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PubMed2001

Occurrence of thyroid papillary carcinoma in young patients. A Chernobyl connection?

The risk of thyroid papillary carcinoma is increased by external radiation particularly in children under 15 years of age as shown by a marked increase in those exposed to radiation after Chernobyl. We were recently confronted in Belgium over a short period with four patients (3 F, 1 M) with papillary thyroid carcinoma who were aged 10 years, 2 months, 2 years and 6 years when the Chernobyl accident occurred. We thus raise the question of a possible relationship. The patients were aged 17, 11, 10, 19 years at presentation. They all presented fortuitously over 3 years which was a very unusual increase in our extensive experience in thyroid surgery (62 cases of thyroid cancer among 1014 thyroidectomies in adults vs 4 cases in 18 children since the Chernobyl accident in 1986). Two out of the four patients had psammoma bodies (identifiable on CT scanning and ultrasound) and thyroglobulin autoantibodies (TgAb). The first patient had positive lymph nodes at the time of surgery. The incidence of thyroid cancers in Belarus and Ukraine rose just 4 years after the Chernobyl disaster; because radioactive clouds passed over Belgium, we wonder whether the occurrence of thyroid cancer in our patients could be related to this irradiation. The mechanism of increased incidence of radiation-induced thyroid cancer is thought to be due to rearrangement of the tyrosine kinase domains of the RET and TTK genes. The other important similarities in our patients are the presence of psammoma bodies that can be visualized on radiological examination and the presence of TgAb that are more frequent in differentiated thyroid cancers. Whether or not these cases reflect an increased incidence in the population as a whole, clinicians must remain vigilant for this rare but curable cancer in young patients, especially if suggestive radiological features or TgAb are present.

Adolescent↗

PubMed2001

Children of chernobyl cleanup workers do not show elevated rates of mutations in minisatellite alleles.

The disaster at the Chernobyl Nuclear Power Plant in April 1986 was accompanied by the release of large amounts of radioisotopes, resulting in the contamination of extensive regions of the Ukraine, Byelorus and the Russian Federation. Cleanup workers (liquidators) and people living on land contaminated with radioactive materials were most exposed. To assess the genetic effects of exposure to ionizing radiation after the Chernobyl accident, we have measured the frequency of inherited mutant alleles at seven hypermutable minisatellite loci in 183 children born to Chernobyl cleanup workers (liquidators) and 163 children born to control families living in nonirradiated areas of the Ukraine. There was no significant difference in the frequency of inherited mutant alleles between the exposed and control groups. The exposed group was then divided into two subgroups according to the time at which the children were conceived with respect to the fathers' work at the power plant. Eighty-eight children were conceived either while their fathers were working at the facility or up to 2 months later (Subgroup 1). The other 95 children were conceived at least 4 months after their fathers had stopped working at the Chernobyl site (Subgroup 2). The frequencies of mutant alleles were higher for the majority of loci (i.e. 1.44 times higher for CEB1) in Subgroup 1 than in Subgroup 2. This result, if confirmed, would reconcile the apparently conflicting results obtained in the chronically exposed Byelorus population and the Hiroshima-Nagasaki A-bomb survivors.

Alleles↗

PubMed2000

[Clinical course of chronic bronchitis in Chernobyl wreckers].

AIM: To characterize clinical symptoms of chronic bronchitis (CB) in Chernobyl wreckers. MATERIAL AND METHODS: 71 CB male Chernobyl wreckers exposed to low-dose radiation and 43 control patients were examined and treated in a specialized hospital in 1988-1996. Clinical features of CB were investigated by clinical (complaints, history, objective examination), laboratory (total blood count, biochemical and immunological blood picture, coagulogram) and instrumental (fibrobronchoscopy, x-ray, radiometry, spirography) findings with further statistical processing. RESULTS: Chernobyl wreckers more frequently had neurocirculatory asthenia and hemoptysis. The latter was caused by bronchial mucosa atrophy. In chronic non-obstructive bronchitis they exhibited mild bronchoobstruction on the distal level. Laboratory indices showed no essential changes. CONCLUSION: Chernobyl wreckers have a more severe course of CB.

