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Sperm angiotensin-converting enzyme activity in Chernobyl victims and patients with chronic prostatitis.

The method for determination of angiotensin-converting enzyme activity in human spermatozoa and seminal plasma was developed. The number of total and active-motile spermatozoa was shown to be lower in Chernobyl victims than in healthy donors. The specific activity of angiotensin-converting enzyme in spermatozoa from Chernobyl victims was 12 times higher than that in donors. Similar results, although to a lesser extent, were observed in patients with chronic prostatitis. In contrast, the enzyme activity in blood serum and seminal plasma was identical for all subjects investigated.

Chronic Disease↗

The Chernobyl accident and mental wellbeing--a population study.

We studied the long-term effects of the 1986 Chernobyl nuclear power plant accident on mental wellbeing 7 years after the event. Mental wellbeing was assessed using a 12-item General Health Questionnaire (GHQ). The study group comprised 325 persons (aged 15-54 years) who had continued to live in the high-fallout area in Bryansk, Russian Federation, classified as a strict control zone with respect to the level of fallout and subsequent radiation protection countermeasures. The control group comprised 278 persons living in a noncontaminated area. The mental wellbeing of women in the study group was poorer than in controls (age-adjusted means). Based on the GHQ score, a minor mental disorder was detected in 48% of the women in the study group and 34% of the female controls. The corresponding figures for men were 26% and 28%, respectively. Those living with a partner coped better mentally than the others. The level of education was not associated with the GHQ score. Poor financial situation and self-rated poor health were associated with a high GHQ score. Fifty-nine per cent of the study group and 14% of the control group wanted to move away from the area of residence, but it was not associated with GHQ score. In a logistic regression analysis, independent factors explaining the GHQ score in the study group were uncertainty about the future in the men and, in addition, poor financial situation and insufficient social support in the women. According the results, the Chernobyl nuclear power plant accident impaired the long-term mental wellbeing of women living in the contaminated area.

Adaptation, Psychological↗

Chromosome aberrations in Norwegian reindeer calves exposed to fallout from the Chernobyl accident.

Chromosome aberrations were analysed in 1222 peripheral blood lymphocytes from 24 reindeer, Rangifer tarandus L., calves from central Norway, where considerable fallout from Chernobyl accident had occurred, and in 1532 lymphocytes from 26 calves from three different districts in Northern Norway which were not affected by fallout from the accident. Three dicentrics, two rings, and three translocations were detected in calves from the exposed area, while no dicentrics, nor rings and only one translocation were detected in the control calves. The frequency of chromatid-type aberrations and chromosome deletions did not significantly differ between the two groups. Although the present study is based on a limited number of observations, the radioactive burden in the exposed reindeer, and the differing character of the chromosome aberrations in the two groups, might indicate that certain genetic effects have occurred as a result of the Chernobyl accident in Norwegian reindeer in the most contaminated areas.

Accidents↗

A visit to Chernobyl.

Details of the accident at the Chernobyl nuclear power plant were given by Soviet experts at a special International Atomic Energy Agency meeting in Vienna, Austria, in August 1986. Several unanswered questions were made much clearer by a visit to the decontaminated and operating power plant at Chernobyl and by discussions with Soviet scientists. The visit gives us insights into the way the Soviets design their technology, the consequences of the accident, and the magnificent way they coped with the disaster. Although there are general conclusions to be drawn for the rest of the world, such as the realization that operators of technological systems can and will deliberately cut out safety systems, the primary specific conclusion is to be grateful that the West did not follow the Soviet route in its development of nuclear power.

Accidents↗

Comparison of the post-Chernobyl 137Cs contamination of mushrooms from eastern Europe, Sweden, and North America.

