ABSTRACT
OBJECTIVE: assessment of clinical-hematological and metabolic-biochemical parameters of the of bone tissue and hormonal regulation depending on the serum iron content and radiation dose values in children living on radiologically contaminated territories after the ChNPP accident in Ukraine. MATERIALS AND METHODS: Children (n = 271) living on radiologically contaminated territories (RCT) of Ukraine were involved in the study. Three study groups were formed according to the serum iron level (SIL), namely group I with SIL 10.0-22.0 µmol/l (n = 92), group II with SIL 23.0-34.0 µmol/l (n = 144), and group III with SIL above 35.0 µmol/l (n = 35). Diseases in the family tree, bodyweight at birth, complaints on osalgia, bone fractures, jaw anomalies, dental caries, and obesity were accounted. Morphometric parameters of erythrocytes and hemogram elements were analyzed. Creatinine, alkaline phosphatase, calcium, total protein, iron, cholesterol, bilirubin, and transaminases were assayed in blood serum. The urine content of the 19 free amino acids, serum content of the free thyroxine (FT4), pituitary thyroid-stimulating hormone (TSH), and cortisol were assayed both with bone tissue density. Individual radiation doses were calculated. RESULTS: In 12.9 % of cases the SIL was > 35.0 µmol/l. Relatives with endocrine diseases were often present in the family tree of children with SIL > 23.0 µmol/l. There were increased urine content of the free amino acids (p < 0.05) and signs of protein degradation under high SIL. Contents of amino acids involved in collagen synthesis and antioxidant status (alanine, serine, glutamine, aspartic acid) and iron metabolism (arginine, leucine) were assayed at the highest levels (p < 0.05). Urinary levels of valine, lysine, and methionine, which are associated with iron metabolism, were decreased (p < 0.05). An inverse correlation (rs = -0.58; p < 0.01) was established between the serum TSH and cortisol levels regardless of the SIL. Serum TSH level directly correlated with urine content of amino acids involved in collagen synthesis. An inverse correlation (rs = -0.55; p < 0.001) was established between the serum TSH level and urine content of tyrosine that is essential for the thyroid hormone (triiodothyronine and thyroxine) synthesis.Cortisol was found having a negative effect on protein synthesis. Inverse correlation was established between the serum cortisol level and urine content of the free amino acids essential for collagen synthesis. There was no dependence of the average radiation dose values on the SIL. An inverse correlation was determined between the patient's radiation dose and SIL > 35.0 µmol/l (rs = -0.29; p < 0.05). CONCLUSIONS: The increased SIL in children living on RCT may occur due to both a genetic predisposition and the acquired factors driving protein and mineral metabolism of bone and their hormonal regulation.
Subject(s)
Hydrocortisone , Thyroxine , Child , Infant, Newborn , Humans , Ukraine , Thyrotropin , Iron , Amino Acids , CollagenABSTRACT
OBJECTIVE: to determine the causes of increased bone mineral density (BMD) based on case history, clinical and laboratory data, including the assay of hormones involved in ossification processes in children, living on radiologically contaminated territories (RCT) after the accident at the ChNPP, compared to the normative BMD patterns. MATERIALS AND METHODS: There were 289 children involved in the study. The 1st group included persons with a BMD above 100 IU, 2nd group - with normative BMD (100-85 IU). Family history of diseases was assessed featuring cancer and endocrine diseases, cholelithiasis, and urolithiasis. Weight of the child at birth, frequency of bone fractures, complaints about osalgia, jaw abnormalities, dental caries, presence or absence of obesity, peripheral blood count, blood biochemical parameters (total protein, creatinine, iron, alkaline phosphatase, calcium), serum pituitary thyroid-stimulating hormone and cortisol were accounted. Children's radiation doses were calculated according to the materials of the «General dosimetric certification of settlements of Ukraine that were exposed to radioactive contamination after the Chornobyl accident¼. RESULTS: Higher than normative BMD values were found in children after puberty, while normative ones - in puberty (Ñ < 0.001), regardless of gender. A direct correlation between the bone fractures frequency was established in children with increased BMD (Ñ < 0.01). Jaw anomalies and dental caries occurred at that significantly less often than in normative BMD (Ñ > 0.05). A direct correlation was established between the obesity and BMD (Ñ < 0.001).Increased alkaline phosphatase activity was inversely correlated with BMD (rs = -0.21; Ñ < 0.05). In children with elevated BMD a direct correlation was established between the level of iron and endocrine disorders in the family history (Ñ > 0.001). Serum level of cortisol was directly correlated with dental caries (Ñ < 0.05). In children, regardless of BMD value, a direct correlation was established between the radiation dose, age and obesity (Ñ < 0.001). CONCLUSIONS: Higher than normative BMD is accompanied by an increased frequency of bone fractures, jaw abnormalities, metabolic changes in bone tissue and bone tissue hormonal regulation in children, which requires application of pathogenetic therapy for the osteogenesis.
