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

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

Behavior and food consumption pattern of the population exposed in 1949-1962 to fallout from Semipalatinsk nuclear test site in Kazakhstan.

The relationship between radiation exposure from nuclear weapons testing fallout and thyroid disease in a group of 2,994 subjects has been the subject of study by the US National Cancer Institute. In that study, radiation doses to the thyroid were estimated for residents of villages in Kazakhstan possibly exposed to deposition of radioactive fallout from nuclear testing conducted by the Soviet Union at the Semipalatinsk Nuclear Test Site in Kazakhstan between 1949 and 1962. The study subjects included individuals of both Kazakh and Russian origin who were exposed during childhood and adolescence. An initial dose reconstruction used for the risk analysis of Land et al. (Radiat Res 169:373-383, 2008) was based on individual information collected from basic questionnaires administered to the study population in 1998. However, because data on several key questions for accurately estimating doses were not obtained from the 1998 questionnaires, it was decided to conduct a second data collection campaign in 2007. Due to the many years elapsed since exposure, a well-developed strategy was necessary to encourage accurate memory recall. In our recent study, a focus group interview data collection methodology was used to collect historical behavioral and food consumption data. The data collection in 2007 involved interviews conducted within four-eight-person focus groups (three groups of women and one group of men) in each of four exposed villages where thyroid disease screening was conducted in 1998. Population-based data on relevant childhood behaviors including time spent in- and outdoors and consumption rates of milk and other dairy products were collected from women's groups. The data were collected for five age groups of children and adolescents ranging from less than 1 year of age to 21 years of age. Dairy products considered included fresh milk and other products from cows, goats, mares, and sheep. Men's focus group interviews pertained to construction materials of houses and schools, and animal grazing patterns and feeding practices. The response data collected are useful for improving estimates of thyroid radiation dose estimates for the subjects of an ongoing epidemiological study.

The Ukrainian-American study of leukemia and related disorders among Chornobyl cleanup workers from Ukraine: II. Estimation of bone marrow doses.

After the accident that took place on 26 April 1986 at the Chornobyl nuclear power plant, hundreds of thousands of cleanup workers were involved in emergency measures and decontamination activities. In the framework of an epidemiological study of leukemia and other related blood diseases among Ukrainian cleanup workers, individual bone marrow doses have been estimated for 572 cases and controls. Because dose records were available for only about half of the study subjects, a time-and-motion method of dose reconstruction that would be applicable to all study subjects, whether dead or alive, was developed. The doses were calculated in a stochastic mode, thus providing estimates of uncertainties. The arithmetic mean individual bone marrow doses were found to range from 0.00004 to 3,300 mGy, with an average value of 87 mGy over the 572 study subjects. The uncertainties, characterized by the geometric standard deviation of the probability distribution of the individual dose, varied from subject to subject and had a median value of about 2. These results should be treated as preliminary; it is likely that the dose calculations and particularly the uncertainty estimates will be improved in the follow-up of this effort.

The chornobyl accident: estimation of radiation doses received by the Baltic and Ukrainian cleanup workers.

During the first day after the explosion, the Chornobyl accident of April 26, 1986 exposed a few hundred emergency workers to high dose levels ranging up to 16 Gy, resulting in acute radiation syndrome. Subsequently, several hundred thousand cleanup workers were sent to the Chornobyl power plant to mitigate the consequences of the accident. Depending on the nature of the work to be carried out, the cleanup workers were sent for periods ranging from several minutes to several months. The average dose from external radiation exposure that was received by the cleanup workers was about 170 mGy in 1986 and decreased from year to year. The radiation exposure was mainly due to external irradiation from gamma-ray-emitting radionuclides and was relatively homogeneous over all organs and tissues of the body. To assess the possible health consequences of external irradiation at relatively low dose rates, the U.S. National Cancer Institute is involved in two studies of Chornobyl cleanup workers: (1) a study of cancer incidence and thyroid disease among Estonian, Latvian and Lithuanian workers, and (2) a study of leukemia and other related blood diseases among Ukrainian workers. After an overview of the sources of exposure and of the radiation doses received by the cleanup workers, a description of the efforts made to estimate individual doses in the Baltic and Ukrainian studies is presented.

Retrospective dose assessment for the population living in areas of local fallout from the Semipalatinsk nuclear test site Part I: External exposure.

