[Show abstract][Hide abstract] ABSTRACT: This paper describes dose reconstruction for a joint Ukrainian-American case-control study of leukemia that was conducted in a cohort of 110,645 male Ukrainian cleanup workers of the Chornobyl (Chernobyl) accident who were exposed to various radiation doses over the 1986-1990 time period. Individual bone-marrow doses due to external irradiation along with respective uncertainty distributions were calculated for 1,000 study subjects using the RADRUE method, which employed personal cleanup history data collected in the course of an interview with the subject himself if he was alive or with two proxies if he was deceased. The central estimates of the bone-marrow dose distributions range from 3.7 × 10 to 3,260 mGy, with an arithmetic mean of 92 mGy. The uncertainties in the individual stochastic dose estimates can be approximated by lognormal distributions; the average geometric standard deviation is 2.0.
Health physics 10/2015; 109(4):296-301. DOI:10.1097/HP.0000000000000341 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Deterministic thyroid radiation doses due to iodine-131 ((131)I) intake were reconstructed in a previous article for 11,732 participants of the Belarusian-American cohort study of thyroid cancer and other thyroid diseases in individuals exposed during childhood or adolescence to fallout from the Chernobyl accident. The current article describes an assessment of uncertainties in reconstructed thyroid doses that accounts for the shared and unshared errors. Using a Monte Carlo simulation procedure, 1,000 sets of cohort thyroid doses due to (131)I intake were calculated. The arithmetic mean of the stochastic thyroid doses for the entire cohort was 0.68 Gy. For two-thirds of the cohort the arithmetic mean of individual stochastic thyroid doses was less than 0.5 Gy. The geometric standard deviation of stochastic doses varied among cohort members from 1.33 to 5.12 with an arithmetic mean of 1.76 and a geometric mean of 1.73. The uncertainties in thyroid dose were driven by the unshared errors associated with the estimates of values of thyroid mass and of the (131)I activity in the thyroid of the subject; the contribution of shared errors to the overall uncertainty was small. These multiple sets of cohort thyroid doses will be used to evaluate the radiation risks of thyroid cancer and noncancer thyroid diseases, taking into account the structure of the errors in the dose estimates.
Radiation Research 07/2015; 184(2). DOI:10.1667/RR13791.1 · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Methods were developed to calculate individual estimates of exposure and dose with associated uncertainties for a sub-cohort (1,857) of 115,329 military veterans who participated in at least one of seven series of atmospheric nuclear weapons tests or the TRINITY shot carried out by the United States. The tests were conducted at the Pacific Proving Grounds and the Nevada Test Site. Dose estimates to specific organs will be used in an epidemiological study to investigate leukemia and male breast cancer. Previous doses had been estimated for the purpose of compensation and were generally high-sided to favor the veteran's claim for compensation in accordance with public law. Recent efforts by the U.S. Department of Defense (DOD) to digitize the historical records supporting the veterans' compensation assessments making it possible to calculate doses and associated uncertainties. Our approach builds upon available film badge dosimetry and other measurement data recorded at the time of the tests and incorporates detailed scenarios of exposure for each veteran based on personal, unit, and other available historical records. Film badge results were available for approximately 25% of the individuals, and these results assisted greatly in reconstructing doses to unbadged persons and in developing distributions of dose among military units. This article presents the methodology developed to estimate doses for selected cancer cases and a 1% random sample of the total cohort of veterans under study.
Radiation Research 04/2014; 181(5). DOI:10.1667/RR13597.1 · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In collaboration with the Ukrainian Research Center for Radiation Medicine, the U.S. National Cancer Institute initiated a cohort study of children and adolescents exposed to Chornobyl fallout in Ukraine to better understand the long-term health effects of exposure to radioactive iodines. All 13,204 cohort members were subjected to at least one direct thyroid measurement between 30 April and 30 June 1986 and resided at the time of the accident in the northern parts of Kyiv, Zhytomyr, or Chernihiv Oblasts, which were the most contaminated territories of Ukraine as a result of radioactive fallout from the Chornobyl accident. Thyroid doses for the cohort members, which had been estimated following the first round of interviews, were re-evaluated following the second round of interviews. The revised thyroid doses range from 0.35 mGy to 42 Gy, with 95% of the doses between 1 mGy and 4.2 Gy, an arithmetic mean of 0.65 Gy, and a geometric mean of 0.19 Gy. These means are 70% of the previous estimates, mainly because of the use of country-specific thyroid masses. Many of the individual thyroid dose estimates show substantial differences because of the use of an improved questionnaire for the second round of interviews. Limitations of the current set of thyroid dose estimates are discussed. For the epidemiologic study, the most notable improvement is a revised assessment of the uncertainties, as shared and unshared uncertainties in the parameter values were considered in the calculation of the 1,000 stochastic estimates of thyroid dose for each cohort member. This procedure makes it possible to perform a more realistic risk analysis.
