Ischemic heart disease in the evacuated adult population as a cause of health loss in the long term after the Chernobyl accident. Results of epidemiological studies 1988-2016

O.A.  Kapustynska

doi:10.26641/2307-0404.2022.4.271241

Authors

O.A. Kapustynska SI "National Research Center of Radiation Medicine of the National Academy of Medical Sciences of Ukraine", Yu. Illienko str., 53, Kyiv, 04050, Ukraine https://orcid.org/0000-0001-9397-475X

DOI:

https://doi.org/10.26641/2307-0404.2022.4.271241

Keywords:

Chernobyl accident, adult evacuated population, morbidity, disability, mortality, coronary heart disease

Abstract

Ischemic heart disease (CHD) is one of the most common diseases of the circulatory system, which is the main cause of death in Ukraine. The purpose of this study was to analyze the incidence, disability, mortality from ischemic heart disease, its individual nosological forms in the adult population evacuated from the 30 km zone of the Chernobyl nuclear power plant in the post-accident period, taking into account the age at the date of the accident, sex and time after the accident for further improving the system of dispensary observation evacuees and reducing the risk of cardiovascular complications. The study used epidemiological surveillance data (1988-2016) for the category of the adult evacuated population (18-60 years old as of the date of the accident) with a population of 42 982 people, of which 58.7% are women according to the data of the State Register of Ukraine of persons injured in as a result of the Chernobyl disaster (GRU). The research results were assessed both in general for ischemic heart disease and the main nosological forms according to ICD-9 and ICD-10. In the study, epidemiological, analytical, mathematical and statistical methods were used, as well as the method of internal comparison (with indicators of 1988-1992). As the results of the study have shown, in the structure of the causes of morbidity, disability and mortality of the adult evacuated population from diseases of the circulatory system, IHD takes a leading place. The statistically significant influence of age, calendar observation period, gender was established. Among nosological forms, chronic CHD is in the lead. Evacuees at the age of 18–39 years show an increase in the incidence of coronary artery disease with a maximum rate after 17 years, and at the age of 40-60 years – at the beginning of the observation with a subsequent noticeable decrease since 2003. In recent years (2013-2016), there has been a significant decrease in the incidence of coronary artery disease at the age of 40-60 years by 9.3 times, and at the age of 18-39 years, on the contrary, an increase by 3.8 times. During the post-accident period, the level of disability and mortality of the studied contingents from ischemic heart disease has significantly increased. High rates of growth of disability in recent years in persons aged 18-39 at the date of the accident. The mortality rate of the evacuees in recent years has increased in comparison with the early observation period by 5.8 times, higher mortality rates in men compared to women. Further more in-depth studies are required to assess the contribution of non-cancer diseases to the total radiation damage to human health.

References

Kovalenko VM, Dorohoi AP. [Cardiovascular diseases: medical and social significance and strategy for the development of cardiology in Ukraine]. Ukrainian Journal of Cardiology. 2016;3:5-14. Ukrainian.

Drozdova IV, Babets AA, Stepanova LG, Omel-nytska LV. [Diseases of the circulatory system in Ukraine as one of the characteristics of public health]. Ukrainian therapeutic journal. 2017;(1):5-14. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/UTJ_2017_1_3

Diachuk DD, Moroz GZ, Gidzinska IM. [Preven-tion of cardiovascular diseases: theoretical principles and practical implementation]. DNU: "NPC PKM" DUS; 2019. Ukrainian.

Terenda NO, Panchyshyn NYa, Lytvynova ON, Petrashyk YuM. [Risk factors in the development of myocardial infarction and ways of their correction]. The health of the nation. 2017;3(44):266-8. Ukrainian.

Townsend N, Wilson L, Bhatnagar P, Wickrama-singhe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. European Heart Journal. 2016;37(42):3232-45. doi: https://doi.org/10.1093/eurheartj/ehw334

Serdiuk AM, Bazyka DA, Los IP, Prysiazh-niuk AE, Chumak VV. [Problems of radiation medicine and safety of Ukraine in the 21st century: historical past and modern tasks]. Scientific journal of the Ministry of Health of Ukraine. 2013;(1):7-17. Ukrainian.

Sushko VO, Kolosynska OO, Tatarenko OM, Ne-zhovorova GA, Berestiana ZhM. [Medical examination of diseases that led to the loss of working capacity and death as a result of exposure to ionizing radiation in the conditions of the Chornobyl disaster (remote post-accident period)]. Journal of the National Academy of Sciences of Ukraine. 2019;25(1):5-12. Ukrainian.

Huskova AK. [30 years of the accident at the Chornobyl nuclear power plant: the experience of liquidating medical consequences]. Meditsinskaia radio-logiia i radiatsionnaia bezopasnost. 2016;(3):30-35. Russian.

Onishchenko GG, Popova AYu, Romanovych IK. [Radiological consequences and lessons of radiation accidents at the Chornobyl NPP and Fukushima-1 NPP]. Radiatsionnaia gigiena. 2021;14(1):6-16. Russian. doi: https://doi.org/10.21514/1998-426X-2021-14-1-6-16

Gurachevskii VL. [Consequences of the Chornobyl accident in Belarus and their overcoming]. Minsk: BGATU; 2017. ISBN 978-985-519-854-4. Russian.

