Abstract
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. 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. 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). 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.
Highlights
Understanding both acute and long term health con sequences of exposure to radiation is critical in devel oping effective countermeasures for preventing adverse health effects following radiation exposure
The most relevant sources of information on the effects of prenatal radioiodine exposure had been a cohort of 2,582 individuals in Ukraine exposed in utero to Chernobyl (Chornobyl) fallout [8, 9]
Thyroid screening of the Belarusian in utero cohort Because of significant radiation exposure to the thy roid gland from 131I, medical screening focuses on thy roid cancer and other thyroid diseases, including fol licular adenoma, benign nodules, diffuse goiter, hypothyroidism, hyperthyroidism, and autoimmune thyroiditis
Summary
Understanding both acute and long term health con sequences of exposure to radiation is critical in devel oping effective countermeasures for preventing adverse health effects following radiation exposure. Knowledge of the carcinogenic effects of in utero exposure to ionizing radiation derives mainly from the follow up of the atomic bomb survivors in Hiroshima and Nagasaki [1, 2] and children born to mothers exposed to diagnostic X rays during pregnan cy [3, 4] While these studies provide information on the effects of external acute gamma or X irradiation, there are two cohorts of subjects exposed prenatal ly to a mixture of gamma and other types of radiation: the offspring of female workers at the Mayak plant in Russia and those born to mothers living near the Techa River [5,6,7]. A remarkably high excess radiation related risk for thyroid cancer and large thyroid nod ules was reported from this study, but the risk estimates were based on a small number of cases with large sta tistical uncertainty
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