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Title: THE DEVELOPMENT OF HYPERTENSION DISEASE AND ISCHEMIC HEART DISEASE IN EMERGENCY WORKERS OF THE CHORNOBYL ACCIDENT AND INFLUENCE ON IT CONDITIONS OF BEING UNDER RADIATION.
Author: Belyi D, Nastina O, Sydorenko G, Kursina N, Bazyka O, Gabulavichene Z, Kovaliov O.
Journal: Probl Radiac Med Radiobiol; 2019 Dec; 24():350-366. PubMed ID: 31841479.
Abstract:
UNLABELLED: The objective of this investigation is to determine features of hypertensive heart disease (HHD) and coronary heart disease (CHD) development in emergency workers (EW) of Chornobyl Nuclear Power Plant (ChNPP) in dependence on gender, occupation, duration of stay under radiation and the nature of performed job. MATERIALS AND METHODS: During the period from 2012 to 2018, 483 male EW (EW-m) and 134 female EW (EW-f), who worked in the accident zone over 1986-1987, were examined. All EW of both gender at the time of emergency works had no signs of cardiac pathology. The diagnosis of cardiovascular disease was established in accordance with the diagnostic standards adopted in Ukraine [2964], on the basis of clinical and laboratory examination. RESULTS: EW could be divided into the following categories according to their occupational membership and nature of performed job: (1) ChNPP staff, (2) persons engaged in construction works (builders), (3) drivers, (4) engineers and technicians, (5) Soviet Army (SA) personnel, policemen and firemen served in Ministry of Internal Affairs (MIA), officers of Interior Troops (IT), (6) low skilled laborers (LSL), (7) medical staff (doctors, nurses, paramedics) and (8) service staff. Among all examined men and women who took part in emergency work, the overwhelming majority stood in the accident area from the end of April to the end of December 1986: 440 men and 111 women. Others were involved to work during 1987. Most men and women worked on liquidation of the accident from April 26, 1986 to the end of May (349 and 71 persons respectively), with the proportion of men was significantly higher. In the rest months of 1986 and the beginning of 1987, on the contrary, the relative number of women involved in the accident exceeded the proportion of men.The EW-m of all occupations were in the risk zone of the cardiovascular diseases, and the HHD development truly correlated with service in MIA, SA and IT, CHD development with profession of engi- neer and technician, and builder as well, and MI development with driver job. The risk of HHD development during the first 10 years after the accident was 4.6 times higher among officers of MIA, SA and IT who had non-shift work in Prypiat and/or at the ChNPP comparing with persons of other occupations and working conditions. The risk of CHD development during the first 15 years was 8.2 times higher in the engineers and technicians who worked in the 30-km zone, compared with other EW and risk of MI throughout the observation period was 6.4 times higher in the drivers, who had shift work in a 30-km zone. In EW-f the risk of HHD developing during the first 10 years after the accident was 2.1 times lower than those who worked in the service sector (kitchen, trade, economists and account- ants, communications, etc.) compared with the representatives of any other profession, and the risk of CHD devel- oping during the first 15 years after the accident was higher in medical staff and EW of other occupational cate- gories that had shift work. Women who worked with shifts had a 4.8-fold higher risk of MI developing than those who had limited terms of work with the subsequent withdrawal from the accident area. CONCLUSIONS: For more accurately assess the radiation effects on the cardiovascular system of persons who took part in the emergency works at the ChNPP, it should not be limited by comparing the effects