Radiation Dose Does Not Affect the Predictive Value of Thyroid Biopsy for Diagnosing Papillary Thyroid Cancer in a Belarusian Cohort Exposed to Chernobyl Fallout.

INTRODUCTION: The Chernobyl nuclear accident exposed residents of contaminated territories to substantial quantities of radioiodines and was followed by an increase in thyroid cancer, primarily papillary thyroid cancer (PTC), among exposed children and adolescents. Although thyroid biopsy is an essential component of screening programs following accidental exposure to radioiodines, it is unknown whether the predictive value of biopsy is affected by different levels of environmental exposure. METHODS: A cohort of 11,732 Belarusians aged ≤18 years at the time of the Chernobyl accident with individual thyroid radiation dose estimates was screened at least once 11-22 years later. Paired cytologic conclusions and histopathologic diagnoses were possible for 258 thyroid nodules from 238 cohort members. Cytologic conclusions were divided into five reporting categories, with all follicular lesion aspirates combined into a single indeterminate category. Standard performance indicators, risk of malignancy (ROM), and odds ratios for a correct cytologic conclusion were calculated, both overall and according to quintile of thyroid radiation dose. RESULTS: The arithmetic mean thyroid dose estimate for the study group was 1.73 Gy (range: 0.00-23.64 Gy). The final histopathologic diagnosis was cancer for 136 of 258 biopsies (52.7%; 135 papillary and 1 follicular). The overall ROM was 96.7% for cytologies definite for PTC, 83.7% for suspicious for PTC, 33.0% for indeterminate, 8.1% for benign, and 31.0% for non-diagnostic. The ROM showed little change according to level of radiation exposure. Overall, there was no association between thyroid radiation dose and the odds ratio for a correct cytologic conclusion (p = 0.24). When analyzed according to dose quintile, the odds ratio for a correct conclusion increased two-fold at 0.10-0.29 Gy compared to a dose of 0.00-0.09 Gy and decreased at doses of 0.3-24 Gy (p value for linear trend = 0.99). CONCLUSIONS: At radiation doses received by a cohort of young Belarusians exposed to radioiodines by the Chernobyl accident, the predictive value of thyroid biopsy for diagnosing PTC was not significantly affected by level of radiation exposure.

Recall of residential history and dietary habits during pregnancy and lactation in the distant past: reliability of questionnaire-based radiation doses for persons exposed in utero and early life.

This study evaluates the reliability of information obtained by standardized questionnaires used in by personal interviews for estimation of radiation thyroid doses of 1065 individuals in the Belarusian cohort of individuals who were exposed in utero and early life following the Chernobyl accident in April 1986. Data from two interviews conducted in 2012-2017 and in 2018-2022 with mothers, who were pregnant or gave birth shortly after the Chernobyl accident, were analysed. The most reliable answers dealt with various attributes related to residential history. In contrast, the reliability of answers regarding consumption rates of milk from privately owned cows or trade network was moderate, while the agreement in responses for consumption of milk products and leafy vegetables was fair. Information from the two interviews was used to calculate thyroid doses received by the cohort members. Specifically, 'model-based' thyroid doses due to 131I were estimated using input data on individual residential history and food consumption reported during the personal interviews and ecological data (131I ground deposition in the corresponding settlements). In addition, for a subset of cohort subjects (n = 205) whose mothers were measured for 131I thyroid activity, 'measurement-based' thyroid doses were calculated by adjusting the model-based dose using a scaling factor that is defined as the ratio of measured 131I thyroid activity to model-based 131I thyroid activity calculated for the date of measurement. A moderate agreement was observed for total (prenatal and postnatal) model-based thyroid doses due to 131I intake, the arithmetic mean ± standard deviation for the Jaccard similarity coefficient ([Formula: see text]) was 0.45 ± 0.34 (median = 0.39), while measurement-based doses showed a much better agreement with a [Formula: see text] of 0.78 ± 0.29 (median = 0.93). For model-based thyroid doses from external irradiation and from ingestion of 134Cs and 137Cs, [Formula: see text] was 0.82 ± 0.23 (median = 0.90) and 0.84 ± 0.24 (median = 0.96), respectively. Measurement-based doses due to ingestion of radiocaesium isotopes resulted in an almost perfect agreement, [Formula: see text] was 0.91 ± 0.19 (median = 1.0). The present findings suggest that long-term memory recall can be reliable, if a person is asked about unique or important life events, such as pregnancy and childbirth occurring around the time of a nuclear reactor accident. However, the substantial difference (more than 10 times) observed for model-bases doses calculated using the two questionnaires represents an important source of human factor uncertainties that needs to be considered in any dose response analyses. Other lessons learned from this study are that (i) individual measurements of radionuclides in the human body are the most valuable source of information for estimating radiation doses, and (ii) whenever a radiation accident occurs, a sample of affected people should be asked to keep a diary, if at all possible.

