Radioactive contamination of forests in Poland

Partial results of a large survey of radioactive contamination in Polish forests are presented. All measurements were performed with low-background gamma spectrometers. The measurement method is briefly described. Activities of 137Cs, 134Cs, 125Sb, 106Ru, 144Ce, 154Eu, 155Eu, and 60Co in A0 and A1 layers of forest litter from all over Poland are determined. The geographical distribution of contamination as well as its origin is discussed. Nonuniform composition of the Chernobyl fallout over Poland is confirmed and documented.

[The organization of hematological monitoring for the population living in regions with strict radiation control]

Presents an algorithm of hematologic check-ups of the population living in regions contaminated as a result of the Chernobyl power plant accident, comprising regular clinical, morphologic, cytochemical, biochemical, immunologic, karyologic studies. Hematologic monitoring will be conducive to an earlier detection of oncohematologic and other blood system diseases, to their prevention and effective therapy.

[Digital bone densitometry]

Normal values of bone mineral composition were defined, based on examinations of 600 male and female volunteers of various age groups by digital roentgenodensitometry. The mineral compactness was found reduced in the patients with endocrine diseases, in subjects who participated in liquidation of the Chernobyl power plant accident aftereffects, and in those suffering from skeletal pains. The authors emphasize the value of digital roentgenodensitometry as a method for monitoring the efficacy of treatment of patients with endocrine diseases and chronic renal insufficiency.

[A cytomorphological basis for the correction of radiation-induced immunodeficiencies and hematopoietic depression using thymus and bone marrow peptides]

The correction of radiation-induced immunodeficiency and hematopoiesis depression in clinical setting (100 patients) and in experiments (160 animals) by peptide preparations of the thymus and bone marrow (thymalin, hemalin, thymogemine and synthetic thymalin analog thymogen) has been studied. Administration of the bone marrow and thymus recovery of damage to the thymus, bone marrow, spleen and lymph nodes, improved the function of circulating neutrophilic granulocytes. Thymalin was able to compensate for immune disturbances and reduce manifestations of asthenia.

[Characteristics of thanatogenesis and pathomorphology of tuberculosis in the Gomel region in relation to the Chernobyl AES accident]

On the basis of 750 autopsy records fatal outcomes were studied in Gomel and Gomel region for the period of 5 years after the Chernobyl accident and for the same period in Minsk and Minsk region. A stereomorphometric method was used for studying thymus morphostructure in 20 fatal cases of tuberculosis among the population of Gomel. Certain specific features of tuberculous thanatogenesis and pathomorphology have been revealed which were most pronounced on the monitored territories of the Gomel region and which manifested themselves in the more remote terms (4-5 years) after the Chernobyl accident. Mortality from fibrocavernous pulmonary tuberculosis with massive destructive components and copious bacilli excretion increased to 63.2% and that from disseminated forms of tuberculosis to 22.5%. In regions under the strict control the frequency of tuberculosis progress among the principal causes of death with the development of caseous pneumonia has grown to 55.5% as against 31.8% on the less contaminated territories (to 1 Ci/km2). The thymus underwent deep reorganization which was inadequate to the severity of the principal disease and age. The evidence of this was overstrain of adaptational-compensatory mechanisms of the immune system that finally led to the development of T-immunodeficiency in 55.3% of the patients.

[Prevalence of radioactive particles in the territory of Byelorussia and their contents in the lungs]

Examination conducted in 1987--1988 included 200 samples of the autopsy material of subjects who died of various causes in different regions of Byelorussia. It revealed the presence of "hot" particles (i.e. particles with high specific radioactivity) in 50% of the samples taken from the northwest and in 70% of those from the southeast regions. A correlation was found to exist between the radioactive particles content in the soil, air and lungs of residents from the contaminated territory. It was shown that in 1990--1991, in contrast to 1987--1988, the particles content in a single lung sample reduced, which was associated both with mechanical removal of particles and their disintegration and, as a consequence with the accumulation of plutonium in the body. Study of radioactive particles distribution in the whole lung showed that at present they are found primarily in the lower segments.

Use of selective decontamination in the prevention of infection after accidental irradiation. A review

Exposure to radiation induces a reduction in the number of gastrointestinal, anaerobic bacterial flora, and an increase in the number of Enterobacteriaceae that are associated with sepsis and mortality. Antimicrobials that suppress anaerobic flora have a deleterious effect on survival by promoting earlier enterobacterial sepsis. In contrast, in studies of animals and immunosuppressed patients, antimicrobials that inhibit gram-negative enteric bacteria and preserve the anaerobic flora have shown a beneficial effect by preventing bacterial translocation and fatal sepsis. The quinolone antimicrobials hold potential for therapy of endogenous and exogenous infection after irradiation.