A comparison was made of 134Cs and 137Cs contamination in fungi from eastern Europe and eastern North America. Mean activities of 25 Ukrainian, 6 Swedish, and 10 North American collections were 4,660, 9,750, and 205 Bq/kg (dry weight), respectively. Additional measurements were made on samples from the Moscow, southern Belarus, and Yugoslavia/Bulgaria regions. Activity values were found to vary by several orders of magnitude within all geographic areas, even for the same mushroom species. Significantly higher specific activities were observed in mycorrhizal species than in saprophytic and parasitic fungi. Unfortunately, many of the European mycorrhizal species considered as prized edibles contained unacceptably high levels of 137Cs (> 1,000 Bq/kg [dry weight]) and should be used sparingly as food. By contrast, no mushrooms collected in Ontario or northern Michigan exceeded 1,000 Bq of 137Cs per kg (dry weight). The excessive 137Cs contamination was evident in mushrooms from areas that had substantial fallout from the 1986 accident in reactor 4 at the Chernobyl nuclear power station. However, observations suggest that about 20% of the 137Cs in eastern Europe (Moscow area, Belarus, and Ukraine) is of non-Chernobyl origin.

Air Pollution, Radioactive↗

The accident at Chernobyl and outcome of pregnancy in Finland.

OBJECTIVE: To evaluate the outcome of pregnancy in Finnish women after the accident at the Chernobyl nuclear power plant on 26 April 1986. DESIGN: Geographic and temporal cohort study. SETTING: Finland divided into three zones according to amount of radioactive fallout. SUBJECTS: All children who were exposed to radiation during their fetal development. Children born before any effects of the accident could be postulated--that is, between 1 January 1984 and 30 June 1986--served as controls. INTERVENTIONS: Children were divided into three temporal groups: controls, children who were expected to be born in August to December 1986, and children who were expected to be born in February to December 1987. They were also divided, separately, into three groups according to the three geographic zones. END POINT: Incidence of congenital malformations, preterm births, and perinatal deaths. MEASUREMENTS AND MAIN RESULTS: There were no significant differences in the incidence of malformations or perinatal deaths among the three temporal and three geographic groups. A significant increase in preterm births occurred among children who were exposed to radiation during the first trimester whose mothers lived in zones 2 and 3, where the external dose rate and estimated surface activity of caesium-137 were highest. CONCLUSIONS: The results suggest that the amount of radioactive fallout that Finnish people were exposed to after the accident at Chernobyl was not high enough to cause fetal damage in children born at term. The higher incidence of premature births among malformed children in the most heavily polluted areas, however, remains unexplained.

Abnormalities, Radiation-Induced↗

Fallout from Chernobyl and incidence of childhood leukaemia in Finland, 1976-92.

OBJECTIVE: To assess effects of fallout from Chernobyl on incidence of childhood leukaemia in Finland. DESIGN: Nationwide cohort study. External exposure measured for 455 Finnish municipalities with instruments driven 19,000 km throughout the country. Values specific to municipalities corrected for shielding due to houses and fallout from A bomb testing. Internal exposure estimated from whole body measurements on a random sample of 81 children. Mean effective dose for two years after incident calculated from these measurements. Data on childhood leukaemia obtained from Finnish cancer registry and verified through hospitals treating childhood cancers. SETTING: Finland, one of the countries most heavily contaminated by the Chernobyl accident; the population was divided into fifths by exposure. SUBJECTS: Children aged 0-14 years in 1976-92. MAIN OUTCOME MEASURES: Standardised incidence ratio of childhood leukaemia and relative excess risk of childhood leukaemia per mSv. From incidence data of Finnish cancer registry for 1976-85, expected numbers specific to sex and age group (0-4, 5-9, and 10-14 years) were calculated for each municipality for three periods (1976-85, 1986-8, and 1989-92) and pooled as exposure fifths. Dose response was estimated as regression slope of standardised incidence ratios on mean doses for fifths for each period. RESULTS: Population weighted mean effective doses for first two years after the accident were 410 microSv for the whole country and 970 microSv for the population fifth with the highest dose. In all Finland the incidence of childhood leukaemia did not increase 1976-92. The relative excess risk 1989-92 was not significantly different from zero (7% per mSv; 95% confidence interval -27% to 41%). CONCLUSIONS: An important increase in childhood leukaemia can be excluded. Any effect is smaller than eight extra cases per million children per year in Finland. The results are consistent with the magnitude of effect expected.

Accidents↗

Long-term mental health effects of the Chernobyl disaster: an epidemiologic survey in two former Soviet regions.

