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 article describes the nutritional measures introduced to protect health after the Chernobyl accident, and the associated costs. The total value of the reindeer meat, mutton, lamb and goat meat saved as a result of such measures in 1987 amounted to approx. NOK 250 million. The measures cost approx. NOK 60 million. The resulting reduction in the radiation dose level to which the population was exposed was 450 manSv. In 1988, mutton/lamb and goat meat valued at approx. NOK 310 million was saved from condemnation by similar measures, which cost approx. NOK 50 million. The resulting dose level reduction was approx. 200 manSv. The relationship (cost/benefit ratio) between the overall cost of the measures taken to reduce radioactivity levels in food and the dose level reduction achieved was acceptable.
Pregnancy outcome has been studied in terms of legal abortions, early spontaneous abortions and total number of pregnancies (in an ad hoc study covering 6 counties) as well as various perinatal health problems (on the basis of routinely recorded data for epidemiological surveillance from the Medical Birth Registry of Norway). Apparently, no effects were observed in terms of an increased occurrence of legal abortions, while spontaneous abortions increased from 7.2% of all pregnancies during the last 12 months before the accident to 8.3% after the accident [corrected]. At the same time, the total number of pregnancies somewhat decreased. Based on monthly measurements in each municipality of external and internal (food-based) doses, dose-response associations were assessed for a number of perinatal health problems. No associations were observed.
Accidents and disasters involving ionizing radiation are rare. Such accidents may occur not only at nuclear power stations but also in medicine and in industry. Only fairly large radiation doses can give acute medical effects. Symptoms and signs depend on the actual dose, and on what parts of the body are irradiated. In connection with a radiation accident, the main points are to recognize in the first place that radiation may be involved, and to have some knowledge of the actual source. Risk of localized irradiation from industrial sources, especially of hands, is a problem that is often overlooked. The paper reviews the principles for action by local health officers, the pathogenesis of radiation injury and early medical management. Some information is also given on the Norwegian system of contingency preparedness against nuclear accidents.