This	  monograph	
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  volume	
  originally	
  published	
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  in	
  2009	  and	  the	
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  (2009)	
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  material,	  excluding	
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Under	  a	
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  Similarly,	
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  photo	
  (T.A.	
  Mousseau)	
  grants	
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ON THE COVER
Pine trees reveal changes in wood color, density, and growthrate following irradiation from the Chernobyl disaster.
T.A. Mousseau, University of South Carolina (2009)	
  Chernobyl
Consequences of the Catastrophe for
People and the Environment

Chernobyl
Consequences of the Catastrophe for
People and the Environment
ALEXEY V. YABLOKOVVASSILY B. NESTERENKO
ALEXEY V. NESTERENKO
Consulting Editor
JANETTE D. SHERMAN-NEVINGER

Chernobyl
Consequences of the Catastrophe for People
and the Environment
ALEXEY V. YABLOKOV, VASSILY B. NESTERENKO, AND ALEXEY V. NESTERENKO
Consulting Editor
JANETTE D. SHERMAN-NEVINGERCONTENTS
Foreword. By Prof. Dr. Biol. Dimitro M. Grodzinsky . . . . . . . . . . . . . . . . . . . . . . . . . .
Preface. By Alexey V. Yablokov and Vassily B. Nesterenko . . . . . . . . . . . . . . . . . . . . .

vii
xAcknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

xiv

Introduction: The Difficult Truth about Chernobyl. By Alexey V. Nesterenko,
Vassily B. Nesterenko, and Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

Chapter I. Chernobyl Contamination: An Overview
1. Chernobyl Contamination through Time and Space. By Alexey V. Yablokov
and Vassily B. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

Chapter II. Consequences of the Chernobyl Catastrophe
for Public Health
2. Chernobyl’s Public Health Consequences: Some Methodological Problems.
By Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
32
3. General Morbidity, Impairment, and Disability after the Chernobyl
Catastrophe. By Alexey V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
4. Accelerated Aging as a Consequence of the Chernobyl Catastrophe. By Alexey
V. Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
55
5. Nonmalignant Diseases after the Chernobyl Catastrophe. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
58
6. Oncological Diseases after the Chernobyl Catastrophe. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
7. Mortality after the Chernobyl Catastrophe. By Alexey V. Yablokov . . . . . . . . . . 192
Conclusion to Chapter II.................................................
v

217

vi

Chapter III. Consequences of the Chernobyl Catastrophe
for the Environment
8. Atmospheric, Water, and Soil Contamination after Chernobyl. By Alexey V.
Yablokov, Vassily B. Nesterenko, and Alexey V. Nesterenko . . . . . . . . . . . . . . . .
9. Chernobyl’s Radioactive Impact on Flora. By Alexey V. Yablokov . . . . . . . . . . .
10. Chernobyl’s Radioactive Impact on Fauna. By Alexey V. Yablokov . . . . . . . . . .
11. Chernobyl’s Radioactive Impact on Microbial Biota. By Alexey V.
Yablokov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Conclusion to Chapter III................................................

223
237
255
281
285

Chapter IV. Radiation Protection after the Chernobyl Catastrophe
12. Chernobyl’s Radioactive Contamination of Food and People. By Alexey V.
Nesterenko, Vassily B. Nesterenko, and Alexey V. Yablokov . . . . . . . . . . . . . . . . 289
13. Decorporation of Chernobyl Radionuclides. By Vassily B. Nesterenko andAlexey V. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
14. Protective Measures for Activities in Chernobyl’s Radioactively ContaminatedTerritories. By Alexey V. Nesterenko and Vassily B. Nesterenko . . . . . . . . . . . . 311
15. Consequences of the Chernobyl Catastrophe for Public Health and theEnvironment 23 Years Later. By Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
Conclusion to Chapter IV................................................

327

CHERNOBYL

ForewordMore than 22 years have passed since the Chernobyl catastrophe burst upon andchanged our world. In just a few days, the air, natural waters, flowers, trees, woods,
rivers, and seas turned to potential sources of danger to people, as radioactive substances
emitted by the destroyed reactor fell upon all life. Throughout the Northern Hemisphereradioactivity covered most living spaces and became a source of potential harm for all
living things.
Naturally, just after the failure, public response was very strong and demonstrated
mistrust of atomic engineering. A number of countries decided to stop the constructionof new nuclear power stations. The enormous expenses required to mitigate the negative
consequences of Chernobyl at once “raised the price” of nuclear-generated electric power.
This response disturbed the governments of many countries, international organizations,and official bodies in charge of nuclear technology and led to a paradoxical polarization
as to how to address the issues of those injured by the Chernobyl catastrophe and theeffects of chronic irradiation on the health of people living in contaminated areas.
Owing to the polarization of the problem, instead of organizing an objective andcomprehensive study of the radiological and radiobiological phenomena induced bysmall doses of radiation, anticipating possible negative consequences, and taking adequate
measures, insofar as possible, to protect the population from possible negative effects,
apologists of nuclear power began a blackout on data concerning the actual amounts ofradioactive emissions, the doses of radiation, and the increasing morbidity among thepeople that were affected.
When it became impossible to hide the obvious increase in radiation-related diseases,
attempts were made to explain it away as being a result of nationwide fear. At thesame time some concepts of modern radiobiology were suddenly revised. For example,
contrary to elementary observations about the nature of the primary interactions ofionizing radiation and the molecular structure of cells, a campaign began to deny nonthreshold radiation effects. On the basis of the effects of small doses of radiation in somenonhuman systems where hormesis was noted, some scientists began to insist that suchdoses from Chernobyl would actually benefit humans and all other living things.
The apogee of this situation was reached in 2006 on the 20th anniversary of theChernobyl meltdown. By that time the health and quality of life had decreased formillions of people. In April 2006 in Kiev, Ukraine, two international conferences were
held in venues close to one another: one was convened by supporters of atomic energy
and the other by a number of international organizations alarmed by the true stateof health of those affected by the Chernobyl catastrophe. The decision of the first
conference has not been accepted up to now because the Ukrainian party disagrees
with its extremely optimistic positions. The second conference unanimously agreed thatradioactive contamination of large areas is accompanied by distinctly negative healthconsequences for the populations and predicted increased risk of radiogenic diseases in
European countries in the coming years.

vii

viii

For a long time I have thought that the time has come to put an end to the opposition
between technocracy advocates and those who support objective scientific approaches
to estimate the negative risks for people exposed to the Chernobyl fallout. The basis forbelieving that these risks are not minor is very convincing.
Declassified documents of that time issued by Soviet Union/Ukraine governmental
commissions in regard to the first decade after 1986 contain data on a number ofpeople who were hospitalized with acute radiation sickness. The number is greater by
two orders of magnitude than was recently quoted in official documents. How can weunderstand this difference in calculating the numbers of individuals who are ill as aresult of irradiation? It is groundless to think that the doctors’ diagnoses were universallywrong. Many knew in the first 10-day period after the meltdown that diseases of thenasopharynx were widespread. We do not know the quantity or dose of hot particles that
settled in the nasopharyngeal epithelium to cause this syndrome. They were probably
higher than the accepted figures.
To estimate doses of the Chernobyl catastrophe over the course of a year, it is critical toconsider the irradiation contributed by ground and foliage fallout, which contaminatedvarious forms of food with short-half-life radionuclides. Even in 1987 activity of some of
the radionuclides exceeded the contamination by Cs-137 and Sr-90. Thus decisions to
calculate dose only on the scale of Cs-137 radiation led to obvious underestimation of
the actual accumulated effective doses. Internal radiation doses were defined on the basisof the activity in milk and potatoes for different areas. Thus in the Ukrainian Poles’eregion, where mushrooms and other forest products make up a sizable share of the foodconsumed, the radioactivity was not considered.
The biological efficiency of cytogenic effects varies depending on whether the radiation
is external or internal: internal radiation causes greater damage, a fact also neglected.
Thus, there is reason to believe that doses of irradiation have not been properly estimated,
especially for the first year after the reactor’s failure. Data on the growth of morbidity
over two decades after the catastrophe confirm this conclusion. First of all, there arevery concrete data about malignant thyroid disease in children, so even supporters of“radiophobia” as the principal cause of disease do not deny it. With the passage of time,
oncological diseases with longer latency periods, in particular, breast and lung cancers’,
became more frequent.
From year to year there has been an increase in nonmalignant diseases, which has raised
the incidence of overall morbidity in children in areas affected by the catastrophe, andthe percent of practically healthy children has continued to decrease. For example, in Kiev,
Ukraine, where before the meltdown, up to 90% of children were considered healthy, thefigure is now 20%. In some Ukrainian Poles’e territories, there are no healthy children,and morbidity has essentially increased for all age groups. The frequency of disease has
increased several times since the accident at Chernobyl. Increased cardiovascular disease
with increased frequency of heart attacks and ischemic disease are evident. Average
life expectancy is accordingly reduced. Diseases of the central nervous system in bothchildren and adults are cause for concern. The incidence of eye problems, particularly
cataracts, has increased sharply. Causes for alarm are complications of pregnancy and thestate of health of children born to so-called “liquidators” (Chernobyl’s cleanup workers)
and evacuees from zones of high radionuclide contamination.
Against the background of such persuasive data, some defenders of atomic energy
look specious as they deny the obvious negative effects of radiation upon populations. In

Grodzinsky: Forewordixfact, their reactions include almost complete refusal to fund medical and biological studies, even liquidating government bodies that were in charge of the “affairs of Chernobyl.”
Under pressure from the nuclear lobby, officials have also diverted scientific personnel
away from studying the problems caused by Chernobyl.
Rapid progress in biology and medicine is a source of hope in finding ways to prevent
many diseases caused by exposure to chronic nuclear radiation, and this research will
advance much more quickly if it is carried out against the background of experience thatUkrainian, Belarussian, and Russian scientists and physicians gained after the Chernobyl
catastrophe. It would be very wrong to neglect the opportunities that are open to us today.
We must look toward the day that unbiased objectivity will win out and lead to unqualified
support for efforts to determine the influence of the Chernobyl catastrophe on the healthof people and biodiversity and shape our approach to future technological progress andgeneral moral attitudes. We must hope and trust that this will happen.
The present volume probably provides the largest and most complete collection ofdata concerning the negative consequences of Chernobyl on the health of people andon the environment. Information in this volume shows that these consequences do notdecrease, but, in fact, are increasing and will continue to do so into the future. The main
conclusion of the book is that it is impossible and wrong “to forget Chernobyl.” Overthe next several future generations the health of people and of nature will continue to be
adversely impacted.
PROF. DR. BIOL. DIMITRO M. GRODZINSKY
Chairman, Department of General Biology, Ukrainian National Academy of Sciences,
Chairman, Ukrainian National Commission on Radiation Protection

CHERNOBYL

Preface

The principal idea behind this volume is to present, in a brief and systematic form,
the results from researchers who observed and documented the consequences of theChernobyl catastrophe. In our view, the need for such an analysis became especially
important after September 2005 when the International Atomic Energy Agency (IAEA)
and the World Health Organization (WHO) presented and widely advertised “TheChernobyl Forum” report [IAEA (2006), The Chernobyl Legacy: Health, Environment and Socio-Economic Impact and Recommendation to the Governments of Belarus, the Russian Federation and Ukraine 2nd Rev. Ed. (IAEA, Vienna): 50 pp.] because it lacked sufficiently detailed facts concerning the consequences of the disaster(http://www.iaea.org/Publications/Booklets/Chernobyl/chernobyl.pdf ).
Stimulated by the IAEA/WHO “Chernobyl Forum” report, and before the 20th
anniversary of the Chernobyl catastrophe, with the initiative of Greenpeace International, many experts, mostly from Belarus, Ukraine, and Russia (see the list below),presented their latest data/publications on the consequences of Chernobyl. GreenpeaceInternational also collected hundreds of Chernobyl publications and doctoral theses.
These materials were added to the Chernobyl literature collected over the years byAlexey Yablokov [A. V. Yablokov (2001): Myth of the Insignificance of the Consequences of
the Chernobyl Catastrophe (Center for Russian Environmental Policy, Moscow): 112 pp.
(//www.seu.ru/programs/atomsafe/books/mif_3.pdf ) (in Russian)].
Just before the 20th anniversary of the Chernobyl catastrophe, on April 18, 2006,
the report “The Chernobyl Catastrophe–Consequences on Human Health” was published by A. Yablokov, I. Labunska, and I. Blokov (Eds.) (Greenpeace, Amsterdam, 2006,
137 pp.; www.greenpeace.org/international/press/reports/chernobylhealthreport). For
technical reasons, it was not possible to include all of the above-mentioned material in that book. Thus part of this original material was published as “The Health
Effects of the Human Victims of the Chernobyl Catastrophe: Collection of Scientific Articles,” I. Blokov, T. Sadownichik, I. Labunska, and I. Volkov (Eds.) (Greenpeace, Amsterdam, 2007, 235 pp.; http://www.greenpeace.to/publications.asp#2007).
In 2006 multiple conferences were convened in Ukraine, Russia, Belarus, Germany, Switzerland, the United States, and other countries devoted to the 20th
anniversary of the Chernobyl catastrophe, and many reports with new materials concerning the consequences of the meltdown were published. Among
them:•“The Other Report on Chernobyl (TORCH)” [I. Fairly and D. Sumner (2006),
Berlin, 90 pp.].
• “Chernobyl Accident’s Consequences: An Estimation and the Forecast of Additional
General Mortality and Malignant Diseases” [Center of Independent Ecological
Assessment, Russian Academy of Science, and Russian Greenpeace Council (2006),
Moscow, 24 pp.].

x

Yablokov & Nesterenko: Prefacexi•

Chernobyl: 20 Years On. Health Effects of the Chernobyl Accident [C. C. Busby and A.V.
Yablokov (Eds.) (2006), European Committee on Radiation Risk, Green Audit,
Aberystwyth, 250 pp.].
• Chernobyl. 20 Years After. Myth and Truth [A. Yablokov, R. Braun, and U. Watermann(Eds.) (2006), Agenda Verlag, Münster, 217 pp.].
• “Health Effects of Chernobyl: 20 Years after the Reactor Catastrophe” [S. Pflugbeil
et al. (2006), German IPPNW, Berlin, 76 pp.].
• Twenty Years after the Chernobyl Accident: Future Outlook [Contributed Papers
to International Conference. April 24–26, 2006. Kiev, Ukraine, vol. 1–3, HOLTEH
Kiev, www.tesec-int.org/T1.pdf].
• Twenty Years of Chernobyl Catastrophe: Ecological and Sociological Lessons. Materials of the International Scientific and Practical Conference. June 5, 2006, Moscow,
305 pp., www.ecopolicy.ru/upload/File/conferencebook_2006.pdf, (in Russian).
• National Belarussian Report (2006). Twenty Years after the Chernobyl Catastrophe: Consequences in Belarus and Overcoming the Obstacles. Shevchyuk, V. E, &Gurachevsky, V. L. (Eds.), Belarus Publishers, Minsk, 112 pp. (in Russian).
• National Ukrainian Report (2006). Twenty Years of Chernobyl Catastrophe: Future
Outlook. Kiev, http://www.mns.gov.ua/news show.php?news id=614&p=1.
• National Russian Report (2006). Twenty Years of Chernobyl Catastrophe: Results
and Perspective on Efforts to Overcome Its Consequences in Russia, 1986–2006.
Shoigu, S. K. & Bol’shov, L. A. (Eds.), Ministry of Emergencies, Moscow, 92 pp. (inRussian).
The scientific literature on the consequences of the catastrophe now includes morethan 30,000 publications, mainly in Slavic languages. Millions of documents/materials
exist in various Internet information systems—descriptions, memoirs, maps, photos, etc.
For example in GOOGLE there are 14.5 million; in YANDEX, 1.87 million; and in
RAMBLER, 1.25 million citations. There are many special Chernobyl Internet portals, especially numerous for “Children of Chernobyl” and for the Chernobyl Cleanup
Workers (“Liquidators so called”) organizations. The Chernobyl Digest—scientific abstract
collections—was published in Minsk with the participation of many Byelorussian andRussian scientific institutes and includes several thousand annotated publications dating
to 1990. At the same time the IAEA/WHO “Chernobyl Forum” Report (2005), advertised by WHO and IAEA as “the fullest and objective review” of the consequences of
the Chernobyl accident, mentions only 350 mainly English publications.
The list of the literature incorporated into the present volume includes about 1,000
titles and reflects more than 5,000 printed and Internet publications, primarily in Slavic
languages. However, the authors apologize in advance to those colleagues whose papers
addressing the consequences of the Chernobyl catastrophe are not mentioned in thisreview—to list all papers is physically impossible.
The authors of the separate parts of this volume are:•

Chapter I: Cherbobyl Contamination: An Overview—A. V. Yablokov and V. B.
Nesterenko;• Chapter II: Consequences of the Chernobyl Catastrophe for Public Health—A. V.
Yablokov;• Chapter III: Consequences of the Chernobyl Catastrophe for the Environment—
A. V. Yablokov, V. B. Nesterenko, and A. V. Nesterenko;

xii•

Chapter IV: Radiation Protection after the Chernobyl Catastrophe—A. V.
Nesterenko, V. B. Nesterenko, and A. V. Yablokov.

The final text was coordinated by all authors and expresses their common viewpoint.
Some important editorial remarks:
1. Specific facts are presented in the form that has long been accepted by the United
Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR)—
itemized by numbered paragraphs.
2. The words “Chernobyl contamination,” “contamination,” “contaminated territories,” and “Chernobyl territories” mean the radioactive contamination caused byradionuclide fallout as a result of the Chernobyl catastrophe. Such expressions as“distribution of diseases in territory. . .” mean occurrence of diseases in the population of the specified territory.
3. The word “catastrophe” means the release of numerous radionuclides into theatmosphere and underground water as a result of the explosion of the fourth reactor
at the Chernobyl nuclear power station (Ukraine), which started on April 26, 1986
and continued thereafter.
4. The expressions “weak,” “low,” and “high” (“heavy”) radioactive contamination
usually indicate a comparison among officially designated different levels of radioactive contamination in the territories: less than 1 Ci/km2 (<37 kBq/m2 ); 1–5
Ci/km2 (37–185 kBq/m2 ); 5–15 Ci/km2 (185–555 kBq/m2 ); and 15–40 Ci/km2(555–1480 kBq/m2 ).
5. The term “clean territory” is a conventional one; however, during the first weeks
and months of the catastrophe practically all territories of Belarus, Ukraine, andEuropean Russia, and Europe and most of the Northern Hemisphere were to someextent contaminated by the Chernobyl radionuclide fallout.
6. Levels (amount) of contamination are expressed as in the original papers—
either in Curies per square kilometer (Ci/km2 ) or in Bequerels per square meter(Bq/m2 ).
The structure of this volume is as follows: Chapter I provides an estimate of thelevel and character of radioactive contamination released from the Chernobyl accident,
affecting primarily the Northern Hemisphere. Chapter II analyzes the public healthconsequences of the catastrophe. Chapter III documents the consequences for the environment. Chapter IV discusses measures for minimizing the Chernobyl consequencesfor Belarus, Ukraine, and Russia. The volume comes to an end with general conclusions
and an index (available online only).
In spite of a vast amount of material, the current information is not comprehensive because new studies are continually being released. However, it is necessary for humankind
to deal with the consequences of this, the largest technological catastrophe in history, andso these data are presented.
For comments and offers for a subsequent edition we ask you to address information
to:Alexey Vladimirovich Yablokov, Russian Academy of Sciences, Leninsky Prospect 33,
Office 319, 119071 Moscow, Russia. Yablokov@ecopolicy.ruorYablokov & Nesterenko: Preface

xiiiAlexey Vassil’evich Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd
Marusinsky Street, 27, Belarus, Minsk, 220053. anester@mail.ru
orJanette D. Sherman-Nevinger, Environmental Institute, Western Michigan University, Kalamazoo, Michigan. Contact: P.O. Box 4605, Alexandria, VA 22303, USA.
toxdoc.js@verizon.net
ALEXEY V. YABLOKOV AND VASSILY B. NESTERENKO

This book had been nearly completed when Prof. Vassily Nesterenko passed away on August 23,
2008. He was a great person who, like Andrey Sakharov, stopped his own bright professional nuclear
career as the general design engineer of the Soviet Union’s mobile nuclear power plant “Pamir” anddirector of Belarussian Nuclear Center to devote his life’s efforts to the protection of humankind from
Chernobyl’s radioactive dangers.
ALEXEY V. YABLOKOVCHERNOBYL

Acknowledgments

The present book would have been impossible without the help of many experts andactivists. Forty-nine researchers, primarily from Ukraine, Belarus, and Russia, provided
original material or reviews of specific topics to Greenpeace International, which havebeen widely used (see below).
Many individuals helped the authors with information and consultations, including(by alphabetical order in each country): Rashid Alymov, Alexander Bahur, Ivan Blokov,
Nikolay Bochkov, Svetlana Davydova, Rimma Filippova, Alexander Glushchenko, Vyacheslav Grishin, Vladimir Gubarev, Rustem Il’ayzov, Vladymir Ivanov, Yury Izrael,
Dilbar Klado, Sergey Klado, Galyna Klevezal’, Lyudmyla Komogortseva, Lyudmyla
Kovalevskaja, Eugen Krysanov, Valery Mentshykov, Mikhail Mina, Eugenia Najdich,Alexander Nikitin, Ida Oradovskaya, Iryna Pelevyna, Lydia Popova, Igor Reformatsky,
Vladimir Remez, Svetlana Revina, Leonid Rikhvanov, Dmitry Rybakov, Dmitry Schepotkin, Galina Talalaeva, Anatoly Tsyb, Leonid Tymonin, Vladimir M. Zakharov, andVladimir P. Zakharov (Russia); Vladymir Borejko, Pavlo Fedirko, Igor Gudkov, Ol’ga Horishna, Nykolay Karpan, Konstantin Loganovsky, Vytaly Mezhzherin, Tatyana Murza,Angelina Nyagu, Natalia Preobrazhenskaya, and Bronislav Pshenichnykov (Ukraine);
Svetlana Aleksievich, Galina Bandazhevskaja, Tatyana Belookaya, Rosa Goncharova,
Elena Klymets, Dmitry Lazjuk, Grigory Lepin, Michail Malko, Elena Mokeeva, andAlexander Oceanov (Belarus); Peter Hill, Alfred Korblein, Sebastian Pflugbeil, Hagen
Scherb, and Inge Schmits-Feuerhake (Germany); Michael Ferne, Alison Katz, VladimirTchertkov, and Jurg Ulrich (Switzerland); Yury Bandazhevsky (Lithuania); Christophe
Bisson and Anders Moller (France); Igor Chasnikov (Kazakhstan); Richard Bramhall
and Chris Busby (England); Rosalia Bertel (Canada); Lym Keisevich (Israel); and Karl
Grossman, Jay Gould, Arjun Makhijani, Joe Mangano, Michael Mariotte, Valery Soyfer,
Ernst Sternglass, and RADNET (USA). We are sincerely grateful to all of them as wellas to many others who aided us in the preparation of this book.
Special thanks go to Prof. Elena B. Burlakova (Moscow) and Prof. Dimitro M. Grodzinsky (Kiev) for reviewing the manuscript, and to Julia F. Morozova (Center for Russian
Environmental Policy, Moscow) for inexhaustible patience in putting numerous variantsof the text in order and laboriously working with the lists of cited literature.
This English edition would have been impossible without Dr. Janette ShermanNevinger, who tirelessly scientifically edited our very rough translation.
The following is a list of the experts who provided original material or reviews ofspecific topics for the first 2006 edition:
Antipkin, Yu.G., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical
Sciences, Kiev, Ukraine.
Arabskaya, L.P., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical
Sciences, Kiev, Ukraine.
Bazyka, D.A., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.

xiv

Acknowledgments

xv

Burlak, G.F., Ministry of Health of Ukraine, Kiev, Ukraine.
Burlakova, E.B., Institute of Biochemical Physics and Russian Academy of Science,
Moscow, Russia.
Buzunov, V.A., Institute of Radiological Hygiene and Epidemiology, Research Center
for Radiation Medicine, Kiev, Ukraine.
Cheban, A.K., “Physicians of Chernobyl” Association, Kiev, Ukraine.
Dashkevich, V.E., Institute of Pediatrics, Obstetrics and Gynecology, Academy of Medical
Sciences, Kiev, Ukraine.
Diomyna, E.A., Institute of Experimental Pathology, Oncology and Radiobiology, Kiev,
Ukraine.
Druzhyna, M.A., Institute of Experimental Pathology, Oncology and Radiobiology, Kiev,
Ukraine.
Fedirko, P.A., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Fedorenko, Z., Institute of Oncology, Academy of Medical Sciences, Kiev, Ukraine.
Fuzik, M., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev,
Ukraine.
Geranios, A., Department of Nuclear Physics and Elementary Particles, University ofAthens, Greece.
Gryshchenko, V., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Gulak, G.L., Institute of Oncology, Academy of Medical Sciences, Kiev, Ukraine.
Khudoley, V.V., N. N. Petrov’ Research Institute of Oncology, Center of Independent
Environmental Expertise, Russian Academy of Sciences, St. Petersburg, Russia.
Komissarenko, I.V., Institute of Endocrinology and Metabolism, Academy of Medical
Sciences, Kiev, Ukraine.
Kovalenko, A.Ye., Institute of Endocrinology and Metabolism, Academy of Medical
Sciences, Kiev, Ukraine.
Lipskaya, A.I., Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences, Kiev, Ukraine.
Loganovsky, K.N., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Malko, M.V., Joint Institute of Power and Nuclear Research, National Academy of
Sciences, Minsk, Belarus.
Mishryna, Zh.A., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Naboka, M.V., Department of Ecohygienic Investigations of the Radioecological Center,
National Academy of Sciences, Kiev, Ukraine.
Nyagu, A.I., “Physicians of Chernobyl” Association, International Journal of Radiation
Medicine, Kiev, Ukraine.
Okeanov, E.A., A. D. Sakharov’ International Environment University, Minsk, Belarus.
Omelyanets, N.I., Laboratory of Medical Demography, Research Center for Radiation
Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Oradovskaya, I.V., Immunology Institute of the Ministry of Public Health, Moscow,
Russia.
Pilinskaya, M.A., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.

xvi

Pintchouk, L.B., Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences, Kiev, Ukraine.
Prysyazhnyuk, A., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Rjazskay, E.S., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Rodionova, N.K., Institute of Experimental Pathology, Oncology and Radiobiology,
National Academy of Sciences, Kiev, Ukraine.
Rybakov, S.I., Surgical Department, Institute of Endocrinology and Metabolism,
Academy of Medical Sciences, Kiev, Ukraine.
Rymyantseva, G.M., V. P. Serbskiy’ Institute for Social and Forensic Psychiatry, Moscow,
Russia.
Schmitz-Feuerhake, I., Department of Physics, University of Bremen, Germany.
Serkiz, Ya.I., Institute of Experimental Pathology, Oncology and Radiobiology, National
Academy of Sciences, Kiev, Ukraine.
Sherashov, V.S., State Scientific Research Center for Preventive Medicine, Moscow,
Russia.
Shestopalov, V.M., Radioecological Center, National Academy of Sciences, Kiev,
Ukraine.
Skvarskaya, E.A., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Slypeyuk, K., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Stepanova, E.I., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Sushko, V.A., Research Center for Radiation Medicine, Academy of Medical Sciences,
Kiev, Ukraine.
Tararukhyna, O.B., Russian Scientific Radiology Center, Moscow, Russia.
Tereshchenko, V.P., Research Center for Radiation Medicine, Academy of Medical
Sciences, Kiev, Ukraine.
Usatenko, V.I., National Commission of Radiation Protection of Ukraine, Kiev, Ukraine.
Vdovenko, V.Yu., Research Center for Radiation Medicine, Academy of Medical Sciences, Kiev, Ukraine.
Wenisch, A., Austrian Institute of Applied Ecology, Vienna, Austria.
Zubovsky, G.A, Russian Scientific Center of Roentgenoradiology, Moscow, Russia.

CHERNOBYLIntroduction: The Difficult Truth
about Chernobyl
Alexey V. Nesterenko,a Vassily B. Nesterenko,aand Alexey V. YablokovbaInstitute of Radiation Safety (BELRAD), Minsk, BelarusbRussian Academy of Sciences, Moscow, Russia

For millions of people on this planet, the explosion of the fourth reactor of theChernobyl nuclear power plant on April 26, 1986 divided life into two parts: before
and after. The Chernobyl catastrophe was the occasion for technological adventurism
and heroism on the part of the “liquidators,” the personnel who worked at the site attempting to contain the escaping radiation, and, in our view, for cowardice on the partof people in public life who were afraid to warn the population of the unimaginable
threat to innocent victims. Chernobyl has become synonymous with human sufferingand has brought new words into our lives—Chernobyl liquidators, children of Chernobyl, Chernobyl AIDs, Chernobyl contamination, Chernobyl heart, Chernobyl dust,
and Chernobyl collar (thyroid disease), etc.
For the past 23 years it has been clear that there is a danger greater than nuclear
weapons concealed within nuclear power. Emissions from this one reactor exceeded ahundredfold the radioactive contamination of the bombs dropped on Hiroshima andNagasaki. No citizen of any country can be assured that he or she can be protected fromradioactive contamination. One nuclear reactor can pollute half the globe. Chernobyl
fallout covered the entire Northern Hemisphere.
The questions persist: How many radionuclides spread over the world? How muchradiation is still stored inside the sarcophagus, the dome that covers the reactor? No
one knows for certain, but the estimates vary from 50 × 106 Ci, or 4–5% of the total
radionuclides released from the reactor, to the reactor being essentially empty and morethan 10 × 109 Ci dispersed over the globe (Chapter I.1). It is not known how manyliquidators ultimately took part in the mitigation; a directive from the USSR Ministry of
Defense, dated June 9, 1989, mandated secrecy (Chapter II.3).
In April 2005, prior to the 20th anniversary of the catastrophe, the Third Chernobyl
Forum Meeting was held in Vienna. Forum experts included representatives from the International Atomic Energy Agency (IAEA), the United Nations Scientific Committee on
the Effects of Atomic Radiation (UNSCEAR), the World Health Organization (WHO),and other individuals from the United Nations, the World Bank, and governmental organizations from Belarus, Russia, and Ukraine. The result was a three-volume reportpresented in September 2005 (IAEA, 2005; UNDP, 2002; WHO, 2006; for the latest
short version see IAEA, 2006).

Address for correspondence: Alexey V. Yablokov, Russian Academy of Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@ecopolicy.ru

1

2

The basic conclusion of the report’s medical volume is that 9,000 victims died ordeveloped radiogenic cancers, but given the background of spontaneous cancers, “itwill be difficult to determine the exact cause of the deaths.” Some 4,000 children wereoperated on for thyroid cancer. In the contaminated areas, cataracts were increasingly
seen in liquidators and children. Some believe that poverty, feelings of victimization, andfatalism, which are widespread among the population of the contaminated areas, aremore dangerous than the radioactive contamination. Those experts, some of whom wereassociated with the nuclear industry, concluded that as a whole, the adverse consequences
for the health of the people were not as significant as previously thought.
An opposing position was voiced by Secretary-General Kofi Annan:
Chernobyl is a word we would all like to erase from our memory. But more than seven million of our
fellow human beings do not have the luxury of forgetting. They are still suffering, everyday, as a resultof what happened . . . The exact number of victims can never be known. But three million children
demanding treatment until 2016 and earlier represents the number of those who can be seriously
ill . . . their future life will be deformed by it, as well as their childhood. Many will die prematurely.
(AP, 2000)

No fewer than three billion persons inhabit areas contaminated by Chernobyl’s radionuclides. More than 50% of the surface of 13 European countries and 30% of eight
other countries have been contaminated by Chernobyl fallout (Chapter I.1). Given biological and statistical laws the adverse effects in these areas will be apparent for many
generations.
Soon after the catastrophe, concerned doctors observed a significant increase in diseases in the contaminated areas and demanded help. The experts involved with thenuclear industry and highly placed tribunals declared that there is no “statistically authentic” proof of Chernobyl radiation, but in the 10 years immediately following thecatastrophe, official documents recognized that the number of thyroid cancers grew “unexpectedly.” Prior to 1985 more than 80% of children in the Chernobyl territories ofBelarus, Ukraine, and European Russia were healthy; today fewer than 20% are well. In
the heavily contaminated areas it is difficult to find one healthy child (Chapter II.4).
We believe it is unreasonable to attribute the increased occurrence of disease in thecontaminated territories to screening or socioeconomic factors because the only variable
is radioactive loading. Among the terrible consequences of Chernobyl radiation are
malignant neoplasms and brain damage, especially during intrauterine development(Chapter II.6).
Why are the assessments of experts so different?
There are several reasons, including that some experts believe that any conclusions
about radiation-based disease requires a correlation between an illness and the received
dose of radioactivity. We believe this is an impossibility because no measurements weretaken in the first few days. Initial levels could have been a thousand times higher thanthe ones ultimately measured several weeks and months later. It is also impossible tocalculate variable and “hot spot” deposition of nuclides or to measure the contributionof all of the isotopes, such as Cs, I, Sr, Pu, and others, or to measure the kinds and total
amount of radionuclides that a particular individual ingested from food and water.
A second reason is that some experts believe the only way to make conclusions is tocalculate the effect of radiation based upon the total radiation, as was done for those
exposed at Hiroshima and Nagasaki. For the first 4 years after the atomic bombs were
dropped on Japan, research was forbidden. During that time more than 100,000 of the3

Introduction

weakest died. A similar pattern emerged after Chernobyl. However, the USSR authorities
officially forbade doctors from connecting diseases with radiation and, like the Japaneseexperience, all data were classified for the first 3 years (Chapter II.3).
In independent investigations scientists have compared the health of individuals invarious territories that are identical in terms of ethnic, social, and economic characteristics and differ only in the intensity of their exposure to radiation. It is scientificallyvalid to compare specific groups over time (a longitudinal study), and such comparisons have unequivocally attributed differences in health outcomes to Chernobyl fallout(Chapter II.3).
This volume is an attempt to determine and document the true scale of the consequences of the Chernobyl catastrophe.
References
AP (2000). Worst effects of Chernobyl to come. Associated Press 25 April 2000 (//www.209.85.135.104/
search?q=cache: EN91goYTe_gJ: www.scorched3d.co.uk/phpBB3/viewtopic.php%3Ff%3D12%
26t%3D5256%26st%3D0%26sk%3Dt%26sd%3Da+Kofi+Annan+million+children+demanding+treatment+Chernobyl+2016&hl=ru&ct&equals;clnk&cd&equals;18&gl&equals;ru).
IAEA (2005). Environmental Consequences of the Chernobyl Accident and Their Remediation: Twenty
Years of Experience. Report of the UN Chernobyl Forum Expert Group “Environment” (EGE) August
2005 (IAEA, Vienna): 280 pp. (//www-pub.iaea.org/MTCD/publications/PDF/Pub1239_web.pdf).
IAEA (2006). The Chernobyl Legacy: Health, Environment and Socio-Economic Impact and Recommendations to the Governments of Belarus, the Russian Federation and Ukraine, 2nd Rev. Edn. (IAEA,
Vienna): 50 pp. (//www.iaea.org/publications/booklets/Chernobyl/Chernobyl.pdf).
UNDP (2002). The Human Consequences of the Chernobyl Nuclear Accident: A Strategy for Recovery. A
Report Commissioned by UNDP and UNICEF with the Support of UN-OCHA and WHO (UNDP,
New York): 75 pp. (//www.chernobyl.undp.org/english/docs/Strategy%20for%20Recovery.pdf).
WHO (2006). Health Effects of the Chernobyl Accident and Special Health Care Programmes. Reportof the UN Chernobyl Forum Expert Group “Health.” B. Bennett, M. Repacholi & Zh. Carr (Eds.)(WHO, Geneva): 167 pp. (//www.who.int/ionizing_radiation/chernobyl/WHO%20Report%20on%
20Chernobyl%20Health%20Effects%20July%2006.pdf).

CHERNOBYL

Chapter I. Chernobyl Contamination:
An Overview
Vassily B. Nesterenkoa and Alexey V. YablokovbaInstitute of Radiation Safety (BELRAD), Minsk, BelarusbRussian Academy of Sciences, Moscow, Russia

Key words: Chernobyl; radioactive contamination; lead contamination; Northern
Hemisphere

4

CHERNOBYL

1. Chernobyl Contamination throughTime and Space
Alexey V. Yablokov and Vassily B. Nesterenko

Radioactive contamination from the Chernobyl meltdown spread over 40% of Europe(including Austria, Finland, Sweden, Norway, Switzerland, Romania, Great Britain,
Germany, Italy, France, Greece, Iceland, Slovenia) and wide territories in Asia (including Turkey, Georgia, Armenia, Emirates, China), northern Africa, and North America.
Nearly 400 million people resided in territories that were contaminated with radioactivity at a level higher than 4 kBq/m2 (0.11 Ci/km2 ) from April to July 1986. Nearly 5
million people (including, more than 1 million children) still live with dangerous levelsof radioactive contamination in Belarus, Ukraine, and European Russia. Claims that
the Chernobyl radioactive fallout adds “only 2%” to the global radioactive backgroundovershadows the fact that many affected territories had previously dangerously highlevels of radiation. Even if the current level is low, there was high irradiation in thefirst days and weeks after the Chernobyl catastrophe. There is no reasonable explanation for the fact that the International Atomic Energy Agency and the World HealthOrganization (Chernobyl Forum, 2005) have completely neglected the consequences ofradioactive contamination in other countries, which received more than 50% of the Chernobyl radionuclides, and addressed concerns only in Belarus, Ukraine, and European
Russia.

1.1. Radioactive Contamination

To fully understand the consequences of Chernobyl it is necessary to appreciate the scaleof the disaster. Clouds of radiation reachedheights between 1,500 and 10,000 m andspread around the globe, leaving deposits ofradionuclides and radioactive debris, primarily
in the Northern Hemisphere (Figure 1.1).
There has been some dispute over the years
as to the volume of radionuclides released whenreactor number four of the Chernobyl Nuclear
Power Plant (ChNPP) exploded, and it is critical to be aware of the fact that there continue
to be emissions. That release, even without taking the gaseous radionuclides into account, wasmany hundreds of millions of curies, a quantity
hundreds of times larger than the fallout fromthe atomic bombs dropped on Hiroshima andNagasaki.

Immediately after the explosion, and evennow, many articles report levels of radioactivity calculated by the density of thecontamination—Ci/km2 (Bq/m2 ). While theselevels form a basis for further calculations of collective and individual doses, as shown below,
such an approach is not completely valid as it
does not take into account either the ecologicalor the physical aspects of radioactive contamination, nor does it provide exact calculations ofreceived doses (see Chapter II.2).

1.2. Geographical Featuresof Contamination
Immediately after the NPP explosion, attempts began to reconstruct the radioactive
fallout picture to determine radioactive fallout distribution levels using hydrometeorological data (wind direction, rainfall, etc.) for each

Address for correspondence: Alexey V. Yablokov, Russian Academyof Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@
ecopolicy.ru

5

6

tled outside of Belarus, Ukraine, and European
Russia (Figure 1.3, Table 1.1).
1.2.1. Europe

Figure 1.1. Spatial distribution of Chernobyl radionuclides in the Northern Hemisphere 10 days after the explosion. U.S. Livermore National Laboratorymodeling (Lange et al., 1992).

subsequent day and include emissions of fuelparticles, aerosol particles, and radioactive
gases from the destroyed reactor (see, e.g.,
Izrael, 1990; Borzylov, 1991; UNSCEAR,
2000; Fairlie and Sumner, 2006). Geographic
distribution of Chernobyl radionuclides aroundthe globe is shown in Figure 1.2. It is clear thatmost of the gaseous–aerosol radionuclides set-

Figure 1.2. Geographic distribution of Chernobyl radionuclides (UNSCEAR, 1988).

According to other data (Fairlie and Sumner,
2006, table 3.6, cc. 48 & 49) Europe received
from about 68 to 89% of the gaseous–aerosolradionuclides from the Chernobyl clouds in a
distribution that was extremely nonuniform.
From April 26 through May 5, 1986, the winds
around Chernobyl varied by 360◦ , so the radioactive emissions from the mix of radionuclides varied from day to day and covered anenormous territory (Figures 1.4, 1.5, and 1.6).
Figure 1.7 is a reconstruction of only one of
the Chernobyl clouds (corresponding to No. 2
on Figure 1.4). It is important to understandthat radionuclide emissions from the burning
reactor continued until the middle of May.
The daily emissions formed several radioactive clouds, and each such cloud had its own
radionuclide composition and geography. We
do not have accurate instrumental data for
Chernobyl radionuclide contamination for allof Europe. Calculated data (averaged for 1 km2 )were published only for Cs-137 and Pu, while
Cs-137 contaminated all of the European countries, without exception (Table 1.2).
The data in Table 1.2 refer only to the distribution of Cs-137, but there were significant
quantities of many other radionuclides in theform of gases, aerosols, and “hot particles” (seebelow) widely dispersed across Europe in thefirst weeks and months following the explosion:
Cs-134, I-131, Sr-90, Te-132, and I-132. For
example, in May 1986 in Wales and in the
Cumbria area of England rainwater contained
up to 345 Bq/liter of I-132 and 150 Bq/liter Cs134 (Busby, 1995). The effective doses in May
1986 for Chernobyl radionuclides in England
were: Cs-134 and Cs-137, 27 mSv; I-131, 6
mSv; Sr-90, 0.9 mSv (Smith et al. (2000).
If the distribution of radioactivity for Cs-134
and Cs-137 corresponds to their ratio in emissions (i.e., 48 and 85 PBq, or 36 and 64%, respectively), then the proportional distribution

Yablokov & Nesterenko: Contamination through Time and Space

7

Figure 1.3. Chernobyl radioactive fallout in the Northern Hemisphere (Livermore National Laboratory data from Yablokov et al., 2006).

of the main Chernobyl radionuclides in England should be as follows [Dreicer et al., 1996;
Fairlie and Sumner, 2006, Table 3.8(i)]:Cs-137
Cs-134
I-131
Sr-90
Total

mSv
17.3
9.7
6.0
0.9
33.9

%
51.0
28.6
17.7
2.7
100

Twenty years after the Chernobyl catastrophe, many areas in Europe remaincontaminated. For example, in 2006, according
to Great Britain’s Ministry of Health 355 farms
in Wales, 11 in Scotland, and 9 in England,
pasturing more than 200,000 sheep, continue
to be dangerously contaminated with Cs-137(McSmith, 2006).
1.2.1.1. Belarus

If the proportional distribution of Chernobyl
radionuclides in England is similar to that ofother European countries (i.e., 70 PBq Cs-137
made up 51% of all the radionuclide fallout),
one can assume that the total amount of radioactive fallout in Europe is nearly 137 PBq:

Cs-137
Cs-134
I-131
Sr-90
Total
a

See Table 1.2.

%
51.0
28.6
17.7
2.7
100

PBq
70a
39
24
3.7
136.7

Practically the entire country of Belarus wascovered by the Chernobyl cloud. I-131, I-132,
and Te-132 radioisotope fallout covered theentire country (Figures 1.8 through 1.12). A
maximum level of I-131 contamination of 600
Ci/km2 was measured in the Svetlovichi village
in Gomel Province in May 1986.
Some 23% of the area of Belarus(47,000 km2 ) was contaminated by Cs-137 at alevel higher than 1 Ci/km2 (Nesterenko, 1996;
Tsalko, 2005). Until 2004, the density of Cs137 contamination exceeded 37 kBq/m2 in
41,100 km2 (Figure 1.10).

8
TABLE 1.1. Estimations of a Geographic Distribution of Chernobyl’s Cs-137, % (PBq) (Fairlie andSumner, 2006, pp. 48–49)

Belarus, Ukraine, European Russia
Other European countries
Asia
AfricaAmericaUNSCEAR, 1988;
Fairlie and Sumner,
2006, p. 48

Goldman, 1987;
Fairlie and Sumner,
2006: table 3.6.

<50
;39
8
6
0.6
100

41 (29)37 (26)21 (15)NoNo
100 (70)

Maximum levels of Cs-137 contamination
were 475 Ci/km2 in the village of Zales’ye,Braginsk District, and 500 Ci/km2 in the village of Dovliady and the Narovlja Districtof Gomel Province. The maximum radioactive contamination in the soil found in 1993
in the village of Tchudyany, Mogilev District,

UNSCEAR, 2000
34 (33)34 (33)33 (32)NoNo
100 (98)

47 (40)60 (45)NoNo
No
100 (85)

was 5,402 kBq/m2 or 145 Ci/km2 , exceeding
the precatastrophe level by a factor of 3,500(Il’yazov, 2002).
Contamination from Sr-90 has a more local character than that of Cs-137. Some 10%of the area of Belarus has levels of Sr-90 soil
contamination above 5.5 kBq/m2 , covering an

Figure 1.4. Six stages of formation of radioactive gaseous–aerosol emissions from Chernobyl from April 26 to May 4, 1986: (1) April 26, 0 hours (Greenwich time); (2) April 27,
0 hours; (3) April 27, 12.00 hours; (4) April 29, 0 hours; (5) May 2, 0 hours; (6) May 4,
12.00 hours (Borzylov, 1991). Shading indicates the main areas of the radionuclide fallout.

Yablokov & Nesterenko: Contamination through Time and Space

9

Figure 1.5. An alternative version of radioactive gaseous–aerosol distribution over Europe from April 26 to May 6, 1986 (National Belarussian Report, 2006).

area of 21,100 km2 (Figure 1.11). Soil contaminated by Pu-238, Pu-239, and Pu-240 at
levels higher than 0.37 kBq/m2 was found in
4,000 km2 , or nearly 2% of the country (Kono-

plya et al., 2006; Figure 1.12). As a whole, morethan 18,000 km2 of agricultural land or 22%
of Belarus farmland is heavily contaminated.
Of that, an area of 2,640 km2 cannot be used

10

Figure 1.6. Some of the main areas of Europe contaminated at a level higher than 1
Ci/km2 by Cs-137 as a result of the Chernobyl catastrophe. Turkey was surveyed only in partand Bulgaria, Yugoslavia, Portugal, Iceland, and Sicily were not surveyed at all (Cort andTsaturov, 1998).

for agriculture and the 1,300-km2 Polessk stateradioactive reserve near the Chernobyl NPP
is forever excluded from any economic activity owing to contamination by long half-life
isotopes.
1.2.1.2. Ukraine
Chernobyl radionuclides have contaminatedmore than a quarter of Ukraine, with Cs-137
levels higher than 1 Ci/km2 in 4.8% of thecountry (Figure 1.13).
1.2.1.3. European Russia
Until 1992 contamination in European
Russia was found in parts of 19 Russian
provinces (Table 1.3), so consideration must be
given to serious contamination in the Asian partof Russia as well.

1.2.1.4. Other European Countries
The level of Chernobyl’s Cs-137 contamination in each European country is shownin Table 1.2; some additional comments
follow.
1. BULGARIA. The primary Chernobyl radionuclides reached Bulgaria on May 1–10,
1986. There were two peaks of fallout: May
1 and 9 (Pourchet et al., 1998).
2. FINLAND. Chernobyl fallout clouds oversouthern Finland reached peak concentrations
between 15:10 and 22:10 hours on April 28,
1986.
3. FRANCE. Official Service Central deProtection Contre les Radiations Ionisantes
initially denied that the radioactive cloud
had passed over France. This is contrary
to the finding that a significant part of thecountry, especially the alpine regions, were11

Yablokov & Nesterenko: Contamination through Time and SpaceTABLE 1.2. Cs-137 Contamination of European Countries from Chernobyl (Cort and Tsaturov, 1998:
table III.1; Fairlie and Sumner, 2006: tables 3.4 and 3.5)
Portion (%)
Country
Russiaa
Belarus
UkraineFinland
Yugoslavia
SwedenNorwayBulgaria
Austria
Romania
Germany
Greece
Italy
Great Britain
PolandCzech Republic
FranceMoldova
Slovenia
Albania
Switzerland
Lithuania
Ireland
Croatia
Slovakia
Hungary
TurkeyaLatviaEstonia
Spain
Denmark
Belgium
The Netherlands
Luxembourg
Europe as a whole

PBq (kCi) Cort andTsaturov, 1998c

Fairlie andSumner, 2006dCort andTsaturov, 1998c

Fairlie andSumner, 2006d

19 (520)
15 (400)
12 (310)
3.1 (8.3)?
2.9 (79)
2.0 (53)?
1.6 (42)1.5 (41)
1.2 (32)
0.69 (19)0.57 (15)b0.53 (14)0.40 (11)0.34 (93)0.35 (9.4)
0.34 (9.2)
0.33 (8.9)?
0.27 (7.3)
0.24 (6.5)
0.21 (5.6)
0.21 (5.8)
0.18 (47)0.15 (4.1)
0.10 (2.8)
0.055 (1.5)
0.051 (1.4)
0.031 (0.83)
0.016 (0.43)
0.01 (0.26)
0.01 (0.26)
0.003 (0.08)
64 (1700)c

29
15
13
3.8
5.4
3.5
2.5
2.7
1.8
2.1
1.9
0.95
0.93
0.88
1.2
0.6
0.93
0.40
0.39
0.4
0.36
0.44
0.35
0.37
0.32
0.35
0.16
0.25
0.18
0.38
0.09
0.05
0.06
0.01
90.8e

29.7
23.0
18.0
4.80
−
4.60
3.10
−
2.40
2.40
1.80
1.10
0.90
0.83
0.63
0.54
0.55
0.53
0.52
−
0.43
0.38
0.33
0.33
0.28
0.24
0.16
0.09
0.08
0.05
0.02
0.02
0.02
<0.01
100.0

31.96
16.53
14.33
4.19
5.95
3.86
2.75
2.98
1.98
2.31
2.10
1.05
1.02
0.97
1.32
0.66
1.02
0.44
0.43
0.44
0.40
0.48
0.39
0.40
0.35
0.39
0.18
0.28
0.2
0.42
0.10
0.06
0.07
0.01
100.0

a

European Russia.
Without Sicily.
cWithout Yugoslavia, Bulgaria, Albania, Portugal, and Iceland.
dWithout Portugal and Iceland.
eIncludes nearly 20 PBq Cs-137, remaining from nuclear weapons tests before the 1970s.
bcontaminated on April 29 and 30, 1986 (seeFigure 1.5).
4. GERMANY. The scale of Chernobyl’s contamination in Germany is reflected in the factthat several shipments of powdered milk to

Africa were returned to West Germany because
they were dangerously contaminated with radiation (Brooke, 1988).
5. GREECE. Greece reported significant
fallout of several Chernobyl radionuclides

12

Figure 1.7. The path of one Chernobyl radioactive cloud across Europe from April 27 toearly May 1986 (Pakumeika and Matveenka, 1996).

including: Ag-110 m, Cs-137, and Sb-125 (Papastefanou et al., 1988a,b; see Figure 1.16).
Noting unusual contamination (see Section
1.4.1 below) is important, but it is also evidenceof the inadequacy of the available data relevant to Chernobyl contamination: where arecomparable data about radioactive Ag-110 m
contamination in other countries? Do data notexist because no one has compiled it or because this radioactive Ag contaminated only
Greece, Italy, and Scotland (Boccolini et al.,
1988; Martin et al., 1988)?
6. ITALY. There were several radioactive
plumes, but the main Chernobyl fallout cloud
passed over northern Italy on May 5, 1986.
Some 97% of the total deposition in Italy occurred between April 30 and May 7 (Spezzano
and Giacomelli, 1990).
7. POLAND. The main plume passed over
Poland around April 30, 1986, with Te-122

as the primary radionuclide. Numerous “hotparticles” were detected with a prevalence of
Ru-103 and Ru-106 (Broda, 1987). In June
1987, a 1,600-ton shipment of powdered milk
from Poland to Bangladesh showed unacceptably high levels of radioactivity (Mydans,
1987).
8. SCOTLAND. The main radioactive plume
passed Scotland between 21:00 and 23:00
hours on May 3, 1986, with the largest concentrations of Te-132, I-132, and I-131 (Martin
et al., 1988).
9. SWEDEN. The peak concentration of Cs137 in air occurred on April 28, 1986, but 99%
of Chernobyl-derived radionuclides were deposited in Sweden during a single period ofrain on May 8, 1986. Patterns of fallout related to local weather conditions: Cs-137 dominated on the coast of southern Norrland, I131 in the north and south, and Te-132 in theYablokov & Nesterenko: Contamination through Time and Space

Figure 1.8. Reconstruction of I-131 contamination of Belarus for May 10, 1986 (National
Belarussian Report, 2006).

Figure 1.9. Reconstruction of Te-132 and I-132 contamination of Belarus from April to
May 1986 (Zhuravkov and Myronov, 2005).

13

14

Figure 1.10. Reconstruction of contamination of territory of Belarus by Cs-137 for May
10, 1986 (National Belarussian Report, 2006).

central Upland area (Kresten and Chyssler,
1989; Mattson and Vesanen, 1988; Mellander,
1987).
10. UNITED KINGDOM. Official reports
grossly underestimated the Chernobyl-derived
fallout and its radiological impact on the United
Kingdom. Cs-137 deposition in Cumbria wasup to 40 times higher than originally reportedby the Ministry of Agriculture, Fisheries andFood (RADNET, 2008; Sanderson and Scott,1989).
11. YUGOSLAVIA. The main radioactive fallout occurred on May 3–5, 1986 (Juznic andFedina, 1987).
1.2.2. Asia
Up to 10% of all the Chernobyl radionuclides fell on Asia, including, basically, sometens of PBq of the first, most powerful emissions
on the first days of the catastrophe. Huge ar-eas of Asian Russia (Siberia, Far East), East andCentral China (Figure 1.14), and the Asian partof Turkey were highly contaminated. Chernobyl fallout was noted in central Asia (Imamniyazova, 2001) and in Japan (Imanaka, 1999;
Figure 1.14).
1. TRANS-CAUCASUS. Western Georgia wasespecially heavily contaminated. The averagesoil radioactivity due to Cs-137 from 1995 to2005 was 530 Bq/kg, and that figure was twice
as high in East Georgia. The combined activityof Cs-137 and Sr-90 reached 1,500 Bq/kg(Chankseliany, 2006; Chankseliany et al., 2006).
2. JAPAN. Twenty Chernobyl radionuclides
were detected in two plumes in early and late
May 1986, with the highest level in northwestern Japan and a maximum concentration on May 5. Chernobyl-derived stratospheric fallout continued until the end of 1988
(Higuchi et al., 1988; Imanaka and Koide,1986).

Yablokov & Nesterenko: Contamination through Time and Space

15

Figure 1.11. Sr-90 contamination of Belarus at the beginning of 2005 (National Belarussian Report, 2006).

There is still a high probability of small
but dangerously radioactive areas in the Caucasus; Trans-Caucasia; lower, central, and middle Asia (including Turkey, Iran, Iraq, andAfghanistan); China; and the Persian Gulf area,
continuing until the present time.
1.2.3. North America
Areas in North America were contaminatedfrom the first, most powerful explosion, which
lifted a cloud of radionuclides to a height of
more than 10 km. Some 1% of all Chernobyl radionuclides—nearly several PBq—fell
on North America.
1. CANADA. There were three waves ofChernobyl airborne radioactivity over eastern
Canada composed of: Be-7, Fe-59, Nb-95, Zr95, Ru-103, Ru-106, I-131, La-140, Ce-141,
Ce-144, Mn-54, Co-60, Zn-65, Ba-140, andCs-137. The fallout of May 6 and 14 arrived

via the Arctic, and that of May 25 and 26 via
the Pacific (Roy et al., 1988). By the official “Environmental Radioactivity in Canada” reportfor 1986 (RADNET, 2008) Chernobyl Ru-103,
Ru-106, Cs-134, and Cs-137 were consistently
measurable until about mid-June.
2. UNITED STATES. The Chernobyl plumes
crossed the Arctic within the lower troposphere and the Pacific Ocean within the
mid-troposphere, respectively. Chernobyl isotopes of Ru-103, Ru-106, Ba-140, La-140,
Zr-95, Mo-95, Ce-141, Ce-144, Cs-134, Cs136, Cs-137, I-132, and Zr-95 were detected in Alaska, Oregon, Idaho, New Jersey,
New York, Florida, Hawaii, and other states(Table 1.4).
An Associated Press release on May 15,
1986, noted “Officials in Oregon have warned
that those who use rainwater for drinking
should use other sources of water for sometime.”

16

Figure 1.12. Transuranic radionuclide contamination of Belarus in 2005 (National Belarussian Report, 2006).

1.2.4. Arctic Regions
A high level of Chernobyl contamination is found in Arctic regions. The moss
Racomitrium on Franz Josef Land contained up
to 630 Bq/kg (dry weight) of Cs-137 of which
548 Bq/kg (87%) came from the Chernobyl
fallout (Rissanen et al., 1999).
1.2.5. Northern Africa
Radionuclide fallout in northern Africa
came from the most powerful emissions on thefirst day of the catastrophe and that area has
been subject to more than 5% of all Chernobyl
releases—up to 20 PBq.
1. EGYPT. The Cs-137 to Pu-239/Pu-240 ratio in accumulated Nile River sediment is evi-

dence of significant Chernobyl contamination(Benninger et al., 1998).
1.2.6. Southern Hemisphere
In the Southern Hemisphere Cs-137 and Cs134 from Chernobyl have been found on Reunion Island in the Indian Ocean and on Tahiti
in the Pacific. The greatest concentration of
Cs-137 in the Antarctic was found near theSouth Pole in snow that fell from 1987 to 1988
(UNSCEAR, 2000).
1.3. Estimates of Primary
Chernobyl Radionuclide Emissions
The official view was that the total radionuclide emissions calculated for May 6, 1986, theYablokov & Nesterenko: Contamination through Time and Space

17

Figure 1.13. Contamination of Ukraine [Cs-137 (above) and Pu (below)] as a result of
the Chernobyl catastrophe (National Report of Ukraine, 2006).

time when most of the short-lived radionuclides
had decayed, was 50 × 106 Ci or 1.85 × 1018
Bq (Izrael, 1990, 1996). It was estimated that
3–4% of the fuel from the moment of meltdown(i.e., from 190.3 tons) was blown out of the reactor, a serious underestimation. Emissions continued after May 6, with intensity decreasingover 10 days until the graphite lining of the reactor stopped burning. Emission of radioactive

substances into the atmosphere was prolonged.
UNSCEAR (2000) estimated that the total activity of ejected radionuclides was 1.2 × 1019
Bq, including 1.2–1.7× 1018 Bq of I-131 and3.7 × 1016 Bq of Cs-137.
UNSCEAR reports (1988, 2000) containdata (comparable with emissions of I-131)
about an enormous volume of emissions of
Te-132 (half-life 78 h and decaying into

18
TABLE 1.3. Radioactive Contamination of European Russia (≥1 Ci/km2 ) as a Result of the Chernobyl Catastrophe (Yaroshinskaya, 1996)
Province
Tula
Bryansk
Oryol
RyazanKursk
Penza
KalugaBelgorod
LipetskUlyanovsk
VoronezhLeningrad
Mordova
Tambov
Tatarstan
Saratov
Nizhniy Novgorod
Chuvashiya
Smolensk
Total

Contaminatedarea, 1 × 103 km2

Population,
103

11.5
11.7
8.4
5.4
1.4
3.9
4.8
1.6
1.6
1.1
1.7
1.2
1.9
0.5
0.2
0.2
0.1
0.1
0.1
56.0

936.2
476.5
346.7
199.6
140.0
130.6
95.0
77.8
71.0
58.0
40.4
19.6
18.0
16.2
7.0a
5.2a
3.7a
1.3a
1.1a
2,644.8aAuthors’ estimation based on average population density in each province.

radioactive iodine), as well as emissions of Zr-95(half-life 64 days). According to calculations by
Vukovic (1996) there were additional emissionsof more than 0.5 × 106 Ci of Ag-110 (half-life
250 days).
Disputes concerning the amount of radionuclides released are important to estiTABLE 1.4. Data on the May 1986 Peak Concentrations of Some Nuclides in Areas of the UnitedStates (RADNET, 2008)
Date
May 5, 1986
May 5, 1986
May 7–8, 1986
May 8, 1986
May 11, 1986
May 11, 1986
May 15, 1986
May 16, 1986

Place

Radionuclide

Forks, WA
Spokane, WA
Augusta, ME
Portland, ME
Rexburg, ID
New York, NY
Chester, NJ
Cheyenne, WY

Ru-103, Cs-134
Total
Total
Total
I-131, air
Cs-137
Total
Total

Figure 1.14. Activity of Cs-137 in sedimentsfrom Dabusupao Lake (northeast of China). The peakof radioactivity of sediment at a depth of about 6 centimeters is associated with atmospheric nuclear tests,
and peaks at a depth of 1–2 centimeters, with theChernobyl fallout (Xiang, 1998).

mate the collective dose. If only about 3%of the fuel (5 tons) was discharged then the
Chernobyl catastrophe caused the world tobe contaminated with 20 kg of Pu, a quantity sufficient to contaminate a territory of
20,000 km2 forever. The half-life of Pu-239 is
24,000 years. If 30–40% of the fuel was released (Gofman, 1994; Medvedev, 1990; Sich,
1996; UNSCEAR, 2000; and others) allowing
nearly 3 × 109 Ci to escape, or 80–90% wasreleased (i.e., 7–8 × 109 Ci; see Chernousenko,
1992; Kyselev et al., 1996; Medvedev,
1991)—the manifold larger territories of theNorthern Hemisphere will be contaminatedforever. Table 1.5 shows some estimates of thetotal of the primary radionuclides emitted during the catastrophe.
All existing estimates of emitted radionuclides are rough calculations and indications
are that we will be seeing an appreciable increase in these estimates as time goes on. It is indicative that even 20 years after the catastrophe
there are new thoughts about the role of someof the radionuclides that initially were not taken
into account at all, such as Cl-36 and Te-99 withhalf-lives of nearly 30,000 years and more than
23,000 years, respectively (Fairlie and Sumner,
2006).

19

Yablokov & Nesterenko: Contamination through Time and SpaceTABLE 1.5. Some Estimates of the Amount of Primary Radionuclides Emitted from April 26 to May 20,
1986, from the Fourth Chernobyl NPP Reactor (106 Ci)
Radionuclide (half-life/full decay
time, hours, days, months, years)
I-135 (6.6 h/2.75 d)
I-133 (20.8 h/8.7 d)La-140 (40.2 h/16.7 d)
Np-239 (2.36 d/23.6 d)
Mo-99 (2.75 d/27.5 d)
Te-132 (3.26 d/32.6 d)Xe-133 (5.3 d/53 d)
I-131 (8.04 d/2.7 mo)
Ba-140 (12.8 d/4.3 mo)
Cs-136 (12.98 d/4.3 mo)Ce-141 (32.5 d/10.8 mo)
Ru-103 (39.4 d/1 y 1 mo)
Sr-89 (50.6 d/1.39 y)
Zr-95 (64.0 d/1.75 y)
Cm-242 (162.8 d/4.6 y)Ce-144 (284 d/7.8 y)
Ru-106 (367 d/10 y)
Cs-134 (2.06 y/20.6 y)
Kr-85 (10.7 y/107 y)
Pu-241 (14.7 y/147 y)
Sr-90 (28.5 y/285 y)
Cs-137 (30.1 y/301 y)
Pu-238 (86.4 y/864 y)
Pu-240 (6,553 y/65,530 y)
Pu-239 (24,100 y/241,000 y)

Nuclear Energy
Agency (1995)

Devellet al. (1995)

5.3
>4.6
∼3.1
5.3
∼0.024
∼3.1
>1.97
∼1.5
0.89
∼0.16
∼0.27
∼2.3
0.001
0.001
0.023

Guntayet al. (1996)

Several140–150
A lot of

∼1.5
25.6
>4.6
∼37.1
175.7
∼47.6
6.5

Medvedev(1991)

4.5
31
180
48
6.4
0.644a
5.3
4.5
3.1
5.3
0.024
3.1
2.0
1.5
—
0.16
0.27
l2.3
0.001
0.001
0.001

A lot of
170
>85b

—
—

c
—

45.9
5.67
27.0
175.5
32.4–45.9
4.59
5.40
4.59
2.19
4.59
0.025
3.78
0.81
1.19–1.30
0.89
0.078
0.22
1.89–2.30
0.00010.001
0.0001aCort and Tsaturov (1998).
Nesterenko (1996)—more than 100.
c
Nesterenko (1996)—total emission of Cs-136 and Cs-137 is up to 420 ×1015 Bq (1.14 × 106 Ci).
b

1.4. Ecological Featuresof Contamination
The three most important factors in connection with the Chernobyl contamination for
nature and public health are: spotty/unevendeposits of contamination, the impact of “hotparticles,” and bioaccumulation of radionuclides (also see Chapter III).
1.4.1. Uneven/Spotty Contamination
Until now the uneven/spotty distribution of
the Chernobyl radioactive fallout has attracted
too little attention. Aerogamma studies, uponwhich most maps of contamination are based,
give only average values of radioactivity for

200–400 m of a route, so small, local, highly
radioactive “hot spots” can exist without being
marked. The character of actual contamination of an area is shown on Figure 1.15. As canbe seen, a distance of 10 m can make a sharp
difference in radionuclide concentrations.

“Public health services of the French department
Vosges found out that a hog hit by one of local
hunters ‘was glowing.’ Experts, armed with supermodern equipment, conveyed a message evenmore disturbing: practically the entire mountain
where the dead animal had just run is radioactive at
a level from 12,000 to 24,000 Bq/m2 . For comparison, the European norm is 600 Bq/m2 . It was remembered that radioactive mushrooms were found20

Figure 1.15. Spotty concentration (Ci/km2 ) of Cs-137 (above) and Ce-144 (below) in
the forest bedding in the 30-km Chernobyl zone. Scale 1:600 (Tscheglov, 1999).

in these forests last autumn. The level of Cs-137
in chanterelles, boleros and stalks of mushrooms
exceeded the norm by approximately forty times. . .” (Chykin, 1997)

There is still uncertainty in regard to contamination not only by Cs-137 and Sr-90, butalso by other radionuclides, including beta andalpha emitters. Detailed mapping of territories
for the varying spectra of radioactive contamination could not be done owing to the impossibility of fast remote detection of beta and alpharadionuclides.
Typical Chernobyl hot spots measure tens
to hundreds of meters across and have levels

Yablokov & Nesterenko: Contamination through Time and Spaceof radioactivity ten times higher than the surrounding areas. The concentration density of
Cs-137 can have several different values even
within the limits of the nutrient area of a single
tree (Krasnov et al., 1997). In Poland, Ru-106
was the predominant hot spot nuclide in 1986,
although a few hot spots were due to Ba-140 or
La-140 (Rich, 1986).
Figure 1.16. shows distinct large-scale spotty
radioactive distribution of Sb, Cs, and Ag inareas of continental Greece.
1.4.2. Problem of “Hot Particles”
A fundamental complexity in estimating thelevels of Chernobyl radioactive contaminationis the problem of so-called “hot particles” or“Chernobyl dust.” When the reactor exploded,
it expelled not only gases and aerosols (the products of splitting of U (Cs-137, Sr-90, Pu, etc.),
but also particles of U fuel melted together
with other radionuclides—firm hot particles.
Near the Chernobyl NPP, heavy large particles of U and Pu dropped out. Areas of Hungary, Germany, Finland, Poland, Bulgaria, andother European countries saw hot particles withan average size of about 15 μm. Their activity mostly was determined to be (UNSCEAR,
2000) Zr-95 (half-life 35.1 days), La-140 (1.68
days), and Ce-144 (284 days). Some hot particles included beta-emitting radionuclides suchas Ru-103 and Ru-106 (39.3 and 368 days,
respectively) and Ba-140 (12.7 days). Particles
with volatile elements that included I-131, Te132, Cs-137, and Sb-126 (12.4 days) spreadover thousands of kilometers. “Liquid hot particles” were formed when radionuclides became
concentrated in raindrops:“Hot particles” were found in new apartment
houses in Kiev that were to be populated in theautumn of 1986. In April and May they stood without roofs or windows, so they absorbed a lot of aradioactive dust, which we found in concrete platesof walls and ceilings, in the carpenter’s room, under plastic covers on a floor, etc. For the most part21

these houses are occupied by staff of the Chernobyl
atomic power station. While planning occupancy
the special dosimeter commands I developed (Ithen was the deputy chief engineer of Chernobyl
NPP on radiation safety and was responsible forthe personnel in areas found to be contaminated)
carried out a radiation check on the apartments. As
a result of these measurements I sent a report to theGovernmental Commission advising of the inadmissibility of inhabiting these “dirty” apartments.
The sanitation service of the Kiev municipality . . .
answered with a dishonest letter in which it agreed
that there was radioactivity in these apartments,
but explained it away as dirt that was brought inby tenants.” (Karpan, 2007 by permission)

Radioactivity of individual hot particles
reached 10 kBq. When absorbed into the body(with water, food, or inhaled air), such particles generate high doses of radiation even if
an individual is in areas of low contamination. Fine particles (smaller than 1 μm) easily penetrate the lungs, whereas larger ones
(20–40 μm) are concentrated primarily in theupper respiratory system (Khruch et al., 1988;
Ivanov et al., 1990; IAEA, 1994). Studies concerning the peculiarities of the formation anddisintegration of hot particles, their properties,
and their impact on the health of humans andother living organisms are meager and totally
inadequate.
1.5. Changes in the Radionuclide
Dose Spectrum
To understand the impact of Chernobyl contamination on public health and the environment it is necessary to consider the essentialchanges in the radionuclide spectrum duringof the first days, weeks, months, and decades
after the Chernobyl catastrophe. The maximum level of activity from Chernobyl’s fallout in the first days and weeks, which was due
mostly to short-lived radionuclides, exceededbackground levels by more than 10,000-fold(Krishev and Ryazantsev, 2000; and many others). Today radioactive contamination is only a

22

Figure 1.16. Maps of the Chernobyl fallout: (A) Sb-124, 125; (B) Cs-137; and (C) Ag125m in areas of continental Greece (by permission of S. E. Simopoulos, National Technical
University of Athens; arcas.nuclear.ntua.gr/apache2-default/radmaps/page1.htm).

Yablokov & Nesterenko: Contamination through Time and Space

23

Figure 1.16. Continued.

small part of all the radiation emitted during
the catastrophe. Based on data from Sweden
and Finland, ratios of Cs-137 and other radionuclide fallout in the first days and weeks
allows for reconstruction of the relative valueof the various nuclides that make up the total
external dose (Figure 1.17).
During the first days after the explosion theshare of total external radiation due to Cs-137
did not exceed 4%, but the level of radiationfrom I-131, I-133, Te-129, Te-132, and several other radionuclides was hundreds of times
higher. Within the succeeding months and thefirst year after the explosion the major externalradiation was due to isotopes of Ce-141, Ce144, Ru-103, Ru-106, Zr-95, Ni-95, Cs-136,
and Np-239. Since 1987, most external radiation levels have been defined by Cs-137, Sr-90,
and Pu. Today these radionuclides, which arefound mostly in soil, seriously impact agricultural production (for details see Chapters III.9
and IV.13).

Timescales of radiation contamination canbe determined by an analysis of tooth enamel.
Such analyses were conducted by experts with
the German group “Physicians of the World for
the Prevention of Nuclear War.” They tested

Figure 1.17. Dynamics of radioisotope structureof Chernobyl’s contamination, percentage of total activity (Yablokov, 2002, from Sokolov and Krivolutsky,1998).

24

the teeth of 6,000 children and found that children born soon after the Chernobyl catastrophe had 10 times more Sr-90 in their teeth
compared with children born in 1983 (Ecologist, 2000).
Problem of Americium-241. The powerful alpha radiation emitter Am-241, formed as a result of the natural disintegration of Pu-241, isa very important factor in the increasing levels of contamination in many areas locatedup to 1,000 km from the Chernobyl NPP.
The territory contaminated by Pu today, where
the level of alpha radiation is usually low, willagain become dangerous as a result of the future disintegration of Pu-241 to Am-241 in
the ensuing tens and even hundreds of years(see also Chapter III.9). An additional dangerof Am-241 is its higher solubility and consequent mobility into ecosystems compared withPu.

2. In Ukraine in the Poles’e District of Kiev
Province, levels of Pb in the air breathedby operators of agricultural machinery
was up to 10 times or more, exceeding
maximum permissible concentrations. Increased levels of Pb were apparent in thesoil and atmosphere and in the urine andthe hair of adults and children in Kiev
soon after the explosion (Bar’yakhtar,
1995).
3. Pb contamination added to radiation
causes harm to living organisms (Petinand Synsynys, 1998). Ionizing radiation
causes biochemical oxidation of free radicals in cells. Under the influence ofheavy metals (such as Pb) these reactions
proceed especially intensively. Belarussianchildren contaminated with both Cs-137
and Pb have an increased frequency of
atrophic gastritis (Gres and Polyakova,
1997).

1.6. Lead Contamination
During operations to quench the fires in
the fourth reactor of the Chernobyl NPP, helicopters dumped 2,400 tons of Pb into the reactor (Samushia et al., 2007; UNSCEAR, 2000);
according to other data, the figure was 6,720
tons (Nesterenko, 1997). During several subsequent days, a significant part of the Pb was
spewed out into the atmosphere as a result of its
fusion, boiling, and sublimation in the burning
reactor. Moreover, Pb poisoning is dangerous
in itself, causing, for example, retardation inchildren (Ziegel and Ziegel, 1993; and manyothers).
1. Blood Pb levels in both children and adults
in Belarus have noticeably increased overthe last years (Rolevich et al., 1996). In the
Brest Province of Belarus, for example, of
213 children studied, the level of Pb was
0.109 ± 0.007 mg/liter, and about halfof these children had levels of 0.188 ±0.003 mg/liter (Petrova et al., 1996),
whereas the World Health Organization(WHO) norm for children is no more than
0.001 mg/liter.

1.7. Evaluation of Chernobyl’s
Population Doses
The International Atomic Energy Agency(IAEA) and WHO (Chernobyl Forum, 2005)
estimated a collective dose for Belarus, Ukraine,and European Russia as 55,000 persons/Sv. Byother more grounded estimates (see Fairlie andSumner, 2006) this collective dose is 216,000–
326,000 persons/Sv (or even 514,000 persons/Sv only for Belarus; National Belarussian
Report, 2006). The worldwide collective dosefrom the Chernobyl catastrophe is estimatedat 600,000–930,000 persons/Sv (Table 1.6).
However, it is now clear that these figures
for collective doses are considerably underestimated.
1.8. How Many People Were andWill Be Exposed to Chernobyl’s
Contamination?
The first official forecasts regarding thehealth impact of the Chernobyl catastrophe

25

Yablokov & Nesterenko: Contamination through Time and SpaceTABLE 1.6. Total Collective Effective Dose (persons/Sv) of Additional Irradiation from the Chernobyl Catastrophe (Fairlie and Sumner, 2006)

Belarus, Ukraine,
European Russia
Other European countries
Rest of the world
Total
a
b

U.S.
Departmentof Energya

UNSCEARb

326,000

216,000

580,000
28,000930,000

318,000
66,000600,000

Anspaugh et al. (1988).
Bennett (1995, 1996).

included only several additional cases of cancer
over a period of some 10 years. In 20 years it has
become clear that no fewer than 8 million inhabitants of Belarus, Ukraine, and Russia havebeen adversely affected (Table 1.7).
One must understand that in areas contaminated above 1 Ci/km2 (a level that undoubtedly

has statistical impact on public health) there areno fewer than 1 million children, and evacuees
and liquidators have had no fewer than 450,000
children. It is possible to estimate the numberof people living in areas subject to Chernobyl
fallout all over the world. Some 40% of Europe has been exposed to Chernobyl’s Cs-137
at a level 4–40 kBq/m2 (0.11–1.08 Ci/km2 ;see Table 1.2). Assuming that about 35% of
the European population lives in this territory(where radionuclides fell on sparsely populated
mountain areas) and counting the total European population at the end of the 1980s, we
can calculate that nearly 550 million people
are contaminated. It is possible to consider thatabout 190 million Europeans live in noticeably
contaminated areas, and nearly 15 million in
the areas where the Cs-137 contamination ishigher than 40 kBq/m2 (1.08 Ci/km2 ).
Chernobyl fallout contaminated about 8%
of Asia, 6% of Africa, and 0.6% of North

TABLE 1.7. Population Suffering from the Chernobyl Catastrophe in Belarus, Ukraine, and European
RussiaIndividuals, 103
Group
Evacuated and movedb

Lived in territory contaminated by
Cs-137 > 555 kBq|m2 (>15 Ci/km2 )Lived in territory contaminated by7
Cs-137 > 37 kBq/m2 (>1 Ci/km2 )Liquidators

Total

Country
Belarus
UkraineRussiaBelarus
UkraineRussiaBelarus
UkraineRussiaOther countries

Different sources

Cardis et al., 1996

135,000a
162,000a
52,400a

135,000——
270,000

2,000,000a
3,500,000a
2,700,000a
130,000
360,000
250,000
Not less than 90,000c
9,379,400

6,800,000——
200,000 (1986–1987)———
7,405,000a
Report of the UN Secretary General (2001). Optimization of international efforts in study, mitigation,and minimization of consequences of the Chernobyl catastrophe (http://daccessdds.un.org/doc/UNDOC/GEN/
N01/568/11/PDF/N0156811.pdf>).
b
Evacuated from city of Pripyat and the railway station at Janov: 49,614; evacuated from 6 to 11 days from 30-km
zone in Ukraine: 41,792, in Belarus: 24,725 (Total 116, 231); evacuated 1986–1987 from territories with density ofirradiation above 15 Ci/km2 —Ukraine: 70,483, Russia: 78,600, Belarus: 110,275. The total number of people forced
to leave their homes because of Chernobyl contamination was nearly 350,400.
c
Kazakhstan: 31,720 (Kaminsky, 2006), Armenia: >3,000 (Oganesyan et al., 2006), Latvia: >6,500, Lithuania:>7,000 (Oldinger, 1993). Also in Moldova, Georgia, Israel, Germany, the United States, Great Britain, and othercountries.

26
TABLE 1.8. Estimation of the Population (103 ) outside of Europe Exposed to Chernobyl Radioactive
Contamination in 1986

Continent

Share of thetotal Chernobyl
Cs-137 fallout,%

Total population,end of 1980s

Population
under fallout of
1–40 kBq/m2

Asia
AfricaAmerica
Total

8
6
0.6
14.6%

2,500,000,000
600,000,000
170,000,000
3,270,000,000

Nearly 150,000,000
Nearly 36,000,000
Nearly 10,000,000
Nearly 196,000,000

America, so by similar reasoning it appears thatoutside of Europe the total number of individuals living in areas contaminated by Chernobyl
Cs-137 at a level up to 40 kBq/m2 could reachnearly 200 million (Table 1.8).
Certainly, the calculated figures in Table 1.8
are of limited accuracy. The true number ofpeople living in 1986 in areas outside of Europe
with noticeable Chernobyl contamination can
be no fewer than 150 million and no more than
230 million. This uncertainty is caused, on the
one hand, by calculations that do not include
several short-lived radionuclides, such as I-131,
I-133, Te-132, and some others, which result inmuch higher levels of radiation than that due
to Cs-137. These include Cl-36 and Te-99 withhalf-lives of nearly 30,000 years and more than
21,000 years, respectively (Fairlie and Sumner,
2006). The latter isotopes cause very low levelsof radiation, but it will persist for many millennia. On the other hand, these calculations
are based on a uniform distribution of population, which is not a legitimate assumption.

In total, in 1986 nearly 400 million individuals (nearly 205 million in Europe and 200
million outside Europe) were exposed to radioactive contamination at a level of 4 kBq/m2(0.1 Ci/km2 ).
Other calculations of populations exposed
to Chernobyl radiation have been based on the
total collective dose. According to one such calculation (Table 1.9) the number of people who
were exposed to additional radiation at a level
higher than 2.5 × 10−2 mSv might be morethan 4.7 billion and at a level of higher than
0.4 mSv more than 605 million.

1.9. Conclusion
Most of the Chernobyl radionuclides (up to57%) fell outside of the former USSR andcaused noticeable radioactive contamination
over a large area of the world—practically theentire Northern Hemisphere.

TABLE 1.9. Population Suffering from Chernobyl Radioactive Contamination at Different Levels ofRadiation Based on Collective Doses (Fairlie, 2007)
Group

Number ofindividuals

Average individual
dose, mSv

USSR liquidatorsa
Evacuees
USSR heavily contaminated areas
USSR less contaminated areas
Other areas in Europe
Outside Europe

240,000
116,000
270,000
5,000,000
600,000,000
4,000,000,000

100
33
50
10
≥0.4
≥2.5 × 10−2aPresumably 1986–1987 (A.Y.).

Yablokov & Nesterenko: Contamination through Time and Space

Declarations that Chernobyl radioactivity
adds only 2% to the natural radioactive background on the surface of the globe obscures thefacts because this contamination exceeded thenatural background in vast areas, and in 1986
up to 600 million men, women, and children
lived in territories contaminated by Chernobyl
radionuclides at dangerous levels of more than
0.1 Ci/km2 .
Chernobyl radioactive contamination isboth dynamic and long term. The dynamic
is delineated as follows: First is the natural
disintegration of radionuclides so that levelsof radioactive contamination in the first days
and weeks after the catastrophe were thousands of times higher than those recorded 2
to 3 years later. Second is the active redistribution of radionuclides in ecosystems (for details
see Chapter III). Third is the contaminationthat will exist beyond the foreseeable future—
not less than 300 years for Cs-137 and Sr-90,
more than 200,000 years for Pu, and several
thousands of years for Am-241.
From the perspective of the 23 years thathave passed since the Chernobyl catastrophe,
it is clear that tens of millions of people, not only
in Belarus, Ukraine, and Russia, but worldwide,
will live under measurable chronic radioactive
contamination for many decades. Even if thelevel of external irradiation decreases in someareas, very serious contamination in the firstdays and weeks after the explosion together
with decades of additional and changing conditions of radioactivity will have an inevitablenegative impact on public health and nature.
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CHERNOBYL

Chapter II. Consequences of the Chernobyl
Catastrophe for Public HealthAlexey B. Nesterenko,a Vassily B. Nesterenko,a,†and Alexey V. YablokovbaInstitute of Radiation Safety (BELRAD), Minsk, BelarusbRussian Academy of Sciences, Moscow, Russia†Deceased

Key words: Chernobyl; secrecy; irradiation; health statistics

31

CHERNOBYL

2. Chernobyl’s Public Health Consequences
Some Methodological Problems
Alexey V. Yablokov

Problems complicating a full assessment of the effects from Chernobyl included official secrecy and falsification of medical records by the USSR for the first 3.5 years
after the catastrophe and the lack of reliable medical statistics in Ukraine, Belarus,
and Russia. Official data concerning the thousands of cleanup workers (Chernobyl liquidators) who worked to control the emissions are especially difficult to reconstruct.
Using criteria demanded by the International Atomic Energy Agency (IAEA), the World
Health Organization (WHO), and the United Nations Scientific Committee on the Effectsof Atomic Radiation (UNSCEAR) resulted in marked underestimates of the number offatalities and the extent and degree of sickness among those exposed to radioactive
fallout from Chernobyl. Data on exposures were absent or grossly inadequate, while
mounting indications of adverse effects became more and more apparent. Using objective information collected by scientists in the affected areas—comparisons of morbidity
and mortality in territories characterized by identical physiography, demography, andeconomy, which differed only in the levels and spectra of radioactive contamination—
revealed significant abnormalities associated with irradiation, unrelated to age orsex (e.g., stable chromosomal aberrations), as well as other genetic and nongenetic
pathologies.

The first official forecasts of the catastrophic
health consequences of the Chernobyl meltdown noted only a limited number of additional cases of cancer over the first decades.
Four years later, the same officials increased
the number of foreseeable cancer cases to several hundred (Il’in et al., 1990), at a time when
there were already 1,000 people suffering from
Chernobyl-engendered thyroid cancer. Twenty
years after the catastrophe, the official positionof the Chernobyl Forum (2006) is that about
9,000 related deaths have occurred and some
200,000 people have illnesses caused by thecatastrophe.
A more accurate number estimates nearly
400 million human beings have been exposed
Address for correspondence: Alexey V. Yablokov, Russian Academy of
Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow, Russia.Voice:+7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@ecopolicy.ru

to Chernobyl’s radioactive fallout and, formany generations, they and their descendants
will suffer the devastating consequences. Globally, adverse effects on public health will require special studies continuing far into the
future. This review concerns the health ofthe populations in the European part of theformer USSR (primarily, Ukraine, Belarus,and European Russia), for which a very large
body of scientific literature has been publishedof which but little is known in the Westernworld.
The aim of the present volume is not topresent an exhaustive analysis of all available facts concerning Chernobyl’s disastrous
effects—analyzing all of the known effects of
the Chernobyl catastrophe would fill many
full-size monographs—but rather to elucidate the known scale and spectrum of its
consequences.

32

33

Yablokov: Public Health Consequences of Chernobyl

2.1. Difficulties in Obtaining
Objective Data on theCatastrophe’s Impact
For both subjective and objective reasons, it is very difficult to draw a complete
picture of Chernobyl’s influence on publichealth.
The subjective reasons include:
1. The official secrecy that the USSR imposed on Chernobyl’s public health datain the first days after the meltdown, which
continued for more than 3 years—until
May 23, 1989, when the ban was lifted.
During those 3 years an unknown number of people died from early leukosis.
Secrecy was the norm not only in the
USSR, but in other countries as well, including France, Great Britain, and even
the United States. After the explosion,
France’s official Service Central de Protection Contre les Radiations Ionisantes(SCPRI) denied that the radioactive cloud
had passed over France (CRIIRAD, 2002)
and the U.S. Department of Agriculture
failed to disclose that dangerous levels ofChernobyl radionuclides had been foundin imported foods in 1987 and 1988. The
first public announcement of these contaminations was not made until 8 years
later (RADNET, 2008, Sect. 6 and Sect.
9, part 4).
2. The USSR’s official irreversible and intentional falsification of medical statistics
for the first 3.5 years after the catastrophe.
3. The lack of authentic medical statistics inthe USSR and after its disintegration in
1991, as well as in Ukraine, Belarus, andRussia, including health data for hundredsof thousands of people who left the contaminated territories.
4. The expressed desire of national and international official organizations and thenuclear industry to minimize the consequences of the catastrophe.

The number of persons added to the Chernobyl
state registers continues to grow, even during themost recent years, which casts doubt on the completeness and accuracy of documentation. Data
about cancer mortality and morbidity are gathered from many and various sources and are coded
without taking into account standard international
principles . . . public health data connected to theChernobyl accident are difficult to compare to official state of health statistics . . . (UNSCEAR, 2000,
Item 242, p. 49).

The situation of the liquidators is indicative.
Their total number exceeds 800,000 (see Chapter I). Within the first years after the catastrophe
it was officially forbidden to associate the diseases they were suffering from with radiation,
and, accordingly, their morbidity data were irreversibly forged until 1989.
EXAMPLES OF OFFICIAL REQUIREMENTS THATFALSIFIED LIQUIDATORS’ MORBIDITY DATA:
1. “. . . For specified persons hospitalized after exposure to ionizing radiation and having no signs
or symptoms of acute radiation sickness at thetime of release, the diagnosis shall be ‘vegetovascular dystonia.’” [From a letter from the
USSR’s First Deputy Minister of Public HealthO. Shchepin, May 21, 1986, # 02–6/83–6 toUkrainian Ministry of Public Health (cit. by V.
Boreiko, 1996, pp. 123–124).]
2. “. . . For workers involved in emergency activities who do not have signs or symptoms ofacute radiation sickness, the diagnosis of vegetovascular dystonia is identical to no change
in their state of health in connection with radiation (i.e., for all intents and purposes healthy
vis-à-vis radiation sickness). Thus the diagnosis does not exclude somatoneurological symptoms, including situational neurosis . . ..” [Froma telegram of the Chief of the Third Main Administration of the USSR’s Ministry of Health,
E. Shulzhenko, # “02 DSP”-1, dated January
4, 1987 (cit. by L. Kovalevskaya, 1995, p. 189).]
3. “(1) For remote consequences caused by ionizing radiation and a cause-and-effect relationship, it is necessary to consider: leukemia or
leukosis 5–10 years after radiation in doses exceeding 50 rad. (2) The presence of acute somatic illness and activation of chronic disease in34

persons who were involved in liquidation andwho do not have ARS (acute radiation sickness– Ed.), the effect of ionizing radiation should not
be included as a causal relationship. (3) Whenissuing certificates of illness for persons involved
in work on ChNPP who did not suffer ARS in
point “10” do not mention participation in liquidation activities or the total dose of radiationthat did not reach a degree of radiation sickness.” [From an explanatory note of the Central Military-Medical Commission of the USSR
Ministry of Defense, # 205 dated July 8, 1987,
directed by the Chief of 10th MMC Colonel V.
Bakshutov to the military registration and enlistment offices (cit. by L. Kovalevskaya, 1995,
p. 12).]

Officially it is admitted that “the full-size personal dosimeter control of liquidators in the
Chernobyl Nuclear Power Plant (ChNPP) zone
managed to be adjusted only for some months”(National Russian Report, 2001, p. 11). It was
typical to use so-called “group dosimetry” and“group assessment.” Even official medical representatives recognize that a number of Russian liquidators could have received doses seventimes (!) higher than 25 cGy, the level specified
in the Russian state register (Il’in et al., 1995).
Based on official data, this evidence makes theliquidators’ “official” dose/sickness correlation
obsolete and unreliable.
TWO EXAMPLES OF CONCEALMENT OF TRUE

Data from the official Liquidators Registers
in Russia, Ukraine, and Belarus cannot be considered reliable because the status of “liquidator” conveyed numerous privileges. We do notknow if an individual described as a “liquidator” was really directly exposed to radiation,
and we do not know the number of individuals who were in the contaminated zone for
only a brief time. At the same time, liquidators
who served at the site and were not included
in official registers are just now coming forward. Among them are the military men who
participated in the Chernobyl operations butlack documentation concerning their participation (Mityunin, 2005). For example, amongnearly 60,000 investigated military servicemen
who participated in the clean-up operations in
the Chernobyl zone, not one (!) had notice ofan excess of the then-existing “normal” reading of 25 R on his military identity card. At thesame time a survey of 1,100 male Ukrainian
military clean-up workers revealed that 37% ofthem have clinical and hematological characteristics of radiation sickness, which means thatthese men received more than 25 R exposure(Kharchenko et al., 2001). It is not by chancethat 15 years after the catastrophe up to 30% of
Russian liquidators did not have radiation dose
data on their official certificates (Zubovsky andSmirnova, 2000).

DATAON THE CATASTROPHE’S CONSEQUENCES

1. “(4) To classify information on the accident. . .
(8) To classify information on results of medical
treatment. (9) To classify information on the degree of radioactive effects on the personnel who
participated in the liquidation of the ChNPP
accident consequences.” [From the order by
the Chief of Third Main Administration of the
USSR’s Ministry of Health E. Shulzhenko concerning reinforcing the secrecy surrounding theactivities on liquidation of the consequences of
the nuclear accident in ChNPP, #U-2617-S,
June 27, 1986 (cit. by L. Kovalevskaya, 1995, p.
188).]
2. “(2) The data on patients’ records related to theaccident and accumulated in medical establishments should have a ‘limited access’ status. And
data generalized in regional and municipal sanitary control establishments, . . . on radioactive
contamination of objects, environment (including food) that exceeds maximum permissible
concentration is ‘classified’.” [From Order #30-S by Minister of Health of Ukraine A. Romanenko on May 18, 1986, about reinforcing
secrecy (cit. by N. Baranov’ska, 1996, p. 139).]

