STATE INSTITUTION «NATIONAL RESEARCH CENTER FOR RADIATION MEDICINE OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE¼ - RESEARCH ACTIVITIES AND SCIENTIFIC ADVANCE IN 2020. / REZUL'TATY ROBOTY DU «NATsIONAL'NYI NAUKOVYI TsENTR RADIATsIINOÏ MEDYTsYNY NATsIONAL'NOÏ AKADEMIÏ MEDYChNYKh NAUK UKRAÏNY¼ U 2020 ROTsI.

Research activities and scientific advance achieved in 2020 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. The report also shows the results of scientific-organizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRM Annual Report.

COMPREHENSIVE RADIATION AND HYGIENIC MONITORING IN POPULATION OF THE RIVNE OBLAST RADIOLOGICALLY CONTAMINATED TERRITORIES. / KOMPLEKSNYI RADIATsIINO/GIGIIeNIChNYI MONITORYNG MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORII RIVNENS'KOÏ OBLASTI U 2020 r.

OBJECTIVE: The key factors identification in radiation dose formation in population of radiologically contaminatedareas of Rivne oblast in the current period of accident through comprehensive radiation and hygienic monitoring inreference settlements in 2020 and estimation of their impact on dose formation were the study objectives. MATERIALS AND METHODS: Comprehensive radiation and hygienic monitoring of settlements in Rivne oblast(province) was provided in Stare Selo, Vezhytsia, Perekhodychi, and Drozdyn villages of Rokytne district, where thehighest radiation doses were registered after the ChNPP accident. Studies were conducted in September 2020.Measurements (n=696, 318 adults, and 378 children) were performed using the whole body counters (WBC) to deter-mine the internal radiation doses. The 48 samples of milk, 45 samples of potatoes and vegetables, and 35 samplesof wild products were collected in local farms and measured for the 137Cs and 90Sr content. Residents of the studiedsettlements (n=229, 140 adults, and 89 children) were interviewed about the levels of consumption of staple food-stuffs. External radiation doses were evaluated in all the studied settlements. Mathematical, dosimetric, and radio-chemical methods were applied. RESULTS AND CONCLUSIONS: Annual effective radiation doses of the Rivne oblast population in 2020 were formedmainly due to internal radiation ones that not exceeded 1.24 mSv · year-1 in adults and 0.65 mSv · year-1 in childrenagainst the RCT criterion of 1 mSv · year-1. Further 1.2-1.9-fold decrease in the annual internal radiation doses vs.the results of WBC-monitoring in autumn of 2017 was registered in the surveyed settlements. The latter confirmeda time pattern of radiation levels gradual reduction at the current stage of Chornobyl accident since 2011. Intakeof 137Cs with milk and wild mushrooms, which traditionally occupy a significant part of diet in the Rivne Polissya areaand have consistently high levels of radioactive cesium contamination, remains a key factor of internal radiationdose forming in residents of the surveyed settlements of Rivne oblast.

Cytogenetic follow-up of an individual after accidental exposure to industrial radiation using dicentric frequency in blood lymphocytes.

A radiation accident occurred in Bursa, Turkey, in July 2005. An industrial radiographer was exposed to industrial iridium-192 gamma rays for 5 h while laying the natural gas line. After 5 h, the victim had a break because of vomiting and nausea. He ended his work, considering that he might have been exposed to radiation. In a few days, erythema, pain, desquamation, edema started in both hands of the victim. The biological dose assessment was started based on frequencies of dicentrics and rings in peripheral blood lymphocytes ten days after the radiation accident. 6 repeated blood samples were taken for 9 years and analyzed staining after giemsa. After 9 years, decline at dicentric frequencies is significant, but still, dicentric contain cells were detected, which were a strong indicator for external radiation exposure.

Retrospective cytogenetic analysis of unstable and stable chromosome aberrations in the victims of radiation accident in Bulgaria.