Assessment of Uncertainties and Errors in Post-Chernobyl Dosimetry.

The present paper reviews the uncertainties and errors in complex dosimetry systems that were developed to estimate individual doses in different post-Chernobyl (Chornobyl) radiation epidemiology studies among the general population and the cleanup workers. These uncertainties and errors are associated with (i) instrumental radiation measurements of humans and environmental samples, (ii) inherent uncertainties arising from the stochastic random variability of the parameters used in exposure assessment and from a lack of knowledge about the true values of the parameters, and (iii) human factor uncertainties due to poor memory recall resulting in incomplete, inaccurate, or missing responses during personal interview with study subjects conducted long after exposure. Relative measurement errors of 131I thyroid activity associated with devices for measuring radioactivity in the thyroid reached up to 0.86 (coefficient of variation). The inherent uncertainty in estimates of individual doses varied between different studies and exposure pathways (GSD from 1.2 to 15 for model-based doses and from 1.3 to 5.1 for measurement-based doses). The human factor uncertainties can cause individual doses to be underestimated or overestimated by an average of 10 times for model-based doses and 2 times for measurement-based doses calculated for the general population and up to 3 times for doses calculated for cleanup workers. The sources of errors and uncertainties, especially the human factor uncertainties, should be carefully considered in dose assessment for radiation epidemiological studies, with particular attention to studies involving persons without instrumental radiation measurements.

Evaluation of 131I transfer in the environment based on the available measurements made in Belarus after the Chernobyl accident.

This study evaluates the 131I transfer from ground deposition to the human thyroid gland after the Chernobyl accident using measurements of 131I concentrations in 1,252 soil, 124 grass, and 136 cow's milk samples as well as 131I thyroid activity measured in 3,100 individuals included in the Belarusian-American cohort. The following parameters of an 131I environmental transfer model used to calculate thyroid doses were evaluated in this study: (i) the interception factor of 131I by pasture grass, which was described by a purely empirical equation, (ii) the removal rate of 131I from pasture grass due to weathering and growth dilution, estimated to be 0.0676 d-1 (half-life of 10.3 d), (iii) the removal rate of 131I from cow's milk, estimated to be 0.0686 d-1 (half-life of 10.1 d), and (iv) the transfer coefficient of 131I from feed to cow's milk, arithmetic mean ± standard deviation of (6.7 ± 8.7) × 10-3 d L-1 (median = 4.0 × 10-3 d L-1). The individual model-based and measurement-based 131I thyroid activities for the Belarusian-American cohort members were calculated using different starting points of 131I transfer in the chain 'ground deposition' → 'vegetation' → 'cow's milk' → 'human thyroid', i.e., the measured 131I concentrations in soil, grass, and cow's milk. De novo thyroid doses from 131I for the 3,100 cohort members were calculated in this study using measured 131I activity concentrations in soil, grass, and cow's milk and were compared with those estimated previously for the same individuals using model-based 131I activity concentrations. It was shown that the use of measured instead of model-based 131I concentrations, in general, did not improve the measurement-based thyroid dose estimates. This is likely to be because there was already a good generic data base for the parameters used in this assessment. This finding indicates that, although the measurements of environmental samples are essential to estimate the parameter values of the 131I transfer model, the individual measurements of 131I thyroid activity are the most valuable information for estimating individual thyroid doses.