Subject(s)
Chernobyl Nuclear Accident , Dental Caries , Fractures, Bone , Child , Humans , Infant, Newborn , Alkaline Phosphatase , Bone Density , Dental Caries/epidemiology , Dental Caries/etiology , Hydrocortisone , Iron , UkraineABSTRACT
OBJECTIVE: to establish the relationship between quantitative and qualitative parameters of peripheral blood cells(lymphocytes, neutrophilic granulocytes, monocytes, platelets) depending on the type of somatic diseases andannual internal radiation doses from 137Cs in children - residents of radiologically contaminated territories in thelate period after the Chornobyl Nuclear Power Plant (ChNPP) accident. MATERIALS AND METHODS: There were 175 children included in the study comprising residents of radiologically con-taminated territories (n = 79) aged from 4 to 18 years. Annual internal radiation doses in children from 137Cs rangedfrom 0.004 to 0.067 mSv. Certain blood parameters were assessed in a comparative mode in children having got theradiation doses up to 0.01 mSv and higher. The comparison group (n = 96) included children living in settlementsnot attributed to the radiologically contaminated ones. Incidence and type of somatic diseases and its impact onquantitative and qualitative changes in blood parameters (i.e. lymphocyte, neutrophilic granulocyte, monocyte, andplatelet count) were studied. The cell size, state of nucleus, membranes and cytoplasm, signs of proliferative anddegenerative processes were taken into account. RESULTS: Incidence and type of somatic diseases in children did not depend on the annual internal radiation dose.Number of cases of monocytosis was significantly higher among the children exposed to ionizing radiation than inthe comparison group (16.6 % vs. 7.3 %). There were, however, no correlation between these changes and radiationdoses. Number of activated blood monocytes with cytoplasmic basophilia and residues of nucleoli in nuclei washigher in individuals with internal radiation doses > 0.01 mSv. A direct correlation between the qualitative param-eters of monocytes and internal radiation doses was established (rs = 0.60; Ñ < 0.001), as well as a direct correlationof different strength between qualitative parameters of blood cells, indicating their unidirectional pattern depend-ing on the somatic morbid conditions. Regardless of annual internal radiation dose, there was an increase in thenumber of degenerative and aberrant cells vs. the comparison group (Ñ < 0.05), which could be due to the role ofnon-radiation factors. CONCLUSIONS: Results of the assessment of quantitative and qualitative parameters of peripheral blood cells reflect-ed the state of morbid conditions in children and are of a diagnostic value. The identified dose-dependent changesin monocyte lineage of hematopoiesis may be the markers of impact of long-term radionuclide incorporation withfood in children living in environmentally unfavorable conditions after the ChNPP accident.
Subject(s)
Blood/radiation effects , Chernobyl Nuclear Accident , Hematologic Diseases/blood , Hematologic Diseases/physiopathology , Radiation Exposure/adverse effects , Radiation Injuries/blood , Radiation, Ionizing , Thyroid Gland/radiation effects , Adolescent , Child , Child, Preschool , Female , Humans , Male , Radiation Injuries/physiopathology , Radiation Monitoring/statistics & numerical data , Ukraine/epidemiologyABSTRACT
OBJECTIVE: to assess the thyroid disease in the late observation period in children who had received chemo- andradiotherapy for the acute lymphoblastic leukemia (ALL) taking into account gender, age period and disease sub-type. MATERIALS AND METHODS: The incidence and nature of thyroid disease (hypothyroidism, thyroiditis, and thyroid can-cer) were studied in children-survivors of acute lymphoblastic leukemia (ALL) being in remission from 6 to 25 years.The distribution of patients by leukemia subtypes was as follows: «common¼ - 67.4 %, pre-B - 23.9 %, pro-B andT-cell - 4.3 %. Children had been receiving chemo- and radiotherapy according to the protocol. Regarding the ageof patients at the time of ALL diagnosis the prepubertal, pubertal and postpubertal periods were taken into account.The endocrine diseases in family history, body weight at birth, serum content of free thyroxine, pituitary thyroid-stimulating hormone, cortisol, iron, ferritin and thyroperoxidase antibodies were evaluated and assayed. RESULTS: Thyroid disease in children was emerging in the first 2-3 years after the ALL treatment with an incidenceof 22.8 % (hypothyroidism - 14.1 %, autoimmune thyroiditis - 7.6 %, papillary cancer - 1.1 %). Seven children inthis group had received radiotherapy (12-18 Gy doses) on the central nervous system (CNS). No correlation wasfound between the radiation exposure event itself, radiation dose to the CNS and thyroid disease in the long-termfollow-up period. Thyroid cancer had developed in a child 11 years upon chemo- and radiotherapy. Hypothyroidismwas more often diagnosed in the patients of prepubertal age (rs = 0.49). There were endocrine diseases in thefamily history in about a half of children, being significantly higher than in the general sample (Ñ < 0.05). The bodyweight at birth of a child who had later developed hypothyroidism was less than in children having got thyroiditis(rs = 0.57). CONCLUSIONS: Disorders in endocrine regulation and of thyroid in particular can affect the prognosis of blood can-cer course in the long-term follow-up in children, especially in prepubertal age, which requires systematic supervi-sion by hematologist and endocrinologist.
Subject(s)
Leukemia, Radiation-Induced/physiopathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Radiation Exposure , Severity of Illness Index , Survivors/statistics & numerical data , Thyroid Diseases/physiopathology , Adolescent , Adult , Age Factors , Chernobyl Nuclear Accident , Child , Female , Humans , Leukemia, Radiation-Induced/etiology , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Sex Factors , Thyroid Diseases/etiology , Ukraine/epidemiology , Young AdultABSTRACT
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.
Subject(s)
Cerebrovascular Disorders/epidemiology , Chernobyl Nuclear Accident , Radiation, Ionizing , Registries , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Case-Control Studies , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/pathology , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Longitudinal Studies , Male , Middle Aged , Radiation Dosage , Radiometry/methods , Sex Factors , Ukraine/epidemiologyABSTRACT
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.
Subject(s)
Anxiety/etiology , Chernobyl Nuclear Accident , Radiation Exposure/adverse effects , Stress, Psychological/etiology , Survivors/psychology , Adolescent , Adult , Anxiety/diagnosis , Anxiety/physiopathology , Anxiety/psychology , Female , Humans , Male , Middle Aged , Psychiatric Rehabilitation/methods , Psychology , Stress, Psychological/diagnosis , Stress, Psychological/physiopathology , Surveys and Questionnaires , Transportation of Patients/methods , UkraineABSTRACT
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.
