Assessment of exposures to firefighters from wildfires in heavily contaminated areas of the Chornobyl Exclusion Zone.

The aim of this study was to assess the exposures received by firefighters engaged in extinguishing the large-scale wildfires in the most contaminated areas of the Ukrainian part of the Chornobyl Exclusion Zone in 2016 and 2020. The assessments are based on measurements of radionuclide airborne concentrations in the breathing zones of workers and at the aerosol sampling stations of the automated radiation monitoring system operated by SSE Ecocenter. During the wildfires, the radionuclide airborne concentrations increased by orders of magnitude compared to the background levels, reaching maximum values in the firefighting area of 1.20 ± 0.01 Bq m-3 for 90Sr, 0.18 ± 0.01 Bq m-3 for 137Cs, (1.8 ± 0.3) ∙10-4 Bq m-3 for 238Pu, (4.5 ± 0.7) ∙10-4 Bq m-3 for 239-240Pu, and (8.0 ± 1.3) ∙10-3 Bq m-3 for 241Pu. The internal effective doses to firefighters due to inhaled radionuclides did not exceed 2 µSv h-1 and were 3-5 times lower compared to the external dose of gamma radiation. Thus, the time of firefighting in the ChEZ will be limited by the external dose.

Environmental radiation exposure at Chornobyl has not systematically affected the genomes or chemical mutagen tolerance phenotypes of local worms.

The 1986 disaster at the Chornobyl Nuclear Power Plant transformed the surrounding region into the most radioactive landscape known on the planet. Whether or not this sudden environmental shift selected for species, or even individuals within a species, that are naturally more resistant to mutagen exposure remains an open question. In this study, we collected, cultured, and cryopreserved 298 wild nematode isolates from areas varying in radioactivity within the Chornobyl Exclusion Zone. We sequenced and assembled genomes de novo for 20 Oscheius tipulae strains, analyzed their genomes for evidence of recent mutation acquisition in the field, and observed no evidence of an association between mutation and radioactivity at the sites of collection. Multigenerational exposure of each of these strains to several chemical mutagens in the lab revealed that strains vary heritably in tolerance to each mutagen, but mutagen tolerance cannot be predicted based on the radiation levels at collection sites, and Chornobyl isolates were not systematically more resistant than strains from undisturbed habitats. In sum, the absence of mutational signatures does not reflect unique capacity for tolerating DNA damage.

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.

Long-term changes in 90Sr pools of Scots pine biomass in the Chornobyl Red Forest.

The trenches of the waste burial site in the Chornobyl Red Forest represent a big reservoir of radionuclides for the artificial plantation of Scots pine established in that area, but the long term dynamics of tree biomass contamination, especially with 90Sr, remains unclear. The present study was conducted between 2005 and 2018 on two groups of trees of the same age. The IN group is represented by trees growing on the trench containing highly radioactive contaminated fertile soil and organic matter, while the OUT group is located outside the trench. Within a little more than one decade, the total aboveground biomass doubled in the trees of the group OUT and increased more than four times in the group IN. In the group OUT, the concentrations of 90Sr have decreased in all biomass compartments compared to 2005, while in the group IN, the concentrations demonstrated a trend to increase. Regression analysis shows that both decrease in the compartment concentrations in the group OUT (slope coefficient 0.55) and increase in the group IN (1.58) were significant. As a result of the changes in the biomass inventories and 90Sr concentrations, in absence of changes in plantation density, the contamination of total aboveground biomass by 90Sr in the group OUT would have increased slightly in 2018 (from approximately 18 GBq ha-1 to 23 GBq ha-1) compared to 2005, while in the group IN it would have increased almost 6-fold, reaching approximately 560 GBq ha-1, or about (19 ± 9) % of the total 90Sr inventory in the trench area. Trenches of the Red Forest were shown to act as long-lasting hot spots of 90Sr bioavailability for forest trees.

INFLUENCE OF IONIZING RADIATION ON THE DEVELOPMENT OF BREAST CANCER. / ВПЛИВ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ НА РОЗВИТОК РАКУ МОЛОЧНОЇ ЗАЛОЗИ.

Breast cancer (BC) is one of the urgent problems of health care, which is due to a constant trend of growth. One of the risk factors for the development of breast cancer is ionizing radiation (IR). Numerous epidemiological and experimental studies have shown the high sensitivity of the mammary gland (MG) to this factor. Consideration of models of absolute and relative risks of the occurrence of radio-induced tumors of the MG in irradiated persons showed the importance of such factors as age at the time of irradiation, multiplicity. frequency of exposure, dose level and concomitant non-neoplastic diseases of the mammary and thyroid gland (TG). Excess radiation-induced cases of cervical cancer were found among irradiated women after the atomic bombings of Hiroshima and Nagasaki.Epidemiological features of the development of breast cancer under the influence of IV are presented in detail, which is one of the environmental factors involved in the formation of the modern carcinogenic situation. In con-nection with the significant sensitivity of the MG to the carcinogenic effect of IR, this form of neoplasms attracted special attention after the Chornobyl accident. The effect of small doses of radiation after the Chornobyl disaster led to a wave-like change in the incidence of breast cancer in certain periods of the year, and the radiation-induced incidence of this pathology can occur spontaneously.

