Chornobyl: the medical consequenses - legacy 40 years after the accident
DOI:
https://doi.org/10.32402/dovkil2025.04.034Keywords:
Chornobyl, radiation exposure, dosimetric monitoring, cancer morbidity, multimorbidity, clean-up workers, 137CsAbstract
Introduction. Nearly 40 years after the Chernobyl Catastrophe, its health effects remain significant for health of the population of Ukraine. Most affected groups include clean-up workers, evacuees, and residents of the radioactively contaminated territories. The aim. To systematize current data on cancer and non-cancer morbidity, mortality, disability, and dose-related factors in the main exposed cohorts; and to define health priorities ahead of the 40th anniversary of the accident. Materials and Methods. Sources include data from the State Registry of Chornobyl victims, long-term epidemiological studies, radiation and hygiene monitoring and dosimetric passportization of settlements. Main indicators: standardized incidence ratios (SIR), excess relative risk (ERR/Gy), mortality structure, and multimorbidity prevalence. Results. Clean-up workers have been found to have an increased cancer incidence (SIR>1), in particular thyroid cancer and leukemia (ERR/Gr>0). The dominance of non-oncological pathology of the cardiovascular, cerebrovascular, endocrine, and respiratory systems has been determined. Increased mortality of victims since the late 1990s and an increase in multimorbidity have been recorded. Current exposure is formed mainly due to the internal accumulation of 137Cs. The full-scale war of 2022 has complicated access to medical care. Conclusions. The high level of cancer morbidity and mortality among victims remains, the main causes of mortality remain cardiovascular and cerebrovascular diseases, and comorbidity plays an important role. Radiation and non-radiation factors of the Chernobyl disaster have a persistent negative impact on health. It is necessary to restore dosimetric control, registry surveillance and international cooperation for effective monitoring and prevention of radiological and medical consequences.Downloads
References
1. Trydtsiat piat rokiv Chornobylskoi katastrofy: radiolohichni ta medychni naslidky, stratehii zakhystu ta vidrodzhennia: Natsionalna dopovid Ukrainy [Thirty-five years of the Chornobyl catastrophe: radiological and medical consequences, strategies of protection and revival: National Report of Ukraine]. Eds Bazyka DA. (chief editor), Tronko MD, Antypkin YG, Sushko VO. Kyiv, 2022. 286 p. In Ukrainian. URL: https://nrcrm.gov.ua/downloads/2021/national_report_2021.pdf. I
2. Cardis E, Hatch M. The Chernobyl accident-an epidemiological perspective. Clin Oncol (R Coll Radiol). 2011 May;23(4):251-60. DOI: https://doi.org/10.1016/j.clon.2011.01.510
3. Sushko VO, Kolosynska OO, Apostolova OV. Structure and characteristics of the Chornobyl NPP accident survivors reasons of death according to the materials of medical expertise for the causal relationship of diseases with the effect of ionizing radiation in the remote postaccidental period (2024 year). Probl Radiac Med Radiobiol. 2024;29:419-424. In English, in Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2024-29-419-424
4. Zakon Ukrainy vid 28 liutoho 1991 r. № 796-XII «Pro status i sotsialnyi zakhyst hromadian, yaki postrazhdaly vnaslidok Chornobylskoi katastrofy». [Ukraine. Law of Ukraine No. 796-XII of 28 Feb 1991. «On the status and social protection of citizens who suffered as a result of the Chornobyl catastrophe»]. In Ukrainian. URL: https://zakon.rada.gov.ua/laws/show/796-12#Text
5. Likhtarov LА, Kovgan LМ, Tabachnyi LYa, et al. Radiatsiino-dozymetrychna pasportyzatsiia naselenykh punktiv terytorii Ukrainy, shcho postrazhdaly vid radioaktyvnoho zabrudnennia vnaslidok Chornobylskoi avarii, vkliuchaiuchy dozymetrychnu pasportyzatsiiu shchytovydnoi zalozy. Instruktsii ta praktychni rekomendatsii: «Metodyka-96». [Radiation and dosimetric passportization of the settlements of Ukrainian territory which suffered from radioactive contamination as a consequence of the Chornobyl accident, including thyroid dosimetric passportization. Instructions and practical policies: «Methods-96»]. Ministry of Health of Ukraine, Ministry of Affairs of Population Protection from the Consequences of Chornobyl Catastrophe of Ukraine, RCRM AMS of Ukraine, RPI ATS of Ukraine. Kyiv; 1996. 74 p. In Ukrainian.
