The mental health impact of Chernobyl is regarded by many experts as the largest public health problem unleashed by the accident to date. This paper reviews findings reported during the 20-y period after the accident regarding stress-related symptoms, effects on the developing brain, and cognitive and psychological impairments among highly exposed cleanup workers. With respect to stress-related symptoms, the rates of depressive, anxiety (especially post-traumatic stress symptoms), and medically unexplained physical symptoms are two to four times higher in Chernobyl-exposed populations compared to controls, although rates of diagnosable psychiatric disorders do not appear to be elevated. The symptom elevations were found as late as 11 y after the accident. Severity of symptomatology is significantly related to risk perceptions and being diagnosed with a Chernobyl-related health problem. In general, the morbidity patterns are consistent with the psychological impairments documented after other toxic events, such as the atomic bombings of Hiroshima and Nagasaki, the Three Mile Island accident, and Bhopal. With respect to the developing brain of exposed children who were in utero or very young when the accident occurred, the World Health Organization as well as American and Israeli researchers have found no significant associations of radiation exposure with cognitive impairments. Cognitive impairments in highly exposed cleanup workers have been reported by Ukrainian researchers, but these findings have not been independently confirmed. A seminal study found a significant excess death rate from suicide in cleanup workers, suggesting a sizable emotional toll. Given the magnitude and persistence of the adverse mental health effects on the general population, long-term educational and psychosocial interventions should be initiated that target primary care physicians, local researchers, and high risk populations, including participants in ongoing cohort studies.
"For instance, the blanket evacuation technique caused a dramatically acute increase in mortality among residents of elderly nursing homes in the Fukushima area. Moreover, evacuation could have long-term adverse health effects; prolonged life as evacuees could represent physical, mental and socioeconomic burdens. "
[Show abstract][Hide abstract] ABSTRACT: Resettlement to their radiation-contaminated hometown could be an option for people displaced at the time of a nuclear disaster; however, little information is available on the safety implications of these resettlement programs. Kawauchi village, located 12-30 km southwest of the Fukushima Daiichi nuclear power plant, was one of the 11 municipalities where mandatory evacuation was ordered by the central government. This village was also the first municipality to organize the return of the villagers. To assess the validity of the Kawauchi villagers' resettlement program, the levels of internal Cesium (Cs) exposures were comparatively measured in returnees, commuters, and non-returnees among the Kawauchi villagers using a whole body counter. Of 149 individuals, 5 villagers had traceable levels of Cs exposure; the median detected level was 333 Bq/body (range, 309-1050 Bq/kg), and 5.3 Bq/kg (range, 5.1-18.2 Bq/kg). Median annual effective doses of villagers with traceable Cs were 1.1 x 10(-2) mSv/y (range, 1.0 x 10(-2)-4.1 x 10(-2) mSv/y). Although returnees had higher chances of consuming locally produced vegetables, Cochran-Mantel-Haenszel test showed that their level of internal radiation exposure was not significantly higher than that in the other 2 groups (p=0.643). The present findings in Kawauchi village imply that it is possible to maintain internal radiation exposure at very low levels even in a highly radiation-contaminated region at the time of a nuclear disaster. Moreover, the risks for internal radiation exposure could be limited with a strict food control intervention after resettlement to the radiation-contaminated village. It is crucial to establish an adequate number of radio-contaminated testing sites within the village, to provide immediate test result feedback to the villagers, and to provide education regarding the importance of re-testing in reducing the risk of high internal radiation exposure.
PLoS ONE 12/2013; 8(12):e81909. DOI:10.1371/journal.pone.0081909 · 3.23 Impact Factor
"However, the difficulties associated with such studies should not be underestimated, and early studies comparing health outcomes among the liquidators with those in the general population could well be affected by ascertainment bias and need to be viewed in this context. As far as the psychological effects of the accident are concerned, there is evidence for raised rates of depression, anxiety and medically unexplained physical symptoms in exposed populations, especially (and understandably) among mothers of young children; but rates of diagnosable psychiatric disorders do not appear to be elevated . There is also evidence of a high rate of suicide among Estonian liquidators . "
"Sublethal doses of whole brain irradiation (WBI) are commonly administered therapeutically (cranial radiation), and might also be administered inadvertently in the event of a nuclear accident or radiological attack [1-3]. Clinical data derived from patients receiving cranial radiation suggest that long term survivors of such exposures are at risk for developing late delayed effects manifesting as chronic and irreversible cognitive impairment and dementia . "
[Show abstract][Hide abstract] ABSTRACT: Sublethal doses of whole brain irradiation (WBI) are commonly administered therapeutically and frequently result in late delayed radiation injuries, manifesting as severe and irreversible cognitive impairment. Neural progenitors within the subgranular zone (SGZ) of the dentate gyrus are among the most radiosensitive cell types in the adult brain and are known to participate in hippocampal plasticity and normal cognitive function. These progenitors and the specialized SZG microenvironment required for neuronal differentiation are the source of neurogenic potential in the adult dentate gyrus, and provide a continuous supply of immature neurons which may then migrate into the adjacent granule cell layer to become mature granule cell neurons. The extreme radiosensitivity of these progenitors and the SGZ microenvironment suggests the hippocampus as a prime target for radiation-induced cognitive impairment. The brain renin-angiotensin system (RAS) has previously been implicated as a potent modulator of neurogenesis within the SGZ and selective RAS inhibitors have been implicated as mitigators of radiation brain injury. Here we investigate the angiotensin converting enzyme (ACE) inhibitor, ramipril, as a mitigator of radiation injury in this context.
Adult male Fisher 344 rats received WBI at doses of 10 Gy and 15 Gy. Ramipril was administered beginning 24 hours post-WBI and maintained continuously for 12 weeks.
Ramipril produced small but significant reductions in the deleterious effects of radiation on progenitor proliferation and neuronal differentiation in the rat dentate gyrus following 10 Gy-WBI, but was not effective following 15 Gy-WBI. Ramipril also reduced the basal rate of neurogenesis within the SGZ in unirradiated control rats.
Our results indicate that chronic ACE inhibition with ramipril, initiated 24 hours post-irradiation, may reduce apoptosis among SGZ progenitors and/or inflammatory disruption of neurogenic signaling within SGZ microenvironment, and suggest that angiotensin II may participate in maintaining the basal rate of granule cell neurogenesis.
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