OBJECTIVE: This study assessed the long-term mental health effects of the nuclear accident at Chernobyl. METHOD: Two population samples (N = 3,044), one from the Gomel region, close to the accident site, and one from Tver, 500 miles away, were studied 6 1/2 years after the event with the use of a variety of self-report questionnaires and a standardized psychiatric interview. RESULTS: The prevalence of psychological distress and DSM-III-R psychiatric disorders was exceptionally high in both regions. Scores on the self-report scales were consistently higher in the exposed region; however, a higher risk of DSM-III-R psychiatric disorders could be demonstrated only among women with children under 18 years of age in the exposed region. CONCLUSIONS: A substantial long-term mental health effect of the Chernobyl incident was demonstrated, mainly at a subclinical level.

Adolescent↗

Semen Quality of Workers Exposed to Ionizing Radiation in Decontamination Work after the Chernobyl Nuclear Reactor Accident.

The objective of the study was to assess effects of radiation on sperm quality, including ultramorphology of spermatozoa of men who worked as salvage workers at the Chernobyl nuclear reactor accident site or in the adjacent region. Semen characteristics were assessed by light microscopy, biochemical analysis, and quantitative ultramorphologic analysis seven years after the accident. Samples were collected in the Ukraine, examined there by routine semen analysis, fixed, and transferred to Israel for further examinations. The study population consisted of 18 radiation-exposed individuals. Eighteen unexposed Ukrainian men were examined as controls. Sperm motility was found to be reduced in the radiation-exposed workers. Ultramorphologic defects were evident in the sperm nucleus. Fertility potential was adversely affected among the exposed workers. Thus, salvage workers who had worked at the Chernobyl nuclear reactor accident site or in the vicinity thereof were found to manifest ultramorphologic abnormalities in the sperm nucleus and to have impaired fertility potential seven years after the radiation exposure. The injury was independent of whether the work site had been located at the reactor site or in the vicinity thereof.

Journal Article↗

Thyroid cancer among "liquidators" of the Chernobyl accident.

In 1986, immediately after the Chernobyl accident, the USSR Ministry of Health adopted a large scale programme of establishing an All-Union Distributed Registry of persons affected by radiation due to the accident. The registry was based at the Medical Radiological Research Centre of the Russian Academy of Medical Sciences (MRRC RAMS). In 1992, when the USSR was dissolved, this registry database contained information on 659,000 persons, including 284,000 Chernobyl accident emergency workers ("liquidators"). Currently, the Russian National Medical Dosimetric Registry (RNMDR) contains data on 435,276 persons, including 167,862 liquidators. This paper reviews the data for 47 verified thyroid cancers in the liquidator subgroup of the RNMDR. Analyses show that there is an excess relative risk of thyroid cancer per Gy of 5.31 (95% confidence intervals 0.04 and 10.58) and an excess absolute risk of thyroid cancer per 10(4) person-years per Gy of 1.15 (95% confidence intervals 0.08 and 2.22).

Adult↗

Thyroid dosimetry in Europe following the Chernobyl accident.

Thyroid dose estimates for European populations following the Chernobyl accident in 1986 have been presented in the literature. These dose estimates used standard values for parameters such as thyroid mass, iodine uptake and biological half-life. Previous work has shown that these values are not representative of European populations and that local values should be utilized. Using published data on revised thyroid dose estimates, thyroid dosimetry data arising as a result of the Chernobyl accident are presented for 22 European countries. When these are compared with previously published estimates it is found that in all cases the previous results underestimate the thyroid dose by up to a factor of 4. Risk estimates on the incidence of fatal and non-fatal thyroid cancers are also determined from this new data and, again, the results are underestimated. The results show an increase in the number of fatal cancers, rising from 149 as predicted by the NEA to 310 under the new estimates, and from 180 as predicted by UNSCEAR to the new estimate of 380.

Adult↗

Radiation and epidemiological analysis for solid cancer incidence among nuclear workers who participated in recovery operations following the accident at the Chernobyl NPP.

