On the 26th of April 1986 at the Chernobyl Nuclear Plant in Northern Ukraine, the Chernobyl Unit 4 nuclear reactor produced two explosions within a time frame of only 3 seconds at approximately 1:23:48 local time (Hohenemser 1988). The explosions blew hot molten and pulverized fuel an astounding altitude of 7.5 km while the resulting fires numbered around 30 and lasted for several days (Hohenemser 1988). Radioactive material was released for 10 days into the surrounding environment and the spread of the radioactive material throughout parts of Europe was astonishing (Hohenemser 1988). The effects were primarily felt throughout Ukraine, Russia, and most especially Belarus (Wakeford 2006:125).

Although the contamination in close proximity to Chernobyl necessitated the evacuation of residents, the effects have been felt on a far grander scale (Wakeford 2006:125). Most notably, there has been a dramatic increase in thyroid carcinoma among children, while cases of breast cancer and childhood leukemia are also on the rise (Wakeford 2006:125). The evacuations of heavily contaminated areas resulted in social and psychological distress, as communities were uprooted and removed from all that was familiar; health-related worries also compounded the already highly-manifested levels of stress (Wakeford 2006:125).

The physical and mental health effects along with the social consequences of the Chernobyl nuclear disaster will be presented and reviewed in this blog dedicated to those affected by the tragedy. The blog will conclude with the lessons learned from Chernobyl and how they relate to the political debate involving the future of nuclear energy.

Physical Health Effects

Immediately following the Chernobyl explosions, those in close proximity were subject to acute medical consequences. Of the 444 workers at the plant and the responding firefighters, 31 succumbed to their injuries (29 to acute radiation sickness) by the end of the summer (Hohenemser 1988). For instance, the firefighters were exposed to steam and radioactively contaminated water which led to whole body doses of radiation, thermal burns, and beta burns to their skin. The symptoms of radiation exposure appeared quickly and included vomiting, nausea, radiation-induced skin burns, and the temporal development of lymphocyte and platelet counts (Hohenemser 1988). Those with radiation doses high enough to affect bone marrow were susceptible to infection and received treatment involving antimicrobial, antifungal, and antiviral medications (Hohenemser 1988). Individuals who received severe amounts of radiation were treated with bone marrow or fetal liver transplants; unfortunately, all but one died from transplant rejection (Hohenemser 1988).

The greatest threat to long-term physical health in the fallout of Chernobyl is, by far, the manifestation of thyroid carcinoma in children, with papillary cancer being the primary pathological type (Cardis et al. 2006). It has been shown that a child’s thyroid is ultra-sensitive to the absorption of cancerous agents, such as the radioiodine isotopes that were released during the Chernobyl explosion (Pacini et al. 1993:3567). Furthermore, the risk of developing thyroid carcinoma in the subsequent years is higher among very young children as opposed to slightly older children (around 9 years old) (Pacini et al. 1993:3568).

Immediately after the fallout, a short latency period was observed, followed by a substantial increase in aggressive cancers among children (Nikiforov and Gnepp 1994). A case-control study done by Astakhova and colleagues indicates that the increase in thyroid cancer among Children in Belarus is, in fact, due to the nuclear fallout and not to the increased and intensive screening in response to the disaster by Soviet health authorities (1998). The study illustrates an increase of thyroid carcinoma well into 1997 (when the study was being undertaken) solely in children that had been alive or in utero in areas affected by the accident (Astakhova et al. 1998). In addition, “a majority of the cancers were larger than 1 cm or had spread beyond the thyroid capsule, and 62% had metastasized to regional lymph nodes, characteristics that distinguish them from occult cancers” (Astakhova 1998:355).

A complimentary study also designed to prove the positive correlation between Chernobyl and thyroid carcinoma in adolescents (ages 14 – 21) is a comparative study undertaken by Pacini et al. (1997). Those studied were adolescents at the time of diagnosis and were compared with other adolescents from Italy and France that exhibited naturally occurring thyroid carcinoma (Pacini et al 1997). The results show that adolescents demonstrated an increase in thyroid carcinoma, similar to children (under the age of 14), but in a less pronounced manner (Pacini et al. 1997). It is thus suggested that the fallout-induced thyroid cancer epidemic may have reached its peak by 1993, before levelling off (Pacini et al. 1997). Furthermore, it was shown that those diagnosed with carcinoma in Belarus were primarily under the age of 14, while those in Italy and France were over the age of 14 and showed a scale of progressive diagnoses over time (Pacini et al. 1997). The cases of thyroid cancer in Belarus then appear to be linked to a rather sudden exposure collectively. In Italy and France, females seem to exhibit higher levels of the cancer, whereas the occurrence in Belarus is much more equal between males and females (Pacini et al. 1997). Such data illustrates the causal significance of exposure to the Chernobyl fallout in comparison to differences in sex.

