Comparison of early forecasts of the incidence of thyroid cancer in residents of the Russian Federation after the Chernobyl accident with observational data

A review of methods for assessing doses in the thyroid gland, predictions of the long-term consequences of its irradiation and the actual incidence of thyroid cancer in residents of four regions of the Russian Federation with the most significant radioactive fallout after the Chernobyl accident are presented. The method for assessing doses in the thyroid gland is based on the results of monitoring in May-June 1986 of radioiodine in the environment, food and in the body of residents. Thyroid doses in the population were used to justify medical and social protection measures, as well as epidemiological studies. In addition, the authorities needed forecasts of the possible morbidity of the population in order to organize adequate medical care. Most of the thyroid cancer cases were predicted among the adult population, which was not confirmed by observations 35 years after the accident. The prognosis of the incidence of thyroid cancer in preschool children differed in different studies due to the use of different coefficients of reducing the biological effectiveness of 131I radiation in the thyroid gland and long-term external and internal irradiation of the whole body with a low dose rate compared to the effect of acute exposure. The increase in the incidence of thyroid cancer among children began five years after the accident at the Chernobyl nuclear power plant. Examples of the dynamics of the incidence for children in the Bryansk region of the Russian Federation are given. The 2018 UNSCEAR Report showed that for 1986-2015, among children and adolescents under 18 years of age on the day of the accident in Belarus, Ukraine and four regions of Russia, more than 19 thousand thyroid cancer cases were detected, of which the share of radiation-induced diseases was estimated at 25%. For four regions of Russia, this amounts to 460 cases with a range of possible estimates from 130 to 900 cases. The highest morbidity was manifested among younger children exposed at the age of 0-4 years. In older children and adolescents, the proportion of radiation-induced diseases has significantly decreased 30 years after the accident. In general, early forecasts of radiation-induced thyroid cancer incidence in children in four regions of the Russian Federation with high levels of radioactive fallout are consistent with the data of subsequent 30-year epidemiological observations within an order of magnitude. With regard to thyroid cancer in adults, such a comparison is difficult, since no radiogenic increase in the incidence has been detected.

Psychophysiological Adaptation of a Patient with Acute Radiated Sickness of Average Degree and Acute Leukemia

Purpose: Clinical and psychophysiological assessment of the adaptation of a patient who suffered from acute radiation sickness of moderate severity after the Chernobyl accident and acute leukemia, which began 30 years after the transferred ARS. Material and methods: A clinical and psychophysiological examination of a patient who suffered from acute radiation sickness of moderate severity after the Chernobyl accident and acute leukemia that occurred 30 years after the Chernobyl accident was carried out. The object of the study was the patient D.R.I., born in 1950, deputy. Head of the Chernobyl NPP workshop, participant in the liquidation of the consequences of the 1986 Chernobyl accident. On April 26, 1986, during an emergency, he underwent relatively uniform beta-gamma radiation with the development of ARS II (moderate) severity. Within 3.5 hours after the accident was in the premises of the Chernobyl nuclear power plant. In the structure of ARS, bone marrow syndrome of the second degree and oropharyngeal syndrome of the first degree of severity were observed. The radiation dose, according to a cytogenetic study, was 3.4 Gy. A psychophysiological study was carried out using the MMPI methodology, the Cattell’s 16 Personality Factors Test, the Expert automated software and methodological complex, designed to study the personality characteristics of a person, the cognitive and intellectual characteristics of a person, the Raven’s Progressive Matrices, simple and complex sensorimotor reactions and reactions to a moving object, 15 (2001) and 30 years (2016) after the Chernobyl radiation accident. Results: The clinical and psychophysiological assessment of the personality and the actual mental state made it possible to determine the demonstrative-hypochondriacal type of disturbance in the psychophysiological adaptation with the tendency for the anxiety-depressive behavior of the patient to progress to a state of increasing depression, more pronounced in dynamics. Conclusion: The psychophysiological assessment of the personality and current mental state of the patient who had ARS, moderate and, 30 years after the Chernobyl accident, acute leukemia showed a demonstrative-hypochondria type of adaptation disorder, as a variant of a disharmonious combination of hypochondria, anxiety-depressive and demonstrative tendencies with a predominance of demonstrativeness (the first, second and third scale of the MMPI methodology) with a significant decrease on the ninth scale in the form of an increase in depression in dynamics. The prevalence of demonstrativeness over growing depression in a person with high intellect, good figurative and logical thinking, and a lack of sensorimotor inhibition is a manifestation of optimism and resistance to a serious illness.

