This section describes the spectrum and the scale of the nonmalignant diseases that have been found among exposed populations. Adverse effects as a result of Chernobyl irradiation have been found in every group that has been studied. Brain damage has been found in individuals directly exposed--liquidators and those living in the contaminated territories, as well as in their offspring. Premature cataracts; tooth and mouth abnormalities; and blood, lymphatic, heart, lung, gastrointestinal, urologic, bone, and skin diseases afflict and impair people, young and old alike. Endocrine dysfunction, particularly thyroid disease, is far more common than might be expected, with some 1,000 cases of thyroid dysfunction for every case of thyroid cancer, a marked increase after the catastrophe. There are genetic damage and birth defects especially in children of liquidators and in children born in areas with high levels of radioisotope contamination. Immunological abnormalities and increases in viral, bacterial, and parasitic diseases are rife among individuals in the heavily contaminated areas. For more than 20 years, overall morbidity has remained high in those exposed to the irradiation released by Chernobyl. One cannot give credence to the explanation that these numbers are due solely to socioeconomic factors. The negative health consequences of the catastrophe are amply documented in this chapter and concern millions of people.
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.
The Chernobyl Forum Report from the 20th anniversary of the Chernobyl nuclear power plant disaster concluded that mental health effects were the most significant public health consequence of the accident. This paper provides an updated review of research on the psychological impact of the accident during the 25 year period since the catastrophe began. First responders and clean-up workers had the greatest exposure to radiation. Recent studies show that their rates of depression and post-traumatic stress disorder remain elevated two decades later. Very young children and those in utero who lived near the plant when it exploded or in severely contaminated areas have been the subject of considerable research, but the findings are inconsistent. Recent studies of prenatally exposed children conducted in Kiev, Norway and Finland point to specific neuropsychological and psychological impairments associated with radiation exposure, whereas other studies found no significant cognitive or mental health effects in exposed children grown up. General population studies report increased rates of poor self-rated health as well as clinical and subclinical depression, anxiety, and post-traumatic stress disorder. Mothers of young children exposed to the disaster remain a high-risk group for these conditions, primarily due to lingering worries about the adverse health effects on their families. Thus, long-term mental health consequences continue to be a concern. The unmet need for mental health care in affected regions remains an important public health challenge 25 years later. Future research is needed that combines physical and mental health outcome measures to complete the clinical picture.
The Chernobyl accident resulted in a number of cases of thyroid cancer in females under the age of 20 y. Many of these individuals were treated with surgical removal of the thyroid gland followed by 131I ablation of residual thyroid tissue. Epidemiologic evidence demonstrates that 131I treatment for thyroid cancer or hyperthyroidism in adult women confers negligible risk of breast cancer. However, comparable data for younger women do not exist. Studies of external radiation exposure indicate that, for radiation exposures of as low as 0.2-0.7 Gy, the risk of breast cancer is greater for infant and adolescent female breast tissues than for adult female breast tissues. METHODS: The effective half-time of 131I measured in athyrotic patients was used together with the OLINDA/EXM computer code to estimate doses to breast tissue in 10-y-old, 15-y-old, and young adult females from ablation treatment. RESULTS: The dose to pediatric and young adult female breast tissue associated with a 5.6-GBq (150 mCi) ablation treatment may range from 0.35 to 0.55 Gy, resulting in a lifetime risk of breast cancer ranging from 2-4 cases per 100 such individuals exposed and a lifetime risk of solid tumors ranging from 8 to 17 solid tumors per 100 such individuals exposed. Administration of multiple ablation treatments, as often occurs with metastases, could result in doses ranging from 0.7 to 1 Gy, with corresponding increases in the lifetime cancer risk. CONCLUSION: These estimates suggest the need for additional research and a possible need for surveillance of young Chernobyl thyroid cancer patients who received 131I ablation treatment.
The nuclear accidents at Chernobyl and Fukushima released large amounts of (137)Cs radionuclides into the atmosphere which spread over large forest areas. We compared the (137)Cs concentration distribution in different parts of two coniferous forest ecosystems (needle litter, stems and at different depths in the soil) over short and long term periods in Finland and Japan. We also estimated the change in (137)Cs activity concentrations in needle and soil between 1995 and 2013 in Southern Finland based on the back-calculated (137)Cs activity concentrations. We hypothesized that if the (137)Cs activity concentrations measured in 1995 and 2013 showed a similar decline in concentration, the (137)Cs activity concentration in the ecosystem was already stable in 1995. But if not, the (137)Cs activity concentrations were still changing in 2013. Our results showed that the vertical distribution of the (137)Cs fallout in the soil was similar in Hyytiälä and Fukushima. The highest (137)Cs concentrations were observed in the uppermost surface layers of the soil, and they decreased exponentially deeper in the soil. We also observed that (137)Cs activity concentrations estimated from the samples in 1995 and 2013 in Finland showed different behavior in the surface soil layers compared to the deep soil layer. These results suggested that the (137)Cs nuclei were still mobile in the surface soil layers 27 years after the accident. Our results further indicated that, in the aboveground parts of the trees, the (137)Cs concentrations were much closer to steady-state when compared to those of the surface soil layers based on the estimated declining rates of (137)Cs concentration activity in needles which were similar in 1995 and 2013. Despite its mobility and active role in the metabolism of trees, the (137)Cs remains in the structure of the trees for decades, and there is not much exchange of (137)Cs between the heartwood and surface layers of the stem.
