LARCalc, a tool to estimate sex- and age-specific lifetime attributable risk in populations after nuclear power plant fallout.

A tool called LARCalc, for calculating the radiological consequences of accidental large scale nuclear power plant releases based on estimates of 137Cs ground deposition, is presented. LARCalc is based on a previously developed models that has been further developed and packaged into an easy-to-use decision support tool for training of decision makers. The software visualises the radiological impact of accidental nuclear power plant releases and the effects of various protective measures. It is thus intended as a rapid alternative for planning protective measures in emergency preparedness management. The tool predicts projected cumulative effective dose, projected lifetime attributable cancer risk, and residual dose for some default accidental release scenarios. Furthermore, it can predict the residual dose and avertable cumulative lifetime attributable risk (LAR) resulting from various protective measures such as evacuation and decontamination. It can also be used to predict the avertable collective dose and the increase in cancer incidence within the specified population. This study presents the theoretical models and updates to the previous models, and examples of different nuclear fallout scenarios and subsequent protective actions to illustrate the potential use of LARCalc.

Assessment of Differentiated Thyroid Carcinomas in French Polynesia After Atmospheric Nuclear Tests Performed by France.

Importance: Due to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma (DTC) is the most serious health risk for the population living near sites of nuclear tests. Whether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of DTCs. Design, Setting, and Participants: This case-control study was conducted by extending a case-control study published in 2010 that included DTCs diagnosed between 1984 and 2003 by adding DTCs diagnosed between 2004 and 2016 and improving the dose assessment methodology. Data on 41 atmospheric nuclear tests conducted by France between 1966 and 1974 in French Polynesia (FP) were assessed from original internal radiation-protection reports, which the French military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all FP archipelagos. These original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 mGy to nearly 5 mGy. Included patients were diagnosed from 1984 to 2016 with DTC at age 55 years or younger and were born in and resided in FP at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the FP birth registry. Data were analyzed from March 2019 through October 2021. Exposure: The radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. Main Outcomes and Measures: The lifetime risk of DTC based on Biological Effects of Ionizing Radiation (BEIR) VII models was estimated. Results: A total of 395 DTC cases (336 females [85.1%]; mean [SD] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [SD] age at end of follow-up, 42.3 [12.5] years) were included. No association was found between thyroid radiation dose received before age 15 years and risk of DTC (excess relative risk [ERR] per milligray, 0.04; 95% CI, -0.09 to 0.17; P = .27). When excluding unifocal noninvasive microcarcinomas, the dose response was significant (ERR per milligray, 0.09; 95% CI, -0.03 to 0.02; P = .02), but several incoherencies with the results of the initial study reduce the credibility of this result. The lifetime risk for the entire FP population was 29 cases of DTC (95% CI, 8-97 cases), or 2.3% (95% CI, 0.6%-7.7%) of 1524 sporadic DTC cases in this population. Conclusions and Relevance: This case-control study found that French nuclear tests were associated with an increase in lifetime risk of PTC in FP residents of 29 cases of PTC. This finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this Pacific territory.

Strontium-90 in Baby Teeth as a Basis for Estimating U.S. Cancer Deaths From Nuclear Weapons Fallout.

Nuclear weapons testing in the atmosphere during the 1950s and 1960s deposited fallout throughout the world, exposing all humans to food and water before the Limited Test Ban Treaty ended large-scale tests. The largest effort to measure in vivo fallout in humans, performed by Washington University (USA), collected over 300,000 deciduous teeth to document a sustained increase in Strontium-90 (Sr-90) during testing and a sharp decline after the test ban. Sr-90 patterns and trends in teeth were consistent with those of bones and milk. Sr-90 is still detectable in about 100,000 of the teeth, which were never tested. Tooth donors were born during atmospheric testing (1946-1965) and thus exposed to fallout in utero and during infancy/childhood, when exposures pose the greatest health risk. Preliminary analysis of global fallout's health risk in the United States indicates recent cancer mortality in several high-fallout areas exceeded that of states with the lowest fallout, peaking for the cohort born in the early 1960s, when fallout was highest. These findings support subsequent measurement of Sr-90 in deciduous teeth of persons who died of diseases such as cancer, along with controls, a novel approach to assessing fallout hazards.

Incidence of lymphoid neoplasms among atomic bomb survivors by histological subtype, 1950 to 1994.

