Lessons from Chernobyl: the event, the aftermath fallout: radioactive, political, social.

The accident at the Chernobyl nuclear power station on April 26, 1986, released about 300 MCi of radioactive substances, including about 40 MCi of 131I and 100 MCi of short-lived radioiodines. In the immediate surroundings there were 143 cases of acute radiation syndrome, 34 deaths, and hundreds of thousands of people displaced from their homes, many permanently. The social and psychologic stresses that followed have been enormous and long-lasting. This article focuses on the rising incidence of thyroid cancer in exposed children. Radiation-induced thyroid cancer following external radiation is well documented but there is little evidence in humans of thyroid cancer from internal radiation and the risk coefficient for radioiodine exposure is known. To achieve this, thyroid dose reconstruction and prospective follow-up of about 50,000 persons who were children in 1986 will be required. Thyroid cancer in children of southern Belarus began to increase in 1990 and there now are about 1,000 cases in Belarus and northern Ukraine. These aggressively growing tumors, almost all variants of papillary thyroid cancer, are typical for thyroid cancer in children not exposed to radiation, and a low mortality rate is to be expected. It also is expected, however, that malignant as well as benign thyroid neoplasms will continue to arise in these exposed children well into their adult life.