Health Physics 03/2014; 106(3):370-396. DOI:10.1097/HP.0b013e31829f3096 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The U.S. National Cancer Institute, in collaboration with the Belarusian Ministry of Health, is conducting a study of thyroid cancer and other thyroid diseases in a cohort of about 12,000 persons who were exposed to fallout from the Chernobyl accident in April 1986. The study subjects were 18 years old or younger at the time of exposure and resided in Belarus in the most contaminated areas of the Gomel and Mogilev Oblasts, as well as in the city of Minsk. All cohort members had at least one direct thyroid measurement made in April-June 1986. Individual data on residential history, consumption of milk, milk products and leafy vegetables as well as administration of stable iodine were collected for all cohort members by means of personal interviews conducted between 1996 and 2007. Based on the estimated (131)I activities in the thyroids, which were derived from the direct thyroid measurements, and on the responses to the questionnaires, individual thyroid doses from intakes of (131)I were reconstructed for all cohort members. In addition, radiation doses to the thyroid were estimated for the following minor exposure pathways: (a) intake of short-lived (132)I, (133)I and (132)Te by inhalation and ingestion; (b) external irradiation from radionuclides deposited on the ground; and (c) ingestion intake of (134)Cs and (137)Cs. Intake of (131)I was the major pathway for thyroid exposure; its mean contribution to the thyroid dose was 92%. The thyroid doses from (131)I intakes varied from 0.5 mGy to almost 33 Gy; the mean was estimated to be 0.58 Gy, while the median was 0.23 Gy. The reconstructed doses are being used to evaluate the risk of thyroid cancer and other thyroid diseases in the cohort.
Radiation Research 04/2013; 179(5). DOI:10.1667/RR3153.1 · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: For the purpose of improving retrospective internal thyroid dose estimations for children and adolescents following the Chernobyl accident, age- and gender-dependent thyroid masses have been estimated for the children of Kiev and Zhytomyr oblasts, which are two of the most contaminated regions of Northern Ukraine. For children ages 6-16 y, the thyroid masses were based on the measurements by ultrasound of the thyroid volumes of about 60,000 children performed by the Sasakawa Memorial Health Foundation in the 1990s. For children aged 0 to 36 mo, because thyroid mass values for Ukrainian children were not found in the literature, autopsies were performed for the specific purpose of this paper. Thyroid mass values for children aged 3-5 and 17-18 y were either interpolated or extrapolated from the measured data sets. The results for children aged 6-16 y indicate that the thyroid masses of rural children are, on average, slightly higher (by about 8%) than the thyroid masses of urban children. The geometric means of the thyroid masses were estimated as 5.2 g, 9.0 g, and 15.8 g for boys and 5.2 g, 9.4 g, and 16.0 g for girls aged 5, 10, and 15 y, respectively. Those values are greater than the reference values that ICRP recommends for iodine-sufficient populations, thus reflecting the fact that the northern part of Ukraine is iodine-deficient.
Health physics 01/2013; 104(1):78-86. DOI:10.1097/HP.0b013e31826e188e · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Results of all available meteorological and radiation measurements that were performed in Belarus during the first three months after the Chernobyl accident were collected from various sources and incorporated into a single database. Meteorological information such as precipitation, wind speed and direction, and temperature in localities were obtained from meteorological station facilities. Radiation measurements include gamma-exposure rate in air, daily fallout, concentration of different radionuclides in soil, grass, cow's milk and water as well as total beta-activity in cow's milk. Considerable efforts were made to evaluate the reliability of the measurements that were collected. The electronic database can be searched according to type of measurement, date, and location. The main purpose of the database is to provide reliable data that can be used in the reconstruction of thyroid doses resulting from the Chernobyl accident.
