The WHO published in 1996 a Technical Report on “Control of Hereditary Diseases”. There, the lack of genetic effects of radiation on the genome after Hiroshima and Nagasaki was again stated, but Chernobyl has to be considered as a fundamentally different problem as the atomic bomb. Facts seem to confirm this difference in all fields of pathology: there is a major difference between the biological effects of an enormous irradiation lasting for a few seconds, and a very chronic low- level irradiation of cells, from inside of the corresponding tissue, e.g.: an endocrine gland or a gonad. This irradiation persists for years.
Geneticists must study actual data, after 10 to 17 year chronic internal irradiation, 10% of the radiation from this isotope being beta rays, more harmful than gamma rays, because they act locally. Scientists must find new ways to calculate the risk per units of dose over years. Calculations based on a homogeneous distribution of Caesium in the orgaism, and only on its activity as a gamma emitter, is wrong. Caesium may concentrate 100 times more in one specific tissue (pancreas, thymus, endocrine glands, heart) than in others (bone, fat tissue, liver).
2. Another SWG could focus on the effect of 137Cs incorporation on the cardiovascular system. There Prof. Bandazhevsky, a pathologist, would be a key figure. Dr. Galina Bandazhevskaya, cardiologist and paediatrician could also make contributions. In areas contaminated by 5 to 15 Ci of 137Cs/km2, up to 80% of the children suffer from cardiac symptoms. The disease is due to degenerative changes of the myocardium (The caesium cardiomyopathy was also observed in rats receiving caesium, with the same degenerative changes in the cardiomyocytes of rats, as those found in caesium-contaminated children with sudden death).
As the caesium cardiomyopathy is reversible for a rather long time, it appears urgent that these most common diseases are studied, prevented or treated with the contribution of the WHO. Vascular diseases, especially hypertension in children, also increase significantly with increasing contamination by caesium, complications are cerebral or myocardial infarction.
3. Radiocaesium and reproduction would be an essential subject for a third SWG. The caesium accumulation in the endocrine glands, the gonads and the placenta may explain spontaneous abortion, fragility of newborns, and the increase of congenital malformations, as well as sterility. (The papers of Y. Bandazhevsky and those of G. Lazjuk. unfortunately were not published in Western j ournals).
During the IAEA Conference in Vienna (1996), because he was sitting in the audience wearing a yellow tag (with no speaking rights), instead of the official red tag, Prof. Laziuk was not allowed to protest when the official rapporteur said (if Michel Fernex remembers correctly the wording): “The proof that there is no increase of malformations after Chernobyl, is the absence of a register”.
First, this is not a scientific proof, and, on the contrary, Belarus was the only country around Chernobyl with a well functioning national register installed 5 years before Chernobyl. It is worrying that experts from Western countries (financed by the French Commissariat a l’Energie Atomique, CEA) are now “improving” and “correcting” the Belarus Register. The NGO’s consider that the sources of financing for “experts” should be examined. If a particular lobby, the tobacco or the nuclear lobby, finances research in the corresponding field, the risks for biased findings are increasing.
4. Chernobyl and the immune system would be a further subject for a SWG. Again, one should concentrate on findings in children. The IAEA specialists claim that stress and vodka are far more important than radiation. This assertion is less convincing for diseases of children. At school in contaminated areas, children receive 2 to 3 meals of “clean” food daily. The follow-up of immunological parameters were started in children immediately after the explosion e.g. by Prof. Titov. in children, and by Prof. Goncharova in wild rodents.
The clinical long-term consequences are allergies, increased incidence ofasthma bronchiale, food allergy, and auto-immune diseases. The epidemic of Hashimoto’s thyroiditis correlates statistically with the caesium contamination of the soil. Even more dramatic is the increase of the incidence of diabetes mellitus type 1. Diabetes occurs at an earlier age than before: in 1996, it started already in some cases below the age of four; in 2000, it may now occur already in infants of 6 to 10 months of age. This disease, due to an autoimmune ilotitis is not increasing “because doctors are looking for it”, as representatives of the lobby usually say: as a rule, children are comatous when entering into the hospital for the first time.
It would be essential to recognise early signs of ilotitis. Bandazhevskaya found a tendency towards hypoglycaemia in highly radio-contaminated children. This could reflect early alterations of beta cells. Prevention of diabetes before the complete destruction of the Langerhans islets would be an important subject to be studied with the WHO.
5. The neuropsychic damages, especially due to the uptake of different uranium or plutonium isotopes by liquidators, may be a subject for a SWG. The Minister of Health of Ukraine stated in Geneva, November 1995, that 10% of the liquidators of his country were already invalid. At the WHO congress of Kiev in June 2001, it appeared in most of the republics of the former Soviet Union, that the proportion of invalids among the liquidators was over 30% !
The deterioration of the neurological status of liquidators is dramatic since 1998, and may lead to the early death of these young and healthy adults, which were aged 33-34 years when mobilized to clean the Chernobyl area. Using different methods, neurologists describe the topography of the lesions, predominantly localized in the left hemisphere, leading to the dramatic deterioration of the mental status of these subjects (they were 600.000, according to data presented in 1995).
