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EVALUATION OF THE HEALTH CONDITION OF CHILDREN RESIDING IN THE CHERNOBYL ZONE IN BELARUS

During the entire period of its existence the Gomel Medical Institute has been carrying out intensive studies of the problem of radiation effects upon the human organism. The health condition of many thousands of children and adults has been investigated, the results of immunological, hematological and biochemical studies have been evaluated, the morphological and structural condition of vital organs has been examined among the individuals living in the Gomel region ind those who suddenly died of various diseases or in Gomel hospitals.

The following methodological approaches have been employed: 1. Evaluation of the medical and biological effects in response to the concentration ofradioisotopes incorporated by the organism. 2. Investigation of the pathological process clinically and by simulating it among experimental laboratory animals (the clinical and experimental approach). 3. Investigation of the structural, functional and metabolic modifications evolving in the entire organism, in individual organs and systems (the morphofunctional approach). 4. Evaluation of the severity of pathological conditions with the consideration of disorders of integrative processes in the organism. in order to combine the modifications evolving in different organs into an integral pathological process (the integrative approach).


The results allow to draw the following conclusions: The health condition of the children and adults living in the areas contaminated with radiocesium tends to deteriorate, the fact is invariably evidenced by the indicators of mortality and birth rate. A pronounced relationship has been revealed between the structures and functions of vital organs in response to the concentration of incorporated radiocesium. Injuries of the myocardium, kidneys and liver cause specific concern. The pathology of the cardiovascular system is registered in the form of functional modifications already among the preschool children aggravating as radiocesium in the organism accumulates [2,3].

Analysis of sections has indicated that the injury of the myocardium is registered in 98.6% of deaths due to various diseases. Diffusive injury of muscular cells typical for the toxic radiocesium effect is noteworthy. Dystrophic modifications of the myocardium are accompanied by pronounced radiocesium incorporation (84 sudden deaths have manifested its average accumulation 26.1 Bq/kg). Pronounced damage of kidneys is noteworthy after it has been registered in 88.8% sudden deaths as well as among the cases of deaths in Gomel hospitals. In the majority of cases this condition had not been registered during life. Damage of this organ is characterized by the disappearance of structural and functional components, primarily glomerules, manifested by a typical histological pattern. The tissues of the organ would manifest pronounced accumulation of radiocesium (36.5 Bq/kg on the average). The results of experimental injections of "pure" 137Cs solution into the organisms of laboratory animals allow to assert that the above modifications have been caused by the toxic effects of this radioisotope. Damage of kidneys is one of the main causes of accumulation of radiocesium and products of metabolism in the organism and their toxic effect upon the myocardium. Its condition governs high mortality rate among adult population. Grave pathological changes in the liver tissues are noteworthy, such as fat hepatosis and cirrhosis. This organ would accumulate 28.1 Bq/kg of radiocesium on the average.

Disorders of the immunity functions manifest themselves by the suppressed activity ofneutrophil leukocytes, IgA generation, intensified allergic responses in the organism [1]. Disorders of endocrine functions induced by radiocesium become specifically manifest during pregnancy. Accumulation of the radioisotope in the placenta alters production of a number of hormones in the mother-fetus system. It relates primarily to testosterone, estradiol, cortisone, thyroxin, triiodine thyronin.

The above modifications are accompanied by the pathologies during parturition and in the post-natal period when separation of the placenta and the afterbirth are inhibited, and by chronic fetus intrauterine hypoxy [3]. The organ of vision requires specific attention. It incorporates over 50 Bq/kg of 137Cs in the areas where contamination exceeds 15 Ci/km2, cataracts are observed in 25% of cases [3]. Considering the above facts, it can be asserted that incorporation of radiocesium induces the evolution of structural and metabolic disorders in vital organs and systems with lethal outcomes in a number of cases. These modifications can be integrated into the syndrome of incorporated long-living radioisotopes (SLLR) with the degree of its expression directly proportional to the concentration of incorporated radiocesium.

The above facts allow to conclude that radiocesium negatively influences the organisms of individuals living in the areas affected by the Chernobyl disaster, primarily through the toxic effect upon vital organs, such as the heart, liver and kidneys. Neglected assessment of their condition, with resultant inappropriate treatment, leads invariably to the death of the organism. The situation is aggravated by the effect of various attendant negative factors, such as nicotine, alcohol, hypodynamism, infectious agents. Based on the presented facts, a conclusion can be made that a comprehensive program of life support is required in order to resist the effects of long living radioactive elements and its immediate implementation.
     
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