STATE INSTITUTION «NATIONAL RESEARCH CENTER FOR RADIATION MEDICINE OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE¼ - RESEARCH ACTIVITIES AND SCIENTIFIC ADVANCE IN 2022. / РЕЗУЛЬТАТИ РОБОТИ ДУ «ÐÐÐ¦Ð†ÐžÐÐÐ›Ð¬ÐÐ˜Ð™ НАУКОВИЙ ЦЕНТРРАДІАЦІЙНОЇ МЕДИЦИНИ НАЦІОНАЛЬНОЇ АКАДЕМІЇ МЕДИЧНИХ НАУК УКРАЇНИ¼ У 2022 РОЦІ.

Research activities and scientific advance achieved in 2022 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident. The report also shows the results of scientificorganizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRM Annual Report.

ON THE METHODOLOGY OF PASSPORT DOSES CALCULATION FOR UKRAINIAN SETTLEMENTS RADIOACTIVELY CONTAMINATED DUE TO THE CHORNOBYL NPP ACCIDENT. / ЩОДО МЕТОДИКИ РОЗРАХУНКУ ПАСПОРТНИХ ДОЗ НАСЕЛЕНИХ ПУНКТІВ УКРАЇНИ, ЯКІ ЗАЗНАЛИ РАДІОАКТИВНОГО ЗАБРУДНЕННЯ В РЕЗУЛЬТАТІ АВАРІЇ НА ЧАЕС.

OBJECTIVE: scientific substantiation of the new methodology for estimation of passport doses of the settlementswhich belong to Zone of Unconditional (obligatory) Resettlement, or 2nd zone and Zone of Granted VoluntaryResettlement, or 3rd zone in the framework of dosimetric passportization in accordance with the legislation ofUkraine. MATERIALS AND METHODS: 37 years after the accident, radioactive contamination of the environment has significantly decreased. However, it is still necessary to carry out ecological and dosimetric monitoring and apply countermeasures in certain territories of Ukraine affected by the accident at the Chornobyl Nuclear Power Plant: restriction of the consumption of locally produced milk, forest products, etc. The methodology, which was since 1996 used to estimate the passport doses of Ukrainian settlements, no longer corresponds to the current level of scientific knowledge about radioactive contamination of environment. The new methods of passport doses calculating presented in the work involves the use of a model whose parameters are determined by the types, quality and completeness of radio-ecological and dosimetric monitoring carried out on the radioactively contaminated territories in 1986-2013. The methodology takes into account the specific of radioactive contamination of each settlement. The passport dose of external exposure is reconstructed only from 137Cs radionuclide, because the contributions of other Chornobyl radionuclides influence the radiation dose only in the first years after the accident. The passport dose of internal exposure is formed as a result of the consumption of 137Cs contaminated food products. It is calculated depending on the availability in the settlement in the current year of the results of measurements of the 137Cs radionuclide activity incorporated in the human body using a whole body counter (WBC) and the activity of 137Cs in the private milk. At the same time, priority is given precisely to the results of WBC measurements of 137Cs. RESULTS AND CONCLUSIONS: A new methodology (Methodology-2023) for passport doses calculation of Ukrainian settlements was substantiated. A comparison of passport doses based on the results of radioecological and dosimetric monitoring in 2011 calculated by Methodology-2023 and passport doses calculated by Methodology-96 was made.Passport doses calculated by Methodology-2023 increased by 40 % on average compared to doses calculated by Methodology-96. At the same time, passport doses of internal radiation calculated by the new methodologyincreased by 1.5 times, and passport doses of external radiation increased by 1.7 times. The passport dose of 2011, calculated by Methodology-2023, exceeds the legally established limit of 1 mSv in 71 settlements, most of which are located in Korostenkyi raion of Zhytomyr Oblast.

STILLBIRTH RATE AND INFANT MORTALITY RATE: STUDY IN THE REGIONS OF UKRAINE MOST INTENSIVELY RADIOCONTAMINATED UPON THE CHORNOBYL NPP ACCIDENT. / МЕРТВОНАРОДЖУВАНІСТЬ ТА МАЛЮКОВА СМЕРТНОСТЬ: ДОСЛІДЖЕННЯ РАЙОНІВ УКРАЇНИ НАЙБІЛЬШ РАДІОАКТИВНО ЗАБРУДНЕНИХ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС.