Adolescent↗

PubMedDate not supplied

[Results of cytogenetic studies of the consequences of the Chernobyl accident].

The selected results of the cytogenetic studies of the Chernobyl accident consequences were summarised. The chromosomal aberrations were used as a method of biodosimetry for a dose assessment for victims during the initial period after the Chernobyl accident. A good correlation between doses calculated based on chromosomal aberrations (dicentrics) and severity of acute radiation syndrome observed in clinic was found. The biodosimetry based on conventional cytogenetic technique (dicentrics) has been unsuccessful for various groups (rehabilitation workers, evacuees, inhabitants of contaminated areas) sampled long time after the Chernobyl accident. The possible reasons of the failure are analysed. The original results of multiaberration cell yield observed in different cohorts of the Chernobyl victims are presented. The problems related to the phenomena are discussed.

Chromosome Aberrations↗

PubMedDate not supplied

Strontium fallout from Chernobyl and perinatal mortality in Ukraine and Belarus.

Perinatal mortality rates in the regions of Ukraine and Belarus surrounding the Chernobyl site increased in 1987, the year following the Chernobyl accident. The same year, increases of perinatal mortality were also observed in Germany and Poland, and the effect can be associated with the caesium burden in pregnant women. After 1989, there is an unexpected second rise of perinatal mortality in Belarus and Ukraine. This increase is shown to correlate with the strontium content in pregnant women. The findings parallel an increase of perinatal mortality in Germany following the atmospheric bomb tests in the 1950's and 1960's. While the effect from caesium is essentially limited to 1987, the effect from strontium persists until the end of the study period in 1998. The cumulative effect from strontium around Chernobyl outweighs the effect from caesium by at least a factor of 10. This is contrary to the assertion that the caesium content in the Chernobyl fallout was more than 10-times greater than the strontium content. Thus, the dose factor presently used seems to severely underestimate the effect of strontium on perinatal mortality.

Fetal Death↗

PubMed1992

[Late effects of psychogenic and radiation factors of the accident at the Chernobyl nuclear power plant on the functional state of human brain].

As many as 97 persons, victims to the Chernobyl accident, who developed vegetative dystonia were examined by clinical, ++patho-psychological and electroencephalography methods. 24 patients with vegetative dystonia who had not taken part in the liquidation of the consequences of the Chernobyl accident and not lived in the zones of alienation and radioactive contamination were examined too. In the victims to the Chernobyl accident, vegetovascular dystonia was marked by certain clinical and neurophysiological peculiarities in the form of combined vegetative disturbances and hypochondriac symptoms, signs of the schizoform organic syndrome with diffuse disorders of brain bioelectric activity and irritation of the subcortical structures. The contribution of psychogenic and prolonged ionizing radiation to the formation of changes in brain function in victims to the Chernobyl accident is under consideration.

Accidents↗

PubMed1992

Thyroid nodules in the population living around Chernobyl.

OBJECTIVE: To determine the baseline incidence, prevalence, and characteristics of thyroid nodules in the population living around the Chernobyl nuclear power plant and to compare the findings with unexposed populations. DESIGN: Prevalence study. Population samples from seven highly contaminated villages were compared with six nearby control villages of the same size and type. The data were obtained as part of the International Chernobyl Project conducted in 1990. SETTING: The study was conducted 4.5 years after the Chernobyl reactor accident that released large quantities of radionuclides, including radioiodine. PATIENTS OR OTHER PARTICIPANTS: Population samples of approximately 100 persons residing in both highly contaminated villages and control villages since the accident were compared. Individuals were selected on the basis of birth date as being 5, 10, 40, or 60 years old at the time of the study. All persons selected underwent a thyroid examination. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Two main outcome measures were used, both for thyroid nodularity: clinical palpation and high-resolution ultrasonography. RESULTS: There was no significant difference in thyroid nodularity between the study groups. Nodules were palpated in 0.7% of children and 2.9% of adults. Discrete nodules were found by ultrasonography in 0.5% of children and 14.9% of adults. Multinodular goiter was found in 3% of adults. Nodules were more common in females. CONCLUSIONS: Four and a half years after the Chernobyl accident, the incidence, prevalence, and characteristics of thyroid nodules were the same in population samples from both highly contaminated and control settlements and similar to results reported for unexposed populations in other countries.

