Investigations on Health Conditions of Chernobyl Nuclear Power Plant Accident Recovery Workers from Latvia in Late Period after Disaster

The paper summarises the main findings on Chernobyl Nuclear Power Plant (CNPP) accident recovery workers from Latvia and their health disturbances, which have been studied by the authors during the last two decades. Approximately 6000 persons from Latvia participated in CNPP clean-up works in 1986–1991. During their work period in Chernobyl they were exposed to external as well as to internal irradiation, but since their return to Latvia they were living in a relatively uncontaminated area. Regular careful medical examinations and clinical studies of CNPP clean-up workers have been conducted during the 25 years after disaster, gathering knowledge on radiation late effects. The aim of the present review is to summarise the most important information about Latvian CNPP clean-up worker health revealed by thorough follow-up and research conducted in the period of 25 years after the accident. This paper reviews data of the Latvian State Register of Persons Exposed to Radiation due to CNPP Accident and gives insight in main health effects found by the researchers from the Centre of Occupational and Radiological Medicine (Pauls Stradiņš Clinical University Hospital) and Rīga Stradiņš University in a number of epidemiological, clinical, biochemical, immunological, and physiological studies. Latvian research data on health condition of CNPP clean-up workers in the late period after disaster indicate that ionising radiation might cause premature ageing and severe polymorbidity in humans.

A randomised prospective study of prolonged treatment with tocopherol and pentoxifylline, in addition to carbogen in the management of radiation late effects

19682 Background: Pentoxifylline (PTX) and tocopherol (Vitamin E) are antioxidants previously shown to be useful in combination in the treatment of late radiation effects. To our knowledge, this is the first study to examine the clinical benefit of combination therapy with carbogen, tocopherol and pentoxifylline in the mitigation of late radiation effects. The optimal duration of PTX and tocopherol treatment has not been fully established. Therefore, we also studied short versus extended treatment duration. Methods: We conducted a phase II prospective randomised study of inhaled carbogen (95% oxygen + 5% carbon dioxide) over 90 minutes, 5 days per week for 3 weeks in addition to short versus prolonged treatment with pentoxifylline (800 mg) and tocopherol (1,000 IU) orally once daily. All 18 patients received carbogen therapy. Patients with grade 3 toxicity post radical radiotherapy for a variety of cancer primaries were eligible for the trial. The primary endpoint was improvement in maximum Lent-Soma toxicity scores. Ethical approval was obtained. Results: Maximum Lent-Soma scores improved with treatment in six of the eighteen patients giving a 33% response rate. The proportion of patients responding to treatment in the prolonged treatment arm B was more than double than in the shorter arm A (Fisher’s exact test: p = 0.321). Two patients in arm B had complete resolution of their symptoms, which was maintained at 2 and 3 years follow up. Conclusions: As late radiation effects are progressive by nature and have such a negative impact on quality of life in long-term cancer survivors, any treatment, which may ameliorate their symptoms, should be considered of benefit. This study confirms the benefit of prolonged treatment and we would recommend clinical use of these agents with treatment duration of at least 12 months, in the management of late radiation effects. No significant financial relationships to disclose.