OBJECTIVE: to evaluate the time pattern peculiarities of stillbirth and infant mortality rates in the radiocontaminated territories of Ukraine in the post-accident period on the basis of the national State Statistics Service data. OBJECT OF THE STUDY: stillbirth and infant mortality rates of population of the most intensively radiocontaminated territories of Ukraine (Lughinskyi, Narodytskyi, Ovrutskyi and Olevskyi districts of Zhytomyrska oblast, Vyshgorodskyi, Ivankivskyi and Poliskyi districts of Kyivska oblast, Rokytnivskyi and Sarnenskyi districts of Rivnenska oblast, and Kozeletskyi and Rypkinskyi districts of Chernihivska oblast).Research materials and methods. Information resources of the State Statistics Service of Ukraine for 1986-2020 regarding the infant mortality and stillbirth rates were used in the study. Demographic, mathematical-statistical, graphical, and software-technological research methods were applies. RESULTS AND CONCLUSIONS: Parameters of infant mortality and stillbirth rates for the 1986-2020 period were studied retrospectively. Significant variations in values were revealed both between the territories and years of survey.

THYROID CANCER INCIDENCE IN THE POPULATION OF UKRAINE AND ITS EPIDEMIOLOGICAL DETERMINANTS: IONIZING RADIATION AND ENDOCRINE DISRUPTORS. / ЧАСТОТА РАКУ ЩИТОПОДІБНОЇ ЗАЛОЗИ У НАСЕЛЕННЯ УКРАЇНИ ТА ЙОГО ЕПІДЕМІОЛОГІЧНІ ДЕТЕРМІНАНТИ: ІОНІЗУЮЧЕ ВИПРОМІНЮВАННЯ ТА ЕНДОКРИННІ РУЙНІВНИКИ.

OBJECTIVE: to estimate the risk of thyroid cancer incidence in the population of Ukraine in connection with its exposure to radioactive iodine fallout of Chornobyl origin and the use of pesticides in agricultural production in the country. OBJECT OF STUDY: Incidence rates of thyroid cancer in the population of Ukraine in 2001-2019, average regional radiation doses absorbed by the thyroid because of the Chornobyl accident, the volume of use of various groups of pesticides in the regions of Ukraine. RESEARCH METHODS: statistical, mathematical and cartographic. RESULTS: The study covering the period of 2001-2019, revealed significant temporal and regional differences in the thyroid cancer incidence in the population of the Ukraine regions in 2001-2019. The existence of a significant correlation between the thyroid cancer incidence and the amount of radiation exposure to the thyroid associated with the Chornobyl accident was established. The existence of a significant correlation between the thyroid cancer incidence and the degree of pesticide use intensity in agriculture in the Ukraine regions was established. A significant value of multiple correlation r = 0.5866 (p < 0.05) was found between the thyroid cancer incidence in Ukraine andthe average regional radiation doses and the pesticide use intensity in agricultural production in the country. CONCLUSIONS: A reliable value of the multiple correlation between the value of the average regional radiation exposure doses to the thyroid associated with the Chornobyl accident and the degree of pesticide use intensity in the national economy of Ukraine and the thyroid cancer incidence in the population was determined.

THE COURSE OF CHRONIC LYMPHOCYTIC LEUKEMIA AFTER SARS-COV-2 VIRUS INFECTION. / ПЕРЕБІГ ХРОНІЧНОЇ ЛІМФОЦИТАРНОЇ ЛЕЙКЕМІЇ НА ТЛІ ІНФЕКЦІЇ ВІРУСОМ SARS-COV-2.

Objective - to investigate the course of B-cell chronic lymphocytic leukemia (CLL) in patients after SARS-CoV-2 virus infection taking into account anamnestic exposure to the ionizing radiation (IR).Methods. The study was performed in a group of 51 CLL patients who were admitted to the Department of Radiation hematology of the National Research Center for Radiation Medicine of NAMS of Ukraine, Kyiv, from January 2020 (the beginning of SARS-CoV-2 epidemic) to August 2023. The group included 19 (37.3 %) clean-up workers of the Chornobyl NPP accident, 15 (29.4 %) inhabitants of radionuclide contaminated areas and 17 (33.3 %) IR non-exposed patients. The diagnosis of CLL was based on clinical history, lymphocyte morphology, and immunophenotypic criteria. Statistical studies were performed using the SPSS software package, version 20.0.Results. The diagnosis of CLL was established for the first time in 14 patients, in seven of them, CLL was diagnosed after 2-17 months after SARS-CoV-2 infection. In contrast to patients who did not suffer from a coronavirus infection, they had pronounced lymphadenopathy, which in some cases was accompanied by hyperleukocytosis, and needed early treatment. Thirteen patients with a previously established CLL were diagnosed with COVID-19 by PCR test. In seven of them (53.8 %) starting treatment was needed, or CLL has progressed. Seven of 51 patients (13.5 %) were vaccinated against SARS-CoV-2. Then, four of them were diagnosed with SARS-CoV-2 infection, confirmed by a positive PCR test, and two patients had a relapse of CLL within 1-2 months after vaccination. Most of patients with signs of the influence of SARS-CoV-2 infection on CLL belonged to sufferers of the Chornobyl NPP accident Conclusions. The clinical features of CLL that developed after SARS-CoV-2 were characterized firstly. The negative impact of SARS-CoV-2 infection on previously established CLL was established. The question about vaccination of CLL patients remains debatable.