Accidents↗

PubMed1996

Internal exposure of the staff involved in the cleanup after the accident at the Chernobyl nuclear power plant in 1986.

This article presents the results of our work from 1987 to 1994 on the reconstruction of internal exposure of the witnesses to the Chernobyl accident with respect to inhalation of airborne particles of nuclear fuel. Our results eliminate the hypothesis that inhalation intake of radioactive aerosols was a considerable pathway of exposure for staff at the Chernobyl nuclear power plant. It would conceivably lead to a nonuniform dose distribution in the body. Under that condition, actual equivalent doses in some organs, e.g., in lungs and in the wall of the lower large intestine are much higher than the actual effective dose. Therefore it is impossible to correctly assess the health risk for certain cohorts of the Chernobyl accident witnesses if the inhalation pathway is neglected. In that case not only the actual effective dose, but the actual equivalent doses too play a role in radiological measurement, when evaluating the hazard for less-exposed accident witnesses. That conclusion is of great importance to radiation protection policy, the planning of epidemiological studies and the carrying out of medical remedial actions for the different cohorts of accident witnesses. The findings should be taken into consideration in planning protective measures and in assessing health effects following the Chernobyl accident.

Air Pollutants, Radioactive↗

PubMed1997

Blood pressure among immigrants to Israel from areas affected by the Chernobyl disaster.

OBJECTIVES: To validate and analyze apparent association of hypertension with exposures to radiation at Chernobyl among immigrants to Israel from the contaminated areas. METHODS: Data were collected in 1991 and 1994 from two samples of persons who immigrated to Israel from the contaminated zone around the Chernobyl nuclear power plant. The first sample were self-referred for evaluation in a clinic by whole-body cesium measurement, physical examination, and questionnaire (N = 756, 328 from less exposed and 438 from more exposed areas). The second wave data were collected in 1994 during home interviews for evaluation of psychosocial factors associated with their experience (N = 708, 121 from more exposed and 253 from less exposed areas). In the second study a referent group was included (n = 334) who were matched by age, sex, and year of immigration who immigrated from other areas outside of the contaminated zone. Estimates of exposure were based on the IAEA map of ground-level cesium isotope (137Cs) contamination. RESULTS: In the 1991 sample, 21% from high exposure areas and 16% from less exposed areas had elevated systolic blood pressure (> 140 mmHg). Elevated diastolic blood pressure (> 90 mmHg) had a similar difference between more and less exposed groups (21% and 16%). Age- and sex-specific analyses showed that statistically different levels were found in the older age groups. In the 1994 sample, we confirmed a relationship between exposure and elevated blood pressure. 33% of those from the more exposed areas and 34% of those from less exposed areas had elevated systolic blood pressure, compared with 23% of the comparison group, with a similar trend found in diastolic blood pressure. The relationship between exposure and blood pressure was accentuated in the group of respondents who had high scores on PTSD symptoms. Of the psychological variables analyzed, systolic blood pressure was most strongly related to cancer-related anxiety and somatization. A discriminant function analysis showed that three variables: age, reporting a significant loss from the Chernobyl accident, and fear of cancer correctly differentiated 72% of those with normal and high blood pressure. CONCLUSIONS: There is a relationship between exposure to Chernobyl and high blood pressure, partly due to the psychological reactions to the accident.

Adolescent↗

PubMed1998

Chernobyl-related thyroid cancer in children of Belarus: a case-control study.