Comparison of the data received via individual biodosimetry methods (by the numberof chromosomal aberrations and by electron
paramagnetic resonance (EPR) dosimetry) has
shown that officially documented doses of radiation can be both over- and underestimatedYablokov: Public Health Consequences of Chernobyl(Elyseeva, 1991; Vinnykov et al., 2002; Maznik
et al., 2003; Chumak, 2006; and others). The
Chernobyl literature widely admits that tensof thousands of the Chernobyl liquidators who
worked in 1986–1987, were irradiated at levels of 110–130 mSv. Some individuals (and,accordingly, some groups) could have received
doses considerably different than the average.
All of the above indicates that from a strictly
methodological point of view, it is impossible tocorrelate sickness among liquidators with theformally documented levels of radiation. Official data of thyroid-dosimetric and dosimetric certification in Ukraine were revised several
times (Burlak et al., 2006).
In addition to the subjective reasons noted
above, there are at least two major objective
reasons for the difficulty in establishing thetrue scale of the catastrophe’s impact on public health. The first impediment is determining the true radioactive impact on individuals
and population groups, owing to the following
factors:•

Difficulty in reconstructing doses from theradionuclides released in the first days,
weeks, and months after the catastrophe.
Levels of radioisotopes such as I-133, I135, Te-132, and a number of other radionuclides having short half-lives were
initially hundreds and thousand of times
higher than when Cs-137 levels were subsequently measured (see Chapter I for details). Many studies revealed that the rateof unstable and stable chromosome aberrations is much higher—by up to one totwo orders of magnitude—than would be
expected if the derived exposures werecorrect (Pflugbeil and Schmitz-Feuerhake,2006).
• Difficulty in calculating the influence of“hot particles” for different radionuclides
owing to their physical and chemical properties.
• Difficulty determining levels of external
and internal radiation for the average
person and/or group because “doses”

35

were not directly measured and calculations were based on dubious assumptions.
These assumptions included an average
consumption of a set of foodstuffs by the“average” person, and an average level ofexternal irradiation owing to each of theradionuclides. As an example, all official
calculations of thyroid irradiation in Belarus were based on about 200,000 measurements done in May–June 1986 on
fewer than 130,000 persons, or only about
1.3% of the total population. All calculations for internal irradiation of millionsof Belarussians were made on the basisof a straw poll of several thousand people
concerning their consumption of milk andvegetables (Borysevich and Poplyko, 2002).
Objective reconstruction of received doses
cannot be done on the basis of such data.
• Difficulty determining the influence of the
spotty distribution of radionuclides (specific for each one; see Chapter I for details)
and, as a result, the high probability thatthe individual doses of personal radiation
are both higher and lower than “average”
doses for the territory.
• Difficulty accounting for all of the multiple
radionuclides in a territory. Sr-90, Pu, andAm can also contaminate an area counted
as contaminated solely by Cs-137. For instance, in 206 samples of breast milk, fromsix districts of the Gomel, Mogilev, andBrest provinces (Belarus), where the official level of radiation was defined only by
Sr-90 contamination, high levels of Cs-137
were also found (Zubovich et al., 1998).
• Difficulty accounting for the movement ofradionuclides from the soil to food chains,levels of contamination for each animal
species and plant cultivar. The same difficulties exist for different soil types, seasons,and climatic conditions, as well as for different years (see Chapter III of this volume
for details).
• Difficulty determining the health of individuals who have moved away fromcontaminated areas. Even considering

36

the incomplete official data for the period 1986–2000 for only Belarus, nearly
1.5 million citizens (15% of the population) changed their place of residence. For
the period 1990–2000 more than 675,000
people, or about 7% of the population
left Belarus (National Belarussian Report,
2006).
The second objective barrier to determining the true radioactive impact on individuals
and/or population groups is the inadequacyof information and, in particular, incomplete
studies of the following:•Specificity of the influence of each radionuclide on an organism, and their effect in combination with other factors in
the environment.
• Variability of populations and individuals in regard to radiosensitivity (Yablokov,
1998; and others).
• The impact of the ultralow doses (Petkau,
1980; Graeub, 1992; Burlakova, 1995;
ECRR, 2003).
• The influences of internally absorbed
radiation (Bandazhevsky et al., 1995;
Bandazhevsky, 2000).
The above are the factors that expose
the scientific fallacy in the requirements outlined by the International Atomic Energy
Agency (IAEA), the World Health Organization (WHO), and the United Nations ScientificCommittee on the Effects of Atomic Radiation (UNSCEAR) and similar official national
bodies that are associated with the nuclear industry. They demand a simple correlation—“alevel of radiation and effect”—to recognize alink to adverse health effects as a consequenceof Chernobyl’s radioactive contamination.
It is methodologically incorrect to combine
imprecisely defined ionizing radiation exposure levels for individuals or groups with themuch more accurately determined impacts on
health (increases in morbidity and mortality)
and to demand a “statistically significant correlation” as conclusive evidence of the delete-rious effects from Chernobyl. More and morecases are coming to light in which the calculated radiation dose does not correlate with observable impacts on health that are obviously
due to radiation (IFECA, 1995; Vorob’iev andShklovsky-Kodry, 1996; Adamovich et al., 1998;
Drozd, 2002; Lyubchenko, 2001; Kornev et al.,
2004; Igumnov et al., 2004; and others). All ofthese factors do not prove the absence of radiation effects but do demonstrate the inaccurate
methodology of the official IAEA, WHO, and
UNSCEAR approach.
2.2. “Scientific Protocols”
According to the Chernobyl Forum (2006),
a common objection to taking into account theenormous body of data on the public healthconsequences of the Chernobyl catastrophe in
Russia, Ukraine, and Belarus is that they werecollected without observing the “scientific protocols” that are the norms for Western science.
Usually this means that there was no statistical processing of the received data. Thus, valid
distinctions among compared parameters, as
for groups from heavily contaminated versus
those from less contaminated territories or forgroups from areas with different levels of radiation, have not demonstrated statistical significance. In the last decade—a sufficient timespan for effects to become manifest—as information has accumulated, a range of values has
been found to be within the limits of true “statistical significance.”
One of the authors has considerable experience in statistical processing of biological material—the review Variability of Mammals(Yablokov, 1976) contains thousands of data calculations of various biological parameters andcomparisons. In other reviews as Introduction into
Population Phenetics (Yablokov and Larina, 1985)
and Population Biology (Yablokov, 1987) methodical approaches were analyzed to obtain reliable
statistically significant conclusions for various
types of biological characteristics. Generalizingthese and other factors concerning statistical

Yablokov: Public Health Consequences of Chernobyl

processing of biological and epidemiological
data, it is possible to formulate four positions:
1. The calculation “reliability of distinctions
by Student,” devised about a century ago
for comparison of very small samples, is
not relevant for large-size samples. Whenthe size of the sample is comparable tothe entire assembly, average value is anexact enough parameter. Many epidemiological studies of Chernobyl contain dataon thousands of patients. In such cases theaverages show real distinctions among thecompared samples with high reliability.
2. To determine the reliability of distinctions
among many-fold divergent averages, it is
not necessary to calculate “standard errors.” For example, why calculate formal“significance of difference” among liquidators’s morbidities for 1987 and 1997
if the averages differ tenfold?
3. The full spectrum of the factors influencing one parameter or another is neverknown, so it does not have a great impact on the accuracy of the distinct factors known to the researcher. Colleagues
from the nuclear establishment have ostracized one of the authors (A. Y.) for citing
in a scientific paper the story from the famous novel Chernobyl Prayer (English translation Voices from Chernobyl, 2006) by Svetlana Aleksievich. Ms. Aleksievich writes
of a doctor seeing a lactating 70-year-old
woman in one Chernobyl village. Subsequently well-founded scientific papers
reported the connection between radiation and abnormal production of prolactin hormone, a cause of lactation inelderly women.
4. When the case analysis of individual
unique characteristics in a big data set
does not fit the calculation of average values, it is necessary to use a probability approach. In some modern epidemiologicalliterature the “case-control” approach is
popular, but it is also possible to calculate
the probability of the constellations of very37

rare cases on the basis of previously published data. Scientific research methodology will be always improved upon, andtoday’s “scientific protocols” with, for example, “confidence intervals” and “casecontrol,” are not perfect.
It is correct and justified for the whole ofsociety to analyze the consequences of thelargest-scale catastrophe in history and to use
the enormous database collected by thousandsof experts in the radioactively contaminatedterritories, despite some data not being in
the form of Western scientific protocols. This
database must be used because it is impossible to collect other data after the fact. The
doctors and scientists who collected such data
were, first of all, trying to help the victims,
and, second, owing to the lack of time andresources, not always able to offer their findings for publication. It is indicative that manyof the medical/epidemiological conferences inBelarus, Ukraine, and Russia on Chernobyl
problems officially were termed “scientific andpractical” conferences. Academic theses andabstracts from these conferences were sometimes unique sources of information resulting
from the examination of hundreds of thousandsof afflicted individuals. Although the catastrophe is quickly and widely being ignored, this information must be made available to the world.
Some very important data that were released
during press conferences and never presented
in any scientific paper are cited in this volume.
Mortality and morbidity are unquestionably
higher among the medical experts who worked
selflessly in the contaminated territories andwere subject to additional radiation, including
exposure to radioactive isotopes from contaminated patients. Many of these doctors and scientists died prematurely, which is one more reason that the medical results from Chernobyl
were never published.
The data presented at the numerous scientifically practical Chernobyl conferences inBelarus, Ukraine, and Russia from 1986 to
1999 were briefly reported in departmental

38

periodic journals and magazines and in various
collections of papers (“sborniks”), but it is impossible to collect them again. We must reject thecriticism of “mismatching scientific protocols,”
and search for ways to extract the valuable objective information from these data.
In November 2006 the German Federal
Committee on Ionizing Radiation organized
the BfS-Workshop on Chernobyl Health Consequences in Nuremberg. It was a rare opportunity for experts with differing approaches tohave open and in-depth discussions and analyze
the public health consequences of the catastrophe. One conclusion reached during this meeting is especially important for the past Chernobyl material: it is reasonable to doubt data
lacking Western scientific protocols only whenstudies using the same or similar material diverge. From both scientific and social-ethicalpoints of view, we cannot refuse to discuss datathat were acquired in the absence of strict scientific protocols.
2.3. Dismissing the Impactof Chernobyl Radionuclides
Is a Fallacy
Natural ionizing radiation has always been
an element of life on Earth. Indeed, it is
one of the main sources of on-going genetic
mutations—the basis for natural selection andall evolutionary processes. All life on Earth—humans included—evolved and adapted in thepresence of this natural background radiation.
Some have estimated that “the fallout from
Chernobyl adds only about 2% to the global
radioactive background.” This “only” 2% mistakenly looks trivial: for many populations in
the Northern Hemisphere the Chernobyl doses
could be many times higher compared with thenatural background, whereas for others (mostly
in the Southern Hemisphere) it can be close to
zero. Averaging Chernobyl doses globally is likeaveraging the temperature of hospital patients.
Another argument is that there are many
places around of the world where the naturalradioactive background is many times greaterthan the average Chernobyl fallouts and as humans successfully inhabit such areas, the Chernobyl radioactive fallout is not so significant.
Let us discuss this argument in detail. Humans
have a similar level of individual variation of radiosensitivity as do voles and dogs: 10–12% of
humans have lower (and about 10–14% havea higher one) individual radiosensitivity thaneveryone else (Yablokov, 1998, 2002). Experiments on mammalian radiosensitivity carriedout on voles showed that it requires strong selection for about 20 generations to establish
a less radiosensitive population (Il’enko andKrapivko, 1988). If what is true for the experimental vole populations is also true forhumans in Chernobyl contaminated areas, itmeans that in 400 years (20 human generations) the local populations in the Chernobylcontaminated areas can be less radiosensitive
than they are today. Will individuals with reduced radioresistance agree that their progeny
will be the first to be eliminated from populations?
One physical analogy can illustrate the importance of even the smallest additional load ofradioactivity: only a few drops of water added
to a glass filled to the brim are needed to initiate a flow. The same few drops can initiate thesame overflow when it is a barrel that is filled tothe brim rather than a glass. Natural radioactive background may be as small as a glass oras big as a barrel. Irrespective of its volume, we
simply do not know when only a small amountof additional Chernobyl radiation will cause an
overflow of damage and irreversible change inthe health of humans and in nature.
All of the above reasoning makes it clear that
we cannot ignore the Chernobyl irradiation,even if it is “only” 2% of the world’s averagebackground radiation.
2.4. Determining the Impact of theChernobyl Catastrophe on Public
HealthIt is clear that various radionuclides caused
radiogenic diseases owing to both internal and39

Yablokov: Public Health Consequences of Chernobyl

external radiation. There are several ways todetermine the influence of such radiation:•

Compare morbidity and mortality andsuch issues as students’ performance indifferent territories identical in environmental, social, and economic features, butdiffering in the level of radioactive contamination (Almond et al., 2007). This is
the most usual approach in the Chernobyl
studies.
• Compare the health of the same individuals (or genetically close relatives—parents,
children, brothers, and sisters) before andafter irradiation using health indices that
do not reflect age and sex differences, forexample, stable chromosomal aberrations.
• Compare the characteristics, mostly morbidity, for groups with different levels of incorporated radionuclides. In the first few
years after the catastrophe, for 80–90% of
the population, the dose of internal radiation was mostly due to Cs-137; thus
for those not contaminated with other radionuclides, comparison of diseases in people with different levels of absorbed Cs-137
will give objective results of its influence. As
demonstrated by the work of the BELRAD
Institute (Minsk), this method is especiallyeffective for children born after the catastrophe (see Chapter IV for details).
• Document the aggregation of clusters ofrare diseases in space and time and compare them with those in contaminated territories (e.g., study on the specific leukoses
in the Russian Bryansk Province; Osechinsky et al., 1998).
• Document the pathological changes inparticular organs and subsequent diseases
and mortality with the levels of incorporated radionuclides, for instance, in hearttissue in Belarus’ Gomel Province (Bandazhevski, 2000).
It is methodologically flawed for some specialists to emphasize “absence of proof” andinsist on “statistically significant” correlation
between population doses and adverse healtheffects. Exact calculations of population doseand dose rate are practically impossible because
data were not accurately collected at the time.
If we truly want to understand and estimate thehealth impact of the Chernobyl catastrophe ina methodologically correct manner, it will bedemonstrated in populations or intrapopulation group differences varying by radioactive
levels in the contaminated territories where theterritories or subgroups are uniform in otherrespects.
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CHERNOBYL

3. General Morbidity, Impairment, andDisability after the Chernobyl Catastrophe
Alexey V. Yablokov
In all cases when comparing the territories heavily contaminated by Chernobyl’s radionuclides with less contaminated areas that are characterized by a similar economy,
demography, and environment, there is a marked increase in general morbidity in theformer. Increased numbers of sick and weak newborns were found in the heavily contaminated territories in Belarus, Ukraine, and European Russia.

There is no threshold for ionizing radiation’s
impact on health. The explosion of the fourth
reactor of the Chernobyl Nuclear Power Plant(NPP) dispersed an enormous amount of radionuclides (see Chapter I for details). Even thesmallest excess of radiation over that of natural
background will statistically (stochastically) affect the health of exposed individuals or theirdescendants, sooner or later. Changes in general morbidity were among the first stochastic
effects of the Chernobyl irradiation.
In all cases when territories heavily contaminated by Chernobyl radionuclides arecompared with less contaminated areas thatare similar in ethnography, economy, demography, and environment, there is increased
morbidity in the more contaminated territories, increased numbers of weak newborns,
and increased impairment and disability. The
data on morbidity included in this chapter
are only a few examples from many similar
studies.
3.1. Belarus
1. The general morbidity of children noticeably increased in the heavily contaminated territories. This includes deaths from common
Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

as well as rare illnesses (Nesterenko et al.,1993).
2. According to data from the Belarussian Ministry of Public Health, just before
the catastrophe (in 1985), 90% of children
were considered “practically healthy.” By 2000
fewer than 20% were considered so, and in
the most contaminated Gomel Province, fewer
than 10% of children were well (Nesterenko,
2004).
3. From 1986 to 1994 the overall death rate
for newborns was 9.5%. The largest increase(up to 205%), found in the most contaminatedGomel Province (Dzykovich et al., 1996), wasdue primarily to disease among the growing
number of premature infants.
4. The number of children with impaired
physical development increased in the heavily
contaminated territories (Sharapov, 2001).
5. Children from areas with contaminationlevels of 15–40 Ci/km2 who were newborn
to 4 years old at the time of the catastrophe have significantly more illnesses than thosefrom places with contamination levels of 5–
15 Ci/km2 (Kul’kova et al., 1996).
6. In 1993, only 9.5% of children (0 to 4
years old at the time of the catastrophe) were
healthy in areas within the Kormyansk andChechersk districts of Gomel Province, where
soil Cs-137 levels were higher than 5 Ci/km2 .
Some 37% of the children there suffer fromchronic diseases. The annual increase in disease (per 1,000, for 16 classes of illnesses) in the

42

43

Yablokov: Morbidity, Impairment, and Disability after Chernobyl

TABLE 3.1. Radioactive and Heavy Metal Contamination in Children from the Heavily and Less Contaminated Areas (Arinchin et al., 2002)
Heavily contaminated: 73 boys,
60 girls, avg. age 10.6 years

mSv
Pb, urine, mg/literCd, urine, mg/literHg, urine, mg/liter∗

Less contaminated: 101 boys,
85 girls, avg. age 9.5 years

First survey (a)Three years later (b)First survey (c)Three years later (d)

0.77
0.040
0.035
0.031

0.81
∗
0.020
0.025
0.021∗

0.02∗∗
0.017∗∗
0.02∗∗
0.022∗∗

0.03∗∗∗
0.03∗
0.015
0.019

b-a, d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).

heavily contaminated areas reached 102–130
cases, which was considerably higher than forless contaminated territories (Gutkovsky et al.,
1995; Blet’ko et al., 1995).
7. In the 8 years after the catastrophe, inthe heavily contaminated Luninetsk District,
Brest Province, illnesses per 1,000 children increased 3.5 times—1986–1988: 166.6; 1989–
1991: 337.3; 1992–1994: 610.7 (Voronetsky,
1995).
8. For children of the Stolinsk District, Brest
Province, who were radiated in utero from ambient Cs-137 levels up to 15 Ci/km2 , morbidity
was significantly higher for the primary classesof illnesses 10 years later. Disease diagnoses
were manifest at ages 6 to 7 years (Sychik andStozharov, 1999).
9. The rates of both premature neonates andsmall-for-gestational-age babies in Belarus as awhole were considerably higher in the more radioactive contaminated territories for 10 years
following the catastrophe (Tsimlyakova andLavrent’eva, 1996).
10. Newborns whose mothers had been
evacuated from a zone of the strict control(≥15 Ci/km2 ) had a statistically significant
longer body, but a smaller head and a smaller
thorax circumference (Akulich and Gerasymovich, 1993).
11. In the Vetca, Narovly, and Hoyniky districts of Gomel Province and the Kalinkovich
District of Mogilev Province, spontaneousabortions and miscarriages and the numbers of
low-birth-weight newborns were significantly

higher in the heavily contaminated territories(Izhevsky and Meshkov, 1998).
12. Table 3.1 shows the results of two groupsof children from the heavily and less contaminated territories surveyed for the years from1995 to 2001. The state of their health was
obtained by subjective (self-estimation) and objective (based on clinical observations) studies.
Each child was followed for 3 years, and individual contamination determined by measuring the level of incorporated radionuclides (using an individual radioactivity counter) and thelevels of Pb and other heavy metals. Data from
Table 3.1 show that within groups the levelof radioactive contamination did not change
statistically over 3 years, whereas heavy metals levels were slightly reduced, with the exception of the Pb level, which increased incontrols.
13. Table 3.2 shows the results of children’s
self-estimation of health. It is clear that children living in the heavily contaminated areas complain more often of various illnesses.
The number of complaints in the group living
in heavily contaminated areas was noticeably
greater than in less contaminated places. Although the number of complaints increased inboth the heavily contaminated and the less contaminated groups after 3 years of observation,
most of the parameters were higher among theheavily contaminated.
Data in Table 3.3 show that children living
in heavily contaminated areas differed noticeably from those in less contaminated places for44
TABLE 3.2. Frequency of Complaints (%) on State of Health—Same Children as Table 3.1 (Arinchin
et al., 2002)
Heavily contaminated areas
First survey
Complaints of state of health
Weakness
Dizziness
Headache
Fainting
Nose bleeds
FatigueHeart arrhythmias
Stomach pain
Vomiting
HeartburnLoss of appetite
Allergy∗Three years later

72.2
31.6
12.8
37.6
0.8
2.3
27.1
1.5
51.9
9.8
1.5
9.0
1.5

Less contaminated areas
First survey
∗∗

78.9
28.6
17.3
45.1
2.3
3.8
23.3
18.8∗
64.7∗
15.8
7.5∗
14.3
3.0

45.7
11.9∗∗
4.9∗∗
20.7∗∗
0
0.5
8.2∗∗
0.5
21.2∗∗
2.2∗∗
1.6
1.1∗∗
0.5

Three years later
66.1∗ , ∗∗∗24.7∗
5.8∗∗∗
25.9∗∗∗
01.2
17.2∗
0.8∗,∗∗∗
44.3∗,∗∗∗
12.6∗
5.8∗
10.3∗
5.8∗

b-a; d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).

practically all diseases in both the first and thesecond survey.
The findings in both Table 3.2 and Table 3.3
give a convincing picture of sharply worsening
health for children in the heavily contaminatedareas. The authors of this research defined
this condition as “ecological disadaptation syndrome” which may be another definitive Chernobyl effect (Gres’ and Arinchin, 2001).
14. According to official statistics in 1993–
1994 primary morbidity was significantly
higher in territories with Cs-137 levels above
15 Ci/km2 (Kozhunov et al., 1996).

15. Primary invalidism in contaminated territories of Belarus noticeably increased after 1993, especially during 1997 and 1998
(Figure 3.1).
16. The number of invalids was noticeably higher in the more contaminated Gomel
and Mogilev provinces than in the country
as a whole. In the Gomel Province the relative number of invalids was higher, but in
Mogilev Province there were more sick children (Kozhunov et al., 1996).
17. According to official data (Medical
Consequences, 2003) morbidity of Belarus

TABLE 3.3. Frequency of Clinical Syndromes and Diagnoses (%)—Same Children as in Tables 3.1 and
3.2 (Arinchin et al., 2002)
Heavily contaminated areas
Syndrome/diagnosis
Chronic gastroenteric pathology
Including chronic duodenitis
Including chronic gastroduodenitis
Gallbladder inflammation
Vascular dystonia and heart syndrome
Asthenia-neurosis
Tonsil hypertrophy and chronic tonsillitis
Tooth caries
Chronic periodontitis∗

Lees contaminated areas

First survey

Three years laterFirst survey

Three years later

44.2
6.2
17.1
43.4
67.9
20.2
11.1
58.9
6.8

36.4
4.7
39.5∗
34.1
73.7
16.9
9.2
59.4
2.4

31.9
1.5
11.6
17.4∗∗
40.3∗∗
7.5∗∗
13.6
42.6∗∗
0∗∗

32.9
1.4
28.7∗
12.6∗∗∗
52.2∗,∗∗∗
11.3
17.2∗∗∗
37.3∗∗∗
0.6

b-a; d-c (P < 0.05); ∗∗ c-a (P < 0.05); ∗∗∗ d-b (P < 0.05).

Yablokov: Morbidity, Impairment, and Disability after Chernobyl

Figure 3.1. Dynamics of primary invalidism
in Belarus that is officially connected with thecatastrophe in heavily (top curve) and less contaminated provinces (Sosnovskaya, 2006).

liquidators 1986–1987 was significantly higher
than for a similarly aged group. The annual disease rate among this group of liquidators was
up to eight times higher than for the adult population of Belarus as a whole (Antypova et al.,1997).
3.2. Ukraine
1. For the first 10 years after the catastrophe, general morbidity in Ukrainian children
increased sixfold (TASS, 1998) followed by aslight reduction, but 15 years after the catastrophe it was 2.9 times higher than in 1986
(Table 3.4).
2. In 1988, there was no indication of significant differences in general morbidity amongchildren living in heavily contaminated versus
less contaminated areas, but comparison of thesame groups in 1995 showed that morbidity
was significantly higher in the highly contamTABLE 3.4. Primary and General Morbidity ofChildren (0 to 14 Years) in the Heavily Contaminated Territories of Ukraine, per 1,000 (Grodzinsky, 1999; Moskalenko, 2003; Horishna, 2005)
Year

Primary
morbidity

Generalmorbidity

1987
1994
2001
2004

455
1,139
n/a
1,423 (1384a )

787
1,652
2,285
n/a

a

By Stepanova (2006).

45

inated areas (Baida and Zhirnosecova, 1998;
Law of Ukraine, 2006).
3. Children radiated in utero had lower birthweight and more diseases during the first yearof life as well as irregularities in their physical development (Stepanova and Davydenko,
1995; Zakrevsky et al., 1993; Zapesochny et al.,
1995; Ushakov et al., 1997; Horishna, 2005).
4. From 1997 to 2005 the number of the“practically healthy” children in heavily contaminated areas decreased more than sixfold—from 3.2 to 0.5% (Horishna, 2005).
5. There was appreciably retarded growthin children from 5 to 12 years of age at thetime of the survey in the heavily contaminatedterritories (Arabskaya, 2001).
6. In 1999 there were fourfold more sickchildren in contaminated territories than the
average of such children in Ukraine (Prysyazhnyuk et al., 2002).
7. At the beginning of 2005 the percentage of invalid children in contaminated territories was more than fourfold that of theaverage among children in other populations(Omelyanets, 2006).
8. Among 252 children in contaminated territories officially recognized as invalids in 2004,
160 had congenital malformations and 47 werecancer victims (Law of Ukraine, 2006).
9. From 1987 to 1989, it was typical forchildren from heavily contaminated territories
to suffer from functional disturbances of various organ systems, indicative of hormonal andimmune imbalance. By 1996 those functional
disturbances had become chronic pathologicalprocesses with long-term relapses that were relatively resistant to treatment (Stepanova et al.,1998).
10. In spite of the intensive social and medical programs in place from 1986 to 2003, thenumber (percentage) of “practically healthy”
children in affected territories decreased 3.7
times (from 27.5 to 7.2%), and the number(percentage) of “chronically ill” children increased from 8.4% in 1986–1987 to 77.8% in2003 (Figure 3.2). The percent of children withchronic diseases increased steadily—from 8.4%

46

Figure 3.2. Number (percentage) of “practically
healthy” children (1) and those with “chronic pathologies” (2) in affected territories in Ukraine from 1987
to 2003 (Stepanova, 2006a).

in 1986–1987 to 77.8% in 2004 (Stepanova,
2006a). At the same time in less contaminatedareas the percentage of healthy children has
been constant during the last 20 years—up to
30% (Burlak et al., 2006).
11. In Ukraine in the 15 to 18 years after thecatastrophe there has been a steady increase in
the numbers of invalid children: 3.1 (per 1,000)
in 2000, 4.0 in 2002, 4.5 in 2003, and 4.57 in
2004 (Stepanova, 2006a; Figure 3.3).
12. The level of general morbidity amongevacuee children increased 1.4 times from 1987
to 1992 (from 1,224 to 1,665 per 1,000). The
prevalence of diseases for this period rose morethan double (1,425 up to 3,046). General morbidity increased 1.5 to 2.4 times in the contaminated territories from the period before thecatastrophe until 1992. At the same time, acrossthe whole of Ukraine child morbidity showed a

Figure 3.3. Number of invalids (per 1,000)
among children in Ukraine from 1987 to 2003
(Stepanova, 2006a).

marked increase (Lukyanova et al., 1995). This
trend is continuing: 455.4 per 1,000 in 1987;
866.5 in 1990; 1,160.9 in 1995; 1,367.2 in 2000;
and 1,422.9 in 2004 (Stepanova, 2006b).
13. After the catastrophe the number (percentage) of “practically healthy” children incontaminated territories declined markedly
and the number of sick children significantly
increased (Table 3.5).
14. According to annual surveys during theperiod from 1988 to 2005 there were severalfold fewer children of liquidators considered“practically healthy” than were found in thecontrol group (2.6–9.2% compared with 18.6–
24.6%); furthermore these liquidators’ children
were statistically significantly taller and more
overweight (Kondrashova et al., 2006).
15. Children in contaminated territories
were undersized and had low body weight(Kondrashova et al., 2006).
16. In the years from 1988 to 2002, among
adult evacuees the number of “healthy” fell
from 68 to 22% and the number “chronicallyill” rose from 32 to 77% (National Ukrainian
Report, 2006).
17. Morbidity among adults and teenagers in
the heavily contaminated territories increased
fourfold: from 137.2 per 1,000 in 1987 to 573.2
in 2004 (Horishna, 2005).
18. In 1991 the prevailing primary physical disabilities in the contaminated territories
were due to circulatory problems (39.0%) anddiseases of the nervous system (32.3%). Since
2001 the primary disability is neoplasm (53.3%
in 2005). For the period 1992 to 2005 disability
due to neoplasm increased nearly fourfold. The
current second set of primary disabilities in thecontaminated territories is due to circulatory
disease (32.5% in 2005; Table 3.6).
19. According to official Ukrainian data, atthe beginning of 2005 there were 148,199 people whose invalidism resulted from the Chernobyl catastrophe; among them were 3,326
children (Ipatov et al., 2006).
20. From 1988 to 1997 increased morbidity
related to radiation levels was more apparent
in the heavily contaminated territories: up to47

Yablokov: Morbidity, Impairment, and Disability after Chernobyl

TABLE 3.5. Children’s Health (percent in each healthy group) in Contaminated Territories in Ukraine,
1986–1991 (Luk’yanova et al., 1995)
Health group

1986

1987

1988

1989

1990

1991

First (healthy)
SecondThird
Fourth

56.6
34.2
8.4
0.8

50.9
39.1
8.9
1.1

54.9
34.7
9.2
1.2

39.9
41.7
16.8
1.6

25.9
29.3
43.1
1.7

19.5
28.0
50.2
2.3

4.2 times in a zone with more than 15 Ci/km2 ,up to 2.3 times in a zone with 5–15 Ci/km2 ,and up to 1.4 times in a zone with 1–5 Ci/km2(Prysyazhnyuk et al., 2002).
21. During the period from 1988 to 2004
the number of liquidators who were healthy
decreased 12.8 times: from 67.6 to 5.3%, andthe number with chronic illnesses increased 6.2
times: from 12.8 to 81.4% (National Ukrainian
Report, 2006; Law of the Ukraine, 2006).
22. Among adult evacuees the occurrenceof nonmalignant diseases increased 4.8 times(from 632 to 3,037 per 10,000) from 1988 to
2002. Beginning in 1991–1992 the occurrence
and prevalence of these diseases was above theaverage for the country (Figure 3.4).
23. From 1988 to 2002 physical disabilities
among adult evacuees increased 42-fold (from4.6 to 193 per 1,000; National Ukrainian Report, 2006).
24. From 1988 to 2003 disabilities amongliquidators increased 76-fold (from 2.7 to 206
per 1,000; Buzunov et al., 2006).
25. From 1988 to 1999 primary morbidity
among the populations in the contaminatedterritories doubled (from 621 to 1,276 andfrom 310 to 746 per 1,000). Beginning in 1993
these parameters have continually exceeded the
Ukrainian norms (Prysyazhnyuk et al., 2002;

National Ukrainian Report, 2006) and are still
increasing (Tables 3.7 and 3.8).
26. In the heavily contaminated districtsof Chernygov Province, the general morbidity
significantly exceeded that in areas with lesscontamination; the general morbidity for theentire province was significantly higher 10 years
after the catastrophe as compared with 10 years
before (Donets, 2005).
27. The general morbidity of Ukrainian liquidators increased 3.5 times in the 10 years following the catastrophe (Serdyuk and Bobyleva,
1998).
28. Typical complaints in the contaminatedterritories in the first year after the catastrophe
included rapidly developing fatigue (59.6%),
headache (65.5%), blood pressure instability(37.8%), abnormal dreaming (37.6%), andaching joints (30.2%) (Buzunov et al., 1995).

TABLE 3.6. Primary Diseases (%) Resulting in Invalidism Connected with the Chernobyl Catastrophe,
1992 to 2005 (Ipatov et al., 2006)
Illness

1992

2001

2005

Neoplasms
Nervous system diseases
Circulatory diseases

8.3
40.9
30.6

43.0
4.5
41.0

53.3
4.5
32.5

Figure 3.4. Prevalence and occurrence of nonmalignant diseases among adult evacuees and the
population of Ukraine from 1988 to 2002 (National
Ukrainian Report, 2006).

48
TABLE 3.7. Percent of “Practically Healthy” Individuals in Three Categories of Chernobyl Victims
in Ukraine, 1987–1994 (Grodzinsky, 1999)
Year

Liquidators

Evacuees

Children born toirradiated parents

1987
1988
1989
1990
1991
1992
1993
1994

82
73
66
58
43
34
25
19

59
48
38
29
25
20
16
18

86
78
72
62
53
45
38
26

29. Since 1987 the number of liquidators in
the category of “ill” has consistently increased:
18, 27, 34, 42, 57, 64, 75, to 81% (Grodzinsky,1999). In the 18 years after the catastrophe thenumber of “sick” liquidators exceeded 94%. In
2003, some 99.9% of the liquidators were officially “sick” in Kiev; 96.5% in Sumy Province
were sick and 96% in Donetsk Province (LIGA,
2004; Lubensky, 2004).
30. For the period from 1988 to 1994 there
was a manifold increase in primary disabilities (invalidism) among liquidators and evacuees, which exceeded the Ukrainian norms(Table 3.9).
31. Disability among liquidators began toincrease sharply from 1991 and by the year
2003 had risen tenfold (Figure 3.5).

TABLE 3.9. Primary Invalidism (per 1, 000) in
Ukraine, 1987–1994 (Grodzinsky, 1999)
Year

Liquidators

Evacuees

Ukraine

1987
1994

9.6
23.2

2.1
9.5

0.5
0.9

during the 10 years after the catastrophe (Tsyb,
1996).
2. Children from radioactive contaminatedprovinces became ill much more often thanchildren in “clean” regions. The greatest differences in morbidity are expressed in the classof illness labeled “symptoms, phenomena, andinexact designated conditions” (Kulakov et al.,1997).
3. From 1995–1998 the annual prevalence of
all registered diseases of children in the southwest districts of Bryansk Province (Cs-137 > 5
Ci/km2 ), was 1.5–3.3 times the provincial level
as well as the level across Russia (Fetysov, 1999;
Kuiyshev et al., 2001). In 2004 childhood morbidity in these districts was double the averagefor the province (Sergeeva et al., 2005).
4. Childhood morbidity in the contaminateddistricts of Kaluga Province 15 years after
the catastrophe was noticeably higher (Ignatov
et al., 2001).

3.3. Russia
1. The total measure of the “health of the
population” (the sum of invalidism and morbidity) in the Russian part of the European
Chernobyl territories worsened up to threefold
TABLE 3.8. Morbidity (per 1,000) in Radioactive
Contaminated Territories of Ukraine (Grodzinsky,
1999; Law of Ukraine, 2006)
Year

Adults and teenagers

1987
1994
2004

421.0
1,255.9
2,097.8

Figure 3.5. Invalidism as a result of nonmalignant diseases in Ukrainian liquidators (1986—1987)
from 1988 to 2003 (National Ukrainian Report,
2006).

49

Yablokov: Morbidity, Impairment, and Disability after Chernobyl

TABLE 3.10. Initially Diagnosed Children’s Morbidity (M ± m per 1,000) in the Contaminated Districtsof Kaluga Province, 1981–2000 (Tsyb et al., 2006)
Districts

1981–1985

1986–1990

1991–1995

1996–2000

Three heavily contaminatedThree less contaminated
Province, total

128.2 ± 3.3
130.0 ± 6.4∗
81.5 ± 6.3

198.6 ± 10.8∗∗
171.6 ± 9.0∗
100.4 ± 5.6

253.1 ± 64.4∗∗
176.3 ± 6.5∗
121.7 ± 3.2

130.1 ± 8.5
108.9 ± 16.8
177.1 ± 10.0∗
Significantly different from province’s average; ∗∗ significantly different from province’s average and from the period
before the catastrophe.

5. Initially diagnosed childhood illnesses
measured in 5-year periods for the years from1981 to 2000 show an increase in the first two
decades after the catastrophe (Table 3.10).
6. The frequency of spontaneous abortions
and miscarriages and the number of newborns
with low birth weight were higher in the morecontaminated Klintsy and Novozybkov districtsof Bryansk Province (Izhevsky and Meshkov,
1998).
7. The number of low-birth-weight children
in the contaminated territories was more than
43%; and the risk of birth of a sick child in thisarea was more than twofold compared with acontrol group: 66.4 ± 4.3% vs. 31.8 ± 2.8%
(Lyaginskaya et al., 2002).
8. Children’s disability in all of Bryansk
Province in 1998–1999 was twice that of threeof the most contaminated districts: 352 vs. 174
per 1,000 (average for Russia, 161; Komogortseva, 2006).
9. The general morbidity of adults in 1995–
1998 in the districts with Cs-137 contaminationof more than 5 Ci/km2 was noticeably higher
than in Bryansk Province as a whole (Fetysov,
1999; Kukishev et al., 2001).
10. The general morbidity of the Russian liquidators (3,882 surveyed) who were “under theage of 30” at the time of the catastrophe increased threefold over the next 15 years; in thegroup “31–40 years of age” the highest morbidity occurred 8 to 9 years after the catastrophe(Karamullin et al., 2004).
11. The morbidity of liquidators exceeds thatof the rest of the Russian population (Byryukov
et al., 2001).

12. In Bryansk Province there was a tendency
toward increased general morbidity in liquidators from 1995 to 1998 (from 1,506 to 2,140
per 1,000; Fetysov, 1999).
13. All the Russian liquidators, mostly youngmen, were initially healthy. Within 5 years after
the catastrophe 30% of them were officiallyrecognized as “sick”; 10 years after fewer than
9% of them were considered “healthy,” andafter 16 years, only up to 2% were “healthy”(Table 3.11).
14. The total morbidity owing to all classesof illnesses for the Russian liquidators in
1993–1996 was about 1.5 times above thatfor corresponding groups in the population(Kudryashov, 2001; Ivanov et al., 2004).
15. The number of diseases diagnosed ineach liquidator has increased: up until 1991
each liquidator had an average of 2.8 diseases; in 1995, 3.5 diseases; and in 1999,
5.0 diseases (Lyubchenko and Agal’tsov, 2001;
Lyubchenko, 2001).
16. Invalidism among liquidators was apparent 2 years after the catastrophe and increased
torrentially (Table 3.12).

TABLE 3.11. State of Health of Russian Liquidators: Percent Officially Recognized as “Sick ”(Ivanov et al., 2004; Prybylova et al., 2004)
Years after the catastrophe
0
5
10
16

Percent “sick”
0
30
90–92
98–99

50
TABLE 3.12. Disability in Liquidators (%) Compared to Calculated Radiation Doses, 1990–1993(Ryabzev, 2008)
Disabled (%)
Year

0–5 cGy

5–20 cGy>20 cGy

1990
1991
1992
1993

6.0
12.5
28.6
43.5

10.3
21.4
50.1
74.0

17.3
31.1
57.6
84.7

17. In 1995 the level of disability among liquidators was triple that of corresponding groups(Russian Security Council, 2002), and in 1998
was four times higher (Romamenkova, 1998).
Some 15 years after the catastrophe, 27% of
the Russian liquidators became invalids at an
average age of 48 to 49 (National Russian Report, 2001). By the year 2004 up to 64.7% of
all the liquidators of working age were disabled(Zubovsky and Tararukhina, 2007).
3.4. Other Countries
1. FINLAND. There was an increase in thenumber of premature births just after the catastrophe (Harjulehto et al., 1989).
2. GREAT BRITAIN. In Wales, one of the regions most heavily contaminated by Chernobyl
fallout, abnormally low birth weights (less than
1,500 g) were noted in 1986–1987 (Figure 3.6).

Figure 3.6. Percent of newborns with birthweight less than 1,500 g from 1983 to 1992 (topcurve) and a level of Sr-90 in soil (bottom curve) in
Wales (Busby, 1995).

3. HUNGARY. Among infants born in May–
June 1986 there was a significantly higher number of low-birth-weight newborns (Wals andDolk, 1990).
4. LITHUANIA. Among liquidators (of whom
1,808 survived) morbidity was noticeably
higher among those who were 45 to 54 years ofage during their time in Chernobyl (Burokaite,2002).
5. SWEDEN. The number of newborns withlow birth weight was significantly higher in July
1986 (Ericson and Kallen, 1994).
∗∗∗∗∗∗
It is clear that there is significantly increased
general morbidity in territories heavily contaminated by the Chernobyl fallout and higher
rates of disability among liquidators and others
who were exposed to higher doses of radiation
than the general population or corresponding
nonradiated groups. Certainly, there is no direct proof of the influence of the Chernobyl
catastrophe on these figures, but the question
is: What else can account for the increased illness and disability that coincide precisely intime and with increased levels of radioactive
contamination, if not Chernobyl?
The IAEA and WHO suggested (Chernobyl
Forum, 2006) that the increased morbidity ispartly due to social, economic, and psychological factors. Socioeconomic factors cannot be
the reason because the compared groups are
identical in social and economic position, natural surroundings, age composition, etc. anddiffer only in their exposure to Chernobyl contamination. Following scientific canons suchas Occam’s Razor, Mills’s canons, and Bradford Hill criteria, we cannot discern any reason for this level of illness other than the radioactive contamination due to the Chernobyl
catastrophe.
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CHERNOBYL

4. Accelerated Aging as a Consequence of theChernobyl Catastrophe
Alexey V. Yablokov
Accelerated aging is one of the well-known consequences of exposure to ionizing radiation. This phenomenon is apparent to a greater or lesser degree in all of the populations
contaminated by the Chernobyl radionuclides.

1. Children living in all the Belarussian territories heavily contaminated by Chernobyl
fallout evidence a characteristic constellation of senile illnesses (Nesterenko, 1996;
and many others).
2. Children from the contaminated areas of Belarus have digestive tract epithelium characteristic of senile changes(Nesterenko, 1996; Bebeshko et al., 2006).
3. Of 69 children and teenagers hospitalizedin Belarus from 1991 to 1996 diagnosed
with premature baldness (alopecia), 70%
came from the heavily contaminated territories (Morozevich et al., 1997).
4. The biological ages of inhabitants fromthe radioactive contaminated territories
of Ukraine exceed their calendar ages by 7
to 9 years (Mezhzherin, 1996). The same
phenomenon is observed in Russia (Malygin et al., 1998).
5. Men and women categorized as middle
aged living in territories with Cs-137 contamination above 555 kBq/m2 died fromheart attacks 8 years younger than the average person in Belarus (Antypova andBabichevskaya, 2001).
6. Inhabitants of Ukrainian territories heavily contaminated with radiation developed abnormalities of accommodation

Address for correspondence: Alexey V. Yablokov, Russian Academyof Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@
ecopolicy.ru

55

and other senile eye changes (Fedirko,
1999; Fedirko and Kadochnykova, 2007).
7. Early aging is a typical characteristic seen
in liquidators, and many of them develop
diseases 10 to 15 years earlier than the average population. The biological ages ofliquidators calculated by characteristics ofaging are 5 to 15 years older than their calendar ages (Gadasyna, 1994; Romanenko
et al., 1995; Tron’ko et al., 1995; Ushakov
et al., 1997).
8. Chernobyl radiation induced premature aging of the eyes (Fedirko and
Kadochnykova, 2007).
9. Presenile characteristics of liquidators
include (Antypova et al., 1997a,b;
Zhavoronkova et al., 2003; Kholodova andZubovsky, 2002; Zubovsky and Malova,
2002; Vartanyan et al., 2002; Krasylenko
and Eler Ayad, 2002; Kirke, 2002;
Stepanenko, 2003; Kharchenko et al.,1998, 2004; Druzhynyna, 2004; Fedirko
et al., 2004; Oradovskaya et al., 2006):•

Multiple illnesses characteristic of senility
in individuals at early ages (10.6 diseases
diagnosed in one liquidator is 2.4 times
higher that the age norm).
• Degenerate and dystrophic changes in various organs and tissues (e.g., osteoporosis, chronic cholecystitis, pancreatitis, fatty
liver, and renal dystrophy).
• Accelerated aging of blood vessels, including those in the brain, leading to senile

56

encephalopathy in those 40 years of age,and generalized arteriosclerosis.
• Ocular changes, including early senile
cataracts and premature presbyopia.
• Decline in higher mental function characteristic of senility.
• Development of Type II diabetes in liquidators younger than 30 years of age.
• Loss of stability in the antioxidant system.
• Retina vessel arteriosclerosis.
• Hearing and vestibular disorders at
younger ages.
10. Evidence of accelerated biological time inliquidators is the shortened rhythm of intracircadian arterial pressure (Talalaeva,
2002).
11. Findings indicating accelerated aging inpractically all liquidators are changes inblood vessel walls leading to the development of atherosclerosis. Changes are also
found in epithelial tissue, including that of
the intestines (Tlepshukov et al., 1998).
12. An accelerated rate of aging, measuredin 5-year intervals, marked by biological and cardiopulmonary changes (andfor 11 years by physiological changes)
was found in 81% of men and 77% of
women liquidators (306 surveyed). Liquidators younger than 45 years of age
were more vulnerable. The biological ageof liquidators who worked at the Chernobyl catastrophe site in the first 4 months
after the meltdown exceeds the biological age of those who labored there subsequently (Polyukhov et al., 2000).
13. It is proposed that the accelerated occurrence of age-related changes in organs ofliquidators is a radiation-induced progeroid
syndrome (Polyukhov et al., 2000; Bebeshko
et al., 2006).

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Malygin, V. L., Atlas, E. E. & Zhavoronkova, V. A. (1998).
Psychological health of the population in radioactive contaminated territories (psycho-physiologicalstudy). In: International Conference of Psychiatry, Moscow(Materials, Moscow): pp. 87–88 (in Russian).
Mezhzherin, V.A. (1996). Civilization and Noosphera. Book
1 (“Logos,” Kiev): 144 pp. (in Russian).
Morozevich, T.S., Gres’, N. A., Arynchyn, A.N. & Petrova,
V. S. (1997). Some eco-pathogenic problems seen in
hair growth abnormalities in Byelorussian children.
Scientific and Practical Conference. Actual Problemsof Medical Rehabilitation of the Population Suffering fromthe Chernobyl Catastrophe. June 30, 1997, Minsk. Dedicated to the Tenth Anniversary of the Republic’s
Radiation Medicine Dispensary (Materials, Minsk):
pp. 38–39 (in Russian).
Nesterenko, V. B. (1996). Scale and Consequences of the Chernobyl Catastrophe for Belarus, Ukraine and Russia (Pravo
and Economica, Minsk): 72 pp. (in Russian).
Oradovskaya, I. V., Vykulov, G. Kh., Feoktystov, V. V.
& Bozheskaya, N. V. (2006). Delayed medical consequences in liquidators: Results of 20 years ofmonitoring. International Conference. Twenty Years
after Chernobyl: Ecological and Social Lessons. June 5,

57

2006, Moscow (Materials, Moscow): pp. 145–166(in Russian).
Polyukhov, A. M., Kobsar, I. V., Grebelnik, V. I. &Voitenko, V. P. (2000). Accelerated occurrence of
age-related organ changes in Chernobyl workers: A
radiation-induced progeroid syndrome? Exper. Gerontol. 35(1): 105–115 (in Russian).
Romanenko, A. E., Pyatak, O. A. & Kovalenko, A. L.
(1995). Liquidators’ health. 2.2. In: Bar’yakhtar, V.
G. (Ed.), Chernobyl Catastrophe: History, Social, Economical, Geochemical, Medical and Biological Consequences(“Naukova Dumka,” Kiev) (//www.stopatom.
slavutich.kiev/1.htm) (in Russian).
Stepanenko, I. V. (2003). Results of immunological characters and blood pH in liquidators. Laborat. Diagnost.
3: 21–23 (in Russian).
Talalaeva, G. V. (2002). Changes of biological time inliquidators. Herald Kazhakh. Nat. Nucl. Cent. 3: 11–17(in Russian).
Tlepshukov, I. K., Baluda, M. V. & Tsyb, A. F. (1998).
Changes in homeostasis in liquidators. Hematol.
Transfusiol. 43(1): 39–41 (in Russian).
Tron’ko, N. D., Cheban, A. K., Oleinik, V. A. & Epshtein,
E. V. (1995). Endocrine system. In: Bar’yakhtar, V.
G. (Ed.), Chernobyl Catastrophe: Historiography, Social,
Economical, Geochemical, Medical and Biological Consequences (“Naukova Dumka”, Kiev): pp. 454–456 (inRussian).
Ushakov, I. B., Arlashchenko, N. I., Dolzhanov, A. J. &Popov, V. I. (1997). Chernobyl: Radiation Psychophysiology
and Ecology of the Person (Institute of Aviation and Space
Medicine, Moscow): 247 pp. (in Russian).
Vartanyan, L. S., Gurevich, S. M., Kozachenko, A. I.,
Nagler, L. G. & Burlakova, E. B. (2002). Long-term
effects of low dose of ionizing radiation on the humananti-oxidant system. Rad. Biol. Radioecol. 43(2): 203–205 (in Russian).
Zhavoronkova, L. A., Gabova, A. V., Kuznetsova, G. D.,
Sel’sky, A. G. & Pasechnik, V. I. et al. (2003). Postradiation effect on inter-hemispheric asymmetry via
EEG and thermographic characteristics. J. High Nervous Activit. 53(4): 410–419 (in Russian).
Zubovsky, G. A. & Malova, Yu. V. (2002). Aging abnormalities in liquidators. Clinic. Gerontol. 8(8): 82–83 (inRussian).

CHERNOBYL

5. Nonmalignant Diseases after the
Chernobyl Catastrophe
Alexey V. Yablokov
This section describes the spectrum and the scale of the nonmalignant diseases thathave been found among exposed populations. Adverse effects as a result of Chernobyl
irradiation have been found in every group that has been studied. Brain damage has
been found in individuals directly exposed—liquidators and those living in the contaminated territories, as well as in their offspring. Premature cataracts; tooth and mouthabnormalities; and blood, lymphatic, heart, lung, gastrointestinal, urologic, bone, andskin diseases afflict and impair people, young and old alike. Endocrine dysfunction,
particularly thyroid disease, is far more common than might be expected, with some
1,000 cases of thyroid dysfunction for every case of thyroid cancer, a marked increase
after the catastrophe. There are genetic damage and birth defects especially in children of liquidators and in children born in areas with high levels of radioisotope contamination. Immunological abnormalities and increases in viral, bacterial, and parasitic diseases are rife among individuals in the heavily contaminated areas. For morethan 20 years, overall morbidity has remained high in those exposed to the irradiation released by Chernobyl. One cannot give credence to the explanation that thesenumbers are due solely to socioeconomic factors. The negative health consequencesof the catastrophe are amply documented in this chapter and concern millions ofpeople.

5.1. Blood and Lymphatic System
Diseases
For both children and adults, diseases ofthe blood and the circulatory and lymphatic
systems are among the most widespread consequences of the Chernobyl radioactive contamination and are a leading cause of morbidity and death for individuals who worked asliquidators.
5.1.1. Diseases of the Blood andBlood-Forming Organs
5.1.1.1. Belarus
1. The incidence of diseases of the bloodand blood-forming organs was 3.8-fold higher

Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

among evacuees 9 years after the catastrophe.
It was 2.4-fold higher for inhabitants of the contaminated territories than for all of the population of Belarus; these rates were, respectively,
279, 175, and 74 per 10,000 (Matsko, 1999).
2. In 1995, for the Belarus liquidators, incidence of diseases of the blood and bloodforming organs was 4.4-fold higher than forcorresponding groups in the general population (304 and 69 per 10,000; Matsko, 1999;
Kudryashov, 2001).
3. The incidence of hematological abnormalities was significantly higher among
1,220,424 newborns in the territories contaminated by Cs-137 at levels above 1 Ci/km2(Busuet et al., 2002).
4. Incidence of diseases of the blood andthe lymphatic system was three- to five-foldhigher in the most contaminated Stolinsk andLuninetsk districts in Brest Province in 1996
than in less contaminated districts (Gordeiko,1998).

58

Yablokov: Nonmalignant Diseases after Chernobyl

59

TABLE 5.1. Statistics of the Annual Cases ofBelarussian Children with Depression of the
Blood-Forming Organs after the Catastrophe(Gapanovich et al., 2001)

tors’ children born in 1987 (Arynchin et al.,1999).
12. There is a correlation between increased
Fe-deficient anemia in Belarus and the levelof radioactive contamination in the territory(Dzykovich et al., 1994; Nesterenko, 1996). In
the contaminated areas of Mogilev Province thenumber of people with leukopenia and anemia
increased sevenfold from 1986 to 1988 compared to 1985 (Gofman, 1994).
13. Primary products of lipid oxidation in
the plasma of children’s blood (0 to 12 months)
from Mogilev (Krasnopolsk District), Gomel(Kormyansk District), and Vitebsk (Ushachy
District) provinces contaminated with Cs-137
statistically significantly declined from 1991 to
1994. The amount of vitamins A and E in babies’ blood from the more contaminated territories (up to 40 Ci/km2 ) decreased 2.0- to
2.7-fold (Voznenko et al., 1996).
14. Children from Chechersk District(Gomel Province) with levels of 15–40 Ci/km2
of Cs-137 and from Mtzensk and Bolkhovsk
districts (Oryol Province, Russia) with levelsof 1–15 Ci/km2 have lipid oxidation productsthat are two- to sixfold higher. The levels of
irreplaceable bioantioxidants (BAO) were twoto threefold lower than norms for the corresponding age ranges. Contaminated children
have rates of metabolism of BAO two- to tenfold higher than the age norms (Baleva et al.,2001a).
15. For boys irradiated in utero there was a reduction in direct and an increase in free bilirubin in blood serum over 10 years. For girls there
was a reduced concentration of both direct
and indirect bilirubin (Sychik and Stozharov,
1999a,b).

1979–1985 1986–1992 1993–1997
Number of cases
9.3
Cases per 10,000 0.60 ± 0.09
1.00
∗

14.0
15.6
0.71 ± 0.1∗
1.46∗
1.73∗

p < 0.05.

5. The activity of serum complement and thenumber of effective C4 component cells was
significantly lower among 350 children fromthe Belarus area contaminated by Cs-137; inmore contaminated areas (>15 Ci/km2 ) there
was a significantly lower level of C3 component
cells (Zafranskaya et al., 1995).
6. Myelotoxic activity of the blood (MTA)
and the number of T lymphocytes were significantly lower in multiple sclerosis patients fromareas with Cs-137 contamination from 5–15
Ci/km2 (Fyllypovich, 2002).
7. Absolute and relative numbers of lymphocytes, as a percent of basophilic cells were significantly higher among adults and teenagers
living in Gomel Province territories with a levelof Cs-137 contamination from 15–40 Ci/km2(Miksha and Danylov, 1997).
8. Evacuees and those still living in heavily contaminated territories have a significantly
lower percent of leukocytes, which have expressed pan-D cellular marker CD3 (Baeva and
Sokolenko, 1998).
9. The leukocyte count was significantly
higher among inhabitants of Vitebsk and
Gomel provinces who developed infectious diseases in the first 3 years after the catastrophecompared with those who already were suffering from these diseases (Matveenko et al., 1995).
10. The number of cases of preleukemic conditions (myelodysplastic syndrome and aplastic
anemia) increased significantly during the first
11 years after the catastrophe (Table 5.1).
11. Significant changes in the structure of
the albumin layer of erythrocyte membranes(increased cell fragility) occurred in liquida-5.1.1.2. Ukraine
1. Children in the heavily contaminated territories have a level of free oxidizing radicals
in their blood that is significantly higher thanin those in the less contaminated territories:
1,278 ± 80 compared with 445 ± 36 measured
as impulses per minute (Horishna, 2005).

60

2. Children of liquidators living in the contaminated territories had two- to threefold
higher blood and blood-forming-organ morbidity compared to children from noncontaminated territories (Horishna, 2005).
3. Diseases of the blood and circulatory system for people living in the contaminated territories increased 11- to 15-fold for the first
12 years after the catastrophe (1988–1999;
Prysyazhnyuk et al., 2002).
4. In 1996, morbidity of the blood-forming
organs in the contaminated territories was 2.4fold higher than for the rest of Ukraine (12.6
and 3.2 per 10,000; Grodzinsky, 1999).
5. For the first 10 years after the catastrophe the number of cases of diseases of bloodand blood-forming organs among adults in thecontaminated territories of Zhytomir Province
increased more than 50-fold: from 0.2 up to
11.5% (Nagornaya, 1995).
6. For a decade after the catastrophe, morbidity of the blood and blood-forming organs
in adults and teenagers living in contaminatedterritories increased 2.4-fold: from 12.7 in 1987
to up to 30.5 per 10,000 in 1996. For the remaining population of Ukraine this level remained at the precatastrophe level (Grodzinsky,1999).
7. During the acute iodic period (the firstmonths after the catastrophe) abnormal blood
cell morphology was found in more than
92% of 7,200 surveyed children living in
the area, and 32% of them also had abnormal blood counts. Abnormalities included
mitochondrial swelling and stratification of
nuclear membranes, expansion of the perinuclear spaces, pathological changes in cell surfaces, decreased concentration of cellular substances, and increase in the volume of water.
The last is an indication of damage to the cellular membranes (Stepanova and Davydenko,
1995).
8. During 1987–1988 qualitative changes
in blood cells were found in 78.3% of children from zones with radiation levels of
5–15 Ci/km2 (Stepanova and Davydenko,
1995).

9. In the contaminated territories, anemia
was found in 11.5% of 1,926 children examinedin 1986–1998 (Bebeshko et al., 2000).
5.1.1.3. Russia
1. Diseases of the blood and blood-forming
organs caused much greater general morbidity
in children from contaminated areas (Kulakov
et al., 1997).
2. Morbidity owing to abnormalities of theblood and the circulatory system has more thandoubled in children in the contaminated districts of Tula Province and has increased in
all the contaminated districts in comparison
with the period before the catastrophe (Sokolov,
2003).
3. In 1998 the annual general morbidity fromblood, blood-forming organs, and the circulatory system of children in the contaminateddistricts of Bryansk Province significantly exceeded the provincial level (19.6 vs. 13.7 per
1,000; Fetysov, 1999a).
4. For liquidators, the morbidity from bloodand blood-forming organs grew 14.5-fold between 1986 and 1993 (Baleva et al., 2001).
5. Critically low lymphocyte counts wereseen in children in the contaminated districtsof Bryansk Province over a 10-year survey after the catastrophe (Luk’yanova and Lenskaya,
1996).
6. In almost half of the children, blood
hemoglobin levels exceeded 150 g/liter in thesettlements of Bryansk Province that had highlevels of Cs-137 soil contamination and a levelof contamination from Sr-90 (Lenskaya et al.,1995).
7. Individuals living in the contaminatedareas have fewer lymphocytes with adaptive
reaction, and the number of people withhigher lymphocytes radiosensitivity increased(Burlakova et al., 1998).
8. The numbers of leukocytes, erythrocytes,
lymphocytes, and thrombocytes in liquidators’ peripheral blood were markedly different(Tukov et al., 2000). The number of large granulocytic lymphocytes decreased by 60–80% 1
month after the liquidators began work and61

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.2. Dynamics of the Interrelation by Lymphopoietic Type (in %, See Text) in Russian Liquidators(Karamullin et al., 2004)
Lymphopoietic types

Time after thecatastrophe

Quasi-normal

Hyperregeneratory

Hyporegeneratory

0 to 5 years
5 to 9 years
10 to 15 years
Control group

32
38
60
76

55
0
17
12

13
62
23
12

stayed at a lower level for at least 1 year
(Antushevich and Legeza, 2002).
9. The glutathione level in blood proteinsand cytogenic characteristics of lymphocytes
were markedly different in children born 5 to
7 years after the catastrophe in the contaminated Mtsensk and Bolkhov districts, Oryol
Province, Russia, and in Chechersk District,
Gomel Province, Belarus (Ivanenko et al.,2004).
10. In the contaminated territories of Kursk
Province changes in lymphocyte counts andfunctional activity and the number of circulating immune complexes were seen in the bloodof children 10 to 13 years of age and in pregnant
women (Alymov et al., 2004).
11. Significant abnormal lymphocytes andlymphopenia was seen more often in children in
the contaminated territories (Sharapov, 2001;
Vasyna et al., 2005). Palpable lymph nodes occurred with greater frequency and were moreenlarged in the heavily contaminated territories. Chronic tonsillitis and hypertrophy of thetonsils and adenoids were found in 45.4% of
468 children and teenagers examined (Bozhko,
2004).
12. Among the liquidators, the following parameters of the blood and lymphatic systemwere significantly different from controls:•

Average duration of nuclear magnetic
resonance relaxation (NPMR) of bloodplasma (Popova et al., 2002).
• Receptor–leukotrene reaction of erythrocyte membranes (Karpova and Koretskaya, 2003).

•

Quantity of the POL by-products (by malonic aldehyde concentration) and by viscosity of membranes and on a degree of thelipids nonsaturation (Baleva et al., 2001a).
• Imbalanceof the intermediate-size
molecules in thrombocytes, erythrocytes,
and blood serum (Zagradskaya, 2002).
• Decreased scattering of the granular component of lymphocyte nuclei reduction of
the area and perimeter of the perigranularzones; and increased toothlike projectionof this zone (Aculich, 2003).
• Increased intravascular thrombocyte aggregation (Tlepshukov et al., 1998).
• Increased blood fibrinolyic activity andfibrinogen concentration in blood serum(Tlepshukov et al., 1998).
13. Liquidators’ lymphopoesis remained
nonfunctional 10 years after the catastrophe(Table 5.2).
It is known that Japanese juvenile atomic
bomb victims suffer from diseases of the bloodforming organs 10 times more often than control groups, even in the second and third generations (Furitsu et al., 1992). Thus it canbe expected that, following the Chernobyl
catastrophe, several more generations will develop blood-forming diseases as a result of theradiation.
5.1.2. Cardiovascular Diseases
Cardiovascular diseases are widespread in
all the territories contaminated by Chernobyl
emissions.

62

5.1.2.1. Belarus
1. Cardiovascular disease increased nationwide three- to fourfold in 10 years comparedto the pre-Chernobyl period and to an evengreater degree in the more heavily contaminated areas (Manak et al., 1996; Nesterenko,
1996).
2. Impaired cardiovascular homeostasis ischaracteristic for more newborns in the first 4
days of life in districts with contamination levels higher than 15–40 Ci/km2 (Voskresenskaya
et al., 1996).
3. Incidence of hemorrhages in newborns in
the contaminated Chechersky District of theGomel Province is more than double than before the catastrophe (Kulakov et al., 1997).
4. Correlated with levels of radiation,changes in the cardiovascular system were
found in more than 70% of surveyed children aged 3 to 7 years from contaminated territories of Gomel Province (Bandazhevskaya,
1994).
5. In 1995, cardiovascular system morbidity
among the population in the contaminated territories and evacuees was threefold higher thanfor Belarus as a whole (4,860 and 1,630 per
100,000; Matsko, 1999).
6. More than 70% of newborn to 1-yearold children in territories with Cs-137 soil
contamination of 5–20 Ci/km2 have had cardiac rhythm abnormalities (Tsybul’skaya et al.,
1992; Bandazhevsky, 1997). Abnormalities ofcardiac rhythm and conductivity correlatedwith the quantity of incorporated radionuclides (Bandazhevsky et al., 1995; Bandazhevsky
1999). There were significantly higher incidence and persistence of abnormalities of cardiac rhythm in patients with ischemic heartdisease in contaminated territories (Arynchyna
and Mil’kmanovich, 1992).
7. Both raised and lowered arterial bloodpressure were found in children and adults
in the contaminated areas (Sykorensky andBagel, 1992; Goncharik, 1992; Nedvetskayaand Lyalykov, 1994; Zabolotny et al., 2001;

and others). Increased arterial pressure occurred significantly more often in adults in the
Mogilev Province, where contamination wasabove 30 Ci/km2 (Podpalov, 1994). Higher
arterial pressure in children correlated with
the quantity of the incorporated Cs-137(Bandazhevskaya, 2003; Kienya and Ermolitsky, 1997).
8. Compared to healthy children, brain arterial vessels in children 4 to 16 years old weremore brittle among children in contaminatedareas in Gomel (Narovlyansky, Braginsk, El’sk,
and Khoiniky districts), Mogilev (Tchernikovsk,
Krasnopol’sk, and Slavgorodsk districts), andBrest provinces (Arynchin et al., 1996, 2002;
Arynchin, 1998).
9. Morbidity of the circulatory system amongchildren born to irradiated parents was significantly higher from 1993 to 2003 (National Belarussian Report, 2006).
10. The volume of blood loss during Caesarean birth was significantly higher for womenfrom Gomel Province living in the territories contaminated by Cs-137 at levels of 1–
5 Ci/km2 compared to those from uncontaminated areas (Savchenko et al., 1996).
11. Blood supply to the legs, as indicated byvasomotor reactions of the large vessels, was significantly abnormal for girls age 10 to 15 years
who lived in areas with a level of Cs-137 contamination higher than 1–5 Ci/km2 comparedwith those in the less contaminated territories(Khomich and Lysenko, 2002; Savanevsky andGamshey, 2003).
12. The primary morbidity of both maleand female liquidators was high blood pressure,acute heart attacks, cerebrovascular diseases,
and atherosclerosis in of the arms and legs,
which increased significantly in 1993–2003, including in the young working group (National
Belarussian Report, 2006).
13. In the observation period 1992–1997
there was a 22.1% increase in the incidence of
fatal cardiovascular disease among liquidators
compared to 2.5% in the general population(Pflugbeil et al., 2006).

63

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.3. Cardiovascular Characteristics of Male Liquidators in Voronezh Province (Babkin et al.,
2002)

Parameter

Liquidators(n = 56)

Inhabitants ofcontaminatedterritory (n = 60)

Control(n = 44)

AP–a systoleAP–diastole
IBH, %
Insult, %Thickness of carotid wall, mm∗
Overburdening heredity, %151.9 ± 1.8∗
91.5 ± 1.5∗
9.1∗
4.5∗
1.71 ± 0.90∗
25129.6 ± 2.1
83.2 ± 1.8
46.4
16.1∗
0.81 ± 0.20
25

126.3 ± 3.2
82.2 ± 2.233.3
00.82 ± 0.04
27.3∗

Statistically significant differences from control group.

5.1.2.2. Ukraine
1. The morbidity from circulatory diseases in1996 in the contaminated territories was 1.5fold higher than in the rest of Ukraine (430 vs.
294 per 10,000; Grodzinsky, 1999).
2. Symptoms of early atherosclerosis wereobserved in 55.2% of children in territories contaminated at a level of 5–15 kBq \ m2 (Burlak
et al. 2006).
3. Diseases of the cardiovascular system occurred significantly more often in children irradiated in utero (57.8 vs. 31.8%, p < 0.05;
Prysyazhnyuk et al., 2002).
4. Incidence of hemorrhage in newborns
in the contaminated Polessk District, Kiev
Province, has more than doubled since thecatastrophe (Kulakov et al., 1997). Atherosclerosis and ischemic disease of the heart are
seen significantly more often in young evacuees
and in those living in contaminated territories(Prokopenko, 2003).
5. Liquidators’ morbidity from vegetalvascular dystonia (tachycardia, hyperthyroidism, and neuropathy) was 16-fold higher
than the average for Ukraine in the first 10 years
after the catastrophe (Serdyuk and Bobyleva,
1998).
5.1.2.3. Russia
1. For the three heavily contaminated districts in Bryansk Province, morbidity in children from circulatory system problems isthree- to fivefold higher than the average(Komogortseva, 2006).
2. The incidence of hemorrhages amongnewborns in the contaminated Mtsensk andVolkovsk districts, Oryol Province, is double
what it was prior to the catastrophe (Kulakov
et al., 1997).
3. For liquidators, morbidity from circulatory disease increased 23-fold between 1986
and 1994 (Baleva et al., 2001). In 1995–1998
morbidity in Bryansk Province liquidators increased 2.2-fold (Fetysov, 1999b). According
to other data, for 1991–1998 morbidity increased 1.6-fold (Byryukov et al., 2001). Some
13 years after the catastrophe cardiovascular morbidity among liquidators was fourfold
higher than in corresponding groups of the
population (National Russian Report, 1999).
4. The health of liquidators differs significantly from that of control groups, the former
having higher arterial blood pressure, more ischemic heart disease, and increased cardiac
wall thickness characteristic of atherosclerosis.
The liquidators living in contaminated territories of Voronezh Province differed from control
groups also in the number of strokes (cerebral
vascular accidents) and the cases of ischemic
heart disease (Table 5.3).
5. Ten years after the catastrophe there wasan increase in the incidence of high arterial
blood pressure among a large group of liquidators who worked from April to June 1986
(Kuznetsova et al., 2004). Increased systolic

64

blood pressure was characteristic for all the liquidators examined (Zabolotny et al., 2001).
6. From 1991 to 1998 the incidence of ischemic heart disease in liquidators increased
threefold, from 20 to 58.9% (Zubovsky andSmirnova, 2000). Ischemic heart disease developed in one-third of 118 liquidators under observation for 15 years (Noskov, 2004).
From 1993 to 1996 another group of liquidators
demonstrated a significant increase in ischemic
heart disease, from 14.6 to 23.0% (Strukov,
2003). Morbidity and the frequency of occurrence of ischemic heart disease in liquidatorsand in the general population of the contaminated territories continue to grow (Khrysanfov
and Meskikh, 2001).
7. For all the liquidators examined, it was
typical to find lowered tonus of arterial vessels
in the circle of Willis in the brain (Kovaleva
et al., 2004).
8. Impairment of blood circulation in thebrain (neurocirculatory dystonia) was found ina majority of the liquidators examined in 1986–
1987, and the number of such cases is increasing (Romanova, 2001; Bazarov et al., 2001;
Antushevich and Legeza, 2002; Kuznetsova
et al., 2004; and others). These changes occur
mainly owing to disease of small arteries andarterioles (Troshyna, 2004) and occurred more
frequently in young liquidators (Kuznetsova
et al., 2004). Impairment of blood circulation in
the brain among liquidators is sometimes defined as dyscirculatory encephalopathy (DCE),a chronic cerebral vascular pathology leading
to functional and organic destruction of thecentral nervous system. DCE was found in
40% of the cases of structural brain circulatory disease in Russian liquidators in 2000. This
pathological condition is specific for the impact
caused by small doses of Chernobyl radioactivity and is not listed in the international classification of illnesses (Khrysanfov and Meskikh,2001).
9. Hypertension is seen markedly more often
among both liquidators and people living in thecontaminated territories. High blood pressure
accounted for 25% of the cases of pathology inliquidators in 2000 (Khrysanfov and Meskikh,2001). Hypertension morbidity in a group ofliquidators increased from 18.5% in 1993 to
24.8% in 1996 (Strukov, 2003). Hypertension isseen even more often in children of liquidators(Kulakov et al., 1997).
10. After a second evaluation in 2000–
2001, atherosclerosis of the brachiocephalic arteries was found in several members of thesame large group of the liquidators originally examined in 1993–1994 (Shamaryn et al.,2001).
11. Left-heart ventricular mass was significantly larger in liquidators although arterial pressures were normal (Shal’nova et al.,1998).
12. Typically abnormalities persisted in liquidators for a long time after the catastrophe (Shamaryn et al., 2001; Khrysanfov andMeskikh, 2001; Kuznetsova et al., 2004).
13. Abnormal vascular circulation of theeye was found in all of the liquidators examined (Rud’ et al., 2001; Petrova, 2003). Liquidators were also found to suffer from diminished antimicrobial properties of vessel walls(Tlepshukov et al., 1998).
14. Liquidators with ischemic heart diseasediffer significantly in many homodynamic parameters compared with other patients of thesame age (Talalaeva, 2002).
5.1.2.4. Other Countries
MOLDOVA. Liquidators from Chisinau evidence a triple increase in cardiovascular diseases over the last years and the incidence
among them is now double that of control
groups. Some 25% of the liquidators examineddeveloped thickening of the aortic wall, and
22% have left ventricular hypertrophy (Kirkae,2002).
5.1.3. Conclusion
Diseases of blood, blood-forming organs,and the circulatory system are, undoubtedly,
major components of the general morbidity of
inhabitants of the territories contaminated by

Yablokov: Nonmalignant Diseases after Chernobyl

65

the Chernobyl radiation, including evacuees,
migrants, and liquidators and their children. In
spite of the fact that the general picture of theblood and circulatory systems is still far fromcomplete, it is clear that one of the common
reasons for these functional impairments is radioactive destruction of the endothelium, thecovering surface of vessels.
The severe impact of radioactive contamination from Chernobyl resulting in increasing
morbidity of the blood and circulatory systemcannot be doubted.

structure and normal number of chromosomesin those radiated by Chernobyl fallout. Accumulated data show genetic polymorphism ofproteins and changes in satellite DNA.

5.2. Genetic Changes
Changes in genetic structures in both reproductive and somatic cells determine and define
the occurrence of many diseases. Ionizing radiation causes damage to hereditary structures.
The huge collective dose from the Chernobyl
catastrophe (127–150 million persons/rad) has
resulted in damage that will span several generations, causing changes in genetic structuresand various types of mutations: genomic mutations (change in the number of chromosomes), chromosomal mutations (damage tothe structure of chromosomes—translocations,deletions, insertions, and inversions), and small(point) mutations.
Twenty-two years after the catastrophe data
concerning genetic damage linked to additional
Chernobyl irradiation was released. This section presents data not only on the various typesof mutations that have resulted from the catastrophe (Section 5.2.1), but also on geneticallycaused congenital developmental anomalies(Section 5.2.4) and the health of the subsequent
generation, the children born to irradiated parents (Section 5.2.5).
5.2.1. Changes in the Frequencyof Mutations
There are many convincing studies showing increased frequency of chromosomal andgenomic mutations, including changes in the

5.2.1.1. Chromosomal Mutations
Ionizing radiation causes various changes in
the general structure of chromosomes: nonstable aberrations (dicentrics, centric rings, noncentric fragments), which are rather quickly
eliminated in subsequent cell generations, andstable aberrations (different types of translocations at separate chromosomal sites), which areretained for many years. The frequency of chromosomal aberrations in somatic cells, obtainedby studying lymphocytes, reflects the general
status of chromosomes throughout the body, including increasing dicentric and ring chromosome abnormalities in mothers and their newborns in the contaminated territories (Matsko,
1999).
Histological analysis of peripheral blood
lymphocytes reveals structural and chromosomal number aberrations. Presence of cells withseveral aberrations (multiaberrant cells) may indicate the level of the impact of Pu (Il’inskikh
et al., 2002). An additional parameter of genetic variability is the so-called mitosis index,
the number of mitoses per 100 cells.
Occurrence of a chromosomal aberration
does not necessarily mean development of disease, but it does signal both the likely emergence of various tumors, owing to somatic cell
impairment (e.g., in blood cells), and also impaired reproductive cells. Altered structure ofgenerative chromosomes (in sperm and ova)
indicates genetic predisposition to various diseases in the next generation.
The incidence of chromosomal aberrations
is significantly higher in all of the territories contaminated by the Chernobyl nuclear fallout (Lazyuk et al., 1990; Stepanova
and Vanyurikhyna, 1993; Pilinskaya, 1994;
Sevan’kaev et al., 1995a; Vorobtsova et al., 1995;
Mikhalevich, 1999; and others; Table 5.4).
The Chernobyl fallout caused a further increase in the already elevated number of

66
TABLE 5.4. Incidence of (%, M ± m) Aberrant Cells and Chromosomal Aberrations (per100 Lymphocytes) before and after the Chernobyl Catastrophe (Bochkov et al., 1972, 2001;
Pilinskaya, 1992; Bezdrobna et al., 2002)
Aberrant
cells, n

Chromosomal
aberrations, nUkraine, early 1970s
n/aUkraine, before 1986
1.43 ± 0.16
Average in the world, 2000 2.13 ± 0.08
Ukraine, Kiev, 1998–1999 3.20 ± 0.84
30-km Chernobyl zone,
5.02 ± 1.95
1998–1999

1.19 ± 0.06
1.47 ± 0.19
2.21 ± 0.14
3.51 ± 0.97
5.32 ± 2.10

chromosomal mutations observed worldwide
that is associated with the atmospheric nuclear
weapons testing that was carried out until the
1980s.
5.2.1.1.1. Belarus
1. The number of chromosomal aberrations
is higher than the norms among children living in areas with elevated levels of radiation(Nesterenko, 1996; Goncharova, 2000). The
genetic changes are especially common amongindividuals who were younger than 6 years ofage at the time of the catastrophe (Ushakov
et al., 1997). Frequency of chromosomal aberrations (dicentrics and centric rings) in womenand newborns from the contaminated areasof Mogilev Province are significantly higher
than in a control group, and the frequencyof such abnormal chromosomes is more thandouble in schoolboys from the contaminatedareas of Brest Province compared with thosefrom less contaminated Minsk (Lazyuk et al.,1994). Some 52% of surveyed children fromthe contaminated territories of Brest Province,
where the Cs-137 levels are 5–15 Ci/km2 ,have a significantly higher number of chromosomal aberrations. These cytogenic changes
are accompanied by molecular-genetic, cytological, and biochemical changes in peripheral
blood (Mel’nov and Lebedeva, 2004).
2. The average incidence of DNA mutations was twice as high in 79 children bornin 1994 in Belarus to parents who continued tolive in contaminated territories after the catastrophe. This was more than twice that in the
DNA of children from 105 controls (families
in Great Britain) and has been correlated withthe level of radioactive contamination in the
district where the parents lived (Dubrova et al.,
1996, 1997, 2002).
3. The same children examined 1 year and2 years after the catastrophe had significant increases in the number of chromosomal aberrations (5.2 + 0.5% in 1987 and 8.7 + 0.6%
in 1988). During the same evaluation, a significant increase in the number of multiaberrant
cells with two to four aberrations was found(16.4 + 3.3% in 1987 and 27.0 + 3.4% in1988). The occurrence of cells with three tofour aberrations was especially higher in children from the more contaminated Khoiniky
and Braginsk districts (Mikhalevich, 1999).
4. Elevated chromosomal aberrations arefound in children born 5 to 7 years after thecatastrophe in the contaminated Chechersk
City, Gomel Province (Ivanenko et al., 2004).
5. There was a sixfold increase in dicentrics
and centric ring frequencies in the blood cells of
the same individual before and after the catastrophe (Matsko, 1999).
6. For liquidators, micronuclei numbers inperipheral lymphocytes increased many years
after their exposure to the radiation (Table 5.5).

TABLE 5.5. Number of Micronuclei in Lymphocytes of Belarussian Liquidators 15 Years after theCatastrophe (Mel’nov, 2002)
Frequency of micronuclei (per 1,000 cells)∗
Dose, Gy
0.01
0.1
0.2
0.3
0.4
0.5
∗

Liquidators,
47.6 ± 1.3 years old

Controls,
40.8 ± 1.7 years old

2.7 ± 1.1
24.9 ± 4.4
45.4 ± 5.0
69.6 ± 10.3
108.0 ± 16.0
149.9 ± 21.1

15.2 ± 2.3
29.4 ± 2.6
47.1 ± 15.4
47.2 ± 12.2
67.2 ± 14.1
108.0 ± 26.0

All distinctions are statistically significant.

Yablokov: Nonmalignant Diseases after Chernobyl

67

TABLE 5.6. Incidence of Various Types of Chromosomal Aberrations (per 100 Lymphocytes)
among “Samosels” (Self-Settlers) and in the Kiev
Area (Bezdrobna et al., 2002)

TABLE 5.7. Frequency of Chromosomal Aberrations (per 100 Lymphocytes) of the Same 20“Samosels” (Self-Settlers) in 1998–1999 and 2001
Surveys (Bezdrobna et al., 2002)

Incidence, per 100 cells

Incidence, per 100 cells

Type of aberration“Samosels”

Kiev area

Type of aberrations

1998–1999

2001

Dicentrics + centric rings
BreaksExchanges∗
Fragments
Insertions
Deletions with fragments
Deletions without fragments
Total abnormal
Monocentrics
Total

3.0 ± 0.2
0.13 ± 0.04
3.1 ± 0.2
1.6 ± 0.2
0.02 ± 0.02
0.22 ± 0.05
0.10 ± 0.03
0.33 ± 0.06
0.23 ± 0.05
2.2 ± 0.2

2.3 ± 0.1
0.02 ± 0.01
2.3 ± 0.1
0.9 ± 0.1
0.04 ± 0.02
0.08 ± 0.03
0.05 ± 0.02
0.13 ± 0.03
0.12 ± 0.03
1.2 ± 0.1

Breaks and exchanges
Insertions
DeletionsWithout fragments
Total abnormal
Monocentrics
Total

0.16 ± 0.07
1.8 ± 0.3
0.025 ± 0.025
0.10 ± 0.04
0.39 ± 0.09
0.32 ± 0.08
2.6 ± 0.4

0.29 ± 0.07
0.8 ± 0.1∗
0.07 ± 0.03
0.18 ± 0.06
0.45 ± 0.09
0.25 ± 0.06
1.6 ± 0.2∗∗

Pre-Chernobyl level: 1.1.

5.2.1.1.2. Ukraine
1. In a survey of more than 5,000 children
radiated at age 0 to 3 years, the number of aberrant cells and stable and nonstable chromosomal aberrations was higher (Stepanova andSkvarskaya, 2002; Stepanova et al., 2002a,b).
2. The incidence of aberrant cells and chromosomal aberrations is significantly higher inchildren radiated in utero (Stepanova et al.,2002a,b; Stepanova et al., 2007).
3. Children evacuated from Pripyat City
had higher incidences of chromatid aberration
10 years after the catastrophe, both as individuals (0.5–5.5 per 100 cells) and as a group (1.2–
2.6 per 100 cells; Pilinskaya, 1999). For children
from the village of Narodichi, where the Cs-137
contamination was 15 Ci/km2 , the frequencyof occurrence of nonstable chromosomal aberrations was maintained at a more-or-less constant level for more than 10 years, whereas thatof stable chromosomal aberrations increased(Pilinskaya et al., 2003a).
4. The children of liquidators have an increased incidence of chromosomal aberrations(Horishna, 2005).
5. In 12 to 15 years after the catastrophe,
the level of chromosomal aberrations and thenumber of multiaberrant cells significantly in-∗

Differences are statistically significant.

creased in “samosels” (self-settlers—the people
who moved into the prohibited 30-km zone;
Tables 5.6, 5.7, and 5.8). The frequency of occurrence of single-hit acentrics and the presence of two-hit dicentrics and circular rings (seeTable 5.6) demonstrate the prolonged effect oflow dose, low linear-energy-transfer of radiation (so-call low-LET radiation).
6. During the first year after their evacuation from the 30-km zone, the level of nonstable chromosomal aberrations among evacuees significantly exceeded control values andgradually decreased during the next 14 years.
Incidence of this cytogenic damage was not sexdependent, and the frequency of occurrence ofdicentrics and rings correlated with durationof residence in a contaminated zone (Maznik,
2004).
TABLE 5.8. Comparison of the Incidence of Chromosomal Aberrations (per 100 Lymphocytes) froma 30-km Zone of Kiev Province, Ukraine, and fromthe Heavily Contaminated Territories of Gomel
Province, Belarus, 1986–1988 (Bezdrobna et al.,
2002; Mikhalevich, 1999)
Person,n
30-km zone
Kiev
Gomel area

33
31
56

Cells,
n

Aberrant Aberrations,cells, nn

11,789 5.0 ± 2.0
12,273 3.2 ± 0.8
12,152 6.4 ± 0.7

5.3 ± 2.1
3.5 ± 1.0
8.7 ± 0.6

68

7. For the majority surveyed in the contaminated territories, with Cs-137 levels in soilof 110–860 kBq/m2 , and among evacuatedyoung men, the incidence of stable aberrations
was significantly higher (Maznik and Vinnykov,
2002; Maznik et al., 2003).
8. Radiation-induced cytogenic effects weremaintained in 30–45% of surveyed liquidators for 10 to 12 years after the catastrophe.
There was stabilization of the number of dicentric and ring chromosomes at a level of
0.5–1 per 100 cells, with controls at 0.2 and increased incidence of stable cytogenetic changes
at 0.5–4.5 per 100 cells, with controls at 0.1(Pilinskaya, 1999).
9. The level of stable chromosomal aberrations in liquidators increased for 10 to 15 years
after the catastrophe (Mel’nikov et al., 1998;
Pilinskaya et al., 2003b).
10. The phenomenon of genetic instability
is found in children of liquidators (Stepanova
et al., 2006).

5.2.1.1.3. Russia
1. The level of chromosomal aberrations
among children radiated in utero was significantly higher than in children who were born
longer after the meltdown (Bondarenko et al.,2004).
2. The index of genomic DNA repair is lower
in the majority of children in the contaminatedregions (Bondarenko et al., 2004).
3. In 1989–1994 a higher incidence of nonstable chromosomal aberrations (dicentrics andcircular rings) was found in 1,200 children fromthe contaminated areas of Bryansk and Kaluga
provinces with Cs-137 levels from 100–1,000
kBq/m2 . The frequency of occurrence of theseaberrations correlated with the level of contamination of the territory (Sevan’kaev et al.,1995a,b; 1998).
4. An increased level of chromosomal aberrations is found in children of the Novozybkov
District of Bryansk Province (Kuz’myna andSuskov, 2002).

TABLE 5.9. Level of Chromosomal Aberrations inChildren and Teenagers from the ContaminatedTerritories 17 Years after the Catastrophe (Cs-137:
111–200 kBq/m2 ) (Sevan’kaev et al., 2005)
Aberration (per 100 cells)

Acentric fragments
Dicentrics and centric rings

Contaminatedareas

Control

0.40
0.04–0.19

0.22
0.03

5. An increased incidence of chromosomal
aberrations is found in children born 5 to 7
years after the catastrophe in the contaminated Mtsensk District and Bolkhov City, Oryol
Province (Ivanenko et al., 2004).
6. DNA repair activity (tested by reactivationand induced mutagenesis of smallpox vaccine
viruses) was impaired in children born after thecatastrophe in territories with Cs-137 contamination levels above 5 Ci/km2 (Unzhakov et al.,1995).
7. The number of aberrant cells and chromosomal aberrations (pair fragments and rings)
and the size of index chromosome breaks innewborns correlated with dose levels and dose
rates at the time of the births (Kulakov et al.,1993).
8. Seventeen years after the catastrophe
there was an increased number of chromosomal aberrations in 30–60% of children andteenagers from territories contaminated by Cs137 to a level of 111–200 kBq/m2 (Table 5.9)
(Sevan’kaev et al., 2005).
9. There was a correlation between living in the contaminated territories (Bryansk,
Tula, and Kaluga provinces, 1991–1997) anda delay in psychomotor development, congenital defects, and/or microanomalies and extremely elevated amount of near-centromer Cheterochromatin (Vorsanova et al., 2000).
10. The frequency of occurrence of chromosomal aberrations increased two- to fourfold
among those individuals in Chernobyl territories with Cs-137 levels of contamination above
3 Ci/km2 (Bochkov, 1993).

69

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.10. Number of Mutant Cells and Incidence of Chromosomal Aberrations (per 100
Metaphases) among Women with Uterine Myoma in the Contaminated Territories of Tula and Bryansk
Provinces (Tsyb et al., 2006)
Metaphases,nMutant cells,nAberrations,nContamination,
Bq/m2

No data
18,703
19,60012,7796.2 ± 0.3∗
5.3 ± 0.5∗
4.6 ± 0.3
4.0 ± 0.2

No data
4.27 ± 0.3∗
2.30 ± 0.1
2.12 ± 0.1

708
322
171
ControlNovozybkovsky District (n = 22)
Klintsovsky District (n = 97)
Uzlovaya Station (n = 100)
Obninsk (n = 42)∗

Differences from the control are significant.

11. The number of lymphocytes with mutations of T-locus (TCR) and the number of chromosomal aberrations correlated with a level ofradiation contamination in women with uterine
tumors (myomas) who continued to live in theheavily contaminated Novozybkov and Klintsy
districts, Bryansk Province, and in Uzlovaya
Station, Tula Province (Table 5.10).
12. The number of chromosomal aberrations among inhabitants of the contaminatedterritories in Bryansk Province is higher thanamong people living in less contaminated areas(Table 5.11).
13. Inhabitants of the heavily contaminated Klintsy and Vyshkov districts of Bryansk
Province demonstrate a significantly higher
mitotic index in comparison with controls(Pelevina et al., 1996).
14. Among 248 individuals aged 15 to 28
years surveyed, the incidence of dicentrics andcentric rings is two- to fourfold higher thanamong control groups. Among those radiatedin utero, the frequency of occurrence of such
aberrations is fivefold higher than in controls(Sevan’kaev et al., 2006).
15. Among inhabitants of four contaminated districts of Oryol Province, the incidenceof gene mutations on locus T-cellular receptor (TCR) and on locus glycophorin (GPA) is
higher than in controls (Sevan’kaev et al., 2006).
16. Among 336 surveyed fertile womenfrom the contaminated Uzlovaya Station,
Tula Province, and Klintsy District, Bryansk
Province, the incidence of chromosomal exchange aberrations was 0.13 ± 0.03 and 0.37 ±0.07 compared to controls, which was two- to
sixfold less (0.6 ± 0.04; Ivanova et al., 2006).
17. The number of lymphocytic and marrow chromosomal mutations correlated withthe radiation dose among liquidators and inhabitants of Pripyat City within 3 months after the catastrophe and were manifestly higher
than among controls (Table 5.12) (Shevchenko
et al., 1995; Svirnovsky et al., 1998; Bezhenar’,
1999; Shykalov et al., 2002; and others).
18. The number of nonstable (dicentrics,
acentric fragments, and centric rings) and stable aberrations (translocations and insertions)in liquidators was significantly higher in thefirst year after the catastrophe (Shevchenko
et al., 1995; Shevchenko and Snegyreva, 1996;
Slozina and Neronova, 2002; Oganesyan et al.,
2002; Deomyna et al., 2002; Maznik, 2003; andothers; Figure 5.1).

TABLE 5.11. Incidence of Chromosomal Aberrations among Inhabitants of the Contaminated Territories of Bryansk Province (Snegyreva and Shevchenko, 2006)

Bryansk Province
Control∗

Individuals, nCells, n

Aberrations, nIncluding dicentrics

80
114

21,02751,4301.43 + 0.08∗
0.66 ± 0.04

0.10 + 0.02∗
0.02 ± 0.01

Differences from control are significant.

70
TABLE 5.12. Chromosomal Mutations among Various Groups of Liquidators within the First 3 Months
after the Catastrophe (Shevchenko and Snegyreva, 1999)
Group

Cells, n

Aberrations, nIncluding dicentricand centric rings

Construction crew for the
sarcophagus∗∗ (n = 71)
Radiation supervisors (n = 23)
NPP staff (n = 83)
Drivers (n = 60)
Pripyat City civilians (n = 35)
Doctors (n = 37)
Control (n = 19)4,937

32.4 ± 2.5∗

4.4 ± 0.9∗

1,641
6,015
5,300
2,593
2,590
3,605

31.1 ± 4.3
23.7 ± 2.0
14.7 ± 1.7
14.3 ± 2.4
13.1 ± 2.3
1.9 ± 0.7

4.8 ± 1.7
5.8 ± 1.0
3.2 ± 0.8
1.9 ± 0.8
2.7 ± 1.0
0.0∗

For all groups differences with controls are significant.
Sarcophagus is the huge concrete construct that covers the exposed Chernobyl reactor.

∗∗

19. In the first 8 to 9 years after the catastrophe the number of cells with translocations
among liquidators was more than twice that incontrols (Table 5.13).
20. The number of translocations in liquidators was significantly higher than in controls(Table 5.14).
21. In the first 6 to 8 years after
the catastrophe the number of chromosomal aberrations in liquidators from the Russian Federal Nuclear Center in Sarov City
was significantly higher than in controls(Table 5.15).

22. Ten years after the catastrophe 1,000 liquidators had a significantly higher average frequency of occurrence of chromosomal aberrations (especially high in liquidators from 1986)(Sevan’kaev et al., 1998).
23. The incidence of dicentrics in liquidators rose during the first 8 to 12 years after the catastrophe (Slozina and Neronova,
2002). More than 1,500 liquidators were examined and even after 15 years the frequencyof occurrence of dicentrics was considerably
higher than in control groups (Snegyreva andShevchenko, 2002).
5.2.1.1.4. Other Countries

Figure 5.1. Average frequency of dicentrics in agroup of 1986 liquidators examined within 18 years
after the catastrophe (Snegyreva and Shevchenko,
2006).

1. YUGOSLAVIA. Among newborns conceived
in the months postcatastrophe, the numberof chromosomal aberrations increased from
4.5% (1976–1985 average) to 7.1% (Lukic et al.,1988).
2. AUSTRIA. In 1987 among 17 adults examined there was a four- to sixfold increase in
the number of chromosomal aberrations, andin two individuals, examined before and 1 year
after the catastrophe, there was an 11-fold increase (Pohl-Rüling et al., 1991).
3. GERMANY (southern areas). Among 29
children and adults examined in 1987–1991
there was a two- to sixfold increase in the number of chromosomal aberrations (Stephan andOestreicher, 1993).

71

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.13. Number of Chromosomal Aberrations in Lymphocytes of Liquidators, 1990–1995(Shevchenko and Snegyreva, 1999; Snegyreva and Shevchenko, 2006)
Year

Number ofindividuals, nCells, n

Aberrations, nIncluding dicentrics
and central rings

1986
1990
1991
1992
1993
1994
1995
Control

443
23
110
136
75
60
41
82

41,927
4,268
20,07732,00018,581
18,17912,16026,84923.2 ± ∗14.9 ± 1.9∗
19.7 ± 1.0∗
31.8 ± 1.0∗
34.8 ± 1.4∗
31.8 ± 1.3∗
18.8 ± 1.2∗
10.5 ± 0.6

0.33 ± 0.01∗
1.0 ± 0.5∗
0.9 ± 0.2∗
1.4 ± 0.2∗
0.9 ± 0.2∗
1.8 ± 0.3∗
0.4 ± 0.02∗
0.02 ± 0.01∗

All differences with the control are significant (p < 0.01–0.05).

4. NORWAY (northern areas). In 1991, a 10fold increase in the number of chromosomal
aberrations was found in 56 adults compared
to controls (Brogger et al., 1996; see review by
Schmitz-Feuerhake, 2006).
5.2.1.2. Genomic Mutations
Trisomies of chromosomes 13, 18, and 21,
which are genomic mutations showing change
in the number of chromosomes, have beenfound in the contaminated territories.
5.2.1.2.1. Trisomy 21 (Down Syndrome)
1. BELARUS. Analysis of annual and monthly
incidences of Down syndrome in 1981–1999(2,786 cases) revealed an annual increase in
1987 for the whole country and monthly increases in January 1987 in Minsk City and
in Gomel and Minsk provinces (Lazjuk et al.,2002). There was also a 49% increase in themost contaminated 17 districts in 1987–1988(Table 5.16) and an increase of 17% for thewhole country for the period from 1987 to 1994
TABLE 5.14. Frequency of Translocations (per100 Cells) among Liquidators (Snegyreva andShevchenko, 2006)

Liquidators
Control∗

p < 0.05.

Individuals, nCells, nTranslocations

52
15

44,283
21,953

1.20 ± 0.16∗
0.47 ± 0.09

(Lazjuk et al., 1997). Detailed analysis revealeda sharp increase in the incidence of Down syndrome in December 1986 and a peak in January 1987 (Figure 5.2).
2. GERMANY. In West Berlin, among babies conceived in May 1986, the number ofnewborns with Down syndrome increased 2.5fold (Wals and Dolk, 1990; Sperling et al.,1991, 1994; and others; Figure 5.3). In southern Germany an increase in the number oftrisomy 21 cases was determined by amniocentesis (Sperling et al., 1991; Smitz-Fuerhake,2006).
3. SWEDEN. There was a 30% increase in
the number of newborns with Down syndromein the northeast of the country, which was
the area most contaminated by Chernobyl radionuclides (Ericson and Kallen, 1994).
4. GREAT BRITAIN. There was a doubling in
the number of newborns with Down syndrome
TABLE 5.15. Number of Chromosomal Aberrations among Liquidator Personnel of the Russian Federal Nuclear Center in Sarov (Khaimovich
et al., 1999)

All aberrations,per 100 cells
Dicentrics% Polyploidy cells

Liquidators(n = 40)

Controls(n = 10)

4.77 ± 0.42

0.90 ± 0.30

0.93 ± 0.19
1.43 ± 0.23

0
0

72
TABLE 5.16. Incidence of Down Syndrome (per1,000 Newborns) in 17 Heavily and 30 Less
Contaminated Districts of Belarus, 1987–2004(National Belarussian Report, 2006)

Heavily contaminatedLess contaminated1987–1988

1990–2004

0.59
0.88

1.01
1.08

in Lothian, Scotland, one of territories contaminated by Chernobyl (Ramsey et al., 1991).
5.2.1.2.2. Trisomy 13 and Other
Genomic Mutations
1. Photos from the contaminated areas ofBelarus and Ukraine indicated that there aremany cases of newborns with characteristics ofPatau syndrome (trisomy 13). The anomalies
included: polydactly, developmental anomalies of the eyes (microphthalmia, congenital
cataracts, coloboma of the iris), trigonocephaly,
cleft lip and palate, defects of the nose, etc.
Statistics regarding such cases are not available.
2. From clinical descriptions of children
born in the contaminated territories there are
known cases of other genomic mutations: Edward’s syndrome (trisomy 18), Kleinfelter syndrome (additional X-chromosome), Turner’s
syndrome (absence of the X-chromosome),
XXX chromosomes in females, and XYY chro-mosomes in males. Statistics regarding suchcases are not available.
5.2.2. Genetic Polymorphism of Proteinsand Other Genetic Disorders
Genetic polymorphism of proteins is an important parameter of intrapopulation genetic
variability. In children radiated in utero and bornafter Chernobyl, the level of genetic polymorphism of proteins is lower compared with children born before the catastrophe. This lower
level of genetic polymorphism in structural proteins is negatively correlated with levels of congenital malformations and allergies, and may
be a factor in the persistent current backgroundof anemia, lymphadenopathies, and infections(Kulakov et al., 1993).
Children born after the catastrophe who
were irradiated in utero have a lower level ofgenetic polymorphism of proteins compared
to children born before the catastrophe fromthe same territories (Kulakov et al., 1993,1997). They also had significantly lower levels of DNA repair both in the short and thelong term after the catastrophe (Bondarenko
et al., 2004).
Proliferation was sharply reduced in HeLa
cell culture 6 days after the explosion in the
30-km zone (beginning with a total dose up to
0.08 Gr), with this effect continuing for seven

Figure 5.2. Prevalence of trisomy 21 in Belarus from 1982 to 1992 (N = 1,720,030;
n = 1,791) and change-point model (see text) allowing for a significant (p < 0.0001) jump
and a “broken stick” in December 1986 and a peak in January 1987 (Sperling et al., 2008).

73

Yablokov: Nonmalignant Diseases after Chernobyl

Figure 5.3. Prevalence of trisomy 21 in West Berlin from 1982 to 1992 (N = 218,497;
n = 237) and change-point model allowing for a significant (p < 0.0001) jump in December
1986 and a peak in January 1987 (Sperling et al., 2008).

cell generations after the irradiation. Numbersof large cells arising persisted for more than
20 cell generations after irradiation and clonogenicity was lower for 24 generations (Nazarov
et al., 2007).
DNA repair activity (tested by reactivationand induced mutagenesis of small-pox vaccine
viruses) was impaired in children born after thecatastrophe in territories with contaminationlevels of Cs-137 above 5 Ci/km2 (Unzhakov
et al., 1995).
5.2.3. Changes in Satellite DNA
The number of mutations due to Chernobyl
radiation has increased not only in somatic, butalso in germ cells. The level of small mutations
in minisatellite DNA in children born to irradiated parents and living in the contaminated territories of Belarus and Ukraine is almost twicethat of children from Great Britain (Dubrova,
2003).
5.2.4. Genetically Caused Congenital
Developmental Anomalies
It is estimated that from 50 to 90% of all congenital malformations (CMs) and congenital
developmental anomalies (CDAs) result frommutations. Therefore the birth of newborns
with anomalies can reveal the presence of genetic disorders, including the influence of addi-

tional irradiation. More than 6,000 geneticallycaused developmental anomalies are known(McKusick, 1998). Medical statistics consider
only about 30 of the commonest CDAs. Some
CDAs have appeared anew in a population
as mutations de novo. De novo mutations determine such CDAs as polydactyly, change inthe size of arms or legs, and so-called plural
CDAs. These CDAs occur more often in theheavily contaminated Belarussian territories,
where levels are higher than 15 Ci/km2 (Lazjuk
et al., 1999a).
Genetically caused CDAs in newborns are
but the tip of the iceberg. They are evidenceof mutations that are not eliminated at previous stages of individual development in gametes (spermatozoa and ova); among impregnated ova up to and during implantation; andin the process of embryonic development.
Most mutations result in termination of embryonic development at an early stage (Nykytin,2005). Thus it is reasonable to assume thatthe increase in the frequency of occurrence ofgenetically caused CDAs reflects an increasein tens (if not in hundreds) of times the rateof mutations at the gamete stage. That theseprocesses occur in the radiation contaminatedterritories is testified to by: (a) an increasein the number abnormal spermatozoids; (b)an increase in the incidence of spontaneousabortions, which reflects increased embryonic

74

mortality; (c) an increase in de novo mutationsin aborted fetuses and those with CDAs; and(d) the greater proportion of CDAs, defined bymutations de novo, that occur in the most contaminated territories (Lazjuk et al., 1999).
5.2.5. Children of Irradiated Parents
There are more and more data showing
poorer health status in children born to irradiated parents.
1. Among children of the Belarus liquidators irradiated during 1986–1987 who received
5 cSv or more, there is a higher level of morbidity, a larger number of CDAs (Figure 5.4), andmore sick newborns in comparison with children whose fathers received a dose less than
5 cSv (Lyaginskaya et al., 2002, 2007).
2. A survey of a group of 11-year-old children
born in 1987 to families of 1986 Belarus liquidators revealed significant differences in theincidence of blood disease and immune status(Table 5.17).
3. The annual general morbidity amongchildren born to irradiated fathers from 2000 to2005 was higher in Ukraine as a whole (1,135–
1,367 per 10,000 vs. the Ukraine average of960–1,200). Among these children only 2.6–
9.2% were considered “practically healthy” (vs.

Figure 5.4. Prevalence of congenital developmental anomalies (CDAs) among infants born to families of liquidator (1986–1987) fathers who worked
for the Russian nuclear industry from 1988 to 1994
(Lyaginskaya et al., 2007). Broken line: level of CDA
by UNSCEAR (1988).

TABLE 5.17. Health Statistics in 1987 for 11Year-Old Children Born to Belarussian Liquidators
Exposed in 1986 (Arynchin et al., 1999)∗
Children of
liquidators(n = 40)
Chronic gastroduodenitis
Dysbacteriosis
Impaired development
Number of B lymphocytes
Number of T lymphocytes
Concentration of IgG, g/liter∗

Controlgroup(n = 48)

17 (42.5%) 13 (21.7%)
6 (15%)0
8 (20%)
2 (4.2%)
14.1 ± 0.7 23.3 ± 1.9
16.9 ± 1.1 28.4 ± 1.6
9.4 ± 0.4 14.2 ± 0.7

All differences are significant.

