Medical monitoring results of survivors with acute radiation syndrome after Chernobyl disaster

A 16-year experience in the follow-up of survivors with acute radiation syndrome (ARS) caused by the Chernobyl Nuclear Power Plant accident is presented. Oncohematological diseases and sudden cardiac death were at the top of the list as causes of death. In the 16th year after the accident, the number of people with hematological syndromes was halved in comparison with the earliest 2 years observation. The radiation-induced combined immunodeficiency of 1986–1987 decreased in the later period of recovery. Nervous system disorders were characterized by a gradual increase in organic changes in the central nervous system. Endocrine system diseases were nodular goiter, thyroid carcinoma, hypothyroidism and diabetes. A slow increase of cardiovascular pathology was discovered during the post-accident years, mainly due to arterial hypertension and ischemic heart disease. Inflammatory and erosive-ulcerous pathological processes of stomach and duodenum have essential ratio in the total morbidity structure of the digestive system. From 1987 to 2002 the bronchopulmonal pathology increased from one-third to one-half of the survivors depending on the degree of ARS. Late skin changes after acute radiation lesion were characterized by atrophy, hyper- and hypopigmentation, peeling, telangiectases and trophic ulcers. The number of radiation cataracts correlated directly with ARS severity. Possible trends in international cooperative investigations of ARS patients are discussed.