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[On the occasion of the 20th anniversary of the accident on the Chernobyl NPP: medical consequences in Armenia].

The aim of this work is the analysis of the indices of the health and of the structure of the sicknesses of the inhabitants of Armenia who took part in the liquidation of the consequences of the Chernobyl accident. Also it is the determination of possible dependence of the frequency of diseases for the most widespread classes of sicknesses on the received dose of the irradiation, according to the data of the clinical examination and dispensarysation; and also it is the revelation of the role of other factors influenced on the health indexes.

Armenia↗

[Dynamics of immune status indices of liquidators in the remote period after the accident at the Chernobyl NPP].

In the report there are present the results of monitoring of the state of immune status in the remote period after the accident at the Chernobyl Nuclear Power Plant among three groups of liquidators, which were from Moscow and the Moscow district, the Northwestern region of Leningrad district and from Krasnoyarsk territory. During the monitoring of the liquidators from different regions there was found phenotype of immune status with regional characteristics. In the Moscow district the clinical displays of immune insufficiency prevail and in the North western region the modifications of immune status prevail among liquidators. In all the groups we could see quantitative and immunoregulatory disbalance with the increase of parameters of cellular activity such as CD95+, HLA-DR+, T-activated lymphocytes, fluctuation cytotoxic cells (CD8+, CD16+), persevering disimmunoglobulinemia with differently directed modification serum of immunoglobulins at decrease B-lymphocytes. By the end of the twenty-year period after the accident we can see a similar phenotype of immune status in all the groups with increasing of the marker of late activation (HLA-DR+) and apoptotic activity (CD95+) and it is potentially dangerous regarding cancerogenesis. According to the basis of long-term monitoring there has been discovered the immune characteristic of proliferative syndrome for the first time. The monitoring of 2004 has revealed a huge similarity immune status at non-malignant growth at significant decrease CD25+ in the Northwestern region and some differences in common IgE.

Chernobyl Nuclear Accident↗

[The experience of FISH technique application for reconstruction of individual radiation doses in Chernobyl liquidators in the framework of Ukrainian-American project "Leukemia"].

The results of proper investigations received under the cytogenetic examination of 225 persons (control groups, Chernobyl liquidators exposed to different radiation doses, oncogematology patients) had been summarized and analyzed. The conclusion concerning possibilities and limitations of FISH technique usage for retrospective biodosimetry of human radiation exposure has been presented.

Adult↗

[State of broncho-pulmonary system in liquidators of Chernobyl power accident consequences].

Liquidators of Chernobyl power accident consiquences were subjected to simultaneous external gamma-beta radiation and inhalation of particles containing radionuclides aerosols, nonradiation toxic chemicals and dust. Typical defects of medical examination of liquidators were seen: sending people with pulmonary diseases to post-accident work, erroneous interpretation of the disease severity with underestimation of previous occupational history and nonradiation factors deteriorating the case.

Adult↗

Completion total thyroidectomy in children with thyroid cancer secondary to the Chernobyl accident.