18.6–24.6% in the control group; National
Ukrainian Report, 2006).
4. There are more congenital malformations
and developmental anomalies among children
born to irradiated fathers (National Ukrainian
Report, 2006).
5. Children irradiated in utero in the Kaluga
Province have a significantly higher level of general morbidity, including thyroid gland diseases(sixfold above the provincial level); CDAs (fourfold above the provincial level); plus urogenitaltract, blood circulation, and digestive systemdiseases (Tsyb et al., 2006a).
6. Among the children of liquidators in the
Ryazan area there was an increased incidenceof sick newborns, CDAs, birth weights below 2,500 g, delays in intrauterine development, higher morbidity, and impaired immunity (Lyaginskaya et al., 2002, 2007).
7. Liquidators’ children up to 10 years of age
in Kaluga Province had an incidence of thyroid
gland disease that was fivefold higher that theprovincial level, a triple increase in CDAs, afourfold increase in mental disorders, double
the occurrence of circulatory system diseases,
and a high incidence of chronic diseases (Tsyb
et al., 2006).
8. Children of liquidators have a high incidence of chronic laryngeal diseases, redblood cell changes, functional impairment of
the nervous system, multiple tooth caries,
chronic catarrhal gingivitis, and dental anomalies (Marapova and Khytrov, 2001).

Yablokov: Nonmalignant Diseases after Chernobyl

75

9. Children of liquidators have more chromosomal aberrations (deletions, inversions,rings, isochromatids, single fragments, andgaps) and more polyploid cells (Ibragymova,
2003). “. . . In families of liquidation participants [in the Tula Province] there were 473
children born after the Chernobyl catastrophe.
At first sight they differed from other kids in
hyperexcitability. They cry, neither from thatnor from this, and do not sit easily in place. . ..”(Khvorostenko, 1999).
10. Children of liquidators have higher levelsof digestive, respiratory, nervous, and endocrine
system diseases; more CDAs and hereditary diseases; and increased incidence of infectious diseases (Ponomarenko et al., 2002).
11. Among 455 children of liquidators from
Bryansk Province who were born between 1987
and 1999 general morbidity increased from1988 to 2000 (Table 5.18). From the table it isobvious that there has been a reduction in theoccurrence of diseases of the blood and bloodforming organs and a significant increase in
all other illnesses. Even more apparent is themorbidity of children of liquidators of Bryansk
Province compared to other children in thearea. Table 5.19 presents data showing a signif-

TABLE 5.19. Primary Morbidity (per 1,000)
among Children of Bryansk Liquidators and All
the Children in Bryansk Province, 1996–2000(Matveenko et al., 2005)

TABLE 5.18. First Reports Concerning Illnesses(per 1,000) among Children of Liquidators inBryansk Province (Matveenko et al., 2005)∗
Number of cases
Illness
Blood andblood-forming organs
Mental disorders
Neoplasms
Respiratory system
Digestive system
Muscle and bone
Urogenital tract
Infectious andparasitic diseases
Total

1988–
1990

1991–
1995

1996–
2000

52.2

30.6

8.3

0
0
790
5.3
0
5.3
15.9

5.9
0
1,009
59.2
16.2
14.7
83.6

12.2
3.3
1,041
93.7
75.9
20.5
71.5

1,343

1,667

1,052

∗
Listed illnesses are those for which there are obvious
trends over time.

Children of
liquidators

Illnesses
Circulatory system
Mental disorders
Digestive system
Muscle and bone
Congenital anomalies∗

Children
Bryansk
Russiaof Bryansk
Province (RSMDR)∗ Province
6.7
12.2
93.7
75.9
11.6

19.7
25.1
83.0
45.8
12.6

3.5
3.3
68.7
43.2
3.0

Russian State Medical Dosimetric Register.

icant difference between children of liquidatorsand children from the Bryansk area as a whole.
12. There is lowered cellular immunity
in children of Russian liquidators, demonstrated by decreases in both absolute and relative cell parameters. They have a relative
increase in cellular immunity (higher numbers of CD4 cells, moderately lower levels of
immunoglobulin-A, and increased basal neutrophilic activity; Kholodova et al., 2001).
13. Children of liquidators and children irradiated in utero have a higher frequency of stable
chromosomal aberrations, lower levels of repair
activity, and a decrease in individual heterozygosis (Sypyagyna, 2002).
The second and the third generations ofchildren whose parents were irradiated by theatomic bomb explosions in Japan in 1945 suffered 10-fold more circulatory system diseases
and impaired liver function, and 3.3-fold more
respiratory system illness than a control group(Furitsu et al., 1992). It is likely that the healthproblems experienced by children born to parents irradiated by Chernobyl will continue insubsequent generations.
5.2.6. Chromosomal Aberrations as
Indicators of Health Status
The response of the International Atomic
Energy Agency (IAEA) and the World Health76

Organization (WHO) (Chernobyl Forum,2005) to the occurrence of chromosomalchanges induced by the catastrophe is thatthese changes do not in any way affect thestate of health—which is scientifically untrue.
Chromosomal changes observed in peripheral
blood cells can reflect general damage to genetic and ontogenetic processes. There are correlations between the level of chromosomal
aberrations and a number of pathological conditions. There are many examples of such links
in the Chernobyl territories. Among them are
the following.
1. The number of chromosomal aberrations
in 88% of liquidators coincides with the level ofpsychopathological illnesses and the expressionof secondary immunosuppression (Kut’ko et al.,1996).
2. The number of chromosomal aberrations is noticeably higher in those withpsycho-organic syndromes, and the number ofchromatid aberrations is noticeably higher inindividuals with asthenia and obsessive–phobic
syndromes (Kut’ko et al., 1996).
3. The number of dicentrics and chromatid
exchanges correlates with congenital developmental anomalies (Kulakov et al., 1997).
4. The number of chromosome breaks correlates with hypothyroidism and a number ofstigma associated with embryogenesis (Kulakov
et al., 2001).
5. The frequency of occurrence of aberrant
cells, pair fragments, rings, and chromosomal
breaks coincides with the level of immunoregulatory system imbalance in newborns (Kulakov
et al., 1997).
6. The incidence of congenital malformations defined by mutations de novo is significantly
higher in territories with contamination levelsof 15 Ci/km2 or higher (Lazjuk et al., 1999b).
7. The number of chromosomal aberrations, number of micronuclei, and incidence of
spot mutations are considerably higher in children with thyroid cancer (Mel’nov et al., 1999;
Derzhitskaya et al., 1997).
8. The frequency of occurrence of aberrations is higher in both tumor cells and in“normal” tissue in individuals who live in thecontaminated territories (Polonetskaya et al.,2001).
9. The incidence of spermatozoid structure abnormalities correlates with the frequency of occurrence of chromosomal aberrations (Kurilo et al., 1993; Vozylova et al., 1997;
Domrachova et al., 1997; Evdokymov et al.,2001).
10. The level of antioxidant activity forvarious groups of liquidators correlates with
the number of chromosomal aberrations(Table 5.20).
11. The prevalence of febrile infections correlates with the level of chromosomal aberrations (Degutene, 2002).
12. In the contaminated territories ofBryansk and Tula provinces there is a correlation between number of aberrant and multiaberrant cells and the development of uterine
myoma (Ivanova et al., 2006).
13. The frequency of cardiovascular andgastroenteric diseases in liquidators correlateswith the level of chromosomal aberrations(Vorobtsova and Semenov, 2006).
All these correlations demonstrate that theincrease in chromosomal damage, which is observable everywhere in the contaminated territories, is a measure of high genetic risk, as wellas the risk of developing many illnesses.
5.2.7. Conclusion
Somatic chromosomal mutations, mutations causing congenital malformations, genetic polymorphism of proteins, and mutations
in minisatellite DNA are only some of thegenetic changes resulting from radionuclides
released from Chernobyl. The overwhelming majority of Chernobyl-induced genetic
changes will not become apparent for several
generations. A fuller account of other genetic
changes will come with progress in scientificmethods. Today it is obvious that changes in
the genetic structure of cells were the first dangerous signs of the Chernobyl catastrophe. Thechanges occurred in the first days after the

77

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.20. Average Value of Antioxidant Characteristics among Groups of Russian Liquidators with
Various Levels of Chromosomal Aberrations (Baleva et al., 2001)a
Control
Aberrations, n
GT
SOD
Hem 1
Hem 2
MDA 1
MDA 2
t1
CP
FR

0.11
16.70
113.12
6.78
7.27
2.08
2.07
1.01
1.16
0.69

Groups of liquidators with various numbers of aberrations
0.18
823.82115.23
7.86
9.22
2.41
2.58∗
1.37∗
1.01∗
1.20∗

0.68
17.57
120.0911.14∗
10.99∗
2.74∗
2.28∗
1.24
0.92∗
1.05

1.15
824.50101.08∗
5.59
5.88
1.88
2.10
1.39∗
1.15
1.02

1.66
21.98∗
136.5
7.74
6.86
2.67∗
2.88∗
1.15
1.18
0.92

2.64
25.66∗
107.76
6.70
8.17
1.83
1.85
1.50∗
1.20
1.04

a
GT: restored glucation; SOD: superoxide-dismutase; Hem 1, Hem 2: hematopoietic proteins; MDA 1:
malondialdehyde in erythrocytes; MDA 2: malondialdehyde in erythrocytes after POL-initiation; t 1 : time of rotary
correlation of spin probe N 1 in erythrocyte membranes; CP: ceruloplasmin; FR: free radicals with the g-factor 2.0.
∗
p < 0.05.

release of radiation and increased the occurrence of various diseases.
Even if the Chernobyl radiation persisted
only a short time (as in Hiroshima and Nagasaki), its consequences, according to thelaws of genetics, would affect some generations of humans (Shevchenko, 2002). Only
10% of all expected Chernobyl genetic damage occurred in the first generation (Pflugbeil
et al., 2006). The Chernobyl radiation is
genetically much more dangerous than that
released in Hiroshima and Nagasaki as thequantity of radionuclides emitted from the
Chernobyl meltdown was several-hundred-foldhigher and there were more different kinds ofradionuclides.
The genetic consequences of the Chernobyl
catastrophe will impact hundreds of millions ofpeople, including: (a) those who were exposedto the first release of short-lived radionuclides
in 1986, which spread worldwide (see Chapter
1 for details); (b) those who live and will continue to live in the territories contaminated by
Sr-90 and Cs-137, as it will take no fewer than
300 years for the radioactive level to decrease
to background; (c) those who will live in the
territories contaminated by Pu and Am, as millennia will pass before that deadly radioactivity
decays; and (d) children of irradiated parents
for as many as seven generations (even if they

live in areas free from Chernobyl radionuclide
fallout).
5.3. Diseases of the Endocrine
SystemRadioactive fallout from Chernobyl has hadserious adverse effects on every part of theendocrine system of irradiated individuals.
Among adults, the thyroid gland concentrates
up to 40% of a radioactive iodine dose, and inchildren up to 70% (Il’in et al., 1989; Dedov
et al., 1993). The hypophysis (pituitary gland)
actively incorporates radioactive iodine at levels 5 to 12 times higher than normal (Zubovsky
and Tararukhina, 1991). These two major portions of the endocrine system were overirradiated during the “iodine” period, the first weeks
after the catastrophe.
All physiological functions such as the onset of puberty and the closing of bone epiphyses that are dependent on the organsof internal secretion—the pancreas, parathyroids, thyroid, and adrenal glands and theovaries and the testes—which control multiple
functions must coordinate to sustain normal development. Thus Chernobyl’s radioactive contamination has adversely impacted the functionof the entire endocrine system.

78

Adequate and timely thyroid function is necessary for physical and intellectual development. Damage to the thyroid gland of the
fetus or the neonate may doom that individual to a life of diminished mental capacity.
In pregnant women, synthesis of cortisol, an
adrenal hormone, and testosterone correlatedwith the level of internal irradiation (Duda andKharkevich, 1996). Children in the contaminated territories had significantly lower cortisol
blood levels (Petrenko et al., 1993). Measurements of immunity in children and teenagers
with Hashimoto autoimmune thyroiditis correlated with the level of environmental radioactive contamination (Kuchinskaya, 2001).
Review of many similar examples clearlyshows that Chernobyl radiation dangerously
impacted the endocrine system. But what is
the scale of such impacts? Concrete examples
are presented in this section to answer some ofthese questions. After a brief review of material
about endocrine system diseases (Section 5.3.1),
we deal with the central problem of endocrine
illnesses linked to the Chernobyl catastrophe—functional impairment of the thyroid gland(Section 5.3.2).

5.3.1. Review of Endocrine System
Disease Data
Endocrine system diseases are widespreadin all of the territories that were exposedto the Chernobyl radioactive fallout (Baleva
et al., 1996; and many others). Compared withdata from normal people, individuals living in
the contaminated territories have 50% lower
sympathetic activity and 36% lower adrenal
cortical activity. In 28% of surveyed newborns in contaminated areas, disorders in the
hypophyseal–thyroid system, expressed as thyroid dysfunction, during the end of the first
and the beginning of the second week of life
ultimately resulted in hypothyroidism with its
attendant mental and physiological abnormalities (Kulakov et al., 1997).

5.3.1.1. Belarus
1. A sharp increase in endocrine diseases inall Belarussian contaminated territories was observed some years after the catastrophe (Lomat’
et al., 1996; Leonova and Astakhova, 1998; andmany others). According to the State Register,in 1994 endocrine system morbidity reached4,851 per 100,000 (Antypova et al., 1995).
2. Children from heavily contaminated territories had blood cortisol levels that were significantly lower than the norm. Cortisol isan adrenal hormone that is released understress (Petrenko et al., 1993). In Gomel andMogilev provinces, the levels of umbilical bloodcortisol and estriol in areas having Cs-137
contamination of less than 1–15 Ci/km2 weresignificantly higher than the level from heavily contaminated territories (15–40 Ci/km2 ;Danil’chik et al., 1996). Overtly healthy newborns in Gomel and Mogilev provinces had elevated cortisol levels where contamination wasless than 15 Ci/km2 and decreased levels inheavily contaminated areas (Danil’chik et al.,1996). The number of children with impaired
hormone secretion (cortisol, thyroxin, and progesterone) was significantly higher in heavily
contaminated territories (Sharapov, 2001).
3. Children from heavily contaminated territories had lower levels of testosterone, a hormone associated with physical development,with low levels linked to impaired reproductivefunction (Lyalykov et al., 1993).
4. Many girls of pubertal age, 13 to 14
years, from the contaminated territories with
autoimmune thyroiditis had accelerated sexual development with significantly increased
blood serum concentrations of gonadotropic
hormones in the lutein phase of their menstrual
cycles (Leonova, 2001).
5. Children aged 10 to 14 years born to irradiated parents diagnosed from 1993 to 2003
showed significantly more morbidity from goiter and thyroiditis (National Belarussian Report, 2006).
6. In some areas where congenital diabetes
had not been seen at all before the catastrophe,Yablokov: Nonmalignant Diseases after Chernobyl

79

there were occurrences afterward and the number of cases has increased since 1986 (Marples,
1996).
7. In Gomel and Minsk provinces the frequency off occurrence of Type-I diabetes rosesignificantly after the catastrophe, with thehighest incidence in the most contaminateddistricts of Gomel Province (Borysevich and
Poplyko, 2002).
8. Six years after the catastrophe incidence ofendocrine organ illnesses was threefold higher
in the heavily contaminated territories (Shilko
et al., 1993). Endocrine pathology was the number one illness diagnosed in a survey of morethan 8,000 children in 1993–1994 in the Slavgorod District of Mogilev Province (Suslov et al.,1997).
9. Nine years after the catastrophe, endocrine organ morbidity among evacuees andin those from heavily contaminated territories
was double that of the general population ofBelarus (Matsko, 1999).
10. Occurrence of Type-I diabetes increased
significantly in all of Belarus after the catastrophe (Mokhort, 2003) and to an even greater
degree in the heavily contaminated territories(Table 5.21).
11. Among 1,026,046 nursing mothers examined, the incidence of diabetes was significantly higher in the women from territories
with Cs-137 contamination above 1 Ci/km2(Busuet et al., 2002).
12. At the time of delivery, women from
more contaminated territories of Gomel andVitebsk provinces had significantly higher
concentrations of T4 and TCG hormones

and lower concentrations of T3 hormone(Dudinskaya and Suryna, 2001).
13. From 1993 to 2003 in the contaminatedterritories, among men younger than 50 yearsof age and women of all ages, there was a significant increase in morbidity owing to nontoxic
single-node and multinode goiters and autoimmune thyroiditis (National Belarussian Report,
2006).
14. Endocrine morbidity among evacuees
was double that of the general population ofBelarus (1,125 vs. 583) even 9 years after thecatastrophe (Matsko, 1999).
15. There was a correlation between the levelof incorporated Cs-137 and prolactin concentration in the serum of young women continuing to live in an area with radioactive contamination of 1–5 Ci/km2 (Gomel City) during
the first and second phases of their menstrual
cycles, as well as a correlation between levels
of incorporated Cs-137 and progesterone concentrations during the second menstrual cycle
phase (Yagovdik, 1998).
16. Belarus liquidators and evacuees had a2.5- to 3-fold increase in the number of individuals with Type-II diabetes and impaired glucose tolerance and a 1.4- to 2.3-fold increase in
hyperinsulinemia (Aderikho, 2003).
17. Ten years after the catastrophe, Belarus
liquidators had decreased function of the hypophyseal/thyroid axis; depression of insulinfunction; exhaustion of the pituitary/adrenal
system; and higher levels of progesterone, prolactin, and renin (Table 5.22).

TABLE 5.21. Occurrence of Type-I Diabetes per
100,000 Children and Teenagers before and after
the Catastrophe in Heavily and Less ContaminatedTerritories in Belarus (Zalutskaya et al. 2004)
Years

1980–1986

1987–2002

Heavily contaminated(Gomel Province)
Less contaminated(Minsk Province)

3.2 ± 0.3

7.9 ± 0.6∗

2.3 ± 0.4

3.3 ± 0.5∗

p < 0.05.

TABLE 5.22. Hormone Concentrations in Male
Belarussian Liquidators∗ (Bliznyuk, 1999)

Aldosterone
Cortisol
Insulin
ACTH
Prolactin
Progesterone
Renin∗

Liquidators

Controls

193.1 ± 10.6
510.3 ± 37.0
12.6 ± 1.2
28.8 ± 2.6
203.7 ± 12.3
2.43 ± 0.18
1.52 ± 0.14

142.8 ± 11.4
724.9 ± 45.4
18.5 ± 2.6
52.8 ± 5.4
142.2 ± 15.2
0.98 ± 0.20
1.02 ± 0.18

All differences are significant.

80

5.3.1.2. Ukraine
1. The noticeable increase in endocrine diseases (autoimmune thyroiditis, thyrotoxicosis,
diabetes) began in 1992 in all the contaminated territories (Tron’ko et al., 1995). In 1996
endocrine illnesses in areas contaminated at
levels higher than 5 Ci/km2 occurred markedly
more often than within the general Ukrainian
population (Grodzinsky, 1999). From 1988
to 1999 endocrine system morbidity incontaminated territories increased up to eightfold (Prysyazhnyuk et al., 2002).
2. Endocrine illnesses were the main causeof medical disability among children in thecontaminated territories (Romanenko et al.,2001). Some 32% of girls irradiated in utero
became infertile (10.5% among controls; p <0.05) owing to damage to the endocrine system(Prysyazhnyuk et al., 2002).
3. Within the first 2 years after the catastrophe hormonal imbalance became typicalamong people in heavily contaminated territories. Both boys and girls in contaminated areas
developed increased insulin synthesis, and girls
developed elevated testosterone levels (Antipkin
and Arabskaya, 2003).
4. In the contaminated territories onset ofpuberty in girls was late and menstrual cycles
among the women were disrupted (Vovk andMysurgyna, 1994; Babich and Lypchanskaya,
1994). In the territories contaminated with Sr90 and Pu, there was a 2-year delay in puberty
for boys and a 1-year delay for girls, whereas
sexual development was accelerated in territories contaminated by Cs-137 (Paramonova and
Nedvetskaya, 1993).
5. The incidence of endocrine disorders inirradiated children increased markedly after
1988 (Luk’yanova et al., 1995).
6. Evaluation of more that 16,000 pregnant
women from 1986 to 1993 in the contaminatedterritories revealed significantly higher levelsof thyrotrophic hormone and thyroxin (TSHand T-4) 2 years after the catastrophe. From1988 to 1990 levels of the principal thyroid
hormones were close to normal, but in 1991–

1992 the levels of the TSH, T-4, and T-3 werereduced. In 1993 hyperthyroidism in pregnant
women and newborns was observed for the firsttime (Dashkevich et al., 1995; Dashkevich andJanyuta, 1997).
7. Some 30% of women older than 50 yearsof age living in contaminated territories are subclinically hypothyroid (Panenko et al., 2003).
8. The level of endocrine morbidity
among adult evacuees is considerably higher
than for the overall population of Ukraine(Prysyazhnyuk et al., 2002).
9. A significant increase in diabetes mellitus
was observed in the contaminated territories
some years after the catastrophe (Gridjyuk et al.,1998).
10. A significant impairment of thepituitary–adrenal system was seen in a majority of 500 surveyed liquidators in the first years
after the catastrophe; 6 years later there wasnormalization of the relevant measurements inthe others at rest, but not in the functional levels(Mytryaeva, 1996).
11. Liquidators with generalized periodontal disease had significantly lower levels of calcium metabolic hormones, including parathormone, calcitonin, and calcitriol (Matchenko
et al., 2001).
12. Practically all liquidators had characteristic hormonal system changes expressed firstas impaired cortisone and insulin secretion(Tron’ko et al., 1995). For some, hormonal system normalization occurred 5 to 6 years after
they were irradiated. At the same time morethan 52% of those examined still had an increased frequency of occurrence of autoimmune endocrine diseases including thyroiditis,
diabetes mellitus, and obesity (Tron’ko et al.,1995).
5.3.1.3. Russia
1. Hormonal imbalance (estradiol, progesterone, luteotrophin, testosterone) became
widespread in the contaminated territories 5
to 6 years after the catastrophe (Gorptchenko
et al., 1995).

Yablokov: Nonmalignant Diseases after Chernobyl

2. Endocrine diseases increased in thecontaminated territories during the first 10
years after the catastrophe (Tsymlyakova andLavrent’eva, 1996).
3. The number of children with endocrine
diseases increased in the heavily contaminated zones (Sharapov, 2001). For children in
the contaminated areas of Tula Province, endocrine morbidity was fivefold higher in 2002
compared to the period before the catastrophe(Sokolov, 2003).
4. In 1995 the number of children with endocrine morbidity peaked as a whole in the contaminated areas of Bryansk Province. In spiteof some decrease in the level of endocrine morbidity from 1995 to 1998, it remained twice
as high as for Russia as a whole. At the sametime in the heavily contaminated Gordeevka,
Novozybkov, and Klymovo districts it remained
highly elevated in 1998 (Table 5.23).
5. A total of 17.7% of pregnant women in
the contaminated territories had significantly
increased levels of prolactin with associated termination of menstruation and loss of fertility(Strukov, 2003).
6. In the contaminated districts of the Kaluga
Province, which as a whole was less contamTABLE 5.23. Overall Endocrine Morbidity (per1,000) among Children of Bryansk Province,
1995– 1998, in Areas with Cs-137 Contamination above 5 Ci/km2 (Fetysov, 1999b: table 6.1)
Number of cases
District

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaGordeevka
Southwest∗
Province total
Russia

21.6
133.4
28.9
31.4
65.0
410.2
104.4
102.2
21.4

29.9
54.5
31.4
69.2
43.8
347.5
97.1
74.2
23.4

25.5
55.0
34.6
41.3
49.7
245.0
67.2
47.2
25.6

83.3
109.6
28.9
25.3
24.9
158.5
68.5
47.3
n/a

∗

All heavily contaminated districts of Bryansk
Province.

81

Figure 5.5. Incidence of endocrine andmetabolic diseases (per 1,000) among children of
liquidators (1) in Obninsk City, Kaluga Province(Borovykova, 2004); (2) children, City; (3) children,
Russia.

inated than Bryansk Province, juvenile endocrine morbidity was 5.8 to 16.1 per 1,000,
which was 1.4- to 3.2-fold more than that of
districts with less contamination (Borovykova
et al., 1996).
7. Endocrine morbidity in children bornto liquidators in Kaluga Province sharply increased in the first 12 years after the catastrophe (Figure 5.5).
8. The rate of increase in overall endocrine
illnesses in adults in the heavily contaminatedterritories was higher than that of children from1995 to 1998, and in most of the heavily contaminated districts of Bryansk Province wasnoticeably higher than for the province and for
Russia as a whole (Table 5.24).
9. Twelve years after the catastrophe overall adult endocrine system morbidity in theheavily contaminated southwest districts ofBryansk Province and liquidators’ morbidity both significantly exceeded the provincial
norms (Table 5.25). The provincial morbidity
for liquidators was noticeably higher than the
Russian average.
10. Fifteen years after the catastrophe overall endocrine system morbidity in the contaminated territories exceeded the provincial level2.6-fold (Sergeeva et al., 2005).

82
TABLE 5.24. General Endocrine Morbidity (per1,000) among Adults in Bryansk Province inTerritories with Cs-137 Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999a: tables 5.1
and 5.2)
Number of cases
District

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaGordeevka
Southwest∗
Province as a whole
Russia

70.8
54.5
48.0
38.2
33.9
32.8
43.2
32.1
28.2

95.5
77.9
83.2
40.4
51.4
46.3
58.6
35.0
29.8

109.3
67.5
75.5
54.0
52.0
57.6
64.2
38.5
31.2

112.2
40.9
74.1
81.1
57.7
72.4
66.6
41.2
n/A

∗

than in corresponding groups of the population(National Russian Report, 1999).
14. Severe changes in hypophyseal function
and changes in hormonal levels were found inliquidators (Drygyna, 2002).
15. High levels of prolactin were found in
22% of surveyed male liquidators, levels typically observed only in young women (Strukov,
2003).
16. Women liquidators have had consistentand significantly higher levels of gonadotropic
and steroidal sex hormones than controls, aswell as abnormal levels of cortisol, testosterone,
thyrotrophic hormone (TGH), triiodothyronine (T-3), and thyroxine (Bezhenar, 1999;
Bezhenar et al., 2000).

All heavily contaminated districts of Bryansk
Province.

11. There is an association between Chernobyl irradiation and impaired exocrine andendocrine testicular function, which includes
low testosterone plasma levels, an increased
level of follicle-stimulating hormone (FSH), anddecreased luteinizing hormone (LH; Byryukov
et al., 1993).
12. Endocrine system morbidity of Russianliquidators increased sharply from 1986 to
1993 (Table 5.26).
13. By 1999, endocrine system morbidity
among Russian liquidators was 10-fold higher
TABLE 5.25. General Endocrine Morbidity (per1,000) among Adults and Liquidators in Territories with Cs-137 Contamination above 5 Ci/km2
in Bryansk Province, 1995–1998 (Fetysov, 1999a:tables 4.1 and 4.2)
Number of cases
1994 1995 1996 1997 1998
Southwestern districts∗
Liquidators
Province as a whole
Russia∗49.9 53.3 58.6 64.2 147.4
92.7 124.5 92.1 153.0 195.0
31.6 32.1 35.0 38.5 41.2
27.8 28.2 29.8 31.2 n/a

All heavily contaminated districts.

“ . . . Last summer Dr. Vvedensky and a group ofcolleagues went to the “chemical filaments” statefactory sanatorium, located several hundred kilometers from Gomel City. Since the accident in
the Chernobyl nuclear power station, this sanatorium has been a place to rehabilitate children
from the most contaminated areas of Belarus . . .
Doctors chose to study 300 girls who were born in
1986–1990 . . . For 1.5 years of the survey doctors
saw surprising results. Anthropometrical research:measurements of growth, weights, volume of thorax, hips, and legs have shown that among girls
from a Chernobyl zone all the parameters were
below the norms. However, the width of shoulders
exceeded the norm and their forearms, shoulders,
and legs were very hairy.
Other scientists have come up against more serious pathologies. As a rule, at the age of 12–13 years
girls begin to menstruate. Not one of the 300 girls
in the study had done so. Ultrasound examinations showed that their uteruses and ovaries were
underdeveloped . . . “Our results could be wildly
accidental, Dr. Vvedensky said, but among these
300 girls there was one who had no internal reproductive organs at all. . . . While we have no right todraw any scientific conclusions—if we had foundat least three out of 10,000 girls with the samedevelopmental anomaly, then it would be possible
to speak about a terrible physiological catastrophe.” However, we doctors do not have money formore detailed and extensive studies. Vvedensky’s
group has come to the conclusion that the reason
for the changes is hormonal imbalance. Under the

83

Yablokov: Nonmalignant Diseases after Chernobyl
TABLE 5.26. Endocrine Morbidity among Russian Liquidators (per 10,000) (Baleva et al., 2001)
Year
Number of cases, n

1986
96

1987
335

1988
764

influence of irradiation a large amount of testosterone develops in the female organism. Testosterone is a male hormone that is normally present
only in very small quantities in females, but when awoman has too much of it she can lose her female
characteristics. . ..” (Ulevich, 2000)

5.3.2. Impairment of Thyroid Gland
Function
Adequate and timely thyroid function is necessary for physical and intellectual developmentof the fetus. Damage to the thyroid gland of theunborn or the neonate may result in diminishedmental capacity for life.
Radiation from I-131 and other radionuclides damages the glandular epithelium,
which is demonstrated by nodular formations. Autoimmune thyroiditis is one of thefirst functional consequences of irradiation(Mozzhukhyna, 2004). Among the subsequent
thyroid illnesses are hypo- and hyperthyroidism, myxedema, and nonmalignant andmalignant tumors. Thyroid gland impairment
leads to decreased production of the glands’
three hormones—thyroxin, triiodothyronine,and calcitonin—which control, for example,
growth and development, thermoregulation,and calcium exchange.
In all of the contaminated territories, there isa marked increase in nonmalignant thyroid diseases (Gofman, 1994; Dedov and Dedov, 1996).
Associated illnesses include: delayed healing ofwounds and ulcers, delay in growth of hair,dryness, fragility, hair loss, increased susceptibility to respiratory infections, night blindness, frequent dizziness, ringing in the ears,
headaches, fatigue and lack of energy, lackof appetite (anorexia), delayed growth in children, male impotence, increased bleeding (including menstrual menorrhagia), lack of gas-

1989
1,340

1990
2,020

1991
2,850

1992
3,740

1993
4,300

tric hydrochloric acid (achlorhydria), and mild
anemia.
Among hypothyroid symptoms that are notnecessarily recorded as illnesses, but are seen
with increased frequency in the contaminatedterritories, are: facial and eyelid swelling; increased sensitivity to cold; decreased perspiration; drowsiness; tongue swelling, slowed
speech, and rough and hoarse voice; muscular
pains and weakness and impaired muscle coordination; joint stiffness; dry, rough, pale, andcold skin; poor memory and slowed thinking;difficult respiration (dyspnoea); and deafness(Gofman, 1990; and others).
Pathological changes in the thyroid glandare closely linked to those in the parathyroid
glands. Parathyroid function was destroyed in
16% of the individuals that underwent thyroid gland surgery (Demedchik et al., 1996).
Many symptoms attributed to parathyroid impairment were observed in the Chernobyl territories. Among them: hypogonadism in men andwomen, impaired normal somatic and sexual
development, hypophyseal tumors, osteoporosis, vertebral compression fractures, stomach
and duodenal ulcers, urolithiasis, and calcium
cholecystitis (Dedov and Dedov, 1996; Ushakov
et al., 1997).
5.3.2.1. Belarus
1. By the year 2000 several hundred thousand people had been registered as having
thyroid pathologies (nodular goiter, thyroid
cancer, thyroiditis). Annually some 3,000 people require thyroid surgery (Borysevich and
Poplyko, 2002).
2. Morbidity among children owing to autoimmune thyroiditis increased almost threefold during the first 10 years after the catastrophe (Leonova and Astakhova, 1998). By 1995
there was an apparent increase in the number

84

of cases of autoimmune thyroiditis in theless contaminated Vitebsk, Minsk, and Brest
provinces (Khmara et al., 1993).
3. In Gomel Province, which was one of
the most contaminated, more than 40% of thechildren examined in 1993 had enlarged thyroid glands. Here endemic goiter increased sevenfold from 1985 to 1993, and autoimmune
thyroiditis increased more than 600-fold from1988 to 1993 (Astakhova et al., 1995; Byryukova
and Tulupova, 1994).
4. Screening of 328 children ages 11 to 14
years in Khoiniky City, Gomel Province, in1998 revealed that 30% had enlarged thyroid
glands (Drozd, 2002).
5. Children irradiated in utero during the firsttrimester have small thyroid glands and are frequently diagnosed with latent hypothyroidism(Drozd, 2002).
6. Surveys disclosed thyroid gland pathology
in 43% of 4- to 5-month-old embryos frommothers from areas contaminated with Cs-137
at levels of 1–15 Ci/km2 (Kapytonova et al.,1996).
7. Children irradiated in utero from theStolinsk District, Brest Province, which had levels of Cs-137 contamination up to 15 Ci/km2 ,had thyroid gland impairment even after morethan 10 years, which included: lowered production of thyroxin-binding globulin (T-4), increased production of triiodothyronine, increased production of thyroglobulin in girls,
and lowered production of thyroxin in boys
(Sychik and Stozharov, 1999a).
8. Enlarged thyroid glands were found in
47% of 3,437 children examined in Mozyr District, Gomel Province (Vaskevitch and Tchernysheva, 1994).
9. Levels of immunity in children andteenagers with autoimmune thyroiditis havebeen correlated with a district’s level of radioactive contamination (Kuchinskaya, 2001).
10. Early sexual maturation was observedin girls from contaminated territories who
had autoimmune thyroiditis and was associated with a significant increase in gonadotropic hormone concentration in the luteil

phase of their menstrual cycles (Leonova,
2001).
11. Among 119,178 children from Ukraine,
Belarus, and Russia under 10 years of age at thetime of catastrophe who were examined within
the framework of the “Sasakava” project, there
were 62 cases of thyroid cancer and 45,873
cases of other thyroid pathology (Yamashita
and Shibata, 1997).
12. There was a significant correlation between environmental Cs-137 contaminationand the incidence of thyroid diseases among
1,026,046 pregnant women (Busuet et al.,2002).
13. From 1993 to 2003 primary nontoxic
multinodular and uninodular goiters and autoimmune thyroiditis significantly increased
among female evacuees (National Belarussian
Report, 2006).
14. From 1993 to 1995 thyroid gland hyperplasia was found in 48% of juvenile immigrants
from the Bragin District and in 17% of juvenile immigrants from the Stolinsk District, Brest
Province (Belyaeva et al., 1996).
15. Thyroid gland pathology in the
Chernobyl-contaminated territories correlatedwith diseases of the gums and teeth (Konoplya,1998).
16. In 1996 thyroid gland illnesses were observed 11.9-fold more often among liquidators
than in the general adult population (Antypova
et al., 1997a,b).
17. The incidence of thyroid gland anatomic
changes in male liquidators who worked in
1986–1987 was noticeably higher in 1994 compared with 1992 (Table 5.27).

TABLE 5.27. Thyroid Gland Structural Changes(% of a Total of 1,752 Cases Examined Annually) in
Belarussian Male Liquidators (1986–1987) (Lyasko
et al., 2000)

NodularHyperplasia
Thyroiditis

1992

1994

13.5
3.5
0.1

19.7
10.6
1.9

85

Yablokov: Nonmalignant Diseases after Chernobyl

5.3.2.2. Ukraine
1. Thyroid gland dysfunction has been observed in the contaminated territories since
1986–1987, and since 1990–1991 there has
been an increase in chronic autoimmune
thyroiditis (Stepanova, 1999; Cheban, 1999,
2002).
2. Eight years after in utero irradiation, thyroid
gland hormone production was low, but it wasalso low in children irradiated during the firstweeks after birth (Gorobets, 2004).
3. Children with secondary thyroid hyperplasia have two to three times more incidence ofallergies, blood vessel pathology, immune disorders, intestinal illnesses, caries, and high bloodpressure (Table 5.28).
4. In thyroid surgical pathology specimens
in 1989, the incidence of goiter was foundto be sharply higher compared with the preChernobyl period (Horishna, 2005).
5. From 1992 to 2000 the incidence ofchronic thyroiditis increased in teenagers andadults, especially among liquidators and evacuees (Figure 5.6).
6. Thyroid gland changes were found in
35.7% of 3,019 teenagers living in Vinnitsa andZhytomir provinces who had been 6 to 8 years
old at the time of the catastrophe (Fedyk, 2000).
7. Thyroid gland pathology is twice as common in children from heavily contaminated territories compared to those from less contaminated areas: 32.6 vs. 15.4% (Stepanova, 1999).
8. Among 1,825 children and teenagers living in Kiev Province who were born before thecatastrophe (1984–1986) the frequency of thyroid gland pathology did not decrease in 11 to

Figure 5.6. Occurrence of chronic thyroiditis
among teenagers and adults from Ukraine from1992 to 2000 (National Ukrainian Report, 2006:
fig. 5.10).

14 years following the catastrophe (Syvachenko
et al., 2003).
9. Among 119,178 children of Ukraine,
Belarus, and Russia who were younger than
10 years of age at the time of the catastrophe examined within the framework of the“Sasakava” project, there were 740 abnormal
thyroid pathologies for each case of thyroid cancer (Yamashita and Shibata, 1997). In anotherstudy in which 51,412 children were examined,
1,125 thyroid pathologies were found for eachcase of cancer (Foly, 2002).
10. Among more than 50,000 children withpsychological problems who were evaluated,
15% have thyroid gland pathology (Contis,
2002).
11. Chronic thyroiditis morbidity significantly increased among Ukrainian liquidators

TABLE 5.28. Incidence (%) of Somatic Pathology among Children with Various Degrees of Thyroid
Hyperplasia (Luk’yanova et al., 1995)

0
I degreeII degree∗

VSD∗

Allergies

Circulation

Infections

CariesIntestinal

7.2
12.4
27.8

1.4
4.8
12.6

3.5
4.3
9.4

5.0
5.8
14.7

32.7
45.8
63.9

20.4
29.3
35.8

Vegetocircular dystonia (autonomic nervous system dysfunction).

86

between 1992 and 2001 (Moskalenko,
2003).
12. Some 150,000 Ukrainians developed
thyroid gland diseases in 10 years that were related to the catastrophe (ITAR–TASS, 1998).
5.3.2.3. Russia
1. Children in territories with high levels of radioactive contamination have a significantly higher incidence of second-degree
thyroid gland hyperplasia and nodular and diffuse forms of goiter (Sharapov, 2001).
2. There is a correlation between the level ofincorporated radionuclides and hyperplasia of
the thyroid gland (Adamovich et al., 1998).
3. Every second child in the heavily contaminated districts of Bryansk Province has
had some thyroid gland pathology (Kashyryna,2005).
4. From 1998 to 2004 in Bryansk Province,
there were 284 cases of thyroid cancer and
7,601 cases of other types of thyroid pathology(Karevskaya et al., 2005).
5. In the heavily contaminated districts ofBryansk Province up to 60% of children havethyroid gland hyperplasia (Table 5.29).
6. In Voronezh Province, where eight districts were officially registered as being contaminated with radioactivity, the incidence ofenlarged thyroids increased in children in thefirst 10 years after the catastrophe. At age 11,
TABLE 5.29. Cases of First and Second Degree
Thyroid Gland Hyperplasia in Children (per 1,000)
in Heavily Contaminated (Cs-137 > 5 Ci/km2 ) Districts of Bryansk Province, 1995–1998 (Fetysov,
1999b: table 6.2)
Number of cases
District

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaSouthwest∗

600.5
449.0
487.6
162.2
245.1
423.4

295.9
449.5
493.0
306.8
549.3
341.0

115.1
385.9
413.0
224.6
348.7
298.7

52.3
329.4
394.3
140.1
195.0
242.7

∗

All heavily contaminated districts.

boys who were born in Voronezh Province in1986 were significantly shorter than boys ofthe same age who were born in 1983, mostprobably owing to thyroid hormone imbalance(Ulanova et al., 2002).
7. In 1998 every third child in the city of
Yekaterinburg, located in the heavily industrialized Ural area that was exposed to Chernobyl
fallout, had abnormal thyroid gland development (Dobrynina, 1998).
5.3.2.4. Other Countries
POLAND. Of the 21,000 individuals living inthe southeast part of the country contaminatedby Chernobyl fallout who were examined, every second woman and every tenth child had
an enlarged thyroid. In some settlements, thyroid gland pathology was found in 70% of the
inhabitants (Associated Press, 2000).
5.3.3. Conclusion
Despite information presented so far, we still
do not have a total global picture of all of thepeople whose hormone function was impairedby radiation from the Chernobyl catastrophe
because medical statistics do not deal with suchillnesses in a uniform way.
At first sight some changes in endocrine function in those subjected to Chernobyl radiation were considered controversial. We havelearned, however, that hormone function may
be depressed in a territory with a low level ofradioactive contamination and increased owing to an increasing dose rate in a neighboring
contaminated area. Diseases of the same organ may lead to opposing signs and symptoms
depending upon the timing and extent of thedamage. With the collection of new data, we
hope that such contradictions can be resolved.
Careful research may uncover the explanation
as to whether the differences are due to past
influences of different isotopes, combinationsof different radioisotopes, timing of exposures,
adaptation of various organs, or factors still tobe uncovered.

Yablokov: Nonmalignant Diseases after Chernobyl

87

The analysis of remote, decades-old data,from the southern Ural area contaminated byradioactive accidents in the 1950s and 1960s
indicates that low-dose irradiation in utero,which was similar to that from Chernobyl, maycause impairment of neuroendocrine and neurohumoral regulation. Using those data, researchers reported vertebral osteochondrosis,
osteoarthritic deformities of the extremities, atrophic gastritis, and other problems in the exposed population (Ostroumova, 2004).
An important finding to date is that for every
case of thyroid cancer there are about 1,000
cases of other kinds of thyroid gland pathology.
In Belarus alone, experts estimate that up to
1.5 million people are at risk of thyroid disease(Gofman, 1994; Lypyk, 2004).
From the data collected from many different areas by many independent researchers, thespectrum and the scale of endocrine pathology
associated with radioactive contamination are
far greater than had been suspected. It is now
clear that multiple endocrine illnesses caused
by Chernobyl have adversely affected millions
of people.

chronic diseases and infections, as is widely observed in the Chernobyl-irradiated territories(Bortkevich et al., 1996; Lenskaya et al., 1999;
and others). The suppression of immunity asa result of this radioactive contamination is
known as “Chernobyl AIDS.”
On the basis of review of some 150 scientific publications the conclusion is that depression of thymus function plays the leading rolein postradiation pathology of the immune system (Savyna and Khoptynskaya, 1995). Some
examples of adverse effects of Chernobyl contamination on the immune system as well as
data showing the scale of damage to the healthof the different populations are described inwhat follows.

5.4. Immune System Diseases
One result of many studies conducted during
the last few years in Ukraine, Belarus, and Russia is the clear finding that Chernobyl radiation
suppresses immunity—a person’s or organism’s
natural protective system against infection andmost diseases.
The lymphatic system—the bone marrow,thymus, spleen, lymph nodes, and Peyer’s
patches—has been impacted by both large
and small doses of ionizing radiation from the
Chernobyl fallout. As a result, the quantityand activity of various groups of lymphocytes
and thus the production of antibodies, including various immunoglobulins, stem cells, andthrombocytes, are altered. The ultimate consequences of destruction of the immune system is immunodeficiency and an increase in
the frequency and seriousness of acute and5.4.1. Belarus
1. Among 3,200 children who were examined from 1986 to 1999 there was a significant
decrease in B lymphocytes and subsequently
in T lymphocytes, which occurred within thefirst 45 days after the catastrophe. In the first
1.5 months, the level of the G-immunoglobulin(IgG) significantly decreased and the concentration of IgA and IgM as circulating immune
complexes (CIC) increased. Seven months after the catastrophe there was a normalizationof most of the immune parameters, except for
the CIC and IgM. From 1987 to 1995 immunosuppression was unchanged and a decrease in the number of T cells indicators wasseen. A total of 40.8 ± 2.4% of children fromthe contaminated territories had high levels of
IgE, rheumatoid factor, CIC, and antibodies
to thyroglobulin. This was especially prominent in children from the heavily contaminated areas. The children also had increased
titers of serum interferon, tumor necrosis factor (TNF-a), R-proteins, and decreased complement activity. From 1996 to 1999 T cellsystem changes showed increased CD3+ andCD4+ lymphocytes and significantly decreased
CD22 and HLA-DR lymphocytes. Children
from areas heavily contaminated with Cs-137
had significantly more eosinophils, eosinophilic

88

protein X concentration in urine, andeosinophilic cation protein concentration inserum (Tytov, 2000).
2. There was a strong correlation between
the level of Cs-137 contamination in the territories and the quantity of the D25+ lymphocytes,
as well as concentration-specific IgE antibodies
to grass and birch pollen (Tytov, 2002).
3. There was an increasing concentration of
the thyroid autoantibodies in 19.5% of “practically healthy” children and teenagers living in
Khoiniky District, Gomel Province. The children and teenagers with thyroid autoimmune
antibodies living in the contaminated territories
have more serious and more persistent changes
in their immune status (Kuchinskaya, 2001).
4. The number of B lymphocytes and thelevel of serum IgG began to increase in children
from the contaminated areas of the Mogilev
and Gomel provinces a year after the catastrophe. The children were 2 to 6 years of age at
the time of the catastrophe (Galitskaya et al.,1990).
5. In children from the territories of Mogilev
Province contaminated by Cs-137 at levels
higher than 5 Ci/km2 there was a significant
decrease in cellular membrane stability and impaired immunity (Voronkin et al., 1995).
6. The level of T lymphocytes in children
who were 7 to 14 years of age at the time of
the catastrophe correlated with radiation levels(Khmara et al., 1993).
7. Antibody formation and neutrophilic activity were significantly lower for the first yearof life in newborns in areas with Cs-137 levels
higher than 5 Ci/km2 (Petrova et al., 1993).
8. Antitumor immunity in children and evacuees was significantly lower in heavily contaminated territories (Nesterenko et al., 1993).
9. Immune system depression occurred inhealthy children in the Braginsk District nearthe 30-km zone immediately after the catastrophe with normalization of some parameters not occurring until 1993 (Kharytonik et al.,1996).
10. Allergy to cow’s milk proteins was foundin more children living in territories more heav-

ily contaminated by Sr-90 than in children
from less contaminated areas: 36.8 vs. 15.0%(Bandazhevsky et al., 1995; Bandazhevsky,
1999).
11. Among 1,313 children examined froman area contaminated by Cs-137 at a levelof 1–5 Ci/km2 some developed immune system problems, which included lowered neutrophil phagocytic activity, reduced IgA and
IgM, and increased clumping of erythrocytes(Bandazhevsky et al., 1995).
12. The immune changes in children of
Gomel Province are dependent upon the spectrum of radionuclides: identical levels of Sr90 and Cs-137 radiation had different consequences (Evets et al., 1993).
13. There was correlation among children
and adults between the level of radioactive contamination in an area and the expression of theantigen APO-1/FAS (Mel’nikov et al., 1998).
14. There are significant competing differences in the immune status of children fromterritories with different Cs-137 contaminationloads (Table 5.30).
15. Levels of immunoglobulins IgA, IgM,
IgG, and A(sA) in mother’s milk were significantly lower in the contaminated areas. Acuterespiratory virus infections (ARV), acute bronchitis, acute intestinal infections, and anemia
were manifoldly higher in breast-fed babies
from the contaminated areas (Zubovich et al.,1998).
16. Significant changes in cellular immunity were documented in 146 children andteenagers operated on for thyroid cancer in
Minsk. These changes included: decrease in thenumber of T lymphocytes (in 30% of children
and 39% of teens), decreased levels of B lymphocytes (42 and 68%), decreased T lymphocytes (58 and 67%), high titers of antibodies tothyroglobulin (ATG), and neutrophilic leukocytosis in 60% of the children (Derzhitskaya et al.,1997).
17. Changes in both cellular and humoral
immunity were found in healthy adults living
in territories with a high level of contamination(Soloshenko, 2002; Kyril’chik, 2000).

89

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.30. Immune Status of Children with Frequent and Prolonged Illnesses from the ContaminatedTerritories of Belarus (Gurmanchuk et al., 1995)
District/radiation level

Parameters of immunity

Pinsk, Brest Province,
1–5 Ci/km2 (n = 67)

Number of T lymphocytes, T suppressors (older children), suppression index,
T helpers (all groups) is lowered. The level of the CIC, IgM (all groups), and IgA(children up to 6 years of age) is raised.
Number of T lymphocytes is raised (all groups), fewer T-lymphocyte helpers (older
children), increased T suppressors (in oldest children).
All children have humoral cellular depression, fewer B lymphocytes, CIC levels
raised, complement overactive, and levels of IgG and IgA phagocyte activity
lowered.

Bragin, Gomel Province,
40–80 Ci/km2 (n = 33)
Krasnopolsk, Mogilev
Province, up to
120 Ci/km2 (n = 57)

18. The levels of IgA, IgG, and IgM immunoglobulins were increased in the postpartum period in women from districts in Gomel
and Mogilev provinces contaminated with Cs137 at a level higher than 5 Ci/km2 andthe immune quality of their milk was lowered(Iskrytskyi, 1995). The quantity of IgA, IgG,
and IgM immunoglobulins and secretory immunoglobulin A(sA) were reduced in womenin the contaminated territories when they began lactating (Zubovich et al., 1998).
19. The number of T and B lymphocytes and phagocytic activity of neutrophilic
leukocytes was significantly reduced in adults
from the contaminated areas (Bandazhevsky,
1999).
20. Significant changes in all parameters ofcellular immunity (in the absence of humoralones) were found in children born to liquidatorsin 1987 (Arynchin et al., 1999).
21. A survey of 150 Belarus liquidators
10 years after the catastrophe showed a significant decrease in the number of T lymphocyte, T suppressor, and T helper cells(Table 5.31).
22. In a group of 72 liquidators from 1986,
serum levels for autoantibodies to thyroid antigens (thyroglobulin and microsomal fraction of
thyrocytes) were raised 48%. Autoantibodies
to lens antigen were increased 44%; to CIC,
55%; and to thyroglobulin, 60%. These shifts
in immune system function are harbingers of
pathology of the thyroid gland and crystalline
lens of the eye (Kyseleva et al., 2000).

5.4.2. Ukraine
1. Immune deficiency was seen in 43.5% ofchildren radiated in utero (vs. 28.0% in the control group; P <0.05) within the first 2 years
after the catastrophe (Stepanova, 1999).
2. A total of 45.4% of 468 children andteenagers who were examined had chronic tonsillitis, hypertrophy of the adenoid glands andtonsils, and increased frequency of neck lymphadenopathies. All of these pathologies wereexpressed more in the areas with higher levelsof contamination (Bozhko, 2004).
3. Quantitative and functional parametersof the immune status of children correlatedwith the level of background radiation in areas of permanent residency. These included
impaired T- and B-cellular immunity, stimulation of Th[2]-cells and increased IgE, absolute and relative number of B lymphocytes, andlevels of immunoglobulins in blood and saliva(Kyril’chik, 2000).
4. Periodic changes in humoral and cellularimmunity were found in healthy children fromthe Komarin settlement, Braginsk District, near
TABLE 5.31. Numbers of T and B Lymphocytes
in 150 Belarussian Male Liquidators in 1996
(Bliznyuk, 1999)

T lymphocytes
B lymphocytes∗

Liquidators

Controls

723.5 ± 50.6
215.7 ± 13.9

1,401.0 ± 107.4∗
272.5 ± 37.3∗

Differences are significant.

90

the 30-km Chernobyl zone. In 1986 the levelof interferon in 40.8 ± 6.2% of children was
significantly below the level of controls. The
greatest immune system depression involved
a decrease in EAC-POK, especially in children aged 4 to 6 years, a decreased level ofT lymphocytes, and an index of suppression(IS) especially for children aged 11 to 14 years.
In 1988 the levels of IgM and CIC remainedraised, as were those of T lymphocytes and T
helper cells. Levels of T suppressor cells significantly decreased, whereas interferon activity
increased. By 1993 there was a normalizationof a number of immune parameters, but forchildren 7 to 14 years of age T lymphocytes
and T helper cells were decreased (Kharytonik
et al., 1996).
5. Immunological status of evacuees’ children in the first 2 years was characterized
by impaired humoral and cellular immunity.
These parameters stabilized only 5 years later(Romanenko et al., 1995a,b).
6. The number of T and B lymphocytes(36 ± 3.5% and 24 ± 1.4%), T helpers,
immune-regulating index Tx:Tc (2.4 ± 0.19 vs.
1.9 ± 0.14), and IgG levels were significantly
higher in patients with chronic pyelonephritis
living in the contaminated areas of Polessk andIvankov districts of Kiev Province (Vozianov
et al., 1996).
7. The number of peripheral blood leukocytes in evacuees remained significantly lower
even 7 to 8 years after the catastrophe (Baeva
and Sokolenko, 1998).
8. The influences of internal and externalradiation on the character of neurohumoral
reactions are sharply different: with internalradiation there is a gradual development of
autoimmune reactions, whereas with externalradiation, development is rapid (Lysyany andLyubich, 2001).
9. A total of 45% of more than 450,000
children living in contaminated territories had
lowered immune status 10 years after the catastrophe (TASS, 1998).
10. Significant impairment of cellular andhumoral immunity, expressed by decreased

numbers of T- and B-rosette forming cells,
T suppressors, and IgA and IgG globulins and an increased index of T helpers/
T suppressors, was found in areas withhigher levels of radionuclides (Soloshenko,
2002).
11. Liquidators from 1986–1987 had impaired immunity expressed as depressedhumoral and cellular immunity and poor resistance to infection 6 to 8 years after the catastrophe (Chumak and Bazyka, 1995).
12. In the 10 to 15 years after the catastrophe
many liquidators had quantitative changes incellular and humoral immunity and altered immune status (Korobko et al., 1996; Matveenko
et al., 1997; Potapnev et al., 1998; Grebenjuk
et al., 1999; Gazheeva et al., 2001; Malyuk andBogdantsova, 2001; Tymoshevsky et al., 2001;
Shubik, 2002; Bazyka et al., 2002; Novykova,
2003; Mel’nov et al., 2003). These changes are
expressed as:•

Changes in the ratio of subpopulationsof T lymphocytes—T helpers/T suppressors.
• Decrease in the general number of T and
B lymphocytes.
• Decrease in the level of serum IgA, IgG,
and IgM immunoglobulins.
• Impaired production of cytokines.
• Activation of neutrophilic granulocytes.
13. Pathological changes in neutrophil ultra structure, which included destruction of cell
contents, hypersegmentation of nuclei, abnormal polymorphic forms and lymphocytes withincreased segmentation, changes in membrane
contour, and chromatin and nuclei segmentation, were found in a majority of 400 liquidators
examined (Zak et al., 1996).
5.4.3. Russia
1. Children living in heavily contaminatedterritories have generalized and specific immunity suppression and malfunction of theirantioxidant and sympathetic adrenal systems(Terletskaya, 2003).

Yablokov: Nonmalignant Diseases after Chernobyl

91

2. A survey of 144 children and teenagers
of Krasnogorsk District, Bryansk Province,with Cs-137 levels up to 101.6 Ci/km2 havedecreased relative and absolute numbers ofT cells; increased immune-regulatory index(T4/T8); and reduced relative numbers of lymphocytes, T helpers (CD4+ ), and relative andabsolute numbers of T suppressors (CD8+ ;Luk’yanova and Lenskaya, 1996).
3. During a survey of 113 children fromthe Krasnogorsk District, Bryansk Province,from 1987 to 1995, parameters of intensive
granular reaction in lymphocytes peaked in
1991, decreased almost to their norms in 1992–
1993, and increased again in 1994–1995. The
number of children with critically low lymphocyte counts also rose in 1994–1995. There
were correlations between an intensive granular reaction in children and additional internal radiation of more than 0.5 mSv annually(Luk’yanova and Lenskaya, 1996).
4. In territories of Krasnogorsk District withhigher radioactive contamination there was significantly less activity of nonspecific esterase(a marker of immature T cells) and a significant increase in the number of medium-size
lymphocytes with intensive granular reaction(Lenskaya et al., 1995).
5. Children 11 to 13 years of age and pregnant women living in districts of Kursk Province
with high levels of contamination had functional and quantitative lymphocyte changes
and significantly increased circulating serum
immune complexes (CICs; Alymov et al., 2004).
6. By 2002 the frequency of occurrence ofimpaired immunity and metabolism in children had increased fivefold in the contaminated districts of Tula Province compared topre-Chernobyl levels. At the same time, morbidity not related to radiation remained thesame in both the clean and contaminated territories (Sokolov, 2003).
7. In the heavily contaminated districts ofBryansk Province, children and teenagers had
markedly lowered relative and absolute numbers of T cells; significantly lowered relative
numbers of lymphocytes, T helpers (CD4+ ),and T suppressors (CD8+ ); and a raised
immune-regulatory index (T4 helpers/T8 suppressors). This index correlated significantlywith the dose level in utero (Kulakov et al., 1997).
8. Absolute levels of all lymphocyte populations were lower in all liquidators’ children
examined at 10 to 13 years of age, which indicated that these children had both absolute andrelative deficiencies in their cellular immunity.
Clinically, infections prevailed: frequent acuterespiratory virus infections (ARV), bronchitis,
pneumonia, otitis, and purulent infections of
the mucous membranes and skin. For others,a relative measure of cellular immunity had atendency to increase owing to an increase in thenumber of CD4+ cells and there was a decreasein the subpopulation T cells and an increase inbasophilic activity. The clinical picture of thesecond group comprised allergies, sensitivity topollens, asthmatic bronchitis, and food allergies(Kholodova et al., 2001).
9. In the contaminated territories the number of individuals with adaptive reaction lymphocytes is lower and the number of people with elevated lymphocyte radiosensitivity
is higher (Burlakova et al., 1998).
10. The number of large granulocytic lymphocytes (NK cells) decreased 60 to 80% in
liquidators 1 month after beginning work in
the contaminated zone and persisted at a low
level for not less than 1 year (Antushevich andLegeza, 2002). After 3 to 4 years liquidators
had persistent changes in T system immunity
with a decrease in T cells and T helpers and areduction in the helper/suppressor index. This
combination was observed in varying degrees
in 80% of cases with bacterial intestinal disease. After 5 years and then 13 to 15 years
most of the parameters of cellular and humoral
immunity in liquidators did not differ from normal, although there were changes in naturalimmunity with decreased activity of myeloperoxidase (MPO) in neutrophils, a markedly reduced subpopulation of active lymphocytes,
and a substantial increase in abnormal erythrocytic forms (Antushevich and Legeza,2002).

92

11. In the 7 to 9 years after the catastrophe, liquidators from Obninsk City, Kaluga
Province, had a higher incidence of allergic diseases: rhinitis (6- to 17-fold) and nettle rash (4to 15-fold) compared to the local population(Tataurtchykova et al., 1996).
12. Four years after their participation in
emergency work the normal levels of dermorphin was restored in only 17% of the liquidators examined. The levels of two other neuropeptides (leu- and methionine-encephalin)
exceeded norms for more than 50% of
the liquidators examined (Sushkevich et al.,1995).
13. Liquidators with neuropsychological disorders developed secondary immunedeficiency conditions (T lymphopenia, loss ofbalance of subpopulations of T cells with impaired T helper/T suppressor ratios, etc.). The
number of T helpers (CD4+ ) decreased in 90%of surveyed liquidators, and 15% of those examined had a significantly reduced number ofcirculating T-suppressor cells. In these groupschanges took place that were opposite in nature to changes in the immune-regulatory index
CD4/CD8). The level of the CIC increased inall surveyed liquidators. Phagocytic activity of
peripheral blood neutrophils was lower in 80%
and macrophage activity was lower in 85% of
those examined (Kut’ko et al., 1996).
14. The immune index of liquidators correlated with the dose of radiation calculated by
the level of chromosomal aberrations (Baleva
et al., 2001).

5.4.4. Conclusion
Data in this section demonstrate the powerful effects of the Chernobyl radioactive fallout
on the immune system and its functions. Despite the fragmentary data, it is clear that thescale of the impacts is enormous. Apparently,
impaired immunity triggered by Chernobyl radionuclides adversely affected all of the individuals, without exception, who were subjected toany additional radiation.

5.5. Respiratory System Diseases
There is a marked increase in respiratory
system morbidity everywhere in the territories
contaminated by Chernobyl fallout. Respiratory system diseases, which include those of thenasal cavity, throat, trachea, bronchial tubes,
and lungs, were among the first apparent consequences of the irradiation and ranged fromnose bleeds and tickling in the throat to lungcancer. Hot particles, or “Chernobyl dust,”
consist of particles containing radionuclides derived from nuclear fuel melted together withparticles from metal construction, soil, etc. (seeChapter 1 for details). These persist for long
periods in pulmonary tissue because of the low
solubility of uranium oxides. In the first days
after the catastrophe, respiratory problems inthe mouth, throat, and trachea in adults werebasically linked to the gaseous–aerosol formsof radionuclides. During this initial period I131, Ru-106, and Ce-144 had the most serious impact on the respiratory system (IAEA,
1992; Chuchalin et al., 1998; Kut’kov et al.,
1993; Tereshenko et al., 2004). Further damage to the respiratory system was caused by hot
particles and external irradiation, and was alsoa consequence of changes in the immune andhormonal systems. The smallest hot particles,
up to 5 μm, easily reached the deepest parts oflungs, while larger particles were trapped in theupper respiratory tract (Khrushch et al., 1988;
Ivanov et al., 1990; IAEA, 1994).
Bronchopulmonary morbidity increased
quickly among liquidators in the contaminatedterritories (Kogan, 1998; Provotvorov andRomashov, 1997; Trakhtenberg and Chissov,
2001; Yakushin and Smirnova, 2002; Tseloval’nykova et al., 2003; and others). Liquidators,
whose health was supervised more carefully
than that of the general population, developed
marked restrictive lung disease due to a functional decrease in lung elasticity (Kuznetsova
et al., 2004). Chernobyl dust was found inliquidators’ bronchial tubes, bronchioles, andalveoli for many years. The syndrome of “acuteinhalation depression of the upper respiratory

Yablokov: Nonmalignant Diseases after Chernobyl

93

system” presents as a combination of a rhinitis, tickling in the throat, dry cough, and difficulty breathing (Chuchalin et al., 1993; Kut’kov,
1998; Romanova, 1998; Chykyna et al., 2001;
and others).

7. In the first 3 years after the catastrophe
respiratory illnesses in children from territories contaminated at a level of 15–40 Ci/km2
were 3.5-fold more common than in less contaminated territories. From 1990 to 1993 children from heavily contaminated territories
had 2.5-fold more illnesses (Gudkovsky et al.,1995).
8. Respiratory morbidity among children
from the Luninetsk District, Brest Province, was
72.9% from 1986 to 1988, 54.1% from 1989 to
1991, and 39.4% from 1992 to 1994. Amongthe most common illnesses were ARV infection,
bronchitis, and chronic tonsillitis (Voronetsky
et al., 1995).
9. Among evacuees, respiratory morbidity in
1995 was 2,566 cases per 10,000 compared tothe country average of 1,660 (Matsko, 1999).

5.5.1. Belarus
1. Children born to mothers in the Chernobyl contaminated territories who were pregnant at the time of the catastrophe have twice
the incidence of acute respiratory diseases(Nesterenko, 1996).
2. Respiratory morbidity in children bornat the time of the catastrophe in territories
with contamination levels of 15–40 Ci/km2
was significantly higher than in children of
the same age from territories with contamination of 5–15 Ci/km2 (Kul’kova et al.,1996).
3. Respiratory diseases were found in 19%
of liquidators’ children up to 1 year of age,and 10% of the children had exudative-mucoid
disease. In older children 60% had documented respiratory diseases (Synyakova et al.,1997).
4. The number of children hospitalized forbronchial asthma was higher in the more contaminated territories and chronic nasopharyngeal pathology was seen twice as often compared to children from less contaminated areas(Sitnykov et al., 1993; Dzykovich et al., 1994;
Gudkovsky et al., 1995).
5. Among 2,335 surveyed evacuees’
teenagers, respiratory morbidity was the third
cause of overall morbidity 10 years after thecatastrophe: 286 per 1,000 (Syvolobova et al.,1997).
6. Among 4,598 children newborn to 4
years old at the time of the meltdown from
Kormyansk and Chechersk districts, Gomel
Province, which had contamination levels of
15–40 Ci/km2 , respiratory system morbidity
was significantly higher than among children
from areas with contamination levels of 5–
15 Ci/km2 (Blet’ko et al., 1995; Kul’kova et al.,1996).

5.5.2. Ukraine
1. In the first months after the catastrophe, more than 30% of children in the contaminated territories had breathing difficulties
defined as a respiratory syndrome (Stepanova
et al., 2003). In 1986–1987, nearly 10,000 children from contaminated territories that were
examined had breathing problems: (a) 53.6%
had bronchial obstruction mainly of the small
bronchial tubes (controls, 18.9%) and (b) 69.1%
had latent bronchospasms (controls, 29.5%;
Stepanova et al., 2003).
2. Asphyxia was observed in half of 345
newborns irradiated in utero in 1986–1987(Zakrevsky et al., 1993).
3. Older children irradiated in utero had
respiratory system pathologies significantly
more often than controls: 26.0 vs. 13.7%(Prysyazhnyuk et al., 2002).
4. In 1994 respiratory system morbidity
among children from contaminated territories
and among evacuees was as high as 61.6% andamong adults and teenagers it reached 35.6%(Grodzinsky, 1999).
5. In 1995 respiratory illnesses in children from the heavily contaminated territories were reported twice as often as from less

94

Figure 5.7. Chronic bronchitis and chronic
obstructive pulmonary disease (COPD) morbidity
among Ukrainian liquidators from 1996 to 2004
(Sushko et al., 2007).

contaminated areas (Baida and Zhirnosekova,
1998).
6. According to the Ukrainian Ministryof Health, bronchitis and emphysema among
teenagers, adults, and evacuees in the contaminated territories increased 1.7-fold from 1990
to 2004 (316.4 and 528.5 per 10,000), andbronchial asthma more than doubled (25.7 and55.4 per 10,000; National Ukrainian Report,
2006).
7. Chronic bronchitis in liquidators morethan doubled between 1996 and 2004, goingfrom 84 to 181 cases per 1,000 (Figure 5.7).
8. In 80% of the cases of chronic nonspecific pulmonary disease among liquidators, atrophy of the mucous membrane covering of
the trachea and bronchus was found, as wellas ciliary flattening and epithelial metaplasia(Romanenko et al., 1995a).
9. Of 873 male liquidators examined 15
years after the catastrophe, 84% had mucous membrane atrophy, usually accompanied
by bronchial tree deformities (Shvayko andSushko, 2001; Tereshchenko et al., 2004).
10. Chronic bronchitis and bronchial asthma
are two of the main reasons for morbidity,
impairment, and mortality among liquidators.
The majority of liquidators during their stay inthe contaminated zone and immediately afterward suffered from a dry cough complicatedby painful breathing. The subsequent development of disease was characterized by progressive obstruction and dyspnoea with shortnessof breath and difficulty or pain in breathing.
Subsequently, symptoms of chronic obstructive
lung disease were observed: cough, sputum production, and dyspnoea in combination with obstructive, restrictive, and mixed ventilation disorders (Tereshchenko et al., 2003; Sushko andShvayko, 2003a).
11. From 1988 to 2006 clinical observation of 2,476 male liquidators ages 36.7 ±8.5 years showed chronic obstructive lung disease and bronchitis in 79%, chronic nonobstructive bronchitis in 13%, and asthma in 8%(Tereshchenko et al., 2004; Dzyublik et al., 1991;
Sushko, 1998, 2000). The occurrence of obstructive disease and bronchitis almost doubled in the second decade after the catastrophe(Figure 5.8).
12. Some 84% of 873 surveyed liquidators
had tracheobronchial mucous membrane thinning and vascular atrophy; 12% had opposite changes in bronchial fiberscopic pathology, including hyperplasia, which consisted of

Figure 5.8. Bronchopulmonary illnesses in
Ukrainian male liquidators over a 20-year period(Tereshchenko et al., 2004; Sushko and Shvayko,
2003a,b).

Yablokov: Nonmalignant Diseases after Chernobyl

95

thickening of the mucous membranes and narrowing of primary and secondary bronchialtubes; and 4% were observed to have bothtypes of pathology—atrophic changes proximally and hyperplasia distally. In 80% of thegroup examined mucoid-sclerotic changes inthe bronchial mucosa were accompanied bytracheobronchial tree deformity. The prevalence of mucoid-sclerotic changes correlateswith endobronchial atrophy. Isolated scleroticchanges of bronchial mucosa were reported in
16% and mucoid changes in 4% (Tereshchenko
et al., 2004).
13. Years after the catastrophe three liquidators were found to have sclerotic pulmonary
mucous membrane changes and bronchial deformities (Sushko et al., 2007).

TABLE 5.32. Respiratory Morbidity among Children of Bryansk Province Districts with a Levelof Contamination above 5 Ci/km2 , 1995–1998(Fetysov, 1999b: table. 6.1)

5.5.3. Russia
1. Broncopulmonary dysplasia was seen inpremature newborns from Novozybkov City,
Bryansk Province, and fetal lung dysplasia wasmore common in 1992–1993 compared with
controls and compared with the number ofcases observed in 1995 (Romanova et al., 2004).
2. The incidence of asphyxia and complicated breathing problems in newborns correlated with the level of contamination in the territory (Kulakov et al., 1997).
3. Noninfectious respiratory disorders inneonates born to mothers from the contaminated territories were encountered 9.6 times
more often than before the catastrophe. The areas and contamination levels were: Polessk District, Kiev Province (20–60 Ci/km2 ); Chechersk District, Gomel Province (5–70 Ci/km2 );and Mtsensk (1–5 Ci/km2 ) and Volkhov (10–15 Ci/km2 ) districts, Oryol Province (Kulakov
et al., 1997).
4. Children in the contaminated territories
currently have more bronchial asthma andchronic bronchitis owing to irreversible structural lung changes. In the contaminated territories there is a marked increase in the incidenceof both acute pneumonia and chronic broncopulmonary pathology, expressed as bronchial

Number of cases

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaSouthwest∗
Province
Russia
∗

1995

1996

1997

1998

781.5
1,435.3
303.4
936.0
1,510.4
1,288.7
855.1
767.2

897.5
1,750.0
342.9
927.3
1,072.0
1,023.8
774.8
715.1

1,080.5
2,006.0
481.3
1,001.3
1,267.6
1,426.2
936.6
790.9

1,281.6
1,743.9
728.5
771.0
1,582.6
1,398.3
918.7
n/a

All contaminated districts.

asthma and chronic bronchitis. In the firstyears after the catastrophe broncopulmonary
illnesses were accompanied by moderate immunological changes and latent functional impairment; 10 to 15 years later the findings
are pneumonia and lung scarring (Terletskaya,
2002, 2003).
5. Children’s overall respiratory morbidity
was much higher in the heavily contaminateddistricts of Bryansk Province 9 to 12 years after
the catastrophe than in the rest of the province
and in Russia as a whole (Table 5.32).
6. For adults in the more contaminated territories of Bryansk Province the general respiratory morbidity is much below that of children,
but the same tendency toward increase was observed from 1995 to 1998, except in one district(Table 5.33).
7. A majority of the surveyed Russian liquidators who were exposed in 1986–1987 havedeveloped progressive pulmonary function impairment (Chykyna et al., 2002). Incidence of
this respiratory abnormality increased continuously for the first 8 years after the catastrophe(Table 5.34).
8. A group of 440 liquidators with chronic
bronchopulmonary pathology were examinedat the Moscow Institute of Pulmonology.
Radionuclides were found in their pulmonary
systems 6 to 10 years after the catastrophe.

96
TABLE 5.33. Respiratory Morbidity among the
Adult Population of Bryansk Province in Areas witha Level of Contamination above 5 Ci/km2 , 1995–
1998 (Fetysov, 1999a: table 5.1)
Territory

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaGordeevka
Southwest
Province
Russia

195.9
302.3
142.5
196.6
192.0
134.0
209.2
197.4
213.6

211.9
288.9
126.2
163.6
230.8
167.6
194.5
168.3
196.6

259.6
238.0
336.8
182.0
298.0
192.0
237.6
199.2
219.2

326.3
233.1
474.5
183.4
309.1
237.0
242.2
192.6
n/a

Combined external radiation and incorporated
radionuclide effects were expressed in a newform of chronic obstructive pulmonary disease
syndrome (Chuchalin et al., 1998).
9. Prolonged persistence of radioactive particles is associated with the appearance ofcancer-related molecular abnormalities in the
bronchial epithelium of former Chernobyl
cleanup workers. These include: K-ras (codon
12) mutation; p16 (INK4A) promoter hypermethylation; microsatellite alterations at sevenchromosomal regions; and allelic loss at 3p12,
3p14.2 (FHIT), 3p21, 3p22–24 (hMLH1), and9p21 (p16INK4A). The incidence of 3p14.2
allelic loss was associated with decreased expression of the FHIT mRNA in the bronchial
epithelium as compared with a control groupof smokers (Chuchalin, 2002; Chizhykov andChizhykov, 2002).
10. The frequency of the chronic bronchopulmonary illnesses in liquidators increased
significantly over the first 15 years after thecatastrophe, with an increase up to 10-fold forsome illnesses. The diseases developed more
rapidly and were more serious (Tseloval’nykova
et al., 2003).

5.5.4. Conclusion
Illnesses of the upper respiratory system (nasopharynx and bronchial tubes) were the initial consequences of Chernobyl irradiation for
the general population and the liquidators in
the first days and weeks after the catastrophe.
In some years the incidence of bronchopulmonary illnesses decreased, but the severity
increased, reflecting significant impairment of
the immune and hormonal systems. Some 10
to 15 years later, respiratory morbidity in Belarus, Ukraine, and Russia remained significantly higher in the contaminated territories.
For children of the Japanese hibakusha who
were not irradiated directly, the incidence of
respiratory system illnesses was higher compared to controls some decades after the bombardments (Furitsu et al., 1992). If such anincrease is observed after a single short-term
irradiation, it is possible to assume that the
Chernobyl irradiation will cause increased respiratory system illnesses over the next several
generations.
5.6. Urogenital Tract Diseases andReproductive Disorders
Irradiation directly damages the kidneys,
bladder, and urinary tract, as well as the ovaries
and testicles, which not only are subject to direct radiation effects, but are indirectly affected
through hormonal disruption. These disorders
in structure and function result in damage tothe reproductive process.
Although there have been some studies ofthe functional changes in the urogenital tract asa consequence of Chernobyl radiation, there is
still not enough information to explain all of theserious changes. It was unexpected, for example, to find increased levels of male hormones

TABLE 5.34. Respiratory Morbidity (per 10,000) among Russian Liquidators for the First 8 Years after
the Catastrophe (Baleva et al., 2001)
Year
Morbidity

1986
645

1987
1,770

1988
3,730

1989
5,630

1990
6,390

1991
6,950

1992
7,010

1993
7,110

Yablokov: Nonmalignant Diseases after Chernobyl

97

in females as a result of internally incorporated
radionuclides (for a review see Bandazhevsky,
1999) and also unexpected to observe contrary effects of various radionuclides on therate of sexual maturation (Paramonova and
Nedvetskaya, 1993).

9. Soon after the catastrophe the majority offertile women from the contaminated territories developed menstrual disorders (Nesterenko
et al., 1993). Frequent gynecologic problems
and delay in the onset of menarche correlatedwith the levels of radioactive contamination in
the area (Kulakov et al., 1997).
10. Abnormalities of menstrual function in
nonparous women in areas with contaminationof 1–5 Ci/km2 (Gomel City) was linked to ovarian cystic-degenerative changes and increased
endometrial proliferation. Ovarian size correlated with testosterone concentration in blood
serum (Yagovdik, 1998).
11. The incidence of endometriosis increased almost 2.5-fold in Gomel, Mogilev, andVitebsk cities from 1981 to 1995 (surgical treatment for 1,254 women), with the disease expressed most often in the first 5 years after thecatastrophe. Among women who developed endometriosis, those in the more contaminatedareas were 4 to 5 years younger than thosefrom less contaminated areas (Al-Shubul and
Suprun, 2000).
12. Primary infertility in the contaminatedareas increased 5.5-fold in 1991 compared with
1986. Among the irrefutable reasons for infertility are sperm pathologies, which increased
6.6-fold; twice the incidence of sclerocystic
ovaries; and a threefold increase in endocrine
disorders (Shilko et al., 1993).
13. Impotence in young men (ages 25 to 30
years) correlated with the level of radioactive
contamination in a territory (Shilko et al., 1993).

5.6.1. Belarus
1. From 1993 to 2003, there was a significant
delay in sexual maturation among girls from 10
to 14 years of age born to irradiated parents(National Belarussian Report, 2006).
2. Up until 2000 children born after thecatastrophe in heavily contaminated territories
had more reproductive organ disorders thanthose born in less contaminated areas: fivefold
higher for girls and threefold higher for boys
(Nesterenko et al., 1993).
3. In territories with heavy Chernobyl contamination, there are increased numbers ofchildren with sexual and physical developmental disorders related to hormone dysfunction—
cortisol, thyroxin, and progesterone (Sharapov,
2001; Reuters, 2000b).
4. Abnormal development of genitalia anddelay in sexual development correlated withthe levels of radioactive contamination in
the Chechersk District, Gomel Province (5–70 Ci/km2 ; Kulakov et al., 1997).
5. Of 1,026,046 pregnant women examined,
the level of urogenital tract disease was significantly higher in the more contaminated territories (Busuet et al., 2002).
6. From 1991 to 2001, the incidence of gynecologic diseases in fertile women in the contaminated territories was considerably increased, as
were the number of complication during pregnancy and birth (Belookaya et al., 2002).
7. Increased gynecologic morbidity (including anemia during pregnancy and postnatal anemia) and birth anomalies correlatedwith the level of radioactive contamination in
the Chechersky District, Gomel Province (5–70 Ci/km2 ; Kulakov et al., 1997).
8. In the contaminated territories, failed
pregnancies and medical abortions increased(Golovko and Izhevsky, 1996).

“. . . The doctors reminisce: ‘In one village wefound twelve lactating∗ elderly women, that is,
women 70 years of age had milk in their breasts,
as though they were nursing. Experts can argue
about the effects of small doses of radiation, but
the ordinary person cannot even begin to imagine
such a thing. . ..’ ” (Aleksievich, 1997).
_________∗
Lactation in the absence of pregnancy (termedgalactoria or hyperprolactinemia) is an expressionof pituitary gland dysfunction.

98

5.6.2. Ukraine
1. Urogenital diseases increased in children
in the contaminated territories: 0.8 per 1,000
in 1987 to 22.8 per 1,000 in 2004 (Horishna,2005).
2. From 1988 to 1999 the incidenceof urogenital diseases in the population ofcontaminated territories more than doubled(Prysyazhnyuk et al., 2002).
3. The level of alpha-radionuclides is significantly higher in bone tissue of aborted fetuses
from mothers from the contaminated territories (Luk’yanova, 2003).
4. Girls have delayed puberty in the contaminated territories (Vovk and Mysurgyna, 1994).
Sexual maturity was retarded in 11% of a groupof 1,017 girls and teenagers from contaminatedterritories (Lukyanova, 2003).
5. In the territories contaminated by Sr-90
and Pu, puberty was delayed by 2 years in boys
and by 1 year in girls. Accelerated rates of sexual
development were observed in territories contaminated by Cs-137 (Paramonova and Nedvetskaya, 1993).
6. Abnormal genital development and delay in sexual development in the Polessk District, Kiev Province, correlated with the levelof radioactive contamination (20–60 Ci/km2 )(Kulakov et al., 1997).
7. Among 1,017 female children of evacuees(aged 8 to 18 years) examined after the catastrophe, 11% had delayed sexual development(underdevelopment of secondary sex characteristics, uterine hypoplasia, and late menarche), and 14% had disturbed menstrual function (Vovk, 1995).
8. Women who were irradiated as girls in1986 have markedly more problems duringchildbirth (Table 5.35).
9. Neonates born to women who were irradiated as girls in 1986 have up to twice
the incidence of physical disorders (Nyagy,2006).
10. A survey of 16,000 pregnant women in
the contaminated territories over an 8-year period after the catastrophe revealed the follow-

TABLE 5.35. Child-Bearing Data Concerning
Women Irradiated as Children in 1986 in Contaminated Territories (Nyagy, 2006)

Normal delivery
Hypogalactia
Hypocalcemia

IrradiatedControl

25.8%
33.8%
74.2%

63.3%
12.5%
12.5%

ing: renal morbidity increased from 12 to 51%,
oligohydramnios increased 48%, newborn respiratory disease increased 2.8-fold, the numberof premature deliveries increased up to twofold,
and there was early placental aging at 30–32
weeks gestation (Dashkevich et al., 1995).
11. Increased gynecologic morbidity (including anemia during and after pregnancy) andbirth anomalies in the Polessk District, Kiev
Province, correlated with the level of radioactive contamination (20–60 Ci/km2 ; Kulakov
et al., 1997).
12. Earlier onset and prolonged puberty anddisorders of secondary sexual characteristics
were found in girls born to liquidator fathers(Teretchenko, 2004).
13. Occurrence of chronic pyelonephritis,
kidney stones, and urinary tract diseases inteenagers correlated with the level of contamination in the territories (Karpenko et al., 2003).
14. The incidence of female genital disorders, including ovarian cysts and uterine fibromas, in the contaminated territories increased
significantly for 5 to 6 years after the catastrophe (Gorptchenko et al., 1995).
15. Menstrual cycle disorders are commonly diagnosed in the contaminated territories (Babich and Lypchanskaya, 1994). The
number of menstrual disorders in the contaminated territories tripled compared with the precatastrophe period. In the first years after thecatastrophe there was heavier menstruation,
and after 5 to 6 years menstruation decreased
or stopped (Gorptychenko et al., 1995). Among
1,017 girls examined who had been exposed toirradiation, 14% had impaired menstruation(Luk’yanova, 2003; Dashkevich and Janyuta,
1997).

Yablokov: Nonmalignant Diseases after Chernobyl99

16. Dystrophic and degenerate changes ofthe placenta in liquidators and in other women
living in the contaminated territories correlated with the level of Cs-137 incorporated
in the placenta. These changes included uneven thickness of the placenta, presence of fibrous scaring, cysts, calcium inclusions, andundifferentiated and undeveloped fibroblasts
in the terminal stromal villi, and resulted
in lower weight of newborns (Luk’yanova,
2003; Luk’yanova et al., 2005; Ivanyuta
and Dubchak, 2000; Zadorozhnaya et al.,1993).
17. Spontaneous interruption of pregnancy,
late gestation, premature birth, and otherpathologies of pregnancy occurred significantly
more often in evacuees and in the contaminatedterritories 8 to 10 years after the catastrophe(Grodzinsky, 1999; Golubchykov et al., 2002;
Kyra et al., 2003).
18. For 8 to 9 years after the catastrophe
the incidence of menstrual disorders was significantly increased in female liquidators. A
total of 84% of young women (average age
30.5 years in 1986–1987) developed hypermenstrual syndrome within 2 to 5 years after being exposed (41.2% had uterine fibromyoma, 19% had mammary fibroadenomatosis,
and 16% had oliogomenses accompanied bypersistent hyperprolactinemia (Bezhenar’ et al.,1999).
19. Female liquidators of perimenopausal
age during the catastrophe had an earlymenopause (46.1 ± 0.9 years), and about 75%
had climacteric syndrome and declining libido(Bezhenar et al., 2000).
20. A total of 54.1% of pregnant
women from the contaminated territories
had preclampsia, anemia, and destruction of
the placenta (controls 10.3%); 78.2% had
birth complications and excess bleeding (2.2fold higher than controls; Luk’yanova, 2003;
Sergienko, 1997, 1998).
21. Miscarriages occurred especially often
in the heavily contaminated territories of Kiev
Province (Gerasymova and Romanenko, 2002).
Risks of spontaneous abortions are higher inthe contaminated territories (Lipchak et al.,2003).
22. Women in the heavily contaminated areas have more frequent miscarriages, complications of pregnancy, aplastic anemia, and premature births (Horishna, 2005).
23. Some 96% of individuals in the contaminated territories with prostatic adenoma
were found to have precancerous changes inthe bladder urothelium (Romanenko et al.,1999).
24. Among 250 married couples of liquidators observed in Donetsk City, 59 ± 5% haveexperienced sexual dysfunction caused by irradiation and 19 ± 3% owing to radiophobia.
In an other study, 41% of 467 male liquidators (age 21 to 45 years) had sexual abnormalities: decreased testicular androgen function andincreased estrogen and follicle-stimulating hormone levels (Bero, 1999).
25. In 7 to 8 years after the catastrophe, about 30% of liquidators had functional sexual disorders and sperm abnormalities (Romanenko et al., 1995b).
26. Among 12 men with chronic radiation dermatitis caused by beta- and gammairradiation during and after the Chernobyl
catastrophe two had erectile dysfunction andthe others reported various impairments ofsexual function. One had aspermia, two had
azoospermia, one had oligospermia, and four
had normal sperm counts. In three samples there was an increase in abnormal
forms of spermatozoa and in three samples
sperm motility was decreased (Byryukov et al.,1993).
27. In 42% of surveyed liquidators sperm
counts were reduced by 53%, the proportionof mobile sperm was lower (35–40% vs. 70–
75% in controls), and the number of deadsperm increased up to 70% vs. 25% in controls (Gorptchenko et al., 1995).
28. From 1988 to 2003 urogenital morbidity
among male liquidators who worked in 1986–
1987 increased 10-fold: 9.8 per 1,000 in 1988,
77.4 per 1,000 in 1999, and 98.4 per 1,000 in
2003 (Baloga, 2006).

100
TABLE 5.36. Urogenital Morbidity among Children (per 1,000) in Bryansk Province Districts with
Levels of Contamination above 5 Ci/km2 , 1995–
1998 (Fetysov, 1999b: table 6.1)

TABLE 5.37. Urogenital Morbidity (per 1,000)
among Adults in Bryansk Province Districts Contaminated above 5 Ci/km2 , 1995–1998 (Fetysov,
1999a: table 5.1)

Number of cases

Klymovo
Novozybkov
Klintsy
Klintsy City
Krasnogorsk
ZlynkaSouthwest∗
Province∗

Number of cases

1995

1996

1997

1998

Territory

1995

1996

1997

1998

34.5
40.2
8.0
22.4
56.7
66.8
30.1
22.4

48.7
43.3
10.8
24.3
51.4
38.7
33.5
25.8

51.6
44.8
11.2
34.6
44.2
44.8
36.7
26.8

79.3
60.1
10.8
34.1
26.0
46.2
41.6
29.2

Klymovo
Novozybkov
Klintsy
Klintsy City
Krasnogorsk
ZlynkaGordeevka
Southwest∗
Province

72.1
68.1
27.3
45.5
78.7
44.8
52.3
54.9
60.4

71.4
70.2
53.8
76.1
82.7
75.7
67.8
88.7
60.4

64.1
72.1
53.0
75.2
95.9
78.7
72.9
78.4
60.7

60.1
81.3
91.3
79.2
114.2
78.7
80.2
75.9
57.1

All heavily contaminated districts.

5.6.3. Russia
1. Impaired genital and delayed sexual development correlated with the level of radioactive
contamination in the Mtsensk (1–5 Ci/km2 )and Volkhov (10–15 Ci/km2 ) districts of Oryol
Province (Kulakov et al., 1997).
2. Increased gynecologic morbidity (including anemia during pregnancy, postnatal
anemia, and abnormal delivery) correlatedwith the level of radioactive contaminationin the Mtsensk (1–5 Ci/km2 ) and Volkhov(10–15 Ci/km2 ) districts of Oryol Province(Kulakov et al., 1997).
3. Overall, from 1995 to 1998, urogenital
morbidity in children was higher in the majority of the contaminated districts of Bryansk
Province than in the province as a whole(Table 5.36).
4. From 1995 to 1998 the overall urogenital morbidity in adults in Bryansk Province
noticeably increased in all but one of the contaminated areas (Table 5.37).
5. The urogenital morbidity among womenin some of the heavily contaminated territories
of Bryansk and Tula provinces correlated withthe levels of contamination (Table 5.38).
6. The frequency of occurrence of spontaneous abortions (miscarriages) in liquidator(1986–1987) families in Ryazan Province was∗

All heavily contaminated districts.

significantly higher during the first 7 years after the catastrophe (Figure 5.9) and was fourfold higher (18.4 ± 2.2%) than that of the general population (4.6 ± 1.2%; Lyaginskaya et al.,2007).
7. A total of 18% of all pregnancies registered among liquidators’ families terminatedin miscarriages (Lyaginskaya et al., 2007).
8. The 1986 liquidators from Ryazan
Province and other nuclear industry personnel went through a prolonged period of sterility, which was not revealed until recently(Lyaginskaya et al., 2007).
9. Four years after the catastrophe up to
15% of liquidators (from 94 evaluated) had
TABLE 5.38. Occurrence of Reproductive System
Illness and Precancer Pathologies among Womenin Some Territories of the Tula and Bryansk
Provinces Contaminated by Cs-137 (Tsyb et al.,2006)
PrecancerAllpathologies, %∗ illnesses, %Klintsy District(n = 1,200) 322 kBq/m2
Novozybkov City(n = 1,000) 708 kBq/m2
Uzlovaya Station(n = 1,000) 171 kBq/m2
∗

21.1

58.2

19.6

66.6

1.8

51.2

Leukoplacias, displasias, polyps, etc.

101

Yablokov: Nonmalignant Diseases after Chernobyl

Figure 5.9. Incidence (%) of spontaneous abortions in liquidators’ families (black rectangles) andin Ryazan’ Province (white rectangles) from 1987 to
1994 (Lyaginskaya et al., 2007).

significantly more dead sperm, lower sperm
mobility, and increased acidic phosphatase levels in ejaculate compared with other males ofthe same age (Ukhal et al., 1991).
10. Liquidators’ virility was noticeably lower
in the year after the catastrophe: up to 42% of
sperm tests did not meet quantitative norms
and up to 52.6% did not meet qualitative
norms (Mikulinsky et al., 2002; Stepanova andSkvarskaya, 2002).
11. Pathomorphological alterations occurred in testicular tissue of liquidators in
Krasnodar Province, and autoimmune orchitis
affecting spermatogenesis occurred soon after
irradiation. Lymphoid infiltration developed in
the seminiferous tubules 5 years after the catastrophe and in the interstitial tissue after 10 to
15 years.
12. Sexual potency was low in half of themale liquidators who were examined (Dubivko
and Karatay, 2001).

13. The incidence of urogenital illnesses inmale liquidators grew from 1.8 to 4% from1991 to 1998 (Byryukov et al., 2001).
14. Fifty liquidators who were examined
had sperm counts significantly lower than thenorms (Tsyb et al., 2002).
15. Urogenital morbidity in liquidators increased more than 40-fold from 1986 to 1993
(Table 5.39).
16. A third of 116 liquidators examined hadintercourse disorders (Evdokymov et al., 2001).
17. A total of 21% of surveyed liquidators
had sperm with reduced mobility and morphologic changes. Sperm of some liquidators
contained 6–8% immature cells (the norm is
1–2%; Evdokymov et al., 2001).
18. The level of abnormal spermatozoids inliquidators correlated with the level of chromosome aberrations (Kondrusev, 1989; Vozylova
et al., 1997; Domrachova et al., 1997).
19. Sclerosis in 50% of seminiferous tubules
and foci of Leydig cell regeneration was seen
after the catastrophe (Cheburakov et al., 2004).
5.6.4. Other Countries
1. ARMENIA. There were spermatogenesis disorders in the majority of the surveyed liquidators 10 years after the catastrophe (Oganesyan et al., 2002). Among 80
children of liquidators who were examined
there was increased incidence of pyelonephritis(Hovhannisyan and Asryan, 2003).
2. BULGARIA. Following the Chernobyl nuclear accident, an increase in maternal toxemia was associated with increased irradiation(Tabacova, 1997).
3. CZECH REPUBLIC. The number of boys
born monthly in Bohemia and Moravia, theCzech Republic territories that suffered most

TABLE 5.39. Dynamics of Urogenital Morbidity among Liquidators (per 10,000), 1986–1993 (Baleva
et al., 2001)
Year
Number of cases

1986
34

1987
112

1988
253

1989
424

1990
646

1991
903

1992
1,180

1993
1,410

102

from Chernobyl fallout changed only once over
600 months of observation (1950–1999). In
November 1986, there were 457 fewer boys
born than expected based on a long-term demographic trend (Perez, 2004). The change occurred among babies who were 7–9 weeks inutero at the time of the catastrophe.
4. ISRAEL. Significant differences in quantitative ultramorphological parameters of sperm
heads were observed in liquidators who hademigrated compared with men of similar age
who were not irradiated (Fischbein et al., 1997).
5. OTHER COUNTRIES. There were long-term
chronic effects of the catastrophe on sex ratios
at birth in Denmark, Finland, Germany, Hungary, Norway, Poland, and Sweden between
1982 and 1992. The proportion of males increased in 1987 with a sex odds ratio of 1.0047(95% CI: 1.0013–1.0081, p < 0.05). A positive association for the male proportion in Germany between 1986 and 1991 with radioactive
exposure at the district level is reflected in a sex
odds ratio of 1.0145 per mSv/year (95% CI:
1.0021 – 1.0271, p < 0.05) (Frentzel-Beyme
and Scherb, 2007).
5.6.5. Conclusion
Clearly there is an increasingly wide spectrum of urogenital illnesses in men, women,
and children from the territories contaminatedby Chernobyl fallout. Although some claimthat poor reproductive function is due solely to
psychological factors (stressful conditions), it isdifficult to blame stress for abnormalities inspermatozoa, reproductive failures, and birthabnormalities in children. The adverse influence of Chernobyl irradiation upon urogenital
morbidity and reproductive function for liquidators and for millions of people living in thecontaminated territories will continue in coming generations.
5.7. Bone and Muscle Diseases
Osteoporosis (decreasing density of bone tissue) results from an imbalance between theformation of bone and the natural reabsorption process. Such imbalance results from either hormonal disorders or direct damage by
irradiation to the cellular predecessors of osteoclasts and osteoblasts (Ushakov et al., 1997).
Liquidators and inhabitants of contaminatedterritories often complain of bone and joint
pain—the indirect indicators of the processesof osteoporosis.
5.7.1. Belarus
1. The number of newborns with developmental osteomuscular anomalies has increasedin the contaminated territories (Kulakov et al.,1997).
2. In 1995, osteomuscular morbidity in evacuees and inhabitants of the contaminated territories was 1.4-fold higher than for the general
population (Matsko, 1999).
3. Osteomuscular illnesses were widespreadamong liquidators under 30 years of age(Antypova et al., 1997a).
5.7.2. Ukraine
1. In recent years, stillbirths from the heavily contaminated territories had increased levels of alpha-radionuclides incorporated in bone
tissue (Horishna, 2005).
2. Cs-137 incorporated in the placenta at alevel of 0.9–3.25 Bq/kg leads to weakness ofthe tubular bone structures and destruction of
spinal cartilage (Arabskaya et al., 2006).
3. In the contaminated territories there havebeen cases of children born practically withoutbones (“jellyfish-children”), a condition seen
previously only in the Marshall Islands after
the nuclear tests of the 1950s.
4. Elevated placental radionuclide concentrations may be a factor in the death of newborns in contaminated territories (Table 5.40).
5. The bones of dead newborns demonstratemorphological defects: reduction in the number and size of osteoblasts, dystrophic changes
in osteoblasts and osteoclasts, and a change
in the osteoblast/osteoclast ratio (Luk’yanova,
2003; Luk’yanova et al., 2005).

Yablokov: Nonmalignant Diseases after Chernobyl

103

TABLE 5.40. Radionuclide Concentration (Bq/kg)
in the Bodies of Pregnant Women and in Organsof Stillborns

TABLE 5.41. Osteomuscular Morbidity (per1,000) among Children in Bryansk Province
Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.1)

Horishna, Lukyanova
2005
et al., 2005 Radionuclides
Mother’s body
Placenta
Liver
SpleenThymusVertebrae
Teeth
Ribs
Tubular bones

0.7 – 1.3
3.5
0.9
7.8
0.2
0.2
0.9
0.4
No data
No data

No data
No data
No data
0.4 ± 0.05
0.2 ± 0.03
0.1 ± 0.02
0.7 ± 0.02
0.4 ± 0.02
1.0 ± 0.24
0.3 ± 0.02

Cs-137
Cs-137
Alpha
Cs-137
Cs-137
Cs-137
Cs-137
Alpha
Cs-137
Cs-137

6. Osteomuscular morbidity among adultevacuees is higher than in the general population of the country (Prysyazhnyuk et al., 2002).
7. In 1996 osteomuscular morbidity in territories with contamination of 5–15 Ci/km2 washigher than for the population of the country
as a whole (Grodzinsky, 1999).
8. From 1988 to 1999 osteomuscular morbidity in the contaminated territories morethan doubled (Prysyazhnyuk et al., 2002).
9. Muscular system and connective tissue
diseases in liquidators increased 2.3-fold from1991 to 2001 (Borysevich and Poplyko, 2002).
5.7.3. Russia
1. In the heavily contaminated districts ofBryansk Province, children’s general osteomuscular morbidity was noticeably higher than thatof the province as a whole (Table 5.41).
2. From 1995 to 1998 primary osteomuscular morbidity in children of Bryansk
Province was higher in the contaminated areas (Table 5.42).
3. General osteomuscular morbidity ofadults is higher in the heavily contaminated districts of Bryansk Province than in the province
as a whole (Table 5.43).
4. Up to 62% of liquidators complain of backpain and pain in the bones of their hands, legs,and joints (Dedov and Dedov, 1996).

Number of cases
Territory

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaSouthwest∗
Province

146.2
31.3
40.4
17.3
58.8
40.9
22.6

124.7
32.7
41.3
15.2
217.2
67.9
25.4

90.3
37.9
69.9
11.2
162.4
49.7
27.0

143.0
29.6
63.5
12.0
174.3
67.1
29.7

∗

All heavily contaminated districts.

