Радиационная гигиена (Sep 2015)
RADIOLOGICAL AND MEDICAL CONSEQUENCES OF THE CHERNOBYL ACCIDENT
Abstract
From the position of a 25-years’ experience to overcome the health effects of Chernobyl the dynamics of the radiation environment, the first summarizing at the international level (1988), the results of completed research and practical monitoring are analyzed. Cohort of acute radiation syndrome (ARS) survivors under medical observation at the S.I. "Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" is the largest. Within the 25 years the functional state of the major organs and body systems, and metabolic homeostasis for this category of persons were studied, a comprehensive assessment of their health, mental and physical performance were given, and risk factors and peculiarities of stochastic and non-stochastic pathology courses were identified, as well as a system of rehabilitation patients after ARS was developed. ARS survivors are suffering from chronic diseases of internal organs and systems (from 5-7 to 10-12 diagnoses at the same time). A correlation between acute radiation effects and specific HLA phenotypes were revealed. The dynamics of the immune system recovery after irradiation was studied. The role and prognostic value of telomere length and programmed cell death of lymphocytes in the formation of the cellular effects of ionizing radiation were determined for the first time. Differences between spontaneous and radiation-induced acute myeloid leukemias were found. Dose-dependent neuropsychiatric, neurophysiological, neuropsychological and neuroimaging deviations were identified after irradiation at doses above 0.3 Sv. It was shown that the lymphocytes of Chernobyl clean-up workers with doses 350 – 690 mGy can induce "the bystander effect" in the non-irradiated cells even after 19 years after exposure. The rates of cancer incidence and mortality of victims, the lessons and key problems to be solved in the third decade after the Chernobyl accident are considered.
