjects did not differ between groups (21.25% in group R vs 18.72% in group B), the mean anti-thyroglobulin level was found to be higher in group R (63.25+/-378.60 vs 51.97+/-333.32 IU/ml; P<0.001) and the mean anti-thyroid peroxidase level was higher in group B (24.14+/-219.09 vs 48.82+/-568.50 IU/ml; P<0.001). The iodine status of the selected regions was found to be significantly different (median urinary iodine excretion was 131 microg/l in Rize and 54 microg/l in Beypazari). CONCLUSIONS: Although there was a slight increase in nodule prevalence and thyroid antibody-positive subjects in the study group, it is hard to conclude that Turkey was affected by the Chernobyl accident. These results, at least the significant differences with regard to the prevalence of goiters between groups, may reflect the different iodine status of the selected regions.

Adolescent↗

Analysis of blood lymphocyte subsets in children living around Chernobyl exposed long-term to low doses of cesium-137 and various doses of iodine-131.

Epidemiological studies have found that children living around Chernobyl have rates of respiratory tract illness that are higher than those seen in the area before the Chernobyl accident. The present study investigates the possible effects of radiation exposure on the composition of peripheral blood lymphocyte subsets in children living around Chernobyl. Two hundred nineteen healthy children and children suffering from recurrent respiratory diseases aged 6-14 years who received both low doses of radiation to the whole body from (137)Cs and various doses of radiation to the thyroid from (131)I as fallout from the accident were assessed 5 (1991) and 8-10 years (1994-1996) after the accident. A total of 148 healthy children and children suffering from recurrent respiratory diseases living in noncontaminated areas were also evaluated as controls. Children with recurrent respiratory diseases who lived around Chernobyl had a significantly lower percentage of T cells and a higher percentage of NK cells compared to control children with recurrent respiratory diseases during the study period. In contrast to the findings in 1991, a significant decrease in the percentage of helper-inducer cells was observed in children with recurrent respiratory diseases in 1994-1996. In contrast to 1991, there is a positive correlation between the percentage of helper-inducer cells, the helper-inducer/cytotoxic-suppressor cell ratio, and the dose of radiation to the thyroid of healthy children from (131)I in 1994-1996. There was a positive correlation between the dose of radiation to the thyroid from (131)I and the percentage of helper-inducer cells in children with recurrent respiratory diseases 5 years (1991) after the accident. Further, the dose of radiation to the thyroid from (131)I correlated negatively with the percentage of T and B cells and positively with the percentage of NK cells in children with recurrent respiratory diseases 8-10 years (1994-1996) after the accident. These results raise the possibility that long-term exposure to low doses of (137)Cs may have altered the composition of the T-cell subsets and NK cells in children with recurrent respiratory diseases. The differences in the composition of the peripheral blood lymphocyte subsets between healthy children and those with recurrent respiratory diseases may be attributed to long-term low-dose exposure of the whole body to radiation from (137)Cs and exposure of the thyroid to radiation from (131)I subsequent to the Chernobyl accident.

Adolescent↗

The impact of information and communication factors on mitigation of workers health in the Chernobyl zone, 1986-1990.

Several important features of the Chernobyl disaster make it an outstanding event among the industrial accidents in the world s history. We want to draw the readers attention to three of them: 1) Chernobyl involved severe occupational injuries and caused chronic disorders in an unprecedented number of mitigation workers; 2) the health problems in question cannot be attributed solely to the specific radiation injury in the zone 1 ; and 3) the Chernobyl disaster has been a unique communication (media, in particular) event in terms of its international coverage, impact, and the controversies it has generated. The purpose of this article is to trace the links between these peculiarities of the accident and to suggest a framework for relating the communication and information factors to the health condition of the people who were occupationally involved in the Chernobyl disaster mitigation. We also will propose a number of ideas about how the factors in question can be managed within the Chernobyl disaster mitigation policy, which at present is critically shaped by the post-Soviet political, economic, and cultural context.

Journal Article↗

[Health effects of the Chernobyl disaster. Fifteen years afterwards].

The Chernobyl nuclear accident of 1986 released large quantities of radioactive material causing heavy contamination in widespread areas of the former Soviet Union. Each summer, several hundred children visit Spain from Chernobyl. In this article we describe the accident, the environmental contamination, the mechanisms of radiation injury and the dose-response relationships. We review the health effects of exposure to ionizing radiation and the health impact of the Chernobyl catastrophe. We propose guidelines for the medical management and evaluation of children on temporary visits. The health status of adults and especially that of children in Belarus, Ukraine and the Russian Federation has been adversely affected. According to present knowledge, Chernobyl has given rise to a marked increase in the incidence of papillary thyroid cancer, psychological consequences and socioeconomic disruption. Many studies report that the incidence of other diseases has increased, but not all health problems seen after the nuclear accident can be attributed to radiation. Given the long latency period for diseases induced by radiation exposure, long-term follow-up of all potentially affected individuals is important. Fifteen years after the Chernobyl accident the international community is still learning scientific, medical and humanitarian lessons.