OBJECTIVE: To evaluate the usefulness of submitting children with thyroid cancer secondary to nuclear accidents to a completion total thyroidectomy. DESIGN: A case series consisting of patients living and operated on in Belarus whose parents had asked for a clinical evaluation in a western European center. SETTING: A tertiary care referral center. PATIENTS: The conditions of 47 children from Gomel, Belarus, with differentiated thyroid carcinoma following the nuclear accident at Chernobyl, Ukraine, were evaluated at the University of Pisa, Pisa, Italy. In approximately half of the cases, the treatment in Belarus consisted of a hemithyroidectomy. After a complete evaluation, the decision was made to reoperate on 19 of them by performing a completion total thyroidectomy. The preoperative evaluation revealed that 5 (26%) of the 19 patients who had undergone a hemithyroidectomy had unilateral recurrent nerve palsy and that 2 (10.5%) had hypoparathyroidism. INTERVENTIONS: Neck ultrasonography was used for the preoperative localization of thyroid residuals, thyroid nodules, suspicious lymph nodes, and a guided fine-needle aspiration biopsy specimen. The circulating thyroglobulin measurement was obtained before reoperation. An iodine 131 whole-body scan (WBS) was performed and circulating thyroglobulin levels were obtained after completion of the thyroidectomy during withdrawal of levothyroxine sodium therapy. MAIN OUTCOME MEASURE: The number of patients with a recurrence of thyroid cancer and lung or lymph node metastases after the completion total thyroidectomy. RESULTS: The results of the histologic examination were positive for papillary thyroid cancer in 6 (28.6%) of 21 patients, 3 with residual cancer in the remaining thyroid lobe and 3 with metastatic lymph node disease. A posttherapy WBS demonstrated lung metastases in 5 (28%) of 18 patients and lymph node metastases in 6 (33%) of 18 patients; the results of a posttherapy WBS were negative for metastases in 7 (39%) of 18 patients. Hypoparathyroidism developed in 4 (21%) of 19 patients who underwent a completion total thyroidectomy; unilateral laryngeal nerve palsy developed in 1 (5.2%) of these 19 patients. Among 22 children who previously underwent total thyroidectomy in Belarus, a diagnostic WBS showed lung metastases in 10 (45%) of the children and lymph node metastases alone in 3 (14%) of the children; the results of a diagnostic WBS were negative for metastases in 9 (41%) of the children. Statistical analysis showed a nonsignificant (P>.05) difference in the prevalence of lung and lymph node metastases in patients who previously underwent total thyroidectomy compared with patients who underwent completion total thyroidectomy. CONCLUSION: Completion total thyroidectomy allowed for the diagnosis and treatment of recurrent thyroid cancer and lung or lymph node metastases in 61% (11/18) of the patients in whom residual differentiated thyroid carcinoma was not previously recognized.

Adolescent↗

Radiation-induced leukemia risk among those aged 0-20 at the time of the Chernobyl accident: a case-control study in the Ukraine.

A case-control study was conducted to estimate the radiation-induced acute leukemia risk for the period 1987-1997 among residents aged 0-20 at the time of the Chernobyl accident in the most radioactively contaminated territories of the Ukraine (Rivno and Zhytomir regions). Data were collected on 272 leukemia cases diagnosed between 1 January 1987 and 31 December 1997. Of these, 98 cases were verified and interviewed. Verified cases were compared to 151 randomly selected controls matched by age, gender and type of settlement. The mean value of the estimated accumulated equivalent dose to the bone marrow was 4.5 mSv, and the maximum value was 101 mSv. A statistically significant increased risk of leukemia was found among males whose estimated radiation exposure was higher than 10 mSv. This association was statistically significant for acute leukemia cases that occurred in the period 1993-1997, particularly for acute lymphoblastic leukemia. A similar association was found for acute myeloid leukemia, diagnosed in the period 1987-1992.

Adolescent↗

Morbidity in a large cohort study of children born to mothers exposed to radiation from Chernobyl.

Reproductive health was reviewed in four oblasts of the Republic of Belarus that were either heavily exposed (Mogilev and Gomel) or lightly exposed (Brest and Vitebsk) to ionizing radiation after the meltdown of a nuclear reactor in Chernobyl. A retrospective analysis was conducted on pregnancies occurring between January 1, 1982, and December 31, 1990, and a comparison of results was made between pregnancy outcomes prior to and after the meltdown for individuals residing in heavily exposed and lightly exposed oblasts. Pregnant women who resided in heavily exposed oblasts appeared to be at risk for development of toxemia, renal insufficiency and anemia. Neonates born in heavily contaminated areas were apparently at risk for development of anemia and congenital malformations and perinatal death. In addition, a cohort of 757 neonates, 0-18 months old, with a normal physical examination, was identified for laboratory analysis of hematological, immunological, endocrinological and nutritional status. Decreased levels of copper and zinc were documented in erythrocytes from neonates from heavily contaminated oblasts, findings that may be related more to inadequate nutrition than to radiation exposure. Increased absolute "null" lymphocyte number and diminished absolute T lymphocyte number with a reduction in the "helper" (i.e., T4) subclass of T cells were evident in neonates born-in heavily exposed oblasts. Geographic differences in reproductive health and immune status are apparent in Belarus that may be related to radiation exposure. Additional studies are required to exclude confounding variables and possible selection bias.

Abnormalities, Radiation-Induced↗

Investigation of the impact of radiation dose on hormones, biologically active metabolites and immunoglobulins in Chernobyl accident recovery workers.

