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根据2024年远程事故后时期电离辐射影响与疾病因果关系医学鉴定材料,切尔诺贝利核电站事故幸存者的结构和特征及死亡原因

STRUCTURE AND CHARACTERISTICS OF THE CHORNOBYL NPP ACCIDENT SURVIVORS REASONS OF DEATH ACCORDING TO THE MATERIALS OF MEDICAL EXPERTISE FOR THE CAUSAL RELATIONSHIP OF DISEASES WITH THE EFFECT OF IONIZING RADIATION IN THE REMOTE POSTACCIDENTAL PERIOD (2024 year).

作者信息

Sushko V O, Kolosynska O O, Apostolova O V

机构信息

State Institution «National Research Center for Radiation Medicine, Hematology and Oncology of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.

出版信息

Probl Radiac Med Radiobiol. 2024 Dec(29):419-424. doi: 10.33145/2304-8336-2024-29-419-424.

Abstract

UNLABELLED

Problem of the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe during performance of professional, military or official duties and / or living on radiation-contaminated areas, additional exposure not through their own fault but due to a radiation accident, caused the development of a special form of medical expertise as part of the of medical social protection system for suffered contingents in the remote postaccidental period.

OBJECTIVE

To study and characterize the structure of the survivor categories (clean-up workers and victims) of the Chernobyl Catastrophe in the remote post-accident period (2013-2024) regarding the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission of the Ministry of Health of Ukraine (CIEC).

MATERIAL AND METHODS

The work was performed in the design of a retrospective study that based on analysis of the structure of all categories of Chornobyl NPP accident (ChNPP) survivors during 2008-2024 years and studying of 58,137 medical expert cases, including 19,524 postmortem cases, which were considered by CIEC during 2013-2023 to establish a causal relationship between the disease and influence of radiation exposure and other harmful factors and conditions during ChNPP accident.

RESULTS

The total number of adult survivors as on 01.01.2024, compared to 2008, decreased by 581,170 persons, or by 31.68 %. The number of clean-up workers of the accident decreased by 124,382 people (45.01 %), that means - during the last 15 years, almost every third-second participant in the liquidation of the consequences of the accident at the ChNPP died. The number of adult victims decreased 29.41 % (458,233 persons). In the structure of medical expert cases, the leading place as a disease that became the reason of death is occupied by oncological diseases - 52.10 %, chronic circulatory diseases and their complications make up 42.00 % (cardiovascular system - 19.60 %, cerebrovascular system - 22.40 %), chronic diseases of the respiratory system - 3.00 %, other diseases in general - 2.90 %. In the structure of oncological postmortem expert cases (n=10,172) during2013-2024 the main reason of death belongs to oncohematological diseases (18.00 %), colon cancer (15.00 %), breast cancer for woman (13.00 %), prostate cancer for man (11.99 %), lung and upper respiratory tract cancer (8.01 %).

CONCLUSION

In the remote post-accidental period (2013-2024) has increased the necessity of expertise of the causal relationship of disease that became the reason of death with the effect of ionizing radiation and the ChNPP accident consequences. During 2013-2024 period quick reducing for all survivors' categories of the Chornobyl NPP accident taken place. In the structure of medical expert cases during 2013-2023 the leading place of the disease that became the reason of death is occupied by oncological, cardiovascular and cerebrovascular diseases.

摘要

未标注

因电离辐射影响以及在执行专业、军事或公务职责期间和/或生活在受辐射污染地区时受切尔诺贝利灾难有害影响而导致的与死亡原因相关的疾病因果关系问题,因辐射事故造成的额外照射并非出于自身过错,这导致在事故后远期为受灾群体建立了一种特殊形式的医学专业鉴定,作为医疗社会保护系统的一部分。

目的

根据乌克兰卫生部中央跨部门专家委员会(CIEC)的专家案例材料,研究并描述切尔诺贝利灾难在事故后远期(2013 - 2024年)幸存者类别(清理人员和受害者)中与因电离辐射影响以及切尔诺贝利灾难有害影响而导致的死亡原因相关的疾病因果关系。

材料与方法

这项工作采用回顾性研究设计,基于对2008 - 2024年期间切尔诺贝利核电站事故(ChNPP)所有类别的幸存者结构进行分析,并研究了58137例医学专家案例,其中包括19524例尸检案例,CIEC在2013 - 2023年期间对这些案例进行审议,以确定疾病与ChNPP事故期间辐射暴露及其他有害因素和状况影响之间的因果关系。

结果

与2008年相比,截至2024年1月1日成年幸存者总数减少了581170人,即减少了31.68%。事故清理人员数量减少了124382人(45.01%),这意味着在过去15年里,切尔诺贝利核电站事故清理工作的参与者中几乎每三到二人就有一人死亡。成年受害者数量减少了29.41%(458233人)。在医学专家案例结构中,作为死亡原因的主要疾病是肿瘤疾病,占52.10%,慢性循环系统疾病及其并发症占42.00%(心血管系统占19.60%,脑血管系统占22.40%),慢性呼吸系统疾病占3.00%,其他各类疾病占2.90%。在2013 - 2024年期间肿瘤尸检专家案例(n = 10172例)结构中,主要死亡原因是血液肿瘤疾病(18.00%)、结肠癌(15.00%)、女性乳腺癌(13.00%)、男性前列腺癌(11.99%)、肺癌和上呼吸道癌(8.01%)。

结论

在事故后远期(2013 - 2024年),对于与因电离辐射影响以及切尔诺贝利核电站事故后果导致的死亡原因相关的疾病进行专业鉴定的必要性增加。在2013 - 2024年期间,切尔诺贝利核电站事故所有幸存者类别数量迅速减少。在2013 - 2023年医学专家案例结构中,作为死亡原因的主要疾病是肿瘤、心血管和脑血管疾病。

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