ChNPP Accident Research Articles

Relation between hormonal and metabolic status in persons affected by the chnpp accident with parathyroid disordres

Relation between hormonal and metabolic status in persons affected by the chnpp accident with parathyroid disordres

Dynamics of <sup>137</sup>Cs concentrations in agricultural products after the Chernobyl accident: cereals, potato, and vegetables

The paper continues the cycle of publications addressed to the study of regularities of 137Cs content changes in agricultural products after the Chernobyl accident. The aim of the studies was to analyze the information describing changes in the 137Cs concentrations in agricultural animal forage: hay, haylage, silage and green fodder in the southwestern districts of the Bryansk region affected by the contamination after the ChNPP accident. The data on countermeasures in the fodder production are given and the system of radiological monitoring of fodder contamination is described. It is shown that the dynamics of changes in the 137Cs concentrations in fodder was mainly determined by the dynamics of implementation of remedial measures. The effective halflives of 137Cs concentration in forages during the first period after the accident (1987-1990) varied from 0.57 to 2.7 years. Subsequently (1991-2021) the decrease in feed contamination slowed down and the half-lives ranged from 8.0 to 50.0 years and longer depending on the scope of remediation and the characteristics of the plants used for the animal feed production.

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).

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). 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. 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 %. 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.

DRIVERS OF HYPERFERREMIA IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES AFTER THE CHNPP ACCIDENT IN UKRAINE.

assessment of clinical-hematological and metabolic-biochemical parameters of the of bone tissue and hormonal regulation depending on the serum iron content and radiation dose values in children living on radiologically contaminated territories after the ChNPP accident in Ukraine. Children (n = 271) living on radiologically contaminated territories (RCT) of Ukraine were involved in the study. Three study groups were formed according to the serum iron level (SIL), namely group I with SIL 10.0-22.0 μmol/l (n = 92), group II with SIL 23.0-34.0 μmol/l (n = 144), and group III with SIL above 35.0 μmol/l (n = 35). Diseases in the family tree, bodyweight at birth, complaints on osalgia, bone fractures, jaw anomalies, dental caries, and obesity were accounted. Morphometric parameters of erythrocytes and hemogram elements were analyzed. Creatinine, alkaline phosphatase, calcium, total protein, iron, cholesterol, bilirubin, and transaminases were assayed in blood serum. The urine content of the 19 free amino acids, serum content of the free thyroxine (FT4), pituitary thyroid-stimulating hormone (TSH), and cortisol were assayed both with bone tissue density. Individual radiation doses were calculated. In 12.9 % of cases the SIL was > 35.0 μmol/l. Relatives with endocrine diseases were often present in the family tree of children with SIL > 23.0 μmol/l. There were increased urine content of the free amino acids (p < 0.05) and signs of protein degradation under high SIL. Contents of amino acids involved in collagen synthesis and antioxidant status (alanine, serine, glutamine, aspartic acid) and iron metabolism (arginine, leucine) were assayed at the highest levels (p < 0.05). Urinary levels of valine, lysine, and methionine, which are associated with iron metabolism, were decreased (p < 0.05). An inverse correlation (rs = -0.58; p < 0.01) was established between the serum TSH and cortisol levels regardless of the SIL. Serum TSH level directly correlated with urine content of amino acids involved in collagen synthesis. An inverse correlation (rs = -0.55; p < 0.001) was established between the serum TSH level and urine content of tyrosine that is essential for the thyroid hormone (triiodothyronine and thyroxine) synthesis.Cortisol was found having a negative effect on protein synthesis. Inverse correlation was established between the serum cortisol level and urine content of the free amino acids essential for collagen synthesis. There was no dependence of the average radiation dose values on the SIL. An inverse correlation was determined between the patient's radiation dose and SIL > 35.0 μmol/l (rs = -0.29; p < 0.05). The increased SIL in children living on RCT may occur due to both a genetic predisposition and the acquired factors driving protein and mineral metabolism of bone and their hormonal regulation.

