Article: 1095 of sgi.talk.ratical From: (dave "who can do? ratmandu!" ratcliffe) Subject: "Nature" 9/92: Thyroid Cancer after Chernobyl soaring Summary: fallout from Chernobyl "on schedule" despite Official "No Danger" Myths Keywords: thyroid carcinoma, fetal thyroid concentrating iodine Date: 25 Jun 1995 21:15:11 GMT Organization: Silicon Graphics, Inc. Lines: 341 One of the most pervasive myths about Chernobyl is that only 3% of the reactor core was released into the biosphere when the explosion occurred on April 26, 1986. Vladimir Chernousenko, Scientific Director of the Ukrainian Academy of Sciences' Task Force for the Rectification of the Consequences of the Accident, in his 1991 book Chernobyl, Insight from the Inside, dispels this myth (and a partial list of 20 others), citing, A more official view on `The Nuclear Accident in Block 4 of the Chernobyl Nuclear Power Station and the Safety of the RBMK Reactor' give[s] the following excerpts from an unpublished report by A.A. Yadrikhinskii, Nuclear Safety Inspection Engineer of the USSR State Atomic Energy Survey Commission (Kurchatov town, RSFSR February, 1988): . . . Radiation emission was no less that 80% of the core (with a total of 192 tons), which amounted to 6.4 x 10^9 Ci.[16] If we divide the figure by the population of the whole earth (4.6 x 10^9 people) then we get 1 Ci per person.[17] Choosing to ignore the facts about how we are collectively contaminating this Earth with lethal-to-all-life-doses of man-made nuclear fission products will ensure the cessation of billions of years of life exploring itself on this planet. It doesn't have to go down this way. If we were living in the areas that the children described below are, we would not be able to ignore the facts which the International Nuclear Mafia continuously deny when they parrot the line in the global media about how "There's no health danger from nuclear power" and "No one died at Chernobyl" and "This form of energy is clean and safe; anyone who says otherwise doesn't know what they're talking about". -- ratitor from the San Francisco Chronicle, Thursday, September 3, 1992: And see the June 30, 1999 Reuters story below regarding Thyroid cancer 10 times higher in Chernobyl kids --------------------------------------------------------------------- Thyroid Cancer on Rise For Chernobyl Children New York Children who were exposed to radiation from the Chernobyl nuclear power plant disaster are developing thyroid cancer sooner and in larger numbers than expected, researchers report. The results are the first reliable data in the population downwind of the Chernobyl accident in 1986, said Dr. Marvin Goldman, a radiation biologist at the University of California at Irvine who was not involved in the new study. An increase in thyroid cancer had been reported earlier, but some Western health officials had expressed concern about the reliability of the data. In a letter published yesterday in Nature, a British science journal, Dr. Vasily S. Kazakov of the Belarus Ministry of Health in Minsk and his colleagues say that the thyroid cancer rates in the regions most heavily irradiated began to soar in 1990. In Gomel, the most contaminated region studied, there used to be just one or two cases of thyroid children a year. But Kazakov and his colleagues found that there were 38 cases in 1991. In six regions of Belarus and the city of Minsk, the investigators found 131 cases of thyroid cancer in young children, some of whom were still in the womb when the Chernobyl accident occurred. Because of questions about the cancer reports, the World Health Organization sent a team of scientists to Minsk to verify the reports. In an accompanying letter in Nature yesterday, they confirmed Kazakov's results. Children are particularly susceptible to thyroid cancer from radioactive iodine because their thyroid glands are small and concentrate the iodine from radioactive fallout because they drink more milk and get larger doses of radioactive iodine and because their thyroids are thought to be more vulnerable to the radiation. Thyroid cancer is usually very amenable to treatment, said Dr. Blake Cady, a cancer surgeon and thyroid cancer specialist at the New England Deaconess Hospital in Boston. But investigators were struck by the seeming aggressiveness of some of the children's cancers. A 7-year-old child died and 10 other children are seriously ill, they reported. _________________________________________________________________________ NATURE, Vol. 359, 3 SEPTEMBER 1992 SCIENTIFIC