NY Academy of Sciences - Chernobyl

This monograph is a reprint of a volume originally published by the New York
Academy of Sciences (NYAS) in 2009 and the copyright (2009) for all material,
excluding the cover photo and this page, is held by the NYAS.

Under a license dated March 15, 2011, the New York Academy of Sciences, has
granted the authors (A. Yablokov et al.) nonexclusive rights to distribute and
republish this volume in print or electronic form. A copy of this license is available
upon request from the authors. Similarly, the copyright holder for the cover photo
(T.A. Mousseau) grants the authors the right to freely distribute this image as part of
this reprint.

ON THE COVER
Pine trees reveal changes in wood color, density, and growth
rate following irradiation from the Chernobyl disaster.
T.A. Mousseau, University of South Carolina (2009)
Chernobyl
Consequences of the Catastrophe for
People and the Environment
Chernobyl
Consequences of the Catastrophe for
People and the Environment
ALEXEY V. YABLOKOV
VASSILY B. NESTERENKO
ALEXEY V. NESTERENKO
Consulting Editor
JANETTE D. SHERMAN-NEVINGER
Chernobyl
Consequences of the Catastrophe for People
and the Environment
ALEXEY V. YABLOKOV, VASSILY B. NESTERENKO, AND ALEXEY V. NESTERENKO
Consulting Editor
JANETTE D. SHERMAN-NEVINGER
CONTENTS
Foreword. By Prof. Dr. Biol. Dimitro M. Grodzinsky . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface. By Alexey V. Yablokov and Vassily B. Nesterenko . . . . . . . . . . . . . . . . . . . . . x
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Introduction: The Difficult Truth about Chernobyl. By Alexey V. Nesterenko,
Vassily B. Nesterenko, and Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter I. Chernobyl Contamination: An Overview

1. Chernobyl Contamination through Time and Space. By Alexey V. Yablokov
and Vassily B. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter II. Consequences of the Chernobyl Catastrophe

for Public Health
2. Chernobyl’s Public Health Consequences: Some Methodological Problems.
By Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3. General Morbidity, Impairment, and Disability after the Chernobyl
Catastrophe. By Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
4. Accelerated Aging as a Consequence of the Chernobyl Catastrophe. By Alexey
V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
5. Nonmalignant Diseases after the Chernobyl Catastrophe. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
6. Oncological Diseases after the Chernobyl Catastrophe. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
7. Mortality after the Chernobyl Catastrophe. By Alexey V. Yablokov . . . . . . . . . . 192
Conclusion to Chapter II ................................................. 217
v
vi
Chapter III. Consequences of the Chernobyl Catastrophe

for the Environment
8. Atmospheric, Water, and Soil Contamination after Chernobyl. By Alexey V.
Yablokov, Vassily B. Nesterenko, and Alexey V. Nesterenko . . . . . . . . . . . . . . . . 223
9. Chernobyl’s Radioactive Impact on Flora. By Alexey V. Yablokov . . . . . . . . . . . 237
10. Chernobyl’s Radioactive Impact on Fauna. By Alexey V. Yablokov . . . . . . . . . . 255
11. Chernobyl’s Radioactive Impact on Microbial Biota. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Conclusion to Chapter III ................................................ 285
Chapter IV. Radiation Protection after the Chernobyl Catastrophe

12. Chernobyl’s Radioactive Contamination of Food and People. By Alexey V.
Nesterenko, Vassily B. Nesterenko, and Alexey V. Yablokov . . . . . . . . . . . . . . . . 289
13. Decorporation of Chernobyl Radionuclides. By Vassily B. Nesterenko and
Alexey V. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
14. Protective Measures for Activities in Chernobyl’s Radioactively Contaminated
Territories. By Alexey V. Nesterenko and Vassily B. Nesterenko . . . . . . . . . . . . 311
15. Consequences of the Chernobyl Catastrophe for Public Health and the
Environment 23 Years Later. By Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
Conclusion to Chapter IV ................................................ 327
CHERNOBYL
Foreword
More than 22 years have passed since the Chernobyl catastrophe burst upon and
changed our world. In just a few days, the air, natural waters, flowers, trees, woods,
rivers, and seas turned to potential sources of danger to people, as radioactive substances
emitted by the destroyed reactor fell upon all life. Throughout the Northern Hemisphere
radioactivity covered most living spaces and became a source of potential harm for all
living things.
Naturally, just after the failure, public response was very strong and demonstrated
mistrust of atomic engineering. A number of countries decided to stop the construction
of new nuclear power stations. The enormous expenses required to mitigate the negative
consequences of Chernobyl at once “raised the price” of nuclear-generated electric power.
This response disturbed the governments of many countries, international organizations,
and official bodies in charge of nuclear technology and led to a paradoxical polarization
as to how to address the issues of those injured by the Chernobyl catastrophe and the
effects of chronic irradiation on the health of people living in contaminated areas.
Owing to the polarization of the problem, instead of organizing an objective and
comprehensive study of the radiological and radiobiological phenomena induced by
small doses of radiation, anticipating possible negative consequences, and taking adequate
measures, insofar as possible, to protect the population from possible negative effects,
apologists of nuclear power began a blackout on data concerning the actual amounts of
radioactive emissions, the doses of radiation, and the increasing morbidity among the
people that were affected.
When it became impossible to hide the obvious increase in radiation-related diseases,
attempts were made to explain it away as being a result of nationwide fear. At the
same time some concepts of modern radiobiology were suddenly revised. For example,
contrary to elementary observations about the nature of the primary interactions of
ionizing radiation and the molecular structure of cells, a campaign began to deny non-
threshold radiation effects. On the basis of the effects of small doses of radiation in some
nonhuman systems where hormesis was noted, some scientists began to insist that such
doses from Chernobyl would actually benefit humans and all other living things.
The apogee of this situation was reached in 2006 on the 20th anniversary of the
Chernobyl meltdown. By that time the health and quality of life had decreased for
millions of people. In April 2006 in Kiev, Ukraine, two international conferences were
held in venues close to one another: one was convened by supporters of atomic energy
and the other by a number of international organizations alarmed by the true state
of health of those affected by the Chernobyl catastrophe. The decision of the first
conference has not been accepted up to now because the Ukrainian party disagrees
with its extremely optimistic positions. The second conference unanimously agreed that
radioactive contamination of large areas is accompanied by distinctly negative health
consequences for the populations and predicted increased risk of radiogenic diseases in
European countries in the coming years.
vii
viii
For a long time I have thought that the time has come to put an end to the opposition
between technocracy advocates and those who support objective scientific approaches
to estimate the negative risks for people exposed to the Chernobyl fallout. The basis for
believing that these risks are not minor is very convincing.
Declassified documents of that time issued by Soviet Union/Ukraine governmental
commissions in regard to the first decade after 1986 contain data on a number of
people who were hospitalized with acute radiation sickness. The number is greater by
two orders of magnitude than was recently quoted in official documents. How can we
understand this difference in calculating the numbers of individuals who are ill as a
result of irradiation? It is groundless to think that the doctors’ diagnoses were universally
wrong. Many knew in the first 10-day period after the meltdown that diseases of the
nasopharynx were widespread. We do not know the quantity or dose of hot particles that
settled in the nasopharyngeal epithelium to cause this syndrome. They were probably
higher than the accepted figures.
To estimate doses of the Chernobyl catastrophe over the course of a year, it is critical to
consider the irradiation contributed by ground and foliage fallout, which contaminated
various forms of food with short-half-life radionuclides. Even in 1987 activity of some of
the radionuclides exceeded the contamination by Cs-137 and Sr-90. Thus decisions to
calculate dose only on the scale of Cs-137 radiation led to obvious underestimation of
the actual accumulated effective doses. Internal radiation doses were defined on the basis
of the activity in milk and potatoes for different areas. Thus in the Ukrainian Poles’e
region, where mushrooms and other forest products make up a sizable share of the food
consumed, the radioactivity was not considered.
The biological efficiency of cytogenic effects varies depending on whether the radiation
is external or internal: internal radiation causes greater damage, a fact also neglected.
Thus, there is reason to believe that doses of irradiation have not been properly estimated,
especially for the first year after the reactor’s failure. Data on the growth of morbidity
over two decades after the catastrophe confirm this conclusion. First of all, there are
very concrete data about malignant thyroid disease in children, so even supporters of
“radiophobia” as the principal cause of disease do not deny it. With the passage of time,
oncological diseases with longer latency periods, in particular, breast and lung cancers’,
became more frequent.
From year to year there has been an increase in nonmalignant diseases, which has raised
the incidence of overall morbidity in children in areas affected by the catastrophe, and
the percent of practically healthy children has continued to decrease. For example, in Kiev,
Ukraine, where before the meltdown, up to 90% of children were considered healthy, the
figure is now 20%. In some Ukrainian Poles’e territories, there are no healthy children,
and morbidity has essentially increased for all age groups. The frequency of disease has
increased several times since the accident at Chernobyl. Increased cardiovascular disease
with increased frequency of heart attacks and ischemic disease are evident. Average
life expectancy is accordingly reduced. Diseases of the central nervous system in both
children and adults are cause for concern. The incidence of eye problems, particularly
cataracts, has increased sharply. Causes for alarm are complications of pregnancy and the
state of health of children born to so-called “liquidators” (Chernobyl’s cleanup workers)
and evacuees from zones of high radionuclide contamination.
Against the background of such persuasive data, some defenders of atomic energy
look specious as they deny the obvious negative effects of radiation upon populations. In
Grodzinsky: Foreword ix
fact, their reactions include almost complete refusal to fund medical and biological stud-
ies, even liquidating government bodies that were in charge of the “affairs of Chernobyl.”
Under pressure from the nuclear lobby, officials have also diverted scientific personnel
away from studying the problems caused by Chernobyl.
Rapid progress in biology and medicine is a source of hope in finding ways to prevent
many diseases caused by exposure to chronic nuclear radiation, and this research will
advance much more quickly if it is carried out against the background of experience that
Ukrainian, Belarussian, and Russian scientists and physicians gained after the Chernobyl
catastrophe. It would be very wrong to neglect the opportunities that are open to us today.
We must look toward the day that unbiased objectivity will win out and lead to unqualified
support for efforts to determine the influence of the Chernobyl catastrophe on the health
of people and biodiversity and shape our approach to future technological progress and
general moral attitudes. We must hope and trust that this will happen.
The present volume probably provides the largest and most complete collection of
data concerning the negative consequences of Chernobyl on the health of people and
on the environment. Information in this volume shows that these consequences do not
decrease, but, in fact, are increasing and will continue to do so into the future. The main
conclusion of the book is that it is impossible and wrong “to forget Chernobyl.” Over
the next several future generations the health of people and of nature will continue to be
adversely impacted.
PROF. DR. BIOL. DIMITRO M. GRODZINSKY

Chairman, Department of General Biology, Ukrainian National Academy of Sciences,
Chairman, Ukrainian National Commission on Radiation Protection
CHERNOBYL
Preface
The principal idea behind this volume is to present, in a brief and systematic form,
the results from researchers who observed and documented the consequences of the
Chernobyl catastrophe. In our view, the need for such an analysis became especially
important after September 2005 when the International Atomic Energy Agency (IAEA)
and the World Health Organization (WHO) presented and widely advertised “The
Chernobyl Forum” report [IAEA (2006), The Chernobyl Legacy: Health, Environ-
ment and Socio-Economic Impact and Recommendation to the Governments of Be-
larus, the Russian Federation and Ukraine 2nd Rev. Ed. (IAEA, Vienna): 50 pp.] be-
cause it lacked sufficiently detailed facts concerning the consequences of the disaster
(http://www.iaea.org/Publications/Booklets/Chernobyl/chernobyl.pdf ).
Stimulated by the IAEA/WHO “Chernobyl Forum” report, and before the 20th
anniversary of the Chernobyl catastrophe, with the initiative of Greenpeace Interna-
tional, many experts, mostly from Belarus, Ukraine, and Russia (see the list below),
presented their latest data/publications on the consequences of Chernobyl. Greenpeace
International also collected hundreds of Chernobyl publications and doctoral theses.
These materials were added to the Chernobyl literature collected over the years by
Alexey Yablokov [A. V. Yablokov (2001): Myth of the Insignificance of the Consequences of
the Chernobyl Catastrophe (Center for Russian Environmental Policy, Moscow): 112 pp.
(//www.seu.ru/programs/atomsafe/books/mif_3.pdf ) (in Russian)].
Just before the 20th anniversary of the Chernobyl catastrophe, on April 18, 2006,
the report “The Chernobyl Catastrophe–Consequences on Human Health” was pub-
lished by A. Yablokov, I. Labunska, and I. Blokov (Eds.) (Greenpeace, Amsterdam, 2006,
137 pp.; www.greenpeace.org/international/press/reports/chernobylhealthreport). For
technical reasons, it was not possible to include all of the above-mentioned mate-
rial in that book. Thus part of this original material was published as “The Health
Effects of the Human Victims of the Chernobyl Catastrophe: Collection of Scien-
tific Articles,” I. Blokov, T. Sadownichik, I. Labunska, and I. Volkov (Eds.) (Green-
peace, Amsterdam, 2007, 235 pp.; http://www.greenpeace.to/publications.asp#2007).
In 2006 multiple conferences were convened in Ukraine, Russia, Belarus, Ger-
many, Switzerland, the United States, and other countries devoted to the 20th
anniversary of the Chernobyl catastrophe, and many reports with new ma-
terials concerning the consequences of the meltdown were published. Among
them:
• “The Other Report on Chernobyl (TORCH)” [I. Fairly and D. Sumner (2006),
Berlin, 90 pp.].
• “Chernobyl Accident’s Consequences: An Estimation and the Forecast of Additional
General Mortality and Malignant Diseases” [Center of Independent Ecological
Assessment, Russian Academy of Science, and Russian Greenpeace Council (2006),
Moscow, 24 pp.].
x
Yablokov & Nesterenko: Preface xi
• Chernobyl: 20 Years On. Health Effects of the Chernobyl Accident [C. C. Busby and A.V.
Yablokov (Eds.) (2006), European Committee on Radiation Risk, Green Audit,
Aberystwyth, 250 pp.].
• Chernobyl. 20 Years After. Myth and Truth [A. Yablokov, R. Braun, and U. Watermann
(Eds.) (2006), Agenda Verlag, Münster, 217 pp.].
• “Health Effects of Chernobyl: 20 Years after the Reactor Catastrophe” [S. Pflugbeil
et al. (2006), German IPPNW, Berlin, 76 pp.].
• Twenty Years after the Chernobyl Accident: Future Outlook [Contributed Papers
to International Conference. April 24–26, 2006. Kiev, Ukraine, vol. 1–3, HOLTEH
Kiev, www.tesec-int.org/T1.pdf].
• Twenty Years of Chernobyl Catastrophe: Ecological and Sociological Lessons. Mate-
rials of the International Scientific and Practical Conference. June 5, 2006, Moscow,
305 pp., www.ecopolicy.ru/upload/File/conferencebook_2006.pdf, (in Russian).
• National Belarussian Report (2006). Twenty Years after the Chernobyl Catastro-
phe: Consequences in Belarus and Overcoming the Obstacles. Shevchyuk, V. E, &
Gurachevsky, V. L. (Eds.), Belarus Publishers, Minsk, 112 pp. (in Russian).
• National Ukrainian Report (2006). Twenty Years of Chernobyl Catastrophe: Future
Outlook. Kiev, http://www.mns.gov.ua/news show.php?news id=614&p=1.
• National Russian Report (2006). Twenty Years of Chernobyl Catastrophe: Results
and Perspective on Efforts to Overcome Its Consequences in Russia, 1986–2006.
Shoigu, S. K. & Bol’shov, L. A. (Eds.), Ministry of Emergencies, Moscow, 92 pp. (in
Russian).
The scientific literature on the consequences of the catastrophe now includes more
than 30,000 publications, mainly in Slavic languages. Millions of documents/materials
exist in various Internet information systems—descriptions, memoirs, maps, photos, etc.
For example in GOOGLE there are 14.5 million; in YANDEX, 1.87 million; and in
RAMBLER, 1.25 million citations. There are many special Chernobyl Internet por-
tals, especially numerous for “Children of Chernobyl” and for the Chernobyl Cleanup
Workers (“Liquidators so called”) organizations. The Chernobyl Digest—scientific abstract
collections—was published in Minsk with the participation of many Byelorussian and
Russian scientific institutes and includes several thousand annotated publications dating
to 1990. At the same time the IAEA/WHO “Chernobyl Forum” Report (2005), adver-
tised by WHO and IAEA as “the fullest and objective review” of the consequences of
the Chernobyl accident, mentions only 350 mainly English publications.
The list of the literature incorporated into the present volume includes about 1,000
titles and reflects more than 5,000 printed and Internet publications, primarily in Slavic
languages. However, the authors apologize in advance to those colleagues whose papers
addressing the consequences of the Chernobyl catastrophe are not mentioned in this
review—to list all papers is physically impossible.
The authors of the separate parts of this volume are:
• Chapter I: Cherbobyl Contamination: An Overview—A. V. Yablokov and V. B.
Nesterenko;
• Chapter II: Consequences of the Chernobyl Catastrophe for Public Health—A. V.
Yablokov;
• Chapter III: Consequences of the Chernobyl Catastrophe for the Environment—
A. V. Yablokov, V. B. Nesterenko, and A. V. Nesterenko;
xii
• Chapter IV: Radiation Protection after the Chernobyl Catastrophe—A. V.

Nesterenko, V. B. Nesterenko, and A. V. Yablokov.
The final text was coordinated by all authors and expresses their common viewpoint.
Some important editorial remarks:
1. Specific facts are presented in the form that has long been accepted by the United
Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR)—
itemized by numbered paragraphs.
2. The words “Chernobyl contamination,” “contamination,” “contaminated territo-
ries,” and “Chernobyl territories” mean the radioactive contamination caused by
radionuclide fallout as a result of the Chernobyl catastrophe. Such expressions as
“distribution of diseases in territory. . .” mean occurrence of diseases in the popu-
lation of the specified territory.
3. The word “catastrophe” means the release of numerous radionuclides into the
atmosphere and underground water as a result of the explosion of the fourth reactor
at the Chernobyl nuclear power station (Ukraine), which started on April 26, 1986
and continued thereafter.
4. The expressions “weak,” “low,” and “high” (“heavy”) radioactive contamination
usually indicate a comparison among officially designated different levels of ra-
dioactive contamination in the territories: less than 1 Ci/km2 (<37 kBq/m2 ); 1–5
Ci/km2 (37–185 kBq/m2 ); 5–15 Ci/km2 (185–555 kBq/m2 ); and 15–40 Ci/km2
(555–1480 kBq/m2 ).
5. The term “clean territory” is a conventional one; however, during the first weeks
and months of the catastrophe practically all territories of Belarus, Ukraine, and
European Russia, and Europe and most of the Northern Hemisphere were to some
extent contaminated by the Chernobyl radionuclide fallout.
6. Levels (amount) of contamination are expressed as in the original papers—
either in Curies per square kilometer (Ci/km2 ) or in Bequerels per square meter
(Bq/m2 ).
The structure of this volume is as follows: Chapter I provides an estimate of the

level and character of radioactive contamination released from the Chernobyl accident,
affecting primarily the Northern Hemisphere. Chapter II analyzes the public health
consequences of the catastrophe. Chapter III documents the consequences for the en-
vironment. Chapter IV discusses measures for minimizing the Chernobyl consequences
for Belarus, Ukraine, and Russia. The volume comes to an end with general conclusions
and an index (available online only).
In spite of a vast amount of material, the current information is not comprehensive be-
cause new studies are continually being released. However, it is necessary for humankind
to deal with the consequences of this, the largest technological catastrophe in history, and
so these data are presented.
For comments and offers for a subsequent edition we ask you to address information
to:
Alexey Vladimirovich Yablokov, Russian Academy of Sciences, Leninsky Prospect 33,
Office 319, 119071 Moscow, Russia. [email protected]
or
Yablokov & Nesterenko: Preface xiii
Alexey Vassil’evich Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd

Marusinsky Street, 27, Belarus, Minsk, 220053. [email protected]
or
Janette D. Sherman-Nevinger, Environmental Institute, Western Michigan Univer-
sity, Kalamazoo, Michigan. Contact: P.O. Box 4605, Alexandria, VA 22303, USA.
[email protected]
ALEXEY V. YABLOKOV AND VASSILY B. NESTERENKO
This book had been nearly completed when Prof. Vassily Nesterenko passed away on August 23,
2008. He was a great person who, like Andrey Sakharov, stopped his own bright professional nuclear
career as the general design engineer of the Soviet Union’s mobile nuclear power plant “Pamir” and
director of Belarussian Nuclear Center to devote his life’s efforts to the protection of humankind from
Chernobyl’s radioactive dangers.
ALEXEY V. YABLOKOV
CHERNOBYL
Acknowledgments
The present book would have been impossible without the help of many experts and
activists. Forty-nine researchers, primarily from Ukraine, Belarus, and Russia, provided
original material or reviews of specific topics to Greenpeace International, which have
been widely used (see below).
Many individuals helped the authors with information and consultations, including
(by alphabetical order in each country): Rashid Alymov, Alexander Bahur, Ivan Blokov,
Nikolay Bochkov, Svetlana Davydova, Rimma Filippova, Alexander Glushchenko, Vy-
acheslav Grishin, Vladimir Gubarev, Rustem Il’ayzov, Vladymir Ivanov, Yury Izrael,
Dilbar Klado, Sergey Klado, Galyna Klevezal’, Lyudmyla Komogortseva, Lyudmyla
Kovalevskaja, Eugen Krysanov, Valery Mentshykov, Mikhail Mina, Eugenia Najdich,
Alexander Nikitin, Ida Oradovskaya, Iryna Pelevyna, Lydia Popova, Igor Reformatsky,
Vladimir Remez, Svetlana Revina, Leonid Rikhvanov, Dmitry Rybakov, Dmitry Schep-
otkin, Galina Talalaeva, Anatoly Tsyb, Leonid Tymonin, Vladimir M. Zakharov, and
Vladimir P. Zakharov (Russia); Vladymir Borejko, Pavlo Fedirko, Igor Gudkov, Ol’ga Ho-
rishna, Nykolay Karpan, Konstantin Loganovsky, Vytaly Mezhzherin, Tatyana Murza,
Angelina Nyagu, Natalia Preobrazhenskaya, and Bronislav Pshenichnykov (Ukraine);
Svetlana Aleksievich, Galina Bandazhevskaja, Tatyana Belookaya, Rosa Goncharova,
Elena Klymets, Dmitry Lazjuk, Grigory Lepin, Michail Malko, Elena Mokeeva, and
Alexander Oceanov (Belarus); Peter Hill, Alfred Korblein, Sebastian Pflugbeil, Hagen
Scherb, and Inge Schmits-Feuerhake (Germany); Michael Ferne, Alison Katz, Vladimir
Tchertkov, and Jurg Ulrich (Switzerland); Yury Bandazhevsky (Lithuania); Christophe
Bisson and Anders Moller (France); Igor Chasnikov (Kazakhstan); Richard Bramhall
and Chris Busby (England); Rosalia Bertel (Canada); Lym Keisevich (Israel); and Karl
Grossman, Jay Gould, Arjun Makhijani, Joe Mangano, Michael Mariotte, Valery Soyfer,
Ernst Sternglass, and RADNET (USA). We are sincerely grateful to all of them as well
as to many others who aided us in the preparation of this book.
Special thanks go to Prof. Elena B. Burlakova (Moscow) and Prof. Dimitro M. Grodzin-
sky (Kiev) for reviewing the manuscript, and to Julia F. Morozova (Center for Russian
Environmental Policy, Moscow) for inexhaustible patience in putting numerous variants
of the text in order and laboriously working with the lists of cited literature.
This English edition would have been impossible without Dr. Janette Sherman-
Nevinger, who tirelessly scientifically edited our very rough translation.
The following is a list of the experts who provided original material or reviews of
specific topics for the first 2006 edition:
Antipkin, Yu.G., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical

Sciences, Kiev, Ukraine.
Arabskaya, L.P., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical
Bazyka, D.A., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
xiv
Acknowledgments xv
Burlak, G.F., Ministry of Health of Ukraine, Kiev, Ukraine.

Burlakova, E.B., Institute of Biochemical Physics and Russian Academy of Science,
Moscow, Russia.
Buzunov, V.A., Institute of Radiological Hygiene and Epidemiology, Research Center
for Radiation Medicine, Kiev, Ukraine.
Cheban, A.K., “Physicians of Chernobyl” Association, Kiev, Ukraine.
Dashkevich, V.E., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical
Diomyna, E.A., Institute of Experimental Pathology, Oncology and Radiobiology, Kiev,
Ukraine.
Druzhyna, M.A., Institute of Experimental Pathology, Oncology and Radiobiology, Kiev,
Ukraine.
Fedirko, P.A., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Fedorenko, Z., Institute of Oncology, Academy of Medical Sciences, Kiev, Ukraine.
Fuzik, M., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev,
Ukraine.
Geranios, A., Department of Nuclear Physics and Elementary Particles, University of
Athens, Greece.
Gryshchenko, V., Research Center for Radiation Medicine, Academy of Medical Sci-
ences, Kiev, Ukraine.
Gulak, G.L., Institute of Oncology, Academy of Medical Sciences, Kiev, Ukraine.
Khudoley, V.V., N. N. Petrov’ Research Institute of Oncology, Center of Independent
Environmental Expertise, Russian Academy of Sciences, St. Petersburg, Russia.
Komissarenko, I.V., Institute of Endocrinology and Metabolism, Academy of Medical
Kovalenko, A.Ye., Institute of Endocrinology and Metabolism, Academy of Medical
Lipskaya, A.I., Institute of Experimental Pathology, Oncology and Radiobiology, Na-
tional Academy of Sciences, Kiev, Ukraine.
Loganovsky, K.N., Research Center for Radiation Medicine, Academy of Medical Sci-
Malko, M.V., Joint Institute of Power and Nuclear Research, National Academy of
Sciences, Minsk, Belarus.
Mishryna, Zh.A., Research Center for Radiation Medicine, Academy of Medical Sci-
Naboka, M.V., Department of Ecohygienic Investigations of the Radioecological Center,
National Academy of Sciences, Kiev, Ukraine.
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Medicine, Kiev, Ukraine.
Okeanov, E.A., A. D. Sakharov’ International Environment University, Minsk, Belarus.
Omelyanets, N.I., Laboratory of Medical Demography, Research Center for Radiation
Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Oradovskaya, I.V., Immunology Institute of the Ministry of Public Health, Moscow,
Russia.
Pilinskaya, M.A., Research Center for Radiation Medicine, Academy of Medical Sci-
xvi
Pintchouk, L.B., Institute of Experimental Pathology, Oncology and Radiobiology, Na-

tional Academy of Sciences, Kiev, Ukraine.
Prysyazhnyuk, A., Research Center for Radiation Medicine, Academy of Medical Sci-
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Kiev, Ukraine.
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National Academy of Sciences, Kiev, Ukraine.
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CHERNOBYL
Introduction: The Difficult Truth

about Chernobyl
Alexey V. Nesterenko,a Vassily B. Nesterenko,a
and Alexey V. Yablokovb
a
Institute of Radiation Safety (BELRAD), Minsk, Belarus
b
Russian Academy of Sciences, Moscow, Russia
For millions of people on this planet, the explosion of the fourth reactor of the
Chernobyl nuclear power plant on April 26, 1986 divided life into two parts: before
and after. The Chernobyl catastrophe was the occasion for technological adventurism
and heroism on the part of the “liquidators,” the personnel who worked at the site at-
tempting to contain the escaping radiation, and, in our view, for cowardice on the part
of people in public life who were afraid to warn the population of the unimaginable
threat to innocent victims. Chernobyl has become synonymous with human suffering
and has brought new words into our lives—Chernobyl liquidators, children of Cher-
nobyl, Chernobyl AIDs, Chernobyl contamination, Chernobyl heart, Chernobyl dust,
and Chernobyl collar (thyroid disease), etc.
For the past 23 years it has been clear that there is a danger greater than nuclear
weapons concealed within nuclear power. Emissions from this one reactor exceeded a
hundredfold the radioactive contamination of the bombs dropped on Hiroshima and
Nagasaki. No citizen of any country can be assured that he or she can be protected from
radioactive contamination. One nuclear reactor can pollute half the globe. Chernobyl
fallout covered the entire Northern Hemisphere.
The questions persist: How many radionuclides spread over the world? How much
radiation is still stored inside the sarcophagus, the dome that covers the reactor? No
one knows for certain, but the estimates vary from 50 × 106 Ci, or 4–5% of the total
radionuclides released from the reactor, to the reactor being essentially empty and more
than 10 × 109 Ci dispersed over the globe (Chapter I.1). It is not known how many
liquidators ultimately took part in the mitigation; a directive from the USSR Ministry of
Defense, dated June 9, 1989, mandated secrecy (Chapter II.3).
In April 2005, prior to the 20th anniversary of the catastrophe, the Third Chernobyl
Forum Meeting was held in Vienna. Forum experts included representatives from the In-
ternational Atomic Energy Agency (IAEA), the United Nations Scientific Committee on
the Effects of Atomic Radiation (UNSCEAR), the World Health Organization (WHO),
and other individuals from the United Nations, the World Bank, and governmental or-
ganizations from Belarus, Russia, and Ukraine. The result was a three-volume report
presented in September 2005 (IAEA, 2005; UNDP, 2002; WHO, 2006; for the latest
short version see IAEA, 2006).
Address for correspondence: Alexey V. Yablokov, Russian Academy of Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. [email protected]
1
2
The basic conclusion of the report’s medical volume is that 9,000 victims died or
developed radiogenic cancers, but given the background of spontaneous cancers, “it
will be difficult to determine the exact cause of the deaths.” Some 4,000 children were
operated on for thyroid cancer. In the contaminated areas, cataracts were increasingly
seen in liquidators and children. Some believe that poverty, feelings of victimization, and
fatalism, which are widespread among the population of the contaminated areas, are
more dangerous than the radioactive contamination. Those experts, some of whom were
associated with the nuclear industry, concluded that as a whole, the adverse consequences
for the health of the people were not as significant as previously thought.
An opposing position was voiced by Secretary-General Kofi Annan:
Chernobyl is a word we would all like to erase from our memory. But more than seven million of our
fellow human beings do not have the luxury of forgetting. They are still suffering, everyday, as a result
of what happened . . . The exact number of victims can never be known. But three million children
demanding treatment until 2016 and earlier represents the number of those who can be seriously
ill . . . their future life will be deformed by it, as well as their childhood. Many will die prematurely.
(AP, 2000)
No fewer than three billion persons inhabit areas contaminated by Chernobyl’s ra-
dionuclides. More than 50% of the surface of 13 European countries and 30% of eight
other countries have been contaminated by Chernobyl fallout (Chapter I.1). Given bi-
ological and statistical laws the adverse effects in these areas will be apparent for many
generations.
Soon after the catastrophe, concerned doctors observed a significant increase in dis-
eases in the contaminated areas and demanded help. The experts involved with the
nuclear industry and highly placed tribunals declared that there is no “statistically au-
thentic” proof of Chernobyl radiation, but in the 10 years immediately following the
catastrophe, official documents recognized that the number of thyroid cancers grew “un-
expectedly.” Prior to 1985 more than 80% of children in the Chernobyl territories of
Belarus, Ukraine, and European Russia were healthy; today fewer than 20% are well. In
the heavily contaminated areas it is difficult to find one healthy child (Chapter II.4).
We believe it is unreasonable to attribute the increased occurrence of disease in the
contaminated territories to screening or socioeconomic factors because the only variable
is radioactive loading. Among the terrible consequences of Chernobyl radiation are
malignant neoplasms and brain damage, especially during intrauterine development
(Chapter II.6).
Why are the assessments of experts so different?
There are several reasons, including that some experts believe that any conclusions
about radiation-based disease requires a correlation between an illness and the received
dose of radioactivity. We believe this is an impossibility because no measurements were
taken in the first few days. Initial levels could have been a thousand times higher than
the ones ultimately measured several weeks and months later. It is also impossible to
calculate variable and “hot spot” deposition of nuclides or to measure the contribution
of all of the isotopes, such as Cs, I, Sr, Pu, and others, or to measure the kinds and total
amount of radionuclides that a particular individual ingested from food and water.
A second reason is that some experts believe the only way to make conclusions is to
calculate the effect of radiation based upon the total radiation, as was done for those
exposed at Hiroshima and Nagasaki. For the first 4 years after the atomic bombs were
dropped on Japan, research was forbidden. During that time more than 100,000 of the
Introduction 3
weakest died. A similar pattern emerged after Chernobyl. However, the USSR authorities
officially forbade doctors from connecting diseases with radiation and, like the Japanese
experience, all data were classified for the first 3 years (Chapter II.3).
In independent investigations scientists have compared the health of individuals in
various territories that are identical in terms of ethnic, social, and economic charac-
teristics and differ only in the intensity of their exposure to radiation. It is scientifically
valid to compare specific groups over time (a longitudinal study), and such compar-
isons have unequivocally attributed differences in health outcomes to Chernobyl fallout
(Chapter II.3).
This volume is an attempt to determine and document the true scale of the conse-
quences of the Chernobyl catastrophe.
References
AP (2000). Worst effects of Chernobyl to come. Associated Press 25 April 2000 (//www.209.85.135.104/
search?q=cache: EN91goYTe_gJ: www.scorched3d.co.uk/phpBB3/viewtopic.php%3Ff%3D12%
26t%3D5256%26st%3D0%26sk%3Dt%26sd%3Da+Kofi+Annan+million+children+demanding+
treatment+Chernobyl+2016&hl=ru&ct=clnk&cd=18&gl=ru).
IAEA (2005). Environmental Consequences of the Chernobyl Accident and Their Remediation: Twenty
Years of Experience. Report of the UN Chernobyl Forum Expert Group “Environment” (EGE) August
2005 (IAEA, Vienna): 280 pp. (//www-pub.iaea.org/MTCD/publications/PDF/Pub1239_web.pdf).
IAEA (2006). The Chernobyl Legacy: Health, Environment and Socio-Economic Impact and Recommen-
dations to the Governments of Belarus, the Russian Federation and Ukraine, 2nd Rev. Edn. (IAEA,
Vienna): 50 pp. (//www.iaea.org/publications/booklets/Chernobyl/Chernobyl.pdf).
UNDP (2002). The Human Consequences of the Chernobyl Nuclear Accident: A Strategy for Recovery. A
Report Commissioned by UNDP and UNICEF with the Support of UN-OCHA and WHO (UNDP,
New York): 75 pp. (//www.chernobyl.undp.org/english/docs/Strategy%20for%20Recovery.pdf).
WHO (2006). Health Effects of the Chernobyl Accident and Special Health Care Programmes. Report
of the UN Chernobyl Forum Expert Group “Health.” B. Bennett, M. Repacholi & Zh. Carr (Eds.)
(WHO, Geneva): 167 pp. (//www.who.int/ionizing_radiation/chernobyl/WHO%20Report%20on%
20Chernobyl%20Health%20Effects%20July%2006.pdf).
CHERNOBYL
Chapter I. Chernobyl Contamination:

An Overview
Vassily B. Nesterenkoa and Alexey V. Yablokovb
a
b
Key words: Chernobyl; radioactive contamination; lead contamination; Northern

Hemisphere
4
CHERNOBYL
1. Chernobyl Contamination through

Time and Space
Alexey V. Yablokov and Vassily B. Nesterenko
Radioactive contamination from the Chernobyl meltdown spread over 40% of Europe
(including Austria, Finland, Sweden, Norway, Switzerland, Romania, Great Britain,
Germany, Italy, France, Greece, Iceland, Slovenia) and wide territories in Asia (includ-
ing Turkey, Georgia, Armenia, Emirates, China), northern Africa, and North America.
Nearly 400 million people resided in territories that were contaminated with radioac-
tivity at a level higher than 4 kBq/m2 (0.11 Ci/km2 ) from April to July 1986. Nearly 5
million people (including, more than 1 million children) still live with dangerous levels
of radioactive contamination in Belarus, Ukraine, and European Russia. Claims that
the Chernobyl radioactive fallout adds “only 2%” to the global radioactive background
overshadows the fact that many affected territories had previously dangerously high
levels of radiation. Even if the current level is low, there was high irradiation in the
first days and weeks after the Chernobyl catastrophe. There is no reasonable expla-
nation for the fact that the International Atomic Energy Agency and the World Health
Organization (Chernobyl Forum, 2005) have completely neglected the consequences of
radioactive contamination in other countries, which received more than 50% of the Cher-
nobyl radionuclides, and addressed concerns only in Belarus, Ukraine, and European
Russia.
To fully understand the consequences of Cher- 1.1. Radioactive Contamination

nobyl it is necessary to appreciate the scale
of the disaster. Clouds of radiation reached Immediately after the explosion, and even
heights between 1,500 and 10,000 m and now, many articles report levels of ra-
spread around the globe, leaving deposits of dioactivity calculated by the density of the
radionuclides and radioactive debris, primarily contamination—Ci/km2 (Bq/m2 ). While these
in the Northern Hemisphere (Figure 1.1). levels form a basis for further calculations of col-
There has been some dispute over the years lective and individual doses, as shown below,
as to the volume of radionuclides released when such an approach is not completely valid as it
reactor number four of the Chernobyl Nuclear does not take into account either the ecological
Power Plant (ChNPP) exploded, and it is criti- or the physical aspects of radioactive contami-
cal to be aware of the fact that there continue nation, nor does it provide exact calculations of
to be emissions. That release, even without tak- received doses (see Chapter II.2).
ing the gaseous radionuclides into account, was
many hundreds of millions of curies, a quantity
hundreds of times larger than the fallout from 1.2. Geographical Features
the atomic bombs dropped on Hiroshima and of Contamination
Nagasaki.
Immediately after the NPP explosion, at-
tempts began to reconstruct the radioactive
Address for correspondence: Alexey V. Yablokov, Russian Academy fallout picture to determine radioactive fall-
of Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@
out distribution levels using hydrometeorologi-
ecopolicy.ru cal data (wind direction, rainfall, etc.) for each
5
6
tled outside of Belarus, Ukraine, and European

Russia (Figure 1.3, Table 1.1).
1.2.1. Europe
According to other data (Fairlie and Sumner,
2006, table 3.6, cc. 48 & 49) Europe received
from about 68 to 89% of the gaseous–aerosol
radionuclides from the Chernobyl clouds in a
distribution that was extremely nonuniform.
From April 26 through May 5, 1986, the winds
around Chernobyl varied by 360◦ , so the ra-
dioactive emissions from the mix of radionu-
clides varied from day to day and covered an
enormous territory (Figures 1.4, 1.5, and 1.6).
Figure 1.7 is a reconstruction of only one of
Figure 1.1. Spatial distribution of Chernobyl ra- the Chernobyl clouds (corresponding to No. 2
dionuclides in the Northern Hemisphere 10 days af-
on Figure 1.4). It is important to understand
ter the explosion. U.S. Livermore National Laboratory
modeling (Lange et al., 1992). that radionuclide emissions from the burning
reactor continued until the middle of May.
The daily emissions formed several radioac-
subsequent day and include emissions of fuel tive clouds, and each such cloud had its own
particles, aerosol particles, and radioactive radionuclide composition and geography. We
gases from the destroyed reactor (see, e.g., do not have accurate instrumental data for
Izrael, 1990; Borzylov, 1991; UNSCEAR, Chernobyl radionuclide contamination for all
2000; Fairlie and Sumner, 2006). Geographic of Europe. Calculated data (averaged for 1 km2 )
distribution of Chernobyl radionuclides around were published only for Cs-137 and Pu, while
the globe is shown in Figure 1.2. It is clear that Cs-137 contaminated all of the European coun-
most of the gaseous–aerosol radionuclides set- tries, without exception (Table 1.2).
The data in Table 1.2 refer only to the dis-
tribution of Cs-137, but there were significant
quantities of many other radionuclides in the
form of gases, aerosols, and “hot particles” (see
below) widely dispersed across Europe in the
first weeks and months following the explosion:
Cs-134, I-131, Sr-90, Te-132, and I-132. For
example, in May 1986 in Wales and in the
Cumbria area of England rainwater contained
up to 345 Bq/liter of I-132 and 150 Bq/liter Cs-
134 (Busby, 1995). The effective doses in May
1986 for Chernobyl radionuclides in England
were: Cs-134 and Cs-137, 27 mSv; I-131, 6
mSv; Sr-90, 0.9 mSv (Smith et al. (2000).
If the distribution of radioactivity for Cs-134
and Cs-137 corresponds to their ratio in emis-
Figure 1.2. Geographic distribution of Cher- sions (i.e., 48 and 85 PBq, or 36 and 64%, re-
nobyl radionuclides (UNSCEAR, 1988). spectively), then the proportional distribution
Yablokov & Nesterenko: Contamination through Time and Space 7
Figure 1.3. Chernobyl radioactive fallout in the Northern Hemisphere (Livermore Na-
tional Laboratory data from Yablokov et al., 2006).
of the main Chernobyl radionuclides in Eng- Twenty years after the Chernobyl catas-
land should be as follows [Dreicer et al., 1996; trophe, many areas in Europe remain
Fairlie and Sumner, 2006, Table 3.8(i)]: contaminated. For example, in 2006, according
to Great Britain’s Ministry of Health 355 farms
mSv % in Wales, 11 in Scotland, and 9 in England,
Cs-137 17.3 51.0 pasturing more than 200,000 sheep, continue
Cs-134 9.7 28.6 to be dangerously contaminated with Cs-137
I-131 6.0 17.7
Sr-90 0.9 2.7
(McSmith, 2006).
Total 33.9 100
1.2.1.1. Belarus
If the proportional distribution of Chernobyl Practically the entire country of Belarus was
radionuclides in England is similar to that of covered by the Chernobyl cloud. I-131, I-132,
other European countries (i.e., 70 PBq Cs-137 and Te-132 radioisotope fallout covered the
made up 51% of all the radionuclide fallout), entire country (Figures 1.8 through 1.12). A
one can assume that the total amount of ra- maximum level of I-131 contamination of 600
dioactive fallout in Europe is nearly 137 PBq: Ci/km2 was measured in the Svetlovichi village
in Gomel Province in May 1986.
% PBq Some 23% of the area of Belarus
Cs-137 51.0 70a
Cs-134 28.6 39
(47,000 km2 ) was contaminated by Cs-137 at a
I-131 17.7 24 level higher than 1 Ci/km2 (Nesterenko, 1996;
Sr-90 2.7 3.7 Tsalko, 2005). Until 2004, the density of Cs-
Total 100 136.7 137 contamination exceeded 37 kBq/m2 in
a
See Table 1.2. 41,100 km2 (Figure 1.10).
8
TABLE 1.1. Estimations of a Geographic Distribution of Chernobyl’s Cs-137, % (PBq) (Fairlie and
Sumner, 2006, pp. 48–49)
UNSCEAR, 1988; Goldman, 1987;
Fairlie and Sumner, Fairlie and Sumner,
2006, p. 48 2006: table 3.6. UNSCEAR, 2000
Belarus, Ukraine, European Russia <50 41 (29) 34 (33) 47 (40)

Other European countries ;39 37 (26) 34 (33) 60 (45)
Asia 8 21 (15) 33 (32) No
Africa 6 No No No
America 0.6 No No No
100 100 (70) 100 (98) 100 (85)
Maximum levels of Cs-137 contamination was 5,402 kBq/m2 or 145 Ci/km2 , exceeding
were 475 Ci/km2 in the village of Zales’ye, the precatastrophe level by a factor of 3,500
Braginsk District, and 500 Ci/km2 in the vil- (Il’yazov, 2002).
lage of Dovliady and the Narovlja District Contamination from Sr-90 has a more lo-
of Gomel Province. The maximum radioac- cal character than that of Cs-137. Some 10%
tive contamination in the soil found in 1993 of the area of Belarus has levels of Sr-90 soil
in the village of Tchudyany, Mogilev District, contamination above 5.5 kBq/m2 , covering an
Figure 1.4. Six stages of formation of radioactive gaseous–aerosol emissions from Cher-
nobyl from April 26 to May 4, 1986: (1) April 26, 0 hours (Greenwich time); (2) April 27,
0 hours; (3) April 27, 12.00 hours; (4) April 29, 0 hours; (5) May 2, 0 hours; (6) May 4,
12.00 hours (Borzylov, 1991). Shading indicates the main areas of the radionuclide fallout.
Figure 1.5. An alternative version of radioactive gaseous–aerosol distribution over Eu-

rope from April 26 to May 6, 1986 (National Belarussian Report, 2006).
area of 21,100 km2 (Figure 1.11). Soil con- plya et al., 2006; Figure 1.12). As a whole, more
taminated by Pu-238, Pu-239, and Pu-240 at than 18,000 km2 of agricultural land or 22%
levels higher than 0.37 kBq/m2 was found in of Belarus farmland is heavily contaminated.
4,000 km2 , or nearly 2% of the country (Kono- Of that, an area of 2,640 km2 cannot be used
10
Figure 1.6. Some of the main areas of Europe contaminated at a level higher than 1
Ci/km2 by Cs-137 as a result of the Chernobyl catastrophe. Turkey was surveyed only in part
and Bulgaria, Yugoslavia, Portugal, Iceland, and Sicily were not surveyed at all (Cort and
Tsaturov, 1998).
for agriculture and the 1,300-km2 Polessk state 1.2.1.4. Other European Countries
radioactive reserve near the Chernobyl NPP The level of Chernobyl’s Cs-137 contam-
is forever excluded from any economic activ- ination in each European country is shown
ity owing to contamination by long half-life in Table 1.2; some additional comments
isotopes. follow.
1. BULGARIA. The primary Chernobyl ra-
1.2.1.2. Ukraine dionuclides reached Bulgaria on May 1–10,
1986. There were two peaks of fallout: May
Chernobyl radionuclides have contaminated
1 and 9 (Pourchet et al., 1998).
more than a quarter of Ukraine, with Cs-137
2. FINLAND. Chernobyl fallout clouds over
levels higher than 1 Ci/km2 in 4.8% of the
southern Finland reached peak concentrations
country (Figure 1.13).
between 15:10 and 22:10 hours on April 28,
1986.
1.2.1.3. European Russia 3. FRANCE. Official Service Central de
Until 1992 contamination in European Protection Contre les Radiations Ionisantes
Russia was found in parts of 19 Russian initially denied that the radioactive cloud
provinces (Table 1.3), so consideration must be had passed over France. This is contrary
given to serious contamination in the Asian part to the finding that a significant part of the
of Russia as well. country, especially the alpine regions, were
TABLE 1.2. Cs-137 Contamination of European Countries from Chernobyl (Cort and Tsaturov, 1998:
table III.1; Fairlie and Sumner, 2006: tables 3.4 and 3.5)
Portion (%)
PBq (kCi) Cort and Fairlie and Cort and Fairlie and
Country Tsaturov, 1998c Sumner, 2006d Tsaturov, 1998c Sumner, 2006d
Russiaa 19 (520) 29 29.7 31.96

Belarus 15 (400) 15 23.0 16.53
Ukraine 12 (310) 13 18.0 14.33
Finland 3.1 (8.3) 3.8 4.80 4.19
Yugoslavia ? 5.4 − 5.95
Sweden 2.9 (79) 3.5 4.60 3.86
Norway 2.0 (53) 2.5 3.10 2.75
Bulgaria ? 2.7 − 2.98
Austria 1.6 (42) 1.8 2.40 1.98
Romania 1.5 (41) 2.1 2.40 2.31
Germany 1.2 (32) 1.9 1.80 2.10
Greece 0.69 (19) 0.95 1.10 1.05
Italy 0.57 (15)b 0.93 0.90 1.02
Great Britain 0.53 (14) 0.88 0.83 0.97
Poland 0.40 (11) 1.2 0.63 1.32
Czech Republic 0.34 (93) 0.6 0.54 0.66
France 0.35 (9.4) 0.93 0.55 1.02
Moldova 0.34 (9.2) 0.40 0.53 0.44
Slovenia 0.33 (8.9) 0.39 0.52 0.43
Albania ? 0.4 − 0.44
Switzerland 0.27 (7.3) 0.36 0.43 0.40
Lithuania 0.24 (6.5) 0.44 0.38 0.48
Ireland 0.21 (5.6) 0.35 0.33 0.39
Croatia 0.21 (5.8) 0.37 0.33 0.40
Slovakia 0.18 (47) 0.32 0.28 0.35
Hungary 0.15 (4.1) 0.35 0.24 0.39
Turkeya 0.10 (2.8) 0.16 0.16 0.18
Latvia 0.055 (1.5) 0.25 0.09 0.28
Estonia 0.051 (1.4) 0.18 0.08 0.2
Spain 0.031 (0.83) 0.38 0.05 0.42
Denmark 0.016 (0.43) 0.09 0.02 0.10
Belgium 0.01 (0.26) 0.05 0.02 0.06
The Netherlands 0.01 (0.26) 0.06 0.02 0.07
Luxembourg 0.003 (0.08) 0.01 <0.01 0.01
Europe as a whole 64 (1700)c 90.8e 100.0 100.0
a
European Russia.
b
Without Sicily.
c
Without Yugoslavia, Bulgaria, Albania, Portugal, and Iceland.
d
Without Portugal and Iceland.
e
Includes nearly 20 PBq Cs-137, remaining from nuclear weapons tests before the 1970s.
contaminated on April 29 and 30, 1986 (see Africa were returned to West Germany because
Figure 1.5). they were dangerously contaminated with ra-
4. GERMANY. The scale of Chernobyl’s con- diation (Brooke, 1988).
tamination in Germany is reflected in the fact 5. GREECE. Greece reported significant
that several shipments of powdered milk to fallout of several Chernobyl radionuclides
12
Figure 1.7. The path of one Chernobyl radioactive cloud across Europe from April 27 to
early May 1986 (Pakumeika and Matveenka, 1996).
including: Ag-110 m, Cs-137, and Sb-125 (Pa- as the primary radionuclide. Numerous “hot
pastefanou et al., 1988a,b; see Figure 1.16). particles” were detected with a prevalence of
Noting unusual contamination (see Section Ru-103 and Ru-106 (Broda, 1987). In June
1.4.1 below) is important, but it is also evidence 1987, a 1,600-ton shipment of powdered milk
of the inadequacy of the available data rele- from Poland to Bangladesh showed unac-
vant to Chernobyl contamination: where are ceptably high levels of radioactivity (Mydans,
comparable data about radioactive Ag-110 m 1987).
contamination in other countries? Do data not 8. SCOTLAND. The main radioactive plume
exist because no one has compiled it or be- passed Scotland between 21:00 and 23:00
cause this radioactive Ag contaminated only hours on May 3, 1986, with the largest con-
Greece, Italy, and Scotland (Boccolini et al., centrations of Te-132, I-132, and I-131 (Martin
1988; Martin et al., 1988)? et al., 1988).
6. ITALY. There were several radioactive 9. SWEDEN. The peak concentration of Cs-
plumes, but the main Chernobyl fallout cloud 137 in air occurred on April 28, 1986, but 99%
passed over northern Italy on May 5, 1986. of Chernobyl-derived radionuclides were de-
Some 97% of the total deposition in Italy oc- posited in Sweden during a single period of
curred between April 30 and May 7 (Spezzano rain on May 8, 1986. Patterns of fallout re-
and Giacomelli, 1990). lated to local weather conditions: Cs-137 dom-
7. POLAND. The main plume passed over inated on the coast of southern Norrland, I-
Poland around April 30, 1986, with Te-122 131 in the north and south, and Te-132 in the
Figure 1.8. Reconstruction of I-131 contamination of Belarus for May 10, 1986 (National
Belarussian Report, 2006).
Figure 1.9. Reconstruction of Te-132 and I-132 contamination of Belarus from April to
May 1986 (Zhuravkov and Myronov, 2005).
14
Figure 1.10. Reconstruction of contamination of territory of Belarus by Cs-137 for May

10, 1986 (National Belarussian Report, 2006).
central Upland area (Kresten and Chyssler, eas of Asian Russia (Siberia, Far East), East and
1989; Mattson and Vesanen, 1988; Mellander, Central China (Figure 1.14), and the Asian part
1987). of Turkey were highly contaminated. Cher-
10. UNITED KINGDOM. Official reports nobyl fallout was noted in central Asia (Imam-
grossly underestimated the Chernobyl-derived niyazova, 2001) and in Japan (Imanaka, 1999;
fallout and its radiological impact on the United Figure 1.14).
Kingdom. Cs-137 deposition in Cumbria was 1. TRANS-CAUCASUS. Western Georgia was
up to 40 times higher than originally reported especially heavily contaminated. The average
by the Ministry of Agriculture, Fisheries and soil radioactivity due to Cs-137 from 1995 to
Food (RADNET, 2008; Sanderson and Scott, 2005 was 530 Bq/kg, and that figure was twice
1989). as high in East Georgia. The combined activity
11. YUGOSLAVIA. The main radioactive fall- of Cs-137 and Sr-90 reached 1,500 Bq/kg
out occurred on May 3–5, 1986 (Juznic and (Chankseliany, 2006; Chankseliany et al., 2006).
Fedina, 1987). 2. JAPAN. Twenty Chernobyl radionuclides
were detected in two plumes in early and late
1.2.2. Asia May 1986, with the highest level in north-
western Japan and a maximum concentra-
Up to 10% of all the Chernobyl radionu- tion on May 5. Chernobyl-derived strato-
clides fell on Asia, including, basically, some spheric fallout continued until the end of 1988
tens of PBq of the first, most powerful emissions (Higuchi et al., 1988; Imanaka and Koide,
on the first days of the catastrophe. Huge ar- 1986).
Figure 1.11. Sr-90 contamination of Belarus at the beginning of 2005 (National Belarus-
sian Report, 2006).
There is still a high probability of small via the Arctic, and that of May 25 and 26 via
but dangerously radioactive areas in the Cau- the Pacific (Roy et al., 1988). By the official “En-
casus; Trans-Caucasia; lower, central, and mid- vironmental Radioactivity in Canada” report
dle Asia (including Turkey, Iran, Iraq, and for 1986 (RADNET, 2008) Chernobyl Ru-103,
Afghanistan); China; and the Persian Gulf area, Ru-106, Cs-134, and Cs-137 were consistently
continuing until the present time. measurable until about mid-June.
2. UNITED STATES. The Chernobyl plumes
1.2.3. North America crossed the Arctic within the lower tropo-
sphere and the Pacific Ocean within the
Areas in North America were contaminated mid-troposphere, respectively. Chernobyl iso-
from the first, most powerful explosion, which topes of Ru-103, Ru-106, Ba-140, La-140,
lifted a cloud of radionuclides to a height of Zr-95, Mo-95, Ce-141, Ce-144, Cs-134, Cs-
more than 10 km. Some 1% of all Cher- 136, Cs-137, I-132, and Zr-95 were de-
nobyl radionuclides—nearly several PBq—fell tected in Alaska, Oregon, Idaho, New Jersey,
on North America. New York, Florida, Hawaii, and other states
1. CANADA. There were three waves of (Table 1.4).
Chernobyl airborne radioactivity over eastern An Associated Press release on May 15,
Canada composed of: Be-7, Fe-59, Nb-95, Zr- 1986, noted “Officials in Oregon have warned
95, Ru-103, Ru-106, I-131, La-140, Ce-141, that those who use rainwater for drinking
Ce-144, Mn-54, Co-60, Zn-65, Ba-140, and should use other sources of water for some
Cs-137. The fallout of May 6 and 14 arrived time.”
16
Figure 1.12. Transuranic radionuclide contamination of Belarus in 2005 (National Be-

larussian Report, 2006).
1.2.4. Arctic Regions dence of significant Chernobyl contamination

(Benninger et al., 1998).
A high level of Chernobyl contamina-
tion is found in Arctic regions. The moss 1.2.6. Southern Hemisphere
Racomitrium on Franz Josef Land contained up
to 630 Bq/kg (dry weight) of Cs-137 of which In the Southern Hemisphere Cs-137 and Cs-
548 Bq/kg (87%) came from the Chernobyl 134 from Chernobyl have been found on Re-
fallout (Rissanen et al., 1999). union Island in the Indian Ocean and on Tahiti
in the Pacific. The greatest concentration of
Cs-137 in the Antarctic was found near the
1.2.5. Northern Africa South Pole in snow that fell from 1987 to 1988
(UNSCEAR, 2000).
Radionuclide fallout in northern Africa
came from the most powerful emissions on the
first day of the catastrophe and that area has 1.3. Estimates of Primary
been subject to more than 5% of all Chernobyl Chernobyl Radionuclide Emissions
releases—up to 20 PBq.
1. EGYPT. The Cs-137 to Pu-239/Pu-240 ra- The official view was that the total radionu-
tio in accumulated Nile River sediment is evi- clide emissions calculated for May 6, 1986, the
Figure 1.13. Contamination of Ukraine [Cs-137 (above) and Pu (below)] as a result of

the Chernobyl catastrophe (National Report of Ukraine, 2006).
time when most of the short-lived radionuclides substances into the atmosphere was prolonged.
had decayed, was 50 × 106 Ci or 1.85 × 1018 UNSCEAR (2000) estimated that the total ac-
Bq (Izrael, 1990, 1996). It was estimated that tivity of ejected radionuclides was 1.2 × 1019
3–4% of the fuel from the moment of meltdown Bq, including 1.2–1.7× 1018 Bq of I-131 and
(i.e., from 190.3 tons) was blown out of the reac- 3.7 × 1016 Bq of Cs-137.
tor, a serious underestimation. Emissions con- UNSCEAR reports (1988, 2000) contain
tinued after May 6, with intensity decreasing data (comparable with emissions of I-131)
over 10 days until the graphite lining of the re- about an enormous volume of emissions of
actor stopped burning. Emission of radioactive Te-132 (half-life 78 h and decaying into
18
TABLE 1.3. Radioactive Contamination of Euro-

pean Russia (≥1 Ci/km2 ) as a Result of the Cher-
nobyl Catastrophe (Yaroshinskaya, 1996)
Contaminated Population,
Province area, 1 × 103 km2 103
Tula 11.5 936.2

Bryansk 11.7 476.5
Oryol 8.4 346.7
Ryazan 5.4 199.6
Kursk 1.4 140.0
Penza 3.9 130.6
Kaluga 4.8 95.0
Belgorod 1.6 77.8 Figure 1.14. Activity of Cs-137 in sediments
Lipetsk 1.6 71.0 from Dabusupao Lake (northeast of China). The peak
Ulyanovsk 1.1 58.0 of radioactivity of sediment at a depth of about 6 cen-
Voronezh 1.7 40.4 timeters is associated with atmospheric nuclear tests,
Leningrad 1.2 19.6 and peaks at a depth of 1–2 centimeters, with the
Mordova 1.9 18.0 Chernobyl fallout (Xiang, 1998).
Tambov 0.5 16.2
Tatarstan 0.2 7.0a
Saratov 0.2 5.2a
Nizhniy Novgorod 0.1 3.7a mate the collective dose. If only about 3%
Chuvashiya 0.1 1.3a of the fuel (5 tons) was discharged then the
Smolensk 0.1 1.1a Chernobyl catastrophe caused the world to
Total 56.0 2,644.8
be contaminated with 20 kg of Pu, a quan-
a
Authors’ estimation based on average population den- tity sufficient to contaminate a territory of
sity in each province.
20,000 km2 forever. The half-life of Pu-239 is
24,000 years. If 30–40% of the fuel was re-
radioactive iodine), as well as emissions of Zr-95 leased (Gofman, 1994; Medvedev, 1990; Sich,
(half-life 64 days). According to calculations by 1996; UNSCEAR, 2000; and others) allowing
Vukovic (1996) there were additional emissions nearly 3 × 109 Ci to escape, or 80–90% was
of more than 0.5 × 106 Ci of Ag-110 (half-life released (i.e., 7–8 × 109 Ci; see Chernousenko,
250 days). 1992; Kyselev et al., 1996; Medvedev,
Disputes concerning the amount of ra- 1991)—the manifold larger territories of the
dionuclides released are important to esti- Northern Hemisphere will be contaminated
forever. Table 1.5 shows some estimates of the
total of the primary radionuclides emitted dur-
TABLE 1.4. Data on the May 1986 Peak Concen- ing the catastrophe.
trations of Some Nuclides in Areas of the United All existing estimates of emitted radionu-
States (RADNET, 2008) clides are rough calculations and indications
Date Place Radionuclide are that we will be seeing an appreciable in-
crease in these estimates as time goes on. It is in-
May 5, 1986 Forks, WA Ru-103, Cs-134
May 5, 1986 Spokane, WA Total
dicative that even 20 years after the catastrophe
May 7–8, 1986 Augusta, ME Total there are new thoughts about the role of some
May 8, 1986 Portland, ME Total of the radionuclides that initially were not taken
May 11, 1986 Rexburg, ID I-131, air into account at all, such as Cl-36 and Te-99 with
May 11, 1986 New York, NY Cs-137 half-lives of nearly 30,000 years and more than
May 15, 1986 Chester, NJ Total
23,000 years, respectively (Fairlie and Sumner,
May 16, 1986 Cheyenne, WY Total
2006).
TABLE 1.5. Some Estimates of the Amount of Primary Radionuclides Emitted from April 26 to May 20,
1986, from the Fourth Chernobyl NPP Reactor (106 Ci)
Radionuclide (half-life/full decay Nuclear Energy Devell Medvedev Guntay
time, hours, days, months, years) Agency (1995) et al. (1995) (1991) et al. (1996)
I-135 (6.6 h/2.75 d) Several

I-133 (20.8 h/8.7 d) ∼1.5 140–150
La-140 (40.2 h/16.7 d) A lot of
Np-239 (2.36 d/23.6 d) 25.6 45.9
Mo-99 (2.75 d/27.5 d) >4.6 4.5 5.67
Te-132 (3.26 d/32.6 d) ∼37.1 31 A lot of 27.0
Xe-133 (5.3 d/53 d) 175.7 180 170 175.5
I-131 (8.04 d/2.7 mo) ∼47.6 48 >85b 32.4–45.9
Ba-140 (12.8 d/4.3 mo) 6.5 6.4 4.59
Cs-136 (12.98 d/4.3 mo) 0.644a
Ce-141 (32.5 d/10.8 mo) 5.3 5.3 5.40
Ru-103 (39.4 d/1 y 1 mo) >4.6 4.5 4.59
Sr-89 (50.6 d/1.39 y) ∼3.1 3.1 2.19
Zr-95 (64.0 d/1.75 y) 5.3 5.3 4.59
Cm-242 (162.8 d/4.6 y) ∼0.024 0.024 0.025
Ce-144 (284 d/7.8 y) ∼3.1 3.1 3.78
Ru-106 (367 d/10 y) >1.97 2.0 0.81
Cs-134 (2.06 y/20.6 y) ∼1.5 1.5 — 1.19–1.30
Kr-85 (10.7 y/107 y) 0.89 — — 0.89
Pu-241 (14.7 y/147 y) ∼0.16 0.16 0.078
Sr-90 (28.5 y/285 y) ∼0.27 0.27 0.22
Cs-137 (30.1 y/301 y) ∼2.3 l2.3 c 1.89–2.30
Pu-238 (86.4 y/864 y) 0.001 0.001 — 0.0001
Pu-240 (6,553 y/65,530 y) 0.001 0.001 0.001
Pu-239 (24,100 y/241,000 y) 0.023 0.001 0.0001
a
Cort and Tsaturov (1998).
b
Nesterenko (1996)—more than 100.
c
Nesterenko (1996)—total emission of Cs-136 and Cs-137 is up to 420 ×1015 Bq (1.14 × 106 Ci).
1.4. Ecological Features 200–400 m of a route, so small, local, highly

of Contamination radioactive “hot spots” can exist without being
marked. The character of actual contamina-
The three most important factors in con- tion of an area is shown on Figure 1.15. As can
nection with the Chernobyl contamination for be seen, a distance of 10 m can make a sharp
nature and public health are: spotty/uneven difference in radionuclide concentrations.
deposits of contamination, the impact of “hot
particles,” and bioaccumulation of radionu-
clides (also see Chapter III). “Public health services of the French department
Vosges found out that a hog hit by one of local
hunters ‘was glowing.’ Experts, armed with su-
1.4.1. Uneven/Spotty Contamination
permodern equipment, conveyed a message even
Until now the uneven/spotty distribution of more disturbing: practically the entire mountain
where the dead animal had just run is radioactive at
the Chernobyl radioactive fallout has attracted a level from 12,000 to 24,000 Bq/m2 . For compar-
too little attention. Aerogamma studies, upon ison, the European norm is 600 Bq/m2 . It was re-
which most maps of contamination are based, membered that radioactive mushrooms were found
give only average values of radioactivity for
20
Figure 1.15. Spotty concentration (Ci/km2 ) of Cs-137 (above) and Ce-144 (below) in
the forest bedding in the 30-km Chernobyl zone. Scale 1:600 (Tscheglov, 1999).
also by other radionuclides, including beta and

in these forests last autumn. The level of Cs-137 alpha emitters. Detailed mapping of territories
in chanterelles, boleros and stalks of mushrooms for the varying spectra of radioactive contami-
exceeded the norm by approximately forty times
. . .” (Chykin, 1997)
nation could not be done owing to the impossi-
bility of fast remote detection of beta and alpha
radionuclides.
There is still uncertainty in regard to con- Typical Chernobyl hot spots measure tens
tamination not only by Cs-137 and Sr-90, but to hundreds of meters across and have levels
of radioactivity ten times higher than the sur-

rounding areas. The concentration density of these houses are occupied by staff of the Chernobyl
Cs-137 can have several different values even atomic power station. While planning occupancy
the special dosimeter commands I developed (I
within the limits of the nutrient area of a single then was the deputy chief engineer of Chernobyl
tree (Krasnov et al., 1997). In Poland, Ru-106 NPP on radiation safety and was responsible for
was the predominant hot spot nuclide in 1986, the personnel in areas found to be contaminated)
although a few hot spots were due to Ba-140 or carried out a radiation check on the apartments. As
La-140 (Rich, 1986). a result of these measurements I sent a report to the
Governmental Commission advising of the inad-
Figure 1.16. shows distinct large-scale spotty
missibility of inhabiting these “dirty” apartments.
radioactive distribution of Sb, Cs, and Ag in The sanitation service of the Kiev municipality . . .
areas of continental Greece. answered with a dishonest letter in which it agreed
that there was radioactivity in these apartments,
but explained it away as dirt that was brought in
1.4.2. Problem of “Hot Particles”
by tenants.” (Karpan, 2007 by permission)
A fundamental complexity in estimating the
levels of Chernobyl radioactive contamination Radioactivity of individual hot particles
is the problem of so-called “hot particles” or reached 10 kBq. When absorbed into the body
“Chernobyl dust.” When the reactor exploded, (with water, food, or inhaled air), such parti-
it expelled not only gases and aerosols (the prod- cles generate high doses of radiation even if
ucts of splitting of U (Cs-137, Sr-90, Pu, etc.), an individual is in areas of low contamina-
but also particles of U fuel melted together tion. Fine particles (smaller than 1 μm) eas-
with other radionuclides—firm hot particles. ily penetrate the lungs, whereas larger ones
Near the Chernobyl NPP, heavy large parti- (20–40 μm) are concentrated primarily in the
cles of U and Pu dropped out. Areas of Hun- upper respiratory system (Khruch et al., 1988;
gary, Germany, Finland, Poland, Bulgaria, and Ivanov et al., 1990; IAEA, 1994). Studies con-
other European countries saw hot particles with cerning the peculiarities of the formation and
an average size of about 15 μm. Their activ- disintegration of hot particles, their properties,
ity mostly was determined to be (UNSCEAR, and their impact on the health of humans and
2000) Zr-95 (half-life 35.1 days), La-140 (1.68 other living organisms are meager and totally
days), and Ce-144 (284 days). Some hot parti- inadequate.
cles included beta-emitting radionuclides such
as Ru-103 and Ru-106 (39.3 and 368 days,
respectively) and Ba-140 (12.7 days). Particles 1.5. Changes in the Radionuclide
with volatile elements that included I-131, Te- Dose Spectrum
132, Cs-137, and Sb-126 (12.4 days) spread
over thousands of kilometers. “Liquid hot parti- To understand the impact of Chernobyl con-
cles” were formed when radionuclides became tamination on public health and the environ-
concentrated in raindrops: ment it is necessary to consider the essential
changes in the radionuclide spectrum during
of the first days, weeks, months, and decades
“Hot particles” were found in new apartment after the Chernobyl catastrophe. The maxi-
houses in Kiev that were to be populated in the mum level of activity from Chernobyl’s fall-
autumn of 1986. In April and May they stood with-
out roofs or windows, so they absorbed a lot of a
out in the first days and weeks, which was due
radioactive dust, which we found in concrete plates mostly to short-lived radionuclides, exceeded
of walls and ceilings, in the carpenter’s room, un- background levels by more than 10,000-fold
der plastic covers on a floor, etc. For the most part (Krishev and Ryazantsev, 2000; and many oth-
ers). Today radioactive contamination is only a
22
Figure 1.16. Maps of the Chernobyl fallout: (A) Sb-124, 125; (B) Cs-137; and (C) Ag-
125m in areas of continental Greece (by permission of S. E. Simopoulos, National Technical
University of Athens; arcas.nuclear.ntua.gr/apache2-default/radmaps/page1.htm).
Figure 1.16. Continued.
small part of all the radiation emitted during Timescales of radiation contamination can
the catastrophe. Based on data from Sweden be determined by an analysis of tooth enamel.
and Finland, ratios of Cs-137 and other ra- Such analyses were conducted by experts with
dionuclide fallout in the first days and weeks the German group “Physicians of the World for
allows for reconstruction of the relative value the Prevention of Nuclear War.” They tested
of the various nuclides that make up the total
external dose (Figure 1.17).
During the first days after the explosion the
share of total external radiation due to Cs-137
did not exceed 4%, but the level of radiation
from I-131, I-133, Te-129, Te-132, and sev-
eral other radionuclides was hundreds of times
higher. Within the succeeding months and the
first year after the explosion the major external
radiation was due to isotopes of Ce-141, Ce-
144, Ru-103, Ru-106, Zr-95, Ni-95, Cs-136,
and Np-239. Since 1987, most external radia-
tion levels have been defined by Cs-137, Sr-90,
and Pu. Today these radionuclides, which are
Figure 1.17. Dynamics of radioisotope structure
found mostly in soil, seriously impact agricul- of Chernobyl’s contamination, percentage of total ac-
tural production (for details see Chapters III.9 tivity (Yablokov, 2002, from Sokolov and Krivolutsky,
and IV.13). 1998).
24
the teeth of 6,000 children and found that chil- 2. In Ukraine in the Poles’e District of Kiev
dren born soon after the Chernobyl catastro- Province, levels of Pb in the air breathed
phe had 10 times more Sr-90 in their teeth by operators of agricultural machinery
compared with children born in 1983 (Ecolo- was up to 10 times or more, exceeding
gist, 2000). maximum permissible concentrations. In-
Problem of Americium-241. The powerful al- creased levels of Pb were apparent in the
pha radiation emitter Am-241, formed as a re- soil and atmosphere and in the urine and
sult of the natural disintegration of Pu-241, is the hair of adults and children in Kiev
a very important factor in the increasing lev- soon after the explosion (Bar’yakhtar,
els of contamination in many areas located 1995).
up to 1,000 km from the Chernobyl NPP. 3. Pb contamination added to radiation
The territory contaminated by Pu today, where causes harm to living organisms (Petin
the level of alpha radiation is usually low, will and Synsynys, 1998). Ionizing radiation
again become dangerous as a result of the fu- causes biochemical oxidation of free rad-
ture disintegration of Pu-241 to Am-241 in icals in cells. Under the influence of
the ensuing tens and even hundreds of years heavy metals (such as Pb) these reactions
(see also Chapter III.9). An additional danger proceed especially intensively. Belarussian
of Am-241 is its higher solubility and conse- children contaminated with both Cs-137
quent mobility into ecosystems compared with and Pb have an increased frequency of
Pu. atrophic gastritis (Gres and Polyakova,
1997).
1.6. Lead Contamination
During operations to quench the fires in 1.7. Evaluation of Chernobyl’s

the fourth reactor of the Chernobyl NPP, heli- Population Doses
copters dumped 2,400 tons of Pb into the reac-
tor (Samushia et al., 2007; UNSCEAR, 2000); The International Atomic Energy Agency
according to other data, the figure was 6,720 (IAEA) and WHO (Chernobyl Forum, 2005)
tons (Nesterenko, 1997). During several sub- estimated a collective dose for Belarus, Ukraine,
sequent days, a significant part of the Pb was and European Russia as 55,000 persons/Sv. By
spewed out into the atmosphere as a result of its other more grounded estimates (see Fairlie and
fusion, boiling, and sublimation in the burning Sumner, 2006) this collective dose is 216,000–
reactor. Moreover, Pb poisoning is dangerous 326,000 persons/Sv (or even 514,000 per-
in itself, causing, for example, retardation in sons/Sv only for Belarus; National Belarussian
children (Ziegel and Ziegel, 1993; and many Report, 2006). The worldwide collective dose
others). from the Chernobyl catastrophe is estimated
at 600,000–930,000 persons/Sv (Table 1.6).
1. Blood Pb levels in both children and adults However, it is now clear that these figures
in Belarus have noticeably increased over for collective doses are considerably underes-
the last years (Rolevich et al., 1996). In the timated.
Brest Province of Belarus, for example, of
213 children studied, the level of Pb was
0.109 ± 0.007 mg/liter, and about half 1.8. How Many People Were and
of these children had levels of 0.188 ± Will Be Exposed to Chernobyl’s
0.003 mg/liter (Petrova et al., 1996), Contamination?
whereas the World Health Organization
(WHO) norm for children is no more than The first official forecasts regarding the
0.001 mg/liter. health impact of the Chernobyl catastrophe
TABLE 1.6. Total Collective Effective Dose (per- has statistical impact on public health) there are
sons/Sv) of Additional Irradiation from the Cher- no fewer than 1 million children, and evacuees
nobyl Catastrophe (Fairlie and Sumner, 2006)
and liquidators have had no fewer than 450,000
U.S. children. It is possible to estimate the number
Department of people living in areas subject to Chernobyl
of Energya UNSCEARb fallout all over the world. Some 40% of Eu-
Belarus, Ukraine, 326,000 216,000 rope has been exposed to Chernobyl’s Cs-137
European Russia at a level 4–40 kBq/m2 (0.11–1.08 Ci/km2 ;
Other European countries 580,000 318,000 see Table 1.2). Assuming that about 35% of
Rest of the world 28,000 66,000
the European population lives in this territory
Total 930,000 600,000
(where radionuclides fell on sparsely populated
a
Anspaugh et al. (1988). mountain areas) and counting the total Euro-
b
Bennett (1995, 1996).
pean population at the end of the 1980s, we
can calculate that nearly 550 million people
included only several additional cases of cancer are contaminated. It is possible to consider that
over a period of some 10 years. In 20 years it has about 190 million Europeans live in noticeably
become clear that no fewer than 8 million in- contaminated areas, and nearly 15 million in
habitants of Belarus, Ukraine, and Russia have the areas where the Cs-137 contamination is
been adversely affected (Table 1.7). higher than 40 kBq/m2 (1.08 Ci/km2 ).
One must understand that in areas contami- Chernobyl fallout contaminated about 8%
nated above 1 Ci/km2 (a level that undoubtedly of Asia, 6% of Africa, and 0.6% of North
TABLE 1.7. Population Suffering from the Chernobyl Catastrophe in Belarus, Ukraine, and European
Russia
Individuals, 103
Group Country Different sources Cardis et al., 1996
Evacuated and movedb Belarus 135,000a 135,000

Ukraine 162,000a —
Russia 52,400a —
Lived in territory contaminated by 270,000
Cs-137 > 555 kBq|m2 (>15 Ci/km2 )
Lived in territory contaminated by Belarus 2,000,000a 6,800,000
7
Cs-137 > 37 kBq/m2 (>1 Ci/km2 ) Ukraine 3,500,000a —
Russia 2,700,000a —
Liquidators Belarus 130,000 200,000 (1986–1987)
Ukraine 360,000 —
Russia 250,000 —
Other countries Not less than 90,000c —
Total 9,379,400 7,405,000
a
Report of the UN Secretary General (2001). Optimization of international efforts in study, mitigation,
and minimization of consequences of the Chernobyl catastrophe (http://daccessdds.un.org/doc/UNDOC/GEN/
N01/568/11/PDF/N0156811.pdf>).
b
Evacuated from city of Pripyat and the railway station at Janov: 49,614; evacuated from 6 to 11 days from 30-km
zone in Ukraine: 41,792, in Belarus: 24,725 (Total 116, 231); evacuated 1986–1987 from territories with density of
irradiation above 15 Ci/km2 —Ukraine: 70,483, Russia: 78,600, Belarus: 110,275. The total number of people forced
to leave their homes because of Chernobyl contamination was nearly 350,400.
c
Kazakhstan: 31,720 (Kaminsky, 2006), Armenia: >3,000 (Oganesyan et al., 2006), Latvia: >6,500, Lithuania:
>7,000 (Oldinger, 1993). Also in Moldova, Georgia, Israel, Germany, the United States, Great Britain, and other
countries.
26
TABLE 1.8. Estimation of the Population (103 ) outside of Europe Exposed to Chernobyl Radioactive
Contamination in 1986
Share of the Population
total Chernobyl Total population, under fallout of
Continent Cs-137 fallout,% end of 1980s 1–40 kBq/m2
Asia 8 2,500,000,000 Nearly 150,000,000

Africa 6 600,000,000 Nearly 36,000,000
America 0.6 170,000,000 Nearly 10,000,000
Total 14.6% 3,270,000,000 Nearly 196,000,000
America, so by similar reasoning it appears that In total, in 1986 nearly 400 million individ-
outside of Europe the total number of individuals (nearly 205 million in Europe and 200
uals living in areas contaminated by Chernobyl million outside Europe) were exposed to ra-
Cs-137 at a level up to 40 kBq/m2 could reach dioactive contamination at a level of 4 kBq/m2
nearly 200 million (Table 1.8). (0.1 Ci/km2 ).
Certainly, the calculated figures in Table 1.8 Other calculations of populations exposed
are of limited accuracy. The true number of to Chernobyl radiation have been based on the
people living in 1986 in areas outside of Europe total collective dose. According to one such cal-
with noticeable Chernobyl contamination can culation (Table 1.9) the number of people who
be no fewer than 150 million and no more than were exposed to additional radiation at a level
230 million. This uncertainty is caused, on the higher than 2.5 × 10−2 mSv might be more
one hand, by calculations that do not include than 4.7 billion and at a level of higher than
several short-lived radionuclides, such as I-131, 0.4 mSv more than 605 million.
I-133, Te-132, and some others, which result in
much higher levels of radiation than that due
to Cs-137. These include Cl-36 and Te-99 with
half-lives of nearly 30,000 years and more than 1.9. Conclusion
21,000 years, respectively (Fairlie and Sumner,
2006). The latter isotopes cause very low levels Most of the Chernobyl radionuclides (up to
of radiation, but it will persist for many mil- 57%) fell outside of the former USSR and
lennia. On the other hand, these calculations caused noticeable radioactive contamination
are based on a uniform distribution of popu- over a large area of the world—practically the
lation, which is not a legitimate assumption. entire Northern Hemisphere.
TABLE 1.9. Population Suffering from Chernobyl Radioactive Contamination at Different Levels of
Radiation Based on Collective Doses (Fairlie, 2007)
Number of Average individual
Group individuals dose, mSv
USSR liquidatorsa 240,000 100

Evacuees 116,000 33
USSR heavily contaminated areas 270,000 50
USSR less contaminated areas 5,000,000 10
Other areas in Europe 600,000,000 ≥0.4
Outside Europe 4,000,000,000 ≥2.5 × 10−2
a
Presumably 1986–1987 (A.Y.).
Declarations that Chernobyl radioactivity Symposium on the Environmental Impact of Ra-

adds only 2% to the natural radioactive back- dioactive Releases, Vienna, May 1995. IAEA-SM-
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Bennett, B. (1996). Assessment by UNSCEAR of world-
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radionuclides at dangerous levels of more than Benninger, L. K., Suayah, I. B. & Stanley, D. J. (1998).
Manzala lagoon, Nile delta, Egypt: Modern sedi-
0.1 Ci/km2 .
ment accumulation based on radioactive tracers. Env.
Chernobyl radioactive contamination is Geology 34(2–3): 183–193.
both dynamic and long term. The dynamic Boccolini, A., Gentili, A., Guidi, P., Sabbatini, V. & Toso,
is delineated as follows: First is the natural A. (1988). Observation of silver-110m in marine mol-
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of radioactive contamination in the first days Borzylov, V. A. (1991). Physical and mathematical mod-
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sands of times higher than those recorded 2 Broda, R. 1987. Gamma spectroscopy analysis of hot par-
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see Chapter III). Third is the contamination Brooke, J. (1988). After Chernobyl, Africans ask if food is
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Chankseliany, Kh. Z. (2006). Soil conditions and le-
not less than 300 years for Cs-137 and Sr-90, gal base for protection from radionuclide contam-
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thousands of years for Am-241. Fifth Congress on Radiation Research (Radiobiol-
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Russian).
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in Belarus, Ukraine, and Russia, but worldwide, T. (2006). Comparative estimation of radioecologi-
will live under measurable chronic radioactive cal situation in Georgian territories 20 years after
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level of external irradiation decreases in some tion Research (Radiobiology Radioecology Radia-
tion Safety), April 10–14, 2006, Moscow (Abstracts,
areas, very serious contamination in the first
Moscow) 3: pp. 12–13 (in Russian).
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with decades of additional and changing con- of the Chernobyl Accident and Their Remediation:
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CHERNOBYL
Chapter II. Consequences of the Chernobyl

Catastrophe for Public Health
Alexey B. Nesterenko,a Vassily B. Nesterenko,a,†
a
b
†Deceased
Key words: Chernobyl; secrecy; irradiation; health statistics
31
CHERNOBYL
2. Chernobyl’s Public Health Consequences

Some Methodological Problems
Alexey V. Yablokov
Problems complicating a full assessment of the effects from Chernobyl included of-
ficial secrecy and falsification of medical records by the USSR for the first 3.5 years
after the catastrophe and the lack of reliable medical statistics in Ukraine, Belarus,
and Russia. Official data concerning the thousands of cleanup workers (Chernobyl liq-
uidators) who worked to control the emissions are especially difficult to reconstruct.
Using criteria demanded by the International Atomic Energy Agency (IAEA), the World
Health Organization (WHO), and the United Nations Scientific Committee on the Effects
of Atomic Radiation (UNSCEAR) resulted in marked underestimates of the number of
fatalities and the extent and degree of sickness among those exposed to radioactive
fallout from Chernobyl. Data on exposures were absent or grossly inadequate, while
mounting indications of adverse effects became more and more apparent. Using objec-
tive information collected by scientists in the affected areas—comparisons of morbidity
and mortality in territories characterized by identical physiography, demography, and
economy, which differed only in the levels and spectra of radioactive contamination—
revealed significant abnormalities associated with irradiation, unrelated to age or
sex (e.g., stable chromosomal aberrations), as well as other genetic and nongenetic
pathologies.
The first official forecasts of the catastrophic to Chernobyl’s radioactive fallout and, for
health consequences of the Chernobyl melt- many generations, they and their descendants
down noted only a limited number of addi- will suffer the devastating consequences. Glob-
tional cases of cancer over the first decades. ally, adverse effects on public health will re-
Four years later, the same officials increased quire special studies continuing far into the
the number of foreseeable cancer cases to sev- future. This review concerns the health of
eral hundred (Il’in et al., 1990), at a time when the populations in the European part of the
there were already 1,000 people suffering from former USSR (primarily, Ukraine, Belarus,
Chernobyl-engendered thyroid cancer. Twenty and European Russia), for which a very large
years after the catastrophe, the official position body of scientific literature has been published
of the Chernobyl Forum (2006) is that about of which but little is known in the Western
9,000 related deaths have occurred and some world.
200,000 people have illnesses caused by the The aim of the present volume is not to
catastrophe. present an exhaustive analysis of all avail-
A more accurate number estimates nearly able facts concerning Chernobyl’s disastrous
400 million human beings have been exposed effects—analyzing all of the known effects of
the Chernobyl catastrophe would fill many
full-size monographs—but rather to eluci-
Address for correspondence: Alexey V. Yablokov, Russian Academy of
Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow, Russia.Voice:
date the known scale and spectrum of its
+7-495-952-80-19; fax: +7-495-952-80-19. [email protected] consequences.
32
Yablokov: Public Health Consequences of Chernobyl 33
2.1. Difficulties in Obtaining

Objective Data on the The number of persons added to the Chernobyl
state registers continues to grow, even during the
Catastrophe’s Impact
most recent years, which casts doubt on the com-
pleteness and accuracy of documentation. Data
For both subjective and objective rea- about cancer mortality and morbidity are gath-
sons, it is very difficult to draw a complete ered from many and various sources and are coded
picture of Chernobyl’s influence on public without taking into account standard international
health. principles . . . public health data connected to the
Chernobyl accident are difficult to compare to offi-
The subjective reasons include: cial state of health statistics . . . (UNSCEAR, 2000,
Item 242, p. 49).
1. The official secrecy that the USSR im-

posed on Chernobyl’s public health data The situation of the liquidators is indicative.
in the first days after the meltdown, which Their total number exceeds 800,000 (see Chap-
continued for more than 3 years—until ter I). Within the first years after the catastrophe
May 23, 1989, when the ban was lifted. it was officially forbidden to associate the dis-
During those 3 years an unknown num- eases they were suffering from with radiation,
ber of people died from early leukosis. and, accordingly, their morbidity data were ir-
Secrecy was the norm not only in the reversibly forged until 1989.
USSR, but in other countries as well, in-
cluding France, Great Britain, and even EXAMPLES OF OFFICIAL REQUIREMENTS THAT
the United States. After the explosion, FALSIFIED LIQUIDATORS’ MORBIDITY DATA:
France’s official Service Central de Pro- 1. “. . . For specified persons hospitalized after ex-
tection Contre les Radiations Ionisantes posure to ionizing radiation and having no signs
(SCPRI) denied that the radioactive cloud or symptoms of acute radiation sickness at the
had passed over France (CRIIRAD, 2002) time of release, the diagnosis shall be ‘vege-
tovascular dystonia.’” [From a letter from the
and the U.S. Department of Agriculture
USSR’s First Deputy Minister of Public Health
failed to disclose that dangerous levels of O. Shchepin, May 21, 1986, # 02–6/83–6 to
Chernobyl radionuclides had been found Ukrainian Ministry of Public Health (cit. by V.
in imported foods in 1987 and 1988. The Boreiko, 1996, pp. 123–124).]
first public announcement of these con- 2. “. . . For workers involved in emergency activ-
taminations was not made until 8 years ities who do not have signs or symptoms of
acute radiation sickness, the diagnosis of veg-
later (RADNET, 2008, Sect. 6 and Sect. etovascular dystonia is identical to no change
9, part 4). in their state of health in connection with radi-
2. The USSR’s official irreversible and ination (i.e., for all intents and purposes healthy
tentional falsification of medical statistics vis-à-vis radiation sickness). Thus the diagno-
for the first 3.5 years after the catastrophe. sis does not exclude somatoneurological symp-
toms, including situational neurosis . . ..” [From
3. The lack of authentic medical statistics in
a telegram of the Chief of the Third Main Ad-
the USSR and after its disintegration in ministration of the USSR’s Ministry of Health,
1991, as well as in Ukraine, Belarus, and E. Shulzhenko, # “02 DSP”-1, dated January
Russia, including health data for hundreds 4, 1987 (cit. by L. Kovalevskaya, 1995, p. 189).]
of thousands of people who left the con- 3. “(1) For remote consequences caused by ioniz-
taminated territories. ing radiation and a cause-and-effect relation-
ship, it is necessary to consider: leukemia or
4. The expressed desire of national and in- leukosis 5–10 years after radiation in doses ex-
ternational official organizations and the ceeding 50 rad. (2) The presence of acute so-
nuclear industry to minimize the conse- matic illness and activation of chronic disease in
quences of the catastrophe.
34
Officially it is admitted that “the full-size per-

persons who were involved in liquidation and sonal dosimeter control of liquidators in the
who do not have ARS (acute radiation sickness Chernobyl Nuclear Power Plant (ChNPP) zone
– Ed.), the effect of ionizing radiation should not
be included as a causal relationship. (3) When
managed to be adjusted only for some months”
issuing certificates of illness for persons involved (National Russian Report, 2001, p. 11). It was
in work on ChNPP who did not suffer ARS in typical to use so-called “group dosimetry” and
point “10” do not mention participation in liq- “group assessment.” Even official medical rep-
uidation activities or the total dose of radiation resentatives recognize that a number of Rus-
that did not reach a degree of radiation sick-
sian liquidators could have received doses seven
ness.” [From an explanatory note of the Cen-
tral Military-Medical Commission of the USSR times (!) higher than 25 cGy, the level specified
Ministry of Defense, # 205 dated July 8, 1987, in the Russian state register (Il’in et al., 1995).
directed by the Chief of 10th MMC Colonel V. Based on official data, this evidence makes the
Bakshutov to the military registration and en- liquidators’ “official” dose/sickness correlation
listment offices (cit. by L. Kovalevskaya, 1995, obsolete and unreliable.
p. 12).]
TWO EXAMPLES OF CONCEALMENT OF TRUE

DATA
Data from the official Liquidators Registers
ON THE CATASTROPHE’S CONSEQUENCES
in Russia, Ukraine, and Belarus cannot be con-
sidered reliable because the status of “liquida- 1. “(4) To classify information on the accident. . .
(8) To classify information on results of medical
tor” conveyed numerous privileges. We do not
treatment. (9) To classify information on the de-
know if an individual described as a “liquida- gree of radioactive effects on the personnel who
tor” was really directly exposed to radiation, participated in the liquidation of the ChNPP
and we do not know the number of individ- accident consequences.” [From the order by
uals who were in the contaminated zone for the Chief of Third Main Administration of the
only a brief time. At the same time, liquidators USSR’s Ministry of Health E. Shulzhenko con-
cerning reinforcing the secrecy surrounding the
who served at the site and were not included activities on liquidation of the consequences of
in official registers are just now coming for- the nuclear accident in ChNPP, #U-2617-S,
ward. Among them are the military men who June 27, 1986 (cit. by L. Kovalevskaya, 1995, p.
participated in the Chernobyl operations but 188).]
lack documentation concerning their partici- 2. “(2) The data on patients’ records related to the
accident and accumulated in medical establish-
pation (Mityunin, 2005). For example, among
ments should have a ‘limited access’ status. And
nearly 60,000 investigated military servicemen data generalized in regional and municipal san-
who participated in the clean-up operations in itary control establishments, . . . on radioactive
the Chernobyl zone, not one (!) had notice of contamination of objects, environment (includ-
an excess of the then-existing “normal” read- ing food) that exceeds maximum permissible
ing of 25 R on his military identity card. At the concentration is ‘classified’.” [From Order #
30-S by Minister of Health of Ukraine A. Ro-
same time a survey of 1,100 male Ukrainian manenko on May 18, 1986, about reinforcing
military clean-up workers revealed that 37% of secrecy (cit. by N. Baranov’ska, 1996, p. 139).]
them have clinical and hematological charac-
teristics of radiation sickness, which means that
these men received more than 25 R exposure Comparison of the data received via indi-
(Kharchenko et al., 2001). It is not by chance vidual biodosimetry methods (by the number
that 15 years after the catastrophe up to 30% of of chromosomal aberrations and by electron
Russian liquidators did not have radiation dose paramagnetic resonance (EPR) dosimetry) has
data on their official certificates (Zubovsky and shown that officially documented doses of ra-
Smirnova, 2000). diation can be both over- and underestimated
(Elyseeva, 1991; Vinnykov et al., 2002; Maznik were not directly measured and calcula-
et al., 2003; Chumak, 2006; and others). The tions were based on dubious assumptions.
Chernobyl literature widely admits that tens These assumptions included an average
of thousands of the Chernobyl liquidators who consumption of a set of foodstuffs by the
worked in 1986–1987, were irradiated at lev- “average” person, and an average level of
els of 110–130 mSv. Some individuals (and, external irradiation owing to each of the
accordingly, some groups) could have received radionuclides. As an example, all official
doses considerably different than the average. calculations of thyroid irradiation in Be-
All of the above indicates that from a strictly larus were based on about 200,000 mea-
methodological point of view, it is impossible to surements done in May–June 1986 on
correlate sickness among liquidators with the fewer than 130,000 persons, or only about
formally documented levels of radiation. Of- 1.3% of the total population. All calcu-
ficial data of thyroid-dosimetric and dosimet- lations for internal irradiation of millions
ric certification in Ukraine were revised several of Belarussians were made on the basis
times (Burlak et al., 2006). of a straw poll of several thousand people
In addition to the subjective reasons noted concerning their consumption of milk and
above, there are at least two major objective vegetables (Borysevich and Poplyko, 2002).
reasons for the difficulty in establishing the Objective reconstruction of received doses
true scale of the catastrophe’s impact on pub- cannot be done on the basis of such data.
lic health. The first impediment is determin- • Difficulty determining the influence of the
ing the true radioactive impact on individuals spotty distribution of radionuclides (spe-
and population groups, owing to the following cific for each one; see Chapter I for details)
factors: and, as a result, the high probability that
the individual doses of personal radiation
• Difficulty in reconstructing doses from the are both higher and lower than “average”
radionuclides released in the first days, doses for the territory.
weeks, and months after the catastrophe. • Difficulty accounting for all of the multiple
Levels of radioisotopes such as I-133, I- radionuclides in a territory. Sr-90, Pu, and
135, Te-132, and a number of other ra- Am can also contaminate an area counted
dionuclides having short half-lives were as contaminated solely by Cs-137. For in-
initially hundreds and thousand of times stance, in 206 samples of breast milk, from
higher than when Cs-137 levels were sub- six districts of the Gomel, Mogilev, and
sequently measured (see Chapter I for de- Brest provinces (Belarus), where the offi-
tails). Many studies revealed that the rate cial level of radiation was defined only by
of unstable and stable chromosome aber- Sr-90 contamination, high levels of Cs-137
rations is much higher—by up to one to were also found (Zubovich et al., 1998).
two orders of magnitude—than would be • Difficulty accounting for the movement of
expected if the derived exposures were radionuclides from the soil to food chains,
correct (Pflugbeil and Schmitz-Feuerhake, levels of contamination for each animal
2006). species and plant cultivar. The same diffi-
• Difficulty in calculating the influence of culties exist for different soil types, seasons,
“hot particles” for different radionuclides and climatic conditions, as well as for dif-
owing to their physical and chemical prop- ferent years (see Chapter III of this volume
erties. for details).
• Difficulty determining levels of external • Difficulty determining the health of in-
and internal radiation for the average dividuals who have moved away from
person and/or group because “doses” contaminated areas. Even considering
36
the incomplete official data for the pe- rious effects from Chernobyl. More and more
riod 1986–2000 for only Belarus, nearly cases are coming to light in which the calcu-
1.5 million citizens (15% of the popula- lated radiation dose does not correlate with ob-
tion) changed their place of residence. For servable impacts on health that are obviously
the period 1990–2000 more than 675,000 due to radiation (IFECA, 1995; Vorob’iev and
people, or about 7% of the population Shklovsky-Kodry, 1996; Adamovich et al., 1998;
left Belarus (National Belarussian Report, Drozd, 2002; Lyubchenko, 2001; Kornev et al.,
2006). 2004; Igumnov et al., 2004; and others). All of
these factors do not prove the absence of radi-
The second objective barrier to determination effects but do demonstrate the inaccurate
ing the true radioactive impact on individuals methodology of the official IAEA, WHO, and
and/or population groups is the inadequacy UNSCEAR approach.
of information and, in particular, incomplete
studies of the following:
• Specificity of the influence of each ra- 2.2. “Scientific Protocols”
dionuclide on an organism, and their ef-
fect in combination with other factors in According to the Chernobyl Forum (2006),
the environment. a common objection to taking into account the
• Variability of populations and individu- enormous body of data on the public health
als in regard to radiosensitivity (Yablokov, consequences of the Chernobyl catastrophe in
1998; and others). Russia, Ukraine, and Belarus is that they were
• The impact of the ultralow doses (Petkau, collected without observing the “scientific pro-
1980; Graeub, 1992; Burlakova, 1995; tocols” that are the norms for Western science.
ECRR, 2003). Usually this means that there was no statisti-
• The influences of internally absorbed cal processing of the received data. Thus, valid
radiation (Bandazhevsky et al., 1995; distinctions among compared parameters, as
Bandazhevsky, 2000). for groups from heavily contaminated versus
those from less contaminated territories or for
The above are the factors that expose groups from areas with different levels of ra-
the scientific fallacy in the requirements out- diation, have not demonstrated statistical sig-
lined by the International Atomic Energy nificance. In the last decade—a sufficient time
Agency (IAEA), the World Health Organiza- span for effects to become manifest—as infor-
tion (WHO), and the United Nations Scientific mation has accumulated, a range of values has
Committee on the Effects of Atomic Radia- been found to be within the limits of true “sta-
tion (UNSCEAR) and similar official national tistical significance.”
bodies that are associated with the nuclear in- One of the authors has considerable ex-
dustry. They demand a simple correlation—“a perience in statistical processing of biologi-
level of radiation and effect”—to recognize a cal material—the review Variability of Mammals
link to adverse health effects as a consequence (Yablokov, 1976) contains thousands of data cal-
of Chernobyl’s radioactive contamination. culations of various biological parameters and
It is methodologically incorrect to combine comparisons. In other reviews as Introduction into
imprecisely defined ionizing radiation expo- Population Phenetics (Yablokov and Larina, 1985)
sure levels for individuals or groups with the and Population Biology (Yablokov, 1987) methodi-
much more accurately determined impacts on cal approaches were analyzed to obtain reliable
health (increases in morbidity and mortality) statistically significant conclusions for various
and to demand a “statistically significant cor- types of biological characteristics. Generalizing
relation” as conclusive evidence of the delete- these and other factors concerning statistical
processing of biological and epidemiological rare cases on the basis of previously pub-
data, it is possible to formulate four positions: lished data. Scientific research methodol-
ogy will be always improved upon, and
1. The calculation “reliability of distinctions today’s “scientific protocols” with, for ex-
by Student,” devised about a century ago ample, “confidence intervals” and “case
for comparison of very small samples, is control,” are not perfect.
not relevant for large-size samples. When
the size of the sample is comparable to It is correct and justified for the whole of
the entire assembly, average value is an society to analyze the consequences of the
exact enough parameter. Many epidemi- largest-scale catastrophe in history and to use
ological studies of Chernobyl contain data the enormous database collected by thousands
on thousands of patients. In such cases the of experts in the radioactively contaminated
averages show real distinctions among the territories, despite some data not being in
compared samples with high reliability. the form of Western scientific protocols. This
2. To determine the reliability of distinctions database must be used because it is impossi-
among many-fold divergent averages, it is ble to collect other data after the fact. The
not necessary to calculate “standard er- doctors and scientists who collected such data
rors.” For example, why calculate formal were, first of all, trying to help the victims,
“significance of difference” among liq- and, second, owing to the lack of time and
uidators’s morbidities for 1987 and 1997 resources, not always able to offer their find-
if the averages differ tenfold? ings for publication. It is indicative that many
3. The full spectrum of the factors influenc- of the medical/epidemiological conferences in
ing one parameter or another is never Belarus, Ukraine, and Russia on Chernobyl
known, so it does not have a great im- problems officially were termed “scientific and
pact on the accuracy of the distinct fac- practical” conferences. Academic theses and
tors known to the researcher. Colleagues abstracts from these conferences were some-
from the nuclear establishment have os- times unique sources of information resulting
tracized one of the authors (A. Y.) for citing from the examination of hundreds of thousands
in a scientific paper the story from the fa- of afflicted individuals. Although the catastro-
mous novel Chernobyl Prayer (English trans- phe is quickly and widely being ignored, this in-
lation Voices from Chernobyl, 2006) by Svet- formation must be made available to the world.
lana Aleksievich. Ms. Aleksievich writes Some very important data that were released
of a doctor seeing a lactating 70-year-old during press conferences and never presented
woman in one Chernobyl village. Sub- in any scientific paper are cited in this volume.
sequently well-founded scientific papers Mortality and morbidity are unquestionably
reported the connection between radia- higher among the medical experts who worked
tion and abnormal production of pro- selflessly in the contaminated territories and
lactin hormone, a cause of lactation in were subject to additional radiation, including
elderly women. exposure to radioactive isotopes from contam-
4. When the case analysis of individual inated patients. Many of these doctors and sci-
unique characteristics in a big data set entists died prematurely, which is one more rea-
does not fit the calculation of average val- son that the medical results from Chernobyl
ues, it is necessary to use a probability ap- were never published.
proach. In some modern epidemiological The data presented at the numerous sci-
literature the “case-control” approach is entifically practical Chernobyl conferences in
popular, but it is also possible to calculate Belarus, Ukraine, and Russia from 1986 to
the probability of the constellations of very 1999 were briefly reported in departmental
38
periodic journals and magazines and in various than the average Chernobyl fallouts and as hu-
collections of papers (“sborniks”), but it is impos- mans successfully inhabit such areas, the Cher-
sible to collect them again. We must reject the nobyl radioactive fallout is not so significant.
criticism of “mismatching scientific protocols,” Let us discuss this argument in detail. Humans
and search for ways to extract the valuable ob- have a similar level of individual variation of ra-
jective information from these data. diosensitivity as do voles and dogs: 10–12% of
In November 2006 the German Federal humans have lower (and about 10–14% have
Committee on Ionizing Radiation organized a higher one) individual radiosensitivity than
the BfS-Workshop on Chernobyl Health Con- everyone else (Yablokov, 1998, 2002). Experi-
sequences in Nuremberg. It was a rare oppor- ments on mammalian radiosensitivity carried
tunity for experts with differing approaches to out on voles showed that it requires strong se-
have open and in-depth discussions and analyze lection for about 20 generations to establish
the public health consequences of the catastro- a less radiosensitive population (Il’enko and
phe. One conclusion reached during this meet- Krapivko, 1988). If what is true for the ex-
ing is especially important for the past Cher- perimental vole populations is also true for
nobyl material: it is reasonable to doubt data humans in Chernobyl contaminated areas, it
lacking Western scientific protocols only when means that in 400 years (20 human genera-
studies using the same or similar material ditions) the local populations in the Chernobyl-
verge. From both scientific and social-ethical contaminated areas can be less radiosensitive
points of view, we cannot refuse to discuss data than they are today. Will individuals with re-
that were acquired in the absence of strict sci- duced radioresistance agree that their progeny
entific protocols. will be the first to be eliminated from popula-
tions?
2.3. Dismissing the Impact One physical analogy can illustrate the im-
of Chernobyl Radionuclides portance of even the smallest additional load of
Is a Fallacy radioactivity: only a few drops of water added
to a glass filled to the brim are needed to initi-
Natural ionizing radiation has always been ate a flow. The same few drops can initiate the
an element of life on Earth. Indeed, it is same overflow when it is a barrel that is filled to
one of the main sources of on-going genetic the brim rather than a glass. Natural radioac-
mutations—the basis for natural selection and tive background may be as small as a glass or
all evolutionary processes. All life on Earth— as big as a barrel. Irrespective of its volume, we
humans included—evolved and adapted in the simply do not know when only a small amount
presence of this natural background radiation. of additional Chernobyl radiation will cause an
Some have estimated that “the fallout from overflow of damage and irreversible change in
Chernobyl adds only about 2% to the global the health of humans and in nature.
radioactive background.” This “only” 2% mis- All of the above reasoning makes it clear that
takenly looks trivial: for many populations in we cannot ignore the Chernobyl irradiation,
the Northern Hemisphere the Chernobyl doses even if it is “only” 2% of the world’s average
could be many times higher compared with the background radiation.
natural background, whereas for others (mostly
in the Southern Hemisphere) it can be close to 2.4. Determining the Impact of the
zero. Averaging Chernobyl doses globally is like Chernobyl Catastrophe on Public
averaging the temperature of hospital patients. Health
Another argument is that there are many
places around of the world where the natural It is clear that various radionuclides caused
radioactive background is many times greater radiogenic diseases owing to both internal and
external radiation. There are several ways to effects. Exact calculations of population dose
determine the influence of such radiation: and dose rate are practically impossible because
•
data were not accurately collected at the time.
Compare morbidity and mortality and
If we truly want to understand and estimate the
such issues as students’ performance in
health impact of the Chernobyl catastrophe in
different territories identical in environ-
a methodologically correct manner, it will be
mental, social, and economic features, but
demonstrated in populations or intrapopula-
differing in the level of radioactive con-
tion group differences varying by radioactive
tamination (Almond et al., 2007). This is
levels in the contaminated territories where the
the most usual approach in the Chernobyl
territories or subgroups are uniform in other
studies.
•
respects.
Compare the health of the same individu-
als (or genetically close relatives—parents,
children, brothers, and sisters) before and References
after irradiation using health indices that
do not reflect age and sex differences, for Adamovich, V. L., Mikhalev, V. P. & Romanova, G. A.
example, stable chromosomal aberrations. (1998). Leucocytic and lymphocytic reactions as fac-
• Compare the characteristics, mostly mor- tors of the population resistance. Hematol. Transfusiol.
bidity, for groups with different levels of in- 43(2): 36–42 (in Russian).
Aleksievich, Sv. (2006). Voices from Chernobyl: The Oral His-
corporated radionuclides. In the first few
tory of the Nuclear Disaster (Picador, New York): XIII +
years after the catastrophe, for 80–90% of 236 pp.
the population, the dose of internal ra- Almond, D. V., Edlund, L. & Palmer, M. (2007). Cher-
diation was mostly due to Cs-137; thus nobyl’s subclinical legacy: Prenatal exposure to
for those not contaminated with other ra- radioactive fallout and school outcomes in Swe-
dionuclides, comparison of diseases in peo- den. NBER Working Paper No. W13347 (//www.
ssrn.com/abstract=1009797).
ple with different levels of absorbed Cs-137 Bandazhevsky, Yu. I. (2000). Medical and Biological Effects
will give objective results of its influence. As of Incorporated Radio-cesium (BELRAD, Minsk): 70 pp.
demonstrated by the work of the BELRAD (in Russian).
Institute (Minsk), this method is especially Bandazhevsky, Yu. I., Lelevich, V. V., Strelko, V. V., Shylo,
effective for children born after the catas- V. V., Zhabinsky, V. N., et al. (1995). Clinical and Ex-
perimental Aspects of the Effect of Incorporated Radionuclides
trophe (see Chapter IV for details).
Upon the Organism (Gomel Medical Institute, Gomel):
• Document the aggregation of clusters of 128 pp. (in Russian).
rare diseases in space and time and com- Baranov’ska, N. P. (Ed.) (1996). Chernobyl Tragedy: Documents
pare them with those in contaminated ter- and Materials (“Naukova Dumka,” Kiev): 784 pp.
ritories (e.g., study on the specific leukoses Boreiko, V. Y. (1996). Stifling the Truth about Chernobyl: White
in the Russian Bryansk Province; Osechin- Spots of the USSR Environmental History—Russia, Ukraine
(Ecological Cultural Center, Kiev) 2: pp. 121–132 (in
sky et al., 1998). Russian).
• Document the pathological changes in Borysevich, N. Y. & Poplyko, I. Y. (2002). Scientific Solution
particular organs and subsequent diseases of the Chernobyl Problems: 2001 Year Results (Republic
and mortality with the levels of incorpo- Radiology Institute, Minsk): 44 pp. (in Russian).
rated radionuclides, for instance, in heart Burlak, G., Naboka, M. & Shestopalov, V. (2006).
Non-cancer endpoints in children-residents after
tissue in Belarus’ Gomel Province (Ban-
Chernobyl accident. In: Proceedings of Interna-
dazhevski, 2000). tional Conference. Twenty Years after Chernobyl Accident:
Future Outlook. Contributed Papers (HOLTEH, Kiev)
It is methodologically flawed for some spe-
1: 37–41 (//www.tesec-int.org/T1.pdf).
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insist on “statistically significant” correlation ological aspects. Rad. Protect. Dosimet. 62(1/2): 13–18
between population doses and adverse health (in Russian).
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Chernobyl Forum (2006). Health Effects of the Chernobyl Kharchenko, V. P., Zubovsky, G. A. & Tararukhyna,
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(Eds.) (WHO, Geneva): 167 pp. (//www.who.int/ Catastrophe (“Viribus Unitis,” Moscow): pp. 46–47
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CHERNOBYL
3. General Morbidity, Impairment, and

