Health State of Belarusian Children Suffering from the Chernobyl Accident:
Sixteen Years after the Catastrophe
Alexander N. ARYNCHYN, Tatiana V. AVHACHEVA, Nika A. GRES,
Ekaterina I. SLOBOZHANINA*
Research Clinical Institute for Radiation Medicine and Endocrinology; Aksakovschina, 223032 Minsk,
Belarus: arynchyn@hotmail.com*Institute of Photobiology, AMS: Kuprevich str. 2, 220141 Minsk, Belarus

Abstract
A prospective cohort study was carried out to investigate the health state of Belarusianchildren suffering from the Chernobyl accident. The main group consisted of 133 children
permanently residing in the radioactively contaminated territories, while the control group was 186
children permanently residing in the territories with natural radiation background. During the periodof observation the constantly increased level of the annual summary effective dose of radiation(0.13-2.24 mSv) were revealed in the children of the main group. All members of both groups wereclinically examined at least two times during the follow-up of 1990 - 2001. Heavy metals burden of
Pb, Cd and Hg were also measured in urine excretion. The results of clinical examination clearly
indicate that the frequency of complaints, as well as the frequency of major clinical syndromes anddiagnoses, was increasing in both groups. A growth of the gastrointestinal pathology, as well as anincrease in cardiovascular manifestations of the vegetative dysfunction syndrome, was the mostimportant. It should be noted that practically all forms of studied nosology were more prevalent in
the main group than in the control both at the first and the second examination. High values ofrelative risk (RR) of the main group were obtained for arterial hypotension (RR=2.21 and 3.73 at
the first and the second examination, respectively) and cardiac metabolic dysfunction (RR=4.66 and3.33). Aggravating situation of the health state of Belarusian children requires urgent
prophylaxis measures for pathologies that are enhanced by environmental factors.