EFFECT OF IRON ON BONE TISSUE METABOLISM AND THYROID FUNCTION IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES SINCE THE ChNPP ACCIDENT.

identification of clinical and metabolic characteristics of osteogenesis and factors affecting bone mineral density (BMD) in children living in radioactively contaminated territories (RCT) after the ChNPP accident for the use of therapeutic and preventive measures aiming to reduce the incidence of disorders. Children aged 4 to 18 years old (n = 539) were involved in the study within 4 age groups, namely under 7 years old, 7-10 years old, 10-14 years old, older than 14 years old. Studied parameters in children with a reduced BMD (85-65 relative units and under 65 relative units) were estimated vs. the normative BMD (100-85 relative units) cases. Diagnosis of osteopenia and osteoporosis in children was established according to the BMD T-index. Family history of the relatives of children was studied. Body weight at birth, fractures of the long bones, complaints of osalgia, jaw anomalies, dental caries, presence of obesity, and hypermobility syndrome (HMS) were assessed. Peripheral blood biochemical tests were performed featuring the serum total protein, alkaline phosphatase (APh), calcium, vitamin D, creatinine, serum iron (SI), ferritin, cortisol, pituitary thyroid-stimulating hormone (TSH), and free thyroxine (FT4) assay. BMD was measured and radiation doses in children were reconstructed. BMD depended on the age of children. A direct correlation was established between the cholelithiasis and urolithiasis incidence (р < 0.01), cancer and endocrine diseases (р < 0.05) in the relatives of children that had BMD under 65 relative units. Dental caries developed more often (р < 0.05), while obesity was less frequent (р < 0.05) in the subjects with BMD < 65 relative units. A direct correlation was established between the level of serum creatinine and BMD (р < 0.01), and there was an inverse correlation between the serum APh level and BMD (р < 0.001).Every third child had a vitamin D deficiency. Fractures of long bones and increased content of SI and TSH were characteristic for the children having got osteopenia (BMD within 85-65 relative units), while besides a predisposition to bone fractures the higher levels of SI, APh, cortisol both with calcium deficiency were found in children with osteoporosis (BMD < 65 relative units) compared to the general group with a similar BMD. An increased incidence of HMS was characteristic too. Radiation doses in children with osteopenia were higher than in those with osteoporosis: (1.17 ± 0.09) mSv and (0.92 ± 0.06) mSv respectively (р < 0.05). No correlation was found between the radiation doses and clinical signs, blood biochemistry or BMD. Study of the functional mechanisms of bone structures in children, depending on their metabolism, had made it possible to reveal the factors that affect bone formation in children living in RCT after the ChNPP accident, and to form the population groups for the timely application of therapeutic and preventive measures aiming to reduce the incidence of disorders of musculoskeletal system.

EFFECT OF IRON ON BONE TISSUE METABOLISM AND THYROID FUNCTION IN CHILDREN LIVING ON RADIOLOGICALLY CONTAMINATED TERRITORIES SINCE THE ChNPP ACCIDENT.

To assess the metabolic processes in bone tissue and state of thyroid gland depending on iron metabolism parameters in children of pre-pubertal, pubertal and post-pubertal age, living on radiologically contaminated territories after the ChNPP accident. Children (n = 119) aged 6 to 18 years were examined and the 4 study groups were formed, featuring the childhood, pre-pubertal, pubertal and post-pubertal life periods. Clinical symptoms, iron metabolism parameters (serum iron (SI) and ferritin (SF) content, transferrin saturation coefficient), parameters of bone tissue metabolism (serum creatinine and alkaline phosphatase (APh)), and amino acid content in urine were taken into account. Functional state of thyroid, titers of antibodies to thyroperoxidase (TPOAb) and thyroglobulin (TgAb) were assayed. Results and their discussion are presented depending on the age of children, biochemical parameters of blood, iron metabolism findings, thyroid gland function and individualized radiation doses. In 13.4 % of pubertal and post-pubertal children an elevated content of SI and SF was observed. APh levels were increased in 20.2 % of children (758.9 ± 16.3 U/l) being directly correlated with SI levels (rs = 0.50; р < 0.01). In 16.3 % of children of pubertal and post-pubertal age, in whom the level of SI was above 27 μmol/l, a direct correlation with serum thyroid-stimulating hormone (TSH) level was established in case of the hormone content above 2.5 mU/l (rs = 0.50; р < 0.05). Serum creatinine level directly correlated with glycine content in urine (rs = 0.70), which is a part of collagen, and inversely correlated with serum APh (rs = -0.47), (р < 0.05). Under the levels of SI higher than (15.1 ± 1.2) μmol/l and SF higher than (87.5 ± 6.4) ng/ml, the TPOAb titer was higher than at lower iron concentrations (U-test = 64.5, р < 0.05). The TgAb titer directly correlated with SI (rs = 0.39) and TSH (rs = 0.81) levels (р < 0.01). The average effective radiation dose in children was (0.75 ± 0.10) mSv. A direct correlation was established between the child's radiation dose and age (rs = 0.33; р < 0.05). Bone metabolism depends on the age of children, characteristics of pubertal period, excess of iron in the body, and functional state of thyroid system, which is involved in collagen formation and protein metabolism.