The accident at the Chernobyl nuclear power plant on April 26, 1986, released approximately 2 EBq of 131I and other radioiodine isotopes that heavily contaminated southern Belarus. An increase in thyroid cancer reported in 1992 and attributed to the Chernobyl accident was challenged as possibly the result of intensive screening. We began a case-control study to test the hypothesis that the Chernobyl accident caused the increase in thyroid cancer. Records of childhood thyroid cancer in the national therapy centers in Minsk in 1992 yielded 107 individuals with confirmed pathology diagnoses and available for interview. Pathways to diagnosis were (1) routine endocrinological screening in 63, (2) presentation with enlarged or nodular thyroid in 25 and (3) an incidental finding in 19. Two sets of controls were chosen, one matched on pathway to diagnosis, the other representing the area of heavy fallout, both matched on age, sex and rural/urban residence in 1986. The 131I dose to the thyroid was estimated from ground deposition of 137Cs, ground deposition of 131I, a data bank of 1986 thyroid radiation measurements, questionnaires and interviews. Highly significant differences were observed between cases and controls (both sets) with respect to dose. The differences persisted within pathway to diagnosis, gender, age and year of diagnosis, and level of iodine in the soil, and were most marked in the southern portion of the Gomel region. The case-control comparisons indicate a strong relationship between thyroid cancer and estimated radiation dose from the Chernobyl accident.

Adolescent↗

PubMed2006

Breast cancer in Belarus and Ukraine after the Chernobyl accident.

An increase in breast cancer incidence has been reported in areas of Belarus and Ukraine contaminated by the Chernobyl accident and has become an issue of public concern. The authors carried out an ecological epidemiological study to describe the spatial and temporal trends in breast cancer incidence in the most contaminated regions of Belarus and Ukraine, and to evaluate whether increases seen since 1986 correlate to radiation exposure from the Chernobyl accident. The authors investigated the trends through age-cohort-period-region analyses of district-specific incidence rates of breast cancer for Gomel and Mogilev regions of Belarus and Chernigiv, Kyiv and Zhytomir regions of Ukraine. Dose-response analyses were based on Poisson regression, using average district-specific whole body doses accumulated since the accident from external exposure and ingestion of long-lived radionuclides. The study demonstrated increases in breast cancer incidence in all areas following the Chernobyl accident, reflecting improvements in cancer diagnosis and registration. In addition, a significant 2-fold increase in risk was observed, during the period 1997-2001, in the most contaminated districts (average cumulative dose of 40.0 mSv or more) compared with the least contaminated districts (relative risk [RR] in Belarus 2.24, 95% confidence interval [CI] 1.51-3.32 and in Ukraine 1.78, 95% CI=1.08-2.93). The increase, though based on a relatively small number of cases, appeared approximately 10 years after the accident, was highest among women who were younger at the time of exposure and was observed for both localised and metastatic diseases. It is unlikely that this excess could be entirely due to the increased diagnostic activity in these areas.

Breast Neoplasms↗

PubMed2005

Urinary 8-hydroxydeoxyguanosine in Belarussian children relates to urban living rather than radiation dose after the chernobyl accident: a pilot study.

As a result of the Chernobyl accident in 1986, exposure to radioactive cesium is still a concern in the contaminated regions of Belarus. We tested the hypothesis that long-term radiation exposure from the Chernobyl accident might increase the urinary excretion of the oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG), in Belarussian children. Urinary 8-OHdG was determined in two groups of children (-n = 31 and n = 46) -living in contaminated and uncontaminated areas of Belarus, respectively (the majority of the unexposed children lived in the capital Minsk). The children from the contaminated areas had a significantly higher annual summary effective dose but significantly lower urinary 8-OHdG levels than the children from the uncontaminated areas. Unexpectedly, children living in uncontaminated urban areas had significantly higher urinary 8-OHdG levels than children living in uncontaminated rural areas. There was no statistically significant effect of sex or body mass index on urinary 8-OHdG, but there was a weak significant inverse correlation to age as well as to the annual summary effective dose. These findings suggest that radiation from the Chernobyl accident is now a less important contributor to oxidative stress in Belarussian children than urban living.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed2005

Predicting radionuclide transfer to wild animals: an application of a proposed environmental impact assessment framework to the Chernobyl exclusion zone.