5. Osteoporosis was found in 30–88% ofliquidators who were examined (Nykytyna,
2002; Shkrobot et al., 2003; Kirkae, 2002;
Druzhynyna, 2004).
6. Osteoporosis develops more often in liquidators than in comparable groups of the population (Nykytyna, 2005).
7. Osteoporosis in liquidators also affects thedental bone tissue (Matchenko et al., 2001).
8. The most frequently occurring osteomuscular pathologies among 600 liquidators who
were examined were osteochondrosis of various parts of vertebrae and diffuse osteoporosis. In 3.5% of cases the osteoporosis was
accompanied by pathological bone fractures,
TABLE 5.42. Osteomuscular Morbidity among
Adults in Bryansk Province Territories with Contamination above 5 Ci/km2 , 1995–1998 (Fetysov,
1999a: table 5.1)
Number of cases
Territory

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaGordeevka
Southwest
Province

173.8
129.6
151.0
136.0
110.2
94.3
100.7
82.5

118.9
120.8
150.6
141.1
110.2
129.3
109.4
81.6

216.0
94.0
159.7
109.7
102.0
105.1
111.7
82.4

236.7
101.1
217.3
89.7
103.0
104.8
111.9
76.4

104
TABLE 5.43. Primary Osteomuscular Morbidity(per 1,000) among Children in Bryansk Province,
1995–1998 (Fetysov, 1999b: table 6.2)
Year
Southwest
Province

1995
19.5
11.5

1996
39.2
13.9

1997
24.5
16.4

1998
42.4
18.5

compression of nerve roots, and osteoalgia andarthralgias (Kholodova et al., 1998).
9. The mineral density of bone in many liquidators is 16–37% lower than the age norms(Kholodova et al., 1998). Some 62% of liquidators among the 274 who were examined had
decreased skeletal mineralization and 8% had
osteoporosis (Khartchenko et al., 1995). Skeletal mineral losses in liquidators who worked in1986 reached 42% (compared with peak age
and weight); there was less loss among liquidators who worked in 1987–1988 (Khartchenko
et al., 1998).
10. Periodontal disease markers were foundin all surveyed liquidators: 88.2% had diffuse
osteoporosis of the jaw; 33.3% had thinning of
the compact plate of the mandible; in addition,
37.3% also had osteoporosis of a vertebral body
(Druzhynyna, 2004).
11. According to National Registry data,from 1991 to 1998 the osteomuscular morbidity of liquidators was significantly higher thanfor the population as a whole (650 vs. 562 per
10,000; Byryukov et al., 2001).
12. From 1994 to 1998, osteomuscular morbidity in liquidators in Bryansk Province wasnoticeably higher than that of the general population of the heavily contaminated districts
and differed considerably from of the population of the province and Russia as a whole(Table 5.44).
5.7.4. Conclusion
Data concerning the influence of Chernobyl
contamination on the osteomuscular system arescarce, not because these diseases are insignificant but because they attract little attention
in terms of survival. Bone and muscle dis-

TABLE 5.44. Osteomuscular Morbidity (per1,000) among Liquidators and the Adult Population of Bryansk Province Territories with Levelsof Contamination above 5 Ci/km2 , 1995–1998(Fetysov, 1999a: table 4.1)
Number of cases

Liquidators
Southwest∗
Province
Russia
∗

1994

1995

1996

1997

1998

114.1
90.0
80.5
80.3

99.3
93.5
82.5
81.5

207.0
109.4
81.6
87.2

221.8
111.7
82.4
87.2

272.9
238.6
76.4
n/a

All heavily contaminated districts.

eases are not insignificant. The loss of teeth
leads to deterioration in a person’s ability to eat
and secondary adverse dietary effects. Chronicbone and muscle pain leads to loss of function and curtailment of activities needed to sustain life. The effects are especially serious forchildren when osteomuscular defects impede
growth and activity.
Undoubtedly, as new material is published,
there will be new data on the effects of Chernobyl’s radioactive contamination on bone andmuscle. It is now clear that structural bone disorders (osteopenia, osteoporosis, and fractures)are characteristic not only of the majority ofliquidators, but also of many residents of thecontaminated territories, including children.
5.8. Diseases of the Nervous
System and the Sense Organs andTheir Impact on Mental HealthThirty-plus years ago, the nervous system
was considered the system most resistant to ionizing radiation, but this is apparently true only
in respect to large doses (see, e.g., Gus’kova
and Baisogolov, 1971). Accordingly, the report of the Chernobyl Forum (2005) attributed
all neurological illnesses, increased levels ofdepression, and mental problems to posttraumatic stress (Havenaar, 1996; Havenaar
et al., 1997a,b).
Since the Chernobyl catastrophe it isclear that low doses and low dose rates ofYablokov: Nonmalignant Diseases after Chernobyl

105

radiation have enormous impact on the finestructures of the nervous system, on higher nervous system activities, and ocular structures, aswell as on neuropsychiatric disorders that arewidespread in all the contaminated territories.
There is a growing body of evidence supporting radiosensitivity of the brain (Nyagu andLoganovsky, 1998).
Mental health assessment in the Former Soviet Union dealt primarily with mental disorders as recorded in the national healthcare
system, not with data obtained from welldesigned psychiatric studies using standardized
diagnostic procedures. Together with the ongoing changes in the way that the countriesof the Former Soviet Union deal with psychiatric problems, this approach may have led todramatic underestimation of mental disorders(Loganovsky, 2002). The first part of this section is devoted to the nervous system itself andthe second to the sense organs.

3. The number of cases of congenital convulsive syndrome (epilepsy) grew significantlyin the contaminated territories in the first 10
years after the catastrophe (Tsymlyakova andLavrent’eva, 1996).
4. From 1993 to 2003 primary morbidityfrom nervous system disease and diseases ofthe eye and its appendages increased markedly
among children aged 10 to 14 years born to irradiated parents (National Belarussian Report,
2006).
5. Nervous system morbidity in children
increased in one of the most contaminatedareas—the Luninetsk District of Brest Province(Voronetsky et al., 1995). From 2000 to 2005
there was a tendency toward an increasing incidence of mental disorders among children inthis district (Dudinskaya et al., 2006).
6. Ten years after the catastrophe nervous
system disorders were the second cause of morbidity among teenagers evacuated from contaminated territories, with 331 cases per 1,000
out of the 2,335 teens that were examined(Syvolobova et al., 1997).
7. Neurological and psychiatric disorders
among adults were significantly higher in thecontaminated territories (31.2 vs. 18.0%). Impaired short-term memory and attention lapse
were observed among high school students
aged 16 to 17 and the seriousness of these conditions correlated directly with the levels of contamination (Ushakov et al. 1997).
8. In a comparison between 340 agricultural
machine operators from the heavily contaminated Narovlya District, Gomel Province, and asimilar group of 202 individuals from the vicinity of less contaminated Minsk, the first groupexhibited a sixfold higher incidence of vascularbrain pathology (27.1 vs. 4.5%; Ushakov et al.,1997).
9. Neurological morbidity of 1,708 adults in
the Kostjukovichi District, Mogilev Province,
which was contaminated with Cs-137 at levels higher than 1,110 kBq/m2 (30 Ci/km2 ),was noticeably higher than in 9,170 individuals
examined from the less contaminated districtsof Vitebsk Province (Lukomsky et al., 1993).

5.8.1. Diseases of Nervous System
Twenty-two years after the Chernobyl catastrophe, it is apparent that low levels of ionizing radiation cause changes in both the central and the autonomic nervous systems andcan precipitate radiogenic encephalopathy (fora review see Loganovsky, 1999). Some parts ofthe central nervous system (CNS) are especiallysusceptible to radiation damage.
5.8.1.1. Belarus
1. According to a longitudinal survey of pregnant women, maternity patients, newborns,
and children in the contaminated territoriesof the Chechersk District, Gomel Province,with radiation levels of 185–2,590 kBq/m2(5–70 Ci/km2 ), the incidence of perinatal encephalopathy after 1986 was two to three times
higher than before the catastrophe (Kulakov
et al., 2001).
2. Morbidity from diseases of the nervous
system and sense organs noticeably increased
in all the contaminated territories (Lomat et al.,1996).

106

10. From 1991 to 2000 there was a 2.2-foldincrease in the incidence of nervous systemand sense organ diseases among Belarussianliquidators (Borysevich and Poplyko, 2002).
5.8.1.2. Ukraine
1. According to a longitudinal survey of pregnant women, maternity patients, newborns,
and children in contaminated territories ofPolessk District, Kiev Province, which hadradiation levels of 740–2,200 kBq/m2 (20–60 Ci/km2 ), the incidence of perinatal encephalopathy after 1986 was observed to be
two to three times higher than before the catastrophe (Kulakov et al., 2001).
2. The incidence of nervous system diseasein children grew markedly in the contaminated territories 2 years after the catastrophe(Stepanova, 1999). By 1998 nervous system andsense organ diseases in children had increased
sixfold compared to 1986 (TASS, 1998). Other
data between 1988 and 1999 indicated that theincidence of neurological disease grew 1.8-foldduring the 10-year period: from 2,369 to 4,350
per 10,000 children (Prysyazhnyuk et al., 2002).
3. Greater fatigue and lowered intellectual
capacity was found in middle and high school
age children in the contaminated villages of
the Chernygov Province 7 to 8 years after thecatastrophe (Bondar et al., 1995).
4. Electroencephalograms (EEGs) for 97% of
70 surveyed evacuees’ children indicated structural and functional immaturity of subcortical and cortical brain structures; that is, only
two out of these 70 children had normal EEGs
(Horishna, 2005).
5. Children irradiated in utero have more
nervous system illnesses and mental disorders(Igumnov et al., 2004; Table 5.45).
6. The number of children with mental illness in the contaminated territories increased:in 1987 the incidence was 2.6 per 1,000,
whereas by 2004 it was 5.3 per 1,000 (Horishna,2005).
7. The incidence of nervous system asthenia and vegetative (autonomic) regulation disorders was more that fivefold higher in evac-

TABLE 5.45. Occurrence (%) of Neurological andPsychiatric Disorders among Children Irradiated In
Utero (Nyagu et al., 2004)
Irradiated, Controls,n = 121n = 77
Neurologically healthy
Predisposition to epilepsy (G40)
Migraine (G43)
Other headaches (G44)
Sleep disturbances (G47)
Other disorders of vegetative
nervous system (G90)
Neurological complications
Intellectual healthOrganic mental disorders (F06
and F07)
Neurotic, stress, and somatoform
disorders (F40-F48)
Physiological developmental
disorders (F80-F89)
Emotional disorders (F90-F98)
Learning disorders

60.3
7.4
2.5
25.6
3.3
2.5

85.7
1.3
0
13.0
0
0

1.6
15.7
16.5

0
58.4
3.9

46.3

26.0

7.4

0

25.6
17.2

11.7
3.9

uees’ children compared with a control group(Romanenko et al., 1995a).
8. Irradiated children have lower IQs(Figure 5.10).

Figure 5.10. Intellectual development scores(IQs) for a group of heavily irradiated evacuee children from Pripyat City and for children from less irradiated Kiev (National Ukrainian Report, 2006).

Yablokov: Nonmalignant Diseases after Chernobyl

107

TABLE 5.46. Quantitative Parameters of Intellectual Development of Heavily Irradiated Evacuees’Children from Pripyat City and Less Exposed Children from Kiev City (Yablokov et al., 2006)

TABLE 5.47. Nervous System Morbidity (per10,000 Adults) in the Contaminated Territories of
Ukraine, 1987–1992 (Nyagu, 1995a)

Verbal intelligence
Distinctions pIQ-vIQ∗

Irradiated,n = 108

Controls,
n = 73

107
10.4

116
2.9∗

p < 0.05.

Number of cases
1987 1988 1989 1990 1991 1992
All nervous
264
system diseases
Vasomotor
128
dyscrasia∗

242

356

563 1,504 1,402

43

32

372

391

312

∗

9. Children exposed in utero at 16 to 25 weeks
of gestation developed a range of conditions,
including:•

Increased incidence of mental and personality disorders owing to brain injury or
brain dysfunction (F06, F07).
• Disorders of psychological development(F80–F89).
• Paroxysmal states (headache syndromes,
G44; migraine, G43; epileptiform syndromes, G40).
• Somatoform
autonomic dysfunction(F45.3).
• Behavioral and emotional disorders ofchildhood (F90–F99).
10. Quantitative parameters of intellectual
development (IQ) of the heavily irradiatedevacuees’ children from Pripyat City were
worse than those of the less heavily irradiatedchildren from Kiev City (Table 5.46).
11. A marked growth of adult nervous system morbidity was observed in the contaminated territories during the first 6 years after thecatastrophe, especially after 1990 (Table 5.47).
12. Nervous system and sense organ morbidity in the contaminated territories increased
3.8- to 5-fold between 1988 and 1999. Among
adult evacuees these illnesses occurred significantly more often than in the population as awhole (Prysyazhnyuk et al., 2002). In 1994, nervous system illnesses in adults and teenagers
and among evacuees accounted for 10.1% of
the overall morbidity in the contaminated territories (Grodzinsky, 1999).

In Russian-language literature often named “vegetative vascular dystonia,” also known as autonomic nervous
system dysfunction.

13. From 93 to 100% of the liquidators
have neuropsychiatric disorders, with predominantly organic symptomatic mental disorders(F00—F09) (Loganovsky, 1999, 2000). Posttraumatic stress disorder (PTSD), psychosomatic, organic, and abnormal schizoid personality development were documented according
to local psychiatric classifications and ICD-10
and DSM-IV criteria (Loganovsky, 2002).
14. A total of 26 out of 100 randomly selected liquidators who suffered from fatigue
met the chronic fatigue syndrome (CFS) diagnostic criteria. CFS may therefore be oneof the most widespread consequences of thecatastrophe for liquidators (Loganovsky, 2000b,2003). Moreover, although CFS incidence decreased significantly (p < 0.001) (from 65.5%
in 1990–1995 to 10.5% in 1996–2001), the frequency of occurrence of metabolic syndrome
X (MSX—a group of risk factors for heart disease) increased significantly (p < 0.001) during the same period (from 15 to 48.2%). CFS
and MSX are considered to be the first stages
in the development of other pathologies, and
CFS can transform into MSX neurodegeneration, cognitive impairment, and neuropsychiatric disorders (Kovalenko and Loganovsky,
2001; Volovik et al., 2005).
15. A cross-sectional study was carried out
on a representative cohort of liquidators within
the frame of the Franco-German Chernobyl
Initiative (Subproject 3.8) using a composite
international diagnostic interview. The results

108

indicated an almost twofold increase in the incidence of all mental disorders (36%) in liquidators compared with the general Ukrainian population (20.5%), and a dramatic increase in theincidence of depression (24.5 vs. 9.1%). Anxiety(panic disorder) was also increased in liquidators (12.6 vs. 7.1%). At the same time, alcohol
dependence among liquidators was not muchhigher than that in the total population (8.6 vs.
6.4%), ruling out a major contribution from thisfactor (Demyttenaere et al., 2004; Romanenko
et al., 2004).
16. In 1996, nervous system and sense organ morbidity among liquidators was morethan triple the country’s average (Serdyuk and
Bobyleva, 1998).
17. Nervous system morbidity among liquidators in 1986–1987 was twice as high as in
1988–1990 (Moskalenko, 2003).
18. In 1986, some 80 male Ukrainian liquidators with encephalopathy had both structural changes and functional impairment in
the frontal and left temporal brain areas(Antipchuk, 2002, 2003).
19. Autonomic nervous system disorders
among liquidators who worked in 1986–1987
differed from disorders in liquidators from1988–1989 in stability, expressiveness, paroxysmal variants, presence of vestibular I–III dysfunction, and peripheral hemodynamic disturbances. Autonomic nervous system disorders
are closely connected to disorders of neuropsychiatric behavior such as asthenia, disturbed
memory, attention deficits, emotional disturbance, neuroses, hypochondriasis, and depression (Romamenko et al., 1995).
20. Increased rates of neuropsychiatric disorders and somatic pathology (F00–F09) wereobserved among liquidators who worked in
1986–1987, especially in those who spent several years working within the Chernobyl exclusion zone (Loganovsky, 1999).
21. Among liquidators the typical structuralbrain disorder involves the frontal and left
temporal lobes with their cortical–subcorticalconnections and the deep structures of thebrain. The cerebral homodynamic disorders

are caused by atherosclerotic changes. With
hypertonic vascular tone, cerebral hemisphereasymmetry, and poor circulation on the left,
there is a high incidence of stenotic processes.
Pathologic radiographic changes in brain structure include atrophy, enlargement of cerebral
ventricles, and focal brain lesions (Loganovsky
et al., 2003; Nyagu and Loganovsky, 1998).
22. The EEG patterns and topographical distribution of spontaneous and evokedbrain bioelectrical activity of liquidators differed significantly from those of the control
groups (Nyagu et al., 1992; Noshchenko andLoganovsky, 1994; Loganovsky and Yuryev,
2001). In some cases, organic brain damage
was verified by clinical neuropsychiatric, neurophysiological, neuropsychological, and neuroimaging methods (Loganovsky et al., 2003,
2005b). The cerebral basis for deteriorationof higher mental activity causing such disorders following a limited period of irradiation ispathology in the frontal and temporal cortexof the dominant hemisphere and the midline
structures with their cortical–subcortical connections (Loganovsky, 2002; Loganovsky andBomko, 2004).
23. The average age of both male and female
Ukrainian liquidators with encephalopathy was
41.2 ± 0.83 years, noticeably younger than forthe population as a whole (Stepanenko et al.,2003).
24. From 1990 there were reports of a significant increase in the incidence of schizophrenia
among the Chernobyl exclusion zone personnel compared to the general population (5.4
vs. 1.1 per 10,000 in the Ukraine in 1990;
Loganovsky and Loganovskaya, 2000). Irradiation occurring in the contaminated territories causes brain damage, with cortical–limbic
system dysfunction and impairment of informative processes at the molecular level that
can trigger schizophrenia in predisposed individuals or cause schizophrenia-like disorders(Loganovsky et al., 2004a, 2005).
25. A longitudinal study of the cognitive effects of the Chernobyl catastrophe on
the liquidators and forestry and agricultural

Yablokov: Nonmalignant Diseases after Chernobyl

109

workers living within 150 km of Chernobyl was
conducted in 1995–1998. The 4-year averaged
levels of accuracy and efficiency of cognitive
performance of the exposed groups (especiallythe liquidators) were significantly lower thanthose of the controls (healthy Ukrainians residing several hundred kilometers away from
Chernobyl). Longitudinal analyses of performance revealed significant declines in accuracy
and efficiency, as well as psychomotor slowing, for all exposed groups over the 4-year period. These findings strongly indicate impairment of brain function resulting from bothacute and chronic exposure to ionizing radiation (Gamache et al., 2005).

TABLE 5.48. General Nervous System and Sense
Organ Morbidity among Children in Bryansk
Province Districts with Contamination above 5 Ci/
km2 , 1995–1998 (Fetysov, 1999b: table 6.1)
Number of cases
Territory

1995

1996

1997

1998

Klymovo
Novozybkov
Klintsy
Klintsy City
Krasnogorsk
ZlynkaGorgdeevo
Southwest∗
Province
Russia

109.2
124.0
49.2
213.3
275.1
187.2
71.2
143.0
123.6
143.8

111.2
155.0
59.9
212.3
237.8
102.8
64.2
134.7
128.6
154.0

109.2
140.8
79.0
178.1
242.8
144.0
70.1
134.6
133.4
159.0

125.7
158.0
54.2
173.6
107.5
125.8
71.0
131.4
135.2
n/a

∗

All heavily contaminated districts.

5.8.1.3. Russia
1. According to a longitudinal survey of pregnant women, maternity patients, newborns,
and children in the contaminated territoriesof the Mtsensk (1–5 Ci/km2 ) and Volkhov(10–15 Ci/km2 ) districts, Orel Province, the incidence of perinatal encephalopathy observed
after 1986 was double that prior to the catastrophe (Kulakov et al., 2001).
2. Electroencephalographic (EEG) studies ofchildren of different ages from heavily contaminated territories revealed increased functional
activity of the diencephalic structures. Ultrasound studies of babies’ brains from these territories revealed ventricular hypertrophy in almost one-third (Kulakov et al., 2001).
3. Children irradiated in utero had the highest
indices of mental disability and were more likely
to display borderline intelligence and mental
retardation linked to their prenatal irradiation(Ermolyna et al., 1996).
4. In the contaminated territories a lower
level of nonverbal intelligence is found in children radiated in the 15th week of intrauterine
development (Rumyantseva et al., 2006).
5. Although data on children’s neurological morbidity in the heavily contaminateddistricts of Bryansk Province are contradictive (Table 5.48), the level of this morbidity
in Klintsy City and Krasnogorsk District sur-passes that of the province and the rest of Russia
by a significant margin.
6. Impaired short-term memory and attention deficit in pupils 16 to 17 years of age
in the contaminated territories correlated withthe level of contamination (Ushakov et al.,1997).
7. Borderline adult neuropsychological disorders occurred noticeably more often in thecontaminated territories (31 vs. 18%; Ushakov
et al., 1997).
8. There are increasing instances of aphenomenon termed “Chernobyl dementia,” which includes disorders of memory,
writing, convulsions, and pulsing headaches,caused by destruction of brain cells in adults(Sokolovskaya, 1997).
9. From 1986 to 1993 neurological morbidity
in liquidators increased 42-fold (Table 5.49).
10. The occurrence of an encephalopathy
in liquidators increased 25% from 1991 to
1998, and by 2004 the increase was up to 34%(Zubovsky and Tararukhyna, 2007).
11. In 1995, nervous system and sense organ
morbidity in liquidators exceeded the country’s average 6.4-fold (Russian Security Council, 2002).
12. Over 40% of the more than 2,000 liquidators that have been observed over many

110
TABLE 5.49. Dynamics of Nervous System and Sense Organ Morbidity (per 1,000) among Russian
Liquidators, 1986–1993 (Baleva et al., 2001)
Year
Number of cases

1986
23

1987
79

1988
181

years suffer from organic brain diseases of vascular or mixed origin. These illnesses are theresult of long-lasting cerebral-ischemia, disruption of central regulatory functions, and possibly of damage to the endothelium of small
blood vessels (Rumyantseva et al., 1998). Of
more than 1,000 liquidators evaluated up until
2005, some 53.7% had mental impairment
caused by damage or dysfunction of the brainor somatic illness (F06, F07). These disorders
became clearly apparent 10 to 12 years after the catastrophe, are more significant withevery passing year, and are characteristic ofdiffuse organic brain lesions with localization
mainly in the frontal area (Rumyantseva et al.,2006).
13. Autoimmune and metabolic thyroid
gland pathologies are also major factors in
the mental disorders found among liquidators(Rumyantseva et al., 2006).
14. Nervous system and sense organ morbidity among liquidators of Bryansk Province wasnoticeably higher than for the general population (Table 5.50).
15. A total of 12% of surveyed liquidators
had polyneuropathy, expressed as excruciating
TABLE 5.50. Nervous System and Sense Organ
Morbidity among Liquidators and the Adult Population of Bryansk Province Territories with Contamination Levels above 5 Ci/km2 , 1994–1998(Fetysov, 1999a: table 4.1)
Number of cases

Group/
Territory

1994

1995

1996

1997

1998

Liquidators
Southwest∗
Province
Russia

312.9
118.6
127.3
126.6

312.5
104.2
136.5
129.7

372.5
130.5
134.6
136.5

376.9
124.2
131.6
136.5

467.6
314.6
134.2
n/a

∗

All heavily contaminated districts.

1989
288

1990
410

1991
585

1992
811

1993
989

burning pains, and limb atrophy (Kholodova
et al., 1998).
16. According to data from the Russian Interdepartmental Expert Council for the years
1999–2000, neuropsychological illnesses were
the second cause of overall morbidity in 18%
of 1,000 surveyed liquidators (Khrysanfov andMeskikh, 2001).
17. The incidence of encephalopathy andproven organic pathology increased from 20 to
34% as compared with 1991–1997 and 2000,
and neurological diagnoses became more serious by diagnostic criteria (Khrysanfov andMeskikh, 2001).
18. Neuropsychological pathology among
Russian liquidators in 1999–2000 included:
34% encephalopathy, 17% organic disordersof the central nervous system, 17% vegetative
vascular dystonia (vasomotor dyscrasia), and
17% neurocirculatory dystonia (Khrysanfov
and Meskikh, 2001).
19. In 150 male liquidators 44.5 ±3 years of age there was an increase in slow
forms of EEG activity, intercerebral asymmetry, decreased quality of performance on
all cognitive tests, impaired memory, andother functional disorders (Zhavoronkova et al.,2002). Observations on liquidators revealed
that changes in brain asymmetry and interhemispheric interaction can be produced not
only by a dysfunction of subcortical limbic–
reticular and mediobasal brain structures, butalso by damage to the white matter, including the corpus callosum (Zhavoronkova et al.,2000). The EEG findings suggested subcortical disorders at different levels (diencephalicor brainstem) and functional failure of either
the right or left hemispheres long after radiation exposure had ceased (Zhavoronkova et al.,2003).

Yablokov: Nonmalignant Diseases after Chernobyl

111

20. There were many reports concerningneurophysiological, neuropsychological, andneuroimaging abnormalities in liquidators(Danylov and Pozdeev, 1994; Zhavoronkova
et al., 1994, 2000; Vyatleva et al., 1997;
Khomskaja, 1995; Khartchenko et al., 1995;
Kholodova et al., 1996; Voloshyna, 1997).
These data strongly support clinical findings of organic brain damage caused byradiation (Chuprykov et al., 1992; Krasnov
et al., 1993; Romodanov and Vynnyts’ky, 1993;
Napreyenko and Loganovsky, 1995, 2001;
Revenok, 1998; Zozulya and Polischuyk, 1995;
Morozov and Kryzhanovskaya, 1998).
21. Many liquidators had complex organic
disorders of the brain, including: (a) hypometabolic centers localized in white and graymatter and in deep subcortical formations; (b)ventricular enlargement, often asymmetric; (c)expansion of the arachnoid cavity; (d) decreased
density of the white brain substance; (e) thinning of the corpus callosum; and (f) diffuse
singular or multiple localized space-occupying
lesions of the brain tissue (Kholodova et al.,
1998; Ushakov et al., 1997; Nyagy and
Loganovsky, 1998; Loganovsky, 2002; andothers).
22. Four hundred liquidators 24 to 59 yearsof age with organic disorders of the central nervous system have irreversible structural brain
defects: structural changes in the frontal lobe,
the left temporal area, and the connectionsin the cortex–subcortex (Khartchenko et al.,
1995; Antipchuk, 2002, 2003; Zhavoronkova
et al., 2002; Antonov et al., 2003; Tsygan,2003).
23. Typical complaints from liquidators include severe headaches, not relieved by medications, impaired memory of current events,
general weakness, fatigue, diminished capacity for work, generalized sweating, palpitations,bone and joint pains and aches that interferewith their sleep, sporadic loss of consciousness,sensation of fever or heat, difficulty in thinking, heart seizures, flashes, loss of vision, andnumbness in hands and feet (Sokolova, 2000;
Kholodova, 2006).

24. The neurological damage suffered byliquidators includes well-marked autonomic
nervous system dysfunction expressed as acrocyanosis, acrohyperhydrosis, and common hyperhydrosis, sponginess and puffiness of soft
tissues, facial redness, diffuse dermographism,
asthenia, and depressive syndromes. Other organic nervous system impairments include cranial nerve abnormalities, marked hyperreflexia,
the presence of pathological reflexes, andabnormal Romberg test scores (Kholodova,
2006).
25. Characteristic dysfunction in liquidators
involves deep parts of the brain: diencephalicareas, deep frontal and temporal lobes, and occipitoparietal parts of the cerebral hemispheres(Kholodova, 2006).
26. Liquidators demonstrate impaired task
performance, a shortening of attention span,and problems with short-term memory and operative thinking. These features correspond toskill levels typical of 10- to 11-year-old children
and cannot be attributed to social factors—theyclearly testify to radiation-induced brain damage (Kholodova, 2006).
27. EEG brain activity demonstrates two
types of pathologies: high-amplitude slowed
alpha- and theta-wave bands, reflecting pathology of the visceral brain, and diffuse decreases
in bioelectric activity, reflecting diffuse cortex and subcortical area damage (Kholodova,
2006).
28. The seriousness of brain pathology in liquidators correlates with impaired blood circulation in various cortical white substance sites
and deep subcortical formations (Kholodova,
2006).
5.8.1.4. Other Countries
1. ESTONIA. After Chernobyl, suicide was theleading cause of death among liquidators living
in Estonia (Rahu et al., 2006).
2. LITHUANIA. Age-adjusted mortality fromsuicide increased among the Chernobyl liquidators compared to the general Lithuanian
population (Kesminiene et al., 1997).

112

3. SWEDEN. A comprehensive analysis of adata set of 562,637 Swedes born from 1983 to
1988 revealed that the cohort in utero during thecatastrophe had poorer school outcomes thanthose born shortly before and shortly after thisperiod. This impairment was greatest for those
exposed 8 to 25 weeks postconception. Moreover, more damage was found among students
born in regions that received more fallout; students from the eight most affected municipalities were significantly (3.6 percentage points)
less likely to qualify for high school (Almond
et al., 2007). These findings correspond to thoseconcerning reduced IQ hibakusha who were irradiated 8 to 25 weeks after ovulation (Otake
and Schull, 1984).

5.8.1.5. Conclusion
Previous views claiming resistance of the nervous system to radiation damage are refuted by
the mounting collective data that demonstrate
nervous system illnesses among the populationsof the contaminated territories, especially liquidators. Even rather small amounts of nuclear
radiation, considered harmless by former measures of radiation protection, have resulted inmarked organic damage. Clearly, the existingradiation levels in the contaminated territories have harmed the central nervous systemof countless people.
For many inhabitants of the contaminatedterritories, especially persons that were radiatedin utero and liquidators, nervous system functions, including perception, short-term memory, attention span, operative thinking, anddreaming, are deteriorating. These conditions
are associated with deep cerebral hemisphericdamage: diencephalic areas, deep frontal, andtemporal lobes, and occipitoparietal parts ofthe cerebral hemisphere. Low-dose radiation
damages the vegetative (autonomic) nervous
system. The fact that intellectual retardation isfound in 45% of children born to mothers whowent through the Hiroshima and Nagasakai
nuclear bombardment is a very troubling concern (Bulanova, 1996).

5.8.2. Diseases of Sense Organs
Throughout the more contaminated territories, visual and hearing abnormalities occur
with greater frequency than in the less contaminated areas: premature cataracts, vitreousdegeneration, refraction errors, uvitis, conjunctivitis, and hearing loss.
5.8.2.1. Belarus
1. A survey of pregnant women, maternity patients, newborns, and children in the
Chechersk District, Gomel Province, with Cs137 contamination of the soil at levels of 5–
70 Ci/km2 showed an increase in the number of sensory organ development abnormalities, including congenital cataracts in neonates(Kulakov et al., 2001).
2. In heavily contaminated territories there
is a noticeably higher incidence of congenital
malformations, including cataracts, microphthalmia, malpositioned ears, and extra ear tissue (Kulakov et al., 2001).
3. Cataracts in children are common in
the territories with contamination levels above
15 Ci/km2 (Paramey et al., 1993; Edwards,
1995; Goncharova, 2000).
4. Retinal pathology in children in the
Khoiniky and Vetka districts, Gomel Province(4,797 people examined), increased about
threefold: from 6 to 17% in the first 3 years after the catastrophe compared to 1985 (Byrich
et al., 1999).
5. From 1988 to 1989 the incidence of congenital eye malformation in children (3 to
4 years after the catastrophe) was fourfold
higher in the heavily contaminated Gomel
Province (1.63%) than from 1961 to 1972 in
Minsk (0.4%; Byrich et al., 1999).
6. Clouding of the lens, an early symptom of cataracts, was found in 24.6% of exposed children compared with 2.9% in controls(Avkhacheva et al., 2001).
7. Children under 5 years of age who were
exposed have more problems with eye accommodation and more overall eye diseases
than controls (Serduchenko and Nostopyrena,2001).

Yablokov: Nonmalignant Diseases after Chernobyl

113

TABLE 5.51. Incidence of Cataracts (per 1,000)
in Belarus, 1993–1995 (Matsko, 1999; Goncharova, 2000)

TABLE 5.52. Incidence (%) of Opacities in Both
Crystalline Lenses among Children Living in Territories with Various Levels of Contamination, 1992
(Arynchin and Ospennikova, 1999)

Contaminatedterritories, Ci/km2
Year

Belarus

1–15>15

Evacuees

1993
1994
1995

136
146
147

190
196
n/a

226
366
n/a

355
425
443

8. Eye disease significantly increased from1993 to 2003 among children 10 to 14 yearsof age born to irradiated parents (National Belarussian Report, 2006).
9. The level of absorbed Cs-137 correlates with the incidence of cataracts in children from the Vetka District, Gomel Province(Bandazhevsky, 1999).
10. From 1993 to 1995, cataracts weremarkedly more common in the more contaminated territories and among evacuees than in
the general population (Table 5.51).
11. Eye diseases were more common in the
more contaminated districts of Gomel Province
and included cataracts, vitreous degeneration,and refraction abnormalities (Bandazhevsky,
1999).
12. Bilateral cataracts occurred more frequently in the more contaminated territories(54 vs. 29% in controls; Arynchin and Ospennikova, 1999).
13. Crystalline lens opacities occur more frequently in the more radioactive contaminatedterritories (Table 5.52) and correlate with thelevel of incorporated Cs-137 (Figure 5.11).
14. Increased incidence of vascular andcrystalline lens pathology, usually combinedwith neurovascular disease, was found in 227
surveyed liquidators and in the population ofcontaminated territories (Petrunya et al., 1999).
15. In 1996, incidence of cataracts among
Belarussian evacuees from the 30-km zone wasmore than threefold that in the population asa whole: 44.3 compared to 14.7 per 1,000(Matsko, 1999).

Incidence of
opacities, %Brest Province,
137–377 kBq/m2 (n = 77)
Vitebsk Province,
3.7 kBq/m2 (n = 56)

1–5

6–10

>10

57.5

17.9

6.7

60.9

7.6

1.1

16. From 1993 to 2003 cataract morbidity
increased 6% annually among male liquidators(National Belarussian Report, 2006).
5.8.2.2. Ukraine
1. A survey of pregnant women, maternity patients, newborns, and children in contaminated territories in the Polessk District,
Kiev Province (soil Cs-137 contamination 20–
60 Ci/km2 ) showed an increase in the numberof sensory organ development defects, including congenital cataracts in neonates (Kulakov
et al., 2001).
2. Hearing disorders are found in more than
54% of inhabitants of the contaminated territories, a level noticeably higher than that of thegeneral population (Zabolotny et al., 2001).

Figure 5.11. Number of bilateral lens opacities
and level of incorporated Cs-137 in Belarussian children (Arynchin and Ospennikova, 1999).

114

3. In 1991 a group of 512 children 7 to 16
years of age from four villages in the Ivankiv
District, Kiev Province, was examined. The
villages differed only in the degree of Cs-137
contamination of the soil:(a) First village: average 12.4 Ci/km2 (maximum 8.0 Ci/km2 ; 90% of the territory,
5.4 Ci/km2 ).
(b) Second village: average 3.11 Ci/km2 (maximum 13.8 Ci/km2 ; 90% of the territory,
4.62 Ci/km2 ).
(c) Third village: average 1.26 Ci/km2 (maximum 4.7 Ci/km2 ; 90% of the territory,
2.1 Ci/km2 ).
(d) Fourth village: average 0.89 Ci/km2 (maximum 2.7 Ci/km2 ; 90% of the territory,
1.87 Ci/km2 ).
Typical lens pathologies were detected in
51% of those examined, and the incidenceof lens pathology was higher in villages withhigher levels of soil contamination. Atypicallens pathologies were observed in 61 children(density of the posterior subcapsular layers,
dimness in the form of small spots and points
between the posterior capsule and the core, andvacuoles) and were highly (r = 0.992) correlated with the average and maximum levels ofsoil contamination. In 1995 the incidence ofatypical lens pathologies in the first and second
villages (with average soil contamination over
2 Ci/km2 ) increased significantly to 34.9%.
Two girls (who had early changes of corticallayer density in 1991) were diagnosed with dimvision, suggesting the development of involutional cataracts (Fedirko and Kadoshnykova,
2007).
4. In 1992–1998 children from Ovruch
City (soil Cs-137 contamination 185–555
kBq/m2 ) had significantly higher subclinicallens changes (234 per 1,000, of 461 examined)
than children from Boyarka City (soil Cs-137
contamination 37–184.9 kBq/m2 or 149 per
1,000, of 1,487 examined). In Ovruch the incidence of myopia and astigmatism was significantly higher (Fedirko and Kadoshnykova,
2007).

5. Children who were exposed before they
were 5 years of age have more problems witheye accommodation (Burlak et al., 2006).
6. Individuals from contaminated territories and liquidators had premature involutionaland dystrophic changes in the eyes, development of ocular vascular diseases, increasing incidence of chorioretinal degeneration such as
age-dependent macular degeneration (AMD),and benign neoplasm of the eyelids. Central
chorioretinal degeneration with clinical symptoms of AMD was the most frequently occurring form of delayed retinal pathology: 136.5 ±10.7 per 1,000 in 1993 and 585.7 ± 23.8 per
1,000 in 2004. Involutional cataracts increased
from 294.3 ± 32.0 per 1,000 in 1993 to 766.7 ±35.9 per 1,000 in 2004 (Fedirko, 2002; Fedirko
and Kadoshnykova, 2007).
7. Individuals from contaminated territories and liquidators had a marked decreasein ocular accommodation (Sergienko andFedirko, 2002).
8. In the heavily contaminated territories, among 841 adults examined from 1991
to 1997, retinal pathologies, involutional
cataracts, chronic conjunctivitis, and vitreous
destruction were observed more often than in
the less contaminated areas, and cataracts wereseen in persons younger than 30 years of age,which has never been observed in less contaminated areas (Fedirko and Kadochnykova,
2007).
9. The occurrence of involutional cataracts
in the contaminated territories increased 2.6fold from 1993 to 2004: from 294.3 ± 32.0 to
766.7 ± 35.9 per 1,000 (Fedirko, 1999).
10. Among 5,301 evacuees examined, eyepathology was diagnosed in 1,405. One
cataract occurred for every four cases of othereye pathologies (Buzunov et al., 1999).
11. Two new syndromes have been seen inliquidators and in those from the contaminatedterritories:•

Diffraction grating syndrome, in whichspots of exudate are scattered on the central part of the retina. This was observedin liquidators who were within direct sightYablokov: Nonmalignant Diseases after Chernobyl

115

of the exposed core of the fourth reactor(Fedirko, 2002).
• Incipient chestnut syndrome, named forthe shape of a chestnut leaf, expressed
as new chorioretinopathy, changes of retinal vessels with multiple microaneurisms,
dilations, and sacs in the retinal veinsaround the macula (Fedirko, 2000).

fer from defects in different parts of the auditory system resulting in progressive hearing
loss and a stuffy sensation and noise in the ears
(Zabolotny et al., 2000).
6. High-frequency audiometry revealed thatthe most abnormalities occurred in liquidators with vocal problems (Kureneva andShidlovskaya, 2005).

12. The frequency of central chorioretinal
degradation increased among the liquidators
4.3-fold from 1993 to 2004: from 136.5 ±10.7 to 585.7 ± 23.8 per 1,000 (Buzunov andFedirko, 1999).
13. The incidence of cataracts was significantly higher for male liquidators comparedwith female liquidators (Ruban, 2001).
14. Retinal pathology was markedly higher
than the norm among 2002 liquidators’ children who were born after the catastrophe andexamined between 1999 and 2006 (Fedirko andKadoshnykova, 2007).
5.8.2.3. Russia
1. A survey of pregnant women, maternity
patients, newborns, and children in the Mtsensk and Volkhovsk districts, Orel Province,
contaminated with Cs-137 levels of 1–5 and10–15 Ci/km2 showed an increase in the number of sensory organ developmental deficiencies, including congenital cataracts in neonates(Kulakov et al., 2001).
2. A total of 6.6% of 182 surveyed liquidators had cataracts (Lyubchenko and Agal’tsev,
2001).
3. More than 52% of 500 surveyed liquidators had retinal vascular abnormalities(Nykyforov and Eskin, 1998).
4. Some 3% of liquidators under 40 yearsof age had cataracts, an incidence 47-fold thatin a similar age group of the general population; 4.7% had glaucoma (Nykyforov and Eskin, 1998).
5. Between 46 and 69% of surveyed liquidators had some hearing disorder (Zabolotny et al.,
2001; Klymenko et al., 1996). Liquidators suf-

5.8.2.4. Other Countries
1. ISRAEL. A 2-year follow-up study of immigrants to Israel from the Former Soviet Union
revealed that the proportion of those reporting
chronic visual and hearing problems was statistically higher for immigrants from contaminated territories (304 individuals) comparedwith immigrants from noncontaminated (217
individuals) and other areas (216 individuals;
Cwikel et al., 1997).
2. NORWAY. Cataracts in newborns occurred
twice as often 1 year after the catastrophe(Irgens et al., 1991).
5.8.3. Conclusion
There is little doubt that specific organic central and peripheral nervous system damage affecting various cognitive endpoints, as observedin both individuals from the contaminated territories and liquidators, is directly related to
Chernobyl’s ionizing radiation. In differing degrees, these conditions affect all liquidators andpractically every person living in the contaminated territories.
Among the consequences of the damage
to the nervous system caused by the Chernobyl catastrophe are cognitive, emotional,
and behavioral disorders. Adverse effects
also include neurophysiological abnormalities
in the prenatally exposed and neurophysiological, neuropsychological, and neuroimaging abnormalities in liquidators, manifested
as left frontotemporal limbic dysfunction,schizophreniform syndrome, chronic fatigue
syndrome, and, combined with psychologicalstress, indications of schizophrenia and relateddisorders.

116

Only after 2000 did medical authorities begin to recognize the radiogenic origin of a universal increase in cataracts among liquidatorsand evacuees from the Chernobyl territories.
Official recognition occurred 10 years (!) after
doctors began to sound the alarm and 13 years
after the problem was first registered.
5.9. Digestive System and Visceral
Organ Diseases
Digestive system diseases are among theleading causes of illness in the contaminatedterritories. Compared to other illnesses, it ismore difficult to classify these with certainty
as being caused by a radiogenic component;
however, the collected data from the contaminated territories point to a solid basis for sucha conclusion.
5.9.1. Belarus
1. The number of digestive organ malformations in newborns increased in the contaminated territories (Kulakov et al., 2001).
2. There was a twofold general increasein chronic gastritis in Brest Province in 1996
compared to 1991. In 1996 the occurrence ofchronic gastritis in children was up to threefold higher in the heavily contaminated territories than in the less contaminated areas. In
the Stolinsk District in 1996 the incidence of
this disease was more than fourfold that seen in1991 (Gordeiko, 1998).
3. Of 135 surveyed juvenile evacuees from
Bragin City and the highly contaminated territories of Stolinsk District, Brest Province, 40%
had gastrointestinal tract illnesses (Belyaeva
et al., 1996).
4. Of 2,535 individuals examined in 1996,
digestive system illnesses were the first cause ofgeneral morbidity in teenage evacuees (556 per
1,000; Syvolobova et al., 1997).
5. Digestive system morbidity increased from
4.6% in 1986 to 83.5% in 1994 and was the second cause of overall morbidity of children in the

Luninetsk District, Brest Province (Voronetsky
et al., 1995).
6. Of 1,033 children examined in the heavily contaminated territories from 1991 to 1993
there was a significantly higher incidence ofserious caries and lowered acid resistance of
tooth enamel (Mel’nichenko and Cheshko,1997).
7. Chronic upper gastrointestinal disease wascommon in children of liquidators (Arynchin
et al., 1999).
8. Gastrointestinal tract pathology is connected to morphologic and functional thyroid
gland changes in children from territories contaminated by Cs-137 at levels of 1–15 Ci/km2(Kapytonova et al., 1996).
9. Digestive diseases in adults and liquidators are more common in the contaminatedterritories. From 1991 to 1996 stomach ulcers
among the population increased 9.6%, whileamong liquidators the increase was 46.7%(Kondratenko, 1998).
10. In 1995, the incidence of diseases ofthe digestive system among liquidators andevacuees in the contaminated territories was
4.3- and 1.8-fold higher than in the general population of the country: respectively,
7,784; 3,298; and 1,817 per 100,000 (Matsko,
1999).
11. Ten years after the catastrophe digestive
illnesses were fourfold more common amongliquidators than in the general adult populationof the country (Antypova et al., 1997a).
12. From 1991 to 2001 digestive system illnesses among liquidators increased 1.65-fold(Borisevich and Poplyko, 2002).
13. Of 2,653 adults and teenagers examined, the incidence of acute hepatitis-B, chronic
hepatitis-C, and hepatic cirrhosis diseases was
significantly higher in the heavily contaminatedterritories of Gomel Province than in the lesscontaminated Vitebsk Province. By 1996 theincidence of these diseases had increased significantly, with chronic hepatitis in liquidators
1.6-fold higher than in 1988–1995 (Transaction, 1996).

117

Yablokov: Nonmalignant Diseases after Chernobyl

5.9.2. Ukraine
1. The number of digestive system diseases
in children rose markedly within the first 2
years after the catastrophe (Stepanova, 1999;
and others).
2. The incidence of digestive diseases inchildren correlated with the level of contamination of the area (Baida and Zhirnosekova,
1998).
3. Premature tooth eruption was observed ingirls born to mothers irradiated during childhood (Tolkach et al., 2003).
4. Tooth caries in boys and girls as young as
1 year are more common in the contaminatedterritories (Tolkach et al., 2003).
5. Digestive system morbidity in children
more than doubled from 1988 to 1999—4,659
compared to 1,122 per 10,000 (Korol et al.,
1999; Romanenko et al., 2001).
6. Children irradiated in utero had significantly higher incidence of gastrointestinal
tract pathology than controls—18.9 vs. 8.9%
(Stepanova, 1999).
7. Atrophy of the stomach mucosa occurred
five times more often, and intestinal metaplasia
twice as often in children living in areas contaminated at a level of 5–15 kBq/m2 than in acontrol group (Burlak et al., 2006).
8. In 1987 and 1988 functional digestive tract
illnesses were prevalent in evacuees’ children,and from 1989 to 1990 allergies, dyspeptic syndromes, and biliary problems were rampant(Romanenko et al., 1995).
9. Peptic ulcer, chronic cholecystitis, gallstone disease, and pancreatitis occurred noticeably more often in inhabitants of territories withhigher levels of contamination (Yakymenko,
1995; Komarenko et al., 1995).
10. From 1993 to 1994 digestive system diseases were second among overall morbidity(Antypova et al., 1995).
11. There were significantly increased levelsof hepatic, gallbladder, and pancreatic diseases
in 1993 and 1994 in the heavily contaminatedterritories (Antypova et al., 1995).

12. Digestive system morbidity in adult evacuees considerably exceeds that of the general
population of the country (Prysyazhnyuk et al.,2002).
13. In 1996 digestive system morbidity of
inhabitants in territories with contamination
greater than 15 Ci/km2 was noticeably higher
than for the country as a whole (281 vs. 210
cases per 1,000; Grodzinsky, 1999).
14. Only 9% of the liquidators evaluatedin 1989 and 1990 had normal stomach andduodenal mucous membranes (Yakymenko,
1995).
15. The incidence of stomach ulcers among
Ukrainian liquidators in 1996 was 3.5-foldhigher than the country average (Serdyuk and
Bobyleva, 1998).
16. In 1990 ulcers and gastric erosion were
found in 60.9% of liquidators (Yakymenko,
1995).
17. After the catastrophe pancreatic abnormalities in liquidators were diagnosed throughechograms (Table 5.53).
18. In 7 to 8 years after the catastrophe
up to 60% of the liquidators examined had
chronic digestive system pathology, which included structural, motor, and functional secretory disorders of the stomach. For the first 2.5
to 3 years inflammation was the most prevalent
symptom, followed by indolent erosive hemorrhagic ulcers (Romanenko et al., 1995).

TABLE 5.53. Pancreatic Echogram Abnormalities
in Male Ukrainian Liquidators (% of Those Examined) (Komarenko et al., 2002; Komarenko andPolyakov, 2003)

Thickening
Increased echo density
Structural change
Contour change
Capsular change
Pancreatic duct dilatation
All echogram abnormalities

1987–1991

1996–2002

31
54
14
7
6
4
37.6 (1987)

67
81
32
26
14
10
87.4 (2002)

118

19. In 7 to 8 years after the catastrophe
liquidators had increasing numbers of hepatobiliary illnesses, including chronic cholecystitis, fatty liver, persistent active hepatitis, and chronic hepatitis (Romamenko et al.,1995).
5.9.3. Russia
1. Children and the teenagers living in thecontaminated territories have a significantly
higher incidence of dental caries (Sevbytov,
2005).
2. In Voronez Province there was an increased number of odontomas in children who
were born after 1986. Tumors were found more
often in girls and the complex form was mostcommon (Vorobyovskaya et al., 2006).
3. Periodontal pathology was more common
in children from contaminated territories andoccurred more often in children born after thecatastrophe (Sevbytov, 2005).
4. Children who were irradiated in utero in thecontaminated territories are significantly more
likely to develop dental anomalies (Sevbytov,
2005).
5. The frequency of the occurrence of dental anomalies is markedly higher in children in
the more contaminated territories. Of 236 examined who were born before the catastrophe
32.6% had normal dentition, whereas of 308
examined who were born in the same territories after the catastrophe only 9.1% had normal
structure (Table 5.54).
6. The incidence of general and primary digestive system diseases in children in the heavily contaminated districts of Bryansk Province
is noticeably higher than the average for theprovince and for Russia as a whole (Tables 5.55
and 5.56).
7. In general, digestive system morbidity inadults increased in the majority of the heavily contaminated districts of Bryansk Province(except in the Krasnogorsk District). This increase occurred against a background of reduced morbidity in the province and acrossRussia (Table 5.57).

TABLE 5.54. Incidence of Dental Anomalies (%)
among Children Born before and after the Catastrophe Exposed to Different Levels of Contamination in Tula and Bryansk Provinces∗ (Sevbytov
et al., 1999)
<5
5–15
15–45
Ci/km2 Ci/km2 Ci/km2
Tooth
anomalies

Dentition
deformities

Occlusion

Age norm

3.7

2.4

2.8

4.2

4.6

6.3

0.6

0.4

0.6

0.6

0.6

1.7

2.6

2.4

2.2

4.4

5.2

6.3

5.3

5.7

3.1

2.6

2.0

0.6

Time
of birth
Before 1986
(n = 48)
After 1986
(n = 82)
Before 1986
(n = 8)After 1986
(n = 15)
Before 1986
(n = 39)
After 1986
(n = 86)
Before 1986
(n = 77)
After 1986
(n = 28)∗
5 Ci/km2 : Donskoy City, Tula Province (n = 183);
5–15 Ci/km2 : Uzlovaya Station, Tula Province (n = 183);
15–45 Ci/km2 : Novozybkov City, Bryansk Province (n =178).

8. Digestive system morbidity in liquidators increased 7.4-fold over a 9-year period(Table 5.58).
9. The Russian National Register reported
that digestive system morbidity among liquidators from 1991 to 1998 was markedly
higher than in corresponding age groups in the
country: 737 vs. 501 per 10,000 (Byryukov et al.,2001).
TABLE 5.55. Overall Digestive System Morbidity(per 1,000) among Children in Bryansk Province
Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.1)
Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

182.9
94.5
114.9

163.5
88.9
115.6

153.6
90.9
114.9

154.7
91.0
n/a

∗

All heavily contaminated districts.

Yablokov: Nonmalignant Diseases after Chernobyl

119

TABLE 5.56. Primary Digestive System Morbidity(per 1,000) among Children in Bryansk Province
Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999b: table 6.2)

12. Of 118 surveyed liquidators, 60.2% havestructural pancreatic changes, 40.6% have liverchanges, and 29% have thickening of the gallbladder wall (Noskov, 2004).
13. Digestive system morbidity among both
liquidators and the population of the contaminated territories of Bryansk Province noticeably increased from 1994 to 1998, which is especially significant against the background of
a decrease in the province and in Russia as awhole (Table 5.59).
14. Ten years after the catastrophe a rapid
increase in digestive organ diseases in liquidators began, together with circulatory, bone,and muscular diseases (Figure 5.12). Making fewer diagnoses of vegetovascular dystonia
has turned this constellation of diseases intoa more serious organic illness—discirculatory
pathology.
15. Pathological tooth enamel erosion
is widespread among liquidators (Pymenov,2001).
16. Among 98 surveyed liquidators 82%
have chronic periodontal disease, an incidence
much more common than in corresponding age
groups in the country as a whole (Druzhynyna,
2004; Matchenko et al., 2001).
17. Chronic catarrhal gingivitis waspresent in 18% of 98 surveyed liquidators(Druzhynyna, 2004).
18. The expression of chronic pancreatitis inliquidators correlated with the level of irradiation and the degree of the lipid peroxidation(Onitchenko et al., 2003).

Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

103.5
51.8
58.1

81.7
42.9
60.2

84.2
46.7
56.4

83.1
42.3
n/a

∗

All heavily contaminated districts.

10. Pathologic ultrastructural digestive tractchanges were observed in liquidators: decreased activity and undifferentiated epithelial cells in the duodenum, endotheliocytes instomach microvessels, and fibrosis of the gastric mucous membrane (Sosyutkin et al., 2004;
Ivanova, 2005).
11. Of 901 pathologies found in 182 liquidators, digestive system morbidity accounted for
28.2%. A total of 87.9% of the liquidators have
had chronic gastritis and gastroduodenitis (often, the erosive type); 33.4% have superficial
destruction of the mucous covering of the gastroduodenal junction, which is six- to eightfold higher than the norm (Lyubchenko andAgal’tsev, 2001).
TABLE 5.57. General Digestive System Morbidity (per 1,000) among Adults in Bryansk Province
Territories with Levels of Contamination above
5 Ci/km2 , 1995–1998 (Fetysov, 1999a: table 6.1)
Number of cases
Territory

1995

1996

1997

1998

5.9.4. Conclusion

Klymovo
Novozybkov
Klintsy
Krasnogorsk
ZlynkaGordeevka
Southwest∗
Province
Russia

88.6
79.6
118.0
90.7
65.8
52.9
79.7
69.0
97.3

98.5
76.7
143.8
74.0
72.2
74.8
95.6
65.6
93.8

84.9
88.6
89.0
46.3
78.1
91.2
88.0
63.2
91.5

157.3
92.4
155.9
57.9
82.8
92.0
105.0
64.4
n/a

The increase in the incidence of digestivesystem diseases as a result of Chernobyl irradiation cannot be doubted. In contaminatedterritories, where Cs-137 was easily detected, it
was accompanied by Sr-90, which is taken up
during intrauterine development and depositedin teeth and bones. Sr-90 decays to Y-90 via release of a beta particle, which is harmful tothe developing teeth, and the resultant decay∗

All heavily contaminated districts.

120
TABLE 5.58. Digestive System Morbidity (per 10,000) among Russian Liquidators (Baleva et al.,
2001)
Year
Number of cases

1986
82

1987
487

1988
1,270

isotope, Y-90, weakens the structural integrityof the teeth.
There was an immediate increase in the incidence of digestive tract diseases among liquidators and a rise in the number of congenital digestive system malformations in babies born inthe contaminated territories. The assumption
appears proven that low-level irradiation acts
in some way to directly affect the function of
the gastrointestinal tract epithelium—and not
only during intrauterine development.
Considering the significantly increased digestive system morbidity among children of irradiated parents in Japan (Furitsu et al., 1992),
and in the southern Ural mountain area owing to radiation contamination (Ostroumova,
2004), it is logical to assume that similar consequences from Chernobyl irradiation will have a
prolonged effect in territories where radioactive
conditions persist.

1989
2,350

1990
3,210

1991
4,200

1992
5,290

1993
6,100

The skin, a multilayered organ with multiple functions, is made up of the epidermis, thedermis, and various cells, including the keratinaceous structures that form nails and hair, plus
melanocytes, and the sebaceous and sweat (eccrine) glands. The skin is richly supplied withnerves and blood vessels. Thus the skin and allof its subcutaneous components reflect internal
damage to blood vessels and other tissues of thebody, as is demonstrated by the research citedin this section.
5.10.1. Belarus
1. By 1994 skin and subcutaneous tissue diseases had increased among children in all of
the heavily contaminated territories comparedwith 1988 (Lomat’ et al., 1996).

5.10. Skin Diseases Associatedwith the Chernobyl Catastrophe
Diseases of the skin reflect not only the effectof external irritants, but also diseases of internalorgans and the effects of organic and inorganic
agents that are absorbed internally.
TABLE 5.59. General Digestive System Morbidity among Liquidators and the Adult Population of
Bryansk Province Territories with Levels of Contamination above 5 Ci/km2 , 1994–1998 (Fetysov,
1999a: table 4.1)
Number of cases

Group/
Territory

1994 1995 1996 1997 1998

Liquidators
All of the Southwest
Province
Russia24.7 45.7 63.0
54.2 523.0 88.7
71.8 69.0 65.6
95.8 97.3 91.5

52.3 346.4
78.4 269.0
63.2 64.4
91.5
n/a

Figure 5.12. Digestive, circulatory, bone, andmuscle diseases among liquidators from Moscow Cityand Moscow Province: (1) digestive system, (2) boneand muscle, (3) hypertension, (4) ischemic heart disease, (5) circulatory encephalopathy, and (6) autonomic nervous system dysfunction (Oradovskaya
et al., 2006, 2007).

Yablokov: Nonmalignant Diseases after Chernobyl

121

2. Of 69 children and teenagers admitted tohospitals with various forms of alopecia, morethan 70% came from the heavily contaminatedterritories (Morozevich et al., 1997).
3. In Senkevichi Village, Luninets District,
Brest Province, the incidence of children’s skinand subcutaneous tissue diseases increased 1.7fold from 2000 to 2005 (Dudinskaya et al.,2006).
4. From 1986 to 1993 the incidence of skindisease among 4,598 children examined in
Kormyansk and Chechersk districts, Gomel
Province, where Cs-137 contamination was
15–40 Ci/km2 , was significantly higher compared to less contaminated districts (Gudkovsky
et al., 1995).
5. The incidence of skin disease amongchildren who were newborn to 4 years oldat the time of the catastrophe is significantly
higher in territories with contamination levelsof 15–40 Ci/km2 than in children of the sameage from territories with contamination of 5–
15 Ci/km2 (Kul’kova et al., 1996).
6. Out of the first 9 years after the catastrophe, skin and subcutaneous morbidity was a
maximum in 1993 (Blet’ko et al., 1995).

TABLE 5.60. Overall Skin Diseases among Children (per 1,000) in the Southwest Territories ofBryansk Province with Levels of Contamination
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999b:table 6.1)

5.10.2. Ukraine
1. Skin diseases among evacuees living in
the heavily contaminated territories from 1988
to 1999 was more than fourfold higher thanin the less contaminated areas (Prysyazhnyuk
et al., 2002).

5.10.3. Russia
1. Exudative diathesis (lymphotoxemia) inpreschool children in the contaminated territories occurred up to four times more often than
before the catastrophe (Kulakov et al., 2001).
2. From 1995 to 1998 the incidence of overall
and primary skin diseases in children in theheavily contaminated territories was noticeably

Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

111.3
83.4
81.9

105.9
80.8
84.6

102.1
78.3
86.0

83.3
76.2
n/a

∗

All heavily contaminated districts.

higher than in the province and in Russia as awhole (Tables 5.60 and 5.61).
3. Dermatological pathology was found in
60% of children and teenagers in Gordeevka,
Bryansk Province, which is one of the most contaminated districts (Kyseleva and Mozzherova,
2003).
4. In 1996 overall skin morbidity in adults
in the heavily contaminated territories ofBryansk Province corresponded to parametersin the province as a whole (Tables 5.62 and5.63).
5. Incidence of diseases of the skin and subcutaneous tissues among liquidators increased
6 years after the catastrophe and in 1992 exceeded the level of 1986 more than 16-fold(Table 5.64).
6. Skin pathology found among liquidators
included thickening of the cornified and subcellular layers of the epidermis, endothelial
TABLE 5.61. Primary Skin Diseases among Children (per 1,000) in Southwestern Territories ofBryansk Province with Levels of Contamination
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999b:table 6.2)
Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

88.5
71.7
73.1

89.2
69.6
71.3

95.7
65.3
68.6

74.8
63.2
n/a

∗

All heavily contaminated districts.

122
TABLE 5.62. Overall Skin Diseases among Adults(per 1,000) in the Southwestern Territories ofBryansk Province with Levels of Contamination
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999a:table 6.1)
Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

60.3
68.5
50.4

67.4
62.4
48.9

61.4
53.0
46.3

58.6
54.0
n/a

∗

All heavily contaminated districts.

swelling, inflammatory lymphocytic infiltrationaccompanied by active panvasculitis of most of
the small arteries; findings correlated with thelevel of the radiation load (Porovsky et al., 2005).
7. Among the 97% of liquidators who developed psoriasis after the catastrophe, the psoriasis was always combined with functional
impairment of the nervous system and withgastrointestinal disorders (Malyuk and Bogdantsova, 2001).
Undoubtedly the post-Chernobyl period has
seen an increase in diseases of the skin and subcutaneous tissues in children and liquidators.
5.11. Infections and Parasitic
Infestations
Ionizing radiation is a powerful mutagenic
factor (see Section 5.2 above for details).
Clouds from Chernobyl dropped a powerTABLE 5.63. Primary Skin Diseases among Adults(per 1,000) in the Southwestern Territories ofBryansk Province with Levels of Contamination
above 5 Ci/km2 , 1995–1998 (Fetysov, 1999a:table 6.1)
Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province
Russia

50.9
54.1
40.6

52.5
50.2
38.7

51.5
42.2
36.7

45.4
45.0
n/a

∗

All heavily contaminated districts.

ful cocktail of radionuclides over the entire
Northern Hemisphere (see Chapter 1 for details). Chernobyl radionuclide contamination
impacted microbial flora and fauna and otherof our symbionts (parasites and commensals)and changed our biological community (seeChapter 11).
There is evidence of increased incidence andseverity of diseases characterized by intestinal toxicoses, gastroenteritis, bacterial sepsis,
viral hepatitis, and respiratory viruses in areas contaminated by Chernobyl radionuclides(Batyan and Kozharskaya, 1993; Kapytonova
and Kryvitskaya, 1994; Nesterenko et al., 1993;
Busuet at al., 2002; and others). Genetic instability markedly increased in the contaminatedterritories and has resulted in increased sensitivity to viral and other types of infections(Vorobtsova et al., 1995).
5.11.1. Belarus
1. Herpes virus activation in the heavily
contaminated territories of Gomel Province
resulted in increased intrauterine and infant
death rates (Matveev et al., 1995).
2. An increased incidence of whipworm (Trichocephalus trichiurus) infestation (trichocephalosis) correlated with the density of radioactive contamination in Gomel and Mogilev
provinces (Stepanov, 1993).
3. In Senkevichi Village, Luninets District,
Brest Province, the occurrence of infectious andparasitic illnesses in children increased 1.54fold from 2000 to 2005 (Dudinskaya et al.,2006).
4. Among 135 children living in the contaminated territories of Stolinsk District and Bragin
City who were examined in 1993–1995, a total of 20% had chronic urogenital infections(Belyaeva et al., 1996).
5. Data for 1,026,046 pregnant women fromterritories with contamination above 1 Ci/km2
showed that incidence of the puerperal sepsis
in heavily contaminated territories was significantly higher than in areas with less contamination (Busuet et al., 2002).

123

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.64. Skin and Subcutaneous Tissue Abnormalities among Russian Liquidators (per 10,000)(Baleva et al., 2001)
Year
Number of cases

1986
46

1987
160

1988
365

6. Neonates born to mothers from territories in the Chechersk District, Gomel Province,
contaminated at a level of 5–70 Ci/km2
had congenital infections 2.9-fold more often
than before the catastrophe (Kulakov et al.,1997).
7. In 1993, women with gestational herpes in
Gomel Province with a Cs-137 contamination
higher than 15 Ci/km2 experienced 8.6-foldmore infant deaths compared to less contaminated territories (Matveev et al., 1995).
8. Among 784 preschool children examinedfrom 1986 to 1991 in territories having contamination levels of 15–40 Ci/km2 , infections
and infestations were significantly higher thanin children from territories with contaminationlevels of 5–15 Ci/km2 , where 1,057 children
were examined (Gutkovsky et al., 1995; Blet’ko
et al., 1995).
9. Tuberculosis was more virulent in the
more contaminated areas (Chernetsky and
Osynovsky, 1993; Belookaya, 1993).
10. During 1991–1995 there was a serious
increase in the incidence of tuberculosis in theheavily contaminated areas of Gomel Province,
where there were drug-resistant forms and “rejuvenation” of the disease (Borschevsky et al.,1996).
11. In the Mogilev and Gomel provinces,
there was a noticeably higher level of cryptosporidium infestation: 4.1 vs. 2.8% in controls(Lavdovskaya et al., 1996).
12. From 1993 to 1997 in Vitebsk Province
the persistence of infectious hepatitis among
adults and teenagers was noticeably higher
than in control groups (Zhavoronok et al.,1998a).
13. Herpes viral diseases doubled in theheavily contaminated territories of Gomel andMogilev provinces 6 to 7 years after the catas-

1989
556

1990
686

1991
747

1992
756

1993
726

trophe compared with the rest of the country(Matveev, 1993).
14. Activation of cytomegalovirus infectionsin pregnant women was found in the heavily
contaminated districts of Gomel and Mogilev
provinces (Matveev, 1993).
15. In all the heavily contaminated territories
there was activation of herpes viruses (Voropaev
et al., 1996).
16. In Gomel Province hepatitis B and C
infections in adults and teenagers rose significantly after 1986. Among 2,653 individuals
examined, the incidence increased from 17.0
cases per 100,000 in 1986 to 35.0 in 1990
(Zhavoronok et al., 1998b).
17. Among 2,814 individuals examined theincidence of specific markers of viral hepatitis
HbsAg, anti-HBc, and anti-HCV was significantly higher in liquidators and evacuees thanin inhabitants of less contaminated districts ofVitebsk Province (Zhavoronok et al., 1998a).
18. From 1988 to 1995 chronic hepatitis in liquidators (1,626 individuals examined) increased from 221 to 349 per 100,000(Zhavoronok et al., 1998b).
5.11.2. Ukraine
1. By 1995, infectious and parasitic diseases
in children were over five times more common in the heavily contaminated territories
compared with less contaminated areas. In
1988 these territories did not differ in termsof the occurrence of such diseases (Baida andZhirnosekova, 1998).
2. Congenital infections in neonates born tomothers in the Polessk District, Kiev Province,
contaminated at a level of 20–60 Ci/km2 , occurred 2.9-fold more often than before thecatastrophe (Kulakov et al., 1997).

124

3. The incidence of kidney infections in
teenagers significantly increased after the catastrophe and correlated with the level of contamination (Karpenko et al., 2003).

TABLE 5.65. Childhood Infectious and Parasitic
Diseases (per 1,000) in Bryansk Province Territories with Levels of Contamination above 5 Ci/km2 ,
1995–1998 (Fetysov, 1999b: table 6.1)
Number of cases

5.11.3. Russia
1. Infectious disease deaths among infants
were significantly correlated with irradiation inutero (Ostroumova, 2004).
2. Infantile infections are noticeably higher
in three of the more contaminated districts of
Kaluga Province (Tsyb et al., 2006a).
3. The incidence of infections resulting in thedeath of children in the heavily contaminateddistricts of Kaluga Province has tripled in the
15 years since the catastrophe (Tsyb et al., 2006).
4. A significantly higher level of cryptosporidium infestation (8 vs. 4% in controls)
occurred in Bryansk Province (Lavdovskaya
et al., 1996).
5. The number of cases of pneumocystis wasnoticeably higher in children in the heavily
contaminated territories of Bryansk Province(56 vs. 30% in controls; Lavdovskaya et al.,1996).
6. The incidence of infectious and parasitic
diseases in children, 0 to 4 years of age at thetime of the catastrophe was significantly higher
in the years 1986–1993 in territories with contamination levels of 15–40 Ci/km2 than in children the same age from territories with contamination of 5–15 Ci/km2 (Kul’kova et al.,1996).
7. Congenital infections in neonates bornto mothers from heavily contaminated territories of the Mtsensk and Volkhovsk districts,
Oryol Province, contaminated at levels of 1–5
and 10–15 Ci/km2 , occurred 2.9-fold more often than before the catastrophe (Kulakov et al.,1997).
8. The overall incidence of infectious andparasitic diseases in the heavily contaminatedterritories of Bryansk Province from 1995 to1998 was highest in 1995, and higher than
the incidence in the province as a whole(Table 5.65).

Territories

1995

1996

1997

1998

Southwest∗
Province
Russia

128.3
104.1
121.6

112.3
79.0
107.4

99.0
68.8
102.7

94.8
71.6
n/a

∗

All heavily contaminated districts.

9. The prevalence and severity of Gruby’s
disease (ringworm), caused by the fungus microsporia Microsporum sp., was significantly
higher in the heavily contaminated areas ofBryansk Province (Table 5.66).
10. One year after the catastrophe, infectious
and parasitic diseases were the primary causeof illness among military men who were liquidators (Nedoborsky et al., 2004).
11. Herpes and cytomegalovirus viruses were
found in 20% of ejaculate samples from 116
liquidators who were examined (Evdokymov
et al., 2001).
5.11.4. Conclusion
The above data concerning infectious andparasitic diseases in liquidators and those living in contaminated territories reflect activation and dispersion of dangerous infections.
Whether this is due to mutational changes inthe disease organisms rendering them more virulent, impaired immunological defenses in the
populations, or a combination of both is not
TABLE 5.66. Gruby’s Disease (Ringworm) Incidence (per 100,000) in Bryansk Province, 1998–
2002 (Rudnitsky et al., 2003)
Year

Heavily contaminateddistricts

Less contaminateddistricts

1998
1999
2000
2001
2002

56.3
58.0
68.2
78.5
64.8

32.8
45.6
52.9
34.6
23.7

Yablokov: Nonmalignant Diseases after Chernobyl

125

fully answered. It is clear that continued detailed observations are needed to document the
spread and virulence of infectious and parasitic
diseases among people in all of the contaminated territories.

TABLE 5.67. Incidence (per 1,000 Births) of the
Officially Accounted for Congenital Malformationsin Belarussian Districts with Different Levels ofContamination, 1982–1992 (Lazjuk et al., 1996a;
Goncharova, 1997)

5.12. Congenital Malformations
There are several thousand large and small
congenital malformations or anomalies. One
type has a strong genetic background (see Section 5.3 above for details) and the second
type includes developmental anomalies resulting from impacts during embryonal development. Among them are the so-called “large”
congenital malformations (CMs), which areoften the only ones officially registered asanomalies. The other developmental anomalies arise as a result of damage during prenatal
development and can be genetic, caused by mutations, or teratogenic, caused by toxic external
influences, usually occurring up to the first 16
weeks of pregnancy.
Wherever there was Chernobyl radioactive
contamination, there was an increase in thenumber of children with hereditary anomalies
and congenital malformations. These included
previously rare multiple structural impairmentsof the limbs, head, and body (Tsaregorodtsev,
1996; Tsymlyakova and Lavrent’eva, 1996;
Goncharova, 2000; Hoffmann, 2001;
Ibragymova, 2003; and others).
This section presents data concerning
congenital malformations and developmental
anomalies.
5.12.1. Belarus
1. The frequency of the occurrence of CMs,
which was stable up to 1986, increased noticeably after the catastrophe. Although theincrease in CMs is marked mainly in theheavily contaminated territories, significant increases in CM morbidity were registered forthe whole country, including the less contaminated Vitebsk Province (Nykolaev and Khmel’,1998).

Level of contamination
Year
1982
1983
1984
1985
1982–1985
1987
1988
1989
1990
1991
1992
1987–1992∗

1–5 Ci/km2>15 Ci/km2<1 Ci/km2

5.74
3.96
4.32
4.46
4.61
5.54
4.62
6.32
7.98
5.65
6.22
6.01∗

3.06
3.58
3.94
4.76
3.87
8.14
8.61
6.50
6.00
4.88
7.77
7.09∗

5.62
4.52
4.17
4.58
4.72
5.94
5.25
5.80
6.76
5.52
5.89
5.85∗

1982–1985 compared with 1987–1992; p < 0.05.

2. Analysis of more than 31,000 abortuses revealed that the incidence of officially registered
CMs increased in all of the contaminated territories, but was especially significant in areas
in Gomel and Mogilev provinces with Cs-137
levels of contamination higher than 15 Ci/km2(Lazjuk et al., 1999b).
3. The incidence of CMs increased significantly from 5.58 per 1,000 before the catastrophe to 9.38 for the years from 2001 to 2004
(National Belarussian Report, 2006).
4. In 1990 the primary, initial diagnosis of
CM in children was twice that of the illnesses
in adolescents 15 to 17 years of age, but by
2001 it was fourfold higher (UNICEF, 2005:
table 1.3).
5. Some 24% of the children in the socalled “clean” regions (<1 Ci/km2 ) were bornwith CMs, in districts with Cs-137 contamination levels of 1–5 Ci/km2 the figure was 30%,and in the districts with contamination levels
above 15 Ci/km2 the number reached 83%(Table 5.67).
6. There was a higher incidence of CM morbidity in the more contaminated areas than inless contaminated ones (Table 5.68).

126
TABLE 5.68. Incidence of Congenital Malformations (per 1,000 Live Births) in Heavily and Less Contaminated Areas of Belarus before and after the Catastrophe (National Belarussian Report, 2006:
table 4.6.)
Heavily contaminated areas

Less contaminated areas

Years

1981–1986

1987–1989

1990–2004

1981–1986

1987–1989

1990–2004

Incidence of all CMs
Anencephaly
Spinal hernia
Polydactyly
Down syndrome
Multiple CMs
Newborn and stillborn total
Children and stillbirths
with CMs

4.08
0.28
0.57
0.22
0.89
1.27
58,128
237

7.82∗
0.33
0.88
1.25∗
0.59
2.97∗
23,925
187

7.88∗
0.75
1.15
1.10
1.01
2.31
76,278
601

4.36
0.36
0.69
0.32
0.64
1.35
98,522
430

4.99
0.29
0.96
0.50
0.88
1.23
47,877
239

8.00∗
0.71
1.41
0.91
1.08
2.32
161,972
1,295∗

p < 0.05.

7. CM incidence increased in the whole ofthe country from 12.5 per 1,000 newborns in
1985 to 17.7 in 1994, with most of the cases interritories with Cs-137 contamination of above
15 Ci/km2 (Lazjuk et al., 1996a).
8. Annually in the country there are no
fewer than 2,500 newborns with CMs. Since
1992 a program to interrupt pregnancy in accordance with medical and genetic parameters (500 to 600 cases in a year) has stabilized
the birth of children with CMs (Lazjuk et al.,1996a,b).
9. Nine years after the catastrophe the number of newborns who died because of nervous
system developmental anomalies was statistically significant (Dzykovich et al., 1996).
10. In Gomel Province congenital anomaliesof the eye increased more than fourfold: from
0.4 to 1.63% from 1961–1972 to 1988–1989(Byrich et al., 1999).
11. In 1994, CMs were the second cause
of infant mortality. The incidence was higher
in Gomel Province (4.1%) than in the least
contaminated Vitebsk Province (3.0%), andaveraged 3.9% for the country as a whole(Bogdanovich, 1997).
12. The incidence of CMs increased significantly in 17 heavily contaminated districts(>5 Ci/km2 ) and in 30 less contaminated dis-

tricts (<1 Ci/km2 ) compared to 5 years before and 5 years after the catastrophe. Heavily
contaminated districts had increased frequencyof occurrence of CMs compared with lesscontaminated ones only from 1987 to 1988
(Table 5.69).
13. There was an increased incidence of
26 officially registered CMs after the catastrophe; heavily and less heavily contaminatedareas differed with some CMs increasingfrom 1987 to 1988, whereas others increased
from 1990 to 2004. Polydactly and limbreduction defects were significantly different
in the heavier and less contaminated districts
in 1987 and 1988. Eventually, there was less

TABLE 5.69. Incidence of Officially Registered
Congenital Malformations (per 1,000 Live Born +Fetuses) in 17 Heavily and 30 Less ContaminatedDistricts of Belarus (National Belarussian Report,
2006)
Districts
A. Heavily
contaminated
B. Less
contaminated1981–1986 1987–1988 1990–2004
4.08

7.82

7.88∗∗

4.36

4.99∗

8.00∗∗∗
p < 0.05, ∗ A compared to B (1987–1988); ∗∗ p < 0.05,
1981–1986 compared with 1990–2004.

Yablokov: Nonmalignant Diseases after Chernobyl

127

TABLE 5.70. Incidence of Officially Registered
Congenital Malformations (per 1,000 Live Births+ Fetuses) in Contaminated Districts in Belarus.
Top Line: Data for 17 Districts with Levels above
5 Ci/km2 ; Bottom Line: Data for 30 Districts with
Levels below 1 Ci/km2 (National Belarussian Report, 2006)

TABLE 5.71. Incidence of Registered Congenital
Malformations (per 1,000 Live Births + Fetuses) in
Gomel and Mogilev Provinces of Belarus before
and after the Catastrophe (Lazjuk et al., 1996a)

1981–1986 1987–1988 1990–2004
Anencephaly
Spinal hernias(Spina bifida)
Lip defects
Polydactyly
Limb reduction
Esophageal andanal atresia
Multiple CMs
∗

0.28
0.36
0.57
0.69
0.65
0.64
0.22
0.32
0.17
0.22
0.14
0.19
1.27
1.35

0.33
0.29
0.88
0.96
1.09
0.84
1.25∗
0.50
0.59∗
0.13
0.21
0.27
2.97∗
1.23

0.75
0.71
1.15
1.41
1.08
1.23
1.10
0.91
0.49
0.35
0.21
0.23
2.31
2.32

p < 0.05.

distinction between heavily and less contaminated districts and the incidence of CMs in theformer decreased in comparison to that in thelatter (Table 5.70).
14. The incidence of registered CMs noticeably increased in 14 out of 16 districts of Gomel
and Mogilev provinces 1 to 2 years after thecatastrophe. In five districts the increase wassignificant compared with precatastrophe data
(Table 5.71).
15. Occurrence of the officially registered
CMs correlated with the level of radioactive
contamination of the territory (Table 5.72).
16. The occurrence of CMs in Gomel
Province was sixfold higher in 1994
(Goncharova, 2000).
17. The frequency of occurrence of CMs
from 1986 to 1996 in areas contaminated at
a level greater than 15 Ci/km2 was significantly higher than in Minsk, with the highest
incidence of 9.87 occurring in 1992 (Lazjuk
et al., 1996b, 1999).
18. Compared with Minsk, the incidenceof CMs among medical abortuses and fe-

Number of cases
District
Gomel area
BraginBuda—Koshelevo
Vetka
DobrushEl’sk
Korma
Lel’chitsy
Loev
Khoiniky
Chechersk
Mogilev area
Bykhov
Klymovychy
Kostyukovychy
Krasnopol’e
Slavgorod
CherykovTotal∗

1982–1985

1987–1989

4.1 ± 1.4
4.7 ± 1.2
2.8 ± 1.0
7.6 ± 2.0
3.3 ± 1.4
3.2 ± 1.2
3.3 ± 1.2
1.6 ± 1.1
4.4 ± 1.2
1.0 ± 0.7

9.0 ± 3.0
9.3 ± 2.0∗
9.9 ± 2.7
12.6 ± 2.6
6.4 ± 2.4
5.9 ± 2.1
6.6 ± 2.0
3.7 ± 2.1
10.2 ± 2.6∗
6.6 ± 2.3∗

4.0 ± 1.1
4.8 ± 1.4
3.0 ± 1.2
3.3 ± 1.5
2.5 ± 1.2
4.1 ± 1.7
4.0 ± 0.3

6.5 ± 1.6
3.2 ± 1.4
12.0 ± 2.9∗
7.6 ± 2.9
7.6 ± 2.7
3.6 ± 1.8
7.2 ± 0.6∗

p < 0.05.

tuses in the contaminated areas of Mogilev
and Gomel provinces was significantly higher
in the first decade after the catastrophe(Table 5.73).
5.12.2. Ukraine
1. Before the Chernobyl catastrophe only
one case of severe CMs in a newborn was seen
TABLE 5.72. Occurrence of Officially Registered
Congenital Malformations (per 1,000 Live Births)
and Different Levels of Contamination (Lazjuk
et al., 1996a; Matsko, 1999)
Number of cases

Level ofcontamination

1982–1985

1987–1992<1 Ci/km2
1–5 Ci/km2>15 Ci/km2

4.72 (4.17 – 5.62)
4.61 (3.96 – 5.74)
3.87 (3.06 – 4.76)

5.85 (5.25 – 6.76)
6.01 (4.62 – 7.98)
7.09 (4.88 – 8.61)∗

All differences are significant.

128
TABLE 5.73. Comparison of the Incidence (per1, 000) of Strictly Registered Congenital Malformations, Medical Abortuses, and Fetuses in Minsk
Compared with Gomel and Mogilev Provinces
Contaminated at Levels above 15 Ci/km2 (Lazjuk
et al., 1999)
Territories/period
MinskContaminated districts

Congenital
1980–1985, 1986∗ –1996, 1986∗ –1995,
malformations n = 10,168 n = 20,507 n = 2,701
All CMs
5.60
4.90
7.21∗∗
CNS anomalies
0.32
0.53
0.54
Polydactyly
0.63
0.53
0.79
Multiple limb
0.07
0.10
0.28
defects∗

Second half 1986; ∗∗ p < 0.05.

in a 5-year period; afterward there were several
cases a year (Horishna, 2005).
2. After 1986 the number of children with
CMs increased in the contaminated territories(TASS, 1998; Golubchykov et al., 2002).
3. Disability owing to congenital defects inchildren newborn to 15 years of age increased
more than threefold in the Ukraine from 1992–
1993 to 2000–2001: from 10 to 31 per 10,000(UNISEF, 2005: table 1.5).
4. The peak incidence of CMs in the period
from 1987 to 1994 occurred in 1990 (Orlov,
1995).
5. For children irradiated in utero, the occurrence of CMs increased significantly (5.52 ±0.22 vs. 2.95 ± 0.18 in controls, p < 0.001)
and the spectrum of CMs changed (Stepanova,
1999).
6. The number of the small congenital malformations (anomalies of development) correlated with the level of in utero irradiation(Stepanova et al., 2002a).
7. Developmental anomalies in children
from heavily contaminated districts occur up
to 2.8-fold more frequently than in less contaminated areas (Horishna, 2005).
8. Previously rare multiple CMs and severe
CMs such as polydactyly, deformed internal organs, absent or deformed limbs, and retarded

growth increased significantly in the contaminated districts (Horishna, 2005).
9. Occurrence of officially registered CMs
increased 5.7-fold during the first 12 years after
the catastrophe (Grodzinsky, 1999).
10. The incidence of CMs is twice as high incontaminated districts (Horishna, 2005).
11. Ten years after the catastrophe, thelevel of congenital malformations in Rivne
Province increased from 15.3 to 37.3 (per 1,000
neonates), most noticeably in the heavily contaminated northern districts (Evtushok, 1999).
12. Among the 13,136 children bornto 1986–1987 liquidators, 9.6% had officially registered CMs. Common developmental anomalies include scoliosis; throat and tooth
deformities; early tooth decay; dry, rough, andleathery skin; abnormally thin, tightly clusteredhair; and alopecia (Stepanova., 1999, 2004;
Horishna, 2005).
13. The highest incidence of CMs amongchildren born to liquidator families was observed in 1987–1988, when there were up to
117 per 1,000. Thereafter the ratio began todecrease: 83–102 children in 1989–1991; 67 in
1992; and 24–60 in 1993–1997 (Figure 5.13).
14. According to the Neurosurgery Institute,
National Ukrainian Medical Academy in Kiev,
after the catastrophe 98% of central nervous
system anomalies were due to hydrocephalus.
The average annual increase in central nervous
system defects was about 39% among 2,209
registered cases in the period from 1981 to 1985
compared with 4,925 cases from 1987 to 1994.
From 1987 to 2004 the incidence of brain tumors in children up to 3 years of age doubled(Figure 5.14) and in infants it increased 7.5-fold(Orlov et al., 2001, 2006).
15. The highest incidence of maxillofacial
CMs (mostly cleft upper lip and palate) occurred in children born within 9 months after
April 26, 1986, and was six- to tenfold morecommon in the more contaminated areas ofKiev City and Kiev and Zhytomir provinces
compared with the less contaminated provincesof Vinnitsa and Khmelnitsk (Nyagu et al.,1998).

129

Yablokov: Nonmalignant Diseases after Chernobyl

Figure 5.13. Incidence (per 1,000) of congenital malformations in children born tofamilies of Ukrainian liquidators who worked in 1986–1987 (Stepanova, 2006).

16. Urogenital tract CMs accounted formore than 20% of all officially registeredanomalies and were more frequent for theperiod from 1998 to 2001 (Sorokman, 1998;
Sorokman et al., 2002).

5.12.3. Russia
1. The number of CMs noticeably increased for several years after the catastrophe(Lyaginskaya and Osypov, 1995; Lyaginskaya
et al., 2007).

2. The number of CMs increased markedly
for several years after the catastrophe in theheavily contaminated districts of Tula Province(Khvorostenko, 1999).
3. The heavily contaminated districts of
Kaluga Province had an increase in the numberof CMs after the catastrophe, which resulted ina twofold increase in children’s deaths in these
districts 15 years later (Tsyb et al., 2006).
4. CMs in contaminated regions increased
three- to fivefold in 1991 and 1992 comparedwith the precatastrophe level, with a noticeable
increase in anomalies of the genitals, nervous

Figure 5.14. Number of cases of central nervous system tumors in children under 3
years of age from 1981 to 2002, taken from Kiev Institute of Neurosurgery data (Orlov andShaversky, 2003).

130
TABLE 5.74. Congenital Malformation Morbidity(per 1,000 Live Births) in Bryansk Province Districts
with Contamination Levels above 5 Ci/km2 , 1995–
1998 (Fetysov, 1999b: table 6.1)
Number of cases
Territory

1995

1996

1997

1998

Southwest∗
Province

14.2
7.9

13.1
8.1

12.7
8.6

11.9
8.9

∗

All heavily contaminated districts.

system, sense organs, bone, muscular and digestive systems, and congenital cataracts (Kulakov
et al., 2001).
5. Infant mortality in Bryansk Province due
to structural CMs was fivefold the Russian average (Zhylenko and Fedorova, 1999).
6. The occurrence of officially registered
CMs in the contaminated districts of Bryansk
Province was significantly higher from 1995
to 1998 than for the province as a whole(Table 5.74).
7. According to the Russian State Registry,
which included more than 30,000 children
born to liquidators, 46.7 had congenital developmental anomalies and “genetic syndromes”
with a prevalence of bone and muscular abnormalities. Occurrence of CMs among childrenof liquidators was 3.6-fold higher than corresponding Russian parameters (Sypyagyna et al.,2006).
5.12.4. Other Countries
Official European registries of CMs (EUROCAT Registry, 1988) collectively cover
only about 10% of the European population(Hoffmann, 2001). Underestimates are thought
to be up to 30% for minor malformations
and 15–20% for Down syndrome (Dolk andLechat, 1993; Czeizel et al., 1991). Most European countries do not routinely register prenatally diagnosed malformations that lead toinduced abortions (Hoffmann, 2001).
1. AUSTRIA. More cases of central nervous
system defects in newborns were observed inAustria after Chernobyl (Hoffmann, 2001).

2. BULGARIA. In Pleven Province there was asignificant increase in CMs of the heart andcentral nervous system, as well as multiple
anomalies following the Chernobyl contamination (Moumdjiev et al., 1992 by Hoffmann,
2001).
3. CROATIA. Analysis of 3,541 autopsies at
the University Clinic of Zagreb between 1980
and 1993 showed a significantly increased incidence of central nervous system anomalies during the post-Chernobyl period (Kruslin et al.,1998, by Schmitz-Feuerhake, 2002).
4. CZECH REPUBLIC. For three preChernobyl years, the rate of registered CMs
was about 16.3 (per 1,000 total births) and 18.3
for three post-Chernobyl years. From 1986 to
1987 the rate of CMs increased significantly—
about 26%, from 15 to 19 per 1,000 (UNICEF,
2005: from table 1.2, calculation by A. Y.)
5. DENMARK. More children in Denmark
were born with central nervous system defects
after Chernobyl (Hoffmann, 2001; SchmitzFeuerhake, 2002).
6. FINLAND. Between February 1987 and December 1987, the number of cases of CMs
were, respectively, 10 and 6% above expectation in the moderately and highly contaminated regions. Subgroups with higher incidence included malformations of the central
nervous system and limb-reduction anomalies(Harjuletho et al., 1989, 1991).
7. GEORGIA. The number of CM cases diagnosed as “harelip” and “wolf mouth” increased
after the catastrophe, especially in what were
probably the most contaminated areas of Ajaria
Republic and Racha Province (Vepkhvadze
et al., 1998).
8. GERMANY. The Jena Regional Malformation Registry recorded an increase in CMs in1986 and 1987 compared with 1985; isolated
malformations leveled off during subsequent
years (Lotz et al., 1996, by Hoffmann, 2001).
The increase was most pronounced for malformations of the central nervous system andanomalies of the abdominal wall. An analysisof the nationwide GDR Malformation Registry
for the prevalence of cleft lip/palate revealed aYablokov: Nonmalignant Diseases after Chernobyl

131

TABLE 5.75. Incidence (per 1,000 Births) of
Neural Tube Defects in Turkey before and after the Catastrophe (Hoffmann, 2001; SchmitzFeuerhake, 2006)

9. HUNGARY. More cases of central nervous
system defects in newborns were observed in
Hungary after Chernobyl (Hoffmann, 2001;
Schmitz-Feuerhake, 2002).
10. MOLDOVA. Out of 8,509 registeredcases of CMs for the period from 1989
to 1996 the highest frequencies of occurrence of malformations (including Down
syndrome, structural limb deformities, andembryonic hernias) were in the most contaminated southeast territories (Grygory et al.,2003).
11. NORWAY. Data on all newborns conceived between May 1983 and April 1989 revealed a positive correlation between calculated
total irradiation from Chernobyl and CMs
such as hydrocephaly. There was a negative
correlation with Down syndrome (Terje Lieet al., 1992; Castronovo, 1999).

Location

BeforeAfter

Bursa, Western Turkey
TrabzonElazig

5.81
2.125
1.77

12.63 –20.02
6.34
4.396
2.2 –12.58
10.09

1
1983–1986; 2 Jan.–June 1987; 3 July–Dec. 1987;
Jan.–June 1988; 5 1981–1986; 6 1987–Oct. 1989;7
1985–1986; 8 1987–1988; 9 1989.
4

9.4% increase in 1987 compared with the country’s average for 1980 and 1986 (Zieglowski
and Hemprich, 1999). This increase was mostpronounced in three northern provinces of the
GDR, those most affected by the Chernobyl
fallout (Hoffmann, 2001).

TABLE 5.76. Congenital Developmental Anomalies in Children Irradiated In Utero as a Result of theChernobyl Catastrophe in Countries Other than Belarus, Ukraine, and European Russia (Hoffmann,
2001; Schmitz-Feuerhake, 2006; Pflugbeil et al., 2006)
Country, territory

Congenital malformations

Austria
Turkey (Bursa, Izmir,Black Sea coast)

CMs
Incidence of CNS among the newborns conceived
in the second half of 1986

Bulgaria (Pleven)
Croatia (Zagreb)

Cardiac anomalies, CNS defects, multiple CMs
CMs among stillbirths and neonatal deaths (including
CNS anomalies)
Neural tube defects (NTD)
Malformations of the CNS and limb-reduction
anomalies
Congenital malformations
Down syndrome (trisomy 21)
Down syndrome (trisomy 21)
Cleft lip and/or palate, other CMs

Denmark (Odense)
Finland
Hungary
Scotland
SwedenEast Germany
BavariaWest Berlin
Jena
Germany total

In 7 months after the catastrophe CM incidence
increased 4%
CMs among stillbirths noticeably increased in 1987
Increase in CMs (including malformations of the CNS
and anomalies of the abdominal wall)
In 1987 CM incidence increased significantly

Reference
Hoffmann, 2001
Akar et al., 1988,1989; Caglayan
et al., 1990; Guvenc et al.,
1993; Mocan et al., 1990
Moumdjiev et al., 1992
Kruslin et al., 1998
EUROCAT, 1988
Harjuletho-Mervaala et al., 1992
Czeizel, 1997
Ramsay et al., 1991
Ericson and Kallen, 1994
Zieglowski and Hemprich, 1999;
Scherb and Weigelt, 2004
Korblein 2002, 2003a, 2004;
Scherb and Weigelt, 2003
Hoffmann, 2001
Lotz et al., 1996
Korblein, 2000

132

Figure 5.15. Typical examples of Chernobyl-induced congenital malformations with multiple structural deformities of the limbs and body (drawing by D. Tshepotkin from Moscow
Times (April 26, 1991) and from www.progetto.humus).

12. TURKEY. At the beginning of 1987, anincreased incidence of CMs was reported inwestern Turkey, which was particularly badly
affected (Akar, 1994; Akar et al., 1988, 1989;Güvenc et al., 1993; Caglayan et al., 1990;
Mocan et al. 1990). Table 5.75 is a summaryof data on the prevalence of neural tube de-fects (including spina bifida occulta and aperta,
encephalocele, and anencephaly) in Turkey before and after the catastrophe.
13. Information on CMs in newborns irradiated in utero as a result of the catastrophe in various countries is presented inTable 5.76.

133

Yablokov: Nonmalignant Diseases after Chernobyl

TABLE 5.77. Incidence (per 10,000) of 12 Disease Groups among Liquidators (Pflugbeil et al., 2006)
Illness/organ group

1986

1988

1990

1992

1993

Increase

Blood and blood-forming organs
Circulation
Endocrine sytem
Respiratory system
Urogenital tract
Nervous system and sense organs
Psychological changes
Digestive System
Skin and subcutaneous tissue
Infections and parasites
TumorsMalignant growths

15
183
96
645
34
232
621
82
46
36
20
13

96
1,150
764
3,730
253
1,810
1,580
1,270
365
197
180
40

191
2,450
2,020
6,390
646
4,100
3,380
3,210
686
325
393
85

226
3,770
3,740
7,010
1,180
8,110
4,540
5,290
756
388
564
159

218
4,250
4,300
7,110
1,410
9,890
4,930
6,100
726
414
621
184

14.5-fold23.2-fold45.1-fold11.0-fold
41.4-fold42.6-fold
7.9-fold
74.4-fold
15.8-fold
11.5-fold31.1-fold
14.2-fold

5.12.5. Conclusion
The appreciable increase in newborns withboth major and minor developmental anomalies is one of the undeniable consequences of
the Chernobyl catastrophe. Everywhere in areas contaminated by Chernobyl radioactivity,
increased numbers of children have been bornwith hereditary anomalies and congenital developmental malformations, including previously rare multiple structural deformities of thelimbs, head, and body (Figure 5.15). The occur-

rence of congenital malformations continues toincrease in several of the contaminated territories and correlates with the levels of irradiation.
Thus the link between congenital and genetic
defects and Chernobyl irradiation is no longer
an assumption, but is proven.
Extrapolating available data on congenital malformations and the total number ofchildren born in the territories contaminatedby Chernobyl, we must assume that eachyear several thousand newborns in Europe will
also bear the greater and smaller hereditary

TABLE 5.78. Incidence (per 100,000) of Juvenile Morbidity in Gomel Province, Belarus (Pflugbeil et al.,2006 Based on Official Gomel Health Center Data, Simplified)Morbidity group/Organ

1985

1990

1995

1997

Increase

Total primary diagnoses
Blood and blood-forming organs
Circulatory diseases
Endocrinological, metabolic, and immune systems
Respiratory system
Urogenital tract
Muscle and bones/connective tissue
Mental disorders
Neural and sense organs
Digestive system
Skin and subcutaneous tissue
Infectious and parasitic illnesses
Congenital malformations∗
Neoplasm∗∗

9,771
54
32
3.7
760
25
13
95
645
26
159
4,761
51
1.4

73,754502
158
116
49,895
555
266
664
2,359
3,108
4,529
6,567
122
323

127,768
859
358
3,549
81,282
961
847
908
7,649
5,879
7,013
11,923
210
144

124,440
1,146
425
1,111
82,689
1,199
1,036
867
7,040
5,548
7,100
8,694
340
134

12.7-fold
21.2-fold
13.3-fold
300.0-fold
108.8-fold
48.0-fold79.7-fold
9.1-fold
10.9-fold213.4-fold
44.7-fold
1.8-fold
6.7-fold
95.7-fold∗High estimation of unreported cases through abortions; ∗∗ 1985 only malignant neuroplasms.

