ObjectiveTo investigate childhood cardiac arrhythmia and chronic exposure to caesium-137 (137Cs) resulting from the Chernobyl accident.DesignProspective cross-sectional study using exposed/unexposed design conducted in the Bryansk region from May 2009 to May 2013 on children selected on the basis of 137Cs soil deposition: control territories ([137Cs]<37 kBq per square metre, where children were considered as unexposed) and contaminated territories ([137Cs]>555 kBq per square metre, where children were considered as exposed).SettingRussian territories affected by the Chernobyl fallout (Bryansk region).ParticipantsThis cross-sectional study included 18 152 children aged 2–18 years and living in the Bryansk region (Russia).Main outcome measuresAll children received three medical examinations (ECG, echocardiography and 137Cs whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests.ResultsCardiac arrhythmia was diagnosed in 1172 children living in contaminated territories and 1354 children living in control territories. The crude prevalence estimated to 13.3% in contaminated territories was significantly lower than in control territories with 15.2% over the period 2009–2013 (P<0.001). Considering 137Cs whole-body burden as exposure, cardiac arrhythmia was found in 449 contaminated children and 2077 uncontaminated children, corresponding to an estimated crude prevalence of 14.5% and 14.2%, respectively, which does not differ significantly (P=0.74). Also, we investigated the association between territory, exposure to 137Cs and cardiac arrhythmia: the adjusted OR was not significant (0.90 with 95% CI 0.81 to 1.00; P=0.06) for the territory. For 137Cs whole-body burden, the ORs close to 1 did not reach statistical significance (P for trend=0.97).ConclusionThis study does not observe an association between cardiac arrhythmia and 137Cs deposition levels in the Bryansk region exposed to Chernobyl fallout. The suspected increase of cardiac arrhythmia in children exposed to Chernobyl fallout is not confirmed.

Thyroid exposure to radioactive iodine is one of the most dangerous consequences of the notorious accident at the Chemobyl Nuclear Power Station in 1986, because iodine radionuclides were dominant components of the radioactive trail.Although the total dose of external gamma-radiation created by these radionuclides was relatively low, local exposure of thyroid was very significant, particularly in children. It should also be noted that most districts of 13ryansk region exposed to the radioactive trail are foci of endemic goiter caused by iodine deficiency of various origin [8, 9].Ultrasonic scanning provides new methods of thyroid volume evaluation [15], which should replace routine palpation, because palpation gives erroneous results in almost 30% of children [3].Ultrasonic assessment of thyroid size and measurements of iodine content in urine are presently the most effective methods of diagnosis of iodine deficiency [2].Various methods of ultrasonic scanning of thyroid volume in normal and pathological states are presently used in clinical practice. Therefore, the results on thyroid pathology published in the literature are difficult to compare.The goal of this work was to determine the capacity of ultrasonic scanning for testing the state of endemic goiter in children of the Bryansk region exposed to the radioactive trail ofthe Chernobyl Nuclear Power Station accident. Materials and MethodsStatistical results on thyroid disease incidence in children in areas with different level of contamination with 131I [1] were used. Experiments were performed in the town of Novozybkov (reconstructed specific activity of 1311 on May 10, 1986 was 55.97 Ci/krn2), Navlya settlement (2.09 Ci/kmZ), and the town of Karachev (1.53 Ci/km2). Children were divided into two age groups: 1) 10-12 years (0-2 years at the time of the Chernobyl accident); 2) 13-15 years (3-5 years, respectively).Medison model Eurica SA-600 ultrasonic scanners with high-frequency (7.5 MHz) linear probes were used to study the structure and volume of the thyroid gland [7, 11].Iodine concentration in urine was measured by the cerium-arsenite method with preliminary wet ashing. Iodine content was expressed in ~g per 100 ml urine (lag %). The results of the study were statistically processed using standard epidemiological criteria of severity of iodine deficiency (Indicators from Assessing Iodine Deficiency Disorders and Their Control Programmes. Report of Joint WHO/UNISEF Consultations, November 3-5, 1992. Revised version. September 1993 WHO/NUT/93.1). Normal level of iodine excretion is 10-20 i.tg %. Iodine content in urine of patients with slight iodine deficiency is 5-10 lag %; medium iodine deficiency, 2-5 I~g %; and severe iodine deficiency, less than 2 i.tg %.If the thyroid volume increase was more than 97 percentile in 5-20%, 20-30%, or more than 30%, the extent of iodine deficiency was considered as light, medium, or severe, respectively. Results and DiscussionAccording to urine tests, in children of the town of Novozybkov and Navlya settlement aged 10-...

The level of iodine consumption of the population living at a territory contaminated by the Chernobyl accident is evaluated for the Bryansk region (more than 30,000 km2). Analysis of iodine concentrations in the urine, carried out in 6750 children and adolescents from 125 settlements indicates that the level of iodine supply at the studied territory varies from normal to medium low iodine insufficiency. Age and sex did not affect renal excretion of iodine. An algorithm is suggested for detailed assessment of iodine consumption at large territories.