Adolescent↗

Possible distinct molecular carcinogenic pathways for bladder cancer in Ukraine, before and after the Chernobyl disaster.

After the Chernobyl accident in 1986, the incidence of urinary bladder cancers in the Ukraine increased gradually from 26.2 to 43.3 per 100,000 people between 1986 and 2001. In the areas of low level but persistent cesium-137 (137Cs) radio-contamination, a unique atypical radiation-related urinary bladder cystitis named 'Chernobyl cystitis', a possible pre-neoplastic condition in humans, has been detected. We have previously documented high incidences of bladder lesions, including severe dysplasias and/or carcinoma in situ, in association with this cystitis and correlating with oxidative DNA damage. To further investigate the molecular mechanisms underlying bladder carcinogenesis with this specific etiology, mutation analysis of p53 gene (exon 5-8) was performed for 11 and 18 paraffin-embedded bladder cancers in Ukrainians, respectively collected before and after the Chernobyl disaster. DNAs were extracted and subjected to nested PCR-single-strand conformational polymorphism analysis followed by direct DNA sequencing, as well as p53 immunohistochemistry (IHC). The incidences of p53 gene mutation were 54.5 and 16.7% for before and after the Chernobyl disaster, respectively, the difference being statistically significant. Also a tendency for higher p53 IHC score was apparent in the earlier group of lesions. No significant difference was noted for the proportions of historical types. These results point to possible distinct molecular carcinogenic pathways of bladder cancer formation, before and after the Chernobyl disaster, on the basis of variation in p53 gene alteration.

Adult↗

The Estonian study of Chernobyl cleanup workers: I. Design and questionnaire data.

Nearly 2% of the male population of Estonia aged 20-39 years were sent to Chernobyl to assist in the cleanup activities after the reactor accident. A cohort of 4,833 cleanup workers was assembled based on multiple and independent sources of information. Information obtained from 3,704 responses to a detailed questionnaire indicated that 63% of the workers were sent to Chernobyl in 1986; 54% were of Estonian and 35% of Russian ethnicity; 72% were married, and 1,164 of their 5,392 children were conceived after the Chernobyl disaster. The workers were less educated than their counterparts in the general population of Estonia, and only 8.5% had attended university. Based on doses entered in worker records, the mean dose was 11 cGy, with only 1.4% over 25 cGy. Nearly 85% of the workers were sent as part of military training activities, and more than half spent in excess of 3 months in the Chernobyl area. Thirty-six percent of the workers reported having worked within the immediate vicinity of the accident site; 11.5% worked on the roofs near the damaged reactor, clearing the highly radioactive debris. The most commonly performed task was the removal and burial of topsoil (55% of the workers). Potassium iodide was given to over 18% of the men. The study design also incorporates biological indicators of exposure based on the glycophorin A mutational assay of red blood cells and chromosome translocation analyses of lymphocytes; record linkage with national cancer registry and mortality registry files to determine cancer incidence and cause-specific mortality; thyroid screening examinations with ultrasound and fine-needle biopsy; and cryopreserved white blood cells and plasma for future molecular studies. Comprehensive studies of Chernobyl cleanup workers have potential to provide new information about cancer risks due to protracted exposures to ionizing radiation.

Alcohol Drinking↗

Do recorded doses overestimate true doses received by Chernobyl cleanup workers? Results of cytogenetic analyses of Estonian workers by fluorescence in situ hybridization.

Studies of workers who were sent to Chernobyl after the 1986 reactor accident are being conducted to provide a better understanding of the effects of chronic low-dose radiation exposures. A crucial component to these investigations is an accurate assessment of the radiation doses received during the cleanup activities. To provide information on biological measurements of dose, fluorescence in situ hybridization (FISH) with whole-chromosome painting probes has been applied to quantify stable chromosome aberrations (translocations and insertions) among a defined cohort of 4,833 cleanup workers from Estonia. Cytogenetic analysis of 48-h lymphocyte cultures from 118 Estonian cleanup workers (10.3 cGy mean recorded dose; 25 cGy maximum), 29 Estonian population controls and 21 American controls was conducted by three laboratories. More than 258,000 painted metaphases were evaluated. Overall, we observed lower translocation frequencies than has been reported in previous studies using FISH among Chernobyl cleanup workers. In our data, a clear association with increased levels of translocations was seen with increasing age at blood drawing. There was no correlation, however, between aberration frequency and recorded measurements of physical dose or any category of potential high-dose and high-dose-rate exposure such as being sent to Chernobyl in 1986, working on the roof near the damaged nuclear reactor, working in special zones or having multiple tours. In fact, the translocation frequency was lower among the exposed workers than the controls, though not significantly so. To estimate the level of effect that would have been expected in a population of men having an average dose of approximately 10 cGy, blood from six donors was exposed to low-LET radiation, and more than 32,000 metaphases were scored to estimate dose-response coefficients for radiation-induced translocations in chromosome pairs 1, 2 and 4. Based on these results, we estimate that had this group of 118 men received an average whole-body dose of 10-11 cGy, as chronic or acute exposures, an increase in the mean frequency of chromosome translocations of more than 40-65% would have been observed in their lymphocytes compared to findings in nonirradiated controls. In spite of evaluating more than a quarter of a million metaphases, we were unable to detect any increase in the mean, median or range in chromosome aberrations in lymphocyte cultures from a group of Estonian men who took part in the cleanup of the Chernobyl nuclear power site and those who did not. We conclude that it is likely that recorded doses for these cleanup workers overestimate their average bone marrow doses, perhaps substantially. These results are consistent with several negative studies of cancer incidence in Chernobyl cleanup workers and, if borne out, suggest that future studies may not be sufficiently powerful to detect increases in leukemia or cancer, much less distinguish differences between the effects of chronic compared to brief radiation exposures.