[Show abstract][Hide abstract] ABSTRACT: This paper presents results of Monte Carlo modeling of the SRP-68-01 survey meter used to measure exposure rates near the thyroid glands of persons exposed to radioactivity following the Chernobyl accident. This device was not designed to measure radioactivity in humans. To estimate the uncertainty associated with the measurement results, a mathematical model of the SRP-68-01 survey meter was developed and verified. A Monte Carlo method of numerical simulation of radiation transport has been used to calculate the calibration factor for the device and evaluate its uncertainty. The SRP-68-01 survey meter scale coefficient, an important characteristic of the device, was also estimated in this study. The calibration factors of the survey meter were calculated for (131)I, (132)I, (133)I, and (135)I content in the thyroid gland for six age groups of population: newborns; children aged 1 yr, 5 yr, 10 yr, 15 yr; and adults. A realistic scenario of direct thyroid measurements with an "extended" neck was used to calculate the calibration factors for newborns and one-year-olds. Uncertainties in the device calibration factors due to variability of the device scale coefficient, variability in thyroid mass and statistical uncertainty of Monte Carlo method were evaluated. Relative uncertainties in the calibration factor estimates were found to be from 0.06 for children aged 1 yr to 0.1 for 10-yr and 15-yr children. The positioning errors of the detector during measurements deviate mainly in one direction from the estimated calibration factors. Deviations of the device position from the proper geometry of measurements were found to lead to overestimation of the calibration factor by up to 24 percent for adults and up to 60 percent for 1-yr children. The results of this study improve the estimates of (131)I thyroidal content and, consequently, thyroid dose estimates that are derived from direct thyroid measurements performed in Belarus shortly after the Chernobyl accident.
Applied radiation and isotopes: including data, instrumentation and methods for use in agriculture, industry and medicine 04/2012; 70(4):743-51. DOI:10.1016/j.apradiso.2011.12.032 · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper describes methods for estimating thyroid doses to Ukrainian children who were subjects of an epidemiological study of prenatal exposure and presents the calculated doses. Participants were 2,582 mother-child pairs in which the mother had been pregnant at the time of the Chernobyl accident on 26 April 1986 or in the 2-3 mo following when (131)I in fallout was still present. Among these, 1,494 were categorized as "exposed;" a comparison group of 1,088 was considered "relatively unexposed." Individual in utero thyroid dose estimates were found to range from less than 1 mGy to 3,200 mGy, with an arithmetic mean of 72 mGy. Thyroid doses varied primarily according to stage of pregnancy at the time of exposure and level of radioactive contamination at the location of residence. There was a marked difference between the dose distributions of the exposed and comparison groups, although nine children in the latter group had calculated doses in the range 100-200 mGy. For those children who were born after the accident and prior to the end of June 1986, postnatal thyroid doses were also estimated. About 7.7% (200) of the subjects received thyroid doses after birth that were at least 10% of their cumulative doses.
Health physics 06/2011; 100(6):583-93. DOI:10.1097/HP.0b013e3181ff391a · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper aims to determine the thyroid volumes in children and teenagers living in Gomel and Mogilev Oblasts, which are the areas of Belarus that were most affected by the Chernobyl accident. Results of thyroid volume measurements performed in 1991-1996 by the Sasakawa Memorial Health Foundation were used to evaluate the variation by age of the thyroid volumes for girls and boys aged from 5 to 16 y. Thyroid volumes for age groups without measurements were also estimated. For a given age and gender, the differences between children from Gomel and Mogilev Oblasts do not exceed 12 %, which is relatively small when the variability of individual values is considered. For children of a given age, the individual values show a variability characterised by geometric standard deviation (GSD) of 1.25-1.4. Values of thyroid mass that were derived from the measured thyroid volumes are being used within the framework of the on-going Belarusian-American cohort study of thyroid cancer and other thyroid diseases after the Chernobyl accident to estimate with more accuracy the thyroid doses that were received by the cohort members.