MEDICAL EXPERTISE FOR ESTABLISH CAUSATION OF DISEASE, LEADING TO LOSS OF HEALTH, DISABILITY AND DEATH WITH THE ACTION OF IONIZING RADIATION AND OTHER HARMFUL FACTORS OF THE CHORNOBYL ACCIDENT IN THE REMOTE POST-ACCIDENTAL PERIOD (2013-2022).

To study and characterize the structure of the affected categories (clean-up workers and victims) of the Chernobyl Catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission (CMEC) in the remote post-accidental period (2013-2022). The work was performed in the design of a retrospective study that based on studying of 50,974 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 using a systematic analytical approach to assessing the medical and nonmedical parameters presented in medical expert documentation. The total number of affected adult citizens as on 01.01.2022, compared to 2008, decreased by 477,953 persons, or by 26.05 % (from 1,834,536 to 1,354,746 persons). The number of clean-up workers of the accident decreased from 276,327 (2013) to 171,725 (2022), or by 104,602 people (37.85 %), that means - during the last 10 years, almost every third clean-up worker who participated in the liquidation of the consequences of the accident at the Chernobyl NPP died. The number of adult victims decreased from 1,558,209 in 2008 to 1,183,021 in 2022, or by 24.08 % (375,188 persons). The average annual reduction in the absolute number of clean-up workers of ChNPP accident during 2013-2022 is about 7,770 people per year (9,424 during 2021), adult victims - 27,045 people per year (28,922 during 2021). 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 - 52.72 %, cerebrovascular diseases and their complications make up 17.08 %, diseases of the cardiovascular system - 19.6 %. In the remote post-accidental period (2013-2022) has increased the need of expertise of the causal relationship of disability and the causes of death with the influence of the Chornobyl NPP accident consequences for medical and social support. During 2013-2022 period quick reducing for all categories of affected due to the Chornobyl NPP accident taken place. In the structure of medical expert cases during 2013-2022 the leading place as the reason of disease, disability and death is occupied by oncological diseases.

DENTAL CARIES INTENSITY IN CHILDREN WITH DISTURBANCES IN TOOTH FORMATION, SURVIVED AFTER THE CHORNOBYL NPP ACCIDENT.

assessment of dental caries intensity in children with disturbances in tooth formation living in radiologically contaminated territories as a result of the Chornobyl NPP accident. Children aged 6-14 years old (n = 1470) suffering from disturbances in tooth formation(DTF) with the residents of radiologically contaminated territories (n = 528) among them were enrolled in the study.The DTF subtypes were assayed, namely the systemic enamel hypoplasia (SEH) and molar incisor hypomineralisation(MIH). Personal radiation history was recorded. Intensity of caries and caries of surfaces in the mixed (i.e. transitional) occlusion (df+DMF, dfs+DMFS coefficients) and permanent occlusion (DMF, DMFS coefficients) was identified. Caries intensity in the exposed children suffering DTF with mixed and permanent dental occlusion was sig-nificantly higher vs. either in children exposed to ionizing radiation with no DTF or in the control group (р < 0.001,р < 0.001 and р < 0.05, р < 0.001 correspondingly). The highest caries intensity of the permanent teeth was revealedin the residents of contaminated territories suffering SEH (6.95 ± 2.3) vs. cases of MIH (5.68 ± 1.97) as a result ofnonsymmetrical teeth involvement. The highest values of df+DMF, dfs+DMFS coefficients were diagnosed in children with a mixed dentalocclusion aged 6-14 years old living on territories contaminated as a result of the ChNPP accident as compared tothe not exposed subjects and control group (7.2 ± 2.07 and 8.98 ± 2.4, р < 0.001). A very high intensity of cariesand surface caries of permanent teeth (DMF = 6.79 ± 2.34, DMFS = 8.69 ± 2.75, р < 0.001) was established in children exposed to ionizing radiation and suffering DTF. Such a high intensity may be due to the impact of a set of negative factors including the ionizing radiation in low doses and peculiarities of economic component of social sta-tus of study subjects, namely the unbalanced diet. In case of permanent occlusion the intensity of caries and cariesof tooth of in children survived after the ChNPP accident and suffering SEH was significantly (р < 0.05) higher compared to the persons suffering MIH.

