Chernobyl Liquidators' Health
as a Psycho-Social Trauma







Chernobyl Liquidators' Health
as a Psycho-Social Trauma


Table of contents

Abstract  
List of Abbreviations  
Illustrations  
Acknowledgements  

1. Introduction  
2. Chernobyl liquidators in the Chernobyl zone: Radiation and non-radiation circumstances  
       2.1. Definitions of the Chernobyl Disaster and “Chernobyl”, and their discussion   
       2.2. Chernobyl liquidators  
       2.3 Non-radiation harmful factors of the liquidators' work and stay in the Chernobyl zone
              2.3.1. Similarity of Chernobyl experience of the liquidators to combat
experience   

       2.4. Radiation exposure of the liquidators
              2.4.1. External beta- and alpha-irradiation
              2.4.2. Internal irradiation
              2.4.3. External gamma-irradiation
                      2.4.3.1. Units of irradiation dose  
                      2.4.3.2. Range of the doses of interest and limits of their accuracy  
              2.4.4. Estimations of the irradiation dose received by the liquidators  
       2.5. Definition of “a model liquidator” of this study  
       2.6. Conclusion  
3. Present health state and working ability of the liquidators  
       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”)  
       3.2. Overview of the reported health state of the liquidators
       3.3. Analytical studies of the liquidators' health as an effect of Chernobyl radiation, psychological and social factors  
       3.4. Health of the liquidators in a psycho-neurological perspective
       3.5. Conclusions  
4. Frameworks of non-radiation impact of stay and work in the Chernobyl zone upon the liquidators  
       4.1. Stress and distress (in the sense of Selye)
              4.1.1. Classical concepts of stress, distress and general adaptation syndrome
              4.1.2. Implications for the Chernobyl liquidators' case
       4.2. Occupational stress
       4.3. Extreme/unusual environments' effects (Classic psychological ideas about effects of extreme and unusual environment on the individuality)  
              4.3.1. Definitions. Dimensions  
              4.3.2. Impacts of the environments
              4.3.3. Effects on health  
              4.3.4. Conclusions  
       4.4. Post-traumatic stress disorder (PTSD)  
              4.4.1. History of recognition of the PTSD as a disease (World War I, World War II, Vietnam War)
              4.4.2. What is psychological trauma?  
              4.4.3. Physiological mechanism and 3 main categories of symptoms of PTSD (hyper-arousal, intrusion, and constriction)
              4.4.4. Disconnection of the PTSD-affected from the community
              4.4.5. Captivity and prolonged exposure as factors exacerbating psychological trauma
       4.5. Summary of possible effects of non-radiation harmful factors upon health  
5. “Post-zone” psychological and social harmful factors and their possible effect upon the liquidators  
       5.1. Highly stressful psycho-social situation in the post-USSR countries  
       5.2. Information-related harmful factors of the Chernobyl Disaster: Flaws of information about Chernobyl and its hazards as a major harmful factor  
       5.3. Harmful impacts associated with medical treatment
              5.3.1. Medical maltreatment
              5.3.2. Medical mistreatment
       5.4. System of Chernobyl welfare (based on the principle “compensation upon disease”) as a harmful factor
       5.5. Comparison of Chernobyl liquidators' case with other cases
              5.5.1. Semipalatinsk area population  
              5.5.2. War veterans (Vietnam, Gulf, Afghan Wars)  
              5.5.3. Inhabitants of the Chernobyl radiation contaminated areas  
       5.6. The results of the study in the prospect of modern notions of health
              5.6.1. WHO definition of health
              5.6.2. Public health approach
6. Conclusions  
7. Afterword: Several personal remarks  
References

APPENDIX
1. How — and if — Chernobyl data can be used to assess impact of radiation on health? Insider's point of view.   
(The paper delivered at the European Parliament at the Workshop on discussion of the project of the European Union radiation protection standards (8 February 1998, Brussels))
2. Chernobyl National-Memorial Park (The bases of the project)  

SUPPLEMENT
1. Chernobyl Disaster as a Model Eco-Social Problem (Course Syllabus, Assessments and List of Readings)
2. Chernobyl Case Study (Course Syllabus)
3. Chernobyl as a Model Case of an Eco-Disaster (Abstract of the presentation at the 5th Conference on environmental education (Zurich, April 1999))

About author  

Comments, critisisms and inquiries should be directed to mirbooks@netscape.net

Budapest, Bogar Kiado.
With support of International Centre for Sustainable Development,
Technological Safety and New Technologies (Kiev), 2001.

Design by: M.Opalev
Studio ARWIS  Kharkov, 2001