Epidemiological data have provided limited and inconsistent evidence on the relationship between radiation exposure and lymphoid neoplasms. We classified 553 lymphoid neoplasm cases diagnosed between 1950 and 1994 in the Life Span Study cohort of atomic bomb survivors into World Health Organization subtypes. Mature B-cell neoplasms represented 58%, mature T-cell and natural killer (NK)-cell neoplasms 20%, precursor cell neoplasms 5%, and Hodgkin lymphoma (HL) 3%, with the remaining 15% classified as non-Hodgkin lymphoid (NHL) neoplasms or lymphoid neoplasms not otherwise specified. We used Poisson regression methods to assess the relationship between radiation exposure and the more common subtypes. As in earlier reports, a significant dose response for NHL neoplasms as a group was seen for males but not females. However, subtype analyses showed that radiation dose was strongly associated with increased precursor cell neoplasms rates, with an estimated excess relative risk per Gy of 16 (95% Confidence interval: 7.0, >533) at age 50. The current data based primarily of tissue-based diagnoses suggest that the association between radiation dose and lymphoid neoplasms as a group is largely driven by the radiation effect on precursor cell neoplasms while presenting no evidence of a radiation dose response for major categories of mature cell neoplasms, either B- or T-/NK-cell, or more specific disease entities (diffuse large B-cell lymphoma, plasma cell myeloma, adult T-cell leukemia/lymphoma) or HL.

THYROID SCREENING AND RELIABILITY OF RADIATION THYROID DOSES FOR THE BELARUSIAN IN UTERO COHORT.

OBJECTIVE: To describe the status and results of thyroid disease screening and assessment of reliability of radiationthyroid doses in the Belarusian in utero cohort of 2,965 individuals exposed to Chernobyl (Chornobyl) fallout. MATERIALS AND METHODS: Thyroid screening examinations are currently underway including thyroid palpation by anendocrinologist, ultrasonographic examination by an ultrasonographer and analysis of blood samples for diagnosisof hypo- and hyperthyroidism, autoimmune thyroiditis, thyroid function tests (thyroid-stimulating hormone [TSH],thyroxine [T4], thyroid peroxidase antibody [anti-TPO], and thyroglobulin antibodies [anti-TG]). Reliability of (i)information from 780 pairs of questionnaires obtained during the first and second interviews of the mothers and (ii)thyroid doses, which were calculated for the cohort members using this information, is evaluated. RESULTS: As of 15 August 2021, 1,267 in utero exposed study subjects had been screened. A single thyroid nodule wasdiagnosed in 167 persons (13.2 % of the total) and multiple thyroid nodules in 101 persons (8.0 %): 189 (14.9 %)persons had nodules detected for the first time at the screening while 79 (6.2 %) persons had nodules detected pre-viously (pre-screening nodules). Fifty-nine out of 268 subjects (22.0 %) with a suspicious thyroid nodule werereferred to fine needle aspiration biopsy, and among them 33 (55.9 %) were biopsied. Reasonable agreement wasobserved for modelqbased doses calculated for the Belarusian in utero cohort members using data from the two inter-views (Spearman's rank-correlation coefficient rs = 0.74, p < 0.001), while measurementqbased doses yielded almost per-fect agreement (rs = 0.99, p < 0.001). CONCLUSIONS: During the thyroid screening, at least one thyroid nodule was identified in 268 of 1,267 (21.2 %) inutero exposed cohort members. Seven thyroid cancer cases were identified in the cohort, including 5 pre-screeningcases and 2 cases detected during the screening. Ongoing research on this unique cohort will provide importantinformation on adverse health effects following prenatal and postnatal exposure to radioiodine and radiocesium iso-topes, for which available epidemiological data are scant.

The Hiroshima A-Bomb Black Rain and the Lifespan Study; A Resolution of the Enigma.

The Japanese Lifespan Study (LSS) of the A-Bomb survivors is the principal basis of the current legal radiological framework. Evidence provided for the first time here shows that internal exposure to radiologically significant quantities of Uranium-234 contained in sub-micron particle rainout from the un-fissioned weapon warhead, the Black Rain, is a missing exposure in the LSS analysis. It is argued that this is responsible for a background excess cancer risk in all the LSS dose groups. This, together with epidemiological evidence based on unexposed controls falsifies the LSS cancer vs. dose regression coefficients for internal exposure.

The secondary sex ratio in Italy over the past eighty years (1940 to 2019) and potential impact of radiological contamination after atmospheric nuclear testing and after Chernobyl: Temporal change-point analysis using Markov Chain Monte Carlo.