[Show abstract][Hide abstract] ABSTRACT: Between 1986 and 1990, several hundred thousand workers, called "liquidators" or "clean-up workers," took part in decontamination and recovery activities within the 30-km zone around the Chernobyl nuclear power plant in Ukraine, where a major accident occurred in April 1986. The Chernobyl liquidators were mainly exposed to external ionizing radiation levels that depended primarily on their work locations and the time after the accident when the work was performed. Because individual doses were often monitored inadequately or were not monitored at all for the majority of liquidators, a new method of photon (i.e., gamma and x rays) dose assessment, called "RADRUE" (Realistic Analytical Dose Reconstruction with Uncertainty Estimation), was developed to obtain unbiased and reasonably accurate estimates for use in three epidemiologic studies of hematological malignancies and thyroid cancer among liquidators. The RADRUE program implements a time-and-motion dose-reconstruction method that is flexible and conceptually easy to understand. It includes a large exposure rate database and interpolation and extrapolation techniques to calculate exposure rates at places where liquidators lived and worked within approximately 70 km of the destroyed reactor. The RADRUE technique relies on data collected from subjects' interviews conducted by trained interviewers, and on expert dosimetrists to interpret the information and provide supplementary information, when necessary, based upon their own Chernobyl experience. The RADRUE technique was used to estimate doses from external irradiation, as well as uncertainties, to the bone marrow for 929 subjects and to the thyroid gland for 530 subjects enrolled in epidemiologic studies. Individual bone marrow dose estimates were found to range from less than one muGy to 3,300 mGy, with an arithmetic mean of 71 mGy. Individual thyroid dose estimates were lower and ranged from 20 muGy to 507 mGy, with an arithmetic mean of 29 mGy. The uncertainties, expressed in terms of geometric standard deviations, ranged from 1.1 to 5.8, with an arithmetic mean of 1.9.
Health physics 11/2009; 97(4):275-98. DOI:10.1097/HP.0b013e3181ac9306 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: After the accident that took place on 26 April 1986 at the Chornobyl nuclear power plant, hundreds of thousands of cleanup workers were involved in emergency measures and decontamination activities. In the framework of an epidemiological study of leukemia and other related blood diseases among Ukrainian cleanup workers, individual bone marrow doses have been estimated for 572 cases and controls. Because dose records were available for only about half of the study subjects, a time-and-motion method of dose reconstruction that would be applicable to all study subjects, whether dead or alive, was developed. The doses were calculated in a stochastic mode, thus providing estimates of uncertainties. The arithmetic mean individual bone marrow doses were found to range from 0.00004 to 3,300 mGy, with an average value of 87 mGy over the 572 study subjects. The uncertainties, characterized by the geometric standard deviation of the probability distribution of the individual dose, varied from subject to subject and had a median value of about 2. These results should be treated as preliminary; it is likely that the dose calculations and particularly the uncertainty estimates will be improved in the follow-up of this effort.
Radiation Research 01/2009; 170(6):698-710. DOI:10.1667/RR1403.1 · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Many estimates of individual thyroid doses to children and adults in Belarus have been based on the results of direct thyroid measurements made using survey meters soon after the Chernobyl accident in 1986. Thyroid doses from internal exposure to 131I that are estimated using such measurements are usually considered to be better than estimates obtained by environmental transport modeling of concentrations expected in milk. Nonetheless, some of the estimated doses, primarily those to children, were high enough to raise questions about their credibility. Questions about high thyroid doses, taken here to be those exceeding 10 Gy, identified the need for further analysis, which is reported in this article. The overall conclusion is that the initial dose estimates exceeding 10 Gy based on direct thyroid measurements in Belarus are credible estimates and not mistakes. While the possibility of copying and data entry errors cannot be completely ruled out, the consistency of multiple measurements for many individuals supports the high dose estimates.
Health Physics 03/2008; 94(2):180-7. DOI:10.1097/01.HP.0000288044.73410.6b · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Radionuclide concentrations in air from uranium milling emissions were estimated for the town of Uravan, Colorado, USA and the surrounding area for a 49-yr period of mill operations beginning in 1936 and ending in 1984. Milling processes with the potential to emit radionuclides to the air included crushing and grinding of ores; conveyance of ore; ore roasting, drying, and packaging of the product (U(3)O(8)); and fugitive dust releases from ore piles, tailings' piles, and roads. The town of Uravan is located in a narrow canyon formed by the San Miguel River in western Colorado. Atmospheric transport modeling required a complex terrain model. Because historical meteorological data necessary for a complex terrain model were lacking, meteorological instruments were installed, and relevant data were collected for 1 yr. Monthly average dispersion and deposition factors were calculated using the complex terrain model, CALPUFF. Radionuclide concentrations in air and deposition on ground were calculated by multiplying the estimated source-specific release rate by the dispersion or deposition factor. Time-dependent resuspension was also included in the model. Predicted concentrations in air and soil were compared to measurements from continuous air samplers from 1979 to 1986 and to soil profile sampling performed in 2006. The geometric mean predicted-to-observed ratio for annual average air concentrations was 1.25 with a geometric standard deviation of 1.8. Predicted-to-observed ratios for uranium concentrations in undisturbed soil ranged from 0.67 to 1.22. Average air concentrations from 1936 to 1984 in housing blocks ranged from about 2.5 to 6 mBq m(-3) for (238)U and 1.5 to 3.5 mBq m(-3) for (230)Th, (226)Ra, and (210)Pb.
