Journal of radiological protection : official journal of the Society for Radiological Protection
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For nearly 100 years, epidemiologic studies of human populations exposed to ionising radiation have provided quantitative information on health risks. High dose deterministic (tissue reaction) effects result when sufficient numbers of functioning cells are killed, such as in bone marrow depression that can lead to death. Lower dose stochastic effects are probabilistic in nature and include an increased risk of cancer later in life and heritable genetic defects, although genetic conditions in the children of irradiated parents have yet to be convincingly demonstrated. ⋯ Studies of populations exposed to low doses are also limited in their ability to account for important lifestyle factors, such as cigarette smoking and medical x-ray exposures, which could distort findings. Studies of the Fukushima population should be and are being considered for reassurance and health care reasons. Apart from as regards the extreme psychological stress caused by the horrific loss of life following the tsunami and the large-scale evacuation from homes and villages, such studies have limited to no chance of providing information on possible health risks following low dose exposures received gradually over time--the estimated doses (to date) are just too small.
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The psychosocial consequences of disasters have been studied for more than 100 years. The most common mental health consequences are depression, anxiety, post-traumatic stress disorder, medically unexplained somatic symptoms, and stigma. The excess morbidity rate of psychiatric disorders in the first year after a disaster is in the order of 20%. ⋯ Thus, based on the studies of adults, the Chernobyl Forum concluded that mental health was the largest public health problem unleashed by the accident. Since mental health is a leading cause of disability, physical morbidity, and mortality, health monitoring after radiation accidents like Fukushima should include standard measures of well-being. Moreover, given the comorbidity of mental and physical health, the findings support the value of training non-psychiatrist physicians in recognizing and treating common mental health problems like depression in Fukushima patients.
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The Chernobyl accident, which occurred on 26 April 1986 at a nuclear power plant located less than 150 km north of Kiev, was the largest nuclear accident to date. The unprecedented scale of the accident was determined not only by the amount of released activity, but also by the number of workers and of the general public involved, and therefore exposed to increased doses of ionising radiation. Due to the unexpected and large scale of the accident, dosimetry techniques and practices were far from the optimum; personal dosimetry of cleanup workers (liquidators) was not complete, and there were no direct measurements of the exposures of members of the public. ⋯ In response, substantial efforts have been made to reconstruct doses for the main exposed cohorts, using a broad variety of newly developed methods: analytical, biological and physical (electron paramagnetic resonance spectroscopy of teeth, thermoluminescence of quartz) and modelling. This paper reviews the extensive experience gained by the National Research Center for Radiation Medicine, Academy of Medical Sciences, Ukraine in the field of retrospective dosimetry of large cohorts of exposed population and professionals. These dose reconstruction projects were implemented, in particular, in the framework of epidemiological studies, designed to follow-up the medical consequences of the Chernobyl accident and study health effects of ionizing radiation, particularly Ukrainian-American studies of cataracts and leukaemia among liquidators.
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The World Health Organization (WHO) has responded to the 2011 East-Japan earthquake and tsunami through the three levels of its decentralised structure. It has provided public health advice regarding a number of issues relating to protective measures, potassium iodide use, as well as safety of food and drinking water, mental health, travel, tourism, and trade. WHO is currently developing an initial health risk assessment linked to a preliminary evaluation of radiation exposure around the world from the Fukushima Daiichi nuclear accident. Lessons learned from this disaster are likely to help future emergency response to multi-faceted disasters.
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As a result of the accident at the Chernobyl Nuclear Power Plant, millions of residents of Belarus, Russia, and Ukraine were exposed to large doses of radioactive iodine isotopes, mainly I-131. The purpose of the Ukraine-American (UkrAm) and Belarus-American (BelAm) projects are to quantify the risks of thyroid cancer in the framework of a classical cohort study, comprising subjects who were aged under 18 years at the time of the accident, had direct measurements of thyroid I-131 radioactivity taken within two months after the accident, and were residents of three heavily contaminated northern regions of Ukraine (Zhitomir, Kiev, and Chernigov regions). ⋯ A standardised procedure of clinical examinations included: thyroid palpation, ultrasound examination, blood collection followed by a determination of thyroid hormone levels, urinary iodine content test, and fine-needle aspiration if required. Among the 110 cases of thyroid cancer diagnosed in UkrAm as the result of four screening examinations, 104 cases (94.5%) of papillary carcinomas, five cases (4.6%) of follicular carcinomas, and one case (0.9%) of medullary carcinoma were diagnosed.