CORRESPONDENCE Thyroid cancer after Chernobyl SIR--We would like to report a great increase in the frequency of thyroid cancer in children in Belarus, which commenced in 1990 and continues. Table 1 shows the incidence of thyroid cancer in children in the six regions of Belarus and Minsk City from 1986 to the end of the first half of 1992. It can be seen that the overall incidence rose from an average of just four cases per year from 1986 to 1989 inclusive, to 55 in 1991 and is projected to be not less than 60 in 1992. This increase is not uniformly distributed across the country: for example, there is no significant increase in Mogilev, Minsk City or Vitebsk. By far the greatest increase is seen in the Gomel region, from one or two cases per year to 38 in 1991, and a less obvious increase is seen in the Brest and Grodno regions. --------------------------------------------------------------------- TABLE 1 Incidence of thyroid cancer in children in Belarus --------------------------------------------------------------------- Region of Years Belarus 1986 1987 1988 1989 1990 1991 1992* Total Brest 0 0 1 1 6 5 5 18 Vitebsk 0 0 0 0 1 3 0 4 Gomel 1 2 1 2 14 38 13 71 Grodno 1 1 1 2 0 2 6 13 Minsk 0 1 1 1 1 4 4 12 Mogilev 0 0 0 0 2 1 1 4 Minsk City 0 0 1 0 5 2 1 9 Total 2 4 5 6 29 55 30 131 --------------------------------------------------------------------- * Six months of 1992 The Gomel region lies immediately to the north of Chernobyl and is known to have received a high level of radioactivity as fallout after the breakdown of reactor number 4 on 26 April 1986. The plume passed first over the Gomel region in the first few hours after the major release of radioactivity, and then over the Brest and Grodno regions. The fallout contained large amounts of iodine-131 and significant amounts of the short-lived isotopes of iodine, although these were too short-lived to be measured. We have classified the tumours according to the World Health Organisation classification (2nd edn) and find that virtually all are papillary carcinomas (128 of 131). They are, however, relatively aggressive, as can be seen from Table 2. Fifty-five of the 131 cases showed direct extension to the perithyroid tissues and six distant metastases, mostly in the lungs. It can be seen that only about 23 per cent were less than 1 cm in diameter. One of the children has died at seven years of age and ten others are seriously ill. --------------------------------------------------------------------------- TABLE 2 Extent of spread (TNM classification) of thyroid cancer in children --------------------------------------------------------------------------- Total Lymph node metastases TNM number of ------------------------------------- symbol cases None(N O) Ipsilateral(N 1a) Other(N 1b) Tumour size <1 cm T1 30 17 10 3 1-4 cm T2 33 17 8 8 >4 cm T3 7 3 4 0 Extending to surrounding tissues T4 55 14 18 23 Distant metastases M1 6 1 1 4 Total 131 52 41 38 --------------------------------------------------------------------------- Classification as in TNM Atlas 3rd edn, eds Spiessl, B. et al., UICC (Springer, Berlin, 1990). The occurrence of this increase in thyroid cancer in children within a few years of exposure to radioactive isotopes of iodine is unexpected, but real. It poses both humanitarian and scientific problems, and is placing great strains upon the health services of our new country. It also provides an opportunity, which we hope will not be repeated, to study the consequences of major exposure of a population to isotopes of iodine from fallout. We are collaborating with several international groups and are preparing detailed reports of various aspects of the problem. We believe that the only realistic explanation for the increase in the frequency of thyroid cancer is that it is a direct consequence of the accident at Chernobyl. Vasili S. Kazakov Ministry of Health of Belarus, House of Government. 