Objective: To determine postaccident changes in health status of the Chornobyl cleanup workers 1986 1987, pecu liarities of nontumor incidence.
Materials and methods: Long term cohort epidemiological study (period of observation 1988-2012) has been con ducted using data of the State Registry of Ukraine of Persons Affected by the Chornobyl Accident. Study cohort - 196,423 males participants of the Chornobyl recovery operations in 1986-1987. Epidemiological and mathematical and statistical methods were used.
Results: We have found a dramatic deterioration of the Chornobyl cleanup workers' health due to the growth of wide range of nontumor diseases, especially circulatory, digestive, respiratory, endocrine, genitourinary and nervous sys tem diseases. In postaccident period, disability and mortality have increased significantly due to nontumor dis eases. Circulatory diseases make major contribution to the structure of causes of disability and death. When study ing the dynamics of nontumor incidence, we have found that in 1988-1992 the highest, throughout postaccident period, rate of mental and behavioral disorders, diseases of the nervous system was mainly due to disorders of the autonomic nervous system. Since 1993-1997, rate of this pathology has significantly reduced and remained stable in subsequent years of observation. Thus, we can assume that in the early postaccident period, stress factor in com bination with radiation one had the greatest impact on health of cleanup workers, resulting in the development of other nontumor diseases in the remote postaccident period.
Conclusions: The study revealed an evident increase in nontumor incidence, disability and mortality from nontumor diseases among Chornobyl cleanup workers 1986-1987; the highest rate of nontumor incidence was observed 12-21 years after the Chornobyl accident.
Meta. Vyznachyty pisliaavariyni zminy stanu zdorov’ia uchasnykiv likvidatsiI naslidkiv avariI na ChAES 1986–1987 rr., osoblyvosti rozvytku nepukhlynnoI zakhvoriuvanosti.Materialy i metody. Provedeno dovgostrokove kogortne epidemiologichne doslidzhennia (period sposterezhennia 1988 2012 rr.) za danymy Derzhavnogo reiestru UkraIny osib, iaki postrazhdaly vnaslidok Chornobyl's'koI katast rofy. Kogorta doslidzhennia – 196 423 osib cholovichoI stati, iaki braly uchast' u likvidatsiI naslidkiv avariI na ChAES v 1986–1987 rr. Dlia doslidzhennia zastosovano epidemiologichni ta matematyko statystychni metody. Rezul'taty. Vstanovleno znachne pogirshennia stanu zdorov’ia uchasnykiv likvidatsiI naslidkiv avariI na ChAES (ULNA), shcho obumovleno rostom shyrokogo spektru nepukhlynnykh zakhvoriuvan', nasampered khvorob systemy kro voobigu, organiv travlennia, dykhannia, nervovoI, endokrynnoI, sechostatevoI system. U pisliaavariynomu periodi suttievo zbil'shylys' rivni invalidnosti y smertnosti vnaslidok nepukhlynnykh khvorob. Osnovna chastka u strukturi prychyn invalidnosti i smerti nalezhyt' khvorobam systemy krovoobigu. Pry doslidzhenni dynamiky nepukhlynnoI zakhvoriuvanosti vstanovleno, shcho na etapi 1988–1992 rr. sposterigaiet'sia nayvyshchyy za ves' pisliaavariynyy period riven' psykhichnykh rozladiv, rozladiv povedinky i khvorob nervovoI systemy, v osnovnomu za rakhunok zbil' shennia rozladiv vegetatyvnoI nervovoI systemy. Pochynaiuchy z etapu 1993–1997 rr., riven' zaznachenoI patologiI suttievo znyzhuiet'sia i zalyshaiet'sia stabil'nym u nastupni roky sposterezhennia. Takym chynom, mozhna prypustyty, shcho u rann'omu pisliaavariynomu periodi naybil'shyy vplyv na stan zdorov’ia ULNA chynyv faktor stresu v komp leksi z radiatsiynym chynnykom. Rezul'tatom kompleksnoI diI tsykh faktoriv mozhna vvazhaty manifestatsiiu inshykh nepukhlynnykh khvorob u viddalenomu pisliaavariynomu periodi.Vysnovky. Za rezul'tatamy doslidzhennia vstanovleno pevne zrostannia rivnia nepukhlynnoI zakhvoriuvanosti, invalidnosti, smertnosti vnaslidok nepukhlynnoI patologiI v ULNA 1986–1987 rr.; maksymal'nyy riven' nepukh lynnoI zakhvoriuvanosti vyiavleno cherez 12–21 rik pislia avariI na ChAES.
Keywords: Chornobyl cleanup workers; Chornobyl disaster; incidence; nontumor diseases.
V. O. Buzunov, Yu. S. Voychulene, T. Ye. Domashevska, T. P. Khabarova, G. I. Kartushin.