The Chernobyl Liquidators

A Health Disaster Scene

Reading the United Nations report on Chernobyl would easily lead you to believe the Chernobyl clean-up workers — aka, the liquidators — suffered at most minimal health effects for their heroic battle against the worst nuclear disaster in history. As the UN’s Scientific Committee on the Effects of Atomic Radiation concluded:

“[S]everal hundred thousand people were involved in recovery operations, but to date, apart from indications of an increase in the incidence of leukemia and cataracts among those who received higher doses, there is no evidence of health effects that can be attributed to radiation exposure.”

So I set out to acquire all scientific research on the health of the liquidators and found a grim reality far removed from the rosy picture painted by the United Nations. In this video I give an overview of that research:

The following is a chronological compilation of all the research investigating the biological health of the Chernobyl liquidators I tracked down. My aim was to acquire all such studies, irrespective of their results so we can determine the balance of results for or against adverse-health consequences. A green check indicates evidence for adverse consequences while a red x indicates no detected health effect. The balance weighs overwhelmingly toward adverse health effects. And lack of detections among the early cancer studies are attributable to the slowness of cancer latency.

CANCER STUDIES

listed chronologically

leukemia     Significantly Increased:  

Finch et al (2016): “A significant increase in the risk of death with increasing radiation dose was observed […] After adjustment for radiation dose, survival of CLL cases was significantly shorter among those with younger age at first exposure […]The current study provides new evidence on the association of radiation dose and younger age at first radiation exposure at Chornobyl with shorter survival after diagnosis.” Study details: 79 cases from 110,645 cohort, study was internal to that subset, median dose of CLL subjects was 22.6 mGy

leukemia     Significantly Increased:  

Gudzenko et al (2015): “A nested case-control study of leukemia was conducted in a cohort of 110,645 male [Chernobyl] clean-up workers […] A total of 162 cases of leukemia was identified among cohort members […] 5 controls for each leukemia case from among cohort members without leukemia [were used …] Individual bone marrow radiation doses for both cases and controls were estimated […] Based on the data for cases with reconstructed dose and corresponding controls, a significant linear dose–response was found for all leukemia (ERR/Gy = 1.26 (95% CI: 0.03, 3.58).” Note: this study found petroleum is also a leukemia risk factor.

morbidity and mortality    Significantly Increased:  

Ivanov et al (2015): “Morbidity and mortality among emergency workers of the Chernobyl accident for the followup period of 1992-2008 is analyzed in the article. The cohort consists of 47,141 emergency workers of 1986-1987. Radiation risks for cancer morbidity (ERR/Gy is 0.76; 95% CI: 0.19; 1.42, p-value=0008) and cancer mortality (ERR/Gy is 0.95; 95% CI: 0.19; 1.89, p-value=0.01) are statistically significant.Study details: this study is in Russian, an in-English abstract is included at the end.

all cancer      Significantly Increased:  

Kashcheev et al (2015): “Analysis of solid cancer incidence in the emergency workers over the period 1992–2009 (the control is the background incidence in the male population of Russia) has shown a statistically significant increase of 18 % for all solid cancers. […] A statistically significant radiation risk of death from all solid cancers has been established.” Study details: 67,568 Russian liquidators, controls are Russian population for incidence and cohort-internal by dose for mortality; dose range 0.1 – 1,240 mGy, median of 102 mGy.

thyroid cancer     Significantly Increased:  

Ostroumova et al (2014): “Our findings support the growing evidence of increased thyroid cancer rates among Chornobyl liquidators. Although this could be partially attributed to increased medical surveillance, the observed pattern of SIR increase warrants further investigation of a potential contribution of radiation exposure to the elevated thyroid cancer rates in this large population.Study details: 150,813 Ukrainian male liquidators, control is general Ukrainian population, no doses given.

all cancer     Significantly Increased:  

Prysyazhnyuk et al (2014): This study showed that all cancer incidences exceeded the national level only in CRW [Chernobyl Recovery Workers] group. […] Statistically significant increase of leukemia incidence in CRW group was registered as well. […]Significant excess was also revealed for breast cancer in female CRW group.” Study details: 96,000 Ukrainian liquidators, Dose: avg external 50 – 200 mSv.

all cancers       Significantly Increased:  

Rahu et al (2013a): “To assess site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986-2007. […] an excess of oesophageal cancers was noted […] Brain cancers were overrepresented among men who arrived in the Chernobyl area in 1986 and had the longer mission […] Excess risk for all cancer sites (except prostate) and alcohol-related cancer sites combined reached borderline statistical significance (SIR = 1.08; 95% CI 1.00–1.16 and SIR = 1.16; 95% CI 1.00–1.31, respectively) […] Consistent evidence of an increase in radiation-related cancers in the Baltic cohort was not observed with the possible exception of thyroid cancer.Study details: 17,040 Baltic liquidators, control is general populations, dose: avg 109 mGy, range 52-163 mGy. The authors define esophageal cancer as alcohol-related cancer despite that it is significantly elevated among the A-bomb survivors (Ozasa 2012).

all cancer    Significantly Increased:  

Rahu et al (2013b):This study examined cancer incidence (1986-2008) and mortality (1986-2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. […] No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent.” Study details: 4,810 Estonian liquidators, controls Estonian male population, average dose ~ 100 mGy.

multiple myeloma     Significantly Increased:  

Bazyka et al (2013):The objective of the study was to analyze the Multiple Myeloma (MM) incidence in clean-up workers preparing the information background for consequent analytical study with a dose-dependent risk estimates. […] Standardized incidence ratio for the 2008–2012 period, that is 22–26 years after the accident, demonstrated the significant excess of MM incidence among male clean up workers in comparison with general population of Ukraine of corresponding age and gender.”Study details: 152,520 Ukranian liquidators, control is general population, dose range 0.12 – 2,920 mGy.