Doses from external irradiation and ingestion of 134Cs, 137Cs and 90Sr of the population of Belarus accumulated over 35 years after the Chernobyl accident.

This study considers the exposure of the population of the most contaminated Gomel and Mogilev Oblasts in Belarus to prolonged sources of irradiation resulting from the Chernobyl accident. Dose reconstruction methods were developed and applied in this study to estimate the red bone-marrow doses (RBMs) from (i) external irradiation from gamma-emitting radionuclides deposited on the ground and (ii) 134Cs, 137Cs and 90Sr ingestion with locally produced foodstuffs. The mean population-weighted RBM doses accumulated during 35 years after the Chernobyl accident were 12 and 5.7 mGy for adult residents in Gomel and Mogilev Oblasts, respectively, while doses for youngest age groups were 20-40% lower. The highest mean area-specific RBM doses for adults accumulated in 1986-2021 were 63, 56 and 46 mGy in Narovlya, Vetka and Korma raions in Gomel Oblast, respectively. For most areas, external irradiation was the predominant pathway of exposure (60-70% from the total dose), except for areas with an extremely high aggregated 137Cs soil to cow's milk transfer coefficient (≥ 5.0 Bq L-1 per kBq m-2), where the contribution of 134Cs and 137Cs ingestion to the total RBM dose was more than 70%. The contribution of 90Sr intake to the total RBM dose did not exceed 4% for adults and 10% for newborns in most raion in Gomel and Mogilev Oblasts. The validity of the doses estimated in this study was assessed by comparison with doses obtained from measurements by thermoluminescence dosimeters and whole-body counters done in 1987-2015. The methodology developed in this study can be used to calculate doses to target organs other than RBM such as thyroid and breast doses. The age-dependent and population-weighted doses estimated in this study are useful for ecological epidemiological studies, for projection of radiation risk, and for justification of analytical epidemiological studies in populations exposed to Chernobyl fallout.

Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later.

BACKGROUND: While there is a robust literature on environmental exposure to iodine-131 (131I) in childhood and adolescence and the risk of thyroid cancer and benign nodules, little is known about its effects on thyroid volume. METHODS: To assess the effect of 131I dose to the thyroid on the volume of the thyroid gland, we examined the data from the baseline screening of the Belarusian-American Cohort Study of residents of Belarus who were exposed to the Chernobyl fallout at ages ≤18 years. Thyroid dose estimates were based on individual thyroid activity measurements made shortly after the accident and dosimetric data from questionnaires obtained 10-15 years later at baseline screening. During baseline screening, thyroid gland volume was assessed from thyroid ultrasound measurements. The association between radiation dose and thyroid volume was modeled using linear regression where radiation dose was expressed with power terms to address non-linearity. The model was adjusted for attained age, sex, and place of residence, and their modifying effects were examined. RESULTS: The analysis was based on 10,703 subjects. We found a statistically significant positive association between radiation dose and thyroid volume (P < 0.001). Heterogeneity of association was observed by attained age (P < 0.001) with statistically significant association remaining only in the subgroup of ≥18 years at screening (P < 0.001). For this group, increase in dose from 0.0005 to 0.15 Gy was associated with a 1.27 ml (95% CI: 0.46, 2.07) increase in thyroid volume. The estimated effect did not change with increasing doses above 0.15 Gy. CONCLUSIONS: This is the first study to examine the association between 131I dose to the thyroid gland and thyroid volume in a population of individuals exposed during childhood and systematically screened 10-15 years later. It provides evidence for a moderate statistically significant increase in thyroid volume among those who were ≥ 18 years at screening. Given that this effect was observed at very low doses and was restricted to a narrow dose range, further studies are necessary to better understand the effect.

Thyroid dose estimates for the genome-wide association study of thyroid cancer in persons exposed in Belarus to 131I after the Chernobyl accident.

