/pdf/health-effects-of-the-chernobyl-accident-and-special-health-4t3u0josfb.pdf

Health Effects of the Chernobyl Accident and Special Health Care Programmes

The paper deals with estimating radiation risks of non-cancer diseases of the circulatory system among the Chernobyl emergency workers based on data from the Russian National Medical and Dosimetric Registry. The results for the cohort of 61,017 people observed between 1986 and 2000 are discussed. These are essentially updated results for the similar cohort that was studied by authors earlier in 1986-1996. Newly discovered is the statistically significant dose risk of ischemic heart disease [ERR Gy -1 = 0.41, 95% CI = (0.05; 0.78)]. Confirmation is provided for the existence of significant dose risks for essential hypertension [ERR Gy -1 = 0.36, 95% CI = (0.005; 0.71)] and cerebrovascular diseases [ERR Gy -1 = 0.45, 95% CI = (0.11; 0.80)]. In 1996-2000, the assessed ERR Gy -1 for cerebrovascular diseases was 0.22 with 95% CI = (-0.15; 0.58). Special consideration is given to cerebrovascular diseases in the cohort of 29,003 emergency workers who arrived in the Chernobyl zone during the first year after the accident. The statistically significant heterogeneity of the dose risk of cerebrovascular diseases is shown as a function of the duration of stay in the Chernobyl zone: ERR Gy -1 = 0.89 for durations of less than 6 wk, and ERR Gy -1 = 0.39 on average. The at-risk group with respect to cerebrovascular diseases are those who received external radiation doses greater than 150 mGy in less than 6 wk [RR = 1.18, 95% CI = (1.00; 1.40)]. For doses above 150 mGy, the statistically significant risk of cerebrovascular diseases as a function of averaged dose rate (mean daily dose) was observed: ERR per 100 mGy d -1 = 2.17 with 95% CI = (0.64; 3.69). The duration of stay within the Chernobyl zone itself, regardless of the dose factor, had little influence on cerebrovascular disease morbidity: ERR wk -1 = -0.002, with 95% CI = (-0.004; -0.001). The radiation risks in this large-scale cohort study were not adjusted for recognized risk factors such as excessive weight, hypercholesterolemia, smoking, alcohol consumption, and others.

The risk of radiation-induced cerebrovascular disease in Chernobyl emergency workers.

Alterations in tandem repetitive DNA sequences such as minisatellite DNA and expanded simple tandem repeats (ESTRs) may provide useful biomarkers of induced germline effects. In this review, I describe the differences between ESTRs and minisatellites with respect to their structure and mutational mechanisms, and discuss field applications measuring induced germline instability. It is evident that both types of loci have high rates of mutation that facilitate the measurement of induced mutation measured in relatively small numbers of samples following environmentally relevant exposures. Several research groups have used these loci to demonstrate a significant increase in germline mutation in humans and animals exposed to radioactive or chemical pollutants in their natural environment. Mutations are manifested as gains or losses in repeat units and are detected either by pedigree screening or by PCR amplification of sperm DNA. Mutations at both ESTRs and minisatellites appear to arise via indirect mechanisms rather than by direct damage to the repeat locus itself. Most interestingly, ESTR instability following radiation has been shown to be heritable and transmitted to subsequent generations. An understanding of the mechanisms involved in induced instability is required in order to begin to decipher the potential biological implications of increased germline tandem repeat mutation. Furthermore, relatively few studies have investigated the ability of different genotoxins to induce tandem repeat instability. Such laboratory-based experiments will be crucial in clarifying the particular environmental or occupational exposures that should be targeted for future studies and for isolating and subsequently identifying the putative mutagens in complex environmental matrices.

Advances in the application of germline tandem repeat instability for in situ monitoring.

This review assesses recent data on mutational risk to the germline after radiation exposure obtained by molecular analysis of tandemly repeated DNA loci (TRDLs): minisatellites in humans and expanded simple tandem repeats in mice. Some studies, particularly those including exposure to internal emitters, indicate that TRDL mutation can be used as a marker of human radiation exposure; most human studies, however, are negative. Although mouse studies have suggested that TRDL mutation analysis may be more widely applicable in biomonitoring, there are important differences between the structure of mouse and human TRDLs. Mutational mechanisms probably differ between the two species, and so care should be taken in predicting effects in humans from mouse data. In mice and humans, TRDL mutations are largely untargeted with only limited evidence of dose dependence. Transgenerational mutation has been observed in mice but not in humans, but the mechanisms driving such mutation transmission are unknown. Some minisatellite variants are associated with human diseases and may affect gene transcription, but causal relationships have not yet been established. It is concluded that at present the TRDL mutation data do not warrant a dramatic revision of germline or cancer risk estimates for radiation.

