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  • Title: EPIDEMIOLOGICAL STUDIES OF CEREBROVASCULAR DISEASE OF THE POPULATION EVACUATED FROM THE 306KM ZONE OF THE ChNPP AT THE AGE OF 18-60 YEARS. ANALYSIS OF THE INFLUENCE OF INTERNAL IONIZING RADIATION ON THE THYROID GLAND 131I.
    Author: Buzunov VO, Kapustynska OA.
    Journal: Probl Radiac Med Radiobiol; 2018 Dec; 23():96-106. PubMed ID: 30582839.
    Abstract:
    UNLABELLED: Cohort epidemiological study of cerebrovascular diseases (CVD) was conducted in population evacuated from the30-km zone of the ChNPP been adult at the time of the accident (age 18-60). Study period was 1988-2016. Reviewof the specific CVD link with internal thyroid radiation dose from 131I has been made. OBJECTIVE: Establishing the time pattern of CVD morbidity in population evacuated from the ChNPP exclusion zonebeen adult at the time of the accident, depending on age, sex, time after the accident and internal thyroid radiation dose from 131I. MATERIALS AND METHODS: Data of the State Register of Ukraine on persons who survived after the ChNPP accident(SRU). The time pattern of morbidity was studied according to the observation periods (1988-1992; 1993-1997;1998-2002; 2003-2007; 2008-2012 and 2013-2016), taking into account age, sex and thyroid radiation dose. Theresearch cohort included 42,982 people with 18,133 men and 24,849 women among them. Data on the thyroid radiation doses in the SRU are seriously limited. Personal data on the radiation dose are available only in 957 people who just were included in the especially studied cohort. Dose intervals 0-0.3, 0.31-0.75, 0.76-2.0 Gy were adopted to review the influence of radiation factor on the CVD development. The data analysis was conducted on a mixed cohort of two age groups under the emergence of radiation effects (the «early» stage, covering the first 6 years from the moment of the accident, the «remote» stage - from 1998 to 2007, the «late» stage - 2008-2016). RESULTS: Study results indicate that the post-accident period is characterized by an increase in the level of CVD. The incidence rate increase occurred in the second observation period (1993-1997), that is, 6 years after the accident, regard-less of sex and age at the time of the accident. The peak of the incidence occurs in the third and fourth periods(1998-2002 and 2003-2007) of observation. Since 2008 there is a gradual decrease in morbidity. In all periods of observation the higher levels of CVD were registered in older people, i.e. 40-60 years at the time of an accident. In the first11 post-accidental years the higher levels of CVD incidence were observed in women, but in a later period after an acci-dent (12-26 years) in men. At a dose interval of 0.31-0.75 Gy a reliable link was established between the level of CVDwith the with internal thyroid radiation dose from 131I. In other dose intervals the dose-dependent effects are unstable. CONCLUSIONS: The post-accident period was marked by a significant increase in the level of CVD morbidity in theadult evacuees from the 30-km zone of the ChNPP. The incidence rate increase occurred since the 7th till the 21styearafter the ChNPP accident with the peak of morbidity from 12th to 21st years upon the accident. In the period that covered 22-30 