The Chernobyl accident on 26 April 1986 led to a sharp increase in thyroid cancer (TC) incidence in the individuals exposed to radiation in childhood. The major risk factor for TC was exposure to Iodine-131 (131I). Here, we estimated the thyroid doses due to 131I intake for 2041 participants of the genome-wide association study of TC in Belarusian people exposed to radioactive fallout from the Chernobyl accident. The following parameter-values specially developed in this study were used to estimate individual thyroid doses: (i) scaling factors for adjustment of the model-based doses, (ii) age and gender diet to characterize 131I intake, and (iii) area-, age- and gender-specific S-values for the thyroid gland per 131I decay in the thyroid. The most reliable doses were calculated for 103 people with measured 131I thyroid activity (the arithmetic mean of 1.2 Gy, median 0.52 Gy), and 275 individuals with detailed residential history and dietary data (the arithmetic mean of 0.41 Gy, median 0.24 Gy). The arithmetic mean of thyroid doses among all study participants was 0.23 Gy (median 0.082 Gy); the highest individual dose was 9.0 Gy. Special attention was paid to the reliability and validity of the obtained estimates, in particular for the individuals without 131I thyroid activity measurements and individual data on residential history and diet, by comparing those with the doses from other post-Chernobyl epidemiological studies. Overall, the doses estimated in the current study were in reasonable agreement with previously reported thyroid doses. These doses will be used in the genome-wide association study of TC in people exposed in Belarus to 131I after the Chernobyl accident.

Thyroid doses in Ukraine due to 131I intake after the Chornobyl accident. Report I: revision of direct thyroid measurements.

The increased risk of thyroid cancer among individuals exposed during childhood and adolescence to Iodine-131 (131I) is the main statistically significant long-term effect of the Chornobyl accident. Several radiation epidemiological studies have been carried out or are currently in progress in Ukraine, to assess the risk of radiation-related health effects in exposed populations. About 150,000 measurements of 131I thyroid activity, so-called 'direct thyroid measurements', performed in May-June 1986 in the Ukrainian population served as the main sources of data used to estimate thyroid doses to the individuals of these studies. However, limitations in the direct thyroid measurements have been recently recognized including improper measurement geometry and unknown true values of calibration coefficients for unchecked thyroid detectors. In the present study, a comparative analysis of 131I thyroid activity measured by calibrated and unchecked devices in residents of the same neighboring settlements was conducted to evaluate the correct measurement geometry and calibration coefficients for measuring devices. As a result, revised values of 131I thyroid activity were obtained. On average, in Vinnytsia, Kyiv, Lviv and Chernihiv Oblasts and in the city of Kyiv, the revised values of the 131I thyroid activities were found to be 10-25% higher than previously reported, while in Zhytomyr Oblast, the values of the revised activities were found to be lower by about 50%. New sources of shared and unshared errors associated with estimates of 131I thyroid activity were identified. The revised estimates of thyroid activity are recommended to be used to develop an updated Thyroid Dosimetry system (TD20) for the entire population of Ukraine as well as to revise the thyroid doses for the individuals included in post-Chornobyl radiation epidemiological studies: the Ukrainian-American cohort of individuals exposed during childhood and adolescence, the Ukrainian in utero cohort and the Chornobyl Tissue Bank.

Reliability of thyroid doses due to 131I intake exceeding 5 Gy in a cohort of Belarusian children exposed to Chernobyl fallout.

High thyroid doses due to Iodine-131 (131I) intake among individuals exposed in childhood and adolescence to Chernobyl fallout raise questions about their reliability and their impact on the analysis of the radiation-related risk of thyroid cancer and other thyroid diseases in the exposed population. In the present study, an in-depth examination was conducted of thyroid doses from 131I intake over 5 Gy calculated for 131 subjects of the Belarusian-American cohort of individuals exposed after the Chernobyl accident. Thyroid doses in this cohort study were estimated based on individual radiation measurements of 131I thyroidal activity and detailed questionnaire data on individual behavior and consumptions of locally produced foodstuffs. Therefore, these doses provide the best basis for assessing reliability. The analysis showed that the result of direct thyroid measurement was mistakenly assigned to three out of 131 study subjects (2.3% of the total), and, therefore, the instrumental thyroid dose for these individuals cannot be correctly estimated. This study confirmed with a high degree of confidence the reliability of thyroid doses due to 131I intake exceeding 5 Gy that were calculated for the Belarusian-American cohort members.