One hundred twenty-five Chernobyl accident recovery workers (liquidators) who were exposed to low-dose radiation were studied over a period of 4-6 years for changes in levels of hormones, arachidonic acid metabolites and cyclic nucleotides. Some significant changes were observed, especially in the levels of metabolites that are regulators of cell functions. In comparison to controls, there were increased levels of thyroxin, cortisol, thromboxane B2, and immunoglobulins G, A and M, and reduced levels of growth hormone, cyclic nucleotides and 6-keto-prostaglandin F1. The degree or presence of these metabolite imbalances did not correlate with the level of the radiation dose received. The only change found that did relate to the radiation dose received was a statistically significant increase in levels of biomarkers for oxidative stress, seen in workers who received higher doses.

Adult↗

Overview of 1993 research activities in Belarus related to the Chernobyl accident.

This overview describes the medical and biological consequences of the Chernobyl nuclear power plant accident that had been assessed by Belarus scientists as of 1993. In particular, childhood thyroid cancer has increased in both frequency and severity. Other malignant tumors may have also increased, as may have childhood diseases that result from impaired immune function. It is unknown whether these increases in human disease (other than thyroid cancer) are due to improved methods of reporting or to exposure to ionizing radiation. In addition to the medical consequences of radiation damage, there are also significant psychological problems endured by the population living in contaminated areas. The Republic of Belarus has participated in several international programs for the study and management of widespread radiation exposure, and will continue to do so. Programs to address issues of radiation protection and population safety are being implemented wherever possible.

Abnormalities, Radiation-Induced↗

The Chernobyl governmental program: two years of experience at the Belarusian Bone Marrow Transplant Centre.

The Bone Marrow Transplantation Program in Belarus was founded in 1992, and in 1993, a Bone Marrow Transplantation Centre was created in Minsk. From February 1994 to April 1996, 19 allogeneic bone marrow, 16 autologous bone marrow and 10 autologous peripheral blood stem cell transplantations were performed. Reasons for transplantation included chronic myeloid leukemia, multiple myeloma, severe aplastic anemia, acute myeloid leukemia, acute lymphoblastic leukemia, progressive myelofibrosis, Hodgkin's disease, non-Hodgkin's lymphoma, and neuroblastoma. Among the patients were two liquidators involved in the Chernobyl cleanup activity, both of whom underwent allogeneic bone marrow transplantation. A variety of ablative preparative regimens were used, and blood progenitor cells were mobilized by treatment with Cytoxan and granulocyte colony-stimulating factor. Therapy-related deaths resulted from graft-versus-host disease, septic shock, veno-occlusive disease bleeding and intestinal pulmonary fibrosis. Because the transplantation procedures were carried out on people who continued to be exposed to low-level irradiation, the post-transplantation period included a conservative strategy for prevention of graft-versus-host disease. There was nothing unusual about the post-transplantation period, although uncertainty about the continuing radiation dose should be taken into account when interpreting these data.

Adolescent↗

131I dose-dependent thyroid autoimmune disorders in children living around Chernobyl.

We assessed the major lymphocyte subsets in the peripheral blood, thyroid ultrasonography, levels of serum autoantibodies to thyroglobulin (AbTg), thyroid hormones, and thyroid-stimulating hormone (TSH) in 53 children without any chronic diseases living continuously around Chernobyl. The subjects ranged in age from 7 to 14 years and had different doses of 131I to their thyroid. Healthy children living on noncontaminated areas were assessed as controls. The majority of children with doses of 131I had normal levels of thyroid hormones. However, the percentages of positive sera for AbTg, TSH levels, ultrasonographic thyroid abnormalities, and abnormal echogenicity were significantly higher in children with doses of 131I than in controls. The dose of 131I to thyroid correlated positively with serum AbTg levels, percentage of CD3+CD4+ cells, and CD3+CD4+/CD3+CD8+ cell ratio and negatively with number of CD3+CD8+ and CD3-/CD16, CD56+ cells. Thus, our study demonstrates an association between dose of 131I and autoimmune thyroid disorders in this population of children.

Adolescent↗

Intraspecific variation in gamma-radiation resistance and genomic structure in the filamentous fungus Alternaria alternata: a case study of strains inhabiting Chernobyl reactor no. 4.

This is probably the first report on intraspecific variation in radiation resistance for filamentous fungi. It was revealed that natural ("field") strains of the filamentous fungus Alternaria alternata are extremely variable in response to gamma-irradiation ranging from supersensitive to highly resistant to radiation. At the same time nearly all strains originating from the highly radiation-polluted reactor of the Chernobyl (Ukraine) Nuclear Power Plant possessed high radiation resistance. The genome structure of strains studied by universally primed polymerase chain reaction (UP-PCR) was found to be well conserved in "reactor" but not in "control" strains. The "reactor" strains appear to be genetically adapted to this high radiation habitat by means of selection, thus providing a natural source of genetically homogeneous fungal lineages.