[Show abstract][Hide abstract] ABSTRACT: A population-based case-control study was conducted to estimate the radiation-related risk of thyroid cancer in persons who were exposed in childhood to (131)I from the Chernobyl accident of April 26, 1986 and to investigate the impact of uncertainties in individual dose estimates. Included were all 66 confirmed cases of primary thyroid cancer diagnosed from April 26, 1986 through September 1998 in residents of Bryansk Oblast, Russia, who were 0-19 years old at the time of the accident, along with two individually matched controls for each case. Thyroid radiation doses, estimated using a semi-empirical model based on environmental contamination data and individual characteristics, ranged from 0.00014 Gy to 2.73 Gy and had large uncertainties (median geometric standard deviation 2.2). The estimated excess relative risk (ERR) associated with radiation exposure, 48.7/Gy, was significantly greater than 0 (P = 0.00013) but had an extremely wide 95% confidence interval (4.8 to 1151/Gy). Adjusting for dose uncertainty nearly tripled the ERR to 138/Gy, although this was likely an overestimate due to limitations in the modeling of dose uncertainties. The radiation-related excess risk observed in this study is quite large, especially if the uncertainty of dose estimation is taken into account, but is not inconsistent with estimates previously reported for risk after (131)I exposure or acute irradiation from external sources.
Radiation Research 09/2006; 166(2):367-74. DOI:10.1667/RR3596.1 · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The U.S. National Cancer Institute (NCI), in cooperation with the Ministries of Health of Belarus and of Ukraine, is involved in epidemiological studies of thyroid diseases presumably related to the Chornobyl accident, which occurred in Ukraine on 26 April 1986. Within the framework of these studies, individual thyroid absorbed doses, as well as uncertainties, have been estimated for all members of the cohorts (13,215 Ukrainians and 11,918 Belarusians), who were selected from the large group of children aged 0 to 18 whose thyroids were monitored for gamma radiation within a few weeks after the accident. Information on the residence history and dietary habits of each cohort member was obtained during personal interviews. The methodology used to estimate the thyroid absorbed doses resulting from intakes of (131)I by the Ukrainian cohort subjects is described. The model of thyroid dose estimation is run in two modes: deterministic and stochastic. In the stochastic mode, the model is run 1,000 times for each subject using a Monte Carlo procedure. The geometric means of the individual thyroid absorbed doses obtained in the stochastic mode range from 0.0006 to 42 Gy. The arithmetic and geometric means of these individual thyroid absorbed doses over the entire cohort are 0.68 and 0.23 Gy, respectively. On average, the individual thyroid dose estimates obtained in the deterministic mode are about the same as the geometric mean doses obtained in the stochastic mode, while the arithmetic mean thyroid absorbed doses obtained in the stochastic mode are about 20% higher than those obtained in the deterministic mode. The distributions of the 1000 values of the individual thyroid absorbed dose estimates are found to be approximately lognormal, with geometric standard deviations ranging from 1.6 to 5.0 for most cohort subjects. For the time being, only the thyroid doses resulting from intakes of (131)I have been estimated for all subjects. Future work will include the estimation of the contributions to the thyroid doses resulting from external irradiation and from intakes of short-lived ((133)I and (132)Te) and long-lived ((134)Cs and (137)Cs) radionuclides, as well as efforts to reduce the uncertainties.
[Show abstract][Hide abstract] ABSTRACT: The Chornobyl accident in 1986 exposed thousands of people to radioactive iodine isotopes, particularly (131)I; this exposure was followed by a large increase in thyroid cancer among those exposed as children and adolescents, particularly in Belarus, the Russian Federation, and Ukraine. Here we report the results of the first cohort study of thyroid cancer among those exposed as children and adolescents following the Chornobyl accident.