Activity concentrations of 131I and other radionuclides in cow's milk in Belarus during the first month following the Chernobyl accident.

The accident at the Chernobyl nuclear power plant (NPP) in Ukraine on April 26, 1986 led to a considerable release of radioactive material resulting in environmental contamination over vast areas of Belarus, Ukraine and western Russian Federation. The major health effect of the Chernobyl accident was an increase in thyroid cancer incidence in people exposed as children and adolescents, so much attention was paid to the thyroid doses resulting from intakes of 131I. Because cow's milk consumption was the main source of 131I intake by people, it was important to measure the 131I activity concentrations in cow's milk to calculate, or to validate, the thyroid doses to the exposed population. Almost 11,000 measurements of total beta-activity in cow's milk were performed using a DP-100 device during the first month after the Chernobyl accident in the most contaminated regions of Belarus. Using an ecological model and calibration coefficients for the DP-100 device the activity concentration of 131I in cow's milk was derived as well as the activity concentrations of the other radiologically important radionuclides, namely 134Cs, 137Cs, 89Sr and 90Sr. The activity concentrations of other radionuclides, such as 90Y, 132Te, 132I, 133I, 136Cs, 140Ba, 140La, 141Ce and 144Ce, in cow's milk were also estimated and were shown to be of minor importance. The concentrations of 95Zr, 95Nb, 103Ru and 106Ru in cow's milk were negligible. The data obtained in this study were validated by comparing derived 131I and 137Cs concentrations in cow's milk with gamma-spectrometry measurements performed in milk produced in the same location close to the same date. The results of this study were essential to assess and validate the radiation doses received by the subjects of epidemiological studies related to the health consequences of the Chernobyl accident.

Belarusian in utero cohort: A new opportunity to evaluate the health effects of prenatal and early-life exposure to ionising radiation.

In April 1986, the Chernobyl nuclear accident resulted in wide-scale contamination of Belarus with significantly elevated levels of radioiodine isotopes, mainly iodine-131 (131I), and long-lived radiocaesium isotopes, mainly caesium-137 (137Cs). Various groups of the population were affected by exposure to ionising radiation, including pregnant women and their foetuses. This paper describes the methods and results related to the establishment of a cohort of 2965 Belarusian people exposed in utero due to Chernobyl fallout. The cohort consists of individuals whose mothers resided in the most radioactively contaminated areas in Belarus at the time of the accident. Prenatal and postnatal doses to the thyroid due to intake of 131I, external irradiation and ingestion of radiocaesium isotopes were estimated for all cohort members. Ongoing research on this unique cohort will provide important information on adverse health effects following prenatal and postnatal exposure to radioiodine and radiocaesium isotopes, for which available epidemiological data are scant.

Thyroid Dose Estimates for a Cohort of Belarusian Persons Exposed in Utero and During Early Life to Chernobyl Fallout.

Thyroid radiation doses were estimated for a cohort of 2,965 Belarusian persons who were exposed in utero and during early life to fallout from the Chernobyl nuclear power plant accident. Prenatal and postnatal doses to the thyroid due to intake of I, external irradiation from radionuclides deposited on the ground, and ingestion of cesium isotopes (Cs and Cs) were calculated for all cohort members. Dose estimation was based on personal interviews with subjects' mothers; the interviews collected data on subjects' residential history, consumption by mothers during time of pregnancy and breast-feeding, as well as consumption by subjects after birth. Direct instrumental measurements of radioactivity in mothers and the study subjects, if available, were also used for calculation of doses. Intake of I by mothers was found to be the predominant pathway for thyroid exposure for the study subjects. The average thyroid dose due to all exposure pathways was estimated to be 137 mGy (median dose of 25 mGy, maximal dose of 14.8 Gy), including 130 mGy (median dose of 17 mGy, maximal dose of 14.8 Gy) from I intake, 4.9 mGy (median dose of 3.0 mGy, maximal dose of 102 mGy) due to external irradiation, and 2.5 mGy (median dose of 1.7 mGy, maximal dose of 47 mGy) due to ingestion of Cs. The dose estimates will be used to evaluate the radiation-related risk of thyroid cancer and other thyroid diseases in this unique cohort.