https://bioone.org/journals/radiation-research/volume-165/issue-3/RR3506.1/Assessing-Radiation-Associated-Mutational-Risk-to-the-Germline--Repetitive/10.1667/RR3506.1.pdf

Assessing Radiation-Associated Mutational Risk to the Germline: Repetitive DNA Sequences as Mutational Targets and Biomarkers

The presented work summarizes data on estimated radiation risks among Chernobyl emergency workers of the Russian Federation. In 1991-1998, the excess relative risk (ERR) of death from malignant neoplasm was statistically significant: excess relative risk per 1 Gy (ERR/Gy)=2.11 with 95% confidence interval (CI) (1.31-2.92). In 1991-2001, the ERR estimation for incident solid cancers gives a positive, but statistically insignificant value: ERR/Gy=0.34 with 95% CI (-0.39; 1.22). In 1986-2003, radiation risk for leukemia incidence was investigated. During the first 10 y after the Chernobyl accident (1986-1996) the relative risk (RR) of leukemia (excluding chronic lymphocytic leukemia) was statistically significant: RR=2.2 with 95% CI (1.3-3.8) for emergency workers with doses>0.15 Gy in comparison with less exposed workers. In 1986-2000, a statistically significant dose response was observed for incident cerebrovascular diseases: ERR/Gy=0.39, 95% CI=(0.004; 0.77). For doses>0.15 Gy a statistically significant risk of cerebrovascular diseases as a function of mean daily dose was observed: ERR per 0.1 Gy d(-1)=2.17 with 95% CI=(0.64; 3.69). Different but overlapping cohorts of Russian emergency workers were used for these estimations. No adjustments were made for recognized risk factors for cerebrovascular diseases. All results should be considered as preliminary.

Late cancer and noncancer risks among Chernobyl emergency workers of Russia

We present a detailed description of dosimetric data entered in the Russian National Medical and Dosimetric Registry (RNMDR) for emergency workers (liquidators) involved in recovery operations (RO) after the Chernobyl accident. The data on the absorbed doses from external exposure are based on the documents given to liquidators by organizations that performed dosimetric monitoring in the zones of operation. Using the data on external doses currently available in the RNMDR for 119 416 liquidators (78.4% of the total number of 152 325 persons), different statistical characteristics were derived to assess the reliability of the information. The paper also discusses dose distributions according to the date of beginning work in the RO zone [up to 250 km from the Chernobyl nuclear power plant (NPP)], on the distance of the settlement where the liquidators were accommodated or worked from the NPP, and on the duration of their stay in the RO zone. To analyse the reliability of the dosimetric data, the notion of an effective exposure dose rate (EEDR), i.e. the ratio of the dose registered in RNMDR and the duration of stay in the RO zone, was introduced for each liquidator, and corresponding statistical characteristics for the distribution of EEDR depending on the date of entry into the RO zone and distance from the place of residence or work to the NPP were obtained. The analysis for different groups of liquidators shows that the dosimetric information of the RNMDR is, as a statistical aggregate, generally consistent with the data on the radiation situation in the RO zones.

Exposure levels for persons involved in recovery operations after the Chernobyl accident. Statistical analysis based on the data of the Russian National Medical and Dosimetric Registry (RNMDR).

The work concerns the assessment of radiation risks for non-cancer diseases of circulatory system among the Chernobyl liquidators. The medical and dosimetric data from Russian National Medical and Dosimetric Registry were used. The cohort data from 1986 to 2000 years of 61017 liquidators are discussed. Radiation risks are established for the cerebrovascular diseases and for the essential hypertension the significant. ERR =0.45/Gy, with 95% CI = (0.11; 0.80) for the cerebrovascular diseases and ERR = 0.36/Gy, with 95% CI = (0.005; 0.71) for the essential hypertension. It approves the results which were established by authors for the similar cohort in 1986-1996. The cerebrovascular diseases (CVD) are considered in greater details. The significant heterogeneity of the radiation risks by working time in Chernobyl zone is shown for the first time. ERR = 0.89/Gy for the working time less then 6 weeks, and ERR = 0.39/Gy in average for all periods of working in the zone. Among the liquidators entered Chernobyl zone during the first year after the accident (29003 liquidators), the CVD's risk group consists of persons accumulated more then 150 mGy from external sources in less, then 6 weeks (RR = 1.18 with 95% CI = (1.00; 1.40)). The significant CVD's risk from averaged dose rate was defined for external doses greater then 150 mGy (ERR for 100 mGy/day = 2.17, with 95% CI = (0.64; 3.69)).

V. A. Matiash

Papers

Exposure levels for persons involved in recovery operations after the Chernobyl accident. Statistical analysis based on the data of the Russian National Medical and Dosimetric Registry (RNMDR).

The radiation risks of cerebrovascular diseases among the liquidators