The State Scientific Automated Medical Registry, Kazakhstan: an important resource for low-dose radiation health research.

Direct quantitative assessment of health risks following exposure to ionizing radiation is based on findings from epidemiological studies. Populations affected by nuclear bomb testing are among those that allow such assessment. The population living around the former Soviet Union's Semipalatinsk nuclear test site is one of the largest human cohorts exposed to radiation from nuclear weapons tests. Following research that started in the 1960s, a registry that contains information on more than 300,000 individuals residing in the areas neighboring to the test site was established. Four nuclear weapons tests, conducted from 1949 to 1956, resulted in non-negligible radiation exposures to the public, corresponding up to approximately 300 mGy external dose. The registry contains relevant information about those who lived at the time of the testing as well as about their offspring, including biological material. An international group of scientists worked together within the research project SEMI-NUC funded by the European Union, and concluded that the registry provides a novel, mostly unexplored, and valuable resource for the assessment of the population risks associated with environmental radiation exposure. Suggestions for future studies and pathways on how to use the best dose assessment strategies have also been described in the project. Moreover, the registry could be used for research on other relevant public health topics.

Methods of minimising doses incurred by external exposure while moving in radiation hazardous areas.

Radiation doses received by workers during their movement within areas contaminated as a result of events and activities, leading to emergency or existing exposure situations, may provide a substantial contribution to total external exposure during remediation work. This paper describes an approach to minimise worker external exposure in these circumstances, based on graph theory. The paper describes several tasks, including: searching for a route with the lowest dose, searching for an optimal bypass with a given set of control points and searching for the optimal road network coverage. Classical graph theory algorithms have been used (Dijkstra's algorithm, Chinese postman problem and travelling salesman problem). Algorithms for solving the above mentioned problems have been developed and were included in the information-analytical system for radiation safety. This software has been applied for optimisation of protection during remediation work at the Andreeva Bay site of temporary storage for spent fuel and radioactive waste in the Kola Peninsula, both in the context of existing exposure situations and improving the preparedness for emergency exposure situations.

Estimation of the contribution of short-lived radioiodines to the thyroid dose for the public in case of inhalation intake following the Fukushima accident.

The purpose of this paper is to present (1) the method of assessing the contribution of short-lived radioiodines to the thyroid for members of the public in Fukushima and neighbouring prefectures based on available data and (2) the results of a realistic assessment of such a contribution. The estimates of that contribution for the inhalation intake that occurred on the day of the main fallout (15 March 2011) are within 15 % of the dose to the thyroid from (131)I. The contribution to the thyroid dose from intake of (132)Te is higher than that from the intake of (133)I by a factor of ∼3. The contribution of short-lived radioiodines to the thyroid dose for the public in the case of inhalation intake occurring as early as March 12 might be as great as 30-40 %.

[Comparative analysis of the radionuclide composition in fallout after the Chernobyl and the Fukushima accidents].

The nuclear accident occurred at Fukushima Dai-ichi Nuclear Power Plant (NPP) (March 11, 2011) similarly to the accident at the Chernobyl NPP (April 26, 1986) is related to the level 7 of the INES. It is of interest to make an analysis of the radionuclide composition of the fallout following the both accidents. The results of the spectrometric measurements were used in that comparative analysis. Two areas following the Chernobyl accident were considered: (1) the near zone of the fallout - the Belarusian part of the central spot extended up to 60 km around the Chernobyl NPS and (2) the far zone of the fallout--the "Gomel-Mogilev" spot centered 200 km to the north-northeast of the damaged reactor. In the case of Fukushima accident the near zone up to about 60 km considered. The comparative analysis has been done with respect to refractory radionuclides (95Zr, 95Nb, 141Ce, 144Ce), as well as to the intermediate and volatile radionuclides 103Ru, 106Ru, 131I, 134Cs, 137Cs, 140La, 140Ba and the results of such a comparison have been discussed. With respect to exposure to the public the most important radionuclides are 131I and 137Cs. For the both accidents the ratios of 131I/137Cs in the considered soil samples are in the similar ranges: (3-50) for the Chernobyl samples and (5-70) for the Fukushima samples. Similarly to the Chernobyl accident a clear tendency that the ratio of 131I/137Cs in the fallout decreases with the increase of the ground deposition density of 137Cs within the trace related to a radioactive cloud has been identified for the Fukushima accident. It looks like this is a universal tendency for the ratio of 131I/137Cs versus the 137Cs ground deposition density in the fallout along the trace of a radioactive cloud as a result of a heavy accident at the NPP with radionuclides releases into the environment. This tendency is important for an objective reconstruction of 131I fallout based on the results of 137Cs measurements of soil samples carried out at late dates after the Fukushima accident.

Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency response at SevRAO facilities is a priority task within the general system of emergency preparedness; (b) there is an effective and improving interaction between SevRAO and the local medical institutions of FMBA and other territorial medical units; (c) the infrastructure of emergency response at SevRAO facilities has been created and operates within the framework of Russian legal and normative requirements. Further proposals have been made aimed at increasing the effectiveness of the available system of emergency preparedness and response, and to promote interagency cooperation.

Ultrasound-detected thyroid nodule prevalence and radiation dose from fallout.

Settlements near the Semipalatinsk Test Site (SNTS) in northeastern Kazakhstan were exposed to radioactive fallout during 1949-1962. Thyroid disease prevalence among 2994 residents of eight villages was ascertained by ultrasound screening. Malignancy was determined by cytopathology. Individual thyroid doses from external and internal radiation sources were reconstructed from fallout deposition patterns, residential histories and diet, including childhood milk consumption. Point estimates of individual external and internal dose averaged 0.04 Gy (range 0-0.65) and 0.31 Gy (0-9.6), respectively, with a Pearson correlation coefficient of 0.46. Ultrasound-detected thyroid nodule prevalence was 18% and 39% among males and females, respectively. It was significantly and independently associated with both external and internal dose, the main study finding. The estimated relative biological effectiveness of internal compared to external radiation dose was 0.33, with 95% confidence bounds of 0.09-3.11. Prevalence of papillary cancer was 0.9% and was not significantly associated with radiation dose. In terms of excess relative risk per unit dose, our dose-response findings for nodule prevalence are comparable to those from populations exposed to medical X rays and to acute radiation from the Hiroshima and Nagasaki atomic bombings.

Thyroid cancer among Ukrainians and Belarusians who were children or adolescents at the time of the Chernobyl accident.

Our objective is to assess the regional and temporal dependences of the baseline cases contributing to thyroid cancer incidence among those exposed in childhood or during adolescence in Belarus and Ukraine after the Chernobyl accident. Data are analysed for Kyiv and Sevastopol City and the 25 oblasts (regions) in Ukraine, and for Minsk and Gomel City and the 6 oblasts in Belarus. Average thyroid doses due to the Chernobyl accident were assessed for every birth year in the period from 1968 to 1985. Case data pertain to people who underwent surgical removal of thyroid cancers during the period 1986 to 2001 and who were allocated to their place of residence at the time of the accident. The 35 oblasts/cities were subdivided into an upper, middle and lower group of baseline thyroid cancer incidence. Poisson regressions were performed to estimate age, time and gender dependences of the baseline incidence rates in the three groups. The majority of oblasts/cities with high average doses and the majority of Belarusian oblasts/cities belong to the upper group of baseline thyroid cancer incidence. The baseline in the upper group is estimated to be larger than in the middle group by a factor of 2.3, and by a factor of 4.0 when compared to the lower group. The baseline incidence increases with age and with time since exposure. Estimated baseline incidence rates were found to increase from 1988 to 1999 by factors of three and two for the upper and the two lower groups respectively. The estimated thyroid cancer incidence rates in Belarus and Ukraine, and their dependences on gender and age, are consistent with observed rates found in the larger cancer registries of other countries. In conclusion, the baseline cases are found to contribute about 70% to the thyroid cancer incidence in Ukraine, and about 40% to the incidence in Belarus.