[Iridodiagnosis in the system of the follow-up of the health status of the population living in an area contaminated by radioactive substances]

The authors substantiate the practical employment of the iridodiagnosis screening-test using a system of archiving and visualization of the iris at the first stage of prophylactic medical examination and management. The economical and medical efficacy of the method has been established. Use of iridodiagnosis improved the detectability of pathologic conditions as compared with complex medical examination. Many specialists were freed from mass medical screening. The expenses for prophylactic medical examination became ten times less.

[A cerebral syndrome appearing after the accident at the Chernobyl Atomic Electric Power Station]

Sixty participants of liquidation of the sequels of the Chernobyl atomic station accident were examined. All of them were subjected to the effect of different doses of ionizing radiation. A complex of symptoms is described characterizing the cerebrosthenic syndrome with vegetative paroxysms and intellectual-mnestic disorders. In accordance with this, approaches to treatment and rehabilitation of these patients are discussed.

[The results of studies of the peripheral blood from children in Polesie District, Kiev Province and in the city of Kiev 4 years after the accident at the Chernobyl Atomic Electric Power Station]

The peripheral blood of 2200 children (age: from 2 to 16 years) inhabiting the Polessye District of Kiev Province and the city of Kiev 4 years after the Chernobyl atomic station accident was studied. An analysis of results revealed the presence of hematologic changes that may be interpreted as sequels of the effect of ionizing radiation on the body, while other changes may be considered as reactive and may in most cases accompany different somatic diseases of infectious-inflammatory character.

Protocol for the treatment of radiation injuries

Despite adequate precautionary measures and high-quality safeguard devices, many accidental radiation exposures continue to occur and may pose greater risks in the future, including radiation exposure in the space environment. The medical management of radiation casualties is of major concern to health care providers. Such medical management was addressed at The First Consensus Development Conference on the Treatment of Radiation Injuries, Washington, DC, 1989. The conference addressed the most appropriate treatment for the hematopoietic and infectious complications that accompany radiation injuries and for combined radiation and traumatic/burn injuries. Based on the evidence presented at the conference, a consensus statement was formulated by expert physicians and scientists. The recommended therapies, including a suggested algorithm incorporating these recommendations for the treatment of radiation injuries, will be discussed.

[Neuroendocrine disorders at long term in persons exposed to ionizing radiation after the accident at the Chernobyl Atomic Electric Power Station]

Endocrinous and metabolism disorders were studied in the remote period in persons subjected to the effect of ionizing radiation after the Chernobyl atomic station accident. Results of the investigation revealed: disorders of the synthesis of sex hormones with small radiation doses; serotonin in increased concentration produced at the level of the hypothalamus a modulating effect on the pituitary-adrenocortical system causing its functional tension; persisting functional changes in the central regulation link--the hypothalamus.

[Study of the effects of some prophylactic measures and radiological contamination in Poland after the Czernobyl accident; Introduction to the research program MZ-XVII]

An aim of the introduction is to remained the scale of radiological contamination in Poland after the accident in the Czernobyl Power Station, the evaluation of findings which led to prophylactic administration of potassium iodide first in part of Poland and later Country-wide. The introduction gives also the history of Research Programme MZ-XVII and its implementation in several regions of Poland. The main aims of the Programme were: 1. Estimation of radioiodine dose accumulated in thyroids of children, youths and adults who lived in different parts of Poland and evaluation whether these doses could lead to the development of thyroid disorders. 2. Evaluation of thyroid function in those exposed to radioiodine in different trimesters of preneonatal life, who were born euthyroid and who were given potassium iodine in first days of life. 3. Evaluation of efficacy of single dose of potassium iodide and estimation of possible intrathyroid and extrathyroid side-effects after prophylactic iodide administration. The foundations of the Programme and Centers involved in its implementation are also specified.