Five occupational workers in an industrial sterilization unit at Stamboliyski in Bulgaria were accidentally exposed to a very high specific activity of Cobalt-60 source on June 14, 2011. Initial cytogenetic analysis performed on days 2 and 7 after radiation exposure revealed the whole body absorbed radiation doses of 5.32 Gy for patient 1, 3.40 Gy for patient 2, 2.50 Gy for patient 3, 1.91 Gy for patient 4 and 1.24 Gy for patient 5 [1]. Here, a retrospective multicolor FISH analysis was performed on three patients (patients 1, 2 and 3) using the blood samples collected over a period of 4 years from 2012 through 2015. In all the three patients, cells with stable chromosome aberrations (simple and complex chromosome translocations) were 3-4 folds more than cells with unstable chromosome aberrations (dicentric, rings and excess acentric chromosome fragments). In corroboration with the results reported in the literature, we observed that the time dependent decline of dicentrics, rings and excess acentric fragments occurred much more rapidly than chromosome translocations in the blood samples of the three victims. Further, inter-individual variation in the decline of radiation induced chromosome aberrations was also noticed among the three victims. The reason for the increased persistence of balanced chromosome translocations is not entirely clear but may be attributed to certain subsets of long-lived T-lymphocytes. The retrospective cytogenetic follow up studies on radiation-exposed victims may be useful for determining the extent of genomic/chromosomal instability in the hematopoietic system.

Comparative assessment of impact analysis methods applied to large commercial aircraft crash on reinforced concrete containment.

The precise evaluation of the potential damage caused by large commercial aircraft crash into civil structures, especially nuclear power plants (NPPs), has become essential design consideration. In this study, impact of Boeing 767 against rigid wall and outer containment building (reinforced concrete) of an NPP are simulated in ANSYS/LS-DYNA by using both force time history and missile target interaction methods with impact velocities ranging from 100 m/s to 150 m/s. The results show that impact loads, displacements, stresses for concrete and steel reinforcement, and damaged elements are higher in case of force time history method than missile target interaction method, making the former relatively conservative. It is observed that no perforation or scabbing takes place in case of 100 m/s impact speed, thus preventing any potential leakage. With full mass of Boeing 767 and impact velocity slightly above 100 m/s, the outer containment building can prevent local failure modes. At impact velocity higher than 120 m/s, scabbing and perforations are dominant. This concludes that in design and assessment of NPP structures against aircraft loadings, sufficient thickness or consideration of steel plates are essential to account for local failure modes and overall structural integrity. Furthermore, validation and application of detail 3D finite element and material models to full-scale impact analysis have been carried out to expand the existing database. In rigid wall impact analysis, the impact forces and impulses from FE analysis and Riera's method correspond well, which satisfies the recommendations of relevant standards and further ensure the accuracy of results in full-scale impact analysis. The methodology presented in this paper is extremely effective in simulating structural evaluation of full-scale aircraft impact on important facilities such as NPPs.

Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level.

In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol-Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine-131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure-response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level.

Estimation of Radiation Doses for a Case-control Study of Thyroid Cancer Among Ukrainian Chernobyl Cleanup Workers.

Thyroid doses were estimated for 607 subjects of a case-control study of thyroid cancer nested in the cohort of 150,813 male Ukrainian cleanup workers who were exposed to radiation as a result of the 1986 Chernobyl nuclear power plant accident. Individual thyroid doses due to external irradiation, inhalation of I and short-lived radioiodine and radiotellurium isotopes (I, I, I, Te, and Te) during the cleanup mission, and intake of I during residence in contaminated settlements were calculated for all study subjects, along with associated uncertainty distributions. The average thyroid dose due to all exposure pathways combined was estimated to be 199 mGy (median: 47 mGy; range: 0.15 mGy to 9.0 Gy), with averages of 140 mGy (median: 20 mGy; range: 0.015 mGy to 3.6 Gy) from external irradiation during the cleanup mission, 44 mGy (median: 12 mGy; range: ~0 mGy to 1.7 Gy) due to I inhalation, 42 mGy (median: 7.3 mGy; range: 0.001 mGy to 3.4 Gy) due to I intake during residence, and 11 mGy (median: 1.6 mGy; range: ~0 mGy to 0.38 Gy) due to inhalation of short-lived radionuclides. Internal exposure of the thyroid gland to I contributed more than 50% of the total thyroid dose in 45% of the study subjects. The uncertainties in the individual stochastic doses were characterized by a mean geometric standard deviation of 2.0, 1.8, 2.0, and 2.6 for external irradiation, inhalation of I, inhalation of short-lived radionuclides, and residential exposure, respectively. The models used for dose calculations were validated against instrument measurements done shortly after the accident. Results of the validation showed that thyroid doses could be estimated retrospectively for Chernobyl cleanup workers two to three decades after the accident with a reasonable degree of reliability.

Trends in the Incidence of Breast Cancer Following the Radiological Accident in Goiânia: A 25-Year Analysis.

