Radiation Risk Analysis of Neuropsychiatric Disorders in Ukrainian Chornobyl Catastrophe Liquidators

Goal: To explore the possible impact of ionizing radiation in the pathophysiology of neuropsychiatric disorders amongst clean-up workers of the Chornobyl catastrophe (liquidators). Design, object, and methods: Retrospective-prospective study (1987-2015) of liquidators from the State Register of Ukraine (SRU) with radiation doses records and Clinical-Epidemiological Register (CER) of the State Institution ≪National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine≫ (NRCRM). Moreover, cohort and cross-sectional studies of the randomized sample of liquidators from the CER (exposed group, 198 subjects) were examined. Internal control group included the liquidators irradiated in doses <50.0 mSv (42 persons). All subjects were assessed by a detailed clinical examination and a battery of standardized neuropsychiatric scales, psychometric, and neuropsychological tests. Descriptive and variation statistics, non-parametric criteria, regression-correlation analysis, survival analysis by Kaplan & Meier, and risk analysis were used. Results: Exposed group vs. control group showed cognitive disorders in 99 (50.0%) vs. 20 (18.1%), (P = 0.04); affective disorders in 96 (48.3%) vs. 36 (32.7%) (P = 0.007), and stress-related disorders in 115 (58.4%) vs. 8 (7.3%) (P < 0.001). In the main group exposed to ≥50 mSv vs. internal control group (exposed to <50 mSv), affective disorders were present, respectively, in 89 (56.4%) vs. 7 (19.1%) (P < 0.001), and stress-related disorders in 98 (62.8%) vs. 17 (40.4%) (P = 0.009). Relative risks (RR) and 95% confidential intervals (95%CI) of Incidence of some neuropsychiatric disorders in liquidators of 1986-1987 related to internal control (doses <50 mSv) were as follows: organic psychosis (RR = 3.15; 95% CI: 2.6; 3.7); non-psychotic organic brain damage (RR = 1.99; 95% CI: 1.6; 2.5); acute (RR = 1.40, 95% CI: 1.3; 1.5), and chronic cerebrovascular disorders (RR = 1.23; 95% CI 1.0;1.5). Neuropsychiatric diseases show a strong, increasing, and approximately quadratic statistically significant (Pv < 0.001) relationship with individual dose, yielding an estimated excess relative risk ERR = 2.76 Sv-2 (95% CI 1.06-7.15). Conclusions: Liquidators have an excess of cognitive, affective, and stress-related disorders. The risk of diseases rises with radiation dose. Radiation risks are revealed for organic psychoses, non-psychotic organic brain damage, acute and chronic cerebrovascular pathology.

RADIATION RISKS OF THYROID CANCER IN CHORNOBYL CLEAN-UP WORKERS USING THE ALTERNATIVE ESTIMATES OF DOSES OF EXTERNAL EXPOSURE

OBJECTIVE

The objective of this study was to estimate the thyroid cancer radiation risks - excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) in the cohort of 150,813 Ukrainian male clean-up workers during the 1986-2012 period (more than 25 years after the Chornobyl accident).

MATERIALS AND METHODS

The cohort under study of 150,813 Ukrainian men who participated emergency and clean-up work in 1986-1990 was formed based on the data of the Ukrainian State Register of persons affected due toChornobyl accident (SRU). The identification of thyroid cancer cases (216) was carried out by linking the SRU data-base with the National Cancer Registry of Ukraine (NCRU) data. Standardised incidence ratios (SIR) were estimatedcomparing thyroid cancer incidence in the cohort with the corresponding national indices. Excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) were calculated accounting for the alterna-tive dose estimates. The following sources of the average dose values for Ukrainian liquidators were used: officialtotal external dose records according to UNSCEAR 2008 report and results of external red bone marrow dose recon-struction by the RADRUE method for the cohort sample. For the radiation risk evaluation, these estimates were con-versed to the average external thyroid dose.

RESULTS

Results of the long term study (1986-2012) of thyroid cancer risks in a cohort of 150813 Chornobyl clean-up workers («liquidators») from Ukraine are presented. Two options for the average thyroid dose estimates were usedfor radiation risks evaluation. According to the SRU and NCRU 216 incident thyroid cancers were diagnosed in 1986-2012 within the studied cohort with an overall SIR of 3.35 (95 % confidence interval (CI) 2.51-3.80). The SIR esti-mates were elevated throughout the entire follow-up period. Investigation of a contribution of the external expo-sure (according to the alternative values) showed the elevated dose associated thyroid cancer rates in the studiedcohort. Alternatively estimated EAR/104 PY Gy were of 1.86 (95 % CI 0.47-3.24) and 2.07 (95 % CI 0.53-3.62);ERR/Gy - 2.38 (95 % CI 0.60-4.15) and 2.66 (95 % CI 0.68-4.64) and AR % (Gy) 70.4 % and 72.7 % Gy.

CONCLUSIONS

Obtained results prove the dose dependent increase of thyroid cancer incidence among UkrainianChornobyl clean-up workers. These conclusions are consistent with those received for combined cohort of Belarus,Russia and Baltic States liquidators.