RADIATION RISKS OF THYROID CANCER IN CHORNOBYL CLEAN-UP WORKERS USING THE ALTERNATIVE ESTIMATES OF DOSES OF EXTERNAL EXPOSURE. / RADIATsIINI RYZYKY RAKU ShchYTOPODIBNOÏ ZALOZY V UChASNYKIV LIKVIDATsIÏ AVARIÏ NA ChAES Z URAKhUVANNIaM AL'TERNATYVNYKh OTsINOK DOZ ZOVNIShN'OGO OPROMINENNIa.

OBJECTIVE: The objective of this study was to estimate the thyroid cancer radiation risks - excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) in the cohort of 150,813 Ukrainian male clean-up workers during the 1986-2012 period (more than 25 years after the Chornobyl accident). MATERIALS AND METHODS: The cohort under study of 150,813 Ukrainian men who participated emergency and clean-up work in 1986-1990 was formed based on the data of the Ukrainian State Register of persons affected due toChornobyl accident (SRU). The identification of thyroid cancer cases (216) was carried out by linking the SRU data-base with the National Cancer Registry of Ukraine (NCRU) data. Standardised incidence ratios (SIR) were estimatedcomparing thyroid cancer incidence in the cohort with the corresponding national indices. Excess absolute risk(EAR), excess relative risk (ERR) and attributable fraction of risk (AR) were calculated accounting for the alterna-tive dose estimates. The following sources of the average dose values for Ukrainian liquidators were used: officialtotal external dose records according to UNSCEAR 2008 report and results of external red bone marrow dose recon-struction by the RADRUE method for the cohort sample. For the radiation risk evaluation, these estimates were con-versed to the average external thyroid dose. RESULTS: Results of the long term study (1986-2012) of thyroid cancer risks in a cohort of 150813 Chornobyl clean-up workers («liquidators¼) from Ukraine are presented. Two options for the average thyroid dose estimates were usedfor radiation risks evaluation. According to the SRU and NCRU 216 incident thyroid cancers were diagnosed in 1986-2012 within the studied cohort with an overall SIR of 3.35 (95 % confidence interval (CI) 2.51-3.80). The SIR esti-mates were elevated throughout the entire follow-up period. Investigation of a contribution of the external expo-sure (according to the alternative values) showed the elevated dose associated thyroid cancer rates in the studiedcohort. Alternatively estimated EAR/104 PY Gy were of 1.86 (95 % CI 0.47-3.24) and 2.07 (95 % CI 0.53-3.62);ERR/Gy - 2.38 (95 % CI 0.60-4.15) and 2.66 (95 % CI 0.68-4.64) and AR % (Gy) 70.4 % and 72.7 % Gy. CONCLUSIONS: Obtained results prove the dose dependent increase of thyroid cancer incidence among UkrainianChornobyl clean-up workers. These conclusions are consistent with those received for combined cohort of Belarus,Russia and Baltic States liquidators.

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.