Drozd Valentina M, Saenko Vladimir A, Brenner Alina V, Drozdovitch Vladimir, Pashkevich Vasilii I, Kudelsky Anatoliy V, Demidchik Yuri E, Branovan Igor, Shiglik Nikolay, Rogounovitch Tatiana I, Yamashita Shunichi, Biko Johannes, Reiners Christoph
The International fund "Help for patients with radiation-induced thyroid cancer "Arnica", Minsk, Belarus; Department of Endocrinology, Belarusian Medical Academy for Postgraduate Education, Minsk, Belarus.
Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Sakamoto, Nagasaki, Japan.
PLoS One. 2015 Sep 23;10(9):e0137226. doi: 10.1371/journal.pone.0137226. eCollection 2015.
One of the major health consequences of the Chernobyl Nuclear Power Plant accident in 1986 was a dramatic increase in incidence of thyroid cancer among those who were aged less than 18 years at the time of the accident. This increase has been directly linked in several analytic epidemiological studies to iodine-131 (131I) thyroid doses received from the accident. However, there remains limited understanding of factors that modify the 131I-related risk. Focusing on post-Chernobyl pediatric thyroid cancer in Belarus, we reviewed evidence of the effects of radiation, thyroid screening, and iodine deficiency on regional differences in incidence rates of thyroid cancer. We also reviewed current evidence on content of nitrate in groundwater and thyroid cancer risk drawing attention to high levels of nitrates in open well water in several contaminated regions of Belarus, i.e. Gomel and Brest, related to the usage of nitrogen fertilizers. In this hypothesis generating study, based on ecological data and biological plausibility, we suggest that nitrate pollution may modify the radiation-related risk of thyroid cancer contributing to regional differences in rates of pediatric thyroid cancer in Belarus. Analytic epidemiological studies designed to evaluate joint effect of nitrate content in groundwater and radiation present a promising avenue of research and may provide useful insights into etiology of thyroid cancer.
1986年切尔诺贝利核电站事故造成的主要健康后果之一，是事故发生时年龄小于18岁人群的甲状腺癌发病率急剧上升。在多项分析性流行病学研究中，这种上升与事故中摄入的碘-131（131I）甲状腺剂量直接相关。然而，对于影响131I相关风险的因素，人们的了解仍然有限。以白俄罗斯切尔诺贝利事故后的儿童甲状腺癌为重点，我们回顾了辐射、甲状腺筛查和碘缺乏对甲状腺癌发病率区域差异影响的证据。我们还回顾了目前关于地下水中硝酸盐含量与甲状腺癌风险的证据，注意到白俄罗斯几个受污染地区（即戈梅利和布列斯特）的露天井水中硝酸盐含量很高，这与氮肥的使用有关。在这项基于生态数据和生物学合理性的假设生成研究中，我们认为硝酸盐污染可能会改变与辐射相关的甲状腺癌风险，从而导致白俄罗斯儿童甲状腺癌发病率的区域差异。旨在评估地下水中硝酸盐含量与辐射联合效应的分析性流行病学研究是一个很有前景的研究途径，可能会为甲状腺癌的病因学提供有用的见解。
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