BACKGROUND: The largest radiological accident to occur in any urban area happened in Goiânia, Brazil, in 1987. One major concern regarding deleterious effects in the population was a possible increase in the breast cancer incidence. This study analyzed trends in the incidence of breast cancer over the 25-year period following the radiological accident. METHODS: This ecological, population-based study was conducted to determine the incidence of breast cancer in female residents of Goiânia, Goiás, Brazil, between 1988 and 2012. The data were collected from the Goiânia population-based cancer registry. Crude and age-standardized incidence rates were calculated. The Joinpoint software program was used to calculate annual percent changes (APC) in the incidence of breast cancer. RESULTS: Overall, 7,365 new cases of breast cancer were identified, with an annual crude incidence rate of 23.09/100,000 women in 1988 and of 71.65/100,000 women in 2012. The age-standardized incidence rate was 35.63/100,000 women in 1988 and 65.63/100,000 women in 2012. Analysis of the APC showed a significant annual increase of 4.8% in the incidence between 1988 and 2005 (p<0.0001) followed by stabilization in 2005-2012, with an APC of -3.5% (p=0.1). CONCLUSION: There was an increase in the incidence of breast cancer in the female residents of Goiânia, Goiás in the first 17 years of evaluation (1988-2004) followed by a period of stabilization until 2012. However, the trends in the incidence suggest a lack of association with the radiological accident.

RESULTS AND DISCUSSION ON JAPANESE PUBLIC OPINION SURVEYS (2006-17) ABOUT NUCLEAR AND RADIATION APPLICATIONS.

Public opinion on the application of nuclear technology and radiation could change when a nuclear related event occurs. Japan Atomic Energy Relations Organization has tracked its variation through a nationwide opinion survey in Japan by almost the same way every year since FY 2006. We can identify a continuous long-term fluctuation of Japanese opinion before and after the TEPCO Fukushima Daiichi nuclear disaster using the data. In this study we focused on the trends of public opinion for nuclear energy, impressions and knowledge on radiation, and zero-risk request. For example, radiation can be recognised that it is dangerous and complicated matter by Japanese public regardless of that accident. However, a big change of opinions on radiation was shown on the impression for the word of 'Useful' between before and after the accident.

A Critical Assessment of the Linear No-Threshold Hypothesis: Its Validity and Applicability for Use in Risk Assessment and Radiation Protection.

The Society of Nuclear Medicine and Molecular Imaging convened a task group to examine the evidence for the risk of carcinogenesis from low-dose radiation exposure and to assess evidence in the scientific literature related to the overall validity of the linear no-threshold (LNT) hypothesis and its applicability for use in risk assessment and radiation protection. In the low-dose and dose-rate region, the group concluded that the LNT hypothesis is invalid as it is not supported by the available scientific evidence and, instead, is actually refuted by published epidemiology and radiation biology. The task group concluded that the evidence does not support the use of LNT either for risk assessment or radiation protection in the low-dose and dose-rate region.

Radiological Risks From Potential Exposure of the Population to Radiation From Orphan Radioactive Sources.

People in their everyday lives are exposed to radiation. Natural radiation is emitted from space, subsoil, and various materials which contain radioactive materials. Humans are also exposed to radiation from medical and industrial applications that use radioactive sources with artificial radioactive materials. Such radioactive sources may nevertheless get out of the control system and become orphan sources. Because these radiation sources are usually contained within metal shields such as lead and iron, the shields can end up as scrap metal being used in the metallurgical industry as raw material. Incidents have been recorded around the world, and several are reported in the literature and described here, where orphan sources have caused direct radiation exposure and/or environmental and personal contamination when the sources leaked. Timely and prompt recognition of an orphan radioactive source or device is crucial in order to minimize the radiological risk and its implications for the general population.

Medical Countermeasures for Children in Radiation and Nuclear Disasters: Current Capabilities and Key Gaps.

OBJECTIVE: Despite children's unique vulnerability, clinical guidance and resources are lacking around the use of radiation medical countermeasures (MCMs) available commercially and in the Strategic National Stockpile to support immediate dispensing to pediatric populations. To better understand the current capabilities and shortfalls, a literature review and gap analysis were performed. METHODS: A comprehensive review of the medical literature, Food and Drug Administration (FDA)-approved labeling, FDA summary reviews, medical references, and educational resources related to pediatric radiation MCMs was performed from May 2016 to February 2017. RESULTS: Fifteen gaps related to the use of radiation MCMs in children were identified. The need to address these gaps was prioritized based upon the potential to decrease morbidity and mortality, improve clinical management, strengthen caregiver education, and increase the relevant evidence base. CONCLUSIONS: Key gaps exist in information to support the safe and successful use of MCMs in children during radiation emergencies; failure to address these gaps could have negative consequences for families and communities. There is a clear need for pediatric-specific guidance to ensure clinicians can appropriately identify, triage, and treat children who have been exposed to radiation, and for resources to ensure accurate communication about the safety and utility of radiation MCMs for children. (Disaster Med Public Health Preparedness. 2019;13:639-646).