years a decrease in the incidence rate was established. Connection of the specific forms of CVD with internal thyroid radiation dose from 131I has been established. Provedeni kogortni epidemiologichni doslidzhennia tserebrovaskuliarnykh zakhvoriuvan' (TsVZ) u doroslogo na chasavariï naselennia (vik 18–60 rokiv), evakuĭovanogo iz 30-km zony ChAES. Period doslidzhen' – 1988–2016 rr.Zrobleno analiz zv’iazku rozvytku okremykh tserebrovaskuliarnykh khvorob (TsVKh) z dozoiu vnutrishn'ogo ionizuiucho-go oprominennia shchytopodibnoï zalozy 131I.Meta. Vstanovlennia dynamiky zakhvoriuvanosti na TsVKh doroslogo na chas avariï naselennia, evakuĭovanogo iz zo-ny vidchuzhennia ChAES zalezhno vid viku, stati, chasu pislia avariï ta dozy vnutrishn'ogo oprominennia shchytopodibnoïzalozy 131I.Materialy i metody. Dzherelom informatsiï sluzhyly dani Derzhavnogo reiestru Ukraïny osib, iaki postrazhdalyvnaslidok avariï na ChAES (DRU). Dynamiku zakhvoriuvanosti vyvchaly za periodamy sposterezhennia (1988–1992;1993–1997; 1998–2002; 2003–2007; 2008–2012 ta 2013–2016 roky) z urakhuvanniam viku, stati ta dozy op-rominennia shchytopodibnoï zalozy (ShchZ). U doslidnyts'ku kogortu uviĭshly 42 982 osib, v t. ch. 18 133 cholovikiv i24 849 zhinok. Dani pro dozy oprominennia ShchZ v DRU suttievo obmezheni. Personal'ni dani pro dozu oprominenniamaiut' lyshe 957 osib, iaki ĭ uviĭshly do spetsial'no doslidzhuvanoï kogorty. Dlia analizu vplyvu radiatsiĭnogo fak-tora na rozvytok TsVKh buly pryĭniati dozovi intervaly – 0–0,3; 0,31–0,75; 0,76–2,0 Gr. Analiz danykh provedenona zmishaniĭ kogorti po dvokh vikovykh grupakh ta za realizatsiieiu radiatsiĭnykh efektiv («ranniĭ» etap, iakyĭ okhopliuiepershi 6 rokiv z momentu avariï; «viddalenyĭ» etap – z 1998 po 2007 rr.; «pizniĭ» etap – 2008–2016 rr.).Rezul'taty doslidzhen' svidchat', shcho pisliaavariĭnyĭ period kharakteryzuiet'sia zrostanniam rivnia tserebrovasku-liarnoï patologiï. Rist zakhvoriuvanosti pochynaiet'sia z drugogo periodu (1993–1997) sposterezhennia, tobto cherez6 rokiv pislia avariï, nezalezhno vid viku na moment avariï ta stati. Piky zakhvoriuvanosti prypadaiut' na tretiĭ tachetvertyĭ periody (1998–2002 ta 2003–2007 rr.) sposterezhennia. Pochynaiuchy z 2008 roku vidbuvaiet'sia postu-pove znyzhennia zakhvoriuvanosti. V usi periody sposterezhennia vstanovleni bil'sh vysoki rivni TsVKh u osib starshoïvikovoï grupy na chas avariï, tobto 40–60 rokiv. V pershi 11 pisliaavariĭnykh rokiv vyshchi rivni tserebrovaskuliarnykhzakhvoriuvan' vidmicheni u zhinok, u bil'sh viddalenyĭ period (12–26 rokiv) pislia avariï – u cholovikiv. Pry dozo-vomu intervali 0,31–0,75 Gr vstanovlenyĭ dostovirnyĭ zv’iazok rivnia TsVKh z dozoiu vnutrishn'ogo ionizuiuchogo op-rominennia shchytopodibnoï zalozy 131I. V inshykh dozovykh intervalakh dozozalezhni efekty nestiĭki.Vysnovky. Pisliaavariĭnyĭ period oznamenuvavsia suttievym zrostanniam rivnia TsVZ u doroslogo evakuĭovanogo z30-km zony ChAES naselennia. Rist zakhvoriuvanosti vstanovleno z 7-go do 21-go roku pislia avariï na ChAES, z pikomv period z 12-go do 21-go roku. U period, iakyĭ okhopyv 22–30 rokiv, vstanovleno znyzhennia rivnia zakhvoriuvanosti.Vyznacheno zv’iazok okremykh form TsVKh z dozoiu oprominennia shchytopodibnoï zalozy 131I.
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