134
TABLE 5.79. Incidence (per 100,000) of Morbidity among Adults and Adolescents in Northern Ukraine,
1987–1992 (Pflugbeil et al., 2006)
Illness/Organ

1987

1989

1991

1992

Increase

Endocrine system
Psychological disturbances
Neural system
Circulatory system
Digestive system
Skin and subcutaneous tissue
Muscles and bones

631
249
2,641
2,236
1,041
1,194
768

886
576
3,559
4,986
2,249
1,262
2,100

4,550
5,769
15,51829,503
14,486
4,268
9,746

16,304
13,145
15,101
98,36362,92060,27173,44025.8-fold52.8-fold
5.7-fold
44.0-fold60.4-fold50.5-fold96.9-foldanomalies caused by Chernobyl’s radioactive
fallout.
5.13. Other Diseases
1. Age-related changes found in liquidators included anoxic, fermentation-type
metabolism and formation of pro-oxidation
conditions (Vartanyan et al., 2002).
2. In 58 children ages 7 to 14 from
Stolinsk and Narovlya districts without clinical pathology, blood vitamin E levels weresignificantly lower than normal and were especially low in territories contaminated at
a level above 6 Ci/km2 (Zaitsev et al.,1996).
3. In 153 pregnant women from the Bragin District, vitamin A levels were noticeably
higher than normal and concentrations of vitamin E were significantly lower—up to eightfold(Zaitsev et al., 1996).
5.14. Conclusion
Only when we know the full scope of theChernobyl catastrophe can we prevent such a
tragedy from ever happening again.
There was widespread damage to the people
living in the contaminated territories. Nearly
all physiological systems were adversely affected, resulting in consequences ranging from
impairment to death. These disorders cannot be attributed to socioeconomic or be-

havioral stress factors. They are real anddocumented.
Liquidators were the most comprehensively observed group after the catastrophe.
Table 5.77 presents dramatic data on the incidence of 12 groups of illnesses suffered by
Russian liquidators.
It is reasonable to suggest that the stateof public health in the affected territories
may be even worse than that of the liquidators. Tables 5.78 and 5.79 provide a comprehensive view of the deterioration in publichealth in the affected territories of Belarus andUkraine.
Existing data presented in this chapter are
irrefutable proof that the frequency of occurrence of nonmalignant illnesses is obviously andsignificantly higher in the contaminated territories.
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CHERNOBYL

6. Oncological Diseases after the Chernobyl
Catastrophe
Alexey V. Yablokov

The most recent forecast by international agencies predicted there would be between
9,000 and 28,000 fatal cancers between 1986 and 2056, obviously underestimating therisk factors and the collective doses. On the basis of I-131 and Cs-137 radioisotope doses
to which populations were exposed and a comparison of cancer mortality in the heavily
and the less contaminated territories and pre- and post-Chernobyl cancer levels, a more
realistic figure is 212,000 to 245,000 deaths in Europe and 19,000 in the rest of the world.
High levels of Te-132, Ru-103, Ru-106, and Cs-134 persisted months after the Chernobyl
catastrophe and the continuing radiation from Cs-137, Sr-90, Pu, and Am will generate
new neoplasms for hundreds of years.

The oncological diseases include neoplasms
and malignant (cancerous) and nonmalignant
tumors as common consequences of ionizing
radiation. There are varying periods of latency
between the exposure and the appearance of atumor. Data collected from the victims of Hiroshima and Nagasaki show radiation-induced
malignancies becoming clinically apparent asfollows:•

Leukemia (various blood cancers)—within
5 years• Thyroid cancer—within 10 years• Breast and lung cancers—in 20 years• Stomach, skin, and rectal cancer—in
30 years

1986, the ongoing irradiation in the wake ofthe meltdown is responsible for an increase inmalignant diseases. Given the ten half-lives thathave to occur before many of the isotopes decay
to safe levels, this means that Chernobyl radiation will engender new neoplasms for hundredsof years.
The initial forecasts insisted that there
would be no significant increase in the occurrence of cancer after the catastrophe.
As is demonstrated by data in this chapter, the Russian and Ukrainian oncologicalstatistics were low and grossly underestimatedthe cancer morbidity. It is officially acceptedthat:

For people living in the areas contaminatedby Chernobyl’s radioactive fallout the cancer
situation is much more complicated. Although
there was not a single case due to direct exposure from the explosion that occurred in April

Address for correspondence: Alexey V. Yablokov, Russian Academyof Sciences, Leninsky Prospect 33, Office 319 119071 Moscow, Russia.
Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@
ecopolicy.ru

161. . . the main source of data for international statistics for cancer morbidity is the collection of papers“Cancer Disease on Five Continents,” publishedby the International Agency for Research on Cancer (IARC). Each five years, since 1960 . . . these
editions publish only those data which correspondto the established quality standards. In the firsteditions across the USSR . . . information has notbeen included. In last two editions of the collection,
containing data for 1983–1987 and 1988–1992,
data are included for Belarus, Estonia and Latvia;
the first of these two collections also contained
information from St. Petersburg and Kirghizia.
Nevertheless, the authors of the collection warn

162that all data from former republics of the USSR
(except for Estonia) underestimate the occurrence of disease. . . (UNSCEAR, 2000, item 234,
p. 48).

This chapter is divided into sections on thevarious cancers that have been found in territories contaminated by Chernobyl radionuclides. Section 6.1 deals with general oncological morbidity, 6.2 with thyroid cancer, 6.3 withleukemia, and 6.4 with all of the other malignant neoplasms. This chapter, as well as others in this book, is not an all-inclusive review,
but does reflect the scope and the scale of the
problem.
6.1. Increase in General
Oncological Morbidity
There are two ways to define the scale of cancer morbidity associated with the Chernobyl
catastrophe: (1) on the basis of calculated received doses (with application of appropriate
risk factors) and (2) by direct comparison ofcancer morbidity in the heavily and less contaminated territories.
6.1.1. Belarus
1. For the period 1990–2000 cancer morbidity in Belarus increased 40%. The increase
was a maximum in the most highly contaminated Gomel Province and lower in the lesscontaminated Brest and Mogilev provinces:52, 33, and 32%, respectively (Okeanov et al.,2004).

2. A significant increase in morbidity for malignant and benign neoplasms occurred in girls
aged 10 to 14 years born to irradiated parents
in the years from 1993 to 2003 (National Belarussian Report, 2006).
3. The highest level of general oncologicalmorbidity among persons 0 to 17 years of age
from 1986 to 2000 occurred in the most contaminated Gomel Province; the lowest was in
the least contaminated areas of the Vitebsk and
Grodno provinces (Borysevich and Poplyko,
2002).
4. The level of the cancer morbidity
in Gomel and Mogilev provinces correlatedwith the level of contamination of the areas(Table 6.1).
5. From 1987 to 1999 some 26,000 casesof radiation-induced malignant neoplasms (including leukemia) were registered. The average annual absolute risk of malignant diseasecalculated from these data is 434 per 10,000
person/Sv. The relative risk for cancer is 3–
13 Sv−1 , an order of magnitude higher that ofHiroshima (Malko, 2002).
6. Cancer morbidity among liquidators(57,440 men and 14,400 women officially registered) sharply and significantly increased from1993 to 2003 compared to individuals exposed
to less contamination (Table 6.2).
7. Cancer morbidity among liquidators who
worked in May–June 1986 (maximal doses anddose rate) is above that of liquidators who
worked in July–December 1986, who received
lower doses (Table 6.3).
8. Cancer mortality in the Narovlia District,
Gomel Province, increased from 0.0 to 26.3%

TABLE 6.1. Occurrence of Cancers (per 100,000) in Belarussian Territories Contaminated by Cs-137
before and after the Catastrophe (Konoplya and Rolevich, 1996; Imanaka, 1999)
Gomel Province

Mogilev ProvinceContamination,
Ci/km2

1977–1985

1986–1994

1977–1985

1986–1994

<5
5–15
>15

181.0 ± 6.7
176.9 ± 9.0
194.6 ± 8.6

238.0 ± 26.8
248.4 ± 12.5∗
304.1 ± 16.5∗

248.8 ± 14.5
241.8 ± 15.4
221.0 ± 8.6

306.2 ± 18.0∗
334.6 ± 12.2∗
303.9 ± 5.1∗∗

P < 0.05.

163

Yablokov: Oncological Diseases after Chernobyl

TABLE 6.2. Cancer Morbidity of Belarussian Liquidators (per 10,000), 1993–2003 (Okeanov et al.,2004)
Morbidity

All cancers
StomachRectalLung
KidneyBladder
Thyroid

Regression coefficientLiquidators

Controls∗∗

Liquidators

Controls∗∗

422.2 ± 20.6∗
41.1 ± 3.4
19.1 ± 2.1
55.6 ± 5.4
15.7 ± 1.9∗
16.7 ± 1.2∗
28.4 ± 4.1∗

366.4 ± 5.3
42.9 ± 1.2
16.1 ± 0.4
53.6 ± 1.2
10.8 ± 0.5
13.8 ± 0.8
10.1 ± 1.0

13.15 ± 5.29∗
1.99 ± 0.92
1.14 ± 0.59∗
3.78 ± 1.26∗
1.78 ± 0.27∗
0.89 ± 0.23
1.08 ± 1.03

4.69 ± 1.10
−0.99 ± 0.19
0.24 ± 0.12
−0.38 ± 0.31
0.68 ± 0.16
0.28 ± 0.12
0.8 ± 0.18∗
p < 0.05; ∗∗ From the less contaminated Vitebsk Province (excluding liquidators and those who migrated to theprovince from the contaminated regions).

in the years from 1986 to 1994 (Zborovsky et al.,1995).
9. Calculated on the basis of official data
for the years 1990 to 2004, Belarussian patients diagnosed with cancer for the first time
has increased from 0.26 to 0.38% (up 46%),and in Gomel Province, from 0.25 to 0.42%(up 68%). This marked deviation from thelong-term trend of cancer mortality is very
likely connected to the Chernobyl contamination (Figure 6.1).
10. Up to 62,500 radiation-induced cancers
are predicted to occur in Belarus over a periodof 70 years after the catastrophe (Malko, 2007).

6.1.2. Ukraine
1. The cancer morbidity of evacuees fromthe heavily contaminated territories is noticeably higher than in the rest of thecountry (Tsimliakova and Lavrent’eva, 1996;
Golubchykov et al., 2002).
2. In the heavily contaminated territories
cancer morbidity increased 18–22% in the 12
years following the catastrophe, and rose by
12% in the entire country (Omelyanets et al.,
2001; Omelyanets and Klement’ev, 2001).
3. For adults in the contaminated districts of
Zhytomir Province cancer morbidity increased
nearly threefold in 1986–1994: from 1.34 to
3.91% (Nagornaya, 1995).

TABLE 6.3. Cancer Morbidity (per 10,000) in Two
Belarussian Liquidator Groups Exposed in Different Periods in 1986, 1993–2003 (Okeanov et al.,2004)
Liquidators
May–June1986

Liquidators
July–December
1986

Controls

All cancers 456.1 ± 10.3∗ 437.8 ± 10.3∗ 366.4 ± 5.3
42.6 ± 3.2
42.9 ± 1.2
Stomach50.4 ± 3.4 ∗16.1 ± 0.4
Rectal18.7 ± 2.1
25.5 ± 2.5∗
53.6 ± 1.2
Lung57.9 ± 3.7
67.1 ± 4.0∗
20.6 ± 2.2∗
10.8 ± 0.4
Kidney20.3 ± 2.2∗
16.6 ± 2.0∗
13.8 ± 0.8
Bladder
20.6 ± 2.2∗
25.2 ± 2.5∗
10.1 ± 1.0
Thyroid40.0 ± 3.1∗∗

p < 0.05 from controls.

Figure 6.1. First-time-registered cases of cancer
in Belarus from 1975 to 2005. Deviation from thetrend after 1986 is very likely associated with additional Chernobyl-related cancers (Malko, 2007).

164
TABLE 6.4. Childhood Cancer Morbidity (per100,000) in Tula Province under Various Levelsof Contamination, 1995–1997 (Ushakova et al.,
2001)
Districts

Morbidity“Clean”≥3 Ci/km2

7.2
18.8

4. Among male liquidators there were 5,396
cases of cancer from 1986 to 2004, whereas
the expected number for that period was 793(Prysyazhnyuk et al., 2007).
5. Cancer morbidity for both men andwomen liquidators increased significantly from1990 to 2004 (National Ukrainian Report,
2006).
6.1.3. Russia
1. In 1997 childhood cancer morbidity inthe contaminated provinces of Bryansk, Oryol,
Tula, Lipetsk, and Smolensk markedly exceeded that in all of Russia (Ushakova et al.,2001).
2. Cancer morbidity in children from areas
contaminated by Cs-137 of 3 Ci/km2 or morein Tula Province increased 1.7-fold from 1995
to 1997 and was noticeably higher than in lesscontaminated areas (Table 6.4).
3. Within 5 years after the catastrophe
the number of malignant neoplasms diagnosed for the first time in Bryansk and Oryol
provinces increased 30% compared with the
pre-Chernobyl period (Parshkov et al., 2006).
4. In 1995 cancer morbidity in the heavily
contaminated districts of Kaluga, Oryol, Tula,and Bryansk provinces was noticeably higher
than in the less contaminated areas (Ushakov
et al., 1997).
5. General cancer morbidity for solid tumors
in Bryansk Province has exceeded the country
average since 1987, even according to official
data (Figure 6.2).
6. Nine years after the catastrophe generalcancer morbidity in districts contaminated by

Figure 6.2. Comparison of the general cancer
morbidity (per 100,000 for solid tumors) in heavily contaminated Bryansk Province to less contaminated Kaluga Province and to Russia (Ivanov andTsyb, 2002).

15 Ci/km2 or more in Bryansk Province was
2.7-fold higher than in the less contaminatedareas (Ushakov et al., 1997).
6.1.4. Other Countries
1. BULGARIA. According to official evaluations some 500 deaths were caused
by Chernobyl-radiation-induced cancers(Dymitrova, 2007).
2. POLAND. It has been estimated that during the next 50 years there will be an annual
additional 740 to 6,600 cancer-related deaths
owing to the catastrophe, which will accountfor about 1–9% of all cancer-related deaths in
the country (Green Brigade, 1994).
3. SWEDEN. A multifaceted epidemiological study based on a comparison of hundredsof administrative units with different levels ofChernobyl Cs-137 contamination revealed unequivocally an increased incidence of all malignancies in northern Sweden, the most contaminated territory in that country (Tondel,2007). “More than 1,000” cancer deaths in
Norrland Province, Sweden, between 1986 and1999 have been attributed to the Chernobyl
fallout (Abdelrahman, 2007).

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6.2. Thyroid Cancer
The initial reports of a rise in the incidenceof thyroid cancer in 1991–1992 were criticized and the figures attributed to such factors as increased screening, random variation,
and wrong diagnoses (for a review see Tondel,2007).
The incidence of thyroid cancer requires special attention, as it is the most prevalent of all
malignant neoplasms caused by the catastrophe. As the thyroid is a critical part of theendocrine system, the gland’s dysfunction results in many other serious illnesses. The clinicaland molecular features of thyroid cancers thatdeveloped following Chernobyl are unique.
Chernobyl thyroid cancers virtually always
occur in the papillary form, are more aggressive at presentation, and are frequently associated with thyroid autoimmunity. Furthermore,
many have an unusual subtype with a large solid
component, grow rapidly, and have high rates
of local and remote metastases (Williams et al.,
2004; Hatch et al., 2005; and many others).
They also often precede or are accompanied
by radiation-induced benign thyroid nodules,
hypothyroidism, autoimmune thyroiditis, andthyroid insufficiency.

Figure 6.3. Annual thyroid cancer incidence
rates in Belarus and Ukraine (per 100,000) for individuals who were children and adolescents in 1986
(Fairlie and Sumner, 2006).

6.2.1.1. Belarus
1. Thyroid cancer morbidity in children andadults has increased sharply in the country
since 1990 (Figure 6.4).
2. Thyroid cancer morbidity in children andadults began to increase sharply after 1989, andchildhood morbidity reached a maximum in
1995–1996, whereas that for adults continued
upward until 2003 (Figure 6.5).
3. Childhood thyroid cancer morbidity increased 43-fold (∼ 0.003–0.13 cases per 1,000)
from 1989 to 1994 (Lomat’ et al., 1996).
4. After 20 years the incidence of thyroid cancer among individuals who were under 18 years

6.2.1. How Many People Have
Thyroid Cancer?
In the first months after the catastrophe, only
several additional cases were predicted, thenhundreds, but then no more than several thousand. There is one common conclusion: without exception, numerous official forecasts were
optimistic—all underestimated the figures for
Chernobyl-induced thyroid cancers (Economist,
1996). The actual count of the thyroid cancer
cases differs from one report and source to another, reflecting mostly real time changes but
may also be due to more accurate diagnoses ofthe disease (Figure 6.3).

Figure 6.4. Prospective (by pre-Chernobyl data)
and real data of thyroid cancer morbidity (per100,000) for children and adults in Belarus (Malko,
2007).

166

Figure 6.5. General thyroid cancer morbidity for Belarussian children and adults after
the catastrophe (National Belarussian Report, 2006: fig. 4.1).

of age at the time of the catastrophe increased
more than 200-fold (Figure 6.6).
5. Compared to the pre-Chernobyl period,by 2000 the number of cases of thyroid cancer
in children had increased 88-fold; in teenagers,
12.9-fold; and in adults, 4.6-fold (Belookaya
et al., 2002).
6. By the year 2000, more than 7,000 people
were registered as suffering from thyroid cancer,
including more than 1,000 people who werechildren at the time of the catastrophe. Annually some 3,000 individuals undergo surgery forthyroid cancer (Borysevich and Poplyko, 2002).
7. Among 1,000 specially surveyed persons,
100 had thyroid nodules and among them twoor three had cancer (Krysenko, 2002).
8. Congenital thyroid cancers have been diagnosed in newborns (Busby, 1995).
9. Summary data on some cases of thyroid
cancer in Belarus are presented in Table 6.5.

Figure 6.6. Primary thyroid cancer morbidity
among those age 0 to 18 years in 1986 (National
Belarussian Report, 2006: fig. 4.2).

10. There were more cases of thyroid cancer
in provinces that had a higher level of I-131
contamination (Figure 6.7).
6.2.1.2. Ukraine
1. Compared to the pre-Chernobyl period,
the number of cases of thyroid cancer increased
5.8-fold from 1990 to 1995, 13.8-fold from1996 to 2001, and 19.1-fold from 2002 to 2004
(Tronko et al., 2006).
2. The prevalence of invasive forms of carcinoma (87.5%) indicates very aggressive tumor
development (Vtyurin et al., 2001). Clinicallythis is expressed by a short latency period, absence of general body signs or symptoms, andhigh lymphatic invasiveness. Some 46.9% of
patients have their tumor spread beyond thethyroid. Regional metastasis into neck lymph
nodes occurred in 55.0% of patients and theserequired repeated operations to remove residual metastases that appeared shortly after the
initial operation. Moreover, 11.6% of patientsdeveloped remote lung metastases (Rybakov
et al., 2000; Komissarenko et al., 2002).
3. Before the catastrophe, the occurrence of
thyroid cancer among children and adolescentswas 0.09 per 100,000; afterward, in 1990, it was
0.57–0.63 per 100,000. The greatest increasein morbidity was recorded in young people living in the most heavily contaminated districtsof Kiev, Chernygov, Zhytomir, Cherkassk, andRovno provinces (Komissarenko et al., 1995). In
these areas thyroid cancer morbidity reached1.32 per 100,000 persons, which was fivefold higher than in other areas. Regression

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Yablokov: Oncological Diseases after Chernobyl

TABLE 6.5. Number of Thyroid Cancer Cases in Belarus from Various Sources (Radiogenic Cases in
Parentheses)
Number of cases, nPeriodAuthorComments

5,470 (3,748)

1987–1998

Ivanov & Tsyb, 2002: tab.
3.1, p. 213(1,067)

1990–1998

UNSCEAR, 2000

(4,409)(674)“More than 8,000”“About 6,000 operated”“More than 7,000”(1,000); 3,000
postsurgery cases
annually(2,430)(2,399)1986–2000
1986–2000
1986–2000
1997–2000
Up to 2001

Malko, 2002
Demidchik et al., 2002
Belookaya et al., 2002
Drozd, 2001
Borysevich and Poplyko,
2002

Six most contaminated provinces(calculated by A. Yablokov, basedon the pre-Chernobyl level)
In persons aged 0–17 years at thetime of the meltdown
Including 700 in children
In children aged 0–14 years

9,650 (4,560–6,840,
average about 5,700)
About 7,000

Jan. 1987–
Dec. 2002
1986–2004

8,161 (1,670)
1,055 new cases
2,200 postsurgery children
More than 10,000
postsurgery (all ages)
12,1361986–2001
2002 alone
1988–2004
1987–2004

Ostapenko, 2002
Postoyalko, 2004
Lypik, 2004
Nesterenko, pers. comm.

1986–2004

Demidchik, 2006

1986–2004
1990–2004

National Belarussian
Report, 2006∗
Malko, 2004
Malko, 2007

coefficients that reflect time trends are: all of
Ukraine, 0.12 ± 0.01 (per 100,000 per year);
Kiev Province, 0.41 ± 0.07; Kiev City, 0.52 ±
0.05; Zhytomir Province, 0.22 ± 0.03; othercontaminated territories, 0.41 ± 0.06. The
first cases of thyroid cancer in children under
14 years of age living in contaminated territories were registered in 1990. From 1980 to1990 instances of this cancer were not tabulated and registered in the areas under study(Prysyazhnyuk et al., 2005).
4. In the Chernygov, Kiev, and Zhytomir
provinces from 1990 to 1999, where I-131 fallout was recorded, the incidence of thyroid cancer was dependent on the level of that fallout.
Truncated age-standardized incidence rates interritories with contamination less than 100
kBq/m2 did not exceed two and five cases
per 100,000, respectively, in males and females.
In territories with contamination greater than

Including 1,600 children
In persons aged 0–17 years at thetime of the meltdown

In persons 0–18 years at the time of
the meltdown
In persons 0–14 years at the time of
the meltdown
In persons 0–14 years at the time of
the meltdown
Belarussian Ministry of Health data

Based on official data

100 kBq/m2 the incidence was four and sixteen cases per 100,000, respectively, in males
and females in 1998 and 1999 (Romanenko
et al., 2004; Prysyazhnyuk et al., 2005).
5. A survey of 26,601 children in 1998 revealed that for each case of thyroid cancer there
were 29 other thyroid pathologies (Shybata
et al., 2006).
6. According to the Ukrainian State Register for the period from 1982 to 2003
the incidence of thyroid cancer rose significantly after 1991 for three different cohorts
studied: liquidators who worked 1986–1987,
evacuees from Pripyat City and the 30-km
exclusion zone, and residents in the radioactively contaminated areas (Prysyazhnyuk et al.,2002).
7. Various estimations of the numbers of the
thyroid cancer cases in Ukraine are presented
in Table 6.6.

168

Figure 6.7. Thyroid cancer morbidity in five contaminated provinces of Belarus and
Minsk compared to the least contaminated Grodno Province. The increase in cancer cases in
the rather less contaminated Vitebsk Province and the city of Minsk may reflect the inflow of
evacuees and refugees (Malko, 2007).

8. A sharp increase in cases of thyroid cancer
began after 1989 in persons who were 0 to
18 years of age at the time of the catastrophe(Figure 6.8).
9. Thyroid cancer morbidity for women in
the heavily contaminated territories is morethan fivefold higher than for men (Figure 6.9).
10. In 1998–1999, thyroid cancer morbidity
was significantly higher in territories contaminated at a level higher than 100 kBq/m2 thanin areas with levels of less than 100 kBq/m2(Prysyazhnyuk et al., 2007). Incidence of thy-roid cancer in various provinces is illustrated in
Figure 6.10.
11. Thyroid cancer morbidity markedly increased in liquidators after 2001 (Law of
Ukraine, 2006).
6.2.1.3. Russia
1. Thyroid cancer morbidity in the age group0–30 years increased 1.5-fold from 1991 to1998 (Ivanov and Tsyb, 2002).
2. From 1986 to 2000 thyroid cancer morbidity for the entire population of Bryansk

169

Yablokov: Oncological Diseases after Chernobyl
TABLE 6.6. Number of Thyroid Cancer Cases in Ukraine (Radiogenic Cases Parentheses)
Number of cases, n

Years

Author

1,420 (585)1990–1997

UNSCEAR, 2000

3,914
(937)
(1,217)(1,400)(572)
2,371 postsurgery

1986–1996
1986–1997
1986–1999
1986–1999
1986–2000
1986–2002

Dobyshevskaya et al., 1996
Interfax-Ukraine, 1998
Associated Press, 2000
Reuters, 2000
Tronko et al., 2002
Tsheglova, 2004

2,674 postsurgery
(585)
3,385

1988–2004
1990–2004
1986–2004

Anonymous, 2005
Prysyazhnyuk, 2007
National Ukrainian Report,
2006: fig. 5.2

Province increased 4.2-fold (3.3–13.8 cases per
100,000) and to 20.7 cases in children in theheavily contaminated districts (Kukishev et al.,
2001; Proshin et al., 2005).
3. Thyroid cancer morbidity in Bryansk
Province was twice that in Russia from 1988
to 1998 and triple that from 1999 to 2004
(Malashenko, 2005). The real level of thyroid
cancer in Bryansk Province might be up to fourtimes higher than the official 13.8 cases per
100,000 (Pylyukova, 2004).

Figure 6.8. Number of thyroid cancer cases in
Ukraine among persons who were 0 to 18 years ofage at the time of the meltdown (National Ukrainian
Report, 2006: fig. 5.2).

Comments
Persons aged 0 – 15 years at the timeof the meltdown
Including 422 children
Referring to official data
Referring to official data
Referring to official data
Children aged 0–14 years
Children aged 0–17 years at the timeof the meltdown
ChildrenChildren aged 0–18 years at the timeof the meltdown (11 died)

4. Since 1995 thyroid cancer morbidity inthe southwest districts contaminated at a level
higher than 5 Ci/km2 has become significantly
higher than the province’s average (Kukishev
et al., 2001).
5. Thyroid cancer morbidity in children increased significantly in Tula Province from1986 to 1997 compared with the years before
the catastrophe (Ushakova et al., 2001).
6. Since 1991, thyroid cancer morbidity inBryansk Province began to increase sharply
among individuals who were under 50 yearsof age at the time of the catastrophe. The relative risk of the disease for adults is twice thatfor children, and higher for women (Zvonova
et al., 2006).
7. There has been noticeable growth of thyroid cancer morbidity in children in the Ural region provinces since 1990 (Dobrynyna, 1998).
8. The thyroid cancer morbidity in Lipetsk
City increased 3.4 times from 1989 to 1995
(Krapyvin, 1997).
9. In the 10 to 15 years after the catastrophe,thyroid cancer morbidity in Oryol Province increased eightfold (Parshkov et al., 2006).
10. Thyroid cancer morbidity in both children and adults in Oryol Province increased
sharply in the 6 to 8 years after the catastrophe (Kovalenko, 2004). The absolute number of cases in the province is shown in
Figure 6.11.

170

Figure 6.9. Thyroid cancer morbidity (per 100,000) in Ukraine for men and women from1962 to 2004 (Prysyazhnyuk et al., 2007).

11. The incidence of thyroid cancer in European Russia is presented in Table 6.7.
6.2.1.4. Other Countries
Globally an increased incidence of thyroid
cancer has been reported in the last 20 years.
Small tumors are discovered incidentally while
exploring and treating benign thyroid diseases,
which may be a reason for the increase, but
this cannot account for most of the increase.
For example, in the Marne-Ardennes French
provinces, the percentage of malignant thyroid
tumors smaller than 5 mm at diagnosis has
increased 20% (from 7 to 27%) from 1975 to
2005. At the same time cancer incidence increased 360% in women and 500% in men(Cherie-Challine et al., 2006).
A common argument against the “Chernobyl effect” of increasing thyroid cancer morbidity is that it does not correlate with the mostcontaminated areas in 1986. However, this ar-

gument is flawed. For example, the official viewin France was that the I-131 contamination was
primarily in the southeastern part of the county(Figure 6.12), but there are data showing thaton some days there were heavier Chernobyl
clouds over the northern part of the country, including the Marne-Ardennes provinces, where
there was increasing incidence of thyroid cancer several years later. It is important to notethat not only I-131, but other radionuclides cancause thyroid cancer.
1. AUSTRIA. An increase in the number ofthyroid cancers began in 1990 and was especially high in the contaminated territories in1995 (Weinisch, 2007).
2. CZECH REPUBLIC. From 1976 to 1990 thyroid cancer morbidity grew 2% a year. From1990 there was a significant increase in therate of this cancer for both sexes to 4.6% a
year (95% CI: 1.2–4.1, P = 0.0003). The values for women are markedly higher than thosefor men. Since Chernobyl there have been 426

Figure 6.10. Thyroid cancer morbidity (per 100,000) in heavily contaminated Kiev
Province and Kiev City and less contaminated Zhytomir Province (Prysyazhnyuk, 2007).

171

Yablokov: Oncological Diseases after Chernobyl

Figure 6.11. Absolute number of thyroid cancer cases in children and teenagers who
were newborn to 18 years of age at the time of the meltdown (above) and among the adult
population (below) in the Oryol Province from 1986 to 2000 (Golyvets, 2002).
TABLE 6.7. Number of Thyroid Cancer Cases in European Russia According to Various Sources (Radiogenic Cases in Parentheses)
Number of cases, n

Years

AuthorComments

4,173 (2,801)

1987–2000

Ivanov and Tsyb, 2002

(205)

1990–1998

UNSCEAR, 2000

1,591

1986–2000

Kukishev et al., 2001

2,638
2,100 (1,071)(“Nearly 1,800”)

1986–2005
1991–2003
1986–1999

Malashenko, 2005
Tsheglova, 2004
UNSCEAR, 2000

Four most contaminated provinces (calculated by
A. Yablokov based on the pre-Chernobyl level)
Whole country; persons aged 0–17 years at the timeof the meltdown
Bryansk Province (more than 50 times higher thanfor 1975–1985)
Bryansk Province
Reference to A. F. Tsyb’s oral message

172

Figure 6.12. Total I-131 contamination of France originating from Chernobyl (CherieChalline et al., 2006).

more cases of thyroid cancer in the Czech Republic alone (95% CI: 187–688) than had been
predicted prior to the meltdown (Mürbeth et al.,
2004; Frentzel-Beyme and Scherb, 2007). Afterthe catastrophe, the thyroid cancer incidence
reveals an additional annual increase of up to
5% depending on age and gender (FrentzelBeyme and Scherb, 2007).
3. FRANCE. From 1975 to 1995, the incidenceof thyroid cancer increased by a factor of 5.2
in men and 2.7 in women (Verger et al., 2003),
but an association with the nuclear catastrophe was officially denied. By 1997–2001 therate was significantly higher in Corsica formen and in Tarn for women. So, too, wasthe rate noticeably higher for women in Calvados and for men in Douds, Isere, and MarneArdennes provinces (Annual Report, 2006).
Marne-Ardennes’ data are especially interesting because they show the sharply increased incidence of thyroid cancer soon after the catastrophe (Figure 6.13), practically synchronouswith the Belarussian data.
4. GREAT BRITAIN. Thyroid cancer morbidity noticeably increased in northern Englandand, especially, in the most contaminated areasof Cumbria, where it was up 12.2% (Cotterill
et al., 2001).

5. GREECE. For three years after the catastrophe, from 1987 to 1991, there was a significant increase in papillary thyroid cancer (more common in women), as well as
mixed forms of cancer (Figure 6.14). An increased incidence of papillary carcinomas wasseen after 1995, reaching the maximum value
in the year 2000 and is likely associatedwith the Chernobyl fallout (Emmanuel et al.,2007).
6. ISRAEL. Analysis of records of 5,864
patients from the Israel National Cancer

Figure 6.13. The thyroid cancer incidence (per100,000) in the Marne-Ardenne provinces, France,
for 1975–2004 (Cherie-Challine et al., 2006). Upper curve – men, lower curve – women.

173

Yablokov: Oncological Diseases after Chernobyl

Figure 6.14. The incidence of the thyroid cancer by different histological types and by gender in
Greece in 1963–2000 (Ilias et al., 2002).

Registry reveal a significant increase in theage-standardized incidence rate (per 100,000)
for thyroid cancer, due primarily to papillarycarcinoma diagnosed between 1992 and 1996
in comparison with patients diagnosed earlier:
1982–1986 (86 vs. 78%, P < 0.01; Lubyna et al.,2006). In spite of the author’s conclusion thatthe reasons for this rise “may relate partly toincreased diagnostic vigilance and changes inclinical practice,” time trends, gender, and ethnicity do not preclude Chernobyl influence.
7. ITALY. There was a twofold increase in thyroid cancer morbidity from 1988 to 2002, especially expressed after 1992. It was claimed that
this increased incidence was most likely due toimproved and more powerful diagnostic techniques, not to Chernobyl-related factors, which“although possible, is not envisaged at this moment” (Pacini, 2007). However, it is noted that
this conclusion was based on a cancer registry that included only 25.5% of the Italian
population.
8. POLAND. There is a noticeable increase in thyroid cancer morbidity in contaminated territories among adolescents and adults(Szybinski et al., 2001, 2005). Owing to theChernobyl catastrophe an additional 80–250
thyroid cancer deaths are estimated to occur
annually (Green Brigade, 1994).
9. ROMANIA. Thyroid cancer morbidity increased in the most contaminated areas of eastern Romania. This increase started in 1990,
and by 1997–1998 was much higher thanduring the pre-Chernobyl years (Davydescu,
2004). The maximum incidence rate for thyroid
cancer in Cluj City was registered in 1996—
10 years after the catastrophe (Salagean et al.,
1998; Figure 6.15).

Figure 6.15. Thyroid cancer morbidity (cases per 10,000) in contaminated areas after the catastrophe in eastern Romania and the whole of Romania from 1982 to 1998
(Davydescu, 2004).

174

Figure 6.16. Papillary thyroid cancer incidence in women, United States from 1975 to1997 (Wartofsky, 2006).

10. SWITZERLAND. Within-country geographical comparisons for current incidence
rates by the Swiss Cancer Registries Network
detected an increase over time for papillarycancers and a decrease for other types.
Age-period-cohort analyses revealed that the
youngest cohorts of men and women bornafter 1940 had an increased risk of all types ofthyroid cancer, whereas the cohort of people
born between 1920 and 1939 were at increased
risk of the papillary subtype. As cautiously
noted by F. Montanaro, “Assuming a higher
sensitivity to ionizing radiation among theyoungest people, a Chernobyl effect cannot be
definitively excluded and continuous study ofthis topic should be encouraged” (Montanaro
et al., 2006).
11. UNITED STATES. From 1988 there wasa marked increase in papillary thyroid cancer
incidence in women (Figure 6.16), which may
partly be explained by Chernobyl radiation. In
Connecticut there were two separate falloutsof Chernobyl radionuclides (in the middle of
May and the second half of June, 1986), resulting in a 7- to 28-fold increased level of I131 in milk. The rate of thyroid cancer among
Connecticut children under the age of 15 years
rose sharply (from 0.16 to 0.31 per 100,000)
from 1985–1989 to 1990–1992. During thesame period rates of thyroid cancer for all
age groups jumped to 23% (from 3.46 to 4.29
per 100,000), after 10 previous years withoutchange (Figure 6.17).

6.2.2. How Many and When Will New
Cases of Chernobyl Thyroid Cancer
Occur?
In 1990, when the serious increase in theincidence of thyroid cancer in contaminatedterritories had already begun, official medical representatives from the Soviet Union indicated they expected 100 additional cases tobe induced by the catastrophe’s radiation (e.g.,
Ilyin et al., 1990). The added risk of thyroid
cancer after Hiroshima and Nagasaki radiation was highest 10 to 15 years later, with cases
appearing 40 to 50 years afterward (Demidchik
et al., 1996). On this basis, it is predicted thatthe number of Chernobyl thyroid cancers will
increase worldwide until 2011 (Tsyb, 1996;
Goncharova, 2000). Various forecasts for future additional radiogenic thyroid cancers areshown in Table 6.8.
The calculations in Table 6.8 are based on
the collective dose estimates and risk coefficients for I-131 by the United Nations Scientific Committee on the Effects of Atomic
Radiation (UNSCEAR), and it is entirely possible that the determinations of collective doses
were seriously underestimated (see, e.g., Fairlieand Sumner, 2006) and that the risk factorsthat were used were not reliable (Busby, 2004).
One also has to consider that the thyroid
cancers were caused not only by I-131, butalso by other isotopes of iodine including I129 and by Te-132, Ru-103, and Ru-106, as175

Yablokov: Oncological Diseases after Chernobyl

Figure 6.17. Thyroid cancer incidence in children (per 1,000,000), age adjusted rate
1935–1992, and I-131 concentration in milk for Connecticut (Reid and Mangano, 1995).
TABLE 6.8. Future Predicted Chernobyl-Induced Thyroid Cancers According to Various Sources
Number of cases
Belarus1,100 in boys, 2,300 in girls(whole country); 730 in boys,
1,500 in girls (Gomel Province)
12,500 (whole country)

PeriodAuthorUp to 2056

Demidchik et al., 1999

In persons aged 0–17 years at thetime of the meltdown

All time

Ostapenko, 2002;
Fedorov, 2002
National Belarussian
Report, 2003
Malko, 2007
Brown, 2000

In persons aged 0–17 years at thetime of the meltdown

All time

Krysenko, 2002;
Fedorov, 2002

In today’s adolescents and young
peopleAll time

Brown, 2000

Data from the International Agency
for Research on Cancer (IARC)

All time

Demidchik et al., 1996

All time
All time

Malko, 1998
Gofman, 1994b

15,000 (whole country)

Up to 2053

14,000–31,400 (whole country)
50,200 (Gomel province), “fromabove 5,000” (Mogilev
Province)“Up to 50,000” (whole country)

Up to 2056
All time

Russia3,700 (Kaluga, Tula, and Oryol
provinces)659 (Bryansk, Tula, Kaluga,
Oryol, Kursk, Ryazan, andLeningrad provinces)
Belarus, Ukraine, Russia
50,33093,00–131,000

Comments

Data from the International Agency
for Research on Cancer (IARC)

Including 5,230 fatalities

176

well as being a result of the adverse effects of
Cs-134 and Cs-137. Therefore, the forecastsin Table 6.8 should be considered minimal
estimates.
Based on real numbers of radiogenic cancers recorded for 1986–2000 in the contaminated territories of Belarus and Ukraine, V.
Malko (2007) calculated a parity between thelevel of radiation and the number of additional
cases due to the influence of that radiation (i.e.,
number of cancers vs. dose of radiation). Thiscan also be done by comparing spontaneous,
pre-Chernobyl and post-Chernobyl instancesof cancer. The post-Chernobyl number is 5.5fold higher than was predicted by most known
international forecasts (Cardis et al., 2006).
Malko also recalculated the relative number of cases of cancer per dose of Chernobyl
radionuclide fallout on populations of European countries. The results of these calculations(as future instances of cancer and the related
death toll) for the total lifetime of the “Chernobyl generation” (1986–2056) are presented
in Table 6.9.
The confidence interval for all of Europe is46,313–138,936 cases of thyroid cancer and13,292–39,875 deaths (Malko, 2007: table 3).
These calculations do not include the liquidators, of which a significant number (830,000) do
not live in the contaminated territories. Malko’s
numbers could be lower owing to severe restrictions on the consumption of vegetables andmilk in many European countries on the second
and third days after the catastrophe. Conversely
the number of cases may increase owing to exposure of several new generations to continuing
Cs-137 radiation.
The prevalence and appearance of Chernobyl thyroid cancers differ widely from theHiroshima and Nagasaki reference data. The
Chernobyl thyroid cancers: (1) appear muchearlier (not in 10, but in 3–4 years after irradiation); (2) develop in a much more aggressive
form; and (3) affect not only children, but also
adults at the time of irradiation.
It is mistaken to think that this cancer is easily treated surgically (Chernobyl Forum, 2006).

TABLE 6.9. Predicted Radiogenic Thyroid Cancer
Cases and the Resultant Death Toll in Europe from1986 to 2056 (Malko, 2007)
Country
Belarus
UkraineRussiaYugoslavia
Italy
Romania
PolandGreeceGermany
Czech and Slovakia
Bulgaria
FranceSwitzerland
Austria
Great Britain
Finland
The Netherlands
Hungary
Belgium
SwedenNorwayIrelandSpain
Denmark
Luxembourg
Portugal
European Total
Included figures
for Belarus, Ukraine,and Russia

Number ofcases, nIncludedfatalities

31,40018,805
8,626
7,137
5,162
3,976
3,221
2,879
2,514
2,347
1,619
1,153
898
812
418
334
328
270
239
165
136
100
54
19
13
2
92,627
58,831

9,012
5,397
2,476
2,048
1,481
1,141
924
826
721
674
465
331
258
233
120
96
94
78
69
47
39
29
15
5
4
1
26,584
16,885

In spite of the fact that the majority of victims undergo surgery, cancer continues to develop in approximately one-third of the cases(Demidchik and Demidchik, 1999). Moreover,without exception, despite surgical treatment,
the person remains impaired for the rest of
his/her life, completely dependent upon pharmacological supplements.
Lastly, thyroid cancer is only the tip of theiceberg for radiogenic thyroid gland disorders(see Section 5.3.2): for each case of cancer, one
finds hundreds of cases of other organic thyroid
gland diseases.

177

Yablokov: Oncological Diseases after Chernobyl

TABLE 6.10. Acute and Chronic Leukosis (Leukemia) Morbidity in Adults (per 100,000) in Gomel
Province, 1993–2003 (National Belarussian Report, 2006)
Whole province
Leukosis
Acute lymphoblastic
Acute nonlymphoblastic
Red cell leukemia
All chronic leukoses
All leukoses∗

Heavily contaminated districts

BeforeAfter

BeforeAfter0.28 ± 0.07
1.23 ± 0.14
0.59 ± 0.11
5.72 ± 0.32
9.05 ± 0.22

0.78 ± 0.11∗∗
1.83 ± 0.11∗∗
0.93 ± 0.12
8.83 ± 0.42∗∗∗
11.79 ± 0.42∗∗∗0.35 ± 0.08
1.07 ± 0.132
0.36 ± 0.13
5.91 ± 0.21
9.45 ± 0.40

0.96 ± 0.28∗
2.30 ± 0.31∗∗
1.25 ± 0.14∗∗∗9.94 ± 0.75∗∗∗
13.44 ± 0.69∗∗∗

P < 0.05; ∗∗ P < 0.01; ∗∗∗ P < 0.001.

6.3. Cancer of the Blood—Leukemia
Radiogenic leukemia was detected in Hiroshima and Nagasaki a few months after thebombing and morbidity peaked in 5 years. The
latency period for radiogenic leukemia is several months to years with the highest incidence
occurring between 6 and 8 years after exposure(Sinclair, 1996). Owing to the secrecy and theofficial falsification of data that continued for 3
years after the catastrophe (see Chapter 3 fordetails), unknown numbers of leukemia cases
in Ukraine, Belarus, and Russia were not included in any registry. These distortions should
be kept in mind when analyzing the following
data.
6.3.1. Belarus
1. There were 1,117 cases of leukemia inchildren 0 to 14 years old from 1990 to 2004
(National Belarussian Report, 2006).
2. Since 1992 (7 years after the catastrophe) there has been a significant increase in
all forms of leukemia in the adult population.
The higher rate of morbidity compared withthe pre-Chernobyl data was observed in 1992–
1994 (Ivanov et al., 1996).
3. Primary lymphatic and blood-forming
cancers significantly increased among maleevacuees from 1993 to 2003 (National Belarussian Report, 2006).
4. Leukemia morbidity in Gomel Province
adults increased significantly after the catastrophe (Table 6.10).

5. Since 1996 the number of preleukemia
cases has increased. For the 1986–1987 liquidators there was a statistically significant additional number of instances of acute leukemia
in 1990–1991 (Ivanov et al., 1997).
6. There was a noticeable increase in lymphoid and blood-forming cancers in men andwomen across Belarus in the first 5 years after
the catastrophe (Figure 6.18).
7. The highest incidence rate for acuteand chronic leukemia and Hodgkin’s disease occurred in the first 5 years after
the catastrophe. The maximum increase in
red cell leukemias, non-Hodgkin’s lymphoma,
and, especially, myelodysplastic syndrome occurred 10 years after the catastrophe. Incidence of all forms of leukemic disease
was significantly higher after the catastrophe(Table 6.11).
8. There were nearly 2,300 cases of leukemia
between 1986 and 2004 (Malko, 2007).

Figure 6.18. Lymphoid and blood-forming tumors in Belarus, 1985–1998: (upper curve) men,
(middle) both sexes, (lower) women (Okeanov et al.,2004).

178
TABLE 6.11. Leukemia Morbidity (per 100,000) among the Adult Population of Belarus, 1979–1997(Gapanovich et al., 2001)
Leukemia types

Number ofcases, n

1979–1985

1986–1992

1993–1997

Acute leukemia
Chronic leukemia
Erythremia
Multiple myeloma
Hodgkin’s disease
Non-Hodgkin’s lymphoma
Myelodysplastic syndrome

4,405
11,052
n/a
2,662
4,870
5,719
1,543∗∗

2.82 ± 0.10
6.09 ± 0.18
0.61 ± 0.05
1.45 ± 0.06
3.13 ± 0.10
2.85 ± 0.08
0.03 ± 0.01

3.17 ± 0.11∗
8.14 ± 0.31∗
0.8 ± 0.05∗
1.86 ± 0.06∗
3.48 ± 0.12∗
4.09 ± 0.16∗
0.12 ± 0.05∗

2.92 ± 0.10
8.11 ± 0.26∗
0.98 ± 0.05∗
2.19 ± 0.14∗
3.18 ± 0.06
4.87 ± 0.15∗
0.82 ± 0.16∗∗

P < 0.05 from pre-Chernobyl status; ∗∗ all cases of bone marrow depression.

9. There was a significant increase inleukemia morbidity for the elderly 15 years
after the catastrophe (Medical Consequences,
2003).
10. After the catastrophe many formsof leukemic disease in adults significantly
increased in Mogilev and Gomel provinces(Tables 6.12 and 6.13).
6.3.2. Ukraine
1. There was an increase in acute leukemia inchildren from the contaminated regions compared with clean areas 10 to 14 years after thecatastrophe (Moroz, 1998; Moroz et al., 1999;
Moroz and Drozdova, 2000).
2. For children, leukemia morbidity began toincrease in 1987 and peaked in 1996 (Horishna,2005).
3. Leukemia incidence in 1986–1996 among
Ukrainian children born in 1986 and thus ex-

posed in utero in the contaminated areas of
Zhytomir Province was compared with children born in the less contaminated Poltava
Province. Risk ratios based on cumulative
incidence show significant increases for all
leukemia (rate ratio: 2.7, 95% CI: 1.9–3.8) andfor acute lymphoblastic leukemia (rate ratio:
3.4, 95% CI: 1.1–10.4; Noshchenko et al., 2001,
2002).
4. From 1993 to 1997 there were 652 casesof acute leukemia (AL) in Kiev City andKiev Province, including 247 cases in children(Gluzman et al., 1998).
5. Morbidity from leukemia in the heavily
contaminated provinces was significantly elevated among children born in 1986 and thehigh morbidity continued for 10 years postexposure. Rates of acute lymphoblastic leukemia(ALL) were dramatically elevated for males andto a lesser extent for females. For both genders combined, the morbidity for ALL was

TABLE 6.12. Leukosis (Leukemia) (per 100,000) among the Adult Population in Mogilev and Gomel
Provinces before and after the Catastrophe∗ (National Belarussian Report, 2006: tables 4.2 and 4.3)
Mogilev Province

Acute lymphoblastic leukosis
Acute nonlymphoblastic leukosis
Erythremia
Others chronic leukoses
All leukoses∗

All differences are significant.

Gomel Province

1979–1985

1993–2003

1979–1985

1993–2003

0.5 ± 0.1
0.3 ± 0.1
0.4 ± 0.1
0.2 ± 0.1
9.8 ± 0.6

0.8 ± 0.1
1.7 ± 0.2
0.8 ± 0.1
0.7 ± 0.1
12.1 ± 0.4

0.2 ± 0.07
1.2 ± 0.1
0.6 ± 0.1
0.2 ± 0.05
9.1 ± 0.2

0.8 ± 0.1
1.8 ± 0.1
0.9 ± 0.1
1.0 ± 0.1
11.8 ± 0.4

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Yablokov: Oncological Diseases after Chernobyl

TABLE 6.13. Multiple Myeloma, Non-Hodgkin’s Lymphoma, and Hodgkin’s Disease Morbidity in Adults
in Gomel and Mogilev Provinces before and after the Catastrophe (National Belarussian Report, 2006:
table 4.4.)
Mogilev Province

Multiple myeloma
Hodgkin’s disease
Non-Hodgkin’s lymphoma∗

Gomel Province

1979–1985

1993–2003

1979–1985

1993–2003

1.68 ± 0.15
3.90 ± 0.14
2.99 ± 0.21

2.39 ± 0.20∗
3.06 ± 0.11∗∗
5.73 ± 0.25∗∗

1.24 ± 0.12
2.95 ± 0.19
2.83 ± 0.20

2.22 ± 0.14∗∗
3.21 ± 0.23
5.57 ± 0.30∗∗

P <0.05; ∗∗ P < 001.

more than threefold higher in the heavily
contaminated provinces compared to those lesscontaminated (Noshchenko et al., 2001).
6. In the children born in 1986–1987
who developed acute leukemia, an increasing relative number of acute myeloid leukemia(AML) cases were reported (21.2 and 25.3%
in 1986 and 1987, respectively; Gluzman et al.,2006).
7. During the first 4 years after the catastrophe, malignant blood diseases were significantly higher in the four most contaminated districts of Zhytomir and Kiev provinces
compared with the pre-Chernobyl period and1999–2000 (Figure 6.19).
8. Blood neoplasms were especially high inchildren during the first 5 years after the catastrophe, and among liquidators who worked in
1986–1987, the maximum incidence occurred
4 to 11 years after the catastrophe (Table 6.14).
9. During the first 4 years after the catastrophe there was an increase in myeloid
leukemia in the first and third years; during
the second 4 years there was a significant in-crease in lymphosarcoma and reticulosarcoma(Table 6.15).
10. There was a significant increase in
the number of leukemia cases in liquidators 15 years after the catastrophe (National
Ukrainian Report, 2006; Law of Ukraine,2006).
11. The incidence of multiple myeloma
among liquidators was twice as high as in thegeneral population (7.8 vs. 4.0%). Five 1986–
1987 liquidators were diagnosed with an unusual chronic lymphoproliferative disorder—
large granular lymphocytic leukemia (Gluzman
et al., 2006).
6.3.3. Russia
1. Childhood leukemia morbidity increasedin the Tula Province after the catastrophe(Table 6.16) and significantly exceeded theRussian average. Acute leukemia in children
was especially high (Ushakova et al., 2001).
2. In Bryansk Province all forms ofleukemia and non-Hodgkin’s lymphoma were

Figure 6.19. Leukemia and lymphoma morbidity (age adjusted, per 100,000, men andwomen) in Ukraine, 1980–2000 (Prysyazhnyuk et al., 2002).

180
TABLE 6.14. Leukemia Morbidity (Standardized
Data, per 100,000) in Ukraine (Prysyazhnyuk
et al., 2002)

Years

Person/years

Number of cases
Observed

Expected

SIR(%)

Leukemia, children, contaminated districts of the Kiev
and Zhytomir provinces
1980–1985 337,076
19
10.88
174.7
1986–1991 209,337
22
6.78
324.4
1992–1997 150,170
7
4.87
143.7
1998–2000
80,6560
2.59
0.0
Leukemia and lymphoma, evacuees, men and women
1990–1993 208,805
43
30.0
143.4
1994–1997 200,077
31
29.6
104.7
Leukemia and lymphoma, liquidators (1986–1987), men
1990–1993 263,084
81
31.8
255.0
1994–1997 314,452
102
49.9
204.6

significantly higher 7 years after the catastrophecompared to the 6 years prior to the catastrophe (UNSCEAR, 2000).
3. A marked increase in acute lymphocyte
leukemia occurred in the six most contaminated districts of Bryansk Province from 1986
to 1993 (Ivanov and Tsyb, 2002).
4. Since 1995 blood-related and lymphatic
cancer morbidity in the southwest districts (contaminated by ≥5 Ci/km2 ) was significantly
higher than the province’s average (Kukishev
et al., 2001).
5. From 1990 to 1994, children in Tula
Province became ill significantly more oftenwith tumors of the bone, soft tissue, and thecentral nervous system (Ushakova et al., 2001).

6. In the city of Lipetsk, leukemia morbidity increased 4.5-fold from 1989 to 1995
(Krapyvin, 1997).
7. In 10 to 15 years after the catastrophe,
lymphatic and blood-forming cancer morbidity
doubled (Parshkov et al., 2006).
8. Among liquidators, the first case ofleukemia was officially registered in 1986; by1991 there were already 11 such cases (Ivanov
et al., 2004: table 6.6).
9. In 10 to 12 years after the catastrophe
the number of leukemia cases among 1986–
1987 liquidators was double the average for thecountry (Tsyb, 1996; Zubovsky and Smirnova,
2000).
10. By 2004, lymphatic and blood-forming
cancer morbidity in liquidators was twice ashigh as the country average (Zubovsky andTararukhyna, 2007).
6.3.4. Other Countries
1. GERMANY. There was 1.5-fold increase in
the incidence of leukemia among infants bornin West Germany between July 1, 1986, andDecember 31, 1987 (Pflugbeil et al., 2006).
2. GREAT BRITAIN. In 1987 in Scotland
leukemia in children under the age of 4 years
rose by 37% (Gibson et al., 1988; Busby andScot Cato, 2000; Busby, 2006).
3. GREECE. Infants born between July 1,
1986, and December 31, 1987, and exposed
to Chernobyl fallout in utero had 2.6 times theincidence of leukemia compared to children

TABLE 6.15. Leukemia and Lymphoma Morbidity (per 10,000) in Five of the Most ContaminatedDistricts of Zhytomir and Kiev Provinces (Prysyazhnyuk et al., 2002)
Occurrence

Leukemia and lymphoma
Lympho- and reticulosarcoma
Hodgkin’s disease
Multiple myeloma
Lymphoid leukemia
Myeloid leukemia

1980–1985

1986–1991

1992–1997

1998–2000

10.12 ± 0.75
1.84 ± 0.33
1.82 ± 0.34
0.54 ± 0.16
3.08 ± 0.40
0.49 ± 0.17

15.63 ± 1.06
2.70 ± 0.41
2.47 ± 0.48
1.03 ± 0.25
4.93 ± 0.59
1.99 ± 0.41

13.41 ± 1.10
3.70 ± 0.58
2.10 ± 0.48
0.78 ± 0.22
2.97 ± 0.49
1.06 ± 0.30

13.82 ± 1.52
3.36 ± 0.90
1.23 ± 0.50
1.38 ± 0.40
4.11 ± 0.75
2.32 ± 0.62

Yablokov: Oncological Diseases after Chernobyl

181

TABLE 6.16. Leukemia Morbidity (per 10,000) in
Children of Tula Province, 1979–1985 and 1986–
1997 (Ushakova et al., 2001)

TABLE 6.17. Predicted Incidence of Radiogenic
Blood Cancer (Leukemia) and the Resultant Death
Toll in Europe for the “Chernobyl Generation,”
1986–2056 (Malko, 2007)

Years
1979–1985
1986–1997

Number of cases, n

95% CI

3.4
4.1

2.6–4.4
3.4–4.9born between January 1, 1980, and December
31, 1985, and between January 1, 1988,
and December 31, 1990. Elevated rates werealso reported for children born in regions of
Greece with higher levels of radioactive fallout(Petridou et al., 1996).
4. ROMANIA. The incidence of leukemia inchildren born between July 1986 and March
1987 was significantly higher than for thoseborn between April 1987 and December 1987
(386 vs. 173, P = 0.03). The most noticeable
effect is in the newborn to 1-year-old age group(Davydescu et al., 2004).
5. EUROPE. Realistic prognosis of blood cancer (all leukemias) morbidity and mortality isshown in Table 6.17.
6.4. Other Cancers
There are many fragmentary reports about
the increased occurrence of breast, lung, andother tumors after the Chernobyl catastrophe.
6.4.1. Belarus
1. Malignant and nonmalignant neoplasms
in girls (0–14 years old) born to irradiated parents increased significantly from 1993 to 2003
(National Belarussian Report, 2006).
2. From 1987 to 1990 (3 years after the catastrophe) there was a doubling of admissions to
the Minsk Eye Microsurgery Center to treat
retinal glioma (retinoblastoma; Byrich et al.,1994).
3. Lung cancer morbidity among the evacuees (about 32,000 examined) was fourfold
higher than the country average (Marples,
1996).
4. From 1987 to 1999, approximately 26,000
cases of radiation-induced malignant neo-

Country
UkraineBelarus
RussiaGermany
Romania
Austria
Great Britain
Czech Republic
Italy
Bulgaria
SwedenGreecePolandFinland
Switzerland
Moldova
FranceSlovenia
NorwaySlovakia
Hungary
Croatia
Lithuania
Ireland
The Netherlands
Belgium
Spain
LatviaDenmark
Estonia
Luxembourg
European total
Included figures
for Belarus, Ukraine,and Russia

Number ofcases, nIncludingfatalities

2,801
2,800
2,512
918
517
500
423
140
373
289
196
186
174
158
151
131
121
95
91
71
62
62
42
37
13
11
8
7
7
6
2
12,904
8,113

1,989
1,988
1,784
652
367
355
300
99
265
205
139
132
124
112
107
93
86
67
65
50
44
44
30
26
9
8
6
5
5
4
1
9,161
5,761

plasms (including leukemia) were registered in
the country, of which skin cancer accounted for
18.7% of the cases, lung cancer 10.5%, andstomach cancer 9.5%. Approximately 11,000
people died, 20.3% because of lung cancer and18.4% from stomach cancer (Okeanov et al.,
1996; Goncharova, 2000).
5. From 1990 to 2003, breast cancer morbidity rates in the districts of Gomel Province

182

Figure 6.20. Breast cancer morbidity (women, per 100,000) in Gomel Province withvarious levels of Cs-137 contamination (National Belarussian Report, 2006).

contaminated by Cs-137 at a level of 185–555
kBq/m2 and above were significantly higher
compared with districts contaminated at levels
lower than 185 kBq/m2 (respectively, 30.2 ±
2.6; 76 ± 12; and 23.2 ± 1.4 per 100,000;
Figure 6.20).
6. The incidence of breast cancer increased
significantly from 1986 to 1999 for the entire
country (1,745 to 2,322 cases; Putyrsky, 2002).
By 2002 breast cancer morbidity in women 45
to 49 years of age increased 2.6-fold for thewhole country compared with 1982. In the
more contaminated Mogilev Province breast
cancer increased fourfold from 1993 to 1996
compared with the period from 1989 to 1992
(Putyrsky and Putyrsky, 2006).
7. In the heavily contaminated Gomel
Province there was a marked increase in thenumber of cases of intestinal, colon, breast,
bladder, kidney, and lung cancers, and the occurrences correlated with the level of Chernobyl contamination (Okeanov et al., 1996;
Okeanov and Yakymovich, 1999).
8. For the second quinquennium after thecatastrophe there was a 10-fold increase in thenumber of cases of pancreatic cancer comparedwith the first quinquennium (UNCSEAR,
2000, point 258, p. 52).
9. Primary malignant intestinal neoplasms
significantly increased among woman evacuees
from 1993 to 2003 (National Belarussian Report, 2006).
10. From 1993 to 2003 general cancer morbidity increased significantly among men andwomen from heavily contaminated territories,
with the annual rate of increase being higher

for women (18%) than for men (4.4%; National
Belarussian Report, 2006).
11. The makeup of cancer morbidity
changed markedly after the catastrophe: theproportion of stomach tumors decreased,
whereas thyroid, lung, breast, urogenital system, colon, and rectal cancers increased(Malko, 2002).
12. From 1993 to 2003 there was a significant
increase in morbidity due to malignancies of
the intestines, respiratory organs, and urinary
tracts in men and woman liquidators (National
Belarussian Report, 2006).
6.4.2. Ukraine
1. The number of children with central nervous system neoplasms (including malignant
forms) increased from 1987 to 1994. The number of children admitted to the Ukrainian Institute of Neurosurgery in Kiev with brain
tumors (data on 1,699 children, aged 0 to
6 years) from 1987 to 1991 increased 63.7%
compared with the period from 1981 to 1985
(Orlov, 1993, 1995; Orlov and Sharevsky, 2003;
Figure 6.21).
2. After the catastrophe there were significant increases in bladder cancer in men in
the contaminated territories (Romanenko et al.,1999).
3. The incidence of breast cancer in themost radioactively contaminated territories wasalmost stable from 1980 to 1992 and lower thanin the large comparison areas (the whole of
Ukraine, Kiev area, and Zhytomir Province).
Then, from 1992 to 2004, the rate increased

183

Yablokov: Oncological Diseases after Chernobyl

Figure 6.21. Central nervous system tumor
cases (per 10,000) in children under 3 years of age,
Ukrainian Institute of Neurosurgery data for the period 1980–2005 (Orlov et al., 2006).

in the contaminated territories (Prysyazhnyuk
et al., 2007). Morbidity due to breast cancer in women living in the contaminated areas and among those evacuated increased 1.5fold from 1993 to 1997 (Moskalenko, 2003;
Prysyazhnyuk et al., 2002).
4. There is an increase in breast cancer inpremenopausal women from contaminated areas of Ukraine close to Chernobyl, comparedwith the general Ukrainian female population(standardized incidence ratio: 1.50, 95% CI:
1.27–1.73; Prysyazhnyuk et al., 2002, cited by
Hatch et al., 2005).
5. Breast cancer morbidity in women in thecontaminated territories and among liquidators and evacuees increased significantly from1990 to 2004 (Moskalenko, 2003; National
Ukrainian Report, 2006; Prysyazhnyuk et al.,2007).
6. Prostate cancer mortality increased in thecontaminated territories up to 2.2-fold andacross all of Ukraine 1.3-fold (Omelyanets et al.,2001).
7. The Kiev Interdepartmental Expert Commission revealed that for liquidators, digestivesystem tumors were the most common typeof cancer (33.7%), followed by tumors of therespiratory system (25.3%), and tumors of theurogenital tract (13.1%). The fastest increase incancer pathology was for the urogenital tract,
for which an almost threefold increase (from11.2 to 39.5%) was observed from 1993 to 1996
(Barylyak and Diomyna, 2003).

8. The rate of oncological illnesses in liquidators’ mortality increased from 9.6 to 25.2%
during the period from 1987 to 2004. For
Ukrainian adults in 2004 the rate was 9.9%
(Horishna, 2005).
9. A significant increase in urinary tract andbladder cancers was found in the contaminatedterritories of Ukraine (Romanenko et al., 1999).
In the period from 1987 to 1994, an increase in
the number of children suffering from tumorsof the nervous system was observed (Orlov,
1995).
10. From 1999 to 2004 cancer mortality inliquidators exceeded similar parameters among
the rest of the population (Law of Ukraine,2006).
6.4.3. Russia
1. There was a noticeable increase in respiratory tract tumors in women in the most contaminated areas of Kaluga Province (Ivanov
et al., 1997).
2. Since 1995 in southwest districts contaminated at levels higher than 5 Ci/km2 , there has
been a significantly larger incidence of somecancers of the stomach, lung, breast, rectum,
and colon than the province average (Kukyshev
et al., 2001).
3. The incidence of oral cavity, pharyngeal,
and adrenal cancers in Tula Province children
increased more than twofold from 1986 to 1997
compared to the period from 1979 to 1985
(Table 6.18).
4. Since 1990–1994 the incidence of tissue,bone, and central nervous system cancers in
Tula Province children has been significantly
higher (Ushakova et al., 2001).
5. Melanoma of the skin increased fivefold
and the incidence of brain cancer tripled in
the first 10 to 15 years after the catastrophe(Parshkov et al., 2006).
6. Infant mortality in the contaminatedprovinces differs from the country as a whole,with an increase in leukemia and brain tumors in both boys and girls (Fedorenko et al.,2006).

184
TABLE 6.18. Increase in Morbidity owing to Various Cancers in Children of Tula Province after theCatastrophe (Ushakova et al., 2001)
Cancer site

Oral cavity
and pharynx

AdrenalglandsSkin

Kidneys

Genitalia(male)

Bones andsoft tissues

BladderAll
cancers

225%

225%

188%

164%

163%

154%

150%

113%

1986–1997 comparedwith 1979–1985, %7. As of 2004, kidney and bladder cancers
were the most prevalent malignancies amongliquidators, accounting for 17.6% of all malignant neoplasms, double the country average of
7.5%. Brain and laryngeal tumors also werewidespread (Khrysanfov and Meskikh, 2001;
Zubovsky and Tararukhyna, 2007).
6.5. Conclusions
UNSCEAR, along with other internationalorganizations loyal to the nuclear industry, estimated the future number of fatal cancers owing to Chernobyl irradiation to be between
22,000 and 28,000, or even as few as 9,000(Chernobyl Forum, 2006). At the time that report was issued, the number of deaths had already risen, but UNSCEAR unequivocally underestimated the number of deaths by basing its
figures on false risk factors and understated collective doses (for details see Busby et al., 2003;
Fairlie and Sumner, 2006). Tables 6.19 and 6.20
TABLE 6.19. Predicted Cancer Morbidity andMortality (Excluding Leukemia∗∗ ) Caused by
the Chernobyl Cs-137 for Future Generations∗(Gofman, 1994b: vol. 2, ch. 24, p. 5)
Number of cases
RegionLethalNonlethal

Belarus, Ukraine, Moldova
Europe (without CIS)
Other countries
Total

212,150
244,786
18,512475,368

212,150
244,786
18,512475,368∗
On the basis of an expected collective dose “indefinitely” of 127.4 million person/rad; ∗∗ Global death ratefrom Chernobyl leukemia by J. Gofman calculation as of
1994: 19,500 persons.

present the results of more realistic mortality
and morbidity calculations for Europe and theworld.
Using the methodology described above foranalyses of thyroid cancers (see Section 6.2),
M. Malko has made the most detailed prognosis of Chernobyl-related cancers in Europe
and the consequent mortality over the lifespanof the “Chernobyl generation” (1986–2056).
Prognoses for the solid cancers are given in
Table 6.21 and those for leukemia were shown
earlier in Table 6.17.
Table 6.21 presents the average data. The
confidence limits for the incidence of cancer are between 62,206 and 196,611, andthe death toll is between 40,427 and 121,277(Malko, 2007). These numbers could increase
for many future generations because of continued radiation from the further release of
Cs-137, Sr-90, Pu-241, Am-241, Cl-36, andTc-99.
Undoubtedly, the above forecasts are incomplete. The fact is that for some years after
the catastrophe, there was a marked increase,
TABLE 6.20. Predicted Additional Chernobyl
Cancer Morbidity and Mortality in Belarus,
Ukraine, and European Russia∗ (Malko, 1998)
CancerBelarus

RussiaUkraineThyroid—morbidity
Thyroid—mortality
Leukemia—mortality
Malignant tumors, otherthan thyroid—mortality

20,3002,030
1,300
12,700

8,000
800
760
7,400

24,0002,400
1,550
15,100Total mortality

16,0308,960
44,04019,050∗

Entire world: 90,000 lethal cancers.

Yablokov: Oncological Diseases after Chernobyl

185

TABLE 6.21. Predicted Incidence of Cancer
Caused by Chernobyl and the Resultant Death Tollin Europe from 1986 to 2056 (Malko, 2007)

Nagasaki, but in only a few years after the
explosion. The assumption (e.g., Pryasyaznjuk
et al., 2007) that Chernobyl’s radioactive influence on the incidence of malignant neoplasms
will be much weaker than that of the Hiroshima
and Nagasaki radiation is very doubtful. In
Chernobyl’s contaminated territories the radioactive impact may be even greater becauseof its duration and character, especially because of irradiation from internally absorbed
radioisotopes.
The number of illnesses and deaths determined by Malko’s (2007) calculations cannot
be dismissed as grossly overestimated: 10,000–
40,000 additional deaths from thyroid cancer,
40,000–120,000 deaths from the other malignant tumors, and 5,000–14,000 deaths fromleukemia, for a total of 55,000 to 174,000
deaths for the “Chernobyl generation” from1986 to 2056.

Number of cases
Country
Belarus
UkraineRussiaGermany
Romania
Austria
Great Britain
Italy
Bulgaria
SwedenGreecePolandFinland
Switzerland
Czech Republic
Moldova
FranceSlovenia
NorwaySlovakia
Croatia
Hungary
Lithuania
Ireland
The Netherlands
Belgium
Spain
LatviaDenmark
Estonia
Luxembourg
European total
Included figures
for Belarus, Ukraine,and European Russia

All

Fatalities

28,30028,30025,400
9,280
5,220
5,050
4,280
3,770
2,920
1,980
1,880
1,755
1,600
1,530
1,410
1,320
1,220
960
920
715
630
625
420
375
135
110
80
75
70
60
15
130,405
82,00017,546
17,546
15,748
5,754
3,236
3,131
2,654
2,337
1,810
1,228
1,166
1,088
992
949
874
818
756
595
570
443
391
388
260
233
84
68
50
47
43
37
9
89,85150,840which is still in evidence, in the incidence ofvarious malignant neoplasms in all of the territories subjected to Chernobyl fallout—that
is, where adequate studies have been carriedout.
Even the incomplete data now available indicate the specific character of cancers caused
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CHERNOBYL

7. Mortality after the Chernobyl Catastrophe
Alexey V. Yablokov

A detailed study reveals that 3.8–4.0% of all deaths in the contaminated territories of
Ukraine and Russia from 1990 to 2004 were caused by the Chernobyl catastrophe. The
lack of evidence of increased mortality in other affected countries is not proof of theabsence of effects from the radioactive fallout. Since 1990, mortality among liquidators has exceeded the mortality rate in corresponding population groups. From 112,000
to 125,000 liquidators died before 2005—that is, some 15% of the 830,000 members of
the Chernobyl cleanup teams. The calculations suggest that the Chernobyl catastrophe has already killed several hundred thousand human beings in a population ofseveral hundred million that was unfortunate enough to live in territories affected by
the fallout. The number of Chernobyl victims will continue to grow over many future
generations.

Twenty years after the Chernobyl catastrophe,
apart from several limited studies among specific groups and in isolated territories dealing primarily with the incidence of cancer (seeChapter 6), there are no official publications on
mortality in areas affected by the nuclear fallout. There is strong evidence of radiation effects on cancer and noncancer mortality basedon the Hiroshima data (Preston et al., 2003).
The analysis in this chapter is based on studies of territories with comparable ethnic, social,and economic factors but with different levels ofradioactive contamination. Since the breakupof the Soviet Union, but even as early as 1987,
life expectancy there has decreased significantly(Figure 7.1), whereas the decline in infant mortality has leveled off.
7.1. Increase in Antenatal
Mortality
Irradiation has an adverse effect on the ovum
and the sperm, as well as on the embryo.

The major observable components of antenatal
mortality are spontaneous abortions or miscarriages (spontaneous interruption of pregnancy
until the 27th week) and stillbirths (after 27
weeks). Increased numbers of stillbirths andmiscarriages are among the first effects of irradiation, with a delay of only some weeks ormonths after exposure. These effects can occur after exposure to very low doses, that is, atwhole body doses as low as 5 mSv (Loganovsky,2005), but the reasons are not yet understood.
As a rule, spontaneous abortions are not registered, so a change in that rate can only be
determined indirectly from a reduction in thebirth rate. Long before the Chernobyl catastrophe, increases in antenatal mortality were
found in the wake of the nuclear fallout fromatmospheric weapons tests (Sternglass, 1972;
Whyte, 1992; Playford et al., 1992; Tchasnikov,
1996; Tkachev et al., 1996; and many others;
for reviews see C. Busby, 1995; A. Yablokov,
2002; A. Durakovič, 2003; and A. Körblein,
2004b).
7.1.1. Belarus

Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

1. The incidence of stillbirths in highly contaminated territories increased (Golovko andIzhevsky, 1996; Figure 7.2).

192

193

Yablokov: Mortality after Chernobyl

Figure 7.1. Average life expectancy for newborn males, 1961–2000, in Belarus,
Ukraine, and Russia (//www.demoscope.ru/weekly/ssp/geO.php?c2).

2. In 1987, a significant reduction in the birthrate was observed in Gomel Province, the mostcontaminated region of Belarus (Kulakov et al.,1993).
7.1.2. Ukraine
1. In the Ukrainian districts of Polessk andCherkassk, there was a significant increase in
the incidence of stillbirths, which was associated with the level of Cs-137 ground contamination. The study was based on more than
7,000 pregnancies 3 years before and 5 years
after Chernobyl (Kulakov et al., 1993).

2. In Kiev Province, a significant increasein spontaneous abortions was found in the
more highly contaminated areas. The study
was based on 66,379 pregnancies from 1999
to 2003 (Timchenko et al., 2006).
3. After 1986, the prevalence of ovarian hypofunction (one of the main causes of spontaneous abortion) increased by a factor of 2.9(Auvinen et al., 2001).
4. After Chernobyl, the number of spontaneous abortions increased significantly in the
Narodychy District (Buzhievskaya et al., 1995).
5. Until 2004, the estimated total numberof miscarriages and stillbirths in Ukraine as aresult of Chernobyl was about 50,000 (Lypic,
2004).

7.1.3. Russia

Figure 7.2. Excess stillbirth rate in 1987
in Sweden, Poland, Hungary, and Greece combined (EAST); Germany; and Belarus (Körblein,
2000, 2003). The error bars show one standard
deviation.

1. The number of spontaneous abortionsin the contaminated territories increased significantly after Chernobyl (Buldakov et al.,1996).
2. In Kaluga Province, the rate of spontaneous abortions increased significantly 5 years
after Chernobyl in the three most contaminated districts (Medvedeva et al., 2001).
3. In the three most contaminated districtsof Kaluga Province the stillbirth rate increased
significantly from 1986 to 1990 relative to therate before Chernobyl, and it continued to behigher than in less contaminated districts forthe whole 15-year study period (Figure 7.3).

194

Figure 7.3. Stillbirth rate (per 1,000 live births plus stillbirths) with higher and lower
contamination in districts of the Kaluga Province, and in Russia, during 1981–1986, 1986–
1990, 1991–1995, and 1996–2000 (Tsyb et al., 2006).

7.1.4. Other Countries
1. CROATIA. Stillbirth rates from 1985 to1990 show significant peaks observed at theend of 1986 and the beginning of 1987 andaround September 1988 (Figure 7.4). The second peak in 1988 may have resulted from theconsumption of contaminated beef.
2. CZECH REPUBLIC. In the sex ratio of newborns the percentage of males was higher than
50% each month between 1950 and 1999, except in November 1986, when it was significantly reduced (Figure 7.5). The hypothesis isthat there is a negative effect of the Chernobyl
catastrophe on male fetuses during the third
month of prenatal development (Peterka et al.,2004).
3. GERMANY. In the former Federal Republic of Germany (excluding Bavaria and West

Berlin), the area of the former German Democratic Republic (including West Berlin), andBavaria alone, the excess perinatal mortality
in 1987 was 2.4, 7.2, and 8.5%, respectively.
In 1988 in the German Democratic Republic plus West Berlin, the perinatal mortality
rate exceeded the expected figure by 7.4%
(Figure 7.6.), which was presumably a consequence of the consumption of contaminatedcanned beef imported from the Soviet Union(Scherb et al., 2000).
In 1987 in the 10 most affected districtsof Bavaria (average Cs-137 ground level, 37.2
kBq/m2 ), there was a 45% increase in the
proportion of stillbirths (P = 0.016); in thethree most contaminated Bavarian districts
combined (Augsburg City, Berchtesgaden, andGarmisch Partenkirchen), the stillbirth proportion in that year was more than double relative

Figure 7.4. Deviation of stillbirth rates in Croatia 1985 to 1991 from the long-term trend
in units of standard deviation (standardized residuals; Körblein, 2008).

Yablokov: Mortality after Chernobyl

Figure 7.5. The percentage of infant boys bornin the Czech Republic each November from 1950
to 2005. Only in November 1986 is the figure lessthan 50% (Peterka et al., 2007).

to the expected figure (P = 0.0004; Scherb et al.,2000).
4. GREAT BRITAIN. A significant increase inperinatal mortality occurred in March 1987,
some 10 months after the catastrophe in thethree most contaminated counties of Englandand Wales: Cumbria, Clwyd, and Gwynedd(Figure 7.7).
5. GREECE. A 10% reduction in the birthrate was observed from January to March 1987,
which was attributed to the Chernobyl fallout.
In May 1986, some 23% of early pregnancies
were aborted for fear of an adverse pregnancy
outcome (Trichopoulos et al., 1987).
6. FINLAND. There was an increase in stillbirth rates from December 1986 through Jan-

Figure 7.6. Perinatal mortality in Germany, theFederal Republic of Germany, and Bavaria (Scherb
et al., 2000).

195

uary 1987, which, however, was not significant(Auvinen et al., 2001). There was a significant
rise in preterm deliveries among infants who
were exposed to radiation in utero during thefirst trimester of pregnancy (Harjulehto et al.,1989).
7. HUNGARY. Birth rates were reduced in
February and March 1987 (Czeizel et al., 1991).
8. ITALY. In Lombardia there was a 20% increase in first-trimester spontaneous abortions
among fetuses conceived during the main fallout period (Semisa, 1988).
9. NORWAY. A higher incidence of spontaneous abortions was observed for pregnancies
conceived during the first 3 months after thecatastrophe (Ulstein et al., 1990). The observed
increase for 36 months after Chernobyl is statistically significant, “but a causal relationshipwith the radiation exposure cannot be proved.”
Pregnancies temporarily decreased in the second half of 1986, during a period in which
pregnancies usually increase, whereas there was
no increase in induced abortions (Irgens et al.,1991).
10. It should be noted that the reduction
in birth rate in Sweden, Italy, Switzerland,
Greece, and Finland in the first year after Chernobyl might not have been caused by radiation,
but rather was due to family planning (Auvinen
et al., 2001).
11. A change point analysis of stillbirth odds
ratios for gender, that is, the ratio of stillbirthodds of males to the stillbirth odds for females,
found a change in 1986 or 1987 (P = 0.01) inseveral European countries (Figure 7.8).
12. Changes in the sex ratio and the stillbirthodds ratio for gender were significant for Denmark, Germany, Hungary, Norway, Poland,
Latvia, and Sweden and visible but not statistically significant for Iceland (Figure 7.9).
13. Findings of increased rates of spontaneous abortions after the Chernobyl catastrophe in several European countries are summarized in Table 7.1.
14. Literature on increased stillbirth rates after Chernobyl in several European countries islisted in Table 7.2.

196

Figure 7.7. Trends of stillbirth rate and neonatal and perinatal mortality in England andWales (Busby, 1995, based on Bentham, 1991).

Over an 18-year period after Chernobyl, if
the number of miscarriages and stillbirths resulting from the Chernobyl fallout was 50,000
in Ukraine alone (Lypik, 2004), it is likely thatthe total antenatal death toll from Chernobyl
in Russia, Belarus, and Ukraine up to 2003 is
more than 100,000. As these three countries received only about 43% of the radioactive fallout
from Chernobyl (see Chapter 1 for details) one
can expect another 100,000 additional antenatal deaths in other European countries and in
the rest of the world. Thus the total antenatal
death toll from Chernobyl adds up to 200,000
cases (Rosen, 2006).

7.2. Increased Perinatal, Infant,and Childhood Mortality
Reports about the most probable adverse
impacts of the Chernobyl contamination on
childhood mortality include: perinatal mortality (stillbirths plus early neonatal deaths, 0–6
days), neonatal mortality (0–27 days), infantmortality (0–364 days), and childhood mortality (0–14 years). In a number of European
countries the definition of stillbirth changed
around 1994, which presents a problem in timetrend analyses. In the Former Soviet Union,
the data for neonatal and infant mortality were

Figure 7.8. Sex ratio and stillbirth odds ratio by gender in several European countries(male stillbirths/male live births)/(female stillbirths/female live births; Scherb et al., 1999).

197

Yablokov: Mortality after Chernobyl

Figure 7.9. Relative risks (RR with 95% confidence limits) for change points for the stillbirthodds ratio in 1986 (Iceland, Latvia, Poland, and Sweden), in 1987 (Germany, Denmark, and
Hungary), and 1989 (Norway), determined with a spatial–temporal trend model by Scherb
and Weigelt (2000).

habitually underreported to “improve” healthstatistics, which makes the figures unreliable(Losoto, 2004).

7.2.1. Perinatal Mortality
7.2.1.1. Belarus
1. Perinatal mortality in Gomel Province increased after 1988. During the 1990s there isa rise and fall relative to the expected trendwith a maximum number from 1993 to 1994
(Körblein, 2002). The additional mortality is
associated with the average calculated Sr-90
burden on pregnant women (Figure 7.10).
2. An analysis of pregnancy outcomes before and after the catastrophe (1982 to 1990)
revealed that neonatal mortality increased in
Gomel and Mogilev, the two most highly contaminated regions of Belarus (Petrova et al.,1997).
7.2.1.2. Ukraine
1. Perinatal mortality, stillbirth rate, andearly neonatal mortality in Zhytomir and Kiev

provinces were noticeably higher in the firstyear after the catastrophe and again 3 years
later (Figure 7.11). The latter increase may beconnected to consumption of locally contaminated food.
2. Comparison of perinatal mortality inthe most contaminated regions of Ukraine(Zhytomir and Kiev provinces and Kiev City)
with the mortality in the rest of Ukraine
shows significantly higher figures 1991–1999(Figure 7.12).
3. The increases in perinatal mortality in
Ukraine and Belarus are associated with the
Sr-90 burden on pregnant women (Körblein,2003).

7.2.1.3. Russia
1. In the three most contaminated districtsof Kaluga Province, infant mortality rates in
1986–1990 and 1991–1995 were higher thanin less contaminated districts and in the Kaluga
Province as a whole: 25.2, 21.5, and 17.0
per 1,000 live births, respectively (Tsyb et al.,2006).

198
TABLE 7.1. Increase of the Rate of Spontaneous Abortions after Chernobyl (from Reviews by Auvinen
et al., 2001 and Körblein, 2006a)
Country

PeriodFinland

July to Dec.,
1986
From 1986

Increased in the territories with high level of
Cs-137 ground contamination
Up to 20%

1986–1988

In 1986 for conceptions during the first 3 months
after Chernobyl in the contaminated territories
Rate of spontaneous abortions increased from
7.2% before Chernobyl to 8.3% the year afterin six contaminated counties
Increased for fetuses under 17 weeks at the timeof the Chernobyl catastrophe
Lombardy, increased 3%
Increased for whole country

Norway1986

Sweden

1986

Italy

July 1986
June, July, Sept.,
1986
1986

Greece,Hungary,
Poland,SwedenPolandComments

1986

20% increase in first-trimester spontaneousabortions
Increased compared to 1985

From 1986

Up to 5%

SwedenDenmark
Hungary
IcelandGermany

1987

Switzerland

Feb. 1987
June 1986

1. GERMANY. Perinatal mortality increased
significantly in 1987 relative to the long-term
trend of the data, 1980–1993. The 1987
increase was 4.8% (P < 0.005) of the expected
proportion of perinatal deaths. Even more pronounced levels of 8.2% (P < 0.05) and 8.5%
(P = 0.0702) can be found in the more heavily contaminated areas of the former German
Democratic Republic, including West Berlin,
and Bavaria, respectively (Scherb and Weigelt,

Auvinen et al., 2001
Frentzel-Beyme andScherb, 2007
Ulstein et al., 1990
Irgens et al., 1991

Ericson and Kallen,
1994
Bertollini et al., 1990
Spinelli and Osborn,
1991; Parazzini
et al., 1988
Semisa, 1988
Scherb et al., 1999

Frentzel-Beyme andScherb, 2007

Up to 10%, in some parts of the country
Up to 20%
Up to 30%
Up to 30%
Increased in Bavaria. Associated with the Cs-137
ground contamination
13% decrease in birth rate in southern Bavaria
Birth rate decreased by 50% in Ticino Canton

7.2.1.4. Other Countries

AuthorScherb et al., 2000
Körblein, 2006
Perucchi and
Domenighetti,
19902000). A highly significant association of perinatal mortality with the Cs-137 burden during pregnancy is found in the combined datafrom West and East Germany (Körblein andKuchenhoff, 1997). Spatial-temporal analysesof the proportion of stillbirths and perinatal
deaths with Cs-137 deposition after the Chernobyl catastrophe in Bavaria on a district level
reveal significant exposure–response relationships (Scherb et al., 2000).
2. POLAND. Perinatal mortality was significantly increased in 1987 relative to the199

Yablokov: Mortality after Chernobyl

TABLE 7.2. Increased Stillbirth Rates, Infant Mortality Rates, and Low Birth Weight Associated with
In Utero Exposure from Chernobyl (mostly by I. Schmitz-Feuerhake, 2006)
Country

Comments

GreeceSwedenIncreased, in some parts up ca. 10%

PolandStillbirth rate increased ca. 5%

NorwayHungary
FinlandIncreased ca. 20%

Germany

England and Wales
Denmark
Iceland
Hungary

Increased twofold in February 1987
Increased 20%
Increased 30%
Increased 30%

long-term trend. Infant mortality monthly
data, 1985–1991, show a significant correlation with the Cs-137 burden during pregnancy(Körblein, 2003, 2006).
3. GREAT BRITAIN. Ten months after thecatastrophe, a significant increase in perinatal mortality was found in the two mostcontaminated areas of the country—Englandand Wales (Bentham, 1991; Busby, 1995; see
Figure 7.7).

References
Scherb and Weigelt, 2003
Scherb and Weigelt, 2003; Frentzel-Beyme andScherb, 2007
Körblein, 2003; Scherb and Weigelt, 2003;
Frentzel-Beyme and Scherb, 2007;
Ulstein et al., 1990
Czeizel and Billege, 1988; Scherb and Weigelt, 2003
Harjulehto et al., 1989, 1991; Scherb and Weigelt,
2003; Frentzel-Beyme and Scherb, 2007
Körblein and Küchenhoff, 1997; Scherb and Weigelt,
2003; Lüning et al., 1989; Grosche et al., 1997;
Scherb et al., 1999; Körblein, 2003a;
Frentzel-Beyme and Scherb, 2007
Bentham, 1991; Busby, 1995
Frentzel-Beyme and Scherb, 2007
Frentzel-Beyme and Scherb, 2007
Frentzel-Beyme and Scherb, 2007

7.2.2. Infant Mortality
7.2.2.1. Ukraine
1. A significant increase in infant mortality was found in 1987–1988 in highly
contaminated territories (Grodzinsky, 1999;
Omelyanets and Klement’ev, 2001). The
main causes of infant death were antenatal pathologies and congenital malformations(Table 7.3).

Figure 7.10. Deviation of perinatal mortality from the long-term trend in Gomel Province
from 1985 to 1998. The columns show the average calculated Sr-90 burden in pregnant
women (Körblein, 2006).

200

Figure 7.11. Perinatal mortality, stillbirth rate, and early neonatal mortality (per 1,000
live births and stillborns) in Zhytomir and Kiev provinces noticeably increased the first year
and again after 3 years after the catastrophe (Dzykovich et al., 2004).

7.2.2.2. Russia

7.2.2.3. Other Countries

1. In 1996 neonatal mortality in more highly
contaminated districts of Bryansk Province wasgreater than in the province as a whole: 7.4 and6.3 per 1,000, respectively (Baleva et al., 2001).
2. In the southwest districts of Bryansk
Province with higher contamination, infantmortality increased after 1986 (see Table 7.4),
whereas in other districts it declined (Utka et al.,2005).
Figure 7.13 shows the deviation of infantmortality in 1987–1989 from a declining longterm trend in Ukraine, Russia, and Belarus.

1. FINLAND. Infant mortality increased significantly immediately after the catastrophe andcontinued to rise until 1993 (Figure 7.14).
2. GERMANY. Infant mortality monthly
data, 1980–1994, show two significant postChernobyl peaks, at the beginning and at theend of 1987 (Figure 7.15).
3. POLAND. Infant mortality monthly data,
1985–1991, show peaks at the beginning andat the end of 1987 (Figure 7.16).
3. SWEDEN. Infant mortality increased
immediately after the catastrophe andFigure 7.12. Deviation of perinatal mortality from the expected long-term trend in the
combined Zhytomir and Kiev provinces and Kiev City, 1985–2004 (Körblein and Omelyanets,
2008).

201

Yablokov: Mortality after Chernobyl
TABLE 7.3. Main Causes of Infant Death(per 1,000 Live Births) in Ukraine, 1990–1995(Grodzinsky, 1999)
Cause

Rate per 1,000

%

4.84
4.26
1.45
1.12

33.0
29.0
9.9
7.6

Antenatal pathologies
Congenital malformations
Respiratory diseases
Infections

increasedsignificantlyin
1989–1992(Figure 7.17).
4. SWITZERLAND. Infant mortality rose tosome extent in 1988 and increased significantly
in 1989 and 1990 (Figure 7.18).
As noted above (Section 7.2.2), a total number of several thousand additional infant deaths
might be expected following the Chernobyl
catastrophe in Europe and other parts of theworld. However, no study will be able to determine the exact number of added deaths because the putative trend without the Chernobyl
catastrophe is unknown.
7.2.3. Childhood Mortality (0–14 Yearsof Age)Figure 7.13. Trend of infant mortality (from topdown) in Ukraine, Russia, and Belarus (//www.
demoscope.ru/weekly/vote/fig_imr11png).

1994. Death from diseases of the nervous system and the sense organs increased by a factorof five and congenital malformations by morethan a factor of two (Grodzinsky, 1999).
2. According to official data, childhood mortality in highly contaminated territories was
4.7% in 1997 and 9.6% among children born toparents who had been irradiated (TASS, 1998).

7.2.3.1. Belarus

7.2.3.3. Russia

1. In Gomel Province, childhood cancers areregistered twice as often in the mortality statistics as in Belarus as a whole and 20-fold more
often than in the least contaminated Vitebsk
Province (Bogdanovich, 1997).

1. In districts of Tula Province with higher
levels of contamination, childhood mortality
was higher than in less contaminated districts(Khvorostenko, 1999).
The childhood death toll from the Chernobyl catastrophe will never be determined
precisely. However, based on the existing fragmentary data, some 10,000 additional childhood deaths can be expected in Belarus,
Ukraine, and Russia.

7.2.3.2. Ukraine
1. Childhood mortality increased from 0.5%
(per 1,000 live born) in 1987 up to 1.2% in
TABLE 7.4. Infant Mortality (per 1,000 Live
Births) in Highly Contaminated Districts of Bryansk
Province, Russia, 1995–1998 (Fetysov, 1999; Komogortseva, 2006)
Highly contaminated districts
Years
Infantmortality

1995
17.2

1996
17.6

1997
17.7

1998
20.0

Province
1998
15.7

7.3. Mortality among Liquidators
The registration of deaths among liquidators
in Ukraine, Russia, and Belarus was not complete in the first years after the Chernobyl catastrophe (see Chapter 1, Section 1.8 for details).
As a rule, the liquidators were healthy young
adults (average age 33 years) so a lower than

202

Figure 7.14. Trend of infant mortality rates in Finland, 1980–2006, and undisturbed
trend line. Based on official statistical data (Körblein, 2008).

Figure 7.15. Deviation of infant mortality from the long-term trend in Germany, 1980–
1994. The peaks of mortality follow peaks of the Cs-137 burden with a time lag of 7 months(Körblein, 2006).

Figure 7.16. Deviation of infant mortality from the long-term trend in Poland, 1985–
1991. The peaks of mortality follow peaks of the Cs-137 burden with a time lag of 7 months(Körblein, 2006).

203

Yablokov: Mortality after Chernobyl

Figure 7.17. Trend in infant mortality rates in Sweden, 1980–2006, and undisturbed
trend line. Based on official statistical data (Körblein, 2008).

average mortality rate among them should be
expected.
7.3.1. Belarus
1. Mortality of male liquidators who worked
in 1986 is higher than liquidators who worked
in 1987 (Borysevich and Poplyko, 2002).
7.3.2. Ukraine
1. The mortality rate of the Ukrainian liquidators from nonmalignant diseases increased
steadily from 1988 to 2003 (Figure 7.19).
2. Total mortality in contaminated territories
and among liquidators increased significantly
from 1987 to 2005 (Figure 7.20).

3. The mortality among male Ukrainianliquidators increased more than fivefold from1989 to 2004, from 3.0 to 16.6 per 1,000,
as compared to mortality rates of 4.1 to 6.0
per 1,000 among other men of working age(Horishna, 2005).
4. After 1995, the mortality of liquidators
exceeded the mortality of the corresponding
population group (Law of Ukraine, 2006).
7.3.3. Russia
1. Ten years after the Chernobyl catastrophe,
the mortality rate among liquidators employed
in 1986 was significantly increased (Ecological
Security, 2002).

Figure 7.18. Trend of infant mortality rates in Switzerland, 1980–2006, and undisturbed
trend line. Based on official statistical data (Körblein, 2008).

204

Figure 7.19. Trend of mortality (per 1,000) of Ukrainian liquidators employed in
1986–1987, from nonmalignant diseases from1988 to 2003 (National Ukrainian Report,
2006).

2. In the Russian National Register, 4,136
deaths were registered from 1991 to 1998 ina cohort of 52,714 liquidators. Only 216 cases(not counting 24 deaths from leukemia from1986 to 1998) are officially accepted as radiation induced (Ivanov et al., 2004).
3. According to official data, already “morethan 10,000 liquidators” had died up until 2001
(National Russian Report, 2001). The standardized mortality ratio (SMR) among this cohort ranges between 0.78 and 0.88 for the categories “all causes,” malignant neoplasm, “allcauses except malignant neoplasm,” and “traumas and poisonings” and does not differ fromcorresponding groups of the general population. Similar results are reported for employ-

Figure 7.20. Total mortality (from all causes,
per 1,000) in contaminated territories of Ukraine
and among liquidators, 1986 to 2006 (Petruk,2006).

ees of the Kurchatov Institute (Shykalov et al.,2002).
4. A significant increase in cancer mortality
was found in 1991–1998 in a cohort of 66,000
liquidators who were exposed (according to official data) to radiation doses of about 100 mSv(Maksyutov, 2002).
5. Figure 7.21 shows data obtained from the
National Register on mortality of liquidatorsfrom nonmalignant causes.
6. According to the nongovernmental organization Chernobyl Union, by 2005 more than
31,700 out of 244,700 Russian liquidators, or
13%, had died (V. V. Grishin, Chernobyl Union
Chairman, pers. comm.).

Figure 7.21. Trend of standardized mortality ratios (SMR) from nonmalignant diseases in liquidators,
1990–1999 (Ivanov et al., 2004: fig. 8.7).

205

Yablokov: Mortality after Chernobyl
TABLE 7.5. Average Age of Deceased Liquidators
Number ofdeathsAverage age atdeath, years

Tolyatti City, Samara Province

163

46.3

Workers in the nuclear industry
Karelian Republic

169
644

45.5
43

Group

7. In the Voronezh Province, of 3,208 liquidators 1,113 (34.7%) have died (source: letter from regional branch of the Chernobyl
Union).
8. In the Karelian Republic, of 1,204 liquidators 644 had died (53%) by the year 2008
(Stolitsa on Onego, 2008).
9. In Angarsk City (Irkutsk Province, Siberia)
up to the year 2007 only about 300 out of 1,300
liquidators were still alive (Rikhvanova, 2007).
10. In Kaluga Province 87% of all liquidators
who died in the first 12 years after the catastrophe were 30 to 39 years old (Lushnykov andLantsov, 1999).
11. In 2001, mortality in male liquidators
was 1.4 to 2.3 times higher than in corresponding age groups of the general population(Gil’manov et al., 2001).
12. According to data from the National
Register, from 1987 to 1996 mortality from malignant neoplasm of the urogenital tract was significantly higher in liquidators under the age of
50 years than in the corresponding age groupin the general population (Kochergyna et al.,2001).
13. The increased mortality results in a comparatively low life expectancy for liquidators(Table 7.5).
14. In 1993, according to the National Register, the three main causes of death amongliquidators were trauma and poisonings (46%),
circulatory diseases (29%), and malignant neoplasm (13%; Ecological Security, 2002).
15. According to the 1999 Registry, among
the Russian liquidators who were employeesof the nuclear industrial complex (14,827 men
and 2,825 women) a significantly increased

Comments
1995–2005, A.Y. calculations fromTymonin data (2005)
1986–1990 (Tukov, 2000)
1986–2008 (Stolitsa on Onego, 2008)

mortality rate was only found in the groups withcirculatory and vegetovascular (autonomic nervous system) diseases (Tukov, 2000).
16. The decline in life expectancy among
the Chernobyl liquidators who were employeesof the nuclear industrial complex (NPPs, othernuclear installations, and atomic scientific institutes) was 16.3% from malignant neoplasms,
25.9% from blood diseases, and 39.6% fromtrauma and poisonings (Ignatov et al., 2001).
17. The data from various sources forcauses of liquidator mortality differ considerably, which indicates that they are of questionable quality (Table 7.6).
The data presented above show that, since
1990, mortality among liquidators exceeded
the rate in corresponding population groups.
By 2005 some 112,000 to 125,000 liquidators
had died, or about 15% of a total cadre of
830,000.
7.4. Overall Mortality
The Chernobyl contamination undoubtedly
caused an increase in overall mortality in thecontaminated areas.
7.4.1. Belarus
1. In 1998, the mortality from malignant
neoplasms for inhabitants of the territories contaminated by Cs-137 at levels higher than 555
kBq/m2 (15 Ci/km2 ) as well as for those who
left such territories after the catastrophe started
to exceed the mortality in the country as awhole (Antypova and Babichevskaya, 2001).

206
TABLE 7.6. Causes of Death (%) of Russian Liquidators in 2000 According to Various Sources
Percentage of the total deaths
Causes of death
Blood and circulatory system pathology
Malignant neoplasm
Gastrointestinal tract pathology
Lung pathology
Trauma and suicide
Tuberculosis
Radiation sickness
Other

Khrysanfov andMeskikh, 2001a

Loskutova, 2002b

Gil’manov et al., 2001c

63
31
7
5
5
3
–
–

45
32
–
–
14
–
1
8

50.9
5.3
5.3
–
26.3
–
–
12.5

a

Data of the official Russian Interdepartmental Advisory Council on the Establishment of a Causal Relationship ofDiseases, Physical Disability and Death of Irradiated Persons.
bData of the Moscow branch of the nongovernmental organization “Widows of Chernobyl” (559 cases).
c
Data of the official Russian National Registry of Liquidators.

