De novo congenital malformation frequencies in children from the Bryansk region following the Chernobyl disaster (2000–2017)

Abstract

Background Ionizing radiation and chemical pollution can disrupt normal embryonic development and lead to congenital malformations and fetal death. We used official government statistical data for 2000–2017 to test the hypothesis that radioactive and chemical pollutants influenced the frequency of de novo congenital malformations in newborns of the Bryansk region of southwest Russia. Methods A variety of statistical approaches were used to assess congenital malformation frequencies including the Shapiro-Wilk test, White's homoscedasticity test, Wilcoxon T-test, Spearman's rank correlation test, and the inversely proportional regression. Results We found that the frequency of polydactyly, multiple congenital malformations, and the frequency of de novo congenital malformations in newborns were significantly higher (p = 0.001–0.054) in regions with elevated radioactive, chemical and combined contamination. Polydactyly, multiple congenital malformations, and the sum of all congenital malformations were 4.7–7.4 times, 2.5–6.8 times, and 3.5–4.6 times higher in contaminated regions in comparison with the control group. The combination of both radioactive and chemical pollutants led to significantly higher frequencies of multiple congenital malformations when compared to regions with only one pollutant (radiation alone: 2.2 times, p = 0.034; chemical pollutants alone: 1.9 times, p = 0.008) implying that the effects of these stressors were at minimum additive. Although there was a trend for decreasing frequencies of multiple congenital malformations during the 2000–2017 period in areas of combined pollution, the opposite was true for regions with radioactive or chemical pollutants alone. However, overall, our models suggest that the frequency of multiple congenital malformations in areas of combined pollution will significantly (p = 0.027) exceed the frequencies observed for regions containing radioactive or chemical pollutants alone by 39.6% and 45.7% respectively, by 2018–2023. Conclusion These findings suggest additive and potentially synergistic effects of radioactive and chemical pollutants on the frequencies of multiple congenital malformations in the Bryansk region of southwestern Russia.

Letter to the editor of Heliyon re: De novo congenital malformation frequencies in children from the Bryansk region following the Chernobyl disaster (2000–2017). Heliyon. 2020; 6(8): e04616

“…In the EUROCAT register, the prevalence of multiple congenital anomalies (MCA) is stated as 1.58 per 1000 [2] while, in Table 4, the prevalence of MCM is 0.19 per 1000 in the control region. This large discrepancy should have been discussed by the authors of [1]. Thus, a prevalence for Total CM of 0.45 per 1000, based on only 3 cases in 18 years, seems highly unlikely.…”

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The article by Korsakov et al [1] compares the prevalence at birth of polydactyly (PD), limb reduction defects (LRD), and multiple congenital malformations (MCM) in the south-west territory (SWT) of the Russian Oblast Bryansk (which is bordering on Gomel Oblast in Belarus and which was highly contaminated from the radioactive fallout of the Chernobyl accident) to the respective prevalence in two districts of Bryansk with little radioactive and chemical contamination (Kletnyansky and Mglinsky). They also conducted a pooled analysis of these three categories of congenital malformations (Total CM).

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“…The results are shown in the table below, together with the relative risks RR ¼ pCM1/pCM0, the 95% confidence intervals of RR, and the two-sided p-values (t-tests). For comparison, the p-values from Table 4 in [1] are added.…”

Response to the “letter to the editor” by Sani Rachman Soleman et al., “spatiotemporal association of low birth weight with Cs-137 deposition at the prefecture level in Japan after the Fukushima nuclear power plant accidents”

“…It is clear from the Life Span Study in Hiroshima and Nagasaki that not only carcinogenesis but also heart disease, respiratory disorders, and digestive disorders continue to occur for a long period of time [ 4 ]. Similarly, numerous studies report reproductive detriment concerning, e.g., stillbirths, perinatal deaths, birth defects, and chromosome aberrations demonstrating that radiation injury persisted for many years [ 5 – 17 ]. The elevation of LBW over long periods, despite declining radiation doses, is a hallmark of radiation injury.…”

Response to the “Letter to the Editor” by Alfred Körblein, “Short term increase in low birthweight babies after Fukushima”

“…We consider Körblein’s amalgamating the periods 1985 to 2011 and 2014 to 2018 in order to obtain a baseline trend illogical since the FDNPP accidents released long-lived radioactive elements. This approach also ignores that radiological accidents have been followed by long-term radiation-induced genetic effects [ 4 – 14 ]. Using a 4th degree polynomial in place of a 5th degree polynomial for modeling the low birth weight proportion in the 10 moderately or highly contaminated prefectures reveals a significant jump in 2012 with OR 1.027, (1.004, 1.051), p -value 0.0203, see Fig.…”