leukemia     Significantly Increased:  

Zablotska et al (2013): “Exposure to low doses and to low dose-rates of radiation from post-Chornobyl cleanup work was associated with a significant increase in risk of leukemia, which was statistically consistent with estimates for the Japanese atomic bomb survivors.” Study details: 110,645 Ukrainian liquidators, controls matched to same birthplace and age, dose among cases: mean 132.3 ± 342.6 mGy, nested case-control study.

leukemia     Significantly Increased:  

Ivanov et al (2012): “For the Russian cohort of Chernobyl emergency workers, a statistically significant radiation risk of leukemia (excluding CLL) incidence was observed for the period 1986–1997, that is, 7–10 years since exposure of the cohort’s members […] The main conclusion from the present study is that the radiation-induced excess in the risk of leukemia incidence is limited on time after exposure. In particular, it is hardly possible to observe radiation-induced cases of leukemia among Russian adult male population 15 years after exposure.Study details: 104,947 Russian liquidators, control is male Russian populatin, dose: mean 108 mGy with range over 500 mGy for several workers, retrospective cohort study.

thyroid cancer     Significantly Increased:  

Kesminiene et al (2012): “A significant dose-response relationship was observed between radiation dose to the thyroid received in adulthood and the risk of subsequent thyroid cancer, with a significantly increased risk at doses of 300 mGy or above. […]screening is unlikely to fully explain the increased risk in this study.” Study details: nested case-control study with 107 cases from 66,000 Belarusian, 65,000 Russian and 15,000 Baltic country liquidators, with 423 controls, median dose among cases 103 mGy with range 0.18–3,308 mGy.

multiple myeloma     Significantly Increased:  

Gluzman et al (2011): “Multiple myeloma (MM) was diagnosed in 19 patients of clean-up worker group (6.44%). […] In our study, MM percentage in the patients of Chernobyl clean-up worker group turned out to be significantly higher than in the patients of the general populations studied at the same period (4.00%).” Study details: 403 liquidators from Keiv city with suspected oncohematological disorders, 2,697 controls from Keiv district with similar preexisitng diagnoses, dose range 75 to 250 mGy, case-control study.

leukemia     Significantly Increased:  

Romanenko et al (2008): “In a nested case-control study of Chornobyl cleanup workers in Ukraine, we observed a significant association between Chornobyl-related radiation dose and increased risk of total leukemia. Our risk estimate for Chornobyl cleanup workers exposed to protracted radiation was comparable to that from the Life Span Study of atomic bomb survivors exposed to high-dose-rate ionizing radiation.”Study details: 71 cases from 110,645 Ukrainian liquidators, with 5 to 9 controls per case.

thyroid cancer     Significantly Increased:  

Ivanov et al (2008): “Based on these data, a statistically significant increase in thyroid cancer incidence was found above the reference level for the male population of Russia, corresponding to a standardized incidence rate […] These results indicate that the exposure to incorporated (131)I was the major risk factor of thyroid cancer among Chernobyl emergency workers.”

blood cancers     Significantly Increased:

Kesminiene et al (2008): “A significantly elevated OR [odds ratio] was seen for all hematological malignancies combined at doses of 200 mGy and above. Although most risk estimates are not statistically significantly elevated, they are based on small numbers of cases and they are statistically compatible with those obtained for atomic bomb survivors and recent low dose-rate studies.” Study details: 66,000 Belarus, 65,000 Russian and 15,000 Baltic liquidators

all cancers    Significantly Increased:  

Prysyazhnyuk et al (2007): “For all cancers combined, statistically significant higher incidence rates than the national rates were found only for the recovery workers […]For female recovery workers there was also an excess of breast cancer over the national rates.” Study details: 106,800 Ukrainian liquidators, controls from general population; mean dose 162.7 mSv

cancer mortality    Significantly Increased:   leukemia         Significantly Increased:  

Ivanov et al (2007): “the excess relative risk (ERR) of death from malignant neoplasm was statistically significant […] During the first 10 y after the Chernobyl accident (1986 –1996) the relative risk (RR) of leukemia (excluding chronic lymphocytic leukemia) was statistically significant.” Study details: this study is a review but the two endpoints cited are their first reports in peer-review. The mortality endpoint is about Ivanov 2004 (listed below but not reported therein) and the leukemia data reveiwed were from this post by Ivanov in 2003. Leukemia cohort was 71,870 Russian liquidators, 107 mGy mean dose; controls age-matched male Russian population.

leukemia    Significantly Increased:  

Gluzman et al (2006): “the relative contribution of CML to the total number of clean-up workers with leukemia was higher than the corresponding percentage value in general population examined at the same period (9.17 vs. 6.59%). The multiple myeloma percentage (7.79%) in the group of patients belonging to clean-up workers in our study turned out to be about twice as much as in the patients of general population (4.00%).[…] The significant excess of LGL-L, which is extremely rare in the general population, is also worthwhile to mention.Study details: study analyzed 218 Ukrainian liquidators with leukemia compared to 2,697 controls with leukemia, dose range was 75 to 250 mGy.

many cancers     Significantly Increased: 

Sosnovskaya (2006): “The incidence of lung, gastric, renal, and bladder MNs[malignant neoplasms] among liquidators increased at a higher rate as compared with the control group in a statistically significant manner. Significant differences in the morbidity for gastric and lung MNs in the cohort of liquidators and in the control are determined by opposing morbidity dynamics, namely, a statistically significant increase in MN morbidity among the ChNA liquidators and a decrease in the control group.” Study details: this quotation is from Oradovskaya (2011) and describes, as referenced: E. Ya. Sosnovskaya, in Health State of the Republic of Belarus Population that Suffered from the Chernobyl Nuclear Accident (Gomel, 2006), pp. 58–69.

tyroid & brain cancer      Significantly Increased:  

