Ischemic heart disease in the evacuated adult population as a cause of health loss in the long term after the Chernobyl accident. Results of epidemiological studies 1988-2016

Abstract

Ischemic heart disease (CHD) is one of the most common diseases of the circulatory system, which is the main cause of death in Ukraine. The purpose of this study was to analyze the incidence, disability, mortality from ischemic heart disease, its individual nosological forms in the adult population evacuated from the 30 km zone of the Chernobyl nuclear power plant in the post-accident period, taking into account the age at the date of the accident, sex and time after the accident for further improving the system of dispensary observation evacuees and reducing the risk of cardiovascular complications. The study used epidemiological surveillance data (1988-2016) for the category of the adult evacuated population (18-60 years old as of the date of the accident) with a population of 42 982 people, of which 58.7% are women according to the data of the State Register of Ukraine of persons injured in as a result of the Chernobyl disaster (GRU). The research results were assessed both in general for ischemic heart disease and the main nosological forms according to ICD-9 and ICD-10. In the study, epidemiological, analytical, mathematical and statistical methods were used, as well as the method of internal comparison (with indicators of 1988-1992). As the results of the study have shown, in the structure of the causes of morbidity, disability and mortality of the adult evacuated population from diseases of the circulatory system, IHD takes a leading place. The statistically significant influence of age, calendar observation period, gender was established. Among nosological forms, chronic CHD is in the lead. Evacuees at the age of 18–39 years show an increase in the incidence of coronary artery disease with a maximum rate after 17 years, and at the age of 40-60 years – at the beginning of the observation with a subsequent noticeable decrease since 2003. In recent years (2013-2016), there has been a significant decrease in the incidence of coronary artery disease at the age of 40-60 years by 9.3 times, and at the age of 18-39 years, on the contrary, an increase by 3.8 times. During the post-accident period, the level of disability and mortality of the studied contingents from ischemic heart disease has significantly increased. High rates of growth of disability in recent years in persons aged 18-39 at the date of the accident. The mortality rate of the evacuees in recent years has increased in comparison with the early observation period by 5.8 times, higher mortality rates in men compared to women. Further more in-depth studies are required to assess the contribution of non-cancer diseases to the total radiation damage to human health.