Bazika DA, Sushko VO, Lohanovskyi KM, Prysiazhniuk AYe, Bilyi DO, Fedirko PA. [Radiation medi-cine of Ukraine - a quarter of a century of progress and priorities for the future]. Journal of the National Academy of Sciences of Ukraine. 2018;24(1-2):26-42. Ukrainian.

Buzunov VA, Pirogova EA, Tereshchenko VM. [Epidemiology of non-neoplastic diseases of participants in the liquidation of the aftermath of the Chornobyl accident]. Problemy radiatsiinoi medytsyny ta radio-biolohii. 2004;(10):187-207. Russian.

Buzunov VA, Pirogov EA, Tsuprikov VA. [Non-tumor morbidity and mortality of the evacuated population. Twenty-five years of the Chornobyl disaster. Future safety]. Natsionalnyi doklad Ukrainy. Kyiv: KIM; 2011. p. 163-74. Russian.

Prykashchikova KYe, Pavlovskyi YeYe, Kos-tiuk GV, Kapustynska OA, Yaroshenko ZhS, Lukia-niuk VO, et al. [Changes in the structures of non-tumor morbidity and mortality in residents of radioactively contaminated areas: epidemiological monitoring for 1988–2015]. Dovkillia ta zdorovia. 2017;84(4):8-13. Ukrainian.

Chekin SYu, Maksiutov MA, Kashcheev VV. [Assessment of radiation risks of non-oncological diseases among Russian participants in the liquidation of the consequences of the accident at the Chornobyl nuclear power plant]. Radiatsiia i risk. 2021;30(1):78-93. Russian.

Pirogova Oya, Buzunov VO, Domashevska TE. [Cardiovascular morbidity of the population evacuated from the 30-km zone of the Chornobyl nuclear power plant in the post-evacuation period (epidemiological study)]. Problemy radiatsiinoi medytsyny ta radiobiolohii. 2011;16:50-58. Ukrainian.

Khomaziuk IM, et al. [Peculiarities of diseases of the circulatory system in participants in the liquidation of the consequences of the Chornobyl accident 25 years later]. Serdiuk AM, Bebeshka VG, Bazyky DA, editors. [Medical consequences of the Chornobyl: 1986–2011]. Ternopil: TDMU; 2011. p. 411-59. Ukrainian.

Chekin SYu, Maksiutov MA, Kashcheev VV, Tumanov KA, Korelo AM, Kochergina EV, et al. [Deter-mination of the group of radiation risk of mortality from circulatory system diseases among Russian participants in the liquidation of the accident at the Chornobyl NPP]. Radiatsiia i risk. 2016;25(3):24-34. Russian. doi: https://doi.org/10.12737/25050

Bilyi DO, Nastina OM, Gabulavichene ZhM, et al. [Radiation and non-radiation factors and their influence on the course of coronary heart disease in participants in the liquidation of the consequences of the Chornobyl accident]. Problemy radiatsiinoi medytsyny ta radiobio-lohii. 2014;19:213-22. Ukrainian.

Buzunov VO, Fedirko PA, Strii NI. [Assessment of the risk of ischemic heart disease and hypertension in participants in the liquidation of the consequences of the accident at the Chornobyl NPP]. Ukrainian Journal of Cardiology. 2006;6:101-5. Ukrainian.

Buzunov VA, Pirogova EA, Krasnikova LI, et al. [Indicators and methods of their calculation in the epidemiology of non-infectious diseases: educational and methodological manual]. Kyiv: Avitsena; 2014. Russian.

Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. Kyiv: Medinform; 2018. Russian.

Khomaziuk IM, et al. [Peculiarities of chronic ischemic heart disease in participants in the liquidation of the consequences of the Chornobyl accident who suffered a myocardial infarction]. Serdiuk AM, Bebeshka VG, Bazika DA, editors. [Medical consequences of the Chornobyl disaster: 1986-2011]. Ternopil: TDMU, Ukrmedknyga; 2011. p. 436-45. Ukrainian.

Bilyi DO, Pleskach GV, Nastina OM, Sydorenko GV, Kursina NV, Bazika OD, et al. [Features of the development of coronary heart disease in liquidation parti¬cipants consequences of the Chornobyl accident depending on the effect of radiation and non-radiation risk factors and the carrier of genotypes according to the polymorphism Rs966221 of the phosphodiesterase 4D gene]. Problemy radiatsiinoi medytsyny ta radiobiolohii. 2016;21:204-17. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/Prmtr_2016_21_17

Ivanov VK, Meniailo AN, Kashcheev VV. [Medical radiological consequences among the participants in the liquidation of the accident at the Chornobyl NPP. Part 1. Prognostic estimates]. Radiatsiia i risk. 2011;20(3):16-39. Russian.

Chekin SYu, Maksiutov MA, Kascheev VV, Kar-penko SV, Tumanov KA, et al. [Asses¬sment of radiation risks of non-oncological diseases among Russian participants in the liquidation of the consequences of the Chornobyl accident]. Radiatsiia i risk. 2021;30(1):78-93. Russian.