Rahu et al (2006): “Statistically significant excess cases of thyroid (SIR = 7.06, 95% CI 5 2.84–14.55; n = 7) and brain cancer (SIR = 2.14, 95% CI = 1.07–3.83; n = 11) were found, mainly based on Latvian data. However, there was no evidence of a dose response for any of these sites, and the relationship to radiation exposure remains to be established.” Study details: 10,332 Baltic liquidators, control general population, mean dose 109 mGy.

mortality     Significantly Increased:  

Rahu et al (2006): “No elevated risk in overall mortality and radiation-related cancers was observed. […] elevated mortality was observed for brain cancer (SMR, 2.78; 95% CI, 1.02–6.05). […] excess mortality from brain cancer, was unexpected and may be a chance finding because brain cancer is not considered to be related to ionizing radiation.Study detail: 4,786 Estonian liquidaotrs, control was entire male population of Estonia.

all cancer     Significantly Increased: 

Okeanov et al (2004): “Average annual excess rates of cancers in all sites in liquidators was 5.5%, which is significantly higher than in the adult population of the Vitebsk region, where it was 1.5% (p <0.05).” Study details: number of presumably Bularussian liquidators is not given, control was adult population of Vitebsk in Belarus, doses are not given.

all cancer     Significantly Increased:  

Ivanov et al (2004): “The analysis of the solid cancer incidence in the cohort of emergency workers—employees of the nuclear industry shows that the cancer incidence rate in the studied cohort does not exceed that in the respective age groups of the population of Russia as a whole.” Study details: 8,654 Russian liquidator, control is matched Russian population, avg dose 50 mSv.

solid cancer incidence     Significantly Increased:  

Ivanov et al (2004): “the results of the study lead us to conclude that there is a positive, yet statistically insignificant excess relative risk of radiogenic solid cancers in the cohort of emergency workers.Study details: 55,718 Russiam liquidators, mean dose 130 mGy

thyroid cancer     Significantly Increased:  

Ivanov et al (2002): “We found a statistically significant increase of the thyroid cancer incidence rate in liquidators as compared to the baseline (male population of Russia) level (SIR=4.33, 95% CI: 3.29; 5.60). It was demonstrated that there is no dependence of incidence rates due to external radiation exposure.” Study details: 99,024 Russian liquidators, control is Russian population, mean dose 33 mGy

leukemia    Significantly Increased:  

Konogorov et al (2000): “The analysis was performed both for the EWs who worked in the ChZ from 1986 to 1990 (all EWs) and for the EWs who worked in the zone from 1986 to 1987 […] No significant association was found between the risk of leukemia and the factors we investigated. […] There was no statistically significant trend with increasing dose.” Study details: nested-case-control design from cohort of 162,684 Russian liquidators, mean external dose was 123 mGy (1986) and 105 mGy (1987), dose range was 1 to 500 mGy.

all solid cancer     Significantly Increased:

Ivanov et al (1998): “Cancer incidence in liquidators is compared to that of the population of Russia as a whole […] Assessment of radiation risks for the same classes of diseases has revealed a statistically significant increase in cancer incidence with external radiation dose.” Study details: 114,504 Russian liquidators, average dose 108 mGy.

thyroid & leukemia     Significantly Increased:  

Ivanov et al (1997): for leukemia, “at the 95% confidence level, the difference is statistically significant only for the cases diagnosed in the period 1990-1993. The absence of a significant increase of leukaemia cases in the years 1986-1989 is in line with the latency period of 2–3 years for the induction of radiogenic leukaemia assumed in the risk models.” Regarding thyroid cancer: “It is notable that there are – 4 years after the disaster – significant excess SIR values for the emergency workers of 1986, while for the emergency workers of 1987, the excess is seen 5 years after the accident. This reaffirms the existence of a latency period of about 4 years for the induction of radiogenic thyroid cancers in both cases.” Study details: 168,000 Russian liquidaotrs, age-matched Russian population as control, mean dose was 170 mGy (1986) and 100 mGy (1987).

thyroid cancer    Significantly Increased:  

Inskip et al (1997): “Chernobyl cleanup workers from Estonia did not experience a markedly increased risk of nodular thyroid disease associated with exposure to external radiation.” Study details: 1,984 Estonian liquidators screened for thyroid cancer, control was by “internal comparisons,”mean dose 108 mGy, maximum dose 610 mGy.

NON-CANCER ILLNESS

listed chronologically

circulatory disease   Significantly Increased:  

Bazyka et al (2015): “In clean-up workers, the post-accident period is characterized by significant growth of circulatory diseases […] We obtained significant values of relative risks in the range of whole-body external doses 0.05-0.7 Gy. It should be noted that the most stable values of risks and excess relative risks were obtained at doses 0.25-0.7 Gy. […] Ionizing radiation is only one of the set of factors inducing CVD. […]additional evidence is needed.” Study deatils: this study is Chapter 6 in Biological Responses, Monitoring and Protection from Radiation Exposure. Ed. KP, Mishra, Nova Science Publishers, 2015. Cohort: 314,192 Ukranian liquidators with internal control being those with doses 0-50 mGy. Significiant dose-response favors a causal role for radiation.

thyroid disease   Significantly Increased:  

Kaminskyi et al (2015): “Retrospective data review indicates the incidence of thyroid disease being 40.29% in all persons survived after the ChNPP accident, 35.37% in the accident clean-up workers, 27.24% in evacuees from the exclusion zone, and 28.6% in population of contaminated territories that much exceeds (p < 0.0001) value (3.9%) in the entire population of Ukraine. […] Such diseases as nodular goiter (diagnosed in 21.8%), chronic autoimmune thyroiditis (12.95%), pre-obesity and obesity (41.71% / 33.61%) pre-diabetes and diabetes mellitus (8.6% / 12.15%) were also most frequent in the ChNPP accident clean up workers.” Study details: 10,798 Ukrainian liquidators, avge dose 187 mGy.