Introduction
Sixteen years passed after the Chernobyl accident, but the problem of radioactive contamination in
Belarus is still actual. During the first months after the accident, radioactive iodine was the main doseforming radionuclide. At present, radioactive cesium-137 holds this place [1-5]. Chronic radiation
exposure by this radionuclide presents a great danger for the population living in the contaminated areas.
In the formation of exposure doses to the population, a considerable role belongs to the type of soils,
which determines the rate of cesium radionuclide migration through the biological (food) chain. Peaty andswampy soils of Belarusian woodlands are typical in the territory of radiation control. These soils arecharacterized with high speed of migration in the biological chain [6]. As a consequence, increased
radiocesium activity in milk is observed, as well as high radionuclide body burden. Residing in theradioactively contaminated territories leads to the formation of accumulated exposure dose of 80 mSv andgreater in separate settlements of Gomel region during the whole period after the accident.
In addition to radioactive contamination, chemical contaminations with heavy metals such as lead(Pb), cadmium (Cd), mercury (Hg) etc. due to various social activities are also playing important roles in
the appearance and development of diseases. Increase of lead burden in human body leads to brain
malformation, embryonic development disorders, atrophy of mucous membrane of gastrointestinal tract,and impairment of structural and functional properties of erythrocyte membranes [7-10]. Cadmium effects
231the state of cell immunity damaging the activity of polymorph nuclear leucocytes and inhibiting theprocesses of clonal differentiation and activation of mature lymphocytes [7]. Chronic mercury intoxication
leads to an increase of goiter prevalence, disturbance of endocrine function of thyroid gland, membranous
proteins SH-groups, oxidation, inhibition of activity of a number of enzymes [7,9].
In the territory of Belarus, a considerable amount of xenobiotics penetrates the organism of children.
The response of children’s organism to the effect of anthropogenic factors differs considerably from thatof adult. Intensity of metabolic processes in children is higher than in adults, but the rate of xenobiotics’
metabolism is lower. With an increase of concentration of chemical substances in the biosphere, thenumber of children with deviations of reactivity is growing [11]. The younger the child, the less manifest
are specific features of toxic effect [12].
According to our studies, in rural districts of Brest and Gomel regions where the territories were
contaminated by the Chernobyl accident, the proportion of the children found to be “contaminated” withlead are 41.1 and 56.7 %, respectively. While, a more favorable situation (15.2%) is observed in rural
districts of Vitebsk region (control) where the technogenic effect is rather less.
Considering the aggravated environmental situation in Belarus, it is urgent to study the combined
effects of radionuclide and several chemicals in their small concentrations, which are most frequent under
the real condition. It should be noted that these effects are not manifested by typical signs of damage withclear-cut clinical pictures, but exist in the form of nonspecific reactions or syndromes of different degreeof manifestation [13-18].
This report presents the results of a prospective cohort study we are continuing to investigate thehealth state of the children suffering from the combined effects of the long-term low-dose radiation andchemical exposure.
Material and Methods
Cohort selection
At the Pediatric Department of the Research Clinical Institute for Radiation Medicine andEndocrinology, during 1990 – 2001, a cohort prospective examination of children (individual examinationin age dynamics) residing in the territory of the Republic of Belarus has been conducted. All the randomly
selected children were divided into 2 groups: the main and the control. The main group included 133
children (73 boys and 60 girls) permanently residing in the radioactively contaminated territories ofGomel (Yelsk, Narovlya, Bragin districts), Mogilev (Cherikov) and Brest (Stolin, Luninets) regions. The
control group consisted of 186 children (101 boys and 85 girls) permanently residing in the territories withnatural radiation background (Braslav district of Vitebsk region).
Medical examination
Standardized protocol of clinical examination included the children’s complaints and case history,
pediatric examination, laboratory findings, ECG, ultrasound examination, fibrogastroscopy with gastricbiopsy and morphological examination of gastric biopsies.
Clinical examinations of the selected children were performed at least two times: the firstexamination was 1995 - 1998 and the second - in 1998 – 2001. Average time interval between theexaminations in the main group was 2.1 years (within the range from 1.5 to 2.5 years) and in the control
group – 2.5 years (from 2 year to 3 years). Mean age of the children at the time of the first examination
was 10.6 years (6 - 15 years) in the main group and in the control group – 9.5 years (6 - 14 years).
Dose assessment and heavy metals determination
Annual summary effective dose of radiation (ASED) was calculated as a result of both individual
whole body counting for internal dose and gamma rate measurements on the ground for external dose [19].
All children underwent whole-body counting based on registration of gamma quantum in a scintillation
detector with a sodium iodine crystal activated with thallium. The whole body counters used in this study232were permanently located at the regional centres and calibrated on a regular basis as part of a national
programme for calculating annual internal dose to the population of Belarus. The calculation of external
dose was based on the annual gamma rate measurements in the villages of Belarus and performed by the
Belarus state committee for the control of radiological situation.
The urine level of lead (Pb), cadmium (Cd) and mercury (Hg) was determined with the method ofroentgen spectral analysis, using a roentgen fluorescent spectrofluorimeter “Spectrace-5000” (“Trackor Xray”, Netherlands).
Erythrocyte membranes statePhysical-chemical state in membrane lipids were estimated using luminescence of lipophylic
fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH) and coefficient of pyren excimerization (CEP),
included into the erythrocytes ghosts. Fluorescent parameters of erythrocytes membranes were measured
using luminescent spectrophotometer LSF 222 (“Solar”, Belarus).
Data processing
Results of examination were input into a database (Paradox 4.0) and processed with methods ofparametric and nonparametric statistics using SPSS 9.0 statistical package. Epidemiological analysis ofdata was performed with the help of EPIINFO6 (version 6.04 b). Relative risk (RR) with confidential
intervals (CI) was calculated and relationships of two variables were determined using χ2-criteria. Resultsof the first and the second clinical and laboratory examination of children are analyzed in this article.
Results and discussion
Radio-ecological status
Radio-ecological parameters of both examined groups are shown in Table 1. The data given in Table
1 testify to a non-significant increase in ASED in the children of the main group during the time period of
two observations. ASED in the exposed children (main group) is characterized with a permanently higher
values compared to the unexposed group (control). Lead, cadmium and mercury urine levels weresignificantly lower in the control group compared to the main at the time of the first examination. Further,changes in heavy metals urine contents were characterized by a decrease of lead, cadmium and mercury
levels in urine in the children of the main group and by an increase of urine lead concentration in thechildren from the control group (Table 1).

Table 1. Radio-ecological parameters in children of observed groups.
GroupsParameters
Main
Control
1st examination
2nd examination
1st examination 2nd examination
a

b

c

d

ASED, mSv

0.770
(0.13-1.297)

0.810(0.13-2.24)

0.024**(0.017-0.037)

0.034***(0.017-0.320)

Pb urine excretion, mg/l

0.040
(0-0.359)

0.020*(0-0.076)

0.0172**(0-0.069)

0.028*(0-0.082)

Cd urine excretion, mg/l

0.035
(0-0.159)

0.025(0-0.053)

0.02**(0-0.08)0.015(0-0.041)

Hg urine excretion, mg/l

0.031
(0-0.078)

0.021*(0-0.063)

0.022**(0-0.102)0.019(0-0.069)

Note: Minimal and maximal values are shown in brackets.

