Hospitalizations Among Chernobyl-Exposed Immigrants to the Negev of Israel, 1992-2017: A Historical Follow-Up Study.

On April 26th, 1986 the nuclear reactor at Chernobyl, Ukraine exploded, causing the worst radiation disaster in history. The aim was to estimate hospitalization rates among exposed civilians who later immigrated to Israel. We conducted a historical follow-up study, among persons exposed to Chernobyl (n = 1128) using linked hospitalization records from Soroka University Medical Center (SUMC), compared with immigrants from other areas of the Former Soviet Union (FSU) (n = 11,574), immigrants not from FSU (n = 11,742) and native-born Israelis (n = 8351), matched on age and gender (N = 32,795). Hospitalizations for specific ICD-10 coded diagnostic groups were analyzed by exposure and comparison groups by gender and age at accident. In addition, the rate of hospitalization, and the duration of hospital days and the number of hospitalizations for these selected diagnostic groups was also calculated. Hospitalizations for specific ICD-10 coded diagnostic groups and for any hospitalization in these diagnostic groups in general were analyzed by exposure and comparison groups and by covariates (gender and age at accident). The rate of any hospitalization for the selected diagnostic groups was elevated in the low exposure Chernobyl group (51.1%), which was significantly higher than the immigrant (41.6%) and the Israel-born comparison group (35.1%) (p < .01) but did not differ from either the high exposure group (46.9%) or the FSU comparison group (46.4%), according to the post-hoc tests. The total number of hospitalizations in the low exposure Chernobyl group (2.35) differed from the immigrant (1.73) and Israel comparison group (1.26) (p < .01) but did not differ from the FSU comparison group (1.73) or the high exposure group (2.10). Low exposure women showed higher rates of circulatory hospitalizations (33.8%) compared to immigrants (22.8%) and Israeli born (16.5%), while high exposure women (27.5%) only differed from Israelis (p < .01). Neither exposure group differed from FSU immigrant women on the rate of circulatory hospitalizations. Post-hoc tests showed that among women in the low exposure group, there was a significant difference in rate of hospitalizations for neoplasms (28.6%) compared to the three comparison groups; FSU (18.6%), immigrants (15.7%) and Israel (13.1) (p < .01). Those among the low exposure group who were over the age of 20 at the time of the accident showed the higher rates of circulatory (51.2%) and neoplasm hospitalizations (33.3%), compared to the other immigrant groups (p < .01). When controlling for both age at accident and gender, hospitalizations for neoplasms were higher among Chernobyl-exposed populations (RR = 1.65, RR = 1.77 for high and low-exposure groups, respectively) compared to other FSU immigrants (RR = 1.31) other immigrants (RR = 1.11) and Israeli born (RR = 1.0) after controlling for gender and age at accident. High RRs attributable to Chernobyl exposure were also found for circulatory diseases compared to other immigrants and Israeli born (RRs = 1.50, 1.47 for high and low exposure compared to 1.11. and 1.0, other immigrants and Israeli born, respectively). Endocrine problems and disorders of the eye also showed elevated RR compared to the immigrant comparison groups. Respiratory and mental disorders did not show any consistent association with Chernobyl exposure. The findings support unique Chernobyl morbidity associations only in some diagnostic groups, particularly for low exposure women. General immigration effects on hospitalizations compared to the Israeli born population were found on all diagnostic groups. There is a need to improve the services and medical follow-up for these Chernobyl exposed groups in specific diagnostic groups.

Reproductive Effects of Exposure to Low-Dose Ionizing Radiation: A Long-Term Follow-Up of Immigrant Women Exposed to the Chernobyl Accident.

The Chernobyl accident in 1986 spread ionizing radiation over extensive areas of Belarus and Ukraine, leading to adverse health effects in exposed children. More than 30 years later, exposed children have grown and became parents themselves. This retrospective study from Israel was aimed to evaluate whether Chernobyl-exposed women are at higher risk for adverse reproductive outcomes. Exposed immigrants were identified as high or low exposure based on Caesium-137 soil contamination levels registered in the town they lived in. The exposed group was age matched with three comparison groups: non-exposed immigrant women from the Former Soviet Union (FSU) excluding Belarus and the Ukraine, immigrants from other countries (Non FSU) and Israeli-born women at a ratio of 1:10. Chernobyl-exposed women were more likely to be nulliparous and have fewer children (2.1 + 0.8 vs. 3.1 + 1.8, p < 0.001), were more likely to undergo fertility treatments (8.8% vs. 5.8%, adjusted OR = 1.8, 95%CI 1.04-3.2, p = 0.036), and were also more likely to have anemia after delivery (49.4% vs. 36.6%, OR = 1.7, 95%CI 1.2-2.3, p = 0.001), compared to women in the combined comparison groups. The overall fertility of Chernobyl-exposed women seems to be reduced as reflected by the lower number of children and their greater need for fertility treatments.