gynecological morbidity    Significantly Increased:  

Mayevska et al (2015): “Exposure to ionizing radiation in the childbearing age (18–45 years old) can be a risk factor of elevated incidence of uterine leiomyoma, benign mammary dysplasia (i.e. benign breast disease), and salpingo oophoritis. It is far to assume that uterine and mammary tissues are more sensitive to impact of ionizing radiation in females of the childbearing age vs. in persons exposed in pre menopause or menopause.Study details: 17,237 female Ukrainian liquidators, internal control by compariosn of subjects according toduration of on-site exposure.

cognitive impairment    Significantly Increased:  

Bazyka et al (2015): “Cognitive functions in cleanup workers exposed to ionizing radiation at adulthood are characterized by symptoms of a mild cognitive impairment according to the MMSE (mean group score 25,58 ± 2,95) and a significantly higher level of mental disorders according to the BPRS in a dose related manner. Cleanup workers exposed to doses over 500 mSv demonstrate a significant cognitive deficit in comparison with those exposed below 500 mSv and especially non-exposed patients.”Study detail: survey of 326 Ukrainian liquidators, internal control by dose grouping.

Many illnesses      Significantly Increased:  

Buzunov et al (2015): “We have found a dramatic deterioration of the Chornobyl cleanup workers’ health due to the growth of wide range of nontumor diseases, especially circulatory, digestive, respiratory, endocrine, genitourinary and nervous system diseases. […] The proportion of healthy and practically healthy people approximated 68% in 1988, while in 2012, i.e. twentysix years after the Chornobyl accident, it fell to 5.5%. […] Almost 90% of disability cases reported in 2012 were likely to be Chornobyl related.” Descriptive health-status study of Ukrainian liquidators.

paroxysmal brain activity    Significantly Increased:  

Podsonnaya et al (2015): “It has been determined that the formation of paroxysmal brain activity in LCND [liquidators of the consequences of the nuclear disaster] occurs 3.5 times more frequent (p<0.001) and 15-17 years earlier (p<0.001) than in the control group and mainly during the first 10 years after the exposure to radiation. […]Stimulating effect of ionizing radiation on the development of PBA [paroxysmal brain activity] related to the age on the date of exposure to radiation was found.”

psychoorganic syndrome     Treatment study

Krasnov et al (2015): “Despite the fact that most of the clean-up workers, involved in the elimination of Chernobyl disaster consequences, were exposed to low doses of radiation (usually not exceeding 0,25 Gy, registered by personal dosimeters), at the early stage it was revealed that they have different polymorphic symptoms with combination of asthenic, psychovegetative, and subaffective disorders, at first with mild, neurodynamic, and reversible cognitive disorders, developing later into a psychoorganic syndrome, based on the early cerebrovascular pathology, as well as neuroendocrine, neurological, immune, and psychosomatic disturbances. […] The most significant factor, which influenced the pathogenesis of psychoorganic syndrome, was the primary radiation reaction.” Study details: this is a study of medical treaments among a cohort of 312 liquidators diagnosed with psychoorganic syndrome. This study demonstrates recognition that disorders among the liquidators require unique treatments.

lung disease      Significantly Increased:  

Sushko et al (2014): “In the Chornobyl clean-up workers who received higher exposure doses, likely observed a gradual increase in the number of bronchopulmonary diseases. […] In general, the correlation coefficient between exposure dose and the development of COPD [chronic obstructive pulmonary disease]was 0.117, p = 0.001 [statistically significant].” Study details: 7,156 Ukrainian liquidators, controls are lower to higher dose, dose range 25-500 mSv

endocrine disease      Significantly Increased:  

Kaminskiy et al (2014): “Effects of ionizing radiation and other hazardous factors on endocrine system in the ChNPP AEW [Chernobyl NPP Accident Emergency Workers]appeared upon 15–25 years. There was a significant (2–10 fold) and reliable (p < 0.01) increase of the incidence of the nodular goiter, autoimmune thyroiditis, obesity, type 2 diabetes mellitus. And there is a trend to further increase.” Study details: 10,771 Ukrainian liquidators; control is Ukrainian population; avg external dose: 187 mGy

endocrine disease      Significantly Increased:  

Kaminskiy et al (2014): Chernobyl workers and residents of contaminated regions had “Significant increase of the incidence of thyroid disease (1.5-3 fold), diabetes mellitus (3-7 fold), pre-obesity and obesity (in 25.67 %), and metabolic syndrome (5-fold) vs. entire population of Ukraine was found.” Study details: 7,588 Ukrainian liquidators; controls residents of Kiev province; avg external dose: 134 mGy

heart disease      Significantly Increased:  

Krasnikova et al (2014): “based on in depth clinical and epidemiological monitoring of male clean up workers (1986–1987 working period) the statistically significant risks of CHD [coronary heart disease] development were established at whole body external doses 0.15 Gy and more, as well as statistically significant non-radiation risks with biological, social hygienic and behavioral factors taken into account.Study details: 8,625 workers with controls being workers with exposures < 100 mGy; significant increases among those exposed to doses over 250 – 500 mGy.

non-cancer mobidity   Significantly Increased:  

Rahu et al (2014): “we observed a very small increase of borderline significance in all-disease risk among Chernobyl cleanup workers […] Increased morbidity was apparent for the broad categories of diseases of the nervous system, digestive system, musculoskeletal system and alcohol-induced diagnoses […] No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases.” Study details: 3,680 Estonian liquidators, 7,631 controls; mean dose 94 mGy, range 0-545 mGy. Table 2shows over a dozen disorders significantly increased among Liquidators.

cerebrovascular disease   Significantly Increased:  