Thyroid cancer risk in areas of Ukraine and Belarus affected by the Chernobyl accident.

The purpose of the present study was to analyze the thyroid cancer incidence risk after the Chernobyl accident and its degree of dependence on time and age. Data were analyzed for 1034 settlements in Ukraine and Belarus, in which more than 10 measurements of the (131)I content in human thyroids had been performed in May/June 1986. Thyroid doses due to the Chernobyl accident were assessed for the birth years 1968-1985 and related to thyroid cancers that were surgically removed during the period 1990-2001. The central estimate for the linear coefficient of the EAR dose response was 2.66 (95% CI: 2.19; 3.13) cases per 10(4) PY-Gy; for the quadratic coefficient, it was -0.145 (95% CI: -0.171; -0.119) cases per 10(4) PY-Gy(2). The EAR was found to be higher for females than for males by a factor of 1.4. It decreased with age at exposure and increased with age attained. The central estimate for the linear coefficient of the ERR dose response was 18.9 (95% CI: 11.1; 26.7) Gy(-1); for the quadratic coefficient, it was -1.03 (95% CI: -1.46; -0.60) Gy(-2). The ERR was found to be smaller for females than for males by a factor of 3.8 and decreased strongly with age at exposure. Both EAR and ERR were higher in the Belarusian settlements than in the Ukrainian settlements. In contrast to ERR, EAR increases with time after exposure. At the end of the observation period, excess risk estimates were found to be close to those observed in a major pooled analysis of seven studies of childhood thyroid cancer after external exposures.

Estimating individual thyroid doses for a case-control study of childhood thyroid cancer in Bryansk Oblast, Russia.

Following the Chernobyl accident, radioactive fission products, including (131)I and (137)Cs, were deposited in Bryansk Oblast in Russia. Intakes of radioiodines, mainly (131)I in milk, were the principal sources of radiation doses to thyroids of residents of the contaminated areas, but those radionuclides decayed before detailed contamination surveys could be performed. As a result, (137)Cs deposition density is the primary measure of the contamination due to the accident and there are relatively few measurements of the ratio of (131)I to (137)Cs in vegetation or soil samples from this area. Although many measurements of radiation emitted from the necks of residents were performed and used to estimate thyroidal (131)I activities and thyroid doses, such data are not available for all subjects. The semi-empirical model was selected to provide a dose calculation method to be applied uniformly to cases and controls in the study. The model was developed using dose estimates from direct measurements of (131)I in adult thyroids, and relates settlement average thyroid doses to (137)Cs contamination levels and ratios of (131)I to (137)Cs. This model is useful for areas where thyroid monitoring was not performed and can be used to estimate doses to exposed individuals. For application to children in this study, adjustment factors are used to address differences in age-dependent intake rates and thyroid dosimetry. Other individual dietary factors and sources (private/public) of milk consumed are reflected in the dose estimates. Countermeasures that reduced thyroid dose, such as cessation of milk consumption and intake of stable iodine, are also considered for each subject. The necessary personal information of subjects was obtained by interview, most frequently of their mothers, using a questionnaire developed for the study. Uncertainties in thyroid dose, estimated using Monte Carlo techniques, are presented for reference conditions. Thyroid dose estimates for individual children made using the semi-empirical model and questionnaire data compare reasonably well with dose estimates made for 19 children whose thyroid burdens of (131)I were measured from May to June 1986.

Chernobyl accident: reconstruction of thyroid dose for inhabitants of the Republic of Belarus.