In Europe, the male to female ratio at birth (secondary sex ratio: SSR; sex odds: SO) is 1.04-1.06, is influenced by many factors and is declining in industrialized countries. This study was carried out to identify possible impacts of fallout by atomic bomb tests or by the Chernobyl event on SSR in Italy. Italy is a country without commercial nuclear power generation for the last four decades and thus nearly free of radiological confounders. Counts of annual male and female live births in Italy are provided by the World Health Organization (WHO) and by the Italian Istituto Nazionale di Statistica (ISTAT). This study included 57.7 million live births (1940-2019) with overall SSR 1.05829. The Italian SSR trend was modelled with linear and non-linear logistic regression. Trend changes, i.e., periods with level shifts were estimated with Markov Chain Monte Carlo (MCMC). Two distinct idealized level shifts were identified superimposed on a uniform secular downward trend. The first one is seen towards the end of the 1960s with a jump sex odds ratio (SOR) 1.00681, p < 0.0001. The second one occurred in 1987 with SOR 1.00474, p < 0.0001. In each of the 3 periods separated by the two jumps, SSR uniformly decreased with trend SOR per 100 years of 0.98549, p < 0.0001. In conclusion, the secular trend in the Italian SSR showed two marked level shifts, at the end of the 1960s and from 1987 onward. These follow the release of radioactivity by atmospheric atomic bomb tests during the 1960s and by Chernobyl in 1986 and corroborate the hypothesis that ionizing radiation increases SSR.

Thyroid Doses to French Polynesians Resulting from Atmospheric Nuclear Weapons Tests: Estimates Based on Radiation Measurements and Population Lifestyle Data.

Thyroid doses were estimated for the subjects of a population-based case-control study of thyroid cancer in a population exposed to fallout after atmospheric nuclear weapons tests conducted in French Polynesia between 1966 and 1974. Thyroid doses due to (1) intake of I and of short-lived radioiodine isotopes (I, I, I) and Te, (2) external irradiation from gamma-emitting radionuclides deposited on the ground, and (3) ingestion of long-lived Cs with foodstuffs were reconstructed for each study subject. The dosimetry model that had been used in 2008 in Phase I of the study was substantially improved with (1) results of radiation monitoring of the environment and foodstuffs, which became available in 2013 for public access, and (2) historical data on population lifestyle related to the period of the tests, which were collected in 2016-2017 using focus-group discussions and key informant interviews. The mean thyroid dose among the study subjects was found to be around 5 mGy while the highest dose was estimated to be around 36 mGy. Doses from I intake ranged up to 27 mGy, while those from intake of short-lived iodine isotopes (I, I, I) and Te ranged up to 14 mGy. Thyroid doses from external exposure ranged up to 6 mGy, and those from internal exposure due to Cs ingestion did not exceed 1 mGy. Intake of I was found to be the main pathway for thyroid exposure accounting for 72% of the total dose. Results of this study are being used to evaluate the risk of thyroid cancer among the subjects of the epidemiologic study of thyroid cancer among French Polynesians.

The Likelihood of Adverse Pregnancy Outcomes and Genetic Disease (Transgenerational Effects) from Exposure to Radioactive Fallout from the 1945 Trinity Atomic Bomb Test.

The potential health consequences of the Trinity nuclear weapon test of 16 July 1945 at Alamogordo, New Mexico, are challenging to assess. Population data are available for mortality but not for cancer incidence for New Mexico residents for the first 25 y after the test, and the estimates of radiation dose to the nearby population are lower than the cumulative dose received from ubiquitous natural background radiation. Despite the estimates of low population exposures, it is believed by some that cancer rates in counties near the Trinity test site (located in Socorro County) are elevated compared with other locations across the state. Further, there is a concern about adverse pregnancy outcomes and genetic diseases (transgenerational or heritable effects) related to population exposure to fallout radiation. The possibility of an intergenerational effect has long been a concern of exposed populations, e.g., Japanese atomic bomb survivors, survivors of childhood and adolescent cancer, radiation workers, and environmentally exposed groups. In this paper, the likelihood of discernible transgenerational effects is discounted because (1) in all large-scale comprehensive studies of exposed populations, no heritable genetic effects have been demonstrated in children of exposed parents; (2) the distribution of estimated doses from Trinity is much lower than in other studied populations where no transgenerational effects have been observed; and (3) there is no evidence of increased cancer rates among the scientific, military, and professional participants at the Trinity test and at other nuclear weapons tests who received much higher doses than New Mexico residents living downwind of the Trinity site.