Pediatric Considerations Before, During, and After Radiological or Nuclear Emergencies.

Infants, children, and adolescents can be exposed unexpectedly to ionizing radiation from nuclear power plant events, improvised nuclear or radiologic dispersal device explosions, or inappropriate disposal of radiotherapy equipment. Children are likely to experience higher external and internal radiation exposure levels than adults because of their smaller body and organ size and other physiologic characteristics as well as their tendency to pick up contaminated items and consume contaminated milk or foodstuffs. This technical report accompanies the revision of the 2003 American Academy of Pediatrics policy statement on pediatric radiation emergencies by summarizing newer scientific data from studies of the Chernobyl and the Fukushima Daiichi nuclear power plant events, use of improvised radiologic dispersal devices, exposures from inappropriate disposal of radiotherapy equipment, and potential health effects from residential proximity to nuclear plants. Also included are recommendations from epidemiological studies and biokinetic models to address mitigation efforts. The report includes major emphases on acute radiation syndrome, acute and long-term psychological effects, cancer risks, and other late tissue reactions after low-to-high levels of radiation exposure. Results, along with public health and clinical implications, are described from studies of the Japanese atomic bomb survivors, nuclear plant accidents (eg, Three Mile Island, Chernobyl, and Fukushima), improper disposal of radiotherapy equipment in Goiania, Brazil, and residence in proximity to nuclear plants. Measures to reduce radiation exposure in the immediate aftermath of a radiologic or nuclear disaster are described, including the diagnosis and management of external and internal contamination, use of potassium iodide, and actions in relation to breastfeeding.

Screening Criteria for the General Public in Radiation Emergencies From Liquid Scintillation Urinalysis.

Gross alpha/beta screening of urine samples was performed to evaluate internal contamination and dose assessment. Data on background radioactivity concentration were extracted by analyzing the urine samples of non-contaminated individuals who had visited a radiation effect medical clinic since 2012. Screening criteria were studied and established for radiation emergencies based on these results. In particular, pure beta-emitting radionuclides (H and Sr) with a high dose conversion factor were considered to be the source of contamination. Moreover, the screening criteria for the general public were determined based on age groups. The liquid scintillation counting method was used for gross alpha/beta radiation counting. A standardized procedure of correction for chemical and color quenching was performed and validated. The gross beta counting method was validated by analyzing standard urine samples. The fluctuation of the screening criteria was large, based on the time elapsed after intake. A screening criterion of 150 Bq L can be applied within 5 d after intake considering the minimum detectable activity. A standard screening criterion set to 250 Bq L will be used as an important reference for decision making and additional monitoring. Although early evaluation and accurate identification of contaminated radionuclides is preferred, these relatively simple criteria were proposed to address radiation emergency situations involving several casualties.

Marine ecological risk assessment methods for radiation accidents.

Ecological risk assessment (ERA) is a powerful technical tool that can be used to analyze potential and extreme adverse environmental impacts. With the rapid development of nuclear power plants in coastal areas around the world, the establishment of approaches and methodologies for marine ERA with a focus on radiation accidents is an urgent requirement for marine environmental management. In this study, the approaches and methodologies for ERA pertaining to marine radiation accidents (MRA) are discussed and summarized with applications in case studies, such as the nuclear accident in Fukushima, Japan, and a hypothetical accident in Daya Bay, China. The concepts of ERA and Risk Degree of ERA on MRA are defined for the first time to optimize the ERA system. The results of case studies show that the ERA approach and methodology for MRA are scientifically sound and effective in both the early and late stage of MRAs along with classic ERA Approach and the ERICA Integrated Approach. The results can be useful in the decision-making processes and the risk management at the beginning of accident as well as the ecological restoration after the accident.

[Comparative evaluation of the prevalence of congenital malformations de novo in newborns from radiation-contaminated territories of the Bryansk region (1999-2014)].