NEUROPHYSIOLOGICAL BASIS OF THE COMBINED EFFECTS OF ACUTE STRESS AND LOW DOSES OF IONIZING RADIATION ON HUMAN BRAIN. / НЕЙРОФІЗІОЛОГІЧНИЙ БАЗИС КОМБІНОВАНИХ ЕФЕКТІВ ГОСТРОГО СТРЕСУ ТА МАЛИХ ДОЗ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ НА ГОЛОВНИЙ МОЗОК ЛЮДИНИ.

OBJECTIVE: to study the clinical and neurophysiological features in the Chornobyl clean-up workers with a verified chronic cerebrovascular disease/cerebral small vessels disease (SVD) exposed to low doses of ionizing radiation (IR), employees of the Chornobyl Nuclear Power Plant (SSE ChNPP), who were exposed to the stress factor of a full-scale war as a result of being held captive by the Russian military at their workplaces, and individuals of the non-irradiated comparison group.Design, object and methods. A cross-sectional clinical study with parallel external control groups. We studied and carried out an expert statistical analysis of the clinical and neurophysiological characteristics of 62 male subjects, from which three examination groups were formed: 1) a randomized sample from the Clinical Epidemiological Register (CER) of the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine¼ (NRCRM) of 22 Chornobyl clean-up workers ('Chornobyl liquidators') in 1986-1990,examined during 2020-2021, aged 50-68 years at the time of examination (M ± SD: (58.1 ± 5.2) years) with a documented external radiation dose of 0.03-2.30 Sv; 2) 24 SSE ChNPP employees exposed to the stress factor impact of a full-scale war as a result of being held captive by the Russian military at their workplaces. The average age of the examined was (54.5 ± 5.8) years (range 46-71 years). 3) Comparison group - 16 non-exposed men with verified chronic cerebrovascular disease/cerebral small vessels disease (SVD). The average age of the examined was (57.8 ± 5.6) years (range 50-70 years). RESULTS: Neurophysiological studies confirm the presence of the pronounced dysfunction of the cortico-limbic system of the left dominant hemisphere of the brain with special involvement of the hippocampus in the Chornobyl clean-up workers. In the SSE ChNPP group, for the first time, the disorders of cerebral neurodynamics were detected in the form of functional hypofrontality and hyperfunction of the cortico-limbic system with lateralization to the right hemisphere. CONCLUSIONS: Today there exists a long-term thorough methodological and evidence base for a possible neurophysiological diagnosis and differential diagnosis of the combined cerebral effects of IR and psycho-emotional stress associated with the conditions of military conflicts. Neurophysiological technologies can be used in the objective professional and qualification selection of employees in a number of professions that require quick and responsible decision-making. Employees of SSE ChNPP need further medical and psychological support due to an increased risk of developing mental health disorders.

THE INFLUENCE OF THE WAR FACTOR ON AGE CHANGES IN THE SUBPOPULATION STRUCTURE OF LEUCOCYTES AS A COMPONENT OF INFLAMMAGING IN THE GROUPS OF MILITARY PERSONNEL AND CLEAN-UP WORKERS OF THE CHORNOBYL ACCIDENT. / ВПЛИВ ФАКТОРА ВІЙНИ НА ВІКОВІ ЗМІНИ СУБПОПУЛЯЦІЙНОЇ СТРУКТУРИ ЛЕЙКОЦИТІВ ЯК СКЛАДОВОЇ ІНФЛАМЕЙДЖИНГУ У ГРУПАХ ВІЙСЬКОВОСЛУЖБОВЦІВ ТА УЧАСНИКІВ ЛІКВІДАЦІЇ НАСЛІДКІВ АВАРІЇ НА ЧАЕС.