Estimated Radiation Doses Received by New Mexico Residents from the 1945 Trinity Nuclear Test.

The National Cancer Institute study of projected health risks to New Mexico residents from the 1945 Trinity nuclear test provides best estimates of organ radiation absorbed doses received by representative persons according to ethnicity, age, and county. Doses to five organs/tissues at significant risk from exposure to radioactive fallout (i.e., active bone marrow, thyroid gland, lungs, stomach, and colon) from the 63 most important radionuclides in fresh fallout from external and internal irradiation were estimated. The organ doses were estimated for four resident ethnic groups in New Mexico (Whites, Hispanics, Native Americans, and African Americans) in seven age groups using: (1) assessment models described in a companion paper, (2) data on the spatial distribution and magnitude of radioactive fallout derived from historical documents, and (3) data collected on diets and lifestyles in 1945 from interviews and focus groups conducted in 2015-2017 (described in a companion paper). The organ doses were found to vary widely across the state with the highest doses directly to the northeast of the detonation site and at locations close to the center of the Trinity fallout plume. Spatial heterogeneity of fallout deposition was the largest cause of variation of doses across the state with lesser differences due to age and ethnicity, the latter because of differences in diets and lifestyles. The exposure pathways considered included both external irradiation from deposited fallout and internal irradiation via inhalation of airborne radionuclides in the debris cloud as well as resuspended ground activity and ingestion of contaminated drinking water (derived both from rivers and rainwater cisterns) and foodstuffs including milk products, beef, mutton, and pork, human-consumed plant products including leafy vegetables, fruit vegetables, fruits, and berries. Tables of best estimates of county population-weighted average organ doses by ethnicity and age are presented. A discussion of our estimates of uncertainty is also provided to illustrate a lower and upper credible range on our best estimates of doses. Our findings indicate that only small geographic areas immediately downwind to the northeast received exposures of any significance as judged by their magnitude relative to natural radiation. The findings presented are the most comprehensive and well-described estimates of doses received by populations of New Mexico from the Trinity nuclear test.

Projected Cancer Risks to Residents of New Mexico from Exposure to Trinity Radioactive Fallout.

The Trinity nuclear test, conducted in 1945, exposed residents of New Mexico to varying degrees of radioactive fallout. Companion papers in this issue have detailed the results of a dose reconstruction that has estimated tissue-specific radiation absorbed doses to residents of New Mexico from internal and external exposure to radioactive fallout in the first year following the Trinity test when more than 90% of the lifetime dose was received. Estimated radiation doses depended on geographic location, race/ethnicity, and age at the time of the test. Here, these doses were applied to sex- and organ-specific risk coefficients (without applying a dose and dose rate effectiveness factor to extrapolate from a population with high-dose/high-dose rates to those with low-dose/low-dose rates) and combined with baseline cancer rates and published life tables to estimate and project the range of radiation-related excess cancers among 581,489 potentially exposed residents of New Mexico. The total lifetime baseline number of all solid cancers [excluding thyroid and non-melanoma skin cancer (NMSC)] was estimated to be 183,000 from 1945 to 2034. Estimates of ranges of numbers of radiation-related excess cancers and corresponding attributable fractions from 1945 to 2034 incorporate various sources of uncertainty. We estimated 90% uncertainty intervals (UIs) of excess cancer cases to be 210 to 460 for all solid cancers (except thyroid cancer and NMSC), 80 to 530 for thyroid cancer, and up to 10 for leukemia (except chronic lymphocytic leukemia), with corresponding attributable fractions ranging from 0.12% to 0.25%, 3.6% to 20%, and 0.02% to 0.31%, respectively. In the counties of Guadalupe, Lincoln, San Miguel, Socorro, and Torrance, which received the greatest fallout deposition, the 90% UI for the projected fraction of thyroid cancers attributable to radioactive fallout from the Trinity test was estimated to be from 17% to 58%. Attributable fractions for cancer types varied by race/ethnicity, but 90% UIs overlapped for all race/ethnicity groups for each cancer grouping. Thus, most cancers that have occurred or will occur among persons exposed to Trinity fallout are likely to be cancers unrelated to exposures from the Trinity nuclear test. While these ranges are based on the most detailed dose reconstruction to date and rely largely on methods previously established through scientific committee agreement, challenges inherent in the dose estimation, and assumptions relied upon both in the risk projection and incorporation of uncertainty are important limitations in quantifying the range of radiation-related excess cancer risk.