6. Zahalna dozymetrychna pasportyzatsiia ta rezultaty monitorynhu leikotsytiv u naselenykh punktakh Ukrainy, zabrudnenykh vnaslidok Chornobylskoi avarii. Dani za 2011 rik. Zbirnyk 14. [General dosimetric passportization and results of WBC monitoring in the settlements of Ukraine, which contaminated by Chornobyl accident. Data for 2011. Collection 14]. Kyiv; 2012. 99 p. In Ukrainian.
7. Zahalna dozymetrychna pasportyzatsiia ta rezultaty monitorynhu leikotsytiv u naselenykh punktakh Ukrainy, zabrudnenykh vnaslidok Chornobylskoi avarii. Dani za 2012 rik. Zbirnyk 15. [General dosimetric passportization and results of WBC monitoring in the settlements of Ukraine, which contaminated by Chornobyl accident. Data for 2012. Collection 15]. Kyiv; 2013. 33 p. In Ukrainian.
8. Bazyka DA, Sushko VO, Ivanova OM, Vasylenko VV, Bilonyk AB, Fedosenko GV, Buderatska VB, Boiko ZN, Chepurny MI, Kuriata MS, Morozov VV, Gorbachov SG, Masiuk SV. On the methodology of passport doses calculation for Ukrainian settlements radioactively contaminated due to the Chornobyl NPP accident. Probl Radiac Med Radiobiol. 2023;28:110-142. In English, in Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2023-28-110-142
9. Masiuk SV, Vasylenko VV. Kompleksna dozymetrychna pasportyzatsiia naselenykh punktiv Ukrainy. Cherez trydtsiat piat rokiv Chornobylskoi katastrofy: radiolohichni ta medychni naslidky, stratehii zakhystu ta vidrodzhennia: Natsionalna dopovid Ukrainy [Integrated dosimetric passportization of settlements of Ukraine. In Thirtyfive years of the Chornobyl catastrophe: radiological and medical consequences, strategies of protection and revival: National Report of Ukraine]. Kyiv, 2022:8-12. In Ukrainian.
10. Buzunov V, Fedirko P. Ophthalmopathology in victims of the Chornobyl catastrophe – results of a clinical epidemiological study. In: Junk AK, Kundiev Y, Vitte P, Worgul BV, editors. Ocular radiation risk assessment in populations exposed to environmental radiation contamination. Dordrecht, Boston, London: Kluwer Academic Publishers. 1999:57–67.
11. Bazyka DA, Prysyazhnyu AP. Onkolohichni naslidky Chornobylskoi katastrofy u viddalenyi 35-richnyi pisliaavariinyi period. [Oncological effects of the Chornobyl catastrophe in the remote 35-year post-accident period]. Journal of the National Academy of Medical Sciences of Ukraine. 2021;27(2):133–9. DOI: https://doi.org/10.37621/JNAMSU-2021-2-7
12. Bazyka DA, Prysyazhnyuk AY, Gudzenko NA, et al. Viddaleni onkolohichni naslidky radiatsiinoho oprominennia, sprychynenoho avariieiu na Chornobylskii AES [Late oncological aftereffects of radiation exposure caused by the Chornobyl accident]. Probl Radiac Med Radiobiol. 2022;27:138-49. In Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2022-27-138-149
13. Prysyazhnyuk AY, Gudzenko NA, Fuzik MM, Trotsiuk NK, Babkina NG, Khukhrianska OM. Epidemiolohichne doslidzhennia formuvannia ryzykiv zloiakisnykh novoutvoren u hrupakh postrazhdalykh vid avarii na Chornobylskii atomnii elektrostantsii (1990–2019). Zvit pro naukovo-doslidnu robotu. [Epidemiological study of the formation of risks of malignant neoplasms in groups of victims of the accident at the Chornobyl Nuclear Power Plant (1990–2019)] [Report on research work]. # 0119U100525; 2019–2021. Manuscript. 148 р. In Ukrainian.