Quality of life of the population resident at the radioactively contaminated area in Zhytomyr Region

The article provides the assessment of the quality of life of the population resident at the radioactively contaminated areas of the Yemilchyno, Malyn, Korosten, Narodychi, Olevsk, Luhyny and Ovruch raions of the Zhytomyr region. The basis for the study and assessment of the quality of life of the population of radioactively contaminated administrative raions of the Zhytomyr region were the statistical data of the Main Directorate of Statistics in Zhytomyr Region, the Health Directorate of Zhytomyr Region State Administration, as well as our own results of a sociological survey. It was established that for the period between 2002 and 2018, the population of radioactively contaminated areas decreased by 24.7% (maximum values are representative of Malyn and Korosten raions). Natural population decline rates in rural settlements exceeded the corresponding values for urban settlements from 1.4 (Malyn raion) to 13 times (Olevsk raion). There is also the aging of the population, the largest share of the elderly (65 years old and older) - 21.7% and 20.8% are resident in the Korosten and Narodychi raions. The values of birth rates (7.5 (Ovruch raion) - 13 (Olevsk raion) per 1,000 of present population) did not have a positive effect on the demographic situation as a whole because of the high mortality rate exceeding the birth rate by 1.1 (Olevsk raion) - 2.9 times (Malyn raion). The main causes of death are diseases of the circulatory system (75.4%), cancer (10%) and external factors (7.3%). It was noted that there is a deterioration of the health of the local population; they pointed out that diseases related to the ChNPP accident include cardiovascular diseases, diseases of the circulatory, nervous and endocrine systems, diseases of bones and joints, headaches. The living conditions of the population resident at the radioactively contaminated areas of Zhytomyr region are unsatisfactory, which is confirmed by both objective data and subjective assessments of the residents themselves. The housing stock is outdated and it needs renovation. In order to improve the quality of life of the population of radioactively contaminated territories in the Zhytomyr region, it is necessary to reform the state policy, to provide financial support for their revival and creation of normal living and reproduction conditions for the population.

Simulation of Entry and Propagation of Pu Isotopes and &amp;lt;sup&amp;gt;241&amp;lt;/sup&amp;gt;Am on Ukraine Territory

Since the entry of transuranium elements (TUE) into the environment, the 241Am content in different ecological system objects continues to increase as a result of 241Pu beta decay. The ionizing radiation of these isotopes and their impact on the ecological situation in the propagation areas give rise to grave concern. The soil contamination with TUE radionuclides in Ukraine has stemmed mainly from two sources: global fallouts and Chernobyl nuclear power plant (NPP) accident. The ChNPP accident has led to nonuniform contamination with transuranium radionuclides, including Pu isotopes and 241Am. To determine the contamination source characteristics, it was used the Receptor Modeling technique. For computing the trajectories of radionuclide propagation in atmosphere, and for preparing the radionuclide fallout maps, the HYSPLIT program was used. In consequence of the present studies it was constructed the maps of 241Pu concentrations in air and soil in the territory of Ukraine in 1986. The forecast model has been created for 241Am distribution at the time of the maximum isotope activity in 2059. The given results point to the necessary of further investigation of the data on the 241Am accumulation and its effect on different ecosystems. This will permit the improvement of forecast models in emergency planning for protection of population health and rehabilitation of affected territories.

IMPACT OF THE RIVNE NPP ACTIVITY ON NATURAL AND SOCIAL ENVIRONMENT OF THE CONTROL AREA.

To assess an impact of the Rivne Nuclear Power Plant (RNPP) activity on the control area (CA) environ- ment according to environmental and radiation monitoring data over time of 2011-2017 as a component of the radiation safety system. Review of geographical and natural features of the territory of the «Rivne NPP» manufac- turing facility was carried out to assess its CA environment. Assessment of environmental and radiation situation of the CA was carried out according to the data of RNPP monitoring systems and a number of state institutions of Rivne oblast over time of 2011-2017. Opinion of the CA population about the RNPP environmental impact was studied. The sampled population of respondents was calculated based on the total population living in CA. The sampling error no more that 7.0%. Data from sociological survey of population were calculated using the statistical programs. The radiation impact of RNPP on environment is related to emissions and discharges of radioactive sub- stances generated in the production cycle. Over time the total index of radionuclide discharge to the Styr River since 2011 is of a marked downward trend from 2.11 % to 0.18 %. The maximum concentrations of 60Co and 137Cs radionuclides at the three sampling points along the Styr River over time of 2011-2016 were about one thousandth of a percent, and of 131I - one hundredth of a permissible value according to the Radiation Safety Standards of Ukraine (RSSU). Emissions of inert radioactive gases and long-lived nuclides into the atmosphere were less than 0.2 % and iodine emissions were 0.01 % to the emission limit. Average radionuclide concentrations in the natural air of the RNPP CA settlements did not exceed the admissible concentration limit (ACL). Concentrations of chem- ical pollutants in discharges of the RNPP to the Styr River over time of 2012-2017 did not exceed the ACL. Integral wastewaters of municipal enterprises of the CA and RNPP result in an increased index of biochemical oxygen uti- lization and ammonium salt content in the Styr River, exceeding the ACL in fishery reservoir water. No exceedance of ACL of repugnant substances in the open air of settlements was observed regarding the pollutants under study. According to population survey the radiation contamination of territories as a result of the ChNPP accident and RNPP activities, which cause anxiety, are the key factors determining an environmental situation at the place of residence. The correlation coefficients between anxiety index and public estimates of environmental situation are established. Content of radionuclides in emissions and discharges generated in the RNPP production cycle under everyday conditions does not exceed the allowed RSSU-97 values. The combined discharges of collective enterpri- ses and RNPP are the main sources of chemical pollution of surface waters in CA. There is a higher correlation coef- ficient between the anxiety and somatization rates and environmental sphere parameter in rural population com- pared to urban one. The combined effect of environmental, radiation and psychological factors on the RNPP CA population makes the health studies necessary in the latter.

