AGING OF THE CHORNOBYL CATASTROPHE SURVIVORS AND PROBLEMS OF THEIR MENTAL HEALTH SURVEY. / STARINNIa POSTRAZhDALYKh VNASLIDOK ChORNOBYL'S'KOÏ KATASTROFY TA PROBLEMY DOSLIDZhENNIa ÏKhN'OGO PSYKhIChNOGO ZDOROV'Ia.

BACKGROUND: Depopulation processes in Ukraine have been affected by the Chornobyl catastrophe (ChC), but therate of demographic aging of survivors remains uncertain. Although the mental health disorders of the survivors arerecognized internationally, problems of their research remain unresolved. Thus, these areas of research are relevant.Objective is to determine the rate of demographic aging of survivors of the Chornobyl NPP (ChNPP) accident and toanalyze the state of their mental health survey, outlining solutions. MATERIALS AND METHODS: Information and statistical sources for 1986-2019 of the Ministry of Health of Ukraine andthe State Statistics Service of Ukraine on the age of the ChC survivors are used. The results of previous own researchand other scientists using the data of the Clinical and Epidemiological Register (CER) of the State Institution«National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼(NRCRM), the State Register of ChC survivors (SRU), and the Department of Radiation Psychoneurology, Institute ofClinical Radiology, NRCRM are integrated. Theoretical, general scientific, demographic and mathematical-statisticalresearch methods and documentary analysis are used. RESULTS: It is shown that in 2018, compared to 1995, the number of the ChC survivors, who are under the supervi-sion of the Ministry of Health of Ukraine, decreased by almost 987 thousand. The part of people born from personsof the 1st-3rd accounting groups increased in the structure of survivors (from 13.1 % in 1995 to 13.6 %), and thisdecreased in persons living or lived in the territories subject to supervision (75.1 % and 63.1 %, respectively), butin evacuees and Chornobyl clean-up workers (liquidators) this did not change significantly. A high level of aging ofthe ChC survivors (except for the 4th group) is revealed: liquidators - 59.0 %; evacuees - 25.0 %, and residents ofradioactively contaminated territories (RCT) - 30.7 %. It has been proved that the countries of RCT differ signifi-cantly in the number of the ChC survivors and their structure. The increase in the post-accident period indicators ofthe level of aging and the average age of the RCT population indicates negative changes in age parameters and theneed to continue research to identify factors «responsible¼ for such changes. Long-term mental health disordersand neuropsychiatric effects in the ChC survivors have been identified - an excess of cerebrovascular pathology andneurocognitive deficits, especially in liquidators, which may indicate an accelerated aging. Radiation risks havebeen revealed for acute and chronic cerebrovascular pathology and organic mental disorders of non-psychotic andpsychotic levels. Neurophysiological and molecular-biological atypia of aging processes under an exposure to lowdoses of and low dose rate of ionizing radiation have been found. The psyche under the age of 40 years old at thetime of exposure is more vulnerable. Existing statistical and registry data underestimate the level of mental disor-ders in the population of Ukraine, including the ChC survivors by an order of magnitude. CONCLUSIONS: The ChC survivors are aging in the country. The negative tendencies in age parameters of survival indi-cate the need to continue research to identify the factors «responsible¼ for such changes. Mental health disordersand neuropsychiatric effects in the ChC survivors are underestimated. It is necessary to create a national psychiatricregistry of Ukraine and long-term (lifelong) monitoring of survivors with well-planned clinical and epidemiologicalstudies of general and mental health with reliable dosimetric support based on national registries using the latest information technologies.

EPIDEMIOLOGICAL STUDIES OF CEREBROVASCULAR DISEASE OF THE POPULATION EVACUATED FROM THE 306KM ZONE OF THE ChNPP AT THE AGE OF 18-60 YEARS. ANALYSIS OF THE INFLUENCE OF INTERNAL IONIZING RADIATION ON THE THYROID GLAND 131I. / EPIDEMIOLOGIChNI DOSLIDZhENNIa TsEREBROVASKULIaRNOÏ ZAKhVORIuVANOSTI NASELENNIa, EVAKUIOVANOGO IZ 306KM ZONY ChAES U VITsI 18­60 ROKIV. ANALIZ VPLYVU VNUTRIShN'OGO IONIZUIuChOGO OPROMINENNIa ShchYTOPODIBNOÏ ZALOZY 131I.

