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  • Title: AGING OF THE CHORNOBYL CATASTROPHE SURVIVORS AND PROBLEMS OF THEIR MENTAL HEALTH SURVEY.
    Author: Gunko N, Loganovsky K, Buzunov V, Korotkova N.
    Journal: Probl Radiac Med Radiobiol; 2021 Dec; 26():162-187. PubMed ID: 34965547.
    Abstract:
    BACKGROUND: Depopulation processes in Ukraine have been affected by the Chornobyl catastrophe (ChC), but therate of demographic aging of survivors remains uncertain. Although the mental health disorders of the survivors arerecognized internationally, problems of their research remain unresolved. Thus, these areas of research are relevant.Objective is to determine the rate of demographic aging of survivors of the Chornobyl NPP (ChNPP) accident and toanalyze the state of their mental health survey, outlining solutions. MATERIALS AND METHODS: Information and statistical sources for 1986-2019 of the Ministry of Health of Ukraine andthe State Statistics Service of Ukraine on the age of the ChC survivors are used. The results of previous own researchand other scientists using the data of the Clinical and Epidemiological Register (CER) of the State Institution«National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine»(NRCRM), the State Register of ChC survivors (SRU), and the Department of Radiation Psychoneurology, Institute ofClinical Radiology, NRCRM are integrated. Theoretical, general scientific, demographic and mathematical-statisticalresearch methods and documentary analysis are used. RESULTS: It is shown that in 2018, compared to 1995, the number of the ChC survivors, who are under the supervi-sion of the Ministry of Health of Ukraine, decreased by almost 987 thousand. The part of people born from personsof the 1st-3rd accounting groups increased in the structure of survivors (from 13.1 % in 1995 to 13.6 %), and thisdecreased in persons living or lived in the territories subject to supervision (75.1 % and 63.1 %, respectively), butin evacuees and Chornobyl clean-up workers (liquidators) this did not change significantly. A high level of aging ofthe ChC survivors (except for the 4th group) is revealed: liquidators - 59.0 %; evacuees - 25.0 %, and residents ofradioactively contaminated territories (RCT) - 30.7 %. It has been proved that the countries of RCT differ signifi-cantly in the number of the ChC survivors and their structure. The increase in the post-accident period indicators ofthe level of aging and the average age of the RCT population indicates negative changes in age parameters and theneed to continue research to identify factors «responsible» for such changes. Long-term mental health disordersand neuropsychiatric effects in the ChC survivors have been identified - an excess of cerebrovascular pathology andneurocognitive deficits, especially in liquidators, which may indicate an accelerated aging. Radiation risks havebeen revealed for acute and chronic cerebrovascular pathology and organic mental disorders of non-psychotic andpsychotic levels. Neurophysiological and molecular-biological atypia of aging processes under an exposure to lowdoses of and low dose rate of ionizing radiation have been found. The psyche under the age of 40 years old at thetime of exposure is more vulnerable. Existing statistical and registry data underestimate the level of mental disor-ders in the population of Ukraine, including the ChC survivors by an order of magnitude. CONCLUSIONS: The ChC survivors are aging in the country. The negative tendencies in age parameters of survival indi-cate the need to continue research to identify the factors «responsible» for such changes. Mental health disordersand neuropsychiatric effects in the ChC survivors are underestimated. It is necessary to create a national psychiatricregistry of Ukraine and long-term (lifelong) monitoring of survivors with well-planned clinical and epidemiologicalstudies of general and mental health with reliable dosimetric support based on national registries using the latest information technologies. Peredumovy. Na depopuliatsiĭni protsesy v Ukraïni vplynula Chornobyl's'ka