A number of assessment frameworks have been proposed to provide a mechanism to demonstrate protection of the environment from ionising radiation. Whilst some of these are being used for assessment purposes they have largely not been validated against field measurements. In this paper we compare the predictions of transfer parameters recommended by one of these frameworks (FASSET) with observed whole-body 90Sr and radiocaesium activity concentrations in a range of mammal and invertebrate species sampled within the Chernobyl exclusion zone. Predicted activity concentrations were generally within the observed ranges and mean predictions for reference organisms were similar to, or circa one order of magnitude higher than, the observed means. However, some predictions were more than one order of magnitude lower than observed values. No data were available to test predictions for the other radionuclides released by the Chernobyl accident. In a separate paper the outputs of this assessment will be used to estimate doses to reference organisms and compare these to observed radiation induced effects reported within the Chernobyl zone.

Animals↗

PubMed2007

Chernobyl disaster sequelae in recent immigrants to the United States from the former Soviet Union (FSU).

Long-term mental health sequelae of the 1986 Chernobyl disaster have been documented for exposed populations who remained in the former Soviet Union (FSU) (Havenaar et al., 1997), and in a cohort migrated to Israel (Cwikel et al., 1997). This paper reports on Chernobyl disaster sequelae in émigrés (n = 321) to the United States. Demographic characteristics, migration factors, and self-reported physical health were considered. Both geographical proximity to the 1986 disaster, and perception of radiation risk stood as long-term indicators of current psychological distress. Proximity was related to poor self-perceived physical health, as well as current symptoms of depression (p<.05), anxiety (p<.01), and Chernobyl-related trauma distress (p<.001) on standardized measures. Environmental contamination as a reason for migration was also associated with greater mental health symptomatology.

Adult↗

PubMed2005

Longitudinal neurocognitive assessments of Ukrainians exposed to ionizing radiation after the Chernobyl nuclear accident.

A 4-year longitudinal study of the cognitive effects of the Chernobyl nuclear accident was conducted from 1995 to 1998. The controls were healthy Ukrainians residing several hundred kilometers away from Chernobyl. The exposed groups included Eliminators, Forestry workers and Agricultural workers living within 150 km of Chernobyl. Accuracy and efficiency of cognitive performance were assessed using ANAMUKR, a specialized subset of the Automated Neuropsychological Assessment Metrics (ANAM) battery of tests. Analyses of variance, followed by appropriate pairwise comparisons, indicated that the 4-year averaged levels of performance of the exposure groups (especially the Eliminators) were significantly lower than those of the controls on most measures; further, analyses of performance across time revealed significant declines in accuracy and efficiency, as well as psychomotor slowing, for all exposed groups over the 4-year period. These findings strongly indicate impairment of brain function resulting from both acute and chronic exposure to ionizing radiation.

Adolescent↗

PubMed2006

Suicide risk among Chernobyl cleanup workers in Estonia still increased: an updated cohort study.

