Dynamics of Health Status of Residents in the Lugyny District after the
Accident at the ChNPS
Ivan GODLEVSKY and Oleg NASVIT*
Hospital of the Lugyny Territorial Medical Association;
23 Chervonoyi Girky str., Lugyny village, Lugyny district, Zhytomyr Region, Ukraine*Institute of Hydrobiology, National Academy of Sciences of Ukraine;
12 Geroev Stalingrada, Kyiv 254210, Ukraine
Introduction

1. Radiation situation within the Lugyny district

The Lugyny district lies in the northern part of theZhytomyr region of Ukraine within 110-150 km fromthe Chernobyl nuclear power station (ChNPS). Its
territory is crossed by the southern and south-western
tracks that were formed by the Chernobyl accident inApril 1986. The total territory of the district constitutes
approximately 900 km2, the territory of agriculturalland — more than 300 km2, and about 190 km2 of themarable land. Practically all agricultural land in the
district have the 137Cs contamination density higher
than 1 Ci/km2 (Table 1).
Prior to the Chernobyl accident about 30 thousand
residents were living in the Lugyny district. By thepresent moment the population of the district has
dropped to approximately 22 thousand people due toresettlement from the most contaminated territories andthe decrease in the birth-rate (Table 2).

All settlements of the Lugyny district (50 in total)
according to [1] are categorised as zones of radioactive
contamination II, III and IV (see Table 3), andpractically all population are qualified for different
categories of the accident sufferers (Table 4).
Local authorities constantly have been taking
measures to resettle the inhabitants in the zone ofobligatory resettlement (zone II). However, many ofthese inhabitants refuse to leave, others return to theirhomes after resettlements. The number of resettled
from the 1st of January 1996 to the 1st of July 1997, as
well as the number of inhabitants of 4 settlements in thezone of obligatory resettlement on the 1st of July 1997,
are given in Table 5.
In 48 settlements of the Lugyny district, i.e. in all
except the completely resettled Granitny Karier, andMoschanitsa where only 5 inhabitants are remaining, aregular dosimetric monitering of lands is performed.

Table 1. Territory of agricultural land of the Lugyny district with different 137Cs
contamination density levels, km2
Agricultural landContamination density Ci/km2
Total agricultural land
Arable land
up to 1
5
2
from 1 to 5283
162
from 5 to 15
42
25
higher than 15
02
1
Total
332
190
Years
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996

Table 2. Population of the Lugyny district in 1984-1996
Total
Children total
Infants under 1 year
30,0496,536
445
29,5756,500
401
29,2766,500
456
29,2256,296
296
28,467
5,809
359
27,9625,819
300
27,4205,595
200
25,0464,799
317
24,803
4,643
335
24,8834,700
352
23,903
4,525
304
23,1254,389
264
22,552
4,327
269
149

Table 3. Number of settlements and population size in territories categorised as different zones ofradioactive contamination
Zones
Number of settlements
Number of inhabitants
Zone ofobligatory resettlement (zone II)4314
Zone of guaranteed voluntary resettlement35
18,815(zone III)
Zone of intensified radio-ecological11
3,423
control (zone IV)
Total
50
22,552
Table 4. Number of inhabitants of the Lugyny district qualifying for different categories ofsufferers
Categories
Total number of inhabitantsChildren
I
232
49
II
18,949
2,666
III
3,173
608
Total
22,354
4,323
Table 5. Number of inhabitants of settlements in zone II by 01.07.97
Number of inhabitants
Number of inhabitants
Settlement
resettled from 01.01.96 toremaining on 01.07.97
01.07.97
village Malahovka
34
64
village Rudnya Povtchanskaya
22
194
village Rudnya Zherevtsy
13
51
village Moschanitsa
2
5
Total
71
314
8-year period (from 1989 to 1996) a total of 33,085
adults and 11,016 children has been examined.
Radionuclide accumulation exceeding the control
norm is found by 3,026 adults and 1,029 children(Table 6). The control norms of 137Cs in the organism
are 0.5 µCi for adults and 0.2 µCi for children.
Dynamics of the relative number of cases with 137Cs
accumulation in organism of adults and children inexcess of the control norms is indicated in Fig.2. A
significant increase is observed in 1994 in the
background of a general trend towards a decrease.
Such splash is explained in the first place by changes