Cohort epidemiological study of cerebrovascular diseases (CVD) was conducted in population evacuated from the30-km zone of the ChNPP been adult at the time of the accident (age 18-60). Study period was 1988-2016. Reviewof the specific CVD link with internal thyroid radiation dose from 131I has been made. OBJECTIVE: Establishing the time pattern of CVD morbidity in population evacuated from the ChNPP exclusion zonebeen adult at the time of the accident, depending on age, sex, time after the accident and internal thyroid radiation dose from 131I. MATERIALS AND METHODS: Data of the State Register of Ukraine on persons who survived after the ChNPP accident(SRU). The time pattern of morbidity was studied according to the observation periods (1988-1992; 1993-1997;1998-2002; 2003-2007; 2008-2012 and 2013-2016), taking into account age, sex and thyroid radiation dose. Theresearch cohort included 42,982 people with 18,133 men and 24,849 women among them. Data on the thyroid radiation doses in the SRU are seriously limited. Personal data on the radiation dose are available only in 957 people who just were included in the especially studied cohort. Dose intervals 0-0.3, 0.31-0.75, 0.76-2.0 Gy were adopted to review the influence of radiation factor on the CVD development. The data analysis was conducted on a mixed cohort of two age groups under the emergence of radiation effects (the «early¼ stage, covering the first 6 years from the moment of the accident, the «remote¼ stage - from 1998 to 2007, the «late¼ stage - 2008-2016). RESULTS: Study results indicate that the post-accident period is characterized by an increase in the level of CVD. The incidence rate increase occurred in the second observation period (1993-1997), that is, 6 years after the accident, regard-less of sex and age at the time of the accident. The peak of the incidence occurs in the third and fourth periods(1998-2002 and 2003-2007) of observation. Since 2008 there is a gradual decrease in morbidity. In all periods of observation the higher levels of CVD were registered in older people, i.e. 40-60 years at the time of an accident. In the first11 post-accidental years the higher levels of CVD incidence were observed in women, but in a later period after an acci-dent (12-26 years) in men. At a dose interval of 0.31-0.75 Gy a reliable link was established between the level of CVDwith the with internal thyroid radiation dose from 131I. In other dose intervals the dose-dependent effects are unstable. CONCLUSIONS: The post-accident period was marked by a significant increase in the level of CVD morbidity in theadult evacuees from the 30-km zone of the ChNPP. The incidence rate increase occurred since the 7th till the 21styearafter the ChNPP accident with the peak of morbidity from 12th to 21st years upon the accident. In the period that covered 22-30 years a decrease in the incidence rate was established. Connection of the specific forms of CVD with internal thyroid radiation dose from 131I has been established.

MORBIDITY OF THE CIRCULATORY SYSTEM DISEASES OF RESIDENTS FROM RADIOACTIVELY CONTAMINATED AREAS. ANALYSIS OF THE EFFECT OF CHRONIC LOW/DOSE IONIZING RADIATION. / Unable to translit this language. You can translit only UK or RU languages.

OBJECTIVE: to study post-accident levels of illnesses system diseases of residents from radioactively contaminatedareas aged 0-60 years on the date of the Chornobyl accident, and to analyze the effect of chronic low-dose ionizingradiation. MATERIALS AND METHODS: Epidemiological research and analysis of morbidity of circulatory system diseases of resi-dents of radioactively contaminated areas (RCA) has been carried out. The individuals who were studied includedRCA residents aged 0-60 (98, 902 persons) on the date of the Chornobyl accident. The data of the victims' annualmedical examinations during 1988-2016 were received from the State Register of Ukraine (SRU). Detection of thepossible dependence of the development of circulatory system diseases on the effects of ionizing radiation was car-ried out in the range of individual total effective doses ranging from 13-40 mSv and more as accumulated over26 years after the Chornobyl accident. The control group consisted of individuals with a radiation dose of <13 mSv.The statistical analysis of data was performed using the Microsoft Office Excel 2013 software packages. RESULTS: For the entire period of the study, 20,552 cases of circulatory system diseases were detected for the firsttime (ID at 103 person-years is 15.66 ± 0.11), incl. men, respectively, 7,211 cases (12.32 ± 0.14), women - 13,341cases (18.35 ± 0.16). It has been determined that among the circulatory system diseases of RZT residents there isthe most express display of ischemic heart disease, a disease characterized by high blood pressure, including otherheart diseases. The dependence of the levels of morbidity on the diseases of the circulatory system on the sex ofvictims was established. A connection has been established between the development of certain circulatory systemdiseases and the amounts of individual total effective doses of ionizing radiation accumulated over the period of1986-2012. Individual total effective doses of ionizing radiation in men and women in the range of doses of13-40 mSv or more. CONCLUSIONS: On the basis of cohort epidemiological studies, there was studied the dynamics of levels of circulatory system diseases among the RCT residents aged 0-60 years on the date of the Chornobyl accident during the observation period of 1988-2016. The overstated levels of cardiovascular and cerebrovascular diseases were established in the first twelve post-accident years, especially in the first six years. The highest morbidity rates for circulatory system diseases were identified in women over men. The development of certain circulatory system diseases, both in men and women, in a certain period is associated with the amount of dose of ionizing radiation from radionuclides 134Сs, 137Сs.