Influence of the external and internal radioactive contamination of the body and the clothes on the results of the thyroidal 131I measurements conducted in Belarus after the Chernobyl accident. Part 1: Estimation of the external and internal radioactive contamination.

The estimation of the thyroid doses received in Belarus after the Chernobyl accident is based on the analysis of exposure-rate measurements performed with radiation detectors placed against the necks of about 130,000 residents. The purpose of these measurements was to estimate the 131I activity contents of the thyroids of the subjects. However, because the radiation detectors were not equipped with collimators and because the subjects usually wore contaminated clothes, among other factors, the radiation signal included, in addition to the gamma rays emitted during the decay of the 131I activity present in the thyroid, contributions from external contamination of the skin and clothes and internal contamination of organs other than the thyroid by various radionuclides. The assessment of the contributions of the external and internal contamination of the body to the radiation signal is divided into two parts: (1) the estimation of the radionuclide activities deposited on, and incorporated in, various parts of the body, and (2) the responses of the radiation detectors to the gamma rays emitted by the radionuclides deposited on, and incorporated in, various parts of the body. The first part, which is presented in this paper, includes a variety of exposure scenarios, models, and calculations for 17 of the most abundant gamma-emitting radionuclides contributing to the thyroid detector signal, while the second part is presented in a companion paper. The results presented in the two papers were combined to calculate the contributions of the external and internal contamination of the body to the radiation signal, and, in turn, the 131I activities in the thyroids of all subjects of an epidemiologic study of thyroid cancer and other thyroid diseases among 11,732 Belarusian-American cohort members who were exposed in childhood and adolescence.

Influence of the external and internal radioactive contamination of the body and the clothes on the results of the thyroidal 131I measurements conducted in Belarus after the Chernobyl accident-Part 2: Monte Carlo simulation of response of detectors near the thyroid.

This paper describes the calculation of the response of the most common types of radiation detectors that were used within the first few weeks after the Chernobyl accident to determine the activity of 131I in the thyroids of Belarusian subjects of an epidemiologic study of thyroid cancer. The radiation detectors, which were placed against the necks of the subjects, measured the exposure rates due to the emission of gamma rays resulting from the radioactive decay of 131I in their thyroids. Because of the external and internal radioactive contamination of the monitored subjects, gamma radiation from many radionuclides in various locations contributed to the exposure rates recorded by the detectors. To estimate accurately the contribution from gamma rays emitted from various internal and external parts of the body, the calibration factors of the radiation detectors, expressed in kBq per µR h- 1, were calculated, by means of Monte Carlo simulation, for external irradiation from unit activities of 17 radionuclides located on 19 parts of the body, as well as for internal irradiation from the same 17 radionuclides in the lungs, from caesium radionuclides distributed uniformly in the whole body, and from 131I in the thyroid. The calculations were performed for six body sizes, representative of the age range of the subjects. In a companion paper, the levels of external and internal contamination of the body were estimated for a variety of exposure conditions. The results presented in the two papers were combined to calculate the 131I activities in the thyroids of all 11,732 Belarusian study subjects of an epidemiologic study of thyroid cancer and, in turn, their thyroid doses.

Risk of Thyroid Nodules in Residents of Belarus Exposed to Chernobyl Fallout as Children and Adolescents.