HYPERPARATHYROIDISM AND PARATHYROID LESIONS IN THE ChNPP ACCIDENT SURVIVORS

Study of the status of parathyroid glands in individuals exposed to ionizing radiation as a result of the ChNPP accident and comparison with the general population of Ukraine. Subjects exposed as a result of the ChNPP accident (n = 1,348) and people from the general population of Ukraine (n=655) were examined. Diagnostic ultrasound scan of thyroid and parathyroid glands (PTG) was conducted in all study subjects. The technique of parathyroid ultrasound screening was developed, which led to an increase in the efficiency of their imaging. Additionally, the 25-hydroxyvitamin D (25(OH)D), parathyroid hor- mone, ionized calcium and some other parameters were selectively assayed in serum. High incidence of parathyroid hyperplasia was detected 27-32 years after the irradiation in persons ex- posed as a result of the ChNPP accident, especially in evacuees from the 30-km exclusion zone (71.4%; χ2Yates' = 24.1; р = 0) and residents of radilogically contaminated territories (41.7%; χ2Yates' = 6.45; p < 0.01) having no primary hyperparathyroidism. High prevalence of vitamin D insufficiency and deficiency was revealed in all study subgroups, namely in 83.1 % of the general population of Ukraine along with a bit better vitamin D status in the ChNPP acci- dent survivors i.e. the vitamin insufficiency and deficiency was found in 78.7 % of them. Incidence of hyperparathy- roidism, predominantly of the secondary (normocalcemic) one, was 33.8 % among persons exposed as a result of the ChNPP accident (p > 0.3) being somewhat higher than in the general population of Ukraine (26.1%), despite above- mentioned better supply of vitamin D. There is a widespread insufficiency or deficiency of vitamin D (over 78.7%) in the population of Ukraine in general providing an unfavorable background for the higher prevalence of health disorders associated with calcium and phosphorus metabolism. The latter features parathyroid hyperplasia and musculosceletal, immune, cardiovascular, and endocrine system comorbidities. Such disorders should exacerbate with a secondary increase in parathyroid hormone secretion (26.1 %). Higher incidence of normocalcemic hyperparathyroidism (33.8% versus 26.1%) against a background of better vitamin D status among irradiated individuals indicates the existence of other factors, where the past combined effects of Chornobyl radioactive fallout and external parathyroid exposure are most likely to be involved. This could explain the greater number of cases of parathyroid hyperplasia and hyper- parathyroidism among the exposed subjects. However the additional precise studies are required here with clarifi- cation of the personal data in population groups of the ChNPP accident survivors. Participants of the ChNPP acci- dent clean-up work in the «iodine period» of 1986 are of especial concern here. Besides that, the study population should be expanded with inclusion of subjects exposed in prenatal period.

Excess of parathyroid hyperplasia incidence in subjects exposed to ionizing radiation after the CHNPP accident

Excess of parathyroid hyperplasia incidence in subjects exposed to ionizing radiation after the CHNPP accident

EPIDEMIOLOGICAL STUDIES OF CEREBROVASCULAR DISEASE OF THE POPULATION EVACUATED FROM THE 306KM ZONE OF THE ChNPP AT THE AGE OF 18-60 YEARS. ANALYSIS OF THE INFLUENCE OF INTERNAL IONIZING RADIATION ON THE THYROID GLAND 131I.