[Chronicled report on the period from May 1 to September 27, 1989. Discussion of risk factors]

The Institute of Mother and Child was invited in 1988 by professor J. Nauman to his Chernobyl program, so as to inspect children born after Chernobyl accident, particularly these born in first days following the accident dated 26 april 1986. The central part of Poland is covered with screening for congenital PKU and hypothyroidism therefore all children had estimated TSH-spot levels between 3rd and 5th day of life. So as to control the present state of general health and thyroid state in the study group a questionnaire with a letter to parents explaining the aim of the inquiry was sent to the parents (see addenda). About 14000 letters were send from which around 12000 responses were returned to the Institute. From informations received this way we draw the preliminary conclusion that no significant damage in health of these children or their siblings can be found. About 20% of the mothers admitted taking the Lugol solution in a last day of pregnancy. However it should be taken into account that these data were collected 2 years after the accident and are not fully reliable. In the period 1989-1990 a group of 1912 children (938 boys and 974 girls) was called to the Department of Endocrinology of the Institute and inspected. The age was from 2.9 to 4.2 years. All children had screening TSH-spot test result negative (below 30 microIU/ml). General health state The general health state of the children inspected was good. Only 33 of them (1.7%) had various congenital malformations what is not different from general population of polish children. Mental development was in 1897 cases normal, in 15 cases IQ was decreased and the score varied from 75 to 80 according the Brunet-Lezine scale. Average physical development was normal. Body height evaluated in standard deviation score (SDS) was as follows: SDS = 0.0 in 359; SDS = +0.9 +/- 0.6 in 906 and SDS = -0.5 +/- 0.3 in 647 cases. Thyroid state At 1904 inspected and analytically estimated children the thyroid function was normal. Only in 8 cases (0.8%) a goiter was found with euthyroid state. Analytical data were as follows: total T4 serum level = 111.8 + 43.1 nmol/l (50.4-171.9), ref. value: 50.1-170.0 nmol/l; total T3 serum level = 2.5 +/- 0.4 nmol/l (ref. value 1.9-3.6); TSH serum level 4.4 +/- 2.6 uIU/ml. Trace amounts of antithyroid membrane antibodies were found at 12 children (0.63%) of the group in serum diluted 1:250.(ABSTRACT TRUNCATED AT 400 WORDS)

[Results of studies on the effect of radiologic contamination after the Czernobyl catastrophe and prophylactic iodine on thyroid morphology and function of inhabitants of North-East Poland]

The results of the investigations of radioactive contamination after the Chernobyl catastrophe and subsequent iodine prophylaxis on the thyroid gland function and morphology in Northeast Poland. The aim of the study was to determine whether kalium iodine in one dose during radioactive contamination in Poland limited the radioactive dose in the thyroid gland and if significant disadvantageous side-effects in the intrathyroid and extrathyroid occurred. Additionally during the studies we tried to determine if radioactive iodine contamination which occurred in the region of the Medical Academy in Białystok caused an increase in thyroid disease. It is interesting to note the different results obtained after radioactive contamination with the results from the investigations in this same territory in 1983-1985. In 1983-1985, before the Chernobyl catastrophe, 6,921 persons in Northeast Poland were investigated. In 1986-1988, immediately after the disaster 4,010 persons were investigated. The main study according to grant No MZ-XVII was carried out in three provinces: Białystok, Suwałki and Olsztyn. In this investigation 10,011 persons born before April 26, 1986 and after January 1, 1936 participated, 5,789 townspeople and 4,222 villagers, 3,987 children up to 16 years of age it the time of the disaster 1,973 boys and 2,009 girls; 6,024 adults 2,509 men and 3,516 women were drawn from a register. Committed doses to the thyroid in the investigated region were one of the highest in Poland and depended on age group and were depended on time of prophylaxis non proportional. Iodine prophylaxis was provided mainly with one dose of Lugol solution about 90%, 95% children and 30% adults took iodine. The majority of the population (53.3%-74%) were given iodine in April. From May 1st to 5th 23.0-43.4% received iodine, but after May 5th very few persons. Iodine was well tolerated, but Lugol Solution was better tolerated than other kinds of iodine. Only 241 (4.4%) cases had side effects, mainly vomiting (143), symptoms such as stomach ache, diarrhea, dyspnoe, skinrash etc. in lesser numbers. 12% (29 persons) were seen by a physician. In the investigated population were 200 pregnant women aged 19-40 years of which the majority (177) delivered full term healthy babies. Only 1 interrupted pregnancy and 7 had spontaneous abortion. Changes in the thyroid were noticed by 187 persons (2.3%-11.7%) most of which were enlargement of the thyroid, but only a few were confirmed by a physician. In the studied population from 1989 to 1990 over 30% of the population had struma.(ABSTRACT TRUNCATED AT 400 WORDS)

[Results of epidemiologic studies performed after the disaster in Czernobyl among the adult part of the population in the region of Krakow]