Krasnikova et al (2013): “Statistically significant radiation risks of chronic cerebrovascular disease were recorded in a young at the time of exposure age group of clean up workers under 0.25–0.99 Gy radiation doses, whereas in emergency workers exposed at age 40 and older – at doses of 0.5 Gy or more. This may be indicative of a greater sensitivity to the effects of ionizing radiation in young people.” Study details: 8,625 Ukrainian liquidators, controls doses < 100 mGy; dose range 250-999 mGy

dyscirculatory encephalopathy   Significantly Increased:  

Podsonnaya et al (2010): “Results obtained over 20-years of following 536 Chernobyl clean-up workers and 436 control subjects arepresented. […] the formation of dyscirculatory encephalopathy in CNPS [Chernobyl nuclear power station] clean-up workers was characterized by rapid increases in the symptoms of brain damage during the first two years after irradiation, relatively stable clinical appearances during the next 5–6 years, and an intensely progressive diffuse process of cerebral decompensation with the early development of autonomic dysfunction, psychoorganic syndrome, and epilepsy […] The course of dyscirculatory encephalopathy in CNPS accident clean-up workers was complicated by the development of major strokes more frequently than in the general population.”

impaired immune system    Significantly Increased:  

Pelevina et al (2010): “We can suppose that genomic instability induced by the liquidators of Chernobyl accident consequences 24 years ago manifests now as increased genome damage and oxidative status decrease that can result in imbalance of cells and humoral immune status, disturbancies of health.”

any illness      Significantly Increased:  

Eglite et al (2009): “The morbidity of Chernobyl NPP accident clean-up workers during 1986–2001 has progressively increased. There is a marked increase in occurrence of diseases of nervous system and organs of sense, mental disorders, thyroid diseases, respiratory diseases and diseases of digestive system. These data are statistically significant and notably higher than that among age- and sex-matched control groups. […] Even taking into account more frequent examination of clean-up workers, the results are a sign of premature aging in this group. […] It is suggested that the CNPP accident clean-up workers may have a specific syndrome, the ‘Chernobyl post-radiation neurosomatic polypathy’, due to sustained oxidant stress injury, as a result of exposure to radiation and lead.” Study details: 5,399 Latvian liquidators, 237 controls age- and sex-matched from Latvia population; dose: range 0.1 – 500 mSv, mean 128.6 ± 70.73 mSv.

musculoskeletal diseases      Significantly Increased:  

Teplyakova & Sokolova (2008): “To assess frequency of pain and functional disability due to musculoskeletal system changes among liquidators of Chernobyl nuclear power plant accident consequences (LAC) […] LAC have high frequency of MD[musculoskeletal diseases] mainly soft tissue diseases […] we believe that they can be considered as markers of remote consequences of ionizing radiation effect onmusculoskeletal system.” Study details: this study is in Russian, an in-English abstract is included at the end.

non-cancer mobidity   Significantly Increased:  

Bebeshko et al (2007): “Incidence of non-cancer diseases is significantly higher in the accident recovery workers irradiated over 250 mSv (Fig. 1) and does not depend on the screening effect […] Coronary heart disease rates were shown to be dose dependent. Minimal radiation dose inducing the higher incidence of cardiovascular non-tumor diseases in recovery operation workers differs from 0.1 Gy for endomyocardial fibrosis to above 1 Gy for essential hypertension. […]Cerebrovascular pathology in liquidators has been found to depend on exposure. The risk of development of these diseases is higher in those exposed to doses of 0.25 Gy and higher as compared with those with an exposure of less than 0.1 Gy.” Study details: case-control desing.

cataracts      Significantly Increased:  

Worgul et al (2007): “The eyes of a prospective cohort of 8,607 Chernobyl cleanup workers (liquidators) were assessed for cataract […] posterior subcapsular or cortical cataracts characteristic of radiation exposure were present in 25% of the subjects. […]the data indicate that any threshold for cataracts is several times lower than that upon which current permissible exposure limits are based; our upper-limit threshold dose is about 0.7 Gy.” Study details: 8,607 Ukrainian liquidators, controls are those with doses 0-99 mGy.

many illnesses     Significantly Increased:  

Oradovskaya (2006): “The comparison of examined groups of liquidators, MCP[Mining Chemical Plant] personnel and population of Krasnoyarsky krai indicated high exceeding of chronic pathology frequency among liquidators of the Chernobyl accident consequences: 3.02 and 2.6 times by CSD, 4.55 and 3.30 times by atherosclerosis with HD [hypertension disease], 22.9 and 9.95 times by CVD:DEP[dyscirculatory encephalopathy]; compared with MCP personnel and the population, respectively. For other classes of diseases and separate nosological forms of diseases, a significant excess of frequency among liquidators is also observed. These data persuasively confirm abrupt deterioration of the liquidators’ health.” This study is Chapter 9 in the textbook, 20 Years after the Chernobyl Accident.

suicide     Significantly Increased:  

Rahu et al (2006): “In 1986 to 2002, a statistically significant excessmortality was found for suicide (SMR, 1.32; 95% CI, 1.03–1.67). […] We found that during the 17 years after the accident, suicide risk among Chernobyl cleanup workers from Estonia was greater than in the male population.Study detail: 4,786 Estonian liquidaotrs, control was entire male population of Estonia.

cerebrovascular disease      Significantly Increased:  

Ivanov et al (2006): “the highest risk of cerebrovascular diseases is inemergency workers who stayed in the zone in the first year after the accident and received external radiation doses more than 150 mGy in less than 6 wk. […] for emergency workers who received external radiation doses of 150 to 250 mGy (subcohort C), a statistically significant dependence of cerebrovascular diseases on mean daily dose was observed […] The radiation risks in this large-scale cohort study were not adjusted for recognized risk factors.” Study details: 18,197 Russian liquidators, controls are those who had doses < 50 mGy.

vascular diseases      Significantly Increased:  