A short analysis of all 111 atmospheric events conducted at the Semipalatinsk Test Site (STS) in 1949-1962 with regard to significant off-site exposure (more than 5 mSv of the effective dose during the first year after the explosion) has been made. The analytical method used to assess external exposure to the residents living in settlements near the STS is described. This method makes use of the archival data on the radiological conditions, including the measurements of exposure rate. Special attention was given to the residents of Dolon and Kanonerka villages exposed mainly as a result of the first test, detonated on August 29, 1949. For the residents of those settlements born in 1935, the dose estimates calculated according to the analytical method, are compared to those derived from the thermoluminescence measurements in bricks and electron paramagnetic resonance measurements in teeth. The methods described in this paper were used for external dose assessment for the cohort members at an initial stage of an ongoing epidemiological study conducted by the U.S. National Cancer Institute in the Republic of Kazakhstan. Recently revised methods and estimates of external exposure for that cohort are given in another paper (Simon et al.) in this conference.

Retrospective dose assessment for the population living in areas of local fallout from the Semipalatinsk Nuclear Test Site Part II: Internal exposure to thyroid.

A methodology to assess internal exposure to thyroid from radioiodines for the residents living in settlements located in the vicinity of the Semipalatinsk Nuclear Test Site is described that is the result of many years of research, primarily at the Moscow Institute of Biophysics. This methodology introduces two important concepts. First, the biologically active fraction, is defined as the fraction of the total activity on fallout particles with diameter less than 50 microns. That fraction is retained by vegetation and will ultimately result in contamination of dairy products. Second, the relative distance is derived as a dimensionless quantity from information on test yield, maximum height of cloud, and average wind velocity and describes how the biologically active fraction is distributed with distance from the site of the explosion. The parameter is derived in such a way that at locations with equal values of relative distance, the biologically active fraction will be the same for any test. The estimates of internal exposure to thyroid for the residents of Dolon and Kanonerka villages, for which the external exposure were assessed and given in a companion paper (Gordeev et al. 2006) in this conference, are presented. The main sources of uncertainty in the estimates are identified.

Biodosimetry study in Dolon and Chekoman villages in the vicinity of Semipalatinsk nuclear test site.

In this paper, the results of a biodosimetry investigation are reported for two villages in the area of the Semipalatinsk nuclear testing site: Chekoman and Dolon. Chekoman village is considered to be relatively less affected by radiation in comparison with Dolon village. The distance between the two villages is about 100 km and the life styles of the residents are similar. Chromosome aberrations in lymphocytes collected from the residents of the two villages were analyzed using the fluorescence in situ hybridization technique. Our results showed that the average frequency of stable translocations for the Dolon group was significantly greater that of the Chekoman group. The elevated level of stable translocations with the Dolon residents corresponds to a dose of about 180 mSv.

Individual thyroid dose estimates for a case-control study of chernobyl-related thyroid cancer among children of Belarus--part II. Contributions from long-lived radionuclides and external radiation.

Significant quantities of long-lived radionuclides were released to the environment during the Chernobyl nuclear power plant accident in 1986. These radionuclides contributed to radiation doses due to ingestion of contaminated foods and external exposure from the ground deposition that resulted. The contributions of these exposure pathways to thyroid doses received by subjects of an epidemiologic study of children from Belarus are evaluated and presented. The analysis shows that ingestion of the long-lived radionuclides, primarily radiocesium, typically contributed a small percentage of the total thyroid dose received by the study subjects. The median and mean fractional contributions were 0.76 and 0.95%, respectively. The contribution of external exposure to the thyroid dose was generally larger and more variable, with median and mean contributions of 1.2 and 1.8% of the total thyroid doses, respectively. For regions close to the reactor site, where radionuclide deposition was highest, the contributions of radiocesium ingestion and external exposure were generally lower than those of the short-lived radioiodine isotopes (132I and 133I) and their precursors (132Te). In other areas, the contributions of these two pathways were comparable to those of the short-lived radioiodines. For all subjects, intakes of 131I were the primary source of dose to the thyroid.

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

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

Dosimetry Support of the Ukrainian-American Case-control Study of Leukemia and Related Disorders Among Chornobyl Cleanup Workers.