*- b-a; d-c (P<0.05) **- c-a (Р<0.05)***- d-b (Р<0.05)
233Clinical findings
Complaints of the examined children
Contents of complaints observed in the examined children are shown in Table 2. The frequency ofthe children with some kinds of complaints is larger in the main group than in the control both at the first
and the second examinations. There is observed a growing tendency of complaints for both groups
between the first and the second examinations.
The frequency of astenoneurotic complaints was significantly higher in the main group than in thecontrol during the first examination. In the children of the main group a growing tendency of suchcomplaints was observed with time. In the control group an increased incidence of astenoneurotic
complaints was also ascertained at the moment of the second investigation, though it did not get the values
observed in the main group.
It should be noted that there were high frequencies of complaints of headaches among the examinedchildren. A Significantly higher prevalence with this complaint in the main group was observed ascompared with the control, while the incidence of headaches increased in both groups with time.
The number of complaints of heart disturbance significantly increased at the second examination inboth groups with a higher prevalence in the main group.
Gastroenterological complaints prevailed among the total structure of complaints. At the time of thesecond examination, significant increases were observed in the frequency complaints such as belch,heartburn and decreased appetite in both groups. Stomachache was the most frequent complaint.
Clinical syndromes and diagnoses
The data shown in Table 3 give the distribution of major clinical syndromes and diagnoses in theexamined children during the both periods of observation.
Table 2. Frequency of complaints in examined children, (%).
GroupsMain
Control
Complaints
1st examination 2nd examination
1st examination
2nd examination
Complaints present
Complaints absent
Weakness
Dizziness
Headache
SyncopeNasal bleeding
Fatigability
Irritability
Troubled sleep
Uracrasia
HeartacheHeart disturbance(arrhythmia)
Stomachache
Belching
HeartburnDecreased appetite
Diarrhea
Constipation
Allergic eruptions
Note :*- b-a; d-c (P<0.05)

a

b

c

d

72.2
27.8
31.6
12.8
37.6
0.8
2.3
27.1
3.0
3.0
0.8
6.8
1.5

78.9
21.1
28.6
17.3
45.1
2.3
3.8
23.3
4.5
1.5
1.5
9.0
18.8*

45.7**
54.3**
11.9**
4.9**
20.7**
0
0.5
8.2**
1.1
0.5
0.5
13.0
0

66.1*,***
33.9*,***
24.7*
5.8***
25.9***
0
1.2
17.2*
2.9
0
1.7
11.5
5.8*,***

64.7*
21.2**
15.8
2.2**
7.5*
1.6
14.3
1.1**
0.8
0.5
0.8
1.1
3.0
0.5
***- d-b (Р<0.05)

44.3*,***
12.6*
5.8*
10.3*
0
0.6
5.8*

51.9
9.8
1.5
9.0
2.3
0.8
1.5
**- c-a (Р<0.05)