Ivanov et al (2005): “The cohort data from 1986 to 2000 years of 61,017 liquidators are discussed. Radiation risks are established for the cerebrovascular diseases and for the essential hypertension. […] Among the liquidators entered Chernobyl zone during the first year after the accident (29,003 liquidators), the CVD’s risk group consists of persons accumulated more then 150 mGy from external sources.”

impaired immune system     Significantly Increased:  

Kurjane et al (2001): “We found significantly decreased numbers of T cells (CD4+ and CD8+ cells) in the whole group of Latvian Chernobyl clean-up workers. […] our results clearly indicate that even after a period of 10-14 years after the accident an impact of both radiation and nonradiation [lead] factors on the immune system can be observed. These included a reduction in NK-cell and T-cell numbers, and an alteration in neutrophil phagocyte activity. Ongoing inflammatory processes are reflected by complement activation. An impairment of the immune system in irradiated Chernobyl clean-up workers could contribute to the development of their thyroid disorders.”

mortality     Significantly Increased:  

Ivanov et al (2001): “The mortality in the cohort of emergency workers does not exceed the spontaneous mortality level in the corresponding age groups of the Russian population. For most causes of death, this level is below the all-Russian by 15–20%. This difference can be due to incomplete data or because it is more difficult to gather mortality data as compared to incidence, or it may result from ‘the health workers effect.Study details: 98,271 Russian liquidators, general population was control; dose range 5–300 mSv

schizophrenia     Significantly Increased:  

Loganovsky et al (2000): “Beginning in 1990, there has been a significant increase in the incidence of schizophrenia in EZ personnel in comparison to the general population (5.4 per 10,000 in the EZ versus 1.1 per 10,000 in the Ukraine in 1990). […] Persons exposed to 0.30 Sv or more are at higher risk of schizophrenia spectrum disorders.” Study details: liquidator data (1986-1997) was from the psychiatric archives of the Medical and Sanitary Department in Chernobyl, control data (1970-1997) from Ministry of Public Health of Ukraine.

many illnesses      Significantly Increased:  

Ivanov et al (2000): “For some classes of non-cancer diseases among liquidators, statistically significant estimates of radiation risk were derived for the first time. […]The main outcome of this study is establishing a statistically significant dose dependency in the liquidators’ cohort as a whole using stratification by age at the time of arrival to the zone, year of arrival to the zone, and area of residence with respect to the following noncancer diseases: endocrine diseases and metabolic disorders […]mental disorders […] diseases of the nervous system and sensory organs […] diseases of the digestive system […] cerebrovascular diseases […] essential hypertension.Study details: 59,207 Russian liquidators, controls were those with doses 0-50 mGy. This study appeared first Radaition & Risk, which is free online here.

sperm malformation      Significantly Increased:  

Goncharov et al (1998): “In the present study, 328 liquidators were examined 7-9 years after the Chernobyl accident. The dose range of radiation exposure was 0.001-0.33 Gy […] testosterone levels in liquidators were even signifcantly higher than in controls. Examination of the semen quality of approximately one quarter of the ‘liquidators’ revealed that, apart from a signitcantly reduced number of morphologically normal spermatozoa in the ejaculates, overall semen parameters did not differ from those of the controls, nor from the WHO defined criteria of normality.However, compared to controls, there was a higher percentage of cases with teratozoospermia (26% vs. 10% in controls), oligozoospermia (23% vs. 10% in controls) and asthenozoospermia (16% vs. 5%) among the `liquidators’, although none of these changes were statistically signifcant.”

heart disease      Significantly Increased:  

Cwikel et al (1997): “Counting all chronic conditions combined, 57% of the liquidators reported three or more chronic conditions,47% of the most exposed and 49% of the less exposed, whereas only 30% of the comparison group reported such a high level of morbidity.” Study details: 30 liquidators (among exposed group (n=305) otherwise consisting of Chernobyl-region residents) and 214 controls. Table 3 shows prevelence of heart disease among liquidators (33%) that is statistically significant comparied to controls (16%), chisquare test, p = 0.025 (analysis).

heart disease      Significantly Increased:  

Cwikel et al (1997): “Counting all chronic conditions combined, 57% of the liquidators reported three or more chronic conditions,47% of the most exposed and 49% of the less exposed, whereas only 30% of the comparison group reported such a high level of morbidity.” Study details: 30 liquidators (among exposed group (n=305) otherwise consisting of Chernobyl-region residents) and 214 controls. Table 3 shows prevelence of heart disease among liquidators (33%) that is statistically significant comparied to controls (16%), chisquare test, p = 0.025 (analysis).

sperm impairment      Significantly Increased:  

Fischbein et al (1997): “These preliminary results of routine semen analysis and QUM of spermatozoa of liquidators from the Chernobyl nuclear reactor reflect a decrease in motility [p ≤ 0.01] and percent of progressive motility [p ≤ 0.01] in the samples from the liquidators as compared with their controls. […] a higher frequency of malformations of certain sperm cell organelles was found in the liquidators group [p ≤ 0.01], detectable only by the quantitative ultramorphological analytic method.”

all diseases      Significantly Increased:  

Ivanov (1996): “the contingents of emergency workers exposed in the range of 0-5 cGy were used as an interval [sic, internal] control group. As is seen from Table 3, the morbidity rates for a series of diseases in the 5-20cGy and over-20 cGy dose groups are significantly higher than those in the 0-5 cGy dose group.” Study details: Study is posted here. Table 3 shows a significnat dose repsonses for diseases of (a) the endocrine system, (b) blood and blood-forming organs, (c) diseases of the circulatroy system, as well as for (e) all classes of diseases.

many illnesses      Significantly Increased:  

Kamarlia & Abdulina (1996): “An analysis has shown that the number of patients among Chernobyl accident cleanup workers increases each year (from 54.5% in 1991 to 60.4% in 1994) and that the number of invalids among them increases in an almost geometrical progression (from 2.3% in 1991 to 20.6% in 1994). This indicates serious disorders in the organisms of people who were subjected to radiation effects while working in the accident zone. […] Above-normal radiation levels and/or the stress and fear of living in contaminated areas can lead to significant increases in nervous disorders, cardiovascular diseases and other problems.The most significant increase was in the suicide rate.”