Alternaria↗

Pregnancy outcome in Sweden after the Chernobyl accident.

OBJECTIVE: To study pregnancy outcome including development of childhood cancer in areas within Sweden with the highest radioactive fallout after the Chernobyl accident in 1986. METHODS: Various Swedish health registries were used in order to identify all pregnancies and their outcome in Sweden according to the measured radioactive fallout. RESULTS: A reduction in conception rate occurred after the accident, as well as possible increase in induced abortion rate during the fall after the accident. No changes in the rate of spontaneous abortions or congenital malformations occurred in pregnancies exposed at the time of the accident. There was a temporary increase in low birth weight which could well be random. Among infants conceived after the accident, a slight excess of Down syndrome infants was found in the most exposed areas but this observation is based on small numbers. No certain excess of childhood cancer was seen in the most exposed areas, but three infants, in utero at the time of the accident, developed leukemia. CONCLUSIONS: No major effects on pregnancy outcome were seen but the indicated increase in Down syndrome and childhood leukemia--if not random--could be a result of radioactive exposure.

Abortion, Spontaneous↗

Changes in incidence of carcinoma in situ after the Chernobyl disaster in central Europe.

The data files from an extensive cytological screening program for cervical intraepithelial neoplasia from a regional Czech hospital were analyzed. The data collection span is from 1985 to 1991 and shows highly significant maximum effects in the years 1988-1989, i.e., shortly after the Chernobyl accident. The increase was concordantly found in all the age categories, but the reaction seems to be faster in younger women. The delayed maximum effect (two years after the accident) also corresponds to the course of total foodstuffs burden and total-body activity.

Adult↗

Hungarian surveillance of germinal mutations. Lack of detectable increase in indicator conditions caused by germinal mutations following the Chernobyl accident.

The Hungarian surveillance of germinal mutations is based on three indicator conditions seen in offspring, i.e., 15 sentinel anomalies, Down syndrome and component anomaly pairs of unidentified multiple congenital anomalies. It is an "opportunistic program," because the necessary data are available from the Hungarian Congenital Malformation Registry. This system is described and the criteria of a good registry are summarized. The analysis of indicator conditions caused by germinal mutations did not reveal any measurable mutagenic effects in Hungary following the accident at the Chernobyl nuclear power plant. The pros and cons of germinal mutation surveillance are discussed.

Abnormalities, Multiple↗

[The strength of evidence of the food inspection after the Chernobyl accident proven by whole body measurements of Basel students].

The radioactive contamination of the food consumed by the inhabitants of Basel after the Chernobyl fallout has been continuously controlled by our laboratory. The activity of ingested Cs-137 has been estimated and is compared here with the activity obtained through whole body counts. The satisfactory correlation between calculated and observed body activities enables an exact estimation of the people's doses applying the same model and demonstrate the reliability of the food control analysis.

Accidents↗

[The transfer of 137Cs and 90Sr into flour, bran and straw from wheat, rye, barley and oats in the years 1982, 1986 (reactor accident in Chernobyl) and 1987 in field studies].

The specific activity of 137Cs and 90Sr from the global fallout, as well as from the fallout after the reactor accident at Chernobyl, was determined in flour, bran and straw from wheat, rye, barley and oats as well in the corresponding soils (Cambisol). The results show that the activity of 137Cs, but not of 90Sr, in the plant material was considerably higher in 1986, and still to some extent in 1987, compared to 1982. For 137Cs an 90Sr, as well as for most cereal samples, the activity in the bran and straw was significantly higher than in the flour. Determination of stable potassium and calcium in all samples revealed that this enrichment is, to a large extent, the result of a comparable enrichment of these elements in brans and straw. The plant/soil concentration ratios, averaged over all cereals, were for 137Cs (1982 and 1987): flour 0.026 +/- 0.018; bran 0.079 +/- 0.042; straw 0.055 +/- 0.027. For 90Sr (1982, 1986, and 1987): flour 0.19 +/- 0.095; bran 0.70 +/- 0.23; straw 2.35 +/- 0.82.

Accidents↗