Risk of thyroid follicular adenoma among children and adolescents in Belarus exposed to iodine-131 after the Chornobyl accident.

Several studies reported an increased risk of thyroid cancer in children and adolescents exposed to radioactive iodines, chiefly iodine-131 ((131)I), after the 1986 Chornobyl (Ukrainian spelling) nuclear power plant accident. The risk of benign thyroid tumors following such radiation exposure is much less well known. We have previously reported a novel finding of significantly increased risk of thyroid follicular adenoma in a screening study of children and adolescents exposed to the Chornobyl fallout in Ukraine. To verify this finding, we analyzed baseline screening data from a cohort of 11,613 individuals aged ≤18 years at the time of the accident in Belarus (mean age at screening = 21 years). All participants had individual (131)I doses estimated from thyroid radioactivity measurements and were screened according to a standardized protocol. We found a significant linear dose response for 38 pathologically confirmed follicular adenoma cases. The excess odds ratio per gray of 2.22 (95% confidence interval: 0.41, 13.1) was similar in males and females but decreased significantly with increasing age at exposure (P < 0.01), with the highest radiation risks estimated for those exposed at <2 years of age. Follicular adenoma radiation risks were not significantly modified by most indicators of past and current iodine deficiency. The present study confirms the (131)I-associated increases in risk of follicular adenoma in the Ukrainian population and adds new evidence on the risk increasing with decreasing age at exposure.

Radiation dosimetry for highly contaminated Belarusian, Russian and Ukrainian populations, and for less contaminated populations in Europe.

The explosions at the Chernobyl Nuclear Power Plant (CNPP) in Ukraine early in the morning of 26 April 1986 led to a considerable release of radioactive materials during 10 d. The cloud from the reactor spread many different radionuclides, particularly those of iodine (131I) and cesium (134Cs and 137Cs), over the majority of European countries, but the greatest contamination occurred over vast areas of Belarus, the Russian Federation and Ukraine. As the major health effect of Chernobyl is an elevated thyroid cancer incidence in children and adolescents, much attention has been paid to the thyroid doses resulting from intakes of 131I, which were delivered within 2 mo following the accident. The thyroid doses received by the inhabitants of the contaminated areas of Belarus, Russia, and Ukraine varied in a wide range, mainly according to age, level of ground contamination, milk consumption rate, and origin of the milk that was consumed. Reported individual thyroid doses varied up to approximately 40,000 mGy, with average doses of a few to 1,000 mGy, depending on the area where people were exposed. In addition, the presence in the environment of long-lived 134Cs and 137Cs has led to a relatively homogeneous exposure of all organs and tissues of the body via external and internal irradiation, albeit at low rates. Excluding the thyroid doses, the whole-body (or effective) dose estimates for the general population accumulated during 20 y after the accident (1986-2005) range from a few millisieverts (mSv) to some hundred mSv with an average dose of approximately 10 mSv in the contaminated areas of Belarus, Russia, and Ukraine. In other European countries, both the thyroid and the effective doses are, on average, much smaller.

Individual thyroid dose estimates for a case-control study of chernobyl-related thyroid cancer among children of Belarus--part II. Contributions from long-lived radionuclides and external radiation.

Significant quantities of long-lived radionuclides were released to the environment during the Chernobyl nuclear power plant accident in 1986. These radionuclides contributed to radiation doses due to ingestion of contaminated foods and external exposure from the ground deposition that resulted. The contributions of these exposure pathways to thyroid doses received by subjects of an epidemiologic study of children from Belarus are evaluated and presented. The analysis shows that ingestion of the long-lived radionuclides, primarily radiocesium, typically contributed a small percentage of the total thyroid dose received by the study subjects. The median and mean fractional contributions were 0.76 and 0.95%, respectively. The contribution of external exposure to the thyroid dose was generally larger and more variable, with median and mean contributions of 1.2 and 1.8% of the total thyroid doses, respectively. For regions close to the reactor site, where radionuclide deposition was highest, the contributions of radiocesium ingestion and external exposure were generally lower than those of the short-lived radioiodine isotopes (132I and 133I) and their precursors (132Te). In other areas, the contributions of these two pathways were comparable to those of the short-lived radioiodines. For all subjects, intakes of 131I were the primary source of dose to the thyroid.