several illnesses      Significantly Increased Risk:  

Kordysh et al (1995): “Liquidators demonstrated significantly higher rates for central nervous system (neurosis, sleep disorders, headache, dizziness), respiratory tract, and cardiovascular system disorders, as well as an increased tendency toward all other symptoms compared to former residents. […] Liquidators reported significantly more nausea and decreases in white blood cell counts than residents.Study details: The study compared 55 liquidators to exposed residents who lived near Chernobyl.

sperm impairment      Significantly Increased:  

Birioukov et al (1993): “Twelve men with different forms and stages of chronic radiation dermatitis caused by accidental exposure to beta and gamma irradiation during and after the Chernobyl atomic power plant accident were examined […] It would appear that there is an association between accidental exposure to ionizing radiation of varying severity and the impairment of exocrine and endocrine testicular function, sometimes resulting in long-lasting physiological and psychological problem.” Study details: these liquidators expereinced acute-radiation sickness with high doses of radiation, between 1 and 5.5 Gy, the upper level is potentially lethal.

impaired immune system     Significantly Increased:  

Iarilin et al (1992): “A study was made of deviations, beyond 1 sigma and 1.5 sigma of a mean value (M) of a donor group, in individual immunological parameters […] in patients suffered acute radiation sickness (ARS) and liquidators of Chernobyl NPP accident. The radiation damage to the immune system was reliably detected in the affected subjects examined.”

impaired immune system     Significantly Increased:  

Moskalenko et al (1990): “Deoxyribonuclease activity in blood serum was comparatively analyzed in 90 subjects who had been engaged in liquidation of consequences of the catastrophe at Chernobyl NPS in 1986, and in 55 normal donors. It was found that the mean value of deoxyribonuclease activity in the group of the liquidators was significantly lower as compared to that of donors […] The anamnesis of most of the patients with lowered deoxyribonuclease activity has revealed transient leukopenia, decreased parameters of T-cellular immunity and phagocytic activity of neutrophils.”

EFFECTS IN OFFSPRING

studies looking for effects in liquidator’s children

DNA methylation    Significantly Increased:  

Kuzmina et al (2016): “One hundred and twenty-four irradiated subjects (24-77 years old at sampling: 83 Chernobyl Nuclear Power Plant clean-up workers, 21 nuclear workers, 20 residents of territories with radioactive contamination) and 208 unirradiated volunteers (19-77 years old at sampling) were enrolled […] No significant difference in promoter methylation was found between offspring born to irradiated and unirradiated parents (power of the test is about 90%) […] Further investigations of different epigenetic changes in the offspring of irradiated parents are also necessary.”

impaired immune system     Significantly Increased:  

Baleva et al (2011): “The descendants of irradiated parents (the 1st generation; children of the Chernobyl accident consequences liquidators, children of the citizens of radiation contaminated territories with various 137Cs levels) had immunity disorders of different type. A change in the total amount of NK-cells (CD16(+)-lymphocytes) is the general sign for all radiation risk groups; however, people subject to direct radiation impact demonstrated reduction of the antitumor protection potency, whereas descendants of irradiated ones demonstrated its activation with typically increasing number of CD16(+)-lymphocytes.” Full study posted here.

genomic instability     Significantly Increased:  

Aghajanyan et al (2011): “Aberrant cell frequencies (ACFs), chromosomal type aberration frequencies, and chromatid break frequencies (CBFs) in the lymphocytes of fathers-liquidators, and their children were significantly higher when compared with the control group (P < 0.05). […] These results suggest that low doses of radiation induce genomic instability in fathers. Moreover, low radiation doses might be responsible for individual peculiarities in transgenerational genomic instability in children (as a consequence of response to primary DNA damage). Thus, genomic instability may contribute to increased morbidity over the lifetime of these children.

genomic instability     Significantly Increased:  

Aghajanyan & Suskov (2010): “The average AC [aberrant cells] frequencies in peripheral blood lymphocytes of the children born to fathers–liquidators were 2.28 ± 0.17 (P < 0.05). Aberrations of both chromatid (in 99% of the children) and chromosomal types were detected. Single fragments prevailed. Single-break aberrations of the chromosomal type were revealed in 72% of the children. Acentric fragments prevailed among them, and their average frequencies significantly exceeded the control (P < 0.01). Among doublebreak aberrations of the chromosomal type, dicentrics and rings were found in 19% of the children and atypical monocentrics in 18% of the children.” This in-Russian study is translated here.

genomic instability     Significantly Increased:  

Aghajanyan & Suskov (2009): “The first group included 79 children born to irradiated fathers (liquidators of the accident at the ChNPP) […] analysis of genomic instability by the test of chromosome aberrations in the offsprings of one or both irradiated parents demonstrated significantly higher AGF [aberrant genomes frequencies] than in children of nonirradiated parents, suggesting the transgenarational character of this phenomenon in somatic cells of their organism.”

congenital malformations     Significantly Increased:  

Liaginskaia et al (2009): “The dependence of the frequency congenital malformations at children from dozes of an irradiation of the fathers–liquidators is revealed. The curve of dependence of the frequency of congenital malformations from time, past after work up to copulation carries arched character with peak of rise of frequency of congenital malformations in 2-3 years and decrease in 6-7 years.” Study details: 2,379 newborns of male liquidators. Full study posted here.

genomic instability      Significantly Increased:  

Vorobtsova & Semenov (2006): “A cytogenetic study was performed on Chernobyl cleanup workers, on their children […] In children of liquidators and in evacuated children we observed genomic instability and increased in vitro chromosomal radiosensitivity.” Full study posted here.