Epidemiologic studies following the Czernobyl accident were performed in region Kraków, including Kraków, Nowy Sacz and Kielce district. 1426 males and 2495 females were selected according to the random sample on the whole population of Kraków and Nowy Sacz, as well as in some selected areas in Swietokrzyski Mountains, and in Kielcecity. The aim of the study was to assess the results of the prophylaxis with Kalium iodine after the radiation and the incidence of the goiter in the population. It was stated, that 19.2% of the population in Kraków district, 16.9% in Nowy Sacz and 20% in Kielce received the prophylactic dosis of K.J. 80% took mainly the Lugol solution, between May, the 1st and 5th, 1986. Among 18 of person showing side effects like gastrointestinal disturbances, 16 were of female sex. Goiter incidence according to WHO classification was 50.7%, 67.3% and 49.9% in Kraków, Nowy Sacz and Kielce respectively. The difference between the incidence of goiter in males and females was 1:3. In women it was rather Ist and IInd degree of goiter, in men OB and Ist. Nodules of thyroid gland in the rural region of Kraków, Nowy Sacz and Kielce were seen in women in 10.8%, 1.7%, add 12.3% consecutively. Hormonal studies i.e T3, T4, TSH serum concentration showed normal results in all groups studied. TSH concentration was the highest in the group OB. The microsomal and antithyroglobulin antibodies level was the same independently on the prophylactic dosis of Lugol solution. The high incidence of thyroid diseases not related to the accident was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Data from the Wrocław region about thyroid diseases and use of prophylactic iodine after the reactor accident in Czernobyl]

The radiological contamination of Wrocław Region after Czernobyl accident was evaluated as moderate. In the frame of Research Programme MZ-XVII 4310 persons (2012 men and 2298 women) were randomly selected and investigated. Among them were 1525 children up to 16 years old. 925 children and 854 adults took potassium iodide; only minority in April but majority between May 1st and May 5th. Side effects was rare phenomenon seen in about 5% of those who ingested potassium iodide and in majority of cases was very mild (with rash and vomiting as most common clinical symptoms). Only 13 persons with side effects have visited physicians. Among 955 women aged 19-40 years 71 were pregnant in May 1986. 55 of them delivered on time, 3 before time. Average health state of newborns was 9.1 according to Apgar scale. 10 women have had spontaneous abortion and 3 decided to terminate pregnancy in first 6 weeks. The physical examination revealed the presence of diffuse goiter in 384 persons and of nodular goiter in 23 persons. In majority of cases the goiter was small, OB or I. according to WHO classification.

[Epidemiologic studies after the disaster in Czernobyl in the population of children in the Krakow region]

In 1989-1990 the epidemiologic studies about the impact of of Czarnobyl events on the health of children in Kraków and Nowy Sacz region were performed. The morphologic and functional changes of thyroid gland in children were estimated. Almost 90% of children in both districts received the iodine preparations for prophylactic reason. The mean time of intake was between 5-10 days following the Czarnobyl explosion. There were no relationship between the dose of iodine absorbed during prophylactic action and incidence of goiter. The prevalence of goiter amounted to 34.8-47.6% in boys and girls consecutively in Kraków district and 53.8-70.5% in Nowy Sacz. No hormonal changes in T3, T4 and TSH serum concentration were found in children with goiter and those without goiter. The complications after iodine intake were transient and seen only in a small number of children.

[Influence of radioactive contamination and iodine prophylaxis after the Czernobyl disaster on thyroid morphology and function of the Poznan region]

The radioactive contamination of Poznań Region was recognized after Chernobyl accident as average. The predicted values of minimal (inhalation) and maximal (inhalation and ingestion) committed dose equivalent to the thyroid varied from 2.5 (min) to 24.7 (max) mSv in different groups of adults and children. To follow up the results of iodine prophylaxis and some aspects of possible thyroid gland morphological and functional changes 11086 persons were carefully investigated clinically and biochemically. Among these 11086 persons were 42.6% males and 57.4% females both adults from 17 till 40 year and children up do 16 years. The following parameters were reviewed: pregnancy, time of residence in the region, thyroid abnormalities, family history concerning thyroid diseases, iodine intake in April and May 1986 with possible side effects, changes in the thyroid size observed before and after 1986, degree and kind of thyroid enlargement, serum concentration of T3, T4, TSH, ATMA and ATG titre and finally the effectiveness of thyroid blockade at 24, 48 and 72 h after ingestion of Lugol's solution. Side effects of the ingestion of potassium iodide from 30-70 mg were observed in 153 cases, 36 of them consulted medical doctors but in no case the side effects (dominated by vomiting) threatened the life. In the investigated group were 144 pregnant women. Majority, because 88% of them delivered the baby on or after time and 6.9% before time, 4.9% of natural abortions were noted but non artificial. In the group of children thyroid gland abnormalities before 1986 were reported in 3 cases in 23 after 1986 it is after Chernobyl accident. This information is interesting but needs more precise analysis of different dependencies occurring. The data obtained indicated the existence in Poznań. Region the goiter endemy because 27.5% of investigated children and adults had goiter classified as grades O-B, I, II and III. The elevation or diminution of T3 values were noted in 1164 cases, for T4 in 418 cases and for TSH in 1412 cases. The presence of antimembrane and antithyroglobulin antibodies were observed in 303 cases. All persons with changes observed in thyroid morphology and function are periodically controlled and the results will be published separately. The investigations performed and results presented concern the early aspects of radioactive contamination and effects of iodine prophylaxis. The answer regarding late effects including thyroid cancer needs further multi year studies for which the clinical material investigated in different parts of Poland and well documented should be used as model group for further periodical studies.