Context: Although radiation exposure is an important predictor of thyroid cancer on diagnosis of a thyroid nodule, the relationship between childhood radiation exposure and thyroid nodules has not been comprehensively evaluated. Objective: To examine the association between internal I-131 thyroid dose and thyroid nodules in young adults exposed during childhood. Design, setting, and participants: In this cross-sectional study, we screened residents of Belarus aged ≤18 years at the time of the Chernobyl nuclear accident for thyroid disease (median age, 21 years) with thyroid palpation, ultrasonography, blood/urine analysis, and medical follow-up when appropriate. Eligible participants (N = 11,421) had intact thyroid glands and doses based on direct individual thyroid activity measurements. Main outcome measures: Excess odds ratios per Gray (EOR/Gy, scaled at age 5 years at exposure) for any thyroid nodule and for nodules grouped by cytology/histology, diameter size, and singularity. Results: Risk of any thyroid nodule increased significantly with I-131 dose and, for a given dose, with younger age at exposure. The EOR/Gy (95% confidence intervals) for neoplastic nodules (3.82; 0.87 to 15.52) was significantly higher than for nonneoplastic nodules (0.32; <0.03 to 0.70) and did not vary by size; whereas the EOR/Gy for nonneoplastic nodules did vary by size (P = 0.02) and was 1.55 (0.36 to 5.46) for nodules ≥10 mm and 0.02 (<-0.02 to 0.70) for nodules <10 mm. EORs/Gy for single and multiple nodules were comparable. Conclusions: Childhood exposure to internal I-131 is associated with increased risk of neoplastic thyroid nodules of any size and nonneoplastic nodules ≥10 mm.

Reliability of Questionnaire Data in the Distant Past: Relevance for Radiation Exposure Assessment.

Interviews with questionnaires are often employed to provide information that may be used for exposure assessment, although the reliability of such information is largely unknown. In this work, the consistency of individual behavior and dietary data collected by means of personal interviews during two study screenings was evaluated. Data were collected for a cohort of about 11,000 persons exposed to 131I in childhood and adolescence shortly after the Chernobyl accident. The best recollection was found for residential history, milk consumption patterns, and, to a lesser degree, stable iodine administration, while reproducibility of responses about consumption of milk products and leafy vegetables was poor. Consistency of information reported during the personal interviews by the study subjects younger than 10 y at the time of the accident was somewhat lower than for the subjects aged 10-18 y. The authors found slightly better reproducibility of responses for female study subjects than for male subjects and when the time span between two interviews was shorter. In the majority of instances, the best consistency in responses was observed when the mother was interviewed during both screenings rather than the subject. Information that was collected during two personal interviews was used to calculate two sets of thyroid doses due to 131I intakes. This study shows that, because dose-related measurements are available for all study subjects, the quality of individual behavior and dietary data has, in general, a small influence on the results of the retrospective dose assessment. For studies in which dose-related measurements are not available for all study subjects and only modeling is used for dose reconstruction, high quality individual behavior and dietary data for the study subjects are required to provide realistic and reliable dose estimates.

Impact of Uncertainties in Exposure Assessment on Thyroid Cancer Risk among Persons in Belarus Exposed as Children or Adolescents Due to the Chernobyl Accident.

BACKGROUND: The excess incidence of thyroid cancer in Ukraine and Belarus observed a few years after the Chernobyl accident is considered to be largely the result of 131I released from the reactor. Although the Belarus thyroid cancer prevalence data has been previously analyzed, no account was taken of dose measurement error. METHODS: We examined dose-response patterns in a thyroid screening prevalence cohort of 11,732 persons aged under 18 at the time of the accident, diagnosed during 1996-2004, who had direct thyroid 131I activity measurement, and were resident in the most radio-actively contaminated regions of Belarus. Three methods of dose-error correction (regression calibration, Monte Carlo maximum likelihood, Bayesian Markov Chain Monte Carlo) were applied. RESULTS: There was a statistically significant (p<0.001) increasing dose-response for prevalent thyroid cancer, irrespective of regression-adjustment method used. Without adjustment for dose errors the excess odds ratio was 1.51 Gy- (95% CI 0.53, 3.86), which was reduced by 13% when regression-calibration adjustment was used, 1.31 Gy- (95% CI 0.47, 3.31). A Monte Carlo maximum likelihood method yielded an excess odds ratio of 1.48 Gy- (95% CI 0.53, 3.87), about 2% lower than the unadjusted analysis. The Bayesian method yielded a maximum posterior excess odds ratio of 1.16 Gy- (95% BCI 0.20, 4.32), 23% lower than the unadjusted analysis. There were borderline significant (p = 0.053-0.078) indications of downward curvature in the dose response, depending on the adjustment methods used. There were also borderline significant (p = 0.102) modifying effects of gender on the radiation dose trend, but no significant modifying effects of age at time of accident, or age at screening as modifiers of dose response (p>0.2). CONCLUSIONS: In summary, the relatively small contribution of unshared classical dose error in the current study results in comparatively modest effects on the regression parameters.