234

In the structure of diseases and clinical syndromes, the most prevalent were cardiovascular
manifestation of the vegetative dysfunction (vegetovascular syndrome), chronic pathology of thegastrointestinal tract (chronic gastritis, duodenitis and gastroduodenitis), caries, asthenoneurotic syndrome,
tonsilla hypertrophy and chronic tonsillitis. A significant increase in the incidence of the combined formof chronic gastrointestinal pathology (chronic gastrodoudenitis) was observed in both groups with its
higher prevalence in the main group.
Cardiovascular syndromes and diagnoses are presented in the form of mitral valve prolapse andvegetovascular syndrome including arterial hypertension, arterial hypotension and cardiac syndrome(arrhythmia, metabolic dysfunction, isolated heart murmur). For the arterial hypertension syndrome, thechildren of both groups were distributed approximately equally. A special attention should be paid to the
distribution of children with the arterial hypotension syndrome: during the first examination, thefrequency of hypotension in the main group exceeded significantly than in the control group; later on,
with age a tendency to a decreased frequency of hypotension was observed only in the control group. An
opposite picture was revealed in the main group: the arterial hypotension syndrome increased at thesecond examination.
In the children suffering from the combined radio-chemical influence the main hemodynamic
mechanism of arterial pressure decrease is the insufficiency of the arterial blood vessels tonus. The socalled syndrome of arterial hypotension is caused by the disturbances in the mechanisms ofneurohormonal regulation of vascular tonus as a decrease in the catecholamine activity combined with adecrease in the hormonal activity of thyroid gland as a result of iodine deficiency observed in Belarus [20]and the impact of radioiodine released after the Chernobyl accident. Besides, a decrease of serum cAPM
level as well as predominance in prostacyclin depressive activity was revealed in the children with
Table 3. Frequency of clinical syndromes and diagnoses in examined children (%).
Clinical syndromes and diagnosis
GroupsMain
Control
1st
2nd
1st
2nd
examination examination examination
examinationaChronic gastritis
44.2
Chronic duodenitis
6.2
Chronic gastroduodenitis
17.1
Bilious dyskinesia
43.4
Mitral valve prolapse
2.9
Vegetovascular and cardiac syndrome
67.9(total):incl. arterial hypertension
5.9
arterial hypotension
14.2
metabolic cardiac dysfunction
14.9
arrhythmia
2.2
isolated heart murmur
40.4
Asthenoneurotic syndrome
20.2
Uracrasia
3.2
Tonsilla hypertrophy
19.8
Chronic sinusitis
0
Adenoiditis
2.4
Chronic tonsillitis
11.1
Caries58.9
Chronic periodontitis
6.8
Iron deficient anemia
6.6
Allergic eruptions
2.5
Note*- b-a; d-c (P<0.05)**- c-a (Р<0.05)

235

b

c

d

36.4
4.7
39.5*
34.1
4.5
73.7

31.9
1.5
11.6
17.4**
5.4
40.3**

32.9
1.4
28.7*
12.6***
4.8
52.2*,***

5.9
6.5**
3.2**
0.5
23.1**
7.5**
1.2
21.2
0
0
13.6
42.6**
0**
6.9
4.6

3.2
4.8***
6.9***
0.5
35.5*
11.3
4.2
16.7
0.6
3.5
17.2***
37.3***
0.6
3.5
1.8

3.8
18.1
23.3
2.3
33.8
16.9
1.5
20.0
1.5
0
9.2
59.4
2.4
3.2
0.8
***- d-b (Р<0.05)

hypotension of the main group [21]. Study of the blood vessels functional reactivity in the sufferingchildren confirms a significant decrease of arterial blood vessels tonus and shows the insufficiency in thenormal arterial pressure supply. Also significant disturbance of peripheral, cerebral and systemic tonus ofarterial vessels has been ascertained on the level of intra systemic relations [22].
During the first examination, the frequency of children with vegetative dysfunction manifestations in
the form of cardiac syndrome was significantly lower in the control group as compared with the main one.
During clinical follow-up this syndrome increased in both groups, which caused an increased number ofcomplaints of heart disturbances. It should be noted that this increase was mainly due to metabolic cardiac
dysfunction both in the main and control groups, as well as due to the isolated systolic murmur in thecontrol group. Metabolic cardiac dysfunction is characterized by a disorder in the phase of ventricle
myocardium repolarization of different degree of manifestation [23].
Distribution of the psycho neurological syndromes and diagnoses was characterized by the fact that
asthenoneurotic syndrome prevailed in the main group both during the first and second examination, thedistinctions being statistically significant in the first case (Table 3).
Relative risk analysis
Epidemiological analysis of the obtained data with the calculation of the relative risk (RR) of thedevelopment of the diseases is performed in Table 4.
The obtained data show that both during the first and second examination, the RR values of thedevelopment of the diseases were higher in the children from the main group as compared with the control.
It mostly concerns arterial hypotension and metabolic form of cardiac syndrome. An increase in the RR ofthe development of arterial hypotension points the relationship between the observed pathology and its
age dynamics, on the one hand, and environmental impact on the children’s organism, on the other hand.
Chronic small doses radiation and chemical exposure causes nonspecific disorders in the organism(changes in oxidative processes, decrease in cell membrane stability, attenuation of protective andadaptive mechanisms). The effect of some of them leads to the development of ecological disadaptation
syndrome [24] and appearance of clinically signed syndromes and diseases.
According to published data, the effect of environmental pollutants on the health of children makes
about 20%, therefore, the health of the population is considered at present as an integral index of thequality of the environment [3-5].
Erythrocyte membranes structural and functional state
Cell membranes are considered to be the initial target of the environmental exposure and pathologic
effect of xenobiotics is mediated, first of all, by membranous effects. Universal property of biological
Table 4. Relative risk (RR) of some clinical syndromes and diseases in observed children.
Clinical syndrome and diagnosis