Disability after the Chernobyl Catastrophe
Alexey V. Yablokov
In all cases when comparing the territories heavily contaminated by Chernobyl’s ra-
dionuclides with less contaminated areas that are characterized by a similar economy,
demography, and environment, there is a marked increase in general morbidity in the
former. Increased numbers of sick and weak newborns were found in the heavily con-
taminated territories in Belarus, Ukraine, and European Russia.
There is no threshold for ionizing radiation’s as well as rare illnesses (Nesterenko et al.,
impact on health. The explosion of the fourth 1993).
reactor of the Chernobyl Nuclear Power Plant 2. According to data from the Belarus-
(NPP) dispersed an enormous amount of ra- sian Ministry of Public Health, just before
dionuclides (see Chapter I for details). Even the the catastrophe (in 1985), 90% of children
smallest excess of radiation over that of natural were considered “practically healthy.” By 2000
background will statistically (stochastically) af- fewer than 20% were considered so, and in
fect the health of exposed individuals or their the most contaminated Gomel Province, fewer
descendants, sooner or later. Changes in gen- than 10% of children were well (Nesterenko,
eral morbidity were among the first stochastic 2004).
effects of the Chernobyl irradiation. 3. From 1986 to 1994 the overall death rate
In all cases when territories heavily con- for newborns was 9.5%. The largest increase
taminated by Chernobyl radionuclides are (up to 205%), found in the most contaminated
compared with less contaminated areas that Gomel Province (Dzykovich et al., 1996), was
are similar in ethnography, economy, demog- due primarily to disease among the growing
raphy, and environment, there is increased number of premature infants.
morbidity in the more contaminated territo- 4. The number of children with impaired
ries, increased numbers of weak newborns, physical development increased in the heavily
and increased impairment and disability. The contaminated territories (Sharapov, 2001).
data on morbidity included in this chapter 5. Children from areas with contamination
are only a few examples from many similar levels of 15–40 Ci/km2 who were newborn
studies. to 4 years old at the time of the catastro-
phe have significantly more illnesses than those
3.1. Belarus from places with contamination levels of 5–
15 Ci/km2 (Kul’kova et al., 1996).
1. The general morbidity of children notice- 6. In 1993, only 9.5% of children (0 to 4
ably increased in the heavily contaminated ter- years old at the time of the catastrophe) were
ritories. This includes deaths from common healthy in areas within the Kormyansk and
Chechersk districts of Gomel Province, where
soil Cs-137 levels were higher than 5 Ci/km2 .
Address for correspondence: Alexey V. Yablokov, Russian Some 37% of the children there suffer from
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
chronic diseases. The annual increase in dis-
[email protected] ease (per 1,000, for 16 classes of illnesses) in the
42
Yablokov: Morbidity, Impairment, and Disability after Chernobyl 43
TABLE 3.1. Radioactive and Heavy Metal Contamination in Children from the Heavily and Less Con-
taminated Areas (Arinchin et al., 2002)
Heavily contaminated: 73 boys, Less contaminated: 101 boys,
60 girls, avg. age 10.6 years 85 girls, avg. age 9.5 years
First survey (a) Three years later (b) First survey (c) Three years later (d)
mSv 0.77 0.81 0.02∗∗ 0.03∗∗∗

∗
Pb, urine, mg/liter 0.040 0.020 0.017∗∗ 0.03∗
Cd, urine, mg/liter 0.035 0.025 0.02∗∗ 0.015
Hg, urine, mg/liter 0.031 0.021∗ 0.022∗∗ 0.019
∗
b-a, d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).
heavily contaminated areas reached 102–130 higher in the heavily contaminated territories
cases, which was considerably higher than for (Izhevsky and Meshkov, 1998).
less contaminated territories (Gutkovsky et al., 12. Table 3.1 shows the results of two groups
1995; Blet’ko et al., 1995). of children from the heavily and less contam-
7. In the 8 years after the catastrophe, in inated territories surveyed for the years from
the heavily contaminated Luninetsk District, 1995 to 2001. The state of their health was
Brest Province, illnesses per 1,000 children in- obtained by subjective (self-estimation) and ob-
creased 3.5 times—1986–1988: 166.6; 1989– jective (based on clinical observations) studies.
1991: 337.3; 1992–1994: 610.7 (Voronetsky, Each child was followed for 3 years, and indi-
1995). vidual contamination determined by measur-
8. For children of the Stolinsk District, Brest ing the level of incorporated radionuclides (us-
Province, who were radiated in utero from ambi- ing an individual radioactivity counter) and the
ent Cs-137 levels up to 15 Ci/km2 , morbidity levels of Pb and other heavy metals. Data from
was significantly higher for the primary classes Table 3.1 show that within groups the level
of illnesses 10 years later. Disease diagnoses of radioactive contamination did not change
were manifest at ages 6 to 7 years (Sychik and statistically over 3 years, whereas heavy met-
Stozharov, 1999). als levels were slightly reduced, with the ex-
9. The rates of both premature neonates and ception of the Pb level, which increased in
small-for-gestational-age babies in Belarus as a controls.
whole were considerably higher in the more ra- 13. Table 3.2 shows the results of children’s
dioactive contaminated territories for 10 years self-estimation of health. It is clear that chil-
following the catastrophe (Tsimlyakova and dren living in the heavily contaminated ar-
Lavrent’eva, 1996). eas complain more often of various illnesses.
10. Newborns whose mothers had been The number of complaints in the group living
evacuated from a zone of the strict control in heavily contaminated areas was noticeably
(≥15 Ci/km2 ) had a statistically significant greater than in less contaminated places. Al-
longer body, but a smaller head and a smaller though the number of complaints increased in
thorax circumference (Akulich and Gerasy- both the heavily contaminated and the less con-
movich, 1993). taminated groups after 3 years of observation,
11. In the Vetca, Narovly, and Hoyniky dis- most of the parameters were higher among the
tricts of Gomel Province and the Kalinkovich heavily contaminated.
District of Mogilev Province, spontaneous Data in Table 3.3 show that children living
abortions and miscarriages and the numbers of in heavily contaminated areas differed notice-
low-birth-weight newborns were significantly ably from those in less contaminated places for
44
TABLE 3.2. Frequency of Complaints (%) on State of Health—Same Children as Table 3.1 (Arinchin
et al., 2002)
Heavily contaminated areas Less contaminated areas
First survey Three years later First survey Three years later
∗∗
Complaints of state of health 72.2 78.9 45.7 66.1∗ , ∗∗∗
Weakness 31.6 28.6 11.9∗∗ 24.7∗
Dizziness 12.8 17.3 4.9∗∗ 5.8∗∗∗
Headache 37.6 45.1 20.7∗∗ 25.9∗∗∗
Fainting 0.8 2.3 0 0
Nose bleeds 2.3 3.8 0.5 1.2
Fatigue 27.1 23.3 8.2∗∗ 17.2∗
Heart arrhythmias 1.5 18.8∗ 0.5 0.8∗,∗∗∗
Stomach pain 51.9 64.7∗ 21.2∗∗ 44.3∗,∗∗∗
Vomiting 9.8 15.8 2.2∗∗ 12.6∗
Heartburn 1.5 7.5∗ 1.6 5.8∗
Loss of appetite 9.0 14.3 1.1∗∗ 10.3∗
Allergy 1.5 3.0 0.5 5.8∗
∗
b-a; d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).
practically all diseases in both the first and the 15. Primary invalidism in contaminated ter-
second survey. ritories of Belarus noticeably increased af-
The findings in both Table 3.2 and Table 3.3 ter 1993, especially during 1997 and 1998
give a convincing picture of sharply worsening (Figure 3.1).
health for children in the heavily contaminated 16. The number of invalids was notice-
areas. The authors of this research defined ably higher in the more contaminated Gomel
this condition as “ecological disadaptation syn- and Mogilev provinces than in the country
drome” which may be another definitive Cher- as a whole. In the Gomel Province the rel-
nobyl effect (Gres’ and Arinchin, 2001). ative number of invalids was higher, but in
14. According to official statistics in 1993– Mogilev Province there were more sick chil-
1994 primary morbidity was significantly dren (Kozhunov et al., 1996).
higher in territories with Cs-137 levels above 17. According to official data (Medical
15 Ci/km2 (Kozhunov et al., 1996). Consequences, 2003) morbidity of Belarus
TABLE 3.3. Frequency of Clinical Syndromes and Diagnoses (%)—Same Children as in Tables 3.1 and
3.2 (Arinchin et al., 2002)
Heavily contaminated areas Lees contaminated areas
Syndrome/diagnosis First survey Three years later First survey Three years later
Chronic gastroenteric pathology 44.2 36.4 31.9 32.9

Including chronic duodenitis 6.2 4.7 1.5 1.4
Including chronic gastroduodenitis 17.1 39.5∗ 11.6 28.7∗
Gallbladder inflammation 43.4 34.1 17.4∗∗ 12.6∗∗∗
Vascular dystonia and heart syndrome 67.9 73.7 40.3∗∗ 52.2∗,∗∗∗
Asthenia-neurosis 20.2 16.9 7.5∗∗ 11.3
Tonsil hypertrophy and chronic tonsillitis 11.1 9.2 13.6 17.2∗∗∗
Tooth caries 58.9 59.4 42.6∗∗ 37.3∗∗∗
Chronic periodontitis 6.8 2.4 0∗∗ 0.6
∗
b-a; d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).
inated areas (Baida and Zhirnosecova, 1998;

Law of Ukraine, 2006).
3. Children radiated in utero had lower birth
weight and more diseases during the first year
of life as well as irregularities in their physi-
cal development (Stepanova and Davydenko,
1995; Zakrevsky et al., 1993; Zapesochny et al.,
1995; Ushakov et al., 1997; Horishna, 2005).
Figure 3.1. Dynamics of primary invalidism
in Belarus that is officially connected with the
4. From 1997 to 2005 the number of the
catastrophe in heavily (top curve) and less contam- “practically healthy” children in heavily con-
inated provinces (Sosnovskaya, 2006). taminated areas decreased more than sixfold—
from 3.2 to 0.5% (Horishna, 2005).
5. There was appreciably retarded growth
liquidators 1986–1987 was significantly higher
in children from 5 to 12 years of age at the
than for a similarly aged group. The annual dis-
time of the survey in the heavily contaminated
ease rate among this group of liquidators was
territories (Arabskaya, 2001).
up to eight times higher than for the adult pop-
6. In 1999 there were fourfold more sick
ulation of Belarus as a whole (Antypova et al.,
children in contaminated territories than the
1997).
average of such children in Ukraine (Prysyazh-
nyuk et al., 2002).
7. At the beginning of 2005 the percent-
3.2. Ukraine
age of invalid children in contaminated ter-
ritories was more than fourfold that of the
1. For the first 10 years after the catastro-
average among children in other populations
phe, general morbidity in Ukrainian children
(Omelyanets, 2006).
increased sixfold (TASS, 1998) followed by a
8. Among 252 children in contaminated ter-
slight reduction, but 15 years after the catas-
ritories officially recognized as invalids in 2004,
trophe it was 2.9 times higher than in 1986
160 had congenital malformations and 47 were
(Table 3.4).
cancer victims (Law of Ukraine, 2006).
2. In 1988, there was no indication of signif-
9. From 1987 to 1989, it was typical for
icant differences in general morbidity among
children from heavily contaminated territories
children living in heavily contaminated versus
to suffer from functional disturbances of vari-
less contaminated areas, but comparison of the
ous organ systems, indicative of hormonal and
same groups in 1995 showed that morbidity
immune imbalance. By 1996 those functional
was significantly higher in the highly contam-
disturbances had become chronic pathological
processes with long-term relapses that were rel-
TABLE 3.4. Primary and General Morbidity of atively resistant to treatment (Stepanova et al.,
Children (0 to 14 Years) in the Heavily Contami- 1998).
nated Territories of Ukraine, per 1,000 (Grodzin- 10. In spite of the intensive social and med-
sky, 1999; Moskalenko, 2003; Horishna, 2005)
ical programs in place from 1986 to 2003, the
Primary General number (percentage) of “practically healthy”
Year morbidity morbidity children in affected territories decreased 3.7
1987 455 787 times (from 27.5 to 7.2%), and the number
1994 1,139 1,652 (percentage) of “chronically ill” children in-
2001 n/a 2,285 creased from 8.4% in 1986–1987 to 77.8% in
2004 1,423 (1384a ) n/a 2003 (Figure 3.2). The percent of children with
a
By Stepanova (2006). chronic diseases increased steadily—from 8.4%
46
marked increase (Lukyanova et al., 1995). This

trend is continuing: 455.4 per 1,000 in 1987;
866.5 in 1990; 1,160.9 in 1995; 1,367.2 in 2000;
and 1,422.9 in 2004 (Stepanova, 2006b).
13. After the catastrophe the number (per-
centage) of “practically healthy” children in
contaminated territories declined markedly
and the number of sick children significantly
increased (Table 3.5).
14. According to annual surveys during the
Figure 3.2. Number (percentage) of “practically period from 1988 to 2005 there were sever-
healthy” children (1) and those with “chronic patholo-
alfold fewer children of liquidators considered
gies” (2) in affected territories in Ukraine from 1987
to 2003 (Stepanova, 2006a). “practically healthy” than were found in the
control group (2.6–9.2% compared with 18.6–
in 1986–1987 to 77.8% in 2004 (Stepanova, 24.6%); furthermore these liquidators’ children
2006a). At the same time in less contaminated were statistically significantly taller and more
areas the percentage of healthy children has overweight (Kondrashova et al., 2006).
been constant during the last 20 years—up to 15. Children in contaminated territories
30% (Burlak et al., 2006). were undersized and had low body weight
11. In Ukraine in the 15 to 18 years after the (Kondrashova et al., 2006).
catastrophe there has been a steady increase in 16. In the years from 1988 to 2002, among
the numbers of invalid children: 3.1 (per 1,000) adult evacuees the number of “healthy” fell
in 2000, 4.0 in 2002, 4.5 in 2003, and 4.57 in from 68 to 22% and the number “chronically
2004 (Stepanova, 2006a; Figure 3.3). ill” rose from 32 to 77% (National Ukrainian
12. The level of general morbidity among Report, 2006).
evacuee children increased 1.4 times from 1987 17. Morbidity among adults and teenagers in
to 1992 (from 1,224 to 1,665 per 1,000). The the heavily contaminated territories increased
prevalence of diseases for this period rose more fourfold: from 137.2 per 1,000 in 1987 to 573.2
than double (1,425 up to 3,046). General mor- in 2004 (Horishna, 2005).
bidity increased 1.5 to 2.4 times in the con- 18. In 1991 the prevailing primary physi-
taminated territories from the period before the cal disabilities in the contaminated territories
catastrophe until 1992. At the same time, across were due to circulatory problems (39.0%) and
the whole of Ukraine child morbidity showed a diseases of the nervous system (32.3%). Since
2001 the primary disability is neoplasm (53.3%
in 2005). For the period 1992 to 2005 disability
due to neoplasm increased nearly fourfold. The
current second set of primary disabilities in the
contaminated territories is due to circulatory
disease (32.5% in 2005; Table 3.6).
19. According to official Ukrainian data, at
the beginning of 2005 there were 148,199 peo-
ple whose invalidism resulted from the Cher-
nobyl catastrophe; among them were 3,326
children (Ipatov et al., 2006).
Figure 3.3. Number of invalids (per 1,000) 20. From 1988 to 1997 increased morbidity
among children in Ukraine from 1987 to 2003 related to radiation levels was more apparent
(Stepanova, 2006a). in the heavily contaminated territories: up to
TABLE 3.5. Children’s Health (percent in each healthy group) in Contaminated Territories in Ukraine,
1986–1991 (Luk’yanova et al., 1995)
Health group 1986 1987 1988 1989 1990 1991
First (healthy) 56.6 50.9 54.9 39.9 25.9 19.5

Second 34.2 39.1 34.7 41.7 29.3 28.0
Third 8.4 8.9 9.2 16.8 43.1 50.2
Fourth 0.8 1.1 1.2 1.6 1.7 2.3
4.2 times in a zone with more than 15 Ci/km2 , National Ukrainian Report, 2006) and are still
up to 2.3 times in a zone with 5–15 Ci/km2 , increasing (Tables 3.7 and 3.8).
and up to 1.4 times in a zone with 1–5 Ci/km2 26. In the heavily contaminated districts
(Prysyazhnyuk et al., 2002). of Chernygov Province, the general morbidity
21. During the period from 1988 to 2004 significantly exceeded that in areas with less
the number of liquidators who were healthy contamination; the general morbidity for the
decreased 12.8 times: from 67.6 to 5.3%, and entire province was significantly higher 10 years
the number with chronic illnesses increased 6.2 after the catastrophe as compared with 10 years
times: from 12.8 to 81.4% (National Ukrainian before (Donets, 2005).
Report, 2006; Law of the Ukraine, 2006). 27. The general morbidity of Ukrainian liq-
22. Among adult evacuees the occurrence uidators increased 3.5 times in the 10 years fol-
of nonmalignant diseases increased 4.8 times lowing the catastrophe (Serdyuk and Bobyleva,
(from 632 to 3,037 per 10,000) from 1988 to 1998).
2002. Beginning in 1991–1992 the occurrence 28. Typical complaints in the contaminated
and prevalence of these diseases was above the territories in the first year after the catastrophe
average for the country (Figure 3.4). included rapidly developing fatigue (59.6%),
23. From 1988 to 2002 physical disabilities headache (65.5%), blood pressure instability
among adult evacuees increased 42-fold (from (37.8%), abnormal dreaming (37.6%), and
4.6 to 193 per 1,000; National Ukrainian Re- aching joints (30.2%) (Buzunov et al., 1995).
port, 2006).
24. From 1988 to 2003 disabilities among
liquidators increased 76-fold (from 2.7 to 206
per 1,000; Buzunov et al., 2006).
25. From 1988 to 1999 primary morbidity
among the populations in the contaminated
territories doubled (from 621 to 1,276 and
from 310 to 746 per 1,000). Beginning in 1993
these parameters have continually exceeded the
Ukrainian norms (Prysyazhnyuk et al., 2002;
TABLE 3.6. Primary Diseases (%) Resulting in Inva-

lidism Connected with the Chernobyl Catastrophe,
1992 to 2005 (Ipatov et al., 2006)
Illness 1992 2001 2005
Neoplasms 8.3 43.0 53.3 Figure 3.4. Prevalence and occurrence of non-
Nervous system diseases 40.9 4.5 4.5 malignant diseases among adult evacuees and the
Circulatory diseases 30.6 41.0 32.5 population of Ukraine from 1988 to 2002 (National
Ukrainian Report, 2006).
48
TABLE 3.7. Percent of “Practically Healthy” Indi- TABLE 3.9. Primary Invalidism (per 1, 000) in
viduals in Three Categories of Chernobyl Victims Ukraine, 1987–1994 (Grodzinsky, 1999)
in Ukraine, 1987–1994 (Grodzinsky, 1999)
Year Liquidators Evacuees Ukraine
Children born to
Year Liquidators Evacuees irradiated parents 1987 9.6 2.1 0.5
1994 23.2 9.5 0.9
1987 82 59 86
1988 73 48 78
1989 66 38 72
1990 58 29 62 during the 10 years after the catastrophe (Tsyb,
1991 43 25 53 1996).
1992 34 20 45 2. Children from radioactive contaminated
1993 25 16 38 provinces became ill much more often than
1994 19 18 26 children in “clean” regions. The greatest dif-
ferences in morbidity are expressed in the class
29. Since 1987 the number of liquidators in of illness labeled “symptoms, phenomena, and
the category of “ill” has consistently increased: inexact designated conditions” (Kulakov et al.,
18, 27, 34, 42, 57, 64, 75, to 81% (Grodzinsky, 1997).
1999). In the 18 years after the catastrophe the 3. From 1995–1998 the annual prevalence of
number of “sick” liquidators exceeded 94%. In all registered diseases of children in the south-
2003, some 99.9% of the liquidators were offi- west districts of Bryansk Province (Cs-137 > 5
cially “sick” in Kiev; 96.5% in Sumy Province Ci/km2 ), was 1.5–3.3 times the provincial level
were sick and 96% in Donetsk Province (LIGA, as well as the level across Russia (Fetysov, 1999;
2004; Lubensky, 2004). Kuiyshev et al., 2001). In 2004 childhood mor-
30. For the period from 1988 to 1994 there bidity in these districts was double the average
was a manifold increase in primary disabili- for the province (Sergeeva et al., 2005).
ties (invalidism) among liquidators and evac- 4. Childhood morbidity in the contaminated
uees, which exceeded the Ukrainian norms districts of Kaluga Province 15 years after
(Table 3.9). the catastrophe was noticeably higher (Ignatov
31. Disability among liquidators began to et al., 2001).
increase sharply from 1991 and by the year
2003 had risen tenfold (Figure 3.5).
3.3. Russia
1. The total measure of the “health of the

population” (the sum of invalidism and mor-
bidity) in the Russian part of the European
Chernobyl territories worsened up to threefold
TABLE 3.8. Morbidity (per 1,000) in Radioactive

Contaminated Territories of Ukraine (Grodzinsky,
1999; Law of Ukraine, 2006)
Year Adults and teenagers
1987 421.0 Figure 3.5. Invalidism as a result of nonmalig-

1994 1,255.9 nant diseases in Ukrainian liquidators (1986—1987)
2004 2,097.8 from 1988 to 2003 (National Ukrainian Report,
2006).
TABLE 3.10. Initially Diagnosed Children’s Morbidity (M ± m per 1,000) in the Contaminated Districts
of Kaluga Province, 1981–2000 (Tsyb et al., 2006)
Districts 1981–1985 1986–1990 1991–1995 1996–2000
Three heavily contaminated 128.2 ± 3.3 198.6 ± 10.8∗∗ 253.1 ± 64.4∗∗ 130.1 ± 8.5
Three less contaminated 130.0 ± 6.4∗ 171.6 ± 9.0∗ 176.3 ± 6.5∗ 108.9 ± 16.8
Province, total 81.5 ± 6.3 100.4 ± 5.6 121.7 ± 3.2 177.1 ± 10.0
∗
Significantly different from province’s average; ∗∗ significantly different from province’s average and from the period
before the catastrophe.
5. Initially diagnosed childhood illnesses 12. In Bryansk Province there was a tendency
measured in 5-year periods for the years from toward increased general morbidity in liquida-
1981 to 2000 show an increase in the first two tors from 1995 to 1998 (from 1,506 to 2,140
decades after the catastrophe (Table 3.10). per 1,000; Fetysov, 1999).
6. The frequency of spontaneous abortions 13. All the Russian liquidators, mostly young
and miscarriages and the number of newborns men, were initially healthy. Within 5 years after
with low birth weight were higher in the more the catastrophe 30% of them were officially
contaminated Klintsy and Novozybkov districts recognized as “sick”; 10 years after fewer than
of Bryansk Province (Izhevsky and Meshkov, 9% of them were considered “healthy,” and
1998). after 16 years, only up to 2% were “healthy”
7. The number of low-birth-weight children (Table 3.11).
in the contaminated territories was more than 14. The total morbidity owing to all classes
43%; and the risk of birth of a sick child in this of illnesses for the Russian liquidators in
area was more than twofold compared with a 1993–1996 was about 1.5 times above that
control group: 66.4 ± 4.3% vs. 31.8 ± 2.8% for corresponding groups in the population
(Lyaginskaya et al., 2002). (Kudryashov, 2001; Ivanov et al., 2004).
8. Children’s disability in all of Bryansk 15. The number of diseases diagnosed in
Province in 1998–1999 was twice that of three each liquidator has increased: up until 1991
of the most contaminated districts: 352 vs. 174 each liquidator had an average of 2.8 dis-
per 1,000 (average for Russia, 161; Komogort- eases; in 1995, 3.5 diseases; and in 1999,
seva, 2006). 5.0 diseases (Lyubchenko and Agal’tsov, 2001;
9. The general morbidity of adults in 1995– Lyubchenko, 2001).
1998 in the districts with Cs-137 contamination 16. Invalidism among liquidators was appar-
of more than 5 Ci/km2 was noticeably higher ent 2 years after the catastrophe and increased
than in Bryansk Province as a whole (Fetysov, torrentially (Table 3.12).
1999; Kukishev et al., 2001).
10. The general morbidity of the Russian liq-
uidators (3,882 surveyed) who were “under the
TABLE 3.11. State of Health of Russian Liq-
age of 30” at the time of the catastrophe in- uidators: Percent Officially Recognized as “Sick ”
creased threefold over the next 15 years; in the (Ivanov et al., 2004; Prybylova et al., 2004)
group “31–40 years of age” the highest morbid-
Years after the catastrophe Percent “sick”
ity occurred 8 to 9 years after the catastrophe
(Karamullin et al., 2004). 0 0
11. The morbidity of liquidators exceeds that 5 30
10 90–92
of the rest of the Russian population (Byryukov
16 98–99
et al., 2001).
50
TABLE 3.12. Disability in Liquidators (%) Com- 3. HUNGARY. Among infants born in May–
pared to Calculated Radiation Doses, 1990–1993 June 1986 there was a significantly higher num-
(Ryabzev, 2008)
ber of low-birth-weight newborns (Wals and
Disabled (%) Dolk, 1990).
Year 0–5 cGy 5–20 cGy >20 cGy
4. LITHUANIA. Among liquidators (of whom
1,808 survived) morbidity was noticeably
1990 6.0 10.3 17.3 higher among those who were 45 to 54 years of
1991 12.5 21.4 31.1
age during their time in Chernobyl (Burokaite,
1992 28.6 50.1 57.6
1993 43.5 74.0 84.7 2002).
5. SWEDEN. The number of newborns with
low birth weight was significantly higher in July
17. In 1995 the level of disability among liq- 1986 (Ericson and Kallen, 1994).
uidators was triple that of corresponding groups
(Russian Security Council, 2002), and in 1998 ∗∗∗∗∗∗
was four times higher (Romamenkova, 1998).
Some 15 years after the catastrophe, 27% of It is clear that there is significantly increased
the Russian liquidators became invalids at an general morbidity in territories heavily con-
average age of 48 to 49 (National Russian Re- taminated by the Chernobyl fallout and higher
port, 2001). By the year 2004 up to 64.7% of rates of disability among liquidators and others
all the liquidators of working age were disabled who were exposed to higher doses of radiation
(Zubovsky and Tararukhina, 2007). than the general population or corresponding
nonradiated groups. Certainly, there is no di-
3.4. Other Countries rect proof of the influence of the Chernobyl
catastrophe on these figures, but the question
1. FINLAND. There was an increase in the is: What else can account for the increased ill-
number of premature births just after the catas- ness and disability that coincide precisely in
trophe (Harjulehto et al., 1989). time and with increased levels of radioactive
2. GREAT BRITAIN. In Wales, one of the re- contamination, if not Chernobyl?
gions most heavily contaminated by Chernobyl The IAEA and WHO suggested (Chernobyl
fallout, abnormally low birth weights (less than Forum, 2006) that the increased morbidity is
1,500 g) were noted in 1986–1987 (Figure 3.6). partly due to social, economic, and psycholog-
ical factors. Socioeconomic factors cannot be
the reason because the compared groups are
identical in social and economic position, nat-
ural surroundings, age composition, etc. and
differ only in their exposure to Chernobyl con-
tamination. Following scientific canons such
as Occam’s Razor, Mills’s canons, and Brad-
ford Hill criteria, we cannot discern any rea-
son for this level of illness other than the ra-
dioactive contamination due to the Chernobyl
catastrophe.
Figure 3.6. Percent of newborns with birth References

weight less than 1,500 g from 1983 to 1992 (top
curve) and a level of Sr-90 in soil (bottom curve) in Akulich, N. S. & Gerasymovich, G. I. (1993). Physi-
Wales (Busby, 1995). cal development abnormalities in newborns born
to mothers exposed to low doses of ionizing radia- Bar’yakhtar, V. G., (Ed.), Chernobyl Catastrophe: Histo-
tion. In: Belarussian Children’s Health in Modern Ecological riography, Social, Economical, Geochemical, Medical and Bi-
Situation: Consequences of Chernobyl Catastrophe. Treatise ological Consequences (“Naukova Dumka,” Kiev): 558
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Antypova, S. I., Korzhunov, V. M. & Suvorova, I. V. & Stry, N. I. (2006). Main results of epidemiological
(1997). Liquidators’ tendency toward chronic non- studies of Chernobyl liquidator’s health (nonmalig-
specific illnesses. Scientific and Practical Conference. nant morbidity, invalidism and mortality). Interna-
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(in Russian). Kruglova, Z. G., Kochergyna, E. V. et al. (2001). Liq-
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CHERNOBYL
4. Accelerated Aging as a Consequence of the

Chernobyl Catastrophe
Alexey V. Yablokov
Accelerated aging is one of the well-known consequences of exposure to ionizing radia-

tion. This phenomenon is apparent to a greater or lesser degree in all of the populations
contaminated by the Chernobyl radionuclides.
1. Children living in all the Belarussian terri- and other senile eye changes (Fedirko,
tories heavily contaminated by Chernobyl 1999; Fedirko and Kadochnykova, 2007).
fallout evidence a characteristic constella- 7. Early aging is a typical characteristic seen
tion of senile illnesses (Nesterenko, 1996; in liquidators, and many of them develop
and many others). diseases 10 to 15 years earlier than the av-
2. Children from the contaminated ar- erage population. The biological ages of
eas of Belarus have digestive tract ep- liquidators calculated by characteristics of
ithelium characteristic of senile changes aging are 5 to 15 years older than their cal-
(Nesterenko, 1996; Bebeshko et al., 2006). endar ages (Gadasyna, 1994; Romanenko
3. Of 69 children and teenagers hospitalized et al., 1995; Tron’ko et al., 1995; Ushakov
in Belarus from 1991 to 1996 diagnosed et al., 1997).
with premature baldness (alopecia), 70% 8. Chernobyl radiation induced prema-
came from the heavily contaminated ter- ture aging of the eyes (Fedirko and
ritories (Morozevich et al., 1997). Kadochnykova, 2007).
4. The biological ages of inhabitants from 9. Presenile characteristics of liquidators
the radioactive contaminated territories include (Antypova et al., 1997a,b;
of Ukraine exceed their calendar ages by 7 Zhavoronkova et al., 2003; Kholodova and
to 9 years (Mezhzherin, 1996). The same Zubovsky, 2002; Zubovsky and Malova,
phenomenon is observed in Russia (Ma- 2002; Vartanyan et al., 2002; Krasylenko
lygin et al., 1998). and Eler Ayad, 2002; Kirke, 2002;
5. Men and women categorized as middle Stepanenko, 2003; Kharchenko et al.,
aged living in territories with Cs-137 con- 1998, 2004; Druzhynyna, 2004; Fedirko
tamination above 555 kBq/m2 died from et al., 2004; Oradovskaya et al., 2006):
heart attacks 8 years younger than the av-
erage person in Belarus (Antypova and • Multiple illnesses characteristic of senility
Babichevskaya, 2001). in individuals at early ages (10.6 diseases
6. Inhabitants of Ukrainian territories heav- diagnosed in one liquidator is 2.4 times
ily contaminated with radiation devel- higher that the age norm).
oped abnormalities of accommodation • Degenerate and dystrophic changes in var-
ious organs and tissues (e.g., osteoporo-
sis, chronic cholecystitis, pancreatitis, fatty
Address for correspondence: Alexey V. Yablokov, Russian Academy liver, and renal dystrophy).
of Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow, •
Accelerated aging of blood vessels, includ-
ecopolicy.ru ing those in the brain, leading to senile
55
56
encephalopathy in those 40 years of age, tional Conference. Medical Consequences of the Chernobyl
and generalized arteriosclerosis. Catastrophe: The Results of 15 Years of Investigation. June
• Ocular changes, including early senile 4–8, 2001, Kiev, Ukraine (Materials, Kiev): pp. 152–
153 (in Russian).
cataracts and premature presbyopia. Antypova, S. I., Korzhunov, V. M., Polyakov, S. M. & Fur-
• Decline in higher mental function charac- manova, V. B. (1997a). Liquidators’ health problems
teristic of senility. In: Medical Biological Effects and Ways to Overcome the
• Development of Type II diabetes in liq- Consequences of the Chernobyl Accident. (Collection of
uidators younger than 30 years of age. Papers Dedicated to the Tenth Anniversary of the
• Chernobyl Accident, Minsk/Vitebsk): pp. 3–6 (in
Loss of stability in the antioxidant system.
Russian).
• Retina vessel arteriosclerosis. Antypova, S. I., Korzhunov, V. M. & Suvorova, I. V.
• Hearing and vestibular disorders at (1997b). Liquidators’ tendency to develop chronic
younger ages. non-specific illnesses. Scientific and Practical Con-
ference. Actual Problems of Medical Rehabilitation of
10. Evidence of accelerated biological time in Victims of the Chernobyl Catastrophe. June 30, 1997,
liquidators is the shortened rhythm of in- Minsk. (Collection of Papers Dedicated to the
Tenth Anniversary of the Republic’s Radiation
tracircadian arterial pressure (Talalaeva, Medicine Dispensary, Materials, Minsk): pp. 59–60
2002). (in Russian).
11. Findings indicating accelerated aging in Bebeshko, V., Bazyka, D., Loganovsky, K., Volovik, S. &
practically all liquidators are changes in Kovalenko, A. et al. (2006). Does ionizing radiation
blood vessel walls leading to the develop- accelerate aging phenomena? International Confer-
ence. Twenty Years after Chernobyl Accident: Future Outlook.
ment of atherosclerosis. Changes are also
April 24–26, 2006, Kiev, Ukraine. Contributed Pa-
found in epithelial tissue, including that of pers (HOLTEH, Kiev) 1: pp. 13–18 (//www.tesec-
the intestines (Tlepshukov et al., 1998). int.org/T1.pdf).
12. An accelerated rate of aging, measured Druzhynyna, I. V. (2004). Condition of liquidators’
in 5-year intervals, marked by biologi- mandibles. Inter-Region Inter-Institute Scientific
cal and cardiopulmonary changes (and Student Conference, Perm’ April 5–7, 2004 (Ma-
terials, Perm’/Izhevsk) 1: pp. 53–54 (in Russian).
for 11 years by physiological changes) Fedirko, P. (1999). Chernobyl accident and the eyes: Some
was found in 81% of men and 77% of results of a prolonged clinical investigation. Ophthal-
women liquidators (306 surveyed). Liq- mol. 2: 69–73.
uidators younger than 45 years of age Fedirko, P. & Kadochnykova, I. (2007). Risks of eye pathol-
were more vulnerable. The biological age ogy in victims of the Chernobyl catastrophe. In:
Blokov, I., Sadownichik, T., Labunska, I. & Volkov,
of liquidators who worked at the Cher-
I. (Eds.), The Health Effects of the Human Victims of the
nobyl catastrophe site in the first 4 months Chernobyl Catastrophe (Greenpeace International, Am-
after the meltdown exceeds the biologi- sterdam): pp. 16–24.
cal age of those who labored there subse- Fedirko, P. A., Mitchanchuk, N. S. & Kholodenko, T. Yu.
quently (Polyukhov et al., 2000). (2004). Atherosclerotic changes of the aorta and eye
13. It is proposed that the accelerated occur- vessels, and acoustic and vestibular disorders as a
syndrome of premature aging in liquidators (clini-
rence of age-related changes in organs of cal experimental study). J. Otolarygolog. 4: 44–49 (in
liquidators is a radiation-induced progeroid Russian).
syndrome (Polyukhov et al., 2000; Bebeshko Gadasyna, A. (1994). Chernobyl tightens spring of life.
et al., 2006). Izvestiya (Moscow) July 22, p. 3.
Kharchenko, V. P., Kholodova, N. B. & Zubovsky,
G. A. (2004). Clinical and psycho-physical corre-
lates of premature aging after low dose irradiation.
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Klempartskaya, I. N. (1964). Endogenous Infection in the Patho- Stepanenko, I. V. (2003). Results of immunological char-
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pp. (in Russian). 3: 21–23 (in Russian).
Krasylenko, E. P. & Eler Ayad, M. S. (2002). Age charac- Talalaeva, G. V. (2002). Changes of biological time in
teristics and correlation of cerebral hemodynamics liquidators. Herald Kazhakh. Nat. Nucl. Cent. 3: 11–17
in persons with high risk to develop cerebral vascu- (in Russian).
lar pathology. Aging Longev. Problem 11(4): 405–416 (in Tlepshukov, I. K., Baluda, M. V. & Tsyb, A. F. (1998).
Russian). Changes in homeostasis in liquidators. Hematol.
Malygin, V. L., Atlas, E. E. & Zhavoronkova, V. A. (1998). Transfusiol. 43(1): 39–41 (in Russian).
Psychological health of the population in radioac- Tron’ko, N. D., Cheban, A. K., Oleinik, V. A. & Epshtein,
tive contaminated territories (psycho-physiological E. V. (1995). Endocrine system. In: Bar’yakhtar, V.
study). In: International Conference of Psychiatry, Moscow G. (Ed.), Chernobyl Catastrophe: Historiography, Social,
(Materials, Moscow): pp. 87–88 (in Russian). Economical, Geochemical, Medical and Biological Conse-
Mezhzherin, V.A. (1996). Civilization and Noosphera. Book quences (“Naukova Dumka”, Kiev): pp. 454–456 (in
1 (“Logos,” Kiev): 144 pp. (in Russian). Russian).
Morozevich, T.S., Gres’, N. A., Arynchyn, A.N. & Petrova, Ushakov, I. B., Arlashchenko, N. I., Dolzhanov, A. J. &
V. S. (1997). Some eco-pathogenic problems seen in Popov, V. I. (1997). Chernobyl: Radiation Psychophysiology
hair growth abnormalities in Byelorussian children. and Ecology of the Person (Institute of Aviation and Space
Scientific and Practical Conference. Actual Problems Medicine, Moscow): 247 pp. (in Russian).
of Medical Rehabilitation of the Population Suffering from Vartanyan, L. S., Gurevich, S. M., Kozachenko, A. I.,
the Chernobyl Catastrophe. June 30, 1997, Minsk. Ded- Nagler, L. G. & Burlakova, E. B. (2002). Long-term
icated to the Tenth Anniversary of the Republic’s effects of low dose of ionizing radiation on the human
Radiation Medicine Dispensary (Materials, Minsk): anti-oxidant system. Rad. Biol. Radioecol. 43(2): 203–
pp. 38–39 (in Russian). 205 (in Russian).
Nesterenko, V. B. (1996). Scale and Consequences of the Cher- Zhavoronkova, L. A., Gabova, A. V., Kuznetsova, G. D.,
nobyl Catastrophe for Belarus, Ukraine and Russia (Pravo Sel’sky, A. G. & Pasechnik, V. I. et al. (2003). Post-
and Economica, Minsk): 72 pp. (in Russian). radiation effect on inter-hemispheric asymmetry via
Oradovskaya, I. V., Vykulov, G. Kh., Feoktystov, V. V. EEG and thermographic characteristics. J. High Ner-
& Bozheskaya, N. V. (2006). Delayed medical con- vous Activit. 53(4): 410–419 (in Russian).
sequences in liquidators: Results of 20 years of Zubovsky, G. A. & Malova, Yu. V. (2002). Aging abnor-
monitoring. International Conference. Twenty Years malities in liquidators. Clinic. Gerontol. 8(8): 82–83 (in
after Chernobyl: Ecological and Social Lessons. June 5, Russian).
CHERNOBYL
5. Nonmalignant Diseases after the

Alexey V. Yablokov
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 contam-
inated 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 chil-
dren of liquidators and in children born in areas with high levels of radioisotope con-
tamination. Immunological abnormalities and increases in viral, bacterial, and para-
sitic 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 irradia-
tion 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.
5.1. Blood and Lymphatic System among evacuees 9 years after the catastrophe.
Diseases It was 2.4-fold higher for inhabitants of the con-
taminated territories than for all of the popu-
For both children and adults, diseases of lation of Belarus; these rates were, respectively,
the blood and the circulatory and lymphatic 279, 175, and 74 per 10,000 (Matsko, 1999).
systems are among the most widespread con- 2. In 1995, for the Belarus liquidators, in-
sequences of the Chernobyl radioactive con- cidence of diseases of the blood and blood-
tamination and are a leading cause of morbid- forming organs was 4.4-fold higher than for
ity and death for individuals who worked as corresponding groups in the general popula-
liquidators. tion (304 and 69 per 10,000; Matsko, 1999;
Kudryashov, 2001).
5.1.1. Diseases of the Blood and
3. The incidence of hematological ab-
Blood-Forming Organs
normalities was significantly higher among
5.1.1.1. Belarus 1,220,424 newborns in the territories contam-
inated by Cs-137 at levels above 1 Ci/km2
1. The incidence of diseases of the blood
(Busuet et al., 2002).
and blood-forming organs was 3.8-fold higher
4. Incidence of diseases of the blood and
the lymphatic system was three- to five-fold
higher in the most contaminated Stolinsk and
Address for correspondence: Alexey V. Yablokov, Russian Luninetsk districts in Brest Province in 1996
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. than in less contaminated districts (Gordeiko,
[email protected] 1998).
58
Yablokov: Nonmalignant Diseases after Chernobyl 59
TABLE 5.1. Statistics of the Annual Cases of tors’ children born in 1987 (Arynchin et al.,
Belarussian Children with Depression of the 1999).
Blood-Forming Organs after the Catastrophe
12. There is a correlation between increased
(Gapanovich et al., 2001)
Fe-deficient anemia in Belarus and the level
1979–1985 1986–1992 1993–1997 of radioactive contamination in the territory
Number of cases 9.3 14.0 15.6 (Dzykovich et al., 1994; Nesterenko, 1996). In
Cases per 10,000 0.60 ± 0.09 0.71 ± 0.1∗ the contaminated areas of Mogilev Province the
1.00 1.46∗ 1.73∗ number of people with leukopenia and anemia
∗
p < 0.05.
increased sevenfold from 1986 to 1988 com-
pared to 1985 (Gofman, 1994).
13. Primary products of lipid oxidation in
5. The activity of serum complement and the the plasma of children’s blood (0 to 12 months)
number of effective C4 component cells was from Mogilev (Krasnopolsk District), Gomel
significantly lower among 350 children from (Kormyansk District), and Vitebsk (Ushachy
the Belarus area contaminated by Cs-137; in District) provinces contaminated with Cs-137
more contaminated areas (>15 Ci/km2 ) there statistically significantly declined from 1991 to
was a significantly lower level of C3 component 1994. The amount of vitamins A and E in ba-
cells (Zafranskaya et al., 1995). bies’ blood from the more contaminated ter-
6. Myelotoxic activity of the blood (MTA) ritories (up to 40 Ci/km2 ) decreased 2.0- to
and the number of T lymphocytes were signif- 2.7-fold (Voznenko et al., 1996).
icantly lower in multiple sclerosis patients from 14. Children from Chechersk District
areas with Cs-137 contamination from 5–15 (Gomel Province) with levels of 15–40 Ci/km2
Ci/km2 (Fyllypovich, 2002). of Cs-137 and from Mtzensk and Bolkhovsk
7. Absolute and relative numbers of lympho- districts (Oryol Province, Russia) with levels
cytes, as a percent of basophilic cells were sig- of 1–15 Ci/km2 have lipid oxidation products
nificantly higher among adults and teenagers that are two- to sixfold higher. The levels of
living in Gomel Province territories with a level irreplaceable bioantioxidants (BAO) were two-
of Cs-137 contamination from 15–40 Ci/km2 to threefold lower than norms for the corre-
(Miksha and Danylov, 1997). sponding age ranges. Contaminated children
8. Evacuees and those still living in heav- have rates of metabolism of BAO two- to ten-
ily contaminated territories have a significantly fold higher than the age norms (Baleva et al.,
lower percent of leukocytes, which have ex- 2001a).
pressed pan-D cellular marker CD3 (Baeva and 15. For boys irradiated in utero there was a re-
Sokolenko, 1998). duction in direct and an increase in free biliru-
9. The leukocyte count was significantly bin in blood serum over 10 years. For girls there
higher among inhabitants of Vitebsk and was a reduced concentration of both direct
Gomel provinces who developed infectious dis- and indirect bilirubin (Sychik and Stozharov,
eases in the first 3 years after the catastrophe 1999a,b).
compared with those who already were suffer-
ing from these diseases (Matveenko et al., 1995).
10. The number of cases of preleukemic con- 5.1.1.2. Ukraine
ditions (myelodysplastic syndrome and aplastic 1. Children in the heavily contaminated ter-
anemia) increased significantly during the first ritories have a level of free oxidizing radicals
11 years after the catastrophe (Table 5.1). in their blood that is significantly higher than
11. Significant changes in the structure of in those in the less contaminated territories:
the albumin layer of erythrocyte membranes 1,278 ± 80 compared with 445 ± 36 measured
(increased cell fragility) occurred in liquida- as impulses per minute (Horishna, 2005).
60
2. Children of liquidators living in the con- 9. In the contaminated territories, anemia

taminated territories had two- to threefold was found in 11.5% of 1,926 children examined
higher blood and blood-forming-organ mor- in 1986–1998 (Bebeshko et al., 2000).
bidity compared to children from noncontam-
5.1.1.3. Russia
inated territories (Horishna, 2005).
3. Diseases of the blood and circulatory sys- 1. Diseases of the blood and blood-forming
tem for people living in the contaminated ter- organs caused much greater general morbidity
ritories increased 11- to 15-fold for the first in children from contaminated areas (Kulakov
12 years after the catastrophe (1988–1999; et al., 1997).
Prysyazhnyuk et al., 2002). 2. Morbidity owing to abnormalities of the
4. In 1996, morbidity of the blood-forming blood and the circulatory system has more than
organs in the contaminated territories was 2.4- doubled in children in the contaminated dis-
fold higher than for the rest of Ukraine (12.6 tricts of Tula Province and has increased in
and 3.2 per 10,000; Grodzinsky, 1999). all the contaminated districts in comparison
5. For the first 10 years after the catastro- with the period before the catastrophe (Sokolov,
phe the number of cases of diseases of blood 2003).
and blood-forming organs among adults in the 3. In 1998 the annual general morbidity from
contaminated territories of Zhytomir Province blood, blood-forming organs, and the circula-
increased more than 50-fold: from 0.2 up to tory system of children in the contaminated
11.5% (Nagornaya, 1995). districts of Bryansk Province significantly ex-
6. For a decade after the catastrophe, mor- ceeded the provincial level (19.6 vs. 13.7 per
bidity of the blood and blood-forming organs 1,000; Fetysov, 1999a).
in adults and teenagers living in contaminated 4. For liquidators, the morbidity from blood
territories increased 2.4-fold: from 12.7 in 1987 and blood-forming organs grew 14.5-fold be-
to up to 30.5 per 10,000 in 1996. For the re- tween 1986 and 1993 (Baleva et al., 2001).
maining population of Ukraine this level re- 5. Critically low lymphocyte counts were
mained at the precatastrophe level (Grodzinsky, seen in children in the contaminated districts
1999). of Bryansk Province over a 10-year survey af-
7. During the acute iodic period (the first ter the catastrophe (Luk’yanova and Lenskaya,
months after the catastrophe) abnormal blood 1996).
cell morphology was found in more than 6. In almost half of the children, blood
92% of 7,200 surveyed children living in hemoglobin levels exceeded 150 g/liter in the
the area, and 32% of them also had ab- settlements of Bryansk Province that had high
normal blood counts. Abnormalities included levels of Cs-137 soil contamination and a level
mitochondrial swelling and stratification of of contamination from Sr-90 (Lenskaya et al.,
nuclear membranes, expansion of the peri- 1995).
nuclear spaces, pathological changes in cell sur- 7. Individuals living in the contaminated
faces, decreased concentration of cellular sub- areas have fewer lymphocytes with adaptive
stances, and increase in the volume of water. reaction, and the number of people with
The last is an indication of damage to the cel- higher lymphocytes radiosensitivity increased
lular membranes (Stepanova and Davydenko, (Burlakova et al., 1998).
1995). 8. The numbers of leukocytes, erythrocytes,
8. During 1987–1988 qualitative changes lymphocytes, and thrombocytes in liquida-
in blood cells were found in 78.3% of chil- tors’ peripheral blood were markedly different
dren from zones with radiation levels of (Tukov et al., 2000). The number of large gran-
5–15 Ci/km2 (Stepanova and Davydenko, ulocytic lymphocytes decreased by 60–80% 1
1995). month after the liquidators began work and
TABLE 5.2. Dynamics of the Interrelation by Lymphopoietic Type (in %, See Text) in Russian Liquidators
(Karamullin et al., 2004)
Lymphopoietic types
Time after the
catastrophe Quasi-normal Hyperregeneratory Hyporegeneratory
0 to 5 years 32 55 13
5 to 9 years 38 0 62
10 to 15 years 60 17 23
Control group 76 12 12
stayed at a lower level for at least 1 year • Quantity of the POL by-products (by mal-
(Antushevich and Legeza, 2002). onic aldehyde concentration) and by vis-
9. The glutathione level in blood proteins cosity of membranes and on a degree of the
and cytogenic characteristics of lymphocytes lipids nonsaturation (Baleva et al., 2001a).
were markedly different in children born 5 to • Imbalance of the intermediate-size
7 years after the catastrophe in the contam- molecules in thrombocytes, erythrocytes,
inated Mtsensk and Bolkhov districts, Oryol and blood serum (Zagradskaya, 2002).
Province, Russia, and in Chechersk District, • Decreased scattering of the granular com-
Gomel Province, Belarus (Ivanenko et al., ponent of lymphocyte nuclei reduction of
2004). the area and perimeter of the perigranular
10. In the contaminated territories of Kursk zones; and increased toothlike projection
Province changes in lymphocyte counts and of this zone (Aculich, 2003).
functional activity and the number of circulat- • Increased intravascular thrombocyte ag-
ing immune complexes were seen in the blood gregation (Tlepshukov et al., 1998).
of children 10 to 13 years of age and in pregnant • Increased blood fibrinolyic activity and
women (Alymov et al., 2004). fibrinogen concentration in blood serum
11. Significant abnormal lymphocytes and (Tlepshukov et al., 1998).
lymphopenia was seen more often in children in
the contaminated territories (Sharapov, 2001; 13. Liquidators’ lymphopoesis remained
Vasyna et al., 2005). Palpable lymph nodes oc- nonfunctional 10 years after the catastrophe
curred with greater frequency and were more (Table 5.2).
enlarged in the heavily contaminated territo- It is known that Japanese juvenile atomic
ries. Chronic tonsillitis and hypertrophy of the bomb victims suffer from diseases of the blood-
tonsils and adenoids were found in 45.4% of forming organs 10 times more often than con-
468 children and teenagers examined (Bozhko, trol groups, even in the second and third gen-
2004). erations (Furitsu et al., 1992). Thus it can
12. Among the liquidators, the following pa- be expected that, following the Chernobyl
rameters of the blood and lymphatic system catastrophe, several more generations will de-
were significantly different from controls: velop blood-forming diseases as a result of the
radiation.
• Average duration of nuclear magnetic
resonance relaxation (NPMR) of blood
plasma (Popova et al., 2002). 5.1.2. Cardiovascular Diseases
• Receptor–leukotrene reaction of erythro- Cardiovascular diseases are widespread in
cyte membranes (Karpova and Koret- all the territories contaminated by Chernobyl
skaya, 2003). emissions.
62
5.1.2.1. Belarus and others). Increased arterial pressure oc-

curred significantly more often in adults in the
1. Cardiovascular disease increased nation- Mogilev Province, where contamination was
wide three- to fourfold in 10 years compared above 30 Ci/km2 (Podpalov, 1994). Higher
to the pre-Chernobyl period and to an even arterial pressure in children correlated with
greater degree in the more heavily contami- the quantity of the incorporated Cs-137
nated areas (Manak et al., 1996; Nesterenko, (Bandazhevskaya, 2003; Kienya and Ermolit-
1996). sky, 1997).
2. Impaired cardiovascular homeostasis is 8. Compared to healthy children, brain ar-
characteristic for more newborns in the first 4 terial vessels in children 4 to 16 years old were
days of life in districts with contamination lev- more brittle among children in contaminated
els higher than 15–40 Ci/km2 (Voskresenskaya areas in Gomel (Narovlyansky, Braginsk, El’sk,
et al., 1996). and Khoiniky districts), Mogilev (Tchernikovsk,
3. Incidence of hemorrhages in newborns in Krasnopol’sk, and Slavgorodsk districts), and
the contaminated Chechersky District of the Brest provinces (Arynchin et al., 1996, 2002;
Gomel Province is more than double than be- Arynchin, 1998).
fore the catastrophe (Kulakov et al., 1997). 9. Morbidity of the circulatory system among
4. Correlated with levels of radiation, children born to irradiated parents was signifi-
changes in the cardiovascular system were cantly higher from 1993 to 2003 (National Be-
found in more than 70% of surveyed chil- larussian Report, 2006).
dren aged 3 to 7 years from contaminated ter- 10. The volume of blood loss during Cae-
ritories of Gomel Province (Bandazhevskaya, sarean birth was significantly higher for women
1994). from Gomel Province living in the territo-
5. In 1995, cardiovascular system morbidity ries contaminated by Cs-137 at levels of 1–
among the population in the contaminated ter- 5 Ci/km2 compared to those from uncontami-
ritories and evacuees was threefold higher than nated areas (Savchenko et al., 1996).
for Belarus as a whole (4,860 and 1,630 per 11. Blood supply to the legs, as indicated by
100,000; Matsko, 1999). vasomotor reactions of the large vessels, was sig-
6. More than 70% of newborn to 1-year- nificantly abnormal for girls age 10 to 15 years
old children in territories with Cs-137 soil who lived in areas with a level of Cs-137 con-
contamination of 5–20 Ci/km2 have had car- tamination higher than 1–5 Ci/km2 compared
diac rhythm abnormalities (Tsybul’skaya et al., with those in the less contaminated territories
1992; Bandazhevsky, 1997). Abnormalities of (Khomich and Lysenko, 2002; Savanevsky and
cardiac rhythm and conductivity correlated Gamshey, 2003).
with the quantity of incorporated radionu- 12. The primary morbidity of both male
clides (Bandazhevsky et al., 1995; Bandazhevsky and female liquidators was high blood pressure,
1999). There were significantly higher inci- acute heart attacks, cerebrovascular diseases,
dence and persistence of abnormalities of car- and atherosclerosis in of the arms and legs,
diac rhythm in patients with ischemic heart which increased significantly in 1993–2003, in-
disease in contaminated territories (Arynchyna cluding in the young working group (National
and Mil’kmanovich, 1992). Belarussian Report, 2006).
7. Both raised and lowered arterial blood 13. In the observation period 1992–1997
pressure were found in children and adults there was a 22.1% increase in the incidence of
in the contaminated areas (Sykorensky and fatal cardiovascular disease among liquidators
Bagel, 1992; Goncharik, 1992; Nedvetskaya compared to 2.5% in the general population
and Lyalykov, 1994; Zabolotny et al., 2001; (Pflugbeil et al., 2006).
TABLE 5.3. Cardiovascular Characteristics of Male Liquidators in Voronezh Province (Babkin et al.,
2002)
Inhabitants of
Liquidators contaminated Control
Parameter (n = 56) territory (n = 60) (n = 44)
AP–a systole 151.9 ± 1.8∗ 129.6 ± 2.1 126.3 ± 3.2

AP–diastole 91.5 ± 1.5∗ 83.2 ± 1.8 82.2 ± 2.2
IBH, % 9.1∗ 46.4 33.3
Insult, % 4.5∗ 16.1∗ 0
Thickness of carotid wall, mm∗ 1.71 ± 0.90∗ 0.81 ± 0.20 0.82 ± 0.04
Overburdening heredity, % 25 25 27.3
∗
Statistically significant differences from control group.
5.1.2.2. Ukraine three- to fivefold higher than the average

1. The morbidity from circulatory diseases in (Komogortseva, 2006).
1996 in the contaminated territories was 1.5- 2. The incidence of hemorrhages among
fold higher than in the rest of Ukraine (430 vs. newborns in the contaminated Mtsensk and
294 per 10,000; Grodzinsky, 1999). Volkovsk districts, Oryol Province, is double
2. Symptoms of early atherosclerosis were what it was prior to the catastrophe (Kulakov
observed in 55.2% of children in territories con- et al., 1997).
taminated at a level of 5–15 kBq \ m2 (Burlak 3. For liquidators, morbidity from circula-
et al. 2006). tory disease increased 23-fold between 1986
3. Diseases of the cardiovascular system oc- and 1994 (Baleva et al., 2001). In 1995–1998
curred significantly more often in children ir- morbidity in Bryansk Province liquidators in-
radiated in utero (57.8 vs. 31.8%, p < 0.05; creased 2.2-fold (Fetysov, 1999b). According
Prysyazhnyuk et al., 2002). to other data, for 1991–1998 morbidity in-
4. Incidence of hemorrhage in newborns creased 1.6-fold (Byryukov et al., 2001). Some
in the contaminated Polessk District, Kiev 13 years after the catastrophe cardiovascu-
Province, has more than doubled since the lar morbidity among liquidators was fourfold
catastrophe (Kulakov et al., 1997). Atheroscle- higher than in corresponding groups of the
rosis and ischemic disease of the heart are population (National Russian Report, 1999).
seen significantly more often in young evacuees 4. The health of liquidators differs signifi-
and in those living in contaminated territories cantly from that of control groups, the former
(Prokopenko, 2003). having higher arterial blood pressure, more is-
5. Liquidators’ morbidity from vegetal- chemic heart disease, and increased cardiac
vascular dystonia (tachycardia, hyperthy- wall thickness characteristic of atherosclerosis.
roidism, and neuropathy) was 16-fold higher The liquidators living in contaminated territo-
than the average for Ukraine in the first 10 years ries of Voronezh Province differed from control
after the catastrophe (Serdyuk and Bobyleva, groups also in the number of strokes (cerebral
1998). vascular accidents) and the cases of ischemic
heart disease (Table 5.3).
5. Ten years after the catastrophe there was
5.1.2.3. Russia an increase in the incidence of high arterial
1. For the three heavily contaminated dis- blood pressure among a large group of liq-
tricts in Bryansk Province, morbidity in chil- uidators who worked from April to June 1986
dren from circulatory system problems is (Kuznetsova et al., 2004). Increased systolic
64
blood pressure was characteristic for all the liq- liquidators in 2000 (Khrysanfov and Meskikh,
uidators examined (Zabolotny et al., 2001). 2001). Hypertension morbidity in a group of
6. From 1991 to 1998 the incidence of is- liquidators increased from 18.5% in 1993 to
chemic heart disease in liquidators increased 24.8% in 1996 (Strukov, 2003). Hypertension is
threefold, from 20 to 58.9% (Zubovsky and seen even more often in children of liquidators
Smirnova, 2000). Ischemic heart disease de- (Kulakov et al., 1997).
veloped in one-third of 118 liquidators un- 10. After a second evaluation in 2000–
der observation for 15 years (Noskov, 2004). 2001, atherosclerosis of the brachiocephalic ar-
From 1993 to 1996 another group of liquidators teries was found in several members of the
demonstrated a significant increase in ischemic same large group of the liquidators origi-
heart disease, from 14.6 to 23.0% (Strukov, nally examined in 1993–1994 (Shamaryn et al.,
2003). Morbidity and the frequency of occur- 2001).
rence of ischemic heart disease in liquidators 11. Left-heart ventricular mass was signif-
and in the general population of the contami- icantly larger in liquidators although arte-
nated territories continue to grow (Khrysanfov rial pressures were normal (Shal’nova et al.,
and Meskikh, 2001). 1998).
7. For all the liquidators examined, it was 12. Typically abnormalities persisted in liq-
typical to find lowered tonus of arterial vessels uidators for a long time after the catastro-
in the circle of Willis in the brain (Kovaleva phe (Shamaryn et al., 2001; Khrysanfov and
et al., 2004). Meskikh, 2001; Kuznetsova et al., 2004).
8. Impairment of blood circulation in the 13. Abnormal vascular circulation of the
brain (neurocirculatory dystonia) was found in eye was found in all of the liquidators exam-
a majority of the liquidators examined in 1986– ined (Rud’ et al., 2001; Petrova, 2003). Liq-
1987, and the number of such cases is increas- uidators were also found to suffer from dimin-
ing (Romanova, 2001; Bazarov et al., 2001; ished antimicrobial properties of vessel walls
Antushevich and Legeza, 2002; Kuznetsova (Tlepshukov et al., 1998).
et al., 2004; and others). These changes occur 14. Liquidators with ischemic heart disease
mainly owing to disease of small arteries and differ significantly in many homodynamic pa-
arterioles (Troshyna, 2004) and occurred more rameters compared with other patients of the
frequently in young liquidators (Kuznetsova same age (Talalaeva, 2002).
et al., 2004). Impairment of blood circulation in
the brain among liquidators is sometimes de- 5.1.2.4. Other Countries
fined as dyscirculatory encephalopathy (DCE), MOLDOVA. Liquidators from Chisinau evi-
a chronic cerebral vascular pathology leading dence a triple increase in cardiovascular dis-
to functional and organic destruction of the eases over the last years and the incidence
central nervous system. DCE was found in among them is now double that of control
40% of the cases of structural brain circula- groups. Some 25% of the liquidators examined
tory disease in Russian liquidators in 2000. This developed thickening of the aortic wall, and
pathological condition is specific for the impact 22% have left ventricular hypertrophy (Kirkae,
caused by small doses of Chernobyl radioactiv- 2002).
ity and is not listed in the international classi-
fication of illnesses (Khrysanfov and Meskikh, 5.1.3. Conclusion
2001).
9. Hypertension is seen markedly more often Diseases of blood, blood-forming organs,
among both liquidators and people living in the and the circulatory system are, undoubtedly,
contaminated territories. High blood pressure major components of the general morbidity of
accounted for 25% of the cases of pathology in inhabitants of the territories contaminated by
the Chernobyl radiation, including evacuees, structure and normal number of chromosomes
migrants, and liquidators and their children. In in those radiated by Chernobyl fallout. Accu-
spite of the fact that the general picture of the mulated data show genetic polymorphism of
blood and circulatory systems is still far from proteins and changes in satellite DNA.
complete, it is clear that one of the common
reasons for these functional impairments is ra- 5.2.1.1. Chromosomal Mutations
dioactive destruction of the endothelium, the Ionizing radiation causes various changes in
covering surface of vessels. the general structure of chromosomes: nonsta-
The severe impact of radioactive contami- ble aberrations (dicentrics, centric rings, non-
nation from Chernobyl resulting in increasing centric fragments), which are rather quickly
morbidity of the blood and circulatory system eliminated in subsequent cell generations, and
cannot be doubted. stable aberrations (different types of transloca-
tions at separate chromosomal sites), which are
retained for many years. The frequency of chro-
5.2. Genetic Changes mosomal aberrations in somatic cells, obtained
by studying lymphocytes, reflects the general
Changes in genetic structures in both repro- status of chromosomes throughout the body, in-
ductive and somatic cells determine and define cluding increasing dicentric and ring chromo-
the occurrence of many diseases. Ionizing ra- some abnormalities in mothers and their new-
diation causes damage to hereditary structures. borns in the contaminated territories (Matsko,
The huge collective dose from the Chernobyl 1999).
catastrophe (127–150 million persons/rad) has Histological analysis of peripheral blood
resulted in damage that will span several gen- lymphocytes reveals structural and chromoso-
erations, causing changes in genetic structures mal number aberrations. Presence of cells with
and various types of mutations: genomic mu- several aberrations (multiaberrant cells) may in-
tations (change in the number of chromo- dicate the level of the impact of Pu (Il’inskikh
somes), chromosomal mutations (damage to et al., 2002). An additional parameter of ge-
the structure of chromosomes—translocations, netic variability is the so-called mitosis index,
deletions, insertions, and inversions), and small the number of mitoses per 100 cells.
(point) mutations. Occurrence of a chromosomal aberration
Twenty-two years after the catastrophe data does not necessarily mean development of dis-
concerning genetic damage linked to additional ease, but it does signal both the likely emer-
Chernobyl irradiation was released. This sec- gence of various tumors, owing to somatic cell
tion presents data not only on the various types impairment (e.g., in blood cells), and also im-
of mutations that have resulted from the catas- paired reproductive cells. Altered structure of
trophe (Section 5.2.1), but also on genetically generative chromosomes (in sperm and ova)
caused congenital developmental anomalies indicates genetic predisposition to various dis-
(Section 5.2.4) and the health of the subsequent eases in the next generation.
generation, the children born to irradiated par- The incidence of chromosomal aberrations
ents (Section 5.2.5). is significantly higher in all of the terri-
tories contaminated by the Chernobyl nu-
5.2.1. Changes in the Frequency clear fallout (Lazyuk et al., 1990; Stepanova
of Mutations and Vanyurikhyna, 1993; Pilinskaya, 1994;
Sevan’kaev et al., 1995a; Vorobtsova et al., 1995;
There are many convincing studies show- Mikhalevich, 1999; and others; Table 5.4).
ing increased frequency of chromosomal and The Chernobyl fallout caused a further in-
genomic mutations, including changes in the crease in the already elevated number of
66
TABLE 5.4. Incidence of (%, M ± m) Aber- in 1994 in Belarus to parents who continued to
rant Cells and Chromosomal Aberrations (per live in contaminated territories after the catas-
100 Lymphocytes) before and after the Cher-
trophe. This was more than twice that in the
nobyl Catastrophe (Bochkov et al., 1972, 2001;
Pilinskaya, 1992; Bezdrobna et al., 2002) DNA of children from 105 controls (families
in Great Britain) and has been correlated with
Aberrant Chromosomal the level of radioactive contamination in the
cells, n aberrations, n
district where the parents lived (Dubrova et al.,
Ukraine, early 1970s n/a 1.19 ± 0.06 1996, 1997, 2002).
Ukraine, before 1986 1.43 ± 0.16 1.47 ± 0.19 3. The same children examined 1 year and
Average in the world, 2000 2.13 ± 0.08 2.21 ± 0.14 2 years after the catastrophe had significant in-
Ukraine, Kiev, 1998–1999 3.20 ± 0.84 3.51 ± 0.97
30-km Chernobyl zone, 5.02 ± 1.95 5.32 ± 2.10
creases in the number of chromosomal aber-
1998–1999 rations (5.2 + 0.5% in 1987 and 8.7 + 0.6%
in 1988). During the same evaluation, a signif-
icant increase in the number of multiaberrant
chromosomal mutations observed worldwide cells with two to four aberrations was found
that is associated with the atmospheric nuclear (16.4 + 3.3% in 1987 and 27.0 + 3.4% in
weapons testing that was carried out until the 1988). The occurrence of cells with three to
1980s. four aberrations was especially higher in chil-
dren from the more contaminated Khoiniky
and Braginsk districts (Mikhalevich, 1999).
5.2.1.1.1. Belarus 4. Elevated chromosomal aberrations are
1. The number of chromosomal aberrations found in children born 5 to 7 years after the
is higher than the norms among children liv- catastrophe in the contaminated Chechersk
ing in areas with elevated levels of radiation City, Gomel Province (Ivanenko et al., 2004).
(Nesterenko, 1996; Goncharova, 2000). The 5. There was a sixfold increase in dicentrics
genetic changes are especially common among and centric ring frequencies in the blood cells of
individuals who were younger than 6 years of the same individual before and after the catas-
age at the time of the catastrophe (Ushakov trophe (Matsko, 1999).
et al., 1997). Frequency of chromosomal aber- 6. For liquidators, micronuclei numbers in
rations (dicentrics and centric rings) in women peripheral lymphocytes increased many years
and newborns from the contaminated areas after their exposure to the radiation (Table 5.5).
of Mogilev Province are significantly higher
than in a control group, and the frequency
of such abnormal chromosomes is more than
TABLE 5.5. Number of Micronuclei in Lympho-
double in schoolboys from the contaminated cytes of Belarussian Liquidators 15 Years after the
areas of Brest Province compared with those Catastrophe (Mel’nov, 2002)
from less contaminated Minsk (Lazyuk et al.,
Frequency of micronuclei (per 1,000 cells)∗
1994). Some 52% of surveyed children from
the contaminated territories of Brest Province, Liquidators, Controls,
where the Cs-137 levels are 5–15 Ci/km2 , Dose, Gy 47.6 ± 1.3 years old 40.8 ± 1.7 years old
have a significantly higher number of chro- 0.01 2.7 ± 1.1 15.2 ± 2.3
mosomal aberrations. These cytogenic changes 0.1 24.9 ± 4.4 29.4 ± 2.6
are accompanied by molecular-genetic, cyto- 0.2 45.4 ± 5.0 47.1 ± 15.4
logical, and biochemical changes in peripheral 0.3 69.6 ± 10.3 47.2 ± 12.2
blood (Mel’nov and Lebedeva, 2004). 0.4 108.0 ± 16.0 67.2 ± 14.1
0.5 149.9 ± 21.1 108.0 ± 26.0
2. The average incidence of DNA muta-
∗
tions was twice as high in 79 children born All distinctions are statistically significant.
TABLE 5.6. Incidence of Various Types of Chro- TABLE 5.7. Frequency of Chromosomal Aber-
mosomal Aberrations (per 100 Lymphocytes) rations (per 100 Lymphocytes) of the Same 20
among “Samosels” (Self-Settlers) and in the Kiev “Samosels” (Self-Settlers) in 1998–1999 and 2001
Area (Bezdrobna et al., 2002) Surveys (Bezdrobna et al., 2002)
Incidence, per 100 cells Incidence, per 100 cells
Type of aberration “Samosels” Kiev area Type of aberrations 1998–1999 2001
Dicentrics + centric rings 3.0 ± 0.2 2.3 ± 0.1 Breaks and exchanges 0.16 ± 0.07 0.29 ± 0.07
Breaks 0.13 ± 0.04 0.02 ± 0.01 Insertions 1.8 ± 0.3 0.8 ± 0.1∗
Exchanges∗ 3.1 ± 0.2 2.3 ± 0.1 Deletions 0.025 ± 0.025 0.07 ± 0.03
Fragments 1.6 ± 0.2 0.9 ± 0.1 Without fragments 0.10 ± 0.04 0.18 ± 0.06
Insertions 0.02 ± 0.02 0.04 ± 0.02 Total abnormal 0.39 ± 0.09 0.45 ± 0.09
Deletions with fragments 0.22 ± 0.05 0.08 ± 0.03 Monocentrics 0.32 ± 0.08 0.25 ± 0.06
Deletions without fragments 0.10 ± 0.03 0.05 ± 0.02 Total 2.6 ± 0.4 1.6 ± 0.2∗
Total abnormal 0.33 ± 0.06 0.13 ± 0.03 ∗
Monocentrics 0.23 ± 0.05 0.12 ± 0.03 Differences are statistically significant.
Total 2.2 ± 0.2 1.2 ± 0.1
∗
Pre-Chernobyl level: 1.1.
creased in “samosels” (self-settlers—the people
who moved into the prohibited 30-km zone;
5.2.1.1.2. Ukraine Tables 5.6, 5.7, and 5.8). The frequency of oc-
currence of single-hit acentrics and the pres-
1. In a survey of more than 5,000 children ence of two-hit dicentrics and circular rings (see
radiated at age 0 to 3 years, the number of aber- Table 5.6) demonstrate the prolonged effect of
rant cells and stable and nonstable chromo- low dose, low linear-energy-transfer of radia-
somal aberrations was higher (Stepanova and tion (so-call low-LET radiation).
Skvarskaya, 2002; Stepanova et al., 2002a,b). 6. During the first year after their evacua-
2. The incidence of aberrant cells and chro- tion from the 30-km zone, the level of non-
mosomal aberrations is significantly higher in stable chromosomal aberrations among evac-
children radiated in utero (Stepanova et al., uees significantly exceeded control values and
2002a,b; Stepanova et al., 2007). gradually decreased during the next 14 years.
3. Children evacuated from Pripyat City Incidence of this cytogenic damage was not sex-
had higher incidences of chromatid aberration dependent, and the frequency of occurrence of
10 years after the catastrophe, both as individ- dicentrics and rings correlated with duration
uals (0.5–5.5 per 100 cells) and as a group (1.2– of residence in a contaminated zone (Maznik,
2.6 per 100 cells; Pilinskaya, 1999). For children 2004).
from the village of Narodichi, where the Cs-137
contamination was 15 Ci/km2 , the frequency
of occurrence of nonstable chromosomal aber- TABLE 5.8. Comparison of the Incidence of Chro-
mosomal Aberrations (per 100 Lymphocytes) from
rations was maintained at a more-or-less con-
a 30-km Zone of Kiev Province, Ukraine, and from
stant level for more than 10 years, whereas that the Heavily Contaminated Territories of Gomel
of stable chromosomal aberrations increased Province, Belarus, 1986–1988 (Bezdrobna et al.,
(Pilinskaya et al., 2003a). 2002; Mikhalevich, 1999)
4. The children of liquidators have an in- Person, Cells, Aberrant Aberrations,
creased incidence of chromosomal aberrations n n cells, n n
(Horishna, 2005).
5. In 12 to 15 years after the catastrophe, 30-km zone 33 11,789 5.0 ± 2.0 5.3 ± 2.1
Kiev 31 12,273 3.2 ± 0.8 3.5 ± 1.0
the level of chromosomal aberrations and the
Gomel area 56 12,152 6.4 ± 0.7 8.7 ± 0.6
number of multiaberrant cells significantly in-
68
7. For the majority surveyed in the contam- TABLE 5.9. Level of Chromosomal Aberrations in
inated territories, with Cs-137 levels in soil Children and Teenagers from the Contaminated
Territories 17 Years after the Catastrophe (Cs-137:
of 110–860 kBq/m2 , and among evacuated
111–200 kBq/m2 ) (Sevan’kaev et al., 2005)
young men, the incidence of stable aberrations
was significantly higher (Maznik and Vinnykov, Aberration (per 100 cells)
2002; Maznik et al., 2003). Contaminated
8. Radiation-induced cytogenic effects were areas Control
maintained in 30–45% of surveyed liquida-
Acentric fragments 0.40 0.22
tors for 10 to 12 years after the catastrophe. Dicentrics and centric rings 0.04–0.19 0.03
There was stabilization of the number of di-
centric and ring chromosomes at a level of
0.5–1 per 100 cells, with controls at 0.2 and in-
creased incidence of stable cytogenetic changes 5. An increased incidence of chromosomal
at 0.5–4.5 per 100 cells, with controls at 0.1 aberrations is found in children born 5 to 7
(Pilinskaya, 1999). years after the catastrophe in the contami-
9. The level of stable chromosomal aberra- nated Mtsensk District and Bolkhov City, Oryol
tions in liquidators increased for 10 to 15 years Province (Ivanenko et al., 2004).
after the catastrophe (Mel’nikov et al., 1998; 6. DNA repair activity (tested by reactivation
Pilinskaya et al., 2003b). and induced mutagenesis of smallpox vaccine
10. The phenomenon of genetic instability viruses) was impaired in children born after the
is found in children of liquidators (Stepanova catastrophe in territories with Cs-137 contam-
et al., 2006). ination levels above 5 Ci/km2 (Unzhakov et al.,
1995).
7. The number of aberrant cells and chro-
mosomal aberrations (pair fragments and rings)
5.2.1.1.3. Russia and the size of index chromosome breaks in
1. The level of chromosomal aberrations newborns correlated with dose levels and dose
among children radiated in utero was signifi- rates at the time of the births (Kulakov et al.,
cantly higher than in children who were born 1993).
longer after the meltdown (Bondarenko et al., 8. Seventeen years after the catastrophe
2004). there was an increased number of chromo-
2. The index of genomic DNA repair is lower somal aberrations in 30–60% of children and
in the majority of children in the contaminated teenagers from territories contaminated by Cs-
regions (Bondarenko et al., 2004). 137 to a level of 111–200 kBq/m2 (Table 5.9)
3. In 1989–1994 a higher incidence of non- (Sevan’kaev et al., 2005).
stable chromosomal aberrations (dicentrics and 9. There was a correlation between liv-
circular rings) was found in 1,200 children from ing in the contaminated territories (Bryansk,
the contaminated areas of Bryansk and Kaluga Tula, and Kaluga provinces, 1991–1997) and
provinces with Cs-137 levels from 100–1,000 a delay in psychomotor development, congen-
kBq/m2 . The frequency of occurrence of these ital defects, and/or microanomalies and ex-
aberrations correlated with the level of con- tremely elevated amount of near-centromer C-
tamination of the territory (Sevan’kaev et al., heterochromatin (Vorsanova et al., 2000).
1995a,b; 1998). 10. The frequency of occurrence of chromo-
4. An increased level of chromosomal aber- somal aberrations increased two- to fourfold
rations is found in children of the Novozybkov among those individuals in Chernobyl territo-
District of Bryansk Province (Kuz’myna and ries with Cs-137 levels of contamination above
Suskov, 2002). 3 Ci/km2 (Bochkov, 1993).
TABLE 5.10. Number of Mutant Cells and Incidence of Chromosomal Aberrations (per 100
Metaphases) among Women with Uterine Myoma in the Contaminated Territories of Tula and Bryansk
Provinces (Tsyb et al., 2006)
Metaphases, Mutant cells, Aberrations, Contamination,
n n n Bq/m2
Novozybkovsky District (n = 22) No data 6.2 ± 0.3∗ No data 708

Klintsovsky District (n = 97) 18,703 5.3 ± 0.5∗ 4.27 ± 0.3∗ 322
Uzlovaya Station (n = 100) 19,600 4.6 ± 0.3 2.30 ± 0.1 171
Obninsk (n = 42) 12,779 4.0 ± 0.2 2.12 ± 0.1 Control
∗
Differences from the control are significant.
11. The number of lymphocytes with muta- of gene mutations on locus T-cellular recep-
tions of T-locus (TCR) and the number of chro- tor (TCR) and on locus glycophorin (GPA) is
mosomal aberrations correlated with a level of higher than in controls (Sevan’kaev et al., 2006).
radiation contamination in women with uterine 16. Among 336 surveyed fertile women
tumors (myomas) who continued to live in the from the contaminated Uzlovaya Station,
heavily contaminated Novozybkov and Klintsy Tula Province, and Klintsy District, Bryansk
districts, Bryansk Province, and in Uzlovaya Province, the incidence of chromosomal ex-
Station, Tula Province (Table 5.10). change aberrations was 0.13 ± 0.03 and 0.37 ±
12. The number of chromosomal aberra- 0.07 compared to controls, which was two- to
tions among inhabitants of the contaminated sixfold less (0.6 ± 0.04; Ivanova et al., 2006).
territories in Bryansk Province is higher than 17. The number of lymphocytic and mar-
among people living in less contaminated areas row chromosomal mutations correlated with
(Table 5.11). the radiation dose among liquidators and in-
13. Inhabitants of the heavily contami- habitants of Pripyat City within 3 months af-
nated Klintsy and Vyshkov districts of Bryansk ter the catastrophe and were manifestly higher
Province demonstrate a significantly higher than among controls (Table 5.12) (Shevchenko
mitotic index in comparison with controls et al., 1995; Svirnovsky et al., 1998; Bezhenar’,
(Pelevina et al., 1996). 1999; Shykalov et al., 2002; and others).
14. Among 248 individuals aged 15 to 28 18. The number of nonstable (dicentrics,
years surveyed, the incidence of dicentrics and acentric fragments, and centric rings) and sta-
centric rings is two- to fourfold higher than ble aberrations (translocations and insertions)
among control groups. Among those radiated in liquidators was significantly higher in the
in utero, the frequency of occurrence of such first year after the catastrophe (Shevchenko
aberrations is fivefold higher than in controls et al., 1995; Shevchenko and Snegyreva, 1996;
(Sevan’kaev et al., 2006). Slozina and Neronova, 2002; Oganesyan et al.,
15. Among inhabitants of four contami- 2002; Deomyna et al., 2002; Maznik, 2003; and
nated districts of Oryol Province, the incidence others; Figure 5.1).
TABLE 5.11. Incidence of Chromosomal Aberrations among Inhabitants of the Contaminated Territo-
ries of Bryansk Province (Snegyreva and Shevchenko, 2006)
Individuals, n Cells, n Aberrations, n Including dicentrics
Bryansk Province 80 21,027 1.43 + 0.08∗ 0.10 + 0.02∗

Control 114 51,430 0.66 ± 0.04 0.02 ± 0.01
∗
Differences from control are significant.
70
TABLE 5.12. Chromosomal Mutations among Various Groups of Liquidators within the First 3 Months
after the Catastrophe (Shevchenko and Snegyreva, 1999)
Including dicentric
Group Cells, n Aberrations, n and centric rings
Construction crew for the 4,937 32.4 ± 2.5∗ 4.4 ± 0.9∗

sarcophagus∗∗ (n = 71)
Radiation supervisors (n = 23) 1,641 31.1 ± 4.3 4.8 ± 1.7
NPP staff (n = 83) 6,015 23.7 ± 2.0 5.8 ± 1.0
Drivers (n = 60) 5,300 14.7 ± 1.7 3.2 ± 0.8
Pripyat City civilians (n = 35) 2,593 14.3 ± 2.4 1.9 ± 0.8
Doctors (n = 37) 2,590 13.1 ± 2.3 2.7 ± 1.0
Control (n = 19) 3,605 1.9 ± 0.7 0.0
∗
For all groups differences with controls are significant.
∗∗
Sarcophagus is the huge concrete construct that covers the exposed Chernobyl reactor.
19. In the first 8 to 9 years after the catas- 22. Ten years after the catastrophe 1,000 liq-
trophe the number of cells with translocations uidators had a significantly higher average fre-
among liquidators was more than twice that in quency of occurrence of chromosomal aberra-
controls (Table 5.13). tions (especially high in liquidators from 1986)
20. The number of translocations in liquida- (Sevan’kaev et al., 1998).
tors was significantly higher than in controls 23. The incidence of dicentrics in liquida-
(Table 5.14). tors rose during the first 8 to 12 years af-
21. In the first 6 to 8 years after ter the catastrophe (Slozina and Neronova,
the catastrophe the number of chromoso- 2002). More than 1,500 liquidators were ex-
mal aberrations in liquidators from the Rus- amined and even after 15 years the frequency
sian Federal Nuclear Center in Sarov City of occurrence of dicentrics was considerably
was significantly higher than in controls higher than in control groups (Snegyreva and
(Table 5.15). Shevchenko, 2002).
5.2.1.1.4. Other Countries

1. YUGOSLAVIA. Among newborns conceived
in the months postcatastrophe, the number
of chromosomal aberrations increased from
4.5% (1976–1985 average) to 7.1% (Lukic et al.,
1988).
2. AUSTRIA. In 1987 among 17 adults ex-
amined there was a four- to sixfold increase in
the number of chromosomal aberrations, and
in two individuals, examined before and 1 year
after the catastrophe, there was an 11-fold in-
crease (Pohl-Rüling et al., 1991).
3. GERMANY (southern areas). Among 29
children and adults examined in 1987–1991
Figure 5.1. Average frequency of dicentrics in a
group of 1986 liquidators examined within 18 years there was a two- to sixfold increase in the num-
after the catastrophe (Snegyreva and Shevchenko, ber of chromosomal aberrations (Stephan and
2006). Oestreicher, 1993).
TABLE 5.13. Number of Chromosomal Aberrations in Lymphocytes of Liquidators, 1990–1995

(Shevchenko and Snegyreva, 1999; Snegyreva and Shevchenko, 2006)
Number of Including dicentrics
Year individuals, n Cells, n Aberrations, n and central rings
1986 443 41,927 23.2 ± ∗ 0.33 ± 0.01∗

1990 23 4,268 14.9 ± 1.9∗ 1.0 ± 0.5∗
1991 110 20,077 19.7 ± 1.0∗ 0.9 ± 0.2∗
1992 136 32,000 31.8 ± 1.0∗ 1.4 ± 0.2∗
1993 75 18,581 34.8 ± 1.4∗ 0.9 ± 0.2∗
1994 60 18,179 31.8 ± 1.3∗ 1.8 ± 0.3∗
1995 41 12,160 18.8 ± 1.2∗ 0.4 ± 0.02∗
Control 82 26,849 10.5 ± 0.6 0.02 ± 0.01
∗
All differences with the control are significant (p < 0.01–0.05).
4. NORWAY (northern areas). In 1991, a 10- (Lazjuk et al., 1997). Detailed analysis revealed
fold increase in the number of chromosomal a sharp increase in the incidence of Down syn-
aberrations was found in 56 adults compared drome in December 1986 and a peak in Jan-
to controls (Brogger et al., 1996; see review by uary 1987 (Figure 5.2).
Schmitz-Feuerhake, 2006). 2. GERMANY. In West Berlin, among ba-
bies conceived in May 1986, the number of
5.2.1.2. Genomic Mutations newborns with Down syndrome increased 2.5-
Trisomies of chromosomes 13, 18, and 21, fold (Wals and Dolk, 1990; Sperling et al.,
which are genomic mutations showing change 1991, 1994; and others; Figure 5.3). In south-
in the number of chromosomes, have been ern Germany an increase in the number of
found in the contaminated territories. trisomy 21 cases was determined by amnio-
centesis (Sperling et al., 1991; Smitz-Fuerhake,
5.2.1.2.1. Trisomy 21 (Down Syndrome) 2006).
1. BELARUS. Analysis of annual and monthly 3. SWEDEN. There was a 30% increase in
incidences of Down syndrome in 1981–1999 the number of newborns with Down syndrome
(2,786 cases) revealed an annual increase in in the northeast of the country, which was
1987 for the whole country and monthly in- the area most contaminated by Chernobyl ra-
creases in January 1987 in Minsk City and dionuclides (Ericson and Kallen, 1994).
in Gomel and Minsk provinces (Lazjuk et al., 4. GREAT BRITAIN. There was a doubling in
2002). There was also a 49% increase in the the number of newborns with Down syndrome
most contaminated 17 districts in 1987–1988
(Table 5.16) and an increase of 17% for the
whole country for the period from 1987 to 1994 TABLE 5.15. Number of Chromosomal Aberra-
tions among Liquidator Personnel of the Rus-
sian Federal Nuclear Center in Sarov (Khaimovich
TABLE 5.14. Frequency of Translocations (per et al., 1999)
100 Cells) among Liquidators (Snegyreva and
Shevchenko, 2006) Liquidators Controls
(n = 40) (n = 10)
Individuals, n Cells, n Translocations
All aberrations, 4.77 ± 0.42 0.90 ± 0.30
Liquidators 52 44,283 1.20 ± 0.16∗ per 100 cells
Control 15 21,953 0.47 ± 0.09 Dicentrics 0.93 ± 0.19 0
∗
% Polyploidy cells 1.43 ± 0.23 0
p < 0.05.
72
TABLE 5.16. Incidence of Down Syndrome (per mosomes in males. Statistics regarding such
1,000 Newborns) in 17 Heavily and 30 Less cases are not available.
Contaminated Districts of Belarus, 1987–2004
(National Belarussian Report, 2006)
5.2.2. Genetic Polymorphism of Proteins
1987–1988 1990–2004
and Other Genetic Disorders
Heavily contaminated 0.59 1.01
Less contaminated 0.88 1.08 Genetic polymorphism of proteins is an im-
portant parameter of intrapopulation genetic
variability. In children radiated in utero and born
in Lothian, Scotland, one of territories contam- after Chernobyl, the level of genetic polymor-
inated by Chernobyl (Ramsey et al., 1991). phism of proteins is lower compared with chil-
dren born before the catastrophe. This lower
level of genetic polymorphism in structural pro-
5.2.1.2.2. Trisomy 13 and Other teins is negatively correlated with levels of con-
Genomic Mutations genital malformations and allergies, and may
1. Photos from the contaminated areas of be a factor in the persistent current background
Belarus and Ukraine indicated that there are of anemia, lymphadenopathies, and infections
many cases of newborns with characteristics of (Kulakov et al., 1993).
Patau syndrome (trisomy 13). The anomalies Children born after the catastrophe who
included: polydactly, developmental anoma- were irradiated in utero have a lower level of
lies of the eyes (microphthalmia, congenital genetic polymorphism of proteins compared
cataracts, coloboma of the iris), trigonocephaly, to children born before the catastrophe from
cleft lip and palate, defects of the nose, etc. the same territories (Kulakov et al., 1993,
Statistics regarding such cases are not available. 1997). They also had significantly lower lev-
2. From clinical descriptions of children els of DNA repair both in the short and the
born in the contaminated territories there are long term after the catastrophe (Bondarenko
known cases of other genomic mutations: Ed- et al., 2004).
ward’s syndrome (trisomy 18), Kleinfelter syn- Proliferation was sharply reduced in HeLa
drome (additional X-chromosome), Turner’s cell culture 6 days after the explosion in the
syndrome (absence of the X-chromosome), 30-km zone (beginning with a total dose up to
XXX chromosomes in females, and XYY chro- 0.08 Gr), with this effect continuing for seven
Figure 5.2. Prevalence of trisomy 21 in Belarus from 1982 to 1992 (N = 1,720,030;

n = 1,791) and change-point model (see text) allowing for a significant (p < 0.0001) jump
and a “broken stick” in December 1986 and a peak in January 1987 (Sperling et al., 2008).
Figure 5.3. Prevalence of trisomy 21 in West Berlin from 1982 to 1992 (N = 218,497;
n = 237) and change-point model allowing for a significant (p < 0.0001) jump in December
1986 and a peak in January 1987 (Sperling et al., 2008).
cell generations after the irradiation. Numbers tional irradiation. More than 6,000 genetically
of large cells arising persisted for more than caused developmental anomalies are known
20 cell generations after irradiation and clono- (McKusick, 1998). Medical statistics consider
genicity was lower for 24 generations (Nazarov only about 30 of the commonest CDAs. Some
et al., 2007). CDAs have appeared anew in a population
DNA repair activity (tested by reactivation as mutations de novo. De novo mutations de-
and induced mutagenesis of small-pox vaccine termine such CDAs as polydactyly, change in
viruses) was impaired in children born after the the size of arms or legs, and so-called plural
catastrophe in territories with contamination CDAs. These CDAs occur more often in the
levels of Cs-137 above 5 Ci/km2 (Unzhakov heavily contaminated Belarussian territories,
et al., 1995). where levels are higher than 15 Ci/km2 (Lazjuk
et al., 1999a).
5.2.3. Changes in Satellite DNA Genetically caused CDAs in newborns are
but the tip of the iceberg. They are evidence
The number of mutations due to Chernobyl of mutations that are not eliminated at pre-
radiation has increased not only in somatic, but vious stages of individual development in ga-
also in germ cells. The level of small mutations metes (spermatozoa and ova); among impreg-
in minisatellite DNA in children born to irradi- nated ova up to and during implantation; and
ated parents and living in the contaminated ter- in the process of embryonic development.
ritories of Belarus and Ukraine is almost twice Most mutations result in termination of em-
that of children from Great Britain (Dubrova, bryonic development at an early stage (Nykytin,
2003). 2005). Thus it is reasonable to assume that
the increase in the frequency of occurrence of
5.2.4. Genetically Caused Congenital genetically caused CDAs reflects an increase
Developmental Anomalies in tens (if not in hundreds) of times the rate
It is estimated that from 50 to 90% of all con- of mutations at the gamete stage. That these
genital malformations (CMs) and congenital processes occur in the radiation contaminated
developmental anomalies (CDAs) result from territories is testified to by: (a) an increase
mutations. Therefore the birth of newborns in the number abnormal spermatozoids; (b)
with anomalies can reveal the presence of ge- an increase in the incidence of spontaneous
netic disorders, including the influence of addi- abortions, which reflects increased embryonic
74
mortality; (c) an increase in de novo mutations TABLE 5.17. Health Statistics in 1987 for 11-
in aborted fetuses and those with CDAs; and Year-Old Children Born to Belarussian Liquidators
Exposed in 1986 (Arynchin et al., 1999)∗
(d) the greater proportion of CDAs, defined by
mutations de novo, that occur in the most con- Children of Control
taminated territories (Lazjuk et al., 1999). liquidators group
(n = 40) (n = 48)
5.2.5. Children of Irradiated Parents Chronic gastroduodenitis 17 (42.5%) 13 (21.7%)