OBJECTIVE: to evaluate the subpopulation structure of peripheral blood leukocytes as a component of inflammaging in the servicemen of the Armed Forces of Ukraine and clean-up workers of the accident at the Chornobyl nuclear power plant. MATERIALS AND METHODS: Three hundred ninety-seven males aged 30-82 (54.99 ± 8.85) years examined. Among them: clean-up workers of the accident at the Chornobyl nuclear power plant, aged 54-64 (59.95 ± 1.88) years, who were examined before the beginning and during the Russian military invasion of Ukraine; 24 civilians of the control group, aged 50-77 (58.87 ± 7.18) years and 15 persons of the age control group, aged 42-49 (46.00 ± 2.26) years, who examined before the war has started; the comparison group-W - 27 civilians (age: 51-82 (65.44 ± 9.13)) and the age control group-W - 14 civilians (age: 31-49 (40.64 ± 5.59)) who examined after the war has started; 73 servicemen of the Armed Forces of Ukraine aged 30-49 (42.20 ± 5.35) years and 54 servicemen aged 50-59 (54.07 ± 2.86) years. The subpopulation distribution of peripheral blood leukocytes was analyzed using flow cytometry. RESULTS: A decrease in the relative number of CD45+ 14- granulocytes, CD3+ HLA-DR+ T-lymphocytes, and CD3-57+ NK against the background of an increase in the number of CD45+ 14+ monocytes, CD3-HLA-DR+ B-lymphocytes found in the majority of people in the examination groups, the study of which conducted after the beginning of the war, CD4+ T-lymphocytes and CD3+ 57+ NKT. The relative number of CD45+ 14- granulocytes increased against the background of a decrease in CD45+ 14- lymphocytes was noted in clean-up workers who were examined before the war started.About 30% of civilians over 50 years of age who were examined before the war started had a decrease in CD19+ B- lymphocytes, CD4+ and CD8+ T-lymphocytes, CD3-57+ NK, CD3+ 57+ NKT, and the CD4+ / CD8+ ratio. Conducted correlation analysis revealed a weak to moderate inverse correlation between the relative number of CD19+ B-lymphocytes and age in civilians, regardless of when they were examined, and the servicemen of the Armed Forces of Ukraine.Inverse correlations of HLA-DR+ B-lymphocytes, CD45+ 14+ monocytes, CD4+ T-lymphocytes, CD4+ / CD8+ ratio, and CD3-57+ NK and CD3+ 57+ NKT with age were noted in civilians who were examined after the war has started. A direct correlation between CD3+ 57+ NKT and age was found in the servicemen of the Armed Forces of Ukraine. CONCLUSIONS: The immunological profile of both clean-up workers in the Chornobyl nuclear power plant and the servicemen of the Armed Forces of Ukraine or civilians was similar compared to the group with reference indicators. Anintergroup study revealed changes in the subpopulation distribution of peripheral blood leukocytes, which may be associated with both aging and changes in living conditions during military operations. Specific changes in cellular immunity can either tip the balance towards inflammaging or indicate already existing immunopathologicalreactions.

CHARACTERISTICS OF NON-RENAL NORMOCALCIEMIC HYPERPARATHYROIDISM IN THE CHORNOBYL NPP ACCIDENT SURVIVORS. / ДОСЛІДЖЕННЯ ОСОБЛИВОСТЕЙ НЕРЕНАЛЬНОГО НОРМОКАЛЬЦІЄМІЧНОГО ГІПЕРПАРАТИРЕОЗУ У ОСІБ, ПОСТРАЖДАЛИХ ВНАСЛІДОК АВАРІЇ НА ЧАЕС.

OBJECTIVE: to assess the hormonal and metabolic disorders in the Chernobyl nuclear power plant (ChNPP) accident survivors (AS), having got secondary normocalcemic non-renal hyperparathyroidism (HPT) in the late period upon exposure to ionizing radiation (IR). MATERIALS AND METHODS: The routine clinical, anthropometric, instrumental (thyroid and parathyroid diagnosticultrasound), laboratory (biochemical, hormonal), statistical methods were applied. In both prospective (n = 48, control group n = 19) and retrospective studies the data of 2,234 subjects including 1,372 irradiated adults (862 non-irradiated persons in the control group) were evaluated. Clinical consequences of exposure to IR on the endocrine system were evaluated in ChNPP AS. RESULTS: High prevalence of vitamin D lack or deficiency was established retrospectively in 81.8 % of the ChNPP AS and in 89.5 % of the control group subjects. In general, there was neither effect of exposure to IR on the vitamin D status in study subjects, nor any difference between the study groups. According to diagnostic ultrasound patterns the parathyroid hyperplasia was diagnosed in 629 cases (28.2 %). Among the ChNPP AS it was found in 32.7 % of cases (n = 450) vs. 20.7 % (p > 0.005) in the control group (a 1.6-fold difference). HPT diagnosed as serum parathyroid hormone content > 65 ng/ml was diagnosed in 123 cases (21.1 %) i.e. in almost every fifth person. Increased serum level of parathyroid hormone was found in the 94 ChNPP AS and in 25 persons of the comparison group. In other words, the frequency of HPT was 23.7 % among the AS being significantly more than in the comparison group (13.2 %, p < 0.005). Frequency of normocalcemic non-renal HPT was slightly different by years of observation with a trend to the year-by-year increase. CONCLUSIONS: High prevalence of vitamin D lack or deficiency was established in the ChNPP AS, being however independent of exposure to IR. Frequency of parathyroid hyperplasia/adenoma was 1.6 times higher in the irradiated subjects than in persons of the control group. Annual increase in frequency of the non-renal normocalcemic HPT was also revealed reaching nowadays 23.7 % among the AS, which is significantly higher than in the comparison group.

