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切尔诺贝利放射性沉降物的长期后果:综合数据探索。

Long-Term Consequences of the Chernobyl Radioactive Fallout: An Exploration of the Aggregate Data.

机构信息

University of Padua.

出版信息

Milbank Q. 2018 Dec;96(4):814-857. doi: 10.1111/1468-0009.12358.

Abstract

UNLABELLED

Policy Points Policymakers should invest more on researching the long-term health effects of low-ionizing radiation exposure, as we are far from reaching a consensus on a topic that is of enormous importance for public health and safety. Public policies such as those limiting the import of contaminated food from areas hit by a radioactive disaster or those regulating the resident population's access to such areas should follow a precautionary approach. Neoplasm diagnosis and medical care should be designed in order to take into account the possible role of long-term, low-dose radiation exposure. Health care policies should provide effective screening and prevention strategies with a specific focus on the regions that were hit most severely by the Chernobyl nuclear fallout. Health care expenditure should be targeted, taking into account the geographical dispersion of the fallout in order to attenuate its possible effect on neoplasm incidence.

CONTEXT

This study investigates the association between the radioactive Cesium fallout originated by the 1986 Chernobyl nuclear accident and dispersed over Western Europe, as a result of a combination of radioactive cloud passage days and rainy days over a 10-day period, and long-term health patterns and related costs. Since the half-life of Cesium is 30.17 years, part of the radioactivity in the affected regions is still present today, and it is usually still detected in the food chain, although at lower concentration levels.

METHODS

We match longitudinal data on neoplasm incidence over the time span 2000-2013 in a number of European regions not immediately adjacent to Chernobyl with the randomly distributed levels of cesium deposition after the nuclear disaster in order to assess whether we can detect an association with the long-term health effects on the European population through a random effects model.

FINDINGS

Considering 3 levels of fallout deposition-low, medium, and high-hospital discharges after treatment for neoplasms are, respectively, 0.36, 0.44, and 0.98 discharges over 100 inhabitants higher compared to regions with no fallout, with the population average being around 1.7 hospital discharges by neoplasms over 100 inhabitants. We checked the robustness of our findings to a number of tests including a placebo simulation and different model specifications.

CONCLUSIONS

Radioactive fallout is positively associated with a higher incidence of hospital discharges after treatment for neoplasms almost 30 years after its release, with larger effects in regions where the radioactivity was more intense. Our estimates are comparable to the findings of the largest-scale study on the long-term health effects of continuous low levels of radiation exposure among workers in the nuclear industry and suggest that more research is needed on this topic, given its enormous importance for public health and safety.

摘要

目的

研究 1986 年切尔诺贝利核事故产生的放射性铯沉降物与西欧长期健康模式之间的关系,并评估相关医疗费用。

背景

铯-137 的半衰期为 30.17 年,受影响地区的部分放射性仍存在于今天的食物链中,尽管浓度较低。

方法

采用随机效应模型,将 2000 年至 2013 年间欧洲部分非紧邻切尔诺贝利地区的肿瘤发病率的纵向数据与核灾难后随机分布的铯沉降水平进行匹配,以评估是否可以检测到与欧洲人口的长期健康影响相关的关联。

结果

考虑到三种沉降水平(低、中、高),与无沉降地区相比,肿瘤治疗后住院人数分别高出 0.36、0.44 和 0.98 人/每 100 居民,而人群平均每 100 居民有 1.7 人因肿瘤住院。我们通过多项测试,包括安慰剂模拟和不同模型规格,检查了我们研究结果的稳健性。

结论

放射性沉降物与肿瘤治疗后住院人数的增加呈正相关,近 30 年后,其释放后近 30 年后,放射性较强的地区影响更大。我们的估计与核工业中连续低水平辐射暴露对工人的长期健康影响的最大规模研究结果相当,鉴于其对公共健康和安全的重要性,需要对此主题进行更多研究。

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