Dysbacteriosis 6 (15%) 0
There are more and more data showing Impaired development 8 (20%) 2 (4.2%)
poorer health status in children born to irra- Number of B lymphocytes 14.1 ± 0.7 23.3 ± 1.9
diated parents. Number of T lymphocytes 16.9 ± 1.1 28.4 ± 1.6
Concentration of IgG, g/liter 9.4 ± 0.4 14.2 ± 0.7
1. Among children of the Belarus liquida-
∗
tors irradiated during 1986–1987 who received All differences are significant.
5 cSv or more, there is a higher level of morbid-
ity, a larger number of CDAs (Figure 5.4), and 18.6–24.6% in the control group; National
more sick newborns in comparison with chil- Ukrainian Report, 2006).
dren whose fathers received a dose less than 4. There are more congenital malformations
5 cSv (Lyaginskaya et al., 2002, 2007). and developmental anomalies among children
2. A survey of a group of 11-year-old children born to irradiated fathers (National Ukrainian
born in 1987 to families of 1986 Belarus liq- Report, 2006).
uidators revealed significant differences in the 5. Children irradiated in utero in the Kaluga
incidence of blood disease and immune status Province have a significantly higher level of gen-
(Table 5.17). eral morbidity, including thyroid gland diseases
3. The annual general morbidity among (sixfold above the provincial level); CDAs (four-
children born to irradiated fathers from 2000 to fold above the provincial level); plus urogenital
2005 was higher in Ukraine as a whole (1,135– tract, blood circulation, and digestive system
1,367 per 10,000 vs. the Ukraine average of diseases (Tsyb et al., 2006a).
960–1,200). Among these children only 2.6– 6. Among the children of liquidators in the
9.2% were considered “practically healthy” (vs. Ryazan area there was an increased incidence
of sick newborns, CDAs, birth weights be-
low 2,500 g, delays in intrauterine develop-
ment, higher morbidity, and impaired immu-
nity (Lyaginskaya et al., 2002, 2007).
7. Liquidators’ children up to 10 years of age
in Kaluga Province had an incidence of thyroid
gland disease that was fivefold higher that the
provincial level, a triple increase in CDAs, a
fourfold increase in mental disorders, double
the occurrence of circulatory system diseases,
and a high incidence of chronic diseases (Tsyb
et al., 2006).
8. Children of liquidators have a high in-
Figure 5.4. Prevalence of congenital develop- cidence of chronic laryngeal diseases, red
mental anomalies (CDAs) among infants born to fam-
ilies of liquidator (1986–1987) fathers who worked
blood cell changes, functional impairment of
for the Russian nuclear industry from 1988 to 1994 the nervous system, multiple tooth caries,
(Lyaginskaya et al., 2007). Broken line: level of CDA chronic catarrhal gingivitis, and dental anoma-
by UNSCEAR (1988). lies (Marapova and Khytrov, 2001).
9. Children of liquidators have more chro- TABLE 5.19. Primary Morbidity (per 1,000)
mosomal aberrations (deletions, inversions, among Children of Bryansk Liquidators and All
the Children in Bryansk Province, 1996–2000
rings, isochromatids, single fragments, and
(Matveenko et al., 2005)
gaps) and more polyploid cells (Ibragymova,
2003). “. . . In families of liquidation partici- Children of
pants [in the Tula Province] there were 473 liquidators
Children
children born after the Chernobyl catastrophe. Bryansk Russia of Bryansk
At first sight they differed from other kids in Illnesses Province (RSMDR)∗ Province
hyperexcitability. They cry, neither from that Circulatory system 6.7 19.7 3.5
nor from this, and do not sit easily in place. . ..” Mental disorders 12.2 25.1 3.3
(Khvorostenko, 1999). Digestive system 93.7 83.0 68.7
10. Children of liquidators have higher levels Muscle and bone 75.9 45.8 43.2
of digestive, respiratory, nervous, and endocrine Congenital anomalies 11.6 12.6 3.0
system diseases; more CDAs and hereditary dis- ∗
Russian State Medical Dosimetric Register.
eases; and increased incidence of infectious dis-
eases (Ponomarenko et al., 2002).
11. Among 455 children of liquidators from icant difference between children of liquidators
Bryansk Province who were born between 1987 and children from the Bryansk area as a whole.
and 1999 general morbidity increased from 12. There is lowered cellular immunity
1988 to 2000 (Table 5.18). From the table it is in children of Russian liquidators, demon-
obvious that there has been a reduction in the strated by decreases in both absolute and rel-
occurrence of diseases of the blood and blood- ative cell parameters. They have a relative
forming organs and a significant increase in increase in cellular immunity (higher num-
all other illnesses. Even more apparent is the bers of CD4 cells, moderately lower levels of
morbidity of children of liquidators of Bryansk immunoglobulin-A, and increased basal neu-
Province compared to other children in the trophilic activity; Kholodova et al., 2001).
area. Table 5.19 presents data showing a signif- 13. Children of liquidators and children irra-
diated in utero have a higher frequency of stable
chromosomal aberrations, lower levels of repair
TABLE 5.18. First Reports Concerning Illnesses activity, and a decrease in individual heterozy-
(per 1,000) among Children of Liquidators in gosis (Sypyagyna, 2002).
Bryansk Province (Matveenko et al., 2005)∗
The second and the third generations of
Number of cases children whose parents were irradiated by the
1988– 1991– 1996– atomic bomb explosions in Japan in 1945 suf-
Illness 1990 1995 2000 fered 10-fold more circulatory system diseases
and impaired liver function, and 3.3-fold more
Blood and 52.2 30.6 8.3
respiratory system illness than a control group
blood-forming organs
Mental disorders 0 5.9 12.2 (Furitsu et al., 1992). It is likely that the health
Neoplasms 0 0 3.3 problems experienced by children born to par-
Respiratory system 790 1,009 1,041 ents irradiated by Chernobyl will continue in
Digestive system 5.3 59.2 93.7 subsequent generations.
Muscle and bone 0 16.2 75.9
Urogenital tract 5.3 14.7 20.5
Infectious and 15.9 83.6 71.5 5.2.6. Chromosomal Aberrations as
parasitic diseases Indicators of Health Status
Total 1,052 1,343 1,667
∗ The response of the International Atomic
Listed illnesses are those for which there are obvious
trends over time. Energy Agency (IAEA) and the World Health
76
Organization (WHO) (Chernobyl Forum, “normal” tissue in individuals who live in the
2005) to the occurrence of chromosomal contaminated territories (Polonetskaya et al.,
changes induced by the catastrophe is that 2001).
these changes do not in any way affect the 9. The incidence of spermatozoid struc-
state of health—which is scientifically untrue. ture abnormalities correlates with the fre-
Chromosomal changes observed in peripheral quency of occurrence of chromosomal aberra-
blood cells can reflect general damage to ge- tions (Kurilo et al., 1993; Vozylova et al., 1997;
netic and ontogenetic processes. There are cor- Domrachova et al., 1997; Evdokymov et al.,
relations between the level of chromosomal 2001).
aberrations and a number of pathological con- 10. The level of antioxidant activity for
ditions. There are many examples of such links various groups of liquidators correlates with
in the Chernobyl territories. Among them are the number of chromosomal aberrations
the following. (Table 5.20).
1. The number of chromosomal aberrations 11. The prevalence of febrile infections cor-
in 88% of liquidators coincides with the level of relates with the level of chromosomal aberra-
psychopathological illnesses and the expression tions (Degutene, 2002).
of secondary immunosuppression (Kut’ko et al., 12. In the contaminated territories of
1996). Bryansk and Tula provinces there is a corre-
2. The number of chromosomal aber- lation between number of aberrant and mul-
rations is noticeably higher in those with tiaberrant cells and the development of uterine
psycho-organic syndromes, and the number of myoma (Ivanova et al., 2006).
chromatid aberrations is noticeably higher in 13. The frequency of cardiovascular and
individuals with asthenia and obsessive–phobic gastroenteric diseases in liquidators correlates
syndromes (Kut’ko et al., 1996). with the level of chromosomal aberrations
3. The number of dicentrics and chromatid (Vorobtsova and Semenov, 2006).
exchanges correlates with congenital develop- All these correlations demonstrate that the
mental anomalies (Kulakov et al., 1997). increase in chromosomal damage, which is ob-
4. The number of chromosome breaks cor- servable everywhere in the contaminated terri-
relates with hypothyroidism and a number of tories, is a measure of high genetic risk, as well
stigma associated with embryogenesis (Kulakov as the risk of developing many illnesses.
et al., 2001).
5. The frequency of occurrence of aberrant 5.2.7. Conclusion
cells, pair fragments, rings, and chromosomal
breaks coincides with the level of immunoregu- Somatic chromosomal mutations, muta-
latory system imbalance in newborns (Kulakov tions causing congenital malformations, ge-
et al., 1997). netic polymorphism of proteins, and mutations
6. The incidence of congenital malforma- in minisatellite DNA are only some of the
tions defined by mutations de novo is significantly genetic changes resulting from radionuclides
higher in territories with contamination levels released from Chernobyl. The overwhelm-
of 15 Ci/km2 or higher (Lazjuk et al., 1999b). ing majority of Chernobyl-induced genetic
7. The number of chromosomal aberra- changes will not become apparent for several
tions, number of micronuclei, and incidence of generations. A fuller account of other genetic
spot mutations are considerably higher in chil- changes will come with progress in scientific
dren with thyroid cancer (Mel’nov et al., 1999; methods. Today it is obvious that changes in
Derzhitskaya et al., 1997). the genetic structure of cells were the first dan-
8. The frequency of occurrence of aber- gerous signs of the Chernobyl catastrophe. The
rations is higher in both tumor cells and in changes occurred in the first days after the
TABLE 5.20. Average Value of Antioxidant Characteristics among Groups of Russian Liquidators with
Various Levels of Chromosomal Aberrations (Baleva et al., 2001)a
Control Groups of liquidators with various numbers of aberrations
Aberrations, n 0.11 0.18 0.68 1.15 1.66 2.64

GT 16.70 823.82 17.57 824.50 21.98∗ 25.66∗
SOD 113.12 115.23 120.09 101.08∗ 136.5 107.76
Hem 1 6.78 7.86 11.14∗ 5.59 7.74 6.70
Hem 2 7.27 9.22 10.99∗ 5.88 6.86 8.17
MDA 1 2.08 2.41 2.74∗ 1.88 2.67∗ 1.83
MDA 2 2.07 2.58∗ 2.28∗ 2.10 2.88∗ 1.85
t1 1.01 1.37∗ 1.24 1.39∗ 1.15 1.50∗
CP 1.16 1.01∗ 0.92∗ 1.15 1.18 1.20
FR 0.69 1.20∗ 1.05 1.02 0.92 1.04
a
GT: restored glucation; SOD: superoxide-dismutase; Hem 1, Hem 2: hematopoietic proteins; MDA 1:
malondialdehyde in erythrocytes; MDA 2: malondialdehyde in erythrocytes after POL-initiation; t 1 : time of rotary
correlation of spin probe N 1 in erythrocyte membranes; CP: ceruloplasmin; FR: free radicals with the g-factor 2.0.
∗
p < 0.05.
release of radiation and increased the occur- live in areas free from Chernobyl radionuclide
rence of various diseases. fallout).
Even if the Chernobyl radiation persisted
only a short time (as in Hiroshima and Na-
gasaki), its consequences, according to the 5.3. Diseases of the Endocrine
laws of genetics, would affect some gener- System
ations of humans (Shevchenko, 2002). Only
10% of all expected Chernobyl genetic dam- Radioactive fallout from Chernobyl has had
age occurred in the first generation (Pflugbeil serious adverse effects on every part of the
et al., 2006). The Chernobyl radiation is endocrine system of irradiated individuals.
genetically much more dangerous than that Among adults, the thyroid gland concentrates
released in Hiroshima and Nagasaki as the up to 40% of a radioactive iodine dose, and in
quantity of radionuclides emitted from the children up to 70% (Il’in et al., 1989; Dedov
Chernobyl meltdown was several-hundred-fold et al., 1993). The hypophysis (pituitary gland)
higher and there were more different kinds of actively incorporates radioactive iodine at lev-
radionuclides. els 5 to 12 times higher than normal (Zubovsky
The genetic consequences of the Chernobyl and Tararukhina, 1991). These two major por-
catastrophe will impact hundreds of millions of tions of the endocrine system were overirradi-
people, including: (a) those who were exposed ated during the “iodine” period, the first weeks
to the first release of short-lived radionuclides after the catastrophe.
in 1986, which spread worldwide (see Chapter All physiological functions such as the on-
1 for details); (b) those who live and will con- set of puberty and the closing of bone epi-
tinue to live in the territories contaminated by physes that are dependent on the organs
Sr-90 and Cs-137, as it will take no fewer than of internal secretion—the pancreas, parathy-
300 years for the radioactive level to decrease roids, thyroid, and adrenal glands and the
to background; (c) those who will live in the ovaries and the testes—which control multiple
territories contaminated by Pu and Am, as mil- functions must coordinate to sustain normal de-
lennia will pass before that deadly radioactivity velopment. Thus Chernobyl’s radioactive con-
decays; and (d) children of irradiated parents tamination has adversely impacted the function
for as many as seven generations (even if they of the entire endocrine system.
78
Adequate and timely thyroid function is nec- 5.3.1.1. Belarus

essary for physical and intellectual develop- 1. A sharp increase in endocrine diseases in
ment. Damage to the thyroid gland of the all Belarussian contaminated territories was ob-
fetus or the neonate may doom that individ- served some years after the catastrophe (Lomat’
ual to a life of diminished mental capacity. et al., 1996; Leonova and Astakhova, 1998; and
In pregnant women, synthesis of cortisol, an many others). According to the State Register,
adrenal hormone, and testosterone correlated in 1994 endocrine system morbidity reached
with the level of internal irradiation (Duda and 4,851 per 100,000 (Antypova et al., 1995).
Kharkevich, 1996). Children in the contami- 2. Children from heavily contaminated ter-
nated territories had significantly lower cortisol ritories had blood cortisol levels that were sig-
blood levels (Petrenko et al., 1993). Measure- nificantly lower than the norm. Cortisol is
ments of immunity in children and teenagers an adrenal hormone that is released under
with Hashimoto autoimmune thyroiditis corre- stress (Petrenko et al., 1993). In Gomel and
lated with the level of environmental radioac- Mogilev provinces, the levels of umbilical blood
tive contamination (Kuchinskaya, 2001). cortisol and estriol in areas having Cs-137
Review of many similar examples clearly contamination of less than 1–15 Ci/km2 were
shows that Chernobyl radiation dangerously significantly higher than the level from heav-
impacted the endocrine system. But what is ily contaminated territories (15–40 Ci/km2 ;
the scale of such impacts? Concrete examples Danil’chik et al., 1996). Overtly healthy new-
are presented in this section to answer some of borns in Gomel and Mogilev provinces had el-
these questions. After a brief review of material evated cortisol levels where contamination was
about endocrine system diseases (Section 5.3.1), less than 15 Ci/km2 and decreased levels in
we deal with the central problem of endocrine heavily contaminated areas (Danil’chik et al.,
illnesses linked to the Chernobyl catastrophe— 1996). The number of children with impaired
functional impairment of the thyroid gland hormone secretion (cortisol, thyroxin, and pro-
(Section 5.3.2). gesterone) was significantly higher in heavily
contaminated territories (Sharapov, 2001).
3. Children from heavily contaminated ter-
5.3.1. Review of Endocrine System ritories had lower levels of testosterone, a hor-
Disease Data mone associated with physical development,
with low levels linked to impaired reproductive
Endocrine system diseases are widespread function (Lyalykov et al., 1993).
in all of the territories that were exposed 4. Many girls of pubertal age, 13 to 14
to the Chernobyl radioactive fallout (Baleva years, from the contaminated territories with
et al., 1996; and many others). Compared with autoimmune thyroiditis had accelerated sex-
data from normal people, individuals living in ual development with significantly increased
the contaminated territories have 50% lower blood serum concentrations of gonadotropic
sympathetic activity and 36% lower adrenal hormones in the lutein phase of their menstrual
cortical activity. In 28% of surveyed new- cycles (Leonova, 2001).
borns in contaminated areas, disorders in the 5. Children aged 10 to 14 years born to ir-
hypophyseal–thyroid system, expressed as thy- radiated parents diagnosed from 1993 to 2003
roid dysfunction, during the end of the first showed significantly more morbidity from goi-
and the beginning of the second week of life ter and thyroiditis (National Belarussian Re-
ultimately resulted in hypothyroidism with its port, 2006).
attendant mental and physiological abnormal- 6. In some areas where congenital diabetes
ities (Kulakov et al., 1997). had not been seen at all before the catastrophe,
there were occurrences afterward and the num- and lower concentrations of T3 hormone
ber of cases has increased since 1986 (Marples, (Dudinskaya and Suryna, 2001).
1996). 13. From 1993 to 2003 in the contaminated
7. In Gomel and Minsk provinces the fre- territories, among men younger than 50 years
quency off occurrence of Type-I diabetes rose of age and women of all ages, there was a signi-
significantly after the catastrophe, with the ficant increase in morbidity owing to nontoxic
highest incidence in the most contaminated single-node and multinode goiters and autoim-
districts of Gomel Province (Borysevich and mune thyroiditis (National Belarussian Report,
Poplyko, 2002). 2006).
8. Six years after the catastrophe incidence of 14. Endocrine morbidity among evacuees
endocrine organ illnesses was threefold higher was double that of the general population of
in the heavily contaminated territories (Shilko Belarus (1,125 vs. 583) even 9 years after the
et al., 1993). Endocrine pathology was the num- catastrophe (Matsko, 1999).
ber one illness diagnosed in a survey of more 15. There was a correlation between the level
than 8,000 children in 1993–1994 in the Slav- of incorporated Cs-137 and prolactin concen-
gorod District of Mogilev Province (Suslov et al., tration in the serum of young women contin-
1997). uing to live in an area with radioactive con-
9. Nine years after the catastrophe, en- tamination of 1–5 Ci/km2 (Gomel City) during
docrine organ morbidity among evacuees and the first and second phases of their menstrual
in those from heavily contaminated territories cycles, as well as a correlation between levels
was double that of the general population of of incorporated Cs-137 and progesterone con-
Belarus (Matsko, 1999). centrations during the second menstrual cycle
10. Occurrence of Type-I diabetes increased phase (Yagovdik, 1998).
significantly in all of Belarus after the catastro- 16. Belarus liquidators and evacuees had a
phe (Mokhort, 2003) and to an even greater 2.5- to 3-fold increase in the number of indi-
degree in the heavily contaminated territories viduals with Type-II diabetes and impaired glu-
(Table 5.21). cose tolerance and a 1.4- to 2.3-fold increase in
11. Among 1,026,046 nursing mothers ex- hyperinsulinemia (Aderikho, 2003).
amined, the incidence of diabetes was signi- 17. Ten years after the catastrophe, Belarus
ficantly higher in the women from territories liquidators had decreased function of the hy-
with Cs-137 contamination above 1 Ci/km2 pophyseal/thyroid axis; depression of insulin
(Busuet et al., 2002). function; exhaustion of the pituitary/adrenal
12. At the time of delivery, women from system; and higher levels of progesterone, pro-
more contaminated territories of Gomel and lactin, and renin (Table 5.22).
Vitebsk provinces had significantly higher
concentrations of T4 and TCG hormones
TABLE 5.22. Hormone Concentrations in Male
TABLE 5.21. Occurrence of Type-I Diabetes per Belarussian Liquidators∗ (Bliznyuk, 1999)
100,000 Children and Teenagers before and after
the Catastrophe in Heavily and Less Contaminated Liquidators Controls
Territories in Belarus (Zalutskaya et al. 2004) Aldosterone 193.1 ± 10.6 142.8 ± 11.4
Years 1980–1986 1987–2002 Cortisol 510.3 ± 37.0 724.9 ± 45.4
Insulin 12.6 ± 1.2 18.5 ± 2.6
Heavily contaminated 3.2 ± 0.3 7.9 ± 0.6∗ ACTH 28.8 ± 2.6 52.8 ± 5.4
(Gomel Province) Prolactin 203.7 ± 12.3 142.2 ± 15.2
Less contaminated 2.3 ± 0.4 3.3 ± 0.5 Progesterone 2.43 ± 0.18 0.98 ± 0.20
(Minsk Province) Renin 1.52 ± 0.14 1.02 ± 0.18
∗ ∗
p < 0.05. All differences are significant.
80
5.3.1.2. Ukraine 1992 the levels of the TSH, T-4, and T-3 were
1. The noticeable increase in endocrine dis- reduced. In 1993 hyperthyroidism in pregnant
eases (autoimmune thyroiditis, thyrotoxicosis, women and newborns was observed for the first
diabetes) began in 1992 in all the contami- time (Dashkevich et al., 1995; Dashkevich and
nated territories (Tron’ko et al., 1995). In 1996 Janyuta, 1997).
endocrine illnesses in areas contaminated at 7. Some 30% of women older than 50 years
levels higher than 5 Ci/km2 occurred markedly of age living in contaminated territories are sub-
more often than within the general Ukrainian clinically hypothyroid (Panenko et al., 2003).
population (Grodzinsky, 1999). From 1988 8. The level of endocrine morbidity
to 1999 endocrine system morbidity in among adult evacuees is considerably higher
contaminated territories increased up to eight- than for the overall population of Ukraine
fold (Prysyazhnyuk et al., 2002). (Prysyazhnyuk et al., 2002).
2. Endocrine illnesses were the main cause 9. A significant increase in diabetes mellitus
of medical disability among children in the was observed in the contaminated territories
contaminated territories (Romanenko et al., some years after the catastrophe (Gridjyuk et al.,
2001). Some 32% of girls irradiated in utero 1998).
became infertile (10.5% among controls; p < 10. A significant impairment of the
0.05) owing to damage to the endocrine system pituitary–adrenal system was seen in a major-
(Prysyazhnyuk et al., 2002). ity of 500 surveyed liquidators in the first years
3. Within the first 2 years after the catas- after the catastrophe; 6 years later there was
trophe hormonal imbalance became typical normalization of the relevant measurements in
among people in heavily contaminated territo- the others at rest, but not in the functional levels
ries. Both boys and girls in contaminated areas (Mytryaeva, 1996).
developed increased insulin synthesis, and girls 11. Liquidators with generalized periodon-
developed elevated testosterone levels (Antipkin tal disease had significantly lower levels of cal-
and Arabskaya, 2003). cium metabolic hormones, including parathor-
4. In the contaminated territories onset of mone, calcitonin, and calcitriol (Matchenko
puberty in girls was late and menstrual cycles et al., 2001).
among the women were disrupted (Vovk and 12. Practically all liquidators had character-
Mysurgyna, 1994; Babich and Lypchanskaya, istic hormonal system changes expressed first
1994). In the territories contaminated with Sr- as impaired cortisone and insulin secretion
90 and Pu, there was a 2-year delay in puberty (Tron’ko et al., 1995). For some, hormonal sys-
for boys and a 1-year delay for girls, whereas tem normalization occurred 5 to 6 years after
sexual development was accelerated in territo- they were irradiated. At the same time more
ries contaminated by Cs-137 (Paramonova and than 52% of those examined still had an in-
Nedvetskaya, 1993). creased frequency of occurrence of autoim-
5. The incidence of endocrine disorders in mune endocrine diseases including thyroiditis,
irradiated children increased markedly after diabetes mellitus, and obesity (Tron’ko et al.,
1988 (Luk’yanova et al., 1995). 1995).
6. Evaluation of more that 16,000 pregnant
women from 1986 to 1993 in the contaminated 5.3.1.3. Russia
territories revealed significantly higher levels 1. Hormonal imbalance (estradiol, pro-
of thyrotrophic hormone and thyroxin (TSH gesterone, luteotrophin, testosterone) became
and T-4) 2 years after the catastrophe. From widespread in the contaminated territories 5
1988 to 1990 levels of the principal thyroid to 6 years after the catastrophe (Gorptchenko
hormones were close to normal, but in 1991– et al., 1995).
2. Endocrine diseases increased in the

contaminated territories during the first 10
years after the catastrophe (Tsymlyakova and
Lavrent’eva, 1996).
3. The number of children with endocrine
diseases increased in the heavily contami-
nated zones (Sharapov, 2001). For children in
the contaminated areas of Tula Province, en-
docrine morbidity was fivefold higher in 2002
compared to the period before the catastrophe
(Sokolov, 2003).
4. In 1995 the number of children with en-
docrine morbidity peaked as a whole in the con-
taminated areas of Bryansk Province. In spite Figure 5.5. Incidence of endocrine and
of some decrease in the level of endocrine mor- metabolic diseases (per 1,000) among children of
liquidators (1) in Obninsk City, Kaluga Province
bidity from 1995 to 1998, it remained twice (Borovykova, 2004); (2) children, City; (3) children,
as high as for Russia as a whole. At the same Russia.
time in the heavily contaminated Gordeevka,
Novozybkov, and Klymovo districts it remained inated than Bryansk Province, juvenile en-
highly elevated in 1998 (Table 5.23). docrine morbidity was 5.8 to 16.1 per 1,000,
5. A total of 17.7% of pregnant women in which was 1.4- to 3.2-fold more than that of
the contaminated territories had significantly districts with less contamination (Borovykova
increased levels of prolactin with associated ter- et al., 1996).
mination of menstruation and loss of fertility 7. Endocrine morbidity in children born
(Strukov, 2003). to liquidators in Kaluga Province sharply in-
6. In the contaminated districts of the Kaluga creased in the first 12 years after the catastro-
Province, which as a whole was less contam- phe (Figure 5.5).
8. The rate of increase in overall endocrine
TABLE 5.23. Overall Endocrine Morbidity (per illnesses in adults in the heavily contaminated
1,000) among Children of Bryansk Province, territories was higher than that of children from
1995– 1998, in Areas with Cs-137 Contamina- 1995 to 1998, and in most of the heavily con-
tion above 5 Ci/km2 (Fetysov, 1999b: table 6.1) taminated districts of Bryansk Province was
noticeably higher than for the province and for
Number of cases Russia as a whole (Table 5.24).
District 1995 1996 1997 1998
9. Twelve years after the catastrophe over-
all adult endocrine system morbidity in the
Klymovo 21.6 29.9 25.5 83.3 heavily contaminated southwest districts of
Novozybkov 133.4 54.5 55.0 109.6 Bryansk Province and liquidators’ morbid-
Klintsy 28.9 31.4 34.6 28.9
ity both significantly exceeded the provincial
Krasnogorsk 31.4 69.2 41.3 25.3
Zlynka 65.0 43.8 49.7 24.9 norms (Table 5.25). The provincial morbidity
Gordeevka 410.2 347.5 245.0 158.5 for liquidators was noticeably higher than the
Southwest∗ 104.4 97.1 67.2 68.5 Russian average.
Province total 102.2 74.2 47.2 47.3 10. Fifteen years after the catastrophe over-
Russia 21.4 23.4 25.6 n/a all endocrine system morbidity in the contam-
∗ inated territories exceeded the provincial level
All heavily contaminated districts of Bryansk
Province. 2.6-fold (Sergeeva et al., 2005).
82
TABLE 5.24. General Endocrine Morbidity (per than in corresponding groups of the population
1,000) among Adults in Bryansk Province in (National Russian Report, 1999).
Territories with Cs-137 Contamination above
14. Severe changes in hypophyseal function
5 Ci/km2 , 1995–1998 (Fetysov, 1999a: tables 5.1
and 5.2) and changes in hormonal levels were found in
liquidators (Drygyna, 2002).
Number of cases 15. High levels of prolactin were found in
District 1995 1996 1997 1998 22% of surveyed male liquidators, levels typi-
cally observed only in young women (Strukov,
Klymovo 70.8 95.5 109.3 112.2
Novozybkov 54.5 77.9 67.5 40.9
2003).
Klintsy 48.0 83.2 75.5 74.1 16. Women liquidators have had consistent
Krasnogorsk 38.2 40.4 54.0 81.1 and significantly higher levels of gonadotropic
Zlynka 33.9 51.4 52.0 57.7 and steroidal sex hormones than controls, as
Gordeevka 32.8 46.3 57.6 72.4 well as abnormal levels of cortisol, testosterone,
Southwest∗ 43.2 58.6 64.2 66.6
thyrotrophic hormone (TGH), triiodothyro-
Province as a whole 32.1 35.0 38.5 41.2
Russia 28.2 29.8 31.2 n/A nine (T-3), and thyroxine (Bezhenar, 1999;
Bezhenar et al., 2000).
∗
All heavily contaminated districts of Bryansk
Province.
“ . . . Last summer Dr. Vvedensky and a group of
colleagues went to the “chemical filaments” state
factory sanatorium, located several hundred kilo-
11. There is an association between Cher-
meters from Gomel City. Since the accident in
nobyl irradiation and impaired exocrine and the Chernobyl nuclear power station, this sana-
endocrine testicular function, which includes torium has been a place to rehabilitate children
low testosterone plasma levels, an increased from the most contaminated areas of Belarus . . .
level of follicle-stimulating hormone (FSH), and Doctors chose to study 300 girls who were born in
decreased luteinizing hormone (LH; Byryukov 1986–1990 . . . For 1.5 years of the survey doctors
saw surprising results. Anthropometrical research:
et al., 1993). measurements of growth, weights, volume of tho-
12. Endocrine system morbidity of Russian rax, hips, and legs have shown that among girls
liquidators increased sharply from 1986 to from a Chernobyl zone all the parameters were
1993 (Table 5.26). below the norms. However, the width of shoulders
13. By 1999, endocrine system morbidity exceeded the norm and their forearms, shoulders,
and legs were very hairy.
among Russian liquidators was 10-fold higher
Other scientists have come up against more seri-
ous pathologies. As a rule, at the age of 12–13 years
girls begin to menstruate. Not one of the 300 girls
TABLE 5.25. General Endocrine Morbidity (per in the study had done so. Ultrasound examina-
1,000) among Adults and Liquidators in Territo- tions showed that their uteruses and ovaries were
ries with Cs-137 Contamination above 5 Ci/km2 underdeveloped . . . “Our results could be wildly
in Bryansk Province, 1995–1998 (Fetysov, 1999a: accidental, Dr. Vvedensky said, but among these
tables 4.1 and 4.2) 300 girls there was one who had no internal repro-
Number of cases ductive organs at all. . . . While we have no right to
draw any scientific conclusions—if we had found
1994 1995 1996 1997 1998 at least three out of 10,000 girls with the same
developmental anomaly, then it would be possible
Southwestern districts∗ 49.9 53.3 58.6 64.2 147.4 to speak about a terrible physiological catastro-
Liquidators 92.7 124.5 92.1 153.0 195.0 phe.” However, we doctors do not have money for
Province as a whole 31.6 32.1 35.0 38.5 41.2 more detailed and extensive studies. Vvedensky’s
Russia 27.8 28.2 29.8 31.2 n/a group has come to the conclusion that the reason
∗
All heavily contaminated districts. for the changes is hormonal imbalance. Under the
TABLE 5.26. Endocrine Morbidity among Russian Liquidators (per 10,000) (Baleva et al., 2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Number of cases, n 96 335 764 1,340 2,020 2,850 3,740 4,300
tric hydrochloric acid (achlorhydria), and mild

influence of irradiation a large amount of testos- anemia.
terone develops in the female organism. Testos- Among hypothyroid symptoms that are not
terone is a male hormone that is normally present
necessarily recorded as illnesses, but are seen
only in very small quantities in females, but when a
woman has too much of it she can lose her female with increased frequency in the contaminated
characteristics. . ..” (Ulevich, 2000) territories, are: facial and eyelid swelling; in-
creased sensitivity to cold; decreased perspi-
ration; drowsiness; tongue swelling, slowed
5.3.2. Impairment of Thyroid Gland speech, and rough and hoarse voice; muscular
Function pains and weakness and impaired muscle co-
ordination; joint stiffness; dry, rough, pale, and
Adequate and timely thyroid function is nec- cold skin; poor memory and slowed thinking;
essary for physical and intellectual development difficult respiration (dyspnoea); and deafness
of the fetus. Damage to the thyroid gland of the (Gofman, 1990; and others).
unborn or the neonate may result in diminished Pathological changes in the thyroid gland
mental capacity for life. are closely linked to those in the parathyroid
Radiation from I-131 and other radionu- glands. Parathyroid function was destroyed in
clides damages the glandular epithelium, 16% of the individuals that underwent thy-
which is demonstrated by nodular forma- roid gland surgery (Demedchik et al., 1996).
tions. Autoimmune thyroiditis is one of the Many symptoms attributed to parathyroid im-
first functional consequences of irradiation pairment were observed in the Chernobyl terri-
(Mozzhukhyna, 2004). Among the subsequent tories. Among them: hypogonadism in men and
thyroid illnesses are hypo- and hyperthy- women, impaired normal somatic and sexual
roidism, myxedema, and nonmalignant and development, hypophyseal tumors, osteoporo-
malignant tumors. Thyroid gland impairment sis, vertebral compression fractures, stomach
leads to decreased production of the glands’ and duodenal ulcers, urolithiasis, and calcium
three hormones—thyroxin, triiodothyronine, cholecystitis (Dedov and Dedov, 1996; Ushakov
and calcitonin—which control, for example, et al., 1997).
growth and development, thermoregulation,
and calcium exchange.
In all of the contaminated territories, there is 5.3.2.1. Belarus
a marked increase in nonmalignant thyroid dis- 1. By the year 2000 several hundred thou-
eases (Gofman, 1994; Dedov and Dedov, 1996). sand people had been registered as having
Associated illnesses include: delayed healing of thyroid pathologies (nodular goiter, thyroid
wounds and ulcers, delay in growth of hair, cancer, thyroiditis). Annually some 3,000 peo-
dryness, fragility, hair loss, increased suscep- ple require thyroid surgery (Borysevich and
tibility to respiratory infections, night blind- Poplyko, 2002).
ness, frequent dizziness, ringing in the ears, 2. Morbidity among children owing to au-
headaches, fatigue and lack of energy, lack toimmune thyroiditis increased almost three-
of appetite (anorexia), delayed growth in chil- fold during the first 10 years after the catastro-
dren, male impotence, increased bleeding (in- phe (Leonova and Astakhova, 1998). By 1995
cluding menstrual menorrhagia), lack of gas- there was an apparent increase in the number
84
of cases of autoimmune thyroiditis in the phase of their menstrual cycles (Leonova,

less contaminated Vitebsk, Minsk, and Brest 2001).
provinces (Khmara et al., 1993). 11. Among 119,178 children from Ukraine,
3. In Gomel Province, which was one of Belarus, and Russia under 10 years of age at the
the most contaminated, more than 40% of the time of catastrophe who were examined within
children examined in 1993 had enlarged thy- the framework of the “Sasakava” project, there
roid glands. Here endemic goiter increased sev- were 62 cases of thyroid cancer and 45,873
enfold from 1985 to 1993, and autoimmune cases of other thyroid pathology (Yamashita
thyroiditis increased more than 600-fold from and Shibata, 1997).
1988 to 1993 (Astakhova et al., 1995; Byryukova 12. There was a significant correlation be-
and Tulupova, 1994). tween environmental Cs-137 contamination
4. Screening of 328 children ages 11 to 14 and the incidence of thyroid diseases among
years in Khoiniky City, Gomel Province, in 1,026,046 pregnant women (Busuet et al.,
1998 revealed that 30% had enlarged thyroid 2002).
glands (Drozd, 2002). 13. From 1993 to 2003 primary nontoxic
5. Children irradiated in utero during the first multinodular and uninodular goiters and au-
trimester have small thyroid glands and are fre- toimmune thyroiditis significantly increased
quently diagnosed with latent hypothyroidism among female evacuees (National Belarussian
(Drozd, 2002). Report, 2006).
6. Surveys disclosed thyroid gland pathology 14. From 1993 to 1995 thyroid gland hyper-
in 43% of 4- to 5-month-old embryos from plasia was found in 48% of juvenile immigrants
mothers from areas contaminated with Cs-137 from the Bragin District and in 17% of juve-
at levels of 1–15 Ci/km2 (Kapytonova et al., nile immigrants from the Stolinsk District, Brest
1996). Province (Belyaeva et al., 1996).
7. Children irradiated in utero from the 15. Thyroid gland pathology in the
Stolinsk District, Brest Province, which had lev- Chernobyl-contaminated territories correlated
els of Cs-137 contamination up to 15 Ci/km2 , with diseases of the gums and teeth (Konoplya,
had thyroid gland impairment even after more 1998).
than 10 years, which included: lowered pro- 16. In 1996 thyroid gland illnesses were ob-
duction of thyroxin-binding globulin (T-4), in- served 11.9-fold more often among liquidators
creased production of triiodothyronine, in- than in the general adult population (Antypova
creased production of thyroglobulin in girls, et al., 1997a,b).
and lowered production of thyroxin in boys 17. The incidence of thyroid gland anatomic
(Sychik and Stozharov, 1999a). changes in male liquidators who worked in
8. Enlarged thyroid glands were found in 1986–1987 was noticeably higher in 1994 com-
47% of 3,437 children examined in Mozyr Dis- pared with 1992 (Table 5.27).
trict, Gomel Province (Vaskevitch and Tcherny-
sheva, 1994).
9. Levels of immunity in children and TABLE 5.27. Thyroid Gland Structural Changes
teenagers with autoimmune thyroiditis have (% of a Total of 1,752 Cases Examined Annually) in
been correlated with a district’s level of radioac- Belarussian Male Liquidators (1986–1987) (Lyasko
tive contamination (Kuchinskaya, 2001). et al., 2000)
10. Early sexual maturation was observed 1992 1994
in girls from contaminated territories who
had autoimmune thyroiditis and was asso- Nodular 13.5 19.7
Hyperplasia 3.5 10.6
ciated with a significant increase in go-
Thyroiditis 0.1 1.9
nadotropic hormone concentration in the luteil
5.3.2.2. Ukraine
1. Thyroid gland dysfunction has been ob-
served in the contaminated territories since
1986–1987, and since 1990–1991 there has
been an increase in chronic autoimmune
thyroiditis (Stepanova, 1999; Cheban, 1999,
2002).
2. Eight years after in utero irradiation, thyroid
gland hormone production was low, but it was
also low in children irradiated during the first
weeks after birth (Gorobets, 2004).
3. Children with secondary thyroid hyper-
plasia have two to three times more incidence of
allergies, blood vessel pathology, immune disor-
ders, intestinal illnesses, caries, and high blood Figure 5.6. Occurrence of chronic thyroiditis
pressure (Table 5.28). among teenagers and adults from Ukraine from
4. In thyroid surgical pathology specimens 1992 to 2000 (National Ukrainian Report, 2006:
fig. 5.10).
in 1989, the incidence of goiter was found
to be sharply higher compared with the pre- 14 years following the catastrophe (Syvachenko
Chernobyl period (Horishna, 2005). et al., 2003).
5. From 1992 to 2000 the incidence of 9. Among 119,178 children of Ukraine,
chronic thyroiditis increased in teenagers and Belarus, and Russia who were younger than
adults, especially among liquidators and evac- 10 years of age at the time of the catastro-
uees (Figure 5.6). phe examined within the framework of the
6. Thyroid gland changes were found in “Sasakava” project, there were 740 abnormal
35.7% of 3,019 teenagers living in Vinnitsa and thyroid pathologies for each case of thyroid can-
Zhytomir provinces who had been 6 to 8 years cer (Yamashita and Shibata, 1997). In another
old at the time of the catastrophe (Fedyk, 2000). study in which 51,412 children were examined,
7. Thyroid gland pathology is twice as com- 1,125 thyroid pathologies were found for each
mon in children from heavily contaminated ter- case of cancer (Foly, 2002).
ritories compared to those from less contami- 10. Among more than 50,000 children with
nated areas: 32.6 vs. 15.4% (Stepanova, 1999). psychological problems who were evaluated,
8. Among 1,825 children and teenagers liv- 15% have thyroid gland pathology (Contis,
ing in Kiev Province who were born before the 2002).
catastrophe (1984–1986) the frequency of thy- 11. Chronic thyroiditis morbidity signifi-
roid gland pathology did not decrease in 11 to cantly increased among Ukrainian liquidators
TABLE 5.28. Incidence (%) of Somatic Pathology among Children with Various Degrees of Thyroid
Hyperplasia (Luk’yanova et al., 1995)
VSD∗ Allergies Circulation Infections Caries Intestinal
0 7.2 1.4 3.5 5.0 32.7 20.4

I degree 12.4 4.8 4.3 5.8 45.8 29.3
II degree 27.8 12.6 9.4 14.7 63.9 35.8
∗
Vegetocircular dystonia (autonomic nervous system dysfunction).
86
between 1992 and 2001 (Moskalenko, boys who were born in Voronezh Province in
2003). 1986 were significantly shorter than boys of
12. Some 150,000 Ukrainians developed the same age who were born in 1983, most
thyroid gland diseases in 10 years that were re- probably owing to thyroid hormone imbalance
lated to the catastrophe (ITAR–TASS, 1998). (Ulanova et al., 2002).
7. In 1998 every third child in the city of
5.3.2.3. Russia
Yekaterinburg, located in the heavily industri-
1. Children in territories with high lev-
alized Ural area that was exposed to Chernobyl
els of radioactive contamination have a sig-
fallout, had abnormal thyroid gland develop-
nificantly higher incidence of second-degree
ment (Dobrynina, 1998).
thyroid gland hyperplasia and nodular and dif-
fuse forms of goiter (Sharapov, 2001). 5.3.2.4. Other Countries
2. There is a correlation between the level of POLAND. Of the 21,000 individuals living in
incorporated radionuclides and hyperplasia of the southeast part of the country contaminated
the thyroid gland (Adamovich et al., 1998). by Chernobyl fallout who were examined, ev-
3. Every second child in the heavily con- ery second woman and every tenth child had
taminated districts of Bryansk Province has an enlarged thyroid. In some settlements, thy-
had some thyroid gland pathology (Kashyryna, roid gland pathology was found in 70% of the
2005). inhabitants (Associated Press, 2000).
4. From 1998 to 2004 in Bryansk Province,
there were 284 cases of thyroid cancer and
7,601 cases of other types of thyroid pathology 5.3.3. Conclusion
(Karevskaya et al., 2005).
5. In the heavily contaminated districts of Despite information presented so far, we still
Bryansk Province up to 60% of children have do not have a total global picture of all of the
thyroid gland hyperplasia (Table 5.29). people whose hormone function was impaired
6. In Voronezh Province, where eight dis- by radiation from the Chernobyl catastrophe
tricts were officially registered as being con- because medical statistics do not deal with such
taminated with radioactivity, the incidence of illnesses in a uniform way.
enlarged thyroids increased in children in the At first sight some changes in endocrine func-
first 10 years after the catastrophe. At age 11, tion in those subjected to Chernobyl radia-
tion were considered controversial. We have
learned, however, that hormone function may
TABLE 5.29. Cases of First and Second Degree be depressed in a territory with a low level of
Thyroid Gland Hyperplasia in Children (per 1,000)
radioactive contamination and increased ow-
in Heavily Contaminated (Cs-137 > 5 Ci/km2 ) Dis-
tricts of Bryansk Province, 1995–1998 (Fetysov, ing to an increasing dose rate in a neighboring
1999b: table 6.2) contaminated area. Diseases of the same or-
gan may lead to opposing signs and symptoms
Number of cases
depending upon the timing and extent of the
District 1995 1996 1997 1998 damage. With the collection of new data, we
Klymovo 600.5 295.9 115.1 52.3 hope that such contradictions can be resolved.
Novozybkov 449.0 449.5 385.9 329.4 Careful research may uncover the explanation
Klintsy 487.6 493.0 413.0 394.3 as to whether the differences are due to past
Krasnogorsk 162.2 306.8 224.6 140.1 influences of different isotopes, combinations
Zlynka 245.1 549.3 348.7 195.0 of different radioisotopes, timing of exposures,
Southwest∗ 423.4 341.0 298.7 242.7
adaptation of various organs, or factors still to
∗
All heavily contaminated districts. be uncovered.
The analysis of remote, decades-old data, chronic diseases and infections, as is widely ob-
from the southern Ural area contaminated by served in the Chernobyl-irradiated territories
radioactive accidents in the 1950s and 1960s (Bortkevich et al., 1996; Lenskaya et al., 1999;
indicates that low-dose irradiation in utero, and others). The suppression of immunity as
which was similar to that from Chernobyl, may a result of this radioactive contamination is
cause impairment of neuroendocrine and neu- known as “Chernobyl AIDS.”
rohumoral regulation. Using those data, re- On the basis of review of some 150 scien-
searchers reported vertebral osteochondrosis, tific publications the conclusion is that depres-
osteoarthritic deformities of the extremities, at- sion of thymus function plays the leading role
rophic gastritis, and other problems in the ex- in postradiation pathology of the immune sys-
posed population (Ostroumova, 2004). tem (Savyna and Khoptynskaya, 1995). Some
An important finding to date is that for every examples of adverse effects of Chernobyl con-
case of thyroid cancer there are about 1,000 tamination on the immune system as well as
cases of other kinds of thyroid gland pathology. data showing the scale of damage to the health
In Belarus alone, experts estimate that up to of the different populations are described in
1.5 million people are at risk of thyroid disease what follows.
(Gofman, 1994; Lypyk, 2004).
From the data collected from many differ- 5.4.1. Belarus
ent areas by many independent researchers, the
spectrum and the scale of endocrine pathology 1. Among 3,200 children who were exam-
associated with radioactive contamination are ined from 1986 to 1999 there was a significant
far greater than had been suspected. It is now decrease in B lymphocytes and subsequently
clear that multiple endocrine illnesses caused in T lymphocytes, which occurred within the
by Chernobyl have adversely affected millions first 45 days after the catastrophe. In the first
of people. 1.5 months, the level of the G-immunoglobulin
(IgG) significantly decreased and the concen-
tration of IgA and IgM as circulating immune
5.4. Immune System Diseases complexes (CIC) increased. Seven months af-
ter the catastrophe there was a normalization
One result of many studies conducted during of most of the immune parameters, except for
the last few years in Ukraine, Belarus, and Rus- the CIC and IgM. From 1987 to 1995 im-
sia is the clear finding that Chernobyl radiation munosuppression was unchanged and a de-
suppresses immunity—a person’s or organism’s crease in the number of T cells indicators was
natural protective system against infection and seen. A total of 40.8 ± 2.4% of children from
most diseases. the contaminated territories had high levels of
The lymphatic system—the bone marrow, IgE, rheumatoid factor, CIC, and antibodies
thymus, spleen, lymph nodes, and Peyer’s to thyroglobulin. This was especially promi-
patches—has been impacted by both large nent in children from the heavily contami-
and small doses of ionizing radiation from the nated areas. The children also had increased
Chernobyl fallout. As a result, the quantity titers of serum interferon, tumor necrosis fac-
and activity of various groups of lymphocytes tor (TNF-a), R-proteins, and decreased com-
and thus the production of antibodies, includ- plement activity. From 1996 to 1999 T cell
ing various immunoglobulins, stem cells, and system changes showed increased CD3+ and
thrombocytes, are altered. The ultimate con- CD4+ lymphocytes and significantly decreased
sequences of destruction of the immune sys- CD22 and HLA-DR lymphocytes. Children
tem is immunodeficiency and an increase in from areas heavily contaminated with Cs-137
the frequency and seriousness of acute and had significantly more eosinophils, eosinophilic
88
protein X concentration in urine, and ily contaminated by Sr-90 than in children

eosinophilic cation protein concentration in from less contaminated areas: 36.8 vs. 15.0%
serum (Tytov, 2000). (Bandazhevsky et al., 1995; Bandazhevsky,
2. There was a strong correlation between 1999).
the level of Cs-137 contamination in the territo- 11. Among 1,313 children examined from
ries and the quantity of the D25+ lymphocytes, an area contaminated by Cs-137 at a level
as well as concentration-specific IgE antibodies of 1–5 Ci/km2 some developed immune sys-
to grass and birch pollen (Tytov, 2002). tem problems, which included lowered neu-
3. There was an increasing concentration of trophil phagocytic activity, reduced IgA and
the thyroid autoantibodies in 19.5% of “practi- IgM, and increased clumping of erythrocytes
cally healthy” children and teenagers living in (Bandazhevsky et al., 1995).
Khoiniky District, Gomel Province. The chil- 12. The immune changes in children of
dren and teenagers with thyroid autoimmune Gomel Province are dependent upon the spec-
antibodies living in the contaminated territories trum of radionuclides: identical levels of Sr-
have more serious and more persistent changes 90 and Cs-137 radiation had different conse-
in their immune status (Kuchinskaya, 2001). quences (Evets et al., 1993).
4. The number of B lymphocytes and the 13. There was correlation among children
level of serum IgG began to increase in children and adults between the level of radioactive con-
from the contaminated areas of the Mogilev tamination in an area and the expression of the
and Gomel provinces a year after the catastro- antigen APO-1/FAS (Mel’nikov et al., 1998).
phe. The children were 2 to 6 years of age at 14. There are significant competing differ-
the time of the catastrophe (Galitskaya et al., ences in the immune status of children from
1990). territories with different Cs-137 contamination
5. In children from the territories of Mogilev loads (Table 5.30).
Province contaminated by Cs-137 at levels 15. Levels of immunoglobulins IgA, IgM,
higher than 5 Ci/km2 there was a significant IgG, and A(sA) in mother’s milk were signifi-
decrease in cellular membrane stability and im- cantly lower in the contaminated areas. Acute
paired immunity (Voronkin et al., 1995). respiratory virus infections (ARV), acute bron-
6. The level of T lymphocytes in children chitis, acute intestinal infections, and anemia
who were 7 to 14 years of age at the time of were manifoldly higher in breast-fed babies
the catastrophe correlated with radiation levels from the contaminated areas (Zubovich et al.,
(Khmara et al., 1993). 1998).
7. Antibody formation and neutrophilic ac- 16. Significant changes in cellular immu-
tivity were significantly lower for the first year nity were documented in 146 children and
of life in newborns in areas with Cs-137 levels teenagers operated on for thyroid cancer in
higher than 5 Ci/km2 (Petrova et al., 1993). Minsk. These changes included: decrease in the
8. Antitumor immunity in children and evac- number of T lymphocytes (in 30% of children
uees was significantly lower in heavily contam- and 39% of teens), decreased levels of B lym-
inated territories (Nesterenko et al., 1993). phocytes (42 and 68%), decreased T lympho-
9. Immune system depression occurred in cytes (58 and 67%), high titers of antibodies to
healthy children in the Braginsk District near thyroglobulin (ATG), and neutrophilic leukocy-
the 30-km zone immediately after the catas- tosis in 60% of the children (Derzhitskaya et al.,
trophe with normalization of some parame- 1997).
ters not occurring until 1993 (Kharytonik et al., 17. Changes in both cellular and humoral
1996). immunity were found in healthy adults living
10. Allergy to cow’s milk proteins was found in territories with a high level of contamination
in more children living in territories more heav- (Soloshenko, 2002; Kyril’chik, 2000).
TABLE 5.30. Immune Status of Children with Frequent and Prolonged Illnesses from the Contaminated
Territories of Belarus (Gurmanchuk et al., 1995)
District/radiation level Parameters of immunity
Pinsk, Brest Province, Number of T lymphocytes, T suppressors (older children), suppression index,
1–5 Ci/km2 (n = 67) T helpers (all groups) is lowered. The level of the CIC, IgM (all groups), and IgA
(children up to 6 years of age) is raised.
Bragin, Gomel Province, Number of T lymphocytes is raised (all groups), fewer T-lymphocyte helpers (older
40–80 Ci/km2 (n = 33) children), increased T suppressors (in oldest children).
Krasnopolsk, Mogilev All children have humoral cellular depression, fewer B lymphocytes, CIC levels
Province, up to raised, complement overactive, and levels of IgG and IgA phagocyte activity
120 Ci/km2 (n = 57) lowered.
18. The levels of IgA, IgG, and IgM im- 5.4.2. Ukraine
munoglobulins were increased in the postpar-
tum period in women from districts in Gomel 1. Immune deficiency was seen in 43.5% of
and Mogilev provinces contaminated with Cs- children radiated in utero (vs. 28.0% in the con-
137 at a level higher than 5 Ci/km2 and trol group; P <0.05) within the first 2 years
the immune quality of their milk was lowered after the catastrophe (Stepanova, 1999).
(Iskrytskyi, 1995). The quantity of IgA, IgG, 2. A total of 45.4% of 468 children and
and IgM immunoglobulins and secretory im- teenagers who were examined had chronic ton-
munoglobulin A(sA) were reduced in women sillitis, hypertrophy of the adenoid glands and
in the contaminated territories when they be- tonsils, and increased frequency of neck lym-
gan lactating (Zubovich et al., 1998). phadenopathies. All of these pathologies were
19. The number of T and B lympho- expressed more in the areas with higher levels
cytes and phagocytic activity of neutrophilic of contamination (Bozhko, 2004).
leukocytes was significantly reduced in adults 3. Quantitative and functional parameters
from the contaminated areas (Bandazhevsky, of the immune status of children correlated
1999). with the level of background radiation in ar-
20. Significant changes in all parameters of eas of permanent residency. These included
cellular immunity (in the absence of humoral impaired T- and B-cellular immunity, stimu-
ones) were found in children born to liquidators lation of Th[2]-cells and increased IgE, abso-
in 1987 (Arynchin et al., 1999). lute and relative number of B lymphocytes, and
21. A survey of 150 Belarus liquidators levels of immunoglobulins in blood and saliva
10 years after the catastrophe showed a sig- (Kyril’chik, 2000).
nificant decrease in the number of T lym- 4. Periodic changes in humoral and cellular
phocyte, T suppressor, and T helper cells immunity were found in healthy children from
(Table 5.31). the Komarin settlement, Braginsk District, near
22. In a group of 72 liquidators from 1986,
serum levels for autoantibodies to thyroid anti- TABLE 5.31. Numbers of T and B Lymphocytes
gens (thyroglobulin and microsomal fraction of in 150 Belarussian Male Liquidators in 1996
thyrocytes) were raised 48%. Autoantibodies (Bliznyuk, 1999)
to lens antigen were increased 44%; to CIC, Liquidators Controls
55%; and to thyroglobulin, 60%. These shifts
in immune system function are harbingers of T lymphocytes 723.5 ± 50.6 1,401.0 ± 107.4∗
B lymphocytes 215.7 ± 13.9 272.5 ± 37.3∗
pathology of the thyroid gland and crystalline
∗
lens of the eye (Kyseleva et al., 2000). Differences are significant.
90
the 30-km Chernobyl zone. In 1986 the level numbers of T- and B-rosette forming cells,
of interferon in 40.8 ± 6.2% of children was T suppressors, and IgA and IgG globu-
significantly below the level of controls. The lins and an increased index of T helpers/
greatest immune system depression involved T suppressors, was found in areas with
a decrease in EAC-POK, especially in chil- higher levels of radionuclides (Soloshenko,
dren aged 4 to 6 years, a decreased level of 2002).
T lymphocytes, and an index of suppression 11. Liquidators from 1986–1987 had im-
(IS) especially for children aged 11 to 14 years. paired immunity expressed as depressed
In 1988 the levels of IgM and CIC remained humoral and cellular immunity and poor re-
raised, as were those of T lymphocytes and T sistance to infection 6 to 8 years after the catas-
helper cells. Levels of T suppressor cells signi- trophe (Chumak and Bazyka, 1995).
ficantly decreased, whereas interferon activity 12. In the 10 to 15 years after the catastrophe
increased. By 1993 there was a normalization many liquidators had quantitative changes in
of a number of immune parameters, but for cellular and humoral immunity and altered im-
children 7 to 14 years of age T lymphocytes mune status (Korobko et al., 1996; Matveenko
and T helper cells were decreased (Kharytonik et al., 1997; Potapnev et al., 1998; Grebenjuk
et al., 1996). et al., 1999; Gazheeva et al., 2001; Malyuk and
5. Immunological status of evacuees’ chil- Bogdantsova, 2001; Tymoshevsky et al., 2001;
dren in the first 2 years was characterized Shubik, 2002; Bazyka et al., 2002; Novykova,
by impaired humoral and cellular immunity. 2003; Mel’nov et al., 2003). These changes are
These parameters stabilized only 5 years later expressed as:
(Romanenko et al., 1995a,b).
• Changes in the ratio of subpopulations
6. The number of T and B lymphocytes
(36 ± 3.5% and 24 ± 1.4%), T helpers, of T lymphocytes—T helpers/T suppres-
immune-regulating index Tx:Tc (2.4 ± 0.19 vs. sors.
• Decrease in the general number of T and
1.9 ± 0.14), and IgG levels were significantly
higher in patients with chronic pyelonephritis B lymphocytes.
• Decrease in the level of serum IgA, IgG,
living in the contaminated areas of Polessk and
Ivankov districts of Kiev Province (Vozianov and IgM immunoglobulins.
• Impaired production of cytokines.
et al., 1996).
• Activation of neutrophilic granulocytes.
7. The number of peripheral blood leuko-
cytes in evacuees remained significantly lower 13. Pathological changes in neutrophil ul-
even 7 to 8 years after the catastrophe (Baeva tra structure, which included destruction of cell
and Sokolenko, 1998). contents, hypersegmentation of nuclei, abnor-
8. The influences of internal and external mal polymorphic forms and lymphocytes with
radiation on the character of neurohumoral increased segmentation, changes in membrane
reactions are sharply different: with internal contour, and chromatin and nuclei segmenta-
radiation there is a gradual development of tion, were found in a majority of 400 liquidators
autoimmune reactions, whereas with external examined (Zak et al., 1996).
radiation, development is rapid (Lysyany and
Lyubich, 2001). 5.4.3. Russia
9. A total of 45% of more than 450,000
children living in contaminated territories had 1. Children living in heavily contaminated
lowered immune status 10 years after the catas- territories have generalized and specific im-
trophe (TASS, 1998). munity suppression and malfunction of their
10. Significant impairment of cellular and antioxidant and sympathetic adrenal systems
humoral immunity, expressed by decreased (Terletskaya, 2003).
2. A survey of 144 children and teenagers and T suppressors (CD8+ ); and a raised
of Krasnogorsk District, Bryansk Province, immune-regulatory index (T4 helpers/T8 sup-
with Cs-137 levels up to 101.6 Ci/km2 have pressors). This index correlated significantly
decreased relative and absolute numbers of with the dose level in utero (Kulakov et al., 1997).
T cells; increased immune-regulatory index 8. Absolute levels of all lymphocyte popu-
(T4/T8); and reduced relative numbers of lym- lations were lower in all liquidators’ children
phocytes, T helpers (CD4+ ), and relative and examined at 10 to 13 years of age, which indi-
absolute numbers of T suppressors (CD8+ ; cated that these children had both absolute and
Luk’yanova and Lenskaya, 1996). relative deficiencies in their cellular immunity.
3. During a survey of 113 children from Clinically, infections prevailed: frequent acute
the Krasnogorsk District, Bryansk Province, respiratory virus infections (ARV), bronchitis,
from 1987 to 1995, parameters of intensive pneumonia, otitis, and purulent infections of
granular reaction in lymphocytes peaked in the mucous membranes and skin. For others,
1991, decreased almost to their norms in 1992– a relative measure of cellular immunity had a
1993, and increased again in 1994–1995. The tendency to increase owing to an increase in the
number of children with critically low lym- number of CD4+ cells and there was a decrease
phocyte counts also rose in 1994–1995. There in the subpopulation T cells and an increase in
were correlations between an intensive gran- basophilic activity. The clinical picture of the
ular reaction in children and additional inter- second group comprised allergies, sensitivity to
nal radiation of more than 0.5 mSv annually pollens, asthmatic bronchitis, and food allergies
(Luk’yanova and Lenskaya, 1996). (Kholodova et al., 2001).
4. In territories of Krasnogorsk District with 9. In the contaminated territories the num-
higher radioactive contamination there was sig- ber of individuals with adaptive reaction lym-
nificantly less activity of nonspecific esterase phocytes is lower and the number of peo-
(a marker of immature T cells) and a signif- ple with elevated lymphocyte radiosensitivity
icant increase in the number of medium-size is higher (Burlakova et al., 1998).
lymphocytes with intensive granular reaction 10. The number of large granulocytic lym-
(Lenskaya et al., 1995). phocytes (NK cells) decreased 60 to 80% in
5. Children 11 to 13 years of age and preg- liquidators 1 month after beginning work in
nant women living in districts of Kursk Province the contaminated zone and persisted at a low
with high levels of contamination had func- level for not less than 1 year (Antushevich and
tional and quantitative lymphocyte changes Legeza, 2002). After 3 to 4 years liquidators
and significantly increased circulating serum had persistent changes in T system immunity
immune complexes (CICs; Alymov et al., 2004). with a decrease in T cells and T helpers and a
6. By 2002 the frequency of occurrence of reduction in the helper/suppressor index. This
impaired immunity and metabolism in chil- combination was observed in varying degrees
dren had increased fivefold in the contami- in 80% of cases with bacterial intestinal dis-
nated districts of Tula Province compared to ease. After 5 years and then 13 to 15 years
pre-Chernobyl levels. At the same time, mor- most of the parameters of cellular and humoral
bidity not related to radiation remained the immunity in liquidators did not differ from nor-
same in both the clean and contaminated ter- mal, although there were changes in natural
ritories (Sokolov, 2003). immunity with decreased activity of myeloper-
7. In the heavily contaminated districts of oxidase (MPO) in neutrophils, a markedly re-
Bryansk Province, children and teenagers had duced subpopulation of active lymphocytes,
markedly lowered relative and absolute num- and a substantial increase in abnormal ery-
bers of T cells; significantly lowered relative throcytic forms (Antushevich and Legeza,
numbers of lymphocytes, T helpers (CD4+ ), 2002).
92
11. In the 7 to 9 years after the catastro- 5.5. Respiratory System Diseases
phe, liquidators from Obninsk City, Kaluga
Province, had a higher incidence of allergic dis- There is a marked increase in respiratory
eases: rhinitis (6- to 17-fold) and nettle rash (4- system morbidity everywhere in the territories
to 15-fold) compared to the local population contaminated by Chernobyl fallout. Respira-
(Tataurtchykova et al., 1996). tory system diseases, which include those of the
12. Four years after their participation in nasal cavity, throat, trachea, bronchial tubes,
emergency work the normal levels of dermor- and lungs, were among the first apparent con-
phin was restored in only 17% of the liquida- sequences of the irradiation and ranged from
tors examined. The levels of two other neu- nose bleeds and tickling in the throat to lung
ropeptides (leu- and methionine-encephalin) cancer. Hot particles, or “Chernobyl dust,”
exceeded norms for more than 50% of consist of particles containing radionuclides de-
the liquidators examined (Sushkevich et al., rived from nuclear fuel melted together with
1995). particles from metal construction, soil, etc. (see
13. Liquidators with neuropsychologi- Chapter 1 for details). These persist for long
cal disorders developed secondary immune- periods in pulmonary tissue because of the low
deficiency conditions (T lymphopenia, loss of solubility of uranium oxides. In the first days
balance of subpopulations of T cells with im- after the catastrophe, respiratory problems in
paired T helper/T suppressor ratios, etc.). The the mouth, throat, and trachea in adults were
number of T helpers (CD4+ ) decreased in 90% basically linked to the gaseous–aerosol forms
of surveyed liquidators, and 15% of those ex- of radionuclides. During this initial period I-
amined had a significantly reduced number of 131, Ru-106, and Ce-144 had the most seri-
circulating T-suppressor cells. In these groups ous impact on the respiratory system (IAEA,
changes took place that were opposite in na- 1992; Chuchalin et al., 1998; Kut’kov et al.,
ture to changes in the immune-regulatory index 1993; Tereshenko et al., 2004). Further dam-
CD4/CD8). The level of the CIC increased in age to the respiratory system was caused by hot
all surveyed liquidators. Phagocytic activity of particles and external irradiation, and was also
peripheral blood neutrophils was lower in 80% a consequence of changes in the immune and
and macrophage activity was lower in 85% of hormonal systems. The smallest hot particles,
those examined (Kut’ko et al., 1996). up to 5 μm, easily reached the deepest parts of
14. The immune index of liquidators corre- lungs, while larger particles were trapped in the
lated with the dose of radiation calculated by upper respiratory tract (Khrushch et al., 1988;
the level of chromosomal aberrations (Baleva Ivanov et al., 1990; IAEA, 1994).
et al., 2001). Bronchopulmonary morbidity increased
quickly among liquidators in the contaminated
territories (Kogan, 1998; Provotvorov and
5.4.4. Conclusion Romashov, 1997; Trakhtenberg and Chissov,
2001; Yakushin and Smirnova, 2002; Tselo-
Data in this section demonstrate the power- val’nykova et al., 2003; and others). Liquidators,
ful effects of the Chernobyl radioactive fallout whose health was supervised more carefully
on the immune system and its functions. De- than that of the general population, developed
spite the fragmentary data, it is clear that the marked restrictive lung disease due to a func-
scale of the impacts is enormous. Apparently, tional decrease in lung elasticity (Kuznetsova
impaired immunity triggered by Chernobyl ra- et al., 2004). Chernobyl dust was found in
dionuclides adversely affected all of the individ- liquidators’ bronchial tubes, bronchioles, and
uals, without exception, who were subjected to alveoli for many years. The syndrome of “acute
any additional radiation. inhalation depression of the upper respiratory
system” presents as a combination of a rhini- 7. In the first 3 years after the catastrophe
tis, tickling in the throat, dry cough, and diffi- respiratory illnesses in children from territo-
culty breathing (Chuchalin et al., 1993; Kut’kov, ries contaminated at a level of 15–40 Ci/km2
1998; Romanova, 1998; Chykyna et al., 2001; were 3.5-fold more common than in less con-
and others). taminated territories. From 1990 to 1993 chil-
dren from heavily contaminated territories
5.5.1. Belarus had 2.5-fold more illnesses (Gudkovsky et al.,
1995).
1. Children born to mothers in the Cher- 8. Respiratory morbidity among children
nobyl contaminated territories who were preg- from the Luninetsk District, Brest Province, was
nant at the time of the catastrophe have twice 72.9% from 1986 to 1988, 54.1% from 1989 to
the incidence of acute respiratory diseases 1991, and 39.4% from 1992 to 1994. Among
(Nesterenko, 1996). the most common illnesses were ARV infection,
2. Respiratory morbidity in children born bronchitis, and chronic tonsillitis (Voronetsky
at the time of the catastrophe in territories et al., 1995).
with contamination levels of 15–40 Ci/km2 9. Among evacuees, respiratory morbidity in
was significantly higher than in children of 1995 was 2,566 cases per 10,000 compared to
the same age from territories with contam- the country average of 1,660 (Matsko, 1999).
ination of 5–15 Ci/km2 (Kul’kova et al.,
1996). 5.5.2. Ukraine
3. Respiratory diseases were found in 19%
of liquidators’ children up to 1 year of age, 1. In the first months after the catastro-
and 10% of the children had exudative-mucoid phe, more than 30% of children in the con-
disease. In older children 60% had docu- taminated territories had breathing difficulties
mented respiratory diseases (Synyakova et al., defined as a respiratory syndrome (Stepanova
1997). et al., 2003). In 1986–1987, nearly 10,000 chil-
4. The number of children hospitalized for dren from contaminated territories that were
bronchial asthma was higher in the more con- examined had breathing problems: (a) 53.6%
taminated territories and chronic nasopharyn- had bronchial obstruction mainly of the small
geal pathology was seen twice as often com- bronchial tubes (controls, 18.9%) and (b) 69.1%
pared to children from less contaminated areas had latent bronchospasms (controls, 29.5%;
(Sitnykov et al., 1993; Dzykovich et al., 1994; Stepanova et al., 2003).
Gudkovsky et al., 1995). 2. Asphyxia was observed in half of 345
5. Among 2,335 surveyed evacuees’ newborns irradiated in utero in 1986–1987
teenagers, respiratory morbidity was the third (Zakrevsky et al., 1993).
cause of overall morbidity 10 years after the 3. Older children irradiated in utero had
catastrophe: 286 per 1,000 (Syvolobova et al., respiratory system pathologies significantly
1997). more often than controls: 26.0 vs. 13.7%
6. Among 4,598 children newborn to 4 (Prysyazhnyuk et al., 2002).
years old at the time of the meltdown from 4. In 1994 respiratory system morbidity
Kormyansk and Chechersk districts, Gomel among children from contaminated territories
Province, which had contamination levels of and among evacuees was as high as 61.6% and
15–40 Ci/km2 , respiratory system morbidity among adults and teenagers it reached 35.6%
was significantly higher than among children (Grodzinsky, 1999).
from areas with contamination levels of 5– 5. In 1995 respiratory illnesses in chil-
15 Ci/km2 (Blet’ko et al., 1995; Kul’kova et al., dren from the heavily contaminated territo-
1996). ries were reported twice as often as from less
94
the contaminated zone and immediately after-

ward suffered from a dry cough complicated
by painful breathing. The subsequent develop-
ment of disease was characterized by progres-
sive obstruction and dyspnoea with shortness
of breath and difficulty or pain in breathing.
Subsequently, symptoms of chronic obstructive
lung disease were observed: cough, sputum pro-
duction, and dyspnoea in combination with ob-
structive, restrictive, and mixed ventilation dis-
orders (Tereshchenko et al., 2003; Sushko and
Shvayko, 2003a).
11. From 1988 to 2006 clinical observa-
tion of 2,476 male liquidators ages 36.7 ±
Figure 5.7. Chronic bronchitis and chronic 8.5 years showed chronic obstructive lung dis-
obstructive pulmonary disease (COPD) morbidity ease and bronchitis in 79%, chronic nonob-
among Ukrainian liquidators from 1996 to 2004
structive bronchitis in 13%, and asthma in 8%
(Sushko et al., 2007).
(Tereshchenko et al., 2004; Dzyublik et al., 1991;
Sushko, 1998, 2000). The occurrence of ob-
contaminated areas (Baida and Zhirnosekova, structive disease and bronchitis almost dou-
1998). bled in the second decade after the catastrophe
6. According to the Ukrainian Ministry (Figure 5.8).
of Health, bronchitis and emphysema among 12. Some 84% of 873 surveyed liquidators
teenagers, adults, and evacuees in the contam- had tracheobronchial mucous membrane thin-
inated territories increased 1.7-fold from 1990 ning and vascular atrophy; 12% had oppo-
to 2004 (316.4 and 528.5 per 10,000), and site changes in bronchial fiberscopic pathol-
bronchial asthma more than doubled (25.7 and ogy, including hyperplasia, which consisted of
55.4 per 10,000; National Ukrainian Report,
2006).
7. Chronic bronchitis in liquidators more
than doubled between 1996 and 2004, going
from 84 to 181 cases per 1,000 (Figure 5.7).
8. In 80% of the cases of chronic nonspe-
cific pulmonary disease among liquidators, at-
rophy of the mucous membrane covering of
the trachea and bronchus was found, as well
as ciliary flattening and epithelial metaplasia
(Romanenko et al., 1995a).
9. Of 873 male liquidators examined 15
years after the catastrophe, 84% had mu-
cous membrane atrophy, usually accompanied
by bronchial tree deformities (Shvayko and
Sushko, 2001; Tereshchenko et al., 2004).
10. Chronic bronchitis and bronchial asthma
Figure 5.8. Bronchopulmonary illnesses in
are two of the main reasons for morbidity, Ukrainian male liquidators over a 20-year period
impairment, and mortality among liquidators. (Tereshchenko et al., 2004; Sushko and Shvayko,
The majority of liquidators during their stay in 2003a,b).
thickening of the mucous membranes and nar- TABLE 5.32. Respiratory Morbidity among Chil-
rowing of primary and secondary bronchial dren of Bryansk Province Districts with a Level
of Contamination above 5 Ci/km2 , 1995–1998
tubes; and 4% were observed to have both
(Fetysov, 1999b: table. 6.1)
types of pathology—atrophic changes proxi-
mally and hyperplasia distally. In 80% of the Number of cases
group examined mucoid-sclerotic changes in 1995 1996 1997 1998
the bronchial mucosa were accompanied by
tracheobronchial tree deformity. The preva- Klymovo 781.5 897.5 1,080.5 1,281.6
Novozybkov 1,435.3 1,750.0 2,006.0 1,743.9
lence of mucoid-sclerotic changes correlates Klintsy 303.4 342.9 481.3 728.5
with endobronchial atrophy. Isolated sclerotic Krasnogorsk 936.0 927.3 1,001.3 771.0
changes of bronchial mucosa were reported in Zlynka 1,510.4 1,072.0 1,267.6 1,582.6
16% and mucoid changes in 4% (Tereshchenko Southwest∗ 1,288.7 1,023.8 1,426.2 1,398.3
et al., 2004). Province 855.1 774.8 936.6 918.7
Russia 767.2 715.1 790.9 n/a
13. Years after the catastrophe three liquida-
∗
tors were found to have sclerotic pulmonary All contaminated districts.
mucous membrane changes and bronchial de-
formities (Sushko et al., 2007).
asthma and chronic bronchitis. In the first
5.5.3. Russia years after the catastrophe broncopulmonary
illnesses were accompanied by moderate im-
1. Broncopulmonary dysplasia was seen in munological changes and latent functional im-
premature newborns from Novozybkov City, pairment; 10 to 15 years later the findings
Bryansk Province, and fetal lung dysplasia was are pneumonia and lung scarring (Terletskaya,
more common in 1992–1993 compared with 2002, 2003).
controls and compared with the number of 5. Children’s overall respiratory morbidity
cases observed in 1995 (Romanova et al., 2004). was much higher in the heavily contaminated
2. The incidence of asphyxia and compli- districts of Bryansk Province 9 to 12 years after
cated breathing problems in newborns corre- the catastrophe than in the rest of the province
lated with the level of contamination in the ter- and in Russia as a whole (Table 5.32).
ritory (Kulakov et al., 1997). 6. For adults in the more contaminated terri-
3. Noninfectious respiratory disorders in tories of Bryansk Province the general respira-
neonates born to mothers from the contam- tory morbidity is much below that of children,
inated territories were encountered 9.6 times but the same tendency toward increase was ob-
more often than before the catastrophe. The ar- served from 1995 to 1998, except in one district
eas and contamination levels were: Polessk Dis- (Table 5.33).
trict, Kiev Province (20–60 Ci/km2 ); Chech- 7. A majority of the surveyed Russian liq-
ersk District, Gomel Province (5–70 Ci/km2 ); uidators who were exposed in 1986–1987 have
and Mtsensk (1–5 Ci/km2 ) and Volkhov (10– developed progressive pulmonary function im-
15 Ci/km2 ) districts, Oryol Province (Kulakov pairment (Chykyna et al., 2002). Incidence of
et al., 1997). this respiratory abnormality increased contin-
4. Children in the contaminated territories uously for the first 8 years after the catastrophe
currently have more bronchial asthma and (Table 5.34).
chronic bronchitis owing to irreversible struc- 8. A group of 440 liquidators with chronic
tural lung changes. In the contaminated territo- bronchopulmonary pathology were examined
ries there is a marked increase in the incidence at the Moscow Institute of Pulmonology.
of both acute pneumonia and chronic bron- Radionuclides were found in their pulmonary
copulmonary pathology, expressed as bronchial systems 6 to 10 years after the catastrophe.
96
TABLE 5.33. Respiratory Morbidity among the 5.5.4. Conclusion

Adult Population of Bryansk Province in Areas with
a Level of Contamination above 5 Ci/km2 , 1995– Illnesses of the upper respiratory system (na-
1998 (Fetysov, 1999a: table 5.1) sopharynx and bronchial tubes) were the ini-
Territory 1995 1996 1997 1998 tial consequences of Chernobyl irradiation for
the general population and the liquidators in
Klymovo 195.9 211.9 259.6 326.3 the first days and weeks after the catastrophe.
Novozybkov 302.3 288.9 238.0 233.1
Klintsy 142.5 126.2 336.8 474.5
In some years the incidence of bronchopul-
Krasnogorsk 196.6 163.6 182.0 183.4 monary illnesses decreased, but the severity
Zlynka 192.0 230.8 298.0 309.1 increased, reflecting significant impairment of
Gordeevka 134.0 167.6 192.0 237.0 the immune and hormonal systems. Some 10
Southwest 209.2 194.5 237.6 242.2 to 15 years later, respiratory morbidity in Be-
Province 197.4 168.3 199.2 192.6
larus, Ukraine, and Russia remained signifi-
Russia 213.6 196.6 219.2 n/a
cantly higher in the contaminated territories.
For children of the Japanese hibakusha who
Combined external radiation and incorporated were not irradiated directly, the incidence of
radionuclide effects were expressed in a new respiratory system illnesses was higher com-
form of chronic obstructive pulmonary disease pared to controls some decades after the bom-
syndrome (Chuchalin et al., 1998). bardments (Furitsu et al., 1992). If such an
9. Prolonged persistence of radioactive par- increase is observed after a single short-term
ticles is associated with the appearance of irradiation, it is possible to assume that the
cancer-related molecular abnormalities in the Chernobyl irradiation will cause increased res-
bronchial epithelium of former Chernobyl piratory system illnesses over the next several
cleanup workers. These include: K-ras (codon generations.
12) mutation; p16 (INK4A) promoter hyper-
methylation; microsatellite alterations at seven 5.6. Urogenital Tract Diseases and
chromosomal regions; and allelic loss at 3p12, Reproductive Disorders
3p14.2 (FHIT), 3p21, 3p22–24 (hMLH1), and
9p21 (p16INK4A). The incidence of 3p14.2 Irradiation directly damages the kidneys,
allelic loss was associated with decreased ex- bladder, and urinary tract, as well as the ovaries
pression of the FHIT mRNA in the bronchial and testicles, which not only are subject to di-
epithelium as compared with a control group rect radiation effects, but are indirectly affected
of smokers (Chuchalin, 2002; Chizhykov and through hormonal disruption. These disorders
Chizhykov, 2002). in structure and function result in damage to
10. The frequency of the chronic bron- the reproductive process.
chopulmonary illnesses in liquidators increased Although there have been some studies of
significantly over the first 15 years after the the functional changes in the urogenital tract as
catastrophe, with an increase up to 10-fold for a consequence of Chernobyl radiation, there is
some illnesses. The diseases developed more still not enough information to explain all of the
rapidly and were more serious (Tseloval’nykova serious changes. It was unexpected, for exam-
et al., 2003). ple, to find increased levels of male hormones
TABLE 5.34. Respiratory Morbidity (per 10,000) among Russian Liquidators for the First 8 Years after
the Catastrophe (Baleva et al., 2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Morbidity 645 1,770 3,730 5,630 6,390 6,950 7,010 7,110
in females as a result of internally incorporated 9. Soon after the catastrophe the majority of
radionuclides (for a review see Bandazhevsky, fertile women from the contaminated territo-
1999) and also unexpected to observe con- ries developed menstrual disorders (Nesterenko
trary effects of various radionuclides on the et al., 1993). Frequent gynecologic problems
rate of sexual maturation (Paramonova and and delay in the onset of menarche correlated
Nedvetskaya, 1993). with the levels of radioactive contamination in
5.6.1. Belarus the area (Kulakov et al., 1997).
10. Abnormalities of menstrual function in
1. From 1993 to 2003, there was a significant nonparous women in areas with contamination
delay in sexual maturation among girls from 10 of 1–5 Ci/km2 (Gomel City) was linked to ovar-
to 14 years of age born to irradiated parents ian cystic-degenerative changes and increased
(National Belarussian Report, 2006). endometrial proliferation. Ovarian size corre-
2. Up until 2000 children born after the lated with testosterone concentration in blood
catastrophe in heavily contaminated territories serum (Yagovdik, 1998).
had more reproductive organ disorders than 11. The incidence of endometriosis in-
those born in less contaminated areas: fivefold creased almost 2.5-fold in Gomel, Mogilev, and
higher for girls and threefold higher for boys Vitebsk cities from 1981 to 1995 (surgical treat-
(Nesterenko et al., 1993). ment for 1,254 women), with the disease ex-
3. In territories with heavy Chernobyl con- pressed most often in the first 5 years after the
tamination, there are increased numbers of catastrophe. Among women who developed en-
children with sexual and physical developmen- dometriosis, those in the more contaminated
tal disorders related to hormone dysfunction— areas were 4 to 5 years younger than those
cortisol, thyroxin, and progesterone (Sharapov, from less contaminated areas (Al-Shubul and
2001; Reuters, 2000b). Suprun, 2000).
4. Abnormal development of genitalia and 12. Primary infertility in the contaminated
delay in sexual development correlated with areas increased 5.5-fold in 1991 compared with
the levels of radioactive contamination in 1986. Among the irrefutable reasons for infer-
the Chechersk District, Gomel Province (5– tility are sperm pathologies, which increased
70 Ci/km2 ; Kulakov et al., 1997). 6.6-fold; twice the incidence of sclerocystic
5. Of 1,026,046 pregnant women examined, ovaries; and a threefold increase in endocrine
the level of urogenital tract disease was signif- disorders (Shilko et al., 1993).
icantly higher in the more contaminated terri- 13. Impotence in young men (ages 25 to 30
tories (Busuet et al., 2002). years) correlated with the level of radioactive
6. From 1991 to 2001, the incidence of gyne- contamination in a territory (Shilko et al., 1993).
cologic diseases in fertile women in the contam-
inated territories was considerably increased, as
were the number of complication during preg-
“. . . The doctors reminisce: ‘In one village we
nancy and birth (Belookaya et al., 2002). found twelve lactating∗ elderly women, that is,
7. Increased gynecologic morbidity (includ- women 70 years of age had milk in their breasts,
ing anemia during pregnancy and postna- as though they were nursing. Experts can argue
tal anemia) and birth anomalies correlated about the effects of small doses of radiation, but
with the level of radioactive contamination in the ordinary person cannot even begin to imagine
such a thing. . ..’ ” (Aleksievich, 1997).
the Chechersky District, Gomel Province (5– _________
70 Ci/km2 ; Kulakov et al., 1997). ∗
Lactation in the absence of pregnancy (termed
8. In the contaminated territories, failed galactoria or hyperprolactinemia) is an expression
pregnancies and medical abortions increased of pituitary gland dysfunction.
(Golovko and Izhevsky, 1996).
98
5.6.2. Ukraine TABLE 5.35. Child-Bearing Data Concerning

Women Irradiated as Children in 1986 in Con-
1. Urogenital diseases increased in children taminated Territories (Nyagy, 2006)
in the contaminated territories: 0.8 per 1,000 Irradiated Control
in 1987 to 22.8 per 1,000 in 2004 (Horishna,
2005). Normal delivery 25.8% 63.3%
Hypogalactia 33.8% 12.5%
2. From 1988 to 1999 the incidence Hypocalcemia 74.2% 12.5%
of urogenital diseases in the population of
contaminated territories more than doubled
(Prysyazhnyuk et al., 2002). ing: renal morbidity increased from 12 to 51%,
3. The level of alpha-radionuclides is signif- oligohydramnios increased 48%, newborn res-
icantly higher in bone tissue of aborted fetuses piratory disease increased 2.8-fold, the number
from mothers from the contaminated territo- of premature deliveries increased up to twofold,
ries (Luk’yanova, 2003). and there was early placental aging at 30–32
4. Girls have delayed puberty in the contam- weeks gestation (Dashkevich et al., 1995).
inated territories (Vovk and Mysurgyna, 1994). 11. Increased gynecologic morbidity (includ-
Sexual maturity was retarded in 11% of a group ing anemia during and after pregnancy) and
of 1,017 girls and teenagers from contaminated birth anomalies in the Polessk District, Kiev
territories (Lukyanova, 2003). Province, correlated with the level of radioac-
5. In the territories contaminated by Sr-90 tive contamination (20–60 Ci/km2 ; Kulakov
and Pu, puberty was delayed by 2 years in boys et al., 1997).
and by 1 year in girls. Accelerated rates of sexual 12. Earlier onset and prolonged puberty and
development were observed in territories con- disorders of secondary sexual characteristics
taminated by Cs-137 (Paramonova and Ned- were found in girls born to liquidator fathers
vetskaya, 1993). (Teretchenko, 2004).
6. Abnormal genital development and de- 13. Occurrence of chronic pyelonephritis,
lay in sexual development in the Polessk Dis- kidney stones, and urinary tract diseases in
trict, Kiev Province, correlated with the level teenagers correlated with the level of contami-
of radioactive contamination (20–60 Ci/km2 ) nation in the territories (Karpenko et al., 2003).
(Kulakov et al., 1997). 14. The incidence of female genital disor-
7. Among 1,017 female children of evacuees ders, including ovarian cysts and uterine fibro-
(aged 8 to 18 years) examined after the catas- mas, in the contaminated territories increased
trophe, 11% had delayed sexual development significantly for 5 to 6 years after the catastro-
(underdevelopment of secondary sex charac- phe (Gorptchenko et al., 1995).
teristics, uterine hypoplasia, and late menar- 15. Menstrual cycle disorders are com-
che), and 14% had disturbed menstrual func- monly diagnosed in the contaminated terri-
tion (Vovk, 1995). tories (Babich and Lypchanskaya, 1994). The
8. Women who were irradiated as girls in number of menstrual disorders in the contami-
1986 have markedly more problems during nated territories tripled compared with the pre-
childbirth (Table 5.35). catastrophe period. In the first years after the
9. Neonates born to women who were ir- catastrophe there was heavier menstruation,
radiated as girls in 1986 have up to twice and after 5 to 6 years menstruation decreased
the incidence of physical disorders (Nyagy, or stopped (Gorptychenko et al., 1995). Among
2006). 1,017 girls examined who had been exposed to
10. A survey of 16,000 pregnant women in irradiation, 14% had impaired menstruation
the contaminated territories over an 8-year pe- (Luk’yanova, 2003; Dashkevich and Janyuta,
riod after the catastrophe revealed the follow- 1997).
16. Dystrophic and degenerate changes of the contaminated territories (Lipchak et al.,
the placenta in liquidators and in other women 2003).
living in the contaminated territories corre- 22. Women in the heavily contaminated ar-
lated with the level of Cs-137 incorporated eas have more frequent miscarriages, compli-
in the placenta. These changes included un- cations of pregnancy, aplastic anemia, and pre-
even thickness of the placenta, presence of fi- mature births (Horishna, 2005).
brous scaring, cysts, calcium inclusions, and 23. Some 96% of individuals in the con-
undifferentiated and undeveloped fibroblasts taminated territories with prostatic adenoma
in the terminal stromal villi, and resulted were found to have precancerous changes in
in lower weight of newborns (Luk’yanova, the bladder urothelium (Romanenko et al.,
2003; Luk’yanova et al., 2005; Ivanyuta 1999).
and Dubchak, 2000; Zadorozhnaya et al., 24. Among 250 married couples of liquida-
1993). tors observed in Donetsk City, 59 ± 5% have
17. Spontaneous interruption of pregnancy, experienced sexual dysfunction caused by irra-
late gestation, premature birth, and other diation and 19 ± 3% owing to radiophobia.
pathologies of pregnancy occurred significantly In an other study, 41% of 467 male liquida-
more often in evacuees and in the contaminated tors (age 21 to 45 years) had sexual abnormali-
territories 8 to 10 years after the catastrophe ties: decreased testicular androgen function and
(Grodzinsky, 1999; Golubchykov et al., 2002; increased estrogen and follicle-stimulating hor-
Kyra et al., 2003). mone levels (Bero, 1999).
18. For 8 to 9 years after the catastrophe 25. In 7 to 8 years after the catastro-
the incidence of menstrual disorders was sig- phe, about 30% of liquidators had func-
nificantly increased in female liquidators. A tional sexual disorders and sperm abnormal-
total of 84% of young women (average age ities (Romanenko et al., 1995b).
30.5 years in 1986–1987) developed hyper- 26. Among 12 men with chronic radia-
menstrual syndrome within 2 to 5 years af- tion dermatitis caused by beta- and gamma-
ter being exposed (41.2% had uterine fibromy- irradiation during and after the Chernobyl
oma, 19% had mammary fibroadenomatosis, catastrophe two had erectile dysfunction and
and 16% had oliogomenses accompanied by the others reported various impairments of
persistent hyperprolactinemia (Bezhenar’ et al., sexual function. One had aspermia, two had
1999). azoospermia, one had oligospermia, and four
19. Female liquidators of perimenopausal had normal sperm counts. In three sam-
age during the catastrophe had an early ples there was an increase in abnormal
menopause (46.1 ± 0.9 years), and about 75% forms of spermatozoa and in three samples
had climacteric syndrome and declining libido sperm motility was decreased (Byryukov et al.,
(Bezhenar et al., 2000). 1993).
20. A total of 54.1% of pregnant 27. In 42% of surveyed liquidators sperm
women from the contaminated territories counts were reduced by 53%, the proportion
had preclampsia, anemia, and destruction of of mobile sperm was lower (35–40% vs. 70–
the placenta (controls 10.3%); 78.2% had 75% in controls), and the number of dead
birth complications and excess bleeding (2.2- sperm increased up to 70% vs. 25% in con-
fold higher than controls; Luk’yanova, 2003; trols (Gorptchenko et al., 1995).
Sergienko, 1997, 1998). 28. From 1988 to 2003 urogenital morbidity
21. Miscarriages occurred especially often among male liquidators who worked in 1986–
in the heavily contaminated territories of Kiev 1987 increased 10-fold: 9.8 per 1,000 in 1988,
Province (Gerasymova and Romanenko, 2002). 77.4 per 1,000 in 1999, and 98.4 per 1,000 in
Risks of spontaneous abortions are higher in 2003 (Baloga, 2006).
100
TABLE 5.36. Urogenital Morbidity among Chil- TABLE 5.37. Urogenital Morbidity (per 1,000)
dren (per 1,000) in Bryansk Province Districts with among Adults in Bryansk Province Districts Con-
Levels of Contamination above 5 Ci/km2 , 1995– taminated above 5 Ci/km2 , 1995–1998 (Fetysov,
1998 (Fetysov, 1999b: table 6.1) 1999a: table 5.1)
Number of cases Number of cases
1995 1996 1997 1998 Territory 1995 1996 1997 1998
Klymovo 34.5 48.7 51.6 79.3 Klymovo 72.1 71.4 64.1 60.1
Novozybkov 40.2 43.3 44.8 60.1 Novozybkov 68.1 70.2 72.1 81.3
Klintsy 8.0 10.8 11.2 10.8 Klintsy 27.3 53.8 53.0 91.3
Klintsy City 22.4 24.3 34.6 34.1 Klintsy City 45.5 76.1 75.2 79.2
Krasnogorsk 56.7 51.4 44.2 26.0 Krasnogorsk 78.7 82.7 95.9 114.2
Zlynka 66.8 38.7 44.8 46.2 Zlynka 44.8 75.7 78.7 78.7
Southwest∗ 30.1 33.5 36.7 41.6 Gordeevka 52.3 67.8 72.9 80.2
Province 22.4 25.8 26.8 29.2 Southwest∗ 54.9 88.7 78.4 75.9
∗
Province 60.4 60.4 60.7 57.1
All heavily contaminated districts.
∗
significantly higher during the first 7 years af-

5.6.3. Russia
ter the catastrophe (Figure 5.9) and was four-
1. Impaired genital and delayed sexual devel- fold higher (18.4 ± 2.2%) than that of the gen-
opment correlated with the level of radioactive eral population (4.6 ± 1.2%; Lyaginskaya et al.,
contamination in the Mtsensk (1–5 Ci/km2 ) 2007).
and Volkhov (10–15 Ci/km2 ) districts of Oryol 7. A total of 18% of all pregnancies regis-
Province (Kulakov et al., 1997). tered among liquidators’ families terminated
2. Increased gynecologic morbidity (in- in miscarriages (Lyaginskaya et al., 2007).
cluding anemia during pregnancy, postnatal 8. The 1986 liquidators from Ryazan
anemia, and abnormal delivery) correlated Province and other nuclear industry person-
with the level of radioactive contamination nel went through a prolonged period of steril-
in the Mtsensk (1–5 Ci/km2 ) and Volkhov ity, which was not revealed until recently
(10–15 Ci/km2 ) districts of Oryol Province (Lyaginskaya et al., 2007).
(Kulakov et al., 1997). 9. Four years after the catastrophe up to
3. Overall, from 1995 to 1998, urogenital 15% of liquidators (from 94 evaluated) had
morbidity in children was higher in the ma-
jority of the contaminated districts of Bryansk TABLE 5.38. Occurrence of Reproductive System
Province than in the province as a whole Illness and Precancer Pathologies among Women
(Table 5.36). in Some Territories of the Tula and Bryansk
4. From 1995 to 1998 the overall urogen- Provinces Contaminated by Cs-137 (Tsyb et al.,
2006)
ital morbidity in adults in Bryansk Province
noticeably increased in all but one of the con- Precancer All
taminated areas (Table 5.37). pathologies, %∗ illnesses, %
5. The urogenital morbidity among women Klintsy District 21.1 58.2
in some of the heavily contaminated territories (n = 1,200) 322 kBq/m2
of Bryansk and Tula provinces correlated with Novozybkov City 19.6 66.6
the levels of contamination (Table 5.38). (n = 1,000) 708 kBq/m2
6. The frequency of occurrence of spon- Uzlovaya Station 1.8 51.2
(n = 1,000) 171 kBq/m2
taneous abortions (miscarriages) in liquidator
∗
(1986–1987) families in Ryazan Province was Leukoplacias, displasias, polyps, etc.
13. The incidence of urogenital illnesses in

male liquidators grew from 1.8 to 4% from
1991 to 1998 (Byryukov et al., 2001).
14. Fifty liquidators who were examined
had sperm counts significantly lower than the
norms (Tsyb et al., 2002).
15. Urogenital morbidity in liquidators in-
creased more than 40-fold from 1986 to 1993
(Table 5.39).
16. A third of 116 liquidators examined had
intercourse disorders (Evdokymov et al., 2001).
17. A total of 21% of surveyed liquidators
had sperm with reduced mobility and mor-
phologic changes. Sperm of some liquidators
Figure 5.9. Incidence (%) of spontaneous abor- contained 6–8% immature cells (the norm is
tions in liquidators’ families (black rectangles) and
1–2%; Evdokymov et al., 2001).
in Ryazan’ Province (white rectangles) from 1987 to
1994 (Lyaginskaya et al., 2007). 18. The level of abnormal spermatozoids in
liquidators correlated with the level of chromo-
some aberrations (Kondrusev, 1989; Vozylova
significantly more dead sperm, lower sperm et al., 1997; Domrachova et al., 1997).
mobility, and increased acidic phosphatase lev- 19. Sclerosis in 50% of seminiferous tubules
els in ejaculate compared with other males of and foci of Leydig cell regeneration was seen
the same age (Ukhal et al., 1991). after the catastrophe (Cheburakov et al., 2004).
10. Liquidators’ virility was noticeably lower
in the year after the catastrophe: up to 42% of
5.6.4. Other Countries
sperm tests did not meet quantitative norms
and up to 52.6% did not meet qualitative 1. ARMENIA. There were spermatogene-
norms (Mikulinsky et al., 2002; Stepanova and sis disorders in the majority of the sur-
Skvarskaya, 2002). veyed liquidators 10 years after the catas-
11. Pathomorphological alterations oc- trophe (Oganesyan et al., 2002). Among 80
curred in testicular tissue of liquidators in children of liquidators who were examined
Krasnodar Province, and autoimmune orchitis there was increased incidence of pyelonephritis
affecting spermatogenesis occurred soon after (Hovhannisyan and Asryan, 2003).
irradiation. Lymphoid infiltration developed in 2. BULGARIA. Following the Chernobyl nu-
the seminiferous tubules 5 years after the catas- clear accident, an increase in maternal tox-
trophe and in the interstitial tissue after 10 to emia was associated with increased irradiation
15 years. (Tabacova, 1997).
12. Sexual potency was low in half of the 3. CZECH REPUBLIC. The number of boys
male liquidators who were examined (Dubivko born monthly in Bohemia and Moravia, the
and Karatay, 2001). Czech Republic territories that suffered most
TABLE 5.39. Dynamics of Urogenital Morbidity among Liquidators (per 10,000), 1986–1993 (Baleva
et al., 2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Number of cases 34 112 253 424 646 903 1,180 1,410
102
from Chernobyl fallout changed only once over formation of bone and the natural reabsorp-
600 months of observation (1950–1999). In tion process. Such imbalance results from ei-
November 1986, there were 457 fewer boys ther hormonal disorders or direct damage by
born than expected based on a long-term de- irradiation to the cellular predecessors of os-
mographic trend (Perez, 2004). The change oc- teoclasts and osteoblasts (Ushakov et al., 1997).
curred among babies who were 7–9 weeks in Liquidators and inhabitants of contaminated
utero at the time of the catastrophe. territories often complain of bone and joint
4. ISRAEL. Significant differences in quanti- pain—the indirect indicators of the processes
tative ultramorphological parameters of sperm of osteoporosis.
heads were observed in liquidators who had
emigrated compared with men of similar age 5.7.1. Belarus
who were not irradiated (Fischbein et al., 1997). 1. The number of newborns with develop-
5. OTHER COUNTRIES. There were long-term mental osteomuscular anomalies has increased
chronic effects of the catastrophe on sex ratios in the contaminated territories (Kulakov et al.,
at birth in Denmark, Finland, Germany, Hun- 1997).
gary, Norway, Poland, and Sweden between 2. In 1995, osteomuscular morbidity in evac-
1982 and 1992. The proportion of males in- uees and inhabitants of the contaminated terri-
creased in 1987 with a sex odds ratio of 1.0047 tories was 1.4-fold higher than for the general
(95% CI: 1.0013–1.0081, p < 0.05). A posi- population (Matsko, 1999).
tive association for the male proportion in Ger- 3. Osteomuscular illnesses were widespread
many between 1986 and 1991 with radioactive among liquidators under 30 years of age
exposure at the district level is reflected in a sex (Antypova et al., 1997a).
odds ratio of 1.0145 per mSv/year (95% CI:
1.0021 – 1.0271, p < 0.05) (Frentzel-Beyme 5.7.2. Ukraine
and Scherb, 2007).
1. In recent years, stillbirths from the heav-
5.6.5. Conclusion ily contaminated territories had increased lev-
els of alpha-radionuclides incorporated in bone
Clearly there is an increasingly wide spec- tissue (Horishna, 2005).
trum of urogenital illnesses in men, women, 2. Cs-137 incorporated in the placenta at a
and children from the territories contaminated level of 0.9–3.25 Bq/kg leads to weakness of
by Chernobyl fallout. Although some claim the tubular bone structures and destruction of
that poor reproductive function is due solely to spinal cartilage (Arabskaya et al., 2006).
psychological factors (stressful conditions), it is 3. In the contaminated territories there have
difficult to blame stress for abnormalities in been cases of children born practically without
spermatozoa, reproductive failures, and birth bones (“jellyfish-children”), a condition seen
abnormalities in children. The adverse influ- previously only in the Marshall Islands after
ence of Chernobyl irradiation upon urogenital the nuclear tests of the 1950s.
morbidity and reproductive function for liq- 4. Elevated placental radionuclide concen-
uidators and for millions of people living in the trations may be a factor in the death of new-
contaminated territories will continue in com- borns in contaminated territories (Table 5.40).
ing generations. 5. The bones of dead newborns demonstrate
morphological defects: reduction in the num-
5.7. Bone and Muscle Diseases ber and size of osteoblasts, dystrophic changes
in osteoblasts and osteoclasts, and a change
Osteoporosis (decreasing density of bone tis- in the osteoblast/osteoclast ratio (Luk’yanova,
sue) results from an imbalance between the 2003; Luk’yanova et al., 2005).
TABLE 5.40. Radionuclide Concentration (Bq/kg) TABLE 5.41. Osteomuscular Morbidity (per
in the Bodies of Pregnant Women and in Organs 1,000) among Children in Bryansk Province
of Stillborns Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.1)
Horishna, Lukyanova
2005 et al., 2005 Radionuclides Number of cases
Mother’s body 0.7 – 1.3 No data Cs-137 Territory 1995 1996 1997 1998
Placenta 3.5 No data Cs-137
Klymovo 146.2 124.7 90.3 143.0
0.9 No data Alpha
Novozybkov 31.3 32.7 37.9 29.6
Liver 7.8 0.4 ± 0.05 Cs-137
Klintsy 40.4 41.3 69.9 63.5
Spleen 0.2 0.2 ± 0.03 Cs-137
Krasnogorsk 17.3 15.2 11.2 12.0
Thymus 0.2 0.1 ± 0.02 Cs-137
Zlynka 58.8 217.2 162.4 174.3
Vertebrae 0.9 0.7 ± 0.02 Cs-137
Southwest∗ 40.9 67.9 49.7 67.1
Teeth 0.4 0.4 ± 0.02 Alpha
Province 22.6 25.4 27.0 29.7
Ribs No data 1.0 ± 0.24 Cs-137
Tubular bones No data 0.3 ± 0.02 Cs-137 ∗
6. Osteomuscular morbidity among adult 5. Osteoporosis was found in 30–88% of

evacuees is higher than in the general popula- liquidators who were examined (Nykytyna,
tion of the country (Prysyazhnyuk et al., 2002). 2002; Shkrobot et al., 2003; Kirkae, 2002;
7. In 1996 osteomuscular morbidity in terri- Druzhynyna, 2004).
tories with contamination of 5–15 Ci/km2 was 6. Osteoporosis develops more often in liq-
higher than for the population of the country uidators than in comparable groups of the pop-
as a whole (Grodzinsky, 1999). ulation (Nykytyna, 2005).
8. From 1988 to 1999 osteomuscular mor- 7. Osteoporosis in liquidators also affects the
bidity in the contaminated territories more dental bone tissue (Matchenko et al., 2001).
than doubled (Prysyazhnyuk et al., 2002). 8. The most frequently occurring osteomus-
9. Muscular system and connective tissue cular pathologies among 600 liquidators who
diseases in liquidators increased 2.3-fold from were examined were osteochondrosis of vari-
1991 to 2001 (Borysevich and Poplyko, 2002). ous parts of vertebrae and diffuse osteoporo-
sis. In 3.5% of cases the osteoporosis was
5.7.3. Russia accompanied by pathological bone fractures,
1. In the heavily contaminated districts of

