Problems of Radiation Medicine and Radiobiology

V. O. Sushko, O. O. Kolosynska, O. M. Tatarenko, G. A. Nezgovorova, Zh. M. Berestjana,
S. I. Ustinov, D. D. Hapeyenko

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

PROBLEMS OF MEDICAL EXPERTISE FOR DISEASES THAT BRING TO DISABILITY AND DEATH AS A RESULT OF RADIATION EXPOSURE INFLUENCE IN CONDITIONS OF THE CHERNOBYL CATASTROPHE IN REMOTE POSTACCIDENTAL PERIOD

Background. The Chornobyl catastrophe (ChCt) resulted in radiation exposure of great quantity of people. Among them there were personnel of Chernobyl NPP (ChNPP) and workers of supporting enterprises, radiation protection professionals, clean-up workers of different specialties including military personnel that were send for liquidation of its consequences, inhabitants of the Prypyat city and Chernobyl 30km exclusive zone (including children) that were evacuated during first days after accident and population of radioactive contaminated territories. Loss of health, disability and death as a result of radiation exposure influence in conditions of the ChCt under discharge of professional, military or official duties and/or living on radiation contaminated territories not by his own fault call for developing of special form of medical expertise as part of medical social protective system for this contingents.
The objective of the study was to analyze the state of medical and social expertise for the interdependence of the diseases that bring to the disability and death with the impact of the Chornobyl accident consequences for the adult population and to determine the main directions for improvement of this system.
Materials and methods. The analysis of the medical expertise state for the interdependence of the diseases that bring to the disability and death by the effect of the Chornobyl accident consequences for the adult population in a remote post-accidental period during 2013–2017 years (26,142 personal medical expert investigations) was performed.
Results and conclusions. It was determined that the total number of population suffered from ChCt during 2007– 2018 years reduced for 26.05 % or by 657,988 persons. At the same time, there has been rapid increase in the number of victims with disability who received positive medical expertize certificate about interdependence of disease with effect of ChCt (the 1^st category according Ukrainian legislation) – from 40,106 in 1995 to 107,115 in 2018. The increase in the frequency of medical expertise cases of oncological diseases – 51.49 %, as well as cases concerning the interdependence of diseases that caused the deaths of the victims – 34.99 % were shown. The outstanding issues of the medical expertise of diseases interdependence with ChCt effects for certain categories of victims (thyroid cancer in persons who have lost their status after reaching adulthood, the definition of the legitimacy of the status of victims for inhabitants of territories that undergone radiation ecological control (the 4^th-V category) that require changes and additions to the legislative framework are discussed.
Key words: radiation exposure, victims of the accident at the Chornobyl Nuclear Power Plant, medical expertise of interdependence of diseases bring to disability and death with the effect of the consequences of the Chornobyl accident.

Problems of radiation medicine and radiobiology.
2018;23:471_480. doi: 10.33145/2304-8336-2018-23-471-480.

full text

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