of unexposed populations, but to take into account the EW professional affiliation, the terms of stay in the accident area and the nature of performed work. Meta doslidzhennia poliagala u vyznachenni osoblyvostey̆ rozvytku gipertonichnoï khvoroby (GKh) ta ishemichnoï khvo- roby sertsia (IKhS) v uchasnykiv likvidatsiï naslidkiv avariï (ULNA) na ChAES zalezhno vid stati, profesiy̆noï nalezh- nosti, strokiv perebuvannia pid diieiu radiatsiï ta kharakteru robit, shcho vykonuvalys'.Materialy ta metody. Za period z 2012 po 2018 rr. obstezheno 483 cholovikiv-ULNA (ULNA-ch) ta 134 zhinok ULNA (ULNA-zh), iaki pratsiuvaly v zoni avariï v 1986–1987 rr. Vsi ULNA, cholovichoï ta zhinochoï stati, na moment uchasti v avariy̆nykh robotakh ne maly oznak kardial'noï patologiï. Diagnoz sertsevo-sudynnogo zakhvoriuvannia (SSZ) vsta- novliuvaly u vidpovidnosti do standartiv diagnostyky, pryy̆niatykh v Ukraïni na osnovi kliniko-laboratornogo obs- tezhennia.Rezul'taty. Za profesiy̆noiu nalezhnistiu ta kharakterom vykonuvanykh robit vsi ULNA buly rozpodileni na nas- tupni kategoriï: (1) operatyvnyy̆ personal ChAES, (2) osoby, zay̆niati na budivel'nykh robotakh (budivel'nyky), (3) vodiï, (4) inzhenerno-tekhnichni robitnyky (ITR), (5) sluzhbovtsi ministerstva vnutrishnikh sprav (MVS), vkliuchaiuchy pozhezhnykiv, vnutrishnikh viy̆s'k (VV), radians'koï armiï (RA), (6) robitnyky nyz'kokvalifikovanoï pratsi (NKP), (7) medychnyy̆ personal (likari, medychni sestry, fel'dshery) i (8) obslugovuiuchyy̆ personal. Iz chysla vsikh obstezhe- nykh cholovikiv i zhinok, iaki braly uchast' v likvidatsiï naslidkiv avariï (LNA), perevazhna bil'shist' pratsiuvala v zo- ni avariï z kintsia kvitnia po kinets' grudnia 1986 roku: 440 cholovikiv i 111 zhinok. Inshi braly uchast' v LNA u 1987 r. Bil'shist' cholovikiv ta zhinok pratsiuvala na avariy̆nykh robotakh z 26 kvitnia 1986 roku po kinets' travnia (349 ta 71 osoba vidpovidno), prychomu chastka cholovikiv bula virogidno bil'shoiu. V inshi misiatsi 1986 roku ta pochynaiuchy z 1987 roku, navpaky, vidnosne chyslo zhinok, zaluchenykh do LNA, perebil'shuvalo chastku cholovikiv. Choloviky-ULNA vsikh profesiy̆ perebuvaly v zoni ryzyku rozvytku SSZ, prychomu dostovirnyy̆ zv’iazok z GKh vidznacheno u sluzh- bovtsiv sylovykh struktur, z IKhS – u ITR i budivel'nykiv, a z infarktom miokarda – u vodiïv. Ryzyk rozvytku GKh v pershi 10 rokiv pislia avariï buv u 4,6 raza vyshche u sluzhbovtsiv MVS, VV i RA, iaki pratsiuvaly v m. Pryp’iat' i/abo na ChAES zvychay̆nym (nevakhtovym) metodom porivniano z osobamy inshykh profesiy̆ ta umov pratsi. Ryzyk rozvytku IKhS v pershi 15 rokiv buv vyshchym u 8,2 raza v ITR, iaki pratsiuvaly v 30-km zoni, porivniano z inshymy ULNA, a infarktu miokarda – vprodovzh vs'ogo periodu sposterezhennia v 6,4 raza vyshche u vodiïv-ULNA, iaki pratsiuvaly v 30-km zoni vakhtovym metodom. U zhinok-ULNA ryzyk rozvytku GKh v pershi 10 rokiv pislia avariï buv v 2,1 raza nyzhchym u tykh, khto pratsiuvav u sferi obslugovuvannia (pratsivnyky kukhni, torgivli, ekonomisty i bukhgaltery, zv’iazkivtsi toshcho) porivniano z predstavnytsiamy bud'-iakoï inshoï profesiï, a IKhS v pershi 15 rokiv pislia avariï – vyshchyy̆ u likariv i medychnykh sester ta ULNA inshykh profesiy̆nykh kategoriy̆, iaki pratsiuvaly vakhtovym metodom. Zhinky, iaki pratsiuva- ly vakhtovym metodom maly v 4,8 raza vyshchyy̆ ryzyk rozvytku infartu miokarda, nizh ti, khto pratsiuvav protiagom pevnogo terminu z nastupnym vyvedenniam iz zony avariï.Vysnovky. Dlia bil'sh tochnoï otsinky radiatsiy̆nogo vplyvu na sertsevo-sudynnu systemu osib, iaki braly uchast' v LNA na ChAES, slid ne obmezhuvatysia til'ky porivnianniam efektiv z neoprominenym naselenniam, ale braty do uva- gy profesiy̆nu nalezhnist' ULNA, terminy perebuvannia v zoni avariï i kharakter pratsi.

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