Overall, it is clear that the increase in thyroid cancer among those that were children during the Chernobyl disaster is directly related to the nuclear fallout. Along with the association between acute radiation sickness and radioiodines, the several studies conducted illustrate an equal association between thyroid carcinoma and radioiodines.

Psycho-Social Effects

With a total of approximately 400 million people affected in some way by the nuclear fallout throughout Europe, psycho-social effects were widespread (Hohenemser 1988). Many of the psychological effects relate to depression and anxiety (post-traumatic stress disorder), medically unexplained somatic symptoms (fatigue, headaches, joint and muscle pain), and substance abuse (Bromet and Havenaar 2007).

Initially following the explosions and ejection of radiation, the Soviet government kept very silent about the truth behind the disaster and its subsequent effects (Rahu 2003). In turn, those actually affected by the fallout felt no need to fear any consequences and instead thought “Look at me. I’m healthy. My cow is healthy. There is no radiation. It’s a fraud. It’s a lie. The government is just trying to take our land” (Rahu 2003:296). These sentiments followed the evacuation requests from government officials and, ultimately, in the vicinity of Chernobyl, 116,000 people were permanently evacuated (Hohenemser 1988). Although the evacuations eventually resulted in fear for the local residents, the lack of information disclosed by the government meant those fears generated rumours. The generation of fear and rumours can have negative psychological and social effects on communities as they are unsure of their futures and harbour a deep distrust of their leader and government (Rahu 2003). Some examples of rumours (Rahu 2003:296-97) existing at the time include:
• in Kiev, 15,000 nuclear victims were bulldozed into mass graves (in 1986);
• the Chernobyl disaster was an intentional experiment aimed at gathering knowledge about the effects of radiation on people (in 1996);
• as a result of radiation, over 300,000 persons have died by now (in 2000);
• most of [the clean-up workers] are now disabled, some are terminally ill and others have died (in 2000);
• as a result of the accident in Chernobyl, the number of skin cancer cases in Romania has increased 60 times (unknown year).

Besides the fear and rumours experienced by the evacuees, negative emotional and psychological distress was also caused by leaving all that was familiar and stepping into a future of unknown consequences and outcomes. Although new housing and services were provided to those that could not return to their hometowns (Becker 2002), the feelings of uncertainty and fear compounded to result in destructive behaviours such as alcohol and cigarette abuse or dietary changes (fear of possible contaminated food) (Baverstock and Williams 2007).

Similarly, negative mental health effects also burdened the clean-up workers of the accident. Although studies undertaken to provide insight on the topic are less than ideal or lacking completely, a distinct rise in suicide rates among the workers is evident (Bromet and Havenaar 2007). According to Rahu et al., the high suicide rate among Estonian clean-up workers was due to their forced recruitment, uncertainty about the radiation doses involved, and their fear surrounding future radiation-induced illnesses (1997, 2006).

Overall, it appears that the psychological effects associated with the Chernobyl disaster are solely emotionally-based. Studies have not proven that mental disorders as a result of radiation fallout has occurred (Bromet and Havenaar 2007). Those with symptoms or illness attributed to Chernobyl are often referred to as “‘Chernobyl victims’ and frequently [take] on the role of ‘invalid’ or disabled” (WHO 2006:95), only compounding the negative psycho-social effects.

Discussion and Conclusion

The main lessons learned at Chernobyl relate to the poor design of the reactors and poor management practices (Hohenemser 1988). Improvements in design and management are essential in the aftermath of the disaster along with improved emergency response plans. Chernobyl demonstrated that a nuclear disaster can have staggering transnational effects and that preparations for such a disaster must be in place. This was not the case in 1986 as was evident by the 6 ½ hour delay in distributing iodine pills to those with radiation exposure (Hohenemser 1988). It was also learned that environmental factors such as terrain and rainfall can affect the distribution of radiation in the surrounding area and thus lead to variable health effects (Hohenemser 1988).