Averting cumulative lifetime attributable risk (LAR) of cancer by decontamination of residential areas affected by a large-scale nuclear power plant fallout: time aspects of radiological benefits for newborns and adults.

The averted cumulative lifetime attributable risk (LAR), the residual dose and highest ground deposition of 137Cs complying with a reference dose level of 20 mSv yr-1 to an individual returning after one year to an area contaminated by unfiltered releases of fission products from a nuclear power plant (NPP) were evaluated by applying an existing exposure model designed to compute age- and gender-dependent time-integrated LAR. The model was applied to four types of nuclear fallout scenarios, partly based on data from the Chernobyl and Fukushima releases and from theoretical source terms from Swedish NPPs. For rapid decontamination measures that achieve a 50% relative reduction in external dose rate within 1 year, compliance with the reference level 20 mSv yr-1 can be attained for an initial 137Cs ground deposition of up to 2 MBq m-2 with relaxed food restrictions. This compliance can be attained at even higher ground deposition (up to 4.5 MBq m-2) if using the strict food restrictions employed in Japan after 2011. Considering longer than 1 year return times it was also found that the benefit of implementing decontamination decreases rapidly with time (2-3 years half-time), especially if the fallout has a high initial 134Cs to 137Cs activity ratio and if the ecological half-time of the external dose rate is short (<5 years). Depending on fallout scenario the averted cumulative LAR for newborn girls by decontamination that is achieved after 5 years is only between 6% and 11% of that obtained by evacuation alone during the same time, indicating a rather limited radiological benefit of decontamination if delayed more than a few years. We conclude that decision makers and emergency response planners need to consider that protracted decontamination measures may have limited radiological benefit compared with evacuation in terms of averted future cancer cases, albeit it may have other societal benefits.

Hematological malignancies in Ukraine in post-Chernobyl era: sources of data and their preliminary analysis.

The major sources of the data on the hematological malignancies in the post-Chernobyl period in the regions of Ukraine differing by the levels of the residual contamination with radionuclides have been analyzed. According to the data collected from the primary hematological facilities in Ukraine in 2010-2017, the incidence of lymphoid neoplasms from mature B cells, acute myeloid leukemia, and multiple myeloma in the most contaminated regions was higher than in the less contaminated ones. For the first time, the relative contribution of the several specific types of leukemia in the total diagnosed hematological malignancies has been analyzed throughout 1997-2017 based on the in-house database compiled by the Reference Laboratory of RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, the National Academy of Sciences of Ukraine. In 2011-2017, the Reference Laboratory provided the diagnostic studies in about 26% of all Ukrainian patients with tumors of hematopoietic and lymphoid tissues (34% of patients with different forms of acute and chronic leukemia). The increased proportion of acute myeloid leukemia and chronic lymphocytic leukemia in the total diagnosed cases of overall leukemia in the patients from contaminated regions has been demonstrated following Chernobyl accident.

Fallout from Nuclear Weapons Tests: Environmental, Health, Political, and Sociological Considerations.

The process of nuclear fission, which was discovered in 1938, opened the door to the production of nuclear weapons, which were used in 1945 by the United States against Japan in World War II, and to the detonation of >500 nuclear weapons tests in the atmosphere by the United States, the former Soviet Union, the United Kingdom, China, and France from 1946-1980. Hundreds of radionuclides, most of them short-lived, were produced in the atmospheric tests. The radioactive clouds produced by the explosions were usually partitioned between the troposphere and the stratosphere: the activity that remained in the troposphere resulted in local and regional fallout, consisting mainly of short-lived radionuclides and in relatively high doses for the populations residing in the vicinity of the test site, whereas the activity that reached the stratosphere returned to the ground with a half-life of ~1 y and was composed of long-lived radionuclides that contaminated all uncovered materials on Earth to a small extent and led to low-level irradiation of the world population for decades or more. The health effects resulting from exposure to radioactive fallout constitute, in most cases, small excesses over baseline rates for thyroid cancer and leukemia. An extra 49,000 cases of thyroid cancer would be expected to occur among the US population from exposure to radioactive fallout from the atmospheric nuclear weapons tests that were conducted at the Nevada Test Site in the 1950s. In addition, there could be as many as 11,000 deaths from non-thyroid cancers related to fallout from all atmospheric tests that were conducted at all sites in the world, with leukemia making up 10% of the total. Public concern arose in part from the secrecy that surrounded the nuclear testing programs and, for a long time, the poor communication regarding the consequences of the tests, both in terms of radiation doses and of health effects. Sociological and political pressures contributed to the establishment of programs of compensation for radiation exposures and evidence of radiation-induced diseases in countries that incurred significant fallout from nuclear weapons testing.