2. The average life expectancy of populations living in territories with Cs-137 groundcontamination above 555 kBq/m2 (15 Ci/km2 )was 8 years less than the national average (Antypova and Babichevskaya, 2001).
3. The concentration of radionuclides in thebodies of most (98%) of the 285 persons whodied suddenly in Gomel Province was significantly increased in the heart, the kidneys, andthe liver (Bandazhevsky, 1999).
4. In highly contaminated districts of Gomel
Province, mortality is significantly higher thanin less contaminated areas and higher than in
the rest of Belarus; the mortality rate started torise in 1989 (Figure 7.22).
5. The general mortality rate in Belarus increased from 6.5 to 9.3 per 1,000, that is, by
43%, from 1990 to 2004 (Malko, 2007).

7.4.2. Ukraine
1. After 1986, the general mortality increased significantly in the contaminated territories (IPHECA, 1996; Omelyanets and Klement’ev, 2001; Grodzinsky, 1999; Kashyryna,
2005; Sergeeva et al., 2005).
2. According to official data, the generalmortality rate in the heavily contaminated territories was 18.3 per 1,000 in 1999, some 28%
higher than the national average of 14.8 per
1,000 (Reuters, 2000).
3. In contaminated territories and amongevacuees, cancer mortality increased by 18 to
22% from 1986 to 1998 as compared to 12%
in Ukraine as a whole (Omelyanets and Klement’ev, 2001; Golubchykov et al., 2002). Mortality from prostate cancer increased by a factor

Figure 7.22. Trends in mortality rates (per 1,000) in several regions of Belarus. The
highest mortality rates are found in the most contaminated districts of Gomel Province, andthe increase after 1989 was greatest in Gomel Province (Rubanova, 2003).

207

Yablokov: Mortality after Chernobyl
TABLE 7.7. Causes of Death in ContaminatedTerritories of Ukraine, 1996 (Grodzinsky, 1999)
Cause of death

Percentage

Blood diseases
Oncological diseases
TraumasRespiratory diseases
Diseases of the digestive tract

61.2
13.2
9.3
6.7
2.2

of 2.2 in contaminated territories and by a factor of 1.3 in Ukraine as a whole (Omelyanets
and Klement’ev, 2001).
4. In 1996, the primary causes of deathamong inhabitants of contaminated territories were circulatory and oncological diseases(Table 7.7).
7.4.3. Russia
1. From 1994 to 2004, the general mortality in highly contaminated districts of Bryansk
Province increased by 22.5%, primarily in theage group 45–49 years, where it increased by
87%. The general mortality in highly contaminated districts was 23 to 34% higher than theprovince average (Kashyryna, 2005; Sergeeva
et al., 2005; Table 7.8).
2. The general mortality in Lipetsk City,
where Cs-137 ground contamination is lessthan 5 Ci/km2 , increased by 67% from 1986
to 1995 (from 7.5 to 12.6 per 1,000; Krapyvin,1997).
3. General mortality in the Klintsy district of
the Bryansk Province, 1997 to 1999, was correTABLE 7.8. General Mortality (per 1,000) in theThree Most Contaminated Districts of the Bryansk
Province, and in Russia, 1995–1998 (Fetysov,
1999)
Highly contaminateddistricts
Year
1995 1996 1997 1998
General16.7 17.0 18.2 17.7
mortality

Province Russia
1998
16.3

1997
13.8

lated with Cs-137 ground contamination. Principal causes of the increased mortality were cardiovascular diseases (60%) and cancers (10.6%;
Sukal’skaya et al., 2004).
7.5. Calculations of General
Mortality Based on the
Carcinogenic Risks
Based on different risk factors (excess risk
per unit dose), various authors have estimatedthe number of additional cancer deaths due toChernobyl (Table 7.9). The estimates presented
in Table 7.9 cover a range that spans two orders of magnitude. This wide range far exceeds
the usual scientific uncertainty. Therefore, estimates of the damage to health from exposure toradiation should be interpreted with due caution given the existing state of knowledge (seeChapter 2 for details).
7.6. Calculations of General
Mortality
An estimate of the additional mortality from
Chernobyl is possible on the basis of a comparison of mortality rates in highly contaminatedterritories and in less contaminated ones—
so called “clean” areas (Rubanova, 2003;
Sergeeva et al., 2005; Khudoley et al., 2006;
and others).
From 1985 to 2001, the standardized mortality ratio increased in the less contaminatedGrodno and Vitebsk provinces of Belarus by
37.4 to 43.1%, and in the heavily contaminatedGomel Province by 59.6%. The socioeconomicand ethnic conditions in these areas are similar;
the only difference is in the level of contamination. Therefore, the observed differences
in mortality increase (16 to 22%) can be attributed to the Chernobyl radiation (Rubanova,
2003).
There are essentially six Russian provinceswith considerable contamination from the
Chernobyl fallout (Tula, Bryansk, Oryol,

208
TABLE 7.9. Estimates of the Number of Cancer Deaths Resulting from the Radionuclides Cs-134,
Cs-137, and Sr-90 Released from the Chernobyl Reactor
Number of deaths

AuthorComments

4,000

Press release to the Chernobyl Forum (2005)

8,930

Chernobyl Forum (2006)

14,000∗17,40028,00030,000∗30,000–60,000
93,080180,000
495,000
899,310–1,786,657

Nuclear Regulatory Commission, USA
Anspaugh et al. (1988)
U.S. Department of Energy (Goldman, 1987)
UNSCEAR (Bennett, 1996)
Fairlie and Sumner (2006)
Malko (2007)
Malko (2007)
Gofman (1994a,b)Bertell (2006)

90 years, Belarus, Ukraine, European partof Russia
90 years, Belarus, Ukraine, European partof Russia
For all time, entire world
50 years, entire world
50 years, entire world
For all time, entire world
For all time, entire world
70 years, entire world
70 years, all Chernobyl causes
For all time, entire world
For all time, all radionuclides, entire world∗

From J. Fairlie and D. Sumner (2006: table 6.2).

Ryazan, Kursk, and Kaluga), which had a total
population of 7,418,000 in 2002 (study region).
In 1999, more than 5% of this population lived
in highly contaminated districts. The mortality
rates in these regions were compared with theRussian average and with the rate in six neighboring (officially) less contaminated provinceswith similar geographical and socioeconomic
status (Smolensk, Belgorod, Lipetsk, Tambov,
and Vladimir provinces and the Republic ofMordova) with a total population of 7,832,000
in 2002 (control region; Khudoley et al., 2006).
In the region under study the general mortality, as well as the increased rate in mortality, exceeded the Russian average. Table 7.10
shows the raw and the age-standardized mortality rates in the six contaminated provinces.
Both the observed and the age standardizedmortality rates exceed the Russian average(Table 7.10). In Figure 7.23 the standardized mortality rates in the six contaminatedprovinces combined are compared with themortality rates in the control region. The total
number of additional deaths from Chernobyl
in the area under study, calculated on the basisof the standardized mortality rates, is estimatedat 60,400 (95% CI: 54,880 to 65,920).
A similar result is obtained when highly
and less contaminated regions are compared.

Figure 7.24 shows the standardized mortality rates for the neighboring Tula and Lipetsk
provinces. The resulting number of about
60,400 additional deaths from 1990 to 2004
in the area under study, corresponding to 34
persons per 1,000, reveals the true dimensionof the death toll from the Chernobyl catastrophe. From 1990 to 2004 the number of additional deaths represents 3.75% of the entire population of the contaminated territories.
This finding agrees well with the figure of 4.2%
for Ukraine given in the National Ukrainian
Report for 2006.

TABLE 7.10. Observed (Raw) and AgeStandardized Mortality Rates (per 1,000) in
the Six Most Contaminated Regions of Russia,
2002 (Khudoley et al., 2006)
Mortality
RegionObserved

Standardized

Tula
Bryansk
Oryol
RyazanKursk
Kaluga
Total

21.9
19.3
18.6
20.6
19.3
18.8

19.6
18.0
18.1
19.3
18.5
17.7
16.2

Yablokov: Mortality after Chernobyl

Figure 7.23. Difference in standardized mortality rates in the combined six most contaminatedprovinces and in the control region. “Zero” is theRussian average (Khudoley et al., 2006).

For the populations in all the contaminated territories together (in European Russia
1,789,000 (1999), in Belarus 1,571,000 (2001),
and in Ukraine 2,290,000 (2002; Khudoley
et al., 2006)), and based on the additional rate in
Russia, the total number of extra deaths from
Chernobyl in Belarus, Ukraine, and the European part of Russia is estimated to be 212,000
for the first 15 years after the catastrophe(Table 7.11).
This calculation seems straightforward, but it
might underestimate the real figures for several
reasons:•

Official data about the radioactive contamination for Belgorod and Lipetsk
provinces do not correlate with corresponding changes in health statistics after
Chernobyl. It means that the differences inmortality between contaminated and noncontaminated populations that were foundby Khudoley et al. (2006) might actually bemore pronounced. If so, the Ukrainian figure of 4.2% for the mortality rate may be
more realistic than the 3.75% determinedin Russia.
• It is well known (see Chapter 1 for details)
that there was considerable contamination(sometimes more than 1 Ci/km2 ) not only

209

Figure 7.24. Standardized mortality rates,
1983–2003, in the more contaminated Tula
Province, the less contaminated Lipetsk Province, andin Russia as a whole (Khudoley et al., 2006).

in the six regions mentioned above but also
in 16 regions of the European part of Russia. This means that the total death toll for
Russia is higher than estimated by Khudoley et al. (2006).
• All the calculations by Khudoley et al.
(2006) cover a 15-year period (1990–2004).
However, the radioactive contaminationfrom Chernobyl had adverse health effects
before 1990 and will continue for many
years into the future.
7.7. What Is the Total Number ofChernobyl Victims?
The Chernobyl Forum (WHO, 2006) calculated a total number of 9,000 cancer deaths
in Belarus, Ukraine, and Russia that can be
attributed to the Chernobyl catastrophe for aperiod of 90 years after the meltdown.
Table 7.9 showed forecasts of the expected
number of additional instances of cancer owing
to the Chernobyl catastrophe. All projections
are based on risk factors for cancer. It is wellknown, however, that cancer is not the only
and not even the most frequent lethal effect ofradiation (see, e.g., Table 7.7).

210
TABLE 7.11. Number of Additional Deaths in Belarus, Ukraine, and the European Part of Russia,
1990–2004, that Can Be Attributed to the Chernobyl Catastrophe (Khudoley et al., 2006)
Region/Country
European Russia

Belarus

UkraineTotal

1,789,000
67,0001,571,000
59,0002,290,000
86,0005,650,000
212,000

Population living in highly contaminated territories
Number of additional deaths

The assumptions concerning nonmalignant
radiation risks differ even more than forradiation-induced cancers. Risk projections
based on observed increases in the general mortality are more meaningful, and they are likely
to be more realistic than calculations that only
use individual and/or collective doses together
with risk factors for fatal cancers.
Based on data presented in Section 7.6, it ispossible to estimate the total death toll from the
Chernobyl catastrophe:•

When we apply the additional mortality of 34 extra deaths per 1,000 population within 15 years (1990–2004), which
was derived above, to the cohort of liquidators not living in contaminated zones(400,000), to the evacuees and to people
who moved away from contaminated areas(350,000), then we expect another 25,500
deaths in this period. The overall numberof Chernobyl-related deaths up until 2004
in Belarus, Ukraine, and Russia was estimated to be 237,500.
• Assuming that 10 million people in Europe, outside the Former Soviet Union,
live in territories with a Cs-137 groundcontamination higher than 40 kBq/m2(>1.08 Ci/km2 ) and that the mortality risk
is only half that determined in the Chernobyl region, that is, 17 deaths per 1,000
inhabitants (better food and better medical and socioeconomic situations), up until
2004, we can expect an additional 170,000
deaths in Europe outside the Former Soviet Union owing to Chernobyl.
• Let us further assume that for the other
150 million Europeans living in territories

with a Cs-137 ground contamination below 40 kBq/m2 (see Chapter 1 for details)
the additional mortality will be 10-foldless (i.e., 1.7 deaths per 1,000 in 1990–
2004). Then we can expect 150,000 ×
1.7 or 255,000 more deaths in the rest ofEurope.
• Assuming that 20% of the radionuclides
released from the Chernobyl reactor were
deposited outside Europe (see Chapter
1) and that the exposed population was
190 million, with a risk factor of 1.7 per
1,000 as before, we could have expected
an additional 323,000 cancer deaths outside Europe until 2004.
Thus the overall mortality for the period
from April 1986 to the end of 2004 fromthe Chernobyl catastrophe was estimated at
985,000 additional deaths. This estimate of thenumber of additional deaths is similar to thoseof Gofman (1994a) and Bertell (2006). A projection for a much longer period—for many future
generations—is very difficult. Some counterdirected aspects of such prognoses are as
follows:•

Given the half-life of the two main radionuclides (Cs-137 and Sr-90) of approximately 30 years each, the radionuclide
load in the contaminated territories will
decrease about 50% for each human generation. The concentrations of Pu, Cl-36,
and Tc-99 will remain practically the same
virtually forever (half-lives consequently
more than 20,000 and 200,000 years), andthe concentration of Am-241, which is adecay product of Pu-241, will increase over
several generations.

Yablokov: Mortality after Chernobyl•

The genetic damage among descendantsof irradiated parents will propagate in the
population and will carry through many
(at least seven) generations.
• Fertility is known to decrease after exposure to radiation (Radzikhovsky and Keisevich, 2002).
• A radiation adaptation process may occur(the effect is known from experiments withmammals) (Yablokov, 2002).
7.8. Conclusion
There are many findings of increased antenatal, childhood, and general mortality in thehighly contaminated territories that are mostprobably associated with irradiation from the
Chernobyl fallout. Significant increases in cancer mortality were observed for all irradiatedgroups.
A detailed study reveals that some 4% of alldeaths from 1990 to 2004 in the contaminatedterritories of Ukraine and Russia were causedby the Chernobyl catastrophe. The lack of evidence of increased mortality in other affected
countries is not proof of the absence of adverse
effects of radiation.
The calculations in this chapter suggest that
the Chernobyl catastrophe has already killed
several hundred thousand human beings ina population of several hundred million thatwas unfortunate enough to live in territories affected by the Chernobyl fallout. The numberof Chernobyl victims will continue to grow in
the next several generations.
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global impact of the Chernobyl reactor accident.
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Conference. Medical Consequences of the Chernobyl Accident: The Results of 15 Years of Investigations. June 4–8, Kiev, Ukraine (Abstracts, Kiev): pp. 152–153 (inRussian).

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CHERNOBYL

Conclusion to Chapter II

Morbidity and prevalence of the separate specific illnesses as documented in Chapter II,
parts 4, 5, 6, and 7 still do not give a complete
picture of the state of public health in the territories affected by Chernobyl. The box below
documents the health of the population in thesmall Ukrainian district of Lugini 10 years after the catastrophe. Lugini is located about 110
km southwest of the Chernobyl Nuclear Power
Plant in Zhytomir Province and has radioactive
contamination at a level above 5 Ci/km2 .
There are tens of similarly contaminated territories in Belarus, Ukraine, European Russia,
Sweden, Norway, Turkey, Austria, South
Germany, Finland, and other European countries. However, Lugini is unique not only because the same medical staff used the same
medical equipment and followed the same protocols that were used before and after thecatastrophe, but also because the doctors collected and published these facts (Godlevsky andNasvit, 1999).

DETERIORATION IN PUBLIC HEALTH IN ONE
UKRAINIAN DISTRICT 10 YEARS AFTER THE
CATASTROPHEDistrict Lugini (Ukraine). The population in 1986:
29,276 persons, in 1996: 22,552 (including 4,227
children). Out of 50 villages 22 were contaminatedin 1986 at a level 1–5 Ci/km2 and 26 villages at alevel under 1 Ci/km2 .
Lifespan from the time of diagnosis of lung or stomach
cancer:Years 1984–1985: 38–62 months
Years 1995–1996: 2–7.2 months
Initial diagnosis of active tuberculosis (percentage of primary diagnosed tuberculosis):
Years 1985–1986: 17.2–28.7 per 100,000
Years 1995–1996: 41.7–50.0 per 100,000
Endocrine system diseases in children:
Years 1985–1990: 10 per 1,000
Years 1994–1995: 90–97 per 1,000

Cases of goiter, children:
Up to 1988: not foundYears 1994–1995: 12–13 per 1,000
Neonatal mortality (0–6 days after birth):
Years 1984–1987: 25–75 per 1,000 live births
Years 1995–1996: 330–340 per 1,000 live births
General mortality:
Year 1985: 10.9 per 1,000
Year 1991: 15.5 per 1,000Life expectancy:
Years 1984–1985: 75 years
Years 1990–1996: 65 years

Figure 1 presents data on the annual numberof newborns with congenital malformations in
Lugini districts. There was an increase in thenumber of such cases seen despite a 25% decrease in the total of Lugini population from1986 to 1996.
In the radioactive-contaminated territories
there is a noticeable increase in the incidence ofa number of illnesses and in signs and symptoms
that are not in official medical statistics. Amongthem there are abnormally poor increasein children’s weight, delayed recovery after
illnesses, frequent fevers, etc. (see Chapter II.5,
Section 5.2).
The Chernobyl catastrophe has endowed
world medicine with new terms, among them:•

The syndrome known as “vegetovascular dystonia” (autonomic nervous system dysfunction): functional disturbanceof nervous regulation of the cardiovascularsystem with various clinical findings arisingon a background of stress.
• The syndrome known as “incorporated
long-living radionuclides” (Bandazhevsky,
1999) that includes pathology of the cardiovascular, nervous, endocrine, reproductive, and other systems as the result of the

217

218

Figure 1. Absolute number of the congenital developmental anomalies in newborns in
Lugini District, Zhytomir Province, Ukraine, from 1983 to 1996 (Godlevsky and Nasvit, 1999).

accumulation of more than 50 Bq/kg of
Cs-137 and Sr-90 in a person.
• The syndrome known as “sharp inhalation effect of the upper respiratory path”(Chuchalin, 2002): a combination of arhinitis, scratchy throat, dry cough, andshortness of breath with physical activity
connected to the impact of inhaled radionuclides, including “hot particles.”Some of the earlier known syndromes havean unprecedented wide incidence of occurrence. Among them is the syndrome known
as “chronic fatigue” (Lloyd et al., 1988), which
manifests as tiredness, disturbed dreams, periodic depression and dysphoria, fatigue without cause, impaired memory, diffuse muscular
pains, pains in large joints, shivering, frequentmood changes, cervical lymph node sensitivity, and decreased body mass. It is postulated
that these symptoms are a result of impaired
immune system function in combination withdisorders of the temporal–limbic parts of thecentral nervous system. These include: (a) the
syndrome called “lingering radiating illness”(Furitsu et al., 1992; Pshenichnykov, 1996), a
combination of unusual weariness, dizziness,trembling, pains in the back, and a humeral
belt, originally described in the hibakusha (survivors of Hiroshima and Nagasaki) and (b)the syndromes comprising choreoretinopathy,changes in retinal vessels, called “incipient

chestnut syndrome” and “diffraction grating
syndrome” (Fedirko, 1999, 2002).
Among conditions awaiting full medical description are other constellations of diseases,
including “irradiation in utero,” “Chernobyl
AIDs,” “Chernobyl heart,” “Chernobyl dementia,” and “Chernobyl legs.”
Chernobyl’s radioactive contamination atlevels in excess of 1 Ci/km2 (as of 1986–1987)
is responsible for 3.8–4.4% of the overall mortality in areas of Russia, Ukraine, and Belarus.
In several other European countries with contamination levels around 0.5 Ci/km2 (as of
1986–1987), the mortality is about 0.3–0.7%(see Chapter II.7). Reasonable extrapolation
for additional mortality in the heavily contaminated territories of Russia, Ukraine, and Belarus brings the estimated death toll to about
900,000, and that is only for the first 15 years
after the Chernobyl catastrophe.
Chernobyl’s contribution to the general morbidity is the determining factor in practically all
territories with a level of contamination higher
than 1 Ci/km2 . Chronic diseases of various etiologies became typical not only for liquidators
but also for the affected populations and appear
to be exacerbated by the radioactive contamination. Polymorbidity, the presence of multiple
diseases in the same individual, has become acommon feature in the contaminated territories. It appears that the Chernobyl cancer toll
is one of the soundest reasons for the “cancer

219

Yablokov et al.: Conclusion to Chapter II

epidemic” that has been afflicting humankind
since the end of the 20th century.
Despite the enormous quantity of data concerning the deterioration of public health in theaffected territories, the full picture of the catastrophe’s health impact is still far from complete.
To ascertain the total complex picture of thehealth consequences of the Chernobyl catastrophe we must, first of all:•Expand, not reduce, as was recently
done in Russia, Ukraine, and Belarus, medical, biological, and radiologicalstudies.
• Obtain correct reconstruction of individual doses, differentiated by the contribution of various radionuclides from bothinternal and external irradiation levels, ascertain personal behavior and habits, andhave a mandatory requirement to determine correct doses based on chromosome
and tooth enamel analysis.
• Perform comparative analyses of monthly
medical statistics before and after thecatastrophe (especially for the first years after the catastrophe) for the administrative
units (local and regional) that were contaminated with various levels of particularradionuclides.
The constantly growing volume of objective scientific data about the negative consequences of the Chernobyl catastrophe for public health, not only for the Former Soviet Union
but also in Sweden, Switzerland, France, Germany, Italy, Turkey, Finland, Moldova, Romania, The Czech Republic, and other countries are not a cause for optimism (details in
Chapter II, parts 4–7). Without special largescale programs of mitigation and preventionof morbidity and consequent mortality, theChernobyl-related diseases linked to contamination that began some 23 years ago will continue to increase.
There are several signals to alert publichealth personnel in territories that have been
contaminated by the Chernobyl fallout in
Belarus, Ukraine, and Russia:•

An absence of a correlation between current average annual doses with doses received in 1986–1987.
• A noticeable growing contribution to a collective dose for individuals in zones with alow level of contamination.
• Increasing (instead of decreasing as was
logically supposed) levels of individual irradiation for many people in the affected
territories.
• A need to end the demand for a 20-year latency period for the development of cancer(skin, breast, lung, etc.). Different cancers
have different latencies following exposure
to various and differing carcinogenic exposures. Juvenile victims are an obvious
example.
As a result of prolonged immune system suppression there will be an increase in manyillnesses. As a result of radiation damage tothe central nervous system in general and to
temporal–limbic structures in the brain there
will be more and more people with problems ofintellectual development that threatens to cause
loss of intellect across the population. As a result of radio-induced chromosomal mutations
a spectrum of congenital illnesses will become
widespread, not only in the contaminated territories but also with migration over many areas
and over several generations.
References
Bandazhevsky, Yu. I. (1999). Pathology of incorporated
ionizing radiation (Belarussian Technological University, Minsk): 136 pp. (in Russian).
Chernobyl Forum (2005). Chernobyl’s Legacy: Health, Environmental and Socio-economic Impacts. Highlights of theChernobyl Forum Studies (IAEA, Vienna): 47 pp.
Chuchalin, A. G. (2002). Functional condition of liquidators’ pulmonary system: 7-years follow up study. Pulmonology 4: 66–71 (in Russian).
Fedirko, P. (1999). Chernobyl accident and the eye: someresults of a prolonged clinical investigation. Ophthalmology 2: 69–73.
Fedirko, P. (2002). Clinical and epidemiological studies of eye occupational diseases in the Chernobyl
accident victims (peculiarities and risks of eye

220pathology formation, prognosis). M.D. Thesis (Institute of Occupational Health, Kiev): 42 pp. (inUkrainian).
Furitsu, K., Sadamori, K., Inomata, M. & Murata
S. (1992). Underestimated radiation risks and ignored injuries of atomic bomb survivors in Hiroshima and Nagasaki. The Investigative Committee of Hibakusha of Hannan Chuo Hospital:
24 pp.
Godlevsky, I. & Nasvit, O. (1999). Dynamics of Health
Status of Residents in the Lugini District after the

Accident at the ChNPS. In: Imanaka, T. (Ed.). Recent
Research Activities about the Chernobyl NPP Accident inBelarus, Ukraine and Russia. KURRI-KR-79 (Kyoto
University, Kyoto): pp. 149–157.
Lloyd, A. R., Hales, J. P. & Gandevia S. C. (1988). Muscle strength, endurance and recovery in the postinfection fatigue syndrome. J. Neurol. Neurosurg. Psychiat. 51(10): 1316–1322.
Pshenichnykov, B. V. (1996). Low dose radioactive irradiation and radiation sclerosis (“Soborna Ukraina,”
Kiev): 40 pp. (in Russian).

CHERNOBYL

Chapter III. Consequences of the Chernobyl
Catastrophe for the Environment
Alexey V. Yablokov,a Vassily B. Nesterenko,band Alexey V. Nesterenkobab

Russian Academy of Sciences, Moscow, Russia
Institute of Radiation Safety (BELRAD), Minsk, Belarus

Key words: Chernobyl; radionuclides; radiolysis; soil; water ecosystems; bioaccumulation; transition ratio; radiomorphosis

The level of radioactivity in the atmosphere,
water, and soil in the contaminated territories will determine the eventual level ofradiation of all living things, both directly
and via the food chain. Patterns of radioactive contamination essentially change when
the radionuclides are transferred by water,
wind, and migrating animals. Land and bodies of water that were exposed to little orno contamination can become much morecontaminated owing to secondary transfer.
Many Russian-language publications have documented such radionuclide transfers, as well
as changes in concentration and bioaccumulation in soil and water affecting various animals and plants (see, e.g., the reviews by Konoplya and Rolevich, 1996; Kutlachmedov andPolykarpov 1998; Sokolov and Kryvolutsky,
1998; Kozubov and Taskaev, 2002). The influence of Chernobyl radionuclide fallout on
ecosystems and populations of animals, plants,
and microorganisms is well documented.
In Chapters I and II we repeatedly emphasize that we do not present all of the available
data on the consequences of Chernobyl, but
only selected parts to reflect the many problems
and to show the enormous scale of the contamination. In Chapter III as well we have included
only part of the material concerning the impactof the catastrophe on the biosphere—on faunaand flora, on water, air, and soil. We emphasizethat like the consequences for public health,which are not declining but rather increasing inscope and severity, the consequences for nature
are neither fully documented nor completely
understood and may also not decline.
Cs-137 is removed from ecological foodchains a hundred times more slowly than waspredicted right after the catastrophe (Smithet al., 2000; and others). “Hot” particles
have disintegrated much more rapidly than
expected, leading to unpredictable secondary
emissions from some radionuclides. Sr-90 andAm-241 are moving through the food chainsmuch faster than predicted because they areso water soluble (Konoplya, 2006; Konoplya
et al., 2006; and many others). Chernobyl radioactive contamination has adversely affected
all biological as well as nonliving components ofthe environment: the atmosphere, surface andground waters, and soil.
References
Konoplya, E. F. (2006). Radioecological, medical and biological consequences of the Chernobyl catastrophe.
In: Fifth Congress of Radiation Research on Radiobiology, Radioecology and Radiation Safety, April
10–14, 2006, Moscow, (Abstracts, Moscow) 2: pp.
101–102 (in Russian).
Konoplya, E. F. & Rolevich, I. V. (Eds.) (1996). Ecological,
Biological, Medical, Sociological and Economic Consequencesof Chernobyl Catastrophe in Belarus (Minsk): 281 pp. (inRussian).
Konoplya, E. F., Kudryashov, V. P. & Grynevich, S.
V. (2006). Formation of air radioactive contamination in Belarus after the Chernobyl catastrophe.
International Scientific and Practical Conference.

221

222
Twenty Years of Chernobyl Catastrophe: Ecological andSociological Lessons. June 5, 2006, Moscow (Materials, Moscow): pp. 91–96 (//www. ecopolicy.ru/upload/File/conferencebook_2006.pdf) (inRussian).
Kozubov, G. M. & Taskaev, A. I. (2002). RadiobiologicalStudy of Conifers in a Chernobyl Catastrophic Area (“DIK,”
Moscow): 272 pp. (in Russian).
Kutlachmedov, Yu. A. & Polykarpov, G. G. (1998). Med-

ical and Biological Consequences of the Chernobyl Accident(“Medecol,” Kiev): 172 pp. (in Russian).
Smith, J. T., Comans, R. N. J., Beresford, N. A., Wright,
S. M., Howard, B. J. & Camplin, W. C. (2000). Contamination: Chernobyl’s legacy in food and water.
Nature 405: p. 141.
Sokolov, V. E. & Kryvolutsky, D. A. (1998). Change in Ecology and Biodiversity after a Nuclear Disaster in the Southern
Urals (“Pentsoft,” Sofia/Moscow): 228 pp.

CHERNOBYL

8. Atmospheric, Water, and Soil
Contamination after Chernobyl
Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko

Air particulate activity over all of the Northern Hemisphere reached its highest levels
since the termination of nuclear weapons testing—sometimes up to 1 million times
higher than before the Chernobyl contamination. There were essential changes in theionic, aerosol, and gas structure of the surface air in the heavily contaminated territories, as measured by electroconductivity and air radiolysis. Many years after thecatastrophe aerosols from forest fires have dispersed hundreds of kilometers away. The
Chernobyl radionuclides concentrate in sediments, water, plants, and animals, sometimes 100,000 times more than the local background level. The consequences of such ashock on aquatic ecosystems is largely unclear. Secondary contamination of freshwater ecosystems occurs as a result of Cs-137 and Sr-90 washout by the high waters ofspring. The speed of vertical migration of different radionuclides in floodplains, lowland moors, peat bogs, etc., is about 2–4 cm/year. As a result of this vertical migrationof radionuclides in soil, plants with deep root systems absorb them and carry the ones
that are buried to the surface again. This transfer is one of the important mechanisms,
observed in recent years, that leads to increased doses of internal irradiation amongpeople in the contaminated territories.

8.1. Chernobyl’s Contaminationof Surface Air
Data below show the detection of surface
air contamination practically over the entire
Northern Hemisphere (see Chapter I for relevant maps).
8.1.1. Belarus, Ukraine, and Russia
There are many hundreds of publications
about specific radionuclide levels in the Former
Soviet Union territories—of which the data below are only examples.
1. Immediately after the first explosion in
the Chernobyl Nuclear Power Plant (NPP) on

Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

April 26, 1986, the concentrations of the primary radionuclides changed drastically fromplace to place and from day to day (Table 8.1).
2. Table 8.2 indicates the dynamics of theaverage annual concentration of some radionuclides in the atmosphere near the Chernobyl
NPP.
3. There were essential changes in theionic, aerosol, and gas structure of the surface air in the catastrophe zone. A year later,
within a 7-km zone of the Chernobyl NPP,
the electroconductivity of the air at groundlevel was 240–570 times higher than in theless contaminated territories several hundred
kilometers away (Smirnov, 1992). Outside of
the 30-km zone air radiolysis depressed theecosystems. Concentrations of ionized surface air in the contaminated territories near
the Chernobyl NPP repeatedly exceeded thislevel in Kaluga Province, Russia, and Zhytomir Province, Ukraine, by 130- to 200-fold(Kryshev and Ryazantsev, 2000).

223

224
TABLE 8.1. Concentration (Bq/m3 ) of Some Radionuclides on April 29–May 1, 1986, in Belarus(Minsk City) and Ukraine, Kiev Province (Kryshev
and Ryazantsev, 2000)

Radionuclide
Te-132
I-131
Ba-140Cs-137
Cs-134
Se-141
Se-144
Zr-95
Ru-103

Minsk City,
April 28–29

Baryshevka,
Kiev Province,
April 30–May 1

74
320
27
93
48
–
–
3
16

3,300
300
230
78
52
26
26
24
24

4. From April to May 1986 surface air radioactivity in Belarus increased up to 1 million times. There was a subsequent gradual decrease until the end of 1986 and thenthe rate fell sharply. In the Berezinsk Nature Reserve (400 km from Chernobyl) on
April 27–28, 1986, the concentrations of I131 and Cs-137 in the air reached 150–
200 Bq/m3 and 9.9 Bq/m3 , respectively. In
1986 in Khoinyki, the midyear concentration of Cs-137 in the surface air was 3.2 ×
10−2 Bq/m3 and in Minsk it was 3.8 ×
10−3 Bq/m3 , levels that are 1,000 to 10,000
times higher than precatastrophe concentrations, which were below 10−6 Bq/m3 . Midyear
concentration of Pu-239 and Pu-240 in surface air in 1986 for Khoinyki was 8.3 × 10−6
Bq/m3 and for Minsk it was 1.1 × 10−6 Bq/
m3 , levels that were 1,000 times higher
than the precatastrophe concentrations, whichwere measured at less than 10−9 Bq/m3(Gres’, 1997). The half-life period to cleanse
the surface air of Pu-239 and Pu-240 was
14.2 months, and for Cs-137 it took up to
40 months (Nesterenko, 2005). Noticeably highlevels of radionuclides in surface air weredetected many years after the catastrophe(Figure 8.1).
5. Surface atmospheric radioactivity rises
markedly after some agricultural work (tilling,

TABLE 8.2. Dynamics of the Concentration ofSome Radionuclides (Bq/m3 ) in the Chernobyl
City Atmosphere, 1986–1991 (Kryshev et al.,
1994)
Year

Sr-90

Ru-106

Cs-137

Se-144

1986, July–
December
1987
1988
1989
1990
1991

n/a

13,0005,000

34,000

n/a
430
130
52
52

4,000
400
–
–
–

2,000
600
90
80
100

12,000
1,400
160
–
–

harrowing, etc.) and other dust-creating activities. There is a tendency for radionuclide levels
in surface air to increase during the spring andsummer months, especially during dry weather.
6. Levels of radioactive contamination of
the surface air in Belarus has three dynamic
components: (1) the general radioecological situation; (2) cyclical, connected with seasonalchanges (e.g., agricultural activities); and (3) incidental, as a consequence of numerous anthropogenic and natural factors. The incidental component was strongly demonstrated in
1992, when there were raging forest fires over
all of Belarus. Their impact on the radioactive
level in the atmosphere was so great that it led
to a significant increase in the midyear concentration of radionuclides in surface air andmost probably in human contamination via inhalation. In territories with a high density ofground-level radioactive contamination (in soil,
water, vegetation) the hot air resulting from thefires caused radionuclides to be carried up to aheight of 3 km and transported over hundredsof kilometers (Konoplia et al., 2006).
7. In Russia beta-activity originating from
Chernobyl was detected several days after
April 26, 1986, in Bryansk, Tula, Kaluga,
Oryol, Voronezh, Smolensk, and Nizhni Novgorod (Gor’ky); also in Rostov, Tambov, andPenza provinces in the Karelia Republic in
the European part of the county; in Ural
(Sverdlovsk Province); and in the far eastern
sector (Khabarovsk and Vladivostok), and in

225

Yablokov et al.: Atmospheric, Water, and Soil Contamination

Figure 8.1. Dynamics of the radionuclides Pu-239, Pu-240, and Cs-137 in the surface
air in Khoiniky, Belarus, 1990–2004 (Konoplya et al., 2006).

some places was more than 10,000 times higher
than the precatastrophe levels (Kryshev andRyazantsev, 2000).
8. Several years after the catastrophe, secondary radioactive contamination from dust
and aerosols became the important factor. On
September 6, 1992, radioactive aerosols liftedby a strong wind from the 30-km Chernobylzone reached the vicinity of Vilnius, Lithuania(about 300 km away) in 5–7 h, where the Cs137 concentration increased 100-fold (Ogorodnykov, 2002). The same scale of radionuclide
dispersion occurs in the wake of forest fires
that at times rage over large areas of the contaminated territories of Belarus, Russia, andUkraine.
8.1.2. Other Countries
Below are some examples of Chernobyl’s radioactive contamination of the atmosphere in
the Northern Hemisphere.
1. CANADA. Three Chernobyl clouds entered eastern Canada: the first on May 6,
1986; the second around May 14; the third on
May 25–26. The fallout included: Be-7, Fe-59,
Nb-95, Zr-95, Ru-103, Ru-106, Cs-137, I-131,
La-141, Ce-141, Ce-144, Mn-54, Co-60, Zn65, and Ba-140 (Roy et al., 1988).
2. DENMARK. From April 27 to 28 themean air concentration of Cs-137 was 0.24

Bq/m3 ; Sr-90, 5.7 mBq/m3 ; Pu-239 + Pu-240,
51 Bq/m3 ; and Am-241, 5.2 μBq/m3(Aarkrog, 1988).
3. FINLAND. The most detailed accounting of
the Chernobyl radionuclide fallout during thefirst days after the catastrophe was in Sweden
and Finland (Table 8.3).
4. JAPAN. Two Chernobyl radioactive clouds
were detected over Japan: one at a height ofabout 1,500 m in the first days of May 1986
and the other at a height of more than 6,000 m
at the end of May (Higuchi et al., 1988). Up
to 20 radionuclides were detected in the surface air, including Cs-137, I-131, and Ru-103.

TABLE 8.3. Airborne Radioactivity (mBq/m3 ) of
19 Radionuclides in Finland, Nurmijarvi, April 28,
1986 (Sinkko et al., 1987)
NuclideActivity

NuclideActivity

I-131
I-133
Te-132
Cs-137
Cs-134Ba-140Te-129m
Ru-103
Mo-99
Cs-136
Np-239223,000
48,00033,00011,900
7,200
7,000
4,000
2,880
2,440
2,740
1,900

Te-131m
Sb-127
Ru-106Ce-141
Cd-115
Zr-95
Sb-125
Ce-143
Nd-147
Ag-110m

1,700
1,650
630
570
400
380
253
240
150
130

226

Concentrations of Cs-131/Cs-134/Cs-137 in
the surface air northwest of Japan increased
more than 1,000 times (Aoyama et al., 1986;
Ooe et al., 1988). Noticeable atmospheric Cs137 fallout was marked in Japan up throughthe end of 1988 (Aoyama et al., 1991).
5. YUGOSLAVIA. The increase in Pu-238/
P239-240 ratios in surface air at the VincaBelgrade site for May 1–15, 1986, confirmsthat Chernobyl was the source (Mani-Kudra
et al., 1995).
6. SCOTLAND. The Chernobyl fallout on theevening of May 3 included Te-132, I-132, I131, Ru-103, Cs-137, Cs-134, and Ba-140/La140 (Martin et al., 1988).
7. UNITED STATES. Chernobyl’s radioactive
clouds were noted in the Bering Sea area of
the north Pacific (Kusakabe and Ku, 1988),
and reached North America. The pathwaysof the Chernobyl plumes crossed the Arctic
within the lower troposphere and the Pacific
Ocean within the mid-troposphere. The firstmeasured radiation arrived in the United States
on May 10, and there was a second peak on
May 20–23. The second phase yielded muchhigher Ru-103 and Ba-140 activity relative toCs-137 (Bondietti et al., 1988; Bondietti and
Brantley, 1986). The air particulate activity
in the United States reached its highest level
since the termination of nuclear weapons testing (US EPA, 1986). Examples of Chernobyl’s
atmospheric contamination are presented inTable 8.4.
Table 8.5 summarizes some examples of surface air contamination in several countries resulting from the Chernobyl catastrophe.
Modern science is far from understandingor even being able to register all of the specific radiogenic effects for each of the Chernobyl radionuclides. However, the effects of the
products of radiolysis from such huge atmospheric radiation fallout demands close attention. The term “atmospheric radiotoxins” appeared after the catastrophe (Gagarinsky et al.,1994). As noted earlier, radionuclide air dispersion may occur secondarily as a result of forest
fires.

TABLE 8.4. Examples of Surface Air Concentrations of I-131, Cs-131, Cs-137, and Cs-134 over
the United States after the Chernobyl Catastrophe,
May 1986 (Larsen and Juzdan, 1986; Larsen et al.,
1986; US EPA, 1986; Toppan, 1986; Feely et al.,
1988; Gebbie and Paris, 1986; Vermont, 1986)
Radionuclide
I-131

Cs-137

Cs-134Gross beta

Location

Activity

New York, NY
Rexburg, ID
Portland, ME
Augusta, ME
Barrow, AL
Mauna Loa, HI
New York, NY
Barrow, AL
Mauna Loa, HI
Mauna Loa, HI
Barrow, AL
Portland, ME
Lincoln, NE
Vermont

20,720 μBq/m3
11,390 μBq/m3
2.9 pCi/m3
0.80 pCi/m3
218.7 fCi/m3
28.5 fCi/m3
9,720 μBq/m3
27.6 fCi/m3
22.9 fCi/m3
11.2 fCi/m3
18.6 fCi/m3
1.031 pCi/m3
14.3 pCi/m3
0.113 pCi/m3

8.2. Chernobyl’s Contaminationof Aquatic Ecosystems
Chernobyl contamination traveled acrossthe Northern Hemisphere for hours, days, andweeks after the catastrophe, was deposited via
rain and snow, and soon ended up in bodies of water—rivers, lakes, and seas. Many
Belarussian, Ukrainian, Russian, Latvian, andLithuanian rivers were shown to be contaminated after the catastrophe, including thewater basins of the Dnepr, Sozha, Pripyat, Neman, Volga, Don, and the Zapadnaya/DvinaDaugava.
8.2.1. Belarus, Ukraine, and Russia
1. In the first days after the catastrophe(the period of primary aerosol contamination),
the total activity in Pripyat River water near
the Chernobyl NPP exceeded 3,000 Bq/liter.
Only by the end of May 1986 had it decreased to 200 Bq/liter. The maximum concentration of Pu-239 in the Pripyat River was
0.37 Bq/liter.

227

Yablokov et al.: Atmospheric, Water, and Soil Contamination

TABLE 8.5. Examples of Surface Air Concentrations of Some Radionuclides in the Northern Hemisphere
after the Catastrophe, 1986
Radionuclide

Concentration

Location

Date

I-131

223 Bq/m3
251 Bq/m3
176 Bq/m3
20.7 Bq/m3
0.8 Bq/m3
9.7 Bq/m3
62.5 Bq/m3
160 Bq/m3
100 Bq/m3
89 μBq/m3
0.4 μBq/m3,∗

Nurmijarvi
Revelstoke, B.C., Canada
Quebec, Canada
New York, NY
Japan
ViennaApr. 28
May 13
May 5–6
May
May 5
Apr. 30RADNET, 2008

Bulgaria
MunichViennaParis

May 1
Apr. 30
May
Apr. 29–30

Pourchet et al., 1997
Hotzl et al., 1987
Irlweck et al., 1993
Thomas and Martin, 1986

Cs-137
Ru-103Gross beta
Pu-239 + Pu-240∗

Reference

Imanaka and Koide, 1986
Irlweck et al., 1993

During 1984, total Pu-239 + Pu-240 activity was 1,000-fold less (10–40 nBq/m3 ).

2. From May to July 1986 the level of radiation in the northern part of the Kiev water
reservoir was 100,000 times higher than the
precatastrophe level (Ryabov, 2004).
3. Concentration of I-131 in surface water in Leningrad Province (Sosnovy Bor
City) on May 2, 1986, was 1,300 Bq/literand on May 4, 1986, it was 740 Bq/liter(Kryshev and Ryazantsev, 2000; Blynova,
1998).
4. During the first period after the catastrophe the littoral zone was heavily contaminatedwith radioactivity. In the years that followed
bodies of water became secondarily contaminated as a result of the washout of Cs-137 andSr-90 by spring high waters and from woodland
fire fallout (Ryabov, 2004).
5. In July 1986, the primary dose-forming
radionuclides in clay in the bodies of water near the Chernobyl NPP were Ni-98 (27kBq/kg), Ce-144 (20.1 kBq/kg), and Zr-96(19.3 kBq/kg). In March–April 1987 the concentration of Ni-95 in aquatic plants there
reached 29 kBq/kg and Zr-95 levels in fowl
were up to 146 kBq/kg (Kryshev et al.,1992).
6. The Sr-90 contamination in the Dnepr
River floodplain–lake ecosystem was concentrated primarily in bivalve mollusks, 10–40%
concentrated in aquatic plants, about 2%

in fish, 1–10% in gastropod mollusks, andless than 1% in plankton (Gudkov et al.,2006).
7. The Cs-137 in the Dnepr Riverfloodplain–lake ecosystem was distributed asfollows: 85–97% in aquatic plants, 1–8% inzoobenthos, 1–8% in fish, and about 1% in
gastropod mollusks (Gudkov et al., 2006).
8. Owing to bioaccumulation, the amount ofradionuclides can be thousands of times higher
in plants, invertebrate, and fishes comparedwith concentrations in water (Table 8.6).
9. In contaminated territories with Cs-137
levels of 0.2 Ci/km2 the rate of transfer fromwater into turf plants can vary 15- to 60-foldfrom year to year (Borysevich and Poplyko,
2002).
10. More than 90% of the Pu + Am inaquatic ecosystems is in the sediment (Borysevich and Poplyko, 2002).
11. The Cs-137 and Sr-90 concentrations increased in underground water and correlatedwith the density of land contamination andzones of aeration. The highest level of Sr-90(up to 2.7 Bq/liter) was observed in rivers that
ran through the heavily contaminated territories. In the Pripyat River floodplains in the
territories with land contamination greaterthan 1,480 kBq/km2 ground water activity reached 3.0 Bq/liter of Cs-137 and228
TABLE 8.6. Coefficients of Accumulation for Some Live Organisms∗ of Chernobyl Radionuclides in theDnepr River and the Kiev Reservoir, 1986–1989 (Kryshev and Ryazantsev, 2000: tables 9.12, 9.13,
9.14; Gudkov et al., 2004)
Radionuclide

Mollusks

Water plants

Fishes (bream, sander,roach, silver bream)Ce-141, Ce-144
Ru-103, Ru-106
Cs-134, Cs-137
Zr-95
Ni-95
Sr-90
Pu
Am
I-131

3,000–4,600
750–1,000
178–500
2,900
3,700
440–3,000——
120

20,000–24,000
11,000–17,000
2,700–3,000
20,00022,000
240
4,175
7,458
60

500–900
120–130
100–1,100
190
220
50–3,000
98
1,667
2–40

∗

Concentration in aquatic flora and fauna as compared with concentration in water.

0.7 Bq/liter of S-90 (Konoplia and Rolevich,
1996).
12. During spring high waters Cs-137 thathas accumulated in bottom sediments becomessuspended and leads to noticeably increased
radioactivity in water. Up to 99% of Sr-90 migrates in a dissolved state (Konoplia and Rolevich, 1996).
13. Owing to its higher solubility, Sr-90
leaves river ecosystems much faster than Cs137. At the same time Cs-137 can accumulate
up to 93 × 10−9 Ci/kg in grass and sod on
flooded land (Borysevich and Poplyko, 2002).
14. The amount of Cs-137 and Sr-90 in water has decreased over time, but it has increasedin aquatic plants and sediments (Konoplia andRolevich, 1996).
15. More intensive radionuclide accumulation occurs in lake sediments owing to annual die-off of vegetation and the absence ofdrainage. In the 5 to 9 years after the catastrophe, in heavily weeded bodies of water there
was a decrease in Cs-137 and Sr-90 in the water
itself but a simultaneous increase in radioactivity in the sediment (Konoplia and Rolevich,
1996).
16. In the Svjetsko Lake (Vetka District, Belarus), total radionuclide concentration in watermeasured 8.7 Bq/liter, in aquatic plants upto
3,700 Bq/kg, and in fish up to 39,000 Bq/kg(Konoplia and Rolevich, 1996).

8.2.2. Other Countries
1. FINLAND, FRANCE, AND CANADA. Dataon some radionuclide concentrations in rainfall and surface water in Finland, France, andCanada are presented in Table 8.7.
2. GREAT BRITAIN (SCOTLAND). On theevening of May 3, one of the Chernobyl clouds
contaminated the sea with Te-132/I-132, I131, Ru-103, Cs-137, Cs-134, and Ba-140/La140 totaling 7,000 Bq/liter (Martin et al.,1988).
3. GREECE. Composition of doseforming radionuclides and their activity
in Greece in May 1986 are presented inTable 8.8.
4. NORTH SEA. In a North Sea sediment
trap, the highest Chernobyl activity reached
670,000 Bq/kg, with Ru-103 being the mostprevalent isotope (Kempe and Nies, 1987). Radionuclide levels in sea spume were several
thousand times higher than in seawater inJune of 1986. Cs-137 and Cs-134 quickly migrated to the sediments, whereas Ru-106 andAg-110 lingered in the spume (Martin et al.,1988).
5. THE NETHERLANDS. I-131, Te-132, I-132,
La-140, Cs-134, Cs-137, and Ru-103 were
measured in rainwater in the Nijmegen area
during May 1–21, 1986. The total activity
on the first rainy day was of 9 kBq/liter

229

Yablokov et al.: Atmospheric, Water, and Soil Contamination

TABLE 8.7. Rainfall and Surface Water Radionuclide Concentrations in Several Countries, 1986–
1987
Radionuclide
Cs-137

Sr-89
Te-132

Maximum
concentration

Location

Date

Reference

5,300 Bq/m3∗
325 mBq/liter
700 Bq/liter
11,000 Bq/m3
7,400 Bq/liter

Finland
Canada, Ontario
France, Paris
FinlandFrance, Paris

1986
May 1986
Apr. 29–30, 1986
1986
Apr. 29–30, 1986

Saxen and Aaltonen, 1987
Joshi, 1988
Thomas and Martin, 1986
Saxen and Aaltonen, 1987
Thomas and Martin, 1986∗
About 1,000 times higher than the precatastrophe concentration, and up to 80 times higher than the highest values
after the nuclear weapons test period in the 1960s.

(2.7 kBq/liter for I-131 and 2.3 kBq/liter each
for Te-132 and I-132). The total activity precipitated per square kilometer in this period
was about 55 GBq (Beentjes and Duijsings,
1987).
6. POLAND. Average values of Pu-239 + Pu240 in the Polish economic zone of the Baltic
Sea ranged from 30 to 98 Bq/m2 in three sampling locations. The highest concentration of
Pu in sediment probably came from the Vistula River, which delivered 192 MBq of Chernobyl’s Pu-239 + Pu-240 to the Baltic Sea in
1989 (Skwarzec and Bojanowski, 1992). The
total Cs-137 loading of Lake Sniardwy was estimated to average 6,100 Bq/m2 (Robbins andJasinski, 1995).
7. SWEDEN. The annual mean concentration of Cs-137 (in Bq/kg) in surface water near
Gotland Island from 1984 to 2004 is shown in
Figure 8.2.
TABLE 8.8. Composition and Activity of the Chernobyl Radioactive Fallout in Thessaloniki, Greece,(Total Wet Deposition, Bq/m2 ), May 5–6, 1986 (Papastefanou et al., 1988)
Radionuclide
I-131
Te-132
I-132
Ru-103Ba-140Cs-137
La-140Cs-134

Maximum concentration
117,278
70,70064,68648,25635,58023,90015,47012,276

8. TYRRHENIAN SEA. Concentration of Cs137 in surface water of the Tyrrhenian Sea rosesignificantly immediately after the catastrophe(Figure 8.3).

8.3. Chernobyl’s Contaminationof the Soil Mantle
The soil mantle will accumulate Chernobyl’sradionuclides with long half-lives for centuries.
As in the previous review, this material is only
a representative selection from the very large
body of existing data.
8.3.1. Belarus, Ukraine, and Russia
1. Radionuclides on sod-podzol and heavily podzolized sandy clay soils move from thesurface to the bottom soil layer during thecourse of time, resulting in the concentration ofradionuclides in the root zone. It is in thisway that soils with low surface contaminationtransfer radioactivity to the vegetative (and edible) parts of plants (Borysevich and Poplyko,
2002).
2. Plowed and natural pastures located 50
to 650 km from the Chernobyl site have levelsof Cs-137 activity in the 1,000 to 25 kBq/m2
range in the upper soil layers (0–5 cm). Levels ofcontamination are higher in natural pastures ascompared with plowed pastures, with the Sr-90
activity ranging from 1.4 to 40 kBq/m2 (Salbu
et al., 1994).

230

Figure 8.2. The annual mean Cs-137 concentrations (in Bq/liter) in surface waters ofEast and West Gotland (sampling depth ≤10 m) from 1984 to 2004. Straight line—average
pre-Chernobyl (1984–1985) level (HELCOM, 2006).

3. The soils most highly contaminated by
I-131 are in northern Ukraine, eastern Belarus, and nearby provinces of Russia, butsome “spots” of radioiodine soil contamination have been detected in many areas, including Kaliningrad Province on the Baltic shore(Makhon’ko, 1992).
4. In many areas up to hundreds of kilometers to the west, northwest, and northeast of
the Chernobyl NPP the levels of Cs-137 soil
contamination exceed 1,489 kBq/m2 (Kryshev
and Ryazantsev, 2000).
5. In humid environments such as flood
planes, lowland moors, and peat bogs verticalmigration is activated at different speeds fordifferent radionuclides (Table 8.9).
6. Self-cleansing of soils by vertical migration of radionuclides can reach 2 to 4 cm/year(Bakhur et al., 2005).
7. The granular composition of soil andagrichemical soil characteristics modifies thetransfer coefficient for Cs-137 (see Chapter
9). There is roughly a 10-fold variation (from0.01 to 0.11 Bq/kg) in the degree of Cs137 transition from soil to beetroots depending on whether the soil is sod-podzol, loamy,
sandy-clay, or sandy (Borysevich and Poplyko,
2002).

Figure 8.3. Concentration of Cs-137 (mBq/liter) in surface waters of the Tyrrhenian Sea,
1960–1995 (Europe Environmental Agency, 1999).

Yablokov et al.: Atmospheric, Water, and Soil Contamination
TABLE 8.9. The Years Needed to Achieve a 50%
Reduction in the Amount of Each Radionuclide in
the Top (0–5 cm) Soil Layer in Areas 50 and 200
km from the Chernobyl NPP (National Belarussian
Report, 2006)
Years
Radionuclide

Up to 50 km

Up to 200 km

Pu-239, Pu-240
Am-241
Sr-90
Cs-137

6–7
6–7
7–12
10–17

>50
>50
7–12
24–27

8.3.2. Other Countries
1. AUSTRIA. The alpine regions were among
the most heavily contaminated territories outside of the Former Soviet Union. In May 1986
in Salzburg Province the median Cs-137 surface deposition was about 31 kBq/m2 withmaximum values exceeding 90 kBq/m2 (Lettner et al., 2007) or even 200 kBq/m2 (Energy,2008). Ten years after the catastrophe 54% ofChernobyl-derived Cs-137 was 2 cm deeper
into the soil layer in a spruce forest stand, withless than 3% having reached layers deeper than
20 cm. The average retention half-life of Cs137 was 5.3 years in the 0–5 cm layer, 9.9 years
in the 5–10 cm layer, and 1.78 years in layers
deeper than 10 cm (Strebl et al., 1996).
2. BULGARIA. Surface soil Cs-137 activity was
up to 81.8 kBq/m2 in the most contaminatedterritories, which is eight times higher than the
cumulative amount deposited during the peak
period of weapons testing (Pourchet et al., 1997).
3. CROATIA. In 1986 Cs-137 fallout deposit
reached 6.3 kBq/m2 (Franić et al., 2006).
4. DENMARK. The total mean Cs-137 and Sr90 deposits over Denmark reached 1.3 and 38
Bq/m2 , respectively, as a result of Chernobyl.
Most of the debris was deposited in the first halfof May. In the Faeroe Islands the mean deposition of Cs-137 was 2 kBq/m2 and in Greenland
it was up to 188 Bq/m2 (Aarkrog, 1988).
5. ESTONIA. The ground deposition from
Chernobyl for Cs-137 was 40 kBq/m2 (Realoet al., 1995).

231

6. FRANCE. The maximal Cs-137 Chernobyl soil contamination reached up to 545
kBq/kg (CRII-RAD, 1988) and radioactivity
from Chernobyl fallout in the French Alps
reached 400 Bq/m2 (Pinglot et al., 1994).
7. GERMANY. Average ground deposition for
total Cs was 6 kBq/m2 (Energy, 2008), andconcentration of radionuclides in the southern part of the country was much higher(Table 8.10).
8. IRELAND. The initial Chernobyl fallout
owing to Cs-137/Cs-134 reached a concentration of 14,200 Bq/m2 , some 20-fold higher
than the pre-catastrophe level (McAuley andMoran,1989).
9. ITALY. In the mountain area of FriuliVenezia Giulia deposition of Cs-137 from
Chernobyl ranged from 20 to 40 kBq/m−2 .
Concentration of Cs-137 in soil 0–5 cm deep
declined only 20% in the first 5 years after thecatastrophe (Velasko et al., 1997).
10. JAPAN. Up to 20 radionuclides weredetected on the ground, including Cs-137,
I-131, and Ru-103, with resulting levels of 414,
19, and 1 Bq/m2 , respectively (Aoyama et al.,1987).
11. NORWAY. Many places in Norway wereheavy contaminated after the catastrophe(Table 8.11).
12. POLAND. Soil in central Poland was contaminated by a wide spectrum of the Chernobyl
radionuclides (Table 8.12). In the northeasternpart of the country Cs-134 + Cs-137 grounddeposition levels were up to 30 kBq/m2 and I131 and I-132 deposition was up to 1 MBq/m2(Energy, 2008).
13. SWEDEN. The mean deposition of Chernobyl Cs-137 in the forest soils was above
50 kBq/m2 (McGee et al., 2000), and maximum Cs-134 + Cs-137 ground deposition was
up to 200 kBq/m2 (Energy, 2008).
14. UNITED KINGDOM. Examples of radioactive contamination in soil are presented inTable 8.13. Floodplain loading of Cs-137 insoil was up to 100 times greater than in soils
above the floodplain (Walling and Bradley,1988). On May 3, one of the Chernobyl clouds

232
TABLE 8.10. Ground Deposition (kBq/m2 ) of Some Chernobyl Radionuclides in Germany, 1986
Radionuclide
Cs-137
Cs-134 + Cs-137
Te-132∗

Location

Concentration, max

Reference

Upper Swabia
BonnSouth Germany
Munich∗

43
1.38
60
120

Bilo et al., 1993
Clooth and Aumann, 1990
Energy, 2008
Gogolak et al., 1986

June 3, 1986; cumulative dry and wet deposition.

TABLE 8.11. Examples of Cs-137 Ground Contamination after the Chernobyl Catastrophe in Norway,
1986
Maximum radioactivity
22 kBq/kg∗
500 kBq/m2∗
22 Bq/kg
80 kBq/m2
54 kBq/m2 (mean)
200 kBq/m2∗∗

Location

ReferenceStream gravel
Average in sediment
Svalbard glaciers
Dovrefjell
Southern Norway, grazing areas
Soils in affected areas

Hongve et al., 1995
Hongve et al., 1995
Pinglot et al., 1994
Solem and Gaare, 1992
Staaland et al., 1995
Blakar et al., 1992

Cs-134 + Cs-137

contaminated the Scottish landscape with Te132/I-132, I-131, Ru-103, Cs-137, Cs-134,
and Ba-140/La-140 totaling 41 kBq/m2 (Martin et al., 1988).
15. UNITED STATES. Observations of radionuclide contamination of U.S. soils from
Chernobyl are listed in Table 8.14. Ground deposition for Cs-137 comes close to or exceeds
the total weapons’ testing fallout (Dibb andRice, 1988). The spectrum of Chernobyl’s soil
contamination in the United States included

TABLE 8.12. Spectrum and Activity of Chernobyl
Radionuclides in Soil Samples (kBq/m2 in 0–5 cm
Layer) in the Krakov Area, May 1, 1986 (Broda,
1987)
Radionuclide

Activity

Radionuclide

Activity

Te-132
I-132
I-131
Te-129m
Ru-103
Cs-137
Cs-134

29.3
25.7
23.6
8.0
6.1
5.2
2.7

Ba-140La-140Mo-99
Ru-106
Sb-127
Cs-136
Total

2.5
2.4
1.7
1.3
0.8
0.7
Up to 360

Ru-103, Ru-106, Cs-134, Cs-136, Cs-137, Ba140, La-140, I-132, Zr-95, Mo-95, Ce-141, andCe-144 (Larsen et al., 1986).
16. Table 8.15 presents data on Cs-137 +Cs-134 contamination in several European
countries.

8.4. Conclusion
Chernobyl’s radioactive contamination has
adversely affected all biological as well as
nonliving components of the environment:
the atmosphere, surface and ground waters,
the surface and the bottom soil layers, especially in the heavily contaminated areas of Belarus, Ukraine, and European Russia. Levels ofChernobyl’s radioactive contamination even in
North America and eastern Asia are above themaximum levels that were found in the wake of
weapons testing in the 1960s.
Modern science is far from understanding oreven being able to register all of the radiologicaleffects on the air, water, and soil ecosystems due
to anthropogenic radioactive contamination.

233

Yablokov et al.: Atmospheric, Water, and Soil Contamination

TABLE 8.13. I-131 and Cs-134/Cs-137 Soil Contamination (kBq/m2 ) from Chernobyl Radionuclides
in Some Parts of the United Kingdom, 1986
Radionuclide

Activity

Location

Date

Reference

I-131

26
41
7.4
15
0.6
100
88.4

Lerwick, Shetland
Holmrook, Cumbria
Sellafield, Cumbria
Ireland
Berkeley, Gloucestershire
Scotland
Strathclyde, Scotland

May 1–6

Cambray et al., 1987

May
1986
May
May
May 6

Fulker, 1987
Rafferty et al., 1993
Nair and Darley, 1986
Wynne, 1989
RADNET, 2008

Cs-137

Cs-134/Cs-137
Gross beta

TABLE 8.14. Examples of Ground Deposition of Chernobyl Radionuclides (Dibb and Rice, 1988; Dreicer
et al., 1986; Miller and Gedulig, 1986; Gebbie and Paris, 1986)
Radionuclide
Cs-137
Cs-134
Ru-103

I-131∗

Location

Date, 1986

Activity

Solomons Island, MD
Chester, NJ
Solomons Island, MD
Solomons Island, MD
Chester, NJ
Chester, NJ
Chester, NJ
Portland, OR

May 8–June 20
May 17
May 8–June 20
May 8–June 20
June 3
May 23
May 23
May 11

4,250 Bq/m2
9.40 Bq/m2∗
2,000 Bq/m2
22,000 Bq/m2
18.46 Bq/m2
15 Bq/m2
47.2 Bq/m2
9,157 pCi/m2

Deposition on grass.

Undoubtedly there are such changes and, owing to the amount of Chernobyl radionuclides
that were added to the biosphere, the changes
will continue for many decades.
Contrary to the common view that the
Chernobyl plumes contained mostly light andgaseous radionuclides, which would disappear without a trace into the Earth’s atmosphere, the available facts indicate that even Pu

TABLE 8.15. Level of Ground Radioactive Contamination after the Chernobyl Catastrophe on
British Embassy Territory in Some European
Countries (http://members.tripod.com/∼BRuslan/
win/energe1.htm)
Location
Czech (Prague)
Hungary (Budapest)
Yugoslavia (Belgrade)
Romania (Bucharest)
Poland (Warsaw)

Cs-134,kBq/m2

Cs-137,
kBq/m2

4.9
8.8
7.3
4.3
2.8

2.9
5.3
4.4
2.6
1.7

concentrations increased thousands of times at
distances as far as many thousands of kilometers
away from Chernobyl.
Common estimates of the level of radioactivity per liter or cubic or square meter mask
the phenomenon of radionuclides concentrating (sometimes many thousands of times) in
sediments, in sea spume, in soil microfilms, etc.,
through bioconcentration (for details see Chapters 9 and 10). This means that harmless looking “average” levels of radionuclides inevitably
have a powerful impact on living organisms in
the contaminated ecosystems.
As a result of vertical migration of radionuclides through soil, they accumulate in plants
with deep root systems. Absorbed by the roots,
the buried radionuclides again rise to the surface and will be incorporated in the food chain.
This transfer is one of the more importantmechanisms observed in recent years that leads
to increased internal irradiation for people in
the all of the territories contaminated by nuclear fallout.

234

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CHERNOBYL

9. Chernobyl’s Radioactive Impact on Flora
Alexey V. Yablokov

Plants and mushrooms accumulate the Chernobyl radionuclides at a level that depends
upon the soil, the climate, the particular biosphere, the season, spotty radioactive contamination, and the particular species and populations (subspecies, cultivars), etc. Eachradionuclide has its own accumulation characteristics (e. g., levels of accumulation for
Sr-90 are much higher than for Cs-137, and a thousand times less than that for Ce-144).
Coefficients of accumulation and transition ratios vary so much in time and space that
it is difficult, if not impossible, to predict the actual levels of Cs-137, Sr-90, Pu-238, Pu239, Pu-240, and Am-241 at each place and time and for each individual plant or fungus.
Chernobyl irradiation has caused structural anomalies and tumorlike changes in many
plant species. Unique pathologic complexes are seen in the Chernobyl zone, such as ahigh percentage of anomalous pollen grains and spores. Chernobyl’s irradiation has led
to genetic disorders, sometimes continuing for many years, and it appears that it has
awakened genes that have been silent over a long evolutionary time.

There are thousands of papers about agricultural, medicinal, and other plants and mushrooms contaminated after the Chernobyl catastrophe (Aleksakhin et al., 1992; Aleksakhin,
2006; Grodzinsky et al., 1991; Ipat’ev 1994,
1999; Parfenov and Yakushev, 1995; Krasnov, 1998; Orlov, 2001; and many others).
There is also an extensive body of literature
on genetic, morphological, and other changes
in plants caused by Chernobyl radiation. In
this chapter we present only a relatively small
number of the many scientific papers that
address Chernobyl’s radioactive impact onflora.
The Chernobyl fallout has ruined the pine
forests near the nuclear power plant, whichwere not able to withstand the powerful radioactive impact, where contamination in thefirst weeks and months after the catastrophereached several thousand curies per square
kilometer. With the catastrophe’s initial atmospheric radiotoxins (see Chapter 8) and theAddress for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

powerful irradiation caused by “hot particles,”the soil and plants surfaces became contaminated and a cycle of absorption and release ofradioisotopes from soil to plants and back again
was put into motion (Figure 9.1).
Soon after the catastrophe plants and fungiin the contaminated territories became concentrators of radionuclides, pulling them fromthe soil via their roots and sending them toother parts of the plant. Radionuclide levels inplants depend on the transfer ratio (TR, transition coefficient) and the coefficient of accumulation (CA)—the relationship of specific activity of a radionuclide in a plant’s biomass tothe specific activity of the same radionuclide insoil: [TR = (Bq/kg of plant biomass)/(kBq/m2
for soil contamination); CA = (Bq/kg of plantbiomass)/(Bq/kg of soil)].

9.1. Radioactive Contamination of
Plants, Mushrooms, and Lichens
The level of radionuclide incorporation (accumulation) in a living organism is a simple
and reliable mark of the potential for damage
to the genetic, immunological, and life-support

237

238

Figure 9.1. Radioautographs of plants with Chernobyl radionuclides: (A) leaf of common
plantain (Plantago major ); (B) aspen leaf (Populus tremula) Bryansk Province, Russia, 1991.
Spots of the raised radioactivity are visible. (A. E. Bakhur photo, with permission.)

systems of that organism. The first part ofthis section presents data regarding radioactive
contamination in plants and the second relates
to the levels of contamination in mushrooms
and lichens.
9.1.1. Plants
1. The levels of surface contamination of
three species of plants in Kiev City reached
399 kBq/kg and varied by specific location andparticular radionuclide (Table 9.1).

2. Table 9.2 presents data on radionuclide
accumulation in the pine needles in Finland
after the catastrophe.
3. Data in Table 9.3 indicate the level of plantradionuclide contamination that was reachedworldwide after the catastrophe.
4. There were high levels of radionuclide accumulation in aquatic plants (Table 9.4).
5. After the catastrophe the levels of incorporated radionuclides jumped in all of the heavily contaminated territories. In annual plants
such as absinthe (Artemisia absinthium), C-14

TABLE 9.1. Chernobyl Radioactivity (Bq/kg, dry weight) of Leafage in Three Species in Kiev City at theEnd of July 1986 (Grodzinsky, 1995b)
NuclidePm-144Ce-141
Ce-144
La-140Cs-137
Cs-134
Ru-103, Rh-103
Ru-106
Zr-95
Nb-95
Zn-65
Total activity∗

Aesculus hippocastanum∗

Tilla cordata∗∗

Betula verrucosa∗∗

Pinus silvestris∗∗

58,80018,80063,300
1,100
4,030
2,000
18,35014,60035,60053,650–312,000

146,150
–
–
1,930
–
–
36,60041,80061,05094,350400
399,600

10,8006,500
21,800
390
3,400
1,540
10,290400
11,40018,500–101,400–
4,100
18,800
660
4,300
2,100
7,180
5,700
6,500
9,900
–
70,300

Near underground station “Darnitza”; ∗∗ near underground station “Lesnaya.”

239

Yablokov: Radioactive Impact on FloraTABLE 9.2. Concentration of Three Radionuclides in Pine Needles in Central Finland, May–
December 1986 (Lang et al., 1988)
Radionuclide

Concentration, Bq/kg

Cs-137Ce-141
Ru-10330,00040,00035,000concentrations increased as much as fivefold
in 1986 (Grodzinsky et al., 1995c). Figure 9.2
shows the concentration of C-14 in three rings(percent compared to the 1950 level) of pine
(Pinus silvestris) from the 10-km zone.
6. There was a marked increase in the total amount of radionuclides in tree rings ofpine (Pinus silvestris) in the Karelia Republic,
Russian northwest (more than 1,200 km from
Chernobyl) after the catastrophe (Figure 9.3).
It is important to note that Karelia officiallycharacterized the level of contamination as very
moderate (<0.5 Ci/km2 ; Cort and Tsaturov,
1998).
7. The Belarussian berries, semifrutex of the
Vacciniaceae species, are characterized by amaximum intensity of Cs-137 accumulation(Mukhamedshin et al., 1995; Kenigsberg et al.,
1996; Jacob and Likhtarev, 1996).

8. The coefficient of accumulation of Cs-137
in cranberries (Oxycoccus palustris) is up to 1,028(Orlov and Krasnov, 1997; Krasnov and Orlov,
2006).
9. There are wide intraspecies variationsin specific Sr-90 activity: from 2–3 up to
555 Bq/kg in fresh bilberries (Vaccinium myrtillus) in mertyllus-type pinewoods (Orlov et al.,1996).
10. More radionuclides accumulated in theroot system (up to sevenfold more than inabove-ground parts of plants). In above-groundparts, the higher radionuclide concentration isin the leaves and lower levels in the flowers(Grodzinsky et al., 1995a). The leaves of bilberry(Vaccinium myrtillus) during fruiting (July) contain
31% of the general Cs-137 activity, stalks have
26%, berries 25%, and rhizomes with roots
18% (Korotkova and Orlov, 1999).
11. Concentration of Cs-137 in the vegetative mass in different lupine (Lupinus) varieties
was on average fivefold more than in maize(Zea), and clover (Trifolium) and vetch (Vicia)
had intermediate levels. Cs-137 accumulationin the various grain crops varied to an evengreater degree than that in vegetative masses,
in dernopodzolic soils by a factor of 38 andin chernozem by a factor of 49 (Kuznetsov

TABLE 9.3. Examples of the Worldwide Contamination of Plants (Bq/kg) in 1986
NuclideSubject

ActivityCountry

ReferenceCs-137

Moss
Hair moss
Moss
Moss
Tea, Thea sinensis
Moss, Hylocomium splendens
Moss
Plants
Edible seaweed
Grass
Pine needles
Pine needles
Hair moss
Herbs
Hair moss

40,180∗28,00020,290∗∗12,370∗∗∗44,00040,00030,0002,100
1,300
15,000 Bq/m2
40,00035,00018,000730
3,500

NorwayFinland
NorwayGermany
TurkeyNorwayGermany
Japan
Japan
UK
FinlandFinlandFinlandFinlandFinland

Staaland et al., 1995
Ilus et al., 1987
Staaland et al., 1995
Elstner et al., 1987
Gedikoglu and Sipahi, 1989
Steinnes and Njastad, 1993
Heinzl et al., 1988
Ishida et al., 1988
Hisamatsu et al., 1987
Clark, 1986
Lang et al., 1988
Lang et al., 1988
Ilus et al., 1987
Rantavaara, 1987
Ilus et al., 1987

I-131

Ce-141
Ru-103Te-132
Sr-89∗∗∗

1987; 1988;∗∗∗

up to 139 times higher than in 1985.

240
TABLE 9.4. Levels of Radionuclide Accumulations (Bq/kg, Dry Weight) by Some Aquatic Plants, Ukraine,
1986–1993 (Bar’yakhtar, 1995)
SpeciesCe-144

Ru-103,
Rh-103

Ru-106,
Rh-106

Cs-137

Cs-134

Nb-95,
Zr-95

Sr-90

Shining pondweed (Potamogeton
natans)Common reed grass (Phragmites
communis), above-water parts
Common reed grass (Phragmites
communis), underwater parts
Narrow-leaved cat’s-tail (Typha
angustifolia)

44,4004,800

33,30012,6008,100

63,000925

26,000

3,700

8,900

12,900

4,800

3,700

5

99,9006,700

129,500

66,60021,80013,7002,400

20,3507,000

24,800

3,700

1,370

1,330

270

et al., 2000). The most active transfer ofradionuclides from soil to plants occurs on peatbog soil. The transfer coefficient for Cs-137
from scrub forests is up to three times higher
for half-submerged soil as compared with driersoil and up to twice that for mixed vegetationas compared with pinewoods (Borysevich and
Poplyko, 2002).
12. The level of incorporated radionuclides
tends to correlate with the density of radioactive
contamination in the soil (Figure 9.4).
13. There are strong correlations between
specific Cs-137 activity in a phytomass of Convallaria majalis and both the density of groundcontamination (r = 0.89) and the specific activity of Cs-137 in the soil (r = 0.84; Elyashevich
and Rubanova, 1993).

Figure 9.2. Concentration of C-14 in tree ringsof pine (Pinis silvestris; percent difference from thelevel in the year 1950) from the 10-km Chernobylzone (Grodzinsky et al., 1995c).

14. The Cs-137 CA of 120 plant species
increases in the following order of ecotopes:
boggy forest (425) > oakwood (241) > depressions between hill-forest of flood plain (188) >pinewood (94) > undrained lowland swamp(78) > hill forest of flood plains (68) > upland meadows (21) > drained peat-bog soil (11)> long-term fallow soil (0.04; Elyashevich and
Rubanova, 1993).
15. Transfer ratios from soil to plants are different for each species and also vary by season
and habitat (Table 9.5).
16. The maximum transfer ratio (from soil
to plant) of Sr-90 was measured in wild strawberries (TR 14–15), and the minimum wasin bilberry (TR 0.6–0.9) in Belarus. The Cs137 transfer ratio in bilberry (Vaccinium myrtillus)
is threefold higher than that for wild strawberry (Fragaria vesca; Ipat’ev, 1994; Bulavik,
1998).
17. Plants growing on hydromorphic landscapes accumulate 10-fold more Cs-137 thanthose in automorphic soil. There is up to a
50-fold difference in the Cs-137 TR between
an automorphic and a hydromorphic environment: intensity of accumulation of Cs-137 in
berries is much lower on richer and dry soils ascompared with poor and wet soils (Tsvetnova
et al., 1990; Wirth et al., 1996; Korotkova, 2000;
and others).
18. There are heavy accumulations of Cs137 in a plant’s above-ground biomass in the
Ukrainian wet pine subor for the cowberryfamily species (Vacciniaceae): TR is about 74

241

Yablokov: Radioactive Impact on Flora

Figure 9.3. Total radioactivity in tree rings of pine (Pinus silvestris) near Petrozavodsk
City, Karelia, for the period 1975–1994 (Rybakov, 2000).

in bilberry (Vaccinium myrtillus), 67 in cowberry(Vaccinium vitis-idaea), and 63 in blueberry (Vaccinium uliginosum; Krasnov, 1998).
19. For nonwood medicinal plants the decreasing order of Cs-137 incorporation is asfollows: berries (Vaccinium myrtillus) > leaf (Vaccinium myrtillus) > grass (Thymus serpyllum) >grass (Convallaria majalis) > grass (Fragaria vesca)> flowers (Helichrysum arenarium) > grass (Hypericum perforatum and Betonica officinalis) > grass(Origanum vulgare; Orlov, 2001).
20. The maximum TR values are: wild plants(Ledum palustre) 451, grass (Polygonum hydropiper)
122, fruits (Vaccinium myrtillus) 159, leaves (Fragaria vesca) 73 and (Vaccinium vitis-idaea) 79, andbuds (Pinus sylvestris) 61 and (Betula pendula) 47(Elyashevich and Rubanova, 1993).
21. In the Ukrainian Poles’e, Cs-137 in fresh
berries and air-dried bilberry offsets decreased
fivefold in 1998 in comparison with 1991
(Korotkov, 2000). In other data, from 1991 to1999 the amount of Cs-137 in bilberry fruit(Vaccinium myrtillus) fluctuated greatly (Orlov,
2001).
22. In mossy pine forests the concentrationof Cs-137 in bilberry (Vaccinium myrtillus) fruit
TABLE 9.5. Cs-137 TR from Soil to Fresh Fruitsof the Principal Wild Ukrainian Berries (Orlov,
2001)

Figure 9.4. Correlation between the amount of
Cs-137 in fresh bilberry (Vaccinium myrtillus) (Bq/kg)
and the level of soil contamination (kBq/m2 ) for
four different biospheres in Central Poles’e, Ukraine(Orlov, 2001): (vertical axis) specific activity, Bq/kg;(horizontal axis) soil contamination, kBq/m2 (B 2 ,fresh subor; B 3 , dry subor; C 2 , fresh sudubrava; C 3 ,dry sudubrava).

SpeciesTR

Vaccinium myrtillus 3.4–16.1
V. vitis-idaea
8.3–12.9
V. uliginosum
9.4–11.7
Oxycoccus palustris 13.0–16.6
Rubus idaeus
0.8–8.4

SpeciesTR

Rubus nessensis 6.6
Rubus caesius
1.0
Fragaria vesca
2.0–10.9
Sorbus aucuparia 1.0
Viburnum opulus 0.3

242
TABLE 9.6. Inter- and Intraspecific Variations ofTR (m2 /kg × 10–3 ) from Soil to Fresh Wild Edible
Berries in Belarussian, Ukrainian, and Russian Forest Zones Affected by Chernobyl Fallout (Based on
Many References from Orlov, 2001)

Figure 9.5. Variations of the transfer ratio for Cs137 for three medicinal plants: the grasses Convallaria majalis and Hypericum perforatum and the bark
Frangula alnus over several years (1991–1995). Average data for 28 stations in Ukrainian Poles’e (Krasnov, 1998).

from 1987 to 1990 was practically stable insome places, whereas in other areas there wasa threefold decrease in the TR in 1989–1990
as compared with 1987–1988 (Parfenov andYakushev, 1995).
23. Maximum Cs-137 activity in thevegetative parts of undershrubs and trees
is observed in May and June (Korotkova
and Orlov, 1999; Borysevich and Poplyko,
2002).

Figure 9.6. Variation of the transfer ratio for Cs137 for three species of wild forest berries in Belarus: raspberry (Rubus idaeus), strawberry (Fragaria
vesca), and blueberry (Vaccinium myrtillus) in thesame area from 1990 to 1998 (Ipat’ev, 1999).

SpeciesTR (Lim)

Max/minRubus idaeus
Fragaria vesca
Vaccinium myrtillus
Vaccinium vitis-idaea
Oxycoccus palustris
Vaccinium uliginosum
Rubus nessensis
Rubus caesius
Sorbus aucuparia
Viburnum opulus

0.8–8.4
2.0–10.9
3.4–16.1
8.1–12.9
13–16.6
9.4–11.7
6.6
1.0
1.0
0.3

10.5
5.5
5.3
1.6
1.3
1.2

24. Specific Sr-90 activity in the fresh fruitsof bilberry (Vaccinium myrtillus) in the Ukrainianpine forests varied from 2 to 555 Bq/kg (Orlov,
2001).
25. Long-term dynamics of Cs-137 TR fromsoil to plants revealed all possible variations:for the grass Convallaria majalis there was a significant decrease over time; for the grass Hypericum perforatum there was a marked decrease
from 1991 to 1992, but more than a twofold
increase from 1993 to 1995; for the bark
Frangula alnus there was a steady total threefold decrease in 1995 as compared with 1991
(Figure 9.5); for blueberries there was a slightdecrease over 9 years; and for strawberries there
was a sharp increase followed by a slower one(Figure 9.6).
26. The lognormal distribution of the TR in
the same species in a similar ecological ambience makes it impossible to correctly estimate
specific TR by sporadic observations (Jacob andLikhtarev, 1996).
27. There are wide inter- and intraspecies
variations in TR for the edible wild berries(Table 9.6).
28. TR differs for the same species for different biotopes (Table 9.7).
29. Dynamics of Cs-137 contamination ofvarious parts of pine (Pinus silvestris) are presented in Figure 9.7. The levels of contamination in the trunk, branches, and needles were
nearly stable over 12 years.

243

Yablokov: Radioactive Impact on FloraTABLE 9.7. Average TR in Fresh Blueberries (Vaccinium myrtillus ) in Three Different Types of Pine
Forests in 1995 (Ipat’ev and Bulko, 2000)
Type of pine forest

TR

Bilberry
Polytric
Ledum

5.19
14.00
24.00

30. In automorphic landscapes the Cs-137
TR decreased in grass species from 1988 to
1995. In hydromorphic landscapes there was
gradual increase in this coefficient beginningin 1992 (Tscheglov, 1999).
31. The intensities of Cs-137 accumulationin herbs that were studied are divided into
five groups: very strong accumulation (average
TR >100), strong accumulation (TR 50–100),moderate accumulation (TR 10–50), weak accumulation (TR 1–10), and very weak accumulation (TR <1; Table 9.8).
32. The highest intensity of Cs-137 accumulation according to species was found in
the families Ericaceae and Fabaceae, somewhat less in the families Boraginaceae andCaryophyllaceae, still less in the species of thefamily Lamiaceae (Origanum vulgare, Salvia officinalis, Thymus sp.), and minimal in species of thefamilies Asteraceae (Achillea millefolium, Calendula
officinalis) and Hypericaceae (Hypericum perforatum; Aleksenyzer et al., 1997).

Figure 9.7. Dynamics of Cs-137 transfer ratio(TR × 10–3 ) for branches and wood of pine (Pinus
silvestris) from 1993 to 2004 (Averin et al., 2006).

33. The TR for Sr-90 from soil to plants is
10 to 20 times higher than the TR of Cs-137 in
the same habitat and the same species (Orlov
et al., 1999).
34. In the Ukrainian Poles’e intensity ofaccumulation of Sr-90 in berry species is asfollows: Fragaria vesca > Vaccinium myrtillus > Vaccinium vitis-idaea > Vaccinium uliginosum > Viburnum opulus.
35. The following order of TR for medicinalundershrubs is: rhamn (Rhamnus) and mountain ash (Sorbus aucuparia), fresh hydrotops 3–
4, quercus bark 7, branches of aglet (Corylus
avellana) and buckthorn (Frangula alnus) 7–9,
branch of raspberry (Rubus idaeus) 11, branchof European dewberry (Rubus caesius) 13, andbranch of mountain ash (Sorbus aucuparia) in thewet biotopes 13–18 (Borysevich and Poplyko,
2002).
36. The TR for Sr-90 was 14.0–15.1 forwild strawberry (Fragaria), 0.6–0.9 for blueberry(Vaccinium myrtillus), and 0.9 for raspberry (Rubus
idaeus; Ipat’ev, 1999).
37. The TR for Sr-90 in wild forest
berries depends on the level of soil contamination: it appears that the TR is lower
under conditions of higher contamination(Table 9.9).
38. In Belarus in increasing order for Cs-137
levels in cereal grains that were studied: spring
wheat < barley < oats; among root vegetables:
carrot < beetroot < radish. For Sr-90 levels
the order was: wheat < oats < barley; radish
and carrot < beetroot (Borysevich and Poplyko,
2002).
39. There are marked differences in theamount of incorporated radionuclides even fordifferent cultivars of the same species among
carrots, beetroots, and radishes (Borysevich and
Poplyko, 2002).
40. Total incorporated gamma-activity invarious populations of lupinus (Lupinus luteus)
differed by as much as 20-fold (Grodzinsky et al.,
1995b).
41. The concentrations of Sr-90 and Pu-238,
Pu-239, and Pu-240 were significantly higher
in the surface phytomass of wild strawberry

244
TABLE 9.8. Intensity of Cs-137 Accumulation in Several Species of Herbs in Ukraine (Krasnov andOrlov, 1996)
Group
Very strong accumulation

Strong accumulation

Moderate accumulation

Weak accumulation

Very weak accumulation

Species

Plant partTR (M ± m)

Inonotus obliquus
Vaccinium myrtillus
Lycopodium clavatum
Vaccinium vitis-idaea
Ledum palustre
Chelidonium majus
Vaccinium myrtillus
Pinus sylvestrisCentaurium erythraea
Viola tricolour
Potentilla alba
Hypericum perforatum
Sambucus nigra
Convallaria majalis
Frangula alnus
Tanacetum vulgare
Potentilla alba
Arctostaphylos uva-ursi
Convallaria majalis
Urtica dioica
Oryganum vulgare
Quercus robur
Helichrysum arenarium
Thymus serpyllum
Digitalis grandiflora
Leonurus cardiaca
Achillea millefolium
Juniperus communis
Valeriana officinalis
Acorus calamus

Fruit body
Berries
SporesLeaf
Branches
Grass
Leaf
Buds
Grass
Grass
Rhizomes
Grass
Inflorescences
Inflorescences
Bark
Inflorescences
Grass
Leaves
Grass
Grass
Grass
Bark
Inflorescences
Grass
Grass
Grass
Grass
Galberry
Rhizomes
Rhizomes

130 ± 30125 ± 18120 ± 2094 ± 1482 ± 1879 ± 1478 ± 677 ± 1161 ± 627 ± 420 ± 318 ± 218 ± 216 ± 215.4 ±1.815.0 ± 1.2
12.5 ± 1.4
12.1 ± 2.5
9.8 ± 0.8
8.6 ± 0.7
7.4 ± 2.8
7.2 ± 1.2
5.4 ± 0.6
4.6 ± 0.5
4.4 ± 0.7
3.9 ± 0.5
2.9 ± 0.6
0.64 ± 0.05
0.36 ± 0.05
0.27 ± 0.03

(Fragaria vesca) as compared with bilberry (Vaccinium myrtillus) in the bilberry pine forests (Parfenov and Yakushev, 1995).
42. The main radioactive contaminants inmost species of medicinal herbs in Belarus prior
TABLE 9.9. TR for Sr-90 in Three Wild BerrySpecies under Various Levels of Soil Contamination (Ipat’ev, 1999)
Species
Blueberry
Raspberry
Wild strawberry

Level of soil
contamination, kBq/m2
1.9
0.8
14.6
22.7

28.1
1.0
9.1
10.0

to 1990 was Cs-137, but with Ce-144 and Ru106 being found in the bark (Tsvetnova et al.,1990).
43. Among annual plant species, those of thepea family (Leguminosae) tend to concentrate
Pu and Am (Borysevich and Poplyko, 2002).
44. Concentrations of Cs-134 and Cs-137
in tree rings of French white fir (Abies concolor)from the French–German border near Nancy,
France, reflect the Chernobyl fallout (Garrec
et al., 1995).
9.1.2. Mushrooms and Lichens
1. Table 9.10 presents data on radionuclide
accumulation in lichens and mushrooms after
the catastrophe.

245

Yablokov: Radioactive Impact on FloraTABLE 9.10. Examples of the Worldwide Contamination of Mushrooms and Lichens (Bq/kg) in 1986
NuclideSubject

ActivityCountry

ReferenceCs-137

Cs-135/Cs-137

LichenLichenReindeer lichen
Mushrooms
LichenMushrooms
Mushrooms
Lichen, Cladonia stellaris

40,040∗36,63025,000∗∗16,30014,5608,300∗∗∗
6,680
60,000

NorwayPolandNorwayJapan
GreeceGermany
Finland
NorwayCe-144
Nb-95
Ru-106/Rh-106
Total activity

Mushrooms
LichenLichenLichenLichen, Cladonia silvatica

24,00018,5008,114
16,570400,000

FrancePolandPolandPolandUkraineStaaland et al., 1995
Seaward et al., 1988
Solem and Gaare, 1992
Yoshida et al., 1994
Papastefanou et al., 1988
Elstner et al.,1987
Rantavaara, 1987
Brittain et al.,1991;
Steinnes et al.,1993
Coles, 1987
Seaward et al., 1988
Seaward et al., 1988
Seaward et al., 1988
Grodzinsky, 1995b∗

1987; ∗∗ up to 75-fold higher than in 1985; ∗∗∗ up to 93-fold more than in 1985.

2. Various species of mushrooms have different TR characteristics (Table 9.11).
3. There is correlation between the specificactivity of Cs-137 in the fruit of the mushrooms
and the radioactive density of soil contamination (Krasnov et al., 1998; Kubert, 1998).
4. The concentration of Cs-137 in mushrooms of the same species differs more than
500-fold depending on the levels of radionuclide concentration in the soil (Shatrova et al.,2002).

TABLE 9.11. TR of Cs-137 in Mushrooms in the
Ukrainian Poles’e Ecosystems (Orlov et al., 1998;
Krasnov et al., 1997; Kubert, 1998)
TR

Species

1–10

Honey mushroom (Armialliela mellea),chanterelle (Cantharellus cibarius), edible
boletus (Boletus edulis), aspen mushroom(Boletus versipellis)
Black milk mushroom (Lactarius sp.), green
boletus (Xerocomus subtomentosus)
Birch mushroom (Leccinum scabrum), russula
marsh (Russula), Polish mushroom(Xerocomus badius), blue boletus (Gyroporus
cyanescens)
Paxill (Paxilus sp.), yellow boletus (Suillus
luteus)1–50
50–100>100

5. The specific Cs-137 activity in the fruitof mushrooms Lactarius necator, Armillariella mellea, and Xerocomus badius increased exponentiallywith increased density of radioactive soil contamination (Krasnov et al., 1998).
6. The Cs-137 accumulation in the fruit ofmushrooms is lower in richer environmental
conditions: in russulas (Russula sp.) a difference
between Cs-137 accumulation in sudubravas(mixed oak forests), pine forests, and subors
are up to fourfold, and in lurid boletus (Boletus luridus) about threefold.
7. The Cs-137 accumulations in the fruit
bodies of the edible boletus (Boletus edulus) were
noticeably low in pine forests and for the Polishmushroom (Xerocomus badius) in subors (Krasnov
et al., 1998).
The level of radionuclide accumulation inplants and mushrooms depends upon thesoil, the climate, the particular biosphere,
the season, spotty radioactive contamination,
the species, and the population (subspecies,
cultivars), etc. Each radionuclide has its own accumulation characteristics. Coefficients of accumulation and transition ratios vary so muchin time and space that it is difficult, if not impossible, to predict the actual levels of the Cs-137,
Sr-90, Pu-238, Pu-239, Pu-240, and Am-241 in246each place and time for each individual plantor mushroom.
9.2. Radioinduced Morphology,
Anomalies, and Tumors
Changes from the normal morphologicalstructure of plants under the impact of irradiation (radiomorphosis) are typical manifestations in the heavily contaminated territories (Grodzinsky et al., 1991; Grodzinsky,
1999c; Gudkov and Vinichuk, 2006; and others). Radiomorphosis arises primarily becauseof the impaired duplication process in live cells
under the influence of external and/or internal
irradiation.
1. Radiation-induced changes that havebeen observed in plants in the Chernobylcontaminated territories include alterationsin shape, intercepts, twists, wrinkling, bifurcations, abnormal flattening of stems, etc.
(Table 9.12).
2. When top buds, which contain the actively dividing cells die, there is a loss of apical domination and transfer of activity to axial buds, which under normal conditions arein a resting state and are more radioresistant.
The newly active buds produce extra shoots,
leaves, and flowers (Gudkov and Vinichuk,2006).
3. Radiation-induced death of the main root
meristem in plants with pivotal root systems
results in more active development of lateralroots, which in turn provokes growth of someabove-ground organs. Swelling-like excrescentson leaves, stems, roots, flowers, and other organs also appeared as the result of irradiation in
the 30-km zone in 1986. In 1987 and the years
following, the number of such abnormalities
increased and were observed mainly in coniferous trees, on which needles are replaced once
every few years and on perennial shoots andbranches (Figure 9.8).
4. Table 9.13 presents examples of radiationinduced morphologic changes in pine (Pinus silvestris) and spruce (Picea abies).

TABLE 9.12. Some Radiation-Induced Morphological Changes in Plants in Heavily Contaminated Territories after the Catastrophe (Grodzinsky, 1999; Gudkov and Vinichuk, 2006)
Part

Morphological changes

LeavesIncrease or decrease in size and quantity
Shape change
TwistsWrinklesNervation break
Asymmetry
Thickening
Leaf plates inosculation
Fasciations and swellings
Appearance of necrotic spots
Loss of leaf plate
Premature defoliation
Additional vegetative lateral andapex shoots
Impairment of geotopical orientationof the shoots“Bald” shoots
Speedup or inhibition of growthPhyllotaxis failure (order of leaf placing)
Color change
Loss of apical dominanceDichotomy and fasciations
Change of intercepts
Swellings
Speedup or inhibition of growth
Splitting of main root
Death of main root
Trimming of meristem zone
Absence of lateral roots
Swellings and twists
Appearance of aerial roots
Heliotropism break
Speedup or inhibition of flowering
Color change
Increase or decrease of quantity
Shape change
Defoliation of flowers and floscules
Swellings
Sterility

Shoots

Stems

Roots

Flowers

5. The number of pollen structural anomalies in winter wheat increased in the heavily contaminated territories (Kovalchuk et al.,2000).
6. Several years after the catastrophe
there was a significant rise in the incidence

247

Yablokov: Radioactive Impact on Flora

Figure 9.8. Anomalies in the shoots of pine (Pinus silvestris: A, B) and spruce (Picea excelsa: C–G) in the
30-km zone in 1986–1987 (Kozubov and Taskaev, 2002; Grodzinsky et al., 1991).

of various teratological characteristics inplantain seedlings (Plantago lanceolata) growing within the 30-km zone (Frolova et al.,1993).
7. The incidence of two morphologic characteristics in winter wheat (Triticum aestivum) increased after the catastrophe and decreased in
the next two generations (Group 1); the frequency of nine other morphologic characteristics (Group 2) increased in subsequent generations (Table 9.14).
8. Irradiation in the contaminated territories caused a noticeably stronger influence onbarley pollen than did experimental gamma-

irradiation done under controlled conditions(Table 9.15).
9. Chernobyl radiation, causing morphogenetic breaks, provokes the development oftumors caused by the bacterium Agrobacterium
tumefaciens. Active development of such tumors
is seen in some plants, including Hieracium
murorum, Hieracium umbellatum, Rubus idaeus, andRubus caesius, in the heavily contaminated territories (Grodzinsky et al., 1991).
10. Tumorlike tissue is found in 80% of individual milk thistle (Sonchus arvensis) plants growing in heavily contaminated soil (Grodzinsky
et al., 1991).

TABLE 9.13. Chernobyl’s Irradiation Impact on Pine (Pinus silvestris ) and Spruce (Picea abies ) Morphometrics (Sorochinsky, 1998)∗

Pine
Spruce∗Characters

Low contamination

Heavy contamination

Length of needles, mm
Weight of needles, mg
Length of needles, mm
Weight of needles, mg

60 ± 480 ± 316 ± 25±1

19 ± 314 ± 240 ± 395 ± 5All differences are significant.