COMORBID PATHOLOGY IN FATAL CASES DUE TO CORONAVIRUS DISEASE (COVID-19) IN VICTIMS OF THE CHORNOBYL NPP ACCIDENT. / КОМОРБІДНА ПАТОЛОГІЯ ПРИ ЛЕТАЛЬНИХ ВИПАДКАХ ВНАСЛІДОК КОРОНАВІРУСНОЇ ХВОРОБИ (COVID-19) У ПОСТРАЖДАЛИХ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС.

INTRODUCTION: The victims of the Chornobyl accident, as well as whole population of Ukraine, have become the object of the COVID-19 pandemic in today's conditions. As of 01.01.2020, 108,898 victims had documented permanent disability (persons with disabilities) and, as a rule, suffered from 4-6 types of non-tumor chronic diseases of internal organs, primarily the circulatory system, as well as oncological and endocrine pathology, that significantly affect the course of COVID-19 in a severe scenario and contribute to death. This determines the relevance of the issue of the impact of comorbid pathology in fatal cases due to coronavirus disease (COVID-19) in victims of the Chornobyl accident.The Objective of the study was to study the nature and significance of comorbid pathology in the victims of the Chernobyl accident who died from COVID-19.Design, object and methods of the study - a retrospective non-randomized, comparative comprehensive analysis of the materials of 134 medical expert cases of male clean-up workers of the Chornobyl accident who died from COVID-19 in 2020-2022 during the pandemic was carried out. The analysis of the materials of expert cases included the study of clinically significant and morphologically confirmed pathological processes. The source of the data was the materials of the Central Interdepartmental Expert Commission of the Ministry of Health of Ukraine on the establishment of causal relationship of diseases, disability and death with the action of ionizing radiation and other harmful factors as a result of the Chernobyl accident. RESULTS: In the structure of comorbid pathology in the clean-up workers of the Chornobyl accident who died due to COVID-19 during 2020-2022, diseases of the circulatory system dominate, which occurred in 86.57% of cases of consideration of medical expert cases. AH complicated the course and contributed to the development of fatal consequences in 52.24% of cases, ChIHD - in 34.32% of cases. The consequences of acute vascular events in the form of post-infarction cardiosclerosis in patients with ChIHD contributed to death in COVID-19 in 29 (21.64%) cases.Cerebrovascular pathology represented by cerebral atherosclerosis was detected in 76 (56.72%) cases of death from COVID-19. Acute vascular cerebral events in the cerebral basin (ischemic and hemorrhagic strokes) contributed to fatal outcomes in 19 (14.18%) cases. The presence and course of diabetes mellitus also had a significant impact on the course and fatal mortality of COVID-19 - 24.63% (33 cases). Chronic respiratory diseases (COPD) influenced the course of COVID-19 and contributed to death in 6.72% (9) of cases, nephrological pathology (ChTIN) - in 2.98% (4) of cases, peptic ulcer disease of the duedenum - in 2.24% (3) of cases. More than half of the clean-up workers of the Chornobyl NPP accident who died due to COVID-19 had more than two severe chronic diseases of the comorbid component and their complications. CONCLUSIONS: Сlean-up workers of the Chornobyl accident who died from COVID-19 had another severe comorbid chronic disease, or several diseases that influenced the course of coronavirus disease and each other and contributed to the development of fatal consequences. Death from COVID-19 is much more common in clean-up workers of the Chornobyl accident suffering from severe disabling non-oncological diseases of the cardiovascular system (arterial hypertension, coronary heart disease), cerebrovascular diseases with consequences of acute vascular events, as well as diabetes mellitus. Victims of the Chornobyl catastrophe, especially clean-up workers of the Chornobyl NPP accident, are at special risk for severe coronavirus disease and death from COVID-19.

STRUCTURE AND CHARACTERISTICS OF THE CHORNOBYL NPP ACCIDENT VICTIMS ACCORDING TO THE MATERIALS OF MEDICAL EXPERTISE OF THE CAUSAL RELATIONSHIP OF DISEASES WITH THE EFFECT OF IONIZING RADIATION IN THE REMOTE POSTACCIDENTAL PERIOD (2023 year). / СТРУКТУРА ТА ХАРАКТЕРИСТИКА ПОСТРАЖДАЛИХ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС ЗА МАТЕРІАЛАМИ МЕДИЧНОЇ ЕКСПЕРТИЗИ ЩОДО ПРИЧИННО-НАСЛІДКОВОГО ЗВ'ЯЗКУЗАХВОРЮВАНЬ З ДІЄЮ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ У ВІДДАЛЕНИЙ ПІСЛЯАВАРІЙНИЙ ПЕРІОД (2023 рік).