Introduction of a method to calculate cumulative age- and gender-specific lifetime attributable risk (LAR) of cancer in populations after a large-scale nuclear power plant accident.

The effect of age and gender in risk estimates related to long-term residence in areas contaminated by nuclear power plant fallout was evaluated by applying the lifetime attributable risk (LAR) concept to an existing exposure model that was previously used for cumulative effective dose estimates. In this study, we investigated the influence of age distribution on the number of cancer cases by applying five different age distributions from nuclear power-producing countries (India, Japan, South Korea, and the United States), and Egypt because of intentions to develop nuclear power. The model was also used to estimate the effective dose and gender-specific LAR as a function of time after fallout for the offspring of the population living in 137Cs fallout areas. The principal findings of this study are that the LAR of cancer incidence (excluding non-fatal skin cancers) over 70 y is about 4.5 times higher for newborn females (5.4% per MBq m-2 of initial 137Cs ground deposition) than the corresponding values for 30 y old women (1.2% per MBq m-2 137Cs deposition). The cumulative LAR for newborn males is more than 3 times higher (3.2% versus 1.0% per MBq m-2 137Cs deposition). The model predicts a generally higher LAR for women until 50 y of age, after which the gender difference converges. Furthermore, the detriment for newborns in the fallout areas initially decreases rapidly (about threefold during the first decade) and then decreases gradually with an approximate half-time of 10-12 y after the first decade. The age distribution of the exposed cohort has a decisive impact on the average risk estimates, and in our model, these are up to about 65% higher in countries with high birth rates compared to low birth rates. This trend implies larger average lifetime attributable risks in countries with a highly proportional younger population. In conclusion, the large dispersion (up to a factor of 4 between newborns and 30 y olds) in the lifetime detriment per unit ground deposition of 137Cs over gender and age in connection with accidental nuclear releases justifies the effort in developing risk models that account for the higher radiation sensitivity in younger populations.

Endemic diseases of geochemical origin and methodological approaches toward their prevention and elimination.

A new approach to the study of diseases of geochemical origin is presented, which is based on the hypothesis that all such geochemical endemias were not possible in conditions of virgin biosphere and are products of human civilization. Two genetically different types of endemic diseases of geochemical origin are distinguished, each having a specifically spatial structure: (1) diseases of natural origin due to natural element deficiency or excess in the particular zones or areas; (2) diseases of anthropogenic origin related to chemical transformation of the environment in the course of agricultural or industrial production. Anthropogenically provoked diseases of geochemical nature always occur in conditions of already formed natural geochemical heterogeneity. As each type of the endemic disease has a peculiar structure of spatial distribution, the present health risk can be mapped as a genetically two-layer structure, characterizing deviation of the existing geochemical conditions from those ideal for specific species. Parameters of geochemical conditions, which are ideal for humans and domesticated species, should be sought within the areas with undisturbed soil cover, where these species have been formed in their present form. The hypothesis is tested on example of thyroid diseases observed in iodine-deficient areas affected by a nuclear accident with 131I fallout. The developed approach is believed to serve as a practical tool for monitoring and prevention of endemic diseases of geochemical origin.

COMPARATIVE CHARACTERISTICS OF SPERMOGRAPHIC INDICATORS IN IDIOPATHIC FORMS OF INFERTILITY IN MEN FROM RADIOACTIVELY CONTAMINATED AND CONVENTIONALLY CLEAN REGIONS OF UKRAINE. / PORIVNIaL'NA KhARAKTERYSTYKA POKAZNYKIV SPERMOGRAMY PRY IDIOPATYChNYKh FORMAKh BEZPLIDDIa U ChOLOVIKIV Z RADIATsIY̆NO ZABRUDNENYKh TA UMOVNO ChYSTYKh REGIONIV UKRAÏNY.

