Childhood leukemia in Ukraine after the Chornobyl accident

Liubarets, T F; Shibata, Yoshisada; Saenko, Vladimir; Bebeshko, V.; Prysyazhnyuk, A E; Bruslova, K M; Fuzik, M M; Yamashita, Shunichi; Bazyka, Dimitry

doi:10.1007/s00411-019-00810-4

Cited by 10 publications

(7 citation statements)

References 35 publications

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“…After duplicates were removed, the titles and abstracts of 1,628 reports were reviewed by one of the authors (JFL), and 131 met the eligibility criteria (Figure 1). The current review was primarily based on 107 full papers, 2‐108 but, due to the scarcity of data, we also chose to cite five relevant abstracts 109‐113 for a more complete picture of child health in Ukraine. Our literature search was limited to papers published in English.…”

Section: Methodsmentioning

confidence: 99%

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Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

Ludvigsson

Лобода

2022

Acta Paediatrica

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Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.

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Section: Methodsmentioning

confidence: 99%

“…The other was the Fukushima Daiichi disaster in 2011. Many of the 1,628 papers we identified focused on the health consequences of the Chernobyl disaster, but few 10,27,71 were relevant to the health needs of children in Ukraine today, apart from the stress experienced by parents and grandparents who survived the accident.…”

Section: The Chernobyl Disastermentioning

confidence: 99%

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

Ludvigsson

Лобода

2022

Acta Paediatrica

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“…High NTD and MIC reported to EUROCAT are also noted in Northern England and Wales regions of the UK which are among the most impacted by Chornobyl IR 6,18,19 . Recent observations in Ukraine note an association of Chornobyl IR exposures with childhood leukemia 20 ; in Germany, childhood leukemia rates were higher among those living in proximities to nuclear power 21,22 ; in Sweden, students exposed to Chornobyl IR had lowered school performance and in Norway adolescents likewise exposed had reduced cognitive functions, 23,24 in the UK, stillbirths and NTD were more frequent in families employed by Sellafield nuclear power plants, 25 and in proximities to the Hanford nuclear power plants complex in the United States clusters of NTD were observed in 1982 and 2010 26‐28 . Current interpretation of these reports require an awareness of at least three notions: (a) that extrapolations from investigations of Hiroshima‐Nagasaki atomic explosions are of limited value because those exposures to IR were mostly direct, intense, and brief in contrast to radiation which reflect the gradual incorporation of nuclides by inhalation and ingestion; (b) that most reports are based on measurements of Cs137 without consideration of concurrent incorporation of other nuclides such as strontium90 (Sr90) and tritium (H3); and (c) that the embryo is significantly more sensitive to radiation than adults.…”

Section: Discussionmentioning

confidence: 95%

Chornobyl radiation—congenital anomalies: A persisting dilemma

Wertelecki

2020

Congenital Anomalies

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We report population prevalence rates of neural tube defects (NDT) and microcephaly (MIC) as well as levels of incorporated Cs137 by pregnant women in two areas of the Rivne Province of Ukraine, a northern half (Polissia) polluted by Chornobyl radiation and not-Polissia areas. Monitoring of congenital malformations was conducted with adherence to methods adopted by a European surveillance network (EUROCAT). Incorporated Cs137 (Bq/kg) by pregnant women residing in the Polissia and not-Polissia areas were obtained concurrently with prenatal ultrasound examinations. In Polissia, the incorporated Cs137 levels by pregnant women as well as the prevalence rates of NDTs and MIC are significantly higher than in not-Polissia. In Polissia, the prevalence rates of NDTs and MIC are among the highest in Europe. The debate concerning the teratogenic impact of chronic exposures to low levels of ionizing radiation was re-ignited by our 2010 report. Health agencies uphold the notion that exposure to Chornobyl radiation levels are too low to be teratogenic, which is inconsistent with our observations. Further investigations in Rivne by international teams can, we believe, contribute facts to the ongoing debate. Our monitoring system, experience and data can facilitate concurrent investigations of teratogenic risks from exposures to other sources of ionizing radiation, alcohol, folate, and zinc deficiencies, among other risk factors. Study of genomic impacts can likewise be undertaken.

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“…Unfortunately, cohort studies of cleanup workers from different countries cannot be accurately compared because of differences in reporting, registration, follow-up and analyses; mortality vs incidence outcomes; special health screenings or not; available information on cofactors (eg, education, ethnicity, smoking); methods of radiation dose determination; and effect measures such as SIR, SMR, excess relative risk per dose unit. [22][23][24] For example, the Russian cohort of 67 568 Chernobyl cleanup workers reported a statistically significant dose response for all incident solid cancers based on official recorded doses (arithmetic mean of 13 cGy) and over the follow-up period 1992 to 2009. 25 However, no attempt was possible, as the authors recognized, to estimate the impact of behavioral factors on cancer risk: "As a weakness of the present study, the analyses did not take into account recognized risk factors such as smoking, alcohol consumption, genetic predisposition, marital status, education, occupational status."…”

Section: Discussionmentioning

confidence: 99%

Cancer incidence among Chernobyl cleanup workers from Estonia: A 34‐year follow‐up

Rahu

Auvinen

et al. 2023

Intl Journal of Cancer

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From 1986 to 1991, 4831 men from Estonia were sent to clean up radioactively contaminated areas near Chernobyl (Chornobyl). Their cancer incidence during 1986 to 2019 was compared to that of the male population of Estonia. The cohort of cleanup workers was linked to national population and cancer registers based on unique personal identification numbers. Nineteen (0.4%) workers could not be traced. A total of 4812 men contributing 120 770 person‐years of follow‐up were eligible for the analyses. Standardized incidence ratios (SIR) and adjusted relative risks (ARR, expressed as ratios of SIRs) with 95% confidence intervals (CI) were calculated. A total of 687 incident cancer cases were registered in the cohort (SIR 1.11, 95% CI 1.03‐1.19). Presumptive radiation‐related cancers combined were in excess, but not when smoking‐ and alcohol‐related cancers were excluded (SIR 0.92, 95% CI 0.71‐1.18). For smoking‐related cancers, the SIR was 1.24 (95% CI 1.13‐1.36) and for alcohol‐related cancer the SIR was 1.53 (95% CI 1.31‐1.75). Less educated workers had a higher risk of all cancers (ARR = 1.21, 95% CI 1.02‐1.44) and smoking‐related cancers (ARR = 1.42, 95% CI 1.14‐1.76). An elevated risk of alcohol‐related cancers was evident 15 to 24 years (vs <15 years) after return from the Chernobyl area. This updated register‐based follow‐up of Chernobyl cleanup workers from Estonia revealed an excess of radiation‐related cancer sites combined, but the excess was not apparent after excluding cancers associated with smoking and alcohol.

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Childhood leukemia in Ukraine after the Chornobyl accident

Cited by 10 publications

References 35 publications

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

Chornobyl radiation—congenital anomalies: A persisting dilemma

Cancer incidence among Chernobyl cleanup workers from Estonia: A 34‐year follow‐up

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