Somatic symptoms in women 11 years after the Chornobyl accident: prevalence and risk factors.

Exposure to the Chornobyl nuclear power plant explosion resulted in widespread, persistent somatic complaints, but little is known about the nature and risk factors for these conditions. This study compares the health reports of 300 women evacuated to Kyiv from the contamination zone around the plant and 300 controls with a child in the same homeroom as the evacuees in 1997. The interview addressed somatic concerns, risk factors for poor health, and Chornobyl-related stress. Compared with controls, evacuees reported significantly more health problems and rated their health more poorly overall. These differences remained significant after controlling for demographic and clinical risk factors, including the tendency to amplify physical symptoms. Significantly more evacuees received a diagnosis of a Chornobyl-related illness by a local physician, believed that their health and their children's health had been adversely affected, and were positive for Chornobyl-induced post-traumatic stress disorder. After controlling for these Chornobyl stress variables, the differences in number of health problems commonly attributed to Chornobyl remained significant but differences in general health ratings did not. The perceptions of controls were similar to those of women in a national sample. The relationship between Chornobyl stress and illness was twice as strong in evacuees (odds ratio = 6.95) as in Kyiv controls (odds ratio = 3.34) and weakest in the national sample (odds ratio = 1.64). The results confirm the persistence and nonspecificity of the subjective medical consequences of Chornobyl and are consistent with the hypothesis that traumatic events exert their greatest negative impacts on health in vulnerable or disadvantaged groups.