Bryansk Province, children’s general osteomus- TABLE 5.42. Osteomuscular Morbidity among
Adults in Bryansk Province Territories with Con-
cular morbidity was noticeably higher than that
tamination above 5 Ci/km2 , 1995–1998 (Fetysov,
of the province as a whole (Table 5.41). 1999a: table 5.1)
2. From 1995 to 1998 primary osteo-
muscular morbidity in children of Bryansk Number of cases
Province was higher in the contaminated ar- Territory 1995 1996 1997 1998
eas (Table 5.42).
Klymovo 173.8 118.9 216.0 236.7
3. General osteomuscular morbidity of Novozybkov 129.6 120.8 94.0 101.1
adults is higher in the heavily contaminated dis- Klintsy 151.0 150.6 159.7 217.3
tricts of Bryansk Province than in the province Krasnogorsk 136.0 141.1 109.7 89.7
as a whole (Table 5.43). Zlynka 110.2 110.2 102.0 103.0
4. Up to 62% of liquidators complain of back Gordeevka 94.3 129.3 105.1 104.8
Southwest 100.7 109.4 111.7 111.9
pain and pain in the bones of their hands, legs,
Province 82.5 81.6 82.4 76.4
and joints (Dedov and Dedov, 1996).
104
TABLE 5.43. Primary Osteomuscular Morbidity TABLE 5.44. Osteomuscular Morbidity (per
(per 1,000) among Children in Bryansk Province, 1,000) among Liquidators and the Adult Popu-
1995–1998 (Fetysov, 1999b: table 6.2) lation of Bryansk Province Territories with Levels
of Contamination above 5 Ci/km2 , 1995–1998
Year 1995 1996 1997 1998 (Fetysov, 1999a: table 4.1)
Southwest 19.5 39.2 24.5 42.4
Province 11.5 13.9 16.4 18.5 Number of cases
1994 1995 1996 1997 1998
Liquidators 114.1 99.3 207.0 221.8 272.9

compression of nerve roots, and osteoalgia and Southwest∗ 90.0 93.5 109.4 111.7 238.6
arthralgias (Kholodova et al., 1998). Province 80.5 82.5 81.6 82.4 76.4
9. The mineral density of bone in many liq- Russia 80.3 81.5 87.2 87.2 n/a
uidators is 16–37% lower than the age norms ∗
(Kholodova et al., 1998). Some 62% of liquida-
tors among the 274 who were examined had
eases are not insignificant. The loss of teeth
decreased skeletal mineralization and 8% had
leads to deterioration in a person’s ability to eat
osteoporosis (Khartchenko et al., 1995). Skele-
and secondary adverse dietary effects. Chronic
tal mineral losses in liquidators who worked in
bone and muscle pain leads to loss of func-
1986 reached 42% (compared with peak age
tion and curtailment of activities needed to sus-
and weight); there was less loss among liquida-
tain life. The effects are especially serious for
tors who worked in 1987–1988 (Khartchenko
children when osteomuscular defects impede
et al., 1998).
growth and activity.
10. Periodontal disease markers were found
Undoubtedly, as new material is published,
in all surveyed liquidators: 88.2% had diffuse
there will be new data on the effects of Cher-
osteoporosis of the jaw; 33.3% had thinning of
nobyl’s radioactive contamination on bone and
the compact plate of the mandible; in addition,
muscle. It is now clear that structural bone dis-
37.3% also had osteoporosis of a vertebral body
orders (osteopenia, osteoporosis, and fractures)
(Druzhynyna, 2004).
are characteristic not only of the majority of
11. According to National Registry data,
liquidators, but also of many residents of the
from 1991 to 1998 the osteomuscular morbid-
contaminated territories, including children.
ity of liquidators was significantly higher than
for the population as a whole (650 vs. 562 per
10,000; Byryukov et al., 2001). 5.8. Diseases of the Nervous
12. From 1994 to 1998, osteomuscular mor- System and the Sense Organs and
bidity in liquidators in Bryansk Province was Their Impact on Mental Health
noticeably higher than that of the general pop-
ulation of the heavily contaminated districts Thirty-plus years ago, the nervous system
and differed considerably from of the popu- was considered the system most resistant to ion-
lation of the province and Russia as a whole izing radiation, but this is apparently true only
(Table 5.44). in respect to large doses (see, e.g., Gus’kova
and Baisogolov, 1971). Accordingly, the re-
5.7.4. Conclusion port of the Chernobyl Forum (2005) attributed
all neurological illnesses, increased levels of
Data concerning the influence of Chernobyl depression, and mental problems to post-
contamination on the osteomuscular system are traumatic stress (Havenaar, 1996; Havenaar
scarce, not because these diseases are insignif- et al., 1997a,b).
icant but because they attract little attention Since the Chernobyl catastrophe it is
in terms of survival. Bone and muscle dis- clear that low doses and low dose rates of
radiation have enormous impact on the fine 3. The number of cases of congenital con-
structures of the nervous system, on higher ner- vulsive syndrome (epilepsy) grew significantly
vous system activities, and ocular structures, as in the contaminated territories in the first 10
well as on neuropsychiatric disorders that are years after the catastrophe (Tsymlyakova and
widespread in all the contaminated territories. Lavrent’eva, 1996).
There is a growing body of evidence support- 4. From 1993 to 2003 primary morbidity
ing radiosensitivity of the brain (Nyagu and from nervous system disease and diseases of
Loganovsky, 1998). the eye and its appendages increased markedly
Mental health assessment in the Former So- among children aged 10 to 14 years born to ir-
viet Union dealt primarily with mental dis- radiated parents (National Belarussian Report,
orders as recorded in the national healthcare 2006).
system, not with data obtained from well- 5. Nervous system morbidity in children
designed psychiatric studies using standardized increased in one of the most contaminated
diagnostic procedures. Together with the on- areas—the Luninetsk District of Brest Province
going changes in the way that the countries (Voronetsky et al., 1995). From 2000 to 2005
of the Former Soviet Union deal with psychi- there was a tendency toward an increasing in-
atric problems, this approach may have led to cidence of mental disorders among children in
dramatic underestimation of mental disorders this district (Dudinskaya et al., 2006).
(Loganovsky, 2002). The first part of this sec- 6. Ten years after the catastrophe nervous
tion is devoted to the nervous system itself and system disorders were the second cause of mor-
the second to the sense organs. bidity among teenagers evacuated from con-
taminated territories, with 331 cases per 1,000
5.8.1. Diseases of Nervous System out of the 2,335 teens that were examined
(Syvolobova et al., 1997).
Twenty-two years after the Chernobyl catas- 7. Neurological and psychiatric disorders
trophe, it is apparent that low levels of ioniz- among adults were significantly higher in the
ing radiation cause changes in both the cen- contaminated territories (31.2 vs. 18.0%). Im-
tral and the autonomic nervous systems and paired short-term memory and attention lapse
can precipitate radiogenic encephalopathy (for were observed among high school students
a review see Loganovsky, 1999). Some parts of aged 16 to 17 and the seriousness of these con-
the central nervous system (CNS) are especially ditions correlated directly with the levels of con-
susceptible to radiation damage. tamination (Ushakov et al. 1997).
8. In a comparison between 340 agricultural
5.8.1.1. Belarus machine operators from the heavily contami-
1. According to a longitudinal survey of preg- nated Narovlya District, Gomel Province, and a
nant women, maternity patients, newborns, similar group of 202 individuals from the vicin-
and children in the contaminated territories ity of less contaminated Minsk, the first group
of the Chechersk District, Gomel Province, exhibited a sixfold higher incidence of vascular-
with radiation levels of 185–2,590 kBq/m2 brain pathology (27.1 vs. 4.5%; Ushakov et al.,
(5–70 Ci/km2 ), the incidence of perinatal en- 1997).
cephalopathy after 1986 was two to three times 9. Neurological morbidity of 1,708 adults in
higher than before the catastrophe (Kulakov the Kostjukovichi District, Mogilev Province,
et al., 2001). which was contaminated with Cs-137 at lev-
2. Morbidity from diseases of the nervous els higher than 1,110 kBq/m2 (30 Ci/km2 ),
system and sense organs noticeably increased was noticeably higher than in 9,170 individuals
in all the contaminated territories (Lomat et al., examined from the less contaminated districts
1996). of Vitebsk Province (Lukomsky et al., 1993).
106
10. From 1991 to 2000 there was a 2.2-fold TABLE 5.45. Occurrence (%) of Neurological and
increase in the incidence of nervous system Psychiatric Disorders among Children Irradiated In
Utero (Nyagu et al., 2004)
and sense organ diseases among Belarussian
liquidators (Borysevich and Poplyko, 2002). Irradiated, Controls,
n = 121 n = 77
5.8.1.2. Ukraine
Neurologically healthy 60.3 85.7
1. According to a longitudinal survey of preg- Predisposition to epilepsy (G40) 7.4 1.3
nant women, maternity patients, newborns, Migraine (G43) 2.5 0
and children in contaminated territories of Other headaches (G44) 25.6 13.0
Polessk District, Kiev Province, which had Sleep disturbances (G47) 3.3 0
Other disorders of vegetative 2.5 0
radiation levels of 740–2,200 kBq/m2 (20– nervous system (G90)
60 Ci/km2 ), the incidence of perinatal en- Neurological complications 1.6 0
cephalopathy after 1986 was observed to be Intellectual health 15.7 58.4
two to three times higher than before the catas- Organic mental disorders (F06 16.5 3.9
trophe (Kulakov et al., 2001). and F07)
Neurotic, stress, and somatoform 46.3 26.0
2. The incidence of nervous system disease
disorders (F40-F48)
in children grew markedly in the contami- Physiological developmental 7.4 0
nated territories 2 years after the catastrophe disorders (F80-F89)
(Stepanova, 1999). By 1998 nervous system and Emotional disorders (F90-F98) 25.6 11.7
sense organ diseases in children had increased Learning disorders 17.2 3.9
sixfold compared to 1986 (TASS, 1998). Other
data between 1988 and 1999 indicated that the
incidence of neurological disease grew 1.8-fold
uees’ children compared with a control group
during the 10-year period: from 2,369 to 4,350
(Romanenko et al., 1995a).
per 10,000 children (Prysyazhnyuk et al., 2002).
8. Irradiated children have lower IQs
3. Greater fatigue and lowered intellectual
(Figure 5.10).
capacity was found in middle and high school
age children in the contaminated villages of
the Chernygov Province 7 to 8 years after the
catastrophe (Bondar et al., 1995).
4. Electroencephalograms (EEGs) for 97% of
70 surveyed evacuees’ children indicated struc-
tural and functional immaturity of subcorti-
cal and cortical brain structures; that is, only
two out of these 70 children had normal EEGs
(Horishna, 2005).
5. Children irradiated in utero have more
nervous system illnesses and mental disorders
(Igumnov et al., 2004; Table 5.45).
6. The number of children with mental ill-
ness in the contaminated territories increased:
in 1987 the incidence was 2.6 per 1,000,
whereas by 2004 it was 5.3 per 1,000 (Horishna,
2005). Figure 5.10. Intellectual development scores
7. The incidence of nervous system asthe- (IQs) for a group of heavily irradiated evacuee chil-
nia and vegetative (autonomic) regulation dis- dren from Pripyat City and for children from less irra-
orders was more that fivefold higher in evac- diated Kiev (National Ukrainian Report, 2006).
TABLE 5.46. Quantitative Parameters of Intellec- TABLE 5.47. Nervous System Morbidity (per
tual Development of Heavily Irradiated Evacuees’ 10,000 Adults) in the Contaminated Territories of
Children from Pripyat City and Less Exposed Chil- Ukraine, 1987–1992 (Nyagu, 1995a)
dren from Kiev City (Yablokov et al., 2006)
Number of cases
Irradiated, Controls,
1987 1988 1989 1990 1991 1992
n = 108 n = 73
Verbal intelligence 107 116 All nervous 264 242 356 563 1,504 1,402
Distinctions pIQ-vIQ 10.4 2.9∗ system diseases
Vasomotor 128 43 32 372 391 312
∗
p < 0.05. dyscrasia∗
∗
In Russian-language literature often named “vegeta-
tive vascular dystonia,” also known as autonomic nervous
system dysfunction.
9. Children exposed in utero at 16 to 25 weeks
of gestation developed a range of conditions,
including: 13. From 93 to 100% of the liquidators
•
have neuropsychiatric disorders, with predom-
Increased incidence of mental and person-
inantly organic symptomatic mental disorders
ality disorders owing to brain injury or
(F00—F09) (Loganovsky, 1999, 2000). Post-
brain dysfunction (F06, F07).
•
traumatic stress disorder (PTSD), psychoso-
Disorders of psychological development
matic, organic, and abnormal schizoid person-
(F80–F89).
•
ality development were documented according
Paroxysmal states (headache syndromes,
to local psychiatric classifications and ICD-10
G44; migraine, G43; epileptiform syn-
and DSM-IV criteria (Loganovsky, 2002).
dromes, G40).
•
14. A total of 26 out of 100 randomly se-
Somatoform autonomic dysfunction
lected liquidators who suffered from fatigue
(F45.3).
•
met the chronic fatigue syndrome (CFS) di-
Behavioral and emotional disorders of
agnostic criteria. CFS may therefore be one
childhood (F90–F99).
of the most widespread consequences of the
10. Quantitative parameters of intellectual catastrophe for liquidators (Loganovsky, 2000b,
development (IQ) of the heavily irradiated 2003). Moreover, although CFS incidence de-
evacuees’ children from Pripyat City were creased significantly (p < 0.001) (from 65.5%
worse than those of the less heavily irradiated in 1990–1995 to 10.5% in 1996–2001), the fre-
children from Kiev City (Table 5.46). quency of occurrence of metabolic syndrome
11. A marked growth of adult nervous sys- X (MSX—a group of risk factors for heart dis-
tem morbidity was observed in the contami- ease) increased significantly (p < 0.001) dur-
nated territories during the first 6 years after the ing the same period (from 15 to 48.2%). CFS
catastrophe, especially after 1990 (Table 5.47). and MSX are considered to be the first stages
12. Nervous system and sense organ mor- in the development of other pathologies, and
bidity in the contaminated territories increased CFS can transform into MSX neurodegen-
3.8- to 5-fold between 1988 and 1999. Among eration, cognitive impairment, and neuropsy-
adult evacuees these illnesses occurred signifi- chiatric disorders (Kovalenko and Loganovsky,
cantly more often than in the population as a 2001; Volovik et al., 2005).
whole (Prysyazhnyuk et al., 2002). In 1994, ner- 15. A cross-sectional study was carried out
vous system illnesses in adults and teenagers on a representative cohort of liquidators within
and among evacuees accounted for 10.1% of the frame of the Franco-German Chernobyl
the overall morbidity in the contaminated ter- Initiative (Subproject 3.8) using a composite
ritories (Grodzinsky, 1999). international diagnostic interview. The results
108
indicated an almost twofold increase in the inci- are caused by atherosclerotic changes. With
dence of all mental disorders (36%) in liquida- hypertonic vascular tone, cerebral hemisphere
tors compared with the general Ukrainian pop- asymmetry, and poor circulation on the left,
ulation (20.5%), and a dramatic increase in the there is a high incidence of stenotic processes.
incidence of depression (24.5 vs. 9.1%). Anxiety Pathologic radiographic changes in brain struc-
(panic disorder) was also increased in liquida- ture include atrophy, enlargement of cerebral
tors (12.6 vs. 7.1%). At the same time, alcohol ventricles, and focal brain lesions (Loganovsky
dependence among liquidators was not much et al., 2003; Nyagu and Loganovsky, 1998).
higher than that in the total population (8.6 vs. 22. The EEG patterns and topographi-
6.4%), ruling out a major contribution from this cal distribution of spontaneous and evoked
factor (Demyttenaere et al., 2004; Romanenko brain bioelectrical activity of liquidators dif-
et al., 2004). fered significantly from those of the control
16. In 1996, nervous system and sense or- groups (Nyagu et al., 1992; Noshchenko and
gan morbidity among liquidators was more Loganovsky, 1994; Loganovsky and Yuryev,
than triple the country’s average (Serdyuk and 2001). In some cases, organic brain damage
Bobyleva, 1998). was verified by clinical neuropsychiatric, neu-
17. Nervous system morbidity among liq- rophysiological, neuropsychological, and neu-
uidators in 1986–1987 was twice as high as in roimaging methods (Loganovsky et al., 2003,
1988–1990 (Moskalenko, 2003). 2005b). The cerebral basis for deterioration
18. In 1986, some 80 male Ukrainian liq- of higher mental activity causing such disor-
uidators with encephalopathy had both struc- ders following a limited period of irradiation is
tural changes and functional impairment in pathology in the frontal and temporal cortex
the frontal and left temporal brain areas of the dominant hemisphere and the midline
(Antipchuk, 2002, 2003). structures with their cortical–subcortical con-
19. Autonomic nervous system disorders nections (Loganovsky, 2002; Loganovsky and
among liquidators who worked in 1986–1987 Bomko, 2004).
differed from disorders in liquidators from 23. The average age of both male and female
1988–1989 in stability, expressiveness, parox- Ukrainian liquidators with encephalopathy was
ysmal variants, presence of vestibular I–III dys- 41.2 ± 0.83 years, noticeably younger than for
function, and peripheral hemodynamic distur- the population as a whole (Stepanenko et al.,
bances. Autonomic nervous system disorders 2003).
are closely connected to disorders of neuropsy- 24. From 1990 there were reports of a signif-
chiatric behavior such as asthenia, disturbed icant increase in the incidence of schizophrenia
memory, attention deficits, emotional distur- among the Chernobyl exclusion zone person-
bance, neuroses, hypochondriasis, and depres- nel compared to the general population (5.4
sion (Romamenko et al., 1995). vs. 1.1 per 10,000 in the Ukraine in 1990;
20. Increased rates of neuropsychiatric dis- Loganovsky and Loganovskaya, 2000). Irradi-
orders and somatic pathology (F00–F09) were ation occurring in the contaminated territo-
observed among liquidators who worked in ries causes brain damage, with cortical–limbic
1986–1987, especially in those who spent sev- system dysfunction and impairment of infor-
eral years working within the Chernobyl exclu- mative processes at the molecular level that
sion zone (Loganovsky, 1999). can trigger schizophrenia in predisposed in-
21. Among liquidators the typical structural dividuals or cause schizophrenia-like disorders
brain disorder involves the frontal and left (Loganovsky et al., 2004a, 2005).
temporal lobes with their cortical–subcortical 25. A longitudinal study of the cogni-
connections and the deep structures of the tive effects of the Chernobyl catastrophe on
brain. The cerebral homodynamic disorders the liquidators and forestry and agricultural
workers living within 150 km of Chernobyl was TABLE 5.48. General Nervous System and Sense
conducted in 1995–1998. The 4-year averaged Organ Morbidity among Children in Bryansk
Province Districts with Contamination above 5 Ci/
levels of accuracy and efficiency of cognitive
km2 , 1995–1998 (Fetysov, 1999b: table 6.1)
performance of the exposed groups (especially
the liquidators) were significantly lower than Number of cases
those of the controls (healthy Ukrainians re- Territory 1995 1996 1997 1998
siding several hundred kilometers away from
Chernobyl). Longitudinal analyses of perfor- Klymovo 109.2 111.2 109.2 125.7
Novozybkov 124.0 155.0 140.8 158.0
mance revealed significant declines in accuracy Klintsy 49.2 59.9 79.0 54.2
and efficiency, as well as psychomotor slow- Klintsy City 213.3 212.3 178.1 173.6
ing, for all exposed groups over the 4-year pe- Krasnogorsk 275.1 237.8 242.8 107.5
riod. These findings strongly indicate impair- Zlynka 187.2 102.8 144.0 125.8
ment of brain function resulting from both Gorgdeevo 71.2 64.2 70.1 71.0
Southwest∗ 143.0 134.7 134.6 131.4
acute and chronic exposure to ionizing radi-
Province 123.6 128.6 133.4 135.2
ation (Gamache et al., 2005). Russia 143.8 154.0 159.0 n/a
∗
5.8.1.3. Russia
1. According to a longitudinal survey of preg- passes that of the province and the rest of Russia
nant women, maternity patients, newborns, by a significant margin.
and children in the contaminated territories 6. Impaired short-term memory and atten-
of the Mtsensk (1–5 Ci/km2 ) and Volkhov tion deficit in pupils 16 to 17 years of age
(10–15 Ci/km2 ) districts, Orel Province, the in- in the contaminated territories correlated with
cidence of perinatal encephalopathy observed the level of contamination (Ushakov et al.,
after 1986 was double that prior to the catas- 1997).
trophe (Kulakov et al., 2001). 7. Borderline adult neuropsychological dis-
2. Electroencephalographic (EEG) studies of orders occurred noticeably more often in the
children of different ages from heavily contam- contaminated territories (31 vs. 18%; Ushakov
inated territories revealed increased functional et al., 1997).
activity of the diencephalic structures. Ultra- 8. There are increasing instances of a
sound studies of babies’ brains from these ter- phenomenon termed “Chernobyl demen-
ritories revealed ventricular hypertrophy in al- tia,” which includes disorders of memory,
most one-third (Kulakov et al., 2001). writing, convulsions, and pulsing headaches,
3. Children irradiated in utero had the highest caused by destruction of brain cells in adults
indices of mental disability and were more likely (Sokolovskaya, 1997).
to display borderline intelligence and mental 9. From 1986 to 1993 neurological morbidity
retardation linked to their prenatal irradiation in liquidators increased 42-fold (Table 5.49).
(Ermolyna et al., 1996). 10. The occurrence of an encephalopathy
4. In the contaminated territories a lower in liquidators increased 25% from 1991 to
level of nonverbal intelligence is found in chil- 1998, and by 2004 the increase was up to 34%
dren radiated in the 15th week of intrauterine (Zubovsky and Tararukhyna, 2007).
development (Rumyantseva et al., 2006). 11. In 1995, nervous system and sense organ
5. Although data on children’s neurolog- morbidity in liquidators exceeded the coun-
ical morbidity in the heavily contaminated try’s average 6.4-fold (Russian Security Coun-
districts of Bryansk Province are contradic- cil, 2002).
tive (Table 5.48), the level of this morbidity 12. Over 40% of the more than 2,000 liq-
in Klintsy City and Krasnogorsk District sur- uidators that have been observed over many
110
TABLE 5.49. Dynamics of Nervous System and Sense Organ Morbidity (per 1,000) among Russian
Liquidators, 1986–1993 (Baleva et al., 2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Number of cases 23 79 181 288 410 585 811 989
years suffer from organic brain diseases of vas- burning pains, and limb atrophy (Kholodova
cular or mixed origin. These illnesses are the et al., 1998).
result of long-lasting cerebral-ischemia, disrup- 16. According to data from the Russian In-
tion of central regulatory functions, and pos- terdepartmental Expert Council for the years
sibly of damage to the endothelium of small 1999–2000, neuropsychological illnesses were
blood vessels (Rumyantseva et al., 1998). Of the second cause of overall morbidity in 18%
more than 1,000 liquidators evaluated up until of 1,000 surveyed liquidators (Khrysanfov and
2005, some 53.7% had mental impairment Meskikh, 2001).
caused by damage or dysfunction of the brain 17. The incidence of encephalopathy and
or somatic illness (F06, F07). These disorders proven organic pathology increased from 20 to
became clearly apparent 10 to 12 years af- 34% as compared with 1991–1997 and 2000,
ter the catastrophe, are more significant with and neurological diagnoses became more se-
every passing year, and are characteristic of rious by diagnostic criteria (Khrysanfov and
diffuse organic brain lesions with localization Meskikh, 2001).
mainly in the frontal area (Rumyantseva et al., 18. Neuropsychological pathology among
2006). Russian liquidators in 1999–2000 included:
13. Autoimmune and metabolic thyroid 34% encephalopathy, 17% organic disorders
gland pathologies are also major factors in of the central nervous system, 17% vegetative
the mental disorders found among liquidators vascular dystonia (vasomotor dyscrasia), and
(Rumyantseva et al., 2006). 17% neurocirculatory dystonia (Khrysanfov
14. Nervous system and sense organ morbid- and Meskikh, 2001).
ity among liquidators of Bryansk Province was 19. In 150 male liquidators 44.5 ±
noticeably higher than for the general popula- 3 years of age there was an increase in slow
tion (Table 5.50). forms of EEG activity, intercerebral asym-
15. A total of 12% of surveyed liquidators metry, decreased quality of performance on
had polyneuropathy, expressed as excruciating all cognitive tests, impaired memory, and
other functional disorders (Zhavoronkova et al.,
TABLE 5.50. Nervous System and Sense Organ
2002). Observations on liquidators revealed
Morbidity among Liquidators and the Adult Pop- that changes in brain asymmetry and inter-
ulation of Bryansk Province Territories with Con- hemispheric interaction can be produced not
tamination Levels above 5 Ci/km2 , 1994–1998 only by a dysfunction of subcortical limbic–
(Fetysov, 1999a: table 4.1) reticular and mediobasal brain structures, but
Number of cases also by damage to the white matter, includ-
Group/ ing the corpus callosum (Zhavoronkova et al.,
Territory 1994 1995 1996 1997 1998
2000). The EEG findings suggested subcorti-
Liquidators 312.9 312.5 372.5 376.9 467.6 cal disorders at different levels (diencephalic
Southwest∗ 118.6 104.2 130.5 124.2 314.6 or brainstem) and functional failure of either
Province 127.3 136.5 134.6 131.6 134.2 the right or left hemispheres long after radia-
Russia 126.6 129.7 136.5 136.5 n/a
tion exposure had ceased (Zhavoronkova et al.,
∗
All heavily contaminated districts. 2003).
20. There were many reports concerning 24. The neurological damage suffered by
neurophysiological, neuropsychological, and liquidators includes well-marked autonomic
neuroimaging abnormalities in liquidators nervous system dysfunction expressed as acro-
(Danylov and Pozdeev, 1994; Zhavoronkova cyanosis, acrohyperhydrosis, and common hy-
et al., 1994, 2000; Vyatleva et al., 1997; perhydrosis, sponginess and puffiness of soft
Khomskaja, 1995; Khartchenko et al., 1995; tissues, facial redness, diffuse dermographism,
Kholodova et al., 1996; Voloshyna, 1997). asthenia, and depressive syndromes. Other or-
These data strongly support clinical find- ganic nervous system impairments include cra-
ings of organic brain damage caused by nial nerve abnormalities, marked hyperreflexia,
radiation (Chuprykov et al., 1992; Krasnov the presence of pathological reflexes, and
et al., 1993; Romodanov and Vynnyts’ky, 1993; abnormal Romberg test scores (Kholodova,
Napreyenko and Loganovsky, 1995, 2001; 2006).
Revenok, 1998; Zozulya and Polischuyk, 1995; 25. Characteristic dysfunction in liquidators
Morozov and Kryzhanovskaya, 1998). involves deep parts of the brain: diencephalic
21. Many liquidators had complex organic areas, deep frontal and temporal lobes, and oc-
disorders of the brain, including: (a) hy- cipitoparietal parts of the cerebral hemispheres
pometabolic centers localized in white and gray (Kholodova, 2006).
matter and in deep subcortical formations; (b) 26. Liquidators demonstrate impaired task
ventricular enlargement, often asymmetric; (c) performance, a shortening of attention span,
expansion of the arachnoid cavity; (d) decreased and problems with short-term memory and op-
density of the white brain substance; (e) thin- erative thinking. These features correspond to
ning of the corpus callosum; and (f) diffuse skill levels typical of 10- to 11-year-old children
singular or multiple localized space-occupying and cannot be attributed to social factors—they
lesions of the brain tissue (Kholodova et al., clearly testify to radiation-induced brain dam-
1998; Ushakov et al., 1997; Nyagy and age (Kholodova, 2006).
Loganovsky, 1998; Loganovsky, 2002; and 27. EEG brain activity demonstrates two
others). types of pathologies: high-amplitude slowed
22. Four hundred liquidators 24 to 59 years alpha- and theta-wave bands, reflecting pathol-
of age with organic disorders of the central ner- ogy of the visceral brain, and diffuse decreases
vous system have irreversible structural brain in bioelectric activity, reflecting diffuse cor-
defects: structural changes in the frontal lobe, tex and subcortical area damage (Kholodova,
the left temporal area, and the connections 2006).
in the cortex–subcortex (Khartchenko et al., 28. The seriousness of brain pathology in liq-
1995; Antipchuk, 2002, 2003; Zhavoronkova uidators correlates with impaired blood circu-
et al., 2002; Antonov et al., 2003; Tsygan, lation in various cortical white substance sites
2003). and deep subcortical formations (Kholodova,
23. Typical complaints from liquidators in- 2006).
clude severe headaches, not relieved by med-
ications, impaired memory of current events,
general weakness, fatigue, diminished capac- 5.8.1.4. Other Countries
ity for work, generalized sweating, palpitations, 1. ESTONIA. After Chernobyl, suicide was the
bone and joint pains and aches that interfere leading cause of death among liquidators living
with their sleep, sporadic loss of consciousness, in Estonia (Rahu et al., 2006).
sensation of fever or heat, difficulty in think- 2. LITHUANIA. Age-adjusted mortality from
ing, heart seizures, flashes, loss of vision, and suicide increased among the Chernobyl liq-
numbness in hands and feet (Sokolova, 2000; uidators compared to the general Lithuanian
Kholodova, 2006). population (Kesminiene et al., 1997).
112
3. SWEDEN. A comprehensive analysis of a 5.8.2. Diseases of Sense Organs

data set of 562,637 Swedes born from 1983 to
1988 revealed that the cohort in utero during the Throughout the more contaminated terri-
catastrophe had poorer school outcomes than tories, visual and hearing abnormalities occur
those born shortly before and shortly after this with greater frequency than in the less con-
period. This impairment was greatest for those taminated areas: premature cataracts, vitreous
exposed 8 to 25 weeks postconception. More- degeneration, refraction errors, uvitis, conjunc-
over, more damage was found among students tivitis, and hearing loss.
born in regions that received more fallout; stu- 5.8.2.1. Belarus
dents from the eight most affected municipal-
1. A survey of pregnant women, mater-
ities were significantly (3.6 percentage points)
nity patients, newborns, and children in the
less likely to qualify for high school (Almond
Chechersk District, Gomel Province, with Cs-
et al., 2007). These findings correspond to those
137 contamination of the soil at levels of 5–
concerning reduced IQ hibakusha who were ir-
70 Ci/km2 showed an increase in the num-
radiated 8 to 25 weeks after ovulation (Otake
ber of sensory organ development abnormali-
and Schull, 1984).
ties, including congenital cataracts in neonates
(Kulakov et al., 2001).
2. In heavily contaminated territories there
5.8.1.5. Conclusion is a noticeably higher incidence of congenital
Previous views claiming resistance of the ner- malformations, including cataracts, microph-
vous system to radiation damage are refuted by thalmia, malpositioned ears, and extra ear tis-
the mounting collective data that demonstrate sue (Kulakov et al., 2001).
nervous system illnesses among the populations 3. Cataracts in children are common in
of the contaminated territories, especially liq- the territories with contamination levels above
uidators. Even rather small amounts of nuclear 15 Ci/km2 (Paramey et al., 1993; Edwards,
radiation, considered harmless by former mea- 1995; Goncharova, 2000).
sures of radiation protection, have resulted in 4. Retinal pathology in children in the
marked organic damage. Clearly, the existing Khoiniky and Vetka districts, Gomel Province
radiation levels in the contaminated territo- (4,797 people examined), increased about
ries have harmed the central nervous system threefold: from 6 to 17% in the first 3 years af-
of countless people. ter the catastrophe compared to 1985 (Byrich
For many inhabitants of the contaminated et al., 1999).
territories, especially persons that were radiated 5. From 1988 to 1989 the incidence of con-
in utero and liquidators, nervous system func- genital eye malformation in children (3 to
tions, including perception, short-term mem- 4 years after the catastrophe) was fourfold
ory, attention span, operative thinking, and higher in the heavily contaminated Gomel
dreaming, are deteriorating. These conditions Province (1.63%) than from 1961 to 1972 in
are associated with deep cerebral hemispheric Minsk (0.4%; Byrich et al., 1999).
damage: diencephalic areas, deep frontal, and 6. Clouding of the lens, an early symp-
temporal lobes, and occipitoparietal parts of tom of cataracts, was found in 24.6% of ex-
the cerebral hemisphere. Low-dose radiation posed children compared with 2.9% in controls
damages the vegetative (autonomic) nervous (Avkhacheva et al., 2001).
system. The fact that intellectual retardation is 7. Children under 5 years of age who were
found in 45% of children born to mothers who exposed have more problems with eye ac-
went through the Hiroshima and Nagasakai commodation and more overall eye diseases
nuclear bombardment is a very troubling con- than controls (Serduchenko and Nostopyrena,
cern (Bulanova, 1996). 2001).
TABLE 5.51. Incidence of Cataracts (per 1,000) TABLE 5.52. Incidence (%) of Opacities in Both
in Belarus, 1993–1995 (Matsko, 1999; Gon- Crystalline Lenses among Children Living in Terri-
charova, 2000) tories with Various Levels of Contamination, 1992
(Arynchin and Ospennikova, 1999)
Contaminated
territories, Ci/km2 Incidence of
opacities, %
Year Belarus 1–15 >15 Evacuees
1–5 6–10 >10
1993 136 190 226 355
1994 146 196 366 425 Brest Province, 57.5 17.9 6.7
1995 147 n/a n/a 443 137–377 kBq/m2 (n = 77)
Vitebsk Province, 60.9 7.6 1.1
3.7 kBq/m2 (n = 56)
8. Eye disease significantly increased from

1993 to 2003 among children 10 to 14 years
16. From 1993 to 2003 cataract morbidity
of age born to irradiated parents (National Be-
increased 6% annually among male liquidators
larussian Report, 2006).
(National Belarussian Report, 2006).
9. The level of absorbed Cs-137 corre-
lates with the incidence of cataracts in chil- 5.8.2.2. Ukraine
dren from the Vetka District, Gomel Province
1. A survey of pregnant women, mater-
(Bandazhevsky, 1999).
nity patients, newborns, and children in con-
10. From 1993 to 1995, cataracts were
taminated territories in the Polessk District,
markedly more common in the more contam-
Kiev Province (soil Cs-137 contamination 20–
inated territories and among evacuees than in
60 Ci/km2 ) showed an increase in the number
the general population (Table 5.51).
of sensory organ development defects, includ-
11. Eye diseases were more common in the
ing congenital cataracts in neonates (Kulakov
more contaminated districts of Gomel Province
et al., 2001).
and included cataracts, vitreous degeneration,
2. Hearing disorders are found in more than
and refraction abnormalities (Bandazhevsky,
54% of inhabitants of the contaminated terri-
1999).
tories, a level noticeably higher than that of the
12. Bilateral cataracts occurred more fre-
general population (Zabolotny et al., 2001).
quently in the more contaminated territories
(54 vs. 29% in controls; Arynchin and Ospen-
nikova, 1999).
13. Crystalline lens opacities occur more fre-
quently in the more radioactive contaminated
territories (Table 5.52) and correlate with the
level of incorporated Cs-137 (Figure 5.11).
14. Increased incidence of vascular and
crystalline lens pathology, usually combined
with neurovascular disease, was found in 227
surveyed liquidators and in the population of
contaminated territories (Petrunya et al., 1999).
15. In 1996, incidence of cataracts among
Belarussian evacuees from the 30-km zone was
more than threefold that in the population as Figure 5.11. Number of bilateral lens opacities
a whole: 44.3 compared to 14.7 per 1,000 and level of incorporated Cs-137 in Belarussian chil-
(Matsko, 1999). dren (Arynchin and Ospennikova, 1999).
114
3. In 1991 a group of 512 children 7 to 16 5. Children who were exposed before they
years of age from four villages in the Ivankiv were 5 years of age have more problems with
District, Kiev Province, was examined. The eye accommodation (Burlak et al., 2006).
villages differed only in the degree of Cs-137 6. Individuals from contaminated territo-
contamination of the soil: ries and liquidators had premature involutional
and dystrophic changes in the eyes, develop-
(a) First village: average 12.4 Ci/km2 (max- ment of ocular vascular diseases, increasing in-
imum 8.0 Ci/km2 ; 90% of the territory, cidence of chorioretinal degeneration such as
5.4 Ci/km2 ). age-dependent macular degeneration (AMD),
(b) Second village: average 3.11 Ci/km2 (max- and benign neoplasm of the eyelids. Central
imum 13.8 Ci/km2 ; 90% of the territory, chorioretinal degeneration with clinical symp-
4.62 Ci/km2 ). toms of AMD was the most frequently occur-
(c) Third village: average 1.26 Ci/km2 (max- ring form of delayed retinal pathology: 136.5 ±
imum 4.7 Ci/km2 ; 90% of the territory, 10.7 per 1,000 in 1993 and 585.7 ± 23.8 per
2.1 Ci/km2 ). 1,000 in 2004. Involutional cataracts increased
(d) Fourth village: average 0.89 Ci/km2 (max- from 294.3 ± 32.0 per 1,000 in 1993 to 766.7 ±
imum 2.7 Ci/km2 ; 90% of the territory, 35.9 per 1,000 in 2004 (Fedirko, 2002; Fedirko
1.87 Ci/km2 ). and Kadoshnykova, 2007).
7. Individuals from contaminated territo-
Typical lens pathologies were detected in ries and liquidators had a marked decrease
51% of those examined, and the incidence in ocular accommodation (Sergienko and
of lens pathology was higher in villages with Fedirko, 2002).
higher levels of soil contamination. Atypical 8. In the heavily contaminated territo-
lens pathologies were observed in 61 children ries, among 841 adults examined from 1991
(density of the posterior subcapsular layers, to 1997, retinal pathologies, involutional
dimness in the form of small spots and points cataracts, chronic conjunctivitis, and vitreous
between the posterior capsule and the core, and destruction were observed more often than in
vacuoles) and were highly (r = 0.992) corre- the less contaminated areas, and cataracts were
lated with the average and maximum levels of seen in persons younger than 30 years of age,
soil contamination. In 1995 the incidence of which has never been observed in less con-
atypical lens pathologies in the first and second taminated areas (Fedirko and Kadochnykova,
villages (with average soil contamination over 2007).
2 Ci/km2 ) increased significantly to 34.9%. 9. The occurrence of involutional cataracts
Two girls (who had early changes of cortical in the contaminated territories increased 2.6-
layer density in 1991) were diagnosed with dim fold from 1993 to 2004: from 294.3 ± 32.0 to
vision, suggesting the development of involu- 766.7 ± 35.9 per 1,000 (Fedirko, 1999).
tional cataracts (Fedirko and Kadoshnykova, 10. Among 5,301 evacuees examined, eye
2007). pathology was diagnosed in 1,405. One
4. In 1992–1998 children from Ovruch cataract occurred for every four cases of other
City (soil Cs-137 contamination 185–555 eye pathologies (Buzunov et al., 1999).
kBq/m2 ) had significantly higher subclinical 11. Two new syndromes have been seen in
lens changes (234 per 1,000, of 461 examined) liquidators and in those from the contaminated
than children from Boyarka City (soil Cs-137 territories:
contamination 37–184.9 kBq/m2 or 149 per
1,000, of 1,487 examined). In Ovruch the in- • Diffraction grating syndrome, in which
cidence of myopia and astigmatism was sig- spots of exudate are scattered on the cen-
nificantly higher (Fedirko and Kadoshnykova, tral part of the retina. This was observed
2007). in liquidators who were within direct sight
of the exposed core of the fourth reactor fer from defects in different parts of the au-
(Fedirko, 2002). ditory system resulting in progressive hearing
• Incipient chestnut syndrome, named for loss and a stuffy sensation and noise in the ears
the shape of a chestnut leaf, expressed (Zabolotny et al., 2000).
as new chorioretinopathy, changes of reti- 6. High-frequency audiometry revealed that
nal vessels with multiple microaneurisms, the most abnormalities occurred in liquida-
dilations, and sacs in the retinal veins tors with vocal problems (Kureneva and
around the macula (Fedirko, 2000). Shidlovskaya, 2005).
5.8.2.4. Other Countries

12. The frequency of central chorioretinal
degradation increased among the liquidators 1. ISRAEL. A 2-year follow-up study of immi-
4.3-fold from 1993 to 2004: from 136.5 ± grants to Israel from the Former Soviet Union
10.7 to 585.7 ± 23.8 per 1,000 (Buzunov and revealed that the proportion of those reporting
Fedirko, 1999). chronic visual and hearing problems was sta-
13. The incidence of cataracts was signif- tistically higher for immigrants from contam-
icantly higher for male liquidators compared inated territories (304 individuals) compared
with female liquidators (Ruban, 2001). with immigrants from noncontaminated (217
14. Retinal pathology was markedly higher individuals) and other areas (216 individuals;
than the norm among 2002 liquidators’ chil- Cwikel et al., 1997).
dren who were born after the catastrophe and 2. NORWAY. Cataracts in newborns occurred
examined between 1999 and 2006 (Fedirko and twice as often 1 year after the catastrophe
Kadoshnykova, 2007). (Irgens et al., 1991).
5.8.3. Conclusion
5.8.2.3. Russia
1. A survey of pregnant women, maternity There is little doubt that specific organic cen-
patients, newborns, and children in the Mt- tral and peripheral nervous system damage af-
sensk and Volkhovsk districts, Orel Province, fecting various cognitive endpoints, as observed
contaminated with Cs-137 levels of 1–5 and in both individuals from the contaminated ter-
10–15 Ci/km2 showed an increase in the num- ritories and liquidators, is directly related to
ber of sensory organ developmental deficien- Chernobyl’s ionizing radiation. In differing de-
cies, including congenital cataracts in neonates grees, these conditions affect all liquidators and
(Kulakov et al., 2001). practically every person living in the contami-
2. A total of 6.6% of 182 surveyed liquida- nated territories.
tors had cataracts (Lyubchenko and Agal’tsev, Among the consequences of the damage
2001). to the nervous system caused by the Cher-
3. More than 52% of 500 surveyed liq- nobyl catastrophe are cognitive, emotional,
uidators had retinal vascular abnormalities and behavioral disorders. Adverse effects
(Nykyforov and Eskin, 1998). also include neurophysiological abnormalities
4. Some 3% of liquidators under 40 years in the prenatally exposed and neurophysio-
of age had cataracts, an incidence 47-fold that logical, neuropsychological, and neuroimag-
in a similar age group of the general popula- ing abnormalities in liquidators, manifested
tion; 4.7% had glaucoma (Nykyforov and Es- as left frontotemporal limbic dysfunction,
kin, 1998). schizophreniform syndrome, chronic fatigue
5. Between 46 and 69% of surveyed liquida- syndrome, and, combined with psychological
tors had some hearing disorder (Zabolotny et al., stress, indications of schizophrenia and related
2001; Klymenko et al., 1996). Liquidators suf- disorders.
116
Only after 2000 did medical authorities be- Luninetsk District, Brest Province (Voronetsky
gin to recognize the radiogenic origin of a uni- et al., 1995).
versal increase in cataracts among liquidators 6. Of 1,033 children examined in the heav-
and evacuees from the Chernobyl territories. ily contaminated territories from 1991 to 1993
Official recognition occurred 10 years (!) after there was a significantly higher incidence of
doctors began to sound the alarm and 13 years serious caries and lowered acid resistance of
after the problem was first registered. tooth enamel (Mel’nichenko and Cheshko,
1997).
7. Chronic upper gastrointestinal disease was
5.9. Digestive System and Visceral
common in children of liquidators (Arynchin
Organ Diseases
et al., 1999).
8. Gastrointestinal tract pathology is con-
Digestive system diseases are among the
nected to morphologic and functional thyroid
leading causes of illness in the contaminated
gland changes in children from territories con-
territories. Compared to other illnesses, it is
taminated by Cs-137 at levels of 1–15 Ci/km2
more difficult to classify these with certainty
(Kapytonova et al., 1996).
as being caused by a radiogenic component;
9. Digestive diseases in adults and liquida-
however, the collected data from the contami-
tors are more common in the contaminated
nated territories point to a solid basis for such
territories. From 1991 to 1996 stomach ulcers
a conclusion.
among the population increased 9.6%, while
5.9.1. Belarus among liquidators the increase was 46.7%
(Kondratenko, 1998).
1. The number of digestive organ malfor- 10. In 1995, the incidence of diseases of
mations in newborns increased in the contam- the digestive system among liquidators and
inated territories (Kulakov et al., 2001). evacuees in the contaminated territories was
2. There was a twofold general increase 4.3- and 1.8-fold higher than in the gen-
in chronic gastritis in Brest Province in 1996 eral population of the country: respectively,
compared to 1991. In 1996 the occurrence of 7,784; 3,298; and 1,817 per 100,000 (Matsko,
chronic gastritis in children was up to three- 1999).
fold higher in the heavily contaminated terri- 11. Ten years after the catastrophe digestive
tories than in the less contaminated areas. In illnesses were fourfold more common among
the Stolinsk District in 1996 the incidence of liquidators than in the general adult population
this disease was more than fourfold that seen in of the country (Antypova et al., 1997a).
1991 (Gordeiko, 1998). 12. From 1991 to 2001 digestive system ill-
3. Of 135 surveyed juvenile evacuees from nesses among liquidators increased 1.65-fold
Bragin City and the highly contaminated terri- (Borisevich and Poplyko, 2002).
tories of Stolinsk District, Brest Province, 40% 13. Of 2,653 adults and teenagers exam-
had gastrointestinal tract illnesses (Belyaeva ined, the incidence of acute hepatitis-B, chronic
et al., 1996). hepatitis-C, and hepatic cirrhosis diseases was
4. Of 2,535 individuals examined in 1996, significantly higher in the heavily contaminated
digestive system illnesses were the first cause of territories of Gomel Province than in the less
general morbidity in teenage evacuees (556 per contaminated Vitebsk Province. By 1996 the
1,000; Syvolobova et al., 1997). incidence of these diseases had increased sig-
5. Digestive system morbidity increased from nificantly, with chronic hepatitis in liquidators
4.6% in 1986 to 83.5% in 1994 and was the sec- 1.6-fold higher than in 1988–1995 (Transac-
ond cause of overall morbidity of children in the tion, 1996).
5.9.2. Ukraine 12. Digestive system morbidity in adult evac-

uees considerably exceeds that of the general
1. The number of digestive system diseases population of the country (Prysyazhnyuk et al.,
in children rose markedly within the first 2 2002).
years after the catastrophe (Stepanova, 1999; 13. In 1996 digestive system morbidity of
and others). inhabitants in territories with contamination
2. The incidence of digestive diseases in greater than 15 Ci/km2 was noticeably higher
children correlated with the level of contam- than for the country as a whole (281 vs. 210
ination of the area (Baida and Zhirnosekova, cases per 1,000; Grodzinsky, 1999).
1998). 14. Only 9% of the liquidators evaluated
3. Premature tooth eruption was observed in in 1989 and 1990 had normal stomach and
girls born to mothers irradiated during child- duodenal mucous membranes (Yakymenko,
hood (Tolkach et al., 2003). 1995).
4. Tooth caries in boys and girls as young as 15. The incidence of stomach ulcers among
1 year are more common in the contaminated Ukrainian liquidators in 1996 was 3.5-fold
territories (Tolkach et al., 2003). higher than the country average (Serdyuk and
5. Digestive system morbidity in children Bobyleva, 1998).
more than doubled from 1988 to 1999—4,659 16. In 1990 ulcers and gastric erosion were
compared to 1,122 per 10,000 (Korol et al., found in 60.9% of liquidators (Yakymenko,
1999; Romanenko et al., 2001). 1995).
6. Children irradiated in utero had signif- 17. After the catastrophe pancreatic abnor-
icantly higher incidence of gastrointestinal malities in liquidators were diagnosed through
tract pathology than controls—18.9 vs. 8.9% echograms (Table 5.53).
(Stepanova, 1999). 18. In 7 to 8 years after the catastrophe
7. Atrophy of the stomach mucosa occurred up to 60% of the liquidators examined had
five times more often, and intestinal metaplasia chronic digestive system pathology, which in-
twice as often in children living in areas concluded structural, motor, and functional secre-
taminated at a level of 5–15 kBq/m2 than in a tory disorders of the stomach. For the first 2.5
control group (Burlak et al., 2006). to 3 years inflammation was the most prevalent
8. In 1987 and 1988 functional digestive tract symptom, followed by indolent erosive hemor-
illnesses were prevalent in evacuees’ children, rhagic ulcers (Romanenko et al., 1995).
and from 1989 to 1990 allergies, dyspeptic syn-
dromes, and biliary problems were rampant
(Romanenko et al., 1995).
9. Peptic ulcer, chronic cholecystitis, gall- TABLE 5.53. Pancreatic Echogram Abnormalities
stone disease, and pancreatitis occurred notice- in Male Ukrainian Liquidators (% of Those Exam-
ably more often in inhabitants of territories with ined) (Komarenko et al., 2002; Komarenko and
Polyakov, 2003)
higher levels of contamination (Yakymenko,
1995; Komarenko et al., 1995). 1987–1991 1996–2002
10. From 1993 to 1994 digestive system dis- Thickening 31 67
eases were second among overall morbidity Increased echo density 54 81
(Antypova et al., 1995). Structural change 14 32
11. There were significantly increased levels Contour change 7 26
of hepatic, gallbladder, and pancreatic diseases Capsular change 6 14
Pancreatic duct dilatation 4 10
in 1993 and 1994 in the heavily contaminated
All echogram abnormalities 37.6 (1987) 87.4 (2002)
territories (Antypova et al., 1995).
118
19. In 7 to 8 years after the catastrophe TABLE 5.54. Incidence of Dental Anomalies (%)
liquidators had increasing numbers of hep- among Children Born before and after the Catas-
trophe Exposed to Different Levels of Contami-
atobiliary illnesses, including chronic chole-
nation in Tula and Bryansk Provinces∗ (Sevbytov
cystitis, fatty liver, persistent active hepati- et al., 1999)
tis, and chronic hepatitis (Romamenko et al.,
1995). <5 5–15 15–45 Time
Ci/km2 Ci/km2 Ci/km2 of birth
Tooth 3.7 2.4 2.8 Before 1986

5.9.3. Russia
anomalies (n = 48)
1. Children and the teenagers living in the 4.2 4.6 6.3 After 1986
(n = 82)
contaminated territories have a significantly Dentition 0.6 0.4 0.6 Before 1986
higher incidence of dental caries (Sevbytov, deformities (n = 8)
2005). 0.6 0.6 1.7 After 1986
2. In Voronez Province there was an in- (n = 15)
creased number of odontomas in children who Occlusion 2.6 2.4 2.2 Before 1986
(n = 39)
were born after 1986. Tumors were found more
4.4 5.2 6.3 After 1986
often in girls and the complex form was most (n = 86)
common (Vorobyovskaya et al., 2006). Age norm 5.3 5.7 3.1 Before 1986
3. Periodontal pathology was more common (n = 77)
in children from contaminated territories and 2.6 2.0 0.6 After 1986
occurred more often in children born after the (n = 28)
catastrophe (Sevbytov, 2005). ∗
5 Ci/km2 : Donskoy City, Tula Province (n = 183);
4. Children who were irradiated in utero in the 5–15 Ci/km2 : Uzlovaya Station, Tula Province (n = 183);
contaminated territories are significantly more 15–45 Ci/km2 : Novozybkov City, Bryansk Province (n =
178).
likely to develop dental anomalies (Sevbytov,
2005).
5. The frequency of the occurrence of den- 8. Digestive system morbidity in liquida-
tal anomalies is markedly higher in children in tors increased 7.4-fold over a 9-year period
the more contaminated territories. Of 236 ex- (Table 5.58).
amined who were born before the catastrophe 9. The Russian National Register reported
32.6% had normal dentition, whereas of 308 that digestive system morbidity among liq-
examined who were born in the same territo- uidators from 1991 to 1998 was markedly
ries after the catastrophe only 9.1% had normal higher than in corresponding age groups in the
structure (Table 5.54). country: 737 vs. 501 per 10,000 (Byryukov et al.,
6. The incidence of general and primary di- 2001).
gestive system diseases in children in the heav-
ily contaminated districts of Bryansk Province TABLE 5.55. Overall Digestive System Morbidity
is noticeably higher than the average for the (per 1,000) among Children in Bryansk Province
province and for Russia as a whole (Tables 5.55 Territories with Levels of Contamination above
and 5.56). 5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.1)
7. In general, digestive system morbidity in Number of cases
adults increased in the majority of the heav- Territory 1995 1996 1997 1998
ily contaminated districts of Bryansk Province
(except in the Krasnogorsk District). This in- Southwest∗ 182.9 163.5 153.6 154.7
crease occurred against a background of re- Province 94.5 88.9 90.9 91.0
Russia 114.9 115.6 114.9 n/a
duced morbidity in the province and across
∗
Russia (Table 5.57). All heavily contaminated districts.
TABLE 5.56. Primary Digestive System Morbidity 12. Of 118 surveyed liquidators, 60.2% have
(per 1,000) among Children in Bryansk Province structural pancreatic changes, 40.6% have liver
Territories with Levels of Contamination above
changes, and 29% have thickening of the gall-
5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.2)
bladder wall (Noskov, 2004).
Number of cases 13. Digestive system morbidity among both
Territory 1995 1996 1997 1998 liquidators and the population of the contam-
inated territories of Bryansk Province notice-
Southwest∗ 103.5 81.7 84.2 83.1 ably increased from 1994 to 1998, which is es-
Province 51.8 42.9 46.7 42.3
Russia 58.1 60.2 56.4 n/a
pecially significant against the background of
a decrease in the province and in Russia as a
∗
All heavily contaminated districts. whole (Table 5.59).
14. Ten years after the catastrophe a rapid
increase in digestive organ diseases in liquida-
10. Pathologic ultrastructural digestive tract tors began, together with circulatory, bone,
changes were observed in liquidators: de- and muscular diseases (Figure 5.12). Mak-
creased activity and undifferentiated epithe- ing fewer diagnoses of vegetovascular dystonia
lial cells in the duodenum, endotheliocytes in has turned this constellation of diseases into
stomach microvessels, and fibrosis of the gas- a more serious organic illness—discirculatory
tric mucous membrane (Sosyutkin et al., 2004; pathology.
Ivanova, 2005). 15. Pathological tooth enamel erosion
11. Of 901 pathologies found in 182 liquida- is widespread among liquidators (Pymenov,
tors, digestive system morbidity accounted for 2001).
28.2%. A total of 87.9% of the liquidators have 16. Among 98 surveyed liquidators 82%
had chronic gastritis and gastroduodenitis (of- have chronic periodontal disease, an incidence
ten, the erosive type); 33.4% have superficial much more common than in corresponding age
destruction of the mucous covering of the gas- groups in the country as a whole (Druzhynyna,
troduodenal junction, which is six- to eight- 2004; Matchenko et al., 2001).
fold higher than the norm (Lyubchenko and 17. Chronic catarrhal gingivitis was
Agal’tsev, 2001). present in 18% of 98 surveyed liquidators
(Druzhynyna, 2004).
18. The expression of chronic pancreatitis in
TABLE 5.57. General Digestive System Morbid- liquidators correlated with the level of irradi-
ity (per 1,000) among Adults in Bryansk Province
ation and the degree of the lipid peroxidation
Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999a: table 6.1) (Onitchenko et al., 2003).
Number of cases
Territory 1995 1996 1997 1998 5.9.4. Conclusion
Klymovo 88.6 98.5 84.9 157.3 The increase in the incidence of digestive
Novozybkov 79.6 76.7 88.6 92.4
system diseases as a result of Chernobyl irra-
Klintsy 118.0 143.8 89.0 155.9
Krasnogorsk 90.7 74.0 46.3 57.9 diation cannot be doubted. In contaminated
Zlynka 65.8 72.2 78.1 82.8 territories, where Cs-137 was easily detected, it
Gordeevka 52.9 74.8 91.2 92.0 was accompanied by Sr-90, which is taken up
Southwest∗ 79.7 95.6 88.0 105.0 during intrauterine development and deposited
Province 69.0 65.6 63.2 64.4 in teeth and bones. Sr-90 decays to Y-90 via re-
Russia 97.3 93.8 91.5 n/a
lease of a beta particle, which is harmful to
∗
All heavily contaminated districts. the developing teeth, and the resultant decay
120
TABLE 5.58. Digestive System Morbidity (per 10,000) among Russian Liquidators (Baleva et al.,
2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Number of cases 82 487 1,270 2,350 3,210 4,200 5,290 6,100
isotope, Y-90, weakens the structural integrity The skin, a multilayered organ with multi-
of the teeth. ple functions, is made up of the epidermis, the
There was an immediate increase in the inci- dermis, and various cells, including the kerati-
dence of digestive tract diseases among liquida- naceous structures that form nails and hair, plus
tors and a rise in the number of congenital di- melanocytes, and the sebaceous and sweat (ec-
gestive system malformations in babies born in crine) glands. The skin is richly supplied with
the contaminated territories. The assumption nerves and blood vessels. Thus the skin and all
appears proven that low-level irradiation acts of its subcutaneous components reflect internal
in some way to directly affect the function of damage to blood vessels and other tissues of the
the gastrointestinal tract epithelium—and not body, as is demonstrated by the research cited
only during intrauterine development. in this section.
Considering the significantly increased di-
gestive system morbidity among children of ir-
5.10.1. Belarus
radiated parents in Japan (Furitsu et al., 1992),
and in the southern Ural mountain area ow- 1. By 1994 skin and subcutaneous tissue dis-
ing to radiation contamination (Ostroumova, eases had increased among children in all of
2004), it is logical to assume that similar conse- the heavily contaminated territories compared
quences from Chernobyl irradiation will have a with 1988 (Lomat’ et al., 1996).
prolonged effect in territories where radioactive
conditions persist.
5.10. Skin Diseases Associated

with the Chernobyl Catastrophe
Diseases of the skin reflect not only the effect

of external irritants, but also diseases of internal
organs and the effects of organic and inorganic
agents that are absorbed internally.
TABLE 5.59. General Digestive System Morbid-

ity among Liquidators and the Adult Population of
Bryansk Province Territories with Levels of Con-
tamination above 5 Ci/km2 , 1994–1998 (Fetysov,
1999a: table 4.1)
Number of cases
Group/
Figure 5.12. Digestive, circulatory, bone, and
Territory 1994 1995 1996 1997 1998
muscle diseases among liquidators from Moscow City
Liquidators 24.7 45.7 63.0 52.3 346.4 and Moscow Province: (1) digestive system, (2) bone
All of the Southwest 54.2 523.0 88.7 78.4 269.0 and muscle, (3) hypertension, (4) ischemic heart dis-
Province 71.8 69.0 65.6 63.2 64.4 ease, (5) circulatory encephalopathy, and (6) au-
Russia 95.8 97.3 91.5 91.5 n/a tonomic nervous system dysfunction (Oradovskaya
et al., 2006, 2007).
2. Of 69 children and teenagers admitted to TABLE 5.60. Overall Skin Diseases among Chil-
hospitals with various forms of alopecia, more dren (per 1,000) in the Southwest Territories of
Bryansk Province with Levels of Contamination
than 70% came from the heavily contaminated
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999b:
territories (Morozevich et al., 1997). table 6.1)
3. In Senkevichi Village, Luninets District,
Brest Province, the incidence of children’s skin Number of cases
and subcutaneous tissue diseases increased 1.7- Territory 1995 1996 1997 1998
fold from 2000 to 2005 (Dudinskaya et al.,
Southwest∗ 111.3 105.9 102.1 83.3
2006). Province 83.4 80.8 78.3 76.2
4. From 1986 to 1993 the incidence of skin Russia 81.9 84.6 86.0 n/a
disease among 4,598 children examined in ∗
Kormyansk and Chechersk districts, Gomel
Province, where Cs-137 contamination was
15–40 Ci/km2 , was significantly higher com-
pared to less contaminated districts (Gudkovsky higher than in the province and in Russia as a
et al., 1995). whole (Tables 5.60 and 5.61).
5. The incidence of skin disease among 3. Dermatological pathology was found in
children who were newborn to 4 years old 60% of children and teenagers in Gordeevka,
at the time of the catastrophe is significantly Bryansk Province, which is one of the most con-
higher in territories with contamination levels taminated districts (Kyseleva and Mozzherova,
of 15–40 Ci/km2 than in children of the same 2003).
age from territories with contamination of 5– 4. In 1996 overall skin morbidity in adults
15 Ci/km2 (Kul’kova et al., 1996). in the heavily contaminated territories of
6. Out of the first 9 years after the catastro- Bryansk Province corresponded to parameters
phe, skin and subcutaneous morbidity was a in the province as a whole (Tables 5.62 and
maximum in 1993 (Blet’ko et al., 1995). 5.63).
5. Incidence of diseases of the skin and sub-
cutaneous tissues among liquidators increased
6 years after the catastrophe and in 1992 ex-
5.10.2. Ukraine ceeded the level of 1986 more than 16-fold
(Table 5.64).
1. Skin diseases among evacuees living in 6. Skin pathology found among liquidators
the heavily contaminated territories from 1988 included thickening of the cornified and sub-
to 1999 was more than fourfold higher than cellular layers of the epidermis, endothelial
in the less contaminated areas (Prysyazhnyuk
et al., 2002).
TABLE 5.61. Primary Skin Diseases among Chil-
dren (per 1,000) in Southwestern Territories of
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999b:
5.10.3. Russia table 6.2)
1. Exudative diathesis (lymphotoxemia) in Number of cases
preschool children in the contaminated territo- Territory 1995 1996 1997 1998
ries occurred up to four times more often than
before the catastrophe (Kulakov et al., 2001). Southwest∗ 88.5 89.2 95.7 74.8
2. From 1995 to 1998 the incidence of overall Province 71.7 69.6 65.3 63.2
Russia 73.1 71.3 68.6 n/a
and primary skin diseases in children in the
∗
heavily contaminated territories was noticeably All heavily contaminated districts.
122
TABLE 5.62. Overall Skin Diseases among Adults ful cocktail of radionuclides over the entire
(per 1,000) in the Southwestern Territories of Northern Hemisphere (see Chapter 1 for de-
tails). Chernobyl radionuclide contamination
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999a:
table 6.1) impacted microbial flora and fauna and other
of our symbionts (parasites and commensals)
Number of cases and changed our biological community (see
Territory 1995 1996 1997 1998 Chapter 11).
There is evidence of increased incidence and
Southwest∗ 60.3 67.4 61.4 58.6
Province 68.5 62.4 53.0 54.0
severity of diseases characterized by intesti-
Russia 50.4 48.9 46.3 n/a nal toxicoses, gastroenteritis, bacterial sepsis,
∗
viral hepatitis, and respiratory viruses in ar-
eas contaminated by Chernobyl radionuclides
(Batyan and Kozharskaya, 1993; Kapytonova
swelling, inflammatory lymphocytic infiltration and Kryvitskaya, 1994; Nesterenko et al., 1993;
accompanied by active panvasculitis of most of Busuet at al., 2002; and others). Genetic insta-
the small arteries; findings correlated with the bility markedly increased in the contaminated
level of the radiation load (Porovsky et al., 2005). territories and has resulted in increased sen-
7. Among the 97% of liquidators who devel- sitivity to viral and other types of infections
oped psoriasis after the catastrophe, the pso- (Vorobtsova et al., 1995).
riasis was always combined with functional
impairment of the nervous system and with
5.11.1. Belarus
gastrointestinal disorders (Malyuk and Bog-
dantsova, 2001). 1. Herpes virus activation in the heavily
Undoubtedly the post-Chernobyl period has contaminated territories of Gomel Province
seen an increase in diseases of the skin and sub- resulted in increased intrauterine and infant
cutaneous tissues in children and liquidators. death rates (Matveev et al., 1995).
2. An increased incidence of whipworm (Tri-
chocephalus trichiurus) infestation (trichocephalo-
5.11. Infections and Parasitic sis) correlated with the density of radioac-
Infestations tive contamination in Gomel and Mogilev
provinces (Stepanov, 1993).
Ionizing radiation is a powerful mutagenic 3. In Senkevichi Village, Luninets District,
factor (see Section 5.2 above for details). Brest Province, the occurrence of infectious and
Clouds from Chernobyl dropped a power- parasitic illnesses in children increased 1.54-
fold from 2000 to 2005 (Dudinskaya et al.,
TABLE 5.63. Primary Skin Diseases among Adults 2006).
(per 1,000) in the Southwestern Territories of 4. Among 135 children living in the contam-
Bryansk Province with Levels of Contamination inated territories of Stolinsk District and Bragin
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999a: City who were examined in 1993–1995, a to-
table 6.1)
tal of 20% had chronic urogenital infections
Number of cases (Belyaeva et al., 1996).
Territory 1995 1996 1997 1998 5. Data for 1,026,046 pregnant women from
territories with contamination above 1 Ci/km2
Southwest∗ 50.9 52.5 51.5 45.4 showed that incidence of the puerperal sepsis
Province 54.1 50.2 42.2 45.0 in heavily contaminated territories was signifi-
Russia 40.6 38.7 36.7 n/a
cantly higher than in areas with less contami-
∗
All heavily contaminated districts. nation (Busuet et al., 2002).
TABLE 5.64. Skin and Subcutaneous Tissue Abnormalities among Russian Liquidators (per 10,000)
(Baleva et al., 2001)
Year 1986 1987 1988 1989 1990 1991 1992 1993
Number of cases 46 160 365 556 686 747 756 726
6. Neonates born to mothers from territo- trophe compared with the rest of the country
ries in the Chechersk District, Gomel Province, (Matveev, 1993).
contaminated at a level of 5–70 Ci/km2 14. Activation of cytomegalovirus infections
had congenital infections 2.9-fold more often in pregnant women was found in the heavily
than before the catastrophe (Kulakov et al., contaminated districts of Gomel and Mogilev
1997). provinces (Matveev, 1993).
7. In 1993, women with gestational herpes in 15. In all the heavily contaminated territories
Gomel Province with a Cs-137 contamination there was activation of herpes viruses (Voropaev
higher than 15 Ci/km2 experienced 8.6-fold et al., 1996).
more infant deaths compared to less contami- 16. In Gomel Province hepatitis B and C
nated territories (Matveev et al., 1995). infections in adults and teenagers rose signif-
8. Among 784 preschool children examined icantly after 1986. Among 2,653 individuals
from 1986 to 1991 in territories having con- examined, the incidence increased from 17.0
tamination levels of 15–40 Ci/km2 , infections cases per 100,000 in 1986 to 35.0 in 1990
and infestations were significantly higher than (Zhavoronok et al., 1998b).
in children from territories with contamination 17. Among 2,814 individuals examined the
levels of 5–15 Ci/km2 , where 1,057 children incidence of specific markers of viral hepatitis
were examined (Gutkovsky et al., 1995; Blet’ko HbsAg, anti-HBc, and anti-HCV was signifi-
et al., 1995). cantly higher in liquidators and evacuees than
9. Tuberculosis was more virulent in the in inhabitants of less contaminated districts of
more contaminated areas (Chernetsky and Vitebsk Province (Zhavoronok et al., 1998a).
Osynovsky, 1993; Belookaya, 1993). 18. From 1988 to 1995 chronic hepati-
10. During 1991–1995 there was a serious tis in liquidators (1,626 individuals exam-
increase in the incidence of tuberculosis in the ined) increased from 221 to 349 per 100,000
heavily contaminated areas of Gomel Province, (Zhavoronok et al., 1998b).
where there were drug-resistant forms and “re-
juvenation” of the disease (Borschevsky et al., 5.11.2. Ukraine
1996).
11. In the Mogilev and Gomel provinces, 1. By 1995, infectious and parasitic diseases
there was a noticeably higher level of cryp- in children were over five times more com-
tosporidium infestation: 4.1 vs. 2.8% in controls mon in the heavily contaminated territories
(Lavdovskaya et al., 1996). compared with less contaminated areas. In
12. From 1993 to 1997 in Vitebsk Province 1988 these territories did not differ in terms
the persistence of infectious hepatitis among of the occurrence of such diseases (Baida and
adults and teenagers was noticeably higher Zhirnosekova, 1998).
than in control groups (Zhavoronok et al., 2. Congenital infections in neonates born to
1998a). mothers in the Polessk District, Kiev Province,
13. Herpes viral diseases doubled in the contaminated at a level of 20–60 Ci/km2 , oc-
heavily contaminated territories of Gomel and curred 2.9-fold more often than before the
Mogilev provinces 6 to 7 years after the catas- catastrophe (Kulakov et al., 1997).
124
3. The incidence of kidney infections in TABLE 5.65. Childhood Infectious and Parasitic
teenagers significantly increased after the catas- Diseases (per 1,000) in Bryansk Province Territo-
ries with Levels of Contamination above 5 Ci/km2 ,
trophe and correlated with the level of contam-
1995–1998 (Fetysov, 1999b: table 6.1)
ination (Karpenko et al., 2003).
Number of cases
5.11.3. Russia Territories 1995 1996 1997 1998
1. Infectious disease deaths among infants Southwest∗ 128.3 112.3 99.0 94.8
Province 104.1 79.0 68.8 71.6
were significantly correlated with irradiation in Russia 121.6 107.4 102.7 n/a
utero (Ostroumova, 2004).
∗
2. Infantile infections are noticeably higher All heavily contaminated districts.
in three of the more contaminated districts of
Kaluga Province (Tsyb et al., 2006a). 9. The prevalence and severity of Gruby’s
3. The incidence of infections resulting in the disease (ringworm), caused by the fungus mi-
death of children in the heavily contaminated crosporia Microsporum sp., was significantly
districts of Kaluga Province has tripled in the higher in the heavily contaminated areas of
15 years since the catastrophe (Tsyb et al., 2006). Bryansk Province (Table 5.66).
4. A significantly higher level of cryp- 10. One year after the catastrophe, infectious
tosporidium infestation (8 vs. 4% in controls) and parasitic diseases were the primary cause
occurred in Bryansk Province (Lavdovskaya of illness among military men who were liq-
et al., 1996). uidators (Nedoborsky et al., 2004).
5. The number of cases of pneumocystis was 11. Herpes and cytomegalovirus viruses were
noticeably higher in children in the heavily found in 20% of ejaculate samples from 116
contaminated territories of Bryansk Province liquidators who were examined (Evdokymov
(56 vs. 30% in controls; Lavdovskaya et al., et al., 2001).
1996).
6. The incidence of infectious and parasitic 5.11.4. Conclusion
diseases in children, 0 to 4 years of age at the The above data concerning infectious and
time of the catastrophe was significantly higher parasitic diseases in liquidators and those liv-
in the years 1986–1993 in territories with con- ing in contaminated territories reflect activa-
tamination levels of 15–40 Ci/km2 than in chil- tion and dispersion of dangerous infections.
dren the same age from territories with con- Whether this is due to mutational changes in
tamination of 5–15 Ci/km2 (Kul’kova et al., the disease organisms rendering them more vir-
1996). ulent, impaired immunological defenses in the
7. Congenital infections in neonates born populations, or a combination of both is not
to mothers from heavily contaminated terri-
tories of the Mtsensk and Volkhovsk districts,
TABLE 5.66. Gruby’s Disease (Ringworm) Inci-
Oryol Province, contaminated at levels of 1–5
dence (per 100,000) in Bryansk Province, 1998–
and 10–15 Ci/km2 , occurred 2.9-fold more of- 2002 (Rudnitsky et al., 2003)
ten than before the catastrophe (Kulakov et al.,
1997). Heavily contaminated Less contaminated
Year districts districts
8. The overall incidence of infectious and
parasitic diseases in the heavily contaminated 1998 56.3 32.8
territories of Bryansk Province from 1995 to 1999 58.0 45.6
1998 was highest in 1995, and higher than 2000 68.2 52.9
2001 78.5 34.6
the incidence in the province as a whole 2002 64.8 23.7
(Table 5.65).
fully answered. It is clear that continued de- TABLE 5.67. Incidence (per 1,000 Births) of the
tailed observations are needed to document the Officially Accounted for Congenital Malformations
in Belarussian Districts with Different Levels of
spread and virulence of infectious and parasitic
Contamination, 1982–1992 (Lazjuk et al., 1996a;
diseases among people in all of the contami- Goncharova, 1997)
nated territories.
Level of contamination
Year 1–5 Ci/km2 >15 Ci/km2 <1 Ci/km2
5.12. Congenital Malformations
1982 5.74 3.06 5.62
There are several thousand large and small 1983 3.96 3.58 4.52
congenital malformations or anomalies. One 1984 4.32 3.94 4.17
1985 4.46 4.76 4.58
type has a strong genetic background (see Sec- 1982–1985 4.61 3.87 4.72
tion 5.3 above for details) and the second 1987 5.54 8.14 5.94
type includes developmental anomalies result- 1988 4.62 8.61 5.25
ing from impacts during embryonal develop- 1989 6.32 6.50 5.80
ment. Among them are the so-called “large” 1990 7.98 6.00 6.76
1991 5.65 4.88 5.52
congenital malformations (CMs), which are
1992 6.22 7.77 5.89
often the only ones officially registered as 1987–1992 6.01∗ 7.09∗ 5.85∗
anomalies. The other developmental anoma-
∗
lies arise as a result of damage during prenatal 1982–1985 compared with 1987–1992; p < 0.05.
development and can be genetic, caused by mu-
tations, or teratogenic, caused by toxic external
2. Analysis of more than 31,000 abortuses re-
influences, usually occurring up to the first 16
vealed that the incidence of officially registered
weeks of pregnancy.
CMs increased in all of the contaminated ter-
Wherever there was Chernobyl radioactive
ritories, but was especially significant in areas
contamination, there was an increase in the
in Gomel and Mogilev provinces with Cs-137
number of children with hereditary anomalies
levels of contamination higher than 15 Ci/km2
and congenital malformations. These included
(Lazjuk et al., 1999b).
previously rare multiple structural impairments
3. The incidence of CMs increased signifi-
of the limbs, head, and body (Tsaregorodtsev,
cantly from 5.58 per 1,000 before the catastro-
1996; Tsymlyakova and Lavrent’eva, 1996;
phe to 9.38 for the years from 2001 to 2004
Goncharova, 2000; Hoffmann, 2001;
Ibragymova, 2003; and others).
4. In 1990 the primary, initial diagnosis of
This section presents data concerning
CM in children was twice that of the illnesses
congenital malformations and developmental
in adolescents 15 to 17 years of age, but by
anomalies.
2001 it was fourfold higher (UNICEF, 2005:
5.12.1. Belarus table 1.3).
5. Some 24% of the children in the so-
1. The frequency of the occurrence of CMs, called “clean” regions (<1 Ci/km2 ) were born
which was stable up to 1986, increased no- with CMs, in districts with Cs-137 contamina-
ticeably after the catastrophe. Although the tion levels of 1–5 Ci/km2 the figure was 30%,
increase in CMs is marked mainly in the and in the districts with contamination levels
heavily contaminated territories, significant in- above 15 Ci/km2 the number reached 83%
creases in CM morbidity were registered for (Table 5.67).
the whole country, including the less contami- 6. There was a higher incidence of CM mor-
nated Vitebsk Province (Nykolaev and Khmel’, bidity in the more contaminated areas than in
1998). less contaminated ones (Table 5.68).
126
TABLE 5.68. Incidence of Congenital Malformations (per 1,000 Live Births) in Heavily and Less Con-
taminated Areas of Belarus before and after the Catastrophe (National Belarussian Report, 2006:
table 4.6.)
Heavily contaminated areas Less contaminated areas

Years 1981–1986 1987–1989 1990–2004 1981–1986 1987–1989 1990–2004
Incidence of all CMs 4.08 7.82∗ 7.88∗ 4.36 4.99 8.00∗

Anencephaly 0.28 0.33 0.75 0.36 0.29 0.71
Spinal hernia 0.57 0.88 1.15 0.69 0.96 1.41
Polydactyly 0.22 1.25∗ 1.10 0.32 0.50 0.91
Down syndrome 0.89 0.59 1.01 0.64 0.88 1.08
Multiple CMs 1.27 2.97∗ 2.31 1.35 1.23 2.32
Newborn and stillborn total 58,128 23,925 76,278 98,522 47,877 161,972
Children and stillbirths 237 187 601 430 239 1,295
with CMs
∗
p < 0.05.
7. CM incidence increased in the whole of tricts (<1 Ci/km2 ) compared to 5 years be-
the country from 12.5 per 1,000 newborns in fore and 5 years after the catastrophe. Heavily
1985 to 17.7 in 1994, with most of the cases in contaminated districts had increased frequency
territories with Cs-137 contamination of above of occurrence of CMs compared with less
15 Ci/km2 (Lazjuk et al., 1996a). contaminated ones only from 1987 to 1988
8. Annually in the country there are no (Table 5.69).
fewer than 2,500 newborns with CMs. Since 13. There was an increased incidence of
1992 a program to interrupt pregnancy in ac- 26 officially registered CMs after the catas-
cordance with medical and genetic parame- trophe; heavily and less heavily contaminated
ters (500 to 600 cases in a year) has stabilized areas differed with some CMs increasing
the birth of children with CMs (Lazjuk et al., from 1987 to 1988, whereas others increased
1996a,b). from 1990 to 2004. Polydactly and limb-
9. Nine years after the catastrophe the num- reduction defects were significantly different
ber of newborns who died because of nervous in the heavier and less contaminated districts
system developmental anomalies was statisti- in 1987 and 1988. Eventually, there was less
cally significant (Dzykovich et al., 1996).
10. In Gomel Province congenital anomalies
of the eye increased more than fourfold: from TABLE 5.69. Incidence of Officially Registered
0.4 to 1.63% from 1961–1972 to 1988–1989 Congenital Malformations (per 1,000 Live Born +
(Byrich et al., 1999). Fetuses) in 17 Heavily and 30 Less Contaminated
Districts of Belarus (National Belarussian Report,
11. In 1994, CMs were the second cause
2006)
of infant mortality. The incidence was higher
in Gomel Province (4.1%) than in the least Districts 1981–1986 1987–1988 1990–2004
contaminated Vitebsk Province (3.0%), and A. Heavily 4.08 7.82 7.88∗∗
averaged 3.9% for the country as a whole contaminated
(Bogdanovich, 1997). B. Less 4.36 4.99∗ 8.00∗∗
12. The incidence of CMs increased sig- contaminated
nificantly in 17 heavily contaminated districts ∗
p < 0.05, ∗ A compared to B (1987–1988); ∗∗ p < 0.05,
(>5 Ci/km2 ) and in 30 less contaminated dis- 1981–1986 compared with 1990–2004.
TABLE 5.70. Incidence of Officially Registered TABLE 5.71. Incidence of Registered Congenital
Congenital Malformations (per 1,000 Live Births Malformations (per 1,000 Live Births + Fetuses) in
+ Fetuses) in Contaminated Districts in Belarus. Gomel and Mogilev Provinces of Belarus before
Top Line: Data for 17 Districts with Levels above and after the Catastrophe (Lazjuk et al., 1996a)
5 Ci/km2 ; Bottom Line: Data for 30 Districts with
Number of cases
Levels below 1 Ci/km2 (National Belarussian Re-
port, 2006) District 1982–1985 1987–1989
1981–1986 1987–1988 1990–2004
Gomel area
Anencephaly 0.28 0.33 0.75 Bragin 4.1 ± 1.4 9.0 ± 3.0
0.36 0.29 0.71 Buda—Koshelevo 4.7 ± 1.2 9.3 ± 2.0∗
Spinal hernias 0.57 0.88 1.15 Vetka 2.8 ± 1.0 9.9 ± 2.7
(Spina bifida) 0.69 0.96 1.41 Dobrush 7.6 ± 2.0 12.6 ± 2.6
Lip defects 0.65 1.09 1.08 El’sk 3.3 ± 1.4 6.4 ± 2.4
0.64 0.84 1.23 Korma 3.2 ± 1.2 5.9 ± 2.1
Polydactyly 0.22 1.25∗ 1.10 Lel’chitsy 3.3 ± 1.2 6.6 ± 2.0
0.32 0.50 0.91 Loev 1.6 ± 1.1 3.7 ± 2.1
Limb reduction 0.17 0.59∗ 0.49 Khoiniky 4.4 ± 1.2 10.2 ± 2.6∗
0.22 0.13 0.35 Chechersk 1.0 ± 0.7 6.6 ± 2.3∗
Esophageal and 0.14 0.21 0.21 Mogilev area
anal atresia 0.19 0.27 0.23 Bykhov 4.0 ± 1.1 6.5 ± 1.6
Multiple CMs 1.27 2.97∗ 2.31 Klymovychy 4.8 ± 1.4 3.2 ± 1.4
1.35 1.23 2.32 Kostyukovychy 3.0 ± 1.2 12.0 ± 2.9∗
Krasnopol’e 3.3 ± 1.5 7.6 ± 2.9
∗
p < 0.05. Slavgorod 2.5 ± 1.2 7.6 ± 2.7
Cherykov 4.1 ± 1.7 3.6 ± 1.8
Total 4.0 ± 0.3 7.2 ± 0.6∗
distinction between heavily and less contami- ∗
p < 0.05.
nated districts and the incidence of CMs in the
former decreased in comparison to that in the
latter (Table 5.70). tuses in the contaminated areas of Mogilev
14. The incidence of registered CMs notice- and Gomel provinces was significantly higher
ably increased in 14 out of 16 districts of Gomel in the first decade after the catastrophe
and Mogilev provinces 1 to 2 years after the (Table 5.73).
catastrophe. In five districts the increase was
significant compared with precatastrophe data 5.12.2. Ukraine
(Table 5.71).
15. Occurrence of the officially registered 1. Before the Chernobyl catastrophe only
CMs correlated with the level of radioactive one case of severe CMs in a newborn was seen
contamination of the territory (Table 5.72).
16. The occurrence of CMs in Gomel TABLE 5.72. Occurrence of Officially Registered
Province was sixfold higher in 1994 Congenital Malformations (per 1,000 Live Births)
(Goncharova, 2000). and Different Levels of Contamination (Lazjuk
17. The frequency of occurrence of CMs et al., 1996a; Matsko, 1999)
from 1986 to 1996 in areas contaminated at Number of cases
Level of
a level greater than 15 Ci/km2 was signifi-
contamination 1982–1985 1987–1992
cantly higher than in Minsk, with the highest
incidence of 9.87 occurring in 1992 (Lazjuk <1 Ci/km2 4.72 (4.17 – 5.62) 5.85 (5.25 – 6.76)
et al., 1996b, 1999). 1–5 Ci/km2 4.61 (3.96 – 5.74) 6.01 (4.62 – 7.98)
>15 Ci/km2 3.87 (3.06 – 4.76) 7.09 (4.88 – 8.61)
18. Compared with Minsk, the incidence
of CMs among medical abortuses and fe- ∗
All differences are significant.
128
TABLE 5.73. Comparison of the Incidence (per growth increased significantly in the contami-
1, 000) of Strictly Registered Congenital Malfor- nated districts (Horishna, 2005).
mations, Medical Abortuses, and Fetuses in Minsk
9. Occurrence of officially registered CMs
Compared with Gomel and Mogilev Provinces
Contaminated at Levels above 15 Ci/km2 (Lazjuk increased 5.7-fold during the first 12 years after
et al., 1999) the catastrophe (Grodzinsky, 1999).
10. The incidence of CMs is twice as high in
Territories/period
contaminated districts (Horishna, 2005).
Minsk Contaminated districts 11. Ten years after the catastrophe, the
Congenital 1980–1985, 1986∗ –1996, 1986∗ –1995,
level of congenital malformations in Rivne
malformations n = 10,168 n = 20,507 n = 2,701 Province increased from 15.3 to 37.3 (per 1,000
All CMs 5.60 4.90 7.21∗∗ neonates), most noticeably in the heavily con-
CNS anomalies 0.32 0.53 0.54 taminated northern districts (Evtushok, 1999).
Polydactyly 0.63 0.53 0.79 12. Among the 13,136 children born
Multiple limb 0.07 0.10 0.28
to 1986–1987 liquidators, 9.6% had offi-
defects
cially registered CMs. Common developmen-
∗
Second half 1986; ∗∗ p < 0.05. tal anomalies include scoliosis; throat and tooth
deformities; early tooth decay; dry, rough, and
leathery skin; abnormally thin, tightly clustered
in a 5-year period; afterward there were several hair; and alopecia (Stepanova., 1999, 2004;
cases a year (Horishna, 2005). Horishna, 2005).
2. After 1986 the number of children with 13. The highest incidence of CMs among
CMs increased in the contaminated territories children born to liquidator families was ob-
(TASS, 1998; Golubchykov et al., 2002). served in 1987–1988, when there were up to
3. Disability owing to congenital defects in 117 per 1,000. Thereafter the ratio began to
children newborn to 15 years of age increased decrease: 83–102 children in 1989–1991; 67 in
more than threefold in the Ukraine from 1992– 1992; and 24–60 in 1993–1997 (Figure 5.13).
1993 to 2000–2001: from 10 to 31 per 10,000 14. According to the Neurosurgery Institute,
(UNISEF, 2005: table 1.5). National Ukrainian Medical Academy in Kiev,
4. The peak incidence of CMs in the period after the catastrophe 98% of central nervous
from 1987 to 1994 occurred in 1990 (Orlov, system anomalies were due to hydrocephalus.
1995). The average annual increase in central nervous
5. For children irradiated in utero, the occur- system defects was about 39% among 2,209
rence of CMs increased significantly (5.52 ± registered cases in the period from 1981 to 1985
0.22 vs. 2.95 ± 0.18 in controls, p < 0.001) compared with 4,925 cases from 1987 to 1994.
and the spectrum of CMs changed (Stepanova, From 1987 to 2004 the incidence of brain tu-
1999). mors in children up to 3 years of age doubled
6. The number of the small congenital mal- (Figure 5.14) and in infants it increased 7.5-fold
formations (anomalies of development) cor- (Orlov et al., 2001, 2006).
related with the level of in utero irradiation 15. The highest incidence of maxillofacial
(Stepanova et al., 2002a). CMs (mostly cleft upper lip and palate) oc-
7. Developmental anomalies in children curred in children born within 9 months after
from heavily contaminated districts occur up April 26, 1986, and was six- to tenfold more
to 2.8-fold more frequently than in less con- common in the more contaminated areas of
taminated areas (Horishna, 2005). Kiev City and Kiev and Zhytomir provinces
8. Previously rare multiple CMs and severe compared with the less contaminated provinces
CMs such as polydactyly, deformed internal or- of Vinnitsa and Khmelnitsk (Nyagu et al.,
gans, absent or deformed limbs, and retarded 1998).
Figure 5.13. Incidence (per 1,000) of congenital malformations in children born to

families of Ukrainian liquidators who worked in 1986–1987 (Stepanova, 2006).
16. Urogenital tract CMs accounted for 2. The number of CMs increased markedly
more than 20% of all officially registered for several years after the catastrophe in the
anomalies and were more frequent for the heavily contaminated districts of Tula Province
period from 1998 to 2001 (Sorokman, 1998; (Khvorostenko, 1999).
Sorokman et al., 2002). 3. The heavily contaminated districts of
Kaluga Province had an increase in the number
of CMs after the catastrophe, which resulted in
5.12.3. Russia a twofold increase in children’s deaths in these
districts 15 years later (Tsyb et al., 2006).
1. The number of CMs noticeably in- 4. CMs in contaminated regions increased
creased for several years after the catastrophe three- to fivefold in 1991 and 1992 compared
(Lyaginskaya and Osypov, 1995; Lyaginskaya with the precatastrophe level, with a noticeable
et al., 2007). increase in anomalies of the genitals, nervous
Figure 5.14. Number of cases of central nervous system tumors in children under 3
years of age from 1981 to 2002, taken from Kiev Institute of Neurosurgery data (Orlov and
Shaversky, 2003).
130
TABLE 5.74. Congenital Malformation Morbidity 2. BULGARIA. In Pleven Province there was a
(per 1,000 Live Births) in Bryansk Province Districts significant increase in CMs of the heart and
with Contamination Levels above 5 Ci/km2 , 1995–
central nervous system, as well as multiple
1998 (Fetysov, 1999b: table 6.1)
anomalies following the Chernobyl contami-
Number of cases nation (Moumdjiev et al., 1992 by Hoffmann,
Territory 1995 1996 1997 1998 2001).
3. CROATIA. Analysis of 3,541 autopsies at
Southwest∗ 14.2 13.1 12.7 11.9 the University Clinic of Zagreb between 1980
Province 7.9 8.1 8.6 8.9
and 1993 showed a significantly increased inci-
∗
All heavily contaminated districts. dence of central nervous system anomalies dur-
ing the post-Chernobyl period (Kruslin et al.,
system, sense organs, bone, muscular and diges- 1998, by Schmitz-Feuerhake, 2002).
tive systems, and congenital cataracts (Kulakov 4. CZECH REPUBLIC. For three pre-
et al., 2001). Chernobyl years, the rate of registered CMs
5. Infant mortality in Bryansk Province due was about 16.3 (per 1,000 total births) and 18.3
to structural CMs was fivefold the Russian av- for three post-Chernobyl years. From 1986 to
erage (Zhylenko and Fedorova, 1999). 1987 the rate of CMs increased significantly—
6. The occurrence of officially registered about 26%, from 15 to 19 per 1,000 (UNICEF,
CMs in the contaminated districts of Bryansk 2005: from table 1.2, calculation by A. Y.)
Province was significantly higher from 1995 5. DENMARK. More children in Denmark
to 1998 than for the province as a whole were born with central nervous system defects
(Table 5.74). after Chernobyl (Hoffmann, 2001; Schmitz-
7. According to the Russian State Registry, Feuerhake, 2002).
which included more than 30,000 children 6. FINLAND. Between February 1987 and De-
born to liquidators, 46.7 had congenital devel- cember 1987, the number of cases of CMs
opmental anomalies and “genetic syndromes” were, respectively, 10 and 6% above expec-
with a prevalence of bone and muscular abnor- tation in the moderately and highly contam-
malities. Occurrence of CMs among children inated regions. Subgroups with higher inci-
of liquidators was 3.6-fold higher than corre- dence included malformations of the central
sponding Russian parameters (Sypyagyna et al., nervous system and limb-reduction anomalies
2006). (Harjuletho et al., 1989, 1991).
7. GEORGIA. The number of CM cases diag-
5.12.4. Other Countries nosed as “harelip” and “wolf mouth” increased
after the catastrophe, especially in what were
Official European registries of CMs (EU- probably the most contaminated areas of Ajaria
ROCAT Registry, 1988) collectively cover Republic and Racha Province (Vepkhvadze
only about 10% of the European population et al., 1998).
(Hoffmann, 2001). Underestimates are thought 8. GERMANY. The Jena Regional Malforma-
to be up to 30% for minor malformations tion Registry recorded an increase in CMs in
and 15–20% for Down syndrome (Dolk and 1986 and 1987 compared with 1985; isolated
Lechat, 1993; Czeizel et al., 1991). Most Eu- malformations leveled off during subsequent
ropean countries do not routinely register pre- years (Lotz et al., 1996, by Hoffmann, 2001).
natally diagnosed malformations that lead to The increase was most pronounced for mal-
induced abortions (Hoffmann, 2001). formations of the central nervous system and
1. AUSTRIA. More cases of central nervous anomalies of the abdominal wall. An analysis
system defects in newborns were observed in of the nationwide GDR Malformation Registry
Austria after Chernobyl (Hoffmann, 2001). for the prevalence of cleft lip/palate revealed a
TABLE 5.75. Incidence (per 1,000 Births) of 9. HUNGARY. More cases of central nervous
Neural Tube Defects in Turkey before and af- system defects in newborns were observed in
ter the Catastrophe (Hoffmann, 2001; Schmitz-
Hungary after Chernobyl (Hoffmann, 2001;
Feuerhake, 2006)
Schmitz-Feuerhake, 2002).
Location Before After 10. MOLDOVA. Out of 8,509 registered
Bursa, Western Turkey 5.81 12.63 –20.02 6.34 cases of CMs for the period from 1989
Trabzon 2.125 4.396 to 1996 the highest frequencies of occur-
Elazig 1.77 2.2 –12.58 10.09 rence of malformations (including Down
1 syndrome, structural limb deformities, and
1983–1986; 2 Jan.–June 1987; 3 July–Dec. 1987;
4
Jan.–June 1988; 5 1981–1986; 6 1987–Oct. 1989; embryonic hernias) were in the most con-
7
1985–1986; 8 1987–1988; 9 1989. taminated southeast territories (Grygory et al.,
2003).
11. NORWAY. Data on all newborns con-
9.4% increase in 1987 compared with the coun- ceived between May 1983 and April 1989 re-
try’s average for 1980 and 1986 (Zieglowski vealed a positive correlation between calculated
and Hemprich, 1999). This increase was most total irradiation from Chernobyl and CMs
pronounced in three northern provinces of the such as hydrocephaly. There was a negative
GDR, those most affected by the Chernobyl correlation with Down syndrome (Terje Lie
fallout (Hoffmann, 2001). et al., 1992; Castronovo, 1999).
TABLE 5.76. Congenital Developmental Anomalies in Children Irradiated In Utero as a Result of the
Chernobyl Catastrophe in Countries Other than Belarus, Ukraine, and European Russia (Hoffmann,
2001; Schmitz-Feuerhake, 2006; Pflugbeil et al., 2006)
Country, territory Congenital malformations Reference
Austria CMs Hoffmann, 2001

Turkey (Bursa, Izmir, Incidence of CNS among the newborns conceived Akar et al., 1988,1989; Caglayan
Black Sea coast) in the second half of 1986 et al., 1990; Guvenc et al.,
1993; Mocan et al., 1990
Bulgaria (Pleven) Cardiac anomalies, CNS defects, multiple CMs Moumdjiev et al., 1992
Croatia (Zagreb) CMs among stillbirths and neonatal deaths (including Kruslin et al., 1998
CNS anomalies)
Denmark (Odense) Neural tube defects (NTD) EUROCAT, 1988
Finland Malformations of the CNS and limb-reduction Harjuletho-Mervaala et al., 1992
anomalies
Hungary Congenital malformations Czeizel, 1997
Scotland Down syndrome (trisomy 21) Ramsay et al., 1991
Sweden Down syndrome (trisomy 21) Ericson and Kallen, 1994
East Germany Cleft lip and/or palate, other CMs Zieglowski and Hemprich, 1999;
Scherb and Weigelt, 2004
Bavaria In 7 months after the catastrophe CM incidence Korblein 2002, 2003a, 2004;
increased 4% Scherb and Weigelt, 2003
West Berlin CMs among stillbirths noticeably increased in 1987 Hoffmann, 2001
Jena Increase in CMs (including malformations of the CNS Lotz et al., 1996
and anomalies of the abdominal wall)
Germany total In 1987 CM incidence increased significantly Korblein, 2000
132
Figure 5.15. Typical examples of Chernobyl-induced congenital malformations with mul-

tiple structural deformities of the limbs and body (drawing by D. Tshepotkin from Moscow
Times (April 26, 1991) and from www.progetto.humus).
12. TURKEY. At the beginning of 1987, an fects (including spina bifida occulta and aperta,
increased incidence of CMs was reported in encephalocele, and anencephaly) in Turkey be-
western Turkey, which was particularly badly fore and after the catastrophe.
affected (Akar, 1994; Akar et al., 1988, 1989; 13. Information on CMs in newborns ir-
Güvenc et al., 1993; Caglayan et al., 1990; radiated in utero as a result of the catas-
Mocan et al. 1990). Table 5.75 is a summary trophe in various countries is presented in
of data on the prevalence of neural tube de- Table 5.76.
TABLE 5.77. Incidence (per 10,000) of 12 Disease Groups among Liquidators (Pflugbeil et al., 2006)
Illness/organ group 1986 1988 1990 1992 1993 Increase
Blood and blood-forming organs 15 96 191 226 218 14.5-fold

Circulation 183 1,150 2,450 3,770 4,250 23.2-fold
Endocrine sytem 96 764 2,020 3,740 4,300 45.1-fold
Respiratory system 645 3,730 6,390 7,010 7,110 11.0-fold
Urogenital tract 34 253 646 1,180 1,410 41.4-fold
Nervous system and sense organs 232 1,810 4,100 8,110 9,890 42.6-fold
Psychological changes 621 1,580 3,380 4,540 4,930 7.9-fold
Digestive System 82 1,270 3,210 5,290 6,100 74.4-fold
Skin and subcutaneous tissue 46 365 686 756 726 15.8-fold
Infections and parasites 36 197 325 388 414 11.5-fold
Tumors 20 180 393 564 621 31.1-fold
Malignant growths 13 40 85 159 184 14.2-fold
5.12.5. Conclusion rence of congenital malformations continues to

increase in several of the contaminated territo-
The appreciable increase in newborns with ries and correlates with the levels of irradiation.
both major and minor developmental anoma- Thus the link between congenital and genetic
lies is one of the undeniable consequences of defects and Chernobyl irradiation is no longer
the Chernobyl catastrophe. Everywhere in ar- an assumption, but is proven.
eas contaminated by Chernobyl radioactivity, Extrapolating available data on congeni-
increased numbers of children have been born tal malformations and the total number of
with hereditary anomalies and congenital de- children born in the territories contaminated
velopmental malformations, including previ- by Chernobyl, we must assume that each
ously rare multiple structural deformities of the year several thousand newborns in Europe will
limbs, head, and body (Figure 5.15). The occur- also bear the greater and smaller hereditary
TABLE 5.78. Incidence (per 100,000) of Juvenile Morbidity in Gomel Province, Belarus (Pflugbeil et al.,
2006 Based on Official Gomel Health Center Data, Simplified)
Morbidity group/Organ 1985 1990 1995 1997 Increase
Total primary diagnoses 9,771 73,754 127,768 124,440 12.7-fold

Blood and blood-forming organs 54 502 859 1,146 21.2-fold
Circulatory diseases 32 158 358 425 13.3-fold
Endocrinological, metabolic, and immune systems 3.7 116 3,549 1,111 300.0-fold
Respiratory system 760 49,895 81,282 82,689 108.8-fold
Urogenital tract 25 555 961 1,199 48.0-fold
Muscle and bones/connective tissue 13 266 847 1,036 79.7-fold
Mental disorders 95 664 908 867 9.1-fold
Neural and sense organs 645 2,359 7,649 7,040 10.9-fold
Digestive system 26 3,108 5,879 5,548 213.4-fold
Skin and subcutaneous tissue 159 4,529 7,013 7,100 44.7-fold
Infectious and parasitic illnesses 4,761 6,567 11,923 8,694 1.8-fold
Congenital malformations∗ 51 122 210 340 6.7-fold
Neoplasm∗∗ 1.4 323 144 134 95.7-fold
∗
High estimation of unreported cases through abortions; ∗∗ 1985 only malignant neuroplasms.
134
TABLE 5.79. Incidence (per 100,000) of Morbidity among Adults and Adolescents in Northern Ukraine,
1987–1992 (Pflugbeil et al., 2006)
Illness/Organ 1987 1989 1991 1992 Increase
Endocrine system 631 886 4,550 16,304 25.8-fold

Psychological disturbances 249 576 5,769 13,145 52.8-fold
Neural system 2,641 3,559 15,518 15,101 5.7-fold
Circulatory system 2,236 4,986 29,503 98,363 44.0-fold
Digestive system 1,041 2,249 14,486 62,920 60.4-fold
Skin and subcutaneous tissue 1,194 1,262 4,268 60,271 50.5-fold
Muscles and bones 768 2,100 9,746 73,440 96.9-fold
anomalies caused by Chernobyl’s radioactive havioral stress factors. They are real and
fallout. documented.
Liquidators were the most comprehen-
sively observed group after the catastrophe.
5.13. Other Diseases Table 5.77 presents dramatic data on the in-
cidence of 12 groups of illnesses suffered by
1. Age-related changes found in liq- Russian liquidators.
uidators included anoxic, fermentation-type It is reasonable to suggest that the state
metabolism and formation of pro-oxidation of public health in the affected territories
conditions (Vartanyan et al., 2002). may be even worse than that of the liquida-
2. In 58 children ages 7 to 14 from tors. Tables 5.78 and 5.79 provide a com-
Stolinsk and Narovlya districts without clin- prehensive view of the deterioration in public
ical pathology, blood vitamin E levels were health in the affected territories of Belarus and
significantly lower than normal and were es- Ukraine.
pecially low in territories contaminated at Existing data presented in this chapter are
a level above 6 Ci/km2 (Zaitsev et al., irrefutable proof that the frequency of occur-
1996). rence of nonmalignant illnesses is obviously and
3. In 153 pregnant women from the Bra- significantly higher in the contaminated terri-
gin District, vitamin A levels were noticeably tories.
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CHERNOBYL
6. Oncological Diseases after the Chernobyl

Catastrophe
Alexey V. Yablokov
The most recent forecast by international agencies predicted there would be between
9,000 and 28,000 fatal cancers between 1986 and 2056, obviously underestimating the
risk factors and the collective doses. On the basis of I-131 and Cs-137 radioisotope doses
to which populations were exposed and a comparison of cancer mortality in the heavily
and the less contaminated territories and pre- and post-Chernobyl cancer levels, a more
realistic figure is 212,000 to 245,000 deaths in Europe and 19,000 in the rest of the world.
High levels of Te-132, Ru-103, Ru-106, and Cs-134 persisted months after the Chernobyl
catastrophe and the continuing radiation from Cs-137, Sr-90, Pu, and Am will generate
new neoplasms for hundreds of years.
The oncological diseases include neoplasms 1986, the ongoing irradiation in the wake of
and malignant (cancerous) and nonmalignant the meltdown is responsible for an increase in
tumors as common consequences of ionizing malignant diseases. Given the ten half-lives that
radiation. There are varying periods of latency have to occur before many of the isotopes decay
between the exposure and the appearance of a to safe levels, this means that Chernobyl radia-
tumor. Data collected from the victims of Hi- tion will engender new neoplasms for hundreds
roshima and Nagasaki show radiation-induced of years.
malignancies becoming clinically apparent as The initial forecasts insisted that there
follows: would be no significant increase in the oc-
currence of cancer after the catastrophe.
• Leukemia (various blood cancers)—within As is demonstrated by data in this chap-
5 years ter, the Russian and Ukrainian oncological
• Thyroid cancer—within 10 years statistics were low and grossly underestimated
• Breast and lung cancers—in 20 years the cancer morbidity. It is officially accepted
• Stomach, skin, and rectal cancer—in that:
30 years
. . . the main source of data for international statis-
For people living in the areas contaminated tics for cancer morbidity is the collection of papers
“Cancer Disease on Five Continents,” published
by Chernobyl’s radioactive fallout the cancer
by the International Agency for Research on Can-
situation is much more complicated. Although cer (IARC). Each five years, since 1960 . . . these
there was not a single case due to direct expo- editions publish only those data which correspond
sure from the explosion that occurred in April to the established quality standards. In the first
editions across the USSR . . . information has not
been included. In last two editions of the collection,
containing data for 1983–1987 and 1988–1992,
data are included for Belarus, Estonia and Latvia;
Address for correspondence: Alexey V. Yablokov, Russian Academy
of Sciences, Leninsky Prospect 33, Office 319 119071 Moscow, Russia. the first of these two collections also contained
Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@ information from St. Petersburg and Kirghizia.
ecopolicy.ru Nevertheless, the authors of the collection warn
161
162
that all data from former republics of the USSR 2. A significant increase in morbidity for ma-
(except for Estonia) underestimate the occur- lignant and benign neoplasms occurred in girls
rence of disease. . . (UNSCEAR, 2000, item 234, aged 10 to 14 years born to irradiated parents
p. 48).
in the years from 1993 to 2003 (National Be-
This chapter is divided into sections on the larussian Report, 2006).
various cancers that have been found in ter- 3. The highest level of general oncological
ritories contaminated by Chernobyl radionu- morbidity among persons 0 to 17 years of age
clides. Section 6.1 deals with general oncologi- from 1986 to 2000 occurred in the most con-
cal morbidity, 6.2 with thyroid cancer, 6.3 with taminated Gomel Province; the lowest was in
leukemia, and 6.4 with all of the other malig- the least contaminated areas of the Vitebsk and
nant neoplasms. This chapter, as well as oth- Grodno provinces (Borysevich and Poplyko,
ers in this book, is not an all-inclusive review, 2002).
but does reflect the scope and the scale of the 4. The level of the cancer morbidity
problem. in Gomel and Mogilev provinces correlated
with the level of contamination of the areas
(Table 6.1).
6.1. Increase in General 5. From 1987 to 1999 some 26,000 cases
Oncological Morbidity of radiation-induced malignant neoplasms (in-
cluding leukemia) were registered. The aver-
There are two ways to define the scale of can- age annual absolute risk of malignant disease
cer morbidity associated with the Chernobyl calculated from these data is 434 per 10,000
catastrophe: (1) on the basis of calculated re- person/Sv. The relative risk for cancer is 3–
ceived doses (with application of appropriate 13 Sv−1 , an order of magnitude higher that of
risk factors) and (2) by direct comparison of Hiroshima (Malko, 2002).
cancer morbidity in the heavily and less con- 6. Cancer morbidity among liquidators
taminated territories. (57,440 men and 14,400 women officially regis-
tered) sharply and significantly increased from
1993 to 2003 compared to individuals exposed
6.1.1. Belarus
to less contamination (Table 6.2).
1. For the period 1990–2000 cancer mor- 7. Cancer morbidity among liquidators who
bidity in Belarus increased 40%. The increase worked in May–June 1986 (maximal doses and
was a maximum in the most highly contam- dose rate) is above that of liquidators who
inated Gomel Province and lower in the less worked in July–December 1986, who received
contaminated Brest and Mogilev provinces: lower doses (Table 6.3).
52, 33, and 32%, respectively (Okeanov et al., 8. Cancer mortality in the Narovlia District,
2004). Gomel Province, increased from 0.0 to 26.3%
TABLE 6.1. Occurrence of Cancers (per 100,000) in Belarussian Territories Contaminated by Cs-137
before and after the Catastrophe (Konoplya and Rolevich, 1996; Imanaka, 1999)
Gomel Province Mogilev Province
Contamination,
Ci/km2 1977–1985 1986–1994 1977–1985 1986–1994
<5 181.0 ± 6.7 238.0 ± 26.8 248.8 ± 14.5 306.2 ± 18.0∗