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ - research activities and scientific advance in 2016. / REZUL'TATY ROBOTY DU «NATsIONAL'NYY̆ NAUKOVYY̆ TsENTR RADIATsIY̆NOÏ MEDYTsYNY NATsIONAL'NOÏ AKADEMIÏ MEDYChNYKh NAUK UKRAÏNY¼ U 2016 ROTsI.

Research activities and scientific advance achieved in 2016 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident; fulfillment of tasks of «State social program for improving safety, occupational health and working environment in 2014-2018 years¼.The report also shows the results of scientific organizational and health care work, staff training. The NRCRM Annual Report was approved at the Scientific Council meeting of NAMS on March 17, 2016.

Psychosocial state of the adult evacuees and risk factors of negative change. / SOTsIAL'NO PSYKhOLOGIChNYY̆ STAN DOROSLOGO EVAKUY̆OVANOGO NASELENNIa. FAKTORY RYZYKU NEGATYVNYKh ZMIN.

Numerous scientific studies have been carried out since the ChNPP accident indicating that the last one has caused a severe psychosocial stress in survivors. Population of radioactively contaminated territories, people migrated from the areas of strict radiation control, and accident consequences clean up participants in 1986 1987 were covered by the conducted research projects. Nature of the stress herewith is polygenic and includes factors directly related to the Chernobyl catastrophe, and factors being a result of social and economic circumstances. This report is devot ed to the results of research on psychosocial state of population evacuated from the 30 km zone of the ChNPP. OBJECTIVE: Study and evaluation of psychosocial state of population evacuated from the 30 km ChNPP zone at the age of 18 years and older; identification of potential psychosocial risk factors for the health loss. MATERIALS AND METHODS: The sampling epidemiological study of psychosocial state of population aged 18-50 years evacuated from the 30 km zone of ChNPP was conducted at the NRCRM Radiation Registry Outpatient Clinic and Radiation Psychoneurology Department. The study subjects (n=258) were mostly (98%) females. Study was con ducted from October 2013 till May 2015. All the sample members were registered since 1992 in the system of life long health monitoring, i.e. the NRCRM Clinical and Epidemiological Registry. Study subjects were interviewed through the method using an original «Questioning Inventory¼. Mathematical processing of study results was held using the Epi Info 7 software package. RESULTS: According to the study results, a nuclear accident at the Chornobyl NPP has become a powerful psychoso cial stress for evacuated people. Psychosocial state of the evacuees, formed during the post accident period, with full reason can be defined as a state of stable, chronic psychosocial stress. Nature of factors that caused the stress development is polygenic. Block of stressors directly related to the accident was determined, namely there were «change of radiation and ecological situation¼, «ionizing irradiation¼, «evacuation¼, and «radical breaking of dynamic stereotype of behavior and life¼. In parallel there was selected a block of stress factors generated by that background, i.e. psychological, social, economic, and cultural, on which a nuclear disaster was imposed upon. The effects of stress have manifested as a persistent syndrome of «anxiety¼ for the personal health and health of fami ly members, primarily the children, and as a stable state of «dissatisfaction¼ with fullness and quality of life. CONCLUSIONS: The nuclear accident at the ChNPP has been the cause of a strong psychosocial stress in adult evacu ated population, especially in women. Further in a remote period the stress was transformed into a stable, chronic form. Nature of stress is polygenic and includes stressors directly related to the accident, and stressors that are not directly related to the accident consequences, but are due to the level of social, economic, medical, and informa tional protection of survivors. Data presented in the paper are rather enough important for the formation of strate gies and measures for social and psychological protection of population in an event of nuclear accidents and incidents.

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ - research activities and scientific advance in 2015. / REZUL'TATY ROBOTY DU «NATsIONAL'NYY̆ NAUKOVYY̆ TsENTR RADIATsIY̆NOÏ MEDYTsYNY NATsIONAL'NOÏ AKADEMIÏ MEDYChNYKh NAUK UKRAÏNY¼ U 2015 ROTsI.

Research activities and scientific advance achieved in 2014 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report.The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident; fulfillment of tasks of «State social program for improving safety, occupational health and working environment in 2014-2018 years¼.The report also shows the results of scientific organizational and health care work, staff training.The NRCRM Annual Report was approved at the Scientific Council meeting of NAMS on March 17, 2016.