According to its results, the registered annual dose rate
(Fig. 1), in 7 settlements of the district does not exceed
0.5 mSv/year, i.e. the criterial limit of qualifying aszone of intensified radiological control. None of theregistered dose rate reach the value to be qualified forof obligatory resettlement (>5mSv/year). 22 and 19
settlements are qualified to be zones of guaranteed
voluntary resettlement and intensified radiologicalcontrol, respectively.
Regular examinations of inhabitants in settlements
qualified for zones of radioactive contamination are
performed with use of whole-body counters. Within the

N um ber of settlem ents

25

22
19

20
15
10

7

5
0

0
<0.5

0.5-1.0
1.0-5.0
Annual doses, m Sv

>5

Fig. 1. Number of settlements of the Lugyny district which fit the criteria to be qualified for different
zones of radioactive contamination (according to [2])150

Table 6. Results of dosimetric control of internal irradiation of the district population living insettlements with soil contamination from 5 to 15 Ci/km2 and higher
Number of examined
Found with doseFound with dose exceeding norm,
persons
exceeding norm, persons%
Years
AdultsChildren
AdultsChildren
AdultsChildren
Total
1989
3,198
696
417
103
13
14.7
13.3
1990
8,432
2,296
809
280
9.5
12.1
10.2
1991
5,550
2,685
603
192
10.8
7.1
9.6
1992
3,892
1,636
432
186
11.1
11.3
9.3
1993
3,164
1,037
167
42
5.2
4
4.9
1994
2,156
534
372
164
17.2
30
19.9
1995
1,697
1,415
41
38
2.4
2.6
2.5
1996
4,996
717
185
24
3.7
3.3
3.6
Table 7. Results of dosimetric examination of the internal irradiation of the inhabitants of the
district, living in settlements in zones II-IV
Zone II
Zone III
Zone IV
Year
With excessive
With excessive
With excessive
Total
Total
Total
dose
dose
dose
1996
155
103 (66%)
4,755
104 (2%)803
2 (0.2%)1997
24
3 (13%)
1,749
21 (1%)
283
30%
adultschildren

25
20
15
10
5
0
1989

1990

1991

1992
1993
Years

1994

1995

1996

Fig. 2. Dynamics of changes in the relative number of cases with 137Cs accumulation inorganism of adults and children in excess of the set control values
According to the data of the UKP "Truskavets"1
2,020 children and parents living in the radiation
contaminated territory of the district have been
examined. In 80% of children the radio-caesium
activity was found to be higher than 1,000 Bq, in 15%— higher than 5,000 Bq.
The relative number of inhabitants with excessive137
Cs accumulation is significantly higher in zones withhigher levels of radioactive contamination (Table 7).
According to the data of the thyroid dosimetricconditioning of settlements in the Zhitomir region
performed by the UNCRM in 1994 by the request of
the Ministry of Chernobyl of the Ukraine, inhabitantsof the Lugyny district had received high thyroidin natural conditions, in particular in the rainfall
amount and cropping capacity of wild mushrooms andberries. According to the data of radiometric control offoodstuffs in the district, radionuclide accumulation inhuman organisms is contributed by consumption ofmilk, mushrooms and berries by the population of the
district. Excess of all-union Tentative Acceptable
Levels (TAL-91) is 3-5% for milk, 1-5% for meat, 50%
for mushrooms and berries for the period of
1993-1995.
Comparison of the internal irradiation dose year by
year shows the following: until 1990 maximal
registered values of 137Cs in adults exceeded 10 µCi,
and beginning from 1991 the maximal values ingeneral constituted 2 µCi in adults and 0.6 µCi inchildren.

1"Truskavets" is a resort in the Carpathians which
receives children from zones of radioactive
contamination for recreation in summertime.

151

20

10
8
5

>240

1

210-240

180-210150-180

90-120120-150

1
60-90

1
30-60

3
1
0-30

Num berofsettlem ents

20
18
16
14
12
10
8
6
4
2
0

Ranges ofdoses,cG yFig. 3. Distribution of the number of settlements in the Lugyny district according to thyroid
irradiation doses for children born in 1986 (according to [3])Lugyny Territorial Medical Association (which is thecentral district hospital) district where one of thepresent authors is working.
As indices of the health status, we shall analysestate of the immune system, spread of endocrine
pathologies,
morbiditybynewly-born,
psycho-neurological status of the population,premature ageing, and structure of mortality.

irradiation doses during the first stage after theaccident, especially children (Fig. 3). In 38 of 50
settlements in the Lugyny district thyroid irradiation
doses by children born in 1986 exceed 90 cGy.
The population is divided into seven age-groups in
the thyroid dosimetric registration and the relative
distribution of thyroid irradiation doses for different
age-groups of the population residing in the same
settlement is given in Fig. 4.