5–15 176.9 ± 9.0 248.4 ± 12.5∗ 241.8 ± 15.4 334.6 ± 12.2∗
>15 194.6 ± 8.6 304.1 ± 16.5∗ 221.0 ± 8.6 303.9 ± 5.1∗
∗
P < 0.05.
Yablokov: Oncological Diseases after Chernobyl 163
TABLE 6.2. Cancer Morbidity of Belarussian Liquidators (per 10,000), 1993–2003 (Okeanov et al.,
2004)
Morbidity Regression coefficient
Liquidators Controls∗∗ Liquidators Controls∗∗
All cancers 422.2 ± 20.6∗ 366.4 ± 5.3 13.15 ± 5.29∗ 4.69 ± 1.10
Stomach 41.1 ± 3.4 42.9 ± 1.2 1.99 ± 0.92 −0.99 ± 0.19
Rectal 19.1 ± 2.1 16.1 ± 0.4 1.14 ± 0.59∗ 0.24 ± 0.12
Lung 55.6 ± 5.4 53.6 ± 1.2 3.78 ± 1.26∗ −0.38 ± 0.31
Kidney 15.7 ± 1.9∗ 10.8 ± 0.5 1.78 ± 0.27∗ 0.68 ± 0.16
Bladder 16.7 ± 1.2∗ 13.8 ± 0.8 0.89 ± 0.23 0.28 ± 0.12
Thyroid 28.4 ± 4.1∗ 10.1 ± 1.0 1.08 ± 1.03 0.8 ± 0.18
∗
p < 0.05; ∗∗ From the less contaminated Vitebsk Province (excluding liquidators and those who migrated to the
province from the contaminated regions).
in the years from 1986 to 1994 (Zborovsky et al., 6.1.2. Ukraine

1995).
9. Calculated on the basis of official data 1. The cancer morbidity of evacuees from
for the years 1990 to 2004, Belarussian pa- the heavily contaminated territories is no-
tients diagnosed with cancer for the first time ticeably higher than in the rest of the
has increased from 0.26 to 0.38% (up 46%), country (Tsimliakova and Lavrent’eva, 1996;
and in Gomel Province, from 0.25 to 0.42% Golubchykov et al., 2002).
(up 68%). This marked deviation from the 2. In the heavily contaminated territories
long-term trend of cancer mortality is very cancer morbidity increased 18–22% in the 12
likely connected to the Chernobyl contamina- years following the catastrophe, and rose by
tion (Figure 6.1). 12% in the entire country (Omelyanets et al.,
10. Up to 62,500 radiation-induced cancers 2001; Omelyanets and Klement’ev, 2001).
are predicted to occur in Belarus over a period 3. For adults in the contaminated districts of
of 70 years after the catastrophe (Malko, 2007). Zhytomir Province cancer morbidity increased
nearly threefold in 1986–1994: from 1.34 to
3.91% (Nagornaya, 1995).
TABLE 6.3. Cancer Morbidity (per 10,000) in Two

Belarussian Liquidator Groups Exposed in Differ-
ent Periods in 1986, 1993–2003 (Okeanov et al.,
2004)
Liquidators Liquidators
May–June July–December
1986 1986 Controls
All cancers 456.1 ± 10.3∗ 437.8 ± 10.3∗ 366.4 ± 5.3

Stomach 50.4 ± 3.4 ∗ 42.6 ± 3.2 42.9 ± 1.2
Rectal 18.7 ± 2.1 25.5 ± 2.5∗ 16.1 ± 0.4
Lung 57.9 ± 3.7 67.1 ± 4.0∗ 53.6 ± 1.2
Kidney 20.3 ± 2.2∗ 20.6 ± 2.2∗ 10.8 ± 0.4
Bladder 20.6 ± 2.2∗ 16.6 ± 2.0∗ 13.8 ± 0.8 Figure 6.1. First-time-registered cases of cancer
Thyroid 40.0 ± 3.1∗ 25.2 ± 2.5∗ 10.1 ± 1.0 in Belarus from 1975 to 2005. Deviation from the
trend after 1986 is very likely associated with addi-
∗
p < 0.05 from controls. tional Chernobyl-related cancers (Malko, 2007).
164
TABLE 6.4. Childhood Cancer Morbidity (per

100,000) in Tula Province under Various Levels
of Contamination, 1995–1997 (Ushakova et al.,
2001)
Districts Morbidity
“Clean” 7.2
≥3 Ci/km2 18.8
4. Among male liquidators there were 5,396

cases of cancer from 1986 to 2004, whereas
the expected number for that period was 793
(Prysyazhnyuk et al., 2007). Figure 6.2. Comparison of the general cancer
5. Cancer morbidity for both men and morbidity (per 100,000 for solid tumors) in heav-
women liquidators increased significantly from ily contaminated Bryansk Province to less contami-
1990 to 2004 (National Ukrainian Report, nated Kaluga Province and to Russia (Ivanov and
2006). Tsyb, 2002).
6.1.3. Russia 15 Ci/km2 or more in Bryansk Province was

1. In 1997 childhood cancer morbidity in 2.7-fold higher than in the less contaminated
the contaminated provinces of Bryansk, Oryol, areas (Ushakov et al., 1997).
Tula, Lipetsk, and Smolensk markedly ex-
ceeded that in all of Russia (Ushakova et al., 6.1.4. Other Countries
2001).
2. Cancer morbidity in children from areas 1. BULGARIA. According to official eval-
contaminated by Cs-137 of 3 Ci/km2 or more uations some 500 deaths were caused
in Tula Province increased 1.7-fold from 1995 by Chernobyl-radiation-induced cancers
to 1997 and was noticeably higher than in less (Dymitrova, 2007).
contaminated areas (Table 6.4). 2. POLAND. It has been estimated that dur-
3. Within 5 years after the catastrophe ing the next 50 years there will be an annual
the number of malignant neoplasms diag- additional 740 to 6,600 cancer-related deaths
nosed for the first time in Bryansk and Oryol owing to the catastrophe, which will account
provinces increased 30% compared with the for about 1–9% of all cancer-related deaths in
pre-Chernobyl period (Parshkov et al., 2006). the country (Green Brigade, 1994).
4. In 1995 cancer morbidity in the heavily 3. SWEDEN. A multifaceted epidemiologi-
contaminated districts of Kaluga, Oryol, Tula, cal study based on a comparison of hundreds
and Bryansk provinces was noticeably higher of administrative units with different levels of
than in the less contaminated areas (Ushakov Chernobyl Cs-137 contamination revealed un-
et al., 1997). equivocally an increased incidence of all ma-
5. General cancer morbidity for solid tumors lignancies in northern Sweden, the most con-
in Bryansk Province has exceeded the country taminated territory in that country (Tondel,
average since 1987, even according to official 2007). “More than 1,000” cancer deaths in
data (Figure 6.2). Norrland Province, Sweden, between 1986 and
6. Nine years after the catastrophe general 1999 have been attributed to the Chernobyl
cancer morbidity in districts contaminated by fallout (Abdelrahman, 2007).
6.2. Thyroid Cancer
The initial reports of a rise in the incidence

of thyroid cancer in 1991–1992 were criti-
cized and the figures attributed to such fac-
tors as increased screening, random variation,
and wrong diagnoses (for a review see Tondel,
2007).
The incidence of thyroid cancer requires spe-
cial attention, as it is the most prevalent of all
malignant neoplasms caused by the catastro-
phe. As the thyroid is a critical part of the Figure 6.3. Annual thyroid cancer incidence
endocrine system, the gland’s dysfunction re- rates in Belarus and Ukraine (per 100,000) for indi-
viduals who were children and adolescents in 1986
sults in many other serious illnesses. The clinical
(Fairlie and Sumner, 2006).
and molecular features of thyroid cancers that
developed following Chernobyl are unique.
6.2.1.1. Belarus
Chernobyl thyroid cancers virtually always
occur in the papillary form, are more aggres- 1. Thyroid cancer morbidity in children and
sive at presentation, and are frequently associ- adults has increased sharply in the country
ated with thyroid autoimmunity. Furthermore, since 1990 (Figure 6.4).
many have an unusual subtype with a large solid 2. Thyroid cancer morbidity in children and
component, grow rapidly, and have high rates adults began to increase sharply after 1989, and
of local and remote metastases (Williams et al., childhood morbidity reached a maximum in
2004; Hatch et al., 2005; and many others). 1995–1996, whereas that for adults continued
They also often precede or are accompanied upward until 2003 (Figure 6.5).
by radiation-induced benign thyroid nodules, 3. Childhood thyroid cancer morbidity in-
hypothyroidism, autoimmune thyroiditis, and creased 43-fold (∼ 0.003–0.13 cases per 1,000)
thyroid insufficiency. from 1989 to 1994 (Lomat’ et al., 1996).
4. After 20 years the incidence of thyroid can-
cer among individuals who were under 18 years
6.2.1. How Many People Have

Thyroid Cancer?
In the first months after the catastrophe, only

several additional cases were predicted, then
hundreds, but then no more than several thou-
sand. There is one common conclusion: with-
out exception, numerous official forecasts were
optimistic—all underestimated the figures for
Chernobyl-induced thyroid cancers (Economist,
1996). The actual count of the thyroid cancer
cases differs from one report and source to an-
Figure 6.4. Prospective (by pre-Chernobyl data)
other, reflecting mostly real time changes but and real data of thyroid cancer morbidity (per
may also be due to more accurate diagnoses of 100,000) for children and adults in Belarus (Malko,
the disease (Figure 6.3). 2007).
166
Figure 6.5. General thyroid cancer morbidity for Belarussian children and adults after
the catastrophe (National Belarussian Report, 2006: fig. 4.1).
of age at the time of the catastrophe increased 10. There were more cases of thyroid cancer
more than 200-fold (Figure 6.6). in provinces that had a higher level of I-131
5. Compared to the pre-Chernobyl period, contamination (Figure 6.7).
by 2000 the number of cases of thyroid cancer
in children had increased 88-fold; in teenagers, 6.2.1.2. Ukraine
12.9-fold; and in adults, 4.6-fold (Belookaya 1. Compared to the pre-Chernobyl period,
et al., 2002). the number of cases of thyroid cancer increased
6. By the year 2000, more than 7,000 people 5.8-fold from 1990 to 1995, 13.8-fold from
were registered as suffering from thyroid cancer, 1996 to 2001, and 19.1-fold from 2002 to 2004
including more than 1,000 people who were (Tronko et al., 2006).
children at the time of the catastrophe. Annu- 2. The prevalence of invasive forms of carci-
ally some 3,000 individuals undergo surgery for noma (87.5%) indicates very aggressive tumor
thyroid cancer (Borysevich and Poplyko, 2002). development (Vtyurin et al., 2001). Clinically
7. Among 1,000 specially surveyed persons, this is expressed by a short latency period, ab-
100 had thyroid nodules and among them two sence of general body signs or symptoms, and
or three had cancer (Krysenko, 2002). high lymphatic invasiveness. Some 46.9% of
8. Congenital thyroid cancers have been di- patients have their tumor spread beyond the
agnosed in newborns (Busby, 1995). thyroid. Regional metastasis into neck lymph
9. Summary data on some cases of thyroid nodes occurred in 55.0% of patients and these
cancer in Belarus are presented in Table 6.5. required repeated operations to remove resid-
ual metastases that appeared shortly after the
initial operation. Moreover, 11.6% of patients
developed remote lung metastases (Rybakov
et al., 2000; Komissarenko et al., 2002).
3. Before the catastrophe, the occurrence of
thyroid cancer among children and adolescents
was 0.09 per 100,000; afterward, in 1990, it was
0.57–0.63 per 100,000. The greatest increase
in morbidity was recorded in young people liv-
ing in the most heavily contaminated districts
of Kiev, Chernygov, Zhytomir, Cherkassk, and
Rovno provinces (Komissarenko et al., 1995). In
Figure 6.6. Primary thyroid cancer morbidity these areas thyroid cancer morbidity reached
among those age 0 to 18 years in 1986 (National 1.32 per 100,000 persons, which was five-
Belarussian Report, 2006: fig. 4.2). fold higher than in other areas. Regression
TABLE 6.5. Number of Thyroid Cancer Cases in Belarus from Various Sources (Radiogenic Cases in
Parentheses)
Number of cases, n Period Author Comments
5,470 (3,748) 1987–1998 Ivanov & Tsyb, 2002: tab. Six most contaminated provinces
3.1, p. 213 (calculated by A. Yablokov, based
on the pre-Chernobyl level)
(1,067) 1990–1998 UNSCEAR, 2000 In persons aged 0–17 years at the
time of the meltdown
(4,409) 1986–2000 Malko, 2002 Including 700 in children
(674) 1986–2000 Demidchik et al., 2002 In children aged 0–14 years
“More than 8,000” 1986–2000 Belookaya et al., 2002
“About 6,000 operated” 1997–2000 Drozd, 2001 Including 1,600 children
“More than 7,000” Up to 2001 Borysevich and Poplyko, In persons aged 0–17 years at the
(1,000); 3,000 2002 time of the meltdown
postsurgery cases
annually
(2,430) 1986–2004
(2,399) 1990–2004 National Belarussian In persons 0–18 years at the time of
Report, 2006∗ the meltdown
9,650 (4,560–6,840, Jan. 1987– Malko, 2004 In persons 0–14 years at the time of
average about 5,700) Dec. 2002 the meltdown
About 7,000 1986–2004 Malko, 2007 In persons 0–14 years at the time of
the meltdown
8,161 (1,670) 1986–2001 Ostapenko, 2002 Belarussian Ministry of Health data
1,055 new cases 2002 alone Postoyalko, 2004
2,200 postsurgery children 1988–2004 Lypik, 2004
More than 10,000 1987–2004 Nesterenko, pers. comm. Based on official data
postsurgery (all ages)
12,136 1986–2004 Demidchik, 2006
coefficients that reflect time trends are: all of 100 kBq/m2 the incidence was four and six-
Ukraine, 0.12 ± 0.01 (per 100,000 per year); teen cases per 100,000, respectively, in males
Kiev Province, 0.41 ± 0.07; Kiev City, 0.52 ± and females in 1998 and 1999 (Romanenko
0.05; Zhytomir Province, 0.22 ± 0.03; other et al., 2004; Prysyazhnyuk et al., 2005).
contaminated territories, 0.41 ± 0.06. The 5. A survey of 26,601 children in 1998 re-
first cases of thyroid cancer in children under vealed that for each case of thyroid cancer there
14 years of age living in contaminated terri- were 29 other thyroid pathologies (Shybata
tories were registered in 1990. From 1980 to et al., 2006).
1990 instances of this cancer were not tabu- 6. According to the Ukrainian State Reg-
lated and registered in the areas under study ister for the period from 1982 to 2003
(Prysyazhnyuk et al., 2005). the incidence of thyroid cancer rose signifi-
4. In the Chernygov, Kiev, and Zhytomir cantly after 1991 for three different cohorts
provinces from 1990 to 1999, where I-131 fall- studied: liquidators who worked 1986–1987,
out was recorded, the incidence of thyroid can- evacuees from Pripyat City and the 30-km
cer was dependent on the level of that fallout. exclusion zone, and residents in the radioac-
Truncated age-standardized incidence rates in tively contaminated areas (Prysyazhnyuk et al.,
territories with contamination less than 100 2002).
kBq/m2 did not exceed two and five cases 7. Various estimations of the numbers of the
per 100,000, respectively, in males and females. thyroid cancer cases in Ukraine are presented
In territories with contamination greater than in Table 6.6.
168
Figure 6.7. Thyroid cancer morbidity in five contaminated provinces of Belarus and
Minsk compared to the least contaminated Grodno Province. The increase in cancer cases in
the rather less contaminated Vitebsk Province and the city of Minsk may reflect the inflow of
evacuees and refugees (Malko, 2007).
8. A sharp increase in cases of thyroid cancer roid cancer in various provinces is illustrated in
began after 1989 in persons who were 0 to Figure 6.10.
18 years of age at the time of the catastrophe 11. Thyroid cancer morbidity markedly in-
(Figure 6.8). creased in liquidators after 2001 (Law of
9. Thyroid cancer morbidity for women in Ukraine, 2006).
the heavily contaminated territories is more
than fivefold higher than for men (Figure 6.9). 6.2.1.3. Russia
10. In 1998–1999, thyroid cancer morbidity 1. Thyroid cancer morbidity in the age group
was significantly higher in territories contami- 0–30 years increased 1.5-fold from 1991 to
nated at a level higher than 100 kBq/m2 than 1998 (Ivanov and Tsyb, 2002).
in areas with levels of less than 100 kBq/m2 2. From 1986 to 2000 thyroid cancer mor-
(Prysyazhnyuk et al., 2007). Incidence of thy- bidity for the entire population of Bryansk
TABLE 6.6. Number of Thyroid Cancer Cases in Ukraine (Radiogenic Cases Parentheses)
Number of cases, n Years Author Comments
1,420 (585) 1990–1997 UNSCEAR, 2000 Persons aged 0 – 15 years at the time
of the meltdown
3,914 1986–1996 Dobyshevskaya et al., 1996 Including 422 children
(937) 1986–1997 Interfax-Ukraine, 1998 Referring to official data
(1,217) 1986–1999 Associated Press, 2000 Referring to official data
(1,400) 1986–1999 Reuters, 2000 Referring to official data
(572) 1986–2000 Tronko et al., 2002 Children aged 0–14 years
2,371 postsurgery 1986–2002 Tsheglova, 2004 Children aged 0–17 years at the time
of the meltdown
2,674 postsurgery 1988–2004 Anonymous, 2005 Children
(585) 1990–2004 Prysyazhnyuk, 2007
3,385 1986–2004 National Ukrainian Report, Children aged 0–18 years at the time
2006: fig. 5.2 of the meltdown (11 died)
Province increased 4.2-fold (3.3–13.8 cases per 4. Since 1995 thyroid cancer morbidity in
100,000) and to 20.7 cases in children in the the southwest districts contaminated at a level
heavily contaminated districts (Kukishev et al., higher than 5 Ci/km2 has become significantly
2001; Proshin et al., 2005). higher than the province’s average (Kukishev
3. Thyroid cancer morbidity in Bryansk et al., 2001).
Province was twice that in Russia from 1988 5. Thyroid cancer morbidity in children in-
to 1998 and triple that from 1999 to 2004 creased significantly in Tula Province from
(Malashenko, 2005). The real level of thyroid 1986 to 1997 compared with the years before
cancer in Bryansk Province might be up to four the catastrophe (Ushakova et al., 2001).
times higher than the official 13.8 cases per 6. Since 1991, thyroid cancer morbidity in
100,000 (Pylyukova, 2004). Bryansk Province began to increase sharply
among individuals who were under 50 years
of age at the time of the catastrophe. The rel-
ative risk of the disease for adults is twice that
for children, and higher for women (Zvonova
et al., 2006).
7. There has been noticeable growth of thy-
roid cancer morbidity in children in the Ural re-
gion provinces since 1990 (Dobrynyna, 1998).
8. The thyroid cancer morbidity in Lipetsk
City increased 3.4 times from 1989 to 1995
(Krapyvin, 1997).
9. In the 10 to 15 years after the catastrophe,
thyroid cancer morbidity in Oryol Province in-
creased eightfold (Parshkov et al., 2006).
10. Thyroid cancer morbidity in both chil-
dren and adults in Oryol Province increased
Figure 6.8. Number of thyroid cancer cases in
sharply in the 6 to 8 years after the catas-
Ukraine among persons who were 0 to 18 years of trophe (Kovalenko, 2004). The absolute num-
age at the time of the meltdown (National Ukrainian ber of cases in the province is shown in
Report, 2006: fig. 5.2). Figure 6.11.
170
Figure 6.9. Thyroid cancer morbidity (per 100,000) in Ukraine for men and women from
1962 to 2004 (Prysyazhnyuk et al., 2007).
11. The incidence of thyroid cancer in Eu- gument is flawed. For example, the official view
ropean Russia is presented in Table 6.7. in France was that the I-131 contamination was
primarily in the southeastern part of the county
(Figure 6.12), but there are data showing that
6.2.1.4. Other Countries on some days there were heavier Chernobyl
Globally an increased incidence of thyroid clouds over the northern part of the country, in-
cancer has been reported in the last 20 years. cluding the Marne-Ardennes provinces, where
Small tumors are discovered incidentally while there was increasing incidence of thyroid can-
exploring and treating benign thyroid diseases, cer several years later. It is important to note
which may be a reason for the increase, but that not only I-131, but other radionuclides can
this cannot account for most of the increase. cause thyroid cancer.
For example, in the Marne-Ardennes French 1. AUSTRIA. An increase in the number of
provinces, the percentage of malignant thyroid thyroid cancers began in 1990 and was espe-
tumors smaller than 5 mm at diagnosis has cially high in the contaminated territories in
increased 20% (from 7 to 27%) from 1975 to 1995 (Weinisch, 2007).
2005. At the same time cancer incidence in- 2. CZECH REPUBLIC. From 1976 to 1990 thy-
creased 360% in women and 500% in men roid cancer morbidity grew 2% a year. From
(Cherie-Challine et al., 2006). 1990 there was a significant increase in the
A common argument against the “Cher- rate of this cancer for both sexes to 4.6% a
nobyl effect” of increasing thyroid cancer mor- year (95% CI: 1.2–4.1, P = 0.0003). The val-
bidity is that it does not correlate with the most ues for women are markedly higher than those
contaminated areas in 1986. However, this ar- for men. Since Chernobyl there have been 426
Figure 6.10. Thyroid cancer morbidity (per 100,000) in heavily contaminated Kiev
Province and Kiev City and less contaminated Zhytomir Province (Prysyazhnyuk, 2007).
Figure 6.11. Absolute number of thyroid cancer cases in children and teenagers who
were newborn to 18 years of age at the time of the meltdown (above) and among the adult
population (below) in the Oryol Province from 1986 to 2000 (Golyvets, 2002).
TABLE 6.7. Number of Thyroid Cancer Cases in European Russia According to Various Sources (Ra-
diogenic Cases in Parentheses)
Number of cases, n Years Author Comments
4,173 (2,801) 1987–2000 Ivanov and Tsyb, 2002 Four most contaminated provinces (calculated by
A. Yablokov based on the pre-Chernobyl level)
(205) 1990–1998 UNSCEAR, 2000 Whole country; persons aged 0–17 years at the time
of the meltdown
1,591 1986–2000 Kukishev et al., 2001 Bryansk Province (more than 50 times higher than
for 1975–1985)
2,638 1986–2005 Malashenko, 2005 Bryansk Province
2,100 (1,071) 1991–2003 Tsheglova, 2004 Reference to A. F. Tsyb’s oral message
(“Nearly 1,800”) 1986–1999 UNSCEAR, 2000
172
Figure 6.12. Total I-131 contamination of France originating from Chernobyl (Cherie-
Challine et al., 2006).
more cases of thyroid cancer in the Czech Re- 5. GREECE. For three years after the catas-
public alone (95% CI: 187–688) than had been trophe, from 1987 to 1991, there was a sig-
predicted prior to the meltdown (Mürbeth et al., nificant increase in papillary thyroid can-
2004; Frentzel-Beyme and Scherb, 2007). After cer (more common in women), as well as
the catastrophe, the thyroid cancer incidence mixed forms of cancer (Figure 6.14). An in-
reveals an additional annual increase of up to creased incidence of papillary carcinomas was
5% depending on age and gender (Frentzel- seen after 1995, reaching the maximum value
Beyme and Scherb, 2007). in the year 2000 and is likely associated
3. FRANCE. From 1975 to 1995, the incidence with the Chernobyl fallout (Emmanuel et al.,
of thyroid cancer increased by a factor of 5.2 2007).
in men and 2.7 in women (Verger et al., 2003), 6. ISRAEL. Analysis of records of 5,864
but an association with the nuclear catastro- patients from the Israel National Cancer
phe was officially denied. By 1997–2001 the
rate was significantly higher in Corsica for
men and in Tarn for women. So, too, was
the rate noticeably higher for women in Calva-
dos and for men in Douds, Isere, and Marne-
Ardennes provinces (Annual Report, 2006).
Marne-Ardennes’ data are especially interest-
ing because they show the sharply increased in-
cidence of thyroid cancer soon after the catas-
trophe (Figure 6.13), practically synchronous
with the Belarussian data.
4. GREAT BRITAIN. Thyroid cancer morbid-
ity noticeably increased in northern England Figure 6.13. The thyroid cancer incidence (per
and, especially, in the most contaminated areas 100,000) in the Marne-Ardenne provinces, France,
of Cumbria, where it was up 12.2% (Cotterill for 1975–2004 (Cherie-Challine et al., 2006). Up-
et al., 2001). per curve – men, lower curve – women.
the reasons for this rise “may relate partly to

increased diagnostic vigilance and changes in
clinical practice,” time trends, gender, and eth-
nicity do not preclude Chernobyl influence.
7. ITALY. There was a twofold increase in thy-
roid cancer morbidity from 1988 to 2002, espe-
cially expressed after 1992. It was claimed that
this increased incidence was most likely due to
improved and more powerful diagnostic tech-
niques, not to Chernobyl-related factors, which
“although possible, is not envisaged at this mo-
ment” (Pacini, 2007). However, it is noted that
this conclusion was based on a cancer reg-
istry that included only 25.5% of the Italian
population.
8. POLAND. There is a noticeable in-
crease in thyroid cancer morbidity in contami-
nated territories among adolescents and adults
(Szybinski et al., 2001, 2005). Owing to the
Chernobyl catastrophe an additional 80–250
Figure 6.14. The incidence of the thyroid can-
cer by different histological types and by gender in
thyroid cancer deaths are estimated to occur
Greece in 1963–2000 (Ilias et al., 2002). annually (Green Brigade, 1994).
9. ROMANIA. Thyroid cancer morbidity in-
creased in the most contaminated areas of east-
Registry reveal a significant increase in the ern Romania. This increase started in 1990,
age-standardized incidence rate (per 100,000) and by 1997–1998 was much higher than
for thyroid cancer, due primarily to papillary during the pre-Chernobyl years (Davydescu,
carcinoma diagnosed between 1992 and 1996 2004). The maximum incidence rate for thyroid
in comparison with patients diagnosed earlier: cancer in Cluj City was registered in 1996—
1982–1986 (86 vs. 78%, P < 0.01; Lubyna et al., 10 years after the catastrophe (Salagean et al.,
2006). In spite of the author’s conclusion that 1998; Figure 6.15).
Figure 6.15. Thyroid cancer morbidity (cases per 10,000) in contaminated areas af-
ter the catastrophe in eastern Romania and the whole of Romania from 1982 to 1998
(Davydescu, 2004).
174
Figure 6.16. Papillary thyroid cancer incidence in women, United States from 1975 to
1997 (Wartofsky, 2006).
10. SWITZERLAND. Within-country geo- 6.2.2. How Many and When Will New
graphical comparisons for current incidence Cases of Chernobyl Thyroid Cancer
rates by the Swiss Cancer Registries Network Occur?
detected an increase over time for papillary
cancers and a decrease for other types. In 1990, when the serious increase in the
Age-period-cohort analyses revealed that the incidence of thyroid cancer in contaminated
youngest cohorts of men and women born territories had already begun, official medi-
after 1940 had an increased risk of all types of cal representatives from the Soviet Union in-
thyroid cancer, whereas the cohort of people dicated they expected 100 additional cases to
born between 1920 and 1939 were at increased be induced by the catastrophe’s radiation (e.g.,
risk of the papillary subtype. As cautiously Ilyin et al., 1990). The added risk of thyroid
noted by F. Montanaro, “Assuming a higher cancer after Hiroshima and Nagasaki radia-
sensitivity to ionizing radiation among the tion was highest 10 to 15 years later, with cases
youngest people, a Chernobyl effect cannot be appearing 40 to 50 years afterward (Demidchik
definitively excluded and continuous study of et al., 1996). On this basis, it is predicted that
this topic should be encouraged” (Montanaro the number of Chernobyl thyroid cancers will
et al., 2006). increase worldwide until 2011 (Tsyb, 1996;
11. UNITED STATES. From 1988 there was Goncharova, 2000). Various forecasts for fu-
a marked increase in papillary thyroid cancer ture additional radiogenic thyroid cancers are
incidence in women (Figure 6.16), which may shown in Table 6.8.
partly be explained by Chernobyl radiation. In The calculations in Table 6.8 are based on
Connecticut there were two separate fallouts the collective dose estimates and risk coeffi-
of Chernobyl radionuclides (in the middle of cients for I-131 by the United Nations Sci-
May and the second half of June, 1986), re- entific Committee on the Effects of Atomic
sulting in a 7- to 28-fold increased level of I- Radiation (UNSCEAR), and it is entirely pos-
131 in milk. The rate of thyroid cancer among sible that the determinations of collective doses
Connecticut children under the age of 15 years were seriously underestimated (see, e.g., Fairlie
rose sharply (from 0.16 to 0.31 per 100,000) and Sumner, 2006) and that the risk factors
from 1985–1989 to 1990–1992. During the that were used were not reliable (Busby, 2004).
same period rates of thyroid cancer for all One also has to consider that the thyroid
age groups jumped to 23% (from 3.46 to 4.29 cancers were caused not only by I-131, but
per 100,000), after 10 previous years without also by other isotopes of iodine including I-
change (Figure 6.17). 129 and by Te-132, Ru-103, and Ru-106, as
Figure 6.17. Thyroid cancer incidence in children (per 1,000,000), age adjusted rate
1935–1992, and I-131 concentration in milk for Connecticut (Reid and Mangano, 1995).
TABLE 6.8. Future Predicted Chernobyl-Induced Thyroid Cancers According to Various Sources
Number of cases Period Author Comments
Belarus
1,100 in boys, 2,300 in girls Up to 2056 Demidchik et al., 1999 In persons aged 0–17 years at the
(whole country); 730 in boys, time of the meltdown
1,500 in girls (Gomel Province)
12,500 (whole country) All time Ostapenko, 2002; In persons aged 0–17 years at the
Fedorov, 2002 time of the meltdown
15,000 (whole country) Up to 2053 National Belarussian
Report, 2003
14,000–31,400 (whole country) Up to 2056 Malko, 2007
50,200 (Gomel province), “from All time Brown, 2000 Data from the International Agency
above 5,000” (Mogilev for Research on Cancer (IARC)
Province)
“Up to 50,000” (whole country) All time Krysenko, 2002; In today’s adolescents and young
Fedorov, 2002 people
Russia
3,700 (Kaluga, Tula, and Oryol All time Brown, 2000 Data from the International Agency
provinces) for Research on Cancer (IARC)
659 (Bryansk, Tula, Kaluga, All time Demidchik et al., 1996
Oryol, Kursk, Ryazan, and
Leningrad provinces)
Belarus, Ukraine, Russia
50,330 All time Malko, 1998 Including 5,230 fatalities
93,00–131,000 All time Gofman, 1994b
176
well as being a result of the adverse effects of TABLE 6.9. Predicted Radiogenic Thyroid Cancer
Cs-134 and Cs-137. Therefore, the forecasts Cases and the Resultant Death Toll in Europe from
1986 to 2056 (Malko, 2007)
in Table 6.8 should be considered minimal
estimates. Number of Included
Based on real numbers of radiogenic can- Country cases, n fatalities
cers recorded for 1986–2000 in the contam- Belarus 31,400 9,012
inated territories of Belarus and Ukraine, V. Ukraine 18,805 5,397
Malko (2007) calculated a parity between the Russia 8,626 2,476
level of radiation and the number of additional Yugoslavia 7,137 2,048
cases due to the influence of that radiation (i.e., Italy 5,162 1,481
Romania 3,976 1,141
number of cancers vs. dose of radiation). This
Poland 3,221 924
can also be done by comparing spontaneous, Greece 2,879 826
pre-Chernobyl and post-Chernobyl instances Germany 2,514 721
of cancer. The post-Chernobyl number is 5.5- Czech and Slovakia 2,347 674
fold higher than was predicted by most known Bulgaria 1,619 465
international forecasts (Cardis et al., 2006). France 1,153 331
Switzerland 898 258
Malko also recalculated the relative num- Austria 812 233
ber of cases of cancer per dose of Chernobyl Great Britain 418 120
radionuclide fallout on populations of Euro- Finland 334 96
pean countries. The results of these calculations The Netherlands 328 94
(as future instances of cancer and the related Hungary 270 78
Belgium 239 69
death toll) for the total lifetime of the “Cher-
Sweden 165 47
nobyl generation” (1986–2056) are presented Norway 136 39
in Table 6.9. Ireland 100 29
The confidence interval for all of Europe is Spain 54 15
46,313–138,936 cases of thyroid cancer and Denmark 19 5
13,292–39,875 deaths (Malko, 2007: table 3). Luxembourg 13 4
Portugal 2 1
These calculations do not include the liquida- European Total 92,627 26,584
tors, of which a significant number (830,000) do Included figures 58,831 16,885
not live in the contaminated territories. Malko’s for Belarus, Ukraine,
numbers could be lower owing to severe re- and Russia
strictions on the consumption of vegetables and
milk in many European countries on the second
and third days after the catastrophe. Conversely
the number of cases may increase owing to ex- In spite of the fact that the majority of vic-
posure of several new generations to continuing tims undergo surgery, cancer continues to de-
Cs-137 radiation. velop in approximately one-third of the cases
The prevalence and appearance of Cher- (Demidchik and Demidchik, 1999). Moreover,
nobyl thyroid cancers differ widely from the without exception, despite surgical treatment,
Hiroshima and Nagasaki reference data. The the person remains impaired for the rest of
Chernobyl thyroid cancers: (1) appear much his/her life, completely dependent upon phar-
earlier (not in 10, but in 3–4 years after irradi- macological supplements.
ation); (2) develop in a much more aggressive Lastly, thyroid cancer is only the tip of the
form; and (3) affect not only children, but also iceberg for radiogenic thyroid gland disorders
adults at the time of irradiation. (see Section 5.3.2): for each case of cancer, one
It is mistaken to think that this cancer is eas- finds hundreds of cases of other organic thyroid
ily treated surgically (Chernobyl Forum, 2006). gland diseases.
TABLE 6.10. Acute and Chronic Leukosis (Leukemia) Morbidity in Adults (per 100,000) in Gomel
Province, 1993–2003 (National Belarussian Report, 2006)
Whole province Heavily contaminated districts
Leukosis Before After Before After
Acute lymphoblastic 0.28 ± 0.07 0.78 ± 0.11∗∗ 0.35 ± 0.08 0.96 ± 0.28∗
Acute nonlymphoblastic 1.23 ± 0.14 1.83 ± 0.11∗∗ 1.07 ± 0.132 2.30 ± 0.31∗∗
Red cell leukemia 0.59 ± 0.11 0.93 ± 0.12 0.36 ± 0.13 1.25 ± 0.14∗∗∗
All chronic leukoses 5.72 ± 0.32 8.83 ± 0.42∗∗∗ 5.91 ± 0.21 9.94 ± 0.75∗∗∗
All leukoses 9.05 ± 0.22 11.79 ± 0.42∗∗∗ 9.45 ± 0.40 13.44 ± 0.69∗∗∗
∗
P < 0.05; ∗∗ P < 0.01; ∗∗∗ P < 0.001.
6.3. Cancer of the Blood—Leukemia 5. Since 1996 the number of preleukemia

cases has increased. For the 1986–1987 liq-
Radiogenic leukemia was detected in Hi- uidators there was a statistically significant ad-
roshima and Nagasaki a few months after the ditional number of instances of acute leukemia
bombing and morbidity peaked in 5 years. The in 1990–1991 (Ivanov et al., 1997).
latency period for radiogenic leukemia is sev- 6. There was a noticeable increase in lym-
eral months to years with the highest incidence phoid and blood-forming cancers in men and
occurring between 6 and 8 years after exposure women across Belarus in the first 5 years after
(Sinclair, 1996). Owing to the secrecy and the the catastrophe (Figure 6.18).
official falsification of data that continued for 3 7. The highest incidence rate for acute
years after the catastrophe (see Chapter 3 for and chronic leukemia and Hodgkin’s dis-
details), unknown numbers of leukemia cases ease occurred in the first 5 years after
in Ukraine, Belarus, and Russia were not in- the catastrophe. The maximum increase in
cluded in any registry. These distortions should red cell leukemias, non-Hodgkin’s lymphoma,
be kept in mind when analyzing the following and, especially, myelodysplastic syndrome oc-
data. curred 10 years after the catastrophe. In-
cidence of all forms of leukemic disease
6.3.1. Belarus was significantly higher after the catastrophe
(Table 6.11).
1. There were 1,117 cases of leukemia in 8. There were nearly 2,300 cases of leukemia
children 0 to 14 years old from 1990 to 2004 between 1986 and 2004 (Malko, 2007).
2. Since 1992 (7 years after the catastro-
phe) there has been a significant increase in
all forms of leukemia in the adult population.
The higher rate of morbidity compared with
the pre-Chernobyl data was observed in 1992–
1994 (Ivanov et al., 1996).
3. Primary lymphatic and blood-forming
cancers significantly increased among male
evacuees from 1993 to 2003 (National Belarus-
sian Report, 2006).
Figure 6.18. Lymphoid and blood-forming tu-
4. Leukemia morbidity in Gomel Province mors in Belarus, 1985–1998: (upper curve) men,
adults increased significantly after the catastro- (middle) both sexes, (lower) women (Okeanov et al.,
phe (Table 6.10). 2004).
178
TABLE 6.11. Leukemia Morbidity (per 100,000) among the Adult Population of Belarus, 1979–1997
(Gapanovich et al., 2001)
Number of
Leukemia types cases, n 1979–1985 1986–1992 1993–1997
Acute leukemia 4,405 2.82 ± 0.10 3.17 ± 0.11∗ 2.92 ± 0.10

Chronic leukemia 11,052 6.09 ± 0.18 8.14 ± 0.31∗ 8.11 ± 0.26∗
Erythremia n/a 0.61 ± 0.05 0.8 ± 0.05∗ 0.98 ± 0.05∗
Multiple myeloma 2,662 1.45 ± 0.06 1.86 ± 0.06∗ 2.19 ± 0.14∗
Hodgkin’s disease 4,870 3.13 ± 0.10 3.48 ± 0.12∗ 3.18 ± 0.06
Non-Hodgkin’s lymphoma 5,719 2.85 ± 0.08 4.09 ± 0.16∗ 4.87 ± 0.15∗
Myelodysplastic syndrome 1,543∗∗ 0.03 ± 0.01 0.12 ± 0.05∗ 0.82 ± 0.16∗
∗
P < 0.05 from pre-Chernobyl status; ∗∗ all cases of bone marrow depression.
9. There was a significant increase in posed in utero in the contaminated areas of

leukemia morbidity for the elderly 15 years Zhytomir Province was compared with chil-
after the catastrophe (Medical Consequences, dren born in the less contaminated Poltava
2003). Province. Risk ratios based on cumulative
10. After the catastrophe many forms incidence show significant increases for all
of leukemic disease in adults significantly leukemia (rate ratio: 2.7, 95% CI: 1.9–3.8) and
increased in Mogilev and Gomel provinces for acute lymphoblastic leukemia (rate ratio:
(Tables 6.12 and 6.13). 3.4, 95% CI: 1.1–10.4; Noshchenko et al., 2001,
2002).
6.3.2. Ukraine 4. From 1993 to 1997 there were 652 cases
of acute leukemia (AL) in Kiev City and
1. There was an increase in acute leukemia in Kiev Province, including 247 cases in children
children from the contaminated regions com- (Gluzman et al., 1998).
pared with clean areas 10 to 14 years after the 5. Morbidity from leukemia in the heavily
catastrophe (Moroz, 1998; Moroz et al., 1999; contaminated provinces was significantly ele-
Moroz and Drozdova, 2000). vated among children born in 1986 and the
2. For children, leukemia morbidity began to high morbidity continued for 10 years postex-
increase in 1987 and peaked in 1996 (Horishna, posure. Rates of acute lymphoblastic leukemia
2005). (ALL) were dramatically elevated for males and
3. Leukemia incidence in 1986–1996 among to a lesser extent for females. For both gen-
Ukrainian children born in 1986 and thus ex- ders combined, the morbidity for ALL was
TABLE 6.12. Leukosis (Leukemia) (per 100,000) among the Adult Population in Mogilev and Gomel
Provinces before and after the Catastrophe∗ (National Belarussian Report, 2006: tables 4.2 and 4.3)
Mogilev Province Gomel Province
1979–1985 1993–2003 1979–1985 1993–2003
Acute lymphoblastic leukosis 0.5 ± 0.1 0.8 ± 0.1 0.2 ± 0.07 0.8 ± 0.1
Acute nonlymphoblastic leukosis 0.3 ± 0.1 1.7 ± 0.2 1.2 ± 0.1 1.8 ± 0.1
Erythremia 0.4 ± 0.1 0.8 ± 0.1 0.6 ± 0.1 0.9 ± 0.1
Others chronic leukoses 0.2 ± 0.1 0.7 ± 0.1 0.2 ± 0.05 1.0 ± 0.1
All leukoses 9.8 ± 0.6 12.1 ± 0.4 9.1 ± 0.2 11.8 ± 0.4
∗
TABLE 6.13. Multiple Myeloma, Non-Hodgkin’s Lymphoma, and Hodgkin’s Disease Morbidity in Adults
in Gomel and Mogilev Provinces before and after the Catastrophe (National Belarussian Report, 2006:
table 4.4.)
Mogilev Province Gomel Province
1979–1985 1993–2003 1979–1985 1993–2003
Multiple myeloma 1.68 ± 0.15 2.39 ± 0.20∗ 1.24 ± 0.12 2.22 ± 0.14∗∗
Hodgkin’s disease 3.90 ± 0.14 3.06 ± 0.11∗∗ 2.95 ± 0.19 3.21 ± 0.23
Non-Hodgkin’s lymphoma 2.99 ± 0.21 5.73 ± 0.25∗∗ 2.83 ± 0.20 5.57 ± 0.30∗∗
∗
P <0.05; ∗∗ P < 001.
more than threefold higher in the heavily crease in lymphosarcoma and reticulosarcoma
contaminated provinces compared to those less (Table 6.15).
contaminated (Noshchenko et al., 2001). 10. There was a significant increase in
6. In the children born in 1986–1987 the number of leukemia cases in liquida-
who developed acute leukemia, an increas- tors 15 years after the catastrophe (National
ing relative number of acute myeloid leukemia Ukrainian Report, 2006; Law of Ukraine,
(AML) cases were reported (21.2 and 25.3% 2006).
in 1986 and 1987, respectively; Gluzman et al., 11. The incidence of multiple myeloma
2006). among liquidators was twice as high as in the
7. During the first 4 years after the catas- general population (7.8 vs. 4.0%). Five 1986–
trophe, malignant blood diseases were sig- 1987 liquidators were diagnosed with an un-
nificantly higher in the four most contami- usual chronic lymphoproliferative disorder—
nated districts of Zhytomir and Kiev provinces large granular lymphocytic leukemia (Gluzman
compared with the pre-Chernobyl period and et al., 2006).
1999–2000 (Figure 6.19).
8. Blood neoplasms were especially high in 6.3.3. Russia
children during the first 5 years after the catas-
trophe, and among liquidators who worked in 1. Childhood leukemia morbidity increased
1986–1987, the maximum incidence occurred in the Tula Province after the catastrophe
4 to 11 years after the catastrophe (Table 6.14). (Table 6.16) and significantly exceeded the
9. During the first 4 years after the catas- Russian average. Acute leukemia in children
trophe there was an increase in myeloid was especially high (Ushakova et al., 2001).
leukemia in the first and third years; during 2. In Bryansk Province all forms of
the second 4 years there was a significant in- leukemia and non-Hodgkin’s lymphoma were
Figure 6.19. Leukemia and lymphoma morbidity (age adjusted, per 100,000, men and
women) in Ukraine, 1980–2000 (Prysyazhnyuk et al., 2002).
180
TABLE 6.14. Leukemia Morbidity (Standardized 6. In the city of Lipetsk, leukemia mor-
Data, per 100,000) in Ukraine (Prysyazhnyuk bidity increased 4.5-fold from 1989 to 1995
et al., 2002)
(Krapyvin, 1997).
Number of cases 7. In 10 to 15 years after the catastrophe,
Person/ SIR
Years years Observed Expected (%) lymphatic and blood-forming cancer morbidity
doubled (Parshkov et al., 2006).
Leukemia, children, contaminated districts of the Kiev 8. Among liquidators, the first case of
and Zhytomir provinces leukemia was officially registered in 1986; by
1980–1985 337,076 19 10.88 174.7 1991 there were already 11 such cases (Ivanov
1986–1991 209,337 22 6.78 324.4
1992–1997 150,170 7 4.87 143.7
et al., 2004: table 6.6).
1998–2000 80,656 0 2.59 0.0 9. In 10 to 12 years after the catastrophe
Leukemia and lymphoma, evacuees, men and women the number of leukemia cases among 1986–
1990–1993 208,805 43 30.0 143.4 1987 liquidators was double the average for the
1994–1997 200,077 31 29.6 104.7 country (Tsyb, 1996; Zubovsky and Smirnova,
Leukemia and lymphoma, liquidators (1986–1987), men 2000).
1990–1993 263,084 81 31.8 255.0
10. By 2004, lymphatic and blood-forming
1994–1997 314,452 102 49.9 204.6
cancer morbidity in liquidators was twice as
high as the country average (Zubovsky and
significantly higher 7 years after the catastrophe Tararukhyna, 2007).
compared to the 6 years prior to the catastro-
phe (UNSCEAR, 2000).
6.3.4. Other Countries
3. A marked increase in acute lymphocyte
leukemia occurred in the six most contami- 1. GERMANY. There was 1.5-fold increase in
nated districts of Bryansk Province from 1986 the incidence of leukemia among infants born
to 1993 (Ivanov and Tsyb, 2002). in West Germany between July 1, 1986, and
4. Since 1995 blood-related and lymphatic December 31, 1987 (Pflugbeil et al., 2006).
cancer morbidity in the southwest districts (con- 2. GREAT BRITAIN. In 1987 in Scotland
taminated by ≥5 Ci/km2 ) was significantly leukemia in children under the age of 4 years
higher than the province’s average (Kukishev rose by 37% (Gibson et al., 1988; Busby and
et al., 2001). Scot Cato, 2000; Busby, 2006).
5. From 1990 to 1994, children in Tula 3. GREECE. Infants born between July 1,
Province became ill significantly more often 1986, and December 31, 1987, and exposed
with tumors of the bone, soft tissue, and the to Chernobyl fallout in utero had 2.6 times the
central nervous system (Ushakova et al., 2001). incidence of leukemia compared to children
TABLE 6.15. Leukemia and Lymphoma Morbidity (per 10,000) in Five of the Most Contaminated
Districts of Zhytomir and Kiev Provinces (Prysyazhnyuk et al., 2002)
Occurrence
1980–1985 1986–1991 1992–1997 1998–2000
Leukemia and lymphoma 10.12 ± 0.75 15.63 ± 1.06 13.41 ± 1.10 13.82 ± 1.52
Lympho- and reticulosarcoma 1.84 ± 0.33 2.70 ± 0.41 3.70 ± 0.58 3.36 ± 0.90
Hodgkin’s disease 1.82 ± 0.34 2.47 ± 0.48 2.10 ± 0.48 1.23 ± 0.50
Multiple myeloma 0.54 ± 0.16 1.03 ± 0.25 0.78 ± 0.22 1.38 ± 0.40
Lymphoid leukemia 3.08 ± 0.40 4.93 ± 0.59 2.97 ± 0.49 4.11 ± 0.75
Myeloid leukemia 0.49 ± 0.17 1.99 ± 0.41 1.06 ± 0.30 2.32 ± 0.62
TABLE 6.16. Leukemia Morbidity (per 10,000) in TABLE 6.17. Predicted Incidence of Radiogenic
Children of Tula Province, 1979–1985 and 1986– Blood Cancer (Leukemia) and the Resultant Death
1997 (Ushakova et al., 2001) Toll in Europe for the “Chernobyl Generation,”
1986–2056 (Malko, 2007)
Years Number of cases, n 95% CI
Number of Including
1979–1985 3.4 2.6–4.4 Country cases, n fatalities
1986–1997 4.1 3.4–4.9
Ukraine 2,801 1,989
Belarus 2,800 1,988
born between January 1, 1980, and December Russia 2,512 1,784
31, 1985, and between January 1, 1988, Germany 918 652
and December 31, 1990. Elevated rates were Romania 517 367
also reported for children born in regions of Austria 500 355
Great Britain 423 300
Greece with higher levels of radioactive fallout
Czech Republic 140 99
(Petridou et al., 1996). Italy 373 265
4. ROMANIA. The incidence of leukemia in Bulgaria 289 205
children born between July 1986 and March Sweden 196 139
1987 was significantly higher than for those Greece 186 132
born between April 1987 and December 1987 Poland 174 124
Finland 158 112
(386 vs. 173, P = 0.03). The most noticeable Switzerland 151 107
effect is in the newborn to 1-year-old age group Moldova 131 93
(Davydescu et al., 2004). France 121 86
5. EUROPE. Realistic prognosis of blood can- Slovenia 95 67
cer (all leukemias) morbidity and mortality is Norway 91 65
shown in Table 6.17. Slovakia 71 50
Hungary 62 44
Croatia 62 44
6.4. Other Cancers Lithuania 42 30
Ireland 37 26
There are many fragmentary reports about The Netherlands 13 9
the increased occurrence of breast, lung, and Belgium 11 8
other tumors after the Chernobyl catastrophe. Spain 8 6
Latvia 7 5
Denmark 7 5
6.4.1. Belarus Estonia 6 4
Luxembourg 2 1
1. Malignant and nonmalignant neoplasms European total 12,904 9,161
in girls (0–14 years old) born to irradiated par- Included figures 8,113 5,761
ents increased significantly from 1993 to 2003 for Belarus, Ukraine,
(National Belarussian Report, 2006). and Russia
2. From 1987 to 1990 (3 years after the catas-
trophe) there was a doubling of admissions to
the Minsk Eye Microsurgery Center to treat plasms (including leukemia) were registered in
retinal glioma (retinoblastoma; Byrich et al., the country, of which skin cancer accounted for
1994). 18.7% of the cases, lung cancer 10.5%, and
3. Lung cancer morbidity among the evac- stomach cancer 9.5%. Approximately 11,000
uees (about 32,000 examined) was fourfold people died, 20.3% because of lung cancer and
higher than the country average (Marples, 18.4% from stomach cancer (Okeanov et al.,
1996). 1996; Goncharova, 2000).
4. From 1987 to 1999, approximately 26,000 5. From 1990 to 2003, breast cancer mor-
cases of radiation-induced malignant neo- bidity rates in the districts of Gomel Province
182
Figure 6.20. Breast cancer morbidity (women, per 100,000) in Gomel Province with
various levels of Cs-137 contamination (National Belarussian Report, 2006).
contaminated by Cs-137 at a level of 185–555 for women (18%) than for men (4.4%; National
kBq/m2 and above were significantly higher Belarussian Report, 2006).
compared with districts contaminated at levels 11. The makeup of cancer morbidity
lower than 185 kBq/m2 (respectively, 30.2 ± changed markedly after the catastrophe: the
2.6; 76 ± 12; and 23.2 ± 1.4 per 100,000; proportion of stomach tumors decreased,
Figure 6.20). whereas thyroid, lung, breast, urogenital sys-
6. The incidence of breast cancer increased tem, colon, and rectal cancers increased
significantly from 1986 to 1999 for the entire (Malko, 2002).
country (1,745 to 2,322 cases; Putyrsky, 2002). 12. From 1993 to 2003 there was a significant
By 2002 breast cancer morbidity in women 45 increase in morbidity due to malignancies of
to 49 years of age increased 2.6-fold for the the intestines, respiratory organs, and urinary
whole country compared with 1982. In the tracts in men and woman liquidators (National
more contaminated Mogilev Province breast Belarussian Report, 2006).
cancer increased fourfold from 1993 to 1996
compared with the period from 1989 to 1992 6.4.2. Ukraine
(Putyrsky and Putyrsky, 2006).
7. In the heavily contaminated Gomel 1. The number of children with central ner-
Province there was a marked increase in the vous system neoplasms (including malignant
number of cases of intestinal, colon, breast, forms) increased from 1987 to 1994. The num-
bladder, kidney, and lung cancers, and the oc- ber of children admitted to the Ukrainian In-
currences correlated with the level of Cher- stitute of Neurosurgery in Kiev with brain
nobyl contamination (Okeanov et al., 1996; tumors (data on 1,699 children, aged 0 to
Okeanov and Yakymovich, 1999). 6 years) from 1987 to 1991 increased 63.7%
8. For the second quinquennium after the compared with the period from 1981 to 1985
catastrophe there was a 10-fold increase in the (Orlov, 1993, 1995; Orlov and Sharevsky, 2003;
number of cases of pancreatic cancer compared Figure 6.21).
with the first quinquennium (UNCSEAR, 2. After the catastrophe there were signif-
2000, point 258, p. 52). icant increases in bladder cancer in men in
9. Primary malignant intestinal neoplasms the contaminated territories (Romanenko et al.,
significantly increased among woman evacuees 1999).
from 1993 to 2003 (National Belarussian Re- 3. The incidence of breast cancer in the
port, 2006). most radioactively contaminated territories was
10. From 1993 to 2003 general cancer mor- almost stable from 1980 to 1992 and lower than
bidity increased significantly among men and in the large comparison areas (the whole of
women from heavily contaminated territories, Ukraine, Kiev area, and Zhytomir Province).
with the annual rate of increase being higher Then, from 1992 to 2004, the rate increased
8. The rate of oncological illnesses in liquida-

tors’ mortality increased from 9.6 to 25.2%
during the period from 1987 to 2004. For
Ukrainian adults in 2004 the rate was 9.9%
(Horishna, 2005).
9. A significant increase in urinary tract and
bladder cancers was found in the contaminated
territories of Ukraine (Romanenko et al., 1999).
In the period from 1987 to 1994, an increase in
Figure 6.21. Central nervous system tumor the number of children suffering from tumors
cases (per 10,000) in children under 3 years of age, of the nervous system was observed (Orlov,
Ukrainian Institute of Neurosurgery data for the pe-
riod 1980–2005 (Orlov et al., 2006).
1995).
10. From 1999 to 2004 cancer mortality in
liquidators exceeded similar parameters among
in the contaminated territories (Prysyazhnyuk the rest of the population (Law of Ukraine,
et al., 2007). Morbidity due to breast can- 2006).
cer in women living in the contaminated ar-
eas and among those evacuated increased 1.5- 6.4.3. Russia
fold from 1993 to 1997 (Moskalenko, 2003;
Prysyazhnyuk et al., 2002). 1. There was a noticeable increase in respi-
4. There is an increase in breast cancer in ratory tract tumors in women in the most con-
premenopausal women from contaminated ar- taminated areas of Kaluga Province (Ivanov
eas of Ukraine close to Chernobyl, compared et al., 1997).
with the general Ukrainian female population 2. Since 1995 in southwest districts contami-
(standardized incidence ratio: 1.50, 95% CI: nated at levels higher than 5 Ci/km2 , there has
1.27–1.73; Prysyazhnyuk et al., 2002, cited by been a significantly larger incidence of some
Hatch et al., 2005). cancers of the stomach, lung, breast, rectum,
5. Breast cancer morbidity in women in the and colon than the province average (Kukyshev
contaminated territories and among liquida- et al., 2001).
tors and evacuees increased significantly from 3. The incidence of oral cavity, pharyngeal,
1990 to 2004 (Moskalenko, 2003; National and adrenal cancers in Tula Province children
Ukrainian Report, 2006; Prysyazhnyuk et al., increased more than twofold from 1986 to 1997
2007). compared to the period from 1979 to 1985
6. Prostate cancer mortality increased in the (Table 6.18).
contaminated territories up to 2.2-fold and 4. Since 1990–1994 the incidence of tissue,
across all of Ukraine 1.3-fold (Omelyanets et al., bone, and central nervous system cancers in
2001). Tula Province children has been significantly
7. The Kiev Interdepartmental Expert Com- higher (Ushakova et al., 2001).
mission revealed that for liquidators, digestive 5. Melanoma of the skin increased fivefold
system tumors were the most common type and the incidence of brain cancer tripled in
of cancer (33.7%), followed by tumors of the the first 10 to 15 years after the catastrophe
respiratory system (25.3%), and tumors of the (Parshkov et al., 2006).
urogenital tract (13.1%). The fastest increase in 6. Infant mortality in the contaminated
cancer pathology was for the urogenital tract, provinces differs from the country as a whole,
for which an almost threefold increase (from with an increase in leukemia and brain tu-
11.2 to 39.5%) was observed from 1993 to 1996 mors in both boys and girls (Fedorenko et al.,
(Barylyak and Diomyna, 2003). 2006).
184
TABLE 6.18. Increase in Morbidity owing to Various Cancers in Children of Tula Province after the
Catastrophe (Ushakova et al., 2001)
Oral cavity Adrenal Genitalia Bones and All
Cancer site and pharynx glands Skin Kidneys (male) soft tissues Bladder cancers
1986–1997 compared 225% 225% 188% 164% 163% 154% 150% 113%
with 1979–1985, %
7. As of 2004, kidney and bladder cancers present the results of more realistic mortality
were the most prevalent malignancies among and morbidity calculations for Europe and the
liquidators, accounting for 17.6% of all malig- world.
nant neoplasms, double the country average of Using the methodology described above for
7.5%. Brain and laryngeal tumors also were analyses of thyroid cancers (see Section 6.2),
widespread (Khrysanfov and Meskikh, 2001; M. Malko has made the most detailed prog-
Zubovsky and Tararukhyna, 2007). nosis of Chernobyl-related cancers in Europe
and the consequent mortality over the lifespan
6.5. Conclusions of the “Chernobyl generation” (1986–2056).
Prognoses for the solid cancers are given in
UNSCEAR, along with other international Table 6.21 and those for leukemia were shown
organizations loyal to the nuclear industry, es- earlier in Table 6.17.
timated the future number of fatal cancers ow- Table 6.21 presents the average data. The
ing to Chernobyl irradiation to be between confidence limits for the incidence of can-
22,000 and 28,000, or even as few as 9,000 cer are between 62,206 and 196,611, and
(Chernobyl Forum, 2006). At the time that re- the death toll is between 40,427 and 121,277
port was issued, the number of deaths had al- (Malko, 2007). These numbers could increase
ready risen, but UNSCEAR unequivocally un- for many future generations because of con-
derestimated the number of deaths by basing its tinued radiation from the further release of
figures on false risk factors and understated col- Cs-137, Sr-90, Pu-241, Am-241, Cl-36, and
lective doses (for details see Busby et al., 2003; Tc-99.
Fairlie and Sumner, 2006). Tables 6.19 and 6.20 Undoubtedly, the above forecasts are incom-
plete. The fact is that for some years after
the catastrophe, there was a marked increase,
TABLE 6.19. Predicted Cancer Morbidity and
Mortality (Excluding Leukemia∗∗ ) Caused by
the Chernobyl Cs-137 for Future Generations∗ TABLE 6.20. Predicted Additional Chernobyl
(Gofman, 1994b: vol. 2, ch. 24, p. 5) Cancer Morbidity and Mortality in Belarus,
Ukraine, and European Russia∗ (Malko, 1998)
Number of cases
Cancer Belarus Russia Ukraine
Region Lethal Nonlethal
Thyroid—morbidity 20,300 8,000 24,000
Belarus, Ukraine, Moldova 212,150 212,150
Thyroid—mortality 2,030 800 2,400
Europe (without CIS) 244,786 244,786
Leukemia—mortality 1,300 760 1,550
Other countries 18,512 18,512
Malignant tumors, other 12,700 7,400 15,100
Total 475,368 475,368
than thyroid—mortality
∗
On the basis of an expected collective dose “indefi- Total mortality 16,030 8,960 19,050
nitely” of 127.4 million person/rad; ∗∗ Global death rate 44,040
from Chernobyl leukemia by J. Gofman calculation as of
∗
1994: 19,500 persons. Entire world: 90,000 lethal cancers.
TABLE 6.21. Predicted Incidence of Cancer Nagasaki, but in only a few years after the
Caused by Chernobyl and the Resultant Death Toll explosion. The assumption (e.g., Pryasyaznjuk
in Europe from 1986 to 2056 (Malko, 2007)
et al., 2007) that Chernobyl’s radioactive influ-
Number of cases ence on the incidence of malignant neoplasms
Country All Fatalities will be much weaker than that of the Hiroshima
and Nagasaki radiation is very doubtful. In
Belarus 28,300 17,546 Chernobyl’s contaminated territories the ra-
Ukraine 28,300 17,546 dioactive impact may be even greater because
Russia 25,400 15,748
Germany 9,280 5,754
of its duration and character, especially be-
Romania 5,220 3,236 cause of irradiation from internally absorbed
Austria 5,050 3,131 radioisotopes.
Great Britain 4,280 2,654 The number of illnesses and deaths deter-
Italy 3,770 2,337 mined by Malko’s (2007) calculations cannot
Bulgaria 2,920 1,810
be dismissed as grossly overestimated: 10,000–
Sweden 1,980 1,228
Greece 1,880 1,166 40,000 additional deaths from thyroid cancer,
Poland 1,755 1,088 40,000–120,000 deaths from the other malig-
Finland 1,600 992 nant tumors, and 5,000–14,000 deaths from
Switzerland 1,530 949 leukemia, for a total of 55,000 to 174,000
Czech Republic 1,410 874 deaths for the “Chernobyl generation” from
Moldova 1,320 818
France 1,220 756
1986 to 2056.
Slovenia 960 595
Norway 920 570
References
Slovakia 715 443
Croatia 630 391
Abdelrahman, R. (2007). Swedes still dying from Cher-
Hungary 625 388
nobyl radiation. The Local-Sweden’s News in En-
Lithuania 420 260
glish (//www.thelocal.se/7200/20070504/).
Ireland 375 233
Annual Report (2006). Industrial Catastrophes and
The Netherlands 135 84
Long-Term Surveillance. Surveillance of Thy-
Belgium 110 68
roid Cancer: Twenty Years after Chernobyl.
Spain 80 50
French Institute for Public Health Surveillance.
Latvia 75 47
(//www.invs.sante.fr/presentations/edito_en_htm).
Denmark 70 43
Anonymous (2005). Even nowadays they are doing their
Estonia 60 37
best to cover the truth of Chernobyl. November 26
Luxembourg 15 9
(www.chernobyl-portal.org.ua) (in Russian).
European total 130,405 89,851
Associated Press (2000). Study cites Chernobyl health ef-
Included figures 82,000 50,840
fects in Poland. April 26, Warsaw, Poland 12:39:09.
for Belarus, Ukraine,
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CHERNOBYL
7. Mortality after the Chernobyl Catastrophe

Alexey V. Yablokov
A detailed study reveals that 3.8–4.0% of all deaths in the contaminated territories of
Ukraine and Russia from 1990 to 2004 were caused by the Chernobyl catastrophe. The
lack of evidence of increased mortality in other affected countries is not proof of the
absence of effects from the radioactive fallout. Since 1990, mortality among liquida-
tors has exceeded the mortality rate in corresponding population groups. From 112,000
to 125,000 liquidators died before 2005—that is, some 15% of the 830,000 members of
the Chernobyl cleanup teams. The calculations suggest that the Chernobyl catastro-
phe has already killed several hundred thousand human beings in a population of
several hundred million that was unfortunate enough to live in territories affected by
the fallout. The number of Chernobyl victims will continue to grow over many future
generations.
Twenty years after the Chernobyl catastrophe, The major observable components of antenatal
apart from several limited studies among spe- mortality are spontaneous abortions or miscar-
cific groups and in isolated territories deal- riages (spontaneous interruption of pregnancy
ing primarily with the incidence of cancer (see until the 27th week) and stillbirths (after 27
Chapter 6), there are no official publications on weeks). Increased numbers of stillbirths and
mortality in areas affected by the nuclear fall- miscarriages are among the first effects of ir-
out. There is strong evidence of radiation ef- radiation, with a delay of only some weeks or
fects on cancer and noncancer mortality based months after exposure. These effects can oc-
on the Hiroshima data (Preston et al., 2003). cur after exposure to very low doses, that is, at
The analysis in this chapter is based on stud- whole body doses as low as 5 mSv (Loganovsky,
ies of territories with comparable ethnic, social, 2005), but the reasons are not yet understood.
and economic factors but with different levels of As a rule, spontaneous abortions are not reg-
radioactive contamination. Since the breakup istered, so a change in that rate can only be
of the Soviet Union, but even as early as 1987, determined indirectly from a reduction in the
life expectancy there has decreased significantly birth rate. Long before the Chernobyl catas-
(Figure 7.1), whereas the decline in infant mor- trophe, increases in antenatal mortality were
tality has leveled off. found in the wake of the nuclear fallout from
atmospheric weapons tests (Sternglass, 1972;
7.1. Increase in Antenatal Whyte, 1992; Playford et al., 1992; Tchasnikov,
Mortality 1996; Tkachev et al., 1996; and many others;
for reviews see C. Busby, 1995; A. Yablokov,
Irradiation has an adverse effect on the ovum 2002; A. Durakovič, 2003; and A. Körblein,
and the sperm, as well as on the embryo. 2004b).
7.1.1. Belarus
Address for correspondence: Alexey V. Yablokov, Russian 1. The incidence of stillbirths in highly con-
taminated territories increased (Golovko and
[email protected] Izhevsky, 1996; Figure 7.2).
192
Yablokov: Mortality after Chernobyl 193
Figure 7.1. Average life expectancy for newborn males, 1961–2000, in Belarus,
Ukraine, and Russia (//www.demoscope.ru/weekly/ssp/geO.php?c2).
2. In 1987, a significant reduction in the birth 2. In Kiev Province, a significant increase

rate was observed in Gomel Province, the most in spontaneous abortions was found in the
contaminated region of Belarus (Kulakov et al., more highly contaminated areas. The study
1993). was based on 66,379 pregnancies from 1999
to 2003 (Timchenko et al., 2006).
7.1.2. Ukraine 3. After 1986, the prevalence of ovarian hy-
pofunction (one of the main causes of spon-
1. In the Ukrainian districts of Polessk and taneous abortion) increased by a factor of 2.9
Cherkassk, there was a significant increase in (Auvinen et al., 2001).
the incidence of stillbirths, which was associ- 4. After Chernobyl, the number of sponta-
ated with the level of Cs-137 ground contam- neous abortions increased significantly in the
ination. The study was based on more than Narodychy District (Buzhievskaya et al., 1995).
7,000 pregnancies 3 years before and 5 years 5. Until 2004, the estimated total number
after Chernobyl (Kulakov et al., 1993). of miscarriages and stillbirths in Ukraine as a
result of Chernobyl was about 50,000 (Lypic,
2004).
7.1.3. Russia
1. The number of spontaneous abortions
in the contaminated territories increased sig-
nificantly after Chernobyl (Buldakov et al.,
1996).
2. In Kaluga Province, the rate of sponta-
neous abortions increased significantly 5 years
after Chernobyl in the three most contami-
nated districts (Medvedeva et al., 2001).
3. In the three most contaminated districts
of Kaluga Province the stillbirth rate increased
Figure 7.2. Excess stillbirth rate in 1987 significantly from 1986 to 1990 relative to the
in Sweden, Poland, Hungary, and Greece com-
rate before Chernobyl, and it continued to be
bined (EAST); Germany; and Belarus (Körblein,
2000, 2003). The error bars show one standard higher than in less contaminated districts for
deviation. the whole 15-year study period (Figure 7.3).
194
Figure 7.3. Stillbirth rate (per 1,000 live births plus stillbirths) with higher and lower
contamination in districts of the Kaluga Province, and in Russia, during 1981–1986, 1986–
1990, 1991–1995, and 1996–2000 (Tsyb et al., 2006).
7.1.4. Other Countries Berlin), the area of the former German Demo-
cratic Republic (including West Berlin), and
1. CROATIA. Stillbirth rates from 1985 to Bavaria alone, the excess perinatal mortality
1990 show significant peaks observed at the in 1987 was 2.4, 7.2, and 8.5%, respectively.
end of 1986 and the beginning of 1987 and In 1988 in the German Democratic Repub-
around September 1988 (Figure 7.4). The sec- lic plus West Berlin, the perinatal mortality
ond peak in 1988 may have resulted from the rate exceeded the expected figure by 7.4%
consumption of contaminated beef. (Figure 7.6.), which was presumably a conse-
2. CZECH REPUBLIC. In the sex ratio of new- quence of the consumption of contaminated
borns the percentage of males was higher than canned beef imported from the Soviet Union
50% each month between 1950 and 1999, ex- (Scherb et al., 2000).
cept in November 1986, when it was signifi- In 1987 in the 10 most affected districts
cantly reduced (Figure 7.5). The hypothesis is of Bavaria (average Cs-137 ground level, 37.2
that there is a negative effect of the Chernobyl kBq/m2 ), there was a 45% increase in the
catastrophe on male fetuses during the third proportion of stillbirths (P = 0.016); in the
month of prenatal development (Peterka et al., three most contaminated Bavarian districts
2004). combined (Augsburg City, Berchtesgaden, and
3. GERMANY. In the former Federal Repub- Garmisch Partenkirchen), the stillbirth propor-
lic of Germany (excluding Bavaria and West tion in that year was more than double relative
Figure 7.4. Deviation of stillbirth rates in Croatia 1985 to 1991 from the long-term trend
in units of standard deviation (standardized residuals; Körblein, 2008).
uary 1987, which, however, was not significant

(Auvinen et al., 2001). There was a significant
rise in preterm deliveries among infants who
were exposed to radiation in utero during the
first trimester of pregnancy (Harjulehto et al.,
1989).
7. HUNGARY. Birth rates were reduced in
February and March 1987 (Czeizel et al., 1991).
8. ITALY. In Lombardia there was a 20% in-
crease in first-trimester spontaneous abortions
Figure 7.5. The percentage of infant boys born
among fetuses conceived during the main fall-
in the Czech Republic each November from 1950 out period (Semisa, 1988).
to 2005. Only in November 1986 is the figure less 9. NORWAY. A higher incidence of sponta-
than 50% (Peterka et al., 2007). neous abortions was observed for pregnancies
conceived during the first 3 months after the
catastrophe (Ulstein et al., 1990). The observed
to the expected figure (P = 0.0004; Scherb et al., increase for 36 months after Chernobyl is sta-
2000). tistically significant, “but a causal relationship
4. GREAT BRITAIN. A significant increase in with the radiation exposure cannot be proved.”
perinatal mortality occurred in March 1987, Pregnancies temporarily decreased in the sec-
some 10 months after the catastrophe in the ond half of 1986, during a period in which
three most contaminated counties of England pregnancies usually increase, whereas there was
and Wales: Cumbria, Clwyd, and Gwynedd no increase in induced abortions (Irgens et al.,
(Figure 7.7). 1991).
5. GREECE. A 10% reduction in the birth 10. It should be noted that the reduction
rate was observed from January to March 1987, in birth rate in Sweden, Italy, Switzerland,
which was attributed to the Chernobyl fallout. Greece, and Finland in the first year after Cher-
In May 1986, some 23% of early pregnancies nobyl might not have been caused by radiation,
were aborted for fear of an adverse pregnancy but rather was due to family planning (Auvinen
outcome (Trichopoulos et al., 1987). et al., 2001).
6. FINLAND. There was an increase in still- 11. A change point analysis of stillbirth odds
birth rates from December 1986 through Jan- ratios for gender, that is, the ratio of stillbirth
odds of males to the stillbirth odds for females,
found a change in 1986 or 1987 (P = 0.01) in
several European countries (Figure 7.8).
12. Changes in the sex ratio and the stillbirth
odds ratio for gender were significant for Den-
mark, Germany, Hungary, Norway, Poland,
Latvia, and Sweden and visible but not sta-
tistically significant for Iceland (Figure 7.9).
13. Findings of increased rates of sponta-
neous abortions after the Chernobyl catastro-
phe in several European countries are summa-
rized in Table 7.1.
Figure 7.6. Perinatal mortality in Germany, the 14. Literature on increased stillbirth rates af-
Federal Republic of Germany, and Bavaria (Scherb ter Chernobyl in several European countries is
et al., 2000). listed in Table 7.2.
196
Figure 7.7. Trends of stillbirth rate and neonatal and perinatal mortality in England and
Wales (Busby, 1995, based on Bentham, 1991).
Over an 18-year period after Chernobyl, if 7.2. Increased Perinatal, Infant,

the number of miscarriages and stillbirths re- and Childhood Mortality
sulting from the Chernobyl fallout was 50,000
in Ukraine alone (Lypik, 2004), it is likely that Reports about the most probable adverse
the total antenatal death toll from Chernobyl impacts of the Chernobyl contamination on
in Russia, Belarus, and Ukraine up to 2003 is childhood mortality include: perinatal mortal-
more than 100,000. As these three countries re- ity (stillbirths plus early neonatal deaths, 0–6
ceived only about 43% of the radioactive fallout days), neonatal mortality (0–27 days), infant
from Chernobyl (see Chapter 1 for details) one mortality (0–364 days), and childhood mor-
can expect another 100,000 additional antena- tality (0–14 years). In a number of European
tal deaths in other European countries and in countries the definition of stillbirth changed
the rest of the world. Thus the total antenatal around 1994, which presents a problem in time-
death toll from Chernobyl adds up to 200,000 trend analyses. In the Former Soviet Union,
cases (Rosen, 2006). the data for neonatal and infant mortality were
Figure 7.8. Sex ratio and stillbirth odds ratio by gender in several European countries
(male stillbirths/male live births)/(female stillbirths/female live births; Scherb et al., 1999).
Figure 7.9. Relative risks (RR with 95% confidence limits) for change points for the stillbirth
odds ratio in 1986 (Iceland, Latvia, Poland, and Sweden), in 1987 (Germany, Denmark, and
Hungary), and 1989 (Norway), determined with a spatial–temporal trend model by Scherb
and Weigelt (2000).
habitually underreported to “improve” health provinces were noticeably higher in the first
statistics, which makes the figures unreliable year after the catastrophe and again 3 years
(Losoto, 2004). later (Figure 7.11). The latter increase may be
connected to consumption of locally contami-
nated food.
7.2.1. Perinatal Mortality 2. Comparison of perinatal mortality in
the most contaminated regions of Ukraine
7.2.1.1. Belarus (Zhytomir and Kiev provinces and Kiev City)
1. Perinatal mortality in Gomel Province in- with the mortality in the rest of Ukraine
creased after 1988. During the 1990s there is shows significantly higher figures 1991–1999
a rise and fall relative to the expected trend (Figure 7.12).
with a maximum number from 1993 to 1994 3. The increases in perinatal mortality in
(Körblein, 2002). The additional mortality is Ukraine and Belarus are associated with the
associated with the average calculated Sr-90 Sr-90 burden on pregnant women (Körblein,
burden on pregnant women (Figure 7.10). 2003).
2. An analysis of pregnancy outcomes be-
fore and after the catastrophe (1982 to 1990)
revealed that neonatal mortality increased in
7.2.1.3. Russia
Gomel and Mogilev, the two most highly con-
taminated regions of Belarus (Petrova et al., 1. In the three most contaminated districts
1997). of Kaluga Province, infant mortality rates in
1986–1990 and 1991–1995 were higher than
in less contaminated districts and in the Kaluga
7.2.1.2. Ukraine Province as a whole: 25.2, 21.5, and 17.0
1. Perinatal mortality, stillbirth rate, and per 1,000 live births, respectively (Tsyb et al.,
early neonatal mortality in Zhytomir and Kiev 2006).
198
TABLE 7.1. Increase of the Rate of Spontaneous Abortions after Chernobyl (from Reviews by Auvinen
et al., 2001 and Körblein, 2006a)
Country Period Comments Author
Finland July to Dec., Increased in the territories with high level of Auvinen et al., 2001
1986 Cs-137 ground contamination
From 1986 Up to 20% Frentzel-Beyme and
Scherb, 2007
Norway 1986–1988 In 1986 for conceptions during the first 3 months Ulstein et al., 1990
after Chernobyl in the contaminated territories
1986 Rate of spontaneous abortions increased from Irgens et al., 1991
7.2% before Chernobyl to 8.3% the year after
in six contaminated counties
Sweden 1986 Increased for fetuses under 17 weeks at the time Ericson and Kallen,
of the Chernobyl catastrophe 1994
Italy July 1986 Lombardy, increased 3% Bertollini et al., 1990
June, July, Sept., Increased for whole country Spinelli and Osborn,
1986 1991; Parazzini
et al., 1988
1986 20% increase in first-trimester spontaneous Semisa, 1988
abortions
Greece, 1986 Increased compared to 1985 Scherb et al., 1999
Hungary,
Poland,
Sweden
Poland From 1986 Up to 5% Frentzel-Beyme and
Scherb, 2007
Sweden Up to 10%, in some parts of the country
Denmark Up to 20%
Hungary Up to 30%
Iceland Up to 30%
Germany 1987 Increased in Bavaria. Associated with the Cs-137 Scherb et al., 2000
ground contamination
Feb. 1987 13% decrease in birth rate in southern Bavaria Körblein, 2006
Switzerland June 1986 Birth rate decreased by 50% in Ticino Canton Perucchi and
Domenighetti,
1990
7.2.1.4. Other Countries 2000). A highly significant association of peri-

natal mortality with the Cs-137 burden dur-
1. GERMANY. Perinatal mortality increased ing pregnancy is found in the combined data
significantly in 1987 relative to the long-term from West and East Germany (Körblein and
trend of the data, 1980–1993. The 1987 Kuchenhoff, 1997). Spatial-temporal analyses
increase was 4.8% (P < 0.005) of the expected of the proportion of stillbirths and perinatal
proportion of perinatal deaths. Even more pro- deaths with Cs-137 deposition after the Cher-
nounced levels of 8.2% (P < 0.05) and 8.5% nobyl catastrophe in Bavaria on a district level
(P = 0.0702) can be found in the more heav- reveal significant exposure–response relation-
ily contaminated areas of the former German ships (Scherb et al., 2000).
Democratic Republic, including West Berlin, 2. POLAND. Perinatal mortality was sig-
and Bavaria, respectively (Scherb and Weigelt, nificantly increased in 1987 relative to the
TABLE 7.2. Increased Stillbirth Rates, Infant Mortality Rates, and Low Birth Weight Associated with
In Utero Exposure from Chernobyl (mostly by I. Schmitz-Feuerhake, 2006)
Country Comments References
Greece Scherb and Weigelt, 2003

Sweden Increased, in some parts up ca. 10% Scherb and Weigelt, 2003; Frentzel-Beyme and
Scherb, 2007
Poland Stillbirth rate increased ca. 5% Körblein, 2003; Scherb and Weigelt, 2003;
Frentzel-Beyme and Scherb, 2007;
Norway Ulstein et al., 1990
Hungary Czeizel and Billege, 1988; Scherb and Weigelt, 2003
Finland Increased ca. 20% Harjulehto et al., 1989, 1991; Scherb and Weigelt,
2003; Frentzel-Beyme and Scherb, 2007
Germany Körblein and Küchenhoff, 1997; Scherb and Weigelt,
2003; Lüning et al., 1989; Grosche et al., 1997;
Scherb et al., 1999; Körblein, 2003a;
Frentzel-Beyme and Scherb, 2007
England and Wales Increased twofold in February 1987 Bentham, 1991; Busby, 1995
Denmark Increased 20% Frentzel-Beyme and Scherb, 2007
Iceland Increased 30% Frentzel-Beyme and Scherb, 2007
Hungary Increased 30% Frentzel-Beyme and Scherb, 2007
long-term trend. Infant mortality monthly 7.2.2. Infant Mortality

data, 1985–1991, show a significant correla-
tion with the Cs-137 burden during pregnancy 7.2.2.1. Ukraine
(Körblein, 2003, 2006). 1. A significant increase in infant mor-
3. GREAT BRITAIN. Ten months after the tality was found in 1987–1988 in highly
catastrophe, a significant increase in peri- contaminated territories (Grodzinsky, 1999;
natal mortality was found in the two most Omelyanets and Klement’ev, 2001). The
contaminated areas of the country—England main causes of infant death were antena-
and Wales (Bentham, 1991; Busby, 1995; see tal pathologies and congenital malformations
Figure 7.7). (Table 7.3).
Figure 7.10. Deviation of perinatal mortality from the long-term trend in Gomel Province
from 1985 to 1998. The columns show the average calculated Sr-90 burden in pregnant
women (Körblein, 2006).
200
Figure 7.11. Perinatal mortality, stillbirth rate, and early neonatal mortality (per 1,000
live births and stillborns) in Zhytomir and Kiev provinces noticeably increased the first year
and again after 3 years after the catastrophe (Dzykovich et al., 2004).
7.2.2.2. Russia 7.2.2.3. Other Countries

1. In 1996 neonatal mortality in more highly 1. FINLAND. Infant mortality increased signif-
contaminated districts of Bryansk Province was icantly immediately after the catastrophe and
greater than in the province as a whole: 7.4 and continued to rise until 1993 (Figure 7.14).
6.3 per 1,000, respectively (Baleva et al., 2001). 2. GERMANY. Infant mortality monthly
2. In the southwest districts of Bryansk data, 1980–1994, show two significant post-
Province with higher contamination, infant Chernobyl peaks, at the beginning and at the
mortality increased after 1986 (see Table 7.4), end of 1987 (Figure 7.15).
whereas in other districts it declined (Utka et al., 3. POLAND. Infant mortality monthly data,
2005). 1985–1991, show peaks at the beginning and
Figure 7.13 shows the deviation of infant at the end of 1987 (Figure 7.16).
mortality in 1987–1989 from a declining long- 3. SWEDEN. Infant mortality increased
term trend in Ukraine, Russia, and Belarus. immediately after the catastrophe and
Figure 7.12. Deviation of perinatal mortality from the expected long-term trend in the
combined Zhytomir and Kiev provinces and Kiev City, 1985–2004 (Körblein and Omelyanets,
2008).
TABLE 7.3. Main Causes of Infant Death

(per 1,000 Live Births) in Ukraine, 1990–1995
(Grodzinsky, 1999)
Cause Rate per 1,000 %
Antenatal pathologies 4.84 33.0

Congenital malformations 4.26 29.0
Respiratory diseases 1.45 9.9
Infections 1.12 7.6
increased significantly in 1989–1992

(Figure 7.17).
4. SWITZERLAND. Infant mortality rose to
some extent in 1988 and increased significantly
in 1989 and 1990 (Figure 7.18). Figure 7.13. Trend of infant mortality (from top
As noted above (Section 7.2.2), a total num- down) in Ukraine, Russia, and Belarus (//www.
demoscope.ru/weekly/vote/fig_imr11png).
ber of several thousand additional infant deaths
might be expected following the Chernobyl
catastrophe in Europe and other parts of the 1994. Death from diseases of the nervous sys-
world. However, no study will be able to de- tem and the sense organs increased by a factor
termine the exact number of added deaths be- of five and congenital malformations by more
cause the putative trend without the Chernobyl than a factor of two (Grodzinsky, 1999).
catastrophe is unknown. 2. According to official data, childhood mor-
tality in highly contaminated territories was
4.7% in 1997 and 9.6% among children born to
7.2.3. Childhood Mortality (0–14 Years
parents who had been irradiated (TASS, 1998).
of Age)
7.2.3.1. Belarus 7.2.3.3. Russia
1. In Gomel Province, childhood cancers are 1. In districts of Tula Province with higher
registered twice as often in the mortality statis- levels of contamination, childhood mortality
tics as in Belarus as a whole and 20-fold more was higher than in less contaminated districts
often than in the least contaminated Vitebsk (Khvorostenko, 1999).
Province (Bogdanovich, 1997). The childhood death toll from the Cher-
nobyl catastrophe will never be determined
7.2.3.2. Ukraine precisely. However, based on the existing frag-
1. Childhood mortality increased from 0.5% mentary data, some 10,000 additional child-
(per 1,000 live born) in 1987 up to 1.2% in hood deaths can be expected in Belarus,
Ukraine, and Russia.
TABLE 7.4. Infant Mortality (per 1,000 Live
Births) in Highly Contaminated Districts of Bryansk 7.3. Mortality among Liquidators
Province, Russia, 1995–1998 (Fetysov, 1999; Ko-
mogortseva, 2006) The registration of deaths among liquidators
Highly contaminated districts Province in Ukraine, Russia, and Belarus was not com-
plete in the first years after the Chernobyl catas-
Years 1995 1996 1997 1998 1998 trophe (see Chapter 1, Section 1.8 for details).
Infant 17.2 17.6 17.7 20.0 15.7
As a rule, the liquidators were healthy young
mortality
adults (average age 33 years) so a lower than
202
Figure 7.14. Trend of infant mortality rates in Finland, 1980–2006, and undisturbed
trend line. Based on official statistical data (Körblein, 2008).
Figure 7.15. Deviation of infant mortality from the long-term trend in Germany, 1980–
1994. The peaks of mortality follow peaks of the Cs-137 burden with a time lag of 7 months
(Körblein, 2006).
Figure 7.16. Deviation of infant mortality from the long-term trend in Poland, 1985–
1991. The peaks of mortality follow peaks of the Cs-137 burden with a time lag of 7 months
(Körblein, 2006).
Figure 7.17. Trend in infant mortality rates in Sweden, 1980–2006, and undisturbed
average mortality rate among them should be 3. The mortality among male Ukrainian
expected. liquidators increased more than fivefold from
1989 to 2004, from 3.0 to 16.6 per 1,000,
7.3.1. Belarus as compared to mortality rates of 4.1 to 6.0
per 1,000 among other men of working age
1. Mortality of male liquidators who worked
(Horishna, 2005).
in 1986 is higher than liquidators who worked
4. After 1995, the mortality of liquidators
in 1987 (Borysevich and Poplyko, 2002).
exceeded the mortality of the corresponding
population group (Law of Ukraine, 2006).
7.3.2. Ukraine
1. The mortality rate of the Ukrainian liq- 7.3.3. Russia
uidators from nonmalignant diseases increased
steadily from 1988 to 2003 (Figure 7.19). 1. Ten years after the Chernobyl catastrophe,
2. Total mortality in contaminated territories the mortality rate among liquidators employed
and among liquidators increased significantly in 1986 was significantly increased (Ecological
from 1987 to 2005 (Figure 7.20). Security, 2002).
Figure 7.18. Trend of infant mortality rates in Switzerland, 1980–2006, and undisturbed
204
Figure 7.19. Trend of mortality (per 1,000) of Ukrainian liquidators employed in

1986–1987, from nonmalignant diseases from1988 to 2003 (National Ukrainian Report,
2006).
2. In the Russian National Register, 4,136 ees of the Kurchatov Institute (Shykalov et al.,
deaths were registered from 1991 to 1998 in 2002).
a cohort of 52,714 liquidators. Only 216 cases 4. A significant increase in cancer mortality
(not counting 24 deaths from leukemia from was found in 1991–1998 in a cohort of 66,000
1986 to 1998) are officially accepted as radia- liquidators who were exposed (according to of-
tion induced (Ivanov et al., 2004). ficial data) to radiation doses of about 100 mSv
3. According to official data, already “more (Maksyutov, 2002).
than 10,000 liquidators” had died up until 2001 5. Figure 7.21 shows data obtained from the
(National Russian Report, 2001). The stan- National Register on mortality of liquidators
dardized mortality ratio (SMR) among this co- from nonmalignant causes.
hort ranges between 0.78 and 0.88 for the cat- 6. According to the nongovernmental orga-
egories “all causes,” malignant neoplasm, “all nization Chernobyl Union, by 2005 more than
causes except malignant neoplasm,” and “trau- 31,700 out of 244,700 Russian liquidators, or
mas and poisonings” and does not differ from 13%, had died (V. V. Grishin, Chernobyl Union
corresponding groups of the general popula- Chairman, pers. comm.).
tion. Similar results are reported for employ-
Figure 7.20. Total mortality (from all causes,

per 1,000) in contaminated territories of Ukraine Figure 7.21. Trend of standardized mortality ra-
and among liquidators, 1986 to 2006 (Petruk, tios (SMR) from nonmalignant diseases in liquidators,
2006). 1990–1999 (Ivanov et al., 2004: fig. 8.7).
TABLE 7.5. Average Age of Deceased Liquidators

Number of Average age at
Group deaths death, years Comments
Tolyatti City, Samara Province 163 46.3 1995–2005, A.Y. calculations from
Tymonin data (2005)
Workers in the nuclear industry 169 45.5 1986–1990 (Tukov, 2000)
Karelian Republic 644 43 1986–2008 (Stolitsa on Onego, 2008)
7. In the Voronezh Province, of 3,208 liq- mortality rate was only found in the groups with
uidators 1,113 (34.7%) have died (source: let- circulatory and vegetovascular (autonomic ner-
ter from regional branch of the Chernobyl vous system) diseases (Tukov, 2000).
Union). 16. The decline in life expectancy among
8. In the Karelian Republic, of 1,204 liq- the Chernobyl liquidators who were employees
uidators 644 had died (53%) by the year 2008 of the nuclear industrial complex (NPPs, other
(Stolitsa on Onego, 2008). nuclear installations, and atomic scientific in-
9. In Angarsk City (Irkutsk Province, Siberia) stitutes) was 16.3% from malignant neoplasms,
up to the year 2007 only about 300 out of 1,300 25.9% from blood diseases, and 39.6% from
liquidators were still alive (Rikhvanova, 2007). trauma and poisonings (Ignatov et al., 2001).
10. In Kaluga Province 87% of all liquidators 17. The data from various sources for
who died in the first 12 years after the catas- causes of liquidator mortality differ consider-
trophe were 30 to 39 years old (Lushnykov and ably, which indicates that they are of question-
Lantsov, 1999). able quality (Table 7.6).
11. In 2001, mortality in male liquidators The data presented above show that, since
was 1.4 to 2.3 times higher than in corre- 1990, mortality among liquidators exceeded
sponding age groups of the general population the rate in corresponding population groups.
(Gil’manov et al., 2001). By 2005 some 112,000 to 125,000 liquidators
12. According to data from the National had died, or about 15% of a total cadre of
Register, from 1987 to 1996 mortality from ma- 830,000.
lignant neoplasm of the urogenital tract was sig-
nificantly higher in liquidators under the age of
50 years than in the corresponding age group 7.4. Overall Mortality
in the general population (Kochergyna et al.,
2001). The Chernobyl contamination undoubtedly
13. The increased mortality results in a com- caused an increase in overall mortality in the
paratively low life expectancy for liquidators contaminated areas.
(Table 7.5).
14. In 1993, according to the National Reg- 7.4.1. Belarus
ister, the three main causes of death among
liquidators were trauma and poisonings (46%), 1. In 1998, the mortality from malignant
circulatory diseases (29%), and malignant neo- neoplasms for inhabitants of the territories con-
plasm (13%; Ecological Security, 2002). taminated by Cs-137 at levels higher than 555
15. According to the 1999 Registry, among kBq/m2 (15 Ci/km2 ) as well as for those who
the Russian liquidators who were employees left such territories after the catastrophe started
of the nuclear industrial complex (14,827 men to exceed the mortality in the country as a
and 2,825 women) a significantly increased whole (Antypova and Babichevskaya, 2001).
206
TABLE 7.6. Causes of Death (%) of Russian Liquidators in 2000 According to Various Sources
Percentage of the total deaths
Khrysanfov and
Causes of death Meskikh, 2001a Loskutova, 2002b Gil’manov et al., 2001c
Blood and circulatory system pathology 63 45 50.9

Malignant neoplasm 31 32 5.3
Gastrointestinal tract pathology 7 – 5.3
Lung pathology 5 – –
Trauma and suicide 5 14 26.3
Tuberculosis 3 – –
Radiation sickness – 1 –
Other – 8 12.5
a
Data of the official Russian Interdepartmental Advisory Council on the Establishment of a Causal Relationship of
Diseases, Physical Disability and Death of Irradiated Persons.
b
Data of the Moscow branch of the nongovernmental organization “Widows of Chernobyl” (559 cases).
c
Data of the official Russian National Registry of Liquidators.
2. The average life expectancy of popula- 7.4.2. Ukraine

tions living in territories with Cs-137 ground
contamination above 555 kBq/m2 (15 Ci/km2 ) 1. After 1986, the general mortality in-
was 8 years less than the national average (An- creased significantly in the contaminated ter-
typova and Babichevskaya, 2001). ritories (IPHECA, 1996; Omelyanets and Kle-
3. The concentration of radionuclides in the ment’ev, 2001; Grodzinsky, 1999; Kashyryna,
bodies of most (98%) of the 285 persons who 2005; Sergeeva et al., 2005).
died suddenly in Gomel Province was signifi- 2. According to official data, the general
cantly increased in the heart, the kidneys, and mortality rate in the heavily contaminated ter-
the liver (Bandazhevsky, 1999). ritories was 18.3 per 1,000 in 1999, some 28%
4. In highly contaminated districts of Gomel higher than the national average of 14.8 per
Province, mortality is significantly higher than 1,000 (Reuters, 2000).
in less contaminated areas and higher than in 3. In contaminated territories and among
the rest of Belarus; the mortality rate started to evacuees, cancer mortality increased by 18 to
rise in 1989 (Figure 7.22). 22% from 1986 to 1998 as compared to 12%
5. The general mortality rate in Belarus in- in Ukraine as a whole (Omelyanets and Kle-
creased from 6.5 to 9.3 per 1,000, that is, by ment’ev, 2001; Golubchykov et al., 2002). Mor-
43%, from 1990 to 2004 (Malko, 2007). tality from prostate cancer increased by a factor
Figure 7.22. Trends in mortality rates (per 1,000) in several regions of Belarus. The
highest mortality rates are found in the most contaminated districts of Gomel Province, and
the increase after 1989 was greatest in Gomel Province (Rubanova, 2003).
TABLE 7.7. Causes of Death in Contaminated lated with Cs-137 ground contamination. Prin-
Territories of Ukraine, 1996 (Grodzinsky, 1999) cipal causes of the increased mortality were car-
Cause of death Percentage diovascular diseases (60%) and cancers (10.6%;
Sukal’skaya et al., 2004).
Blood diseases 61.2
Oncological diseases 13.2
Traumas 9.3
Respiratory diseases 6.7 7.5. Calculations of General
Diseases of the digestive tract 2.2 Mortality Based on the
Carcinogenic Risks
Based on different risk factors (excess risk

of 2.2 in contaminated territories and by a fac- per unit dose), various authors have estimated
tor of 1.3 in Ukraine as a whole (Omelyanets the number of additional cancer deaths due to
and Klement’ev, 2001). Chernobyl (Table 7.9). The estimates presented
4. In 1996, the primary causes of death in Table 7.9 cover a range that spans two or-
among inhabitants of contaminated territo- ders of magnitude. This wide range far exceeds
ries were circulatory and oncological diseases the usual scientific uncertainty. Therefore, esti-
(Table 7.7). mates of the damage to health from exposure to
radiation should be interpreted with due cau-
7.4.3. Russia tion given the existing state of knowledge (see
Chapter 2 for details).
1. From 1994 to 2004, the general mortal-
ity in highly contaminated districts of Bryansk
Province increased by 22.5%, primarily in the 7.6. Calculations of General
age group 45–49 years, where it increased by Mortality
87%. The general mortality in highly contam-
inated districts was 23 to 34% higher than the An estimate of the additional mortality from
province average (Kashyryna, 2005; Sergeeva Chernobyl is possible on the basis of a compar-
et al., 2005; Table 7.8). ison of mortality rates in highly contaminated
2. The general mortality in Lipetsk City, territories and in less contaminated ones—
where Cs-137 ground contamination is less so called “clean” areas (Rubanova, 2003;
than 5 Ci/km2 , increased by 67% from 1986 Sergeeva et al., 2005; Khudoley et al., 2006;
to 1995 (from 7.5 to 12.6 per 1,000; Krapyvin, and others).
1997). From 1985 to 2001, the standardized mor-
3. General mortality in the Klintsy district of tality ratio increased in the less contaminated
the Bryansk Province, 1997 to 1999, was corre- Grodno and Vitebsk provinces of Belarus by
37.4 to 43.1%, and in the heavily contaminated
TABLE 7.8. General Mortality (per 1,000) in the
Gomel Province by 59.6%. The socioeconomic
Three Most Contaminated Districts of the Bryansk and ethnic conditions in these areas are similar;
Province, and in Russia, 1995–1998 (Fetysov, the only difference is in the level of contam-
1999) ination. Therefore, the observed differences
Highly contaminated in mortality increase (16 to 22%) can be at-
districts Province Russia tributed to the Chernobyl radiation (Rubanova,
2003).
Year 1995 1996 1997 1998 1998 1997
There are essentially six Russian provinces
General 16.7 17.0 18.2 17.7 16.3 13.8
mortality with considerable contamination from the
Chernobyl fallout (Tula, Bryansk, Oryol,
208
TABLE 7.9. Estimates of the Number of Cancer Deaths Resulting from the Radionuclides Cs-134,
Cs-137, and Sr-90 Released from the Chernobyl Reactor
Number of deaths Author Comments
4,000 Press release to the Chernobyl Forum (2005) 90 years, Belarus, Ukraine, European part
of Russia
8,930 Chernobyl Forum (2006) 90 years, Belarus, Ukraine, European part
of Russia
14,000∗ Nuclear Regulatory Commission, USA For all time, entire world
17,400 Anspaugh et al. (1988) 50 years, entire world
28,000 U.S. Department of Energy (Goldman, 1987) 50 years, entire world
30,000∗ UNSCEAR (Bennett, 1996) For all time, entire world
30,000–60,000 Fairlie and Sumner (2006) For all time, entire world
93,080 Malko (2007) 70 years, entire world
180,000 Malko (2007) 70 years, all Chernobyl causes
495,000 Gofman (1994a,b) For all time, entire world
899,310–1,786,657 Bertell (2006) For all time, all radionuclides, entire world
∗
From J. Fairlie and D. Sumner (2006: table 6.2).
Ryazan, Kursk, and Kaluga), which had a total Figure 7.24 shows the standardized mortal-
population of 7,418,000 in 2002 (study region). ity rates for the neighboring Tula and Lipetsk
In 1999, more than 5% of this population lived provinces. The resulting number of about
in highly contaminated districts. The mortality 60,400 additional deaths from 1990 to 2004
rates in these regions were compared with the in the area under study, corresponding to 34
Russian average and with the rate in six neigh- persons per 1,000, reveals the true dimension
boring (officially) less contaminated provinces of the death toll from the Chernobyl catastro-
with similar geographical and socioeconomic phe. From 1990 to 2004 the number of ad-
status (Smolensk, Belgorod, Lipetsk, Tambov, ditional deaths represents 3.75% of the en-
and Vladimir provinces and the Republic of tire population of the contaminated territories.
Mordova) with a total population of 7,832,000 This finding agrees well with the figure of 4.2%
in 2002 (control region; Khudoley et al., 2006). for Ukraine given in the National Ukrainian
In the region under study the general mor- Report for 2006.
tality, as well as the increased rate in mortal-
ity, exceeded the Russian average. Table 7.10
shows the raw and the age-standardized mor-
tality rates in the six contaminated provinces. TABLE 7.10. Observed (Raw) and Age-
Standardized Mortality Rates (per 1,000) in
Both the observed and the age standardized the Six Most Contaminated Regions of Russia,
mortality rates exceed the Russian average 2002 (Khudoley et al., 2006)
(Table 7.10). In Figure 7.23 the standard-
Mortality
ized mortality rates in the six contaminated
provinces combined are compared with the Region Observed Standardized
mortality rates in the control region. The total
Tula 21.9 19.6
number of additional deaths from Chernobyl Bryansk 19.3 18.0
in the area under study, calculated on the basis Oryol 18.6 18.1
of the standardized mortality rates, is estimated Ryazan 20.6 19.3
at 60,400 (95% CI: 54,880 to 65,920). Kursk 19.3 18.5
A similar result is obtained when highly Kaluga 18.8 17.7
Total 16.2
and less contaminated regions are compared.
Figure 7.23. Difference in standardized mor-

tality rates in the combined six most contaminated
provinces and in the control region. “Zero” is the Figure 7.24. Standardized mortality rates,
Russian average (Khudoley et al., 2006). 1983–2003, in the more contaminated Tula
Province, the less contaminated Lipetsk Province, and
in Russia as a whole (Khudoley et al., 2006).
For the populations in all the contami-

nated territories together (in European Russia in the six regions mentioned above but also
1,789,000 (1999), in Belarus 1,571,000 (2001), in 16 regions of the European part of Rus-
and in Ukraine 2,290,000 (2002; Khudoley sia. This means that the total death toll for
et al., 2006)), and based on the additional rate in Russia is higher than estimated by Khudo-
Russia, the total number of extra deaths from ley et al. (2006).
• All the calculations by Khudoley et al.
Chernobyl in Belarus, Ukraine, and the Euro-
pean part of Russia is estimated to be 212,000 (2006) cover a 15-year period (1990–2004).
for the first 15 years after the catastrophe However, the radioactive contamination
(Table 7.11). from Chernobyl had adverse health effects
This calculation seems straightforward, but it before 1990 and will continue for many
might underestimate the real figures for several years into the future.
reasons:
• Official data about the radioactive con- 7.7. What Is the Total Number of
tamination for Belgorod and Lipetsk Chernobyl Victims?
provinces do not correlate with corre-
sponding changes in health statistics after The Chernobyl Forum (WHO, 2006) calcu-
Chernobyl. It means that the differences in lated a total number of 9,000 cancer deaths
mortality between contaminated and non- in Belarus, Ukraine, and Russia that can be
contaminated populations that were found attributed to the Chernobyl catastrophe for a
by Khudoley et al. (2006) might actually be period of 90 years after the meltdown.
more pronounced. If so, the Ukrainian fig- Table 7.9 showed forecasts of the expected
ure of 4.2% for the mortality rate may be number of additional instances of cancer owing
more realistic than the 3.75% determined to the Chernobyl catastrophe. All projections
in Russia. are based on risk factors for cancer. It is well
• It is well known (see Chapter 1 for details) known, however, that cancer is not the only
that there was considerable contamination and not even the most frequent lethal effect of
(sometimes more than 1 Ci/km2 ) not only radiation (see, e.g., Table 7.7).
210
TABLE 7.11. Number of Additional Deaths in Belarus, Ukraine, and the European Part of Russia,
1990–2004, that Can Be Attributed to the Chernobyl Catastrophe (Khudoley et al., 2006)
Region/Country
European Russia Belarus Ukraine Total
Population living in highly contaminated territories 1,789,000 1,571,000 2,290,000 5,650,000

