AIM: To study whether Chernobyl accident has implications for acute leukemia (AL) incidence rate in Donetsk region. MATERIALS AND METHODS: Records of the Donetsk regional hematological center for new verified cases of AL have been analysed for 1977-1987 and 1989-1994. RESULTS: Four years after the accident AL morbidity was higher than before the accident. After 1991 AL morbidity returned to the preaccident level. CONCLUSION: A rise in AL incidence is attributed to radionuclide contamination after the Chernobyl accident of a region with initially unfriendly environment.
During 1993-1997, 247 cases of childhood acute leukemia (AL) were analyzed among inhabitants of the city of Kiev and Kiev region, excluding the most contaminated areas belonging to the strict control zone. The criteria of an FAB classification supplemented by immunophenotyping data were applied. The AL pattern was shown to be quite typical except for several peculiar features characteristic of this regional group of patients, especially the absence of age peaks in children with acute myelogenous leukemias (AML), increased frequency of the T1 variant in T-cell acute lymphoblastic leukemia (ALL), and higher levels of M4 and M5 variants in AML. A typical variant of M5a-AML with minimal signs of differentiation was found.
A case-referent study that investigated possible associations between environmental and occupational exposures and acute myeloid leukemia was performed on 86 cases and 172 referents, all of whom were living. Exposure information was obtained through a questionnaire mailed to each subject. An association was found between time spent in concrete buildings at home and work and leukemia morbidity. In addition, extensive x-ray examinations that occurred more than 5 y prior to diagnosis were more common among cases than referents.
[Analysis of the epidemiological data concerning radiation carcinogenic effects and approaches to the low doses' upper limits determination in the aspect of a threshold of the unhealthy influences of ionizing radiation]
The analysis of the epidemiological data regarding cancer mortality in cohorts of Japanese A-bomb survivors and Chermobyl liquidators exposed to different doses suggests that there are good reasons for recognizing the threshold of the radiocarcinogenic effect in the region of about 200 Gy (mSv). The analysis of solid cancer mortality in Japanese cohort, which exceeded the expected one in a dose diapason of 5-200 mSv, revealed a (quasi) plateau in a dose-effect curve and led to the conclusion that the nature of the overshoot is non-radiogenic. The analysis of supposedly dose dependent leucosis incidence in the limited low dose diapason in the Chernobyl cohort showed that the real coefficient of the excess absolute or relative radiation risk could not be received in the case because the larger part curve was placed under the control level. In supporting the principle of single hit in a cell nucleus as a base of microdosimetric determination of low radiation doses, the approach to objective delimitation between low, intermediate and high doses regions has been proposed. The low doses upper limit of sparse ionizing radiation for cell nucleus of 8 microns in diameter has been evaluated as 0.65 mGy. It can serve for evaluation of the dose rate threshold regarding the safe chronic radiation levels in the environment.
Cancer has long been known to be a hazard of exposure to ionizing radiation. However, the assessment of health effects from exposure to radiation is a matter of considerable controversy. This paper presents results of a retrospective study of leukemia incidence (203-207, ICD-9) around the highest 137Cs pollution in Poland (as an effect of the Czarnobyl disaster and/or military bomb tests). The data relating to all the registered leukemias in males and females originated from the Regional Cancer Registry in Opole. The information on 137Cs concentration rates in Opole province was derived from the state monitoring provided by the Polish Geological Institute in Warsaw. The spatial analysis--based on the random-effects Poisson regression model--was carried out via the Markov Chain Monte Carlo (MCMC) technique (Gibbs sampling) using BUGS software. The model incorporated epidemiological data and an ecological covariate--isotope concentrations--and provided a framework for estimating the strength of a dose-response relationship. The differences in incidence levels were quantified by traditional standardized morbidity ratios (SMRs) and presented in thematic maps as well as in combined charts of distance-disease-dose relations. Additionally, to assess spatial disease clustering, a Tango test was adopted. The results of this ecological study suggest that the 137Cs concentrations did not have any negative influence on the exposed population.