The Chernobyl accident in April 1986 resulted in widespread contamination of the environment with radioactive materials, including (131)I and other radioiodines. This environmental contamination led to substantial radiation doses in the thyroids of many inhabitants of the Republic of Belarus. The reconstruction of thyroid doses received by Belarussians is based primarily on exposure rates measured against the neck of more than 200,000 people in the more contaminated territories; these measurements were carried out within a few weeks after the accident and before the decay of (131)I to negligible levels. Preliminary estimates of thyroid dose have been divided into 3 classes: Class 1 ("measured" doses), Class 2 (doses "derived by affinity"), and Class 3 ("empirically-derived" doses). Class 1 doses are estimated directly from the measured thyroidal (131)I content of the person considered, plus information on lifestyle and dietary habits. Such estimates are available for about 130,000 individuals from the contaminated areas of the Gomel and Mogilev Oblasts and from the city of Minsk. Maximum individual doses are estimated to range up to about 60 Gy. For every village with a sufficient number of residents with Class 1 doses, individual thyroid dose distributions are determined for several age groups and levels of milk consumption. These data are used to derive Class 2 thyroid dose estimates for unmeasured inhabitants of these villages. For any village where the number of residents with Class 1 thyroid doses is small or equal to zero, individual thyroid doses of Class 3 are derived from the relationship obtained between the mean adult thyroid dose and the deposition density of (131)I or 137Cs in villages with Class 2 thyroid doses presenting characteristics similar to those of the village considered. In order to improve the reliability of the Class 3 thyroid doses, an extensive program of measurement of (129)I in soils is envisaged.

Chernobyl-related thyroid cancer in children of Belarus: a case-control study.

The accident at the Chernobyl nuclear power plant on April 26, 1986, released approximately 2 EBq of 131I and other radioiodine isotopes that heavily contaminated southern Belarus. An increase in thyroid cancer reported in 1992 and attributed to the Chernobyl accident was challenged as possibly the result of intensive screening. We began a case-control study to test the hypothesis that the Chernobyl accident caused the increase in thyroid cancer. Records of childhood thyroid cancer in the national therapy centers in Minsk in 1992 yielded 107 individuals with confirmed pathology diagnoses and available for interview. Pathways to diagnosis were (1) routine endocrinological screening in 63, (2) presentation with enlarged or nodular thyroid in 25 and (3) an incidental finding in 19. Two sets of controls were chosen, one matched on pathway to diagnosis, the other representing the area of heavy fallout, both matched on age, sex and rural/urban residence in 1986. The 131I dose to the thyroid was estimated from ground deposition of 137Cs, ground deposition of 131I, a data bank of 1986 thyroid radiation measurements, questionnaires and interviews. Highly significant differences were observed between cases and controls (both sets) with respect to dose. The differences persisted within pathway to diagnosis, gender, age and year of diagnosis, and level of iodine in the soil, and were most marked in the southern portion of the Gomel region. The case-control comparisons indicate a strong relationship between thyroid cancer and estimated radiation dose from the Chernobyl accident.

The feasibility of using 129I to reconstruct 131I deposition from the Chernobyl reactor accident.

Radioiodine released to the atmosphere from the accident at the Chernobyl nuclear power station in the spring of 1986 resulted in large-scale thyroid-gland exposure of populations in Ukraine, Belarus, and Russia. Because of the short half life of 131I (8.04 d), adequate data on the intensities and patterns of iodine deposition were not collected, especially in the regions where the incidence of childhood-thyroid cancer is now increasing. Results are presented from a feasibility study that show that accelerator-mass-spectrometry measurements of 129I (half life 16 x 106 y) in soil can be used to reconstruct 131I-deposition density and thus help in the thyroid-dosimetry effort that is now urgently needed to support epidemiologic studies of childhood-thyroid cancer in the affected regions.

[Characteristics and results of the determination of the doses of internal irradiation of the thyroid gland in the population of contaminated districts of the Byelorussian Republic]. / Osobennosti i rezul'taty opredeleniia doz vnutrennego oblucheniia shchitovidnoi zhelezy dlia naseleniia zagriaznennykh raionov Respubliki Belarus'.

The authors provide the results of studying the reconstruction of individual doses of thyroid radiation among the community living in polluted areas of the Byelorussian Republic according to radiation monitoring data and with regard to the nature of radioactive pollution of the land. Every individual result of estimating the degree of thyroid radiation was characterized by 3 magnitudes: the lower and upper limit of possible values and by the intermediate (basic) value. The authors hold that studies of the correlations between the values of individual doses of thyroid radiation and different parameters of the radiation situation in every region will promote further specification of individual doses of thyroid radiation.