Number of additional deaths 67,000 59,000 86,000 212,000
The assumptions concerning nonmalignant with a Cs-137 ground contamination be-

radiation risks differ even more than for low 40 kBq/m2 (see Chapter 1 for details)
radiation-induced cancers. Risk projections the additional mortality will be 10-fold
based on observed increases in the general mor- less (i.e., 1.7 deaths per 1,000 in 1990–
tality are more meaningful, and they are likely 2004). Then we can expect 150,000 ×
to be more realistic than calculations that only 1.7 or 255,000 more deaths in the rest of
use individual and/or collective doses together Europe.
with risk factors for fatal cancers. • Assuming that 20% of the radionuclides
Based on data presented in Section 7.6, it is released from the Chernobyl reactor were
possible to estimate the total death toll from the deposited outside Europe (see Chapter
Chernobyl catastrophe: 1) and that the exposed population was
190 million, with a risk factor of 1.7 per
• When we apply the additional mortal- 1,000 as before, we could have expected
ity of 34 extra deaths per 1,000 popula- an additional 323,000 cancer deaths out-
tion within 15 years (1990–2004), which side Europe until 2004.
was derived above, to the cohort of liq-
Thus the overall mortality for the period
uidators not living in contaminated zones
from April 1986 to the end of 2004 from
(400,000), to the evacuees and to people
the Chernobyl catastrophe was estimated at
who moved away from contaminated areas
985,000 additional deaths. This estimate of the
(350,000), then we expect another 25,500
number of additional deaths is similar to those
deaths in this period. The overall number
of Gofman (1994a) and Bertell (2006). A projec-
of Chernobyl-related deaths up until 2004
tion for a much longer period—for many future
in Belarus, Ukraine, and Russia was esti-
generations—is very difficult. Some counter-
mated to be 237,500.
•
directed aspects of such prognoses are as
Assuming that 10 million people in Eu-
follows:
rope, outside the Former Soviet Union,
live in territories with a Cs-137 ground • Given the half-life of the two main ra-
contamination higher than 40 kBq/m2 dionuclides (Cs-137 and Sr-90) of approx-
(>1.08 Ci/km2 ) and that the mortality risk imately 30 years each, the radionuclide
is only half that determined in the Cher- load in the contaminated territories will
nobyl region, that is, 17 deaths per 1,000 decrease about 50% for each human gen-
inhabitants (better food and better medi- eration. The concentrations of Pu, Cl-36,
cal and socioeconomic situations), up until and Tc-99 will remain practically the same
2004, we can expect an additional 170,000 virtually forever (half-lives consequently
deaths in Europe outside the Former So- more than 20,000 and 200,000 years), and
viet Union owing to Chernobyl. the concentration of Am-241, which is a
• Let us further assume that for the other decay product of Pu-241, will increase over
150 million Europeans living in territories several generations.
• The genetic damage among descendants Auvinen, A., Vahteristo, M., Arvela, H., Suomela, M.,
of irradiated parents will propagate in the Rahola, T., et al. (2001). Chernobyl fallout and out-
population and will carry through many come of pregnancy in Finland. Env. Health Perspect.
109: 179–185 (//www.ehponline.org/members/
(at least seven) generations. 2001/109p179-185auvinen/auvinen-full.html).
• Fertility is known to decrease after expo- Baleva, L. S., Terletskaya, R. N. & Zimlakova, L. M.
sure to radiation (Radzikhovsky and Kei- (2001). Abnormal health of children in territories
sevich, 2002). of the Russian Federation with radiation exposure
• A radiation adaptation process may occur as the result of the Chernobyl NPS accident. In:
Ecological Anthropology, Yearbook. Eighth Inter-
(the effect is known from experiments with
national Science and Practical Conference. Human
mammals) (Yablokov, 2002). Ecology in the Post-Chernobyl Period. October 4–6, 2000,
Minsk (Belarussian Committee on Chernobyl Chil-
dren, Minsk): pp. 15–23 (in Russian).
7.8. Conclusion Bandazhevsky, Yu. I. (1999). Pathology of Incorporated Ionizing
Radiation (Gomel Medical Institute, Minsk): 136 pp.
There are many findings of increased ante- (in Russian).
natal, childhood, and general mortality in the Bennett, B. (1996). Assessment by UNSCEAR of world-
wide doses from the Chernobyl accident. Interna-
highly contaminated territories that are most tional Conference. One Decade after Chernobyl: Sum-
probably associated with irradiation from the ming Up the Consequences of the Accident. April 8–12,
Chernobyl fallout. Significant increases in can- 1996, Vienna (Materials/IAEA, Vienna): pp. 117–
cer mortality were observed for all irradiated 126.
groups. Bentham, G. (1991). Chernobyl fallout and perinatal mor-
tality in England and Wales. Soc. Sci. Medic. 33(4):
A detailed study reveals that some 4% of all
429–434.
deaths from 1990 to 2004 in the contaminated Bertell, R. (2006). The death toll of the Chernobyl ac-
territories of Ukraine and Russia were caused cident. In: Busby, C. C. & Yablokov, A. V. (Eds.),
by the Chernobyl catastrophe. The lack of ev- ECRR Chernobyl 20 Years On: Health Effects of the Cher-
idence of increased mortality in other affected nobyl Accident. ECRR Doc. 1 (Green Audit Books,
countries is not proof of the absence of adverse Aberystwyth): pp. 245–248.
Bertollini, R., di Lallo, D., Mastroiacovo, P. & Perucci,
effects of radiation. C. A. (1990). Reduction of births in Italy after the
The calculations in this chapter suggest that Chernobyl accident. Scand. J. Work Env. Health 16:
the Chernobyl catastrophe has already killed 96–101.
several hundred thousand human beings in Bogdanovich, I. P. (1997). Comparative analysis of chil-
a population of several hundred million that dren’s (0–5 years) mortality in 1994 in the radioactive
contaminated and clean areas of Belarus. Medical Bi-
was unfortunate enough to live in territories af-
ological Effects and Ways to Overcome the Consequences of
fected by the Chernobyl fallout. The number the Chernobyl Accident (Collected Papers Devoted to
of Chernobyl victims will continue to grow in the Tenth Anniversary of the Chernobyl Accident,
the next several generations. Minsk/Vitebsk): 47 pp. (in Russian).
Borysevich, N. Y. & Poplyko, I. Y. (2002). Scientific
Solution of the Chernobyl Problems: Year 2001
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216
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CHERNOBYL
Conclusion to Chapter II
Morbidity and prevalence of the separate spe-

cific illnesses as documented in Chapter II, Cases of goiter, children:
parts 4, 5, 6, and 7 still do not give a complete Up to 1988: not found
Years 1994–1995: 12–13 per 1,000
picture of the state of public health in the ter-
Neonatal mortality (0–6 days after birth):
ritories affected by Chernobyl. The box below Years 1984–1987: 25–75 per 1,000 live births
documents the health of the population in the Years 1995–1996: 330–340 per 1,000 live births
small Ukrainian district of Lugini 10 years af- General mortality:
ter the catastrophe. Lugini is located about 110 Year 1985: 10.9 per 1,000
km southwest of the Chernobyl Nuclear Power Year 1991: 15.5 per 1,000
Life expectancy:
Plant in Zhytomir Province and has radioactive Years 1984–1985: 75 years
contamination at a level above 5 Ci/km2 . Years 1990–1996: 65 years
There are tens of similarly contaminated ter-
ritories in Belarus, Ukraine, European Russia,
Sweden, Norway, Turkey, Austria, South Figure 1 presents data on the annual number
Germany, Finland, and other European coun- of newborns with congenital malformations in
tries. However, Lugini is unique not only be- Lugini districts. There was an increase in the
cause the same medical staff used the same number of such cases seen despite a 25% de-
medical equipment and followed the same pro- crease in the total of Lugini population from
tocols that were used before and after the 1986 to 1996.
catastrophe, but also because the doctors col- In the radioactive-contaminated territories
lected and published these facts (Godlevsky and there is a noticeable increase in the incidence of
Nasvit, 1999). a number of illnesses and in signs and symptoms
that are not in official medical statistics. Among
them there are abnormally poor increase
DETERIORATION IN PUBLIC HEALTH IN ONE in children’s weight, delayed recovery after
UKRAINIAN DISTRICT 10 YEARS AFTER THE illnesses, frequent fevers, etc. (see Chapter II.5,
CATASTROPHE Section 5.2).
District Lugini (Ukraine). The population in 1986: The Chernobyl catastrophe has endowed
29,276 persons, in 1996: 22,552 (including 4,227 world medicine with new terms, among them:
children). Out of 50 villages 22 were contaminated
in 1986 at a level 1–5 Ci/km2 and 26 villages at a
level under 1 Ci/km2 . • The syndrome known as “vegetovascu-
Lifespan from the time of diagnosis of lung or stomach
cancer: lar dystonia” (autonomic nervous sys-
Years 1984–1985: 38–62 months tem dysfunction): functional disturbance
Years 1995–1996: 2–7.2 months of nervous regulation of the cardiovascular
Initial diagnosis of active tuberculosis (percentage of pri- system with various clinical findings arising
mary diagnosed tuberculosis): on a background of stress.
Years 1985–1986: 17.2–28.7 per 100,000 •
Years 1995–1996: 41.7–50.0 per 100,000
The syndrome known as “incorporated
Endocrine system diseases in children: long-living radionuclides” (Bandazhevsky,
Years 1985–1990: 10 per 1,000 1999) that includes pathology of the car-
Years 1994–1995: 90–97 per 1,000 diovascular, nervous, endocrine, reproduc-
tive, and other systems as the result of the
217
218
Figure 1. Absolute number of the congenital developmental anomalies in newborns in

Lugini District, Zhytomir Province, Ukraine, from 1983 to 1996 (Godlevsky and Nasvit, 1999).
accumulation of more than 50 Bq/kg of chestnut syndrome” and “diffraction grating

Cs-137 and Sr-90 in a person. syndrome” (Fedirko, 1999, 2002).
• The syndrome known as “sharp inhala- Among conditions awaiting full medical de-
tion effect of the upper respiratory path” scription are other constellations of diseases,
(Chuchalin, 2002): a combination of a including “irradiation in utero,” “Chernobyl
rhinitis, scratchy throat, dry cough, and AIDs,” “Chernobyl heart,” “Chernobyl de-
shortness of breath with physical activity mentia,” and “Chernobyl legs.”
connected to the impact of inhaled ra- Chernobyl’s radioactive contamination at
dionuclides, including “hot particles.” levels in excess of 1 Ci/km2 (as of 1986–1987)
is responsible for 3.8–4.4% of the overall mor-
Some of the earlier known syndromes have tality in areas of Russia, Ukraine, and Belarus.
an unprecedented wide incidence of occur- In several other European countries with con-
rence. Among them is the syndrome known tamination levels around 0.5 Ci/km2 (as of
as “chronic fatigue” (Lloyd et al., 1988), which 1986–1987), the mortality is about 0.3–0.7%
manifests as tiredness, disturbed dreams, pe- (see Chapter II.7). Reasonable extrapolation
riodic depression and dysphoria, fatigue with- for additional mortality in the heavily contam-
out cause, impaired memory, diffuse muscular inated territories of Russia, Ukraine, and Be-
pains, pains in large joints, shivering, frequent larus brings the estimated death toll to about
mood changes, cervical lymph node sensitiv- 900,000, and that is only for the first 15 years
ity, and decreased body mass. It is postulated after the Chernobyl catastrophe.
that these symptoms are a result of impaired Chernobyl’s contribution to the general mor-
immune system function in combination with bidity is the determining factor in practically all
disorders of the temporal–limbic parts of the territories with a level of contamination higher
central nervous system. These include: (a) the than 1 Ci/km2 . Chronic diseases of various eti-
syndrome called “lingering radiating illness” ologies became typical not only for liquidators
(Furitsu et al., 1992; Pshenichnykov, 1996), a but also for the affected populations and appear
combination of unusual weariness, dizziness, to be exacerbated by the radioactive contami-
trembling, pains in the back, and a humeral nation. Polymorbidity, the presence of multiple
belt, originally described in the hibakusha (sur- diseases in the same individual, has become a
vivors of Hiroshima and Nagasaki) and (b) common feature in the contaminated territo-
the syndromes comprising choreoretinopathy, ries. It appears that the Chernobyl cancer toll
changes in retinal vessels, called “incipient is one of the soundest reasons for the “cancer
Yablokov et al.: Conclusion to Chapter II 219
epidemic” that has been afflicting humankind • An absence of a correlation between cur-
since the end of the 20th century. rent average annual doses with doses re-
Despite the enormous quantity of data conceived in 1986–1987.
cerning the deterioration of public health in the • A noticeable growing contribution to a col-
affected territories, the full picture of the catas- lective dose for individuals in zones with a
trophe’s health impact is still far from complete. low level of contamination.
To ascertain the total complex picture of the • Increasing (instead of decreasing as was
health consequences of the Chernobyl catas- logically supposed) levels of individual ir-
trophe we must, first of all: radiation for many people in the affected
•
territories.
Expand, not reduce, as was recently • A need to end the demand for a 20-year la-
done in Russia, Ukraine, and Be-
tency period for the development of cancer
larus, medical, biological, and radiological
(skin, breast, lung, etc.). Different cancers
studies.
•
have different latencies following exposure
Obtain correct reconstruction of individ-
to various and differing carcinogenic ex-
ual doses, differentiated by the contribu-
posures. Juvenile victims are an obvious
tion of various radionuclides from both
example.
internal and external irradiation levels, as-
certain personal behavior and habits, and
As a result of prolonged immune system sup-
have a mandatory requirement to deter-
pression there will be an increase in many
mine correct doses based on chromosome
illnesses. As a result of radiation damage to
and tooth enamel analysis.
•
the central nervous system in general and to
Perform comparative analyses of monthly
temporal–limbic structures in the brain there
medical statistics before and after the
will be more and more people with problems of
catastrophe (especially for the first years af-
intellectual development that threatens to cause
ter the catastrophe) for the administrative
loss of intellect across the population. As a re-
units (local and regional) that were con-
sult of radio-induced chromosomal mutations
taminated with various levels of particular
a spectrum of congenital illnesses will become
radionuclides.
widespread, not only in the contaminated terri-
The constantly growing volume of objec- tories but also with migration over many areas
tive scientific data about the negative conse- and over several generations.
quences of the Chernobyl catastrophe for pub-
lic health, not only for the Former Soviet Union
References
but also in Sweden, Switzerland, France, Ger-
many, Italy, Turkey, Finland, Moldova, Roma- Bandazhevsky, Yu. I. (1999). Pathology of incorporated
nia, The Czech Republic, and other coun- ionizing radiation (Belarussian Technological Uni-
tries are not a cause for optimism (details in versity, Minsk): 136 pp. (in Russian).
Chapter II, parts 4–7). Without special large- Chernobyl Forum (2005). Chernobyl’s Legacy: Health, En-
vironmental and Socio-economic Impacts. Highlights of the
scale programs of mitigation and prevention Chernobyl Forum Studies (IAEA, Vienna): 47 pp.
of morbidity and consequent mortality, the Chuchalin, A. G. (2002). Functional condition of liquida-
Chernobyl-related diseases linked to contam- tors’ pulmonary system: 7-years follow up study. Pul-
ination that began some 23 years ago will con- monology 4: 66–71 (in Russian).
tinue to increase. Fedirko, P. (1999). Chernobyl accident and the eye: some
results of a prolonged clinical investigation. Ophthal-
There are several signals to alert public
mology 2: 69–73.
health personnel in territories that have been Fedirko, P. (2002). Clinical and epidemiological stud-
contaminated by the Chernobyl fallout in ies of eye occupational diseases in the Chernobyl
Belarus, Ukraine, and Russia: accident victims (peculiarities and risks of eye
220
pathology formation, prognosis). M.D. Thesis (In- Accident at the ChNPS. In: Imanaka, T. (Ed.). Recent
stitute of Occupational Health, Kiev): 42 pp. (in Research Activities about the Chernobyl NPP Accident in
Ukrainian). Belarus, Ukraine and Russia. KURRI-KR-79 (Kyoto
Furitsu, K., Sadamori, K., Inomata, M. & Murata University, Kyoto): pp. 149–157.
S. (1992). Underestimated radiation risks and ig- Lloyd, A. R., Hales, J. P. & Gandevia S. C. (1988). Mus-
nored injuries of atomic bomb survivors in Hi- cle strength, endurance and recovery in the post-
roshima and Nagasaki. The Investigative Com- infection fatigue syndrome. J. Neurol. Neurosurg. Psy-
mittee of Hibakusha of Hannan Chuo Hospital: chiat. 51(10): 1316–1322.
24 pp. Pshenichnykov, B. V. (1996). Low dose radioactive irra-
Godlevsky, I. & Nasvit, O. (1999). Dynamics of Health diation and radiation sclerosis (“Soborna Ukraina,”
Status of Residents in the Lugini District after the Kiev): 40 pp. (in Russian).
CHERNOBYL
Chapter III. Consequences of the Chernobyl

Catastrophe for the Environment
Alexey V. Yablokov,a Vassily B. Nesterenko,b
and Alexey V. Nesterenkob
a
b
Key words: Chernobyl; radionuclides; radiolysis; soil; water ecosystems; bio-

accumulation; transition ratio; radiomorphosis
The level of radioactivity in the atmosphere, scope and severity, the consequences for nature
water, and soil in the contaminated terri- are neither fully documented nor completely
tories will determine the eventual level of understood and may also not decline.
radiation of all living things, both directly Cs-137 is removed from ecological food
and via the food chain. Patterns of radioac- chains a hundred times more slowly than was
tive contamination essentially change when predicted right after the catastrophe (Smith
the radionuclides are transferred by water, et al., 2000; and others). “Hot” particles
wind, and migrating animals. Land and bod- have disintegrated much more rapidly than
ies of water that were exposed to little or expected, leading to unpredictable secondary
no contamination can become much more emissions from some radionuclides. Sr-90 and
contaminated owing to secondary transfer. Am-241 are moving through the food chains
Many Russian-language publications have doc- much faster than predicted because they are
umented such radionuclide transfers, as well so water soluble (Konoplya, 2006; Konoplya
as changes in concentration and bioaccumu- et al., 2006; and many others). Chernobyl ra-
lation in soil and water affecting various ani- dioactive contamination has adversely affected
mals and plants (see, e.g., the reviews by Kono- all biological as well as nonliving components of
plya and Rolevich, 1996; Kutlachmedov and the environment: the atmosphere, surface and
Polykarpov 1998; Sokolov and Kryvolutsky, ground waters, and soil.
1998; Kozubov and Taskaev, 2002). The in-
fluence of Chernobyl radionuclide fallout on References
ecosystems and populations of animals, plants,
and microorganisms is well documented. Konoplya, E. F. (2006). Radioecological, medical and bi-
In Chapters I and II we repeatedly empha- ological consequences of the Chernobyl catastrophe.
In: Fifth Congress of Radiation Research on Radio-
size that we do not present all of the available
biology, Radioecology and Radiation Safety, April
data on the consequences of Chernobyl, but 10–14, 2006, Moscow, (Abstracts, Moscow) 2: pp.
only selected parts to reflect the many problems 101–102 (in Russian).
and to show the enormous scale of the contami- Konoplya, E. F. & Rolevich, I. V. (Eds.) (1996). Ecological,
nation. In Chapter III as well we have included Biological, Medical, Sociological and Economic Consequences
only part of the material concerning the impact of Chernobyl Catastrophe in Belarus (Minsk): 281 pp. (in
Russian).
of the catastrophe on the biosphere—on fauna Konoplya, E. F., Kudryashov, V. P. & Grynevich, S.
and flora, on water, air, and soil. We emphasize V. (2006). Formation of air radioactive contami-
that like the consequences for public health, nation in Belarus after the Chernobyl catastrophe.
which are not declining but rather increasing in International Scientific and Practical Conference.
221
222
Twenty Years of Chernobyl Catastrophe: Ecological and ical and Biological Consequences of the Chernobyl Accident
Sociological Lessons. June 5, 2006, Moscow (Ma- (“Medecol,” Kiev): 172 pp. (in Russian).
terials, Moscow): pp. 91–96 (//www. ecopol- Smith, J. T., Comans, R. N. J., Beresford, N. A., Wright,
icy.ru/upload/File/conferencebook_2006.pdf) (in S. M., Howard, B. J. & Camplin, W. C. (2000). Con-
Russian). tamination: Chernobyl’s legacy in food and water.
Kozubov, G. M. & Taskaev, A. I. (2002). Radiobiological Nature 405: p. 141.
Study of Conifers in a Chernobyl Catastrophic Area (“DIK,” Sokolov, V. E. & Kryvolutsky, D. A. (1998). Change in Ecol-
Moscow): 272 pp. (in Russian). ogy and Biodiversity after a Nuclear Disaster in the Southern
Kutlachmedov, Yu. A. & Polykarpov, G. G. (1998). Med- Urals (“Pentsoft,” Sofia/Moscow): 228 pp.
CHERNOBYL
8. Atmospheric, Water, and Soil

Contamination after Chernobyl
Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko
Air particulate activity over all of the Northern Hemisphere reached its highest levels
since the termination of nuclear weapons testing—sometimes up to 1 million times
higher than before the Chernobyl contamination. There were essential changes in the
ionic, aerosol, and gas structure of the surface air in the heavily contaminated ter-
ritories, as measured by electroconductivity and air radiolysis. Many years after the
catastrophe aerosols from forest fires have dispersed hundreds of kilometers away. The
Chernobyl radionuclides concentrate in sediments, water, plants, and animals, some-
times 100,000 times more than the local background level. The consequences of such a
shock on aquatic ecosystems is largely unclear. Secondary contamination of freshwa-
ter ecosystems occurs as a result of Cs-137 and Sr-90 washout by the high waters of
spring. The speed of vertical migration of different radionuclides in floodplains, low-
land moors, peat bogs, etc., is about 2–4 cm/year. As a result of this vertical migration
of radionuclides in soil, plants with deep root systems absorb them and carry the ones
that are buried to the surface again. This transfer is one of the important mechanisms,
observed in recent years, that leads to increased doses of internal irradiation among
people in the contaminated territories.
8.1. Chernobyl’s Contamination April 26, 1986, the concentrations of the pri-
of Surface Air mary radionuclides changed drastically from
place to place and from day to day (Table 8.1).
Data below show the detection of surface 2. Table 8.2 indicates the dynamics of the
air contamination practically over the entire average annual concentration of some radionu-
Northern Hemisphere (see Chapter I for rele- clides in the atmosphere near the Chernobyl
vant maps). NPP.
3. There were essential changes in the
8.1.1. Belarus, Ukraine, and Russia ionic, aerosol, and gas structure of the sur-
face air in the catastrophe zone. A year later,
There are many hundreds of publications within a 7-km zone of the Chernobyl NPP,
about specific radionuclide levels in the Former the electroconductivity of the air at ground
Soviet Union territories—of which the data be- level was 240–570 times higher than in the
low are only examples. less contaminated territories several hundred
1. Immediately after the first explosion in kilometers away (Smirnov, 1992). Outside of
the Chernobyl Nuclear Power Plant (NPP) on the 30-km zone air radiolysis depressed the
ecosystems. Concentrations of ionized sur-
face air in the contaminated territories near
the Chernobyl NPP repeatedly exceeded this
Address for correspondence: Alexey V. Yablokov, Russian level in Kaluga Province, Russia, and Zhy-
tomir Province, Ukraine, by 130- to 200-fold
[email protected] (Kryshev and Ryazantsev, 2000).
223
224
TABLE 8.1. Concentration (Bq/m3 ) of Some Ra- TABLE 8.2. Dynamics of the Concentration of
dionuclides on April 29–May 1, 1986, in Belarus Some Radionuclides (Bq/m3 ) in the Chernobyl
(Minsk City) and Ukraine, Kiev Province (Kryshev City Atmosphere, 1986–1991 (Kryshev et al.,
and Ryazantsev, 2000) 1994)
Baryshevka, Year Sr-90 Ru-106 Cs-137 Se-144
Minsk City, Kiev Province,
Radionuclide April 28–29 April 30–May 1 1986, July– n/a 13,000 5,000 34,000
December
Te-132 74 3,300 1987 n/a 4,000 2,000 12,000
I-131 320 300 1988 430 400 600 1,400
Ba-140 27 230 1989 130 – 90 160
Cs-137 93 78 1990 52 – 80 –
Cs-134 48 52 1991 52 – 100 –
Se-141 – 26
Se-144 – 26
Zr-95 3 24
Ru-103 16 24 harrowing, etc.) and other dust-creating activi-
ties. There is a tendency for radionuclide levels
in surface air to increase during the spring and
4. From April to May 1986 surface air ra- summer months, especially during dry weather.
dioactivity in Belarus increased up to 1 mil- 6. Levels of radioactive contamination of
lion times. There was a subsequent grad- the surface air in Belarus has three dynamic
ual decrease until the end of 1986 and then components: (1) the general radioecological sit-
the rate fell sharply. In the Berezinsk Na- uation; (2) cyclical, connected with seasonal
ture Reserve (400 km from Chernobyl) on changes (e.g., agricultural activities); and (3) in-
April 27–28, 1986, the concentrations of I- cidental, as a consequence of numerous an-
131 and Cs-137 in the air reached 150– thropogenic and natural factors. The inciden-
200 Bq/m3 and 9.9 Bq/m3 , respectively. In tal component was strongly demonstrated in
1986 in Khoinyki, the midyear concentra- 1992, when there were raging forest fires over
tion of Cs-137 in the surface air was 3.2 × all of Belarus. Their impact on the radioactive
10−2 Bq/m3 and in Minsk it was 3.8 × level in the atmosphere was so great that it led
10−3 Bq/m3 , levels that are 1,000 to 10,000 to a significant increase in the midyear con-
times higher than precatastrophe concentra- centration of radionuclides in surface air and
tions, which were below 10−6 Bq/m3 . Midyear most probably in human contamination via in-
concentration of Pu-239 and Pu-240 in sur- halation. In territories with a high density of
face air in 1986 for Khoinyki was 8.3 × 10−6 ground-level radioactive contamination (in soil,
Bq/m3 and for Minsk it was 1.1 × 10−6 Bq/ water, vegetation) the hot air resulting from the
m3 , levels that were 1,000 times higher fires caused radionuclides to be carried up to a
than the precatastrophe concentrations, which height of 3 km and transported over hundreds
were measured at less than 10−9 Bq/m3 of kilometers (Konoplia et al., 2006).
(Gres’, 1997). The half-life period to cleanse 7. In Russia beta-activity originating from
the surface air of Pu-239 and Pu-240 was Chernobyl was detected several days after
14.2 months, and for Cs-137 it took up to April 26, 1986, in Bryansk, Tula, Kaluga,
40 months (Nesterenko, 2005). Noticeably high Oryol, Voronezh, Smolensk, and Nizhni Nov-
levels of radionuclides in surface air were gorod (Gor’ky); also in Rostov, Tambov, and
detected many years after the catastrophe Penza provinces in the Karelia Republic in
(Figure 8.1). the European part of the county; in Ural
5. Surface atmospheric radioactivity rises (Sverdlovsk Province); and in the far eastern
markedly after some agricultural work (tilling, sector (Khabarovsk and Vladivostok), and in
Yablokov et al.: Atmospheric, Water, and Soil Contamination 225
Figure 8.1. Dynamics of the radionuclides Pu-239, Pu-240, and Cs-137 in the surface
air in Khoiniky, Belarus, 1990–2004 (Konoplya et al., 2006).
some places was more than 10,000 times higher Bq/m3 ; Sr-90, 5.7 mBq/m3 ; Pu-239 + Pu-240,
than the precatastrophe levels (Kryshev and 51 Bq/m3 ; and Am-241, 5.2 μBq/m3
Ryazantsev, 2000). (Aarkrog, 1988).
8. Several years after the catastrophe, sec- 3. FINLAND. The most detailed accounting of
ondary radioactive contamination from dust the Chernobyl radionuclide fallout during the
and aerosols became the important factor. On first days after the catastrophe was in Sweden
September 6, 1992, radioactive aerosols lifted and Finland (Table 8.3).
by a strong wind from the 30-km Chernobyl 4. JAPAN. Two Chernobyl radioactive clouds
zone reached the vicinity of Vilnius, Lithuania were detected over Japan: one at a height of
(about 300 km away) in 5–7 h, where the Cs- about 1,500 m in the first days of May 1986
137 concentration increased 100-fold (Ogorod- and the other at a height of more than 6,000 m
nykov, 2002). The same scale of radionuclide at the end of May (Higuchi et al., 1988). Up
dispersion occurs in the wake of forest fires to 20 radionuclides were detected in the sur-
that at times rage over large areas of the con- face air, including Cs-137, I-131, and Ru-103.
taminated territories of Belarus, Russia, and
Ukraine.
TABLE 8.3. Airborne Radioactivity (mBq/m3 ) of
8.1.2. Other Countries 19 Radionuclides in Finland, Nurmijarvi, April 28,
1986 (Sinkko et al., 1987)
Below are some examples of Chernobyl’s ra-
Nuclide Activity Nuclide Activity
dioactive contamination of the atmosphere in
the Northern Hemisphere. I-131 223,000 Te-131m 1,700
1. CANADA. Three Chernobyl clouds en- I-133 48,000 Sb-127 1,650
Te-132 33,000 Ru-106 630
tered eastern Canada: the first on May 6,
Cs-137 11,900 Ce-141 570
1986; the second around May 14; the third on Cs-134 7,200 Cd-115 400
May 25–26. The fallout included: Be-7, Fe-59, Ba-140 7,000 Zr-95 380
Nb-95, Zr-95, Ru-103, Ru-106, Cs-137, I-131, Te-129m 4,000 Sb-125 253
La-141, Ce-141, Ce-144, Mn-54, Co-60, Zn- Ru-103 2,880 Ce-143 240
65, and Ba-140 (Roy et al., 1988). Mo-99 2,440 Nd-147 150
Cs-136 2,740 Ag-110m 130
2. DENMARK. From April 27 to 28 the Np-239 1,900
mean air concentration of Cs-137 was 0.24
226
Concentrations of Cs-131/Cs-134/Cs-137 in TABLE 8.4. Examples of Surface Air Concentra-

the surface air northwest of Japan increased tions of I-131, Cs-131, Cs-137, and Cs-134 over
the United States after the Chernobyl Catastrophe,
more than 1,000 times (Aoyama et al., 1986;
May 1986 (Larsen and Juzdan, 1986; Larsen et al.,
Ooe et al., 1988). Noticeable atmospheric Cs- 1986; US EPA, 1986; Toppan, 1986; Feely et al.,
137 fallout was marked in Japan up through 1988; Gebbie and Paris, 1986; Vermont, 1986)
the end of 1988 (Aoyama et al., 1991).
Radionuclide Location Activity
5. YUGOSLAVIA. The increase in Pu-238/
P239-240 ratios in surface air at the Vinca- I-131 New York, NY 20,720 μBq/m3
Belgrade site for May 1–15, 1986, confirms Rexburg, ID 11,390 μBq/m3
that Chernobyl was the source (Mani-Kudra Portland, ME 2.9 pCi/m3
Augusta, ME 0.80 pCi/m3
et al., 1995).
Barrow, AL 218.7 fCi/m3
6. SCOTLAND. The Chernobyl fallout on the Mauna Loa, HI 28.5 fCi/m3
evening of May 3 included Te-132, I-132, I- Cs-137 New York, NY 9,720 μBq/m3
131, Ru-103, Cs-137, Cs-134, and Ba-140/La- Barrow, AL 27.6 fCi/m3
140 (Martin et al., 1988). Mauna Loa, HI 22.9 fCi/m3
7. UNITED STATES. Chernobyl’s radioactive Cs-134 Mauna Loa, HI 11.2 fCi/m3
Barrow, AL 18.6 fCi/m3
clouds were noted in the Bering Sea area of Gross beta Portland, ME 1.031 pCi/m3
the north Pacific (Kusakabe and Ku, 1988), Lincoln, NE 14.3 pCi/m3
and reached North America. The pathways Vermont 0.113 pCi/m3
of the Chernobyl plumes crossed the Arctic
within the lower troposphere and the Pacific
Ocean within the mid-troposphere. The first
measured radiation arrived in the United States 8.2. Chernobyl’s Contamination
on May 10, and there was a second peak on of Aquatic Ecosystems
May 20–23. The second phase yielded much
higher Ru-103 and Ba-140 activity relative to Chernobyl contamination traveled across
Cs-137 (Bondietti et al., 1988; Bondietti and the Northern Hemisphere for hours, days, and
Brantley, 1986). The air particulate activity weeks after the catastrophe, was deposited via
in the United States reached its highest level rain and snow, and soon ended up in bod-
since the termination of nuclear weapons test- ies of water—rivers, lakes, and seas. Many
ing (US EPA, 1986). Examples of Chernobyl’s Belarussian, Ukrainian, Russian, Latvian, and
atmospheric contamination are presented in Lithuanian rivers were shown to be contam-
Table 8.4. inated after the catastrophe, including the
Table 8.5 summarizes some examples of sur- water basins of the Dnepr, Sozha, Pripyat, Ne-
face air contamination in several countries re- man, Volga, Don, and the Zapadnaya/Dvina-
sulting from the Chernobyl catastrophe. Daugava.
Modern science is far from understanding
or even being able to register all of the spe- 8.2.1. Belarus, Ukraine, and Russia
cific radiogenic effects for each of the Cher-
nobyl radionuclides. However, the effects of the 1. In the first days after the catastrophe
products of radiolysis from such huge atmo- (the period of primary aerosol contamination),
spheric radiation fallout demands close atten- the total activity in Pripyat River water near
tion. The term “atmospheric radiotoxins” ap- the Chernobyl NPP exceeded 3,000 Bq/liter.
peared after the catastrophe (Gagarinsky et al., Only by the end of May 1986 had it de-
1994). As noted earlier, radionuclide air disper- creased to 200 Bq/liter. The maximum con-
sion may occur secondarily as a result of forest centration of Pu-239 in the Pripyat River was
fires. 0.37 Bq/liter.
TABLE 8.5. Examples of Surface Air Concentrations of Some Radionuclides in the Northern Hemisphere
after the Catastrophe, 1986
Radionuclide Concentration Location Date Reference
I-131 223 Bq/m3 Nurmijarvi Apr. 28 RADNET, 2008

251 Bq/m3 Revelstoke, B.C., Canada May 13
176 Bq/m3 Quebec, Canada May 5–6
20.7 Bq/m3 New York, NY May
0.8 Bq/m3 Japan May 5 Imanaka and Koide, 1986
Cs-137 9.7 Bq/m3 Vienna Apr. 30 Irlweck et al., 1993
Ru-103 62.5 Bq/m3
Gross beta 160 Bq/m3 Bulgaria May 1 Pourchet et al., 1997
100 Bq/m3 Munich Apr. 30 Hotzl et al., 1987
Pu-239 + Pu-240 89 μBq/m3 Vienna May Irlweck et al., 1993
0.4 μBq/m3,∗ Paris Apr. 29–30 Thomas and Martin, 1986
∗
During 1984, total Pu-239 + Pu-240 activity was 1,000-fold less (10–40 nBq/m3 ).
2. From May to July 1986 the level of radi- in fish, 1–10% in gastropod mollusks, and
ation in the northern part of the Kiev water less than 1% in plankton (Gudkov et al.,
reservoir was 100,000 times higher than the 2006).
precatastrophe level (Ryabov, 2004). 7. The Cs-137 in the Dnepr River
3. Concentration of I-131 in surface wa- floodplain–lake ecosystem was distributed as
ter in Leningrad Province (Sosnovy Bor follows: 85–97% in aquatic plants, 1–8% in
City) on May 2, 1986, was 1,300 Bq/liter zoobenthos, 1–8% in fish, and about 1% in
and on May 4, 1986, it was 740 Bq/liter gastropod mollusks (Gudkov et al., 2006).
(Kryshev and Ryazantsev, 2000; Blynova, 8. Owing to bioaccumulation, the amount of
1998). radionuclides can be thousands of times higher
4. During the first period after the catastro- in plants, invertebrate, and fishes compared
phe the littoral zone was heavily contaminated with concentrations in water (Table 8.6).
with radioactivity. In the years that followed 9. In contaminated territories with Cs-137
bodies of water became secondarily contami- levels of 0.2 Ci/km2 the rate of transfer from
nated as a result of the washout of Cs-137 and water into turf plants can vary 15- to 60-fold
Sr-90 by spring high waters and from woodland from year to year (Borysevich and Poplyko,
fire fallout (Ryabov, 2004). 2002).
5. In July 1986, the primary dose-forming 10. More than 90% of the Pu + Am in
radionuclides in clay in the bodies of wa- aquatic ecosystems is in the sediment (Bory-
ter near the Chernobyl NPP were Ni-98 (27 sevich and Poplyko, 2002).
kBq/kg), Ce-144 (20.1 kBq/kg), and Zr-96 11. The Cs-137 and Sr-90 concentrations in-
(19.3 kBq/kg). In March–April 1987 the con- creased in underground water and correlated
centration of Ni-95 in aquatic plants there with the density of land contamination and
reached 29 kBq/kg and Zr-95 levels in fowl zones of aeration. The highest level of Sr-90
were up to 146 kBq/kg (Kryshev et al., (up to 2.7 Bq/liter) was observed in rivers that
1992). ran through the heavily contaminated territo-
6. The Sr-90 contamination in the Dnepr ries. In the Pripyat River floodplains in the
River floodplain–lake ecosystem was concen- territories with land contamination greater
trated primarily in bivalve mollusks, 10–40% than 1,480 kBq/km2 ground water activ-
concentrated in aquatic plants, about 2% ity reached 3.0 Bq/liter of Cs-137 and
228
TABLE 8.6. Coefficients of Accumulation for Some Live Organisms∗ of Chernobyl Radionuclides in the
Dnepr River and the Kiev Reservoir, 1986–1989 (Kryshev and Ryazantsev, 2000: tables 9.12, 9.13,
9.14; Gudkov et al., 2004)
Fishes (bream, sander,
Radionuclide Mollusks Water plants roach, silver bream)
Ce-141, Ce-144 3,000–4,600 20,000–24,000 500–900

Ru-103, Ru-106 750–1,000 11,000–17,000 120–130
Cs-134, Cs-137 178–500 2,700–3,000 100–1,100
Zr-95 2,900 20,000 190
Ni-95 3,700 22,000 220
Sr-90 440–3,000 240 50–3,000
Pu — 4,175 98
Am — 7,458 1,667
I-131 120 60 2–40
∗
Concentration in aquatic flora and fauna as compared with concentration in water.
0.7 Bq/liter of S-90 (Konoplia and Rolevich, 8.2.2. Other Countries

1996).
12. During spring high waters Cs-137 that 1. FINLAND, FRANCE, AND CANADA. Data
has accumulated in bottom sediments becomes on some radionuclide concentrations in rain-
suspended and leads to noticeably increased fall and surface water in Finland, France, and
radioactivity in water. Up to 99% of Sr-90 mi- Canada are presented in Table 8.7.
grates in a dissolved state (Konoplia and Role- 2. GREAT BRITAIN (SCOTLAND). On the
vich, 1996). evening of May 3, one of the Chernobyl clouds
13. Owing to its higher solubility, Sr-90 contaminated the sea with Te-132/I-132, I-
leaves river ecosystems much faster than Cs- 131, Ru-103, Cs-137, Cs-134, and Ba-140/La-
137. At the same time Cs-137 can accumulate 140 totaling 7,000 Bq/liter (Martin et al.,
up to 93 × 10−9 Ci/kg in grass and sod on 1988).
flooded land (Borysevich and Poplyko, 2002). 3. GREECE. Composition of dose-
14. The amount of Cs-137 and Sr-90 in wa- forming radionuclides and their activity
ter has decreased over time, but it has increased in Greece in May 1986 are presented in
in aquatic plants and sediments (Konoplia and Table 8.8.
Rolevich, 1996). 4. NORTH SEA. In a North Sea sediment
15. More intensive radionuclide accumula- trap, the highest Chernobyl activity reached
tion occurs in lake sediments owing to an- 670,000 Bq/kg, with Ru-103 being the most
nual die-off of vegetation and the absence of prevalent isotope (Kempe and Nies, 1987). Ra-
drainage. In the 5 to 9 years after the catas- dionuclide levels in sea spume were several
trophe, in heavily weeded bodies of water there thousand times higher than in seawater in
was a decrease in Cs-137 and Sr-90 in the water June of 1986. Cs-137 and Cs-134 quickly mi-
itself but a simultaneous increase in radioactiv- grated to the sediments, whereas Ru-106 and
ity in the sediment (Konoplia and Rolevich, Ag-110 lingered in the spume (Martin et al.,
1996). 1988).
16. In the Svjetsko Lake (Vetka District, Be- 5. THE NETHERLANDS. I-131, Te-132, I-132,
larus), total radionuclide concentration in water La-140, Cs-134, Cs-137, and Ru-103 were
measured 8.7 Bq/liter, in aquatic plants upto measured in rainwater in the Nijmegen area
3,700 Bq/kg, and in fish up to 39,000 Bq/kg during May 1–21, 1986. The total activity
(Konoplia and Rolevich, 1996). on the first rainy day was of 9 kBq/liter
TABLE 8.7. Rainfall and Surface Water Radionuclide Concentrations in Several Countries, 1986–
1987
Maximum
Radionuclide concentration Location Date Reference
Cs-137 5,300 Bq/m3∗ Finland 1986 Saxen and Aaltonen, 1987

325 mBq/liter Canada, Ontario May 1986 Joshi, 1988
700 Bq/liter France, Paris Apr. 29–30, 1986 Thomas and Martin, 1986
Sr-89 11,000 Bq/m3 Finland 1986 Saxen and Aaltonen, 1987
Te-132 7,400 Bq/liter France, Paris Apr. 29–30, 1986 Thomas and Martin, 1986
∗
About 1,000 times higher than the precatastrophe concentration, and up to 80 times higher than the highest values
after the nuclear weapons test period in the 1960s.
(2.7 kBq/liter for I-131 and 2.3 kBq/liter each 8. TYRRHENIAN SEA. Concentration of Cs-
for Te-132 and I-132). The total activity pre- 137 in surface water of the Tyrrhenian Sea rose
cipitated per square kilometer in this period significantly immediately after the catastrophe
was about 55 GBq (Beentjes and Duijsings, (Figure 8.3).
1987).
6. POLAND. Average values of Pu-239 + Pu-
240 in the Polish economic zone of the Baltic 8.3. Chernobyl’s Contamination
Sea ranged from 30 to 98 Bq/m2 in three sam- of the Soil Mantle
pling locations. The highest concentration of
Pu in sediment probably came from the Vis- The soil mantle will accumulate Chernobyl’s
tula River, which delivered 192 MBq of Cher- radionuclides with long half-lives for centuries.
nobyl’s Pu-239 + Pu-240 to the Baltic Sea in As in the previous review, this material is only
1989 (Skwarzec and Bojanowski, 1992). The a representative selection from the very large
total Cs-137 loading of Lake Sniardwy was es- body of existing data.
timated to average 6,100 Bq/m2 (Robbins and
Jasinski, 1995).
7. SWEDEN. The annual mean concentra- 8.3.1. Belarus, Ukraine, and Russia
tion of Cs-137 (in Bq/kg) in surface water near 1. Radionuclides on sod-podzol and heav-
Gotland Island from 1984 to 2004 is shown in ily podzolized sandy clay soils move from the
Figure 8.2. surface to the bottom soil layer during the
course of time, resulting in the concentration of
TABLE 8.8. Composition and Activity of the Cher- radionuclides in the root zone. It is in this
nobyl Radioactive Fallout in Thessaloniki, Greece, way that soils with low surface contamination
(Total Wet Deposition, Bq/m2 ), May 5–6, 1986 (Pa- transfer radioactivity to the vegetative (and ed-
pastefanou et al., 1988)
ible) parts of plants (Borysevich and Poplyko,
Radionuclide Maximum concentration 2002).
2. Plowed and natural pastures located 50
I-131 117,278
Te-132 70,700 to 650 km from the Chernobyl site have levels
I-132 64,686 of Cs-137 activity in the 1,000 to 25 kBq/m2
Ru-103 48,256 range in the upper soil layers (0–5 cm). Levels of
Ba-140 35,580 contamination are higher in natural pastures as
Cs-137 23,900 compared with plowed pastures, with the Sr-90
La-140 15,470
activity ranging from 1.4 to 40 kBq/m2 (Salbu
Cs-134 12,276
et al., 1994).
230
Figure 8.2. The annual mean Cs-137 concentrations (in Bq/liter) in surface waters of
East and West Gotland (sampling depth ≤10 m) from 1984 to 2004. Straight line—average
pre-Chernobyl (1984–1985) level (HELCOM, 2006).
3. The soils most highly contaminated by migration is activated at different speeds for
I-131 are in northern Ukraine, eastern Be- different radionuclides (Table 8.9).
larus, and nearby provinces of Russia, but 6. Self-cleansing of soils by vertical migra-
some “spots” of radioiodine soil contamination of radionuclides can reach 2 to 4 cm/year
tion have been detected in many areas, includ- (Bakhur et al., 2005).
ing Kaliningrad Province on the Baltic shore 7. The granular composition of soil and
(Makhon’ko, 1992). agrichemical soil characteristics modifies the
4. In many areas up to hundreds of kilome- transfer coefficient for Cs-137 (see Chapter
ters to the west, northwest, and northeast of 9). There is roughly a 10-fold variation (from
the Chernobyl NPP the levels of Cs-137 soil 0.01 to 0.11 Bq/kg) in the degree of Cs-
contamination exceed 1,489 kBq/m2 (Kryshev 137 transition from soil to beetroots depend-
and Ryazantsev, 2000). ing on whether the soil is sod-podzol, loamy,
5. In humid environments such as flood sandy-clay, or sandy (Borysevich and Poplyko,
planes, lowland moors, and peat bogs vertical 2002).
Figure 8.3. Concentration of Cs-137 (mBq/liter) in surface waters of the Tyrrhenian Sea,
1960–1995 (Europe Environmental Agency, 1999).
TABLE 8.9. The Years Needed to Achieve a 50% 6. FRANCE. The maximal Cs-137 Cher-
Reduction in the Amount of Each Radionuclide in nobyl soil contamination reached up to 545
the Top (0–5 cm) Soil Layer in Areas 50 and 200
kBq/kg (CRII-RAD, 1988) and radioactivity
km from the Chernobyl NPP (National Belarussian
Report, 2006) from Chernobyl fallout in the French Alps
reached 400 Bq/m2 (Pinglot et al., 1994).
Years 7. GERMANY. Average ground deposition for
Radionuclide Up to 50 km Up to 200 km total Cs was 6 kBq/m2 (Energy, 2008), and
concentration of radionuclides in the south-
Pu-239, Pu-240 6–7 >50
Am-241 6–7 >50
ern part of the country was much higher
Sr-90 7–12 7–12 (Table 8.10).
Cs-137 10–17 24–27 8. IRELAND. The initial Chernobyl fallout
owing to Cs-137/Cs-134 reached a concen-
tration of 14,200 Bq/m2 , some 20-fold higher
8.3.2. Other Countries than the pre-catastrophe level (McAuley and
Moran,1989).
1. AUSTRIA. The alpine regions were among 9. ITALY. In the mountain area of Friuli-
the most heavily contaminated territories out- Venezia Giulia deposition of Cs-137 from
side of the Former Soviet Union. In May 1986 Chernobyl ranged from 20 to 40 kBq/m−2 .
in Salzburg Province the median Cs-137 sur- Concentration of Cs-137 in soil 0–5 cm deep
face deposition was about 31 kBq/m2 with declined only 20% in the first 5 years after the
maximum values exceeding 90 kBq/m2 (Let- catastrophe (Velasko et al., 1997).
tner et al., 2007) or even 200 kBq/m2 (Energy, 10. JAPAN. Up to 20 radionuclides were
2008). Ten years after the catastrophe 54% of detected on the ground, including Cs-137,
Chernobyl-derived Cs-137 was 2 cm deeper I-131, and Ru-103, with resulting levels of 414,
into the soil layer in a spruce forest stand, with 19, and 1 Bq/m2 , respectively (Aoyama et al.,
less than 3% having reached layers deeper than 1987).
20 cm. The average retention half-life of Cs- 11. NORWAY. Many places in Norway were
137 was 5.3 years in the 0–5 cm layer, 9.9 years heavy contaminated after the catastrophe
in the 5–10 cm layer, and 1.78 years in layers (Table 8.11).
deeper than 10 cm (Strebl et al., 1996). 12. POLAND. Soil in central Poland was con-
2. BULGARIA. Surface soil Cs-137 activity was taminated by a wide spectrum of the Chernobyl
up to 81.8 kBq/m2 in the most contaminated radionuclides (Table 8.12). In the northeastern
territories, which is eight times higher than the part of the country Cs-134 + Cs-137 ground
cumulative amount deposited during the peak deposition levels were up to 30 kBq/m2 and I-
period of weapons testing (Pourchet et al., 1997). 131 and I-132 deposition was up to 1 MBq/m2
3. CROATIA. In 1986 Cs-137 fallout deposit (Energy, 2008).
reached 6.3 kBq/m2 (Franić et al., 2006). 13. SWEDEN. The mean deposition of Cher-
4. DENMARK. The total mean Cs-137 and Sr- nobyl Cs-137 in the forest soils was above
90 deposits over Denmark reached 1.3 and 38 50 kBq/m2 (McGee et al., 2000), and maxi-
Bq/m2 , respectively, as a result of Chernobyl. mum Cs-134 + Cs-137 ground deposition was
Most of the debris was deposited in the first half up to 200 kBq/m2 (Energy, 2008).
of May. In the Faeroe Islands the mean deposi- 14. UNITED KINGDOM. Examples of radioac-
tion of Cs-137 was 2 kBq/m2 and in Greenland tive contamination in soil are presented in
it was up to 188 Bq/m2 (Aarkrog, 1988). Table 8.13. Floodplain loading of Cs-137 in
5. ESTONIA. The ground deposition from soil was up to 100 times greater than in soils
Chernobyl for Cs-137 was 40 kBq/m2 (Realo above the floodplain (Walling and Bradley,
et al., 1995). 1988). On May 3, one of the Chernobyl clouds
232
TABLE 8.10. Ground Deposition (kBq/m2 ) of Some Chernobyl Radionuclides in Germany, 1986
Radionuclide Location Concentration, max Reference
Cs-137 Upper Swabia 43 Bilo et al., 1993

Bonn 1.38 Clooth and Aumann, 1990
Cs-134 + Cs-137 South Germany 60 Energy, 2008
Te-132 Munich∗ 120 Gogolak et al., 1986
∗
June 3, 1986; cumulative dry and wet deposition.
TABLE 8.11. Examples of Cs-137 Ground Contamination after the Chernobyl Catastrophe in Norway,
1986
Maximum radioactivity Location Reference
22 kBq/kg∗ Stream gravel Hongve et al., 1995

500 kBq/m2∗ Average in sediment Hongve et al., 1995
22 Bq/kg Svalbard glaciers Pinglot et al., 1994
80 kBq/m2 Dovrefjell Solem and Gaare, 1992
54 kBq/m2 (mean) Southern Norway, grazing areas Staaland et al., 1995
200 kBq/m2∗ Soils in affected areas Blakar et al., 1992
∗
Cs-134 + Cs-137
contaminated the Scottish landscape with Te- Ru-103, Ru-106, Cs-134, Cs-136, Cs-137, Ba-
132/I-132, I-131, Ru-103, Cs-137, Cs-134, 140, La-140, I-132, Zr-95, Mo-95, Ce-141, and
and Ba-140/La-140 totaling 41 kBq/m2 (Mar- Ce-144 (Larsen et al., 1986).
tin et al., 1988). 16. Table 8.15 presents data on Cs-137 +
15. UNITED STATES. Observations of ra- Cs-134 contamination in several European
dionuclide contamination of U.S. soils from countries.
Chernobyl are listed in Table 8.14. Ground de-
position for Cs-137 comes close to or exceeds
the total weapons’ testing fallout (Dibb and 8.4. Conclusion
Rice, 1988). The spectrum of Chernobyl’s soil
contamination in the United States included Chernobyl’s radioactive contamination has
adversely affected all biological as well as
nonliving components of the environment:
TABLE 8.12. Spectrum and Activity of Chernobyl the atmosphere, surface and ground waters,
Radionuclides in Soil Samples (kBq/m2 in 0–5 cm the surface and the bottom soil layers, espe-
Layer) in the Krakov Area, May 1, 1986 (Broda,
cially in the heavily contaminated areas of Be-
1987)
larus, Ukraine, and European Russia. Levels of
Radionuclide Activity Radionuclide Activity Chernobyl’s radioactive contamination even in
Te-132 29.3 Ba-140 2.5 North America and eastern Asia are above the
I-132 25.7 La-140 2.4 maximum levels that were found in the wake of
I-131 23.6 Mo-99 1.7 weapons testing in the 1960s.
Te-129m 8.0 Ru-106 1.3 Modern science is far from understanding or
Ru-103 6.1 Sb-127 0.8 even being able to register all of the radiological
Cs-137 5.2 Cs-136 0.7
Cs-134 2.7 Total Up to 360
effects on the air, water, and soil ecosystems due
to anthropogenic radioactive contamination.
TABLE 8.13. I-131 and Cs-134/Cs-137 Soil Contamination (kBq/m2 ) from Chernobyl Radionuclides
in Some Parts of the United Kingdom, 1986
Radionuclide Activity Location Date Reference
I-131 26 Lerwick, Shetland May 1–6 Cambray et al., 1987

41 Holmrook, Cumbria
Cs-137 7.4 Sellafield, Cumbria May Fulker, 1987
15 Ireland 1986 Rafferty et al., 1993
0.6 Berkeley, Gloucestershire May Nair and Darley, 1986
Cs-134/Cs-137 100 Scotland May Wynne, 1989
Gross beta 88.4 Strathclyde, Scotland May 6 RADNET, 2008
TABLE 8.14. Examples of Ground Deposition of Chernobyl Radionuclides (Dibb and Rice, 1988; Dreicer
et al., 1986; Miller and Gedulig, 1986; Gebbie and Paris, 1986)
Radionuclide Location Date, 1986 Activity
Cs-137 Solomons Island, MD May 8–June 20 4,250 Bq/m2

Chester, NJ May 17 9.40 Bq/m2∗
Cs-134 Solomons Island, MD May 8–June 20 2,000 Bq/m2
Ru-103 Solomons Island, MD May 8–June 20 22,000 Bq/m2
Chester, NJ June 3 18.46 Bq/m2
Chester, NJ May 23 15 Bq/m2
I-131 Chester, NJ May 23 47.2 Bq/m2
Portland, OR May 11 9,157 pCi/m2
∗
Deposition on grass.
Undoubtedly there are such changes and, ow- concentrations increased thousands of times at
ing to the amount of Chernobyl radionuclides distances as far as many thousands of kilometers
that were added to the biosphere, the changes away from Chernobyl.
will continue for many decades. Common estimates of the level of radioac-
Contrary to the common view that the tivity per liter or cubic or square meter mask
Chernobyl plumes contained mostly light and the phenomenon of radionuclides concentrat-
gaseous radionuclides, which would disap- ing (sometimes many thousands of times) in
pear without a trace into the Earth’s atmo- sediments, in sea spume, in soil microfilms, etc.,
sphere, the available facts indicate that even Pu through bioconcentration (for details see Chap-
ters 9 and 10). This means that harmless look-
ing “average” levels of radionuclides inevitably
TABLE 8.15. Level of Ground Radioactive Con- have a powerful impact on living organisms in
tamination after the Chernobyl Catastrophe on the contaminated ecosystems.
British Embassy Territory in Some European As a result of vertical migration of radionu-
Countries (http://members.tripod.com/∼BRuslan/
win/energe1.htm)
clides through soil, they accumulate in plants
with deep root systems. Absorbed by the roots,
Cs-134, Cs-137, the buried radionuclides again rise to the sur-
Location kBq/m2 kBq/m2
face and will be incorporated in the food chain.
Czech (Prague) 4.9 2.9 This transfer is one of the more important
Hungary (Budapest) 8.8 5.3 mechanisms observed in recent years that leads
Yugoslavia (Belgrade) 7.3 4.4 to increased internal irradiation for people in
Romania (Bucharest) 4.3 2.6
the all of the territories contaminated by nu-
Poland (Warsaw) 2.8 1.7
clear fallout.
234
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CHERNOBYL
9. Chernobyl’s Radioactive Impact on Flora

Alexey V. Yablokov
Plants and mushrooms accumulate the Chernobyl radionuclides at a level that depends
upon the soil, the climate, the particular biosphere, the season, spotty radioactive con-
tamination, and the particular species and populations (subspecies, cultivars), etc. Each
radionuclide has its own accumulation characteristics (e. g., levels of accumulation for
Sr-90 are much higher than for Cs-137, and a thousand times less than that for Ce-144).
Coefficients of accumulation and transition ratios vary so much in time and space that
it is difficult, if not impossible, to predict the actual levels of Cs-137, Sr-90, Pu-238, Pu-
239, Pu-240, and Am-241 at each place and time and for each individual plant or fungus.
Chernobyl irradiation has caused structural anomalies and tumorlike changes in many
plant species. Unique pathologic complexes are seen in the Chernobyl zone, such as a
high percentage of anomalous pollen grains and spores. Chernobyl’s irradiation has led
to genetic disorders, sometimes continuing for many years, and it appears that it has
awakened genes that have been silent over a long evolutionary time.
There are thousands of papers about agricul- powerful irradiation caused by “hot particles,”
tural, medicinal, and other plants and mush- the soil and plants surfaces became contami-
rooms contaminated after the Chernobyl catas- nated and a cycle of absorption and release of
trophe (Aleksakhin et al., 1992; Aleksakhin, radioisotopes from soil to plants and back again
2006; Grodzinsky et al., 1991; Ipat’ev 1994, was put into motion (Figure 9.1).
1999; Parfenov and Yakushev, 1995; Kras- Soon after the catastrophe plants and fungi
nov, 1998; Orlov, 2001; and many others). in the contaminated territories became con-
There is also an extensive body of literature centrators of radionuclides, pulling them from
on genetic, morphological, and other changes the soil via their roots and sending them to
in plants caused by Chernobyl radiation. In other parts of the plant. Radionuclide levels in
this chapter we present only a relatively small plants depend on the transfer ratio (TR, tran-
number of the many scientific papers that sition coefficient) and the coefficient of accu-
address Chernobyl’s radioactive impact on mulation (CA)—the relationship of specific ac-
flora. tivity of a radionuclide in a plant’s biomass to
The Chernobyl fallout has ruined the pine the specific activity of the same radionuclide in
forests near the nuclear power plant, which soil: [TR = (Bq/kg of plant biomass)/(kBq/m2
were not able to withstand the powerful ra- for soil contamination); CA = (Bq/kg of plant
dioactive impact, where contamination in the biomass)/(Bq/kg of soil)].
first weeks and months after the catastrophe
reached several thousand curies per square
kilometer. With the catastrophe’s initial atmo- 9.1. Radioactive Contamination of
spheric radiotoxins (see Chapter 8) and the Plants, Mushrooms, and Lichens
The level of radionuclide incorporation (ac-

Address for correspondence: Alexey V. Yablokov, Russian cumulation) in a living organism is a simple
and reliable mark of the potential for damage
[email protected] to the genetic, immunological, and life-support
237
238
Figure 9.1. Radioautographs of plants with Chernobyl radionuclides: (A) leaf of common
plantain (Plantago major ); (B) aspen leaf (Populus tremula) Bryansk Province, Russia, 1991.
Spots of the raised radioactivity are visible. (A. E. Bakhur photo, with permission.)
systems of that organism. The first part of 2. Table 9.2 presents data on radionuclide
this section presents data regarding radioactive accumulation in the pine needles in Finland
contamination in plants and the second relates after the catastrophe.
to the levels of contamination in mushrooms 3. Data in Table 9.3 indicate the level of plant
and lichens. radionuclide contamination that was reached
worldwide after the catastrophe.
9.1.1. Plants 4. There were high levels of radionuclide ac-
cumulation in aquatic plants (Table 9.4).
1. The levels of surface contamination of 5. After the catastrophe the levels of incorpo-
three species of plants in Kiev City reached rated radionuclides jumped in all of the heav-
399 kBq/kg and varied by specific location and ily contaminated territories. In annual plants
particular radionuclide (Table 9.1). such as absinthe (Artemisia absinthium), C-14
TABLE 9.1. Chernobyl Radioactivity (Bq/kg, dry weight) of Leafage in Three Species in Kiev City at the
End of July 1986 (Grodzinsky, 1995b)
Nuclide Aesculus hippocastanum∗ Tilla cordata∗∗ Betula verrucosa∗∗ Pinus silvestris∗∗
Pm-144 58,800 146,150 10,800 –

Ce-141 18,800 – 6,500 4,100
Ce-144 63,300 – 21,800 18,800
La-140 1,100 1,930 390 660
Cs-137 4,030 – 3,400 4,300
Cs-134 2,000 – 1,540 2,100
Ru-103, Rh-103 18,350 36,600 10,290 7,180
Ru-106 14,600 41,800 400 5,700
Zr-95 35,600 61,050 11,400 6,500
Nb-95 53,650 94,350 18,500 9,900
Zn-65 – 400 – –
Total activity 312,000 399,600 101,400 70,300
∗
Near underground station “Darnitza”; ∗∗ near underground station “Lesnaya.”
Yablokov: Radioactive Impact on Flora 239
TABLE 9.2. Concentration of Three Radionu- 8. The coefficient of accumulation of Cs-137

clides in Pine Needles in Central Finland, May– in cranberries (Oxycoccus palustris) is up to 1,028
December 1986 (Lang et al., 1988)
(Orlov and Krasnov, 1997; Krasnov and Orlov,
Radionuclide Concentration, Bq/kg 2006).
9. There are wide intraspecies variations
Cs-137 30,000
Ce-141 40,000
in specific Sr-90 activity: from 2–3 up to
Ru-103 35,000 555 Bq/kg in fresh bilberries (Vaccinium myr-
tillus) in mertyllus-type pinewoods (Orlov et al.,
1996).
concentrations increased as much as fivefold 10. More radionuclides accumulated in the
in 1986 (Grodzinsky et al., 1995c). Figure 9.2 root system (up to sevenfold more than in
shows the concentration of C-14 in three rings above-ground parts of plants). In above-ground
(percent compared to the 1950 level) of pine parts, the higher radionuclide concentration is
(Pinus silvestris) from the 10-km zone. in the leaves and lower levels in the flowers
6. There was a marked increase in the to- (Grodzinsky et al., 1995a). The leaves of bilberry
tal amount of radionuclides in tree rings of (Vaccinium myrtillus) during fruiting (July) contain
pine (Pinus silvestris) in the Karelia Republic, 31% of the general Cs-137 activity, stalks have
Russian northwest (more than 1,200 km from 26%, berries 25%, and rhizomes with roots
Chernobyl) after the catastrophe (Figure 9.3). 18% (Korotkova and Orlov, 1999).
It is important to note that Karelia officially 11. Concentration of Cs-137 in the vegeta-
characterized the level of contamination as very tive mass in different lupine (Lupinus) varieties
moderate (<0.5 Ci/km2 ; Cort and Tsaturov, was on average fivefold more than in maize
1998). (Zea), and clover (Trifolium) and vetch (Vicia)
7. The Belarussian berries, semifrutex of the had intermediate levels. Cs-137 accumulation
Vacciniaceae species, are characterized by a in the various grain crops varied to an even
maximum intensity of Cs-137 accumulation greater degree than that in vegetative masses,
(Mukhamedshin et al., 1995; Kenigsberg et al., in dernopodzolic soils by a factor of 38 and
1996; Jacob and Likhtarev, 1996). in chernozem by a factor of 49 (Kuznetsov
TABLE 9.3. Examples of the Worldwide Contamination of Plants (Bq/kg) in 1986

Nuclide Subject Activity Country Reference
Cs-137 Moss 40,180∗ Norway Staaland et al., 1995

Hair moss 28,000 Finland Ilus et al., 1987
Moss 20,290∗∗ Norway Staaland et al., 1995
Moss 12,370∗∗∗ Germany Elstner et al., 1987
Tea, Thea sinensis 44,000 Turkey Gedikoglu and Sipahi, 1989
Moss, Hylocomium splendens 40,000 Norway Steinnes and Njastad, 1993
Moss 30,000 Germany Heinzl et al., 1988
I-131 Plants 2,100 Japan Ishida et al., 1988
Edible seaweed 1,300 Japan Hisamatsu et al., 1987
Grass 15,000 Bq/m2 UK Clark, 1986
Ce-141 Pine needles 40,000 Finland Lang et al., 1988
Ru-103 Pine needles 35,000 Finland Lang et al., 1988
Hair moss 18,000 Finland Ilus et al., 1987
Te-132 Herbs 730 Finland Rantavaara, 1987
Sr-89 Hair moss 3,500 Finland Ilus et al., 1987
∗ ∗∗ ∗∗∗
1987; 1988; up to 139 times higher than in 1985.
240
TABLE 9.4. Levels of Radionuclide Accumulations (Bq/kg, Dry Weight) by Some Aquatic Plants, Ukraine,
1986–1993 (Bar’yakhtar, 1995)
Ru-103, Ru-106, Nb-95,
Species Ce-144 Rh-103 Rh-106 Cs-137 Cs-134 Zr-95 Sr-90
Shining pondweed (Potamogeton 44,400 4,800 33,300 12,600 8,100 63,000 925
natans)
Common reed grass (Phragmites 26,000 3,700 8,900 12,900 4,800 3,700 5
communis), above-water parts
Common reed grass (Phragmites 99,900 6,700 129,500 66,600 21,800 13,700 2,400
communis), underwater parts
Narrow-leaved cat’s-tail (Typha 20,350 7,000 24,800 3,700 1,370 1,330 270
angustifolia)
et al., 2000). The most active transfer of 14. The Cs-137 CA of 120 plant species
radionuclides from soil to plants occurs on peat- increases in the following order of ecotopes:
bog soil. The transfer coefficient for Cs-137 boggy forest (425) > oakwood (241) > depres-
from scrub forests is up to three times higher sions between hill-forest of flood plain (188) >
for half-submerged soil as compared with drier pinewood (94) > undrained lowland swamp
soil and up to twice that for mixed vegetation (78) > hill forest of flood plains (68) > up-
as compared with pinewoods (Borysevich and land meadows (21) > drained peat-bog soil (11)
Poplyko, 2002). > long-term fallow soil (0.04; Elyashevich and
12. The level of incorporated radionuclides Rubanova, 1993).
tends to correlate with the density of radioactive 15. Transfer ratios from soil to plants are dif-
contamination in the soil (Figure 9.4). ferent for each species and also vary by season
13. There are strong correlations between and habitat (Table 9.5).
specific Cs-137 activity in a phytomass of Con- 16. The maximum transfer ratio (from soil
vallaria majalis and both the density of ground to plant) of Sr-90 was measured in wild straw-
contamination (r = 0.89) and the specific activ- berries (TR 14–15), and the minimum was
ity of Cs-137 in the soil (r = 0.84; Elyashevich in bilberry (TR 0.6–0.9) in Belarus. The Cs-
and Rubanova, 1993). 137 transfer ratio in bilberry (Vaccinium myrtillus)
is threefold higher than that for wild straw-
berry (Fragaria vesca; Ipat’ev, 1994; Bulavik,
1998).
17. Plants growing on hydromorphic land-
scapes accumulate 10-fold more Cs-137 than
those in automorphic soil. There is up to a
50-fold difference in the Cs-137 TR between
an automorphic and a hydromorphic environ-
ment: intensity of accumulation of Cs-137 in
berries is much lower on richer and dry soils as
compared with poor and wet soils (Tsvetnova
et al., 1990; Wirth et al., 1996; Korotkova, 2000;
and others).
Figure 9.2. Concentration of C-14 in tree rings
18. There are heavy accumulations of Cs-
of pine (Pinis silvestris; percent difference from the 137 in a plant’s above-ground biomass in the
level in the year 1950) from the 10-km Chernobyl Ukrainian wet pine subor for the cowberry
zone (Grodzinsky et al., 1995c). family species (Vacciniaceae): TR is about 74
Figure 9.3. Total radioactivity in tree rings of pine (Pinus silvestris) near Petrozavodsk
City, Karelia, for the period 1975–1994 (Rybakov, 2000).
in bilberry (Vaccinium myrtillus), 67 in cowberry grass (Convallaria majalis) > grass (Fragaria vesca)
(Vaccinium vitis-idaea), and 63 in blueberry (Vac- > flowers (Helichrysum arenarium) > grass (Hy-
cinium uliginosum; Krasnov, 1998). pericum perforatum and Betonica officinalis) > grass
19. For nonwood medicinal plants the de- (Origanum vulgare; Orlov, 2001).
creasing order of Cs-137 incorporation is as 20. The maximum TR values are: wild plants
follows: berries (Vaccinium myrtillus) > leaf (Vac- (Ledum palustre) 451, grass (Polygonum hydropiper)
cinium myrtillus) > grass (Thymus serpyllum) > 122, fruits (Vaccinium myrtillus) 159, leaves (Fra-
garia vesca) 73 and (Vaccinium vitis-idaea) 79, and
buds (Pinus sylvestris) 61 and (Betula pendula) 47
(Elyashevich and Rubanova, 1993).
21. In the Ukrainian Poles’e, Cs-137 in fresh
berries and air-dried bilberry offsets decreased
fivefold in 1998 in comparison with 1991
(Korotkov, 2000). In other data, from 1991 to
1999 the amount of Cs-137 in bilberry fruit
(Vaccinium myrtillus) fluctuated greatly (Orlov,
2001).
22. In mossy pine forests the concentration
of Cs-137 in bilberry (Vaccinium myrtillus) fruit
TABLE 9.5. Cs-137 TR from Soil to Fresh Fruits

of the Principal Wild Ukrainian Berries (Orlov,
2001)
Figure 9.4. Correlation between the amount of
Species TR Species TR
Cs-137 in fresh bilberry (Vaccinium myrtillus) (Bq/kg)
and the level of soil contamination (kBq/m2 ) for Vaccinium myrtillus 3.4–16.1 Rubus nessensis 6.6
four different biospheres in Central Poles’e, Ukraine V. vitis-idaea 8.3–12.9 Rubus caesius 1.0
(Orlov, 2001): (vertical axis) specific activity, Bq/kg; V. uliginosum 9.4–11.7 Fragaria vesca 2.0–10.9
(horizontal axis) soil contamination, kBq/m2 (B 2 , Oxycoccus palustris 13.0–16.6 Sorbus aucuparia 1.0
fresh subor; B 3 , dry subor; C 2 , fresh sudubrava; C 3 , Rubus idaeus 0.8–8.4 Viburnum opulus 0.3
dry sudubrava).
242
TABLE 9.6. Inter- and Intraspecific Variations of

TR (m2 /kg × 10–3 ) from Soil to Fresh Wild Edible
Berries in Belarussian, Ukrainian, and Russian For-
est Zones Affected by Chernobyl Fallout (Based on
Many References from Orlov, 2001)
Species TR (Lim) Max/min
Rubus idaeus 0.8–8.4 10.5
Fragaria vesca 2.0–10.9 5.5
Vaccinium myrtillus 3.4–16.1 5.3
Vaccinium vitis-idaea 8.1–12.9 1.6
Oxycoccus palustris 13–16.6 1.3
Vaccinium uliginosum 9.4–11.7 1.2
Figure 9.5. Variations of the transfer ratio for Cs- Rubus nessensis 6.6
137 for three medicinal plants: the grasses Conval- Rubus caesius 1.0
laria majalis and Hypericum perforatum and the bark Sorbus aucuparia 1.0
Frangula alnus over several years (1991–1995). Av- Viburnum opulus 0.3
erage data for 28 stations in Ukrainian Poles’e (Kras-
nov, 1998). 24. Specific Sr-90 activity in the fresh fruits
of bilberry (Vaccinium myrtillus) in the Ukrainian
pine forests varied from 2 to 555 Bq/kg (Orlov,
from 1987 to 1990 was practically stable in 2001).
some places, whereas in other areas there was 25. Long-term dynamics of Cs-137 TR from
a threefold decrease in the TR in 1989–1990 soil to plants revealed all possible variations:
as compared with 1987–1988 (Parfenov and for the grass Convallaria majalis there was a sig-
Yakushev, 1995). nificant decrease over time; for the grass Hy-
23. Maximum Cs-137 activity in the pericum perforatum there was a marked decrease
vegetative parts of undershrubs and trees from 1991 to 1992, but more than a twofold
is observed in May and June (Korotkova increase from 1993 to 1995; for the bark
and Orlov, 1999; Borysevich and Poplyko, Frangula alnus there was a steady total three-
2002). fold decrease in 1995 as compared with 1991
(Figure 9.5); for blueberries there was a slight
decrease over 9 years; and for strawberries there
was a sharp increase followed by a slower one
(Figure 9.6).
26. The lognormal distribution of the TR in
the same species in a similar ecological ambi-
ence makes it impossible to correctly estimate
specific TR by sporadic observations (Jacob and
Likhtarev, 1996).
27. There are wide inter- and intraspecies
variations in TR for the edible wild berries
(Table 9.6).
28. TR differs for the same species for differ-
ent biotopes (Table 9.7).
29. Dynamics of Cs-137 contamination of
Figure 9.6. Variation of the transfer ratio for Cs-
137 for three species of wild forest berries in Be- various parts of pine (Pinus silvestris) are pre-
larus: raspberry (Rubus idaeus), strawberry (Fragaria sented in Figure 9.7. The levels of contamina-
vesca), and blueberry (Vaccinium myrtillus) in the tion in the trunk, branches, and needles were
same area from 1990 to 1998 (Ipat’ev, 1999). nearly stable over 12 years.
TABLE 9.7. Average TR in Fresh Blueberries (Vac- 33. The TR for Sr-90 from soil to plants is
cinium myrtillus ) in Three Different Types of Pine 10 to 20 times higher than the TR of Cs-137 in
Forests in 1995 (Ipat’ev and Bulko, 2000)
the same habitat and the same species (Orlov
Type of pine forest TR et al., 1999).
34. In the Ukrainian Poles’e intensity of
Bilberry 5.19
Polytric 14.00
accumulation of Sr-90 in berry species is as
Ledum 24.00 follows: Fragaria vesca > Vaccinium myrtillus > Vac-
cinium vitis-idaea > Vaccinium uliginosum > Vibur-
num opulus.
30. In automorphic landscapes the Cs-137 35. The following order of TR for medicinal
TR decreased in grass species from 1988 to undershrubs is: rhamn (Rhamnus) and moun-
1995. In hydromorphic landscapes there was tain ash (Sorbus aucuparia), fresh hydrotops 3–
gradual increase in this coefficient beginning 4, quercus bark 7, branches of aglet (Corylus
in 1992 (Tscheglov, 1999). avellana) and buckthorn (Frangula alnus) 7–9,
31. The intensities of Cs-137 accumulation branch of raspberry (Rubus idaeus) 11, branch
in herbs that were studied are divided into of European dewberry (Rubus caesius) 13, and
five groups: very strong accumulation (average branch of mountain ash (Sorbus aucuparia) in the
TR >100), strong accumulation (TR 50–100), wet biotopes 13–18 (Borysevich and Poplyko,
moderate accumulation (TR 10–50), weak ac- 2002).
cumulation (TR 1–10), and very weak accumu- 36. The TR for Sr-90 was 14.0–15.1 for
lation (TR <1; Table 9.8). wild strawberry (Fragaria), 0.6–0.9 for blueberry
32. The highest intensity of Cs-137 accu- (Vaccinium myrtillus), and 0.9 for raspberry (Rubus
mulation according to species was found in idaeus; Ipat’ev, 1999).
the families Ericaceae and Fabaceae, some- 37. The TR for Sr-90 in wild forest
what less in the families Boraginaceae and berries depends on the level of soil con-
Caryophyllaceae, still less in the species of the tamination: it appears that the TR is lower
family Lamiaceae (Origanum vulgare, Salvia offici- under conditions of higher contamination
nalis, Thymus sp.), and minimal in species of the (Table 9.9).
families Asteraceae (Achillea millefolium, Calendula 38. In Belarus in increasing order for Cs-137
officinalis) and Hypericaceae (Hypericum perfora- levels in cereal grains that were studied: spring
tum; Aleksenyzer et al., 1997). wheat < barley < oats; among root vegetables:
carrot < beetroot < radish. For Sr-90 levels
the order was: wheat < oats < barley; radish
and carrot < beetroot (Borysevich and Poplyko,
2002).
39. There are marked differences in the
amount of incorporated radionuclides even for
different cultivars of the same species among
carrots, beetroots, and radishes (Borysevich and
Poplyko, 2002).
40. Total incorporated gamma-activity in
various populations of lupinus (Lupinus luteus)
differed by as much as 20-fold (Grodzinsky et al.,
1995b).
Figure 9.7. Dynamics of Cs-137 transfer ratio 41. The concentrations of Sr-90 and Pu-238,
(TR × 10–3 ) for branches and wood of pine (Pinus Pu-239, and Pu-240 were significantly higher
silvestris) from 1993 to 2004 (Averin et al., 2006). in the surface phytomass of wild strawberry
244
TABLE 9.8. Intensity of Cs-137 Accumulation in Several Species of Herbs in Ukraine (Krasnov and
Orlov, 1996)
Group Species Plant part TR (M ± m)
Very strong accumulation Inonotus obliquus Fruit body 130 ± 30

Vaccinium myrtillus Berries 125 ± 18
Lycopodium clavatum Spores 120 ± 20
Vaccinium vitis-idaea Leaf 94 ± 14
Strong accumulation Ledum palustre Branches 82 ± 18
Chelidonium majus Grass 79 ± 14
Vaccinium myrtillus Leaf 78 ± 6
Pinus sylvestris Buds 77 ± 11
Centaurium erythraea Grass 61 ± 6
Viola tricolour Grass 27 ± 4
Moderate accumulation Potentilla alba Rhizomes 20 ± 3
Hypericum perforatum Grass 18 ± 2
Sambucus nigra Inflorescences 18 ± 2
Convallaria majalis Inflorescences 16 ± 2
Frangula alnus Bark 15.4 ±1.8
Tanacetum vulgare Inflorescences 15.0 ± 1.2
Potentilla alba Grass 12.5 ± 1.4
Arctostaphylos uva-ursi Leaves 12.1 ± 2.5
Weak accumulation Convallaria majalis Grass 9.8 ± 0.8
Urtica dioica Grass 8.6 ± 0.7
Oryganum vulgare Grass 7.4 ± 2.8
Quercus robur Bark 7.2 ± 1.2
Helichrysum arenarium Inflorescences 5.4 ± 0.6
Thymus serpyllum Grass 4.6 ± 0.5
Digitalis grandiflora Grass 4.4 ± 0.7
Leonurus cardiaca Grass 3.9 ± 0.5
Achillea millefolium Grass 2.9 ± 0.6
Very weak accumulation Juniperus communis Galberry 0.64 ± 0.05
Valeriana officinalis Rhizomes 0.36 ± 0.05
Acorus calamus Rhizomes 0.27 ± 0.03
(Fragaria vesca) as compared with bilberry (Vac- to 1990 was Cs-137, but with Ce-144 and Ru-
cinium myrtillus) in the bilberry pine forests (Par- 106 being found in the bark (Tsvetnova et al.,
fenov and Yakushev, 1995). 1990).
42. The main radioactive contaminants in 43. Among annual plant species, those of the
most species of medicinal herbs in Belarus prior pea family (Leguminosae) tend to concentrate
Pu and Am (Borysevich and Poplyko, 2002).
TABLE 9.9. TR for Sr-90 in Three Wild Berry
44. Concentrations of Cs-134 and Cs-137
Species under Various Levels of Soil Contamina- in tree rings of French white fir (Abies concolor)
tion (Ipat’ev, 1999) from the French–German border near Nancy,
France, reflect the Chernobyl fallout (Garrec
Level of soil
Species contamination, kBq/m2 et al., 1995).
1.9 28.1 9.1.2. Mushrooms and Lichens

Blueberry 0.8 1.0
Raspberry 14.6 9.1 1. Table 9.10 presents data on radionuclide
Wild strawberry 22.7 10.0 accumulation in lichens and mushrooms after
the catastrophe.
TABLE 9.10. Examples of the Worldwide Contamination of Mushrooms and Lichens (Bq/kg) in 1986
Nuclide Subject Activity Country Reference
Cs-137 Lichen 40,040∗ Norway Staaland et al., 1995

Lichen 36,630 Poland Seaward et al., 1988
Reindeer lichen 25,000∗∗ Norway Solem and Gaare, 1992
Mushrooms 16,300 Japan Yoshida et al., 1994
Lichen 14,560 Greece Papastefanou et al., 1988
Mushrooms 8,300∗∗∗ Germany Elstner et al.,1987
Mushrooms 6,680 Finland Rantavaara, 1987
Cs-135/Cs-137 Lichen, Cladonia stellaris 60,000 Norway Brittain et al.,1991;
Steinnes et al.,1993
Mushrooms 24,000 France Coles, 1987
Ce-144 Lichen 18,500 Poland Seaward et al., 1988
Nb-95 Lichen 8,114 Poland Seaward et al., 1988
Ru-106/Rh-106 Lichen 16,570 Poland Seaward et al., 1988
Total activity Lichen, Cladonia silvatica 400,000 Ukraine Grodzinsky, 1995b
∗
1987; ∗∗ up to 75-fold higher than in 1985; ∗∗∗ up to 93-fold more than in 1985.
2. Various species of mushrooms have differ- 5. The specific Cs-137 activity in the fruit
ent TR characteristics (Table 9.11). of mushrooms Lactarius necator, Armillariella mel-
3. There is correlation between the specific lea, and Xerocomus badius increased exponentially
activity of Cs-137 in the fruit of the mushrooms with increased density of radioactive soil con-
and the radioactive density of soil contamina- tamination (Krasnov et al., 1998).
tion (Krasnov et al., 1998; Kubert, 1998). 6. The Cs-137 accumulation in the fruit of
4. The concentration of Cs-137 in mush- mushrooms is lower in richer environmental
rooms of the same species differs more than conditions: in russulas (Russula sp.) a difference
500-fold depending on the levels of radionu- between Cs-137 accumulation in sudubravas
clide concentration in the soil (Shatrova et al., (mixed oak forests), pine forests, and subors
2002). are up to fourfold, and in lurid boletus (Bole-
tus luridus) about threefold.
7. The Cs-137 accumulations in the fruit
TABLE 9.11. TR of Cs-137 in Mushrooms in the bodies of the edible boletus (Boletus edulus) were
Ukrainian Poles’e Ecosystems (Orlov et al., 1998; noticeably low in pine forests and for the Polish
Krasnov et al., 1997; Kubert, 1998)
mushroom (Xerocomus badius) in subors (Krasnov
TR Species et al., 1998).
The level of radionuclide accumulation in
1–10 Honey mushroom (Armialliela mellea),
chanterelle (Cantharellus cibarius), edible plants and mushrooms depends upon the
boletus (Boletus edulis), aspen mushroom soil, the climate, the particular biosphere,
(Boletus versipellis) the season, spotty radioactive contamination,
1–50 Black milk mushroom (Lactarius sp.), green the species, and the population (subspecies,
boletus (Xerocomus subtomentosus) cultivars), etc. Each radionuclide has its own ac-
50–100 Birch mushroom (Leccinum scabrum), russula
marsh (Russula), Polish mushroom
cumulation characteristics. Coefficients of ac-
(Xerocomus badius), blue boletus (Gyroporus cumulation and transition ratios vary so much
cyanescens) in time and space that it is difficult, if not impos-
>100 Paxill (Paxilus sp.), yellow boletus (Suillus sible, to predict the actual levels of the Cs-137,
luteus) Sr-90, Pu-238, Pu-239, Pu-240, and Am-241 in
246
each place and time for each individual plant TABLE 9.12. Some Radiation-Induced Morpho-
or mushroom. logical Changes in Plants in Heavily Contami-
nated Territories after the Catastrophe (Grodzin-
sky, 1999; Gudkov and Vinichuk, 2006)
9.2. Radioinduced Morphology, Part Morphological changes

Anomalies, and Tumors Leaves Increase or decrease in size and quantity
Shape change
Changes from the normal morphological Twists
structure of plants under the impact of ir- Wrinkles
radiation (radiomorphosis) are typical mani- Nervation break
Asymmetry
festations in the heavily contaminated terri- Thickening
tories (Grodzinsky et al., 1991; Grodzinsky, Leaf plates inosculation
1999c; Gudkov and Vinichuk, 2006; and oth- Fasciations and swellings
ers). Radiomorphosis arises primarily because Appearance of necrotic spots
of the impaired duplication process in live cells Loss of leaf plate
Premature defoliation
under the influence of external and/or internal
Shoots Additional vegetative lateral and
irradiation. apex shoots
1. Radiation-induced changes that have Impairment of geotopical orientation
been observed in plants in the Chernobyl- of the shoots
contaminated territories include alterations “Bald” shoots
in shape, intercepts, twists, wrinkling, bifur- Stems Speedup or inhibition of growth
Phyllotaxis failure (order of leaf placing)
cations, abnormal flattening of stems, etc. Color change
(Table 9.12). Loss of apical dominance
2. When top buds, which contain the ac- Dichotomy and fasciations
tively dividing cells die, there is a loss of api- Change of intercepts
cal domination and transfer of activity to ax- Swellings
Roots Speedup or inhibition of growth
ial buds, which under normal conditions are
Splitting of main root
in a resting state and are more radioresistant. Death of main root
The newly active buds produce extra shoots, Trimming of meristem zone
leaves, and flowers (Gudkov and Vinichuk, Absence of lateral roots
2006). Swellings and twists
3. Radiation-induced death of the main root Appearance of aerial roots
Heliotropism break
meristem in plants with pivotal root systems Flowers Speedup or inhibition of flowering
results in more active development of lateral Color change
roots, which in turn provokes growth of some Increase or decrease of quantity
above-ground organs. Swelling-like excrescents Shape change
on leaves, stems, roots, flowers, and other or- Defoliation of flowers and floscules
gans also appeared as the result of irradiation in Swellings
Sterility
the 30-km zone in 1986. In 1987 and the years
following, the number of such abnormalities
increased and were observed mainly in conifer-
ous trees, on which needles are replaced once 5. The number of pollen structural anoma-
every few years and on perennial shoots and lies in winter wheat increased in the heav-
branches (Figure 9.8). ily contaminated territories (Kovalchuk et al.,
4. Table 9.13 presents examples of radiation- 2000).
induced morphologic changes in pine (Pinus sil- 6. Several years after the catastrophe
vestris) and spruce (Picea abies). there was a significant rise in the incidence
Figure 9.8. Anomalies in the shoots of pine (Pinus silvestris: A, B) and spruce (Picea excelsa: C–G) in the
30-km zone in 1986–1987 (Kozubov and Taskaev, 2002; Grodzinsky et al., 1991).
of various teratological characteristics in irradiation done under controlled conditions

plantain seedlings (Plantago lanceolata) grow- (Table 9.15).
ing within the 30-km zone (Frolova et al., 9. Chernobyl radiation, causing morpho-
1993). genetic breaks, provokes the development of
7. The incidence of two morphologic char- tumors caused by the bacterium Agrobacterium
acteristics in winter wheat (Triticum aestivum) in- tumefaciens. Active development of such tumors
creased after the catastrophe and decreased in is seen in some plants, including Hieracium
the next two generations (Group 1); the fre- murorum, Hieracium umbellatum, Rubus idaeus, and
quency of nine other morphologic characteris- Rubus caesius, in the heavily contaminated terri-
tics (Group 2) increased in subsequent genera- tories (Grodzinsky et al., 1991).
tions (Table 9.14). 10. Tumorlike tissue is found in 80% of indi-
8. Irradiation in the contaminated territo- vidual milk thistle (Sonchus arvensis) plants grow-
ries caused a noticeably stronger influence on ing in heavily contaminated soil (Grodzinsky
barley pollen than did experimental gamma- et al., 1991).
TABLE 9.13. Chernobyl’s Irradiation Impact on Pine (Pinus silvestris ) and Spruce (Picea abies ) Mor-
phometrics (Sorochinsky, 1998)∗
Characters Low contamination Heavy contamination
Pine Length of needles, mm 60 ± 4 19 ± 3

Weight of needles, mg 80 ± 3 14 ± 2
Spruce Length of needles, mm 16 ± 2 40 ± 3
Weight of needles, mg 5±1 95 ± 5
∗
248
TABLE 9.14. Frequency of Some Morphologic TABLE 9.16. Influence of a Chernobyl Soil Extract
Changes in Three Generations of a Species of Win- (Cs-137 and Ce-144 with Total Activity of 3.1 ×
ter Wheat (Triticum aestivum) in the Chernobyl- 104 Bq/kg) on Growth and Cell Division of a Stra-
Contaminated Territories (Grodzinsky et al., 1999; monium (Datura stramonium; Grodzinsky, 2006)
Grodzinsky, 2006)
Year Cells, Cells,
per 1 g tissue, per callus
Characters 1986 1987 1988
n × 105 % n × 105 %
Group 1
Infertile zones in spike 49.0 29.8 1.9 Normal tissue 39.7 100 78.6 100
Truncated spike 10.0 9.4 0.8 With an extract 38.9 98 100.4 127.6
Lengthened stem 4.4 4.7 5.4 Tumorous tissue 23.0 100 74.5 100
Scabrous beard 1.4 3.4 2.9 With an extract 32.4 140.7 91.5 122.8
Group 2
Split spike 4.5 11.1 9.4
Lengthened beard 2.8 2.8 4.7 with radioactivity has been confirmed experi-
Angular forms 4.9 14.0 24.7 mentally (Table 9.16).
Change of stalk color 0.9 1.7 1.9 13. There is some tendency toward normal-
Spike gigantism 1.4 1.8 2.9 ization of the number of gametogenetic anoma-
Stem plate 4.5 5.7 4.9
Additional spikelets 14.0 14.8 29.7
lies in soft wheat (Triticum aestivum) in four to
six generations after the Chernobyl irradiation,
but there was an accumulation of mutations
in some wheat populations (Grodzinsky et al.,
11. In the heavily contaminated territories 1995a).
there was a significant increase in gall forma-
tion on oak (Quercus) leaves (Grodzinsky et al.,
9.3. Genetic Changes
1991).
12. Formation of tumoral tissue (callus) in 1. Immediately after the catastrophe, the fre-
plants under the influence of soil contaminated quency of plant mutations in the contaminated
territories increased sharply, and the increase
TABLE 9.15. Frequency of Abnormal Barley
was maintained at a high level for several years
(Hordeum vulgare ) Pollen Grains (per 1,000,000) (Tables 9.17 and 9.18).
after 55 Days of Irradiation around Chernobyl’s
NPP and in the Experimental Gamma-Field 2. In the first 2–3 years after the catas-
(Bubryak et al., 1991) trophe, the number of lethal and chlorophyll
Dose rate, Dose, Abnormal
μSv/h mSv grains,% TABLE 9.17. Frequency (%) of Chlorophyll Muta-
30-km zone Control (0.96) 1.3 0 tions in Barley (Hordeum vulgare ), and Rye (Se-
59 75 23 cale seriale ) in the 30-km Zone with Cs-134, Cs-
320 422 79 137, Ce-144, and Ru-106 Ground Contamination
400 528 86 (Grodzinsky et al., 1991)
515 680 90 Contamination
Experimental Background 0.1 0 Years
gamma-field (0.11) Control 1986 1987 1988 1989
5 3.0 43
50 29.6 45 Rye, var. “Kiev-80” 0.01 0.14 0.40 0.91 0.71
500 296 59 Rye, var. 0.02 0.80 0.99 1.20 1.14
5,000 2,960 57 “Kharkov-03”
50,000 29,600 72 Barley, var. # 2 0.35 0.81 0.63 0.70 0.71
TABLE 9.18. Frequency of Chromosomal Aber- residual karyo nucleus at metaphase, anaphase,
rations (%) in Root Meristems of Some Cultivated and telophase and with multinucleated cells
Plants in the Chernobyl-Contaminated Territories,
persisting “many years” after the catastro-
1986–1989 (Grodzinsky, 2006)∗
phe (Butoryna et al., 2000; Artyukhov et al.,
Years 2004).
Control 1986 1987 1988 1989 5. The level of chromosomal aberrations
in onions was correlated with the density
Lupinus alba 0.9 19.4 20.9 14.0 15.9 of radioactive contamination of the territory
Pisum sativum 0.2 12.9 14.1 9.1 7.9
Secale cereale 0.7 14.9 18.7 17.1 17.4
(Table 9.19).
Triticum aestivum 0.9 16.7 19.3 17.7 14.2 6. The average frequency of mutations in
Hordeum vulgare 0.8 9.9 11.7 14.5 9.8 pine (Pinus silvestris) correlated with the density
∗ of radiation contamination in an area, and in
All differences from controls are significant.
the 30-km zone was 10-fold higher than in con-
trol locations (Shevchenko et al., 1996).
mutations in all studied populations of Arabidop- 7. Progeny tests of plantain (Plantago lance-
sis thaliana in the 30-km zone increased signifi- olata), gosmore (Hypochoeris radicata), autum-
cantly. The original spontaneous level of mu- nal hawkbit (Leontodon autumnalis), wall lettuce
tation was reached in 6 years in areas with (Mycelis muralis), bloodwort (Achillea millefolium),
gamma-radiation levels up to 10 mR/h. In gold birch (Solidago virgaurea), and field worm-
areas with gamma-radiation levels up to 130 wood (Artemisia camprestris) collected in the 30-
mR/h the level of mutations was up to eight- km zone (gamma-activity at ground level 130–
fold higher than the spontaneous level for 8 3,188 Ci/km2 ) and after additional intense irra-
years after the catastrophe (Abramov et al., diation developed significantly more mutations
1995). than in controls (i.e., the number of chromoso-
3. The frequency of mutations in wheat mal aberrations is correlated with the density of
(Triticum aestivum) was sixfold higher in the con- contamination). Only devil’s-bit (Succisa praten-
taminated territories (Kovalchuk et al., 2000). sis) showed increased resistance to radioactivity
Some 13 years after the catastrophe the fre- (Dmitryeva, 1996).
quency of chromosome aberrations in two 8. The significantly increased mutation level
wheat cultivars in the 30-km zone was signifi- in pine (Pinus sylvestris) seeds from the 30-km
cantly higher than the spontaneous frequency zone persisted for 8 years after the catastrophe
(Yakimchuk et al., 2001). (Kal’chenko et al., 1995).
4. In acorns of the oak Quercus robur and 9. In the 6 to 8 years after the catastro-
the pine Pinus silvestris in Voronez City areas phe, the number of meiosis anomalies in mi-
contaminated by Chernobyl fallout there was crospore formation (the number of anomalies
significantly increased mitotic activity, demon- in a root meristem) and the number of pollen
strated by increased frequency of cells with a grain anomalies documented in 8–10% of
TABLE 9.19. Damage of Apical Root Meristem (Growing Tip) of Onions (Allium cepa) under Different
Levels of the Chernobyl Soil Contamination (Grodzinsky, 2006)
Percent of control
Soil activity, Number of Mitotic Aberrant Cells with Degenerate
kBq/kg cells, n index,% cells micronucleus cells
Control 15,005 4.1 100 100 100

37 33,275 4.4 240 171 250
185 29,290 4.4 216 129 500
370 23,325 117 150 229 900
250
TABLE 9.20. Change in Anthocyanin Concentra- est”) as compared with mixed and deciduous
tion in Irradiated Plants (Grodzinsky, 2006) forests (Kryshev and Ryazantsev, 2000).
Levels of Anthocyanin 2. Some metabolic processes in plants
irradiation (% of control) are disturbed in the contaminated territories
(Sorochin’sky, 1998). Table 9.20 lists examples
Corn (Zea mays), Soil 975 Bq/kg 119
sprouts of such impairments, expressed in changes of
Mung (Phaseolus Chronic irradiation, 157 anthocyanin (purple color) concentration.
aureus) 0.5 Gy 3. Radiosensitivity of some plant species in-
Arabidopsis Chronic irradiation, 173 creases under chronic low-rate irradiation in
thaliana 0.5 Gy the 30-km zone owing to a gradual loss of the
ability to repair DNA (Grodzinsky, 1999).
4. Some phenolic compounds with altered
94 plant species correlate with the level of
qualitative structure accumulated in all winter
gamma-irradiation (Kordyum and Sydorenko,
wheat, winter rye, and corn cultivars in the
1997).
30-km zone during the 6 years after the catas-
10. In natural populations of Crepis tectorum
trophe (Fedenko and Struzhko, 1996).
from the 30-km zone, the sprouting of seeds
5. The radial growth in trees in the heavily
did not exceed 50%. The number of a grow-
contaminated territories was slowed (Kozubov
ing root cells with chromosome disorders (in-
and Taskaev, 1994; Shmatov et al., 2000).
versions, translocations, change in number of
6. A new form of stem rust fungus (Puccinia
chromosomes, etc.) is significantly higher than
graminis) is present in the Chernobyl zone, and
in controls (Shevchenko et al., 1995).
its virulence is greater than in the control form
11. The number of sterile pollen grains in
(Dmitryev et al., 2006).
violets (Viola matutina) correlates with the level
It is clear that plants and mushrooms became
of radioactive soil contamination (Popova et al.,
natural accumulators of Chernobyl radionu-
1991).
clides. The levels of such uptake and the tran-
12. More than a 10-fold lower fre-
sition of radionuclides from soil to plants and
quency of extrachromosomal homologous
mushrooms are specific for each radionuclide
recombinations are found in native Arabidopsis
and vary from species to species, by season, by
thaliana plants from radioactively contaminated
year, and by landscape, etc.
territories (Kovalchuk et al., 2004).
Chernobyl irradiation has caused many
13. Unique polynoteratogenic complexes are
structural anomalies and tumorlike changes in
seen in the 30-km Chernobyl zone: a high
many plant species and has led to genetic disor-
percentage of pollen grains and spores with
ders, sometimes continuing for many years. It
different genetic anomalies (underdeveloped
appears that the Chernobyl irradiation awak-
pollen grains/spores, dwarf and ultradwarf
ened genes that had been quiescent for long
forms, and polynomorphs that diverge from
evolutionary periods.
the norm in several morphological charac-
Twenty-three years after the catastrophe it is
ters). This indicates that the Chernobyl catas-
still too early to know if the whole spectrum of
trophe caused a “geobotanical catastrophe”
plant radiogenic changes has been discerned.
(Levkovskaya, 2005).
We are far from knowing all of the conse-
quences for flora resulting from the catastrophe.
9.4. Other Changes in Plants and
Mushrooms in the Contaminated
Territories References
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CHERNOBYL
10. Chernobyl’s Radioactive Impact on Fauna

