Chernobyl: The Human Toll

by Trisha Pritikin

The Chernobyl nuclear reactor disaster, which took place on April 26, 1986, has yet to reveal the full spectrum of disease and death which are to occur in its wake. Latency periods following radiation exposure can delay the onset of radiogenic diseases, sometimes for decades, and often do not present an end time after which exposed individuals are no longer at risk for the development of radiogenic disease.

The primary component of the radioactive contamination released at Chernobyl was radioiodine (including the short-lived isotopes) like that covertly released at the Hanford nuclear weapons facility as a by-product of plutonium production or emitted in other nuclear accidents and detonations of atomic bombs. The health problems occurring now within the Chernobyl-exposed population are relevant to individuals exposed to atomic fallout and related releases of ionizing radiation at Hanford and other sites in the United States and worldwide.

Large-scale cohort epidemiological studies of thyroid cancer and other thyroid diseases in Ukraine are planned to occur over thirty years within the framework of the joint Ukrainian-American Programme, co-directed by members of the Academy of Medical Sciences in Ukraine and the Department of Radiation Effects of the National Institute for Cancer in the U.S.

Since 1990 there has been a significant increase in thyroid cancer cases among children in Ukraine, with more than 60% of all observed cases registered in the area affected by the Chernobyl accident.

A very recent report from the deputy director of the Russian Federation Medical Radiological Research Center and director of the World Health Organization (WHO) Collaborating Center for Radiation Epidemiology at Obninsk, Russia, advises the establishment of four units within the Collaborating Center Chernobyl sector, addressing dosimetry, epidemiology, medical effects and treatment, and data collection and registry maintenance about individuals exposed to radiation at Chernobyl.

Several “oblasts” surrounding Chernobyl (an oblast being defined as an administrative subdivision of approximate areas 25,000 to 35,000 square kilometers) received radiation dose levels that are substantially similar to the dose levels received between 1944 and 1972 by men, women, and children downwind of the Hanford atomic weapons facility in Washington State, considered a “chronic, low dose” exposure scenario.

Therefore, it is relevant for those working on Hanford health-related matters to remain informed of the results of regular medical follow-ups on the approximately 30,000 persons studied beginning only weeks after their exposure at Chernobyl. It is felt that health problems seen among the Chernobyl exposed will also be detected among those exposed to Hanford’s releases of ionizing radiation.

Regular, twice-yearly medical examinations of sure Chernobyl-exposed children include examination by an endocrinologist, ultrasound scan of the thyroid establishing its volume (accompanied by ultrasound-guided fine needle aspiration biopsy in the case of thyroid nodules, with subsequent cytologic analysis of the punctate), and determination of blood levels of thyrotropin, total and free thyroxine, triiodothyronine, thyroglobulin, antibodies against thyroglobulin and microsomal fractions of the thyroid.

Regular examinations are necessary due to the appearance of thyroid cancers among Chernobyl-exposed individuals, which metastasize quickly and can be life-threatening if not detected early and treated immediately. Such aggressive thyroid cancers have also been seen among Hanford-exposed individuals, pointing out the necessity of frequent, comprehensive monitoring and early intervention for these individuals to prevent death.

Unfortunately, individuals exposed at Hanford to radioiodine and its shorter-lived isotopes were unaware of these releases until citizen groups made repeated Freedom of Information Act requests following reports of the high incidence of thyroid disease and another potentially radiogenic illness in the mid-1980s. Incredibly, the Department of Energy did not make its first public release of 19,000 pages of Hanford documents until 1986. And, seriously, individuals exposed to Hanford’s covert emissions of radioiodine 131 and other radioactive substances are still trying to convince government officials to monitor their health, to study the health problems being reported in high frequency among Hanford downwinders, and to provide health care for those health problems which are induced by radiation exposure.

Several specialists in radiogenic disease who have been involved in the medical examinations and medical monitoring of Hibakusha (survivors of the atomic bombs detonated on Hiroshima and Nagasaki) have been involved in the efforts at Chernobyl to monitor and treat those exposed. It would seem that health officials in the United States have something to learn from the cooperative and comprehensive nature of the health monitoring and care provided to innocent men, women, and children who have been unwittingly exposed to ionizing radiation in other parts of the world.

May innocent Americans, exposed to environmental releases of ionizing radiation, often without their knowledge or consent, finally receive the monitoring and care they deserve, and they cannot survive.

Trisha Pritikin is a registered occupational therapist and attorney. She was born in the early 1950s in Richland, Washington, a community adjacent to the Hanford nuclear weapons facility, and resided there for the first ten years of her life. She is co-chairperson of the Hanford Health Information Network Resource Center Advisory Board. She is an appointee to the Hanford Health Effects Subcommittee, advisory to the Agency for Toxic Substances and Disease Registry, and to the Centers for Disease Control and Prevention.

Trisha Pritikin: “This article is dedicated to the memory of my father, a kind and gentle man, a former worker at the Hanford nuclear weapons facility, who died this February of aggressive, metastatic thyroid cancer.”