A cohort of 32 385 individuals younger than 18 years of age and resident in the most heavily contaminated areas in Ukraine at the time of the accident was invited to be screened for any thyroid pathology by ultrasound and palpation between 1998 and 2000; 13 127 individuals (44%) were actually screened. Individual estimates of radiation dose to the thyroid were available for all screenees based on radioactivity measurements made shortly after the accident and on interview data. The excess relative risk per gray (Gy) was estimated using individual doses and a linear excess relative risk model.
Forty-five pathologically confirmed cases of thyroid cancer were found during the 1998-2000 screening. Thyroid cancer showed a strong, monotonic, and approximately linear relationship with individual thyroid dose estimate (P<.001), yielding an estimated excess relative risk of 5.25 per Gy (95% confidence interval [CI] = 1.70 to 27.5). Greater age at exposure was associated with decreased risk of radiation-related thyroid cancer, although this interaction effect was not statistically significant.
Exposure to radioactive iodine was strongly associated with increased risk of thyroid cancer among those exposed as children and adolescents. In the absence of Chornobyl radiation, 11.2 thyroid cancer cases would have been expected compared with the 45 observed, i.e., a reduction of 75% (95% CI = 50% to 93%). The study also provides quantitative risk estimates minimally confounded by any screening effects. Caution should be exercised in generalizing these results to any future similar accidents because of the potential differences in the nature of the radioactive iodines involved, the duration and temporal patterns of exposures, and the susceptibility of the exposed population.
Journal of the National Cancer Institute 08/2006; 98(13):897-903. DOI:10.1093/jnci/djj244 · 12.58 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Significant quantities of long-lived radionuclides were released to the environment during the Chernobyl nuclear power plant accident in 1986. These radionuclides contributed to radiation doses due to ingestion of contaminated foods and external exposure from the ground deposition that resulted. The contributions of these exposure pathways to thyroid doses received by subjects of an epidemiologic study of children from Belarus are evaluated and presented. The analysis shows that ingestion of the long-lived radionuclides, primarily radiocesium, typically contributed a small percentage of the total thyroid dose received by the study subjects. The median and mean fractional contributions were 0.76 and 0.95%, respectively. The contribution of external exposure to the thyroid dose was generally larger and more variable, with median and mean contributions of 1.2 and 1.8% of the total thyroid doses, respectively. For regions close to the reactor site, where radionuclide deposition was highest, the contributions of radiocesium ingestion and external exposure were generally lower than those of the short-lived radioiodine isotopes (132I and 133I) and their precursors (132Te). In other areas, the contributions of these two pathways were comparable to those of the short-lived radioiodines. For all subjects, intakes of 131I were the primary source of dose to the thyroid.
Health Physics 05/2006; 90(4):312-27. DOI:10.1097/01.HP.0000183761.30158.c1 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is little evidence regarding the risk of leukaemia in children following exposure to radionuclides from the Chernobyl Nuclear Power Plant explosion on April 26, 1986.
This population-based case-control study investigated whether acute leukaemia is increased among children who were in utero or <6 years of age at the time of the Chernobyl accident. Confirmed cases of leukaemia diagnosed from April 26, 1986 through December 31, 2000 in contaminated regions of Belarus, Russia, and Ukraine were included. Two controls were matched to each case on sex, birth year, and residence. Accumulated absorbed radiation dose to the bone marrow was estimated for each subject.
Median estimated radiation doses of participants were <10 mGy. A significant increase in leukaemia risk with increasing radiation dose to the bone marrow was found. This association was most evident in Ukraine, apparent (but not statistically significant) in Belarus, and not found in Russia.
Taken at face value, these findings suggest that prolonged exposure to very low radiation doses may increase leukaemia risk as much as or even more than acute exposure. However the large and statistically significant dose-response might be accounted for, at least in part, by an overestimate of risk in Ukraine. Therefore, we conclude this study provides no convincing evidence of an increased risk of childhood leukaemia as a result of exposure to Chernobyl radiation, since it is unclear whether the results are due to a true radiation-related excess, a sampling-derived bias in Ukraine, or some combination thereof. However, the lack of significant dose-responses in Belarus and Russia also cannot convincingly rule out the possibility of an increase in leukaemia risk at low dose levels.
International Journal of Epidemiology 04/2006; 35(2):386-96. DOI:10.1093/ije/dyi220 · 9.18 Impact Factor