OBJECTIVE: the compare of men reproductive function with idiopathic infertility on the grounds of spermogram tests from the radioactively contaminated and conventionally clean regions of Ukraine. MATERIALS AND METHODS: There are 143 men (group I) with idiopathic infertility in the form of asthenozoospermia of the II degree living in the territories of the Kyiv region were investigated in the Department of Sexual Pathology and Andrology of the SI «Institute of Urology of the National Academy of Medical Sciences of Ukraine¼ and exposed to ionizing radiation due to the Chornobyl accident in 1986. All individuals in the I group were born from parents who were in the accident at the Chornobyl Nuclear Power Plant in the area of radioactive contamination and perma- nently resided in areas with a high level of radioactivity. The control group was made up of persons born and living in the Ivano-Frankivsk region with a similar with a similar state of health (group II, n = 157). The mean age of the studied group I was (28.3 ± 2.4) years, and persons of the II group were (30.1 ± 2.8) years. Diagnosis of II was per- formed ambulatory in accordance with WHO and Ministry of Health of Ukraine standards. The research was to study and compare spermogram parameters in patients from both groups. RESULTS: It has been established that the reproductive problems of men with idiopathic infertility living in radia- tively contaminated areas of the Kyiv region of Ukraine consist in a significant violation of the quality indicators of ejaculate (mobility by the pool A+B is less than 1.6 times, р < 0.05) correlating with modifications of physicochemi- cals (the average time of liquefaction is 1.4 times greater, р < 0.05) and biochemical (decrease of levels of fructose by 2.2 times, citrate - by 1.6 times, р < 0.001-0.05) investigation. CONCLUSIONS: The study found that the level of general indicators of spermogram is significantly worse in the regions of Ukraine who were exposed to radioactive contamination due to the Chornobyl accident, in contrast to the indicators of persons from conventionally clean regions.

STATE OF COGNITIVE FUNCTIONS IN CHILDREN WITH PATHOLOGY OF DIGESTIVE ORGANS, WHO LIVE AT RADIOACTIVE CONTAMINATED TERRITORIES OF UKRAINE. / STAN KOGNITYVNYKh FUNKTsIY̆ U DITEY̆ Z PATOLOGIIeIu ORGANIV TRAVLENNIa, IaKI PROZhYVAIuT' NA RADIOAKTYVNO ZABRUDNENYKh TERYTORIIaKh UKRAÏNY.

OBJECTIVE: to study the state of cognitive functions in children who were born and permanently live at radioactive contaminated territories (RCT) with pathology of the upper digestive tract, using pathopsychological testing; to increase the effectiveness of treatment and prophylactic measures aimed at preserving and restoring the health of RCT residents. DESIGN, PATIENTS AND METHODS: A randomized blind controlled clinical trial was conducted. There were examined, a total of 90 persons aged 6 to 17 years (35 boys and 55 girls) who were divided into two groups: the control group (I) included 30 persons of the conventional «clean¼ territories, and the main group (II) - 60 patients with patho- logy of the digestive organs who were born and live at the RCT. The study program included: the collection of anam- nesis, complaints; clinical and instrumental examinations. The following tests were applied by us: «What things are hidden in the drawings¼, Toulouse-Pieron, Raven, and Luria testing. For detecting the anxiety level, and the subjec- tive signs of autonomic dysfunctions were used the Spilberg-Hanin self-diagnosis and the Wein questionnaire, respectively. RESULTS: It was shown that in children aged 6-11 years, according to the results of the Toulouse-Pieron test, speed of cognitive information-processing was significantly decreased by 7.17 conventional units, while on the back- ground of the etiopathogenetic treatment of the digestive tract - by 10.24 conventional units relative to the va- lues of the control group. The long-term memory was statistically significantly decreased in the examined children of senior school age (from 12 to 17 years). A significant increase in reactive anxiety and a reverse correlation between the personal anxiety (PA) and speed of cognitive information-processing (r = -0.331) were recorded in patients aged 6-11 years. In older patients, PA was increased.Сonclusions. The obtained results indicate that the state of cognitive functions was characterized by a decrease in speed of cognitive information-processing, long-term memory and a high level of anxiety in children aged from 6 to 17 years residents of RСT with pathology of digestive organs, according to the used testing.

APPLICATION OF ART THERAPY FOR CORRECTION OF PERSONAL DISORDERS OF PSYCHOEMOTIONAL STATE OF CHILDREN - INHABITANTS OF RADIATION POLLUTED TERRITORIES AND CHILDREN DISPLACED FROM THE ARMED CONFLICT ON THE SOUTHERN EAST OF UKRAINE. / ZASTOSUVANNIa ART-TERAPIÏ DLIa KOREKTsIÏ PORUShEN' PSYKhOEMOTsIY̆NOGO STANU DITEY̆-MEShKANTsIV RADIOAKTYVNO ZABRUDNENYKh TERYTORIY̆ TA DITEY̆, PEREMIShchENYKh IZ ZONY ZBROY̆NOGO KONFLIKTU NA PIVDENNOMU SKhODI UKRAÏNY.