Social and psychological state of the Chornobyl clean up workers. Risk factors for negative changes. / SOTsIAL'NO PSYKhOLOGIChNYY̆ STAN UChASNYKIV LNA NA ChORNOBYL'S'KIY̆ AES. FAKTORY RYZYKU NEGATYVNYKh ZMIN.

It is generally recognized that the Chornobyl nuclear accident caused strong psychosocial stress affecting the entire population of Ukraine, primarily people involved in recovery operations. But what are the reasons? What is the struc ture of stressors? What are their social, medical and biological consequences, what are strategy and preventive meas ures? Issues that require special research and development. OBJECTIVE: To study social and psychological state of the Chornobyl cleanup workers 1986-1987, and to determine regularities of changes and dangerous risk factors. MATERIALS AND METHODS: On the basis of Polyclinic of Radiation Registry, NRCRM, we conducted sample epidemiolog ical study of social and psychological state of the Chornobyl clean up workers 1986-1987. We used method of inter viewing based on «questionnaire¼, specially developed for this purpose. The study was conducted in October 2013 - May 2015. The sample numbered 235 males aged 18-50 at the time of the accident. Their average age was (31.3 ± 5.3) years at the time of the accident and (58.9 ± 5.3) at the time of survey. RESULTS: The results revealed that the Chornobyl nuclear accident and its consequences caused strong social and psychological stress among clean up workers 1986-1987. We have identified a set of factors closely related to the Chornobyl accident, they have caused a sustainable development of mental syndrome - «Anxiety about their own health and the health of family members, especially children¼. The other set of stressors which are not closely relat ed to the Chornobyl accident but are the result of the social and economic, social and political situation in the coun try. However the former was found to be the cause of such a psychological state as «dissatisfaction with the com pleteness and quality of life¼. CONCLUSIONS: Social and psychological state of the Chornobyl clean up workers 1986-1987 is estimated as «poor¼ and it integrally can be characterized as a state of chronic psychosocial stress. Mental syndrome «Anxiety about per sonal health and the health of family members¼ and psychological syndrome «Dissatisfaction with living condi tions¼ are main consequences of this state. We identified the main stressors closely related to the consequences of the Chornobyl accident as well as those that are not related to the accident but affect profoundly the level of men tal, social and physical well being. Results of the research are of great importance in organization and provision of social, medical and antiradiation protection of population under emergency situations involving radiation exposure. Key words: Chornobyl accident, clean up workers, social and psychological state, risk factors.

State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" - research activities and scientific advance in 2014. / REZUL'TATY ROBOTY DU "NATsIONAL'NYY NAUKOVYY TsENTR RADIATsIYNOI MEDYTsYNY NATsIONAL'NOI AKADEMII MEDYChNYKh NAUK UKRAINY " U 2014 ROTsI.

Research activities and scientific advance achieved in 2014 at the State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report.Epidemiological cohort studies found increased incidence (1990-2012 gg.) of thyroid cancer in victims of Chernobyl accident (liquidators - in 4.6 times, evacuated - in 4.0 times, residents of contaminated areas - in 1.3 times) and increased incidence of breast cancer in female workers of 1986-1987. (in the 1994-2012 biennium. SIR = 160,0%, 95% CI: 142,4-177,6). Retrospective studies of thyroid cancer ("case control") in cohorts and 152 thousand of liquidators were continued together with the US National Cancer Institute. Radiation risks of multiple myeloma and chronic lymphocytic leukemia were found.Molecular effects of remote period after radiation exposure include changes in gene expression TERF1, TERF2, CCND1, telomere length, the protein expression of cyclin D1, histone gamma H2AX. An association of molecular changes with cognitive deficits were defined. Genetic polymorphisms of rs2981582 gene FGFR2, rs12443621 gene TNRC9, rs3817198 gene LSP1, rs3803662 gene TNRC9, rs889312 gene MAP3K1 and their association with breast can cer were studied; the expression by tumor cells of estrogen and progesterone receptor, antigens of c kit, cytoker atins 5/6, TP53 and ki67, amplification status of the gene Her2 / neu, mutation status of the genes BRCA1 (muta tions 185delAG and 5382insC) and BRCA2 (mutation 6174delT) were studied. The possibility of persistence of radi ation modified hidden chromosomal instability in consecutive generations of human somatic cells was proven.The status of reproductive function and peculiarities of baby nutrition in population of contaminated areas were studied. In the framework of National social programs for improving safety, occupational health and working envi ronment in 2014 2018 for the first time in Ukraine developed and successfully completed intercalibration of 18 lab oratories for individual monitoring. Studying of medical effects of radiation in interventional cardiologists was started.Experimental studies concerned the impact of radiomodyficans on cell systems. The report also shows the results of scientific organizational and health care work, staff training.The NRCRM Annual Report was approved at the Scientific Council meeting of NAMS on March 17, 2015.