This study examines the molecular pathways of cell-cell communication in chronic inflammatory processes associated with long-term low-dose urinary bladder exposure to ionizing radiation in people without major disease living more than 19 years in radio-contaminated areas of Ukraine after the Chernobyl accident. Patterns of components of the E-cadherin/beta-catenin complex, and transforming growth factor-beta1 (TGF-beta1) and inducible nitric oxide synthase (iNOS) expression were immunohistochemically evaluated in urinary bladder biopsies from 52 males with benign prostate hyperplasia and 8 females with chronic cystitis (group 1). For comparison, 25 males and 6 females living in non-contaminated areas of Ukraine were also investigated (group 2). Fourteen patients with primary urothelial carcinomas, which were operated on before the Chernobyl accident, were included as a carcinoma group. Chronic proliferative atypical cystitis ('Chernobyl cystitis') was observed in group 1 patients. Foci of dysplasia and carcinoma in situ were found in 51 (85%) and 34 (57%) of the 60 cases, respectively. Chronic cystitis with areas of dysplasia was detected in only 4 (13%) cases of 31 group 2 patients. Statistically significant differences in immunohistochemical scores for TGF-beta1 in the urothelium and lamina propria, iNOS in the urothelium and both beta-catenin and E-cadherin in the cytoplasm were observed between groups 1 and 2 with marked expression in group 1. Furthermore, TGF-beta1 overexpression and alteration in E-cadherin/beta-catenin complexes in bladder urothelium might play a crucial role in urinary bladder carcinogenesis in humans exposed to long-term low-dose ionizing radiation.
Irritable bowel syndrome is observed mostly in Ukrainian children and may be related to adverse health effects as a result of the Chernobyl disaster. The aim of this study was to determine status of T-cell population lymphocytes in children with clinical symptom of irritable bowel syndrome. The test population consisted of 95 participants: 75 rural patients aged 4 to 18 who lived in a contaminated area exposed to natural environmental radiation with clinical symptom of irritable bowel syndrome (categorized in three groups) and 20 healthy urban participants from Kiev aged 5 to 15 as control group. Internal radiation activity has been measured by gamma-ray spectrometry. Peripheral blood leukocytes were analyzed for T-lymphocytes subset such as T-lymphocytes (CD3(+)), T-helper (CD4(+)) and T-cytotoxic (CD8(+)) and then CD4/CD8 ratio was calculated. Percentage of CD3(+) and CD4(+) in all study groups decreased significantly in comparison to control group (p
Peculiarities of changes of the endothelium-dependent and endothelium-independent vascular reactions of relaxation, and the content of oxygen free radicals and stable metabolites of nitric oxide (NO) were studied in the aorta preparations of BALB/c mice of the two age groups (6 and 18 months), which were born and lived in the Chernobyl alienation zone. The results obtained showed no endothelium-dependent reactions of aortal smooth muscles relaxation to acetylcholine and only partially impaired endothelium-independent reactions to sodium nitroprusside in animals of both age groups. There was a significant decrease in the content of high-molecular nitrosothiols (HMNT) in old animals, which may signify a depletion of NO depot in the aorta. A decrease of HMNT levels induced an increase of the shares of anion nitrite and low-molecular nitrosothiols (LMNT) in the total amount of endogenous donors of NO in the aorta of old animals. Exposure of old animals to low doses of radiation resulted in an over 3-fold increase of LMNT. In old mice the levels of oxygen active forms, superoxide and hydroxyl radicals increase, while the level of H2O2 remained unchanged.
Individual measurement data on radiological surveillance of people residing in the territories most radioactively contaminated following the Chernobyl accident are analyzed to provide a comparison of doses from caesium radionuclides to children and adults. The external doses to children does not exceed those to adult inhabitants of the same settlement. By the results of surveillance in 1986 more than 80 thousand inhabitants of the western areas of Bryansk region, a specific activity of caesium radionuclides and corresponding internal radiation dose rate in a number of settlements appeared at children age under 3 years old exceeding the appropriate parameters for adult inhabitants. Among persons evacuated from the contaminated areas, such excess in day of departure from an area averaged 3.8 for surveyed pairs the child-parent.