Fortunately, some actions were undertaken to relieve some of the negative psychological health effects experienced by those involved. For instance, a health information centre was created in Gomel, Belarus to provide aid to the general public in the form of social and psychological counselling and health promotion campaigns (Nijenhuis et al., 1995). The United Nations Education, Scientific and Cultural Organization (UNESCO) also established nine Community Development Centres across Belarus, Ukraine, and Russia in areas with high populations of evacuees and clean-up workers (Becker 2002). Used by thousands of people, these centres focus on activities for different age groups, such as support groups, individual and family counselling, day-care, a variety of workshops and classes, and radiation and ecology education.

Although there is much political debate over the future of nuclear energy, the risks and consequences must be fully explored. The need for energy has continued to result in the push for more nuclear plants, despite concerns and potential disastrous effects. The current situation in Japan illustrates the fears of nuclear energy critics: supposed failure-proof safety measures are in fact far from failure-proof. Much more research into the positive and negative aspects of nuclear energy need to be explored before communities will be open to the idea of a nuclear plant in their backyard.

The Chernobyl disaster resulted in widespread effects felt by millions of people. All those that suffered and continue to suffer the negative physical and psychological effects must be remembered in any further discourse on the subject. In other words, the key is to take what was learned and apply it to the seemingly inevitable future of nuclear energy while keeping the Chernobyl victims in our thoughts and memories.

References

Astakhova, L. N., Anspaugh, L. R., Beebe, G. W., Bouville, A., Drozdovitch, V. V., Garber, V., et al. (1998). Chernobyl-related thyroid cancer in children of belarus: A case-control study. Radiation Research, 349-356.

Baverstock, K., & Williams, D. (2007). The chernobyl accident 20 years on: An assessment of the health consequences and the international response. Ciência & Saúde Coletiva, 12, 689-698.

Becker, S.M. (2002) Responding to the psychosocial effects of toxic disaster: policy initiatives, constraints and challenges. In: Toxic Turmoil: Psychological and Societal Consequences of Ecological Disasters. Eds.: J.M. Havenaar, J.G. Cwikel, E.J. Bromet. New York, Kluwer Academic and Plenum Press, pp 199-216.

Bennett, B., Repacholi, M., & Carr, Z. (2006). Health effects of the chernobyl accident and special health care programmes World Health Organization.

Bromet, E. J., & Havenaar, J. M. (2007). Psychological and perceived health effects of the chernobyl disaster: A 20-year review. Health Physics, 93(5), 516.

Cardis, E., Howe, G., Ron, E., Bebeshko, V., Bogdanova, T., Bouville, A., et al. (2006). Cancer consequences of the chernobyl accident: 20 years on. Journal of Radiological Protection, 26, 127.

Havenaar, J.M. and PA, B. (1995) Belarusian-Dutch Humanitarian Aid Project: "Gomel Project." Bilthoven, National Institute for Public Health and Environmental Protection.

Hohenemser, C. (1988). The accident at chernobyl: Health and environmental consequences and the implications for risk management. Annual Review of Energy, 13(1), 383-428.

Nikiforov, Y., & Gnepp, D. R. (1994). Pediatric thyroid cancer after the chernobyl disaster. pathomorphologic study of 84 cases (1991-1992) from the republic of belarus. Cancer, 74(2), 748-766.

Pacini, F., Vorontsova, T., Demidchik, E. P., Molinaro, E., Agate, L., Romei, C., et al. (1997). Post-chernobyl thyroid carcinoma in belarus children and adolescents: Comparison with naturally occurring thyroid carcinoma in italy and france. Journal of Clinical Endocrinology & Metabolism, 82(11), 3563.

Rahu, M. (2003). Health effects of the chernobyl accident: Fears, rumours and the truth. European Journal of Cancer, 39(3), 295-299.
Wakeford, R. (2006). Chernobyl-20 years on. Journal of Radiological Protection, 26, 125.

Images

http://en.wikipedia.org/wiki/Chernobyl_disaster
http://www.chernobylee.com/articles/chernobyl/interview-with-a-chernobyl-liquidator-sergei-b---part-i.php
http://www.myhero.com/go/hero.asp?hero=RyuichiHirokawaJapan
http://news.kievukraine.info/2006/04/twenty-years-on-effects-from-chernobyl.html