The immune system
2. Health status indices of the Lugyny district

The state of the immune system is one of the mostimportant indices of the health status. According to thedata of the Central District Hospital of the Lugyny
district, depression of reactivity of the immune system
is found practically by all patients. This depression isclinically manifested through the increase in thenumber and duration of infectious diseases, growth ofdestructive forms of tuberculosis, relapse of diseases,
increase in the number of frequently ill people,
reduction of remaining life of oncology patients after

R elative dose

The medical system of the former Soviet Union was
succeeded by the Ukrane, as well as its merits anddemerits. It constitutes one kind of hierarchy structureof medical institutions, ranking from national medical
centres down to hospitals in regions, districts, andtowns (villages). Within the structure of this system,
one central hospital is distributed in each district. In the
Lugyny district we can, therefore, collect all medical
information of the population at the Hospital of the

Group
1
2
3
4
5
6
7

1,00
0,90
0,80
0,70
0,60
0,50
0,40
0,30
0,20
0,10
0,00
1

2

3

4

5

6

Year of birth
1986
1983-1985
1979-1982
1975-1978
1971-1974
1968-1970
before 1968

7

A ge groups

Fig. 4. Relative thyroid gland irradiation doses for different age-groups of inhabitants residing inthe same settlement
152

Table 8. Remaining life of patients in the Lugyny district with grade III-IV malignant tumours of thestomach and lungs after the moment of diagnosis before and after the Chernobyl accident,(in months)
Remaining life by cancerYearsstomach
lungs
1984
62
38
1985
57
42
1992
15.5
8.0
1993
11.0
5.6
1994
7.5
7.6
1995
7.2
5.2
1996
2.3
2.0
Table 9. Dynamics of the number of the first detected tuberculosis cases in the Lugyny district, per
100 thousand inhabitants
All forms, per 100
Destructive forms among firstYears
thousand inhabitants
detected cases, %
1985
75.8
17.2
1986
84.5
28.7
1987
64.0
17.7
1988
54.7
14.5
1989
91.2
37.5
1990
12.2
66.6
1991
28.4
42.3
1992
49.8
33.3
1993
53.9
54.5
1994
59.8
50.0
1995
73.3
50.0
1996
84.0
41.7
in contraction of incurable infection and associateddiseases, that are generally the cause of death of suchpatients
Special concern of physicians is also caused by thegrowth of the number of destructive forms oftuberculosis among the first detected tuberculosis cases(Table 9), which is also an evidence of the depressionof the immune system.
By an order of the administration of Health Careauthorities, the number of roentgeno-photography
examinations in the framework of sanitary observation
programmes was sharply decreased in 1990 in order toprevent unjustified additional irradiation of the
population. Namely this fact explains the drop in thenumber of the first detected tuberculosis cases in 1990
as compared to the previous year (Table 9). The drop in1990 was not the actual decrease in the number oftuberculosis patients. Subsequently, after renovation of
the roentgeno-photography rooms and installation of
more up-to-date equipment, the roentgenophotography
examinations have been resumed to the initial extent.

their diagnosis, a more severe course of diseases,
increase in virulence of infecting agents, as well as
growth of the number of allergic diseases.
Investigation of medical records of the patients
suffering from malignant tumours has disclosed thefollowing regularity: after the accident at the
Chernobyl NPS the remaining life of such patients after
the moment of their diagnosis decreases with every
year. Before the accident, in 1984-1985 the remaining
life of patients with grade III-IV cancer of stomach was
about 60 months after the moment of diagnosis, withgrade III-IV pulmonary tumours — about 40 months.
In 1992 the remaining life made up 15.5 months in thecase of grade III-IV cancer of stomach and 8 months in
the case of grade III-IV lung cancer, and in 1996 — 2.3
and 2 months (!!!) respectively (Table 8). At the sametime the detection techniques, diagnostics andtreatment remain at the level of the pre-accident years.
Where does the reason of such difference in theremaining life lie? The importance of the immune
system for viability of organism has become especiallyevident after the accident at ChNPS. The immune
system plays an important role in maintenance of stableinternal environment of the organism and is involved inanti-tumour protection. Effects of radiation expose theimmune system to extreme stress with subsequentdevelopment of immune deficiency, which in turnresults in progressing of malignant diseases, as well as

Endocrine pathology
Endocrine pathology includes diffuse goitre,
nodular goitre, diabetes mellitus, liposis and others.
Special concern is the growth of endocrine pathology
in children. Beginning from 1990-1991 a stable
increase in the number of endocrine system diseases in

