The nuclear accident at Chernobyl accounted for an acute radiation syndrome in 237 persons on the site. Triage was the initial problem and was carried out according to clinical and biological criteria; evaluating the doses received was based on these criteria. Thirty one persons died and only 1 survived a dose higher than 6 Gy. Skin radiation burns which were due to inadequate decontamination, greatly worsened prognosis. The results of 13 bone marrow transplantations were disappointing, with only 2 survivors. Some time after the accident, these severely irradiated patients are mainly suffering from psychosomatic disorders, in the USSR, some areas have been significantly contaminated and several measures were taken to mitigate the impact on population: evacuating 135,000 persons, distributing prophylactic iodine, establishing standards and controls on foodstuff. Radiation phobia syndrome which developed in many persons, is the only sanitary effect noticed up to now. Finally, in Europe, there was only an increase in induced abortions and this was totally unwarranted. If we consider the risk of radiation induced cancer, an effect might not be demonstrated.
Presented are the results of morphological studies of radiation sickness, congenital malformations and malignant tumors which have developed in Chemobyl victims. Until now consequences of the accident remain a subject of practical and research medicine. Scope of relevant topical problems the pathologists will have to investigate in the future is discussed.
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.
Comment In: BMJ. 1989 May 20;298(6684):13842502266
In Norway, external doses of radiation resulting from fallout from the Chernobyl nuclear accident were estimated from detailed measurements, including soil deposition patterns. Internal doses were estimated from measurements of radioactive cesium in meat and milk supplies. The doses were calculated as average monthly doses for each of 454 municipalities during 36 consecutive months after the accident in spring 1986. Prospectively collected data on all newborns listed in the Medical Birth Registry of Norway who were conceived in the period May 1983-April 1989 were used to assess possible dose-response relations between estimated external and food-based exposures and congenital malformations and some other conditions. A positive association was observed between total radiation dose (external plus food-based) and hydrocephaly, while a negative association was observed for Down's syndrome. However, an important conclusion of the study was that no associations were found for conditions previously reported to be associated with radiation, i.e., small head circumference, congenital cataracts, anencephaly, spina bifida, and low birth weight. Potential sources of bias, including exposure misclassification and incomplete ascertainment of cases, are discussed.
This study considers whether or not exposure to radioactive fallout from the Chernobyl accident led to an increased prevalence of congenital malformations in infants born in Bavaria, the German state with the highest levels of contamination after the accident. The odds ratios for major malformations after the accident relative to before were used as indicators for adverse health effects. Since measurements of caesium in soil showed that contamination was considerably higher in Southern Bavaria than in Northern Bavaria, the odds ratios were calculated for both regions separately. Analysis did not show a significant increase in any of the odds ratios of the selected malformations in Southern Bavaria as compared to Northern Bavaria. Consequently, this study provides no evidence that radiation from Chernobyl caused an increase in the birth prevalence of major congenital malformations.
BACKGROUND: Cleft lip and palates (CLP) occur with a frequency of between 1 and 2 cases in 1000 live births and thus belong to the most frequent congenital anomalies. In the former German Democratic Republic (GDR), records covering 1967-1989 for CLP newborns show a 9.4% increase of the prevalence of CLP from 1987 to 1989, possibly due to Chernobyl. DATA AND STATISTICAL METHOD: In Bavaria, all congenital malformations in children's hospitals have been recorded from 1984 to 1991. Among these data, 1324 cases with CLP were found. A spatial-temporal analysis aimed at uncovering a possible association of the CLP occurrence with the Chernobyl fallout on a district level, as well as a synoptic analysis of the GDR and Bavarian data, were carried out. RESULTS: In Bavaria, from October 1986 to December 1990, the CLP frequency increased by 9.5% (p=0.10) relative to the trend as computed from the remaining years. The association of CLP rates with fallout on a district level is reflected by a significant relative risk (RR) per kBq/m(2) of RR=1.008 (p=0.03). A synoptic analysis of the Bavarian data and the GDR data restricted to the overlapping time window from 1984 to 1989 discloses a simultaneous significant jump of the CLP prevalence by 8.6% (p=0.02) after 1986. CONCLUSION: The presumption of a long-term increase of CLP after exposure to Chernobyl fallout is corroborated by the analysis of the Bavarian congenital malformation data.
In this study, we analyzed the frequency, type and sex distribution of congenital anomalies of the central nervous system (CNS) at autopsy in the period prior to and after the Chernobyl accident in northwest Croatia, one of the areas with the highest exposure to nuclear contamination from Chernobyl. All autopsies in both periods were performed by the same technique, i.e. dissection of the trunk and head, and inspection of the extremities. There were 53 infants with congenital anomalies of the CNS in the period prior to, and 99 in the period after the Chernobyl accident. Our results showed a statistically significant increase in the incidence of CNS anomalies in general (chi 2 = 4,719, p