248
TABLE 9.14. Frequency of Some Morphologic
Changes in Three Generations of a Species of Winter Wheat (Triticum aestivum) in the ChernobylContaminated Territories (Grodzinsky et al., 1999;
Grodzinsky, 2006)

TABLE 9.16. Influence of a Chernobyl Soil Extract(Cs-137 and Ce-144 with Total Activity of 3.1 ×
104 Bq/kg) on Growth and Cell Division of a Stramonium (Datura stramonium; Grodzinsky, 2006)

Year
Characters

1986

Group 1
Infertile zones in spike
Truncated spike
Lengthened stem
Scabrous beard
Group 2
Split spike
Lengthened beard
Angular forms
Change of stalk color
Spike gigantism
Stem plate
Additional spikelets

1987

1988

49.0
10.0
4.4
1.4

29.8
9.4
4.7
3.4

1.9
0.8
5.4
2.9

4.5
2.8
4.9
0.9
1.4
4.5
14.0

11.1
2.8
14.0
1.7
1.8
5.7
14.8

9.4
4.7
24.7
1.9
2.9
4.9
29.7

11. In the heavily contaminated territories
there was a significant increase in gall formation on oak (Quercus) leaves (Grodzinsky et al.,1991).
12. Formation of tumoral tissue (callus) inplants under the influence of soil contaminated
TABLE 9.15. Frequency of Abnormal Barley(Hordeum vulgare ) Pollen Grains (per 1,000,000)
after 55 Days of Irradiation around Chernobyl’s
NPP and in the Experimental Gamma-Field(Bubryak et al., 1991)

30-km zone

Experimental
gamma-field

Cells,
per 1 g tissue,

Dose rate,
μSv/h

Dose,
mSv

Abnormalgrains,%Control (0.96)
59
320
400
515

1.3
75
422
528
680

0
23
79
86
90

Background(0.11)
5
50
500
5,000
50,000

0.1

0

3.0
29.6
296
2,960
29,600

43
45
59
57
72

Normal tissue
With an extract
Tumorous tissue
With an extract

Cells,
per callusn × 105%n × 105

%

39.7
38.9
23.0
32.4

100
98
100
140.7

78.6
100.4
74.5
91.5

100
127.6
100
122.8

with radioactivity has been confirmed experimentally (Table 9.16).
13. There is some tendency toward normalization of the number of gametogenetic anomalies in soft wheat (Triticum aestivum) in four to
six generations after the Chernobyl irradiation,
but there was an accumulation of mutations
in some wheat populations (Grodzinsky et al.,1995a).
9.3. Genetic Changes
1. Immediately after the catastrophe, the frequency of plant mutations in the contaminatedterritories increased sharply, and the increase
was maintained at a high level for several years(Tables 9.17 and 9.18).
2. In the first 2–3 years after the catastrophe, the number of lethal and chlorophyll
TABLE 9.17. Frequency (%) of Chlorophyll Mutations in Barley (Hordeum vulgare ), and Rye (Secale seriale ) in the 30-km Zone with Cs-134, Cs137, Ce-144, and Ru-106 Ground Contamination(Grodzinsky et al., 1991)
Contamination
Years
Control 1986 1987 1988 1989
Rye, var. “Kiev-80”
Rye, var.
“Kharkov-03”
Barley, var. # 2

0.01
0.02

0.14 0.40 0.91 0.71
0.80 0.99 1.20 1.14

0.35

0.81 0.63 0.70 0.71

249

Yablokov: Radioactive Impact on FloraTABLE 9.18. Frequency of Chromosomal Aberrations (%) in Root Meristems of Some CultivatedPlants in the Chernobyl-Contaminated Territories,
1986–1989 (Grodzinsky, 2006)∗
Years

Lupinus alba
Pisum sativum
Secale cereale
Triticum aestivum
Hordeum vulgare∗

Control

1986

1987

1988

1989

0.9
0.2
0.7
0.9
0.8

19.4
12.9
14.9
16.7
9.9

20.9
14.1
18.7
19.3
11.7

14.0
9.1
17.1
17.7
14.5

15.9
7.9
17.4
14.2
9.8

All differences from controls are significant.

mutations in all studied populations of Arabidopsis thaliana in the 30-km zone increased significantly. The original spontaneous level of mutation was reached in 6 years in areas withgamma-radiation levels up to 10 mR/h. In
areas with gamma-radiation levels up to 130
mR/h the level of mutations was up to eightfold higher than the spontaneous level for 8
years after the catastrophe (Abramov et al.,1995).
3. The frequency of mutations in wheat(Triticum aestivum) was sixfold higher in the contaminated territories (Kovalchuk et al., 2000).
Some 13 years after the catastrophe the frequency of chromosome aberrations in two
wheat cultivars in the 30-km zone was significantly higher than the spontaneous frequency(Yakimchuk et al., 2001).
4. In acorns of the oak Quercus robur andthe pine Pinus silvestris in Voronez City areas
contaminated by Chernobyl fallout there wassignificantly increased mitotic activity, demonstrated by increased frequency of cells with aresidual karyo nucleus at metaphase, anaphase,and telophase and with multinucleated cells
persisting “many years” after the catastrophe (Butoryna et al., 2000; Artyukhov et al.,2004).
5. The level of chromosomal aberrations
in onions was correlated with the densityof radioactive contamination of the territory(Table 9.19).
6. The average frequency of mutations inpine (Pinus silvestris) correlated with the densityof radiation contamination in an area, and in
the 30-km zone was 10-fold higher than in control locations (Shevchenko et al., 1996).
7. Progeny tests of plantain (Plantago lanceolata), gosmore (Hypochoeris radicata), autumnal hawkbit (Leontodon autumnalis), wall lettuce(Mycelis muralis), bloodwort (Achillea millefolium),
gold birch (Solidago virgaurea), and field wormwood (Artemisia camprestris) collected in the 30km zone (gamma-activity at ground level 130–
3,188 Ci/km2 ) and after additional intense irradiation developed significantly more mutations
than in controls (i.e., the number of chromosomal aberrations is correlated with the density ofcontamination). Only devil’s-bit (Succisa pratensis) showed increased resistance to radioactivity(Dmitryeva, 1996).
8. The significantly increased mutation levelin pine (Pinus sylvestris) seeds from the 30-km
zone persisted for 8 years after the catastrophe(Kal’chenko et al., 1995).
9. In the 6 to 8 years after the catastrophe, the number of meiosis anomalies in microspore formation (the number of anomalies
in a root meristem) and the number of pollen
grain anomalies documented in 8–10% of

TABLE 9.19. Damage of Apical Root Meristem (Growing Tip) of Onions (Allium cepa) under Different
Levels of the Chernobyl Soil Contamination (Grodzinsky, 2006)
Percent of control
Soil activity,
kBq/kgControl
37
185
370

Number ofcells, n

Mitotic
index,%

Aberrant
cells

Cells withmicronucleus

Degenerate
cells

15,00533,27529,29023,325

4.1
4.4
4.4
117

100
240
216
150

100
171
129
229

100
250
500
900

250
TABLE 9.20. Change in Anthocyanin Concentration in Irradiated Plants (Grodzinsky, 2006)
Levels ofirradiation
Corn (Zea mays),sprouts
Mung (Phaseolus
aureus)Arabidopsis
thaliana

Anthocyanin(% of control)

Soil 975 Bq/kg

119

Chronic irradiation,
0.5 GyChronic irradiation,
0.5 Gy157
173

94 plant species correlate with the level ofgamma-irradiation (Kordyum and Sydorenko,
1997).
10. In natural populations of Crepis tectorum
from the 30-km zone, the sprouting of seeds
did not exceed 50%. The number of a growing root cells with chromosome disorders (inversions, translocations, change in number ofchromosomes, etc.) is significantly higher thanin controls (Shevchenko et al., 1995).
11. The number of sterile pollen grains inviolets (Viola matutina) correlates with the levelof radioactive soil contamination (Popova et al.,1991).
12. More than a 10-fold lower frequency of extrachromosomal homologous
recombinations are found in native Arabidopsis
thaliana plants from radioactively contaminatedterritories (Kovalchuk et al., 2004).
13. Unique polynoteratogenic complexes areseen in the 30-km Chernobyl zone: a highpercentage of pollen grains and spores withdifferent genetic anomalies (underdeveloped
pollen grains/spores, dwarf and ultradwarf
forms, and polynomorphs that diverge fromthe norm in several morphological characters). This indicates that the Chernobyl catastrophe caused a “geobotanical catastrophe”(Levkovskaya, 2005).
9.4. Other Changes in Plants andMushrooms in the ContaminatedTerritories
1. Coniferous forests have suffered moststrongly from irradiation (so-called “Red for-est”) as compared with mixed and deciduous
forests (Kryshev and Ryazantsev, 2000).
2. Some metabolic processes in plants
are disturbed in the contaminated territories(Sorochin’sky, 1998). Table 9.20 lists examples
of such impairments, expressed in changes ofanthocyanin (purple color) concentration.
3. Radiosensitivity of some plant species increases under chronic low-rate irradiation in
the 30-km zone owing to a gradual loss of theability to repair DNA (Grodzinsky, 1999).
4. Some phenolic compounds with alteredqualitative structure accumulated in all winterwheat, winter rye, and corn cultivars in the
30-km zone during the 6 years after the catastrophe (Fedenko and Struzhko, 1996).
5. The radial growth in trees in the heavily
contaminated territories was slowed (Kozubov
and Taskaev, 1994; Shmatov et al., 2000).
6. A new form of stem rust fungus (Puccinia
graminis) is present in the Chernobyl zone, andits virulence is greater than in the control form
(Dmitryev et al., 2006).
It is clear that plants and mushrooms became
natural accumulators of Chernobyl radionuclides. The levels of such uptake and the transition of radionuclides from soil to plants andmushrooms are specific for each radionuclide
and vary from species to species, by season, byyear, and by landscape, etc.
Chernobyl irradiation has caused many
structural anomalies and tumorlike changes inmany plant species and has led to genetic disorders, sometimes continuing for many years. It
appears that the Chernobyl irradiation awakened genes that had been quiescent for longevolutionary periods.
Twenty-three years after the catastrophe it isstill too early to know if the whole spectrum ofplant radiogenic changes has been discerned.
We are far from knowing all of the consequences for flora resulting from the catastrophe.
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CHERNOBYL

10. Chernobyl’s Radioactive Impact on Fauna
Alexey V. Yablokov
The radioactive shock when the Chernobyl reactor exploded in 1986 combined withchronic low-dose contamination has resulted in morphologic, physiologic, and genetic
disorders in every animal species that has been studied—mammals, birds, amphibians, fish, and invertebrates. These populations exhibit a wide variety of morphologicaldeformities not found in other populations. Despite reports of a “healthy” environment in proximity to Chernobyl for rare species of birds and mammals, the presence of such wildlife is likely the result of immigration and not from locally sustained populations. Twenty-three years after the catastrophe levels of incorporated
radionuclides remain dangerously high for mammals, birds, amphibians, and fish insome areas of Europe. Mutation rates in animal populations in contaminated territories are significantly higher and there is transgenerational genomic instability inanimal populations, manifested in adverse cellular and systemic effects. Long-term
observations of both wild and experimental animal populations in the heavily contaminated areas show significant increases in morbidity and mortality that bear astriking resemblance to changes in the health of humans—increased occurrence oftumor and immunodeficiencies, decreased life expectancy, early aging, changes inblood and the circulatory system, malformations, and other factors that compromise
health.

The Chernobyl catastrophe has impacted on
fauna and will continue to have an impact for
many decades to come, with effects ranging
from changes in population vitality to abnormal reproductive and genetic disorders. It is
well to remember that Homo sapiens are a part of
the animal kingdom and suffer the same kindsof health consequences that are observed inanimals.
As in the earlier chapters, only a smallpart of the available scientific literature ispresented here, but several monographic reviews have been included: Frantsevich et al.,
1991; Sutshenya et al., 1995; Zakharov andKrysanov, 1996; Sokolov and Kryvolutsky,
1998; Ryabov, 2002; Goncharova, 2000; andothers.

Apart from zoological studies, there aremany hundreds of studies published by veterinarians in Ukraine, Belarus, and Russia thatshow deterioration in the health of cows, boars,
sheep, and chickens in the areas contaminatedby Chernobyl.
The first section of this chapter is devoted
to levels of Chernobyl radionuclide accumulations in various species. The second section
addresses reproductive impairment in animals
in the contaminated territories and the resultant genetic changes. The order of presentation is mammals, birds, amphibians, fish, andinvertebrates.

Address for correspondence: Alexey V. Yablokov, Russian Academyof Sciences, Leninsky Prospect 33, Office 319, 119071 Moscow,
Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19. Yablokov@
ecopolicy.ru

The level of radionuclides maintained in an
animal’s body depends on the transfer ratio(TR, transition coefficient) and the coefficient10.1. Incorporationof Radionuclides

255

256
TABLE 10.1. Maximum Concentration (Bq/kg, Fresh Weight) of Some Radionuclides after theCatastrophe
Nuclide

Bq/kg

Sr-90
Cs-1371,870
400,000
187,000
74,75048,35542,00024,630
7,500
3,320
1,954
1,888
1,610
7601

Cs-134
Cs134/Cs-137

Pu-239 + Pu-240
Pu-238Am-241

Ag-110m
Total gamma

720
60,000100,000
15,000
3,898
3,200
1.3
0.6
12
<0.01
74
58,000113,000
79,500 d.w.2

Species

Country

Bank vole (Clethrionomys glareolus) Belarus
Bank vole (Clethrionomys glareolus) Belarus
Wild swine (Sus scrofa)
RussiaRoe deer (Capreolus capreolus)
RussiaCommon shrew (Sorex araneus) Russia
Little shrew (Sorex minutus)
RussiaYellow neck mouse
Russia(Apodemus flavicollis)
Brown hare (Lepus europaeus)
RussiaMoose (Alces alces)
RussiaWhite tailed deer
Finland
Arctic hare (Lepus timidus)
Finland
Moose (Alces alces)
Finland
Moose (Alces alces)
SwedenReindeer (Rangifer tarandus)
Finland
Bank vole (Clethrionomys glareolus) Belarus
Reindeer (Rangifer tarandus)
NorwaySheep (Ovis ammon)
NorwaySheep (Ovis ammon)
Great Britain(Cumbria)
Roe deer (Capreolus capreolus)
Germany
Bank vole (Clethrionomys glareolus) Belarus
Bank vole (Clethrionomys glareolus) Belarus
Bank vole (Clethrionomys glareolus) Belarus
Wild boar (Sus scrofa)
BelarusCow (Bos taurus)
Roe deer (Capreolus capreolus)
Wild boar (Sus scrofa)
Otter scats

Reference
Ryabokon’ et al., 2005∗
Ryabokon’ et al., 2005∗
Pel’gunov et al., 2006
Pel’gunov et al., 2006
Ushakov et al., 1996
Ushakov et al., 1996
Ushakov et al., 1996
Pel’gunov et al., 2006
Pel’gunov et al., 2006
Rantavaara, 1987
Rantavaara et al., 1987
Rantavaara et al., 1987
Johanson andBergström, 1989
Rissanen et al., 1987
Ryabokon’ et al., 2005∗
Strand, 1987
Strand, 1987
Sherlock et al., 1988

Heinzl et al., 1988
Ryabokon’ et al., 2005∗
Ryabokon’ et al., 2005∗
Ryabokon’ et al., 2005∗
Borysevich and
Poplyko, 2002
Great Britain, 1986 Jones et al., 1986
Western Europe
Eriksson et al., 1996
FranceTchykin, 1997
Scotland, July 1986 Mason and
MacDonald, 1988∗

Calculation from figure (A.Y.).
Up to 33 times higher than pre-Chernobyl level (Danell et al., 1989).
2
10.7 times higher than the pre-Chernobyl peak concentration.
1of accumulation (CA), that is, on the relationship between the specific activity of a radionuclide in a body and the specific activity of thesame radionuclide in the environment [TR =(Bq/kg of animal biomass)/(kBq/m2 for background contamination); CA = (Bq/kg of animal biomass)/(Bq/kg of air, soil, or water)].
Animals, from mammals to birds, fish, worms,
and insects, depend upon whatever food they
can catch or forage. The health and survival of

the animals provide a view into environmental
radiation levels and effects.
1. Table 10.1 presents the maximum concentrations of some radionuclides in mammals
after the catastrophe.
2. Indicator species such as the bank vole
(Clethrionomys glareolus) and the yellow-neckedmouse (Apodemus flavicollus) that inhabit the natural forest ecosystems of Belarus showed maximum levels of Cs-134 and Cs-137 for 1 toYablokov: Radioactive Impact on Fauna

Figure 10.1. Time course of Sr-90 activity concentration (Bq/kg) in two Belarussian populations ofbank voles (Clethrionomys glareolus) in 1991 and1996 (5 and 10 years after the catastrophe). Standard deviations of mean values are indicated: p <0.01 in comparison with previous year (Ryabokon’
et al., 2005).

2 years after the catastrophe, followed by an
exponential decrease. However, incorporated
Sr-90 concentrations increased up to 10 years
after the catastrophe (Figure 10.1).
3. Five years after the meltdown, significant
Am-241 activity was detected in bank voles(Clethrionomys glareolus) from areas with high levels of contamination. Levels increased up to the10th year and are expected to increase further(Ryabokon’ et al., 2005).
4. There is marked individual variability inthe incorporation of Cs-134, Cs-137, Sr-90, Pu,
and Am-241 in the bank vole (Clethrionomys glareolus) populations living in contaminated territories of Belarus (Figure 10.2) (Ryabokon’ et al.,2005).
5. Radionuclide level accumulation for roe
deer (Capreolus capreolus) can vary from 10- to 30fold according to seasons (McGee et al., 2000).
6. During the autumn in Ukraine, the levelof Cs-137 accumulation in mice species (Muridae) and the internal organs of fawns increased
11-fold (Krasnov et al., 1997). The greatest contamination in fawns was due to grazing on aspen, oak, bilberry, and heather (Krasnov et al.,1998).

257

7. Ten years after the catastrophe, in contaminated areas of Western Europe, radioactivity in the meat of roe deer (Capreolus capreolus)
reached an average of 58,000 Bq/kg and that inwild boar (Sus scrofa) was up to 113,000 Bq/kg(Eriksson and Petrov, 1995; Eriksson et al., 1996;
Tchykin, 1997).
8. Decrease in Cs-137 concentration in cattle(Bos taurus) in the contaminated territories is
occurring more slowly than was predicted by
all of the International Atomic Energy Agency(IAEA) models (Thiessen et al., 1997).
9. The level of Cs-137 incorporation issignificantly different in cattle (Bos taurus) in theheavily and less contaminated areas in Ukraine(Table 10.2).
10. Accumulation of Cs-137 shows significant individual variation in wild boar (Sus scrofa)
and roe deer (Capreolus capreolus) and is morehomogeneous in moose (Alces alces), depending
not only upon species-specific food chains, butalso upon spotty radioactive contamination (seeChapter 1 for details) and on activity in a specific area (Table 10.3).
11. The concentration of Cs-137 in wild
ungulates in the contaminated territories increased for 7 to 20 years after the catastrophe, and the increased uptake occurred despite
lower levels of ambient radioactive contamination in some areas (Figure 10.3).
12. Study of 44 bird species in the Chernobyl
5-km zone from 2003 to 2005 revealed thatthe greatest contamination was present during nesting and hatching. Females accumulate
more Sr-90 than males, and nestlings and juveniles accumulate more than females. Cs-137
accumulation did not differ between young andadult birds or between the sexes. Maximum
levels of Sr-90 and Cs-137 accumulation are
shown in Table 10.4.
13. In Belarus, 10 years after the catastrophe,levels of total gamma-radionuclides in the bodies of teals (Querquedula querquedula and Q. crecca)
exceeded 13,000 Bq/kg; in mallard ducks (Anasplatyrhynchos) it was about 10,000 Bq/kg; and incoots (Fulica atra) it was more than 4,000 Bq/kg(Sutchenya et al., 1995).

258

Figure 10.2. Individual variability in the level of incorporated radionuclides in the bankvole (Clethrionomys glareolus) population in Belarus: Cs-137 and Cs-134 (3 years after thecatastrophe) and Pu-238, Pu-239, Pu-240, Am–241, and Sr-90 (10 years after) (Ryabokon’
et al., 2005).

14. Intraspecies (individual) variations of
Cs-137 concentrations are greater than interspecies ones (Table 10.5).
15. In the 30-km zone, accumulations of Cs137 and Sr-90 reached 5.3 kBq/kg in some amphibians. The transfer rate (TR) from substrate
to animal measured in Bq/kg demonstrated

that the TR is higher for Sr-90 and less for
Cs-137 in all the amphibians studied. The TRs
for Sr-90 in decreasing order were: red-bellied
toad (Bombina bombina), spade-footed toad (Pelobates fuscus), tree frog (Hyla sp.), and true frogs(Rana sp.), respectively, 44.1, 34.4, 20.6, and20.4 (Bondar’kov et al., 2002).

259

Yablokov: Radioactive Impact on Fauna
TABLE 10.2. Cs-137 Incorporation (Bq/kg,
Bq/liter) in Amniotic Membranes, Placentas, andColostral Milk of Cows from More Heavily andLess Contaminated Areas, Zhytomir Province,
Ukraine, 1997–1999 (Karpuk, 2001)1
Level of contamination

Afterbirth andamniotic membranes
Placentas (cotyledons)
Colostral milk1∗

5–15 Ci/km2< 0.1 Ci/km2

24.3 ± 2.1∗

3.1 ± 0.1

36.3 ± 4.2∗
17.3 ± 1.4∗

4.9 ± 0.4
4.4 ± 0.5

Data for Ci/km2 – summarized for two farms by A. Y.
p < 0.001.

16. The highest TR for Cs-137 was foundin the European common toad (Bufo bufo),12.9 and the moor frog (Rana arvalis), 10.0
(Bondar’kov et al., 2002).
17. Levels of contamination after the catastrophe in some fishes are listed in Table 10.6.
18. Initial forecasts of a rapid Cs-137 elimination from fishes (in 7 to 8 years) appear to beinaccurate: after 3 to 4 years of fast decline, lowering of contamination levels slowed drastically(Figure 10.4).
19. Up until 1994 the level of Cs-137 in perch(Perca fluviatilis) in Swedish and Finnish lakes
exceeded the official safe level (Kryshev andRyazantsev, 2000).
TABLE 10.3. Cs-137 Accumulation (Bq/kg of Wet
Weight) in the Muscles of Several Species of Game
Mammals from Bryansk Province Areas Contaminated at a Level of 8–28 Ci/km2 , 1992–2006(Pel’gunov et al., 2006)
Species

M ±m

Wild boar (Sus scrofa), 13,120 ± 3,410
n = 59Roe deer (Capreolus
12,660 ± 1,340
capreolus), n = 97
Moose (Alces alces),
1,860 ± 160
n = 30Brown hare (Lepus
2,560
europaeus), n = 8∗

Russian permissible level = 320 Bq/kg.

Min–max
250–187,900∗
800–74,750

Figure 10.3. Average concentration of Cs-137(Bq/kg fresh weight) in moose (Alces alces) in contaminated territories of Bryansk Province, Russia, forthree periods after the catastrophe (Pel’gunov et al.,2006).

20. From 1987 to 2002 the amount of Cs-137
in catfish (Silurus glanis) muscle in the Chernobyl
Nuclear Power Plant (NPP) cooler reservoir increased from 1,140 to 6,500 Bq/kg (Zarubin,2004).
21. In landlocked bodies of water in thecontaminated areas, radionuclide concentration in raptorial fish reached 300 × 103 Bq/kg(Gudkov et al., 2004).
22. Several hours after the catastrophe,
honey in Germany was heavily contaminatedwith I-131 (>14 × 103 Bq/kg) and by Ru-193(>750 Bq/kg; Bunzl and Kracke, 1988).
23. Table 10.7 provides data on Chernobyl
radionuclide concentrations in zooplankton
that reflect both high levels of bioaccumulationand the wide range of contaminated waters.
24. Radioactive contamination of Baltic
plankton in 1986 reached 2,600 Bq/kg(gross-beta) and 3,900 Bq/kg of Np-239(Ikaheimonen et al., 1988).

240–3,320

10.2. Reproductive Abnormalities

504–7,500

Regular biological observations in the heavily contaminated territories of Ukraine, Belarus, and European Russia were not begun

260
TABLE 10.4. Concentration of Some Radionuclides (Bq/kg, Fresh Weight) in Several Bird Species after
the CatastropheRadionuclide
Sr-90

Cs-137

Cs-134
Cs-134, Cs-137
Zr-95
Nb-95
Total gamma

Bq/kg

Species

Country

Reference

1,635,000
556,000
226,000
367,000
305,000
85,000
1,930
450
470
350
112
10,469
6,666
467
1,292
>13,000

Great tit (Parus major)
Long-tailed tit (Aegithalos caudatus)
Nightingale (Luscinia luscinia)
Great tit (Parus major)
Blackbird (Turdus merula)Song thrush(Turdus philomelos)
Mallard duck (Anas platyrynchus)
Gray partridge (Perdix perdix)
Woodcock (Scopolas rusticola)
Robin (Erithacus rubecola)
Robin (Erithacus rubecola)
Waterfowl (Anas sp.)
Goldeneye (Bucephala clangula)
Robin (Erithacus rubecola)
Robin (Erithacus rubecola)
Teal (Quercuedula quercuedula
and Q. crecca)
Mallard ducks (Anas platyrhyncha)
Coots (Fulica atra)

UkraineUkraineUkraineUkraineUkraineUkraineRussiaRussiaRussiaNetherlands
Netherlands
FinlandFinlandNetherlands
Netherlands
BelarusGaschak et al., 2008
Gaschak et al., 2008
Gaschak et al., 2008
Gaschak et al., 2008
Gaschak et al., 2008
Gaschak et al., 2008
Pel’gunov et al., 2006
Pel’gunov et al., 2006
Pel’gunov et al., 2006
De Knijff and Van Swelm, 2008
De Knijff and Van Swelm, 2008
Rantavaara et al., 1987
Rantavaara et al., 1987
De Knijff and Van Swelm, 2008
De Knijff and Van Swelm, 2008
Sutchenya et al., 1995

BelarusBelarus

Sutchenya et al., 1995
Sutchenya et al., 1995

10,000>4,000

until 2 months after the explosion. Fortunately,
during that time, data concerning the harmful
effects of the Chernobyl contamination on cattle and other farm animals were collected frommany veterinarians (Il’yazov, 2002; Konyukhov
et al., 1994; Novykov et al., 2006; and manyothers).
1. By September 1986, the population ofmurine species in the heavily contaminatedUkrainian territories had decreased up to fivefold (Bar’yakhtar, 1995).
TABLE 10.5. Cs-137 Accumulation (Bq/kg of
Wet Weight) in Three Game Bird Species from
Bryansk Province Areas Contaminated at a Levelof 8–28 Ci/km2 , 1992–2006 (Pel’gunov et al.,2006)
Species
Mallard duck (Anasplatyrynchus), n = 28
Gray partridge (Perdix
perdix), n = 14
Woodcock (Scopolas
rusticola), n = 11∗

Average

Min–max∗920

314–1,930

350

280–450370

270–470

Russian permissible level—180 Bq/kg.

2. The mortality of laboratory mice (Musmusculus) that remained in the 10-km zone from
1 to 14 days increased significantly and is associated with additional radiation (Nazarov et al.,2007).
3. There was an increasing incidence of embryo deaths over 22 generations of bank voles(Clethrionomys glareolus) from the contaminatedterritories that correlated with the radionuclide levels in monitored areas. A significantly
high prenatal mortality has persisted despitea decrease in the level of ground contamination (Goncharova and Ryabokon’, 1998a,b;Smolich and Ryabokon’, 1997).
4. For 1.5 months sexually active male rats
(Rattus norvegicus) within the 30-km zone demonstrated suppressed sexual motivation and erections, which resulted in a reduction in thenumber of inseminated females, reduced fertility, and an increase in preimplantation deaths(Karpenko, 2000).
5. Observations in farm hog sires (Sus
scrofa) with Cs-137 contamination levels of
1–5 Ci/km2 plus Sr-90 at a level of 0.04–
0.08 Ci/km2 demonstrated significantly fewer

261

Yablokov: Radioactive Impact on Fauna
TABLE 10.6. Concentration (Bq/kg) of Some Radionuclides in Fishes after the Catastrophe
NuclideConcentration

Species

Country

ReferenceCs-137

16,00010,000
7,100
6,500
4,500
2,000
708
493
190
15–30
55,00012,500157
300,000

Perch (Perca fluviatilis)
Pike (Esox luceus)Whitefish (Coregonus sp.)
Catfish (Silurus glanis)
Bream (Abramis brama)
Vendace (Coregonus albula)
Crucian carp (Carassius carassius)
Bream (Abramis brama)∗“Fish”“Pike and cod”∗∗“Freshwater fish”
Brown trout (Salmo trutta)
Crucian carp (Carassius carassius)
Raptorial fish

FinlandFinlandFinlandUkraineFinlandFinland
RussiaPolandBalticBalticNorwayNorwayRussiaUkraine

Saxen and Rantavaara, 1987
Saxen and Rantavaara, 1987
Saxen and Rantavaara, 1987
Zarubin, 2006
Saxen and Rantavaara, 1987
Saxen and Rantavaara, 1987
Ushakov et al., 1996
Robbins and Jasinski, 1995
Ilus et al., 1987
Ikaheimonen et al., 1988
Strand, 1987
Brittain et al., 1991
Ushakov et al., 1996
Gudkov et al., 2004

Cs-134/137
Sr-90
Total gamma∗

120 times that of pre-Chernobyl level.
About five times the pre-Chernobyl level.

∗∗

semen channels (especially for hogs 2 to 4 years
old), as well as widening, necrosis, and unusual positions of sex cells within the channels(Table 10.8).
6. There was a marked decrease in insemination and 1.8 to 2.5% of the piglets were born
dead or with congenital malformations involving the mouth, anus, legs, and gigantic heads,
etc. (Oleinik, 2005).
7. Pregnancy outcomes and some healthcharacteristics of calves (Bos taurus) (a Poles’e
breed) in the heavily contaminated Korosten
and Narodnitsky districts, Zhytomir Province,
Ukraine (Cs-137 levels of 5–15 Ci/km2 ) weresignificantly different from the same species
bred in the less contaminated (<0.1 Ci/km2 )Baranovka District. More calves had abnormal weights, and morbidity and mortality
were higher in the heavily contaminated areas(Table 10.9).
8. Calving problems included delayed delivery of the placenta and amniotic membranes.
The weight of the amniotic tissues and placental lobule characteristics were significantly
lower in cows (Bos taurus) in contaminated areas(Table 10.10).
9. House mice (Mus musculus) populationsin the heavily contaminated areas decreased

Figure 10.4. Dynamics of concentration of Chernobyl Cs-137 in lake trout (Salmo trutta) and charr(Salvelinus alpinus) in lakes in northern Norway from1986 to 1998. Dotted line, forecast; solid line, actual
concentration (Jonsson et al., 1999).

262
TABLE 10.7. Some Recorded Chernobyl Radionuclides in Zooplankton (after J. Turner, 2002)
Sea

Date

North Sea off Norway

May–June

Mediterranean off
CorsicaMay 8–15 (rainfall on
May 4–5), 1986

Black Sea

May–June, 1986

North Pacific andBering Sea

June–July, 1986

Notes

Reference

At depth of 222 m. Fecal pellets insediment traps
Ce-141 and Ce-144, 200 m depth.
>70% composed of copepod fecalpellets
At a depth of 1,071 m (Emiliania
huxleyi)From 110 to 780 m

owing to sterility, as well as to abnormal
spermatozoa (Pomerantseva et al., 1990, 1996).
10. Higher antenatal mortality was observed in field mice (Clethrionomys and Microtus sp.) in the first years after the catastrophe in the heavily contaminated areas owing
to pathologic changes in the urogenital tractand embryo resorption in the early stages ofdevelopment (Medvedev, 1991; Sokolov andKrivolutsky, 1998).
11. In October 1986 in Chernobyl City, aspecial animal facility was established for laboratory rats (Rattus norvegicus) from the breedinggroup that originated in the Kiev laboratorycolony. After the catastrophe there was a significant decrease in the average life span of laboratory rats (Rattus norvegicus) in animal facilities inboth Chernobyl and Kiev (Table 10.11).
12. The sex ratio of bank voles (Clethrionomyssp.) as a percent of the current year of breeding
young deviated significantly in the heavily contaminated territories (Kudryashova et al., 2004).

Kempe and Nies, 1987
Fowler et al., 1987

Buesseler et al., 1987;
Kempe et al., 1987
Kusakabe and Ku, 1988

13. Irradiation caused increased prenatal
and postnatal mortality and reduced breeding
success for bank vole populations (Clethrionomyssp.) in contaminated areas (Kudryashova et al.,2004).
14. Radiation contamination caused bankvole populations (Clethrionomys sp.) to mature
early and intensified reproduction, both ofwhich are associated with premature aging andreduced life expectancy (Kudryashova et al.,2004).
15. The reproductive rate (number of litters
during the reproductive period and numberof newborns in each litter) of laboratory mice(Mus musculus) line CC57W of a Chernobyl experimental population steadily decreased overseven generations. At the same time the number that died in the first month postnatal period and preimplantation period significantly
increased (Stolyna and Solomko, 1996).
16. Long-term studies of small-rodent populations (Clethrionomys glareolus and others) in

TABLE 10.8. Histological Characteristics of Hog Testes Associated with Sr-90 and Cs-137 Contamination (Oleinik, 2005)
Specific numbers of semen channels
Age
5 months
8 months
2 years
4 years∗p < 0.05.

Thickness of white envelopes, mkm

ContaminatedControl

ContaminatedControl

39.0 ± 0.7
20.5 ± 0.9
13.4 ± 0.4
12.9 ± 0.6

63.7 ± 2.8∗
21.4 ± 0.9∗
21.2 ± 0.8
19.2 ± 0.9∗

178.0 ± 8.5∗
231.0 ± 12.7∗
335.0 ± 8.81∗
380.3 ± 22.2

465.2 ± 11.7
572.0 ± 18.1
428.0 ± 17.3
349.5 ± 26.0

263

Yablokov: Radioactive Impact on Fauna

TABLE 10.9. Weight, Total Morbidity, and Mortality (%) of Calves from Heavily (5–15 Ci/m2 ) and Lower(<1 Ci/km2 ) Contaminated Districts of Zhytomir Province, Ukraine, 1997–1999 (Karpuk, 2001)
WeightHeavy contamination
Low contamination∗

Less than 26 kgMore than 35 kg

NormalTotal
morbidity

Mortality

13.3
20

10
15

76.7
65

34
50.5∗

7
12∗

p < 0.01.

the Kanev Natural Reserve pre- and postcatastrophe revealed disturbances in ecological balance, delay in the “population clock” run, andbiotic turnover (Mezhzherin and Myakushko,1998).
17. The litter size of wolves (Lupus lupus)
in Russian contaminated territories correlateswith the level of radioactive contaminationand specific activity of Cs-137 in their fur(Adamovich, 1998).
18. Observations from 1978 to 1999, covering 5,427 horse-breeding years, indicated thatthe success of breeding free-range horses (Equus
caballus) correlated with the level of farm radioactive contamination: the greatest numberof abortions, stillbirths, and sick foals occurredin a horse-breeding center in the Gomel area
(Belarus) from 1993 to 1999 when contamination levels were up to 40 Ci/km2 . Anintermediate level of problems was in a horsebreeding center in the Bryansk area, Russia, with background radiation levels of 1–

TABLE 10.10. Some Characters of Afterbirth
Membranes in Cows (Bos taurus ) from Greater andLesser Contaminated Areas, Zhytomir Province,
Ukraine, 1997–1999 (Karpuk, 2001)1
Contamination level

Weight amniotic
membranes, kg
Placental lobules
Numbercm2
1∗

5–15 Ci/km2<0.1 Ci/km2

4.6 ± 0.3

5.6 ± 0.3∗

76.9 ± 4.0
4,043 ± 118∗

5 Ci/km2 , and the fewest problems occurred ina horse-breeding center in the Smolensk area,
Russia, with contamination levels less than
1 Ci/km2 (Yakovleva, 2005).
19. Decreased clutch size of some bird
species was found in the United States in
California, Washington, and Oregon in June–
July 1986, most probably connected with theChernobyl fallout (DeSante and Geupel, 1987;
Millpointer, 1991).
20. Survival rates of barn swallows (Hirundo
rustica) in the most contaminated sites near the
Chernobyl NPP are close to zero. In areas ofmoderate contamination, annual survival is lessthan 25% (vs. about 40% in control populations in Ukraine, Spain, Italy, and Denmark).
Overall, Chernobyl bird populations show dramatically reduced reproductive rates and lower
offspring survival rates (Møller et al., 2005).
21. Abnormal spermatozoa (head deviations, two heads, two tails, etc.) in barn swallows (Hirundo rustica) occurred at significantly
higher frequencies in heavily contaminated areas (Møller et al., 2005).
22. The Chernobyl barn swallow populations are only sustained via immigration fromadjacent, uncontaminated populations. Stable
TABLE 10.11. Average Life Span of Laboratory
Rats (Rattus norvegicus ) under Heavy Irradiation in
Chernobyl City, and Less Irradiation in Kiev (Serkiz,
1995)
October 1986 to 1989

88.0 ± 2.7
4,853 ± 206∗

Data for Ci/km2 —summarized for two farms by A. Y.
p < 0.05.

Life spanmonthsChernobyl City

Kiev

Kiev before
April 1986

20.3 ± 0.8

21.6 ± 0.5

28.2 ± 0.6

264isotope analyses on current and past specimens(from museums) have indicated that current
Chernobyl populations are composed of a morediverse group of individuals (i.e., immigrants)
than is observed in control populations or in
populations collected from the Chernobyl region prior to the disaster (Møller et al., 2006).
23. Detailed surveys of birds indicate thatmany species are either absent or present invery low numbers in the Chernobyl region.
Brightly colored and migratory bird species appear to be particularly sensitive to radioactive
contaminants (Møller and Moussaeu, 2007a).
24. Concentrations of total carotenoids andvitamins A and E in the yolks of the great tit(Parus major) were depressed in the 10-km zone
as compared to concentrations in a less contaminated Ukrainian area or in France. Egg-laying
dates were advanced and clutch sizes increased
in nest boxes with high dose rates. There was
reduced hatching in boxes with high levels of radiation, which eventually eliminated and evenreversed the differences in reproductive success associated with early reproduction andlarge clutch size. These findings are consistent
with the hypothesis that radioactive contamination reduces levels of dietary antioxidants
in yolks, resulting in negative consequences
for hatching and reproductive success (Møller
et al., 2008b).
25. Species richness and abundance of forest
birds declined by more than 50% as contamination levels increased. Abundance of birds
decreased by about 66% in the most contaminated areas as compared to sites with typical(control) background radiation levels (Møller
and Mousseau, 2007a).
26. Great tit (Parus major) and pied flycatcher(Ficedula hypoleuca) species avoided nest boxes in
the heavily contaminated areas to a marked
degree. Where it interacted with habitat for
the great tit and with the laying date for thepied flycatcher, hatching success was depressed
as radioactive contamination increased (Møller
and Mousseau, 2007b).
27. A significant decrease in volume andconcentration of seminal fluids and destruc-tive changes in the testes were observed in several generations of white silver carp (Hypophthalmichthys molitrix) from the breeding stock at a
Chernobyl NPP reservoir-cooler (Verygin et al.,1996).
28. Abnormal growth of testicular connective tissue, decreased sperm concentration, andincreased numbers of abnormal spermatozoa
were found in motley silver carp (Aristichthys
nobilis) that were radiated in 1986 at the ageof 1–2 years and then lived under conditionsof chronic low-dose radiation (Makeeva et al.,1996).
29. Reproductive characteristics of carp
(Cyprinus carpio) correlated with levels of incorporated radionuclides in sperm and eggs
(Figure 10.5).
30. Degenerative morphological changes
were seen in oocytes of pike (Esox lucius) during vitellogenesis in heavily contaminated waters. In gonads of fish from two lakes within the
30-km zone (Smerzhov Lake with Cs-134 andCs-137 levels of 5,800 Bq/kg in 1991, and Perstok Lake, with levels up to 199,900 Bq/kg in1995) the thickness of the radial membrane inegg cells reached 25 − 30 μm, compared with athickness of about 10 μm for egg cells from the
Pripyat River (875 Bq/kg in 1992; Kokhnenko,
2000).
31. Deviation in gametogenesis (i.e., changes
in normal oocytes and nucleus size, developmental abnormalities of oocytes, thickening of
the follicular wall, decomposition of the nucleus, etc.) was found in bream (Abramis brama)
and small fry (Rutilus rutilus) from the Pripyat
River and Smerzhov Lake (Gomel Province,
Belarus). Changes were correlated with thelevel of radiation contamination of the reservoirs (Petukhov and Kokhnenko, 1998).
32. Adult earthworms dominated in heavily
contaminated sites during the first period after
the catastrophe, whereas in control areas there
was parity between adult and young individuals(Victorov, 1993; Krivolutsky and Pokarzhevsky,
1992).
33. Nine years after the catastrophe in bodies of water with heavy radioactivity, 20% of265

Yablokov: Radioactive Impact on Fauna

Figure 10.5. Coefficients of correlation between reproductive characteristics of carp
(Cyprinus carpio) and radionuclide concentration in their eggs and sperm (milt; coefficientsof correlation are given in absolute values): (1) number of eggs (thousands per female); (2)amount of milt (ml per male); (3) quality of milt; (4) fertilization, %; (5) number of prelarvae(thousands per female); (6) number of larvae (thousands per female); (7) larva survival, %;(8) frequency of morphological abnormalities, %; (9) mitotic index, %; (10) frequency ofchromosome aberrations at late blastula stage, % (Goncharova, 1997).

oligochaete (Stylaria lacustris) specimens have sex
cells, whereas normally this species reproduces
asexually (Tsytsugyna et al., 2005).

10.3. Genetic Changes
1. In 1989 there was a significantly higher
frequency of cytogenetic disorders in somaticand germinal cells (number of chromosomes
and aberrations in marrow cells) in bank voles(Clethrionomys glareolus) and yellow-necked mice
(Apodemus flavicollis) in territories with Cs-137
levels of 8–1,526 kBq/m2 and in laboratory
mice (Mus musculus) lines CBA × C57Bl/6j(F1) in the heavily contaminated areas. Theseabnormalities were maintained at high levels
for no fewer than 22 generations, which increased from 1986 until 1991/1992 in all the
populations studied, despite a decrease incontamination (Goncharova and Ryabokon’,1998a,b; Smolitch and Ryabokon’, 1997;
Ryabokon’, 1999a).
2. In all the studied populations of bankvoles (Clethrionomys glareolus) in heavily contaminated Belarussian territories, polyploidy cells

occurred in an excess of up to three orders ofincidence as compared with precatastrophe frequencies (Ryabokon’, 1999).
3. The number of polyploidy cells in all studied populations of bank voles (Clethrionomys glareolus) in heavily contaminated Belarussian territories correlates with the level of incorporated
radionuclides (Ryabokon’, 1999).
4. The number of genomic mutations in a
population of bank voles (Clethrionomys glareolus)
increased to the 12th generation after the catastrophe (from 1986 to 1991) despite a decreasein background radioactivity (Ryabokon’, 1999).
5. The offspring of female bank voles (Clethrionomys glareolus) captured in the contaminatedterritories and raised under contamination-free
conditions showed the same enhanced level ofchromosomal aberrations as the contaminatedmothers (Ryabokon’ and Goncharova, 2006).
6. Wild populations of house mice (Musmusculus) living in the contaminated territories
have a significantly increased level of dominant lethal mutations and chromosome translocations. The frequency of reciprocal translocations in spermatocytes was higher in areas
with more intensive contamination during the266
TABLE 10.12. Abnormalities in Laboratory Mice(Mus musculus ) Fibroblast Cell Cultures after
5 Days of Exposure in the 10-km Zone (Pelevyna
et al., 2006)

TABLE 10.13. Number of Micronuclei in Polychromatic Erythrocytes of Bone Marrow in Laboratory Mice (Mus musculus ) after 12 Weeks in 30-km
Chernobyl Zone (Sushko et al., 2006)∗

Chromosomal aberrations

Controls
Afterexposure

Percent of cells

Types

Up to 3Up to 24.5

Deletions
Deletions, fragments,
and translocations

Controls
30-km zone∗

period from 1986 to 1994 (Pomerantseva et al.,1990, 1996).
7. The frequency of mutations through several generations in both somatic and germinal
cells of house mice (Mus musculus) remained significantly higher after irradiation as compared
to nonradiated descendants (Dubrova et al.,2000).
8. Laboratory mice (Mus musculus) lines
C57BL/6, BALB/C, CC57W/Mv contained
within the 30-km zone and other rodentscaught in 1995 in the 10-km zone, were foundto have a wide spectrum of cytogenetic anomalies (Glazko et al., 1996).
9. The frequency of mitochondrial DNA mutations in voles in the 30-km zone was significantly increased in the first years after the catastrophe (Freemantle, 1996; Baker, 1996; Hillis,
1996).
10. The number of aberrant alveolar
macrophage cells in bank voles (Clethrionomys
glareolus) was significantly higher in the populations living in heavily contaminated territories(Yelyseeva et al., 1996).
11. The micronuclear frequencies in laboratory mice (Mus musculus) increased significantly
after a 10-day stay in the “Red Forest” (10-kmzone) for the BALB/c line and after 30 days for
the C57BL/6 line (Wickliffe et al., 2002).
12. The rate of chromosome aberrations andembryonic lethality noticeably increased formore than 22 generations of bank voles (Clethrionomys glareolus), whereas the whole-body absorbed dose rates decreased exponentially after
1986 (Goncharova et al., 2005).

Sex

Studiedcells, nCells withmicronucleus

♂
♀
♂
♀

5,000
5,000
5,000
5,000

0.34 ± 0.11
0.29 ± 0.09
4.1 ± 0.45
4.06 ± 0.53

All significantly different from controls.

13. In laboratory mice (Mus musculus), cell
fibroblast cultures originating from embryos
conceived in the 10-km zone demonstratesignificantly increased numbers of cells withchromosomal aberrations, including cells withmultiple aberrations (Nazarov et al., 2007;
Table 10.12).
14. Keeping laboratory mice (Mus musculus)
for 4 months in the 30-km zone resulted in a
sharp and significantly increased incidence of
micronuclei in polychromatic cells of the bonemarrow (Table 10.13).
15. The number of chromosome aberrations in the bank vole (Clethrionomys glareolus) was
higher in a more radioactively contaminatedenvironment (Table 10.14).
16. The level of both somatic and genomic
mutations in a population of barn swallows(Hirundo rustica) in the Chernobyl zone was
two to ten times greater than in other populations in Ukraine or in Italy (Ellegren et al.,1997).
TABLE 10.14. Frequency of Aberrant Cells inBank Voles (Clethrionomys glareolus ) under Various Levels of Radioactive Contamination, 1993,
Bryansk Province, Russia (Krysanov et al., 1996)
Contaminationlevel
20 μR/h
60 μR/h180 μR/h
220 μR/hCells studiednAberrant cell
frequencies

229
593
325
864

0.04 ± 0.008
0.06 ± 0.006
0.13 ± 0.02
0.11 ± 0.02

267

Yablokov: Radioactive Impact on Fauna

Figure 10.6. Normal barn swallow (left) and partial albino (right; photo by T. Mousseau).

17. Barn swallow populations (Hirundo rustica) that originated in the Ukrainian Chernobyl zone after the catastrophe have significantly more (up to 15%) albino mutations(Figure 10.6). Mutation rates seen in Chernobyl
populations have significantly higher numbersof morphological defects as compared to control populations in Ukraine, Italy, Spain, andDenmark (Møller and Mousseau, 2001; Møller
et al., 2007).
18. There are positive correlations between
the number of abnormalities in black redstart(Phoenicurus ochruros) and house sparrows (Passer
domestica) and the level of background radiationin Ukraine (Møller et al., 2007).
19. From 2005 to 2006 there were significant
differences in motility and morphology of live
sperm of barn swallows (Hirundo rustica) breeding in heavily radioactively contaminated areas(390 mR/h) around Chernobyl as compared tosperm from swallows in two less contaminated(0.25 and 0.006 mR/h) areas in Ukraine. The
incidence of sperm with low motility, high linearity, small amplitude, lateral head displacement, and low track velocity increased with increasing background radiation levels (Møller
et al., 2008b).
20. Brown frogs (Rana temporaria, R. arvalis) from the heavily contaminated territories
showed a significantly higher number of aberrant bone marrow and intestinal epithelial cells

and an increased number of micronuclei in peripheral blood (Yelyseeva et al., 1996).
21. The incidence of erythrocytes with micronuclei was higher in the hybrid frog complex(Rana esculenta) in the more contaminated areas
in Bryansk Province (Table 10.15).
22. The frequency of morphological anomalies (congenital malformations) in carp (Cyprinus carpio) embryos, larvae, and fingerlings
was significantly higher in more contaminatedponds in Belarus (Slukvin and Goncharova,
1998).
23. The frequency of chromosome aberrations and genomic mutations in carp (Cyprinus carpio) populations was significantly higher
in more contaminated ponds in Belarus(Goncharova et al., 1996).
24. Colorado beetle (Leptinotarsa decemlineata)
wing color pattern mutations occurred withgreater frequency in the more contaminatedterritories in Belarus (Makeeva et al., 1995).
TABLE 10.15. The Frequency of Micronuclei in
Erythrocytes in Frog Hybrid Complex (Rana esculenta) in Three Populations in Bryansk Province,
1993 (Chubanishvyli, 1996)
Contamination, dose
15 μ R/h
0.22%∗

p < 0.05.

60 μR/h
1.33%

220 μR/h
1.55∗

268
TABLE 10.16. The Frequency of Dominant Lethal
Mutations (DLM) and Recessive Sex-Linked Lethal
Mutations (RLM) in Natural Drosophila (Drosophilamelanogaster ) Populations from the Vetka District
in Gomel Province as Compared with the Population from the Less Contaminated Berezinsk Reserve, Belarus (Glushkova et al., 1999)

DLM
RLM
∗

Vetka
District

Berezinsky
Reserve

42.76 ± 0.88
6.65 ± 0.66

63.09 ± 0.91∗
12.64 ± 1.15∗∗

p < 0.05; ∗∗ p < 0.001.

25. The frequency of lethal and semilethal
mutations in drosophila (Drosophila melanogaster)
populations is significantly higher in the Belarussian contaminated territories (Makeeva
et al., 1995).
26. In natural drosophila (Drosophilamelanogaster) populations from the Vetka District, Gomel Province (radiation level of 24
Ci/km2 ), the incidence of dominant lethal
and recessive sex-linked lethal mutations is
significantly lower than in the less contami-

nated Berezinsky Reserve, as a result of increased radioresistance in the irradiated population (Table 10.16).
27. The highest level of mutations wasobserved in aquatic crustaceans Amphipoda
and Platyhelminth worm populations in the
Chernobyl 10-km zone as compared with populations from the Black and Aegean seas andthe Danube and Dnieper rivers (Tsytsugyna
and Polycarpov, 2007).
28. Table 10.17 presents some additional
data on genetic changes in animals associatedwith the Chernobyl contamination.
10.4. Changes in Other Biological
Characteristics
1. Voles (Clethrionomys sp. and Microtus sp.)from the contaminated areas showed impaired brain development and deformed limbs(Sokolov and Kryvolutsky, 1998).
2. Neutrophilic phagocytic activity to Staphylococcus aureus in the blood serum and the Blymphocytic system was significantly lower in

TABLE 10.17. Examples of Genetic Changes in Animals as a Consequence of the Chernobyl Catastrophe (Based on Møller and Mousseau, 2006)
Species

Genetic marker

Effect, comments

Apodemus flavicollis
Mus musculus

Chromosome aberrations
Reciprocal translocations

Increase by a factor of 3–7
Increase by a factor of 15

Clethryonomys glareolus

Somatic mutation
Multiple substitutions in
Cytochrome-b andtransversions
Mutation and heteroplasmy∗∗
Point mutations

Increased∗
Only from Chernobyl
samples
Increased∗
Increased∗

Microsatellites
DNA breakage I
DNA content
Frequency of aneuploidy
Sex-linked lethal mutations
Chromosomal aberrations

Increased by a factor of 2–10
Increased rate
Changes
Increased
Increased
Increased by a factor of ∼2

Hirundo rustica
Icterus punctatus
Carassius carassius
Four fish species
Drosophila melanogasterThree Oligochaete
species∗

Not statistically significant.
Heteroplasmy—mixed mitochondria in a single cell.

∗∗

Reference
Savchenko, 1995
Pomerantseva et al., 1990,
1996
Matson, 2000
Baker et al., 1999

Wickliffe et al., 2002
Dubrova, 2003; Wickliffe
et al., 2002
Ellegren et al., 1997
Snugg, 1996
Lingerfelser, 1997
Dallas, 1998
Zainullin, 1992
Tsytsugyna and Polycarpov,
2003

269

Yablokov: Radioactive Impact on Fauna
TABLE 10.18. Some Hematological Characteristics of Calf-Bearing Cows from Heavily and Less
Contaminated Areas, Zhytomir Province, Ukraine,
1997–1999 (Karpuk, 2001)1

TABLE 10.19. Frequency of Lung Neoplasms inLaboratory Mice (Mus musculus ) after 20 Weeks
Exposure in the 30-km Zone (Sushko et al.,2006)

5–15 Ci/km2 <0.1 Ci/km2

Neoplasms per mouse

Erythrocytes(thousands/liter)
Leucocytes (g/liter)
Hemoglobin (g/liter)
Basophiles, %Eosinophils, %Segmented
neutrophiles, %Lymphocytes, %Monocytes, %4.8 ± 0.1

5.8 ± 0.2∗

6.2 ± 0.4
78.6 ± 2.0
0.3 ± 0.2
10.0 ± 1.0
24.7 ± 1.5

6.9 ± 0.3
91.4 ± 2.8∗
1.3 ± 0.2∗
4.6 ± 0.3
32 ± 0.9∗

57.7 ± 1.5
3.8 ± 0.3

60.9 ± 0.8∗
4.5 ± 0.3

1

Data for Ci/km2 —summarized for two farms by
A. Y.
∗
p < 0.01.

cows from more contaminated areas (p < 0.05
and p < 0.001; Karpuk, 2001).
3. Hematological characteristics differ significantly in cattle (Bos taurus) from areas withdifferent levels of contamination (Table 10.18).
4. Hypoplasia and degenerative-dystrophic
changes developed in the thymus glands of 20day-old laboratory albino rats (Rattus norvegicus)
whose pregnant mothers lived for 25 days inan area with a Cs-137 level of 116 Ci/km2 andan Sr-90 level of 26 Ci/km2 . Changes included
accelerated cytolysis and lowered mitotic activity. Such thymus gland changes led to immune
disorders (Amvros’ev et al., 1998).
5. Endogenous activity changed significantlyin spinal cord nerve cells and in the cerebrum oflaboratory mice (Mus musculus) lines C57BI/6
after they were in the Chernobyl zone for 40days with background radiation of 100–120
mR/h (Mustafin et al., 1996).
6. Dairy cows (Bos taurus) from areas
contaminated at levels of 15–40 Ci/km2
developed inflammatory and atrophic changes
in lymphoid tissue accompanied by decreased T-lymphocyte functional activity, andthey demonstrated abnormal connective tissue
growth 4 years after the catastrophe (Velykanov
and Molev, 2004).

Control
30-km zone

0.26 ± 0.06
0.77 ± 0.17

7. Dairy cows (Bos taurus) in areas with contamination levels of 15–40 Ci/km2 developed
indurated spleens with reduced volume andsharply reduced white pulp area. There wascoarsening of reticular fibrous structures anddispersed and reduced lymph nodes in the cortex (Velykanov and Molev, 2004).
8. Asymmetry of yellow-neck mouse (Apodemus flavicollis) skulls was significantly higher in
populations from more contaminated territories (Smith et al., 2002).
9. After 20 weeks of exposure in the 30-km
zone the incidence of lung neoplasms in laboratory mice (Mus musculus) was significantly
greater (Table 10.19).
10. There was a decreased density of endotheliocytes in various parts of the brain inlaboratory mice (Mus musculus) after they had
lived in the 10-km zone for 1 month (Pelevyna
et al., 2006; Nazarov et al., 2007).
11. Large horned livestock (Bos taurus) in contaminated areas had lowered lysozymic activity in whey and lowered resistance to skin infections, which indicated the development of
immunodeficiency (Il’yazov, 1993, 2002).
12. Resistance to skin infections is lowered in wild murine rodents in heavily contaminated territories (Kozynenko and Zavodnykova, 1993).
13. There was increased sensitivity to viral
infections in laboratory mice (Mus musculus) after they had been in the 10-km zone (Savtsova
et al., 1991).
14. There was a significantly increased frequency of tumors in laboratory mice (Mus musculus) experimentally inoculated with tumor
cells after they had been in the 10-km zone
(Savtsova et al., 1991).

270

15. Animals in the Chernobyl zone had
accelerated aging of the immune system(Savtsova, 1995).
16. Laboratory rats (Rattus norvegicus) kept in
the 10-km zone from 1986 to 1993 were foundto have (Pinchuk and Rodionova, 1995; Serkiz
et al., 2003):

TABLE 10.20. Cause of Death (%) in Laboratory Rats (Rattus norvegicus ) from the Experimental
Animal Facilities in Chernobyl City (Heavy Background Radiation) and Kiev (Less Background Radiation), October 1986–December 1989 (Serkiz,
1995)
Cause of death

Kiev

Chernobyl
City

Pneumonia, lung hemorrhage
Pulmonitis
ColitisLymph node hyperplasia
Thymus gland/spleen hyperplasia

10.3
8.4
19.1
10.3
2.4

35.5
11.1
31.1
13.2
4.4

•

Decreased numbers of bone marrowcells, peripheral blood leukocytes, andmyelokaryocytes.
• Hypochromatic anemia, leukocytopenia(onset during the third month of being
in the radioactive zone), granulocytopenia
with very high levels of eosinophils, andeosinophilia.
• Increased numbers of abnormal cells (hugehypersegmented neutrophilic leukocytes,
cells with fragmented nuclei, cells withshaggy chromatin structure, cytoplasm
nuclear inclusions, and multinucleatedlymphocytes.
17. After being in the 10-km zone for 3
to 6 months, laboratory rats (Rattus norvegicus)
developed significant mitotic growth activity(sometimes accompanied by an increase in thenumber of bone marrow cells) and then had asubsequent decrease in mitotic activity. Similar
processes were observed in wild murines livingin the 10-km zone (Serkiz et al., 2003).
18. Low red cell counts, decreased
hemoglobin levels, and decreased percentage ofneutrophils and monocytes were seen in cattle(Bos taurus) that remained in the 12-km zone for2 months after the catastrophe (Il’yazov, 1993;
Il’yazov et al., 1990).
19. Until October 1986 free-range cattle(Bos taurus) living 3–6 km from the Chernobyl
NPP had high eosinophil and low lymphocyte
counts, as well as undifferentiated cells, broken
cell forms, and hyperchromic anemia (Glazko
et al., 1996).
20. In farm-raised hog sires (Sus scrofa) in
Mlinivs’sk and Sarnens’k districts of Rivne
Province, Ukraine, from 1997 to 2001, where
Cs-137 contamination levels were 1–5 Ci/km2
and Sr-90 levels were 0.04–0.08 Ci/km2 , ery-throcyte counts were significantly lower (up to
15.0%), hemoglobin was lower (up to 45.0%),
the percentage of young and stick hearted
leukocytes increased 1.3 to 2.8 times, and bloodlevels of alpha- and gammaglobulins decreased
up to 44.4% (Oleinik, 2005).
21. Laboratory rats (Rattus norvegicus) kept
in the 30-km zone for 1 month had significantly increased leukocytes and have a tendency toward increased numbers of marrowcells (Izmozherov et al., 1990).
22. Laboratory mice (Mus musculus) kept in
the 30-km zone for 1 month had significantly
increased numbers of lymphocytes and leukocytes (Pelevyna et al., 1993).
23. The most common immediate causesof death for laboratory rats (Rattus norvegicus)
in the animal facilities in Chernobyl City andKiev after the catastrophe were inflammatory
processes of the lungs and intestines (Serkiz,
1995). Table 10.20 presents data on their mortality from 1986 to 1989.
24. Mammary adenofibromas and malignant lung and intestinal tumors appeared
at earlier ages in laboratory rats (Rattus
norvegicus) in the Chernobyl animal facility from1987 to 1989 and included lymphoid and connective tissue tumors, including lymphatic sarcoma (Table 10.21).
25. Tumors developed in 74% of laboratory rats (Rattus norvegicus) in the Chernobyl and Kiev experimental breeding colonies

271

Yablokov: Radioactive Impact on Fauna
TABLE 10.21. Average Age of Occurrence andProbability of Occurrence (%) of Malignant Tumors
in Laboratory Rats (Rattus norvegicus ) under Different Levels of Contamination before and after
the Catastrophe (Pinchuk, 1995)

TABLE 10.23. Occurrence and Features of Breast
Neoplasms in Laboratory Rats (Rattus norbegicus )from 1989 to 1992 in Chernobyl City and Kiev
Experimental Animal Facilities (Pinchuk, 1995)

After 1986
Chernobyl Kiev 1985
Average age for malignant
tumors, months
Probability of occurrence oftumors, months

10

14

16

35

17

5

Chernobyl
City

Kiev

14.7

9.5

29

27

58.8

20.3

Breast adenofibroma withmalignancy, %∗Animals with multiple mammary
tumors, %∗∗Animals with a breast tumors
combined with other tumors∗∗∗

from 1989 to 1992. Endocrine gland tumors(Table 10.22) in combination with mammary
tumors (Table 10.23) were typical for rats from
Chernobyl. Adenocarcinoma and epithelial tumors in Chernobyl rats were not observed inrats in the Kiev group and were not seen as
spontaneous tumors in this breeding line before the catastrophe (Pinchuk, 1995).
26. Female rats (Rattus norvegicus) age 4–5
months with hyperthyroidism kept in the 30-km
zone for 30 days had significantly reduced basal
activity of myocardial adenyl cyclase (ACS;
14.48 ± 0.78 nMol/mg protein/min as compared with 20.78 ± 0.57 in the controls). A testof F-dependent enzyme activation revealed asignificant reduction in the stimulative effect of
ACS activity on myocardium in animals kept
under irradiation. The data point to the possibility of modulating hyperthyroid effects at
TABLE 10.22. Occurrence (% of Total Tumors) inLaboratory Rats (Rattus norvegicus ) from 1986 to
1992 in Chernobyl City and Kiev Experimental Animal Facilities (Pinchuk, 1995)

Thymus gland tumor∗
Adrenal cortex adenoma
Thyroid gland tumor
Cellular adenoma of islet of
Langerhans∗

Chernobyl
City

Kiev

15.9
43.2
43.2
34.1

2.7
6.8
15.7
1

Between 1986 and 1989 the animals in Kiev had nosuch tumors, but such tumors did develop in 4.8% of all
the animals in the Chernobyl facility.

From the total number of animals.
From number of animals with mammary glandtumors.
∗∗the β-adrenergic link level of ACS in cardiomyocytes in animals exposed to radiation (Komar
et al., 2000).
27. The level of fluctuating asymmetry inpopulations of the common shrew (Sorex araneus)
was higher in the more radioactively contaminated environment in Bryansk Province, Russia(Table 10.24).
28. The level of developmental stability (byfluctuating asymmetry of many morphologicalcharacters) in barn swallows (Hirundo rustica)
was significantly higher in the contaminatedareas (Møller, 1993).
29. Carbohydrate metabolism and lipid balance were noticeably abnormal in some birds
from the Chernobyl zone, reflecting endocrine
system impairment (Mykytyuk and Ermakov,
1990).
30. The percentage of dead cells in the spleen
and bone marrow of moor frogs (Rana arvalis)
TABLE 10.24. Level of Fluctuating Asymmetry (Asymmetric Cases per Character) in Three
Populations of Common Shrew (Sorex araneus )with Different Levels of Radioactive Contamination, Bryansk Province, 1992 (Zakharov et al.,1996b)
Contamination, dose
60 μR/h0.016 ± 0.03

180 μR/h
0.24 ± 0.03

220 μR/h
0.26 ± 0.03

272
TABLE 10.25. Immune Status of the Frog HybridComplex Rana esculenta in Two Populations withDifferent Contamination Levels, Bryansk Province,
1994 (Isaeva and Vyazov, 1996)
Contamination, μR/h
Index

60

Leukocytes, 106 /liter15.32 ± 0.99
Lymphocytes, 106 /liter 6.16 ± 0.41
Neutrophils, %47.2 ± 1.11
T lymphocytes, %47.1 ± 1.45
B lymphocytes, %20.9 ± 0.56
Zero-cells, %32.0 ± 1.59
Rosette-forming
22.8 ± 1.22
neutrophiles, %TABLE 10.26. The Level of Developmental Stability (Asymmetric Cases Per Character) in Populations of Frog Hybrid Complex Rana esculenta
with Different Levels of Radioactive Contamination, Bryansk Province, 1992–1993 (Chubanishvyli
et al., 1996)

220
21.7 ± 1.83
11.08 ± 1.0
28.9 ± 1.55
26.6 ± 1.03
12.5 ± 0.67
61.9 ± 1.38
17.7 ± 0.49

from populations living under heavy radiationfor 7–8 years differed significantly from controls after exposure to additional experimental
radiation (Afonin and Voitovich, 1998; Afonin
et al., 1999).
31. The number of micronucleated erythrocytes in all the populations of brown frogs(Rana temporaria) from heavily contaminated areas caught before 1991 was significantly higher(p < 0.001) than from less contaminated areas(in some cases by a factor of 30). Both brown (R.
temporaria) and narrow-muzzled (R. arvalis) frogs
inhabiting radiation-contaminated areas haveincreased cytogenetic damage in bone marrowcells and erythrocytes and a change in the ratioof erythrocytes in peripheral blood (Voitovich,
2000).
32. Additional gamma-irradiation-induced
apoptosis of bone marrow cells was discoveredin narrow-muzzled frogs (Rana arvalis) inhabiting the 30-km zone. The initial level of cells withchromatin changes was significantly higher (p <0.05) in animals from the 30-km zone (Afonin
et al., 1999).
33. Changes were demonstrated in the functional immune status activity in the frog hybrid(Rana esculenta) in the more contaminated areas(Table 10.25).
34. The level of developmental stability (bynumber of asymmetric cases per character)in three populations of frogs (Rana esculenta)

Contamination, doseYear

15 μR/h

60 μR/h

220 μR/h

1994
1993

0.45 ± 0.03—

0.46 ± 0.03
0.54 ± 0.03

0.54 ± 0.03
0.64 ± 0.03

was lower in less contaminated environments(Table 10.26).
35. The level of fluctuating asymmetry andthe number of phenodeviations in populations of crucian carp (Carassius carassius) andwild goldfish (Carassius auratus) were higher inthose living in water with more radioactive
contamination in Bryansk Province, Russia(Table 10.27).
36. After the catastrophe, there were many
malformed specimens of true insect (Heteroptera)
species collected in areas with the most radioactive contamination in eastern Sweden(Gysinge, Osterfarnebo, and Galve) and southern Switzerland (Melano near Ticino). In 1990
up to 22% of all insects collected in the Polessk
District, near the 30-km zone, were malformed(Hesse-Honegger, 2001; Hesse-Honegger andWallimann, 2008).
37. The number of oribatid mite species,
inhabitants on pine bark and the lichen Hypogymnia physodes significantly declined on radioactively contaminated trees 2–3 km from the
Chernobyl NPP. Before the catastrophe, there
were 16 species; afterward the numbers were:1986, 0; 1987, 2; 1988, 2; 1991, 4; 1999, 6; and2002, 8 (Kryvolutsky, 2004).
38. In the 5 to 6 years after the catastrophe
the species diversity of large soil invertebrates
was significantly lowered, and even 13 to 15
years after there were also fewer small-sized
species (Pokarzhevsky et al., 2006).
39. The intensity of nematode and cestodeinvasions was higher in more radioactively contaminated environments (Table 10.28).

273

Yablokov: Radioactive Impact on Fauna

TABLE 10.27. Level of Fluctuating Asymmetry and Number of Phenodeviation in Populations of Crucian Carp (Carassius carassius ) and Wild Goldfish (Carassius auratus ) with Different Levels of Radioactive Contamination of the Water, Bryansk Province, 1992 (Zakharov et al., 1996a)
Species

Character

60 μR/h

80 μR/h180 μR/h

C. carassius

Asymmetric cases per character
Phenodeviation per specimen
Asymmetric cases per character
Phenodeviation per specimen

0.31 ± 0.07
1.57 ± 0.61
0.26 ± 0.03
2.0 ± 0.29

0.37 ± 0.04
2.93 ± 0.26
0.45 ± 0.04
4.10 ± 0.27

0.42 ± 0.06
4.88 ± 0.30-

C. auratus

40. In the 10 years after the catastrophe thebiodiversity of soil protozoa did not exceed 50%of the precatastrophe level (Pokarzhevsky et al.,2006).
10.5. Conclusion
In 1986 in the contaminated territories, anenormous amount of many different radionuclides was absorbed by animals through food,water, and air. Levels of incorporated radionuclides were sometimes hundreds of times higher
than precatastrophe ones. Now, 23 years after
the catastrophe, the levels of incorporated radionuclides in some areas of Europe remain
dangerous for mammals, birds, amphibians,
and fish. This first radioactive shock together

TABLE 10.28. Intensity of the Invasion of Bank
Voles (Clethrionomys glareolus ) by Nematodes
and Cestodes, Bryansk Province, Russia, 1992–
1995 (Pel’gunov, 1996)

Nematodes∗
Intensity, %Index ofabundance
Cestodes∗∗Intensity, %Index ofabundance∗

60 μR/h180 μR/h

220 μR/h

3.5
3.0

5.0
3.9

48.1
40.0

1.6
0.53

1.1
0.71

3.4
2.1

Predominant species: Heligmosomum mixtum, Heligmosomoides glareoli, and Syphacia obvelata.
∗∗
Predominant species: Catenotaenia cricetorum and Paranoplocephala omphalodes.

with chronic low-dose contamination has resulted in morphologic, physiologic, and genetic disorders in all of the animals studied—mammals, birds, amphibians, fish, and invertebrates. “Chernobyl” populations exhibit a wide
variety of morphological deformities that are
not found in normal populations of domestic
animals, even beetles, living in the contaminated territories.
Some bird species may persist in the 30-km
Chernobyl zone only via immigration fromuncontaminated areas. Despite reports of a“healthy” Chernobyl environment for rare
species of birds and mammals, their existence
there is likely the result of immigration and notfrom locally sustained populations.
Mutation rates in animal populations in contaminated territories are significantly higher.
There is transgenerational accumulation of genomic instability in animal populations, manifested as adverse cellular and systemic effects.
These long-term effects may be even moredetrimental because the genomes of animals
in subsequent generations are more sensitive
to the impact of very low doses of radiation(Goncharova, 2005).
Since the catastrophe, long-term observations of both wild and experimental animal
populations in the heavily contaminated areas
show serious increases in morbidity and mortality that bear striking resemblance to changes in
the public health of humans—increasing tumor
rates, immunodeficiencies, decreasing life expectancy, early aging, changes in blood formation, malformations, and other compromises tohealth.

274

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CHERNOBYL

11. Chernobyl’s Radioactive Impact
on Microbial Biota
Alexey V. Yablokov
Of the few microorganisms that have been studied, all underwent rapid changes in
the areas heavily contaminated by Chernobyl. Organisms such as tuberculosis bacilli;
hepatitis, herpes, and tobacco mosaic viruses; cytomegalovirus; and soil micromycetes
and bacteria were activated in various ways. The ultimate long-term consequences for
the Chernobyl microbiologic biota may be worse than what we know today. Comparedto humans and other mammals, the profound changes that take place among thesesmall live organisms with rapid reproductive turnover do not bode well for the healthand survival of other species.

One gram of soil contains some 2,500,000,000
microorganisms (bacteria, microfungi, and protozoa). Up to 3 kg of the mass of an adult humanbody is made up of bacteria, viruses, and microfungi. In spite of the fact that these represent
such important and fundamentally live ecosystems there are only scarce data on the various microbiological consequences of the Chernobyl catastrophe.
Several incidences of increased morbidity
owing to certain infectious diseases may be due
to increased virulence of microbial populations
as a result of Chernobyl irradiation.
1. Soon after the catastrophe studies observed activation of retroviruses (Kavsan
et al., 1992).
2. There is evidence of increased susceptibility to Pneumocystis carinii and cytomegalovirus in children whose immune
systems were suppressed in the contaminated territories of Novozybkov District,
Bryansk Province (Lysenko et al., 1996).
3. Tuberculosis became more virulent in
the more contaminated areas of Belarus(Chernetsky and Osynovsky, 1993; Belookaya, 1993; Borschevsky et al., 1996).

Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

281

4. In some heavily contaminated areas of Belarus and Russia there was a markedly
higher level of cryptosporidium infestation (Lavdovskaya et al., 1996).
5. From 1993 to 1997 the hepatitis viruses
B, C, D, and G became noticeably
activated in the heavily contaminatedareas of Belarus (Zhavoronok et al.,1998a,b).
6. Herpes viruses were activated in the heavily contaminated territories of Belarus 6
to 7 years after the catastrophe (Matveev,
1993; Matveev et al., 1995; Voropaev et al.,1996).
7. Activation of cytomegalovirus was foundin the heavily contaminated districts ofGomel and Mogilev provinces, Belarus(Matveev, 1993).
8. Prevalence of Pneumocystis was noticeably
higher in the heavily contaminated territories of Bryansk Province (Lavdovskaya
et al., 1996).
9. The prevalence and severity of Gruby’s
disease (ringworm), caused by the fungus
microsporia Microsporum sp., was significantly higher in the heavily contaminatedareas of Bryansk Province (Rudnitsky et al.,2003).
10. The number of saprophytic bacteria in
Belarussian sod-podzolic soils is at maximum in areas with radioactivity levels of
15 Ci/km2 or less and minimal in areas

282

with up to 40 Ci/km2 (Zymenko et al.,1995).
11. There is a wide range of radionuclide
bioaccumulations in soil micromycetes.
The accumulation factor of Cs-137 in
Stemphylium (family Dematiaceae) is 348
and in Verticillium (family Muctdinaceae)
28 (Zymenko et al., 1995).
12. Since the catastrophe, the prevalence of
black microfungi has dramatically increased in contaminated soil surrounding
Chernobyl (Zhdanova et al., 1991, 1994).
13. Among soil bacteria that most actively
accumulate Cs-137 are Agrobacterium sp.
(accumulation factor 587), Enterobacter sp.
(60–288), and Klebsiella sp. (256; Zymenko
et al., 1995).
14. In all soil samples from the 10-km Chernobyl zone the abundance of soil bacteria (nitrifying, sulfate-reducing, nitrogenfixing, and cellulose-fermenting bacteria,
and heterotrophic iron-oxidizing bacteria)
was reduced by up to two orders of magnitude as compared to control areas (Romanovskaya et al., 1998).
15. In contaminated areas several new variants of tobacco mosaic virus appearedthat affect plants other than Solanaceous
species, and their virulence is most likely
correlated with the level of radioactive
contamination in the areas. Infection of
tobacco plants with tobacco mosaic virus
and oilseed rape mosaic virus was shownto induce a threefold increase in homologous DNA recombination in noninfected
tissues (Boyko et al., 2007; Kovalchuk et al.,2003).
16. All the strains of microfungi species
that were studied (Alternaria alternata, Mucorhiemalis, and Paecilomyces lilacinus) fromthe heavily contaminated Chernobyl areas have aggregated growth of threadlike
hyphae, whereas the same species fromsoil with low radionuclide contamination
show normal growth. Only slowly growing Cladosporium cladosporioides has aggregated growth both in contaminated and

TABLE 11.1. Characteristics of Oocysts of Coccidia (Eimeria cerna) in Voles (Clethrionomys
glareolus ) from Two Differently ContaminatedSites, Bryansk Province (Pel’gunov, 1996)
Level of contamination

NormalAnomalous
Nonsporulated

20 μR/h180–220 μR/h

94.5
0
5.2

76.6
6.3
12.2

lightly contaminated soils (Ivanova et al.,2006).
17. Sharp reduction in the abundance of bifidus bacteria and the prevalence of microbes of the class Escherichia; in particular,a sharp increase in E. coli has been notedin the intestines of evacuee children livingin Ukraine (Luk’yanova et al., 1995).
18. In a long-term study (1954 to 1994—
before and after the catastrophe) in Belarus, Ukraine, and Russia it was revealed that in areas with a high levelof radioactive contamination (740–1,480
kBq/m2 and higher) in Bryansk, Mogilev,
Gomel, Chernygov, Sumy, Kaluga, Oryol,
Smolensk, and Kursk provinces, practically no cases of rabies in wild animals
have been reported since the catastrophe(Adamovich, 1998). This suggests that the
rabies virus has either disappeared or become inactivate.
19. Rodents in the heavily contaminated territories of Belarus have been extensively
invaded by coccids (obligate intracellular
protozoan parasites from the phylum Apicomplexa; Sutchenya et al., 1995).
20. There are fewer than normal, moreanomalous, and no sporulated oocysts ofcoccidia Eimeria cerna in voles (Clethrionomys
glareolus) in Bryansk Province (Table 11.1).
21. Six years after the catastrophe a population of Eimeria cernae from Clethrionomys
glareolus living in heavily contaminatedsoil (up to 7.3 kBq/kg of Cs-134, Cs137, Sr-90, and Pu-106) in Kiev Province

Yablokov: Radioactive Impact on Microbial Biota283

had anomalous oocysts (Soshkin and
Pel’gunov, 1994).
22. There was a significant decline in the
Shannon diversity index of infusoria
species and a concomitant increase in
their abundance in the Pripyat Rivermouth from 1986 to 1988 (Nebrat,1992).

The long-term consequences for microbial
biota may be worse than what we understand
today.

All microorganisms (viruses, bacteria, fungi,
and protozoa) and microbiological communities as a whole undergo rapid changes after any
additional irradiation. The mechanism of suchchanges is well known: inclusion and increase in
the frequency of mutations by natural selection
and preservation of beneficial novel genes thatfor whatever reason appear more viable under the new conditions. This microevolutionary
mechanism has been activated in all radioactively contaminated areas and leads to activation of old and the occurrence of new formsof viruses and bacteria. All but a few microorganisms that have been studied in Chernobylaffected territories underwent rapid changes inheavily contaminated areas.
Our contemporary knowledge is too limited to understand even the main consequencesof the inevitable radioactive-induced genetic
changes among the myriad of viruses, bacteria,
protozoa, and fungi that inhabit the intestines,
lungs, blood, organs, and cells of human beings.
The strong association between carcinogenesis and viruses (papilloma virus, hepatitis virus,
Helicobacter pylori, Epstein–Barr virus, Kaposi’s
sarcoma, and herpes virus) provides anotherreason why the cancer rate increased in areas
contaminated by Chernobyl irradiation (for areview, see Sreelekha et al., 2003).
Not only cancer, but also many other illnesses
are connected with viruses and bacteria. Radiologically induced pathologic changes in the microflora in humans can increase susceptibility
to infections, inflammatory diseases of bacterial and viral origin (influenza, chronic intestinal diseases, pyelonephritis, cystitis, vaginitis,
endocolitis, asthma, dermatitis, and ischemia),
and various pathologies of pregnancy.

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Bar’yakhtar, V. G. (Ed.), Chernobyl Catastrophe: History,Social, Economical, Geochemical, Medical and BiologicalConsequences (//www.stopatom.slavutich.kiev.ua/23-19.htm) (in Russian).
Lysenko, A., Lavdovskaya, M. V., Basova, E. N., Lozovaya, G. A., Baleva, L. S. & Rybalkyna, T. N.
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CHERNOBYL

Conclusion to Chapter III

The 1986 radioactive fallout from Chernobyl
impacted fauna and flora over the entire Northern Hemisphere. Elevated radiation levels were
documented in plants and animals (including microorganisms) in Western Europe, North
America, the Arctic, and east Asia, and the levels were often hundreds of times higher thanprevious background levels that were considered “normal.” This huge outpouring of highlevel radioactivity together with the ensuing
low-level chronic irradiation resulted in morphologic, physiologic, and genetic disorders inall living organisms: plants, mammals, birds,
amphibians, fish, invertebrates, and bacteria,
as well as viruses. Without exception, adverse
effects were evident in all the plants and animals
that were studied.
Affected populations exhibited a wide variety of morphological deformities that were
extremely rare or not known before the catastrophe. Twenty-plus years later, game animals
and livestock in some Chernobyl-contaminatedareas far from Ukraine continue to have dangerous levels of absorbed radionuclides.
Chernobyl’s overall radioactive effect on water, atmosphere, and soil is dynamic from both
the radionuclide decay transformations as well
as from biologic, geologic, chemical, and other
ecological processes such as migration and accumulation of radionuclides throughout theecosystems, including introduction into multiple food chains. The active migration of Sr-90,
Cs-137, Pu, Am, and other isotopes results inbioaccumulation that will present unforeseensurprises for decades to centuries to come.
The data presented in Chapter III, however
varied, show that the Chernobyl catastrophe
has had and will continue to have multiple impacts upon flora and fauna.
As soon as industrial, agricultural, and otheranthropogenic pressures on wildlife in the heav-

ily contaminated areas eased, wildlife began
to be restored and even appeared to flourish.
Large mammals—wolves, elk, wild boars, deer,
and birds, including eagles—are living in the
Chernobyl zone of contamination, but the prosperity of this wildlife is deceptive. Studies ofbirds indicate that some species may be foundin the contaminated regions only because of
migration from uncontaminated areas (Møller
and Moussaeu, 2007). Morphologic, cytogenic,
and immunological studies of plant, fish, amphibian, and mammalian populations reveal
deterioration in all the organisms that werestudied in detail (For review see Grodzinsky,
2006 and Zakharov and Krysanov, 1996).
Mutation loads and mutation rates inplants, animals, and microorganisms in the
Chernobyl-contaminated territories are muchhigher than elsewhere. Chronic low-dose exposure to Chernobyl irradiation has resulted
in transgenerational accumulation of genomic
instability, manifested by abnormal cellularand systemic effects. These transgenerational
long-term effects are detrimental because thegenomes of animals in more distant generations are more sensitive to very low radiation
doses, as compared to the genomes of animals
that were exposed in the first few generations(Goncharova, 2000; Pelevyna et al., 2006).
Conversely, in the contaminated territories
there are also active processes of natural selection for the survival of less radiosensitive
individuals—the processes of a radioadaptation. Radioadaptation in a population underconditions of chronic contamination will leadto diminish radiosensitivity over many generations, and evolutionary theory predicts that
this will result because of special adaptationaccompanied by elimination of sensitive genotypes and pauperization of the gene pool. Some
plants and animals in the Chernobyl zone

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demonstrate a return to historically atavistic,primitive types of genetic systems (Glazko et al.,1996). These facts predict increased numbers
and kinds of insects harmful to agriculture in areas that have increased radiation backgrounds(Mosse, 2002). Considering the short life spanof a generation of microorganisms, this rapid
microevolutionary process can lead to activation of more primitive life forms as well as tothe occurrence of new forms of viruses, bacteria, and fungi.
The material presented in Chapter III testifies to the fact that it is dangerous and shortsighted to consider the Chernobyl radioactive
zone as a natural reserve where plants and animals can develop and thrive. For deeper understanding of the many processes currently continuing in the Chernobyl-contaminated zone,
biological research should not be curtailed andstopped (as is happening in Belarus, Ukraine,and Russia), but must be supported, expanded,
and intensified to understand, predict, andavoid unexpected and dangerous successionsof events.
There is another more critical dimension to
the study of animals in the contaminated territories. We, human beings, belong to the animal
kingdom and have the same organs and biological systems as other animals such as miceand rats. The material in Chapter III demonstrates a sharply increasing mutational load,increasing morbidity, and cancer. More than
70% of all experimental rats raised under conditions of Chernobyl contamination developed
cancer within the next few years and sufferedmultiple other diseases and impaired immunological competence. All of these processes that
occurred in the first 5 to 7 years around Chernobyl definitely foreshadowed what happened
later to the exposed human populations.

Chernobyl is, on the one hand, a microevolutionary incubator, actively transforming thegene pool with unpredictable consequences,and on the other hand, a black hole into which
there is accelerated genetic degeneration oflarge animals. We ignore these findings at ourperil.

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Cytology and Genetics 30(4): 49–54 (in Russian).
Goncharova, R. I. (2000). Remote consequences of theChernobyl disaster: Assessment after 13 years. In:
Burlakova, E. B. (Ed.). Low Doses of Radiation: Are They
Dangerous? (NOVA, New York): pp. 289–314.
Grodzinsky, D. M. (2006). Reflection of the Chernobyl
catastrophe on the plant world: Special and general
biological aspects. In: Busby, C. C. & Yablokov, A. V.
(Eds.). ECRR Chernobyl: 20 Years On: Health Consequencesof the Chernobyl Accident. ECRR Doc 1 (Green Audit
Book, Aberystwyth): pp. 117–134.
Møller, A. P. & Mousseau, T. A. (2007). Species richness
and abundance of forest birds in relation to radiation
at Chernobyl. Biol. Lett. Roy. Soc. 3: 483–486.
Mosse, I. B. (2002). Genetic effects in natural populationsof animals from the Belarussian radiocontaminatedareas: Biological effects of low doses. Information
Bulletin 3 (Belarussian Chernobyl Children Committee, Minsk): pp. 28–30. (in Russian).
Pelevyna, I. I., Gorlib, A. Ya. & Konradov, A. A. (2006).
20 years is much or little for an estimation ofChernobyl consequencies. In: International Scientific Practical Conference. 20 Years of the Chernobyl
Catastrophe: Ecological and Sociological Lessons. June 5,
2006, Moscow (Materials, Moscow), pp. 185–196(//www.ecopolicy.ru/upload/File/conferencebook_2006.pdf) (in Russian).
Zakharov, V. M. & Krysanov, E. Yu. (Eds.). (1996). Consequences of the Chernobyl Catastrophe: Environmental Health(Center for Russian Environmental Policy, Moscow),
160 pp. (in Russian).

CHERNOBYL

Chapter IV. Radiation Protection after the
Chernobyl Catastrophe
Alexey V. Nesterenko,a Vassily B. Nesterenko,a, †and Alexey V. YablokovbaInstitute of Radiation Safety (BELRAD), Minsk, BelarusbRussian Academy of Sciences, Moscow, Russia

Key words: Chernobyl; dose burden; radionuclide decorporation

Since the Chernobyl catastrophe more than 5
million people in Belarus, Ukraine, and European Russia continue to live in the contaminated territories. Many thousands more live inother European countries contaminated withradiation, including Sweden, Finland, Norway,
Scotland, Britain, and Wales (see Chapter I for
details). Radiation protection is necessary for
all of these people.
After the catastrophe there were enormous
efforts to introduce countermeasures in Belarus, Ukraine, and Russia—to relocate hundreds of thousands of people and to try tolessen exposure to radioactive contamination.
Steps that were taken included restricted foodconsumption and changes in food preparation,
as well as changes in agricultural, fishery, andforestry practices under the guidance of qualified scientists (Bar’yachtar, 1995; Aleksakhin
et al., 2006).
The situation in regard to radiation protection in the contaminated territories places
public health advocates in what is describedin Russian as between an “upper and nether
millstone,” and in the West, as between a rockand a hard place. Authorities allocate as little aspossible to provide financial resources for rehabilitation and disaster management and at thesame time are reluctant to accept data about
dangerous levels of contamination of populations, food, and the environment. These attitudes hold for officials practically everywhere.
†Deceased.

The reluctance on the part of officialdom
to acknowledge the truth about Chernobyl’s
consequences has led to concerned citizens
organizing to find additional sources of information and devising ways to help those
who are suffering. Hundreds of such public local, national, and international organizations have been created, such as “Children of
Chernobyl,” “Physicians of Chernobyl,” “Widows of Chernobyl,” and Liquidator’s Unionsin Belarus, Ukraine, Russia, and many othercountries including Germany, Austria, France,
Switzerland, Canada, the United States, andIsrael.
In 1987, initiated by physicist and humanist Andrei Sakharov, famous Belarussian writer
Ales’ Adamovich, and world chess champion
Anatoly Karpov, the Belarussian Institute ofRadiation Safety–BELRAD was established as
an independent public organization devoted tohelping Belarussian children—those who suffered most after the catastrophic contaminationfrom Chernobyl. For 21 years the BELRAD
Institute has collected an extensive databasein the field of radiation protection and has
become unique as a nongovernmental Chernobyl center for both scientific and practicalinformation.
Chapter IV is based primarily on the BELRAD materials. Chapter IV.12 presents dataon the Chernobyl contamination of food andhumans in many countries, Chapter IV.13 reports on the Belarussian experience with effective countermeasures to lower levels of incorporated radionuclides such as the use of

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enterosorbents, and Chapter IV.14 outlines
common countermeasures against radioactive
contamination in agriculture and forestry.
References
Aleksakhin, R. M., Bagdevich, I. M., Fesenko, S. V.,
Sanzheva, N. I., Ageets, V. Yu. & Kashparov, V. A.

(2006). Protecting measures’ role in rehabilitation ofcontaminated territories. In: International Conference. Chernobyl 20 Years After: Strategy for Recovering andSustaining Development of Affected Territories. April 19–21,
2006 (Materials, Minsk): pp. 103–108 (in Russian).
Bar’yakhtar, V. G. (Ed.) (1995). Chernobyl Catastrophe: Historiography, Social Economic, Geochemical, Medical and Biological Consequences (“Naukova Dumka,” Kiev): 558
pp. (in Russian).

CHERNOBYL

12. Chernobyl’s Radioactive Contaminationof Food and People
Alexey V. Nesterenko, Vassily B. Nesterenko,
and Alexey V. Yablokov

In many European countries levels of I-131, Cs-134/137, Sr-90, and other radionuclides
in milk, dairy products, vegetables, grains, meat, and fish increased drastically (sometimes as much as 1,000-fold) immediately after the catastrophe. Up until 1991 the UnitedStates imported food products with measurable amounts of Chernobyl radioactive
contamination, mostly from Turkey, Italy, Austria, West Germany, Greece, Yugoslavia,
Hungary, Sweden, and Denmark. These products included juices, cheeses, pasta, mushrooms, hazelnuts, sage, figs, tea, thyme, juniper, caraway seeds, and apricots. In Gomel,
Mogilev, and Brest provinces in Belarus 7–8% of milk and 13–16% of other food products
from small farms exceeded permissible levels of Cs-137, even as recently as 2005–2007.
As of 2000, up to 90% of the wild berries and mushrooms exceeded permissible levelsof Cs-137 in Rovno and Zhytomir provinces, Ukraine. Owing to weight and metabolic
differences, a child’s radiation exposure is 3–5 times higher than that of an adult on
the same diet. From 1995 to 2007, up to 90% of the children from heavily contaminatedterritories of Belarus had levels of Cs-137 accumulation higher than 15–20 Bq/kg, withmaximum levels of up to 7,300 Bq/kg in Narovlya District, Gomel Province. Average levels of incorporated Cs-137 and Sr-90 in the heavily contaminated territories of Belarus,
Ukraine, and European Russia did not decline, but rather increased from 1991 to 2005.
Given that more than 90% of the current radiation fallout is due to Cs-137, with a half-lifeof about 30 years, we know that the contaminated areas will be dangerously radioactive
for roughly the next three centuries.

However much money is allocated by any government for radiation protection (e.g., in Belarus in 2006 nearly $300 million was allocatedto reduce radioactive contamination in agricultural production), no nation has the ability
to provide total protection from radiation for
populations living in contaminated areas andeating locally produced vegetables, forest products, and fish and game that are contaminatedwith radionuclides.
Thus it is of prime importance that radiationmonitoring capability be established on the local level so that citizens have access to the information and the ability to monitor their own

Address for correspondence: Alexey V. Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk 220053, Belarus.
Fax: +375 17 289-03-85. anester@mail.ru

locally produced food and to actively participate in organizing and carrying out radiation
protection. Too often, central data monitoring
repositories have little incentive to ensure thatpeople around the country get the informationthat they should have.
12.1. Radiation Monitoring of Food
12.1.1. Belarus
At the end of 1993, in order to monitor food radiation, the BELRAD Institutewith support from the State Belarus Committee of Chernobyl Affairs (“Comchernobyl”)
created 370 public local centers for radiation control (LCRC) to monitor foodstuffs in
the contaminated areas. The general database

289

290

on contaminated foodstuffs available fromBELRAD today has more than 340,000 measurements, including some 111,000 tests ofmilk.
1. According to the BELRAD database up
to 15% of milk from small farms and up to
80% of other food produce in three Belarus
provinces was contaminated with Cs-137 above
the permissible levels (Table 12.1).
2. The percentage of food products with radioactive contamination in excess of official
permissible levels did not decrease for 14 years
after the catastrophe; on the contrary, in 1997
in the Gomel and Brest areas this percentage
began to increase (Table 12.2).
3. Up to 34.3% of all milk tested fromBrest Province in 1996 had radiation levels
higher than the permissible ones. The number of milk tests showing dangerous levels
was significantly higher in Gomel and Brest
than in Mogilev province. From 1993 to 2006,
there was some reduction in the number ofmilk tests that exceeded the permissible level(Table 12.3).
4. The portion of dangerous milk tests noticeably increased year by year: for example, from 19.3% in 1994 to 32.7% in 1995
in Brest Province; from 9.9% in 2003 to
15.8% in 2004 in Gomel Province; and from
0.7% in 2004 to 7.2% in 2005 in Mogilev
Province.
5. In some places the percent of milk tests
that showed dangerous levels of Cs-137 wassignificantly above the average. For example,
in 2006 in Luga Village, Luninetsk District,
Gomel Province, results in 90.7% of the tests
exceeded the permissible level and levels weremore than 16-fold higher than the province
average.
12.1.2. Ukraine
1. Even up to the year 2000, Cs-137 levels
remained in excess of admissible levels: 80%
in berries and mushrooms in Rovno Province,
90% in Zhytomir Province, 24% in foreststeppe Vinnitsa and Cherkassk provinces,

TABLE 12.1. Cs-137 Concentration in Some
Foodstuffs in Brest, Gomel, and Mogilev Provinces,
Belarus, 1993 (BELRAD data)

Foodstuff
Mushrooms(starry agaric)
CranberryBlackberry
Meat (game)Mushrooms(dried)Rough boletus
Edible boletus
Mushrooms(boiled)
Chanterelle
Blackberry(preserves)
Kefir
Honey fungus
Milk
Lard
Sour cream
Raspberry
Pot cheese
Carp
Strawberry
Water
BeetrootCream
Gardenstrawberries
Carrots
Cabbage
Meat (beef)
CucumberTomatoes
Pears
ApplesOnion
CherryMeat (pork)
Butter
Potatoes

Above
Official
official
permissible
permissible
level
Number oflevel for(1992),
samples
1992
Bq/kg
133

80.5

370

429
1,383
125
459

62.7
61.0
58.4
57.7

185
185
600
3,700

160
561
87

57.5
54.4
52.9

370
370
370

125
150

52.8
42.0

370
185

71
57
19,111
234
242
154
344
152
73
2,141
1,628
51
389

25.4
22.8
14.9
14.1
12.8
11.7
11.6
11.2
9.6
8.8
8.2
7.8
6.4

111
370
111
185
111
185
111
370
185
185
185
111
185

1,439
590
297
433
141
208
1,547
435
196
969
51
4,996

5.8
4.4
3.7
3.2
2.8
2.4
2.3
2.1
2.0
2.0
2.0
1.6

185
185
600
185
185
185
185
185
185
600
185
370

and 15% in the Volyn’ Province (Orlov,
2002).
2. According to data from the Ukrainian
Ministry of Health, in 2000, from 1.1 up to291

Nesterenko et al.: Radioactive Contamination of Food and People

TABLE 12.2. Percent of Food Products with Excess of Permissible Levels of Cs-137 in Gomel, Mogilev,
and Brest Provinces, Belarus, 1993–2007 (BELRAD Database)
Years
Province

1993–1994

1995–1996

1997–1998

1999–2000

2001–2002

2003–2004

2005–2006

2007

Gomel
Mogilev
Brest

12.1
9.2
15.5

9.6
4.0
16.6

12.0∗
4.2
14.2

12.7
5.3
17.8

14.8
4.8
18.0

19.9
5.4
19.2

14.8
15.2
13.0

16.3
n/a
12.5

∗
Data on the Gomel Province since 1995 may be underestimated (24 LCRC from the heavily contaminatedLel’chitsy District were withdrawn from BELRAD and transferred to the official Institute of Radiology—
Comchernobyl).

70.8% of milk and meat in the private sector
in Volyn’, Zhytomir, Kiev, Rovno, and Chernygov provinces had levels of Cs-137 in excess ofallowable limits (Omelyanets, 2001).
12.1.3. Other Countries and Areas
There are considerable data in other countries concerning the contamination of food asa result of Chernobyl.
1. FINLAND. The level of Cs-137 in milk,
beef, and pork in Finland drastically increased immediately after the catastrophe(Figure 12.1). Beginning in 1995, some 7.7
tons of mushrooms (mostly Lactarium genus) thatwere collected annually contained 1,600 MBq
of Cs-137, or about 300 Bq of Cs-137 per person (Rantavaara and Markkula, 1999).
2. BALTIC SEA AREA. A significantly increased Cs-137 contamination occurred in
Baltic fish (Figure 12.2) and there was an evengreater increase in freshwater fish (Table 12.4).
All game species were heavily contaminated;for example, Cs-137 and Cs-134 levels reachedabout 6,700 Bq/kg in the golden-eye duckand about 10,500 Bq/kg in other waterfowl(Rantavaara et al., 1987).
3. CROATIA. After the catastrophe the concentration of Cs-137 in wheat increased morethan 100-fold (Figure 12.3).
4. FRANCE. In 1997 in Vosges Cs-137 contamination in wild hogs and mushrooms exceeded the norms by up to 40-fold (Chykin,1997).
5. GREAT BRITAIN. The peak Chernobyl contamination of milk was reached in May 1986
and was up to 1,000-fold as compared with themean values reported in 1985 for I-131 andCs-137 and up to four times higher for Sr-90(Jackson et al., 1987). Twenty-three years after
the catastrophe, according to Great Britain’s
Ministry of Health, 369 farms in Great Britain,
accounting for more than 190,000 sheep, continued to be dangerously contaminated withChernobyl’s Cs-137 (Macalister and Carter,2009).

TABLE 12.3. Percent of a Milk Tests Exceeding the Permissible Level of Cs-137 in Gomel, Mogilev, andBrest Provinces, Belarus, 1993–2007 (BELRAD Database)
Years
Province

1993–1994

1995–1996

1997–1998

1999–2000

2001–2002

2003–2004

2005–2006

2007

Gomel
Mogilev
Brest

16.6
12.0
21.7

8.6∗
2.8
33.5

8.7
1.2
18.5

9.6
0.5
21.4

8.6
0.2
22.8

12.9
0.6
17.8

6.8
7.2
7.9

6.7
n/a
8.0

∗

See the footnote to Table 12.2.

292

Figure 12.1. Countrywide mean concentrationof Cs-137 in meat and milk in Finland (UNSCEAR,
1988).

6. ITALY. According to radiation measurements from the Directorate of Nuclear Safety
Health Protection obtained in June 1988,
meat, noodles, bread, milk, and cheese werestill markedly contaminated by Chernobyl radionuclides (WISE, 1988a).