Medical Radiological Consequences after 35 Years after the Accident at the Chernobyl NPP

Purpose: In an article prepared on the basis of the conclusion of the Russian Scientific Commission on Radiological Protection (RSCRP) at the Department of Medical Sciences of the Russian Academy of Sciences "Assessment of the radiological consequences of the Chernobyl accident after 35 years according to the National Radiation and Epidemiological Register" (NRER), the main conclusions of the large-scale radiation-epidemiological studies carried out. Material and methods: The work uses information NRER – liquidators of the consequences of the Chernobyl accident and the Branch Register of FMBA of Russia – liquidators. When assessing the excess relative risk of malignant neoplasms, the EPICURE. Results: The current status of the National Radiation and Epidemiological Register, which is currently functioning within the framework of the Law of the Russian Federation of 30.12.2012 No. 329-FZ “On Amendments to Certain Legislative Acts of the Russian Federation in terms of ensuring that changes in the health status of certain categories of citizens are taken into account exposed to radiation". For the first time in an integral form, the article presents the medical radiological consequences of the accident at the Chernobyl nuclear power plant for the population of Russia. It was found that an increase in the incidence of thyroid cancer due to incorporated exposure to 131I was found in a cohort of children and adolescents (28 856 people) who received radiation doses of more than 200 mGy in 1986. There was no increase in the incidence of thyroid cancer among the adult population. Analysis of the incidence of solid cancers in the territories of the Bryansk, Kaluga, Tula and Oryol regions contaminated with radionuclides did not reveal an increase in the frequency of this pathology for children and adults. It is shown that in the cohort of liquidators of the Chernobyl accident, who received radiation doses of more than 150 mGy (35 303 people), an increase in the incidence of leukemia during the first 11 years after the accident at the Chernobyl nuclear power plant and solid cancers was revealed in comparison with the spontaneous level. Conclusions: The article points out serious limitations associated with a high degree of uncertainty in the received personal dosimetric data on liquidators in 1986–1987. and the need to use the total dose from all types of radiation (professional, emergency, medical, natural) to calculate the radiation risk. RSCRP emphasizes the high urgency of continuing work on reducing the uncertainty of dosimetry data and assessing the radiological consequences of the Chernobyl accident based on a comprehensive analysis of the NRER data.

Clinical and laboratory algorithm for diagnosis of metabolic syndrome with use of new medical technologies in liquidators of Chernobyl accident

Based on a long-term dynamic study of the state of health of liquidators of the consequences of the Chernobyl accident, it was found that 75 % of patients have a metabolic syndrome, burdened with concomitant somatic pathology. The article presents literature data on the key role of adipokine levels in the development of the metabolic syndrome of adipose tissue, hormonal indicators, vitamins and other nutrients, which require modern methods of laboratory diagnostics to determine.The aim. To develop a clinical and laboratory algorithm for diagnosing metabolic syndrome in liquidators of the consequences of the Chernobyl accident using new medical technologies.Methods. 122 liquidators of the consequences of the Chernobyl accident with cerebrovascular diseases, diseases of the digestive system and endocrine system pathology were examined. Based on the International recommendations of 2009, two groups were formed: those with the absence (n = 32) and the presence (n = 90) of metabolic syndrome (MS). The control group consisted of 30 people with MS who were examined and treated at the clinic, but did not have contact with radiation. All patients were male, with an average age of 64–66 years. The main biochemical parameters in blood serum were determined. Immunochemiluminescent method was used to determine hormonal parameters. Mass spectrometry was used to determine the indicators of oxidative stress (MDA, fat-soluble vitamins A, E, D, polyunsaturated fatty acids), and trace elements.Results and analysis. A characteristic feature of MS in LPA is a signifcantly (p < 0.05) low level of total testosterone in the blood serum and the calculated ratio of testosterone/estradiol. With increasing number of MS components signifcantly (p < 0.05) increases in serum level of basal insulin and HOMA IR, leptin levels, decreases the concentration of adiponectin. The analysis of the obtained results did not reveal signifcant differences in the content of the main markers of MS in LP and patients of the control group with MS. In 25% of LPA with MS, adiponectin values are determined below the lower limit of the reference range (less than 5.6 μg/ml), and the leptin content is higher than 21.0 ng/ml at the upper limit of the reference range of 5.6 ng/ml. there Is a stable tendency to reduce HDL cholesterol. When comparing the studied indicators for MS in patients with MS at the Chernobyl NPP and the control group, a statistically signifcant increase in the concentration of vitamin E (9.7 [6.8–12.7] and 6.3 [5.3–7.7]; p = 0.001) was found by 54 % and a decrease in the level of linoleic acid (230.9 [184.6–293.0] and 262.3 [214.1–426.3]; p = 0.014) by 12 %. A decrease in selenium, zinc, copper and iodine was detected.Conclusion. The results of the study demonstrated that liquidators of the consequences of the Chernobyl accident with metabolic syndrome may develop various pathogenetic variants of MS, which can be clarifed by the proposed additional criteria of the diagnostic algorithm. Identifying the pathogenetic variant of MS opens up the possibility of a personalized approach to MS therapy and prevention of the development of circulatory diseases and diabetes.