220010 Minsk, Belarus Evgeni P. Demidchik Thyroid Tumour Centre, F. Skorinay Avenue 64, 220600 Minsk, Belarus Larisa N. Astakhova Radiation Medicine Institute, Masherov Avenue 23, 220600 Minsk, Belarus SIR--We have recently visited Belarus under the auspices of the WHO regional office for Europe and the Swiss government, and have had the opportunity to see some of the children with thyroid cancer, to study the pathology of the cases and to examine the relevant data. We examined 11 children who had had operations for thyroid carcinoma and were now hospitalized for post-operative management or evaluation of metastatic disease. We were shown the complete records for these patients, including X-rays and echograms before and after treatment. All were diagnosed during the past 3 years, eight having been living in the Gomel region at the time of the Chernobyl accident and two in the Brest region. The age at diagnosis of the six females and five males was between 4 and 13 years of age; the youngest was born two days after the accident. We have studied the histological slides from 104 cases of children from Belarus in whom the diagnosis of thyroid carcinoma had been made since January 1989. We agree both with the diagnosis of malignancy and of the type of malignancy in 102 of the cases. We also examined the data on the incidence of thyroid carcinoma in Belarus. There is a marked increase in frequency from 1990 onwards over the average for the years from 1986 to 1990. This increase started only 4 years after the Chernobyl accident, a surprisingly short time by comparison with studies of thyroid carcinoma that have followed exposure to external radiation in infants[1,2]. Of the children with thyroid carcinoma in Belarus since 1990, the eight youngest at exposure were in utero, but were more than 3 months of fetal age at the time of Chernobyl. The fetal thyroid is known to start concentrating iodine at 12-14 weeks of gestation. We do not believe that increased ascertainment of cases could have played more than a minor role in the recorded incidence of thyroid carcinoma. The proportion of resected nodules that are malignant is high and the type of tumour is aggressive. The ratio of thyroid carcinoma in children to that in adults has increased dramatically, although there are now signs that the incidence in patients over the age of 15 is beginning to increase. The rate is greatly in excess of the reported incidence of this disease in children under 15 years of age, which is of the order of I per million per year[3-6]. In the Gomel region (total population about 2.5 million), the region of Belarus that received the highest fallout from Chernobyl, the incidence in 1991 and the first part of 1992 is approximately 80 per million children per year. It is generally accepted that external radiation to the neck is associated with an increased incidence of thyroid carcinoma in man, and there is an increased sensitivity of the infant thyroid to the carcinogenic effect of radiation[2]. In some animal studies, but not all[7,8], external radiation is found to be a more effective carcinogen for the thyroid than iodine-131. Clear evidence that the diagnostic or therapeutic use of radioiodine in man carries a carcinogenic risk is lacking[9,10], and iodine-131 has provided a safe and effective treatment of Graves' disease in adults, although it is rarely used in young children. The combination of the high level of exposure to radioactive fallout and the numbers exposed within a short time after its release makes the Chernobyl accident an unprecedented event. In the Marshall Islands, although the doses were probably comparable, the number of people exposed was several orders of magnitude smaller[11]. In the case of the accident at Windscale (now called Sellafield), the number exposed was substantial but the doses were smaller[12], and no adequate study of any long-term thyroid effects has yet been reported. Other studies of fallout from weapons and of nuclear accidents (such as on Three Mile Island) have yielded inconclusive evidence. A close relationship between radiation dose and the incidence of thyroid carcinoma has been documented in atomic bomb survivors in Japan[13], but the radiation received was mostly external and the contribution from fallout is uncertain. We believe that the experience in Belarus suggests that the consequences to the human thyroid, especially in fetuses and young children, of the carcinogenic effects of radioactive fallout is much greater than previously thought. Studies of the Marshall Islanders, of the atomic bomb survivors and of the effects of external radiation on the thyroid suggest that the incidence of thyroid cancer in Belarus will be raised for many years. The accident and its impact on Belarus poses a challenge to the international community to help, both in dealing with the extensive present and future public health consequences, and in promoting research for the understanding of the basic processes underlying the phenomenon. Understanding the consequences of Chernobyl will provide an important basis for preventive action in future. Keith Baverstock WHO European Centre for Environment and Health, 00156 Rome, Italy Bruno Egloff Pathology Institute, Kantonspital, 8401 Winterthur, Switzerland Aldo Pinchera Institute of Endocrinology, University of Pisa, 56100 Pisa, Italy Charles Ruchtl Pathology Institute, University of Berne, 3010 Berne, Switzerland Dillwyn Williams Department of Pathology, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, UK _________________________ 1. Shore, R. E. et al. J. natn. Cancer Inst. 74, 1177-1184 (1985). 