Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, 20892-9778, USA.
Radiation Programme, Barcelona Institute for Global Health (ISGlobal), Campus Mar, Barcelona Biomedical Research Park (PRBB), Dr Aiguader 88, 08003, Barcelona, Spain.
Eur J Epidemiol. 2017 Dec;32(12):1047-1054. doi: 10.1007/s10654-017-0303-6. Epub 2017 Sep 19.
2016 marked the 30th anniversary of the Chernobyl Nuclear Power Plant accident. We and others wrote reviews for the 25th anniversary. Since then, additional papers have appeared and it seems timely to highlight lessons learned. To present, not a systematic review, but a commentary drawing attention to notable findings. We include not only recent reports and updates on previous results, but key findings from prior Chernobyl studies. The dose-dependent increase in Papillary Thyroid Cancer (PTC) following childhood I-131 exposure in Ukraine and Belarus has now been shown to persist for decades. Studies of post-Chernobyl PTCs have produced novel information on chromosomal rearrangements and gene fusions, critical to understanding molecular mechanisms. Studies of clean-up workers/liquidators suggest dose-related increases of thyroid cancer and hematological malignancies in adults. They also report increases in cardiovascular and cerebrovascular disease. If confirmed, these would have significant public health and radiation protection implications. The lens opacities following low to moderate doses found earlier are also a concern, particularly among interventional radiologists who may receive substantial lens doses. Finally, there is some, inconsistent, evidence for genetic effects among offspring of exposed persons. Further efforts, including improved dosimetry, collection of information on other risk factors, and continued follow-up/monitoring of established cohorts, could contribute importantly to further understand effects of low doses and dose-rates of radiation, particularly in young people, and ensure that appropriate public health and radiation protection systems are in place. This will require multinational collaborations and long-term funding.
2016 年标志着切尔诺贝利核电站事故发生 30 周年。我们和其他人曾为 25 周年纪念撰写过评论。自那时以来，又出现了其他一些论文，现在似乎是时候强调从中吸取的教训了。本文不是系统综述，而是一篇评论，提请注意值得注意的发现。我们不仅包括最近关于先前结果的报告和更新，还包括来自先前切尔诺贝利研究的关键发现。在乌克兰和白俄罗斯，儿童时期 I-131 暴露后甲状腺癌（PTC）的剂量依赖性增加，现在已经显示出持续数十年。对切尔诺贝利后 PTC 的研究产生了关于染色体重排和基因融合的新信息，这对于理解分子机制至关重要。对清理人员/液体处理人员的研究表明，成年人的甲状腺癌和血液恶性肿瘤与剂量有关，也报告了心血管和脑血管疾病的增加。如果得到证实，这将对公共卫生和辐射防护产生重大影响。早些时候发现的低至中等剂量下的晶状体混浊也是一个问题，特别是在可能接受大量晶状体剂量的介入放射科医生中。最后，暴露人群的后代存在一些不一致的遗传效应证据。进一步的努力，包括改进剂量测定、收集其他风险因素的信息以及对已建立队列的持续随访/监测，可能会对进一步了解低剂量和剂量率辐射的影响，特别是对年轻人的影响，以及确保适当的公共卫生和辐射防护系统的建立，做出重要贡献。这将需要跨国合作和长期资金。