Postaccident changes in health status of the Chornobyl cleanup workers 1986-1987 (period of observation 1988-2012). / PISLIaAVARIY̆NI ZMINY STANU ZDOROV'Ia UChASNYKIV LIKVIDATsII NASLIDKIV AVARII NA ChAES 1986-1987 rr. (PERIOD SPOSTEREZhENNIa 1988-2012 rr.).

OBJECTIVE: To determine postaccident changes in health status of the Chornobyl cleanup workers 1986 1987, pecu liarities of nontumor incidence. MATERIALS AND METHODS: Long term cohort epidemiological study (period of observation 1988-2012) has been con ducted using data of the State Registry of Ukraine of Persons Affected by the Chornobyl Accident. Study cohort - 196,423 males participants of the Chornobyl recovery operations in 1986-1987. Epidemiological and mathematical and statistical methods were used. RESULTS: We have found a dramatic deterioration of the Chornobyl cleanup workers' health due to the growth of wide range of nontumor diseases, especially circulatory, digestive, respiratory, endocrine, genitourinary and nervous sys tem diseases. In postaccident period, disability and mortality have increased significantly due to nontumor dis eases. Circulatory diseases make major contribution to the structure of causes of disability and death. When study ing the dynamics of nontumor incidence, we have found that in 1988-1992 the highest, throughout postaccident period, rate of mental and behavioral disorders, diseases of the nervous system was mainly due to disorders of the autonomic nervous system. Since 1993-1997, rate of this pathology has significantly reduced and remained stable in subsequent years of observation. Thus, we can assume that in the early postaccident period, stress factor in com bination with radiation one had the greatest impact on health of cleanup workers, resulting in the development of other nontumor diseases in the remote postaccident period. CONCLUSIONS: The study revealed an evident increase in nontumor incidence, disability and mortality from nontumor diseases among Chornobyl cleanup workers 1986-1987; the highest rate of nontumor incidence was observed 12-21 years after the Chornobyl accident.

Age peculiarities of reproductive morbidity in female participants of the ChNPP accident consequences clean up (according to the figures from SRU, 1988-2012 survey period). / VIKOVI OSOBLYVOSTI ZAKhVORIuVANOSTI ZhINOK UChASNYTs' LIKVIDATsII NASLIDKIV AVARII NA ChAES NA KhVOROBY REPRODUKTYVNOI SYSTEMY (ZA DANYMY DRU, PERIOD SPOSTEREZhENNIa 1988 2012 RR.).

OBJECTIVE: to assess and estimate the peculiarities of genital system morbidity in female participants of the ChNPP accident clean up works in 1986-1987 depending on age at exposure to ionizing radiation and time since exposure. MATERIALS AND METHODS: Data on the Chernobyl disaster survivors received from the State Registry of Ukraine are out line in the paper. Review of the level and pattern of genital system morbidity was carried out for the 17,237 female participants of the ChNPP accident clean up works in 1986-1987 depending on time under risk upon radiation expo sure and reproductive age at exposure. Survey period lasted since 1988 till 2012. Assessment of morbidity level, con fidential intervals, and statistical significance was carried out using the trial version of ОpenEpiversion 2.3.1. soft ware. Statistical significance was also rated using the z score and t criterion. RESULTS: The results of this cohort epidemiological study showed that there are some peculiarities of natural course of the female genital system disease depending on reproductive age at exposure and time under risk upon radiation impact. Comparative statistical review of the level and pattern of genital system morbidity at different times within a survey period. CONCLUSION: Exposure to ionizing radiation in the childbearing age (18-45 years old) can be a risk factor of elevated incidence of uterine leiomyoma, benign mammary dysplasia (i.e. benign breast disease), and salpingo oophoritis. It is far to assume that uterine and mammary tissues are more sensitive to impact of ionizing radiation in females of the childbearing age vs. in persons exposed in pre menopause or menopause.

State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" - research activities and scientific advance in 2013. / Rezul''taty roboty DU Nacional''nyj Naukovyj Centr Radiacijnoi' Medycyny Nacional''noi' Akademii' Medychnyh Nauk Ukrai'ny u 2013 roci.