2. Ron, E. et al. Radiat. Res. 120, 516-531 (1989). 3. Brown, P. D. et al. Int. J. Epidem. 18, 546-555 (1989). 4. McWhiner, W. R. & Petroeschevsy, A. L. Int. J. Cancer 45, 1002-1005 (1990). 5. Young, J. L., Ries, L. G., Silverberg, E., Horm, J. W. & Miller, R. W. Cancer 58, 598-602 (1986). 6. Muir, C., Waterhouse, J., Mack, T., Powell, J. & Whelan, S. IARC Sci. Publ. no. 88, Vol. 5 (International Agency for Research on Cancer, Lyon. 1987). 7. National Council on Radiation Protection and Measurements NCRP report no. 80 (Washington DC, 1985). 8. Lee, W., Chiacchierini, R. P., Shleien, B. & Telles, N. C. Radiat. Res. 92, 307-319 (1982). 9. Holm, L. E., Dahiqvist, I., Israelsson, A. & Lundell, G. New Engl. J. Med. 303, 188-191 (1980). 10. Holm, L. E. et al. J. natn. Cancer Inst. 80, 1132-1138 (1988). 11. Conard, R. A. in Radiation Carcinogenesis Epidemiology and Biological Significance, Boice, J. D. & Fraumeni, J. F. eds (Raven, New York, 1984). 12. Baverstock, K. F. & Vennart, J. Health Phys. 30, 339-344 (1976). 13. Ezaki, H., Ishimaru, T., Hayashi, Y. & Takeichi, N. GANN Monogr. Cancer Res. 32, 129-142 (1986). ______ . . . the number of children and grandchildren with cancer in their bones, with leukemia in their blood, or with poison in their lungs might seem statistically small to some, in comparison with natural health hazards, but this is not a natural health hazard--and it is not a statistical issue. The loss of even one human life, or the malformation of even one baby--who may be born long after we are gone--should be of concern to us all. Our children and grandchildren are not merely statistics toward which we can be indifferent. -- President Kennedy, June, 1963 Thyroid cancer 10 times higher in Chernobyl kids Wednesday, June 30, 1999 WASHINGTON (Reuters) - The rate of thyroid cancer remains 10 times higher than normal among young Ukrainian children 13 years after the accident at the Chernobyl nuclear power plant, researchers said Wednesday. They reported 577 cases of thyroid cancer in Ukrainian children between 1986, when the accident occurred, and 1997, compared to 59 cases in the same age group from 1981 to 1985. The reactor at Chernobyl caught fire in the early hours of April 26, 1986, spreading a radioactive cloud over much of Ukraine, Russia, Belarus and other parts of Europe. It killed 31 people and affected thousands more. In Belarus, where 70 percent of the radiation was deposited, the World Health Organization says thyroid cancer rates among children are 100 times pre-accident levels. "Children constitute the most vulnerable group of exposed individuals, because their thyroid sensitivity to radiation is high, and there is a longer life span to manifest its effects," Dr. Virginia LiVolsi of the University of Pennsylvania Medical Center in Philadelphia, said in a statement. "These factors make it necessary to follow thyroid function in exposed subjects for decades." Reporting in the journal cancer, LiVolsi said her team found that 64 percent of all Ukrainian thyroid cancer patients aged 15 or younger lived in the most contaminated regions -- the provinces of Kiev, Chernigov, Zhitomir, Cherkassy and Rovno. More than 40 percent of patients were children 4 or younger at the time of the accident. "The group at maximum risk is those exposed to high radiation levels when they were younger than 5 years," LiVolsi said. "This is the age when the thyroid gland is most sensitive to ionizing radiation." The American Cancer Society predicts that more than 18,000 adults in the United States will be diagnosed with thyroid cancer in 1999. About 1,200 will die. There is a way to help prevent thyroid cancer caused because of exposure to radioactivity. In Poland, where potassium iodide was given to 97 percent of children, there has been no similar increase in thyroid cancer although the country was also exposed to radioactive clouds from Chernobyl. Last week the U.S. Nuclear Regulatory Commission proposed that potassium iodide be stockpiled to protect the public from a major release of radiation during a nuclear power plant accident.