Establishing the time pattern of CVD morbidity in population evacuated from the ChNPP exclusion zonebeen adult at the time of the accident, depending on age, sex, time after the accident and internal thyroid radiation dose from 131I. Data of the State Register of Ukraine on persons who survived after the ChNPP accident(SRU). The time pattern of morbidity was studied according to the observation periods (1988-1992; 1993-1997;1998-2002; 2003-2007; 2008-2012 and 2013-2016), taking into account age, sex and thyroid radiation dose. Theresearch cohort included 42,982 people with 18,133 men and 24,849 women among them. Data on the thyroid radiation doses in the SRU are seriously limited. Personal data on the radiation dose are available only in 957 people who just were included in the especially studied cohort. Dose intervals 0-0.3, 0.31-0.75, 0.76-2.0 Gy were adopted to review the influence of radiation factor on the CVD development. The data analysis was conducted on a mixed cohort of two age groups under the emergence of radiation effects (the «early» stage, covering the first 6 years from the moment of the accident, the «remote» stage - from 1998 to 2007, the «late» stage - 2008-2016). Study results indicate that the post-accident period is characterized by an increase in the level of CVD. The incidence rate increase occurred in the second observation period (1993-1997), that is, 6 years after the accident, regard-less of sex and age at the time of the accident. The peak of the incidence occurs in the third and fourth periods(1998-2002 and 2003-2007) of observation. Since 2008 there is a gradual decrease in morbidity. In all periods of observation the higher levels of CVD were registered in older people, i.e. 40-60 years at the time of an accident. In the first11 post-accidental years the higher levels of CVD incidence were observed in women, but in a later period after an acci-dent (12-26 years) in men. At a dose interval of 0.31-0.75 Gy a reliable link was established between the level of CVDwith the with internal thyroid radiation dose from 131I. In other dose intervals the dose-dependent effects are unstable. The post-accident period was marked by a significant increase in the level of CVD morbidity in theadult evacuees from the 30-km zone of the ChNPP. The incidence rate increase occurred since the 7th till the 21styearafter the ChNPP accident with the peak of morbidity from 12th to 21st years upon the accident. In the period that covered 22-30 years a decrease in the incidence rate was established. Connection of the specific forms of CVD with internal thyroid radiation dose from 131I has been established.

Psychophysiological characteristics in the ChNPP accident clean-up workers, exclusion zone evacuees and anti-terrorist operation servicemen

Evaluation of interdependencies between psychometric parameters and spontaneous cerebral electric activity in the ChNPP accident clean up workers, evacuees from exclusion zone, and anti terrorist operation service men. Psychometric and neurophysiological parameters were reviewed in the study subjects retro spectively and in comparison. Study population included the ChNPP accident clean up workers (ACUW), evacuees from the 30 kilometer exclusion zone, specifically in a sample from a cohort of the NRCRM Clinical Epidemiological Register (n=316), and anti terrorist operation servicemen (n=81) undergoing rehabilitation in the NRCRM Radiation psychoneurology department. A control group of persons (n=84) was also involved in the study. Diagnostic method ology for the characteristic personality features, namely the personality test of character accentuation by G. Shmishek and K. Leonhard, and Eysenck Personality Inventory (by H. J. Eysenck) were applied. Computer EEGs were registered and analyzed on the 16 channel electroencephalograph DX 4000 (Kharkiv, Ukraine). In the aftermath of the emergency period, a personality deformation occurs in the clean up workers and survivors of the ChNPP accident, which is characterized by aggravation of such personality traits as jam (fixedness), emotiveness, pedantry, anxiety, cyclothymia, excitability and disthymia, with diminished hyperthymia and ostenta tion (demonstrability). Increased incidence of fixedness, pedantry, cyclothymia, affectability and disthymia with decreased hyperthymia were revealed in the group of ATO participants. Cerebral bioelectrical activity in the ChNPP ACUW was characterized by an increased delta activity power with decreased beta and theta activity power and dom inant frequency in comparison with all groups of survivors and control group. The ATO group was different from groups of survivors and control group with a lower power of delta, theta and beta activity, and a higher dominant frequency. Introversion featured a negative correlation with delta and theta activity index along with positive cor relation with alpha activity index. The absolute spectral power of beta, alpha and theta bands positively correlated with introversion. Increase in neuroticism featured a decrease in theta activity index and an increase in beta activ ity index along with decreased theta and delta band absolute spectral power. There is a deformation of personality in the group of ChNPP ACUW, evacuees from the 30 kilometer zone and ATO servicemen. Deformation of personality correlates with abnormal cerebral bioelectrical activity.

