Chernobyl Liquidators' Health
as a Psycho-Social Trauma









3.1. Discussion of certain health effects of the Chernobyl Disaster often believed to be most important
(cancer, impact upon the reproductive function, consequences of inhalation of Pu-containing “hot particles”)

       Before dealing with the general picture of the liquidators' health as reported in medical scientific literature, I want, in addition to the discussion of the possibility of acute irradiation sickness and effects of the radioactive iodine, already discussed in Ch.2.4, to clarify three issues widely believed to be of paramount importance in the picture of Chernobyl medical impact; namely, the issues of:
— cancer,
— impact upon reproductive function, and
— supposedly deadly consequences of inhaling “hot” Pu-containing particles.
       Without estimation of these effects, more detailed analysis of the health consequences may seem to be not important as dealing with some minor, marginal issues.

       “Cancer” — is likely to be the answer of a layperson to a question about the most important medical impact of Chernobyl. However, it does not seem to be the case: according to the results of calculations of expected radiation-induced increase of onco-mortality for the liquidators during their lifetime (Chernobyl'skaya katastrofa 1995: 441):
— for the liquidators of 1986 the radiation-induced increase is estimated to be equal to 12% of the expected spontaneous onco-mortality of this group;
— for the liquidators of 1987, the increase is less than 4%.
       Despite these figures may be disputed, they provide important insight into the range of possible cancerogenic effects of Chernobyl irradiation on the liquidators. Fortunately, these effects seem to be far enough from the myth, widely-spread among the general public, the myth about “total mortality of the Chernobyl-affected from cancer”.

       Dramatic negative impact upon reproductive function is another widely believed aftermath of the Chernobyl irradiation.
       I will briefly discuss 3 possible components of this impact:
— sexual potency,
— fertility (quantity of spermatozoids),
— genetic disorders.
       1. Sexual potency. One can find apparent example of this negative impact in, e.g., (Gorpinchenko 1995): in the sample of 567 examined liquidators, sexual disorders were observed in 38% ; of this share, 20 % had total absence of libido. However, several remarks will help to place these findings in the correct perspective:
— First, such figures, though apparently high, cannot make sufficient sense without comparison with data for the intact population. Research in this area often leads to very surprising (and high) rates of sexual problems of the ordinary, not affected by Chernobyl, men.
— Second, if one multiplies two figures presented above (i.e., 20% of 38%), the share of “totally impotent” individuals among the Chernobyl liquidators will be equal to 7.6%. This figure seems to be within expected limits for intact male population, and, moreover, arguably closer to the lower limit of this range.
— Third, 75% (!) of the liquidators with sexual disorders had such dominating traits of personality as high suggestibility, suspiciousness, susceptibility; 34% of the liquidators had accentuation of the character, mostly of astheno-neurotic and anxious type, with domination of neurasthenic, melancholic, hypochondriac and anxious attitudes both to their state and to people surrounding them. One can speculate that an essential share of the reported disorders are curable, and their origin is rather psychological than irradiation-induced.
       2. Fertility/Quantity of spermatozoids. In fact, “even irradiation at a dose of 0.1 Gy results in decrease of the quantity of spermatozoids during 1 year” (Moskalev 1991: 348; emphasis added); threshold of temporal sterility is reported to be within 0.1—1 Gy (10—fold discrepancy!) of fractionated irradiation. Moreover, for the testicles, unlike the majority of tissues/organs, continuos irradiation may be equally or even more harmful as compared to acute irradiation. However, permanent sterility can result from the irradiation equal to several Gy — i.e., roughly speaking, several 100's R of external gamma-irradiation (Moskalev 1991: 349—351). Furthermore, even in the cases of acute irradiation within this range, the function can regenerate. For example, for Japanese fishermen, who got 1.7—6 Gy (170—600 R) as a consequence of the nuclear tests at the atoll Bikini, disorders of spermatogenesis were established 2 month afterwards. However, spermatogenesis restored in 2 years, and the majority of the children, conceived after the irradaition, were healthy.
       3. Genetic disorders. The calculations based upon the collective dose of the liquidators and risk coefficients showed insignificant increase of the irradiation-induced genetic disorders as compared to the background, spontaneous values for the population of Ukraine (Chernobyl'skaya katastrofa 1995: 442—443): genetic consequences of irradiation of the liquidators “sink” in the high level of spontaneous genetic disorders.

       “Hot particles”, inhaled in the lungs, have been considered to be potentially deadly, as inevitably “burning out” the lung tissues and inducing cancers. “Hot particles” is a term denoting small particles (from fractions to dozens of micrometers, and larger) of highly radioactive (in particular, containing plutonium) aerosols. They were released from the broken Reactor 4 into the atmosphere. (Chernobyl'skaya katastrofa 1995: 438) states that the aerosols were in the atmosphere of the contaminated zone only for about 2—4 weeks, though this opinion is rather disputable; the hot particles migrated between the soil and atmosphere for much longer period, though, of course, in smaller concentration and of a lower activity. However, there is a widely spread opinion among the general public and even experts that “inhalation of just one such particle into the lungs will inevitably lead to death”. This means a rather gloomy forecast for the majority of the liquidators — virtually nobody wore a respirator round-the-clock while working and living in the contaminated areas, and was hardly able to avoid inhaling such a particle.
       However, a complex research of the hazard of inhaling hot particles (Chernobyl'skaya katastrofa 1995: 438—441) has led to rather favourable conclusions, coinciding with the fact of absence of “total mortality” of the liquidators due to this factor. The research was based upon a series of experimental and theoretical studies of physical-chemical, dosimetric and radiobiological properties of the hot particles, epidemiological studies, models of carcinogenesis and data on anatomy and functions of the lungs. The researchers have pointed out several safeguards counteracting fixation of the hot particles in the lung. First, the larger particles are more likely not to be let into deeper — and thinner — tubes of the lung system, and to stick to the walls of the tubes. The particles, which stuck at the mucous membrane of the respiratory tract, by the mechanism of self-cleansing (by epithelial escalation), are evacuated from the lung rather quickly — within 30—40 hours. Even if the particle remains in the lung, the risk that it will initiate cancer was estimated as approximately 1,000—10,000 lower than that of uniform general irradiation of the lungs with the same dose. These findings coincide with the fact that mortality of the liquidators because of this reason does not seem to be reported.
       Thus, the overview of the three effects of irradiation upon the health, which are often thought to be most important, has shown that common beliefs about them are ungrounded, and justifies the following more detailed analysis of the Chernobyl liquidators' health state.

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Design by: M.Opalev
Studio ARWIS  Kharkov, 2001