katastrofa (ChK), ale shvydkist'demografichnogo starinnia postrazhdalykh zalyshaiet'sia nevyznachenoiu. Khocha porushennia psykhichnogo zdorov’iapostrazhdalykh vyznani na mizhnarodnomu rivni, problemy ïkh doslidzhennia zalyshaiut'sia nevyrishenymy. Takymchynom, zaznacheni napriamky doslidzhennia ie aktual'nymy. Meta. Vyznachyty shvydkist' demografichnogo starinnia postrazhdalykh vnaslidok avariï na Chornobyl's'kiĭ AES(ChAES) ta proanalizuvaty stan doslidzhennia ïkhn'ogo psykhichnogo zdorov’ia z okreslenniam shliakhiv vyrishennia.Ob’iekt ta metody doslidzhennia. Informatsiĭno-statystychni dzherela za 1986–2019 rr. Ministerstva okhoronyzdorov’ia Ukraïny ta Derzhavnoï sluzhby statystyky Ukraïny shchodo vikovogo skladu postrazhdalykh vnaslidok ChKosib. Uzagal'nennia rezul'tativ poperednikh vlasnykh doslidzhen' ta inshykh naukovtsiv iz vykorystanniam danykhKliniko-epidemiologichnogo reiestru (KER) Derzhavnoï ustanovy «Natsional'nyĭ naukovyĭ tsentr radiatsiĭnoï me-dytsyny Natsional'noï akademiï medychnykh nauk Ukraïny» (NNTsRM), Derzhavnogo reiestru Ukraïny osib, iaki post-razhdaly vnaslidok Chornobyl's'koï katastrofy (DRU) ta viddilu radiatsiĭnoï psykhonevrologiï Instytutuklinichnoï radiologiï NNTsRM. Vykorystano teoretychni, zagal'nonaukovi, demografichni ta matematyko-statys-tychni metody doslidzhennia ta dokumentarnyĭ analiz. Rezul'taty. Pokazano, shcho u 2018 r. porivniano z 1995 r. chysel'nist' postrazhdalykh vnaslidok ChK osib, iaki perebu-vaiut' pid sposterezhenniam ustanov MOZ Ukraïny, zmenshylasia maĭzhe na 987 tys. U strukturi postrazhdalykh zbil'-shylasia chastka osib, iaki narodylysia vid osib 1–3-ï grup obliku (z 13,1 % u 1995 r. do 13,6 %), zmenshylasia – osib,iaki prozhyvaiut' abo prozhyvaly na terytoriiakh, shcho pidliagaiut' nagliadu (vidpovidno, 75,1% ta 63,1 %), ta suttievo nezminylasia – evakuĭovanykh ta uchasnykiv likvidatsiï naslidkiv avariï na ChAES (ULNA). Vyiavleno vysokyĭ riven' po-starinnia postrazhdalykh vnaslidok ChK osib (za vyniatkom 4-ï grupy): ULNA – 59,0 %; evakuĭovani – 25,0 %, zhytelivradioaktyvno zabrudnenykh terytoriĭ (RZT) – 30,7 %. Dovedeno, shcho RZT kraïny znachno rizniat'sia iak za kil'kistiupostrazhdalykh vnaslidok ChK, tak i ïkh strukturoiu. Zbil'shennia u pisliaavariĭnyĭ period pokaznykiv rivnia postarinniata seredn'ogo viku naselennia na RZT svidchyt' pro negatyvni zrushennia u vikovykh parametrakh dozhyttia ĭ neobkhidnist'provedennia doslidzhen' dlia vyiavlennia faktoriv, «vidpovidal'nykh» za taki zrushennia. Vyiavleno dovgostrokovi po-rushennia psykhichnogo zdorov’ia i neĭropsykhiatrychni efekty u postrazhdalykh vnaslidok ChK – ekstses tserebrovaskuliar-noï patologiï i neĭrokognityvnogo defitsytu, osoblyvo v ULNA, shcho mozhe vkazuvaty na pryskorene starinnia. Dliagostroï i khronichnoï tserebrovaskuliarnoï patologiï ta organichnykh psykhichnykh rozladiv nepsykhotychnogo i psykhotychno-go rivniv vyznacheni radiatsiĭni ryzyky. Vyiavlena neĭrofiziologichna ta molekuliarno-biologichna atypiia protsesivstarinnia za diieiu malykh doz ionizuiuchoï radiatsiï i nyz'kykh rivniv oprominennia. Psykhika u vitsi molodshe za 40 rokivna moment ekspozytsiï bil'sh vrazlyva. Isnuiuchi statystychni i reiestrovi dani nedootsiniuiut' riven' psykhichnykh poru-shen' v populiatsiï Ukraïny, u tomu chysli v postrazhdalykh vnaslidok ChK, na poriadok.Vysnovky. U kraïni vidbuvaiet'sia postarinnia postrazhdalykh vnaslidok Chornobyl's'koï katastrofy. Negatyvnizrushennia u vikovykh parametrakh dozhyttia svidchat' pro neobkhidnist' prodovzhennia doslidzhen' dlia vyiavlenniafaktoriv, «vidpovidal'nykh» za taki zrushennia. Porushennia psykhichnogo zdorov’ia i neĭropsykhiatrychni efekty upostrazhdalykh vnaslidok ChK nedootsiniuiut'sia. Potribni stvorennia natsional'nogo psykhiatrychnogo reiestruUkraïny ta dovgostrokovyĭ (dovichnyĭ) monitoryng postrazhdalykh z dobre splanovanymy kliniko-epidemiolo-gichnymy doslidzhenniamy zagal'nogo i psykhichnogo zdorov’ia z nadiĭnym dozymetrychnym suprovodom na bazinatsional'nykh reiestriv z vykorystanniam naĭsuchasnishykh informatsiĭnykh tekhnologiĭ.
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