Alexey V. Yablokov
The radioactive shock when the Chernobyl reactor exploded in 1986 combined with
chronic low-dose contamination has resulted in morphologic, physiologic, and genetic
disorders in every animal species that has been studied—mammals, birds, amphib-
ians, fish, and invertebrates. These populations exhibit a wide variety of morphological
deformities not found in other populations. Despite reports of a “healthy” environ-
ment in proximity to Chernobyl for rare species of birds and mammals, the pres-
ence of such wildlife is likely the result of immigration and not from locally sus-
tained populations. Twenty-three years after the catastrophe levels of incorporated
radionuclides remain dangerously high for mammals, birds, amphibians, and fish in
some areas of Europe. Mutation rates in animal populations in contaminated terri-
tories are significantly higher and there is transgenerational genomic instability in
animal populations, manifested in adverse cellular and systemic effects. Long-term
observations of both wild and experimental animal populations in the heavily con-
taminated areas show significant increases in morbidity and mortality that bear a
striking resemblance to changes in the health of humans—increased occurrence of
tumor and immunodeficiencies, decreased life expectancy, early aging, changes in
blood and the circulatory system, malformations, and other factors that compromise
health.
The Chernobyl catastrophe has impacted on Apart from zoological studies, there are
fauna and will continue to have an impact for many hundreds of studies published by veteri-
many decades to come, with effects ranging narians in Ukraine, Belarus, and Russia that
from changes in population vitality to abnor- show deterioration in the health of cows, boars,
mal reproductive and genetic disorders. It is sheep, and chickens in the areas contaminated
well to remember that Homo sapiens are a part of by Chernobyl.
the animal kingdom and suffer the same kinds The first section of this chapter is devoted
of health consequences that are observed in to levels of Chernobyl radionuclide accumu-
animals. lations in various species. The second section
As in the earlier chapters, only a small addresses reproductive impairment in animals
part of the available scientific literature is in the contaminated territories and the resul-
presented here, but several monographic re- tant genetic changes. The order of presenta-
views have been included: Frantsevich et al., tion is mammals, birds, amphibians, fish, and
1991; Sutshenya et al., 1995; Zakharov and invertebrates.
Krysanov, 1996; Sokolov and Kryvolutsky,
1998; Ryabov, 2002; Goncharova, 2000; and
others.
10.1. Incorporation
of Radionuclides
Address for correspondence: Alexey V. Yablokov, Russian Academy The level of radionuclides maintained in an
of Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
animal’s body depends on the transfer ratio
ecopolicy.ru (TR, transition coefficient) and the coefficient
255
256
TABLE 10.1. Maximum Concentration (Bq/kg, Fresh Weight) of Some Radionuclides after the
Catastrophe
Nuclide Bq/kg Species Country Reference
Sr-90 1,870 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
Cs-137 400,000 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
187,000 Wild swine (Sus scrofa) Russia Pel’gunov et al., 2006
74,750 Roe deer (Capreolus capreolus) Russia Pel’gunov et al., 2006
48,355 Common shrew (Sorex araneus) Russia Ushakov et al., 1996
42,000 Little shrew (Sorex minutus) Russia Ushakov et al., 1996
24,630 Yellow neck mouse Russia Ushakov et al., 1996
(Apodemus flavicollis)
7,500 Brown hare (Lepus europaeus) Russia Pel’gunov et al., 2006
3,320 Moose (Alces alces) Russia Pel’gunov et al., 2006
1,954 White tailed deer Finland Rantavaara, 1987
1,888 Arctic hare (Lepus timidus) Finland Rantavaara et al., 1987
1,610 Moose (Alces alces) Finland Rantavaara et al., 1987
7601 Moose (Alces alces) Sweden Johanson and
Bergström, 1989
720 Reindeer (Rangifer tarandus) Finland Rissanen et al., 1987
Cs-134 60,000 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
Cs134/Cs-137 100,000 Reindeer (Rangifer tarandus) Norway Strand, 1987
15,000 Sheep (Ovis ammon) Norway Strand, 1987
3,898 Sheep (Ovis ammon) Great Britain Sherlock et al., 1988
(Cumbria)
3,200 Roe deer (Capreolus capreolus) Germany Heinzl et al., 1988
Pu-239 + Pu-240 1.3 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
Pu-238 0.6 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
Am-241 12 Bank vole (Clethrionomys glareolus) Belarus Ryabokon’ et al., 2005∗
<0.01 Wild boar (Sus scrofa) Belarus Borysevich and
Poplyko, 2002
Ag-110m 74 Cow (Bos taurus) Great Britain, 1986 Jones et al., 1986
Total gamma 58,000 Roe deer (Capreolus capreolus) Western Europe Eriksson et al., 1996
113,000 Wild boar (Sus scrofa) France Tchykin, 1997
79,500 d.w.2 Otter scats Scotland, July 1986 Mason and
MacDonald, 1988
∗
Calculation from figure (A.Y.).
1
Up to 33 times higher than pre-Chernobyl level (Danell et al., 1989).
2
10.7 times higher than the pre-Chernobyl peak concentration.
of accumulation (CA), that is, on the relation- the animals provide a view into environmental
ship between the specific activity of a radionu- radiation levels and effects.
clide in a body and the specific activity of the 1. Table 10.1 presents the maximum con-
same radionuclide in the environment [TR = centrations of some radionuclides in mammals
(Bq/kg of animal biomass)/(kBq/m2 for back- after the catastrophe.
ground contamination); CA = (Bq/kg of an- 2. Indicator species such as the bank vole
imal biomass)/(Bq/kg of air, soil, or water)]. (Clethrionomys glareolus) and the yellow-necked
Animals, from mammals to birds, fish, worms, mouse (Apodemus flavicollus) that inhabit the nat-
and insects, depend upon whatever food they ural forest ecosystems of Belarus showed max-
can catch or forage. The health and survival of imum levels of Cs-134 and Cs-137 for 1 to
Yablokov: Radioactive Impact on Fauna 257
7. Ten years after the catastrophe, in con-

taminated areas of Western Europe, radioac-
tivity in the meat of roe deer (Capreolus capreolus)
reached an average of 58,000 Bq/kg and that in
wild boar (Sus scrofa) was up to 113,000 Bq/kg
(Eriksson and Petrov, 1995; Eriksson et al., 1996;
Tchykin, 1997).
8. Decrease in Cs-137 concentration in cattle
(Bos taurus) in the contaminated territories is
occurring more slowly than was predicted by
all of the International Atomic Energy Agency
(IAEA) models (Thiessen et al., 1997).
9. The level of Cs-137 incorporation is
significantly different in cattle (Bos taurus) in the
Figure 10.1. Time course of Sr-90 activity con- heavily and less contaminated areas in Ukraine
centration (Bq/kg) in two Belarussian populations of (Table 10.2).
bank voles (Clethrionomys glareolus) in 1991 and
10. Accumulation of Cs-137 shows signifi-
1996 (5 and 10 years after the catastrophe). Stan-
dard deviations of mean values are indicated: p < cant individual variation in wild boar (Sus scrofa)
0.01 in comparison with previous year (Ryabokon’ and roe deer (Capreolus capreolus) and is more
et al., 2005). homogeneous in moose (Alces alces), depending
not only upon species-specific food chains, but
2 years after the catastrophe, followed by an also upon spotty radioactive contamination (see
exponential decrease. However, incorporated Chapter 1 for details) and on activity in a spe-
Sr-90 concentrations increased up to 10 years cific area (Table 10.3).
after the catastrophe (Figure 10.1). 11. The concentration of Cs-137 in wild
3. Five years after the meltdown, significant ungulates in the contaminated territories in-
Am-241 activity was detected in bank voles creased for 7 to 20 years after the catastro-
(Clethrionomys glareolus) from areas with high lev- phe, and the increased uptake occurred despite
els of contamination. Levels increased up to the lower levels of ambient radioactive contamina-
10th year and are expected to increase further tion in some areas (Figure 10.3).
(Ryabokon’ et al., 2005). 12. Study of 44 bird species in the Chernobyl
4. There is marked individual variability in 5-km zone from 2003 to 2005 revealed that
the incorporation of Cs-134, Cs-137, Sr-90, Pu, the greatest contamination was present dur-
and Am-241 in the bank vole (Clethrionomys glare- ing nesting and hatching. Females accumulate
olus) populations living in contaminated terri- more Sr-90 than males, and nestlings and ju-
tories of Belarus (Figure 10.2) (Ryabokon’ et al., veniles accumulate more than females. Cs-137
2005). accumulation did not differ between young and
5. Radionuclide level accumulation for roe adult birds or between the sexes. Maximum
deer (Capreolus capreolus) can vary from 10- to 30- levels of Sr-90 and Cs-137 accumulation are
fold according to seasons (McGee et al., 2000). shown in Table 10.4.
6. During the autumn in Ukraine, the level 13. In Belarus, 10 years after the catastrophe,
of Cs-137 accumulation in mice species (Muri- levels of total gamma-radionuclides in the bod-
dae) and the internal organs of fawns increased ies of teals (Querquedula querquedula and Q. crecca)
11-fold (Krasnov et al., 1997). The greatest con- exceeded 13,000 Bq/kg; in mallard ducks (Anas
tamination in fawns was due to grazing on as- platyrhynchos) it was about 10,000 Bq/kg; and in
pen, oak, bilberry, and heather (Krasnov et al., coots (Fulica atra) it was more than 4,000 Bq/kg
1998). (Sutchenya et al., 1995).
258
Figure 10.2. Individual variability in the level of incorporated radionuclides in the bank
vole (Clethrionomys glareolus) population in Belarus: Cs-137 and Cs-134 (3 years after the
catastrophe) and Pu-238, Pu-239, Pu-240, Am–241, and Sr-90 (10 years after) (Ryabokon’
et al., 2005).
14. Intraspecies (individual) variations of that the TR is higher for Sr-90 and less for
Cs-137 concentrations are greater than inter- Cs-137 in all the amphibians studied. The TRs
species ones (Table 10.5). for Sr-90 in decreasing order were: red-bellied
15. In the 30-km zone, accumulations of Cs- toad (Bombina bombina), spade-footed toad (Pelo-
137 and Sr-90 reached 5.3 kBq/kg in some am- bates fuscus), tree frog (Hyla sp.), and true frogs
phibians. The transfer rate (TR) from substrate (Rana sp.), respectively, 44.1, 34.4, 20.6, and
to animal measured in Bq/kg demonstrated 20.4 (Bondar’kov et al., 2002).
TABLE 10.2. Cs-137 Incorporation (Bq/kg,

Bq/liter) in Amniotic Membranes, Placentas, and
Colostral Milk of Cows from More Heavily and
Less Contaminated Areas, Zhytomir Province,
Ukraine, 1997–1999 (Karpuk, 2001)1
Level of contamination
5–15 Ci/km2 < 0.1 Ci/km2
Afterbirth and 24.3 ± 2.1∗ 3.1 ± 0.1

amniotic membranes
Placentas (cotyledons) 36.3 ± 4.2∗ 4.9 ± 0.4
Colostral milk 17.3 ± 1.4∗ 4.4 ± 0.5
1
Data for Ci/km2 – summarized for two farms by A. Y.
∗
p < 0.001.
Figure 10.3. Average concentration of Cs-137

(Bq/kg fresh weight) in moose (Alces alces) in con-
16. The highest TR for Cs-137 was found
taminated territories of Bryansk Province, Russia, for
in the European common toad (Bufo bufo), three periods after the catastrophe (Pel’gunov et al.,
12.9 and the moor frog (Rana arvalis), 10.0 2006).
(Bondar’kov et al., 2002).
17. Levels of contamination after the catas- 20. From 1987 to 2002 the amount of Cs-137
trophe in some fishes are listed in Table 10.6. in catfish (Silurus glanis) muscle in the Chernobyl
18. Initial forecasts of a rapid Cs-137 elimi- Nuclear Power Plant (NPP) cooler reservoir in-
nation from fishes (in 7 to 8 years) appear to be creased from 1,140 to 6,500 Bq/kg (Zarubin,
inaccurate: after 3 to 4 years of fast decline, low- 2004).
ering of contamination levels slowed drastically 21. In landlocked bodies of water in the
(Figure 10.4). contaminated areas, radionuclide concentra-
19. Up until 1994 the level of Cs-137 in perch tion in raptorial fish reached 300 × 103 Bq/kg
(Perca fluviatilis) in Swedish and Finnish lakes (Gudkov et al., 2004).
exceeded the official safe level (Kryshev and 22. Several hours after the catastrophe,
Ryazantsev, 2000). honey in Germany was heavily contaminated
with I-131 (>14 × 103 Bq/kg) and by Ru-193
(>750 Bq/kg; Bunzl and Kracke, 1988).
TABLE 10.3. Cs-137 Accumulation (Bq/kg of Wet 23. Table 10.7 provides data on Chernobyl
Weight) in the Muscles of Several Species of Game
Mammals from Bryansk Province Areas Contam-
radionuclide concentrations in zooplankton
inated at a Level of 8–28 Ci/km2 , 1992–2006 that reflect both high levels of bioaccumulation
(Pel’gunov et al., 2006) and the wide range of contaminated waters.
24. Radioactive contamination of Baltic
Species M ±m Min–max
plankton in 1986 reached 2,600 Bq/kg
Wild boar (Sus scrofa), 13,120 ± 3,410 250–187,900∗ (gross-beta) and 3,900 Bq/kg of Np-239
n = 59 (Ikaheimonen et al., 1988).
Roe deer (Capreolus 12,660 ± 1,340 800–74,750
capreolus), n = 97
Moose (Alces alces), 1,860 ± 160 240–3,320 10.2. Reproductive Abnormalities
n = 30
Brown hare (Lepus 2,560 504–7,500 Regular biological observations in the heav-
europaeus), n = 8
ily contaminated territories of Ukraine, Be-
∗
Russian permissible level = 320 Bq/kg. larus, and European Russia were not begun
260
TABLE 10.4. Concentration of Some Radionuclides (Bq/kg, Fresh Weight) in Several Bird Species after
the Catastrophe
Radionuclide Bq/kg Species Country Reference
Sr-90 1,635,000 Great tit (Parus major) Ukraine Gaschak et al., 2008
556,000 Long-tailed tit (Aegithalos caudatus) Ukraine Gaschak et al., 2008
226,000 Nightingale (Luscinia luscinia) Ukraine Gaschak et al., 2008
Cs-137 367,000 Great tit (Parus major) Ukraine Gaschak et al., 2008
305,000 Blackbird (Turdus merula) Ukraine Gaschak et al., 2008
85,000 Song thrush(Turdus philomelos) Ukraine Gaschak et al., 2008
1,930 Mallard duck (Anas platyrynchus) Russia Pel’gunov et al., 2006
450 Gray partridge (Perdix perdix) Russia Pel’gunov et al., 2006
470 Woodcock (Scopolas rusticola) Russia Pel’gunov et al., 2006
350 Robin (Erithacus rubecola) Netherlands De Knijff and Van Swelm, 2008
Cs-134 112 Robin (Erithacus rubecola) Netherlands De Knijff and Van Swelm, 2008
Cs-134, Cs-137 10,469 Waterfowl (Anas sp.) Finland Rantavaara et al., 1987
6,666 Goldeneye (Bucephala clangula) Finland Rantavaara et al., 1987
Zr-95 467 Robin (Erithacus rubecola) Netherlands De Knijff and Van Swelm, 2008
Nb-95 1,292 Robin (Erithacus rubecola) Netherlands De Knijff and Van Swelm, 2008
Total gamma >13,000 Teal (Quercuedula quercuedula Belarus Sutchenya et al., 1995
and Q. crecca)
10,000 Mallard ducks (Anas platyrhyncha) Belarus Sutchenya et al., 1995
>4,000 Coots (Fulica atra) Belarus Sutchenya et al., 1995
until 2 months after the explosion. Fortunately, 2. The mortality of laboratory mice (Mus
during that time, data concerning the harmful musculus) that remained in the 10-km zone from
effects of the Chernobyl contamination on cat- 1 to 14 days increased significantly and is asso-
tle and other farm animals were collected from ciated with additional radiation (Nazarov et al.,
many veterinarians (Il’yazov, 2002; Konyukhov 2007).
et al., 1994; Novykov et al., 2006; and many 3. There was an increasing incidence of em-
others). bryo deaths over 22 generations of bank voles
1. By September 1986, the population of (Clethrionomys glareolus) from the contaminated
murine species in the heavily contaminated territories that correlated with the radionu-
Ukrainian territories had decreased up to five- clide levels in monitored areas. A significantly
fold (Bar’yakhtar, 1995). high prenatal mortality has persisted despite
a decrease in the level of ground contami-
TABLE 10.5. Cs-137 Accumulation (Bq/kg of nation (Goncharova and Ryabokon’, 1998a,b;
Wet Weight) in Three Game Bird Species from Smolich and Ryabokon’, 1997).
Bryansk Province Areas Contaminated at a Level 4. For 1.5 months sexually active male rats
of 8–28 Ci/km2 , 1992–2006 (Pel’gunov et al., (Rattus norvegicus) within the 30-km zone demon-
2006)
strated suppressed sexual motivation and erec-
Species Average Min–max∗ tions, which resulted in a reduction in the
number of inseminated females, reduced fertil-
Mallard duck (Anas 920 314–1,930
platyrynchus), n = 28 ity, and an increase in preimplantation deaths
Gray partridge (Perdix 350 280–450 (Karpenko, 2000).
perdix), n = 14 5. Observations in farm hog sires (Sus
Woodcock (Scopolas 370 270–470 scrofa) with Cs-137 contamination levels of
rusticola), n = 11 1–5 Ci/km2 plus Sr-90 at a level of 0.04–
∗
Russian permissible level—180 Bq/kg. 0.08 Ci/km2 demonstrated significantly fewer
TABLE 10.6. Concentration (Bq/kg) of Some Radionuclides in Fishes after the Catastrophe
Nuclide Concentration Species Country Reference
Cs-137 16,000 Perch (Perca fluviatilis) Finland Saxen and Rantavaara, 1987
10,000 Pike (Esox luceus) Finland Saxen and Rantavaara, 1987
7,100 Whitefish (Coregonus sp.) Finland Saxen and Rantavaara, 1987
6,500 Catfish (Silurus glanis) Ukraine Zarubin, 2006
4,500 Bream (Abramis brama) Finland Saxen and Rantavaara, 1987
2,000 Vendace (Coregonus albula) Finland Saxen and Rantavaara, 1987
708 Crucian carp (Carassius carassius) Russia Ushakov et al., 1996
493 Bream (Abramis brama)∗ Poland Robbins and Jasinski, 1995
190 “Fish” Baltic Ilus et al., 1987
15–30 “Pike and cod”∗∗ Baltic Ikaheimonen et al., 1988
Cs-134/137 55,000 “Freshwater fish” Norway Strand, 1987
12,500 Brown trout (Salmo trutta) Norway Brittain et al., 1991
Sr-90 157 Crucian carp (Carassius carassius) Russia Ushakov et al., 1996
Total gamma 300,000 Raptorial fish Ukraine Gudkov et al., 2004
∗
120 times that of pre-Chernobyl level.
∗∗
About five times the pre-Chernobyl level.
semen channels (especially for hogs 2 to 4 years

old), as well as widening, necrosis, and un-
usual positions of sex cells within the channels
(Table 10.8).
6. There was a marked decrease in insemi-
nation and 1.8 to 2.5% of the piglets were born
dead or with congenital malformations involv-
ing the mouth, anus, legs, and gigantic heads,
etc. (Oleinik, 2005).
7. Pregnancy outcomes and some health
characteristics of calves (Bos taurus) (a Poles’e
breed) in the heavily contaminated Korosten
and Narodnitsky districts, Zhytomir Province,
Ukraine (Cs-137 levels of 5–15 Ci/km2 ) were
significantly different from the same species
bred in the less contaminated (<0.1 Ci/km2 )
Baranovka District. More calves had abnor-
mal weights, and morbidity and mortality
were higher in the heavily contaminated areas
(Table 10.9).
8. Calving problems included delayed deliv-
ery of the placenta and amniotic membranes.
The weight of the amniotic tissues and pla-
cental lobule characteristics were significantly
lower in cows (Bos taurus) in contaminated areas Figure 10.4. Dynamics of concentration of Cher-
nobyl Cs-137 in lake trout (Salmo trutta) and charr
(Table 10.10). (Salvelinus alpinus) in lakes in northern Norway from
9. House mice (Mus musculus) populations 1986 to 1998. Dotted line, forecast; solid line, actual
in the heavily contaminated areas decreased concentration (Jonsson et al., 1999).
262
TABLE 10.7. Some Recorded Chernobyl Radionuclides in Zooplankton (after J. Turner, 2002)
Sea Date Notes Reference
North Sea off Norway May–June At depth of 222 m. Fecal pellets in Kempe and Nies, 1987
sediment traps
Mediterranean off May 8–15 (rainfall on Ce-141 and Ce-144, 200 m depth. Fowler et al., 1987
Corsica May 4–5), 1986 >70% composed of copepod fecal
pellets
Black Sea May–June, 1986 At a depth of 1,071 m (Emiliania Buesseler et al., 1987;
huxleyi) Kempe et al., 1987
North Pacific and June–July, 1986 From 110 to 780 m Kusakabe and Ku, 1988
Bering Sea
owing to sterility, as well as to abnormal 13. Irradiation caused increased prenatal

spermatozoa (Pomerantseva et al., 1990, 1996). and postnatal mortality and reduced breeding
10. Higher antenatal mortality was ob- success for bank vole populations (Clethrionomys
served in field mice (Clethrionomys and Micro- sp.) in contaminated areas (Kudryashova et al.,
tus sp.) in the first years after the catastro- 2004).
phe in the heavily contaminated areas owing 14. Radiation contamination caused bank
to pathologic changes in the urogenital tract vole populations (Clethrionomys sp.) to mature
and embryo resorption in the early stages of early and intensified reproduction, both of
development (Medvedev, 1991; Sokolov and which are associated with premature aging and
Krivolutsky, 1998). reduced life expectancy (Kudryashova et al.,
11. In October 1986 in Chernobyl City, a 2004).
special animal facility was established for labo- 15. The reproductive rate (number of litters
ratory rats (Rattus norvegicus) from the breeding during the reproductive period and number
group that originated in the Kiev laboratory of newborns in each litter) of laboratory mice
colony. After the catastrophe there was a signif- (Mus musculus) line CC57W of a Chernobyl ex-
icant decrease in the average life span of labora- perimental population steadily decreased over
tory rats (Rattus norvegicus) in animal facilities in seven generations. At the same time the num-
both Chernobyl and Kiev (Table 10.11). ber that died in the first month postnatal pe-
12. The sex ratio of bank voles (Clethrionomys riod and preimplantation period significantly
sp.) as a percent of the current year of breeding increased (Stolyna and Solomko, 1996).
young deviated significantly in the heavily con- 16. Long-term studies of small-rodent pop-
taminated territories (Kudryashova et al., 2004). ulations (Clethrionomys glareolus and others) in
TABLE 10.8. Histological Characteristics of Hog Testes Associated with Sr-90 and Cs-137 Contamina-
tion (Oleinik, 2005)
Specific numbers of semen channels Thickness of white envelopes, mkm
Age Contaminated Control Contaminated Control
5 months 39.0 ± 0.7 63.7 ± 2.8∗ 178.0 ± 8.5∗ 465.2 ± 11.7

8 months 20.5 ± 0.9 21.4 ± 0.9∗ 231.0 ± 12.7∗ 572.0 ± 18.1
2 years 13.4 ± 0.4 21.2 ± 0.8 335.0 ± 8.81∗ 428.0 ± 17.3
4 years 12.9 ± 0.6 19.2 ± 0.9∗ 380.3 ± 22.2 349.5 ± 26.0
∗
p < 0.05.
TABLE 10.9. Weight, Total Morbidity, and Mortality (%) of Calves from Heavily (5–15 Ci/m2 ) and Lower
(<1 Ci/km2 ) Contaminated Districts of Zhytomir Province, Ukraine, 1997–1999 (Karpuk, 2001)
Weight
Total
Less than 26 kg More than 35 kg Normal morbidity Mortality
Heavy contamination 13.3 10 76.7 34 7

Low contamination 20 15 65 50.5∗ 12∗
∗
p < 0.01.
the Kanev Natural Reserve pre- and postcatas- 5 Ci/km2 , and the fewest problems occurred in
trophe revealed disturbances in ecological bal- a horse-breeding center in the Smolensk area,
ance, delay in the “population clock” run, and Russia, with contamination levels less than
biotic turnover (Mezhzherin and Myakushko, 1 Ci/km2 (Yakovleva, 2005).
1998). 19. Decreased clutch size of some bird
17. The litter size of wolves (Lupus lupus) species was found in the United States in
in Russian contaminated territories correlates California, Washington, and Oregon in June–
with the level of radioactive contamination July 1986, most probably connected with the
and specific activity of Cs-137 in their fur Chernobyl fallout (DeSante and Geupel, 1987;
(Adamovich, 1998). Millpointer, 1991).
18. Observations from 1978 to 1999, cover- 20. Survival rates of barn swallows (Hirundo
ing 5,427 horse-breeding years, indicated that rustica) in the most contaminated sites near the
the success of breeding free-range horses (Equus Chernobyl NPP are close to zero. In areas of
caballus) correlated with the level of farm ra- moderate contamination, annual survival is less
dioactive contamination: the greatest number than 25% (vs. about 40% in control popula-
of abortions, stillbirths, and sick foals occurred tions in Ukraine, Spain, Italy, and Denmark).
in a horse-breeding center in the Gomel area Overall, Chernobyl bird populations show dra-
(Belarus) from 1993 to 1999 when contam- matically reduced reproductive rates and lower
ination levels were up to 40 Ci/km2 . An offspring survival rates (Møller et al., 2005).
intermediate level of problems was in a horse- 21. Abnormal spermatozoa (head devia-
breeding center in the Bryansk area, Rus- tions, two heads, two tails, etc.) in barn swal-
sia, with background radiation levels of 1– lows (Hirundo rustica) occurred at significantly
higher frequencies in heavily contaminated ar-
eas (Møller et al., 2005).
TABLE 10.10. Some Characters of Afterbirth 22. The Chernobyl barn swallow popula-
Membranes in Cows (Bos taurus ) from Greater and tions are only sustained via immigration from
Lesser Contaminated Areas, Zhytomir Province, adjacent, uncontaminated populations. Stable
Ukraine, 1997–1999 (Karpuk, 2001)1
Contamination level TABLE 10.11. Average Life Span of Laboratory
5–15 Ci/km2 <0.1 Ci/km2 Rats (Rattus norvegicus ) under Heavy Irradiation in
Chernobyl City, and Less Irradiation in Kiev (Serkiz,
Weight amniotic 4.6 ± 0.3 5.6 ± 0.3∗ 1995)
membranes, kg
Placental lobules October 1986 to 1989
Kiev before
∗
Number 76.9 ± 4.0 88.0 ± 2.7 Chernobyl City Kiev April 1986
cm2 4,043 ± 118 4,853 ± 206∗
1
Life span 20.3 ± 0.8 21.6 ± 0.5 28.2 ± 0.6
Data for Ci/km2 —summarized for two farms by A. Y. months
∗
p < 0.05.
264
isotope analyses on current and past specimens tive changes in the testes were observed in sev-
(from museums) have indicated that current eral generations of white silver carp (Hypoph-
Chernobyl populations are composed of a more thalmichthys molitrix) from the breeding stock at a
diverse group of individuals (i.e., immigrants) Chernobyl NPP reservoir-cooler (Verygin et al.,
than is observed in control populations or in 1996).
populations collected from the Chernobyl re- 28. Abnormal growth of testicular connec-
gion prior to the disaster (Møller et al., 2006). tive tissue, decreased sperm concentration, and
23. Detailed surveys of birds indicate that increased numbers of abnormal spermatozoa
many species are either absent or present in were found in motley silver carp (Aristichthys
very low numbers in the Chernobyl region. nobilis) that were radiated in 1986 at the age
Brightly colored and migratory bird species ap- of 1–2 years and then lived under conditions
pear to be particularly sensitive to radioactive of chronic low-dose radiation (Makeeva et al.,
contaminants (Møller and Moussaeu, 2007a). 1996).
24. Concentrations of total carotenoids and 29. Reproductive characteristics of carp
vitamins A and E in the yolks of the great tit (Cyprinus carpio) correlated with levels of in-
(Parus major) were depressed in the 10-km zone corporated radionuclides in sperm and eggs
as compared to concentrations in a less contam- (Figure 10.5).
inated Ukrainian area or in France. Egg-laying 30. Degenerative morphological changes
dates were advanced and clutch sizes increased were seen in oocytes of pike (Esox lucius) dur-
in nest boxes with high dose rates. There was ing vitellogenesis in heavily contaminated wa-
reduced hatching in boxes with high levels of ra- ters. In gonads of fish from two lakes within the
diation, which eventually eliminated and even 30-km zone (Smerzhov Lake with Cs-134 and
reversed the differences in reproductive suc- Cs-137 levels of 5,800 Bq/kg in 1991, and Per-
cess associated with early reproduction and stok Lake, with levels up to 199,900 Bq/kg in
large clutch size. These findings are consistent 1995) the thickness of the radial membrane in
with the hypothesis that radioactive contam- egg cells reached 25 − 30 μm, compared with a
ination reduces levels of dietary antioxidants thickness of about 10 μm for egg cells from the
in yolks, resulting in negative consequences Pripyat River (875 Bq/kg in 1992; Kokhnenko,
for hatching and reproductive success (Møller 2000).
et al., 2008b). 31. Deviation in gametogenesis (i.e., changes
25. Species richness and abundance of forest in normal oocytes and nucleus size, develop-
birds declined by more than 50% as contam- mental abnormalities of oocytes, thickening of
ination levels increased. Abundance of birds the follicular wall, decomposition of the nu-
decreased by about 66% in the most contam- cleus, etc.) was found in bream (Abramis brama)
inated areas as compared to sites with typical and small fry (Rutilus rutilus) from the Pripyat
(control) background radiation levels (Møller River and Smerzhov Lake (Gomel Province,
and Mousseau, 2007a). Belarus). Changes were correlated with the
26. Great tit (Parus major) and pied flycatcher level of radiation contamination of the reser-
(Ficedula hypoleuca) species avoided nest boxes in voirs (Petukhov and Kokhnenko, 1998).
the heavily contaminated areas to a marked 32. Adult earthworms dominated in heavily
degree. Where it interacted with habitat for contaminated sites during the first period after
the great tit and with the laying date for the the catastrophe, whereas in control areas there
pied flycatcher, hatching success was depressed was parity between adult and young individuals
as radioactive contamination increased (Møller (Victorov, 1993; Krivolutsky and Pokarzhevsky,
and Mousseau, 2007b). 1992).
27. A significant decrease in volume and 33. Nine years after the catastrophe in bod-
concentration of seminal fluids and destruc- ies of water with heavy radioactivity, 20% of
Figure 10.5. Coefficients of correlation between reproductive characteristics of carp

(Cyprinus carpio) and radionuclide concentration in their eggs and sperm (milt; coefficients
of correlation are given in absolute values): (1) number of eggs (thousands per female); (2)
amount of milt (ml per male); (3) quality of milt; (4) fertilization, %; (5) number of prelarvae
(thousands per female); (6) number of larvae (thousands per female); (7) larva survival, %;
(8) frequency of morphological abnormalities, %; (9) mitotic index, %; (10) frequency of
chromosome aberrations at late blastula stage, % (Goncharova, 1997).
oligochaete (Stylaria lacustris) specimens have sex occurred in an excess of up to three orders of
cells, whereas normally this species reproduces incidence as compared with precatastrophe fre-
asexually (Tsytsugyna et al., 2005). quencies (Ryabokon’, 1999).
3. The number of polyploidy cells in all stud-
ied populations of bank voles (Clethrionomys glare-
10.3. Genetic Changes olus) in heavily contaminated Belarussian terri-
tories correlates with the level of incorporated
1. In 1989 there was a significantly higher radionuclides (Ryabokon’, 1999).
frequency of cytogenetic disorders in somatic 4. The number of genomic mutations in a
and germinal cells (number of chromosomes population of bank voles (Clethrionomys glareolus)
and aberrations in marrow cells) in bank voles increased to the 12th generation after the catas-
(Clethrionomys glareolus) and yellow-necked mice trophe (from 1986 to 1991) despite a decrease
(Apodemus flavicollis) in territories with Cs-137 in background radioactivity (Ryabokon’, 1999).
levels of 8–1,526 kBq/m2 and in laboratory 5. The offspring of female bank voles (Clethri-
mice (Mus musculus) lines CBA × C57Bl/6j onomys glareolus) captured in the contaminated
(F1) in the heavily contaminated areas. These territories and raised under contamination-free
abnormalities were maintained at high levels conditions showed the same enhanced level of
for no fewer than 22 generations, which in- chromosomal aberrations as the contaminated
creased from 1986 until 1991/1992 in all the mothers (Ryabokon’ and Goncharova, 2006).
populations studied, despite a decrease in 6. Wild populations of house mice (Mus
contamination (Goncharova and Ryabokon’, musculus) living in the contaminated territories
1998a,b; Smolitch and Ryabokon’, 1997; have a significantly increased level of domi-
Ryabokon’, 1999a). nant lethal mutations and chromosome translo-
2. In all the studied populations of bank cations. The frequency of reciprocal translo-
voles (Clethrionomys glareolus) in heavily contam- cations in spermatocytes was higher in areas
inated Belarussian territories, polyploidy cells with more intensive contamination during the
266
TABLE 10.12. Abnormalities in Laboratory Mice TABLE 10.13. Number of Micronuclei in Poly-
(Mus musculus ) Fibroblast Cell Cultures after chromatic Erythrocytes of Bone Marrow in Labora-
5 Days of Exposure in the 10-km Zone (Pelevyna tory Mice (Mus musculus ) after 12 Weeks in 30-km
et al., 2006) Chernobyl Zone (Sushko et al., 2006)∗
Chromosomal aberrations Studied Cells with
Sex cells, n micronucleus
Percent of cells Types
Controls ♂ 5,000 0.34 ± 0.11
Controls Up to 3 Deletions ♀ 5,000 0.29 ± 0.09
After Up to 24.5 Deletions, fragments, 30-km zone ♂ 5,000 4.1 ± 0.45
exposure and translocations ♀ 5,000 4.06 ± 0.53
∗
All significantly different from controls.
period from 1986 to 1994 (Pomerantseva et al.,

1990, 1996). 13. In laboratory mice (Mus musculus), cell
7. The frequency of mutations through sev- fibroblast cultures originating from embryos
eral generations in both somatic and germinal conceived in the 10-km zone demonstrate
cells of house mice (Mus musculus) remained sig- significantly increased numbers of cells with
nificantly higher after irradiation as compared chromosomal aberrations, including cells with
to nonradiated descendants (Dubrova et al., multiple aberrations (Nazarov et al., 2007;
2000). Table 10.12).
8. Laboratory mice (Mus musculus) lines 14. Keeping laboratory mice (Mus musculus)
C57BL/6, BALB/C, CC57W/Mv contained for 4 months in the 30-km zone resulted in a
within the 30-km zone and other rodents sharp and significantly increased incidence of
caught in 1995 in the 10-km zone, were found micronuclei in polychromatic cells of the bone
to have a wide spectrum of cytogenetic anoma- marrow (Table 10.13).
lies (Glazko et al., 1996). 15. The number of chromosome aberra-
9. The frequency of mitochondrial DNA mu- tions in the bank vole (Clethrionomys glareolus) was
tations in voles in the 30-km zone was signifi- higher in a more radioactively contaminated
cantly increased in the first years after the catas- environment (Table 10.14).
trophe (Freemantle, 1996; Baker, 1996; Hillis, 16. The level of both somatic and genomic
1996). mutations in a population of barn swallows
10. The number of aberrant alveolar (Hirundo rustica) in the Chernobyl zone was
macrophage cells in bank voles (Clethrionomys two to ten times greater than in other popu-
glareolus) was significantly higher in the popula- lations in Ukraine or in Italy (Ellegren et al.,
tions living in heavily contaminated territories 1997).
(Yelyseeva et al., 1996).
11. The micronuclear frequencies in labora-
TABLE 10.14. Frequency of Aberrant Cells in
tory mice (Mus musculus) increased significantly
Bank Voles (Clethrionomys glareolus ) under Var-
after a 10-day stay in the “Red Forest” (10-km ious Levels of Radioactive Contamination, 1993,
zone) for the BALB/c line and after 30 days for Bryansk Province, Russia (Krysanov et al., 1996)
the C57BL/6 line (Wickliffe et al., 2002).
Contamination Cells studied Aberrant cell
12. The rate of chromosome aberrations and level n frequencies
embryonic lethality noticeably increased for
more than 22 generations of bank voles (Clethri- 20 μR/h 229 0.04 ± 0.008
onomys glareolus), whereas the whole-body ab- 60 μR/h 593 0.06 ± 0.006
180 μR/h 325 0.13 ± 0.02
sorbed dose rates decreased exponentially after 220 μR/h 864 0.11 ± 0.02
1986 (Goncharova et al., 2005).
Figure 10.6. Normal barn swallow (left) and partial albino (right; photo by T. Mousseau).
17. Barn swallow populations (Hirundo rus- and an increased number of micronuclei in pe-
tica) that originated in the Ukrainian Cher- ripheral blood (Yelyseeva et al., 1996).
nobyl zone after the catastrophe have signif- 21. The incidence of erythrocytes with mi-
icantly more (up to 15%) albino mutations cronuclei was higher in the hybrid frog complex
(Figure 10.6). Mutation rates seen in Chernobyl (Rana esculenta) in the more contaminated areas
populations have significantly higher numbers in Bryansk Province (Table 10.15).
of morphological defects as compared to con- 22. The frequency of morphological anoma-
trol populations in Ukraine, Italy, Spain, and lies (congenital malformations) in carp (Cypri-
Denmark (Møller and Mousseau, 2001; Møller nus carpio) embryos, larvae, and fingerlings
et al., 2007). was significantly higher in more contaminated
18. There are positive correlations between ponds in Belarus (Slukvin and Goncharova,
the number of abnormalities in black redstart 1998).
(Phoenicurus ochruros) and house sparrows (Passer 23. The frequency of chromosome aberra-
domestica) and the level of background radiation tions and genomic mutations in carp (Cypri-
in Ukraine (Møller et al., 2007). nus carpio) populations was significantly higher
19. From 2005 to 2006 there were significant in more contaminated ponds in Belarus
differences in motility and morphology of live (Goncharova et al., 1996).
sperm of barn swallows (Hirundo rustica) breed- 24. Colorado beetle (Leptinotarsa decemlineata)
ing in heavily radioactively contaminated areas wing color pattern mutations occurred with
(390 mR/h) around Chernobyl as compared to greater frequency in the more contaminated
sperm from swallows in two less contaminated territories in Belarus (Makeeva et al., 1995).
(0.25 and 0.006 mR/h) areas in Ukraine. The
incidence of sperm with low motility, high lin- TABLE 10.15. The Frequency of Micronuclei in
earity, small amplitude, lateral head displace- Erythrocytes in Frog Hybrid Complex (Rana escu-
ment, and low track velocity increased with in- lenta) in Three Populations in Bryansk Province,
creasing background radiation levels (Møller 1993 (Chubanishvyli, 1996)
et al., 2008b). Contamination, dose
20. Brown frogs (Rana temporaria, R. ar-
valis) from the heavily contaminated territories 15 μ R/h 60 μR/h 220 μR/h
0.22% 1.33% 1.55∗
showed a significantly higher number of aber-
∗
rant bone marrow and intestinal epithelial cells p < 0.05.
268
TABLE 10.16. The Frequency of Dominant Lethal nated Berezinsky Reserve, as a result of in-
Mutations (DLM) and Recessive Sex-Linked Lethal creased radioresistance in the irradiated pop-
Mutations (RLM) in Natural Drosophila (Drosophila
ulation (Table 10.16).
melanogaster ) Populations from the Vetka District
in Gomel Province as Compared with the Popu- 27. The highest level of mutations was
lation from the Less Contaminated Berezinsk Re- observed in aquatic crustaceans Amphipoda
serve, Belarus (Glushkova et al., 1999) and Platyhelminth worm populations in the
Vetka Berezinsky
Chernobyl 10-km zone as compared with pop-
District Reserve ulations from the Black and Aegean seas and
the Danube and Dnieper rivers (Tsytsugyna
DLM 42.76 ± 0.88 63.09 ± 0.91∗ and Polycarpov, 2007).
RLM 6.65 ± 0.66 12.64 ± 1.15∗∗
28. Table 10.17 presents some additional
∗
p < 0.05; ∗∗ p < 0.001. data on genetic changes in animals associated
with the Chernobyl contamination.
25. The frequency of lethal and semilethal

mutations in drosophila (Drosophila melanogaster) 10.4. Changes in Other Biological
populations is significantly higher in the Be- Characteristics
larussian contaminated territories (Makeeva
et al., 1995). 1. Voles (Clethrionomys sp. and Microtus sp.)
26. In natural drosophila (Drosophila from the contaminated areas showed im-
melanogaster) populations from the Vetka Dis- paired brain development and deformed limbs
trict, Gomel Province (radiation level of 24 (Sokolov and Kryvolutsky, 1998).
Ci/km2 ), the incidence of dominant lethal 2. Neutrophilic phagocytic activity to Staphy-
and recessive sex-linked lethal mutations is lococcus aureus in the blood serum and the B-
significantly lower than in the less contami- lymphocytic system was significantly lower in
TABLE 10.17. Examples of Genetic Changes in Animals as a Consequence of the Chernobyl Catas-
trophe (Based on Møller and Mousseau, 2006)
Species Genetic marker Effect, comments Reference
Apodemus flavicollis Chromosome aberrations Increase by a factor of 3–7 Savchenko, 1995

Mus musculus Reciprocal translocations Increase by a factor of 15 Pomerantseva et al., 1990,
1996
Clethryonomys glareolus Somatic mutation Increased∗ Matson, 2000
Multiple substitutions in Only from Chernobyl Baker et al., 1999
Cytochrome-b and samples
transversions
Mutation and heteroplasmy∗∗ Increased∗ Wickliffe et al., 2002
Point mutations Increased∗ Dubrova, 2003; Wickliffe
et al., 2002
Hirundo rustica Microsatellites Increased by a factor of 2–10 Ellegren et al., 1997
Icterus punctatus DNA breakage I Increased rate Snugg, 1996
Carassius carassius DNA content Changes Lingerfelser, 1997
Four fish species Frequency of aneuploidy Increased Dallas, 1998
Drosophila melanogaster Sex-linked lethal mutations Increased Zainullin, 1992
Three Oligochaete Chromosomal aberrations Increased by a factor of ∼2 Tsytsugyna and Polycarpov,
species 2003
∗
Not statistically significant.
∗∗
Heteroplasmy—mixed mitochondria in a single cell.
TABLE 10.18. Some Hematological Characteris- TABLE 10.19. Frequency of Lung Neoplasms in
tics of Calf-Bearing Cows from Heavily and Less Laboratory Mice (Mus musculus ) after 20 Weeks
Contaminated Areas, Zhytomir Province, Ukraine, Exposure in the 30-km Zone (Sushko et al.,
1997–1999 (Karpuk, 2001)1 2006)
5–15 Ci/km2 <0.1 Ci/km2 Neoplasms per mouse
Erythrocytes 4.8 ± 0.1 5.8 ± 0.2∗ Control 0.26 ± 0.06

(thousands/liter) 30-km zone 0.77 ± 0.17
Leucocytes (g/liter) 6.2 ± 0.4 6.9 ± 0.3
Hemoglobin (g/liter) 78.6 ± 2.0 91.4 ± 2.8∗
Basophiles, % 0.3 ± 0.2 1.3 ± 0.2∗ 7. Dairy cows (Bos taurus) in areas with con-
Eosinophils, % 10.0 ± 1.0 4.6 ± 0.3
Segmented 24.7 ± 1.5 32 ± 0.9∗
tamination levels of 15–40 Ci/km2 developed
neutrophiles, % indurated spleens with reduced volume and
Lymphocytes, % 57.7 ± 1.5 60.9 ± 0.8∗ sharply reduced white pulp area. There was
Monocytes, % 3.8 ± 0.3 4.5 ± 0.3 coarsening of reticular fibrous structures and
1
Data for Ci/km2 —summarized for two farms by
dispersed and reduced lymph nodes in the cor-
A. Y. tex (Velykanov and Molev, 2004).
∗ 8. Asymmetry of yellow-neck mouse (Apode-
p < 0.01.
mus flavicollis) skulls was significantly higher in
populations from more contaminated territo-
cows from more contaminated areas (p < 0.05 ries (Smith et al., 2002).
and p < 0.001; Karpuk, 2001). 9. After 20 weeks of exposure in the 30-km
3. Hematological characteristics differ sig- zone the incidence of lung neoplasms in lab-
nificantly in cattle (Bos taurus) from areas with oratory mice (Mus musculus) was significantly
different levels of contamination (Table 10.18). greater (Table 10.19).
4. Hypoplasia and degenerative-dystrophic 10. There was a decreased density of en-
changes developed in the thymus glands of 20- dotheliocytes in various parts of the brain in
day-old laboratory albino rats (Rattus norvegicus) laboratory mice (Mus musculus) after they had
whose pregnant mothers lived for 25 days in lived in the 10-km zone for 1 month (Pelevyna
an area with a Cs-137 level of 116 Ci/km2 and et al., 2006; Nazarov et al., 2007).
an Sr-90 level of 26 Ci/km2 . Changes included 11. Large horned livestock (Bos taurus) in con-
accelerated cytolysis and lowered mitotic activ- taminated areas had lowered lysozymic activ-
ity. Such thymus gland changes led to immune ity in whey and lowered resistance to skin in-
disorders (Amvros’ev et al., 1998). fections, which indicated the development of
5. Endogenous activity changed significantly immunodeficiency (Il’yazov, 1993, 2002).
in spinal cord nerve cells and in the cerebrum of 12. Resistance to skin infections is low-
laboratory mice (Mus musculus) lines C57BI/6 ered in wild murine rodents in heavily con-
after they were in the Chernobyl zone for 40 taminated territories (Kozynenko and Zavod-
days with background radiation of 100–120 nykova, 1993).
mR/h (Mustafin et al., 1996). 13. There was increased sensitivity to viral
6. Dairy cows (Bos taurus) from areas infections in laboratory mice (Mus musculus) af-
contaminated at levels of 15–40 Ci/km2 ter they had been in the 10-km zone (Savtsova
developed inflammatory and atrophic changes et al., 1991).
in lymphoid tissue accompanied by de- 14. There was a significantly increased fre-
creased T-lymphocyte functional activity, and quency of tumors in laboratory mice (Mus mus-
they demonstrated abnormal connective tissue culus) experimentally inoculated with tumor
growth 4 years after the catastrophe (Velykanov cells after they had been in the 10-km zone
and Molev, 2004). (Savtsova et al., 1991).
270
15. Animals in the Chernobyl zone had TABLE 10.20. Cause of Death (%) in Labora-
accelerated aging of the immune system tory Rats (Rattus norvegicus ) from the Experimental
Animal Facilities in Chernobyl City (Heavy Back-
(Savtsova, 1995).
ground Radiation) and Kiev (Less Background Ra-
16. Laboratory rats (Rattus norvegicus) kept in diation), October 1986–December 1989 (Serkiz,
the 10-km zone from 1986 to 1993 were found 1995)
to have (Pinchuk and Rodionova, 1995; Serkiz
Chernobyl
et al., 2003): Cause of death Kiev City
• Decreased numbers of bone marrow
Pneumonia, lung hemorrhage 10.3 35.5
cells, peripheral blood leukocytes, and Pulmonitis 8.4 11.1
myelokaryocytes. Colitis 19.1 31.1
• Hypochromatic anemia, leukocytopenia Lymph node hyperplasia 10.3 13.2
(onset during the third month of being Thymus gland/spleen hyperplasia 2.4 4.4
in the radioactive zone), granulocytopenia
with very high levels of eosinophils, and
eosinophilia.
• Increased numbers of abnormal cells (huge throcyte counts were significantly lower (up to
hypersegmented neutrophilic leukocytes, 15.0%), hemoglobin was lower (up to 45.0%),
cells with fragmented nuclei, cells with the percentage of young and stick hearted
shaggy chromatin structure, cytoplasm leukocytes increased 1.3 to 2.8 times, and blood
nuclear inclusions, and multinucleated levels of alpha- and gammaglobulins decreased
lymphocytes. up to 44.4% (Oleinik, 2005).
21. Laboratory rats (Rattus norvegicus) kept
17. After being in the 10-km zone for 3 in the 30-km zone for 1 month had signif-
to 6 months, laboratory rats (Rattus norvegicus) icantly increased leukocytes and have a ten-
developed significant mitotic growth activity dency toward increased numbers of marrow
(sometimes accompanied by an increase in the cells (Izmozherov et al., 1990).
number of bone marrow cells) and then had a 22. Laboratory mice (Mus musculus) kept in
subsequent decrease in mitotic activity. Similar the 30-km zone for 1 month had significantly
processes were observed in wild murines living increased numbers of lymphocytes and leuko-
in the 10-km zone (Serkiz et al., 2003). cytes (Pelevyna et al., 1993).
18. Low red cell counts, decreased 23. The most common immediate causes
hemoglobin levels, and decreased percentage of of death for laboratory rats (Rattus norvegicus)
neutrophils and monocytes were seen in cattle in the animal facilities in Chernobyl City and
(Bos taurus) that remained in the 12-km zone for Kiev after the catastrophe were inflammatory
2 months after the catastrophe (Il’yazov, 1993; processes of the lungs and intestines (Serkiz,
Il’yazov et al., 1990). 1995). Table 10.20 presents data on their mor-
19. Until October 1986 free-range cattle tality from 1986 to 1989.
(Bos taurus) living 3–6 km from the Chernobyl 24. Mammary adenofibromas and malig-
NPP had high eosinophil and low lymphocyte nant lung and intestinal tumors appeared
counts, as well as undifferentiated cells, broken at earlier ages in laboratory rats (Rattus
cell forms, and hyperchromic anemia (Glazko norvegicus) in the Chernobyl animal facility from
et al., 1996). 1987 to 1989 and included lymphoid and con-
20. In farm-raised hog sires (Sus scrofa) in nective tissue tumors, including lymphatic sar-
Mlinivs’sk and Sarnens’k districts of Rivne coma (Table 10.21).
Province, Ukraine, from 1997 to 2001, where 25. Tumors developed in 74% of labo-
Cs-137 contamination levels were 1–5 Ci/km2 ratory rats (Rattus norvegicus) in the Cher-
and Sr-90 levels were 0.04–0.08 Ci/km2 , ery- nobyl and Kiev experimental breeding colonies
TABLE 10.21. Average Age of Occurrence and TABLE 10.23. Occurrence and Features of Breast
Probability of Occurrence (%) of Malignant Tumors Neoplasms in Laboratory Rats (Rattus norbegicus )
in Laboratory Rats (Rattus norvegicus ) under Dif- from 1989 to 1992 in Chernobyl City and Kiev
ferent Levels of Contamination before and after Experimental Animal Facilities (Pinchuk, 1995)
the Catastrophe (Pinchuk, 1995)
Chernobyl
After 1986 City Kiev
Chernobyl Kiev 1985 Breast adenofibroma with 14.7 9.5
malignancy, %∗
Average age for malignant 10 14 16 Animals with multiple mammary 29 27
tumors, months tumors, %∗∗
Probability of occurrence of 35 17 5 Animals with a breast tumors 58.8 20.3
tumors, months combined with other tumors∗∗
∗
From the total number of animals.
∗∗
from 1989 to 1992. Endocrine gland tumors From number of animals with mammary gland
(Table 10.22) in combination with mammary tumors.
tumors (Table 10.23) were typical for rats from
Chernobyl. Adenocarcinoma and epithelial tu- the β-adrenergic link level of ACS in cardiomy-
mors in Chernobyl rats were not observed in ocytes in animals exposed to radiation (Komar
rats in the Kiev group and were not seen as et al., 2000).
spontaneous tumors in this breeding line be- 27. The level of fluctuating asymmetry in
fore the catastrophe (Pinchuk, 1995). populations of the common shrew (Sorex araneus)
26. Female rats (Rattus norvegicus) age 4–5 was higher in the more radioactively contami-
months with hyperthyroidism kept in the 30-km nated environment in Bryansk Province, Russia
zone for 30 days had significantly reduced basal (Table 10.24).
activity of myocardial adenyl cyclase (ACS; 28. The level of developmental stability (by
14.48 ± 0.78 nMol/mg protein/min as com- fluctuating asymmetry of many morphological
pared with 20.78 ± 0.57 in the controls). A test characters) in barn swallows (Hirundo rustica)
of F-dependent enzyme activation revealed a was significantly higher in the contaminated
significant reduction in the stimulative effect of areas (Møller, 1993).
ACS activity on myocardium in animals kept 29. Carbohydrate metabolism and lipid bal-
under irradiation. The data point to the pos- ance were noticeably abnormal in some birds
sibility of modulating hyperthyroid effects at from the Chernobyl zone, reflecting endocrine
system impairment (Mykytyuk and Ermakov,
TABLE 10.22. Occurrence (% of Total Tumors) in 1990).
Laboratory Rats (Rattus norvegicus ) from 1986 to 30. The percentage of dead cells in the spleen
1992 in Chernobyl City and Kiev Experimental An- and bone marrow of moor frogs (Rana arvalis)
imal Facilities (Pinchuk, 1995)
Chernobyl
TABLE 10.24. Level of Fluctuating Asymme-
City Kiev
try (Asymmetric Cases per Character) in Three
Thymus gland tumor∗ 15.9 2.7 Populations of Common Shrew (Sorex araneus )
Adrenal cortex adenoma 43.2 6.8 with Different Levels of Radioactive Contamina-
Thyroid gland tumor 43.2 15.7 tion, Bryansk Province, 1992 (Zakharov et al.,
Cellular adenoma of islet of 34.1 1 1996b)
Langerhans Contamination, dose
∗
Between 1986 and 1989 the animals in Kiev had no
60 μR/h 180 μR/h 220 μR/h
such tumors, but such tumors did develop in 4.8% of all
0.016 ± 0.03 0.24 ± 0.03 0.26 ± 0.03
the animals in the Chernobyl facility.
272
TABLE 10.25. Immune Status of the Frog Hybrid TABLE 10.26. The Level of Developmental Sta-
Complex Rana esculenta in Two Populations with bility (Asymmetric Cases Per Character) in Pop-
Different Contamination Levels, Bryansk Province, ulations of Frog Hybrid Complex Rana esculenta
1994 (Isaeva and Vyazov, 1996) with Different Levels of Radioactive Contamina-
tion, Bryansk Province, 1992–1993 (Chubanishvyli
Contamination, μR/h et al., 1996)
Index 60 220 Contamination, dose
Leukocytes, 106 /liter 15.32 ± 0.99 21.7 ± 1.83 Year 15 μR/h 60 μR/h 220 μR/h
Lymphocytes, 106 /liter 6.16 ± 0.41 11.08 ± 1.0
Neutrophils, % 47.2 ± 1.11 28.9 ± 1.55 1994 0.45 ± 0.03 0.46 ± 0.03 0.54 ± 0.03
T lymphocytes, % 47.1 ± 1.45 26.6 ± 1.03 1993 — 0.54 ± 0.03 0.64 ± 0.03
B lymphocytes, % 20.9 ± 0.56 12.5 ± 0.67
Zero-cells, % 32.0 ± 1.59 61.9 ± 1.38
Rosette-forming 22.8 ± 1.22 17.7 ± 0.49 was lower in less contaminated environments
neutrophiles, % (Table 10.26).
35. The level of fluctuating asymmetry and
the number of phenodeviations in popula-
from populations living under heavy radiation tions of crucian carp (Carassius carassius) and
for 7–8 years differed significantly from con- wild goldfish (Carassius auratus) were higher in
trols after exposure to additional experimental those living in water with more radioactive
radiation (Afonin and Voitovich, 1998; Afonin contamination in Bryansk Province, Russia
et al., 1999). (Table 10.27).
31. The number of micronucleated erythro- 36. After the catastrophe, there were many
cytes in all the populations of brown frogs malformed specimens of true insect (Heteroptera)
(Rana temporaria) from heavily contaminated ar- species collected in areas with the most ra-
eas caught before 1991 was significantly higher dioactive contamination in eastern Sweden
(p < 0.001) than from less contaminated areas (Gysinge, Osterfarnebo, and Galve) and south-
(in some cases by a factor of 30). Both brown (R. ern Switzerland (Melano near Ticino). In 1990
temporaria) and narrow-muzzled (R. arvalis) frogs up to 22% of all insects collected in the Polessk
inhabiting radiation-contaminated areas have District, near the 30-km zone, were malformed
increased cytogenetic damage in bone marrow (Hesse-Honegger, 2001; Hesse-Honegger and
cells and erythrocytes and a change in the ratio Wallimann, 2008).
of erythrocytes in peripheral blood (Voitovich, 37. The number of oribatid mite species,
2000). inhabitants on pine bark and the lichen Hy-
32. Additional gamma-irradiation-induced pogymnia physodes significantly declined on ra-
apoptosis of bone marrow cells was discovered dioactively contaminated trees 2–3 km from the
in narrow-muzzled frogs (Rana arvalis) inhabit- Chernobyl NPP. Before the catastrophe, there
ing the 30-km zone. The initial level of cells with were 16 species; afterward the numbers were:
chromatin changes was significantly higher (p < 1986, 0; 1987, 2; 1988, 2; 1991, 4; 1999, 6; and
0.05) in animals from the 30-km zone (Afonin 2002, 8 (Kryvolutsky, 2004).
et al., 1999). 38. In the 5 to 6 years after the catastrophe
33. Changes were demonstrated in the func- the species diversity of large soil invertebrates
tional immune status activity in the frog hybrid was significantly lowered, and even 13 to 15
(Rana esculenta) in the more contaminated areas years after there were also fewer small-sized
(Table 10.25). species (Pokarzhevsky et al., 2006).
34. The level of developmental stability (by 39. The intensity of nematode and cestode
number of asymmetric cases per character) invasions was higher in more radioactively con-
in three populations of frogs (Rana esculenta) taminated environments (Table 10.28).
TABLE 10.27. Level of Fluctuating Asymmetry and Number of Phenodeviation in Populations of Cru-
cian Carp (Carassius carassius ) and Wild Goldfish (Carassius auratus ) with Different Levels of Radioac-
tive Contamination of the Water, Bryansk Province, 1992 (Zakharov et al., 1996a)
Species Character 60 μR/h 80 μR/h 180 μR/h
C. carassius Asymmetric cases per character 0.31 ± 0.07 0.37 ± 0.04 0.42 ± 0.06
Phenodeviation per specimen 1.57 ± 0.61 2.93 ± 0.26 4.88 ± 0.30
C. auratus Asymmetric cases per character 0.26 ± 0.03 0.45 ± 0.04 -
Phenodeviation per specimen 2.0 ± 0.29 4.10 ± 0.27 -
40. In the 10 years after the catastrophe the with chronic low-dose contamination has re-
biodiversity of soil protozoa did not exceed 50% sulted in morphologic, physiologic, and ge-
of the precatastrophe level (Pokarzhevsky et al., netic disorders in all of the animals studied—
2006). mammals, birds, amphibians, fish, and inverte-
brates. “Chernobyl” populations exhibit a wide
10.5. Conclusion variety of morphological deformities that are
not found in normal populations of domestic
In 1986 in the contaminated territories, an animals, even beetles, living in the contami-
enormous amount of many different radionu- nated territories.
clides was absorbed by animals through food, Some bird species may persist in the 30-km
water, and air. Levels of incorporated radionu- Chernobyl zone only via immigration from
clides were sometimes hundreds of times higher uncontaminated areas. Despite reports of a
than precatastrophe ones. Now, 23 years after “healthy” Chernobyl environment for rare
the catastrophe, the levels of incorporated ra- species of birds and mammals, their existence
dionuclides in some areas of Europe remain there is likely the result of immigration and not
dangerous for mammals, birds, amphibians, from locally sustained populations.
and fish. This first radioactive shock together Mutation rates in animal populations in con-
taminated territories are significantly higher.
There is transgenerational accumulation of ge-
nomic instability in animal populations, man-
TABLE 10.28. Intensity of the Invasion of Bank ifested as adverse cellular and systemic effects.
Voles (Clethrionomys glareolus ) by Nematodes
These long-term effects may be even more
and Cestodes, Bryansk Province, Russia, 1992–
1995 (Pel’gunov, 1996) detrimental because the genomes of animals
in subsequent generations are more sensitive
60 μR/h 180 μR/h 220 μR/h to the impact of very low doses of radiation
Nematodes∗ (Goncharova, 2005).
Intensity, % 3.5 5.0 48.1 Since the catastrophe, long-term observa-
Index of 3.0 3.9 40.0 tions of both wild and experimental animal
abundance populations in the heavily contaminated areas
Cestodes∗∗
show serious increases in morbidity and mortal-
Intensity, % 1.6 1.1 3.4
Index of 0.53 0.71 2.1 ity that bear striking resemblance to changes in
abundance the public health of humans—increasing tumor
∗
rates, immunodeficiencies, decreasing life ex-
Predominant species: Heligmosomum mixtum, Heligmoso-
moides glareoli, and Syphacia obvelata.
pectancy, early aging, changes in blood forma-
∗∗
Predominant species: Catenotaenia cricetorum and Para- tion, malformations, and other compromises to
noplocephala omphalodes. health.
274
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sophila melanogaster populations living under condi- In: Zakharov, V. M. & Krysanov, E. Yu. (Eds.), Con-
tions of increased background radiation due to the sequences of the Chernobyl Catastrophe: Environmental Health
Chernobyl accident. Sci. Total Environ. 112: pp. 37– (Center for Russian Environmental Policy, Moscow):
44. pp. 62–72 (in Russian).
Zakharov, V. M. & Krysanov, E. Yu. (Eds.) (1996). Conse- Zarubin, O. L., Volkova, E. N., Belyaev, V. V. & Zalissky, A.
quences of the Chernobyl Catastrophe: Environmental Health A. (2006). Dynamics of radionuclide incorporation
(Center for Russian Environmental Policy, Moscow): in fishes from large bodies of water in Kiev Province
160 pp. (in Russian). (1986–2005). International Conference. Twenty Years
Zakharov, V. M., Borysov, V. I., Borysov, A. S. & Valet- after Chernobyl Accident: Future Outlook. April 24–26,
sky, A. V. (1996a). Fish: Developmental stability. In: 2006, Kiev, Ukraine (Abstracts, Kiev): pp. 245–246
Zakharov, V. M. & Krysanov, E. Yu. (Eds.), Conse- (in Russian).
CHERNOBYL
11. Chernobyl’s Radioactive Impact

on Microbial Biota
Alexey V. Yablokov
Of the few microorganisms that have been studied, all underwent rapid changes in
the areas heavily contaminated by Chernobyl. Organisms such as tuberculosis bacilli;
hepatitis, herpes, and tobacco mosaic viruses; cytomegalovirus; and soil micromycetes
and bacteria were activated in various ways. The ultimate long-term consequences for
the Chernobyl microbiologic biota may be worse than what we know today. Compared
to humans and other mammals, the profound changes that take place among these
small live organisms with rapid reproductive turnover do not bode well for the health
and survival of other species.
One gram of soil contains some 2,500,000,000 4. In some heavily contaminated areas of Be-
microorganisms (bacteria, microfungi, and pro- larus and Russia there was a markedly
tozoa). Up to 3 kg of the mass of an adult human higher level of cryptosporidium infesta-
body is made up of bacteria, viruses, and mi- tion (Lavdovskaya et al., 1996).
crofungi. In spite of the fact that these represent 5. From 1993 to 1997 the hepatitis viruses
such important and fundamentally live ecosys- B, C, D, and G became noticeably
tems there are only scarce data on the vari- activated in the heavily contaminated
ous microbiological consequences of the Cher- areas of Belarus (Zhavoronok et al.,
nobyl catastrophe. 1998a,b).
Several incidences of increased morbidity 6. Herpes viruses were activated in the heav-
owing to certain infectious diseases may be due ily contaminated territories of Belarus 6
to increased virulence of microbial populations to 7 years after the catastrophe (Matveev,
as a result of Chernobyl irradiation. 1993; Matveev et al., 1995; Voropaev et al.,
1. Soon after the catastrophe studies ob- 1996).
served activation of retroviruses (Kavsan 7. Activation of cytomegalovirus was found
et al., 1992). in the heavily contaminated districts of
2. There is evidence of increased suscep- Gomel and Mogilev provinces, Belarus
tibility to Pneumocystis carinii and cy- (Matveev, 1993).
tomegalovirus in children whose immune 8. Prevalence of Pneumocystis was noticeably
systems were suppressed in the contami- higher in the heavily contaminated terri-
nated territories of Novozybkov District, tories of Bryansk Province (Lavdovskaya
Bryansk Province (Lysenko et al., 1996). et al., 1996).
3. Tuberculosis became more virulent in 9. The prevalence and severity of Gruby’s
the more contaminated areas of Belarus disease (ringworm), caused by the fungus
(Chernetsky and Osynovsky, 1993; Be- microsporia Microsporum sp., was signifi-
lookaya, 1993; Borschevsky et al., 1996). cantly higher in the heavily contaminated
areas of Bryansk Province (Rudnitsky et al.,
2003).
10. The number of saprophytic bacteria in
Address for correspondence: Alexey V. Yablokov, Russian Belarussian sod-podzolic soils is at maxi-
mum in areas with radioactivity levels of
[email protected] 15 Ci/km2 or less and minimal in areas
281
282
with up to 40 Ci/km2 (Zymenko et al., TABLE 11.1. Characteristics of Oocysts of Coc-

1995). cidia (Eimeria cerna) in Voles (Clethrionomys
glareolus ) from Two Differently Contaminated
11. There is a wide range of radionuclide
Sites, Bryansk Province (Pel’gunov, 1996)
bioaccumulations in soil micromycetes.
The accumulation factor of Cs-137 in Level of contamination
Stemphylium (family Dematiaceae) is 348
20 μR/h 180–220 μR/h
and in Verticillium (family Muctdinaceae)
28 (Zymenko et al., 1995). Normal 94.5 76.6
12. Since the catastrophe, the prevalence of Anomalous 0 6.3
black microfungi has dramatically in- Nonsporulated 5.2 12.2
creased in contaminated soil surrounding
Chernobyl (Zhdanova et al., 1991, 1994).
13. Among soil bacteria that most actively lightly contaminated soils (Ivanova et al.,
accumulate Cs-137 are Agrobacterium sp. 2006).
(accumulation factor 587), Enterobacter sp. 17. Sharp reduction in the abundance of bi-
(60–288), and Klebsiella sp. (256; Zymenko fidus bacteria and the prevalence of mi-
et al., 1995). crobes of the class Escherichia; in particular,
14. In all soil samples from the 10-km Cher- a sharp increase in E. coli has been noted
nobyl zone the abundance of soil bacte- in the intestines of evacuee children living
ria (nitrifying, sulfate-reducing, nitrogen- in Ukraine (Luk’yanova et al., 1995).
fixing, and cellulose-fermenting bacteria, 18. In a long-term study (1954 to 1994—
and heterotrophic iron-oxidizing bacteria) before and after the catastrophe) in Be-
was reduced by up to two orders of mag- larus, Ukraine, and Russia it was re-
nitude as compared to control areas (Ro- vealed that in areas with a high level
manovskaya et al., 1998). of radioactive contamination (740–1,480
15. In contaminated areas several new vari- kBq/m2 and higher) in Bryansk, Mogilev,
ants of tobacco mosaic virus appeared Gomel, Chernygov, Sumy, Kaluga, Oryol,
that affect plants other than Solanaceous Smolensk, and Kursk provinces, practi-
species, and their virulence is most likely cally no cases of rabies in wild animals
correlated with the level of radioactive have been reported since the catastrophe
contamination in the areas. Infection of (Adamovich, 1998). This suggests that the
tobacco plants with tobacco mosaic virus rabies virus has either disappeared or be-
and oilseed rape mosaic virus was shown come inactivate.
to induce a threefold increase in homolo- 19. Rodents in the heavily contaminated ter-
gous DNA recombination in noninfected ritories of Belarus have been extensively
tissues (Boyko et al., 2007; Kovalchuk et al., invaded by coccids (obligate intracellular
2003). protozoan parasites from the phylum Api-
16. All the strains of microfungi species complexa; Sutchenya et al., 1995).
that were studied (Alternaria alternata, Mu- 20. There are fewer than normal, more
corhiemalis, and Paecilomyces lilacinus) from anomalous, and no sporulated oocysts of
the heavily contaminated Chernobyl ar- coccidia Eimeria cerna in voles (Clethrionomys
eas have aggregated growth of threadlike glareolus) in Bryansk Province (Table 11.1).
hyphae, whereas the same species from 21. Six years after the catastrophe a popu-
soil with low radionuclide contamination lation of Eimeria cernae from Clethrionomys
show normal growth. Only slowly grow- glareolus living in heavily contaminated
ing Cladosporium cladosporioides has aggre- soil (up to 7.3 kBq/kg of Cs-134, Cs-
gated growth both in contaminated and 137, Sr-90, and Pu-106) in Kiev Province
Yablokov: Radioactive Impact on Microbial Biota 283
had anomalous oocysts (Soshkin and The long-term consequences for microbial
Pel’gunov, 1994). biota may be worse than what we understand
22. There was a significant decline in the today.
Shannon diversity index of infusoria
species and a concomitant increase in
their abundance in the Pripyat River References
mouth from 1986 to 1988 (Nebrat,
1992). Adamovich, V. L. (1998). Hydrophobia in animals on ra-
dioactively contaminated territories. Ecolog 3: 237–
All microorganisms (viruses, bacteria, fungi, 240 (in Russian).
Belookaya, T. V. (1993). Dynamics of Belarussian chil-
and protozoa) and microbiological communi-
dren’s health status under modern ecological condi-
ties as a whole undergo rapid changes after any tions. Scientific and Practical Conference. Chernobyl
additional irradiation. The mechanism of such Catastrophe: Diagnostics and Medical and Psychological Re-
changes is well known: inclusion and increase in habilitation of Sufferers (Materials, Minsk): pp. 3–10 (in
the frequency of mutations by natural selection Russian).
and preservation of beneficial novel genes that Borschevsky, V. V., Kalechits, O. M. & Bogomazova, A.
V. (1996). Course of tuberculosis morbidity after the
for whatever reason appear more viable un- Chernobyl catastrophe in Belarus. Med. Biol. Aspects
der the new conditions. This microevolutionary Chernobyl Accident (Slavutich) 1: pp. 33–37 (in Rus-
mechanism has been activated in all radioac- sian).
tively contaminated areas and leads to activa- Boyko, A., Kathyria, P., Zemp, F. J., Yao, Y., Pogribny, I.
tion of old and the occurrence of new forms & Kovalchuk, I. (2007). Transgenerational changes
in genome stability and methylation in pathogen-
of viruses and bacteria. All but a few microor-
infected plants (virus-induced plant genome insta-
ganisms that have been studied in Chernobyl- bility). Nucl. Acids Res. 35(5): 1714–1725.
affected territories underwent rapid changes in Chernetsky, V. D. & Osynovsky, D. F. (1993). Epidemio-
heavily contaminated areas. logical abnormalities of tuberculosis in a region with
Our contemporary knowledge is too lim- a low level of radioactive contamination. Scientific
ited to understand even the main consequences and Practical Conference. Chernobyl Catastrophe: Diag-
nostics, Medical and Psychological Rehabilitation of Sufferers
of the inevitable radioactive-induced genetic (Materials, Minsk): pp. 100–104 (in Russian).
changes among the myriad of viruses, bacteria, Ivanova, A. E., Aslanydi, K. B., Karpenko, Yu. V., Be-
protozoa, and fungi that inhabit the intestines, lozerskaya, T. A. & Zhdanova, N. N. (2006). Pheno-
lungs, blood, organs, and cells of human beings. typical characteristics of microfungi from the exclu-
The strong association between carcinogene- sion zone of the Chernobyl NPP. Adv. Med. Mycol. 7:
10–11 (//www.mycology.ru/nam/pdf/vol7.pdf) (in
sis and viruses (papilloma virus, hepatitis virus,
Russian).
Helicobacter pylori, Epstein–Barr virus, Kaposi’s Kavsan, V. M., Frolov, A. F. & Antonenko, S. V.
sarcoma, and herpes virus) provides another (1992). Activation of human retroviruses after
reason why the cancer rate increased in areas the Chernobyl accident. International Conference.
contaminated by Chernobyl irradiation (for a AIDs, Cancer and Human Retroviruses. November 18–
review, see Sreelekha et al., 2003). 22, 1992, St. Petersburg (//www.biomed.spb.ru/
conf_program/1992rus.pdf.) (in Russian).
Not only cancer, but also many other illnesses Kovalchuk, I., Kovalchuk, O., Kalck, V., Boyko, V.,
are connected with viruses and bacteria. Radio- Filkowski, J., et al. (2003). Pathogen-induced systemic
logically induced pathologic changes in the mi- plant signal triggers DNA rearrangements. Nature
croflora in humans can increase susceptibility 423: 760–762.
to infections, inflammatory diseases of bacte- Lavdovskaya, M. V., Lysenko, A. Ya., Basova, E. N., Lozo-
vaya, G. A., Baleva, L. S. & Rybalkina, T. N. (1996).
rial and viral origin (influenza, chronic intesti-
The “host-opportunistic protozoa” system: Effect of
nal diseases, pyelonephritis, cystitis, vaginitis, ionizing radiation on incidence of cryptosporidiosis
endocolitis, asthma, dermatitis, and ischemia), and pneumocystosis. Parasitology 30(2): 153–157 (in
and various pathologies of pregnancy. Russian).
284
Luk’yanova, E. M., Denysova, M. F. & Lapshin, V. F. cidiida, Eimeriidae) from red voles Clethrionomys glare-
(1995). Children’s digestive systems. Sect 3.19. In: olus (Rodentia, Cricetidae) in a low level radioactive
Bar’yakhtar, V. G. (Ed.), Chernobyl Catastrophe: History, contaminated territory. Zool. J. 73(7–8): 5–7 (in
Social, Economical, Geochemical, Medical and Biological Russian).
Consequences (//www.stopatom.slavutich.kiev.ua/2- Sreelekha, T. T., Bency, K. T., Jansy, J., Thankappan,
3-19.htm) (in Russian). B., Hareendran, N. K., et al. (2003). Environmental
Lysenko, A., Lavdovskaya, M. V., Basova, E. N., Lo- contamination impact on carcinogenesis. Third
zovaya, G. A., Baleva, L. S. & Rybalkyna, T. N. International Conference on Environment and
(1996). The host-opportunistic protozoa system, and Health, December 15–17, 2003, Chennai, India
the incidence of mixed infections (Pneumocystis and (Proceedings, Chennai): pp. 502–511 (//www.yorku.
cytomegalovirus) in children living in radionuclide ca/bunchmj/ICEH/proceedings/Sreelekha_TT_
contaminated areas. Parasitol. 30(3): 223–228 (in ICEH_papers_502to511.pdf).
Russian). Sutchenya, L. M., Pikulik, M. M. & Plenin, A. E. (Eds.)
Matveev, V. A. (1993). Activity of cytomegalovirus infec- (1995). Animals in the Chernobyl Zone (“Nauka Tekhn,”
tion in pregnant women as an index of herd im- Minsk): 263 pp. (in Russian).
munity in the radionuclide contaminated regions Voropaev, E. V., Matveev, V. A., Zhavoronok, S. V.
resulting from the Chernobyl accident. Effect of & Naralenkov, V. A. (1996). Activation of VPG-
radionuclides environmental contamination on the infections after the Chernobyl accident. Scientific
population health: Clinical and experimental study. Conference. Ten Years after Chernobyl Catastrophe: Sci-
In: Collected Transactions (Vitebsk Medical Institute, entific Aspect of Problems (Abstracts, Minsk): pp. 65–66
Vitebsk): pp. 97–100 (in Russian). (in Russian).
Matveev, V. A., Voropaev, E. V. & Kolomiets, N. D. (1995). Zhavoronok, S. V., Kalynin, A. L., Fyliptsevich, N. N.,
Role of the herpes virus infections in infant mortality Okeanov, A. E., Greenbaum, O. A., et al. (1998a).
of Gomel province areas with different densities of Analyses of chronic hepatitis and liver cirrhosis in a
radionuclide contamination. Third Congress of the population in Belarus, suffering from the Chernobyl
Belarussian Scientific Society of Immunology and accident. Med. Radiol. Radiat. Safety 43(5): 18–24 (in
Allergy. Actual Problems of Immunology and Allergy (Ab- Russian).
stracts, Grodno): pp. 90–91 (in Russian). Zhavoronok, S. V., Kalynin, A. L., Greenbaum, O.
Nebrat, A. A. (1992). Plankton infusorias from down- A., Chernovetsky, M. A., Babarykyna, N. Z. &
stream in the Pripyat River. Hydrobiol. J. 28(6): 27–31 Ospovat, M. A. (1998b). Hepatoviruses B, C,
(in Russian). D, and G markers in those suffering from the
Pel’gunov, A. N. (1996). Parasitological study of rodents. Chernobyl catastrophe. Publ. Health 8: 46–48 (in
In: Zakharov, V. M. & Krysanov, E. Yu. (Eds.), Conse- Russian).
quences of the Chernobyl Catastrophe: Environmental Health Zhdanova, N. N., Vasylevskaya, A. I., Artyshkova, L. V.,
(Center for Russian Environmental Policy, Moscow): Gavrylyuk, V. I., Lashko, T. N. & Sadovnikov, Yu. S.
pp. 136–143 (in Russian). (1991). Complexes of soil micromycetes in the area
Romanovskaya, V. A., Sokolov, I. G., Rokitko, P. V. & influenced by the Chernobyl NPP. Microbiol. J. 53:
Chernaya, N. A. (1998). Ecological consequences of 3–9 (in Russian).
radioactive contamination for soil bacteria in the 10- Zhdanova, N. N., Zakharenko, V., Vasylevskaya, A.,
km Chernobyl zone. Microbiology 67(2): 274–280 (in Shkol’nyi, O., Nakonechnaya, L. & Artyshkova, L.
Russian). (1994). Abnormalities in soil mycobiologic composi-
Rudnitsky, E. A., Sobolev, A. V. & Kyseleva, L. F. (2003). tion around Chernobyl NPP. Ukr. Bot. J. 51: 134–143
Incidence of human microsporia in radionuclide (in Russian).
contaminated areas. Probl. Med. Mycol. 5(2): 68–69 Zymenko, T. G., Chernetsova, I. B. & Mokhova, S. V.
(in Russian). (1995). Microbiologic complex in radioactively con-
Soshkin, D. V. & Pel’gunov, A. N. (1994). Three-years taminated sod-potboil soils. Herald Nat. Belar. Acad.
of morphological monitoring of Eimeria cernae (Eucoc- Sci. (Biol.) 4: 69–72 (in Belarussian).
CHERNOBYL
Conclusion to Chapter III
The 1986 radioactive fallout from Chernobyl ily contaminated areas eased, wildlife began
impacted fauna and flora over the entire North- to be restored and even appeared to flourish.
ern Hemisphere. Elevated radiation levels were Large mammals—wolves, elk, wild boars, deer,
documented in plants and animals (includ- and birds, including eagles—are living in the
ing microorganisms) in Western Europe, North Chernobyl zone of contamination, but the pros-
America, the Arctic, and east Asia, and the lev- perity of this wildlife is deceptive. Studies of
els were often hundreds of times higher than birds indicate that some species may be found
previous background levels that were consid- in the contaminated regions only because of
ered “normal.” This huge outpouring of high- migration from uncontaminated areas (Møller
level radioactivity together with the ensuing and Moussaeu, 2007). Morphologic, cytogenic,
low-level chronic irradiation resulted in mor- and immunological studies of plant, fish, am-
phologic, physiologic, and genetic disorders in phibian, and mammalian populations reveal
all living organisms: plants, mammals, birds, deterioration in all the organisms that were
amphibians, fish, invertebrates, and bacteria, studied in detail (For review see Grodzinsky,
as well as viruses. Without exception, adverse 2006 and Zakharov and Krysanov, 1996).
effects were evident in all the plants and animals Mutation loads and mutation rates in
that were studied. plants, animals, and microorganisms in the
Affected populations exhibited a wide va- Chernobyl-contaminated territories are much
riety of morphological deformities that were higher than elsewhere. Chronic low-dose ex-
extremely rare or not known before the catas- posure to Chernobyl irradiation has resulted
trophe. Twenty-plus years later, game animals in transgenerational accumulation of genomic
and livestock in some Chernobyl-contaminated instability, manifested by abnormal cellular
areas far from Ukraine continue to have dan- and systemic effects. These transgenerational
gerous levels of absorbed radionuclides. long-term effects are detrimental because the
Chernobyl’s overall radioactive effect on wa- genomes of animals in more distant genera-
ter, atmosphere, and soil is dynamic from both tions are more sensitive to very low radiation
the radionuclide decay transformations as well doses, as compared to the genomes of animals
as from biologic, geologic, chemical, and other that were exposed in the first few generations
ecological processes such as migration and ac- (Goncharova, 2000; Pelevyna et al., 2006).
cumulation of radionuclides throughout the Conversely, in the contaminated territories
ecosystems, including introduction into multi- there are also active processes of natural se-
ple food chains. The active migration of Sr-90, lection for the survival of less radiosensitive
Cs-137, Pu, Am, and other isotopes results in individuals—the processes of a radioadapta-
bioaccumulation that will present unforeseen tion. Radioadaptation in a population under
surprises for decades to centuries to come. conditions of chronic contamination will lead
The data presented in Chapter III, however to diminish radiosensitivity over many gener-
varied, show that the Chernobyl catastrophe ations, and evolutionary theory predicts that
has had and will continue to have multiple im- this will result because of special adaptation
pacts upon flora and fauna. accompanied by elimination of sensitive geno-
As soon as industrial, agricultural, and other types and pauperization of the gene pool. Some
anthropogenic pressures on wildlife in the heav- plants and animals in the Chernobyl zone
285
286
demonstrate a return to historically atavistic, Chernobyl is, on the one hand, a microevo-
primitive types of genetic systems (Glazko et al., lutionary incubator, actively transforming the
1996). These facts predict increased numbers gene pool with unpredictable consequences,
and kinds of insects harmful to agriculture in ar- and on the other hand, a black hole into which
eas that have increased radiation backgrounds there is accelerated genetic degeneration of
(Mosse, 2002). Considering the short life span large animals. We ignore these findings at our
of a generation of microorganisms, this rapid peril.
microevolutionary process can lead to activa-
tion of more primitive life forms as well as to
the occurrence of new forms of viruses, bacte- References
ria, and fungi.
The material presented in Chapter III testi- Glazko, V. I., Arkhypov, N. P. & Sozynov, A. A. (1996).
fies to the fact that it is dangerous and short- Dynamic of biochemical markers’ allele variants in
sighted to consider the Chernobyl radioactive cattle generations in the Chernobyl exclusion zone.
Cytology and Genetics 30(4): 49–54 (in Russian).
zone as a natural reserve where plants and ani-
Goncharova, R. I. (2000). Remote consequences of the
mals can develop and thrive. For deeper under- Chernobyl disaster: Assessment after 13 years. In:
standing of the many processes currently con- Burlakova, E. B. (Ed.). Low Doses of Radiation: Are They
tinuing in the Chernobyl-contaminated zone, Dangerous? (NOVA, New York): pp. 289–314.
biological research should not be curtailed and Grodzinsky, D. M. (2006). Reflection of the Chernobyl
stopped (as is happening in Belarus, Ukraine, catastrophe on the plant world: Special and general
biological aspects. In: Busby, C. C. & Yablokov, A. V.
and Russia), but must be supported, expanded, (Eds.). ECRR Chernobyl: 20 Years On: Health Consequences
and intensified to understand, predict, and of the Chernobyl Accident. ECRR Doc 1 (Green Audit
avoid unexpected and dangerous successions Book, Aberystwyth): pp. 117–134.
of events. Møller, A. P. & Mousseau, T. A. (2007). Species richness
There is another more critical dimension to and abundance of forest birds in relation to radiation
at Chernobyl. Biol. Lett. Roy. Soc. 3: 483–486.
the study of animals in the contaminated terri-
Mosse, I. B. (2002). Genetic effects in natural populations
tories. We, human beings, belong to the animal of animals from the Belarussian radiocontaminated
kingdom and have the same organs and bio- areas: Biological effects of low doses. Information
logical systems as other animals such as mice Bulletin 3 (Belarussian Chernobyl Children Com-
and rats. The material in Chapter III demon- mittee, Minsk): pp. 28–30. (in Russian).
strates a sharply increasing mutational load, Pelevyna, I. I., Gorlib, A. Ya. & Konradov, A. A. (2006).
20 years is much or little for an estimation of
increasing morbidity, and cancer. More than Chernobyl consequencies. In: International Scien-
70% of all experimental rats raised under con- tific Practical Conference. 20 Years of the Chernobyl
ditions of Chernobyl contamination developed Catastrophe: Ecological and Sociological Lessons. June 5,
cancer within the next few years and suffered 2006, Moscow (Materials, Moscow), pp. 185–196
multiple other diseases and impaired immuno- (//www.ecopolicy.ru/upload/File/conferencebook
_2006.pdf) (in Russian).
logical competence. All of these processes that
Zakharov, V. M. & Krysanov, E. Yu. (Eds.). (1996). Conse-
occurred in the first 5 to 7 years around Cher- quences of the Chernobyl Catastrophe: Environmental Health
nobyl definitely foreshadowed what happened (Center for Russian Environmental Policy, Moscow),
later to the exposed human populations. 160 pp. (in Russian).
CHERNOBYL
Chapter IV. Radiation Protection after the

Alexey V. Nesterenko,a Vassily B. Nesterenko,a, †
a
b
Key words: Chernobyl; dose burden; radionuclide decorporation
Since the Chernobyl catastrophe more than 5 The reluctance on the part of officialdom
million people in Belarus, Ukraine, and Euro- to acknowledge the truth about Chernobyl’s
pean Russia continue to live in the contami- consequences has led to concerned citizens
nated territories. Many thousands more live in organizing to find additional sources of in-
other European countries contaminated with formation and devising ways to help those
radiation, including Sweden, Finland, Norway, who are suffering. Hundreds of such pub-
Scotland, Britain, and Wales (see Chapter I for lic local, national, and international organiza-
details). Radiation protection is necessary for tions have been created, such as “Children of
all of these people. Chernobyl,” “Physicians of Chernobyl,” “Wid-
After the catastrophe there were enormous ows of Chernobyl,” and Liquidator’s Unions
efforts to introduce countermeasures in Be- in Belarus, Ukraine, Russia, and many other
larus, Ukraine, and Russia—to relocate hun- countries including Germany, Austria, France,
dreds of thousands of people and to try to Switzerland, Canada, the United States, and
lessen exposure to radioactive contamination. Israel.
Steps that were taken included restricted food In 1987, initiated by physicist and human-
consumption and changes in food preparation, ist Andrei Sakharov, famous Belarussian writer
as well as changes in agricultural, fishery, and Ales’ Adamovich, and world chess champion
forestry practices under the guidance of qual- Anatoly Karpov, the Belarussian Institute of
ified scientists (Bar’yachtar, 1995; Aleksakhin Radiation Safety–BELRAD was established as
et al., 2006). an independent public organization devoted to
The situation in regard to radiation pro- helping Belarussian children—those who suf-
tection in the contaminated territories places fered most after the catastrophic contamination
public health advocates in what is described from Chernobyl. For 21 years the BELRAD
in Russian as between an “upper and nether Institute has collected an extensive database
millstone,” and in the West, as between a rock in the field of radiation protection and has
and a hard place. Authorities allocate as little as become unique as a nongovernmental Cher-
possible to provide financial resources for reha- nobyl center for both scientific and practical
bilitation and disaster management and at the information.
same time are reluctant to accept data about Chapter IV is based primarily on the BEL-
dangerous levels of contamination of popula- RAD materials. Chapter IV.12 presents data
tions, food, and the environment. These atti- on the Chernobyl contamination of food and
tudes hold for officials practically everywhere. humans in many countries, Chapter IV.13 re-
ports on the Belarussian experience with ef-
fective countermeasures to lower levels of in-
†Deceased. corporated radionuclides such as the use of
287
288
enterosorbents, and Chapter IV.14 outlines (2006). Protecting measures’ role in rehabilitation of
common countermeasures against radioactive contaminated territories. In: International Confer-
contamination in agriculture and forestry. ence. Chernobyl 20 Years After: Strategy for Recovering and
Sustaining Development of Affected Territories. April 19–21,
2006 (Materials, Minsk): pp. 103–108 (in Russian).
References Bar’yakhtar, V. G. (Ed.) (1995). Chernobyl Catastrophe: His-
toriography, Social Economic, Geochemical, Medical and Bi-
Aleksakhin, R. M., Bagdevich, I. M., Fesenko, S. V., ological Consequences (“Naukova Dumka,” Kiev): 558
Sanzheva, N. I., Ageets, V. Yu. & Kashparov, V. A. pp. (in Russian).
CHERNOBYL
12. Chernobyl’s Radioactive Contamination

of Food and People
Alexey V. Nesterenko, Vassily B. Nesterenko,
and Alexey V. Yablokov
In many European countries levels of I-131, Cs-134/137, Sr-90, and other radionuclides
in milk, dairy products, vegetables, grains, meat, and fish increased drastically (some-
times as much as 1,000-fold) immediately after the catastrophe. Up until 1991 the United
States imported food products with measurable amounts of Chernobyl radioactive
contamination, mostly from Turkey, Italy, Austria, West Germany, Greece, Yugoslavia,
Hungary, Sweden, and Denmark. These products included juices, cheeses, pasta, mush-
rooms, hazelnuts, sage, figs, tea, thyme, juniper, caraway seeds, and apricots. In Gomel,
Mogilev, and Brest provinces in Belarus 7–8% of milk and 13–16% of other food products
from small farms exceeded permissible levels of Cs-137, even as recently as 2005–2007.
As of 2000, up to 90% of the wild berries and mushrooms exceeded permissible levels
of Cs-137 in Rovno and Zhytomir provinces, Ukraine. Owing to weight and metabolic
differences, a child’s radiation exposure is 3–5 times higher than that of an adult on
the same diet. From 1995 to 2007, up to 90% of the children from heavily contaminated
territories of Belarus had levels of Cs-137 accumulation higher than 15–20 Bq/kg, with
maximum levels of up to 7,300 Bq/kg in Narovlya District, Gomel Province. Average lev-
els of incorporated Cs-137 and Sr-90 in the heavily contaminated territories of Belarus,
Ukraine, and European Russia did not decline, but rather increased from 1991 to 2005.
Given that more than 90% of the current radiation fallout is due to Cs-137, with a half-life
of about 30 years, we know that the contaminated areas will be dangerously radioactive
for roughly the next three centuries.
However much money is allocated by any gov- locally produced food and to actively partici-
ernment for radiation protection (e.g., in Be- pate in organizing and carrying out radiation
larus in 2006 nearly $300 million was allocated protection. Too often, central data monitoring
to reduce radioactive contamination in agri- repositories have little incentive to ensure that
cultural production), no nation has the ability people around the country get the information
to provide total protection from radiation for that they should have.
populations living in contaminated areas and
eating locally produced vegetables, forest prod-
ucts, and fish and game that are contaminated 12.1. Radiation Monitoring of Food
with radionuclides.
Thus it is of prime importance that radiation- 12.1.1. Belarus
monitoring capability be established on the lo-
cal level so that citizens have access to the in- At the end of 1993, in order to mon-
formation and the ability to monitor their own itor food radiation, the BELRAD Institute
with support from the State Belarus Com-
mittee of Chernobyl Affairs (“Comchernobyl”)
created 370 public local centers for radia-
Address for correspondence: Alexey V. Nesterenko, Institute of Radia-
tion Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk 220053, Belarus.
tion control (LCRC) to monitor foodstuffs in
Fax: +375 17 289-03-85. [email protected] the contaminated areas. The general database
289
290
on contaminated foodstuffs available from TABLE 12.1. Cs-137 Concentration in Some

BELRAD today has more than 340,000 mea- Foodstuffs in Brest, Gomel, and Mogilev Provinces,
Belarus, 1993 (BELRAD data)
surements, including some 111,000 tests of
milk. Above Official
1. According to the BELRAD database up official permissible
to 15% of milk from small farms and up to permissible level
Number of level for (1992),
80% of other food produce in three Belarus Foodstuff samples 1992 Bq/kg
provinces was contaminated with Cs-137 above
the permissible levels (Table 12.1). Mushrooms 133 80.5 370
2. The percentage of food products with ra- (starry agaric)
Cranberry 429 62.7 185
dioactive contamination in excess of official
Blackberry 1,383 61.0 185
permissible levels did not decrease for 14 years Meat (game) 125 58.4 600
after the catastrophe; on the contrary, in 1997 Mushrooms 459 57.7 3,700
in the Gomel and Brest areas this percentage (dried)
began to increase (Table 12.2). Rough boletus 160 57.5 370
3. Up to 34.3% of all milk tested from Edible boletus 561 54.4 370
Mushrooms 87 52.9 370
Brest Province in 1996 had radiation levels (boiled)
higher than the permissible ones. The num- Chanterelle 125 52.8 370
ber of milk tests showing dangerous levels Blackberry 150 42.0 185
was significantly higher in Gomel and Brest (preserves)
than in Mogilev province. From 1993 to 2006, Kefir 71 25.4 111
Honey fungus 57 22.8 370
there was some reduction in the number of Milk 19,111 14.9 111
milk tests that exceeded the permissible level Lard 234 14.1 185
(Table 12.3). Sour cream 242 12.8 111
4. The portion of dangerous milk tests no- Raspberry 154 11.7 185
ticeably increased year by year: for exam- Pot cheese 344 11.6 111
ple, from 19.3% in 1994 to 32.7% in 1995 Carp 152 11.2 370
Strawberry 73 9.6 185
in Brest Province; from 9.9% in 2003 to Water 2,141 8.8 185
15.8% in 2004 in Gomel Province; and from Beetroot 1,628 8.2 185
0.7% in 2004 to 7.2% in 2005 in Mogilev Cream 51 7.8 111
Province. Garden 389 6.4 185
5. In some places the percent of milk tests strawberries
Carrots 1,439 5.8 185
that showed dangerous levels of Cs-137 was
Cabbage 590 4.4 185
significantly above the average. For example, Meat (beef) 297 3.7 600
in 2006 in Luga Village, Luninetsk District, Cucumber 433 3.2 185
Gomel Province, results in 90.7% of the tests Tomatoes 141 2.8 185
exceeded the permissible level and levels were Pears 208 2.4 185
more than 16-fold higher than the province Apples 1,547 2.3 185
Onion 435 2.1 185
average. Cherry 196 2.0 185
Meat (pork) 969 2.0 600
Butter 51 2.0 185
12.1.2. Ukraine
Potatoes 4,996 1.6 370
1. Even up to the year 2000, Cs-137 levels
remained in excess of admissible levels: 80% and 15% in the Volyn’ Province (Orlov,
in berries and mushrooms in Rovno Province, 2002).
90% in Zhytomir Province, 24% in forest- 2. According to data from the Ukrainian
steppe Vinnitsa and Cherkassk provinces, Ministry of Health, in 2000, from 1.1 up to
Nesterenko et al.: Radioactive Contamination of Food and People 291
TABLE 12.2. Percent of Food Products with Excess of Permissible Levels of Cs-137 in Gomel, Mogilev,
and Brest Provinces, Belarus, 1993–2007 (BELRAD Database)
Years
Province 1993–1994 1995–1996 1997–1998 1999–2000 2001–2002 2003–2004 2005–2006 2007
Gomel 12.1 9.6 12.0∗ 12.7 14.8 19.9 14.8 16.3

Mogilev 9.2 4.0 4.2 5.3 4.8 5.4 15.2 n/a
Brest 15.5 16.6 14.2 17.8 18.0 19.2 13.0 12.5
∗
Data on the Gomel Province since 1995 may be underestimated (24 LCRC from the heavily contaminated
Lel’chitsy District were withdrawn from BELRAD and transferred to the official Institute of Radiology—
Comchernobyl).
70.8% of milk and meat in the private sector for example, Cs-137 and Cs-134 levels reached
in Volyn’, Zhytomir, Kiev, Rovno, and Cherny- about 6,700 Bq/kg in the golden-eye duck
gov provinces had levels of Cs-137 in excess of and about 10,500 Bq/kg in other waterfowl
allowable limits (Omelyanets, 2001). (Rantavaara et al., 1987).
3. CROATIA. After the catastrophe the con-
12.1.3. Other Countries and Areas centration of Cs-137 in wheat increased more
than 100-fold (Figure 12.3).
There are considerable data in other coun- 4. FRANCE. In 1997 in Vosges Cs-137 con-
tries concerning the contamination of food as tamination in wild hogs and mushrooms ex-
a result of Chernobyl. ceeded the norms by up to 40-fold (Chykin,
1. FINLAND. The level of Cs-137 in milk, 1997).
beef, and pork in Finland drastically in- 5. GREAT BRITAIN. The peak Chernobyl con-
creased immediately after the catastrophe tamination of milk was reached in May 1986
(Figure 12.1). Beginning in 1995, some 7.7 and was up to 1,000-fold as compared with the
tons of mushrooms (mostly Lactarium genus) that mean values reported in 1985 for I-131 and
were collected annually contained 1,600 MBq Cs-137 and up to four times higher for Sr-90
of Cs-137, or about 300 Bq of Cs-137 per per- (Jackson et al., 1987). Twenty-three years after
son (Rantavaara and Markkula, 1999). the catastrophe, according to Great Britain’s
2. BALTIC SEA AREA. A significantly in- Ministry of Health, 369 farms in Great Britain,
creased Cs-137 contamination occurred in accounting for more than 190,000 sheep, con-
Baltic fish (Figure 12.2) and there was an even tinued to be dangerously contaminated with
greater increase in freshwater fish (Table 12.4). Chernobyl’s Cs-137 (Macalister and Carter,
All game species were heavily contaminated; 2009).
TABLE 12.3. Percent of a Milk Tests Exceeding the Permissible Level of Cs-137 in Gomel, Mogilev, and
Brest Provinces, Belarus, 1993–2007 (BELRAD Database)
Years
Province 1993–1994 1995–1996 1997–1998 1999–2000 2001–2002 2003–2004 2005–2006 2007
Gomel 16.6 8.6∗ 8.7 9.6 8.6 12.9 6.8 6.7

Mogilev 12.0 2.8 1.2 0.5 0.2 0.6 7.2 n/a
Brest 21.7 33.5 18.5 21.4 22.8 17.8 7.9 8.0
∗
See the footnote to Table 12.2.
292
7. MEXICO. In 1988 Mexico returned 3,000

tons of milk powder to Northern Ireland be-
cause of radioactive contamination from Cher-
nobyl (WISE, 1988b).
8. POLAND. In June 1987, a 1,600-ton
shipment of powdered milk from Poland to
Bangladesh showed unacceptably high levels
of radioactivity (Mydans, 1987).
9. SWEDEN. Average Cs-137 concentration in
moose (Alces alces) meat was 9–14 times higher
after Chernobyl. Levels were 470 Bq/kg for
calves and 300 Bq/kg for older animals, com-
pared with the precatastrophe average level of
33 Bq/kg (Danell et al., 1989).
10. TURKEY. Some 45,000 tons of tea was
Figure 12.1. Countrywide mean concentration contaminated with Chernobyl radioactivity in
of Cs-137 in meat and milk in Finland (UNSCEAR, 1986–1987, and more than a third of the 1986
1988).
harvest could not be used (WISE, 1988c).
11. UNITED STATES. Food contaminated in
6. ITALY. According to radiation measure- the United States as a result of Chernobyl is
ments from the Directorate of Nuclear Safety especially interesting because of the wide geo-
Health Protection obtained in June 1988, graphical scale of contamination and the broad
meat, noodles, bread, milk, and cheese were range of contaminated foods. In spite of offi-
still markedly contaminated by Chernobyl ra- cial secrecy (see Chapter II.3 for details) the
dionuclides (WISE, 1988a). full picture of Chernobyl food contamination
Figure 12.2. Cs-137 concentrations (Bq/kg) in: (1) plaice (Platichthys flesus) and
(2) flounder (Pleuronectes platessa) from 1984 to 2004, as annual mean values
in the Bornholm and southern Baltic seas. Pre-Chernobyl (1984–1985) concentrations
were 2.9 for plaice and flounder (HELCOM Indicator Fact Sheets. 2006. Online
22.04.2008;//www.helcom.fi/environment2/ifs/en_GB/cover/).
TABLE 12.4. Fish Cs-137 Contamination in Fin- exceeded the I-131 level of 1,000 pCi/kg. Some
land, 1986 (Saxen and Rantavaara, 1987) 44% of such samples from February 1 to Oc-
Species Concentration, Bq/kg∗ tober 4, 1987, had Cs-137 levels higher than
100 pCi/kg, and 5% exceeded 5,000 pCi/kg.
Perch 16,000 More than 50% of samples from February 5
Pike 10,000
Whitefish 7,100
to January 25, 1987, had Cs-137 levels higher
Bream 4,500 than 1,000 pCi/kg, and about 7% of samples
Vendace 2,000 had more than 5,000 pCi/kg.
∗ According to other data (Cunningham and
EU limit of Cs-137 for consumption of wild freshwater
fish is 3,000 Bq/kg. Anderson, 1994), up to 24% of the imported
food sampled in 1989 was noticeably contami-
in the United States continues to become more nated. By 1990, 25% of samples were contam-
visible. The peak of Chernobyl-derived I-131 inated; in 1991, 8% of samples; and in 1992,
in imported foods was observed in May–June 2%. “In spite of the general decline, contami-
1986, and for Cs-134 and Cs-137, some 10 nated foods were still occasionally found during
to 16 months after the catastrophe (RADNET, FY91 and FY92; indeed, elk meat collected in
2008, Section 9, Part 4). FY91 contained the highest Cs-137 contam-
Between May 5, 1986, and December 22, ination found since the Chernobyl accident
1988, the FDA tested 1,749 samples of im- occurred”: 81,000 pCi/kg (Cunningham and
ported foods for I-131, Cs-134, and Cs-137 Anderson, 1994, p. 1426; cit. by RADNET,
contamination. The survey had been classi- 2008). According to U.S. federal regulations,
fied and was only obtained after a recent free- imported foods containing more than 10,000
dom of information request (RADNET, 2008). pCi of Cs-134 + Cs-137 must be seized and de-
The first food imported into the United States stroyed (U.S. FDA guidelines on May 16, 1986,
that was contaminated from Chernobyl ra- by RADNET, 2008). The official documents
dioactivity was fish from Norway with a de- obtained through the RADNET request (Sec-
tectable level of Cs-137. The contamination tion 9) shows that between 1986 and 1988 there
was revealed on May 5, 1986, that is, 11 days were 12 such occasions.
after the catastrophe. In May–June 1986, it The food products contaminated by Cher-
was found that 15 samples of imported foods nobyl radioactivity imported into the United
(mostly mushrooms and cheese from Italy, but States from 1986 to 1988 originated from (in
also cheese from West Germany and Denmark) order of the number of cases): Turkey, Italy,
Figure 12.3. Cs-137 concentration in wheat in Croatia from 1965 to 2004 (Franic et al.,
2006).
294
TABLE 12.5. Concentration (pCi/l) of Chernobyl 12. Some examples of radioactive contami-
Radionuclides in Milk in the United States, 1986 nation of food products in other countries are
(Various Authors from RADNET, 2008)
listed in Table 12.6. Although Cs-137, Sr-90,
Radionuclide Concentration Location Date Pu, and Am concentrate in the root zone of
plants, they will be mobilized for decades to
I-131 560 Redland May 5
167 Willamette May 12 hundreds of years into the future, and agricul-
Valley tural products will continue to contain radioac-
88 Vermont May tivity in all of the Northern Hemisphere coun-
82 New York area May 28 tries contaminated by Chernobyl.
52.5 Maine May 16
40 New York area May 12
Cs-137 20.3 Maine June 12.2. Monitoring of Incorporated
39.7 Chester, New May 17 Radionuclides
Jersey
40.5 New York City May For effective radiation protection, especially
66 Seattle June 4 for children, it is necessary to monitor not
80 New York area May 12
only food, but also to directly monitor ra-
97 Willamette May 19
Valley dionuclides incorporated into the body. Such
Cs-134 9.7 Maine June monitoring can determine the level of contam-
Cs-134 + 1,250∗ East May 5 ination for each particular location in a contam-
Cs-137 Washington inated territory and for every group of people
∗
Food, pCi/kg. with high levels of incorporated radionuclides
in order to adequately implement radiation
protection.
Austria, West Germany, Greece, Yugoslavia,
Hungary, Sweden, Denmark, Egypt, France, 12.2.1. Belarus
The Netherlands, Spain, and Switzerland. The
contaminated foodstuffs, in order of preva- To determine the correlation between ra-
lence, were: apple juice, cheese, pasta, oregano, dioactive contamination of food and incorpo-
berry juices, mushrooms, hazelnuts, filberts rated radionuclides in children (as children are
(Corylus sp.), sage (Salvia sp.), figs, laurel leaves, the most subject to radiation risk) the BEL-
tea, thyme, red lentils (Lens sp.), juniper, car- RAD Institute chose the most intensely con-
away seeds (Carum sp.), endive (Cychorium sp.), taminated territories from the point of view of
apricots, and even Swiss chocolate. size of the mid-annual effective radiation dose
Table 12.5 shows the level of radioactive con- and the level of local food contamination.
tamination in local milk after the catastrophe From 1995 to 2007 BELRAD con-
all over of the United States. In spite of all ducted measurements of absorbed radionu-
the measurements, according to the official de- clides in about 300,000 Belarussian children.
rived intervention level (DIL), it is a fact that Measurement of the Cs-137 contamination is
Chernobyl fallout has deposited harmful ra- carried out by automated complex spectrom-
dioisotopes across the entire extent of North etry of internal radiation, utilizing an indi-
America. vidual radiation counter (IRC) “SCANNER-
Concentration of Chernobyl Cs-134 + Cs- 3.” The Institute of Ecological and Medical
137 in elk meat was up to 3,000 Bq/kg (RAD- Systems, Kiev, Ukraine, makes the equipment.
NET, 2008); the concentration of Ru-106 and The BELRAD Institute has eight such
Cs-137 in fiddleheads was 261 and 328 pCi/kg, IRC SCANNER-3M instruments, which
respectively; in mushrooms the C-137 concen- measure the activity of incorporated gamma-
tration was 3,750 pCi/kg (RADNET, 2008). radionuclides (Cs-137, Cs-134, Ca-40, Ra-226,
TABLE 12.6. Chernobyl Radioactive Contamination of Food in Several Countries, 1986–1987