Thyroid Dose Estimates for a Cohort of Belarusian Children Exposed to (131)I from the Chernobyl Accident: Assessment of Uncertainties.

Deterministic thyroid radiation doses due to iodine-131 ((131)I) intake were reconstructed in a previous article for 11,732 participants of the Belarusian-American cohort study of thyroid cancer and other thyroid diseases in individuals exposed during childhood or adolescence to fallout from the Chernobyl accident. The current article describes an assessment of uncertainties in reconstructed thyroid doses that accounts for the shared and unshared errors. Using a Monte Carlo simulation procedure, 1,000 sets of cohort thyroid doses due to (131)I intake were calculated. The arithmetic mean of the stochastic thyroid doses for the entire cohort was 0.68 Gy. For two-thirds of the cohort the arithmetic mean of individual stochastic thyroid doses was less than 0.5 Gy. The geometric standard deviation of stochastic doses varied among cohort members from 1.33 to 5.12 with an arithmetic mean of 1.76 and a geometric mean of 1.73. The uncertainties in thyroid dose were driven by the unshared errors associated with the estimates of values of thyroid mass and of the (131)I activity in the thyroid of the subject; the contribution of shared errors to the overall uncertainty was small. These multiple sets of cohort thyroid doses will be used to evaluate the radiation risks of thyroid cancer and noncancer thyroid diseases, taking into account the structure of the errors in the dose estimates.

Thyroid dose estimates for a cohort of Belarusian children exposed to radiation from the Chernobyl accident.

The U.S. National Cancer Institute, in collaboration with the Belarusian Ministry of Health, is conducting a study of thyroid cancer and other thyroid diseases in a cohort of about 12,000 persons who were exposed to fallout from the Chernobyl accident in April 1986. The study subjects were 18 years old or younger at the time of exposure and resided in Belarus in the most contaminated areas of the Gomel and Mogilev Oblasts, as well as in the city of Minsk. All cohort members had at least one direct thyroid measurement made in April-June 1986. Individual data on residential history, consumption of milk, milk products and leafy vegetables as well as administration of stable iodine were collected for all cohort members by means of personal interviews conducted between 1996 and 2007. Based on the estimated (131)I activities in the thyroids, which were derived from the direct thyroid measurements, and on the responses to the questionnaires, individual thyroid doses from intakes of (131)I were reconstructed for all cohort members. In addition, radiation doses to the thyroid were estimated for the following minor exposure pathways: (a) intake of short-lived (132)I, (133)I and (132)Te by inhalation and ingestion; (b) external irradiation from radionuclides deposited on the ground; and (c) ingestion intake of (134)Cs and (137)Cs. Intake of (131)I was the major pathway for thyroid exposure; its mean contribution to the thyroid dose was 92%. The thyroid doses from (131)I intakes varied from 0.5 mGy to almost 33 Gy; the mean was estimated to be 0.58 Gy, while the median was 0.23 Gy. The reconstructed doses are being used to evaluate the risk of thyroid cancer and other thyroid diseases in the cohort.

Database of meteorological and radiation measurements made in Belarus during the first three months following the Chernobyl accident.

Results of all available meteorological and radiation measurements that were performed in Belarus during the first three months after the Chernobyl accident were collected from various sources and incorporated into a single database. Meteorological information such as precipitation, wind speed and direction, and temperature in localities were obtained from meteorological station facilities. Radiation measurements include gamma-exposure rate in air, daily fallout, concentration of different radionuclides in soil, grass, cow's milk and water as well as total beta-activity in cow's milk. Considerable efforts were made to evaluate the reliability of the measurements that were collected. The electronic database can be searched according to type of measurement, date, and location. The main purpose of the database is to provide reliable data that can be used in the reconstruction of thyroid doses resulting from the Chernobyl accident.