Adult↗

Cancer risk among Chernobyl cleanup workers in Estonia and Latvia, 1986-1998.

Two cohorts of Chernobyl cleanup workers from Estonia (4,786 men) and Latvia (5,546 men) were followed from 1986 to 1998 to investigate cancer incidence among persons exposed to ionizing radiation from the Chernobyl accident. Each cohort was identified from various independent sources and followed using nationwide population and mortality registries. Cancers were ascertained by linkage with nationwide cancer registries. Overall, 75 incident cancers were identified in the Estonian cohort and 80 in the Latvian cohort. The combined-cohort standardized incidence ratio (SIR) for all cancers was 1.15 (95% confidence interval (CI) = 0.98-1.34) and for leukemia, 1.53 (95% CI = 0.62-3.17; n = 7). Statistically significant excess cases of thyroid (SIR = 7.06, 95% CI = 2.84-14.55; n = 7) and brain cancer (SIR = 2.14, 95% CI = 1.07-3.83; n = 11) were found, mainly based on Latvian data. However, there was no evidence of a dose response for any of these sites, and the relationship to radiation exposure remains to be established. Excess of thyroid cancer cases observed may have been due to screening, the leukemia cases included 2 unconfirmed diagnoses, and the excess cases of brain tumors may have been a chance finding. There was an indication of increased risk associated with early entry to the Chernobyl area and late follow-up, though not statistically significant. Further follow-up of Chernobyl cleanup workers is warranted to clarify the possible health effects of radiation exposure.

Adolescent↗

Clinical analysis of thyroid cancer in adult patients exposed to ionizing radiation due to the Chernobyl nuclear accident: 5-year comparative investigations based on the results of surgical treatment.

The aim of study was to compare clinical and pathologic findings of surgically removed thyroid tumors in adults with or without history of irradiation due to the Chernobyl accident. From 1990 to 2003, 2363 adults with no evidence of radiation influence in their history (group A) have undergone operation for thyroid nodules. During the same period, 311 patients (born before 1969) with strict evidence of Chernobyl irradiation also underwent operation (group B). Both groups were similar in age, sex, and preoperative examination. Group B represented three of the four official categories of people affected by the Chernobyl accident: 1-recovery operation workers; 2-people evacuated from the restricted area; 3-inhabitants of contaminated areas. The rate of thyroid carcinoma among all cases of thyroid nodules was significantly higher in group B--32.8% (102 patients) versus 27.2% (644 patients) in group A (p < 0.05). But a more distinct difference was observed in 1 and 2 categories of group B patients (the rate of cancer was, correspondingly, 54.8% and 47.8%;p < 0.01). The percentage of the invasive form of cancer (T4) was significantly higher in irradiated patients-39% versus 23% (p < 0.05) as were regional metastases (N1a,1b)--41% versus 19% (p < 0.01) and frequency of multifocality (33% versus 24%; p < 0.05). The most distinguished features were found in 1 category of group B: T4--in 47%, N1a-1b--in 62%, multifocality--in 41%. Our results suggest the irradiation as a cause of thyroid cancer in adult victims of Chernobyl and confirm the increasing aggressiveness of such tumors.

Adult↗

No increase in thyroid cancer among children and adolescents in Finland due to Chernobyl accident.

The aim of the study was to assess whether radioactive fallout from the Chernobyl accident in 1986 influenced thyroid cancer incidence among children and adolescents in Finland. The population was divided into two: those with thyroid doses less than 0 6 mSv and above 0.6 mSv. Cumulative incidence of thyroid cancer was identified from the Finnish Cancer Registry from a population aged 0-20 years in 1986 with a total of 1,356,801 persons. No clear difference in underlying thyroid cancer incidences rates were found during the pre-Chernobyl period (1970-1985) (rate ratio RR 0.95, 95% confidence interval CI 0.81-1.10). During the post-Chernobyl period (1991-2003), thyroid cancer incidence was lower in the more exposed population than in the less exposed population (RR 0.76, 95% CI 0.59-0.98). Our results did not indicate any increase in thyroid cancer incidence related to exposure to radiation from the Chernobyl accident.

Adolescent↗