Research activities and scientific advance achieved in 2013 at the State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. Key points include the research results of XRCC1 and XPD gene polymorphism in thyroid cancer patients, CD38 gene GG genotype as a risk factor for chronic lymphocytic leukemia, frequency of 185delAG and 5382insC mutations in BRCA1 gene in women with breast cancer, cognitive function and TERF1, TERF2, TERT gene expression both with telomere length in human under the low dose radiation exposure. The "source-scattering/shielding structures- man" models for calculation of partial dose values to the eye lens and new methods for radiation risk assessment were developed and adapted. Radiation risks of leukemia including chronic lymphocytic leukemia in the cohort of liquidators were published according to the "case-control" study results after 20 years of survey. Increase of non-tumor morbidity in liquidators during the 1988-2011 with the maximum level 12-21 years upon irradiation was found. Incidence in evacuees appeared being of two-peak pattern i.e. in the first years after the accident and 12 years later. Experimental studies have concerned the impact of radio-modifiers on cellular systems, reproductive function in the population, features of the child nutrition in radiation contamination area were studied. Report also shows the results of scientific and organizational, medical and preventive work, staff training, and implementation of innovations. The NRCRM Annual Report was approved at the Scientific Council meeting of NAMS on March 3, 2014.

Dose- and age-dependent cardiovascular mortality among inhabitants of the Chornobyl contaminated areas. 1988-2010 observation period. / Smertnist'' vid hvorob systemy krovoobigu meshkanciv radioaktyvno zabrudnenyh terytorij ukrai'ny vnaslidok avarii' na chaes zalezhno vid doz radiacijnogo oprominennja ta viku. 1988-2010 roky sposterezhennja.

Objective. The goal of this study was to conduct a descriptive epidemiological analysis of cardiovascular disease mortality among people living in contaminated areas of Ukraine with regard for total cumulative effective doses and age at the time of the Chornobyl accident. Materials and methods. Depending on respective total cumulative effective doses for 1986-2010 the people living in contaminated areas of Ukraine were divided into cohorts of those exposed to 5.6-20.99 mSv (cohort 1) and 21.00-50.99 mSv (cohort 2) radiation doses. Each one was stratified by age categories - younger than 18 years old, aged 18-39 and 40-60 respectively. Death rate (ID/10^3 person-years) and mean error (±m) were calculated and Student's test (t) was applied to estimate the mortality from cardiovascular diseases for 1988-2010 period. Results. The significantly higher (ID/10^3 person-years is 8.08 ± 0.10) cardiovascular disease mortality was revealed within 1988-2010 observation period among inhabitants of contaminated areas exposed to 21.00-50.00 mSv total effective radiation doses accumulated over 1986-2010 as compared to that in cohort 1 (ID/10^3 person-years is 6.29 ± 0.06) for the same period. In the age groups (under 18, 18-39 and 40-60 years old) exposed to 21.0-50.0 mSv doses the mortality rate was significantly higher than in the corresponding age groups of the inhabitants with 5.6-20.99 mSv exposure (1.31 ± 0.08 ID/10^3 person-years, 8.50 ± 0.19, 48.95 ± 0.33 vs 0.75 ± 0.04, 5.00 ± 0.11, 23.52 ± 0.24 respectively). In the elder age groups with higher radiation doses the mortality was significantly higher (p < 0.05) than in those with lower doses: ID/10^3 person-years was 1.31 ± 0.08 vs. 0.75 ± 0.04 (those under 18 years); 8.50 ± 0.19 vs. 5.00 ± 0,11 (those aged 18-39); 48.95 ± 0.33 vs. 23.54 ± 0.24 (people aged 40-60). Among inhabitants with higher radiation doses the mortality rates for certain groups of cardiovascular diseases (coronary heart disease, cerebrovascular disease, arterial hypertension, diseases of arteries, arterioles and capillaries) were significantly higher compared to those having lower radiation doses. Conclusions. Cardiovascular mortality among inhabitants of contaminated areas of Ukraine is dependent on the total cumulative effective doses and age at the time of the Chornobyl accident. It is proved by a significantly higher (p < 0.05) mortality in people exposed to 21.00-50.0 mSv radiation doses compared to those having 5.6-20.99 mSv exposures. Mortality was significantly higher (p < 0.05) in age groups with higher doses as opposed to those with low ones. Maximum mortality was observed among inhabitants aged 40-60, while the lowest death rate in patients younger than 18 years old. The data obtained also suggest that the radiation factor can be considered here as one accelerating the aging and pathophysiological abnormalities in survivors. Coronary heart disease, cerebrovascular disease, arterial hypertension, diseases of arteries, arterioles and capillaries are the main causes of death from cardiovascular disease in people under investigation.

Role of radiation and non-radiation factors on the development of coronary heart disease in the Chornobyl clean-up workers: epidemiological study results. / Vplyv radiacijnogo j neradiacijnyh faktoriv na rozvytok ishemichnoi' hvoroby sercja v uchasnykiv likvidacii' naslidkiv avarii' na ChAES. Rezul''taty epidemiologichnyh doslidzhen''.