OBJECTIVE: to identify the psycho-emotional state of children - residents of radioactively contaminated territories and children displaced from the zone of armed conflict in the south-east of Ukraine, and evaluate the effectiveness of art therapy application to correct its disturbances. MATERIALS AND METHODS: The psycho-emotional state was determined in 113 children, of which 57 children from radioactively contaminated territories with 137Cs content in the body from 269 Bq to 7024 Bq (group I) and 56 chil- dren displaced from the zone of military conflict in the Southeast of Ukraine (group II). The age of children ranged from 10 to 17 years. The children were hospitalized to the childrens' clinics of the NRCRM because of functional dis- orders and chronic somatic pathology. The psycho-emotional state of children was evaluated using the «non-exis- tent animal¼ test. It was analyzed for three symptoms - anxiety, aggressiveness and neuropsychiatric exhaustion and was evaluated by scoring points. Correction of the psychoemotional condition was carried out by the method of art therapy in the form of a serial drawing. Psychological testing was performed twice: at admission to the hospital and after the end of the art therapy. RESULTS: The results of the primary examination of the psycho-emotional state of children by the «non-existent ani- mal¼ test showed that in children - residents of radioactively contaminated territories the state of anxiety was reg- istered in all 57 children (100 %), the state of aggression - in 38 children (66.7%); exhaustion - in 37 children (64.9 %). In children who have been displaced from the zone of armed conflict in the south-east of Ukraine, the state of anxiety was also registered in all 56 children (100 %), the status of aggression was determined in 53 chil- dren (94.6 %), and the state of exhaustion - in 44 children (78.6 %). It was established that in children displaced from the combat zone in the Southeast of Ukraine, the quantitative indices of anxiety and aggression states were sig- nificantly higher than in children living in radioactively contaminated territories (p < 0.001), whereas nor by frequen- cy, nor by the degree of severity of exhaustion state they did not clearly differ (p > 0.05). Correlation analysis with the definition of Spearman's criterion did not reveal likely association between the content of 137Cs in the body of children - residents of radioactively contaminated territories and the peculiarities of their psycho-emotional state. CONCLUSIONS: The use of the art therapy method in the form of a serial drawing for children - residents of radioac- tively contaminated territories and children moved from the combat zone in the south-east of Ukraine, led to a sig- nificant positive effect, which was characterized by a decrease in the manifestations of symptoms of anxiety and aggressiveness. The state of exhaustion was less well corrected and its indices only had a tendency to improve. Thus, the method of art therapy in the form of a serial drawing is characterized by efficiency, simplicity of execution, low cost, it can be widely used in children's teams to correct disorders of the psycho-emotional state.

History of Dose, Risk, and Compensation Assessments for US Veterans of the 1966 Plutonium Cleanup in Palomares, Spain.

In 1966, about 1,600 US military men-mostly Air Force-participated in a cleanup of plutonium dispersed from two nuclear bombs in Palomares, Spain. As a base for future analyses, we provide a history of the Palomares incident, including the dosimetry and risk analyses carried out to date and the compensation assessments made for veterans. By law, compensation for illnesses attributed to ionizing radiation is based on maximum estimated doses and standard risk coefficients, with considerable benefit of the doubt given to claimants when there is uncertainty. In the Palomares case, alpha activity in urine fell far faster than predicted by plutonium biokinetic excretion models used at the time. Most of the measurements were taken on-site but were disqualified on the grounds that they were "unreasonably high" and because there was a possibility of environmental contamination. Until the end of 2013, the Air Force used low dose estimates derived from environmental measurements carried out well after the cleanup. After these estimates were questioned by Congress, the Air Force adopted higher dose estimates based on plutonium concentration measurements in urine samples collected from 26 veterans after they left Palomares. The Air Force assumed that all other cleanup veterans received lower doses and therefore assigned to them maximum organ doses based on the individual among the 26 with the lowest urine measurements. These resulting maximum organ doses appear to be sufficient to justify compensation to all Palomares veterans with lung and bone cancer and early-onset liver cancer and leukemia but not other radiogenic cancers.