The objective of the European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS) is to investigate trends in incidence rates of childhood leukaemia and lymphoma in Europe, in relation to the exposure to radiation which resulted from the accident at the Chernobyl nuclear power plant in April 1986. In this first report, the incidence of leukaemia in children aged 0-14 is presented from cancer registries in 20 European countries for the period 1980-1988. Risk of leukaemia in 1987-1988 (8-32 months post-accident) relative to that before 1986, is compared with estimated average dose of radiation received by the population in 30 geographic areas. The observed changes in incidence do not relate to exposure. The period of follow-up is so far rather brief, and the study is planned to continue for at least 10 years.
To assess effects of fallout from Chernobyl on incidence of childhood leukaemia in Finland.
Nationwide cohort study. External exposure measured for 455 Finnish municipalities with instruments driven 19,000 km throughout the country. Values specific to municipalities corrected for shielding due to houses and fallout from A bomb testing. Internal exposure estimated from whole body measurements on a random sample of 81 children. Mean effective dose for two years after incident calculated from these measurements. Data on childhood leukaemia obtained from Finnish cancer registry and verified through hospitals treating childhood cancers.
Finland, one of the countries most heavily contaminated by the Chernobyl accident; the population was divided into fifths by exposure.
Children aged 0-14 years in 1976-92.
Standardised incidence ratio of childhood leukaemia and relative excess risk of childhood leukaemia per mSv. From incidence data of Finnish cancer registry for 1976-85, expected numbers specific to sex and age group (0-4, 5-9, and 10-14 years) were calculated for each municipality for three periods (1976-85, 1986-8, and 1989-92) and pooled as exposure fifths. Dose response was estimated as regression slope of standardised incidence ratios on mean doses for fifths for each period.
Population weighted mean effective doses for first two years after the accident were 410 microSv for the whole country and 970 microSv for the population fifth with the highest dose. In all Finland the incidence of childhood leukaemia did not increase 1976-92. The relative excess risk 1989-92 was not significantly different from zero (7% per mSv; 95% confidence interval -27% to 41%).
An important increase in childhood leukaemia can be excluded. Any effect is smaller than eight extra cases per million children per year in Finland. The results are consistent with the magnitude of effect expected.
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Comment In: BMJ. 1994 Nov 12;309(6964):12997888859
An international committee (2) which has studied the health and environmental effects of the Chernobyl accident within the borders of the former Soviet Union does not expect that any increase in cancer frequency among adults can be demonstrated epidemiologically. However, the possibility of an observable increase in the incidence of thyroid cancer and increase in juvenile leukemia could not be excluded. The statistics in Sweden is more accurate, though the radiation doses were significantly lower. It would appear to be unlikely that any changes in cancer incidence (even among children), in mental development in children, in malformations or genetic changes ascribable to the Chernobyl accident will ever be demonstrated in Sweden.
Petridou et al.  have reported an increase in infant leukemia in Greek children born between 1/7/86 and 31/12/87 and have linked this increase to in utero radiation exposure due to the Chernobyl accident. Subsequently, Michaelis et al.  have reported a similar trend for Germany but found that it was not correlated to the levels of contamination. For Belarus, which was much more severely affected, a similar but much weaker trend is found.
On April 26, 1986 a major nuclear disaster took place at 1 h 24 min local time, destroying the fourth reactor of the Chernobyl plant. Five years later the consequences of the disaster are still not fully known. Nevertheless the long term future of nuclear energy in the world is uncertain. Questions need to be answered by observing hard facts if emotional attitudes are not to prevail over reality. The reactor and its core were destroyed by an explosion, causing two radioactive jet emissions of iodine 131, followed by caesium 137. Both elements are mainly incorporated in the body via food. The Chernobyl disaster was a consequence of inadequate safety regulations and human error. Enforcement of strict regulations are likely to be highly effective in preventing a further catastrophe. However, governments should consider another possibility. What would be the consequences for public health if a terroristic act deliberately destroyed a nuclear power station?
Hemoblastosis morbidity in children and adult populations and its structure were studied during the period of 1981-1992 at Rovensky district of Ukraine, 6 northern districts of which were affected by radionuclides after Chernobyl AES accident. Primary documentation, actual and archival records were the object of study: registration diaries, records and ambulatory cards. Expeditional method of investigation. During the last 11 years a rise of hemoblastosise morbidity was stated in Rovensky district, especially after the accident, and it was confirmed by a profound statistical analysis of data on leukemia morbidity before and after the accident. Among different nosological forms after the accident the rate of leukemia morbidity as well as myeloma disease and malignant lymphoma morbidity, rose markedly. No significant difference was marked in hemoblastoses (excluding acute leukemia) in non-contaminated and contaminated with radionuclides regions of the district, and in contaminated zones depending on effective equivalent doze. Acute leukemia morbidity in contaminated regions after the accident was statistically reliably higher.
The paper deals with the problems in the case follow-up of the population exposed to radiation caused by the accident at the Chernobyl Atomic Power Station on the basis of the automated systems for collecting and processing medical information. A number of organizational, medical, technological, computational problems in setting up teh National Distribution Registry should be solved for a complete and long-term follow-up. A differential approach was proposed to the information provision of health care services and to the determination of a population size and principles of selecting the populations to be followed up in the Registry.