Objective. The objective of this study was to establish the risks for coronary heart disease in the Chornobyl clean-up workers with regard to a whole-body external radiation dose and non-radiation (biological, social-and-hygienic and behavioral) factors. Materials and methods. Risk-analysis was based on the cohort of the Chornobyl male clean-up workers 1986-1987 (8,625 men, including 3,623 with available whole-body external doses). Data of clinical-and-epidemiological registry, National Research Centre for Radiation Medicine were used for 1992-2013 monitoring period. We used the internal control group with radiation doses less than 0.05 Gy. Results. Statistically significant radiation risks in the Chornobyl clean-up workers were established for the coronary heart disease at doses 0.15-0.249 Gy, 0.25-0.99 Gy, 1 Gy and more (dose group 0.15-0.249 Gy RRY=1.9 (1.2; 3.1), ERR=4.6 (1.5; 14.9) Gy-1, EAR=64.2 cases per 1000 person-years, Gy); among exposed people aged 40 years and older - at doses 0.5-0.99 Gy (RRY=1.4 (1.05; 1.81), ERR=0.5 (0.03; 1.1) Gy-1, EAR=30.5 cases per 1000 person-years, Gy). Statistically significant risks for the disease under consideration were also identified with regard to non-radiation factors (smoking, improper physical training, adverse working conditions, diseases etc; age and psychoemotional overstrain were of a particular impact). Non-radiation factors are at most responsible for development of coronary heart disease. For this reason the control of potential confounding factors is required to assess the effect of the radiation factor both at a stage of comparison groups selection and analysis using the Mantel-Haenszel method.

State institution "National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine" 2012 annual report.

The 2012 annual results of NRCRM activity in research and its implementation in healthcare practice, aid to survivors, and international collaboration were summarized in the report by Director General of the NRCRM D.A. Bazyka at the Scientific Council meeting of NAMS on March 26, 2013.

Way to improve the radiation hygenic monitoring on contaminated territories.

STUDY OBJECTIVE: To provide an effective radiation hygienic inspection and population protection from ionizing radiation in the late period after the Chornobyl NPP (ChNPP) accident within reforming of the state sanitary & epidemiological supervision services. MATERIALS AND METHODS: The radiation hygienic monitoring (RHM) is performed in Ukraine within the scope of state sanitary & epidemiologic supervision by 158 radiological subdivisions of the sanitary & epidemiological station (SES). The structure of these subdivisions has been created taking into account the territorial regional bounds, a presence of radiological supervision services and ChNPP accident consequences. Nowadays it consists of regional, district, municipal subdivisions, central SESs of Crimea autonomous republic and transport subdivision. In 2012-2013 the State Sanitary & Epidemiological Service of Ukraine had been reformed and reorganized and then in several cases it wasn't optimal for RHM performance. RESULTS AND CONCLUSIONS: The fulfilled analysis of radiation hygienic supervision and protection of population of contaminated regions and efficiency analysis of that supervision and protection allowed to find out and to propose some methods to improve the actual radiation hygienic supervision monitoring system on contaminated Ukrainian areas after the ChNPP accident. It is essential to restore the radiological subdivision (departments, units, labs or groups) work in the State sanitary & epidemiology service structure and to design coordinated and approved methodical recommendations to implement the RHM on contaminated areas to improve and optimize the RHM performance there.

Radiation dose- and sex-dependent cardiovascular mortality in residents of contaminated areas after the Chornobyl NPP accident, 1988-2010 observation period.

OBJECTIVE: To estimate the circulatory system disease death rates for people living in areas contaminated after the Chornobyl accident. Epidemiological estimation covered the post-accident period (1988-2010) and was focused on the relationship between death rates and doses accumulated over 1986-2010 or sex of survivors aged under 60 at the time of the accident. MATERIALS AND METHODS: We used data from the State Registry of Ukraine on persons affected by the Chornobyl accident. Residents of contaminated areas were grouped into the two cohorts according to cumulative dose values. Cohort 1 numbered 155,592 people (86,787 females and 68,805 males), their radiation doses were 5.6-20.99 mSv; cohort 2 totaled 98,830 people (52,640 females and 46,190 males) with radiation doses 21.00-50.99 mSv. Mean age (X ± δ) of inhabitants of contaminated areas at the time of the accident (April 26, 1986) was 29.5 ± 23.2 years (30.6 ± 22.3 for women and 28.3 ± 23.2 for men) in the cohort 1, and 28.7 ± 17.3 years (29.8 ± 17.7 and 27.5 ± 16.2 respectively) in the cohort 2). These cohorts were subdivided by sex (males and females). RESULTS: Significantly higher (ID per 103 person-years is 8.08 ± 0.10) cardiovascular mortality was revealed among members of the cohort 2 vs. cohort 1 (ID per 103 person-years is 6.29 ± 0.06). Mortality from cardiovascular diseases in both sex groups of the cohort 2 is higher (ID per 103 person-years is 6.80 ± 0.12 in women and 9.43 ± 0.15 - in men) than that of the cohort 1 (ID per 103 person-years is 5.34 ± 0.08 in women, 7.37 ± 0.10 - in men). Whatever accumulated doses the mortality from circulatory diseases was significantly higher in men vs. women. CONCLUSION: Cardiovascular mortality in population of radiation-contaminated territories depends on the integral radiation exposure and gender. Death rates are clearly higher (p<0.05) in persons having more radiation doses vs. those exposed to less ones. Mortality is significantly higher in males vs. females despite integral radiation doses values. The coronary heart disease, cerebrovascular disease, arterial hypertension, heart diseases, diseases of arteries, arterioles and capillaries) were the main causes of death.