This paper discusses the results of the analysis of the relationship between dose and solid cancer incidence among nuclear workers (males) who worked as liquidators after the Chernobyl accident. Information on this cohort of individuals is available at the regional center of Russian National Medical and Dosimetric Registry operating at the RF State Research Centre-Institute of Biophysics. Medical and dosimetric information on 8,654 persons 18-60 years of age with documented external radiation doses is used for the analysis. These data were gathered in the period from 1996 to 2001 and cover a total of 45,166.5 follow-up person-years. In the cohort under study, 179 solid cancers occurred during this period. The average age of liquidators at the time of exposure was 35.8 years, and the average dose as a result of the Chernobyl exposure was about 0.05 Sv. For an analysis of the dose-effect relationship (induction of radiation-induced malignant neoplasms) the statistical software EPICURE was used. The results of the analysis show that the cancer incidence in this cohort does not exceed cancer incidence in relevant age groups of the Russian population. The mean value of SIR for all cancer diseases was 0.88 (0.76, 1.02, 95% CI) for the whole period of follow-up. Risks for the induction of radiation-related cancer diseases were not statistically meaningful. Excess relative risk per 1 Sv was 0.95 (-1.52, 4.49, 95% CI).

Adolescent↗

Health effects in a casual sample of immigrants to Israel from areas contaminated by the Chernobyl explosion.

We analyzed questionnaire and physician examination data for 1560 new immigrants from the former USSR divided into three groups by potential exposure to Chernobyl radiation. Two groups were chosen according to soil contamination by cesium-137 at former residences, as confirmed by our findings in a 137Cs body burden study. The third group consisted of "liquidators," persons who worked at the Chernobyl site after the disaster. Liquidators had greater self-reported incidences of symptoms commonly accepted as acute effects of radiation exposure, increases in prevalence of hypertension, and more health complaints. Excesses of bronchial asthma and health complaints were reported in children from the more exposed communities. Asthma prevalence in children potentially exposed in utero appears to be increased eightfold. Older adults from more exposed areas had more hypertension as assessed by history and measurements. These findings suggest the possible association of radiation exposure with several nonmalignant effects.

Adolescent↗

Ultramorphological sperm characteristics in the risk assessment of health effects after radiation exposure among salvage workers in Chernobyl.

We present a pilot study of individuals (liquidators) who were engaged in clean-up operations after the disaster at the nuclear power plant at Chernobyl in Ukraine. In the 10 years since the disaster, adverse health effects among exposed individuals have not been clearly defined. There is widespread fear of damage to the reproductive system, with implications for fertility problems and adverse effects on offspring. Bearing this in mind, methods to evaluate the potential for production of fertile semen have been applied using quantitative ultramorphological (QUM) analysis. QUM analysis examines the organization and integrity of sperm organelles by electron microscopy, using both transmission electron microscopy and scanning electron microscopy. Significant differences were observed between clean-up workers and controls of similar age regarding certain ultramorphological parameters of the sperm head. The results of this pilot study suggest that QUM analysis of human sperm is a feasible approach for evaluating the fertility potential of individuals who were exposed to ionizing radiation from the Chernobyl nuclear power plant accident.

Adult↗

Iodine deficiency in Belarusian children as a possible factor stimulating the irradiation of the thyroid gland during the Chernobyl catastrophe.

Ten years after the Chernobyl nuclear plant catastrophe more than 500 children in Belarus are suffering from thyroid cancer. The major cause of the high incidence of thyroid cancer in children under 15 years of age appears to be contamination resulting from that catastrophe, mainly with isotopes of radioactive iodine. Another important factor may be iodine deficiency in the environment. A countrywide program for investigation of goiter prevalence and iodine deficiency has been established in the Republic of Belarus with the assistance of the European World Health Organization office. The program will oversee the examination of 11,000 children and adolescents 6 to 18 years of age from 30 schools in urban and rural areas. The results obtained in a group of 824 children and adolescents (the pilot phase) are typical for significant iodine deficiency and moderate goiter endemism. It is clear that the present situation does not completely reflect the situation that existed at the time of the Chernobyl catastrophe. However, data from epidemiologic studies conducted many years before the accident showed high goiter prevalence in the contaminated areas, indicating that the prevalence of iodine deficiency at the time of the catastrophe was similar to the present one or even greater. Such an assumption could lead to a better understanding of the thyroid pathologies that have been observed.

Adolescent↗

Incidence of childhood disease in Belarus associated with the Chernobyl accident.