Radionuclide Food Maximum concentration Country Reference
Cs-137∗ Reindeer meat 44,800 Bq/kg Sweden Ahman and Ahman, 1994
Mushrooms > 20,000 Bq/kg Germany UNSCEAR, 1988
Sheep’s milk 18,000 Bq/liter Greece Assikmakopoulos et al., 1987
Mushrooms 16,300 Bq/kg∗∗ Japan Yoshida et al., 1994
Reindeer >10,000 Bq/kg Sweden UNSCEAR, 1988
Potatoes 1.100 ± 0.650 Bq/kg Croatia Franic et al., 2006
Lamb 1,087 Bq/kg Sweden Rosen et al., 1995
Milk 500 Bq/liter United Kingdom Clark, 1986
Meat 395 Bq/kg Italy Capra et al., 1989
Milk 254 Bq/dm3 Italy Capra et al., 1989
Perch 6,042 (mean) Bq/kg Sweden Hakanson et al., 1989
Perch 3,585 (mean) Bq/kg Sweden Hakanson et al., 1989
Farm milk 2,900 Bq/liter Sweden Reizenstein, 1987
Milk 400 Bq/liter Bulgaria Energy, 2008
I-131 Milk 135,000 Italy Orlando et al., 1986
Yogurt 6,000 Bq/kg Greece Assikmakopoulos et al., 1987
Edible seaweed 1,300 Bq/kg Japan Hisamatsu et al., 1987
Milk 500 Bq/liter United Kingdom Clark, 1986
Breast milk 110 Bq/liter (mean) Czechoslovakia Kliment and Bucina, 1990
Breast milk 55 Bq/l (mean Czechoslovakia Kliment and Bucina, 1990
Pork 45 Bq/kg (mean) Czechoslovakia Kliment and Bucina, 1990
Milk 21.8 Bq/liter Japan Nishizawa et al., 1986
Milk 20.7 Bq/liter United States RADNET, 2008
Total Reindeer meat 15,000 Bq/kg Sweden Fox, 1988
Mutton 10,000 Bq/kg Yugoslavia Energy, 2008
Milk 3,000 Bq/liter Yugoslavia Energy, 2008
Fruits >1,000 Bq/kg Italy Energy, 2008
∗
Limits of Cs-137 for consumption in EU: 600 Bq/kg for food items; 370 Bq/kg for milk and baby food; 3,000
Bq/kg for game and reindeer meat.
∗∗
Year 1990.
Th-232, Mn-54, Co-60, I-131, etc.) in an in- 159 children. The village is located in an
dividual’s body as well as the specific dose. area with Cs-137 contamination of 8.3 Ci/km2
It is certified by the Belarus State Commit- (307 kBq/m2 ). According to the 2004 data, the
tee on Standardization and also registered total annual effective dose was 2.39 mSv/year,
by the State Registry of Belarus. Each IRC and an internal irradiation dose was
scanner undergoes an annual official inspec- 1.3 mSv/year.
tion. All measurements are done according 2. There was a correlation between the levels
to protocols approved by that committee. of local food contamination (Figure 12.4) and
For additional accuracy, the BELRAD IRC the level of incorporated radionuclides in the
SCANNER-3M system was calibrated with children’s bodies (Figure 12.5).
the “Julich” Nuclear Center in Germany (see The pattern of curves in Figures 12.4 and
Table 12.7). 12.5 reflects the seasonal (within the year) vari-
1. Measurements were taken in Valavsk Vil- ation of contaminated food consumption and
lage, in the El’sk District, Gomel Province, thus the accumulation of Cs-137 in a child’s
where there were 800 inhabitants, including body. As a rule, the level of contamination
296
TABLE 12.7. Cs-137 Body Burden in Children of Narovlya, Bragin, and Chechersk Districts as Mea-
sured by Individual Radiation Counters, 1999–2003 (BELRAD Data)
Measured by IRC children, % Children with exposure
Date Location n (% of total inhabitants) dose ≥ 1 mSv/year
June 1999 Grushevka 35 (18.6) 26

November 2001 44 (23.4) 11
April 2002 64 (34) 11
November 2001 Verbovichi 60 (20) 33
January 2002 65 (21.5) 9
April 2002 64 (21) 5
November 2002 41 (13.5) 20
December 2002 35 (11.6) 13
November 2003 51 (16.8) 20
November 2001 Golovchitsy 139 (33) 8
January 2002 56 (13.3) 4
November 2002 103 (24.5) 2
October 2003 130 (30.9) 2
January 1999 Demidov 109 (38.5) 10
November 2001 110 (38.8) 12
December 2001 91 (32.3) 9
April 2002 94 (33.2) 9
November 2002 75 (26.5) 12
January 2003 65 (23) 5
January 2000 Zavoit 51 (12.8) 4
November 2001 52 (13) 19
January 2002 49 (12.3) 2
October 2003 50 (12.5) 6
January 1999 Kyrov 94 (22.2) 16
March 1999 98 (23.1) 21
November 2001 92 (21.7) 22
January 2002 84 (19.8) 13
March 2002 91 (21.5) 22
April 2002 75 (17.7) 12
May 2002 90 (21.2) 12
June 2003 43 (10.1) 7
June 1999 Krasnovka 21 (11) 14
November 2001 Narovlya 34 5
January 2002 221 14
February 2002 170 8
November 2002 56 7
November 2003 140 6
December 2003 35 6
February 1999 Dublin 98 (28.3) 4
February 1999 Belyaevka 98 (23.8) 11
March 1999 96 (23.3)
October 2001 81 (19.7)
January 1999 Poles’e 132 (25.3) 14
October 1999 185 (35.4) 3
October 2001 95 (18.2) 25
November 2001 95 (18.2) 25
January 2002 148 (28.4) 11
April 2002 144 (27.6) 3
(Continued)
TABLE 12.7. Continued

Measured by IRC children, % Children with exposure
Date Location n (% of total inhabitants) dose ≥ 1 mSv/year
January 2003 148 (28.4) 5

September 2003 141 (27) 9
November 2003 140 (26.8) 10
December 2001 Sydorovychi 84 (30.3)
January 2002 105 (37.9)
increased in the autumn and winter (third and eases and death rates and a decrease in the
fourth quarters) because of increased consump- number of healthy children (Resolution, 2006;
tion of especially heavily contaminated foods see also Chapter II).
(mushrooms, berries, wild animal meat). Milk 5. High levels of the accumulation of Cs-137
contamination reflects forage with high levels have been found in a significant number of chil-
of Cs-137 prepared for the winter. dren in the Lel’chitsy District (Figure 12.6), the
3. Of about 300,000 children from heav- El’sk District (Figure 12.7), and the Chechersk
ily contaminated territories of Belarus who District (Figure 12.8) of Gomel Province. Max-
were tested by BELRAD from 1995 to 2007, imum levels of accumulation of Cs-137 (6,700–
some 70–90% had levels of Cs-137 accumula- 7,300 Bq/kg) have been found in a significant
tion higher than 15–20 Bq/kg (leading to 0.1 number of children in the Narovlya District of
mSv/year internal irradiation). In many vil- Gomel Province. In many villages in this dis-
lages levels of Cs-137 accumulation reached trict up to 33% of children have dose levels ex-
200–400 Bq/kg, and some children in Gomel ceeding the officially permissible 1 mSv/year
and Brest provinces had levels up to 2,000 (Figure 12.9).
Bq/kg (up to 100 mSv/year) (Table 12.7). 6. The level of radionuclide incorporation
4. Belarus and Ukraine, with levels of in- is significantly different for different organs
corporation of 50 Bq/kg, which is common (Table 12.8).
for territories with Cs-137 contamination of 7. Average Sr-90 concentration in the bodies
555 kBq/m2 , show an increase in various dis- of inhabitants of Gomel Province noticeably
Figure 12.4. Percentage of foodstuffs exceeding permissible levels of Cs-137 for the
years 2000 to 2005, Valavsk Village, Gomel Province, Belarus (BELRAD data). The horizon-
tal axis shows the year divided into quarters; the vertical axis indicates the percentage of
foodstuffs in which levels exceeded the norm.
298
Figure 12.5. Average specific activity of Cs-137 (Bq/kg) in children from Valavsk Village,
Gomel Province, Belarus, from 2000 to 2005 (BELRAD data).
increased from 1991 to 2000 (Borysevich and human vertebral bone collected in 1992 was
Poplyko, 2002). 18 Bq (kg Ca)−1 . Whole body measurements
8. The Pu body contamination of Gomel of Cs-137 were resumed after the Chernobyl
citizens 4–5 years after the Chernobyl accident accident. The measured mean level of Cs-137
is on average three to four times higher than in 1990 was 359 Bq (kg K)−1 (Aarkrog et al.,
global levels (Hohryakov et al., 1994). 1995).
2. FINLAND. Peak body burdens in Finland in
12.2.2. Other Countries 1986 were 6,300 and 13,000 Bq for Cs-134 and
for Cs-137, respectively (Rahola et al., 1987).
1. DENMARK. Sr-90 and Cs-137 contamina- The average Cs-137 body burden 17 years
tion occurs in humans, with Sr accumulating after the catastrophe for the entire country
along with Ca and Cs occurring in the same was about 200 Bq; for inhabitants of Padasyoki
tissues as K. The Sr-90 mean content in adult
Figure 12.6. Cs-137 levels in children Figure 12.7. Cs-137 levels in children of
of Lel’chitsy District, Gomel Province, Belarus El’sk District, Gomel Province, Belarus (Nesterenko,
(Nesterenko, 2007). 2007).
TABLE 12.8. Concentration (Bq/kg) of the Cs-

137 in Autopsied Organs (56 Persons), Gomel
Province, 1997 (Bandazhevsky, 2003)
Organ Concentration
Thyroid 2,054 ± 288

Adrenal glands 1,576 ± 290
Pancreas 1,359 ± 350
Thymus 930 ± 278
Skeletal muscle 902 ± 234
Spleen 608 ± 109
Heart 478 ± 106
Liver 347 ± 61
6,300 and 13,000 Bq, respectively (Rahola et al.,

Figure 12.8. Cs-137 levels in children of Chech- 1987).
ersk District, Gomel Province, Belarus (Nesterenko, 3. JAPAN. Before the Chernobyl accident Cs-
2007). 137 body burdens were about 30 Bq, rising the
year following 1986 to more than 50 Bq with
values still increasing in May 1987. This com-
City it was 3,000 Bq (the maximum figure was
pares to body burdens in England of 250–450
15,000 Bq). At the end of 1986 the mean Cs-
Bq (Uchiyama et al., 1998). Peak concentra-
134 body burden was 730 Bq. The Cs-137
tions of I-131 in urine increased to 3.3 Bq/ml
mean body burden increased from 150 to 1,500
in adult males (Kawamura et al., 1988). Before
Bq in December 1986. The maximum levels
the Chernobyl catastrophe Cs-137 body bur-
of body burdens for Cs-134 and C-137 were
dens were about 30 Bq, rising to more than
50 Bq in 1986 with values continuing to in-
crease in May 1987 (Uchiyama and Kobayashi,
1988).
4. ITALY. Average I-131 thyroid incorpora-
tion for 51 adults was 6.5 Bq/g from May 3 to
June 16, 1986 (Orlando et al., 1986). Peak uri-
nary excretion of Cs-137 occurred 300 to 425
days after the main fallout cloud had passed on
May 5, 1986: pv 15–20 Bq/day (Capra et al.,
1989).
5. GERMANY AND FRANCE. There are data
concerning human contamination by Cher-
nobyl radionuclides outside of the Former So-
viet Union. Figure 12.10 shows body burden
levels of Cs-137 in Germany and France.
6. GREAT BRITAIN. Average Cs-134 + Cs-
137 body burden levels for adults in Scotland
in 1986 after the catastrophe were: Cs-134, 172
Figure 12.9. Cs-137 levels in children Bq; Cs-137, 363 Bq; and K-40, 4,430 Bq. Peak
of Narovlya District, Gomel Province, Belarus concentrations were: Cs-134, 285 Bq and Cs-
(Nesterenko, 2007). 137, 663 Bq (Watson, 1986). The Cs-137 body
300
Figure 12.10. Body burden of Cs-137 (Bq) in humans in Munich, Germany: (A) males,
(B) females); in Grenoble, France (C) adults (UNSCEAR, 1988).
burden in England in 1987 was 250–450 Bq Chapter II of this volume detailed many
(Uchiyama and Kobayashi, 1988). The thyroid cases of deterioration in public health associ-
I-131 burden measured in the neck region was ated with the Chernobyl radionuclide contam-
up to 33 Bq in adults and up to 16 Bq in children ination. Many people suffer from continuing
in Britain (Hill et al., 1986). chronic low-dose radiation 23 years after the
catastrophe, owing primarily to consumption
of radioactively contaminated food. An impor-
12.3. Conclusion tant consideration is the fact that given an iden-
tical diet, a child’s radiation exposure is three-
All people living in territories heavily con- to fivefold higher than that of an adult. Since
taminated by Chernobyl fallout continue to be more than 90% of the radiation burden nowa-
exposed to low doses of chronic radiation. Hu- days is due to Cs-137, which has a half-life of
man beings do not have sense organs to detect about 30 years, contaminated areas will con-
ionizing radiation because it cannot be per- tinue to be dangerously radioactive for roughly
ceived by sight, smell, taste, hearing, or touch. the next three centuries.
Therefore without special equipment to iden- Experience has shown that existing official
tify levels of environmental contamination, it radioactive monitoring systems are inadequate
is impossible to know what radionuclide levels (not only in the countries of the Former Soviet
are in our food and water or have been incor- Union). Generally, the systems cover territo-
porated into our bodies. ries selectively, do not measure each person,
The simplest way to ensure radiation safety and often conceal important facts when releas-
in all areas contaminated by Chernobyl is to ing information. The common factor among
monitor food for incorporated radionuclides. all governments is to minimize spending for
Analysis of levels of incorporated gamma- which they are not directly responsible, such as
radionuclides by individual spectrometry (IRC) the Chernobyl meltdown, which occurred 23
and radioactive monitoring of local food years ago. Thus officials are not eager to ob-
in many Belarussian locations have demon- tain objective data of radioactive contamina-
strated a high correlation between Cs-137 food tion of communities, individuals, or food. Un-
contamination and the amount of radionu- der such circumstances, which are common,
clides in humans and, most importantly, in an independent system of public monitoring is
children. needed. Such an independent system is not a
substitute for official responsibility or control, the United States, 1987–92. J. AOAC Int. 77(6): pp.
but is needed to provide regular voluntary 1422–1427.
monitoring of food for each family, which Danell, K., Nelin, P. & Wickman, G. (1989). Cesium-137
in Northern Swedish moose: The first year after the
would determine the radionuclide level in each Chernobyl accident. Ambio 18(2): 108–111.
person. Energy (2008). Chernobyl echo in Europe (//www.
We have to take responsibility not only for members.tripod.com/∼BRuslan/win/energe1.htm)
our own health, but for the health of future (in Russian).
generations of humans, plants, and animals, Fox, B. (1988). Porous minerals soak up Chernobyl’s fall-
out. New Sci. 2: 36–38.
which can be harmed by mutations resulting
Franic, Z., Marovic, G. & Lokobauer, N. (2006). Radio-
from exposure to even the smallest amount of cesium activity concentration in wheat grain in the
radioactive contamination. Republic of Croatia for the years 1965 to 2003 and
dose assessment. Env. Monit. Assess. 115: 51–67.
Hakanson, L., Andersson, T. & Nilsson, A. (1989). Ra-
References dioactive cesium in fish in Swedish lakes 1986–1988:
General pattern related to fallout and lake charac-
Aarkrog, A., Bøtter-Jensen, L., Chen, Q. J., Clausen, J. teristics. J. Env. Radioact. 15(3): 207–230.
L., Dahlgaard, H., et al. (1995). Environmental Ra- HELCOM Indicator Fact Sheets (2006). (//www.helcom.
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(Riso National Laboratory, Roskilde): 130 pp. (cited Hill, C. R., Adam, I., Anderson, W., Ott, R. J. &
by RADNET, 2008). Sowby, F. D. (1986). Iodine-131 in human thyroids
Ahman, B. & Ahman, G. (1994). Radiocesium in Swedish in Britain following Chernobyl. Nature 321: 655–
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ations and long-term decline. Health Physics 66(5): Hisamatsu, S., Takizawa, Y. & Abe, T. (1987). Reduction
506–508. of I-131 content in leafy vegetables and seaweed by
Assikmakopoulos, P. A., Ioannides, K. G. & Pakou, cooking. J. Rad. Res. 28(1): 135–140 (cited by RAD-
A. (1987). Transport of radioisotopes iodine-131, NET, 2008).
cesium-134, and cesium-137 into cheese and cheese- Hohryakov, V. F., Syslova, C. G. & Skryabin, A. M. (1994).
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70: 1338–1343. clear plants (Chelyabinsk-65, Gomel area) and global
Bandazhevsky, Yu. I. (2003). Cs-137 incorporation in chil- fallout. Sci. Total Env. 142(1–2): 101–104.
dren’s organs. Swiss Med. Week. 133: 488–490. Kawamura, H., Sakurai, Y., Shiraishi, K. & Yanagisawa,
Borysevich, N. Y. & Poplyko, I. Y. (2002). Scientific Solution K. (1988). Concentrations of I-131 in the urine of
of the Chernobyl Problems: Year 2001 Results (Radiology Japanese adults and children following the Cher-
Institute, Minsk): 44 pp. (in Russian). nobyl nuclear accident. J. Env. Radioact. 6: 185–
Capra, E., Drigo, A. & Menin, A. (1989). Cesium-137 189.
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Health Physics 57(1): 99–106. Chernobyl accident. J. Env. Radioact. 12(2): 167–
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Twenty Years of Experience. Report of the UN Cher- restricted by Chernobyl nuclear fallout. The Guardian.
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Komsomol’skaya Pravda (Moscow), March 25: p. 6 (in itants and their foodstuff in the Chernobyl zone of
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Cunningham W.C., Anderson D.L. & Baratta, E.J. (1994). jima S., et al. (1986). I-131 in milk and rain after
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(1987). Radioactivity of game meat in Finland after www.nuclearfiles.org/menu/key-issues/nuclear-
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Resolution (2006). International Conference. Medical Japan. J. Env. Radioact. 22(2): 141–154.
CHERNOBYL
13. Decorporation of Chernobyl

Radionuclides
Vassily B. Nesterenko and Alexey V. Nesterenko
Tens of thousands of Chernobyl children (mostly from Belarus) annually leave to receive
treatment and health care in other countries. Doctors from many countries gratuitously
work in the Chernobyl contaminated territories, helping to minimize the consequences
of this most terrible technologic catastrophe in history. But the scale and spectrum of
the consequences are so high, that no country in the world can cope alone with the
long-term consequences of such a catastrophe as Chernobyl. The countries that have
suffered the most, especially Ukraine and Belarus, extend gratitude for the help that
has come through the United Nations and other international organizations, as well
as from private funds and initiatives. Twenty-two years after the Chernobyl releases,
the annual individual dose limit in heavily contaminated territories of Belarus, Ukraine,
and European Russia exceed 1 mSv/year just because of the unavoidable consumption of
locally contaminated products. The 11-year experience of the BELRAD Institute shows
that for effective radiation protection it is necessary to establish the interference level
for children at 30% of the official dangerous limit (i.e., 15–20 Bq/kg). The direct whole
body counting measurements of Cs-137 accumulation in the bodies of inhabitants of
the heavily contaminated Belarussian region shows that the official Dose Catalogue un-
derestimates the annual dose burdens by three to eight times. For practical reasons the
curative-like use of apple-pectin food additives might be especially helpful for effective
decorporation of Cs-137. From 1996 to 2007 a total of more than 160,000 Belarussian
children received pectin food additives during 18 to 25 days of treatment (5 g twice a
day). As a result, levels of Cs-137 in children’s organs decreased after each course of
pectin additives by an average of 30 to 40%. Manufacture and application of various
pectin-based food additives and drinks (using apples, currants, grapes, sea seaweed,
etc.) is one of the most effective ways for individual radioprotection (through decorpo-
ration) under circumstances where consumption of radioactively contaminated food is
unavoidable.
There are three basic ways to decrease the ra- 13.1. Reducing Radionuclides
dionuclide levels in the bodies of people living in Food
in contaminated territories: reduce the amount
of radionuclides in the food consumed, accel- Soaking in water, scalding, salting, and pick-
erate removal of radionuclides from the body, ling foods such as mushrooms and vegetables
and stimulate the body’s immune and other and processing the fats in milk and cheeses can
protective systems. reduce the amount of radionuclides in some
foods severalfold.
Stimulation of the body’s natural defenses
through the use of food additives that raise
one’s resistance to irradiation is also useful.
Among such additives are the antioxidant vita-
Address for correspondence: Alexey V. Nesterenko, Institute of Radia- mins A and C and the microelements I, Cu, Zn,
tion Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk, 220053, Belarus.
Fax: +375 17 289-03-85. [email protected] Se, and Co, which interfere with free-radical
303
304
formation. The additives prevent the oxida- proaches should be employed to mitigate the
tion of organic substances caused by irradiation consequences of that irradiation.
(lipid peroxidation). Various food supplements There is evidence that incorporation of
can stimulate immunity: sprouts of plants, such 50 Bq/kg of Cs-137 into a child’s body can
as wheat, seaweed (e.g., Spirulina), pine needles, produce pathological changes in vital organ sys-
mycelium, and others. tems (cardiovascular, nervous, endocrine, and
Accelerating the removal of radionuclides immune), as well as in the kidneys, liver, eyes,
is done in three ways (Rudnev et al., 1995; and other organs (Bandazhevskaya et al., 2004).
Trakhtenberg, 1995; Leggett et al., 2003; and Such levels of radioisotope incorporation are
many others): not unusual in the Chernobyl-contaminated
•
areas of Belarus, Ukraine, and European Rus-
Increase the stable elements in food to im-
sia nowadays (see Chapter III.11 for details),
pede the incorporation of radionuclides.
which is why it is necessary to use any and
For example, K and Rb interfere with the
all possible measures to decrease the level of
incorporation of Cs; Ca interferes with Sr;
radionuclide incorporation in people living in
and trivalent Fe interferes with the uptake
those territories. When children have the same
of Pu.
•
menu as adults, they get up to five times higher
Make use of the various food additives that
dose burdens from locally produced foodstuffs
can immobilize radionuclides.
•
because of their lower weight and more ac-
Increase consumption of liquids to “wash
tive processes of metabolism. Children liv-
away” radionuclides—infusions, juices,
ing in rural villages have a dose burden five
and other liquids as well as enriched food
to six times higher than city children of the
with dietary fiber.
same age.
Decorporants (decontaminants) are prepa-
rations that promote the removal of incorpo-
rated radionuclides via excretion in feces and 13.2. Results of Decontamination
urine. Several effective decorporants specific by the Pectin Enterosorbents
for medical treatment of heavy radionuclide
contamination are known (for Cs, Fe com- It is known that pectin chemically binds
pounds; for Sr, alginates and barium sulfates; cations such as Cs in the gastrointestinal tract
for Pu, ion-exchange resins, etc.). They are ef- and thereby increases fecal excretion. Research
fective in cases of sudden contamination. In the and development by the Ukrainian Center
heavily contaminated Belarussian, Ukrainian, of Radiation Medicine (Porokhnyak-Ganovska,
and European Russian territories the situation 1998) and the Belarussian Institute of Radia-
is different. Daily exposure to small amounts tion Medicine and Endocrinology (Gres’ et al.,
of radionuclides (mostly Cs-137) is virtually un- 1997) have led to the conclusion that adding
avoidable as they get into the body with food pectin preparations to the food of inhabitants
(up to 94%), with drinking water (up to 5%), of the Chernobyl-contaminated regions pro-
and through the air (about 1%). Accumulation motes an effective excretion of incorporated
of radionuclides in the body is dangerous, pri- radionuclides.
marily for children, and for those living in the 1. In 1981, based on 2-year clinical tests, the
contaminated territories where there are high Joint Committee of the World Health Organi-
levels of Cs-137 in local foodstuffs (see Chap- zation (WHO) and the U.N. Food and Agri-
ter IV.12). The incorporation of radionuclides culture Organization (FAO) on Food Additives
is now the primary cause of the deterioration declared the pectinaceous enterosorbents ef-
of public health in the contaminated territories fective and harmless for everyday use (WHO,
(see Chapter II for details), and all possible ap- 1981).
Nesterenko & Nesterenko: Decorporation of Radionuclides 305
2. In Ukraine and Belarus various pectin- TABLE 13.1. Decreased Cs-137 Concentration
based preparations have been studied as agents after Using Vitapect for 21 Days (Total 615 Chil-
dren) in 2001 in the Silver Springs Belarussian
to promote the excretion of incorporated ra-
Sanatorium (BELRAD Institute Data)
dionuclides (Gres’, 1997; Ostapenko, 2002;
Ukrainian Institute, 1997). The product based Concentration of Cs-137, Bq/kg
on the pectin from an aquatic plant (Zostera), Group Before In 21 days Decrease,%
known commercially as Zosterin-Ultra is a
mass prophylaxis agent used in the Russian Vitapect 30.1 ± 0.7 10.4 ± 1.0 63.6∗
Placebo 30.0 ± 0.9 25.8 ± 0.8 13.9
nuclear industry. As it is a nonassimilated
∗
pectin, the injection of zosterine into the blood- p < 0.01.
stream does not harm nutrition, metabolism, or
other functions. Zosterin-Ultra in liquid form
for oral administration was approved by the and that of the placebo group was 14.2 ±
Ukrainian Ministry of Health (1998) and the 0.5% (p > 0.001), with a mean effective half-
Russian Ministry of Health (1999) as a biolog- life for Cs-137 in a body of 27 days for the
ically active (or therapeutic) food additive en- pectin group, as compared with 69 days with-
dowed with enterosorption and hemosorption out pectin. This was a reduction of the effective
properties. half-life by a factor of 2.4. These results mean
3. In 1996, the BELRAD Institute initiated that the pectin additive Vitapect with clean nu-
enterosorbent treatments based on pectin food trition appears to be 50% more effective in de-
additives (Medetopect , France; Yablopect , creasing the levels of Cs-137 than clean nutri-
Ukraine) to accelerate the excretion of Cs- tion alone (Nesterenko et al., 2004).
137. In 1999 BELRAD together with “Her- 6. A clinical study of 94 children, 7 to 17
mes” Hmbh (Munich, Germany) developed a years of age, divided into two groups accord-
composition of apple pectin additives known as ing to their initial level of Cs-137 contami-
Vitapect powder, made up of pectin (concen- nation determined by whole body counting
tration 18–20%) supplemented with vitamins (WBC) and given Vitapect orally for 16 days
B1, B2, B6, B12, C, E, beta-carotene, folic acid; (5 g twice a day) revealed both a significant
the trace elements K, Zn, Fe, and Ca; and fla- decrease in incorporated Cs-137 and marked
voring. BELRAD has been producing this food
additive, which has been approved by the Be-
larussian Ministry of Health, since 2000.
4. In June–July 2001 BELRAD together with
the association “Children of Chernobyl of Be-
larus” (France) in the Silver Springs sanatorium
(Svetlogorsk City, Gomel Province) conducted
a placebo-controlled double-blind study of 615
children with internal contamination who were
treated with Vitapect (5 g twice a day) for a 3-
week period. In children taking the Vitapect
(together with clean food) Cs-137 levels were
lowered much more effectively than in the con-
trol group, who had clean food combined with
a placebo (Table 13.1 and Figure 13.1).
Figure 13.1. Decrease in levels of specific ac-
5. In another group of children the relative tivity of Cs-137 in children’s bodies after Vitapect
reduction in the specific activity of Cs-137 in intake (5 g twice a day) for 21 days (Nesterenko
the Vitapect-intake group was 32.4 ± 0.6%, et al., 2004).
306
TABLE 13.2. EKG Normalization Results in the TABLE 13.3. Results of Treatment of 46 Children
Two Groups of Children Contaminated with Cs- for 30 Days in France in 2004 (BELRAD Institute
137 Treated with Vitapect (Bandazevskaya et al., Data)
2004)
Concentration, Bq/kg
Before After 16 days Decrease,
Before After %
Normal Normal
Group EKG,% Bq/kg EKG,% Bq/kg Vitapect 39.0 ± 4.4 24.6 ± 3.4 37∗
Placebo 29.6 ± 2.7 24.6 ± 2.1 17
1 72 38 ± 2.4 87 23 ∗
2 79 122 ± 18.5 93 88 p < 0.05.
project “Highly-Irradiated Belarus Children”

improvement in their electrocardiograms with the support of the German Federal Office
(EKG; Table 13.2). of Radiation Protection (BfS). Tests carried out
7. From 2001 to 2003 the association “Chil- in three Belarus sanatoriums (Timberland, Sil-
dren of Chernobyl in Belarus” (France), Mit- ver Springs, and Belarussian Girls) showed that
terand’s Fund (France), the Fund for Children Vitapect does not impair the positive balance
of Chernobyl (Belgium), and the BELRAD In- of the K, Zn, Cu, and Fe in children’s blood
stitute treated 1,400 children (10 schools serv- (Nesterenko et al., 2004).
ing 13 villages) in the Narovlyansky District, 9. At the request of the “Chernobyl’s Chil-
Gomel Province, in cycles in which the children” NGOs initiatives in Germany, France,
dren received the pectin preparation Vitapect England, and Ireland, the BELRAD Institute
five times over the course of a year. The re- conducted measurements of Cs-137 in children
sults demonstrated a three- to fivefold annual before departure to and after their return from
decrease in radioactive contamination in chil- health programs in these countries. Children
dren who took the Vitapect. The results for one who only ate clean food during the 25–30 days
village can be seen in Figure 13.2. showed a decrease in Cs-137 levels of some 20
8. There was concern that pectin enterosor- to 22%, whereas children who also received a
bents remove not only Cs-137, but also vital course of treatment with Vitapect showed an
microelements. Special studies were carried out even further decrease in the level of Cs-137 in-
in 2003 and 2004 within the framework of the corporation (Tables 13.3 and 13.4).
Figure 13.2. Changes in average specific activity of Cs-137 (Bq/kg) in the bodies of
children of Verbovichi Village, Narovlyansky District, Gomel Province. Averages for these data
are shown. Dotted line indicates the periods of Vitapect intake (Nesterenko et al., 2004).
TABLE 13.4. Several Results of Vitapect Treat-

ment of Belarussian Children (BELRAD Institute
Data)
Concentration,
Bq/kg
Decreasing,
Before After % Group data
30.0 ± 1.5 19.2 ± 1.4∗ 36 Germany, n = 43;

Jul. 7 to Aug. 29,
2007
42.1 ± 5.1 19.6 ± 2.5∗ 53 Spain, n = 30;
Jul. 2 to Aug. 30,
2007
26.4 ± 1.5 13.2 ± 0.8∗ 50 Canada, n = 22; Figure 13.3. Frequency of occurrence of ob-
Jun. 26 to Aug. 22, served relative reduction of the Cs-137 body burden
2007 with Vitapect treatment in Belarussian children (Hill
23.4 ± 2.0 11.8 ± 0.7∗ 49 Canada, n = 15; et al., 2007).
Jun. 24 to Aug. 22,
2007
∗
p < 0.01. Based on long-term experience, the BEL-
RAD Institute recommends that all children
10. The frequency distribution of the activ- living in radioactive contaminated territories
ity reduction in one experiment is shown in receive a quadruple course of oral pectin food
Figure 13.3. The relative reduction of the spe- additives annually along with their conven-
cific activity for the pectin groups was 32.4% tional food ration. Eleven years of BELRAD’s
(arithmetic mean) and 33.6% (median), respec- activities in controlling levels of incorporated
tively, whereas the specific activity in the chil- Cs-137 in more than 327,000 children has
dren who received placebos decreased only by not caused alarm in the population or radio-
14.2% (arithmetic mean) and 13.1% (median), phobia and has led to the spread of knowl-
respectively. This corresponds to a reduction in edge concerning radiation protection and an
the mean effective half-life of 27 days for the
pectin groups, as compared with 69 days for
the placebo groups.
11. The two calculated whole-body reten-
tion functions are shown in Figure 13.4 (for
adults). The first curve represents the effect of
replacing contaminated food by clean food ef-
fective from t = 0 and the second corresponds
to clean food plus Vitapect, also effective from
t = 0. The observed reduction of mean effective
half-life (69→27 days) corresponds to a factor
of 2.5.
12. From 1996 to 2007 a total of more than
160,000 Belarussian children received oral Vi-
Figure 13.4. Theoretical retention functions for
tapect (5 g twice a day) for an 18- to 25-day adults based on the model of Leggett et al. (2003).
course of treatment. The results showed a de- The upper curve shows the effect of clean food and
crease in Cs-137 levels after each course of the lower one illustrates the additional effect of block-
treatment by an average of 30–40%. ing adsorption using Vitapect (Hill et al., 2007).
308
increased sense of personal responsibility for 13.4. Where International Help

one’s health. for Chernobyl’s Children Would
Be Especially Effective
No country in the world is able to cope alone

13.3. New Principles of Radiation with the long-term consequences of a catastro-
Protection Based on Direct phe of the magnitude of the meltdown in Cher-
Measurements nobyl. The countries most severely affected, es-
pecially Ukraine and Belarus, which suffered
The BELRAD Institute’s 11 years of ex- greatly, are grateful for the help they get from
perience shows that for effective radiation the United Nations and other international or-
protection in the contaminated territories, an ganizations, as well as from private funds and
intervention level—30% of the official danger- initiatives.
ous limit (i.e., 15–20 Bq/kg)—must be estab- Annually, tens of thousands of Chernobyl
lished for children. children go to other countries for treatment
1. The direct whole body counting (WBC) to improve their health. Doctors from many
measurements of Cs-137 accumulation in indi- countries work pro bono in the Chernobyl-
viduals in the heavily contaminated Belarussian contaminated territories to help minimize the
regions showed that the official Dose Catalogue consequences of this most terrible technologic
prepared on the basis of the Cs-137 concentra- catastrophe in history. The scale and the range
tions in 10 milk samples and 10 potato samples of the consequences are so great that there is
underestimates the annual personal dose bur- always the question of how to make such help
den three- to eightfold and cannot be relied on even more effective.
for effective radiation protection. Experience from large-scale long-term pro-
2. It is obvious that a true dose catalogue of grams to monitor foodstuffs and the levels of
the contaminated population should be devel- incorporated radionuclides in the bodies of
oped on the basis of the data obtained from the those living in the contaminated territories is
direct WBC measurements of Cs-137, which the basis for the following proposals to increase
reflect the accumulated internal dose burden. the efficacy of the international and national
This should be done via reliable sampling of programs:
inhabitants from each area of Belarus affected
by Chernobyl. • Joint studies to determine the frequency
3. Only by combining WBC measurements and intensity of various diseases, especially
of Cs-137 accumulation in the body with medi- in children, correlated with levels of incor-
cal evaluations can the causal relationship (dose porated radionuclides.
dependence) between the increase in morbidity • Regular individual radiometric evaluation
and incorporated radionuclides in the popula- of the populations, especially children, in
tion be known. At this time, these data can only all contaminated territories. To accom-
be obtained in the Chernobyl-contaminated plish this, Belarus will have to increase
regions of Belarus, Ukraine, and European the number of mobile laboratories from
Russia. This information can be an important eight to twelve or fifteen. Similar to the
factor in designing radiation protection and Belarussian system, independent, practi-
treating people, in persuading the world com- cal, science/clinical centers must be estab-
munity of the need to help Belarus minimize lished in Ukraine and European Russia to
radiation exposures, and in understanding the use the results of such regular radiometric
dimensions of the consequences of the Cher- monitoring to identify critical groups with
nobyl catastrophe. high radionuclide incorporation.
• Manufacture and administer various bents and by separating the milk to pro-
pectin-based food additives and drinks duce cream and butter.
(based on apples, currants, grapes, sea- • Provide children and pregnant women
weed, etc.) as one of the most effec- with clean foodstuffs and with food ad-
tive ways of providing individual radiation ditives to increase the elimination of ra-
protection (through decorporation) when dionuclides and heavy metals from their
circumstances make using contaminated bodies.
food unavoidable. • Inform the population about the levels of
• Independent radiation monitoring and ra- radionuclide contamination of the local
diation control of local foodstuffs, mak- foodstuffs and the radionuclide concentra-
ing use of the BELRAD Institute’s ex- tion in the bodies of the inhabitants (espe-
perience in organizing local centers for cially children), taking into consideration
radioactive control. This does not re- the existing available foods and the local
place, but can add to the existing official way of life.
system. • Institute the practice of regular decorpo-
• Regular courses of oral pectin food addi- ration of radionuclides into the lifestyle as
tives for preventive maintenance. an effective measure of radiation protec-
tion for the population of the Chernobyl-
Twenty-two years after the catastrophe the
contaminated regions.
true situation in Chernobyl’s heavily contami-
nated territories shows that the internationally
accepted individual dose limit is in excess of The use of food additives, pectin prepa-
1 mSv/year because of the unavoidable con- rations with a complex of vitamins and
sumption of local radioactively contaminated microelements, demonstrated a high efficiency
products. Thus the most advisable way to lower in eliminating incorporated radionuclides.
the levels of incorporated radionuclides is to
consume only clean food. In those situations References
where clean food is not available, decorporant
and sorbent additives should be used to remove Bandazhevskaya, G. S., Nesterenko, V. B., Babenko, V.
as much as possible of the absorbed and incor- I., Babenko, I. V., Yerkovich, T. V. & Bandazhevsky,
Yu. I. (2004). Relationship between Cesium (Cs-137)
porated radionuclides.
load, cardiovascular symptoms, and source of food
There are many more-or-less effective decor- in “Chernobyl” children: Preliminary observations
porants and sorbents: a wide spectrum of prod- after intake of oral apple pectin. Swiss Med. Wkly.
ucts with alginic acid-alginates (mostly from 134: 725–729.
brown seaweed) promotes the reduction of Sr, Gres’, N. A. (1997). Influence of pectinous formulations
iron and copper cyanides (e.g., ferrocyanide on dynamics of micro elementary composition of
children’s blood. In: Micro Elementary Disorders and Be-
blue) promote the reduction of Cs. Activated larusian Children’s Health after Chernobyl Catastrophe. Col-
charcoal, cellulose, and various pectins are also lected Papers (Institute for Radiation Medicine and
effective sorbents for incorporated radionu- Endocrinology, Minsk): 108–116 (in Russian).
clides. For practical reasons the curative-like Hill, P., Schläger, M., Vogel, V., Hille, R., Nesterenko,
application of apple-pectin food additives may A. V. & Nesterenko, V. ; (2007). Studies on the
current Cs-137 body burden of children in Belarus:
be especially helpful to effectively decorporate
Can the dose be further reduced? Rad. Protec. Dosim.
Cs-137. 125(1–4): 523–526 (//www.rpd.oxfordjournals.
What can be done: org/misc/terms.shtm) (in Russian).
Leggett, R. W., Williams, L. R., Melo, D. R. & Lipsztein,
• Reduce Cs-137 concentration in the main J. L. (2003). A physiologically based biokinetic model
dose-forming product—milk—by feeding for Cesium in the human body. Sci. Total Env. 317:
cows with mixed fodder containing sor- 235–255.
310
Nesterenko, V. B. (2005). Radiation monitoring of inhab- Rudnev, M. I., Malyuk, V. I. & Korzun, V. N. (1995).
itants and their foodstuffs in Chernobyl zone of Be- Decorporants. Sect 6.7. In: Bar’yakhtar, V. G. (Ed.),
larus. BELRAD Inform. Bull. 28 (BELRAD, Minsk): Chernobyl Catastrophe: History, Social, Economical, Geo-
129 pp. (in Russian). chemical, Medical and Biological Consequences (“Naukova
Nesterenko, V. B., Nesterenko, A. V., Babenko, V. I., Dumka,” Kiev) (//www.stopatom.slavutich.kiev.ua)
Yerkovich, T. V. & Babenko, I. V. (2004). Reducing (in Russian).
the Cs-137 load in the organs of Chernobyl children Trakhtenberg, I. M. (1995). Enterosorbents. Sect. 6.8.
with apple-pectin. Swiss Med. Wkly. 134: 24–27. In: Bar’yakhtar, V. G. (Ed.), Chernobyl Catastrophe:
Ostapenko, V. (2002) (Interview). Belarussian Minis- History, Social, Economical, Geochemical, Medical and
ter of Public Health predicts increasing thyroid Biological Consequences (“Naukova Dumka,” Kiev)
cancer morbidity in Belarussian population. (//www.stopatom.slavutich.kiev.ua) (in Russian).
Problems with Chemical Safety, UCS-INFO 864 Ukrainian Institute (1997). Report on Scientific Research
(//www.seu.ru /members /ucs/ucs-info /864.htm) of Clinical Studies of Pectinaceous Preparations
(in Russian). Based on Apple Flakes “Yablopect” (Ukrainian In-
Porokhnyak-Ganovska, L. V. (1998). New ways of prophy- stitute of Industrial Medicine, Kryvoy Rog): 58 pp.
laxis and rehabilitation of populations from radioac- (in Russian).
tive contaminated territories: Apple-pectin powder WHO (1981). Toxicological evaluation of certain food ad-
and fortified vitamized soluble tablets “Yablopect.” ditives: Pectins and Amidated. WHO Food Additives
Med. Adviser 1: 7–8 (in Russian). Series, 16 (WHO, Geneva) (//www.inchem.org).
CHERNOBYL
14. Protective Measures for Activities in

Chernobyl’s Radioactively Contaminated
Territories
Alexey V. Nesterenko and Vassily B. Nesterenko
Owing to internally absorbed radionuclides, radiation levels for individuals living in the
contaminated territories of Belarus, Ukraine, and Russia have been increasing steadily
since 1994. Special protective measures in connection with agriculture, forestry, hunt-
ing, and fishing are necessary to protect the health of people in all the radioactively
contaminated territories. Among the measures that have proven to be effective in re-
ducing levels of incorporated radionuclides in meat production are food additives with
ferrocyanides, zeolites, and mineral salts. Significant decreases in radionuclide levels in
crops are achieved using lime/Ca as an antagonist of Sr-90, K fertilizers as antagonists
of Cs-137, and phosphoric fertilizers that form a hard, soluble phosphate with Sr-90.
Disk tillage and replowing of hayfields incorporating applications of organic and min-
eral fertilizers reduces the levels of Cs-137 and Sr-90 three- to fivefold in herbage grown
in mineral soils. Among food technologies to reduce radionuclide content are cleaning
cereal seeds, processing potatoes into starch, processing carbohydrate-containing prod-
ucts into sugars, and processing milk into cream and butter. There are several simple
cooking techniques that decrease radionuclides in foodstuffs. Belarus has effectively
used some forestry operations to create “a live partition wall,” to regulate the redistri-
bution of radionuclides into ecosystems. All such protective measures will be necessary
in many European territories for many generations.
As a result of the Chernobyl catastrophe, that figure is 26%. Millions of hectares of Be-
millions of hectares of agricultural lands are larussian, Russian, and Ukrainian forests (more
dangerously contaminated with Cs-137 with than 22% of all Belarussian woodlands) ap-
concentrations higher than 37 kBq/m2 : in pear to be dangerously contaminated (National
Belarus, 1.8 million hectares; in Russia, 1.6 Belarussian Report, 2006). More than 5 mil-
million hectares; and in Ukraine, 1.2 million lion people live in the contaminated territo-
hectares. According to the Belarus Ministry ries of Belarus, Ukraine, and Russia (see Chap-
of Agriculture, agricultural production now ter I for details). Moreover, some grasslands,
takes place on more than 1.1 million hectares forests, mountains, and lakes in Sweden, Nor-
of land contaminated with Cs-137 at a level way, Scotland, Germany, Switzerland, Austria,
from 37 to 1,480 kBq/m2 , and 0.38 million Italy, France, and Turkey continue to show
more hectares are similarly contaminated by measurable contamination.
Sr-90 at a level of more than 5.55 kBq/m2 . Over the 23 years since the catastrophe, ow-
In Gomel Province 56% of all the agricultural ing to the devoted activities of many thousands
land is contaminated, and in Mogilev Province of scientists and technical specialists, some
methods and practical measures have been de-
veloped to decrease the risks from the con-
tamination linked to the use of natural re-
Address for correspondence: Alexey V. Nesterenko, Institute of Radia-
tion Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk, 220053, Belarus. sources (agricultural, forestry, hunting, etc.). As
Fax: +375 17 289-03-85. [email protected] a comprehensive review all these results would
311
312
require a separate monograph. This short TABLE 14.1. Efficiency of Agrochemical Mea-
chapter simply outlines some basic techniques sures to Reduce Cs-137 and Sr-90 Concentrations
in Plant Production (Gudkov, 2006)
designed to achieve radiation protection for the
resources utilized in the course of everyday liv- Reduction factor
ing in the contaminated territories. Method Cs-137 Sr-90
Lime 1.5–4 1.5–2.5

14.1. Measures for Radiation Higher level of:
Phosphoric fertilizers 1.5–2 1.2–1.5
Protection in Agriculture Potassium fertilizers 1.8 None
Organic fertilizers 40 tons/ha 1.5–3 1.5–2
1. Where production with “permissible” Combined application of lime, 2–5 2–4
amounts of radionuclides is impossible, agri- mineral, and organic fertilizers
cultural lands have been taken out of use: in Mineral soil absorbents (zeolites, 1.5–2.5 1.5–2
vermiculites, bentonites, etc.)∗
Belarus, 265,000 hectares; in Ukraine, 130,000
hectares; and in Russia, 17,000 hectares ∗
They were most effective during the first 5 years after
(Aleksakhin et al., 2006). the catastrophe (Kenik, 1998).
2. Agricultural land with radioactive con-
tamination is subject to obligatory monitoring 137 and Sr-90 accumulation three- to fivefold
of both soil and production processes for end- in herbage grown in mineral soils. Such radi-
product control technology to ensure permis- cal treatment of hayfields on peat soils sharply
sible levels of Cs-137 and Sr-90 in foodstuffs. reduces Cs-137, but is less effective for Sr-90.
This permissible level is established by calculat- Owing to degradation of cultivated hayfields,
ing the combined individual average annual repeated grassland renovation with an applica-
food intake so as to limit the effective equiva- tion of fertilizers is needed every 3 to 6 years.
lent radiation dose to less than 1 mSv/year. For 5. As noted above, radiation protection mea-
beef and mutton the level of Cs-137 should sures are effectively applied in large state-
be no higher than 500 Bq/kg in Belarus owned and collective farms. In small private-
and 160 Bq/kg in Russia and Ukraine, flour sector households and farms, which in Belarus
and groats (buckwheat) should have no more account for more than 50% of agricultural pro-
than 90 Bq/kg, etc. (Bagdevich et al., 2001). duction, these measures are incidental. Gener-
Each country has its own radioprotection ally for each cow on a private Belarus farm
policy. there is about 1 hectare of hayfield and im-
3. Effective decreases in the levels of ra- proved pasture. This is not sufficient to sus-
dionuclides in crops are achieved by applica- tain the animal so the farmers have to get hay
tions of lime/Ca as antagonists of Sr-90, K from grassy forest glades and unarable lands
fertilizers as antagonists of Cs-137, phosphoric that are contaminated with higher levels of ra-
fertilizers that form a hard soluble phosphate dioactivity than cultivated hayfields. Thus a sig-
and precipitate Sr-90, plus zeolites, sapropel nificant number of settlements, even 23 years
(gyttja), and other natural antagonists and ab- since the catastrophe, had inadequate radiation
sorbents (Aleksakhin et al., 1992; and many oth- protection for agricultural production. There
ers; Table 14.1). are more than 300 such settlements each in
4. Hayfields (meadows and pastures) used to Belarus and Ukraine, and more than 150 in
support milk and meat production account for Russia (Kashparov et al., 2005).
up to half of all contaminated agricultural land 6. Twenty years after the catastrophe, some
in Belarus. Disk tilling and replowing of hay- 10 to 15% of the milk on private Belarus-
fields incorporating an application of organic sian farms had a higher Cs-137 contamination
and mineral fertilizers reduces the levels of Cs- than the permissible level. In 2006 there were
Nesterenko & Nesterenko: Protective Measures for Activities 313
TABLE 14.2. Efficiency of Measures to Reduce Cs- TABLE 14.4. Chemical and Pharmacological An-
137 and Sr-90 Concentrations in Animal-Breeding tiradiation Remedies (Based on Gudkov, 2006)
Production (Gudkov, 2006)
Radionuclide blockers and decontaminants
Reduction factor Antagonists— Stable isotopes,
competitors chemical analogues
Measure Cs-137 Sr-90
Enterosorbents Activated charcoal, zeolite,
Improvement of meadows and 1.5–10 1.5–5 Vitapect, Algisorb, etc.
pastures∗ Insoluble complexes Ferrocyanides, alginates, pectins,
Food additives with ferrocyanide 2–8 (to 20) None phosphates
Food additives with zeolites 2–4 None Soluble complexes Natural (flavonoids: flavones,
Food additives with mineral salts 1.5–2 2–3 anthocyans, catechins) and
Month on clean fodder before 2–4 None synthetic (Zinkacyne, etc.)
slaughter Radioprotectants
Antioxidants Aminothiols; disulfides;
∗
Less effective on peat soils. thiosulfates; vitamins A, C, E
Stabilizers of DNA Metal ions, chelates, flavonoids
instances in which household milk contained and membranes
Cs-137 at a value as high as 1,000 Bq/liter. In Metabolism Cyanides, nitriles, azides,
inhibitors endotoxins
Gomel Province in 2004, some 12% of beef Adaptogenes Immunostimulants, vitamins,
had Cs-137 levels above 160 Bq/kg (BELRAD microelements, etc.
Institute data).
7. There are some effective measures to
reduce levels of incorporated radionuclides
in meat production (Table 14.2) and food- promised. In spite of measures taken and sub-
processing technologies to reduce radionuclide sidies, agricultural production in radioactive
content in foodstuffs (Table 14.3). contaminated areas continues to be difficult
8. Table 14.4 presents the primary known and the farmers often turn to specialized en-
antiradiation chemical and pharmacological terprises for cattle breeding for meat produc-
measures to achieve clean animal breeding in tion, production of oils and industrial crops,
the contaminated territories. etc.
9. All the methods described to reduce
radiation in agricultural production require
additional material and labor; thus economic 14.2. Radiation Protection
efficiency in the contaminated areas is com- Measures for Forestry, Hunting,
and Fisheries
TABLE 14.3. Efficiency of Measures to Reduce
Forestlands accumulated about 70% of the
Cs-137 and Sr-90 Content in Foodstuffs (Gudkov,
2006) Chernobyl radionuclides that fell on Belarus.
Shortly after the catastrophe most forest ra-
Reduction factor dionuclide contamination was on the surface
Measure Cs-137 Sr-90 of trees. Roots absorb Cs-137 and Sr-90 from
the soil and transport them into the wood and
Cleaning of cereals seeds 1.5–2
Processing of potato to starch 15–50
other parts of the plant. Specific activity of Cs-
Processing carbohydrate- 60–70 137 can exceed 20 kBq/kg in forest berries and
containing: Production to sugars mushrooms, as much as 150 kBq/kg in dried
Production to ethyl alcohol Up to 1,000 mushrooms, and 250 kBq/kg in wild game
Processing of milk to cream 6–12 5–10 meat. In predatory fish breeds in landlocked
Processing of milk to butter 20–30 30–50
reservoirs the levels can reach 300 kBq/kg (see
Culinary treatment of meat 2–4 None
Chapter III for details).
314
1. In the exclusion zone, which in 1986–1987 nated. Up to 50% of all the mushrooms and
was 30 km wide, as well as in the zone of in- berries that were measured exceeded the per-
voluntary resettlement, all forestry activities are missible level of Cs-137 (370 Bq/kg). Consump-
forbidden where there is risk to an individual of tion of forest products accounts for up to 40%
a dose greater than 5.0 mSv. In this zone per- of the annual individual dose of internal ra-
manent housing is banned and economic activ- diation in Belarus. Persistence of Cs-137 in
ity is strictly limited. The zone of involuntary forest products exceeds the permissible level
resettlement is an area outside the exclusion even in territories with soil contamination be-
zone where the level of ground contamination low 37 kBq/m2 (<1 Ci/km2 ).
from Cs-137 is above 15 Ci/km2 , that from Sr- 7. The Belarus National Academy Forest In-
90 is above 3 Ci/km2 , or that from Pu-239 and stitute revealed that the forest can serve as “a
Pu-240 is above 0.1 Ci/km2 . The territories of live partition wall,” by regulating redistribution
involuntary resettlement also include some ar- of radionuclides in ecosystems. In test plots in
eas with low-level radioactivity where radionu- sections of the Vetka and El’sk forests in Gomel
clides migrate into plants from contaminated Province the amounts of radionuclides in the
soil. roots of trees, in forest berries, and in mush-
2. According to official Belarussian data, for rooms have been decreased up to sevenfold as
several years after the catastrophe radiation a result of special forestry and reclamation mea-
levels in contaminated forest products (wild sures (Ipat’ev, 2008).
berries, mushrooms, firewood, etc.) exceeded 8. To prevent dispersion of radionuclides
those in domestic agricultural products (milk, from contaminated forest areas to adjoining
bread, cereals, etc.). territories as a result of water and wind erosion
3. Ten years after the catastrophe, the it is necessary to reforest eroded land. Univer-
amount of radionuclides in underground parts sal efforts to prevent forest fires and improve
of trees doubled and reached 15% of the to- fire-fighting efficiency are needed to stop ra-
tal amount in forest ecosystems. Even now, in dionuclide dispersion via wind currents several
Belarus, owing to external radiation contam- hundred or even thousands of kilometers away
ination, foresters are exposed to levels two to from contaminated territories. Unfortunately,
three times higher than agricultural workers. this was not done during the fires that raged in
4. Among the principal measures proposed 1992.
to decrease radiation risk for forestry workers 9. In zones with a Cs-137 level of more than
are: (a) shorten the length of stay in contami- 15 Ci/km2 it is dangerous to consume wild
nated territory; (b) minimize manned technolo- game. Obligatory total control over all game
gies and maximize mechanization; (c) provide production is needed in zones contaminated
individual safety equipment and shielding for up to 15 Ci/km2 . In contaminated territories
the driver’s cabin on farm machines and de- it is recommended to shoot wild boars and roe
vices for protection from gamma irradiation; (d) deer aged 2 years or older because they have
require special permission to enter the forests; lower levels of incorporated radionuclides than
and (e) impose seasonal regulations on forestry younger ones.
operations (Maradudin et al., 1997). 10. The situation with elk is the oppo-
5. Contamination is increasing and it ap- site. The level of radionuclide incorporation
pears that it will rise even more with the use of is significantly lower among young animals as
contaminated firewood as fuel and its radioac- compared to adults.
tive ashes as fertilizer; all of these activities will 11. Radionuclide concentrations in the vis-
increase individual radiation doses. ceral organs of game mammals (heart, liver, kid-
6. Among forest products, mushrooms, neys, lungs, etc.) are significantly higher than in
berries, and hazelnuts are the most contami- muscle tissue.
12. Decreasing levels of specific radioactive region owing to differences in soils, cultivars,
contamination of principal game species are as agriculture techniques, etc.
follows: wolf > fox > wild boar > roe deer > Several examples of differing levels of con-
hare > duck > elk. tamination are presented below.
13. In contaminated territories the same 1.1. Vegetables: Order of decreasing Cs-137
species of fish taken from rivers and streams in some areas of Belarus: sweet pepper > cab-
have significantly lower radionuclide levels than bage >potatoes > beetroot > sorrel > let-
those from lakes and ponds. Phytophagous fish tuce > radish > onion > garlic > carrots >
have three to four times lower radionuclide lev- cucumbers > tomatoes. Order of decreasing
els than predatory species (catfish, pike, etc.). levels in Gomel Province: sorrel > beans >
Benthic fishes (crucian, tench, etc.) have sev- radish > carrots > been root > potatoes >
eral times more contamination than fish that garlic > sweet pepper > tomatoes > squash >
live in the top water layers (small fry, chub, cucumbers > cabbage (kohlrabi) > cauliflower
etc.). > colewort (Radiology Institute, 2003).
14. There are some effective methods to sig- 1.2. Berries: Order of decreasing Cs-137
nificantly decrease radionuclide contamination among some berries: blueberry (Vaccinium myr-
in pond cultures by plowing from the pond bot- tillus), cowberry (V. vitis-idaea), red and black
tom down to a depth up to 50 cm and washing currants (Ribes sp.), and cranberry (Oxycoccus)
with flowing water, applying potash fertilizers, usually accumulate more Cs-137 than straw-
and using vitamins and antioxidants (radiopro- berry (Fragaria), gooseberry (Grossularia), white
tectants) as food additives for the fish (Slukvin currant, raspberry (Rubus), and mountainash
and Goncharova, 1998). (Sorbus).
1.3. Meat: Order of decreasing Cs-137 in
some meats: poultry > beef > mutton > pork.
14.3. Radiation Protection Meats from older animals have more radionu-
Measures in Everyday Life clides that meat from younger ones owing to
accumulation over time. Bones of young ani-
Instructions for radiation protection and mals have more Sr-90. Among visceral organs
self-help countermeasures can be found in the order of decreasing levels of Cs-137 is: lung
Ramzaev, 1992; Nesterenko, 1997; Beresdorf > kidney > liver > fat.
and Wright, 1999; Annenkov and Averin, 2003; 1.4. Eggs: Order of decreasing levels: shell >
Babenko, 2008; Parkhomenko et al., 2008; and egg-white > yolk.
many others. 1.5. Fish: Predatory and benthic fishes (pike,
It is very important to avoid radionuclides in perch, carp, catfish, tench, etc.) are more con-
food and if they are consumed to try to elimi- taminated, and fish living in rivers and streams
nate them from the body as quickly as possible. are always less contaminated than those from
In a baby, the biological half-life of Cs-137 is 14 lakes and ponds.
days; for a 5-year old it is 21 days; for a 10-year 1.6. Mushrooms: The cap usually contains
old, 49 days; for teenagers, about 90 days; and more Cs-137 than the pedicle. Agaric (Agari-
for a young male, about 100 days (Nesterenko, cales) mushrooms usually concentrate more ra-
1997). dionuclides than boletuses (Boletus).
1. The most direct way of decreasing ra- 2. The biological properties of Cs-137 are
dionuclide intake is to avoid foods that are po- similar to those of stable K and Rb, and Sr-90
tentially heavily contaminated and to consume and Pu are similar to Ca. These properties de-
foodstuffs with lower levels. However, this is termine where they concentrate in the body so
not easy to do because the average level of the use of stable elements may help to decrease
radionuclide bioaccumulation differs in each the absorption of radionuclides.
316
Foods rich in K include potatoes, maize, meat, maintained cattle in stalls, deactivated
beans, beets, raisins, dried apricots, tea, nuts, pastures and reservoirs, and mandated that
potatoes, lemons, and dried plums. Ca-rich prior to slaughter the cattle be fed on clean for-
foods include milk, eggs, legumes, horseradish, age, etc. This disparity in contamination doses
green onions, turnip, parsley, dill, and spinach. occurred even though the level of contamina-
Green vegetables, apples, sunflower seeds, tion in Bulgaria was measurably lower than that
black chokeberries, and rye bread are rich in in Norway (Energy, 2008).
Fe; and Rb is found in red grapes. Since 1994, radiation exposure of individuals
3. A diet to protect against radioactive living in the contaminated territories of Belarus,
contamination should include uncontaminated Ukraine, and Russia has continued to increase
fruits and vegetables, those rich in pectin, and owing to internal absorption of radionuclides—
those with high-fiber complexes to promote the the most dangerous form of radiation exposure
rapid elimination of radionuclides. despite natural radioactive decay.
4. High intake of fluids including fruit drinks Migration of Chernobyl radionuclides into
helps promote excretion of contaminants in soil root zones allows plants to absorb them,
urine. transport them to the surface, and incorporate
5. Daily addition of antioxidants (vitamins A, them into edible portions of the plant. Agricul-
C, E, and the trace elements Zn, Co, Cu, and tural and forest product radionuclides are intro-
Se) is recommended. duced into food chains, significantly increasing
6. Individuals exposed to radioactive con- the radiation danger for all who consume those
tamination should consume special food addi- foodstuffs. Today the most serious contaminat-
tives such as Vitapect (see Chapter IV.13) and ing agents are Cs-137 and Sr-90. In coming
products made from apples, green algae (Spir- years the situation will change and Am-241 will
ulinae), fir-needles, etc. present a very serious problem (see Chapter I
7. There are several simple cooking tech- for details).
niques that decrease radionuclides: boil foods For at least six to seven generations, vast
several times and discard the water, wash food territories of Belarus, Russia, and Ukraine
thoroughly, soak some foods and discard the must take special measures to control radia-
water, avoid the rinds of fruits and vegetables, tion exposure in agriculture, forestry, hunting,
salt and pickle some foods but throw away the and fishing. So too must other countries with
pickling juice! Avoid eating strong bouillon, use areas of high radioactive contamination, in-
rendered butter, etc. cluding Sweden, Norway, Switzerland, Austria,
Experiences from around the world after the France, and Germany. This means, that local
catastrophe show that citizens of countries that economies will require external grants-in-aid
did not provide information and methods to and donations to minimize the level of radionu-
counter the effects of the radioactive fallout clides in all products because many areas sim-
fared more poorly than those in countries that ply do not have the funds to monitor, teach,
did provide such help. In 1986 the effective and mandate protection. Thus the problem of
individual dose to the “average” person in Bul- contamination is dynamic and requires con-
garia, where there was no emergency protec- stant monitoring and control—for Cs-137 and
tion was 0.7 to 0.8 mSv, or about threefold Sr-90 pollution at least 150 to 300 years into
higher than the dose for the “average” Nor- the future. The contamination from the wider
wegian. The Norwegian government placed a spectrum of radioisotopes is dynamic and will
prohibition against eating leafy vegetables and require constant monitoring and control essen-
drinking fresh milk, destroyed contaminated tially forever.
References Ipat’ev, V. (2008). Clean soil under radio-contaminated

forest: Is it real? Sci. Innovat. 61(3): 36–38 (in
Aleksakhin, R. M., Bagdevich, I. M., Fesenko, S. V., Russian).
Sanzheva, N. I., Ageets, V. Yu. & Kashparov, V. Kashparov, V. A., Lazarev, N. M. & Poletchyuk, S. V.
A. (2006). Role of protective measures in rehabilita- (2005). Actual problems of agricultural radiology in
tion of contaminated territories. International Con- Ukraine. Agroecolog. J. 3: 31–41 (in Ukrainian).
ference. Chernobyl 20 Years After: Strategy for Recovering Kenik, I. A. (Ed.) (1998). Belarus and Chernobyl: Priorities
and Sustainable Development of Affected Territories. April for Second Decade after the Accident (Belarus Ministry for
19–21, 2006, Minsk, Belarus (Materials, Minsk): pp. Emergency Situations, Minsk): 92 pp. (in Russian).
103–108 (in Russian). Maradudin, I. I., Panfylov, A. V., Rusyna, T. V., Shubin, V.
Aleksakhin, R. M., Vasyl’ev, A. V. & Dykarev, V. G. (1992). A., Bogachev, V. K., et al. (1997). Manual for forestry
Agricultural Radioecology (“Ecologiya,” Moscow): 400 in Chernobyl radioactively contaminated zones (for
pp. (in Russian). period 1997–2000). Authorized by order N 40 from
Annenkov, B. N. & Averin, V. S. (2003). Agriculture in 1.03.97 of Russian Federal Forestry Service: 7 pp. (in
Radioactive Contaminated Areas: Radionuclides in Food Russian).
(“Propiley,” Minsk): 84 pp. (in Russian). National Belarussian Report (2006). Twenty Years after Cher-
Babenko, V. I. (2008). How to protect yourself and nobyl Catastrophe: Consequences for Belarus Republic and Its
your child from radiation (//www.belradinstitute. Surrounding Areas (Shevchuk, V. F. & Gurachevsky, V.
boom.ru/frameru.htm) (in Russian). L., Eds.) (Belarus National Publishers, Minsk): 112
Bagdevich, I. M., Putyatin, Yu. V., Shmigel’skaya, I. A., pp. (in Russian).
Tarasyuk, S. V., Kas’yanchik, S. A. & Ivanyutenko, V. Nesterenko, V. B. (1997). Radiation monitoring of inhab-
V. (2001). Agricultural Production on Radioactive Contam- itants and their foodstuffs in Chernobyl zone of Be-
inated Territories (Institute for Soil Science and Agro- larus. BELRAD Inform. Bull. 6 (“Pravo Ekonomika,”
chemistry, Minsk): 30 pp. (in Russian). Minsk): 71 pp. (in Russian).
Beresdorf, N, A. & Wright, S. M. (Eds.) (1999). Self- Parkhomenko, V. I., Shutov, V. N., Kaduka, M. V.,
help countermeasure strategies for populations liv- Kravtsova, O. S., Samiolenko, V. M., et al. (2008).
ing within contaminated areas of the former Soviet Protection from radiation: Manual on radiation
Union and an assessment of land currently removed safety (//www.eco.scilib.debryansk.ru//2infres/
from agricultural usage. EC projects RESTORE radiation/content.html) (in Russian).
(F14-CT95–0021) and RECLAIM (ERBIC15- Radiology Institute (2003). Life in territory contami-
CT96–0209) (Institute of Terrestrial Ecology, Monks nated by radioactive substances (Radiology Insti-
Wood): 83 pp. tute, Gomel): 21 pp. (//www.mondoincammino.
Energy (2008). Chernobyl echo in Europe (//www. org/humus/azioni/docs/opuscolo.pdf) (in Russian).
members.tripod.com/B̃Ruslan / win / energe1.htm) Ramzaev, P. V. (Ed.) (1992). Recommendations to
(in Russian). public on behavior on radionuclide contami-
Gudkov, I. N. (2006). Strategy of biological radiation nated territory (“IzDAT,” Moscow): 16 pp. (in
protection of biota in radionuclide contaminated Russian).
territories. In: Signa, A. A. & Durante, M. (Eds.), Slukvin, A. M. & Goncharova, R. I. (1998). Pond carp
Radiation Risk Estimates in Normal and Emergency Sit- defenses from low doses on outer and inner chronic
uations (Dordrecht Springer, Berlin/London/New irradiation. Chernobyl Ecol. Health (Gomel) 2(6): 56–57
York): pp. 101–108. (in Russian).
CHERNOBYL
15. Consequences of the Chernobyl

Catastrophe for Public Health and the
Environment 23 Years Later
Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko
More than 50% of Chernobyl’s radionuclides were dispersed outside of Belarus, Ukraine,
and European Russia and caused fallout as far away as North America. In 1986 nearly
400 million people lived in areas radioactively contaminated at a level higher than
4 kBq/m2 and nearly 5 million individuals are still being exposed to dangerous con-
tamination. The increase in morbidity, premature aging, and mutations is seen in all
the contaminated territories that have been studied. The increase in the rates of total
mortality for the first 17 years in European Russia was up to 3.75% and in Ukraine it
was up to 4.0%. Levels of internal irradiation are increasing owing to plants absorb-
ing and recycling Cs-137, Sr-90, Pu, and Am. During recent years, where internal levels
of Cs-137 have exceeded 1 mSv/year, which is considered “safe,” it must be lowered
to 50 Bq/kg in children and to 75 Bq/kg in adults. Useful practices to accomplish this
include applying mineral fertilizers on agricultural lands, K and organosoluble lignin
on forestlands, and regular individual consumption of natural pectin enterosorbents.
Extensive international help is needed to provide radiation protection for children,
especially in Belarus, where over the next 25 to 30 years radionuclides will continue
to contaminate plants through the root layers in the soil. Irradiated populations of
plants and animals exhibit a variety of morphological deformities and have significantly
higher levels of mutations that were rare prior to 1986. The Chernobyl zone is a “black
hole”: some species may persist there only via immigration from uncontaminated
areas.
The explosion of the fourth block of the Cher- of Chernobyl by comparing differences among
nobyl nuclear power plant in Ukraine on April, populations, including territories or subgroups
26, 1986 was the worst technogenic accident that had and have different levels of contam-
in history. The information presented in the ination but are comparable to one another in
first 14 parts of this volume was abstracted ethnic, biologic, social, and economic charac-
from the several thousand cited scientific pa- teristics. This approach is clearly more valid
pers and other materials. What follows here is than trying to find “statistically significant” cor-
a summary of the main results of this meta- relations between population doses that are im-
analysis of the consequences of the Chernobyl possible to quantify after the fact and health
catastrophe. outcomes that are defined precisely by morbid-
The principal methodological approach of ity and mortality data.
this meta-review is to reveal the consequences
15.1. The Global Scale of the
Catastrophe
Address for correspondence: Alexey V. Yablokov, Russian
1. As a result of the catastrophe, 40%
[email protected] of Europe was contaminated with dangerous
318
Yablokov et al.: Consequences of the Chernobyl Catastrophe 319
radioactivity. Asia and North America were

also exposed to significant amounts of ra-
dioactive fallout. Contaminated countries in-
clude Austria, Finland, Sweden, Norway,
Switzerland, Romania, Great Britain, Ger-
many, Italy, France, Greece, Iceland, and Slove-
nia, as well as wide territories in Asia, includ-
ing Turkey, Georgia, Armenia, The Emirates,
China, and northern Africa. Nearly 400 million
people lived in areas with radioactivity at a level
exceeding 4 kBq/m2 (≥0.1 Ci/km2 ) during the
period from April to July 1986.
2. Belarus was especially heavily contami-
nated. Twenty-three years after the catastro-
phe nearly 5 million people, including some 1
million children, live in vast areas of Belarus, Figure 15.1. Total additional radioactivity (in
petabequerels) in the global environment after the
Ukraine, and European Russia where danger-
Chernobyl catastrophe: (1) Am-241, (2) Pu (239 +
ous levels of radioactive contamination persist 240), (3) Pu-241, (4) Sr-90, (5) Cs-137, (6) I-131
(see Chapter 1). (Mulev, 2008).
3. The claim by the International Atomic
Energy Agency (IAEA), the United Nations where about 57% of the Chernobyl radionu-
Scientific Committee on the Effects of Atomic clides were deposited.
Radiation (UNSCEAR), and several other
groups that the Chernobyl radioactive fallout
adds “only” 2% to the natural radioactive back- 15.2. Obstacles to Analysis of the
ground ignores several facts: Chernobyl Consequences
1. Among the reasons complicating a full-

• First, many territories continue to have danger- scale estimation of the impact of the Chernobyl
ously high levels of radiation. catastrophe on health are the following:
• Second, high levels of radiation were spread far
and wide in the first weeks after the catas- • Official secrecy and unrectifiable falsifica-
trophe. tion of Soviet Union medical statistics for
• Third, there will be decades of chronic, the first 3.5 years after the catastrophe.
low-level contamination after the • Lack of detailed and clearly reliable med-
catastrophe (Fig. 15.1). ical statistics in Ukraine, Belarus, and
• Fourth, every increase in nuclear radiation has Russia.
• Difficulties in estimating true individual ra-
an effect on both somatic and reproductive
cells of all living things. dioactive doses in view of: (a) reconstruc-
tion of doses in the first days, weeks, and
4. There is no scientific justification for the months after the catastrophe; (b) uncer-
fact that specialists from IAEA and the World tainty as to the influence of individual “hot
Health Organization (WHO) (Chernobyl Fo- particles”; (c) problems accounting for un-
rum, 2005) completely neglected to cite the even and spotty contamination; and (d)
extensive data on the negative consequences inability to determine the influence of each
of radioactive contamination in areas other of many radionuclides, singly and in com-
than Belarus, Ukraine, and European Russia, bination.
320
• Inadequacy of modern knowledge as to: tive for evaluating children who were born
(a) the specific effect of each of the many after the catastrophe.
radionuclides; (b) synergy of interactions of • Correlate pathological changes in partic-
radionuclides among themselves and with ular organs by measuring their levels of
other environmental factors; (c) population incorporated radionuclides.
and individual variations in radiosensitiv-
ity; (d) impact of ultralow doses and dose
The objective documentation of the catas-
rates; and (e) impact of internally absorbed
trophe’s consequences requires the analysis of
radiation on various organs and biological
the health status of about 800,000 liquidators,
systems.
hundreds of thousands of evacuees, and those
who voluntary left the contaminated territo-
2. The demand by IAEA and WHO experts
ries of Belarus, Ukraine, and Russia (and their
to require “significant correlation” between the
children), who are now living outside of these
imprecisely calculated levels of individual radi-
territories, even in other countries.
ation (and thus groups of individuals) and pre-
5. It is necessary to determine territories in
cisely diagnosed illnesses as the only iron clad
Asia (including Trans-Caucasus, Iran, China,
proof to associate illness with Chernobyl radi-
Turkey, Emirates), northern Africa, and North
ation is not, in our view, scientifically valid.
America that were exposed to the Chernobyl
3. We believe it is scientifically incorrect to
fallout from April to July 1986 and to analyze
reject data generated by many thousands of sci-
detailed medical statistics for these and sur-
entists, doctors, and other experts who directly
rounding territories.
observed the suffering of millions affected by ra-
dioactive fallout in Belarus, Ukraine, and Rus-
15.3. Health Consequences
sia as “mismatching scientific protocols.” It is
of Chernobyl
scientifically valid to find ways to abstract the
valuable information from these data.
1. A significant increase in general morbidity
4. The objective information concerning the
is apparent in all the territories contaminated
impact of the Chernobyl catastrophe on health
by Chernobyl that have been studied.
can be obtained in several ways:
2. Among specific health disorders associ-
•
ated with Chernobyl radiation there are in-
Compare morbidity and mortality of ter-
creased morbidity and prevalence of the fol-
ritories having identical physiographic, so-
lowing groups of diseases:
cial, and economic backgrounds and that
differ only in the levels and spectra of
radioactive contamination to which they • Circulatory system (owing primarily to ra-
have been and are being exposed. dioactive destruction of the endothelium,
• Compare the health of the same group of the internal lining of the blood vessels).
individuals during specific periods after the • Endocrine system (especially nonmalig-
catastrophe. nant thyroid pathology).
• Compare the health of the same individual • Immune system (“Chernobyl AIDS,” in-
in regard to disorders linked to radiation creased incidence and seriousness of all ill-
that are not a function of age or sex (e.g., nesses).
stable chromosomal aberrations). • Respiratory system.
• Compare the health of individuals living in • Urogenital tract and reproductive disor-
contaminated territories by measuring the ders.
level of incorporated Cs-137, Sr-90, Pu, • Musculoskeletal system (including patho-
and Am. This method is especially effec- logic changes in the structure and
composition of bones: osteopenia and os- • Increased incidence of multiple somatic

teoporosis). and genetic mutations.
• Central nervous system (changes in frontal,
4. Chronic diseases associated with radioac-
temporal, and occipitoparietal lobes of the
tive contamination are pervasive in liquida-
brain, leading to diminished intelligence
tors and in the population living in con-
and behaviorial and mental disorders).
•
taminated territories. Among these individuals
Eyes (cataracts, vitreous destruction,
polymorbidity is common; that is, people are
refraction anomalies, and conjunctive
often afflicted by multiple illnesses at the same
disorders).
•
time.
Digestive tract.
•
5. Chernobyl has “enriched” world medicine
Congenital malformations and anomalies
with such terms, as “cancer rejuvenescence,” as
(including previously rare multiple defects
well as three new syndromes:
of limbs and head).
• Thyroid cancer (All forecasts concern- • “Vegetovascular dystonia”—dysfunction-
ing this cancer have been erroneous; al regulation of the nervous system
Chernobyl-related thyroid cancers have involving cardiovascular and other organs
rapid onset and aggressive development, (also called autonomic nervous system dys-
striking both children and adults. After function), with clinical signs that present
surgery the person becomes dependent on against a background of stress.
replacement hormone medication for life.) • “Incorporated long-life radionuclides”—
• Leukemia (blood cancers) not only in chil- functional and structural disorders of the
dren and liquidators, but in the gen- cardiovascular, nervous, endocrine, repro-
eral adult population of contaminated ductive, and other systems owing to ab-
territories. sorbed radionuclides.
• Other malignant neoplasms. • “Acute inhalation lesions of the upper res-
piratory tract”—a combination of a rhini-
3. Other health consequences of the catas-
tis, throat tickling, dry cough, difficulty
trophe:
breathing, and shortness of breath owing
• Changes in the body’s biological balance, to the effect of inhaled radionuclides, in-
leading to increased numbers of serious cluding “hot particles.”
illnesses owing to intestinal toxicoses, bac-
6. Several new syndromes, reflecting in-
terial infections, and sepsis.
•
creased incidence of some illnesses, appeared
Intensified infectious and parasitic dis-
after Chernobyl. Among them:
eases (e.g., viral hepatitis and respiratory
viruses). • “Chronic fatigue syndrome”—excessive
• Increased incidence of health disorders in and unrelieved fatigue, fatigue without ob-
children born to radiated parents (both to vious cause, periodic depression, memory
liquidators and to individuals who left the loss, diffuse muscular and joint pains, chills
contaminated territories), especially those and fever, frequent mood changes, cervical
radiated in utero. These disorders, involv- lymph node sensitivity, weight loss; it is also
ing practically all the body’s organs and often associated with immune system dys-
systems, also include genetic changes. function and CNS disorders.
• Catastrophic state of health of liquida- • “Lingering radiating illness syndrome”—a
tors (especially liquidators who worked in combination of excessive fatigue, dizziness,
1986–1987). trembling, and back pain.
• Premature aging in both adults and chil- • “Early aging syndrome”—a divergence
dren. between physical and chronological age
322
with illnesses characteristic of the elderly about 9,000 and the number of sick about
occurring at an early age. 200,000. These numbers cannot distinguish
7. Specific Chernobyl syndromes such as radiation-related deaths and illnesses from the
“radiation in utero,” “Chernobyl AIDS,” natural mortality and morbidity of a huge pop-
“Chernobyl heart,” “Chernobyl limbs,” and ulation base.
others await more detailed definitive medical 2. Soon after the catastrophe average life ex-
descriptions. pectancy noticeably decreased and morbidity
8. The full picture of deteriorating health and mortality increased in infants and the el-
in the contaminated territories is still far from derly in the Soviet Union.
complete, despite a large quantity of data. Med- 3. Detailed statistical comparisons of heav-
ical, biological, and radiological research must ily contaminated territories with less contam-
expand and be supported to provide the full pic- inated ones showed an increase in the mor-
ture of Chernobyl’s consequences. Instead this tality rate in contaminated European Russia
research has been cut back in Russia, Ukraine, and Ukraine of up to 3.75% and 4.0%, re-
and Belarus. spectively, in the first 15 to 17 years after the
9. Deterioration of public health (especially catastrophe.
of children) in the Chernobyl-contaminated 4. According to evaluations based on de-
territories 23 years after the catastrophe is not tailed analyses of official demographic statistics
due to psychological stress or radiophobia, or in the contaminated territories of Belarus,
from resettlement, but is mostly and primarily Ukraine, and European Russia, the additional
due to Chernobyl irradiation. Superimposed Chernobyl death toll for the first 15 years after
upon the first powerful shock in 1986 is con- the catastrophe amounted to nearly 237,000
tinuing chronic low-dose and low-dose-rate ra- people. It is safe to assume that the total Cher-
dionuclide exposure. nobyl death toll for the period from 1987
10. Psychological factors (“radiation pho- to 2004 has reached nearly 417,000 in other
bia”) simply cannot be the defining reason parts of Europe, Asia, and Africa, and nearly
because morbidity continued to increase for 170,000 in North America, accounting for
some years after the catastrophe, whereas radi- nearly 824,000 deaths worldwide.
ation concerns have decreased. And what is the 5. The numbers of Chernobyl victims will
level of radiation phobia among voles, swallows, continue to increase for several generations.
frogs, and pine trees, which demonstrate simi-
lar health disorders, including increased muta-
tion rates? There is no question but that social 15.5. Chernobyl Releases and
and economic factors are dire for those sick Environmental Consequences
from radiation. Sickness, deformed and im-
paired children, death of family and friends, 1. Displacement of the long half-life Cher-
loss of home and treasured possessions, loss of nobyl radionuclides by water, winds, and mi-
work, and dislocation are serious financial and grating animals causes (and will continue to
mental stresses. cause) secondary radioactive contamination
hundreds and thousands of kilometers away
from the Ukrainian Chernobyl Nuclear Power
15.4. Total Number of Victims Station.
2. All the initial forecasts of rapid clearance
1. Early official forecasts by IAEA and WHO or decay of the Chernobyl radionuclides from
predicted few additional cases of cancer. In ecosystems were wrong: it is taking much longer
2005, the Chernobyl Forum declared that the than predicted because they recirculate. The
total death toll from the catastrophe would be overall state of the contamination in water, air,
and soil appears to fluctuate greatly and the deformities that were rare or unheard of prior
dynamics of Sr-90, Cs-137, Pu, and Am con- to the catastrophe.
tamination still present surprises. 8. Stability of individual development (de-
3. As a result of the accumulation of Cs-137, termined by level of fluctuating symmetry—a
Sr-90, Pu, and Am in the root soil layer, ra- specific method for detecting the level of indi-
dionuclides have continued to build in plants vidual developmental instability) is lower in all
over recent years. Moving with water to the the plants, fishes, amphibians, birds, and mam-
above-ground parts of plants, the radionuclides mals that were studied in the contaminated
(which earlier had disappeared from the sur- territories.
face) concentrate in the edible components, re- 9. The number of the genetically anomalous
sulting in increased levels of internal irradiation and underdeveloped pollen grains and spores
and dose rate in people, despite decreasing total in the Chernobyl radioactively contaminated
amounts of radionuclides from natural disinte- soils indicates geobotanical disturbance.
gration over time. 10. All of the plants, animals, and mi-
4. As a result of radionuclide bioaccumula- croorganisms that were studied in the Cher-
tion, the amount in plants, mushrooms, and nobyl contaminated territories have signifi-
animals can increase 1,000-fold as compared cantly higher levels of mutations than those in
with concentrations in soil and water. The fac- less contaminated areas. The chronic low-dose
tors of accumulation and transition vary con- exposure in Chernobyl territories results in a
siderably by season even for the same species, transgenerational accumulation of genomic in-
making it difficult to discern dangerous levels stability, manifested in cellular and systemic
of radionuclides in plants and animals that ap- effects. The mutation rates in some organ-
pear to be safe to eat. Only direct monitoring isms increased during the last decades, de-
can determine actual levels. spite a decrease in the local level of radioactive
5. In 1986 the levels of irradiation in contamination.
plants and animals in Western Europe, North 11. Wildlife in the heavily contaminated
America, the Arctic, and eastern Asia were Chernobyl zone sometimes appears to flourish,
sometimes hundreds and even thousands of but the appearance is deceptive. According to
times above acceptable norms. The initial morphogenetic, cytogenetic, and immunologi-
pulse of high-level irradiation followed by ex- cal tests, all of the populations of plants, fishes,
posure to chronic low-level radionuclides has amphibians, and mammals that were studied
resulted in morphological, physiological, and there are in poor condition. This zone is analo-
genetic disorders in all the living organisms in gous to a “black hole”—some species may only
contaminated areas that have been studied— persist there via immigration from uncontam-
plants, mammals, birds, amphibians, fish, in- inated areas. The Chernobyl zone is the mi-
vertebrates, bacteria, and viruses. croevolutionary “boiler,” where gene pools of
6. Twenty years after the catastrophe all living creatures are actively transforming, with
game animals in contaminated areas of Belarus, unpredictable consequences.
Ukraine, and European Russia have high levels 12. What happened to voles and frogs in the
of the Chernobyl radionuclides. It is still pos- Chernobyl zone shows what can happen to hu-
sible to find elk, boar, and roe deer that are mans in coming generations: increasing muta-
dangerously contaminated in Austria, Sweden, tion rates, increasing morbidity and mortality,
Finland, Germany, Switzerland, Norway, and reduced life expectancy, decreased intensity of
several other countries. reproduction, and changes in male/female sex
7. All affected populations of plants and an- ratios.
imals that have been the subjects of detailed 13. For better understanding of the pro-
studies exhibit a wide range of morphological cesses of transformation of the wildlife in the
324
Chernobyl-contaminated areas, radiobiologi- some Belarus villages in 2006 some children

cal and other scientific studies should not had levels up to 2,500 Bq/kg!
be stopped, as has happened everywhere in 5. The experience of BELRAD Institute in
Belarus, Ukraine, and Russia, but must be Belarus has shown that active decorporation
extended and intensified to understand and measures should be introduced when Cs-137
help to mitigate expected and unexpected levels become higher than 25 to 28 Bq/kg.
consequences. This corresponds to 0.1 mSv/year, the same
level that according to UNSCEAR a person
inevitably receives from external irradiation liv-
15.6. Social and Environmental ing in the contaminated territories.
Efforts to Minimize the 6. Owing to individual and family food
Consequences of the Catastrophe consumption and variable local availability of
food, permanent radiation monitoring of lo-
1. For hundreds of thousands of individuals cal food products is needed along with mea-
(first of all, in Belarus, but also in vast territo- surement of individual radionuclide levels, es-
ries of Ukraine, Russia, and in some areas of pecially in children. There must be general
other countries) the additional Chernobyl irra- toughening of allowable local food radionuclide
diation still exceeds the considered “safe” level levels.
of 1 mSv/year. 7. In order to decrease irradiation to a con-
2. Currently for people living in the contam- sidered safe level (1 mSv/year) for those in
inated regions of Belarus, Ukraine, and Russia, contaminated areas of Belarus, Ukraine, and
90% of their irradiation dose is due to con- Russia it is good practice to:
sumption of contaminated local food, so mea-
sures must be made available to rid their bod- • Apply mineral fertilizers not less than three
ies of incorporated radionuclides (see Chapter times a year on all agricultural lands, in-
IV.12–14). cluding gardens, pastures, and hayfields.
3. Multiple measures have been undertaken • Add K and soluble lignin to forest ecosys-
to produce clean food and to rehabilitate the tems within a radius up to 10 km from set-
people of Belarus, Ukraine, and European tlements for effective reduction of Cs-137
Russia. These include application of additional in mushrooms, nuts, and berries, which are
amounts of select fertilizers, special programs important local foods.
to reduce levels of radionuclides in farm prod- • Provide regular individual intake of nat-
ucts and meat, organizing radionuclide-free ural pectin enterosorbents (derived from
food for schools and kindergartens, and spe- apples, currants, etc.) for 1 month at least
cial programs to rehabilitate children by pe- four times a year and include juices with
riodically relocating them to uncontaminated pectin daily for children in kindergartens
places. Unfortunately these measures are not and schools to promote excretion of
sufficient for those who depend upon food from radionuclides.
their individual gardens, or local forests, and • Undertake preventive measures for milk,
waters. meat, fish, vegetables, and other local food
4. It is vitally necessary to develop measures products to reduce radionuclide levels.
to decrease the accumulation of Cs-137 in the • Use enterosorbents (ferrocyanides, etc.)
bodies of inhabitants of the contaminated ar- when fattening meat animals.
eas. These levels, which are based upon avail-
able data concerning the effect of incorporated 8. To decrease the levels of illness and pro-
radionuclides on health, are 30 to 50 Bq/kg mote rehabilitation it is a good practice in the
for children and 70 to 75 Bq/kg for adults. In contaminated areas to provide:
• Annual individual determination of actual led to substantial increases in the number of

levels of incorporated radionuclides using victims. Thyroid disease is one of the first con-
a whole-body radiation counter (for chil- sequences when a nuclear power plant fails,
dren, this must be done quarterly). so a dependable system is needed to get this
• Reconstruction of all individual external simple chemical to all of those in the path of
irradiation levels from the initial period af- nuclear fallout. It is clear that every country
ter the catastrophe using EPR-dosimetry with nuclear power plants must help all coun-
and measurement of chromosomal aber- tries stockpile potassium iodine in the event of
rations, etc. This should include all vic- another nuclear plant catastrophe.
tims, including those who left contam- 11. The tragedy of Chernobyl shows that
inated areas—liquidators, evacuees, and societies everywhere (and especially in Japan,
voluntary migrants and their children. France, India, China, the United States, and
• Obligatory genetic consultations in the Germany) must consider the importance of in-
contaminated territories (and voluntary for dependent radiation monitoring of both food
all citizens of childbearing age) for the risks and individual irradiation levels with the aim
of severe congenital malformations in off- of ameliorating the danger and preventing ad-
spring. Using the characteristics and spec- ditional harm.
tra of mutations in the blood or bone mar- 12. Monitoring of incorporated radionu-
row of future parents, it is possible to define clides, especially in children, is necessary
the risk of giving birth to a child with se- around every nuclear power plant. This mon-
vere genetic malformations and thus avoid itoring must be independent of the nuclear in-
family tragedies. dustry and the data results must be made avail-
• Prenatal diagnosis of severe congenital able to the public.
malformations and support for programs
for medical abortions for families living
in the contaminated territories of Belarus, 15.7. Organizations Associated
Ukraine, and Russia. with the Nuclear Industry Protect
• Regular oncological screening and pre- the Industry First—Not the Public
ventive and anticipatory medical practices
for the population of the contaminated 1. An important lesson from the Chernobyl
territories. experience is that experts and organizations
tied to the nuclear industry have dismissed and
9. The Chernobyl catastrophe clearly shows ignored the consequences of the catastrophe.
that it is impossible to provide protection from 2. Within only 8 or 9 years after the catas-
the radioactive fallout using only national re- trophe a universal increase in cataracts was ad-
sources. In the first 20 years the direct economic mitted by medical officials. The same occurred
damage to Belarus, Ukraine, and Russia has ex- with thyroid cancer, leukemia, and organic cen-
ceeded 500 billion dollars. To mitigate some of tral nervous system disorders. Foot-dragging in
the consequences, Belarus spends about 20% of recognizing obvious problems and the resultant
its national annual budget, Ukraine up to 6%, delays in preventing exposure and mitigating
and Russia up to 1%. Extensive international the effects lies at the door of nuclear power ad-
help will be needed to protect children for at vocates more interested in preserving the sta-
least the next 25 to 30 years, especially those tus quo than in helping millions of innocent
in Belarus because radionuclides remain in the people who are suffering through no fault
root layers of the soil. of their own. It need to change official
10. Failure to provide stable iodine in April agreement between WHO and IAEA (WHO,
1986 for those in the contaminated territories 1959) providing hiding from public of any
326
information which can be unwanted of nuclear statistically small to some, in comparison with nat-
industry. ural health hazards, but this is not a natural health
hazard—and it is not a statistical issue. The loss of
even one human life or the malformation of even
15.8. It Is Impossible one baby—who may be born long after we are
to Forget Chernobyl gone—should be of concern to us all. Our children
and grandchildren are not merely statistics toward
which we can be indifferent.
1. The growing data about of the negative
consequences of the Chernobyl catastrophe for The Chernobyl catastrophe demonstrates
public health and nature does not bode well that the nuclear industry’s willingness to risk
for optimism. Without special large-scale na- the health of humanity and our environment
tional and international programs, morbidity with nuclear power plants will result, not only
and mortality in the contaminated territories theoretically, but practically, in the same level
will increase. Morally it is inexplicable that the of hazard as nuclear weapons.
experts associated with the nuclear industry
claim: “It is time to forget Chernobyl.”
2. Sound and effective international and na- References
tional policy for mitigation and minimization
of Chernobyl’s consequences must be based Chernobyl Forum (2005). Environmental Consequences
on the principle: “It is necessary to learn of the Chernobyl Accident and Their Remedi-
ation: Twenty Years of Experience. Report of
and minimize the consequences of this terri-
the UN Chernobyl Forum Expert Group “En-
ble catastrophe.” vironment” (EGE) Working Draft, August 2005
(IAEA, Vienna): 280 pp. (//www-pub.iaea.org/
MTCD/publications/PDF/Pub1239_web.pdf).
15.9. Conclusion Kennedy, J. F. (1963). Radio/TV address regarding the
Nuclear Test Ban Treaty, July 26, 1963 (//www.rat-
U.S. President John F. Kennedy speaking ical.org/radiation/inetSeries/ChernyThyrd.html).
about the necessity to stop atmospheric nuclear Mulev, St. (2008). Chernobyl’s continuing hazards. BBC
News website, April 25, 17.25. GMT (//www.
tests said in June 1963:
news.bbc.co.uk/1/hi/world/europe/4942828.stm).
. . . The number of children and grandchildren WHO (1959). Resolution World Health Assembly.
with cancer in their bones, with leukemia in their Rez WHA 12–40, Art. 3, §1(//www.resosol.
blood, or with poison in their lungs might seem org/InfoNuc/IN_DI.OMS_AIEA.htm).
CHERNOBYL
Conclusion to Chapter IV
In the last days of spring and the beginning veloped for those living in contaminated territo-
of summer of 1986, radioactivity was released ries, including organizing individual radiation
from the Chernobyl power plant and fell upon protection, support for radioactive-free agricul-
hundreds of millions of people. The resulting tural production, and safer ways to engage in
levels of radionuclides were hundreds of times forestry.
higher than that from the Hiroshima atomic Most of the efforts to help people in the
bomb. contaminated territories are spearheaded by
The normal lives of tens of millions have state-run programs. The problem with these
been destroyed. Today, more than 6 million programs is the dual issue of providing help
people live on land with dangerous levels of while hoping to minimize charges that Cher-
contamination—land that will continue to be nobyl fallout has caused harm.
contaminated for decades to centuries. Thus To simplify life for those suffering irradiation
the daily questions: how to live and where to effects a tremendous amount of educational
live? and organizational work has to be done to mon-
In the territories contaminated by the Cher- itor incorporated radionuclides, monitor (with-
nobyl fallout it is impossible to engage safely out exception) all foodstuffs, determine individ-
in agriculture; impossible to work safely in ual cumulative doses using objective methods,
forestry, in fisheries, and hunting; and dan- and provide medical and genetic counseling,
gerous to use local foodstuffs or to drink especially for children.
milk and even water. Those who live in More than 20 years after the catastrophe, by
these areas ask how to avoid the tragedy of virtue of the natural migration of radionuclides
a son or daughter born with malformations the resultant danger in these areas has not de-
caused by irradiation. Soon after the catas- creased, but increases and will continue to do
trophe these profound questions arose among so for many years to come. Thus there is the
liquidators’ families, often too late to avoid need to expand programs to help people still
tragedy. suffering in the contaminated territories, which
During this time, complex measures to min- requires international, national, state, and phil-
imize risks in agriculture and forestry were de- anthropic assistance.
327

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Chapter I. Chernobyl Contamination: An Overview

Chapter II. Consequences of the Chernobyl Catastrophe

Chapter III. Consequences of the Chernobyl Catastrophe

Chapter IV. Radiation Protection after the Chernobyl Catastrophe

PROF. DR. BIOL. DIMITRO M. GRODZINSKY

• Chapter IV: Radiation Protection after the Chernobyl Catastrophe—A. V.

The structure of this volume is as follows: Chapter I provides an estimate of the

Alexey Vassil’evich Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd

ALEXEY V. YABLOKOV AND VASSILY B. NESTERENKO

Antipkin, Yu.G., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical

Burlak, G.F., Ministry of Health of Ukraine, Kiev, Ukraine.

Pintchouk, L.B., Institute of Experimental Pathology, Oncology and Radiobiology, Na-

Introduction: The Difficult Truth

Chapter I. Chernobyl Contamination:

Key words: Chernobyl; radioactive contamination; lead contamination; Northern

1. Chernobyl Contamination through

To fully understand the consequences of Cher- 1.1. Radioactive Contamination

tled outside of Belarus, Ukraine, and European

Belarus, Ukraine, European Russia <50 41 (29) 34 (33) 47 (40)

Figure 1.5. An alternative version of radioactive gaseous–aerosol distribution over Eu-

Russiaa 19 (520) 29 29.7 31.96

Figure 1.10. Reconstruction of contamination of territory of Belarus by Cs-137 for May

Figure 1.12. Transuranic radionuclide contamination of Belarus in 2005 (National Be-

1.2.4. Arctic Regions dence of significant Chernobyl contamination

Figure 1.13. Contamination of Ukraine [Cs-137 (above) and Pu (below)] as a result of

TABLE 1.3. Radioactive Contamination of Euro-

Tula 11.5 936.2

I-135 (6.6 h/2.75 d) Several

1.4. Ecological Features 200–400 m of a route, so small, local, highly

also by other radionuclides, including beta and

of radioactivity ten times higher than the sur-

Figure 1.16. Continued.

During operations to quench the fires in 1.7. Evaluation of Chernobyl’s

Evacuated and movedb Belarus 135,000a 135,000

Asia 8 2,500,000,000 Nearly 150,000,000

USSR liquidatorsa 240,000 100

Declarations that Chernobyl radioactivity Symposium on the Environmental Impact of Ra-

Chapter II. Consequences of the Chernobyl

Key words: Chernobyl; secrecy; irradiation; health statistics

2. Chernobyl’s Public Health Consequences

2.1. Difficulties in Obtaining

1. The official secrecy that the USSR im-

Officially it is admitted that “the full-size per-

TWO EXAMPLES OF CONCEALMENT OF TRUE

3. General Morbidity, Impairment, and

mSv 0.77 0.81 0.02∗∗ 0.03∗∗∗

Chronic gastroenteric pathology 44.2 36.4 31.9 32.9

inated areas (Baida and Zhirnosecova, 1998;

marked increase (Lukyanova et al., 1995). This

First (healthy) 56.6 50.9 54.9 39.9 25.9 19.5

TABLE 3.6. Primary Diseases (%) Resulting in Inva-

1. The total measure of the “health of the

TABLE 3.8. Morbidity (per 1,000) in Radioactive

1987 421.0 Figure 3.5. Invalidism as a result of nonmalig-

Figure 3.6. Percent of newborns with birth References

(//www.chernobyl.gov.by/index.php?option=com_ Ryabzev, I. A. (2002). Epidemiological studies in Russia

4. Accelerated Aging as a Consequence of the

Accelerated aging is one of the well-known consequences of exposure to ionizing radia-

5. Nonmalignant Diseases after the

2. Children of liquidators living in the con- 9. In the contaminated territories, anemia