genomic instability     Significantly Increased:  

Suskov et al (2006): “The second cohort included children born in 1987-1991 and 1993-2002 from irradiated fathers (Chernobyl clean-up workers) and unirradiated mothers living on territories without radionuclide contamination. These children also displayed increased frequencies of aberrant genomes as compared to the control (p < 0.001). The analysis of the dynamics years of birth of cytogenetic disturbances in the same cohorts of children showed the average frequencies of aberrant genomes remain higher than the control level. In most of the children of both cohorts the repair synthesis of genome DNA by gamma- and UV-radiation is reduced as compared to one in the children from the control group.” This study is Chapter 4 in the textbook, 20 Years after the Chernobyl Accident.

offspring morbidity     Significantly Increased:  

Ministry of Ukraine (2006): “Children born by exposed parents also have poor health. […] According to data of an in-depth survey, the number of healthy children among them is 2.6–9.2%, (in control group – 18.6–24.6%), and the pathological injury index equals to 5.4–6. This cohort of children is characterised by a reduced capability to adapt to the environment, a retardation of biological age comparing to calendar age, and immunity disorders with most prominent changes in children born of cleanup workers in 1986–1987 exposed to radiation doses of 25 cSv or more.”

microsatellite mutations    Significantly Increased:  

Furitsu et al (2005): “We performed a study on Belarusian ‘liquidators’, exploring whether increase in the frequencies of germline mutations at microsatellite loci could be found in their progeny. […] Mutations were detected as variations in the length of the loci. At the Y-linked loci, the mutation rates (expressed as number of mutations among the total number of loci for the individuals included) are 2.9 x 10(-3) (4/1392) and 2.1 x 10(-3) (3/1458) in the children of exposed and control parents, respectively. This difference is not statistically significant.”

genomic instability      Significantly Increased:  

Pilins’ka et al (2005): “Four children groups with and without thyroid pathology born to fathers exposed to ionizing irradiation in 1986 during Chernobyl accident as liquidators as well as residents of territory with radioactive contamination have been cytogenetically observed […] In long-termed lymphocyte cultures of children with chronic thyroiditis the significantly increased cytogenetic effects of both chromatid (single fragments) and chromosome types (abnormal monocentrics, centric rings) have been established. The data received testified the reality of the transmissible chromosome instability phenomenon in progeny of irradiated parents and confirmed the possibility of its expression in consequent mitoses.” Full study posted here.

microsatellite mutations    Significantly Increased:  

Ryo et al (2004): “the children of Chernobyl liquidators were examined for mutations at a total of 72 (31 autosomal, 1 X-linked and 40 Y-linked) microsatellite loci. […] We examined 64 liquidator families (70 children) and 66 control families (70 children). However, no increases in mutation rates were found. The estimated mean dose to the liquidators was about 39 mSv and this might be one possible reason why no increases of mutations could be found.”

microsatellite mutations    Significantly Increased:  

Slebos et al (2004): “ To test whether ionizing radiation can cause paternal genetic mutations that are transmitted to offspring, we enrolled families of 88 Chernobyl cleanup workers exposed to ionizing radiation […] In conclusion, our results do not support an increased level of germline minisatellite mutations but suggest a modest increase in germline mutations in tetranucleotide repeats. Small sample size, however, limited statistical power.”

offspring morbidity     Significantly Increased:  

Tsyb et al (2004): “A significant increase of an integrated index of disease prevalence regarding all classes of diseases (ICD-10) for children of liquidators in compare with other children of the Russian Federation was observed. […] it should be stressed that the above-presented results are preliminary. They should not be considered in favor of genetic effects of low doses of ionizing radiation due to a relatively small number of examined children.” Study details: 300 children of liquidators from Obninsk, Russia, control group 1 was other children from Obninsk and control group 2 was children from the Russian Federation as a whole.

minisatellite mutations    Significantly Increased:  

Kiuru et al (2003):The minisatellite mutation rate was nonsignificantly increased among children born after the accident (0.042 compared to 0.036, OR 1.33, 95% CI 0.80-2.20). Furthermº≠ore, there was some indication of an increased mutation rate among offspring born after the accident to workers who had received doses of 20 cSv or above compared with their siblings born before the accident […] Our results are consistent with both no effect of radiation on minisatellite mutations and a slight increase at dose levels exceeding 20 cSv.”

minisatellite mutations    Significantly Increased:  

Livshits et al (2001): “To assess the genetic effects of exposure to ionizing radiation after the Chernobyl accident, we have measured the frequency of inherited mutant alleles at seven hypermutable minisatellite loci in 183 children born to Chernobyl cleanup workers (liquidators) and 163 children born to control families living in nonirradiated areas of the Ukraine. There was no significant difference in the frequency of inherited mutant alleles between the exposed and control groups.”

DNA fingerprinting    Significantly Increased:  

Weinberg et al (2001): “In this study, children born to liquidator families (currently either in the Ukraine or Israel) conceived after (CA) parental exposure to radiation were screened for the appearance of new fragments using multi-site DNA fingerprinting […] A strong tendency for the number of new bands to decrease with elapsed time between exposure and offspring conception was established for the Ukrainian families. These results indicate that low doses of radiation can induce multiple changes in human germline DNA.

genomic instability & impaired immunity     Significantly Increased:  

Frolov et al (1994): “Children born in families of liquidators of the ChNPP accident in the first year after their return from the accident zone have substantial cytogenetic and immune disturbances.” Full study posted here.

microsatellite mutations    Significantly Increased Risk:  

Weinberg et al (1997): “The primary goal of this research was to reveal de novo mutations in the liquidators (cleanup personnel) who emigrated to Israel from the Chernobyl disaster area […] Our studies have reproducibly detected new bands that appeared in the children born after the disaster. No such bands appeared in the children born in the same family before the accident or in the children of control families who had not been exposed to radiation.”