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

Health Effects of the Chernobyl Accident and Special Health Care Programmes

26 April 2006 marks the 20th anniversary of the Chernobyl accident. On this occasion, the World Health Organization (WHO), within the UN Chernobyl Forum initiative, convened an Expert Group to evaluate the health impacts of Chernobyl. This paper summarises the findings relating to cancer. A dramatic increase in the incidence of thyroid cancer has been observed among those exposed to radioactive iodines in childhood and adolescence in the most contaminated territories. Iodine deficiency may have increased the risk of developing thyroid cancer following exposure to radioactive iodines, while prolonged stable iodine supplementation in the years after exposure may reduce this risk. Although increases in rates of other cancers have been reported, much of these increases appear to be due to other factors, including improvements in registration, reporting and diagnosis. Studies are few, however, and have methodological limitations. Further, because most radiation-related solid cancers continue to occur decades after exposure and because only 20 years have passed since the accident, it is too early to evaluate the full radiological impact of the accident. Apart from the large increase in thyroid cancer incidence in young people, there are at present no clearly demonstrated radiation-related increases in cancer risk. This should not, however, be interpreted to mean that no increase has in fact occurred: based on the experience of other populations exposed to ionising radiation, a small increase in the relative risk of cancer is expected, even at the low to moderate doses received. Although it is expected that epidemiological studies will have difficulty identifying such a risk, it may nevertheless translate into a substantial number of radiation-related cancer cases in the future, given the very large number of individuals exposed.

https://iopscience.iop.org/article/10.1088/0952-4746/26/2/001/pdf

Cancer consequences of the Chernobyl accident: 20 years on

Summary The Chernobyl nuclear accident on 26 th April, 1986, led to a massive release of radionuclides into the environment. Although vast areas of Europe were affected by Chernobyl-related ionising radiation, the accident had the greatest impact in Belarus, Ukraine, and the Russian Federation. Epidemiological studies that have investigated the link between the Chernobyl accident and cancer have largely focused on malignant diseases in children, specifically thyroid cancer and leukaemia. There is good evidence to suggest that rates of thyroid cancer in children from the countries that were formally part of the Soviet Union have risen as a consequence of the Chernobyl accident. The findings for childhood leukaemia are less conclusive. Overall rates for this disease do not seem to have been affected by the Chernobyl-related ionising radiation, but there may be a larger risk of infant leukaemia in contaminated areas of Europe. Among adult populations, there is no strong evidence to suggest that risk of thyroid cancer, leukaemia, or other malignant disease has increased as a result of the Chernobyl accident.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470204502007271.pdf

Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review

A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries to assess the effect of low- to medium-dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked around the Chernobyl plant in 1986-1987. A total of 117 cases [69 leukemia, 34 non-Hodgkin lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue] and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The excess relative risk (ERR) per 100 mGy was 0.60 [90% confidence interval (CI) -0.02, 2.35]. The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90% CI -0.38, 5.7). It is slightly higher than but statistically compatible with those estimated from A-bomb survivors and recent low-dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over- or underestimation of the risk in this study.

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Risk of hematological malignancies among Chernobyl liquidators.

The Chernobyl nuclear power plant, located in Ukraine about 130 km north of the capital of Kiev and about 10 km south of the border with Belarus, was the scene of the most severe accident that has ever occurred in the nuclear industry. On April 26, 1986, two violent explosions destroyed the core of unit 4 of the power plant and the roof of the building, resulting in a series of fires and in massive releases of radioactive materials into the atmosphere. The releases consisted of gases, aerosols, and finely fragmented nuclear fuel particles. From the radiologic point of view, iodine-131 (131I) and cesium-137 (137Cs) are the most important radionuclides to consider (1, 2). During the 10 days of massive releases, the wind direction changed frequently, so that all areas surrounding the reactor received some fallout at one time or another. In addition, rainfall occurred in an irregular pattern, causing varying degrees of deposition. The releases of radioactive materials were such that contamination of the ground was found to some extent in every country in the Northern Hemisphere (3). However, the most contaminated areas were in Belarus, Russia, and Ukraine (table 1).