On the basis of official statistics for 1999-2014 there was performed the comparative evaluation of the prevalence of congenital malformations de novo: polydactyly, reduction limb defects and multiple congenital malformations in newborns of radiation-contaminated areas of the Bryansk area residing in areas with the various density of radioactive contamination by long lived radionuclides cesium-137 (from 10.0 to 2523.4 kBq/m) and strontium-90 (from 0.7 to 42.5 kBq/m). The findings showed no statistically significant differences in the prevalence of polydactyly, reduction limb defects and multiple congenital malformations in newborns in the South-Western areas compared to medium regional values, although the maximum value of the amount of congenital malformations de novo is found in most radiation-contaminated areas.

[The morbidity and mortality of residents of Kazakhstan exposed to radiation impact and their posterity].

The most part of population exposed to radiation and their offspring residing in territories bordering upon the Semipalatinsk nuclear testing area represent objects of studying aged 40 years and older because the age is the factor decreasing health indices at the expense of natural gerontological processes. In these conditions, additional radiation exposition, besides radiological biological effects, plays the role ofpotentiation of common biological and environmental risk factors. From the archives of research institute of radiation medicine and ecology the primary medical documents were retrieved containing information about established diagnoses of individuals included into elaboration of epidemiological statistical analysis of dynamics of morbidity of persons in 2008-2012. Within the same period, the acts-certificates of causes of death of specific persons included into study groups were retrieved. It is established that in 8 classes of diseases in the main group and in 5 classes of diseases in comparison group significant exceeding of average annual indices of prevalence of diseases as compared with control group was established. The common prevalence of diseases in the main group comprised 3147.5 cases, in the comparison group - 2615.6 cases and in control group - 2203.8 cases per 1000 of population (RR=1.42;1.19; p<0.05;0.05). The indices of total mortality in the main group comprised 1887.3 cases, in the comparison group - 1531.2 cases and in control group - 1155.1 cases per 100 000 of population (RR=1.58;1.36; p<0.05;0.05). Among persons in the main group in 7 classes of diseases and in the comparison group in 5 classes of diseases significant exceeding of indices of mortality was registered over same indices in control group was registered as causes of death.

Reconstructive dosimetry for cutaneous radiation syndrome.

According to the International Atomic Energy Agency (IAEA), a relatively significant number of radiological accidents have occurred in recent years mainly because of the practices referred to as potentially high-risk activities, such as radiotherapy, large irradiators and industrial radiography, especially in gammagraphy assays. In some instances, severe injuries have occurred in exposed persons due to high radiation doses. In industrial radiography, 80 cases involving a total of 120 radiation workers, 110 members of the public including 12 deaths have been recorded up to 2014. Radiological accidents in industrial practices in Brazil have mainly resulted in development of cutaneous radiation syndrome (CRS) in hands and fingers. Brazilian data include 5 serious cases related to industrial gammagraphy, affecting 7 radiation workers and 19 members of the public; however, none of them were fatal. Some methods of reconstructive dosimetry have been used to estimate the radiation dose to assist in prescribing medical treatment. The type and development of cutaneous manifestations in the exposed areas of a person is the first achievable gross dose estimation. This review article presents the state-of-the-art reconstructive dosimetry methods enabling estimation of local radiation doses and provides guidelines for medical handling of the exposed individuals. The review also presents the Chilean and Brazilian radiological accident cases to highlight the importance of reconstructive dosimetry.

Reconstructive dosimetry for cutaneous radiation syndrome

According to the International Atomic Energy Agency (IAEA), a relatively significant number of radiological accidents have occurred in recent years mainly because of the practices referred to as potentially high-risk activities, such as radiotherapy, large irradiators and industrial radiography, especially in gammagraphy assays. In some instances, severe injuries have occurred in exposed persons due to high radiation doses. In industrial radiography, 80 cases involving a total of 120 radiation workers, 110 members of the public including 12 deaths have been recorded up to 2014. Radiological accidents in industrial practices in Brazil have mainly resulted in development of cutaneous radiation syndrome (CRS) in hands and fingers. Brazilian data include 5 serious cases related to industrial gammagraphy, affecting 7 radiation workers and 19 members of the public; however, none of them were fatal. Some methods of reconstructive dosimetry have been used to estimate the radiation dose to assist in prescribing medical treatment. The type and development of cutaneous manifestations in the exposed areas of a person is the first achievable gross dose estimation. This review article presents the state-of-the-art reconstructive dosimetry methods enabling estimation of local radiation doses and provides guidelines for medical handling of the exposed individuals. The review also presents the Chilean and Brazilian radiological accident cases to highlight the importance of reconstructive dosimetry.