1st examination

2nd examination

Chronic gastroduodenitis

1.46 (0.85-2.51)
χ2 =1.49, P<0.223

1.40 (1.03-1.90)
χ2 = 4.01, P<0.045

Arterial hypotension

2.21 (1.11-4.40)
χ2 = 4.57, P<0.03

3.73 (1.79-7.76)
χ2 = 13.19, P<0.0002

Cardiac metabolic dysfunction

4.66 (1.92-11.92)
χ2 = 12.92, P<0.0003

3.33 (1.82-6.13)
χ2 = 16.02, P<0.00006

Vegetovascular syndrome

1.68 (1.36-2.07)
χ = 22.14, P<0.000003

1.41 (1.19-1.68)
χ = 14.24, P<0.0002

2

Note: Confidential Interval (CI) is shown in brackets.

236

2membranes is their high sensitivity to the environmental influences. Structural changes in erythrocyte
membranes may be indicated both in the lipid bilayer and proteins. At present, it has been ascertained that
proteins and lipids jointly participate in structural reformation of biological membranes. Investigation of
membranes with the help of lipophilic fluorescent probes makes it possible to judge about the changes in
micro viscosity of membrane lipids.
While studying the changes of physical-chemical state of erythrocyte membranes with the help of
lipophilic fluorescent probes, it has been shown that fluorescent intensity of the lipophilic probe DPH
included into the erythrocyte ghosts was 0.84 ± 0.07 relative units in the children of the main group, which
was significantly higher than in the control one (0.66±0.02) (P<0.05) (Figure 1).
A decrease by 18.5% in the value of pyren excimerization coefficient (CEP) included into theerythrocytes ghosts of the children from the main group has been ascertained as compared with the groupof children living in the Vitebsk region (control group) (Figure 1).
Stability and rheological properties of plasmatic erythrocyte membranes and parameters ofhemoglobin reactions determine the supply of body tissue with oxygen. Erythrocyte membrane provides
integration and conformation of red blood cell, controls the flow of metabolites inside the cell and outside,and participates in different intercellular interactions and reactions of the erythrocyte cytoplasm to theoutside effects. There exist a large number of biochemical and biophysical mechanisms which determine
the relation between the state of plasmatic membranes and components of cytoplasm, and regulate thetransmission of signal lengthwise through membrane. Changes in the structural organization, properties
and stability of erythrocyte membrane in response to environmental effects plays a regulatory role
controlling the state of intra erythrocyte components and acting as a means of erythrocyte adaptation to
the changing situation in serum. The obtained data show that physical and chemical state of erythrocyte
membranes in children from the main group was characterized by changes in micro viscosity ofmembranous lipids, which may result from the effect of environmental impact. These changes could be
estimated as general biological response of cell membranes of all types for the environmental exposure
and play significant unified role in development of disadaptation syndrome and different health disorders
and diseases.
Conclusions

Relative
unit 0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
DP
Main

CE
Control group

Figure 1. Mean values of lipophilic fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH) andcoefficient of excimerization of pyren (CEP) in examined children.
237