The effect of potential risk factors for acute myeloid leukemia was evaluated in a case-referent study encompassing 59 cases and 354 referents, all of whom were alive. Information on exposure was obtained through a questionnaire mailed to the subjects. The possible effect of background radiation was evaluated by means of a gamma radiation index, which accounted for the differences between cases and referents in this respect, i.e., in time spent in concrete buildings both at home and at work places. In the 20-54 yr old age group, there was an association between leukemia morbidity and index of background radiation. X-ray treatment and electrical work were also associated with increased rate ratios. With regard to solvents, only styrene appeared as a risk factor, but the number of exposed subjects was small. Other exposures were less clearly associated with increased risks.
The accident which occurred during the night of April 25-26, 1986 in reactor 4 of the Chernobyl nuclear power plant in the Ukraine released considerable amounts of radioactive substances into the environment. Outside the former USSR, the highest levels of contamination were recorded in Bulgaria, Austria, Greece and Romania, followed by other countries of Central, Southeast and Northern Europe. Studies of the health consequences of the accident have been carried out in these countries, as well as in other countries in Europe. This report presents the results of a critical review of cancer studies of the exposed population in Europe, carried out on the occasion of the 10th anniversary of the Chernobyl accident. Overall, three is no evidence to date of a major public health impact of the Chernobyl accident in the field of cancer in countries of Europe outside the former USSR.
The radioactive fallout from the Chernobyl accident, on 26 April 1986, has caused contamination of very wide areas of the northern hemisphere, in particular in Europe, causing chronic exposure of millions of people to a mixture of external and internal radiation. This paper summarizes the epidemiological studies published to date on the risks of cancer following the Chernobyl accident. An increase in the incidence of thyroid cancer observed among those exposed in childhood and adolescence in the most contaminated territories of Belarus, Russia and Ukraine is at present the only scientifically demonstrated radiation-related increase in cancer incidence. This observation provided important information on the risk of thyroid cancer related to 131I and on factors, such as iodine deficiency and stable iodine supplementation, which can modify this risk. The reports on increases in the incidence of other types of cancer are difficult to interpret because of methodological limitations. As the majority of these studies cover a relatively short time period, it is not possible to fully evaluate the radiological impact of the accident, and it is premature to draw conclusions on the risk of cancers other than that of thyroid. Predictions, based on the experience of other populations exposed to ionizing radiation, suggest that a substantial number of cancers could occur in Europe, especially in the most contaminated areas. Well-focused studies could verify these predictions, in particular with regard to the risks of leukaemia among liquidators and breast cancer among young women in the most contaminated areas.
BACKGROUND: Studies of groups of patients given injections of the alpha-emitting x-ray contrast medium Thorotrast may provide information on human alpha-ray carcinogenesis. PURPOSE: We re-established a formerly identified cohort of neurological patients receiving injections of Thorotrast for cerebral arteriography and assessed their incidence of cancer. METHODS: Using the national population register, the Danish Cancer Registry, and other registers, we determined the incidence of cancer among Thorotrast-injected patients. Incidence ratios were standardized to the general population and computed for different cancer sites. RESULTS: The cumulative risk for cancer at all sites (excluding brain tumors where the standardized incidence ratio [SIR] was 28) reached 86% 50 years after Thorotrast injection. SIR was greatly elevated at all sites except the brain and CNS (3.3, 95% confidence interval = 3.0-3.7), mainly because of liver cancers (SIR = 126) as well as leukemia (SIR = 10) for which a relationship was found between the time since injection and the estimated dose (but not the age at injection). Other sites with significantly increased risks of cancer included the gallbladder and extrahepatic bile ducts (SIR = 14), peritoneum (SIR = 8.6), sites of multiple myeloma (SIR = 4.6), metastatic sites (SIR = 12), and unspecified sites (SIR = 11). Cancers of the lung and breast also occurred in significant excess, but no relationship between SIR and volume of injected Thorotrast or time since injection was observed. Cancer risk was increased at most other sites, although this increase was not statistically significant. CONCLUSION: Alpha radiation may account for the increased risk of tumors of the liver, gallbladder, and peritoneum as well as leukemia and multiple myeloma, whereas confounding factors most probably contribute to the increased risks at other sites.