Chronic diseases and mortality among immigrants to Israel from areas contaminated by the Chernobyl disaster: a follow-up study.

OBJECTIVES: To examine six chronic diseases and all-cause mortality among immigrants to Israel from areas contaminated by the Chernobyl accident. METHODS: The medical data were obtained from the two largest HMOs in Israel. In the assessment of chronic diseases, individuals were divided into three groups: less exposed (n = 480), more exposed (n = 359), and liquidators (n = 45) and in the mortality analysis, into two groups: less exposed (n = 792) and more exposed (n = 590). RESULTS: Compared to the less exposed, adults from the more exposed group had increased odds of respiratory disorders (OR = 2.34, 95% CI 1.21, 4.54) and elevated odds, with borderline significance, of ischemic heart disease (OR = 2.01, 95% CI 0.97, 4.20). In addition, the liquidators had increased odds of hypertension compared to the less exposed (OR = 2.64, 95% CI 1.24, 5.64). The Cox proportional-hazards model indicated no difference in the ratio of all-cause mortality between the exposed groups during the follow up period. CONCLUSIONS: Our study, conducted approximately two decades after the accident, suggests that exposure to radionuclides may be associated with increased odds of respiratory disorders and hypertension.

Low-dose environmental radiation, DNA damage, and cancer: the possible contribution of psychological factors.

Radiation causes DNA damage, increases risk of cancer, and is associated with psychological stress responses. This article proposes an evidence-based integrative model in which psychological factors could interact with radiation by either augmenting or moderating the adverse effects of radiation on DNA integrity and eventual tumorigenesis. Based on a review of the literature, we demonstrate the following: (1) the effects of low-dose radiation exposures on DNA integrity and on tumorigenesis; (2) the effects of low-dose radiation exposure on psychological distress; (3) the relationship between psychological factors and DNA damage; and (4) the possibility that psychological stress augments and that psychological resource variables moderate radiation-induced DNA damage and risk of cancer. The additional contribution of psychological processes to radiation-DNA damage-cancer relationships needs further study, and if verified, has clinical implications.

Positive cooperativity in the cellular uptake of a boronated porphyrin.

This work was undertaken to assess the kinetics of boronated porphyrin cellular uptake, which has been reported to occur by way of the low-density lipoprotein receptors. Because of current interest in the use of boronated porphyrins in boron neutron capture therapy of tumors, this pathway was investigated for the cellular uptake of a boronated porphyrin (tetrakis-carborane-carboxylate, esters of 2,4-bis (alpha,beta-dihydroxyethyl) deuteroporphyrin IX). Boron uptake occurred even without low-density lipoprotein in the culture medium. Pre-incubation of V-79 Chinese hamster cells for 24 h in medium containing delipidized fetal bovine serum markedly increased the subsequent uptake of boron when compared with cells pre-incubated with medium containing 10% fetal bovine serum. The increased uptake was characterized by greater affinity for boronated porphyrin, compared to cells pre-incubated in 10% fetal bovine serum. Twenty-four hour preincubation of cells with increasing concentrations of LDL added to delipidized medium suppressed the up-regulation of the boron level. In contrast, incubation with added acetylated LDL did not prevent the up-regulation of boron uptake. Positive cooperativity was demonstrated by Hill and Scatchard plots. It is concluded that uptake of boronated porphyrin is characterized by positive cooperativity, that its uptake is markedly enhanced when preincubated in delipidized serum, and that significant uptake occurs even in the absence of low density lipoprotein in the medium. These data suggest a novel way for enhancing uptake of boron (and perhaps other agents) into tissues using carrier porphyrins, by increasing the number and/or affinity of cellular LDL receptors.

Linkage of boronated polylysine to glycoside moieties of polyclonal antibody; boronated antibodies as potential delivery agents for neutron capture therapy.

Among the ways to deliver comparatively large amounts of boron to cells in vitro for boron neutron capture studies is the linkage of a boronated macromolecule such as polylysine to an antibody. In order to reduce interference with immunoreactivity, boronated polylysine (BPL) was linked to oligosaccharide moieties on the IgG molecule distant from the antibody combining sites. The resultant bioconjugate was chromatographically separated from free BPL and unconjugated antibody using a Sephacryl S300 column. The total measured boron per BPL-IgG conjugate, determined by direct current plasma atomic emission spectroscopy, was estimated to be approximately 6 x 10(3) atoms. This, together with molecular weight estimations, indicated conjugation of about 3 polylysines to each IgG molecule. Immunoreactivity of the conjugate was found to be the same as that of the unconjugated polyclonal antibody. This was based on its concentration dependent interference with immunometric reactions for an antigen (TSH), whereas heat inactivated or non-specific antibody had no such inhibitory effects. The results support the hypothesis that the binding affinity of the conjugate for antigen was preserved after its linkage to BPL under the conditions described. The methodology described in this report may have applicability for the preparation of boronated antibodies as delivery agents for BNCT.