153

14
Endocrine pathology
G oitres128
6

G oitres

10

4
2
1995

1994

1993

1992

1991

1990

1989

0
1988

Endocrine pathologies

100
90
80
70
60
50
40
30
20
10
0

Years

Fig. 5. Dynamics of the growth of endocrine pathology and goitres in children after the Chernobyl
accident (per 1,000 children)
500
450
400
350
300
250
200
150
100
50
0
1988

1989

1990

1991 1992
Years

1993

1994

1995

Fig. 6. Dynamics of the number of thyroid gland hyperplasia in children (per 1,000 children)
tendency in the post-accident period. However, as Fig.
8 shows, their average level in the period after 1988 isseveral times as large as the pre-accident level.

children is observed (Fig. 5). Prior to 1986 morbidityof endocrine pathology did not exceeded 10/1000.
Nodular and diffuse goitres had not been registered in
the district at all. By analysis of thyroid morbidity, it isnoted that the sufferers are mainly children who were
subject to the iodine strike in 1986, when noprophylactics was performed. Iodine potassium
prophylactics was started 3 weeks after the accident.
Thyroid gland pathology is also observed in adults.
Unfortunately, there are practically no medical
facilities and financial means to conduct specialised
examinations of the population aimed at detection of
nodular goitre. Tumours of thyroid gland have not beenregistered within the period since the accident.
However, a significant increase in the number ofthyroid gland hyperplasia is established (Fig. 6).
Hyperplasia (enlargement) of thyroid gland is not an
illness proper, but indicates the reaction of theorganism to external injurious effects. Before 1988
hyperplasia of thyroid gland was not registered in the
district; at present it is typical of almost half of thechildren in the district.

Psycho-neurological disorders
Of the most important problems which physicians
had to face suddenly and which have been
continuously aggravated — is psychologicalpathology. More and more patients go to physicianswith anxiety-depression syndromes and different
phobias. Predominant symptoms are neurosis-like
conditions, and asthenic and psycho-chondric
symptoms that are manifested by way of anxiety, fearand emotional imbalance.
Apparently, as a result of the combined effect ofionising radiation and psycho-emotional stress on theorganism, its homeostasis is impaired and an
endogenic intoxication emerges, which are leading to
psycho-neurological disorders. It is possible as wellthat low radiation doses determine dysfunction of brain
structures, which are being manifested throughsignificant increase of vegeto-vascular dystonia with
diencephalic syndromes. Before the accident,
practically no cases of vegeto-vascular pathology wereregistered. At present, this pathology is one of the mostwidespread causes for people to see physicians.
Physicians
faced
the
problemofpsycho-neurological disorders only in the last 4 years.

Morbidity in newly-born
A growth of the morbidity in newly-born (age of up
to 7 days) is marked after the Chernobyl accident, as
well as the number of their anomalies (Fig. 7).
Dynamics of newly-born anomalies (they are cleft lip,
atresia of internal organs), shows a more complex
154

96

95

94

93

92

91

90

89

88

87

86

85

84

M orbidity of new -born

350
300
250
200
150
100
50
0

Years

35
30
25
20
15
10

1996

1995

1994

1993

1992

1991

1990

1989

1988

1987

1986

1985

0

1984

5
1983

A bsolute num ber of anom alies

Fig. 7. Morbidity in newly-born (age of up to 7 days), including inherent development anomalies inchildren (per 1,000 newly-born)

