Risk Factors for Long-Term Mental and Psychosomatic Distress in Latvian Chernobyl Liquidators

Viel, Jean-François; Čurbakova, Elvīra; Dzerve, Baiba; Eglīte, M.; Zvagule, Tija; Vincent, Claude

doi:10.2307/3433667

Cited by 8 publications

(7 citation statements)

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“…Both thyroid cancers in the Estonian cohort, for example, were detected during thyroid examinations conducted on a sample of 1,984 cleanup workers in March-April 1995. 15 In Latvia, the majority of cleanup workers received, first, annual 16 and, later, biannual routine medical check-ups in outpatient clinics, and thus were under much closer medical surveillance than that of the general male population. Comparison with the general population that has not received similar examinations could produce spurious results.…”

Section: Discussionmentioning

confidence: 99%

Cancer risk among chernobyl cleanup workers in Estonia and Latvia, 1986–1998

Rahu

Auvinen

et al. 2006

Intl Journal of Cancer

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Two cohorts of Chernobyl cleanup workers from Estonia (4,786 men) and Latvia (5,546 men) were followed from 1986 to 1998 to investigate cancer incidence among persons exposed to ionizing radiation from the Chernobyl accident. Each cohort was identified from various independent sources and followed using nationwide population and mortality registries. Cancers were ascertained by linkage with nationwide cancer registries. Overall, 75 incident cancers were identified in the Estonian cohort and 80 in the Latvian cohort. The combined-cohort standardized incidence ratio (SIR) for all cancers was 1.15 (95% confidence interval (CI) 5 0.98-1.34) and for leukemia, 1.53 (95% CI 5 0.62-3.17; n 5 7). Statistically significant excess cases of thyroid (SIR 5 7.06, 95% CI 5 2.84-14.55; n 5 7) and brain cancer (SIR 5 2.14, 95% CI 5 1.07-3.83; n 5 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. Excess of thyroid cancer cases observed may have been due to screening, the leukemia cases included 2 unconfirmed diagnoses, and the excess cases of brain tumors may have been a chance finding. There was an indication of increased risk associated with early entry to the Chernobyl area and late follow-up, though not statistically significant. Further follow-up of Chernobyl cleanup workers is warranted to clarify the possible health effects of radiation exposure. ' 2006 Wiley-Liss, Inc. Key words: neoplasms; incidence; cohort; Chernobyl; Estonia; Latvia; radiation effects After the reactor accident at the Chernobyl nuclear power station in April 1986,~600,000 persons from throughout the former Soviet Union were sent to the Chernobyl area for environmental cleanup and related activities. 1 The cleanup workers, also known as liquidators, remained in the area for an average of 3 months. 2 Although average radiation doses to these workers are now known to have been low,~0.1 Gy, some workers received higher doses. 3,4 To assess cancer risks related to working in a radioactively contaminated area, cohort studies of cleanup workers in Belarus, 5 Ukraine, 6 the Russian Federation, 7 Lithuania, 8 Latvia 9 and Estonia 10 were initiated.The first results on cancer incidence and cause-specific mortality of the Estonian Study of Chernobyl Cleanup Workers covered the period 1986-1993. 10 No significant increase in the incidence of any cancer was found; however, significant excess cases of suicide deaths were observed. To evaluate further the possible effect of radiation exposure on the incidence of leukemia and other cancers among Chernobyl cleanup workers, a Baltic cohort was established. Here we report the results from Estonia and Latvia. Material and methodsThe establishment of the Chernobyl cleanup worker cohort in Estonia has been described in detail. 2 In brief, the cohort was assembled in 1992 using multiple data sources, including the General Staff of Estonian Defence Forces, the former Estonian Chernobyl ...