Loss of health and workability, as well as deaths due to harmful influence of the Chornobyl catastrophe (including radiation exposure) during performance of professional, military or official duties and / or living on radiation-contaminated areas, additional exposure not through their own fault but due to a radiation accident, caused the development of a special form of medical expertise as part of the of medical social protection system for these suffered contingents. OBJECTIVE: To study and characterize the structure of the affected categories (clean-up workers and victims) of the Chornobyl catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission of Ministry of Health of Ukraine (CIEC) in the remote post-accidental period (2013-2023). MATERIAL AND METHODS: The work was performed in the design of a retrospective study that based on analysis of the structure of all categories of Chornobyl NPP accident (ChNPP) victims during 2008-2023 years and studying of more 57 000 medical expert cases, which were considered by CIEC during 2013-2022 to establish a causal relationship between the disease and influence of radiation exposure and other harmful factors and conditions during ChNPP accident. RESULTS: The total number of affected adult citizens as on 01.01.2023, compared to 2008, decreased by 511,877 persons, or by 27.90 % (from 1,834,536 to 1,322,659 persons). The number of clean-up workers of the accident decreased from 276,327 (2008) to 162,180 (2023), or by 114,147 people (41.30 %), that means - during the last 15 years, almost every third-second clean-up worker who participated in the liquidation of the consequences of the accident at the ChNPP died. The number of adult victims decreased from 1,558,209 in 2008 to 1,160,479 in 2023, or by 25.52 % (397,730 persons). In the structure of medical expert cases during 2013-2022 the leading place as the reason of disease, disability and death is occupied by oncological diseases - 60.3 %, cerebrovascular diseases and their complications make up 10.00 %, diseases of the cardiovascular system - 19.6 %. CONCLUSION: In the remote post-accidental period (2013-2023) has increased the need of expertise of the causal relationship of disability and the causes of death with the influence of the ChNPP accident consequences for medical and social support. During 2013-2023 period quick reducing for all categories of affected due to the Chornobyl NPP accident taken place. In the structure of medical expert cases during 2013-2023 the leading place as the reason of disease, disability and death is occupied by oncological, cardiovascular and cerebrovascular diseases.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. PART V - ORGANIC AND FUNCTIONAL CHANGES CORRELATION ON THE EXAMPLE OF CERTAIN DISEASES. / ГОЛОВНИЙ МОЗОК ТА ОРГАН ЗОРУ ЯК ПОТЕНЦІЙНІ МІШЕНІ ДЛЯ ВПЛИВУ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ: ЧАСТИНА V ­ СПІВВІДНОШЕННЯ ОРГАНІЧНИХ І ФУНКЦІОНАЛЬНИХ ЗМІН НА ПРИКЛАДІ ОКРЕМИХ ЗАХВОРЮВАНЬ.

The question about correlation between organic and functional changes in persons, exposed to radiation is still insufficiently studied. Dynamics of morbidity for different forms and classes of non-tumour diseases periodisation, proposed by epidemiologists, suggests the identification of three main periods: «early¼ (the first 6 post-Chornobyl accident years); «distant¼ (12-21 years) and «late¼ (22-30 years). However, the correspondence this periodisation to the results of epidemiological data, without taking into account the clinical features of the diseases, may contribute to the impression, that in the first period after a radiation disaster functional disorders (or autonomic regulation disorders, etc.) prevail in all cases. Meanwhile, the data from ophthalmological and neurological studies, which we aim to demonstrate in this paper, rather indicate the presence of a significant morphological basis for the development of functional disorders in early period after a radiation disaster. The objective of this work is analyse modern experimental, epidemiological and clinical data on the correlation between organic and functional changes, characteristic of radiation cerebro-ophthalmological effects - radiation cataracts, age-related macular degeneration, cerebral small vessel disease, and neurocognitive deficits. Materials and methods. The criteria for inclusion in the analytical review were peer-reviewed publications in PubMed/MEDLINE, Scopus, Web of Science, and manually selected papers; the results of our own research were also used. An additional analysis of the results of examinations conducted in 1991-2004 was performed, which included a total of 11 123 persons irradiated as the result of catastrophy at the Chornobyl NPP. Results. In the first period of radiation cataract development, which is a specific consequence of radiation exposure, morphological changes (lens opacities) are observed, which lead to a decrease in visual function only later. Analysing the correlation between organic and functional changes in the development of diseases, for which ionising radiation exposure is a significant risk factor, we observe a similar picture. For example, CSVD associated with arterial hypertension may be a manifestation of accelerated aging associated with exposure to ionising radiation.Similarly, the initial signs of age-related macular degeneration in radiation-exposed individuals are usually manifested by changes in the morphology of the retina, choroid, and pigment epithelium in the macular area, while functional disorders in the form of decreased central vision and metamorphopsia, etc., occur later.

THE COMBINATION OF CHRONIC RESPIRATORY DISEASES WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME IN CLEAN-UP WORKERS OF CHORNOBYL NPP ACCIDENT. / ПОЄДНАННЯ ХРОНІЧНИХ ЗАХВОРЮВАНЬ ОРГАНІВ ДИХАННЯ ІЗ СИНДРОМОМ ОБСТРУКТИВНОГО АПНОЕ/ГІПОПНОЕ СНУ В ОСІБ, ЯКІ ПОСТРАЖДАЛИ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС.