This paper describes dose reconstruction for a joint Ukrainian-American case-control study of leukemia that was conducted in a cohort of 110,645 male Ukrainian cleanup workers of the Chornobyl (Chernobyl) accident who were exposed to various radiation doses over the 1986-1990 time period. Individual bone-marrow doses due to external irradiation along with respective uncertainty distributions were calculated for 1,000 study subjects using the RADRUE method, which employed personal cleanup history data collected in the course of an interview with the subject himself if he was alive or with two proxies if he was deceased. The central estimates of the bone-marrow dose distributions range from 3.7 × 10(-5) to 3,260 mGy, with an arithmetic mean of 92 mGy. The uncertainties in the individual stochastic dose estimates can be approximated by lognormal distributions; the average geometric standard deviation is 2.0.

A cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident: objectives, design and methods.

The thyroid gland in children is one of the organs that is most sensitive to external exposure to X and gamma rays. However, data on the risk of thyroid cancer in children after exposure to radioactive iodines are sparse. The Chornobyl accident in Ukraine in 1986 led to the exposure of large populations to radioactive iodines, particularly (131)I. This paper describes an ongoing cohort study being conducted in Belarus and Ukraine that includes 25,161 subjects under the age of 18 years in 1986 who are being screened for thyroid diseases every 2 years. Individual thyroid doses are being estimated for all study subjects based on measurement of the radioactivity of the thyroid gland made in 1986 together with a radioecological model and interview data. Approximately 100 histologically confirmed thyroid cancers were detected as a consequence of the first round of screening. The data will enable fitting appropriate dose-response models, which are important in both radiation epidemiology and public health for prediction of risks from exposure to radioactive iodines from medical sources and any future nuclear accidents. Plans are to continue to follow-up the cohort for at least three screening cycles, which will lead to more precise estimates of risk.

Individual thyroid dose estimation for a case-control study of Chernobyl-related thyroid cancer among children of Belarus-part I: 131I, short-lived radioiodines (132I, 133I, 135I), and short-lived radiotelluriums (131MTe and 132Te).

Large amounts of radioiodines were released into the atmosphere during the accident at the Chernobyl nuclear power plant on 26 April 1986. In order to investigate whether the thyroid cancers observed among children in Belarus could have been caused by radiation exposures from the Chernobyl accident, a team of Belarusian, Russian, and American scientists conducted a case-control study to compare cases and controls according to estimated thyroid dose. The primary purpose of this paper is to present detailed information on the estimated thyroid doses, due to intakes of 131I, that were used in the case-control study. The range of the 131I thyroid doses among the 107 cases and the 214 controls was found to extend from 0.00002 to 4.3 Gy, with medians of approximately 0.2 Gy for the cases and 0.07 Gy for the controls. In addition, the thyroid doses resulting from the intakes of short-lived radioiodines (132I, 133I, and 135I) and radiotelluriums (131mTe and 132Te) were estimated and compared to the doses from 131I. The ratios of the estimated thyroid doses from the short-lived radionuclides and from I for the cases and the controls range from 0.003 to 0.1, with median values of approximately 0.02 for both cases and controls.

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

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

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

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

Mathematical modeling of a survey-meter used to measure radioactivity in human thyroids: Monte Carlo calculations of the device response and uncertainties.

This paper presents results of Monte Carlo modeling of the SRP-68-01 survey meter used to measure exposure rates near the thyroid glands of persons exposed to radioactivity following the Chernobyl accident. This device was not designed to measure radioactivity in humans. To estimate the uncertainty associated with the measurement results, a mathematical model of the SRP-68-01 survey meter was developed and verified. A Monte Carlo method of numerical simulation of radiation transport has been used to calculate the calibration factor for the device and evaluate its uncertainty. The SRP-68-01 survey meter scale coefficient, an important characteristic of the device, was also estimated in this study. The calibration factors of the survey meter were calculated for (131)I, (132)I, (133)I, and (135)I content in the thyroid gland for six age groups of population: newborns; children aged 1 yr, 5 yr, 10 yr, 15 yr; and adults. A realistic scenario of direct thyroid measurements with an "extended" neck was used to calculate the calibration factors for newborns and one-year-olds. Uncertainties in the device calibration factors due to variability of the device scale coefficient, variability in thyroid mass and statistical uncertainty of Monte Carlo method were evaluated. Relative uncertainties in the calibration factor estimates were found to be from 0.06 for children aged 1 yr to 0.1 for 10-yr and 15-yr children. The positioning errors of the detector during measurements deviate mainly in one direction from the estimated calibration factors. Deviations of the device position from the proper geometry of measurements were found to lead to overestimation of the calibration factor by up to 24 percent for adults and up to 60 percent for 1-yr children. The results of this study improve the estimates of (131)I thyroidal content and, consequently, thyroid dose estimates that are derived from direct thyroid measurements performed in Belarus shortly after the Chernobyl accident.