14. Romanenko AY, Finch SC, Hatch M, Lubin JH, Bebeshko VG, Bazyka DA, et al. The Ukrainian-American study of Leukaemia and related disordersamong Chornobyl cleanup workers from Ukraine: III. Radiation risks. Radiat Res. 2008;170:711-20. DOI: https://doi.org/10.1667/RR1404.1
15. Gudzenko N, Hatch M, Bazyka D, Dyagil I, Reiss RF, Brenner A, et al. Non-radiation risk factors for Leukaemia: A case-control study among Chornobyl cleanup workers in Ukraine. Environ Res. 2015;140:72-76. DOI: https://doi.org/10.1016/j.envres.2015.06.019
16. Zablotska L, Bazyka D, Lubin JH, Gudzenko N, Little MP, Hatch M, et al. Radiation and the risk of chronic lymphocytic and other Leukaemias among Chornobyl cleanup workers. Environ Health Persp. 2013;121(1):59-65. DOI: https://doi.org/10.1289/ehp.1204996
17. Gudzenko N, Mabuchi K, Brenner AV, Little MP, Hatch M, Drozdovitch V, Vij V, Chumak V, Bakhanova E, Trotsyuk N, Kryuchkov V, Golovanov I, Bazyka D, Cahoon EK. Risk of thyroid cancer in Ukrainian cleanup workers following the Chornobyl accident. Eur J Epidemiol. 2022 Jan;37(1):67-77. DOI: https://doi.org/10.1007/s10654-021-00822-9
18. Prysyazhnyuk A, Pyatak O, Buzunov V, Reeves GK, Beral V. Cancer in the Ukraine post Chornobyl. Lancet. 1991;338:23. DOI: https://doi.org/10.1016/0140-6736(91)92632-C
19. Bazyka D, Sushko V, Chumak A, Chumak V, Yanovych L, editors. Naslidky Chornobylskoi avarii dlia zdorovia – trydtsiat rokiv pislia nei [Health effects of the Chornobyl accident – thirty years aftermath]. Kyiv: DIA, 2016:524 p.
20. . Little MP, Bazyka D, Berrington de Gonzбlez A, Brenner AV, Chumak VV, et al. A historical survey of key epidemiological studies of ionizing radiation exposure. Radiat Res. 2024 Aug 1;202(2):432–87. DOI: https://doi.org/10.1667/RADE-24-00021.1
21. Fedirko PA, Babenko TF, Kapustinska OA, Belyaev YM, Tereshchenko SO, Dorichevska RY. Rivni ta vidnosni ryzyky smertnosti uchasnykiv likvidatsii naslidkiv Chornobylskoi AES u 1986-1987 rokakh vid osnovnykh nepukhlynnykh zakhvoriuvan (period sposterezhennia 1988-2021) [Levels and relative risks of mortality of Chornobyl clean-up workers in 1986-1987 years from main non-neoplastic diseases (observation period 1988-2021)]. Probl Radiac Med Radiobiol. 2024 Dec;(29):182-98. In Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2024-29-182-198
22. Gunko NV, Fedirko PA, Tereshchenko SA, Korotkova NV, Kortushin GI, Gubina IG, Dubova OS. Retrospektyvne doslidzhennia smertnosti uchasnykiv likvidatsii naslidkiv avarii na Chornobylskii AES vnaslidok travm, otruien ta deiakykh inshykh naslidkiv zovnishnikh prychyn (2000-2020 rr.). [A retrospective study of deaths among participants in the liquidation of the consequences of the accident at the Chornobyl NPP due to injury, poisoning and certain other consequences of external causes (2000-2020)]. Probl Radiac Med Radiobiol. 2024 Dec;(29):92-114. In Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2024-29-92-114
23. Little MP, Azizova TV, Richardson DB, Tapio S, Bernier MO, et al. Ionising radiation and cardiovascular disease: systematic review and meta-analysis. BMJ. 2023 Mar 8;380:e072924. DOI: https://doi.org/10.1136/bmj-2022-072924
24. Babenko TF, Fedirko PA, Dorichevska RY, Denysenko NV, Samoteikina LA, Tyshchenko OP. Ryzyk rozvytku makuliarnoi deheneratsii u osib, oprominenykh prenatalnomu periodu vnaslidok avarii na Chornobylskii AES. [The risk of macular degeneration development in persons antenatally irradiated as a result of Chornobyl NPP accident]. Probl Radiac Med Radiobiol. 2016 Dec;21:172-7. In Ukrainian. DOI: https://doi.org/10.33145/2304-8336-2016-21-172-177
25. Buzunov V, Fedirko P. Ophthalmopathology in victims of the Chornobyl catastrophe – results of a clinical epidemiological study. In: Junk AK, Kundiev Y, Vitte P, Worgul BV, editors. Ocular radiation risk assessment in populations exposed to environmental radiation contamination. Dordrecht, Boston, London: Kluwer Academic Publisher, 1999:57–67.
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