The objective of the study was to establish the relationship between functional status of bronchopulmonary system and obstructive sleep apnea in clean-up workers of Chornobyl NPP accident in a remote post-accident period. MATERIALS AND METHODS: We included 58 COPD male patients clean-up workers of Chornobyl NPP accident: 21 with obstructive sleep apnea syndrome (OSA), 37 - without. A complex of functional tests and OSA screening was provided. RESULTS: In clean-up workers of Chornobyl NPP accident with COPD and obstructive sleep apnea in a remote post-accident period apnea-hypopnea index (AHI) negatively correlated with FVC, % of predicted (r = -0.36, p < 0.05), the intrathoracic gas volume (ITGV), % of predicted (r = -0.40, p < 0.05); AHI positively correlated with diffusion lung capacity (DLCO), % of predicted values (r = 0.57, p < 0.05), with the intrathoracic gas volume (ITGV), % of predicted (r = 0.53, p < 0.05), body mass index (r = 0.49, p < 0.05) and age (r = 0.62, p < 0.05). CONCLUSIONS: Obstructive sleep apnea was diagnosed in 36.3 % of patients with COPD clean up workers of Chornobyl NPP accident. Screening for OSA in patients with COPD, clean-up workers of Chornobyl NPP accident is a very important clinical task for prognosis and treatment.

REVIEW OF THE NATURE OF ANTI/INFLAMMATORY AND PRO-INFLAMMATORY CYTOKINE REGULATION IN DIFFERENT PERIODS OF PLASMA CELL MYELOMA NATURAL HISTORY IN THE CHORNOBYL NPP ACCIDENT SURVIVORS. / АНАЛІЗ ХАРАКТЕРУ РЕГУЛЯЦІЇ ПРОТИЗАПАЛЬНИХ І ПРОЗАПАЛЬНИХ ЦИТОКІНІВ НА РІЗНИХ ЕТАПАХ ПЕРЕБІГУ ПЛАЗМОКЛІТИННОЇ МІЄЛОМИ У ХВОРИХ, ЯКІ ПОСТРАЖДАЛИ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС.

OBJECTIVE: identify the nature of anti-inflammatory and pro-inflammatory cytokine regulation in different periods of plasma cell myeloma (PCM) natural history with evaluation of its role as a prognostic criterion for the disease course in the Chornobyl NPP (ChNPP) accident survivors. MATERIALS AND METHODS: Levels of pro-inflammatory (IL-6, TNF-α) and anti-inflammatory (IL-10) cytokines both with their relationship were studied in the stage I-II and stage III PCM patients (n = 74) in different periods of the disease natural history i.e. remission/stabilization and progression. Study groups included the ChNPP accident survivors (n = 35) and non-irradiated subjects (n = 39). Immunoenzymatic method was applied using the Vector-Best CJSC commercial kits. RESULTS: There was a unidirectional increase in the levels of IL-6, TNF-α, and IL-10 in irradiated persons, and an elevation of IL-6 and TNF-α concentration but with a decreased level of IL-10 in non-irradiated subjects compared to control at the time of PCM diagnosis. Period of the disease remission/stabilization in PCM stage I-II patients featured a decrease in IL-6 concentration regardless of the exposure to ionizing radiation, while TNF-α content remained at the level of the control group. There was a significant increase in IL-6 concentration in both study groups during the disease relapse, while TNF-α level remained unchanged compared to stabilization phase of the disease. According to the obtained data a certain contribution of radiation exposure to the PCM pathogenesis as a possible predictor of the exacerbated disease course cannon be excluded. CONCLUSION: Determining the serum level of pro-inflammatory and anti-inflammatory cytokines (IL-6, TNF-α and IL-10 respectively) provides advancement in assessment of the PCM course and predict the effectiveness of administration of therapy protocols.

Some observations on perceptions of radiation risks in the context of nuclear power plant accidents.

As highlighted by public reactions to accidents at nuclear plants in the past, such as those that occurred in Chernobyl (1986) and Fukushima (2011), and from numerous opinion surveys, there are considerable differences or gaps between how the public and radiation experts perceive the risks from radiation. Even within the community of experts, radiation risk perception differences can be present. The reasons for differences in radiation risk perceptions between the public and experts are complex and involve sociological, ethical and behavioural aspects of society. This presents significant challenges to authorities in trying to improve radiation risk communications targeted at the public within the context of radiation emergency preparedness planning. Of particular importance is to make the communications more citizen-centred than heretofore by having meaningful two-way communications and dialogue with the public. It is emphasised that such strategies should take into account and address the significant mental health and socio-economic impacts of such accidents on affected populations. In particular, the mental health impacts are inadequately addressed by current international radiation protection recommendations reflecting their long established emphasis only on physical health effects. This approach is no longer acceptable or justified.