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Section: Discussionmentioning

confidence: 99%

Cancer risk among chernobyl cleanup workers in Estonia and Latvia, 1986–1998

Rahu

Auvinen

et al. 2006

Intl Journal of Cancer

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“…Involuntary migrants are often victims of powerful external forces over which they have little or no control (Cernea, 1993), a condition that is particularly prone to stress (Pearlin, 1989). Project-induced migrants are similar to refugees (Porter & Haslam, 2001 and victims of natural and man-made disasters (Burton, 2006;Cwikel, Abdelgani, Goldsmith, Quastel & Yevelson, 1997;Viel, Curbakova, Dzerve, Eglite, Zvagule & Vincent, 1997) because they all experience losses, life changes, and adaptation challenges during the resettlement. Such experiences not only affect mental well-being directly, but also lead to chronic strains in other spheres of life.…”

Section: Involuntary Migration As a Stressormentioning

confidence: 99%

Anticipation of migration and psychological stress and the Three Gorges Dam project, China

Hwang

Cao

et al. 2007

Social Science & Medicine

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Findings from a prospective study of project-induced migration in China's Three Gorges Dam project are reported. The study tests the hypotheses that anticipation of involuntary migration is stressful and that the harmful effects are partially mediated and moderated by the resources migrants possess. Using data collected from a sample of designated migrants (n = 975) who will be forced to relocate because they live in an area which will be flooded once the Three Gorges project is completed, and non-migrants (n = 555) in the same region, our analysis indicates that anticipation of involuntary migration is a robust predictor of mental distress. Anticipation of forced migration elevates depression (CES-D) not only directly, but also indirectly by weakening the social and the psychological resources (i.e., social support and mastery) which safeguard the mental well-being of migrants. However, our results show much less support for the hypothesis that resources moderate harmful effects of forced migration. KeywordsChina; Three Gorges; Development; Involuntary migration; Stress Main textMoving has often been seen as a stressful life event because it disturbs the equilibrium between the mover and the environment and compels the mover to readjust (Ben-Sira, 1997;Bhugra, 2004;Lev-Wiesel, 1998). While this view has been proven useful to explain the prevalence ofCorresponding Author E-Mail: shwang@uab.edu. 2 Although sample size may have played a role in these tests, we believe the effect of the variable is robust using even the most rigid definition of robustness.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

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“…This statement received considerable support at the International Conference on Radiation and Health. Papers presented at this conference by researchers from Ukraine, Russia, Belarus, France, Israel, the Netherlands, and the United States underlined the fact that the 1986 accident at Chernobyl had a major impact on the psychosocial well-being of many people (2)(3)(4)(5)(6). Now we also know that the problem of psychosocial effects goes beyond the accident at Chernobyl.…”

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“…It is also possible that there is an alternative biological pathway that we do not understand completely. It may also be possible, as some have suggested, that radiation exposure itself alters the cardiovascular system (6,(12)(13)(14)(15).…”

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confidence: 99%

“…Some physical and mental health problems may develop over long periods of time and may not be apparent immediately after an accidental exposure, or health problems may become evident only as the person matures. We know from studies of Holocaust survivors and rape victims that symptoms may be expressed and bring the person to treatment years or even decades after the initial traumatic event (3,(17)(18)(19) (6,15,20). Much better multidisciplinary models are needed to address a broader range of issues.…”

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Comments on the psychosocial aspects of the International Conference on Radiation and Health.

Cwikel

1997

Environ Health Perspect

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Summary comments on the psychosocial aspects of the International Conference on Radiation and Health highlighted the issues that were salient in the conference. There was a broad consensus that long-term psychosocial effects may turn out to be the most significant source of morbidity. In addressing health concerns there is a need to consider psychological responses, as they may be the source of the high rate of morbidity and use of health services. The public's response to radiation is one of anxiety, fear, and concerns about lack of control over modern technology. Aside from stress there may be alternative mechanisms that explain the high rates of morbidity, such as direct biological effects of radiation on the cardiovascular system. The issue of social stigma is not addressed in most studies of affected populations but may be a potent social force. There is a need for concerned scientists to reach a better consensus about the health effects of radiation and to communicate effectively with the lay public. We need more crosscultural research on psychosocial aspects and how to more effectively help affected populations. There are auspicious beginnings in this direction.

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Risk Factors for Long-Term Mental and Psychosomatic Distress in Latvian Chernobyl Liquidators

Cited by 8 publications

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Cancer risk among chernobyl cleanup workers in Estonia and Latvia, 1986–1998

Cancer risk among chernobyl cleanup workers in Estonia and Latvia, 1986–1998

Anticipation of migration and psychological stress and the Three Gorges Dam project, China

Comments on the psychosocial aspects of the International Conference on Radiation and Health.

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