Serum content of total adipionectin in the ChNPP accident clean/up workers of the «iodine period» suffering from type 2 diabetes mellitus (literature review and research data)

assay of the total adiponectin level in the ChNPP accident clean up workers (ACUW) of the «iodine peri od» exposed to ionizing radiation in a young age and suffering now from type 2 diabetes mellitusMaterials and methods. The Chernobyl Nuclear Power Plant accident clean up workers (ACUW) of the iodine period (n=111) exposed to ionizing radiation at a young age (18-35 years) were examined in two groups: Group I (main study group, n=66) of persons with type 2 diabetes mellitus (DM) and Group II (comparison group, n=45) of persons with normal glucose challenge test results. Total radiation doses varied in the range of 10.0-860.0 mSv. Group III (nosological control group, n=20) included persons suffering type 2 DM but not exposed to ionizing radiation (IR) and Group IV were apparently healthy. All study groups were representative by the age. Anthropometric data and parameters of glycemic control were assayed. Index of the homeostatic model for assessing insulin resistance (HOMA IR) was calculated. Level of total adiponectin was assayed by the immune enzyme method. Statistical pro cessing of the data was carried out using Missrosoft® Exxel 2002 software. Serum concentration of total adiponectin in the Chornobyl NPP ACUW of the iodine peri od and suffering type 2 DM despite having normal body weight or overweight or any degree of obesity was signifi cantly lower compared to apparently healthy persons ACUW with and normal glycemic control. Moderate negative correlation was found between the level of total adiponectin and degree of obesity in the ACUW suffering type 2 DM (t = 0.367, p <0.05). With an increase in the duration of the disease there was a decrease in serum concentration of total adiponectin in the Chornobyl NPP ACUW of iodine period suffering type 2 DM and in the group of nosologi cal control. The most favorable type of glycemic profile was peculiar for patients in the main group with higher lev els of total serum adiponectin and the lowest body mass index (up to 25 kg/m2). An increase in the body mass index was accompanied by an adverse combination of abnormalities in glycemic metabolism (increased glucose concen tration, IRI, and HbA1c), insulin resistance (a significant increase in HOMA) against the background of a decrease in concentration of total adiponectin. No significant differences were found in adiponectin levels in dose subgroups. At the same time, the reliable differences between the main group and comparison group were found in the 2-5th dose subgroups, which are due to differences in numbers of people with metabolic syndrome (obesity) in the groups.

Influence of polymorphic variants of the SLC6A4 gene on the frequency of detection of depressive states in the group of the clean/up workers of consequences of Chornobyl accident in the remote period after the Chornobyl catastrophe

To determine the effect of polymorphic variants of the SLC6A4 gene on the frequency of detection of depression in a group of clean up workers in the remote period after the Chornobyl catastrophe. The study was conducted in a group of 59 victims of the Chornobyl NPP accident, divided into two groups (without depression and with depressive symptoms). The diagnosis of depressive disorders was based on a compre hensive assessment of the complaints of the surveyed, the clinical and psychopathological data, the values of the Zung Self Rating Depression Scale (SDS), the Brief Psychiatric Rating Scale (BPRS), the General Health Questionnaire (GHQ 28). DNA from the peripheral blood mononuclear cells was isolated, and the 5 HTTLPR polymorphism was determined by polymerase chain reaction (PCR). Depressive symptoms were more often found among reconvalescents of acute radiation sickness (ARS) than in the clean up workers without ARS: (p = 0.006). The tendencies of the association of the received dose of exter nal exposure with the number of points on the SDS scale (r = 0.284; p = 0.043), the sum of scores on the BPRS scale (r = 0.686; p = 0.001), depression (r = 0.323, p = 0.017) and its severity (r = 0.273; p = 0.051) were found. Among the examined clean up workers, in comparison with a large group of Europeans without mental disorders, an increase in the number of carriers of the genotype S/S SLC6A4 was found (p = 0.03). Only for the carriers of the S/S genotype, the reciprocal association between the development of depression and the age of the patient was found: r = 0.503 (p = 0.033), between the development of depression and the time from the ChNPP accident: r = 0.581 (p = 0.011), as well as positive correlation of development of depression with dose of irradiation: r = 0.515 (p = 0.025). Among people aged 55 and older, the development of depression was associated with a decrease in the frequency of high ly functional genotype LА/LА to 4.76% versus 31.25% in the absence of depressed symptoms (p = 0.042). In the group of younger patients, the distribution of genotypes did not differ depending on the signs of depression (p = 0.476). The pilot analysis of the distribution of genotypes of the SLC6A4 gene for polymorphisms of 5 HTTLPR and rs25531 in the clean up workers group showed the promise of further studies of the contribution of LА/LА і S/S genotypes to the development of depressive states in combination with the action of the radiation factor.

