Health Effects in Those With Acute Radiation Sickness From the Chernobyl Accident

Abstract

The Chernobyl accident resulted in almost one-third of the reported cases of acute radiation sickness (ARS) reported worldwide. Cases occurred among the plant employees and first responders but not among the evacuated populations or general population. The diagnosis of ARS was initially considered for 237 persons based on symptoms of nausea, vomiting, and diarrhea. Ultimately, the diagnosis of ARS was confirmed in 134 persons. There were 28 short term deaths of which 95% occurred at whole body doses in excess of 6.5 Gy. Underlying bone marrow failure was the main contributor to all deaths during the first 2 mo. Allogenic bone marrow transplantation was performed on 13 patients and an additional six received human fetal liver cells. All of these patients died except one individual who later was discovered to have recovered his own marrow and rejected the transplant. Two or three patients were felt to have died as a result of transplant complications. Skin doses exceeded bone marrow doses by a factor of 10-30, and at least 19 of the deaths were felt to be primarily due to infection from large area beta burns. Internal contamination was of relatively minor importance in treatment. By the end of 2001, an additional 14 ARS survivors died from various causes. Long term treatment has included therapy for beta burn fibrosis and skin atrophy as well as for cataracts.

Individual whole-body concentration of 137Cesium is associated with decreased blood counts in children in the Chernobyl-contaminated areas, Ukraine, 2008–2010

“…Although the acute detrimental effects of high-dose radiation on the hematopoietic system are well known, both from Chernobyl (13), and other radiation accidents (14), there is little information on long-term low dose radiation effects on the hematopoietic system. The Techa river incident, a plutonium processing facility established in 1948 with radioactive waste leakage into the river, caused decreased levels of thrombocytes, erythrocytes and hemoglobin, in addition to a range of other symptoms which together were labeled "chronic radiation syndrome" (15,16).…”

Development and Evaluation of Therapeutics in the Setting of Radiation Injury

“…Symptoms of moderate Hem-ARS is due to exposure to levels of ionizing radiation greater than 1-2 Gray, and manifests as bone marrow damage (Figure 1-3) [3]. Severe Hem-ARS is seen at ionizing radiation doses from 4 Gy [2,4]. It is estimated that without supportive care (antibiotics and transfusions), a radiation dose of approximately 3.5-4.5 Gy will result in death of 50% of persons exposed within 60 days (LD 50/60 ) [3,5,6].…”

“…Symptoms of moderate Hem-ARS is due to exposure to levels of ionizing radiation around 3-4 Gray. Severe Hem-ARS is seen at ionizing radiation doses from 4 Gy [2,4]. While ARS can affect many organ systems (e.g., dermal, cardiovascular), acute lethality generally results from destruction of the hematopoietic system ("Hem-ARS") or related complications (e.g.…”

“…27 of the 31 patients that received BMT died. The four survivors rejected the transplant and spontaneously repopulated with their own stem cells [1,4]. Furthermore, bone marrow transplants would not be practical after a large scale disaster involving large numbers of patients requiring treatment.…”

“…Surgery was carried out as described previously [3,4] with modifications. All surgical procedures were carried out aseptically.…”