[Effectiveness of iodine prophylaxis and frequency of thyroid enlargement (thyroid goiter) and clinical diagnosis of thyroid diseases in inhabitants of the Szczecin region after the Czernobyl accident]

The study, supported by program MZ-XVII, was carried on 4567 inhabitants of the area of Szczecin (2350 females and 2217 males). The population was chosen randomly, according to a simple drawing scheme. All subjects were clinically examined using standardised questionnaires. In 3468 persons (including 1807 girls and women, 1661 boys and men) apart form clinical examination, the assessment of thyrotropin, thyroxine and triiodothyronine in serum and frequency of antithyroglobulin antibodies and antithyroid membrane antibodies were evaluated. The data indicate that 94% of children in Szczecin's region received the prophylactic dose of iodine, mostly between the 1st and the 5th of May 1986. Only 17% of the adults received iodine. The most common preparation was Lugol solution given in a single dose. Among all persons who received iodine, only in 5% of subjects the side effects were noted (mostly in children), including symptoms of gastrointestinal tract (vomiting, abdomen pain) and occasionally intrathyroid side effects (thyroid pains). In examined population the high frequency of thyroid enlargement, mainly in women (up to 43-44% at the age group 30-50 years) was found. The frequency of clinical diagnosis of thyroid disease was higher in women than in man (most often the diffuse goiter, rarely the nodular goiter). The frequency of thyroid enlargement and clinical diagnosis of thyroid disease was not dependent on prophylactic iodine intake. The iodine prophylaxis did not influence on thyroid hormones and TSH serum levels and on frequency of antithyroid antibodies.

[Results of studies performed with the MZ-XVII program on a national scale; summary and conclusions]

MOST IMPORTANT OBSERVATIONS: (FROM COUNTRY-WIDE POPULATION STUDIES) 1. In some voivodships localized in south-east and north-east parts of Poland thyroids of young children would, without protective measures, accumulate more then 60 MsV of radioiodine, thus exceeding intervention level settled for the country. 2. Thyroid function of newborns exposed to radioiodine during neonatal life was normal and frequency of neonatal hypothyroidism similar to that seen in years before Czernobyl accident. 3. Potassium iodide administrated to newborns in some of them profuced transient rise of TSH (Wolff-Chaikoff phenomenon), thus suggesting, that ki dose settled for newborns could be to high. 4. Thyroid radioiodine dose accumulated in thyroids of older children, teenagers and adults was in majority of regions well below the dose of 50 MsV. 5. The frequency of non-toxic diffuse goiter, especially in traditional endemic goiter area was found to be high, but is also relatively high in others regions of Poland and seems to depend on iodine deficiency or relative iodine deficiency. 6. The frequency of other thyroid disorders is within the limit reported in countries with relative iodine deficiency. 7. More than 95% of children and teenagers took protective, single dose of potassium iodide (about 10 millions). 8. Approximately 27% of adults took protective dose of potassium iodide (about 7 millions). 9. Organization of protective action in 11 north-east and south-east voivodoships was good about 75% of all obtain ki solution within 24 hours. In the rest of the country where protective action was ordered april 30, in afternoon hrs only about 25% obtained ki the same day and the rest during next 48-72 hrs. 10. The fact that prior to the protective action limited number of children was given iodine alcohol solution permitted for external use speaks about the fear and panic observed in Poland in first days after Czernobyl accident. 11. Extrathyroidal side-effects after ki administration appeared in about 5% were usually light or moderate and in majority of cases disappearing without medical assistance. Vomiting was most commonly seen side-effect in young children, thus suggesting that either dose, or the chemical form of the drug for this group of age was unproper. 12. Intrathyroidal side-effects of single dose of ki was rare phenomenon seen mostly in newborns, very young children and some adults with history of thyroid disease in the past. 13. Its possible that even small dose of radioiodine accumulated in thyroid produce immunological response leading to the appearance of thyroid antibodies in blood serum.