Cerebral impact of prenatal irradiation by 131I: an experimental model of clinical neuroradioembryological effects

To create an experimental model of prenatal cerebral radiation effects of 131I in human and to determine the experimental and clinical neuroradioembryological effects.Study object. The neuroradioembryological effects in Vistar rats exposed to 131I in prenatal period. Nervous system status and mental status in 104 persons exposed to ionizing radiation in utero due to the ChNPP accident and the same in 78 not exposed subjects. Experimental i.e. behavioral techniques, including the spontaneous locomotive, exploratory activity and learning ability assessment, clinical i.e. neuropsychiatric, neuro and psychometric, neuropsychological, neurophys iological methods, both with dosimetric and statistical methods were applied. Intrauterine irradiation of Wistar rats by 131I was simulated on a model of one time oral 27.5 kBq radionu clide administration in the mid gestation period (0.72±0.14 Gy fetal thyroid dose), which provides extrapolation of neuroradioembryological effects in rats to that in humans exposed to intrauterine radiation as a result of the Chornobyl catastrophe. Abnormalities in behavioral reactions and decreased output of conditioned reflex reactions identified in the 10 month old rats suggest a deterioration of cerebral cognition in exposed animals. Specific cog nitive deficit featuring a disharmonic intellectual development through the relatively decreased verbal intelligence versus relative increase of nonverbal one is remained in prenatally exposed persons. This can indicate to dysfunc tion of cortical limbic system with especial involvement of a dominant hemisphere hippocampus. Decreased theta band spectral power (4-7 Hz range) of cerebral bioelectrical activity in the left frontotemporal area is suggestive of hippocampal dysfunction mainly in dominant hemisphere of prenatally irradiated persons. Disorders of hippocam pal neurogenesis due to prenatal exposure by radioactive iodine can be a biologic basis here. Innovative approach es in social adaptation, psychoprophylaxis and psychorehabilitation involve the maximum effective application and development of just the most developed psychological and cognitive abilities in survivors.

Radiation induced violations of blood circulation in the ciliary body and changes of the anterior chamber angle in the pathogenesis of glaucoma in clean/up workers of the Chornobyl NPP accident and residents of contaminated areas

Estimate changes blood filling of the ciliary body and changes of the anterior chamber angle; study their influence to glaucoma pathogenesis in irradiated persons. Used the results of a randomly selected group survey of 41 clean up workers of the Chornobyl NPP accident (clean up workers), and 18 inhabitants of the zone of guaranteed voluntary resettlement; age at the time of the survey was 45-50 years. The control group consisted of 41 persons of the same age had not radiation exposure. State of the anterior chamber angle studied by gonioscopy, which was conducted 35 clean up workers and 35 persons of the control group. Changes of the blood circulation in the ciliary body examine by the ophtalmoreog raphy, what was done on 12 eyes of 6 clean up workers, control was 12 eyes of 6 persons had not radiation exposure. Detection revealed of the blood circulation in the ciliary body in all clean up workers, reography coefficient was probably lower (p < 0.05), than in the control group. The research of the state of the anterior chamber angle revealed a higher relative risk of appearance of involution changes of the anterior chamber angle in clean up work ers of ChNPP accident, in comparison with the control group was 3.5 (1.27; 9.5) χ2 = 7.48, p = 0.031. The same changes are characteristic for inhabitants of radiation polluted territories. Influence ionizing radiation causes a blood circulation decrease in the ciliary body and development changes of the angle of the anterior chamber. Presence of these changes can explain the features of the pathogene sis of glaucoma in irradiated late manifestation and, at the same time, severe course.

Myelodysplastic Syndrome in Patients with Acute Radiation Syndrome Following the Chornobyl Nuclear Power Plant Accident

The MDS cases (n=3) among acute radiation syndrome (ARS) survivors after the ChNPP accident were analyzed. MDS diagnoses were based on FAB (1982) and WHO classifications and included the refractory anemia (RA) (patient D. with ARS grade III), refractory anemia with ringed sideroblasts (RARS) (patient B. with ARS grade III), and unclassified MDS (MDS-U) (patient S. with ARS grade I). Clinical management of MDS in ARS patients was analyzed taking into consideration the morphological, immunological, and cytochemical peculiarities of haemopoietic cells. The ARS diagnoses were confirmed in a survey on a regular basis using standard cytogenetic method. Described MDS cases in ARS patients may be the secondary MDS variants taking into consideration possible radiation-induced injuries of hematopoietic cell genome due to the high dose of IR (1.7-5.5 Sv). The possible role of previous irradiation in a range of occupational dose limits before the ChNPP catastrophe for patients D. and B. with ARS grade III, both with possible role of such a confounding factor as petroleum exposure for patient S. (ARS grade I) for the development of MDS cannot be excluded.