Radrue method for reconstruction of external photon doses for Chernobyl liquidators in epidemiological studies.

Between 1986 and 1990, several hundred thousand workers, called "liquidators" or "clean-up workers," took part in decontamination and recovery activities within the 30-km zone around the Chernobyl nuclear power plant in Ukraine, where a major accident occurred in April 1986. The Chernobyl liquidators were mainly exposed to external ionizing radiation levels that depended primarily on their work locations and the time after the accident when the work was performed. Because individual doses were often monitored inadequately or were not monitored at all for the majority of liquidators, a new method of photon (i.e., gamma and x rays) dose assessment, called "RADRUE" (Realistic Analytical Dose Reconstruction with Uncertainty Estimation), was developed to obtain unbiased and reasonably accurate estimates for use in three epidemiologic studies of hematological malignancies and thyroid cancer among liquidators. The RADRUE program implements a time-and-motion dose-reconstruction method that is flexible and conceptually easy to understand. It includes a large exposure rate database and interpolation and extrapolation techniques to calculate exposure rates at places where liquidators lived and worked within approximately 70 km of the destroyed reactor. The RADRUE technique relies on data collected from subjects' interviews conducted by trained interviewers, and on expert dosimetrists to interpret the information and provide supplementary information, when necessary, based upon their own Chernobyl experience. The RADRUE technique was used to estimate doses from external irradiation, as well as uncertainties, to the bone marrow for 929 subjects and to the thyroid gland for 530 subjects enrolled in epidemiologic studies. Individual bone marrow dose estimates were found to range from less than one muGy to 3,300 mGy, with an arithmetic mean of 71 mGy. Individual thyroid dose estimates were lower and ranged from 20 muGy to 507 mGy, with an arithmetic mean of 29 mGy. The uncertainties, expressed in terms of geometric standard deviations, ranged from 1.1 to 5.8, with an arithmetic mean of 1.9.

A cohort study of thyroid cancer and other thyroid diseases after the chornobyl accident: thyroid cancer in Ukraine detected during first screening.

BACKGROUND: The Chornobyl accident in 1986 exposed thousands of people to radioactive iodine isotopes, particularly (131)I; this exposure was followed by a large increase in thyroid cancer among those exposed as children and adolescents, particularly in Belarus, the Russian Federation, and Ukraine. Here we report the results of the first cohort study of thyroid cancer among those exposed as children and adolescents following the Chornobyl accident. METHODS: A cohort of 32 385 individuals younger than 18 years of age and resident in the most heavily contaminated areas in Ukraine at the time of the accident was invited to be screened for any thyroid pathology by ultrasound and palpation between 1998 and 2000; 13 127 individuals (44%) were actually screened. Individual estimates of radiation dose to the thyroid were available for all screenees based on radioactivity measurements made shortly after the accident and on interview data. The excess relative risk per gray (Gy) was estimated using individual doses and a linear excess relative risk model. RESULTS: Forty-five pathologically confirmed cases of thyroid cancer were found during the 1998-2000 screening. Thyroid cancer showed a strong, monotonic, and approximately linear relationship with individual thyroid dose estimate (P<.001), yielding an estimated excess relative risk of 5.25 per Gy (95% confidence interval [CI] = 1.70 to 27.5). Greater age at exposure was associated with decreased risk of radiation-related thyroid cancer, although this interaction effect was not statistically significant. CONCLUSION: Exposure to radioactive iodine was strongly associated with increased risk of thyroid cancer among those exposed as children and adolescents. In the absence of Chornobyl radiation, 11.2 thyroid cancer cases would have been expected compared with the 45 observed, i.e., a reduction of 75% (95% CI = 50% to 93%). The study also provides quantitative risk estimates minimally confounded by any screening effects. Caution should be exercised in generalizing these results to any future similar accidents because of the potential differences in the nature of the radioactive iodines involved, the duration and temporal patterns of exposures, and the susceptibility of the exposed population.