7. MEXICO. In 1988 Mexico returned 3,000
tons of milk powder to Northern Ireland because of radioactive contamination from Chernobyl (WISE, 1988b).
8. POLAND. In June 1987, a 1,600-ton
shipment of powdered milk from Poland to
Bangladesh showed unacceptably high levelsof radioactivity (Mydans, 1987).
9. SWEDEN. Average Cs-137 concentration inmoose (Alces alces) meat was 9–14 times higher
after Chernobyl. Levels were 470 Bq/kg forcalves and 300 Bq/kg for older animals, compared with the precatastrophe average level of
33 Bq/kg (Danell et al., 1989).
10. TURKEY. Some 45,000 tons of tea wascontaminated with Chernobyl radioactivity in
1986–1987, and more than a third of the 1986
harvest could not be used (WISE, 1988c).
11. UNITED STATES. Food contaminated in
the United States as a result of Chernobyl isespecially interesting because of the wide geographical scale of contamination and the broad
range of contaminated foods. In spite of official secrecy (see Chapter II.3 for details) the
full picture of Chernobyl food contamination

Figure 12.2. Cs-137 concentrations (Bq/kg) in: (1) plaice (Platichthys flesus) and(2) flounder (Pleuronectes platessa) from 1984 to 2004, as annual mean values
in the Bornholm and southern Baltic seas. Pre-Chernobyl (1984–1985) concentrations
were 2.9 for plaice and flounder (HELCOM Indicator Fact Sheets. 2006. Online
22.04.2008;//www.helcom.fi/environment2/ifs/en_GB/cover/).

Nesterenko et al.: Radioactive Contamination of Food and People
TABLE 12.4. Fish Cs-137 Contamination in Finland, 1986 (Saxen and Rantavaara, 1987)
Species

Concentration, Bq/kg∗

Perch
Pike
Whitefish
Bream
Vendace

16,00010,000
7,100
4,500
2,000

∗
EU limit of Cs-137 for consumption of wild freshwater
fish is 3,000 Bq/kg.

in the United States continues to become more
visible. The peak of Chernobyl-derived I-131
in imported foods was observed in May–June
1986, and for Cs-134 and Cs-137, some 10
to 16 months after the catastrophe (RADNET,
2008, Section 9, Part 4).
Between May 5, 1986, and December 22,
1988, the FDA tested 1,749 samples of imported foods for I-131, Cs-134, and Cs-137
contamination. The survey had been classified and was only obtained after a recent freedom of information request (RADNET, 2008).
The first food imported into the United Statesthat was contaminated from Chernobyl radioactivity was fish from Norway with a detectable level of Cs-137. The contamination
was revealed on May 5, 1986, that is, 11 days
after the catastrophe. In May–June 1986, it
was found that 15 samples of imported foods(mostly mushrooms and cheese from Italy, butalso cheese from West Germany and Denmark)293

exceeded the I-131 level of 1,000 pCi/kg. Some
44% of such samples from February 1 to October 4, 1987, had Cs-137 levels higher than
100 pCi/kg, and 5% exceeded 5,000 pCi/kg.
More than 50% of samples from February 5
to January 25, 1987, had Cs-137 levels higher
than 1,000 pCi/kg, and about 7% of samples
had more than 5,000 pCi/kg.
According to other data (Cunningham andAnderson, 1994), up to 24% of the imported
food sampled in 1989 was noticeably contaminated. By 1990, 25% of samples were contaminated; in 1991, 8% of samples; and in 1992,
2%. “In spite of the general decline, contaminated foods were still occasionally found during
FY91 and FY92; indeed, elk meat collected in
FY91 contained the highest Cs-137 contamination found since the Chernobyl accident
occurred”: 81,000 pCi/kg (Cunningham andAnderson, 1994, p. 1426; cit. by RADNET,
2008). According to U.S. federal regulations,
imported foods containing more than 10,000
pCi of Cs-134 + Cs-137 must be seized and destroyed (U.S. FDA guidelines on May 16, 1986,
by RADNET, 2008). The official documents
obtained through the RADNET request (Section 9) shows that between 1986 and 1988 there
were 12 such occasions.
The food products contaminated by Chernobyl radioactivity imported into the UnitedStates from 1986 to 1988 originated from (inorder of the number of cases): Turkey, Italy,

Figure 12.3. Cs-137 concentration in wheat in Croatia from 1965 to 2004 (Franic et al.,2006).

294
TABLE 12.5. Concentration (pCi/l) of Chernobyl
Radionuclides in Milk in the United States, 1986
(Various Authors from RADNET, 2008)
Radionuclide Concentration
I-131

Cs-137

560
167
88
82
52.5
40
20.3
39.7
40.5
66
80
97

Cs-134
Cs-134 +Cs-137∗9.7
1,250∗

Location

Date

Redland
WillametteValleyVermont
New York area
Maine
New York area
Maine
Chester, New
JerseyNew York City
SeattleNew York area
WillametteValleyMaine
East
Washington

May 5
May 12May
May 28May 16
May 12June
May 17
May
June 4
May 12
May 19June
May 5

Food, pCi/kg.

Austria, West Germany, Greece, Yugoslavia,
Hungary, Sweden, Denmark, Egypt, France,
The Netherlands, Spain, and Switzerland. The
contaminated foodstuffs, in order of prevalence, were: apple juice, cheese, pasta, oregano,berry juices, mushrooms, hazelnuts, filberts(Corylus sp.), sage (Salvia sp.), figs, laurel leaves,tea, thyme, red lentils (Lens sp.), juniper, caraway seeds (Carum sp.), endive (Cychorium sp.),
apricots, and even Swiss chocolate.
Table 12.5 shows the level of radioactive contamination in local milk after the catastrophe
all over of the United States. In spite of all
the measurements, according to the official derived intervention level (DIL), it is a fact that
Chernobyl fallout has deposited harmful radioisotopes across the entire extent of North
America.
Concentration of Chernobyl Cs-134 + Cs137 in elk meat was up to 3,000 Bq/kg (RADNET, 2008); the concentration of Ru-106 andCs-137 in fiddleheads was 261 and 328 pCi/kg,
respectively; in mushrooms the C-137 concentration was 3,750 pCi/kg (RADNET, 2008).

12. Some examples of radioactive contamination of food products in other countries arelisted in Table 12.6. Although Cs-137, Sr-90,
Pu, and Am concentrate in the root zone ofplants, they will be mobilized for decades tohundreds of years into the future, and agricultural products will continue to contain radioactivity in all of the Northern Hemisphere countries contaminated by Chernobyl.
12.2. Monitoring of Incorporated
Radionuclides
For effective radiation protection, especiallyfor children, it is necessary to monitor not
only food, but also to directly monitor radionuclides incorporated into the body. Suchmonitoring can determine the level of contamination for each particular location in a contaminated territory and for every group of people
with high levels of incorporated radionuclides
in order to adequately implement radiation
protection.
12.2.1. Belarus
To determine the correlation between radioactive contamination of food and incorporated radionuclides in children (as children are
the most subject to radiation risk) the BELRAD Institute chose the most intensely contaminated territories from the point of view ofsize of the mid-annual effective radiation dose
and the level of local food contamination.
From 1995 to 2007 BELRAD conducted measurements of absorbed radionuclides in about 300,000 Belarussian children.
Measurement of the Cs-137 contamination iscarried out by automated complex spectrometry of internal radiation, utilizing an individual radiation counter (IRC) “SCANNER3.” The Institute of Ecological and Medical
Systems, Kiev, Ukraine, makes the equipment.
The BELRAD Institute has eight such
IRC SCANNER-3M instruments, whichmeasure the activity of incorporated gammaradionuclides (Cs-137, Cs-134, Ca-40, Ra-226,

295

Nesterenko et al.: Radioactive Contamination of Food and People
TABLE 12.6. Chernobyl Radioactive Contamination of Food in Several Countries, 1986–1987
Radionuclide
Cs-137∗

I-131

Total

Food

Maximum concentration

Country

Reference

Reindeer meat
Mushrooms
Sheep’s milk
Mushrooms
Reindeer
Potatoes
Lamb
Milk
Meat
Milk
Perch
Perch
Farm milk
Milk
Milk
YogurtEdible seaweed
Milk
Breast milk
Breast milk
Pork
Milk
Milk
Reindeer meat
MuttonMilk
Fruits44,800 Bq/kg> 20,000 Bq/kg
18,000 Bq/liter
16,300 Bq/kg∗∗>10,000 Bq/kg
1.100 ± 0.650 Bq/kg
1,087 Bq/kg
500 Bq/liter
395 Bq/kg
254 Bq/dm3
6,042 (mean) Bq/kg
3,585 (mean) Bq/kg
2,900 Bq/liter
400 Bq/liter
135,000
6,000 Bq/kg
1,300 Bq/kg
500 Bq/liter
110 Bq/liter (mean)
55 Bq/l (mean
45 Bq/kg (mean)
21.8 Bq/liter20.7 Bq/liter
15,000 Bq/kg
10,000 Bq/kg
3,000 Bq/liter>1,000 Bq/kg

SwedenGermany
GreeceJapan
SwedenCroatia
SwedenUnited Kingdom
Italy
Italy
SwedenSwedenSwedenBulgaria
Italy
GreeceJapan
United Kingdom
Czechoslovakia
Czechoslovakia
Czechoslovakia
Japan
United States
SwedenYugoslavia
Yugoslavia
Italy

Ahman and Ahman, 1994
UNSCEAR, 1988
Assikmakopoulos et al., 1987
Yoshida et al., 1994
UNSCEAR, 1988
Franic et al., 2006
Rosen et al., 1995
Clark, 1986
Capra et al., 1989
Capra et al., 1989
Hakanson et al., 1989
Hakanson et al., 1989
Reizenstein, 1987
Energy, 2008
Orlando et al., 1986
Assikmakopoulos et al., 1987
Hisamatsu et al., 1987
Clark, 1986
Kliment and Bucina, 1990
Kliment and Bucina, 1990
Kliment and Bucina, 1990
Nishizawa et al., 1986
RADNET, 2008
Fox, 1988
Energy, 2008
Energy, 2008
Energy, 2008∗

Limits of Cs-137 for consumption in EU: 600 Bq/kg for food items; 370 Bq/kg for milk and baby food; 3,000
Bq/kg for game and reindeer meat.
∗∗
Year 1990.

Th-232, Mn-54, Co-60, I-131, etc.) in an individual’s body as well as the specific dose.
It is certified by the Belarus State Committee on Standardization and also registeredby the State Registry of Belarus. Each IRC
scanner undergoes an annual official inspection. All measurements are done according
to protocols approved by that committee.
For additional accuracy, the BELRAD IRC
SCANNER-3M system was calibrated withthe “Julich” Nuclear Center in Germany (seeTable 12.7).
1. Measurements were taken in Valavsk Village, in the El’sk District, Gomel Province,
where there were 800 inhabitants, including

159 children. The village is located in anarea with Cs-137 contamination of 8.3 Ci/km2(307 kBq/m2 ). According to the 2004 data, thetotal annual effective dose was 2.39 mSv/year,
and an internal irradiation dose was
1.3 mSv/year.
2. There was a correlation between the levelsof local food contamination (Figure 12.4) andthe level of incorporated radionuclides in thechildren’s bodies (Figure 12.5).
The pattern of curves in Figures 12.4 and12.5 reflects the seasonal (within the year) variation of contaminated food consumption andthus the accumulation of Cs-137 in a child’sbody. As a rule, the level of contamination

296
TABLE 12.7. Cs-137 Body Burden in Children of Narovlya, Bragin, and Chechersk Districts as Measured by Individual Radiation Counters, 1999–2003 (BELRAD Data)
Date
June 1999
November 2001
April 2002
November 2001
January 2002
April 2002
November 2002
December 2002
November 2003
November 2001
January 2002
November 2002
October 2003
January 1999
November 2001
December 2001
April 2002
November 2002
January 2003
January 2000
November 2001
January 2002
October 2003
January 1999
March 1999
November 2001
January 2002
March 2002
April 2002
May 2002
June 2003
June 1999
November 2001
January 2002
February 2002
November 2002
November 2003
December 2003
February 1999
February 1999
March 1999
October 2001
January 1999
October 1999
October 2001
November 2001
January 2002
April 2002

Location
Grushevka

Verbovichi

Golovchitsy

Demidov

ZavoitKyrov

Krasnovka
Narovlya

DublinBelyaevka

Poles’e

Measured by IRC children,n (% of total inhabitants)% Children with exposure
dose ≥ 1 mSv/year

35 (18.6)
44 (23.4)
64 (34)60 (20)65 (21.5)
64 (21)41 (13.5)
35 (11.6)
51 (16.8)
139 (33)
56 (13.3)
103 (24.5)
130 (30.9)
109 (38.5)
110 (38.8)
91 (32.3)
94 (33.2)
75 (26.5)
65 (23)51 (12.8)
52 (13)49 (12.3)
50 (12.5)
94 (22.2)
98 (23.1)
92 (21.7)
84 (19.8)
91 (21.5)
75 (17.7)
90 (21.2)
43 (10.1)
21 (11)
34
221
170
56
140
35
98 (28.3)
98 (23.8)
96 (23.3)
81 (19.7)
132 (25.3)
185 (35.4)
95 (18.2)
95 (18.2)
148 (28.4)
144 (27.6)

26
11
11
33
9
5
20
13
20
8
4
2
2
10
12
9
9
12
5
4
19
2
6
16
21
22
13
22
12
12
7
14
5
14
8
7
6
6
4
11

14
3
25
25
11
3
(Continued)

297

Nesterenko et al.: Radioactive Contamination of Food and People
TABLE 12.7. Continued
Date

LocationJanuary 2003
September 2003
November 2003
December 2001
January 2002

Measured by IRC children,n (% of total inhabitants)% Children with exposure
dose ≥ 1 mSv/year

148 (28.4)
141 (27)140 (26.8)
84 (30.3)
105 (37.9)5
910

Sydorovychi

increased in the autumn and winter (third andfourth quarters) because of increased consumption of especially heavily contaminated foods(mushrooms, berries, wild animal meat). Milk
contamination reflects forage with high levelsof Cs-137 prepared for the winter.
3. Of about 300,000 children from heavily contaminated territories of Belarus who
were tested by BELRAD from 1995 to 2007,
some 70–90% had levels of Cs-137 accumulation higher than 15–20 Bq/kg (leading to 0.1
mSv/year internal irradiation). In many villages levels of Cs-137 accumulation reached
200–400 Bq/kg, and some children in Gomel
and Brest provinces had levels up to 2,000
Bq/kg (up to 100 mSv/year) (Table 12.7).
4. Belarus and Ukraine, with levels of incorporation of 50 Bq/kg, which is common
for territories with Cs-137 contamination of
555 kBq/m2 , show an increase in various dis-eases and death rates and a decrease in thenumber of healthy children (Resolution, 2006;
see also Chapter II).
5. High levels of the accumulation of Cs-137
have been found in a significant number of children in the Lel’chitsy District (Figure 12.6), theEl’sk District (Figure 12.7), and the Chechersk
District (Figure 12.8) of Gomel Province. Maximum levels of accumulation of Cs-137 (6,700–
7,300 Bq/kg) have been found in a significant
number of children in the Narovlya District ofGomel Province. In many villages in this district up to 33% of children have dose levels exceeding the officially permissible 1 mSv/year(Figure 12.9).
6. The level of radionuclide incorporation
is significantly different for different organs(Table 12.8).
7. Average Sr-90 concentration in the bodies
of inhabitants of Gomel Province noticeably

Figure 12.4. Percentage of foodstuffs exceeding permissible levels of Cs-137 for theyears 2000 to 2005, Valavsk Village, Gomel Province, Belarus (BELRAD data). The horizontal axis shows the year divided into quarters; the vertical axis indicates the percentage offoodstuffs in which levels exceeded the norm.

298

Figure 12.5. Average specific activity of Cs-137 (Bq/kg) in children from Valavsk Village,
Gomel Province, Belarus, from 2000 to 2005 (BELRAD data).

increased from 1991 to 2000 (Borysevich and
Poplyko, 2002).
8. The Pu body contamination of Gomel
citizens 4–5 years after the Chernobyl accident
is on average three to four times higher thanglobal levels (Hohryakov et al., 1994).
12.2.2. Other Countries
1. DENMARK. Sr-90 and Cs-137 contamination occurs in humans, with Sr accumulating
along with Ca and Cs occurring in the same
tissues as K. The Sr-90 mean content in adult

Figure 12.6. Cs-137 levels in childrenof Lel’chitsy District, Gomel Province, Belarus(Nesterenko, 2007).

human vertebral bone collected in 1992 was
18 Bq (kg Ca)−1 . Whole body measurementsof Cs-137 were resumed after the Chernobyl
accident. The measured mean level of Cs-137
in 1990 was 359 Bq (kg K)−1 (Aarkrog et al.,1995).
2. FINLAND. Peak body burdens in Finland in1986 were 6,300 and 13,000 Bq for Cs-134 andfor Cs-137, respectively (Rahola et al., 1987).
The average Cs-137 body burden 17 years
after the catastrophe for the entire country
was about 200 Bq; for inhabitants of Padasyoki

Figure 12.7. Cs-137 levels in children ofEl’sk District, Gomel Province, Belarus (Nesterenko,
2007).

Nesterenko et al.: Radioactive Contamination of Food and People

299

TABLE 12.8. Concentration (Bq/kg) of the Cs137 in Autopsied Organs (56 Persons), Gomel
Province, 1997 (Bandazhevsky, 2003)

Figure 12.8. Cs-137 levels in children of Chechersk District, Gomel Province, Belarus (Nesterenko,
2007).

City it was 3,000 Bq (the maximum figure was
15,000 Bq). At the end of 1986 the mean Cs134 body burden was 730 Bq. The Cs-137
mean body burden increased from 150 to 1,500
Bq in December 1986. The maximum levelsof body burdens for Cs-134 and C-137 were

Figure 12.9. Cs-137 levels in childrenof Narovlya District, Gomel Province, Belarus(Nesterenko, 2007).

Organ

Concentration

Thyroid
Adrenal glands
Pancreas
ThymusSkeletal muscle
SpleenHeart
Liver

2,054 ± 288
1,576 ± 290
1,359 ± 350
930 ± 278902 ± 234
608 ± 109478 ± 106347 ± 61

6,300 and 13,000 Bq, respectively (Rahola et al.,1987).
3. JAPAN. Before the Chernobyl accident Cs137 body burdens were about 30 Bq, rising theyear following 1986 to more than 50 Bq withvalues still increasing in May 1987. This compares to body burdens in England of 250–450
Bq (Uchiyama et al., 1998). Peak concentrations of I-131 in urine increased to 3.3 Bq/ml
in adult males (Kawamura et al., 1988). Before
the Chernobyl catastrophe Cs-137 body burdens were about 30 Bq, rising to more than
50 Bq in 1986 with values continuing to increase in May 1987 (Uchiyama and Kobayashi,1988).
4. ITALY. Average I-131 thyroid incorporation for 51 adults was 6.5 Bq/g from May 3 toJune 16, 1986 (Orlando et al., 1986). Peak urinary excretion of Cs-137 occurred 300 to 425
days after the main fallout cloud had passed on
May 5, 1986: pv 15–20 Bq/day (Capra et al.,1989).
5. GERMANY AND FRANCE. There are data
concerning human contamination by Chernobyl radionuclides outside of the Former Soviet Union. Figure 12.10 shows body burden
levels of Cs-137 in Germany and France.
6. GREAT BRITAIN. Average Cs-134 + Cs137 body burden levels for adults in Scotland
in 1986 after the catastrophe were: Cs-134, 172
Bq; Cs-137, 363 Bq; and K-40, 4,430 Bq. Peakconcentrations were: Cs-134, 285 Bq and Cs137, 663 Bq (Watson, 1986). The Cs-137 body

300

Figure 12.10. Body burden of Cs-137 (Bq) in humans in Munich, Germany: (A) males,(B) females); in Grenoble, France (C) adults (UNSCEAR, 1988).

burden in England in 1987 was 250–450 Bq(Uchiyama and Kobayashi, 1988). The thyroid
I-131 burden measured in the neck region was
up to 33 Bq in adults and up to 16 Bq in children
in Britain (Hill et al., 1986).
12.3. Conclusion
All people living in territories heavily contaminated by Chernobyl fallout continue to be
exposed to low doses of chronic radiation. Human beings do not have sense organs to detectionizing radiation because it cannot be perceived by sight, smell, taste, hearing, or touch.
Therefore without special equipment to identify levels of environmental contamination, it
is impossible to know what radionuclide levels
are in our food and water or have been incorporated into our bodies.
The simplest way to ensure radiation safety
in all areas contaminated by Chernobyl is tomonitor food for incorporated radionuclides.
Analysis of levels of incorporated gammaradionuclides by individual spectrometry (IRC)
and radioactive monitoring of local foodin many Belarussian locations have demonstrated a high correlation between Cs-137 foodcontamination and the amount of radionuclides in humans and, most importantly, inchildren.

Chapter II of this volume detailed manycases of deterioration in public health associated with the Chernobyl radionuclide contamination. Many people suffer from continuing
chronic low-dose radiation 23 years after thecatastrophe, owing primarily to consumptionof radioactively contaminated food. An important consideration is the fact that given an identical diet, a child’s radiation exposure is threeto fivefold higher than that of an adult. Since
more than 90% of the radiation burden nowadays is due to Cs-137, which has a half-life ofabout 30 years, contaminated areas will continue to be dangerously radioactive for roughly
the next three centuries.
Experience has shown that existing official
radioactive monitoring systems are inadequate(not only in the countries of the Former Soviet
Union). Generally, the systems cover territories selectively, do not measure each person,and often conceal important facts when releasing information. The common factor among
all governments is to minimize spending forwhich they are not directly responsible, such as
the Chernobyl meltdown, which occurred 23
years ago. Thus officials are not eager to obtain objective data of radioactive contamination of communities, individuals, or food. Under such circumstances, which are common,an independent system of public monitoring isneeded. Such an independent system is not a

Nesterenko et al.: Radioactive Contamination of Food and People

substitute for official responsibility or control,
but is needed to provide regular voluntary
monitoring of food for each family, which
would determine the radionuclide level in each
person.
We have to take responsibility not only forour own health, but for the health of future
generations of humans, plants, and animals,
which can be harmed by mutations resulting
from exposure to even the smallest amount ofradioactive contamination.
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L., Dahlgaard, H., et al. (1995). Environmental Radioactivity in Denmark in 1992 and 1993, Risø-R-756(Riso National Laboratory, Roskilde): 130 pp. (citedby RADNET, 2008).
Ahman, B. & Ahman, G. (1994). Radiocesium in Swedish
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Assikmakopoulos, P. A., Ioannides, K. G. & Pakou,
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Hill, C. R., Adam, I., Anderson, W., Ott, R. J. &Sowby, F. D. (1986). Iodine-131 in human thyroids
in Britain following Chernobyl. Nature 321: 655–
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Hisamatsu, S., Takizawa, Y. & Abe, T. (1987). Reductionof I-131 content in leafy vegetables and seaweed bycooking. J. Rad. Res. 28(1): 135–140 (cited by RADNET, 2008).
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fallout. Sci. Total Env. 142(1–2): 101–104.
Kawamura, H., Sakurai, Y., Shiraishi, K. & Yanagisawa,K. (1988). Concentrations of I-131 in the urine ofJapanese adults and children following the Chernobyl nuclear accident. J. Env. Radioact. 6: 185–
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Mydans, S. (1987). Specter of Chernobyl looms overBangladesh. New York Times, June 5 (cited by RADNET, 2008).
Nesterenko, V. B. (2007). Radiation monitoring of inhabitants and their foodstuff in the Chernobyl zone ofBelarus (Gomel region, Narovlya district). BELRAD
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CHERNOBYL

13. Decorporation of Chernobyl
Radionuclides
Vassily B. Nesterenko and Alexey V. Nesterenko
Tens of thousands of Chernobyl children (mostly from Belarus) annually leave to receive
treatment and health care in other countries. Doctors from many countries gratuitously
work in the Chernobyl contaminated territories, helping to minimize the consequencesof this most terrible technologic catastrophe in history. But the scale and spectrum of
the consequences are so high, that no country in the world can cope alone with thelong-term consequences of such a catastrophe as Chernobyl. The countries that havesuffered the most, especially Ukraine and Belarus, extend gratitude for the help thathas come through the United Nations and other international organizations, as well
as from private funds and initiatives. Twenty-two years after the Chernobyl releases,
the annual individual dose limit in heavily contaminated territories of Belarus, Ukraine,and European Russia exceed 1 mSv/year just because of the unavoidable consumption of
locally contaminated products. The 11-year experience of the BELRAD Institute showsthat for effective radiation protection it is necessary to establish the interference levelfor children at 30% of the official dangerous limit (i.e., 15–20 Bq/kg). The direct wholebody counting measurements of Cs-137 accumulation in the bodies of inhabitants of
the heavily contaminated Belarussian region shows that the official Dose Catalogue underestimates the annual dose burdens by three to eight times. For practical reasons thecurative-like use of apple-pectin food additives might be especially helpful for effective
decorporation of Cs-137. From 1996 to 2007 a total of more than 160,000 Belarussianchildren received pectin food additives during 18 to 25 days of treatment (5 g twice aday). As a result, levels of Cs-137 in children’s organs decreased after each course ofpectin additives by an average of 30 to 40%. Manufacture and application of various
pectin-based food additives and drinks (using apples, currants, grapes, sea seaweed,etc.) is one of the most effective ways for individual radioprotection (through decorporation) under circumstances where consumption of radioactively contaminated food is
unavoidable.

There are three basic ways to decrease the radionuclide levels in the bodies of people living
in contaminated territories: reduce the amountof radionuclides in the food consumed, accelerate removal of radionuclides from the body,and stimulate the body’s immune and otherprotective systems.

Address for correspondence: Alexey V. Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk, 220053, Belarus.
Fax: +375 17 289-03-85. anester@mail.ru

13.1. Reducing Radionuclides
in Food
Soaking in water, scalding, salting, and pickling foods such as mushrooms and vegetables
and processing the fats in milk and cheeses can
reduce the amount of radionuclides in somefoods severalfold.
Stimulation of the body’s natural defenses
through the use of food additives that raise
one’s resistance to irradiation is also useful.
Among such additives are the antioxidant vitamins A and C and the microelements I, Cu, Zn,
Se, and Co, which interfere with free-radical

303

304

formation. The additives prevent the oxidation of organic substances caused by irradiation(lipid peroxidation). Various food supplements
can stimulate immunity: sprouts of plants, suchas wheat, seaweed (e.g., Spirulina), pine needles,
mycelium, and others.
Accelerating the removal of radionuclides
is done in three ways (Rudnev et al., 1995;
Trakhtenberg, 1995; Leggett et al., 2003; andmany others):•

Increase the stable elements in food to impede the incorporation of radionuclides.
For example, K and Rb interfere with theincorporation of Cs; Ca interferes with Sr;
and trivalent Fe interferes with the uptakeof Pu.
• Make use of the various food additives that
can immobilize radionuclides.
• Increase consumption of liquids to “washaway” radionuclides—infusions, juices,and other liquids as well as enriched foodwith dietary fiber.
Decorporants (decontaminants) are preparations that promote the removal of incorporated radionuclides via excretion in feces andurine. Several effective decorporants specificfor medical treatment of heavy radionuclide
contamination are known (for Cs, Fe compounds; for Sr, alginates and barium sulfates;for Pu, ion-exchange resins, etc.). They are effective in cases of sudden contamination. In theheavily contaminated Belarussian, Ukrainian,and European Russian territories the situation
is different. Daily exposure to small amountsof radionuclides (mostly Cs-137) is virtually unavoidable as they get into the body with food(up to 94%), with drinking water (up to 5%),and through the air (about 1%). Accumulationof radionuclides in the body is dangerous, primarily for children, and for those living in thecontaminated territories where there are highlevels of Cs-137 in local foodstuffs (see Chapter IV.12). The incorporation of radionuclides
is now the primary cause of the deteriorationof public health in the contaminated territories(see Chapter II for details), and all possible ap-

proaches should be employed to mitigate theconsequences of that irradiation.
There is evidence that incorporation of
50 Bq/kg of Cs-137 into a child’s body can
produce pathological changes in vital organ systems (cardiovascular, nervous, endocrine, andimmune), as well as in the kidneys, liver, eyes,
and other organs (Bandazhevskaya et al., 2004).
Such levels of radioisotope incorporation are
not unusual in the Chernobyl-contaminatedareas of Belarus, Ukraine, and European Russia nowadays (see Chapter III.11 for details),
which is why it is necessary to use any andall possible measures to decrease the level ofradionuclide incorporation in people living in
those territories. When children have the samemenu as adults, they get up to five times higher
dose burdens from locally produced foodstuffs
because of their lower weight and more active processes of metabolism. Children living in rural villages have a dose burden fiveto six times higher than city children of thesame age.
13.2. Results of Decontaminationby the Pectin Enterosorbents
It is known that pectin chemically binds
cations such as Cs in the gastrointestinal tract
and thereby increases fecal excretion. Researchand development by the Ukrainian Centerof Radiation Medicine (Porokhnyak-Ganovska,
1998) and the Belarussian Institute of Radiation Medicine and Endocrinology (Gres’ et al.,1997) have led to the conclusion that adding
pectin preparations to the food of inhabitantsof the Chernobyl-contaminated regions promotes an effective excretion of incorporated
radionuclides.
1. In 1981, based on 2-year clinical tests, theJoint Committee of the World Health Organization (WHO) and the U.N. Food and Agriculture Organization (FAO) on Food Additives
declared the pectinaceous enterosorbents effective and harmless for everyday use (WHO,1981).

305

Nesterenko & Nesterenko: Decorporation of Radionuclides

2. In Ukraine and Belarus various pectinbased preparations have been studied as agentsto promote the excretion of incorporated radionuclides (Gres’, 1997; Ostapenko, 2002;
Ukrainian Institute, 1997). The product basedon the pectin from an aquatic plant (Zostera),
known commercially as Zosterin-Ultra is amass prophylaxis agent used in the Russian
nuclear industry. As it is a nonassimilated
pectin, the injection of zosterine into the bloodstream does not harm nutrition, metabolism, orother functions. Zosterin-Ultra in liquid form
for oral administration was approved by the
Ukrainian Ministry of Health (1998) and theRussian Ministry of Health (1999) as a biologically active (or therapeutic) food additive endowed with enterosorption and hemosorption
properties.
3. In 1996, the BELRAD Institute initiatedenterosorbent treatments based on pectin foodadditives (Medetopect , France; Yablopect ,Ukraine) to accelerate the excretion of Cs137. In 1999 BELRAD together with “Hermes” Hmbh (Munich, Germany) developed acomposition of apple pectin additives known as
Vitapect powder, made up of pectin (concentration 18–20%) supplemented with vitamins
B1, B2, B6, B12, C, E, beta-carotene, folic acid;the trace elements K, Zn, Fe, and Ca; and flavoring. BELRAD has been producing this foodadditive, which has been approved by the Belarussian Ministry of Health, since 2000.
4. In June–July 2001 BELRAD together withthe association “Children of Chernobyl of Belarus” (France) in the Silver Springs sanatorium(Svetlogorsk City, Gomel Province) conducteda placebo-controlled double-blind study of 615
children with internal contamination who weretreated with Vitapect (5 g twice a day) for a 3week period. In children taking the Vitapect(together with clean food) Cs-137 levels werelowered much more effectively than in the control group, who had clean food combined witha placebo (Table 13.1 and Figure 13.1).
5. In another group of children the relative
reduction in the specific activity of Cs-137 in
the Vitapect-intake group was 32.4 ± 0.6%,

TABLE 13.1. Decreased Cs-137 Concentration
after Using Vitapect for 21 Days (Total 615 Children) in 2001 in the Silver Springs Belarussian
Sanatorium (BELRAD Institute Data)
Concentration of Cs-137, Bq/kg
Group

BeforeIn 21 days

Decrease,%

Vitapect
Placebo30.1 ± 0.7
30.0 ± 0.9

10.4 ± 1.0
25.8 ± 0.8

63.6∗
13.9

∗

p < 0.01.

and that of the placebo group was 14.2 ±
0.5% (p > 0.001), with a mean effective halflife for Cs-137 in a body of 27 days for the
pectin group, as compared with 69 days without pectin. This was a reduction of the effective
half-life by a factor of 2.4. These results meanthat the pectin additive Vitapect with clean nutrition appears to be 50% more effective in decreasing the levels of Cs-137 than clean nutrition alone (Nesterenko et al., 2004).
6. A clinical study of 94 children, 7 to 17
years of age, divided into two groups according to their initial level of Cs-137 contamination determined by whole body counting(WBC) and given Vitapect orally for 16 days
(5 g twice a day) revealed both a significant
decrease in incorporated Cs-137 and marked

Figure 13.1. Decrease in levels of specific activity of Cs-137 in children’s bodies after Vitapect
intake (5 g twice a day) for 21 days (Nesterenko
et al., 2004).

306
TABLE 13.2. EKG Normalization Results in the
Two Groups of Children Contaminated with Cs137 Treated with Vitapect (Bandazevskaya et al.,2004)
BeforeGroup
1
2

TABLE 13.3. Results of Treatment of 46 Children
for 30 Days in France in 2004 (BELRAD Institute
Data)
Concentration, Bq/kg

After 16 days

Normal
EKG,%

Bq/kg

Normal
EKG,%

Bq/kg

Vitapect
Placebo

72
79

38 ± 2.4
122 ± 18.5

87
93

23
88

∗

improvement in their electrocardiograms(EKG; Table 13.2).
7. From 2001 to 2003 the association “Children of Chernobyl in Belarus” (France), Mitterand’s Fund (France), the Fund for Childrenof Chernobyl (Belgium), and the BELRAD Institute treated 1,400 children (10 schools serving 13 villages) in the Narovlyansky District,
Gomel Province, in cycles in which the children received the pectin preparation Vitapect
five times over the course of a year. The results demonstrated a three- to fivefold annual
decrease in radioactive contamination in children who took the Vitapect. The results for one
village can be seen in Figure 13.2.
8. There was concern that pectin enterosorbents remove not only Cs-137, but also vital
microelements. Special studies were carried out
in 2003 and 2004 within the framework of the

BeforeAfter

Decrease,%

39.0 ± 4.4
29.6 ± 2.7

24.6 ± 3.4
24.6 ± 2.1

37∗17p < 0.05.

project “Highly-Irradiated Belarus Children”
with the support of the German Federal Officeof Radiation Protection (BfS). Tests carried out
in three Belarus sanatoriums (Timberland, Silver Springs, and Belarussian Girls) showed that
Vitapect does not impair the positive balanceof the K, Zn, Cu, and Fe in children’s blood(Nesterenko et al., 2004).
9. At the request of the “Chernobyl’s Children” NGOs initiatives in Germany, France,
England, and Ireland, the BELRAD Instituteconducted measurements of Cs-137 in children
before departure to and after their return fromhealth programs in these countries. Children
who only ate clean food during the 25–30 days
showed a decrease in Cs-137 levels of some 20
to 22%, whereas children who also received acourse of treatment with Vitapect showed aneven further decrease in the level of Cs-137 incorporation (Tables 13.3 and 13.4).

Figure 13.2. Changes in average specific activity of Cs-137 (Bq/kg) in the bodies ofchildren of Verbovichi Village, Narovlyansky District, Gomel Province. Averages for these data
are shown. Dotted line indicates the periods of Vitapect intake (Nesterenko et al., 2004).

Nesterenko & Nesterenko: Decorporation of Radionuclides

307

TABLE 13.4. Several Results of Vitapect Treatment of Belarussian Children (BELRAD Institute
Data)
Concentration,
Bq/kg
BeforeAfter

Decreasing,%

30.0 ± 1.5 19.2 ± 1.4∗

36

42.1 ± 5.1 19.6 ± 2.5∗

53

26.4 ± 1.5 13.2 ± 0.8∗

50

23.4 ± 2.0 11.8 ± 0.7∗49∗Group data
Germany, n = 43;
Jul. 7 to Aug. 29,
2007
Spain, n = 30;
Jul. 2 to Aug. 30,
2007
Canada, n = 22;
Jun. 26 to Aug. 22,
2007
Canada, n = 15;
Jun. 24 to Aug. 22,
2007

p < 0.01.

10. The frequency distribution of the activity reduction in one experiment is shown in
Figure 13.3. The relative reduction of the specific activity for the pectin groups was 32.4%(arithmetic mean) and 33.6% (median), respectively, whereas the specific activity in the children who received placebos decreased only by
14.2% (arithmetic mean) and 13.1% (median),
respectively. This corresponds to a reduction in
the mean effective half-life of 27 days for the
pectin groups, as compared with 69 days forthe placebo groups.
11. The two calculated whole-body retention functions are shown in Figure 13.4 (foradults). The first curve represents the effect of
replacing contaminated food by clean food effective from t = 0 and the second corresponds
to clean food plus Vitapect, also effective fromt = 0. The observed reduction of mean effective
half-life (69→27 days) corresponds to a factorof 2.5.
12. From 1996 to 2007 a total of more than160,000 Belarussian children received oral Vitapect (5 g twice a day) for an 18- to 25-daycourse of treatment. The results showed a decrease in Cs-137 levels after each course oftreatment by an average of 30–40%.

Figure 13.3. Frequency of occurrence of observed relative reduction of the Cs-137 body burdenwith Vitapect treatment in Belarussian children (Hillet al., 2007).

Based on long-term experience, the BELRAD Institute recommends that all children
living in radioactive contaminated territories
receive a quadruple course of oral pectin foodadditives annually along with their conventional food ration. Eleven years of BELRAD’s
activities in controlling levels of incorporated
Cs-137 in more than 327,000 children has
not caused alarm in the population or radiophobia and has led to the spread of knowledge concerning radiation protection and an

Figure 13.4. Theoretical retention functions for
adults based on the model of Leggett et al. (2003).
The upper curve shows the effect of clean food andthe lower one illustrates the additional effect of blocking adsorption using Vitapect (Hill et al., 2007).

308

increased sense of personal responsibility for
one’s health.

13.3. New Principles of Radiation
Protection Based on Direct
Measurements
The BELRAD Institute’s 11 years of experience shows that for effective radiation
protection in the contaminated territories, anintervention level—30% of the official dangerous limit (i.e., 15–20 Bq/kg)—must be established for children.
1. The direct whole body counting (WBC)measurements of Cs-137 accumulation in individuals in the heavily contaminated Belarussian
regions showed that the official Dose Catalogue
prepared on the basis of the Cs-137 concentrations in 10 milk samples and 10 potato samples
underestimates the annual personal dose burden three- to eightfold and cannot be relied onfor effective radiation protection.
2. It is obvious that a true dose catalogue ofthe contaminated population should be developed on the basis of the data obtained from thedirect WBC measurements of Cs-137, whichreflect the accumulated internal dose burden.
This should be done via reliable sampling of
inhabitants from each area of Belarus affectedby Chernobyl.
3. Only by combining WBC measurementsof Cs-137 accumulation in the body with medical evaluations can the causal relationship (dosedependence) between the increase in morbidity
and incorporated radionuclides in the population be known. At this time, these data can only
be obtained in the Chernobyl-contaminatedregions of Belarus, Ukraine, and European
Russia. This information can be an importantfactor in designing radiation protection andtreating people, in persuading the world community of the need to help Belarus minimize
radiation exposures, and in understanding thedimensions of the consequences of the Chernobyl catastrophe.

13.4. Where International Help
for Chernobyl’s Children Would
Be Especially Effective
No country in the world is able to cope alone
with the long-term consequences of a catastrophe of the magnitude of the meltdown in Chernobyl. The countries most severely affected, especially Ukraine and Belarus, which suffered
greatly, are grateful for the help they get fromthe United Nations and other international organizations, as well as from private funds andinitiatives.
Annually, tens of thousands of Chernobyl
children go to other countries for treatment
to improve their health. Doctors from many
countries work pro bono in the Chernobylcontaminated territories to help minimize theconsequences of this most terrible technologic
catastrophe in history. The scale and the rangeof the consequences are so great that there isalways the question of how to make such help
even more effective.
Experience from large-scale long-term programs to monitor foodstuffs and the levels ofincorporated radionuclides in the bodies of
those living in the contaminated territories isthe basis for the following proposals to increase
the efficacy of the international and national
programs:•

Joint studies to determine the frequency
and intensity of various diseases, especiallyin children, correlated with levels of incorporated radionuclides.
• Regular individual radiometric evaluationof the populations, especially children, in
all contaminated territories. To accomplish this, Belarus will have to increase
the number of mobile laboratories fromeight to twelve or fifteen. Similar to the
Belarussian system, independent, practical, science/clinical centers must be established in Ukraine and European Russia to
use the results of such regular radiometricmonitoring to identify critical groups withhigh radionuclide incorporation.

309

Nesterenko & Nesterenko: Decorporation of Radionuclides•

Manufacture and administer various
pectin-based food additives and drinks(based on apples, currants, grapes, seaweed, etc.) as one of the most effective ways of providing individual radiation
protection (through decorporation) whencircumstances make using contaminatedfood unavoidable.
• Independent radiation monitoring and radiation control of local foodstuffs, making use of the BELRAD Institute’s experience in organizing local centers forradioactive control. This does not replace, but can add to the existing official
system.
• Regular courses of oral pectin food additives for preventive maintenance.
Twenty-two years after the catastrophe thetrue situation in Chernobyl’s heavily contaminated territories shows that the internationallyaccepted individual dose limit is in excess of
1 mSv/year because of the unavoidable consumption of local radioactively contaminatedproducts. Thus the most advisable way to lower
the levels of incorporated radionuclides is toconsume only clean food. In those situations
where clean food is not available, decorporantand sorbent additives should be used to remove
as much as possible of the absorbed and incorporated radionuclides.
There are many more-or-less effective decorporants and sorbents: a wide spectrum of products with alginic acid-alginates (mostly frombrown seaweed) promotes the reduction of Sr,iron and copper cyanides (e.g., ferrocyanideblue) promote the reduction of Cs. Activatedcharcoal, cellulose, and various pectins are also
effective sorbents for incorporated radionuclides. For practical reasons the curative-likeapplication of apple-pectin food additives may
be especially helpful to effectively decorporate
Cs-137.
What can be done:•

Reduce Cs-137 concentration in the main
dose-forming product—milk—by feedingcows with mixed fodder containing sor-bents and by separating the milk to produce cream and butter.
• Provide children and pregnant womenwith clean foodstuffs and with food additives to increase the elimination of radionuclides and heavy metals from theirbodies.
• Inform the population about the levels ofradionuclide contamination of the local
foodstuffs and the radionuclide concentration in the bodies of the inhabitants (especially children), taking into consideration
the existing available foods and the local
way of life.
• Institute the practice of regular decorporation of radionuclides into the lifestyle asan effective measure of radiation protection for the population of the Chernobylcontaminated regions.
The use of food additives, pectin preparations with a complex of vitamins andmicroelements, demonstrated a high efficiency
in eliminating incorporated radionuclides.
References
Bandazhevskaya, G. S., Nesterenko, V. B., Babenko, V.
I., Babenko, I. V., Yerkovich, T. V. & Bandazhevsky,
Yu. I. (2004). Relationship between Cesium (Cs-137)
load, cardiovascular symptoms, and source of foodin “Chernobyl” children: Preliminary observations
after intake of oral apple pectin. Swiss Med. Wkly.
134: 725–729.
Gres’, N. A. (1997). Influence of pectinous formulations
on dynamics of micro elementary composition ofchildren’s blood. In: Micro Elementary Disorders and Belarusian Children’s Health after Chernobyl Catastrophe. Collected Papers (Institute for Radiation Medicine andEndocrinology, Minsk): 108–116 (in Russian).
Hill, P., Schläger, M., Vogel, V., Hille, R., Nesterenko,
A. V. & Nesterenko, V. ; (2007). Studies on thecurrent Cs-137 body burden of children in Belarus:
Can the dose be further reduced? Rad. Protec. Dosim.
125(1–4): 523–526 (//www.rpd.oxfordjournals.
org/misc/terms.shtm) (in Russian).
Leggett, R. W., Williams, L. R., Melo, D. R. & Lipsztein,
J. L. (2003). A physiologically based biokinetic model
for Cesium in the human body. Sci. Total Env. 317:
235–255.

310
Nesterenko, V. B. (2005). Radiation monitoring of inhabitants and their foodstuffs in Chernobyl zone of Belarus. BELRAD Inform. Bull. 28 (BELRAD, Minsk):
129 pp. (in Russian).
Nesterenko, V. B., Nesterenko, A. V., Babenko, V. I.,
Yerkovich, T. V. & Babenko, I. V. (2004). Reducing
the Cs-137 load in the organs of Chernobyl children
with apple-pectin. Swiss Med. Wkly. 134: 24–27.
Ostapenko, V. (2002) (Interview). Belarussian Minister of Public Health predicts increasing thyroid
cancer morbidity in Belarussian population.
Problems with Chemical Safety, UCS-INFO 864(//www.seu.ru /members /ucs/ucs-info /864.htm)(in Russian).
Porokhnyak-Ganovska, L. V. (1998). New ways of prophylaxis and rehabilitation of populations from radioactive contaminated territories: Apple-pectin powder
and fortified vitamized soluble tablets “Yablopect.”Med. Adviser 1: 7–8 (in Russian).

Rudnev, M. I., Malyuk, V. I. & Korzun, V. N. (1995).
Decorporants. Sect 6.7. In: Bar’yakhtar, V. G. (Ed.),
Chernobyl Catastrophe: History, Social, Economical, Geochemical, Medical and Biological Consequences (“Naukova
Dumka,” Kiev) (//www.stopatom.slavutich.kiev.ua)(in Russian).
Trakhtenberg, I. M. (1995). Enterosorbents. Sect. 6.8.
In: Bar’yakhtar, V. G. (Ed.), Chernobyl Catastrophe:
History, Social, Economical, Geochemical, Medical andBiological Consequences (“Naukova Dumka,” Kiev)(//www.stopatom.slavutich.kiev.ua) (in Russian).
Ukrainian Institute (1997). Report on Scientific Researchof Clinical Studies of Pectinaceous Preparations
Based on Apple Flakes “Yablopect” (Ukrainian Institute of Industrial Medicine, Kryvoy Rog): 58 pp.
(in Russian).
WHO (1981). Toxicological evaluation of certain food additives: Pectins and Amidated. WHO Food Additives
Series, 16 (WHO, Geneva) (//www.inchem.org).

CHERNOBYL

14. Protective Measures for Activities in
Chernobyl’s Radioactively ContaminatedTerritories
Alexey V. Nesterenko and Vassily B. Nesterenko

Owing to internally absorbed radionuclides, radiation levels for individuals living in thecontaminated territories of Belarus, Ukraine, and Russia have been increasing steadily
since 1994. Special protective measures in connection with agriculture, forestry, hunting, and fishing are necessary to protect the health of people in all the radioactively
contaminated territories. Among the measures that have proven to be effective in reducing levels of incorporated radionuclides in meat production are food additives withferrocyanides, zeolites, and mineral salts. Significant decreases in radionuclide levels incrops are achieved using lime/Ca as an antagonist of Sr-90, K fertilizers as antagonistsof Cs-137, and phosphoric fertilizers that form a hard, soluble phosphate with Sr-90.
Disk tillage and replowing of hayfields incorporating applications of organic and mineral fertilizers reduces the levels of Cs-137 and Sr-90 three- to fivefold in herbage grownin mineral soils. Among food technologies to reduce radionuclide content are cleaning
cereal seeds, processing potatoes into starch, processing carbohydrate-containing products into sugars, and processing milk into cream and butter. There are several simple
cooking techniques that decrease radionuclides in foodstuffs. Belarus has effectively
used some forestry operations to create “a live partition wall,” to regulate the redistribution of radionuclides into ecosystems. All such protective measures will be necessary
in many European territories for many generations.

As a result of the Chernobyl catastrophe,
millions of hectares of agricultural lands are
dangerously contaminated with Cs-137 withconcentrations higher than 37 kBq/m2 : in
Belarus, 1.8 million hectares; in Russia, 1.6
million hectares; and in Ukraine, 1.2 million
hectares. According to the Belarus Ministryof Agriculture, agricultural production now
takes place on more than 1.1 million hectaresof land contaminated with Cs-137 at a levelfrom 37 to 1,480 kBq/m2 , and 0.38 million
more hectares are similarly contaminated by
Sr-90 at a level of more than 5.55 kBq/m2 .
In Gomel Province 56% of all the agriculturalland is contaminated, and in Mogilev Province

Address for correspondence: Alexey V. Nesterenko, Institute of Radiation Safety (BELRAD), 2-nd Marusinsky St. 27, Minsk, 220053, Belarus.
Fax: +375 17 289-03-85. anester@mail.ru

that figure is 26%. Millions of hectares of Belarussian, Russian, and Ukrainian forests (morethan 22% of all Belarussian woodlands) appear to be dangerously contaminated (National
Belarussian Report, 2006). More than 5 million people live in the contaminated territories of Belarus, Ukraine, and Russia (see Chapter I for details). Moreover, some grasslands,
forests, mountains, and lakes in Sweden, Norway, Scotland, Germany, Switzerland, Austria,
Italy, France, and Turkey continue to show
measurable contamination.
Over the 23 years since the catastrophe, owing to the devoted activities of many thousandsof scientists and technical specialists, somemethods and practical measures have been developed to decrease the risks from the contamination linked to the use of natural resources (agricultural, forestry, hunting, etc.). As
a comprehensive review all these results would

311

312

require a separate monograph. This shortchapter simply outlines some basic techniquesdesigned to achieve radiation protection for the
resources utilized in the course of everyday living in the contaminated territories.
14.1. Measures for Radiation
Protection in Agriculture
1. Where production with “permissible”
amounts of radionuclides is impossible, agricultural lands have been taken out of use: inBelarus, 265,000 hectares; in Ukraine, 130,000
hectares; and in Russia, 17,000 hectares(Aleksakhin et al., 2006).
2. Agricultural land with radioactive contamination is subject to obligatory monitoringof both soil and production processes for endproduct control technology to ensure permissible levels of Cs-137 and Sr-90 in foodstuffs.
This permissible level is established by calculating the combined individual average annual
food intake so as to limit the effective equivalent radiation dose to less than 1 mSv/year. For
beef and mutton the level of Cs-137 should
be no higher than 500 Bq/kg in Belarus
and 160 Bq/kg in Russia and Ukraine, flourand groats (buckwheat) should have no morethan 90 Bq/kg, etc. (Bagdevich et al., 2001).
Each country has its own radioprotection
policy.
3. Effective decreases in the levels of radionuclides in crops are achieved by applications of lime/Ca as antagonists of Sr-90, K
fertilizers as antagonists of Cs-137, phosphoric
fertilizers that form a hard soluble phosphate
and precipitate Sr-90, plus zeolites, sapropel(gyttja), and other natural antagonists and absorbents (Aleksakhin et al., 1992; and many others; Table 14.1).
4. Hayfields (meadows and pastures) used tosupport milk and meat production account for
up to half of all contaminated agricultural land
in Belarus. Disk tilling and replowing of hayfields incorporating an application of organicand mineral fertilizers reduces the levels of Cs-

TABLE 14.1. Efficiency of Agrochemical Measures to Reduce Cs-137 and Sr-90 Concentrations
in Plant Production (Gudkov, 2006)
Reduction factor
MethodCs-137

Sr-90

Lime
Higher level of:
Phosphoric fertilizers
Potassium fertilizers
Organic fertilizers 40 tons/haCombined application of lime,
mineral, and organic fertilizers
Mineral soil absorbents (zeolites,
vermiculites, bentonites, etc.)∗

1.5–4

1.5–2.5

1.5–2
1.8
1.5–3
2–5

1.2–1.5
None
1.5–2
2–4

1.5–2.5

1.5–2∗

They were most effective during the first 5 years after
the catastrophe (Kenik, 1998).

137 and Sr-90 accumulation three- to fivefold
in herbage grown in mineral soils. Such radical treatment of hayfields on peat soils sharply
reduces Cs-137, but is less effective for Sr-90.
Owing to degradation of cultivated hayfields,
repeated grassland renovation with an application of fertilizers is needed every 3 to 6 years.
5. As noted above, radiation protection measures are effectively applied in large stateowned and collective farms. In small privatesector households and farms, which in Belarus
account for more than 50% of agricultural production, these measures are incidental. Generally for each cow on a private Belarus farm
there is about 1 hectare of hayfield and improved pasture. This is not sufficient to sustain the animal so the farmers have to get hay
from grassy forest glades and unarable lands
that are contaminated with higher levels of radioactivity than cultivated hayfields. Thus a significant number of settlements, even 23 years
since the catastrophe, had inadequate radiation
protection for agricultural production. There
are more than 300 such settlements each in
Belarus and Ukraine, and more than 150 in
Russia (Kashparov et al., 2005).
6. Twenty years after the catastrophe, some
10 to 15% of the milk on private Belarussian farms had a higher Cs-137 contamination
than the permissible level. In 2006 there were

Nesterenko & Nesterenko: Protective Measures for Activities
TABLE 14.2. Efficiency of Measures to Reduce Cs137 and Sr-90 Concentrations in Animal-Breeding
Production (Gudkov, 2006)
Reduction factor
MeasureCs-137

Sr-90

Improvement of meadows andpastures∗Food additives with ferrocyanide
Food additives with zeolites
Food additives with mineral salts
Month on clean fodder before
slaughter

1.5–10

1.5–5

2–8 (to 20)
2–4
1.5–2
2–4

None
None
2–3
None

∗

Less effective on peat soils.

instances in which household milk contained
Cs-137 at a value as high as 1,000 Bq/liter. In
Gomel Province in 2004, some 12% of beef
had Cs-137 levels above 160 Bq/kg (BELRAD
Institute data).
7. There are some effective measures toreduce levels of incorporated radionuclides
in meat production (Table 14.2) and foodprocessing technologies to reduce radionuclide
content in foodstuffs (Table 14.3).
8. Table 14.4 presents the primary known
antiradiation chemical and pharmacologicalmeasures to achieve clean animal breeding in
the contaminated territories.
9. All the methods described to reduceradiation in agricultural production require
additional material and labor; thus economic
efficiency in the contaminated areas is comTABLE 14.3. Efficiency of Measures to ReduceCs-137 and Sr-90 Content in Foodstuffs (Gudkov,
2006)
Reduction factor
MeasureCs-137

Sr-90

Cleaning of cereals seeds
1.5–2
Processing of potato to starch
15–50
Processing carbohydrate60–70
containing: Production to sugars
Production to ethyl alcohol
Up to 1,000
Processing of milk to cream
6–12
5–10
Processing of milk to butter
20–30
30–50
Culinary treatment of meat
2–4
None

313

TABLE 14.4. Chemical and Pharmacological Antiradiation Remedies (Based on Gudkov, 2006)
Radionuclide blockers and decontaminants
Antagonists—
Stable isotopes,
competitors
chemical analogues
Enterosorbents
Activated charcoal, zeolite,
Vitapect, Algisorb, etc.
Insoluble complexes Ferrocyanides, alginates, pectins,
phosphates
Soluble complexes Natural (flavonoids: flavones,
anthocyans, catechins) andsynthetic (Zinkacyne, etc.)
Radioprotectants
Antioxidants
Aminothiols; disulfides;
thiosulfates; vitamins A, C, E
Stabilizers of DNA Metal ions, chelates, flavonoids
and membranes
Metabolism
Cyanides, nitriles, azides,
inhibitors
endotoxins
Adaptogenes
Immunostimulants, vitamins,
microelements, etc.

promised. In spite of measures taken and subsidies, agricultural production in radioactive
contaminated areas continues to be difficult
and the farmers often turn to specialized enterprises for cattle breeding for meat production, production of oils and industrial crops,etc.
14.2. Radiation Protection
Measures for Forestry, Hunting,and Fisheries
Forestlands accumulated about 70% of theChernobyl radionuclides that fell on Belarus.
Shortly after the catastrophe most forest radionuclide contamination was on the surfaceof trees. Roots absorb Cs-137 and Sr-90 fromthe soil and transport them into the wood andother parts of the plant. Specific activity of Cs137 can exceed 20 kBq/kg in forest berries andmushrooms, as much as 150 kBq/kg in dried
mushrooms, and 250 kBq/kg in wild gamemeat. In predatory fish breeds in landlocked
reservoirs the levels can reach 300 kBq/kg (seeChapter III for details).

314

1. In the exclusion zone, which in 1986–1987
was 30 km wide, as well as in the zone of involuntary resettlement, all forestry activities are
forbidden where there is risk to an individual ofa dose greater than 5.0 mSv. In this zone permanent housing is banned and economic activity is strictly limited. The zone of involuntary
resettlement is an area outside the exclusionzone where the level of ground contaminationfrom Cs-137 is above 15 Ci/km2 , that from Sr90 is above 3 Ci/km2 , or that from Pu-239 andPu-240 is above 0.1 Ci/km2 . The territories of
involuntary resettlement also include some areas with low-level radioactivity where radionuclides migrate into plants from contaminatedsoil.
2. According to official Belarussian data, forseveral years after the catastrophe radiationlevels in contaminated forest products (wildberries, mushrooms, firewood, etc.) exceeded
those in domestic agricultural products (milk,
bread, cereals, etc.).
3. Ten years after the catastrophe, theamount of radionuclides in underground partsof trees doubled and reached 15% of the total amount in forest ecosystems. Even now, inBelarus, owing to external radiation contamination, foresters are exposed to levels two to
three times higher than agricultural workers.
4. Among the principal measures proposed
to decrease radiation risk for forestry workers
are: (a) shorten the length of stay in contaminated territory; (b) minimize manned technologies and maximize mechanization; (c) provide
individual safety equipment and shielding forthe driver’s cabin on farm machines and devices for protection from gamma irradiation; (d)require special permission to enter the forests;and (e) impose seasonal regulations on forestry
operations (Maradudin et al., 1997).
5. Contamination is increasing and it appears that it will rise even more with the use ofcontaminated firewood as fuel and its radioactive ashes as fertilizer; all of these activities will
increase individual radiation doses.
6. Among forest products, mushrooms,
berries, and hazelnuts are the most contami-

nated. Up to 50% of all the mushrooms andberries that were measured exceeded the permissible level of Cs-137 (370 Bq/kg). Consumption of forest products accounts for up to 40%of the annual individual dose of internal radiation in Belarus. Persistence of Cs-137 inforest products exceeds the permissible leveleven in territories with soil contamination below 37 kBq/m2 (<1 Ci/km2 ).
7. The Belarus National Academy Forest Institute revealed that the forest can serve as “alive partition wall,” by regulating redistributionof radionuclides in ecosystems. In test plots in
sections of the Vetka and El’sk forests in Gomel
Province the amounts of radionuclides in theroots of trees, in forest berries, and in mushrooms have been decreased up to sevenfold asa result of special forestry and reclamation measures (Ipat’ev, 2008).
8. To prevent dispersion of radionuclides
from contaminated forest areas to adjoining
territories as a result of water and wind erosion
it is necessary to reforest eroded land. Universal efforts to prevent forest fires and improve
fire-fighting efficiency are needed to stop radionuclide dispersion via wind currents several
hundred or even thousands of kilometers awayfrom contaminated territories. Unfortunately,
this was not done during the fires that raged in1992.
9. In zones with a Cs-137 level of more than
15 Ci/km2 it is dangerous to consume wild
game. Obligatory total control over all gameproduction is needed in zones contaminatedup to 15 Ci/km2 . In contaminated territories
it is recommended to shoot wild boars and roe
deer aged 2 years or older because they havelower levels of incorporated radionuclides than
younger ones.
10. The situation with elk is the opposite. The level of radionuclide incorporation
is significantly lower among young animals ascompared to adults.
11. Radionuclide concentrations in the visceral organs of game mammals (heart, liver, kidneys, lungs, etc.) are significantly higher than inmuscle tissue.

Nesterenko & Nesterenko: Protective Measures for Activities

12. Decreasing levels of specific radioactive
contamination of principal game species are as
follows: wolf > fox > wild boar > roe deer >hare > duck > elk.
13. In contaminated territories the same
species of fish taken from rivers and streams
have significantly lower radionuclide levels thanthose from lakes and ponds. Phytophagous fish
have three to four times lower radionuclide levels than predatory species (catfish, pike, etc.).
Benthic fishes (crucian, tench, etc.) have several times more contamination than fish thatlive in the top water layers (small fry, chub,etc.).
14. There are some effective methods to significantly decrease radionuclide contaminationin pond cultures by plowing from the pond bottom down to a depth up to 50 cm and washingwith flowing water, applying potash fertilizers,
and using vitamins and antioxidants (radioprotectants) as food additives for the fish (Slukvin
and Goncharova, 1998).
14.3. Radiation Protection
Measures in Everyday Life
Instructions for radiation protection andself-help countermeasures can be found in
Ramzaev, 1992; Nesterenko, 1997; Beresdorf
and Wright, 1999; Annenkov and Averin, 2003;
Babenko, 2008; Parkhomenko et al., 2008; andmany others.
It is very important to avoid radionuclides infood and if they are consumed to try to eliminate them from the body as quickly as possible.
In a baby, the biological half-life of Cs-137 is 14
days; for a 5-year old it is 21 days; for a 10-year
old, 49 days; for teenagers, about 90 days; andfor a young male, about 100 days (Nesterenko,
1997).
1. The most direct way of decreasing radionuclide intake is to avoid foods that are potentially heavily contaminated and to consume
foodstuffs with lower levels. However, this is
not easy to do because the average level ofradionuclide bioaccumulation differs in each315

region owing to differences in soils, cultivars,
agriculture techniques, etc.
Several examples of differing levels of contamination are presented below.
1.1. Vegetables: Order of decreasing Cs-137
in some areas of Belarus: sweet pepper > cabbage >potatoes > beetroot > sorrel > lettuce > radish > onion > garlic > carrots >cucumbers > tomatoes. Order of decreasinglevels in Gomel Province: sorrel > beans >radish > carrots > been root > potatoes >garlic > sweet pepper > tomatoes > squash >cucumbers > cabbage (kohlrabi) > cauliflower> colewort (Radiology Institute, 2003).
1.2. Berries: Order of decreasing Cs-137
among some berries: blueberry (Vaccinium myrtillus), cowberry (V. vitis-idaea), red and black
currants (Ribes sp.), and cranberry (Oxycoccus)
usually accumulate more Cs-137 than strawberry (Fragaria), gooseberry (Grossularia), white
currant, raspberry (Rubus), and mountainash(Sorbus).
1.3. Meat: Order of decreasing Cs-137 insome meats: poultry > beef > mutton > pork.
Meats from older animals have more radionuclides that meat from younger ones owing toaccumulation over time. Bones of young animals have more Sr-90. Among visceral organs
the order of decreasing levels of Cs-137 is: lung> kidney > liver > fat.
1.4. Eggs: Order of decreasing levels: shell >egg-white > yolk.
1.5. Fish: Predatory and benthic fishes (pike,perch, carp, catfish, tench, etc.) are more contaminated, and fish living in rivers and streams
are always less contaminated than those fromlakes and ponds.
1.6. Mushrooms: The cap usually contains
more Cs-137 than the pedicle. Agaric (Agaricales) mushrooms usually concentrate more radionuclides than boletuses (Boletus).
2. The biological properties of Cs-137 aresimilar to those of stable K and Rb, and Sr-90
and Pu are similar to Ca. These properties determine where they concentrate in the body so
the use of stable elements may help to decrease
the absorption of radionuclides.

316

Foods rich in K include potatoes, maize,
beans, beets, raisins, dried apricots, tea, nuts,
potatoes, lemons, and dried plums. Ca-richfoods include milk, eggs, legumes, horseradish,green onions, turnip, parsley, dill, and spinach.
Green vegetables, apples, sunflower seeds,
black chokeberries, and rye bread are rich in
Fe; and Rb is found in red grapes.
3. A diet to protect against radioactive
contamination should include uncontaminatedfruits and vegetables, those rich in pectin, andthose with high-fiber complexes to promote therapid elimination of radionuclides.
4. High intake of fluids including fruit drinks
helps promote excretion of contaminants inurine.
5. Daily addition of antioxidants (vitamins A,
C, E, and the trace elements Zn, Co, Cu, andSe) is recommended.
6. Individuals exposed to radioactive contamination should consume special food additives such as Vitapect (see Chapter IV.13) andproducts made from apples, green algae (Spirulinae), fir-needles, etc.
7. There are several simple cooking techniques that decrease radionuclides: boil foods
several times and discard the water, wash foodthoroughly, soak some foods and discard thewater, avoid the rinds of fruits and vegetables,
salt and pickle some foods but throw away the
pickling juice! Avoid eating strong bouillon, use
rendered butter, etc.
Experiences from around the world after thecatastrophe show that citizens of countries that
did not provide information and methods tocounter the effects of the radioactive fallout
fared more poorly than those in countries that
did provide such help. In 1986 the effective
individual dose to the “average” person in Bulgaria, where there was no emergency protection was 0.7 to 0.8 mSv, or about threefold
higher than the dose for the “average” Norwegian. The Norwegian government placed aprohibition against eating leafy vegetables anddrinking fresh milk, destroyed contaminatedmeat, maintained cattle in stalls, deactivatedpastures and reservoirs, and mandated thatprior to slaughter the cattle be fed on clean forage, etc. This disparity in contamination doses
occurred even though the level of contamination in Bulgaria was measurably lower than thatin Norway (Energy, 2008).
Since 1994, radiation exposure of individuals
living in the contaminated territories of Belarus,
Ukraine, and Russia has continued to increase
owing to internal absorption of radionuclides—
the most dangerous form of radiation exposure
despite natural radioactive decay.
Migration of Chernobyl radionuclides into
soil root zones allows plants to absorb them,transport them to the surface, and incorporate
them into edible portions of the plant. Agricultural and forest product radionuclides are introduced into food chains, significantly increasing
the radiation danger for all who consume thosefoodstuffs. Today the most serious contaminating agents are Cs-137 and Sr-90. In coming
years the situation will change and Am-241 will
present a very serious problem (see Chapter I
for details).
For at least six to seven generations, vastterritories of Belarus, Russia, and Ukraine
must take special measures to control radiation exposure in agriculture, forestry, hunting,and fishing. So too must other countries withareas of high radioactive contamination, including Sweden, Norway, Switzerland, Austria,
France, and Germany. This means, that local
economies will require external grants-in-aid
and donations to minimize the level of radionuclides in all products because many areas simply do not have the funds to monitor, teach,and mandate protection. Thus the problem ofcontamination is dynamic and requires constant monitoring and control—for Cs-137 andSr-90 pollution at least 150 to 300 years into
the future. The contamination from the wider
spectrum of radioisotopes is dynamic and will
require constant monitoring and control essentially forever.

Nesterenko & Nesterenko: Protective Measures for Activities

References
Aleksakhin, R. M., Bagdevich, I. M., Fesenko, S. V.,
Sanzheva, N. I., Ageets, V. Yu. & Kashparov, V.
A. (2006). Role of protective measures in rehabilitation of contaminated territories. International Conference. Chernobyl 20 Years After: Strategy for Recoveringand Sustainable Development of Affected Territories. April
19–21, 2006, Minsk, Belarus (Materials, Minsk): pp.
103–108 (in Russian).
Aleksakhin, R. M., Vasyl’ev, A. V. & Dykarev, V. G. (1992).
Agricultural Radioecology (“Ecologiya,” Moscow): 400
pp. (in Russian).
Annenkov, B. N. & Averin, V. S. (2003). Agriculture inRadioactive Contaminated Areas: Radionuclides in Food(“Propiley,” Minsk): 84 pp. (in Russian).
Babenko, V. I. (2008). How to protect yourself andyour child from radiation (//www.belradinstitute.
boom.ru/frameru.htm) (in Russian).
Bagdevich, I. M., Putyatin, Yu. V., Shmigel’skaya, I. A.,
Tarasyuk, S. V., Kas’yanchik, S. A. & Ivanyutenko, V.
V. (2001). Agricultural Production on Radioactive Contaminated Territories (Institute for Soil Science and Agrochemistry, Minsk): 30 pp. (in Russian).
Beresdorf, N, A. & Wright, S. M. (Eds.) (1999). Selfhelp countermeasure strategies for populations living within contaminated areas of the former Soviet
Union and an assessment of land currently removed
from agricultural usage. EC projects RESTORE(F14-CT95–0021) and RECLAIM (ERBIC15CT96–0209) (Institute of Terrestrial Ecology, Monks
Wood): 83 pp.
Energy (2008). Chernobyl echo in Europe (//www.
members.tripod.com/B̃Ruslan / win / energe1.htm)(in Russian).
Gudkov, I. N. (2006). Strategy of biological radiation
protection of biota in radionuclide contaminatedterritories. In: Signa, A. A. & Durante, M. (Eds.),
Radiation Risk Estimates in Normal and Emergency Situations (Dordrecht Springer, Berlin/London/New
York): pp. 101–108.

317

Ipat’ev, V. (2008). Clean soil under radio-contaminatedforest: Is it real? Sci. Innovat. 61(3): 36–38 (inRussian).
Kashparov, V. A., Lazarev, N. M. & Poletchyuk, S. V.
(2005). Actual problems of agricultural radiology in
Ukraine. Agroecolog. J. 3: 31–41 (in Ukrainian).
Kenik, I. A. (Ed.) (1998). Belarus and Chernobyl: Priorities
for Second Decade after the Accident (Belarus Ministry for
Emergency Situations, Minsk): 92 pp. (in Russian).
Maradudin, I. I., Panfylov, A. V., Rusyna, T. V., Shubin, V.
A., Bogachev, V. K., et al. (1997). Manual for forestry
in Chernobyl radioactively contaminated zones (forperiod 1997–2000). Authorized by order N 40 from
1.03.97 of Russian Federal Forestry Service: 7 pp. (inRussian).
National Belarussian Report (2006). Twenty Years after Chernobyl Catastrophe: Consequences for Belarus Republic and Its
Surrounding Areas (Shevchuk, V. F. & Gurachevsky, V.
L., Eds.) (Belarus National Publishers, Minsk): 112
pp. (in Russian).
Nesterenko, V. B. (1997). Radiation monitoring of inhabitants and their foodstuffs in Chernobyl zone of Belarus. BELRAD Inform. Bull. 6 (“Pravo Ekonomika,”
Minsk): 71 pp. (in Russian).
Parkhomenko, V. I., Shutov, V. N., Kaduka, M. V.,
Kravtsova, O. S., Samiolenko, V. M., et al. (2008).
Protection from radiation: Manual on radiation
safety(//www.eco.scilib.debryansk.ru//2infres/radiation/content.html) (in Russian).
Radiology Institute (2003). Life in territory contaminated by radioactive substances (Radiology Institute, Gomel): 21 pp. (//www.mondoincammino.
org/humus/azioni/docs/opuscolo.pdf) (in Russian).
Ramzaev, P. V. (Ed.) (1992). Recommendations topublic on behavior on radionuclide contaminated territory (“IzDAT,” Moscow): 16 pp. (inRussian).
Slukvin, A. M. & Goncharova, R. I. (1998). Pond carp
defenses from low doses on outer and inner chronic
irradiation. Chernobyl Ecol. Health (Gomel) 2(6): 56–57(in Russian).

CHERNOBYL

15. Consequences of the Chernobyl
Catastrophe for Public Health and theEnvironment 23 Years Later
Alexey V. Yablokov, Vassily B. Nesterenko,
and Alexey V. Nesterenko
More than 50% of Chernobyl’s radionuclides were dispersed outside of Belarus, Ukraine,and European Russia and caused fallout as far away as North America. In 1986 nearly
400 million people lived in areas radioactively contaminated at a level higher than
4 kBq/m2 and nearly 5 million individuals are still being exposed to dangerous contamination. The increase in morbidity, premature aging, and mutations is seen in all
the contaminated territories that have been studied. The increase in the rates of total
mortality for the first 17 years in European Russia was up to 3.75% and in Ukraine it
was up to 4.0%. Levels of internal irradiation are increasing owing to plants absorbing and recycling Cs-137, Sr-90, Pu, and Am. During recent years, where internal levelsof Cs-137 have exceeded 1 mSv/year, which is considered “safe,” it must be lowered
to 50 Bq/kg in children and to 75 Bq/kg in adults. Useful practices to accomplish thisinclude applying mineral fertilizers on agricultural lands, K and organosoluble lignin
on forestlands, and regular individual consumption of natural pectin enterosorbents.
Extensive international help is needed to provide radiation protection for children,
especially in Belarus, where over the next 25 to 30 years radionuclides will continue
to contaminate plants through the root layers in the soil. Irradiated populations ofplants and animals exhibit a variety of morphological deformities and have significantly
higher levels of mutations that were rare prior to 1986. The Chernobyl zone is a “blackhole”: some species may persist there only via immigration from uncontaminatedareas.

The explosion of the fourth block of the Chernobyl nuclear power plant in Ukraine on April,
26, 1986 was the worst technogenic accident
in history. The information presented in thefirst 14 parts of this volume was abstracted
from the several thousand cited scientific papers and other materials. What follows here isa summary of the main results of this metaanalysis of the consequences of the Chernobyl
catastrophe.
The principal methodological approach ofthis meta-review is to reveal the consequencesof Chernobyl by comparing differences among
populations, including territories or subgroups
that had and have different levels of contamination but are comparable to one another in
ethnic, biologic, social, and economic characteristics. This approach is clearly more valid
than trying to find “statistically significant” correlations between population doses that are impossible to quantify after the fact and healthoutcomes that are defined precisely by morbidity and mortality data.
15.1. The Global Scale of theCatastrophe

Address for correspondence: Alexey V. Yablokov, Russian
Academy of Sciences, Leninsky Prospect 33, Office 319, 119071
Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.
Yablokov@ecopolicy.ru

1. As a result of the catastrophe, 40%of Europe was contaminated with dangerous

318

Yablokov et al.: Consequences of the Chernobyl Catastropheradioactivity. Asia and North America werealso exposed to significant amounts of radioactive fallout. Contaminated countries include Austria, Finland, Sweden, Norway,
Switzerland, Romania, Great Britain, Germany, Italy, France, Greece, Iceland, and Slovenia, as well as wide territories in Asia, including Turkey, Georgia, Armenia, The Emirates,
China, and northern Africa. Nearly 400 million
people lived in areas with radioactivity at a levelexceeding 4 kBq/m2 (≥0.1 Ci/km2 ) during theperiod from April to July 1986.
2. Belarus was especially heavily contaminated. Twenty-three years after the catastrophe nearly 5 million people, including some 1
million children, live in vast areas of Belarus,
Ukraine, and European Russia where dangerous levels of radioactive contamination persist(see Chapter 1).
3. The claim by the International Atomic
Energy Agency (IAEA), the United Nations
Scientific Committee on the Effects of Atomic
Radiation (UNSCEAR), and several othergroups that the Chernobyl radioactive fallout
adds “only” 2% to the natural radioactive background ignores several facts:• First, many territories continue to have danger-

ously high levels of radiation.

319

Figure 15.1. Total additional radioactivity (inpetabequerels) in the global environment after the
Chernobyl catastrophe: (1) Am-241, (2) Pu (239 +240), (3) Pu-241, (4) Sr-90, (5) Cs-137, (6) I-131(Mulev, 2008).

where about 57% of the Chernobyl radionuclides were deposited.
15.2. Obstacles to Analysis of theChernobyl Consequences
1. Among the reasons complicating a fullscale estimation of the impact of the Chernobyl
catastrophe on health are the following:• Second, high levels of radiation were spread far

and wide in the first weeks after the catastrophe.
• Third,there will be decades of chronic,
low-level
contamination
after
the
catastrophe (Fig. 15.1).

• Fourth, every increase in nuclear radiation has

an effect on both somatic and reproductive
cells of all living things.

4. There is no scientific justification for thefact that specialists from IAEA and the World
Health Organization (WHO) (Chernobyl Forum, 2005) completely neglected to cite theextensive data on the negative consequencesof radioactive contamination in areas otherthan Belarus, Ukraine, and European Russia,•

Official secrecy and unrectifiable falsification of Soviet Union medical statistics forthe first 3.5 years after the catastrophe.
• Lack of detailed and clearly reliable medical statistics in Ukraine, Belarus, andRussia.
• Difficulties in estimating true individual radioactive doses in view of: (a) reconstruction of doses in the first days, weeks, andmonths after the catastrophe; (b) uncertainty as to the influence of individual “hotparticles”; (c) problems accounting for uneven and spotty contamination; and (d)inability to determine the influence of eachof many radionuclides, singly and in combination.

320•

Inadequacy of modern knowledge as to:(a) the specific effect of each of the many
radionuclides; (b) synergy of interactions ofradionuclides among themselves and withother environmental factors; (c) populationand individual variations in radiosensitivity; (d) impact of ultralow doses and dose
rates; and (e) impact of internally absorbed
radiation on various organs and biologicalsystems.

2. The demand by IAEA and WHO experts
to require “significant correlation” between theimprecisely calculated levels of individual radiation (and thus groups of individuals) and precisely diagnosed illnesses as the only iron clad
proof to associate illness with Chernobyl radiation is not, in our view, scientifically valid.
3. We believe it is scientifically incorrect toreject data generated by many thousands of scientists, doctors, and other experts who directly
observed the suffering of millions affected by radioactive fallout in Belarus, Ukraine, and Russia as “mismatching scientific protocols.” It is
scientifically valid to find ways to abstract thevaluable information from these data.
4. The objective information concerning theimpact of the Chernobyl catastrophe on healthcan be obtained in several ways:•

Compare morbidity and mortality of territories having identical physiographic, social, and economic backgrounds and thatdiffer only in the levels and spectra ofradioactive contamination to which they
have been and are being exposed.
• Compare the health of the same group ofindividuals during specific periods after thecatastrophe.
• Compare the health of the same individual
in regard to disorders linked to radiationthat are not a function of age or sex (e.g.,
stable chromosomal aberrations).
• Compare the health of individuals living incontaminated territories by measuring thelevel of incorporated Cs-137, Sr-90, Pu,
and Am. This method is especially effec-

tive for evaluating children who were bornafter the catastrophe.
• Correlate pathological changes in particular organs by measuring their levels ofincorporated radionuclides.
The objective documentation of the catastrophe’s consequences requires the analysis of
the health status of about 800,000 liquidators,
hundreds of thousands of evacuees, and those
who voluntary left the contaminated territories of Belarus, Ukraine, and Russia (and theirchildren), who are now living outside of these
territories, even in other countries.
5. It is necessary to determine territories in
Asia (including Trans-Caucasus, Iran, China,
Turkey, Emirates), northern Africa, and North
America that were exposed to the Chernobyl
fallout from April to July 1986 and to analyze
detailed medical statistics for these and surrounding territories.
15.3. Health Consequencesof Chernobyl
1. A significant increase in general morbidity
is apparent in all the territories contaminatedby Chernobyl that have been studied.
2. Among specific health disorders associated with Chernobyl radiation there are increased morbidity and prevalence of the following groups of diseases:•

Circulatory system (owing primarily to radioactive destruction of the endothelium,
the internal lining of the blood vessels).
• Endocrine system (especially nonmalignant thyroid pathology).
• Immune system (“Chernobyl AIDS,” increased incidence and seriousness of all illnesses).
• Respiratory system.
• Urogenital tract and reproductive disorders.
• Musculoskeletal system (including pathologic changes in the structure andYablokov et al.: Consequences of the Chernobyl Catastrophecomposition of bones: osteopenia and osteoporosis).
• Central nervous system (changes in frontal,
temporal, and occipitoparietal lobes of thebrain, leading to diminished intelligenceand behaviorial and mental disorders).
• Eyes(cataracts, vitreous destruction,refraction anomalies, and conjunctive
disorders).
• Digestive tract.
• Congenital malformations and anomalies(including previously rare multiple defects
of limbs and head).
• Thyroid cancer (All forecasts concerning this cancer have been erroneous;
Chernobyl-related thyroid cancers have
rapid onset and aggressive development,
striking both children and adults. After
surgery the person becomes dependent on
replacement hormone medication for life.)• Leukemia (blood cancers) not only in children and liquidators, but in the general adult population of contaminatedterritories.
• Other malignant neoplasms.
3. Other health consequences of the catastrophe:•

Changes in the body’s biological balance,
leading to increased numbers of serious
illnesses owing to intestinal toxicoses, bacterial infections, and sepsis.
• Intensified infectious and parasitic diseases (e.g., viral hepatitis and respiratory
viruses).
• Increased incidence of health disorders inchildren born to radiated parents (both toliquidators and to individuals who left thecontaminated territories), especially thoseradiated in utero. These disorders, involving practically all the body’s organs andsystems, also include genetic changes.
• Catastrophic state of health of liquidators (especially liquidators who worked in
1986–1987).
• Premature aging in both adults and children.

•

321

Increased incidence of multiple somaticand genetic mutations.

4. Chronic diseases associated with radioactive contamination are pervasive in liquidators and in the population living in contaminated territories. Among these individuals
polymorbidity is common; that is, people areoften afflicted by multiple illnesses at the sametime.
5. Chernobyl has “enriched” world medicine
with such terms, as “cancer rejuvenescence,” aswell as three new syndromes:•“Vegetovascular dystonia”—dysfunctional regulation of the nervous system
involving cardiovascular and other organs(also called autonomic nervous system dysfunction), with clinical signs that present
against a background of stress.
• “Incorporated long-life radionuclides”—
functional and structural disorders of the
cardiovascular, nervous, endocrine, reproductive, and other systems owing to absorbed radionuclides.
• “Acute inhalation lesions of the upper respiratory tract”—a combination of a rhinitis, throat tickling, dry cough, difficulty
breathing, and shortness of breath owing
to the effect of inhaled radionuclides, including “hot particles.”
6. Several new syndromes, reflecting increased incidence of some illnesses, appeared
after Chernobyl. Among them:•“Chronic fatigue syndrome”—excessive
and unrelieved fatigue, fatigue without obvious cause, periodic depression, memory
loss, diffuse muscular and joint pains, chills
and fever, frequent mood changes, cervicallymph node sensitivity, weight loss; it is also
often associated with immune system dysfunction and CNS disorders.
• “Lingering radiating illness syndrome”—acombination of excessive fatigue, dizziness,trembling, and back pain.
• “Early aging syndrome”—a divergence
between physical and chronological age

322with illnesses characteristic of the elderly
occurring at an early age.
7. Specific Chernobyl syndromes such as“radiation in utero,” “Chernobyl AIDS,”“Chernobyl heart,” “Chernobyl limbs,” andothers await more detailed definitive medical
descriptions.
8. The full picture of deteriorating healthin the contaminated territories is still far fromcomplete, despite a large quantity of data. Medical, biological, and radiological research must
expand and be supported to provide the full picture of Chernobyl’s consequences. Instead thisresearch has been cut back in Russia, Ukraine,and Belarus.
9. Deterioration of public health (especiallyof children) in the Chernobyl-contaminatedterritories 23 years after the catastrophe is notdue to psychological stress or radiophobia, orfrom resettlement, but is mostly and primarily
due to Chernobyl irradiation. Superimposed
upon the first powerful shock in 1986 is continuing chronic low-dose and low-dose-rate radionuclide exposure.
10. Psychological factors (“radiation phobia”) simply cannot be the defining reason
because morbidity continued to increase forsome years after the catastrophe, whereas radiation concerns have decreased. And what is thelevel of radiation phobia among voles, swallows,
frogs, and pine trees, which demonstrate similar health disorders, including increased mutation rates? There is no question but that socialand economic factors are dire for those sickfrom radiation. Sickness, deformed and impaired children, death of family and friends,
loss of home and treasured possessions, loss ofwork, and dislocation are serious financial andmental stresses.
15.4. Total Number of Victims
1. Early official forecasts by IAEA and WHO
predicted few additional cases of cancer. In
2005, the Chernobyl Forum declared that the
total death toll from the catastrophe would be

about 9,000 and the number of sick about
200,000. These numbers cannot distinguishradiation-related deaths and illnesses from thenatural mortality and morbidity of a huge population base.
2. Soon after the catastrophe average life expectancy noticeably decreased and morbidity
and mortality increased in infants and the elderly in the Soviet Union.
3. Detailed statistical comparisons of heavily contaminated territories with less contaminated ones showed an increase in the mortality rate in contaminated European Russia
and Ukraine of up to 3.75% and 4.0%, respectively, in the first 15 to 17 years after thecatastrophe.
4. According to evaluations based on detailed analyses of official demographic statistics
in the contaminated territories of Belarus,
Ukraine, and European Russia, the additional
Chernobyl death toll for the first 15 years after
the catastrophe amounted to nearly 237,000
people. It is safe to assume that the total Chernobyl death toll for the period from 1987
to 2004 has reached nearly 417,000 in otherparts of Europe, Asia, and Africa, and nearly
170,000 in North America, accounting fornearly 824,000 deaths worldwide.
5. The numbers of Chernobyl victims willcontinue to increase for several generations.
15.5. Chernobyl Releases andEnvironmental Consequences
1. Displacement of the long half-life Chernobyl radionuclides by water, winds, and migrating animals causes (and will continue tocause) secondary radioactive contamination
hundreds and thousands of kilometers awayfrom the Ukrainian Chernobyl Nuclear Power
Station.
2. All the initial forecasts of rapid clearance
or decay of the Chernobyl radionuclides fromecosystems were wrong: it is taking much longer
than predicted because they recirculate. The
overall state of the contamination in water, air,Yablokov et al.: Consequences of the Chernobyl Catastropheand soil appears to fluctuate greatly and the
dynamics of Sr-90, Cs-137, Pu, and Am contamination still present surprises.
3. As a result of the accumulation of Cs-137,
Sr-90, Pu, and Am in the root soil layer, radionuclides have continued to build in plants
over recent years. Moving with water to theabove-ground parts of plants, the radionuclides(which earlier had disappeared from the surface) concentrate in the edible components, resulting in increased levels of internal irradiationand dose rate in people, despite decreasing total
amounts of radionuclides from natural disintegration over time.
4. As a result of radionuclide bioaccumulation, the amount in plants, mushrooms, andanimals can increase 1,000-fold as comparedwith concentrations in soil and water. The factors of accumulation and transition vary considerably by season even for the same species,
making it difficult to discern dangerous levelsof radionuclides in plants and animals that appear to be safe to eat. Only direct monitoring
can determine actual levels.
5. In 1986 the levels of irradiation inplants and animals in Western Europe, North
America, the Arctic, and eastern Asia weresometimes hundreds and even thousands oftimes above acceptable norms. The initial
pulse of high-level irradiation followed by exposure to chronic low-level radionuclides has
resulted in morphological, physiological, andgenetic disorders in all the living organisms incontaminated areas that have been studied—plants, mammals, birds, amphibians, fish, invertebrates, bacteria, and viruses.
6. Twenty years after the catastrophe allgame animals in contaminated areas of Belarus,
Ukraine, and European Russia have high levelsof the Chernobyl radionuclides. It is still possible to find elk, boar, and roe deer that are
dangerously contaminated in Austria, Sweden,
Finland, Germany, Switzerland, Norway, andseveral other countries.
7. All affected populations of plants and animals that have been the subjects of detailed
studies exhibit a wide range of morphological323

deformities that were rare or unheard of prior
to the catastrophe.
8. Stability of individual development (determined by level of fluctuating symmetry—aspecific method for detecting the level of individual developmental instability) is lower in all
the plants, fishes, amphibians, birds, and mammals that were studied in the contaminatedterritories.
9. The number of the genetically anomalous
and underdeveloped pollen grains and sporesin the Chernobyl radioactively contaminatedsoils indicates geobotanical disturbance.
10. All of the plants, animals, and microorganisms that were studied in the Chernobyl contaminated territories have significantly higher levels of mutations than those inless contaminated areas. The chronic low-dose
exposure in Chernobyl territories results in atransgenerational accumulation of genomic instability, manifested in cellular and systemic
effects. The mutation rates in some organisms increased during the last decades, despite a decrease in the local level of radioactive
contamination.
11. Wildlife in the heavily contaminatedChernobyl zone sometimes appears to flourish,
but the appearance is deceptive. According tomorphogenetic, cytogenetic, and immunological tests, all of the populations of plants, fishes,
amphibians, and mammals that were studied
there are in poor condition. This zone is analogous to a “black hole”—some species may only
persist there via immigration from uncontaminated areas. The Chernobyl zone is the microevolutionary “boiler,” where gene pools of
living creatures are actively transforming, with
unpredictable consequences.
12. What happened to voles and frogs in the
Chernobyl zone shows what can happen to humans in coming generations: increasing mutation rates, increasing morbidity and mortality,
reduced life expectancy, decreased intensity of
reproduction, and changes in male/female sex
ratios.
13. For better understanding of the processes of transformation of the wildlife in the324

Chernobyl-contaminated areas, radiobiological and other scientific studies should not
be stopped, as has happened everywhere in
Belarus, Ukraine, and Russia, but must be
extended and intensified to understand andhelp to mitigate expected and unexpectedconsequences.
15.6. Social and Environmental
Efforts to Minimize theConsequences of the Catastrophe
1. For hundreds of thousands of individuals(first of all, in Belarus, but also in vast territories of Ukraine, Russia, and in some areas ofother countries) the additional Chernobyl irradiation still exceeds the considered “safe” levelof 1 mSv/year.
2. Currently for people living in the contaminated regions of Belarus, Ukraine, and Russia,
90% of their irradiation dose is due to consumption of contaminated local food, so measures must be made available to rid their bodies of incorporated radionuclides (see Chapter
IV.12–14).
3. Multiple measures have been undertaken
to produce clean food and to rehabilitate thepeople of Belarus, Ukraine, and European
Russia. These include application of additionalamounts of select fertilizers, special programs
to reduce levels of radionuclides in farm products and meat, organizing radionuclide-freefood for schools and kindergartens, and special programs to rehabilitate children by periodically relocating them to uncontaminatedplaces. Unfortunately these measures are notsufficient for those who depend upon food fromtheir individual gardens, or local forests, andwaters.
4. It is vitally necessary to develop measures
to decrease the accumulation of Cs-137 in thebodies of inhabitants of the contaminated areas. These levels, which are based upon available data concerning the effect of incorporated
radionuclides on health, are 30 to 50 Bq/kg
for children and 70 to 75 Bq/kg for adults. In

some Belarus villages in 2006 some children
had levels up to 2,500 Bq/kg!
5. The experience of BELRAD Institute in
Belarus has shown that active decorporation
measures should be introduced when Cs-137
levels become higher than 25 to 28 Bq/kg.
This corresponds to 0.1 mSv/year, the samelevel that according to UNSCEAR a person
inevitably receives from external irradiation living in the contaminated territories.
6. Owing to individual and family foodconsumption and variable local availability offood, permanent radiation monitoring of local food products is needed along with measurement of individual radionuclide levels, especially in children. There must be general
toughening of allowable local food radionuclide
levels.
7. In order to decrease irradiation to a considered safe level (1 mSv/year) for those incontaminated areas of Belarus, Ukraine, andRussia it is good practice to:•

Apply mineral fertilizers not less than threetimes a year on all agricultural lands, including gardens, pastures, and hayfields.
• Add K and soluble lignin to forest ecosystems within a radius up to 10 km from settlements for effective reduction of Cs-137
in mushrooms, nuts, and berries, which areimportant local foods.
• Provide regular individual intake of natural pectin enterosorbents (derived fromapples, currants, etc.) for 1 month at least
four times a year and include juices with
pectin daily for children in kindergartensand schools to promote excretion ofradionuclides.
• Undertake preventive measures for milk,
meat, fish, vegetables, and other local foodproducts to reduce radionuclide levels.
• Use enterosorbents (ferrocyanides, etc.)
when fattening meat animals.
8. To decrease the levels of illness and promote rehabilitation it is a good practice in thecontaminated areas to provide:Yablokov et al.: Consequences of the Chernobyl Catastrophe•

Annual individual determination of actuallevels of incorporated radionuclides using
a whole-body radiation counter (for children, this must be done quarterly).
• Reconstruction of all individual external
irradiation levels from the initial period after the catastrophe using EPR-dosimetry
and measurement of chromosomal aberrations, etc. This should include all victims, including those who left contaminated areas—liquidators, evacuees, andvoluntary migrants and their children.
• Obligatory genetic consultations in thecontaminated territories (and voluntary for
all citizens of childbearing age) for the risksof severe congenital malformations in offspring. Using the characteristics and spectra of mutations in the blood or bone marrow of future parents, it is possible to define
the risk of giving birth to a child with severe genetic malformations and thus avoid
family tragedies.
• Prenatal diagnosis of severe congenital
malformations and support for programsfor medical abortions for families livingin the contaminated territories of Belarus,
Ukraine, and Russia.
• Regular oncological screening and preventive and anticipatory medical practices
for the population of the contaminatedterritories.
9. The Chernobyl catastrophe clearly showsthat it is impossible to provide protection fromthe radioactive fallout using only national resources. In the first 20 years the direct economic
damage to Belarus, Ukraine, and Russia has exceeded 500 billion dollars. To mitigate some of
the consequences, Belarus spends about 20% of
its national annual budget, Ukraine up to 6%,
and Russia up to 1%. Extensive international
help will be needed to protect children for atleast the next 25 to 30 years, especially thosein Belarus because radionuclides remain in theroot layers of the soil.
10. Failure to provide stable iodine in April
1986 for those in the contaminated territories

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led to substantial increases in the number ofvictims. Thyroid disease is one of the first consequences when a nuclear power plant fails,
so a dependable system is needed to get thissimple chemical to all of those in the path of
nuclear fallout. It is clear that every country
with nuclear power plants must help all countries stockpile potassium iodine in the event ofanother nuclear plant catastrophe.
11. The tragedy of Chernobyl shows thatsocieties everywhere (and especially in Japan,
France, India, China, the United States, andGermany) must consider the importance of independent radiation monitoring of both foodand individual irradiation levels with the aimof ameliorating the danger and preventing additional harm.
12. Monitoring of incorporated radionuclides, especially in children, is necessaryaround every nuclear power plant. This monitoring must be independent of the nuclear industry and the data results must be made available to the public.
15.7. Organizations Associatedwith the Nuclear Industry Protect
the Industry First—Not the Public
1. An important lesson from the Chernobyl
experience is that experts and organizations
tied to the nuclear industry have dismissed andignored the consequences of the catastrophe.
2. Within only 8 or 9 years after the catastrophe a universal increase in cataracts was admitted by medical officials. The same occurredwith thyroid cancer, leukemia, and organic central nervous system disorders. Foot-dragging inrecognizing obvious problems and the resultant
delays in preventing exposure and mitigating
the effects lies at the door of nuclear power advocates more interested in preserving the status quo than in helping millions of innocent
people who are suffering through no faultof their own. It need to change official
agreement between WHO and IAEA (WHO,1959) providing hiding from public of any

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information which can be unwanted of nuclear
industry.
15.8. It Is Impossible
to Forget Chernobyl
1. The growing data about of the negative
consequences of the Chernobyl catastrophe forpublic health and nature does not bode wellfor optimism. Without special large-scale national and international programs, morbidity
and mortality in the contaminated territories
will increase. Morally it is inexplicable that theexperts associated with the nuclear industry
claim: “It is time to forget Chernobyl.”
2. Sound and effective international and national policy for mitigation and minimizationof Chernobyl’s consequences must be basedon the principle: “It is necessary to learn
and minimize the consequences of this terrible catastrophe.”15.9. Conclusion
U.S. President John F. Kennedy speaking
about the necessity to stop atmospheric nuclear
tests said in June 1963:. . . The number of children and grandchildren
with cancer in their bones, with leukemia in theirblood, or with poison in their lungs might seemstatistically small to some, in comparison with natural health hazards, but this is not a natural healthhazard—and it is not a statistical issue. The loss ofeven one human life or the malformation of evenone baby—who may be born long after we aregone—should be of concern to us all. Our children
and grandchildren are not merely statistics toward
which we can be indifferent.

The Chernobyl catastrophe demonstrates
that the nuclear industry’s willingness to risk
the health of humanity and our environment
with nuclear power plants will result, not only
theoretically, but practically, in the same levelof hazard as nuclear weapons.

References
Chernobyl Forum (2005). Environmental Consequencesof the Chernobyl Accident and Their Remediation: Twenty Years of Experience. Report of
the UN Chernobyl Forum Expert Group “Environment” (EGE) Working Draft, August 2005
(IAEA, Vienna): 280 pp. (//www-pub.iaea.org/
MTCD/publications/PDF/Pub1239_web.pdf).
Kennedy, J. F. (1963). Radio/TV address regarding the
Nuclear Test Ban Treaty, July 26, 1963 (//www.ratical.org/radiation/inetSeries/ChernyThyrd.html).
Mulev, St. (2008). Chernobyl’s continuing hazards. BBCNews website, April 25, 17.25. GMT (//www.
news.bbc.co.uk/1/hi/world/europe/4942828.stm).
WHO (1959). Resolution World Health Assembly.
Rez WHA 12–40, Art. 3, §1(//www.resosol.
org/InfoNuc/IN_DI.OMS_AIEA.htm).

CHERNOBYL

Conclusion to Chapter IV

In the last days of spring and the beginningof summer of 1986, radioactivity was released
from the Chernobyl power plant and fell uponhundreds of millions of people. The resulting
levels of radionuclides were hundreds of times
higher than that from the Hiroshima atomic
bomb.
The normal lives of tens of millions havebeen destroyed. Today, more than 6 million
people live on land with dangerous levels ofcontamination—land that will continue to becontaminated for decades to centuries. Thus
the daily questions: how to live and where to
live?
In the territories contaminated by the Chernobyl fallout it is impossible to engage safely
in agriculture; impossible to work safely inforestry, in fisheries, and hunting; and dangerous to use local foodstuffs or to drink
milk and even water. Those who live inthese areas ask how to avoid the tragedy ofa son or daughter born with malformations
caused by irradiation. Soon after the catastrophe these profound questions arose amongliquidators’ families, often too late to avoid
tragedy.
During this time, complex measures to minimize risks in agriculture and forestry were de-veloped for those living in contaminated territories, including organizing individual radiation
protection, support for radioactive-free agricultural production, and safer ways to engage inforestry.
Most of the efforts to help people in thecontaminated territories are spearheaded bystate-run programs. The problem with these
programs is the dual issue of providing help
while hoping to minimize charges that Chernobyl fallout has caused harm.
To simplify life for those suffering irradiation
effects a tremendous amount of educationaland organizational work has to be done to monitor incorporated radionuclides, monitor (without exception) all foodstuffs, determine individual cumulative doses using objective methods,
and provide medical and genetic counseling,
especially for children.
More than 20 years after the catastrophe, by
virtue of the natural migration of radionuclides
the resultant danger in these areas has not decreased, but increases and will continue to doso for many years to come. Thus there is theneed to expand programs to help people still
suffering in the contaminated territories, which
requires international, national, state, and philanthropic assistance.

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