Problems of Radiation Medicine and Radiobiology

N. Gunko, K. Loganovsky, V. Buzunov, N. Korotkova

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine

AGING OF THE CHORNOBYL CATASTROPHE SURVIVORS AND PROBLEMS OF THEIR MENTAL HEALTH SURVEY

Background. Depopulation processes in Ukraine have been affected by the Chornobyl catastrophe (ChC), but the rate of demographic aging of survivors remains uncertain. Although the mental health disorders of the survivors are recognized 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 to analyze 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 and the State Statistics Service of Ukraine on the age of the ChC survivors are used. The results of previous own research and 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 of Clinical Radiology, NRCRM are integrated. Theoretical, general scientific, demographic and mathematical-statistical research 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 supervision of the Ministry of Health of Ukraine, decreased by almost 987 thousand. The part of people born from persons of the 1^st–3^rd accounting groups increased in the structure of survivors (from 13.1 % in 1995 to 13.6 %), and this decreased in persons living or lived in the territories subject to supervision (75.1 % and 63.1 %, respectively), but in evacuees and Chornobyl clean-up workers (liquidators) this did not change significantly. A high level of aging of the ChC survivors (except for the 4th group) is revealed: liquidators – 59.0 %; evacuees – 25.0 %, and residents of radioactively contaminated territories (RCT) – 30.7 %. It has been proved that the countries of RCT differ significantly in the number of the ChC survivors and their structure. The increase in the post-accident period indicators of the level of aging and the average age of the RCT population indicates negative changes in age parameters and the need to continue research to identify factors «responsible» for such changes. Long-term mental health disorders and neuropsychiatric effects in the ChC survivors have been identified – an excess of cerebrovascular pathology and neurocognitive deficits, especially in liquidators, which may indicate an accelerated aging. Radiation risks have been revealed for acute and chronic cerebrovascular pathology and organic mental disorders of non-psychotic and psychotic levels. Neurophysiological and molecular-biological atypia of aging processes under an exposure to low doses of and low dose rate of ionizing radiation have been found. The psyche under the age of 40 years old at the time of exposure is more vulnerable. Existing statistical and registry data underestimate the level of mental disorders 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 indicate the need to continue research to identify the factors «responsible» for such changes. Mental health disorders and neuropsychiatric effects in the ChC survivors are underestimated. It is necessary to create a national psychiatric registry of Ukraine and long-term (lifelong) monitoring of survivors with well-planned clinical and epidemiological studies of general and mental health with reliable dosimetric support based on national registries using the latest information technologies.
Key words: Chornobyl catastrophe survivors, demographic aging, mental health, registers.

Problems of Radiation Medicine and Radiobiology.
2021;26:162-187. doi: 10.33145/2304-8336-2021-26-162-187

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