Comparative assessment of the circulatory system diseases in the recovery operation workers of the Chornobyl nuclear plant and evacuated adults in the post-accident period
National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, Kyiv
Full article (PDF), UKR
Introduction. According to experts from the World Health Organization, non-communicable diseases have become one of the main problems for health systems in the 21st century, negatively affecting sustainable development and the socio-economic structure of countries. Risk factors include adverse industrial and environmental factors, including ionizing radiation. A number of previous studies by Ukrainian scientists have shown a significant deterioration in the health of various contingents of the population affected by the Chornobyl accident, primarily from circulatory system diseases (CSD). Minimizing the medical consequences of the Chornobyl accident and increasing the effectiveness of medical care for persons exposed to radiation remain relevant.
The aim of the study is to investigate the dynamics and structure of the incidence of the circulatory system diseases in recovery operation workers and adults evacuated from the 30-km Chornobyl zone in the post accident period and provide a comparative assessment.
Materials and methods of research. The materials for the study were data from the State Register of Ukraine of Victims of the Chornobyl Accident. For this purpose two retrospective cohorts of recovery operation workers and adult evacuees were formed. The observation period was from 1988 to 2016. The incidence of CSD was studied depending on age and time since the accident. Epidemiological, analytical, mathematical and statistical research methods were used. The main indicators were calculated by methods used in the modern epidemiology of non-communicable diseases.
Results. It was found that the incidence of CSD in recovery operation workers and adult evacuees throughout the observation period has the same steady trend, as CSD remains the leading pathology in the structure of non-neoplastic morbidity; maximum levels of circulatory system in the remote period (1998-2007) with a further decline in the last period; higher incidence rates were found in persons aged 40-60 years at the date of the accident; the main components of CSD are traditionally represented by coronary heart disease, hypertension and cerebrovascular disease.
At the same time, the results of research revealed certain differences in the structure and levels of both the overall incidence of CSD and individual classes of pathology depending on age and time elapsed after the accident in recovery operation workers and adult evacuees. One of the main factors that led to the differences is the nature of the impact of ionizing radiation on recovery operation workers (higher radiation doses and duration of action) and the adult evacuated population (urgent evacuation of the population from the adjacent 30 km area; thyroid irradiation and total external gamma irradiation of the body).
Conclusions. A comparative analysis of morbidity among different groups of the affected population makes it possible to track changes in the state of health by individual classes and groups of diseases over time since the Chornobyl accident. An important role in preventing the development of diseases should be the consideration of individual and population risk factors leading to complications of CSD.
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