/pdf/the-chernobyl-disaster-cancer-following-the-accident-at-the-47iz1abtra.pdf

The Chernobyl Disaster: Cancer following the Accident at the Chernobyl Nuclear Power Plant

Cancer morbidity and mortality were studied in areas of the Kaluga oblast contaminated with radionuclides. The main objective of the study was to assess the influence of radiation exposure on existing levels of cancer morbidity and mortality. Time trends and relative population risks were analysed. Based on this analysis, it was concluded that the current levels of morbidity from cancers among the populations residing in the studied areas were primarily a result of a complex of factors which predated the exposure from the Chernobyl accident. However, there seems to be an unfavourable trend concerning malignant neoplasms of the respiratory organs for women residing in the contaminated areas. To date, no statistically significant effect of radiation on cancer morbidity (except for thyroid cancer in women) has been noted. The levels of cancer morbidity and mortality in the contaminated areas generally reflect the changes in cancer incidence in the oblast as a whole. The findings are consistent with international data on latent periods for the induction of radiogenic cancers and the biological effects for similar levels of exposure to populations residing in contaminated territories. Further studies are necessary in order to monitor possible effects that are related to the accident.

Cancer risks in the Kaluga oblast of the Russian Federation 10 years after the Chernobyl accident

A study of cancer morbidity and mortality was performed in those rayons of the Kaluga oblast that were contaminated with radionuclides. The main objective of the study was the assessment of the influence of the radiation to the existing levels of cancer morbidity and mortality. Time trends and relative population risks were analysed. Basing on this analysis, it was concluded, that the current levels of morbidity from malignant neoplasms among the population residing in the studied rayons exposed in the result of the Chernobyl accident had been formed mainly in response to a complex of factors arisen before the accident. At present no statistically significant effect of radiation on cancer morbidity (except for thyroid cancer in women of contaminated rayons) has been noted. Levels of cancer morbidity and mortality in contaminated areas basically reflect a general tendency to the changes in cancer incidence in the oblast as a whole. The conclusion is in general agreement with the world data on latent periods for induction of radiogenic cancers and biological effects for levels of irradiation of the population residing in contaminated territories.

Oncoepidemiological situation in the Kaluga oblast of Russian Federation 10 years after the Chernobyl accident

Медицинский радиологический научный центр РАМН , Обнинск; ∗ - Управление здравоохранения администрации Калужской области , Калуга Проведено исследование онкозаболеваемости и смертности в загрязненных ра -дионуклидами районах Калужской области . Главной целью исследования являлось опре-деление степени влияния радиационного фактора на существующие уровни онкозаболе-ваемости и онкосмертности . Проведен анализ динамики стандартизованных отношений онкозаболеваемости и онкосмертности и соответствующих популяционных рисков . На основании анализа сделан вывод , что в основном формирование существующих ныне уровней заболеваемости злокачественными новообразованиями населения изу-ченных районов , пострадавших в результате аварии на Чернобыльской АЭС , происходи-ло под влиянием комплекса факторов , сложившегося до аварии . Неблагоприятными представляются тенденции развития онкоэпидемиологических процессов в Ульяновском районе области . В настоящий период статистически достоверного эффекта влияния радиационного фактора на онкозаболеваемость ( кроме рака щитовидной железы у женщин в загрязнен -ных районах) не наблюдается , уровни онкозаболеваемости и онкосмертности в загряз-ненных регионах в основном отражают общую тенденцию изменения онкозаболеваемо-сти в целом по области . Сделанный вывод в общем согласуется с данными мировой практики по латентным периодам индукции радиогенных раков и величинам биологиче-ских эффектов для уровней облучения , которым подвергается население , проживающее на загрязненных территориях.

http://cyberleninka.ru/article/n/onkoepidemiologicheskaya-situatsiya-na-territorii-kaluzhskoy-oblasti-cherez-10-let-posle-chernobylskoy-katastrofy.pdf

V I Shiryaev

Papers

Cancer risks in the Kaluga oblast of the Russian Federation 10 years after the Chernobyl accident

Oncoepidemiological situation in the Kaluga oblast of Russian Federation 10 years after the Chernobyl accident

Oncoepidemiologic situation on the territory of the Kaluga region 10 years after the Chernobyl accident