Standardization of implementation of the mandatory privately managed pillar of the pension system of Ukraine

According to the current legislation, the modern Ukrainian pension system is not yet fully formed. In Ukraine, PFC contributions currently form a source of pension benefits for citizens. The solidarity pension system is crumbling . That is, as in the rest of the world, the nation is aging, the share of retirees is growing, and there is less able-bodied population. The search for new ways to save for old age is in the direction of creating a mandatory accumulation under the supervision of the state. Thus, today, a second level of the pension system, mandatory accumulative component, and a rather underdeveloped and unpopular non-state pension system, which forms the third level of the national pension system, do not function. However, in 2020, the work on the concept and bill on the mandatory savings system was intensified. Its introduction is seen as a tool that can increase both the level of pensions and their differentiation. But the world experience of such reforms shows that the real effect on payments from the savings system will have to wait at least 15-20 or even 25 years. The article examines the issue of introducing a funded pension level at the legislative level. According to the results of an expanded analysis of 19 draft laws on reforming the current pension legislation and proposals for new laws on these issues in the period from 2018 to 2021, we can conclude that there is no single concept of amending legislation, so most bills are either withdrawn or sent for further refinement. Currently, various aspects of the pension system of Ukraine are regulated by a large number of legislative acts, so there are signs of dispersion in these draft legislative changes. Most of the bills are developed to enhance the welfare of certain categories of citizens, including servicemen, single mothers, victims of the Chernobyl accident, war veterans and more. The issues of the accumulative pension system are mainly raised in the bills of 2020–2021.

Comparing the risk of mortality from solid cancer after radiation incidents and occupational radiation exposure

The purpose of the study is to compare the excess relative risk (ERR per 1 Sv) of solid cancer mortality in acute - catastrophic or emergency, and occupational - fractionated or chronic exposure. Materials and research methods. A maintained database (database of sources) on nuclear workers from about 40 countries, on the basis of it a combined data analysis was carried out to determine the integral ERR value per 1 Gy for cancer mortality for comparison with parameters of cohorts exposed to catastrophic and emergency exposure: the LSS cohort victims of the atomic bombings in Japan, residents of the Techa River (radioactive contamination due to emissions from the Mayak plant) and Russian liquidators of the Chernobyl accident. Results. Comparison of the ERR per 1 Sv for cancer mortality for workers in the global nuclear industry (combining analysis of data from 37 studies) with the parameters of the LSS cohort, residents on the Techa River and liquidators of the Chernobyl accident showed the absence of logical and principial differences, and the risks for the last two cohorts were the highest. Although the data obtained partly confirm the approach of recent years by the United Nations Scientific Committee on the Effects of Atomic Radiation, according to which the carcinogenic effects of acute, accidental, and fractionated or chronic radiation exposure do not depend on the dose rate factor (DDREF), nevertheless, taking into account biological mechanisms and data radiobiological experiments, this issue cannot be considered unambiguously resolved. Conclusion. Based on the ERR per 1 Sv, the average external dose, and the annual background cancer mortality in Russia and the United States, the expected increase in cancer mortality for 100,000 nuclear workers will average 32-69 people over 10 years (0.032-0.069% of the group). Such risks, due to the many carcinogenic non-radiation factors of life and work, as well as fluctuations in the background value, cannot be taken into account in the practice of medicine and health care.

Radionuclides in marine and terrestrial ecosystems of the North European region

The paper presents an analysis of the radioecological state of the terrestrial ecosystems in north european part of the Russia, which were exposed to the a products of the Chernobyl accident. The analysis of the state of marine and terrestrial objects included in the food network of the population and forming the dose of internal radiation of the population of the Murmansk region is given. Comparative estimates of the effects of global radionuclide deposition in the North-European territory are given.