Study of the childhood incidence of cancer and other diseases in Belarus is of great importance because of the present unfavorable environmental situation. About 20% of the children in the republic were exposed in various degrees to radiation as a result of the Chernobyl accident. Since 1987 increases in the incidence of most classes of disease have been reported, including the development of thyroid cancer. From 1987 to 1995, thyroid cancer was diagnosed in 424 children; its incidence having increased from 0.2 to 4.0/10(5) in 1995. According to preliminary data for 1996, 81 childhood cancer cases were reported. During 1995 there also were increases in the incidence of endocrine and dermatologic diseases and mental disorders. During the period 1987 to 1995 significant increases in the incidences of all illnesses were observed for children listed in the Chernobyl registry. The highest incidence rates were found in evacuated children and those residing in contaminated areas. There also were increased incidences of thyroid and digestive organ diseases among these children and in addition, high prevalence of chronic tonsillitis and adenoiditis was observed. Since 1990 an increase of autoimmune thyroiditis has been observed. The highest rates of hematopoietic tissue diseases were found in children born after the accident to irradiated parents.

Child↗

Risk factors for long-term mental and psychosomatic distress in Latvian Chernobyl liquidators.

Epidemiologic studies on the health effects of the Chernobyl disaster have focused largely on physical health, whereas the psychological consequences have received little attention. The authors have assessed the associations of various exposure variables with mental and psychosomatic distress in a sample of 1412 Latvian liquidators drawn from the State Latvian Chernobyl Clean-up Workers Registry. The outcome was a mixed mental-psychosomatic disorder occurring during 1986 to 1995. Comparisons among subgroups of the cohort classified according to exposure type or level were based on the proportional hazards model. Length of work (> or = 28 days) in a 10-km radius from the reactor (relative risk [RR] = 1.39, 95% confidence interval [CI] 1.14-1.70), work (> 1 time) on the damaged reactor roof (RR = 1.46, 95% CI 1.02-2.09), forest work (RR = 1.41, 95% CI 1.19-1.68), fresh fruit consumption (> or = 1 time/day) (RR = 1.72, 95% CI 1.12-2.65) are risk factors for mixed mental-psychosomatic disorder. Construction of the sarcophagus (RR = 1.82, 95% CI 0.89-3.72) is also associated with this outcome, although nonsignificantly. Distinguishing stress-related from radiation-induced effects in this data set was difficult and these findings should provide a basis for later hypothesis testing in other cohorts.

Adult↗

The outcome of local radiation injuries: 14 years of follow-up after the Chernobyl accident.

The Chernobyl nuclear power plant accident on April 26, 1986 was the largest in the history of the peaceful use of nuclear energy. Of the 237 individuals initially suspected to have been significantly exposed to radiation during or in the immediate aftermath of the accident, the diagnosis of acute radiation sickness (ARS) could be confirmed in 134 cases on the basis of clinical symptoms. Of these, 54 patients suffered from cutaneous radiation syndrome (CRS) to varying degrees. Among the 28 patients who died from the immediate consequences of accidental radiation exposure, acute hemopoietic syndrome due to bone marrow failure was the primary cause of death only in a minority. In 16 of these 28 deaths, the primary cause was attributed to CRS. This report describes the characteristic cutaneous sequelae as well as associated clinical symptoms and diseases of 15 survivors of the Chernobyl accident with severe localized exposure who were systematically followed up by our groups between 1991 and 2000. All patients presented with CRS of varying severity, showing xerosis, cutaneous telangiectasias and subungual splinter hemorrhages, hemangiomas and lymphangiomas, epidermal atrophy, disseminated keratoses, extensive dermal and subcutaneous fibrosis with partial ulcerations, and pigmentary changes including radiation lentigo. Surprisingly, no cutaneous malignancies have been detected so far in those areas that received large radiation exposures and that developed keratoses; however, two patients first presented in 1999 with basal cell carcinomas on the nape of the neck and the right lower eyelid, areas that received lower exposures. During the follow-up period, two patients were lost due to death from myelodysplastic syndrome in 1995 and acute myelogenous leukemia in 1998, respectively. Other radiation-induced diseases such as dry eye syndrome (3/15), radiation cataract (5/15), xerostomia (4/15) and increased FSH levels (7/15) indicating impaired fertility were also documented. This study, which analyzes 14 years in the clinical course of a cohort of patients with a unique exposure pattern, corroborates the requirement for long-term, if not life-long, follow-up not only in atomic bomb survivors, but also after predominantly local radiation exposure.

Cohort Studies↗