PURPOSE: The aim of the study is to examine the mortality experience among Chernobyl cleanup workers. METHODS: A cohort study of 4786 men from Estonia who participated in the Chernobyl cleanup from 1986 to 1991 and were traced until December 31, 2002. Standardized mortality ratio (SMR) and adjusted mortality rate ratio (RR) derived through Poisson regression analysis were calculated. RESULTS: During follow-up, 550 deaths occurred, yielding an SMR of 1.01 (95% confidence interval [CI], 0.92-1.09). Increased risks were observed for suicide alone (SMR, 1.32; 95% CI, 1.03-1.67) and suicide combined with undetermined injury (SMR, 1.29; 95% CI, 1.03-1.60). One leukemia death occurred, and no thyroid cancer deaths were found. Elevated mortality also was observed for brain cancer (SMR, 2.78; 95% CI, 1.02-6.05). The adjusted RR for suicide remained stable over the time passed since return from the Chernobyl area, showing RRs of 1.09 (95% CI, 0.56-2.10) for 5 to 9 years and 1.00 (95% CI, 0.48-2.05) for 10 or more years compared with less than 5 years. CONCLUSIONS: During the 17 years after the accident, suicide risk in the cohort was greater than in the general male population. No elevated risk in overall mortality and radiation-related cancers was observed. The long-term nature of this elevated risk provides concrete evidence that psychological consequences represent the largest public health problem caused by the accident to date.

Chernobyl Nuclear Accident↗

PubMed2005

Accumulation of Chernobyl-derived 137Cs in bottom sediments of some Finnish lakes.

The amount and vertical distribution of Chernobyl-derived 137Cs in the bottom sediments of some Finnish lakes were studied. Sediment and surface water samples were taken in 2000 and 2003 from 12 stations in nine lakes and the results were compared with those obtained in corresponding surveys carried out in 1969, 1978, 1988 and 1990. Each of the five deposition categories of Chernobyl fallout in Finland were represented. The depth profiles of 137Cs in the sediments showed considerable variety in the lakes studied. The peak values varied between 1.5 and 46 kBq kg(-1) dry wt. The size and shape of the peak did not always correlate with the amount of deposition in the area, but on the other hand, reflected differences in sedimentation processes in different lakes. In some of the lakes the peak still occurred in the uppermost (0-2 cm) sediment layer, but in an extreme case the peak occurred at a depth of 22-23 cm corresponding to a sedimentation rate of 16 mm year(-1) during the 14 years after the Chernobyl accident. The total amounts of 137Cs in sediments varied from 15 to 170 kBq m(-2) at the sampling stations studied. Since 1990, the amounts have continued to increase slightly in two lakes, but started to decrease in the other lakes. In most of the lakes, the total amounts of 137Cs in sediments were about 1.5-2 times higher than in local deposition. In two lakes, the ratio was below 1, but in one case 3.2. Compared with the total amounts of 137Cs at the same stations in the late 1960s and 1970s, the values were now at their highest, at about 60-fold. The most important factors affecting 137Cs values in sediments were the local amount of deposition and the type of the lake and the sediment, but in addition, there were a number of other factors to be considered.

Animals↗

PubMed2006

Seasonal 7Be and 137Cs activities in surface air before and after the Chernobyl event.

Seasonal fluctuations of cosmogenic (7)Be (T(1/2)=53.4 days) and anthropogenic (137)Cs (T(1/2)=30 years) activities in surface air (aerosols) have been extracted from a long data record (1972-2000) at high latitude (56 degrees N-68 degrees N, Sweden). Normalization to weekly average values was used to control long-term trends so that cyclical trends could be investigated. Enhanced (7)Be activity was observed in spring and summer seasons and likely relates to the seasonal thinning of the tropopause. Variations in the (137)Cs activity record seem to reflect how the isotope was injected in the atmosphere (stratospheric from bomb tests and tropospheric from the Chernobyl accident) and subsequent transport mechanisms. Accordingly, until 1986, the surface air (137)Cs activity was strongly related to nuclear weapons test fallout and exhibits temporal fluctuations resembling the (7)Be. Conversely, since 1986 the Chernobyl-produced (137)Cs dominates the long-term record that shows annual cycles that are strongly controlled by atmospheric boundary layer conditions. Additionally, short-term data within the post-Chernobyl period suggest subtle intrusion of air masses rich in (137)Cs that may occur throughout the year, and differences resulting from spatial occurrence at these latitudes. This is an important observation that may have to do with year-to-year variation and calls for caution when interpreting short-term data records.

Air Pollutants, Radioactive↗