Clinical follow-up of two groups of Belarusian children (the main and the control) clearly indicatesan aggravating situation of their health state by both the number of complaints and the number of majorclinical syndromes and diagnoses. The most important is the growth of the gastrointestinal pathology, as
well as an increase in cardiovascular manifestations of the vegetative dysfunction syndrome.
Practically all forms of studied nosology are more prevalent in the main group compared to thecontrol both at the first and the second examinations. High values of relative risk (RR) are obtained forarterial hypotension (RR=2.21 and 3.73 at the first and the second examination, respectively) and cardiac
metabolic dysfunction (RR=4.66 and 3.33).
The present situation requires that measures for correction and prophylaxis of environmental
depending pathology should be conducted. These measures should cover all aspects of etiopathogenesis
and be directed to restoration of the impaired resistance of the children’s organisms using first of all,medication free (medicines free or non medicament) means and methods.
References
1. Astakhova LN, Demidchik EP, Davydova EV et al. Health state of Belarus children and adolescents sufferedfrom the Chernobyl accident. Vestnik of the USSR Academy of Medical Sciences. 1991, N11, P.25-27. (Russian)
2. Erzinkyan KL Anthropogenic factors of the environment and health. Vestnik of the USSR Academy of Medical
Sciences. 1989, N8, P.59-68. (Russian)
3. Ilyin VA Problems of medical ecology and health of children and adolescents. Adstract of the Republican
conference. Vladivostok, 1991, P.21-23. (Russian)
4. Oleshkevich LA, Sokolov SM Individual sensitivity as the basis of the morbidity risk group formation in the
population. In “Modern technologies and human health. Minsk, 1991, P.28-29 (Russian)
5. Shandala MG, Zvinyatzkovskiy YaI Health of population as a criteria of the anthropologic system. In“Methodological problems of human ecology”. Novosibirsk, 1988, P.82-85. (Russian)
6. Zhukova OM, Matveenko II, Germenchuk MG Belarus Polesie: radio-chenical contamination and health of the
population. Proceedings of the International conference. Minsk, 1988, P.166. (Russian)
7. Gres NA, Polyakova TI Microelement state of human being and the problems of health. In “Microelement
disorders and health of Belarus children after the Chernobyl accident”, Minsk, 1997, P.5-25. (Russian)
8. Kozarezova TI, Slobozhanina EI et al. State of erythrocyte system in children suffered from the radiation
exposure after the Chernobyl accident. In “State of the gematoimmune system in Belarus children after the
Chernobyl accident”. Minsk, 1996, P.86-89. (Russian)
9. Kozareziva TI, Gres NA et al. State of the erythrocyte system in children with anemia residing in the large
industrial center. In “State of the gematoimmune system in Belarus children after the Chernobyl accident”. Minsk,
1996, P.63-77. (Russian)
10. IPCS. Lead - environmental aspects. Environmental health criteria 85. WHO, Geneva, 1992.
11. Veltishev YV, Fokeeva VV Ecology and children’s health. Maternity and Childhood. 1992, N12, P.30-35.
(Russian)
12. Turovetz GL, Orlova EV et al. Differential estimation of the environmental factors and health of schoolchildren.
Vestnik of the Russian Academy of Medical Sciences. 1993, N6, P.46-50. (Russian)
13. Vasilenko IYa About radioactive cesium. Medical Military Journal. 1989, N5, P.37-39. (Russian)
14. Gres NA, Arinchin AN, Petrova VS Environmental aspects of pediatrics in Belarus. In “Ecological and social
problems of protection and control over the health state of young generation on the way to the 21 century”. 4’th
International Congress, St. Petersburg, 1998, P.99-101. (Russian)
15. Monaenkova AM, Zorina LA, Ryzhkova MN About the problem of chronic poisoning of chemicals. Labor
hygiene and occupational diseases. 1981, N10, P.4-7 (Russian)
16. Petrenko ZN Ultrastructural characteristics of stomach mucous membrane in human and experimental animals
being in the zone of the high radiation exposure after the Chernobyl accident. Abstract of the candidate
dissertation. Kiev, 1990, 28 p. (Russian)
17. IPCS. Quality management for chemical safety testing. Environmental health criteria 141. WHO, Geneva, 1992.112 p.

238

18. IPCS.Priciples for evaluating chemical effects on the aged population. Environmental health criteria 144. WHO,
Geneva, 1993.-159 p.
19. M.Balonov, P.Jacob, I.Likhtarev, V.Minenko. Pathways, levels, and trends of population exposure after the
Chernobyl accident // The radiological consequences of the Chernobyl accident. Proceedings of the international
conference. Minsk, Belarus, 18-22 March, 1996, EUR 16544 EN, Brussels-Luxembourg, 1966:235-249.
20. Arinchin A., Gembicki M. et al. Goiter Prevalence and urinary iodine excretion in Belarus Children Born after
the Chernobyl accident. IDD Newsletter, vol.16, num.1, February, 2000:7-9.
21. Arynchyn AN Blood circulation in children suffered from the combined chronic low doses radio-chemical
exposure. Zdravoohranenie. 2000, N2, P.6-10. (Russian)
22. Arynchyn AN Reactivity of cardiovascular system in children suffered from the long term low doses radiation
exposure. Zdravoohranenie. 1999, N2, P.9-13. (Russian)
23. Arynchyn AN, Nalivaiko GV Bioelectrical activity of myocardium in children residing in the contaminated withradionuclides territories. Zdravoohranenie Belorussii. 1991, N1, P.4-7. (Russian)
24. Gres NA, Polyakova TI et al. Patomorphosis of choric gastritis in children and adolescents suffered from the
combined radio-chemical exposure. In “Patomorphosis of choric gastritis in children and adolescents of Belarus
after the Chernobyl accident”. Minsk, 1995, P.107-165. (Russian)239