Years

Fig. 8. Dynamics of inherent development anomalies in newly-born (absolute number)processes in organs and systems of the organism
Today, one needs to realise the responsibility to cope
determining premature ageing and death. Averagewith these psychosomatic disorders and diseases
life-expectancy of the Lugyny district population
because an increase in the number of suicides andbefore the accident at the Chernobyl NPS (1984, 1985)
severe psychic diseases is to be expected in the future.
has been 75 years, after the accident (1990-1996) — 65
Premature ageing
years.
In the course of life process, more and more cells
are decaying due to effects of internal and external
Mortality structureirradiation factors. This leads to premature ageing andAccording to the mortality data, after the accident
shortening of life span. The fact of early ageing isdeath has become 10 years "younger" than before theconfirmed by markers of ageing in younger ages. These
accident and the mortality peak falls on the age ofmarkers include different tests that determine
65-69 years (Fig. 9). Women live approximately 8capabilities of all systems of the organism, e.g. for theyears longer than men. The total mortality of the
cardiovascular system — blood pressure, rapid pulse inpopulation in 1985 in the district was 10.9 per 1,000
young ages, statistically reliable increase in the number
inhabitants with maximum mortality in the age of moreof hypertension and ischemic cases in young ages; forthan 80 years. Oncologic diseases occupied the third
nervous system — increase in the number ofplace in the mortality structure with an index of 0.7.
anxiety-depression syndromes, phobic neurosis-like
The first and second places were occupied byconditions arising on somatic grounds and others. All
cardiovascular diseases (6.5) and diseases of theof these phenomena can be easily checked in clinicalrespiratory organs (1.7), respectively. In the age
observation.
structure of mortality a smooth rise of the curve wasWhat has been influencing on the increase offound to the 80-years age in both men and women, withageing pathologies and associating premature deaths?
a 10 year longer life expectancy for women.
The major factors are — the increased level of
In 1990 the total mortality was 12.9 per 1,000
radiation and presence of permanent stress situations.
inhabitants. As seen in Fig.9, a mortality increase of
Mechanisms of the effects of these factors are
step character can be noted in the 50-54 years interval
practically the same: their direct or indirect impact on(0.8 per 1,000), and a second peak in the 65-69 years
the systems and organs impairs metabolism andinterval (1.9). As compared to 1985, thecirculation of blood, which results in dystrophic
life-expectancy for men in 1990 has dropped by 10
155

4,50
4,00

1984-1985
1991-1996

M ortality

3,50
3,00
2,50
2,00
1,50
1,00
0,50
0,00
1519

2024

2529

3034

3539

4044

45504954
A ge,years

5559

6064

6569

7074

7579

>80

Fig. 9. Age structure of mortality in the Lugyny district in the pre- and post-accident periods
In the third place is a yet incomprehensible for us
years. In the case of women, the mortality curve is still
physicians psycho-neurological aspect with its
smoothly rising with a peak on the 65-69 years interval.
The life-expectancy for women was 10-15 years longer
anxiety-phobic depression syndromes, which will leadto unpredictable consequences in future.
than for men. Mortality from oncologic diseases was
A growth of the morbidity in newly-born is
1.9 per 1,000 inhabitants and moves to the second
established, to be more exact — the prenatal morbidity
place after cardiovascular diseases (5.7).
of the foetus (e.g., inherent pneumonia, etc.).
The total mortality in 1991 has increased and was
15.5 per 1,000 inhabitants. The mortality curve of men
More and more cases of vegeto-vascular dystonia
sharply stepped up with a peak in the 50-54 years
with diencephalic syndromes are registered.
interval (0.8) and kept the increased level till 65-69
Premature ageing and a significant reduction ofyears. In women the mortality curve is still smoothly
life expectancy is found in inhabitants of the district.
rising with a peak on the 60-64 years. On the average,
References
the life expectancy for men was 15 years shorter than
1. Decree of Cabinet of Ministers of the Ukrainian SSR
for women. Mortality from oncologic diseasesof July, 23, 1991, No.106, with changes andoccupied the second place (1.6) after cardiovascular
additions introduced by the Instructions of Cabinet of
diseases (7.3).
Ministers of January, 12, 1993, No.17-p and of
The age-profile of mortality of men in 1990-1992
January, 27, 1995, No.37-p.
as compared to 1985 clearly indicated that death came
2. General dosimetric passport registration system of
15 years earlier in men than in 1985. Peak of thesettlements of Ukraine, which were subjected tomortality curve of men has moved to younger ages,
radioactive contamination after the Chernobyl
indicating that more younger men will die in the future.
accident. Generalised data for 1996. Collection 6.
As far as mortality of women is concerned, theHealth Ministry of Ukraine, AMSU, Ministry ofmortality curve has been moving slower and in
Emergencies of Ukraine, SCRM of AMSU, Inst.
comparison with 1985 the life expectancy was 5-8
Radiol. Protect. of ATSU. - Kyiv, 1997. - 103 p.
years shorter.
3. Thyroid dosimetric passport registration system ofConclusion
settlements of Zhytomyr region. Approved by Chief
At first it should be noted that the immune systemsanitary inspector of Ukraine, Health Ministry ofof inhabitants in the Lugyny district is depressed. This
Ukraine and NCRP of Ukraine. - Kyiv, 1994. - 45 p.
fact is indicated by the followings: drop in remaining
life of oncologic patients, reduction of the periods
between stages of oncologic diseases, a more severe
course of diseases, increase in the destruction of lungs
on the background of growth of tuberculosis of lungs,
increased morbidity of children, and increase in thenumber of infectious diseases.
The increase in the number of nodular goitres inthe background of a significant growth of thyroid
gland hyperplasia in children occupies the second
place.

156