Radiation and non-radiation factors impact on development of cerebrovascular diseases in the Chornobyl clean-up workers. The epidemiological study results.

OBJECTIVE: To establish the cerebrovascular disease risks in the Chornobyl clean-up workers with regard to whole-body external dose and non-radiation factors i.e. biological, social-and-hygienic, behavioral ones. MATERIALS AND METHODS: Risk-analysis was based on the cohort of the Chornobyl male clean-up workers of 1986-1987 period (8625 men including 3623 with known whole-body external radiation dose values). Data from the Clinical-and-epidemiological registry, National Research Centre for Radiation Medicine were used. Observation period was since 1992 till 2010. We have used the approach with the internal control group with radiation doses less than 0.05 or 0.1 Gy. RESULTS: The statistically significant radiation risks were established for the chronic forms of cerebrovascular disease at doses 0.5 Gy and higher, for some forms of the disease in certain dose-age strata i.e. 0.25 Gy and more. Statistically significant non-radiation risks for cerebrovascular disease were recorded with regard to age, psychoemotional stress, alcohol abuse, malnutrition, smoking, harmful working conditions etc. Role of age as a confounding factor was analyzed under the assessing of radiation risks with Mantel-Haenszel method application to improve the estimates of radiation effects.

Physical dosimetry and biological indicators of carcinogenic risk in a cohort of persons exposed to unhealthy ecological factors following the Chernobyl Nuclear Power Plant accident.

The April 1986 Chernobyl Nuclear Power Plant accident caused ecological changes in the Ovruch State forests in the Zhytomir oblast in the Ukraine. The highest radioactivity existed in moss, followed by the pine-forest substrate and soil. During 1984-1985, the pine needles were primarily surface contaminated, whereas during 1986-1988, they were contaminated secondarily. Radioactivity in air was highest (1.07+/-0.185 Bq/l) during dry and sunny weather and when trees were felled; the lowest levels (0.196+/-0.044 Bq/l) occurred during periods of stable snow coverage. Between 1987 and 1989 (i.e., after the Chernobyl accident), the caesium levels in forestry employees exceeded by 13.9-fold the average levels found in the Ukrainian Polessje population. Ovruch forest guards and woodcutters had the highest effective equivalent doses of radiation, and they therefore exhibited the highest carcinogenic risk.

Epidemiological survey of the medical consequences of the Chernobyl accident in Ukraine.

The characteristics of the contamination resulting from the Chernobyl accident are defined, as a basis for epidemiological investigations. Due to loss of integrity of the nuclear fuel and thermal buoyancy from fire and nuclear heating, a large quantity of radioisotopes were released over a period of up to 16 days. The areas affected were very large, 37 million hectares in Ukraine alone. About 5 million persons were affected in one way or another, over 2 million of them in Ukraine. For registration and follow-up of health consequences from the accident, 4 main groups were distinguished, namely: (1) the participants in the containment of the accident and its cleanup ("liquidators"); (2) evacuees; (3) residents of contaminated areas; and (4) children born to parents with significant radiation exposure. Registration and epidemiological follow-up in the former USSR and the three republics afterwards are presented with an emphasis on Ukraine. Considering the long incubation times for some of the expected illnesses and relatively low average doses, the difficulties of confirming significant effects become evident. For example leucosis morbidity among cleanup personnel within a 30 km zone around the accident was 3.4 per 100,000 before the accident and 7 per 100,000 afterwards. The question of the statistical significance of such numbers is discussed by the authors, in the context of confounding factors. For some of the observed effects it has already been established that stress and anxiety caused by the accident and living conditions in the affected areas are the principal cause rather than radiation. According to the authors, more detailed retrospective and prospective epidemiological studies are needed in the future, in order to clarify the causes of observed health effects.