Prof. Pierre Flor-Henry from the University of Alberta in Edmonton, finds a destruction of neurones selectively in the left hemisphere of such patients. Children irradiated in utero also seem to have brain damages predominantly in the left hemisphere. Flor-Henry who studied the neuropsychic findings in veterans of the Gulf war, found lesions similar to those of liquidators. E.g.: the so called “chronic fatigue syndrome” is occurring in both groups.
It may be too late to help the victims of the dust contaminated with heavy atoms releasing alpha radiation around Chernobyl. However, for the WHO a study of the effect of particles or heavy atoms chronically producing alpha particles in surrounding tissues, may be relevant: a preventive measure could be the decision to use no more uranium 238 in ammunitions, tanks and planes.
6. Other subjects :
A. The role of a cancer register in case of environmental catastrophes, using Chernobyl as an example, could be taken up by a SWG. After Chernobyl, most of the cancers are still in a latency stage. Studying one or two types of cancers may mask the real problem. Brain tumors in children exposed to radiation were an important subject some years ago, in the Ukraine and in Minsk.
IPPNW regrets that the Cancer Register of Belarus was dismantled, soon after the Vienna Conference of 1996. Researchers, very close to the IAEA, took over the management of the most important part. Many persons think that Okeanov was not dismissed because he spoke too clearly during the Geneva Conference in November 1995, but because he answered questions, after the official presentation at the IAEA meeting, in Vienna 1996, saying the contrary of what the official rapporteur just had stated (absence of any cancer except that of the thyroid, in children exclusively).
Prof. Okeanov lost the direction of his former institute (with accusations similar of those which were used to imprison Prof. Bandazhevsky), and was put aside for some years, the register being dismantled into three pieces.
As he has recently been rehabilitated, some observers think that it would be possible to restore the National Cancer Register. However, Okeanov may still be very fragile. One of his own collaborators, politically much stronger than him, being very close or very supportive of the IAEA policy, is in charge of an important part of the Register since 1996.
B. The consequences of Chernobyl
on gastrointestinal functions seem to be important, although we did not collect many documents on this subject. There the stress as a component will be difficult to separate from the radiotoxic effect of caesium. The kidney, the liver and other organs should be studied, as well as wound healing. The difficulty would be to find a correlation with the accumulation of caesium, as most of the hospitals have no anthropogammameters. Where no valid data are available for epidemiologists, experimental work seems to be indicated.
7. All findings by Bandazhevsky’s team on radiocaesium incorporation have to be confirmed, e.g. studied again, and his experimental work must be repeated. This would require an international coordination. A SWG could set up such a project.
In hundreds of autopsies of adults, children and foetuses, Bandazhevsky studied the comparative distribution of this radionuclide. The distribution of 137Cs depends on the species (human, animals), but also on age, activity, sex etc.. Under Bandazhevsky’s direction, members of the Institute of Medicine of Gomel studied metabolic changes produced by radiocaesium in rodents (and human). Bandazhevsky published findings on different endocrine and haematological disorders induced by radiocaesium, comparing animals and human living in more or less contaminated areas, the similarity between experimetal and clinical findings being impressive.
Congenital defects depending on the 137Cs accumulation in the placenta of Hamster are similar to those observed in foetuses or children of Caesium-contaminated mothers. The 137Cs concentration in the placenta appears to be the most important parameter for the correlation with malformations in human. All experimental work has to be repeated in several species, and in different laboratories. Again the WHO could play a key role in the coordination.
The correlation is often based on the 137Cs contamination of the soil, or on the emission of gamma rays measured in human or animal. Bandazhevsky has shown that these measurements are not sufficient, as 137Cs concentration varies in given organs: The highest values were found in the pancreas, adrenals, thyroid and thymus in infants, the Caesium load being 100 time higher than in bone or fatty tissue, 50 times higher than in the liver. Dosimetry based on speculations, mean values and and mathematics, should be replaced by precise and direct radiametric measurements.
Experimental work could help to design preventive or therapeutic measures for the exposed population. Bandazhevsky already showed that natural apple pectin was able to reduce the uptake of radiocaesium in rats (the same was found with strontium), and to prevent the cardiomyopathy in animal, (and also in children as preliminary findings of Bandazhevskaya tend to show).
Pectin accelerates the elimination of caesium from the organism. The mechanisms still are not well studied. Other absorbents could be tested. Simple pectin extracts from apples, with a purity of 12 to 16% are cheap and capable of mobilizing caesium from the organism of children. it was widely used to protect children in contaminated regions in the Ukraine and recently also in Belarus (see attachment 4: manuscript of Nesterenko et al.).
Dr. Nabarro asked us if we would be in favour of the publication of the proceedings of the WHO Conference of 1995.
The Proceedings, which were to be payed for by the participants, would have been a bestseller in March 1996, the date foreseen and promised by the organizers of the WHO Conference of 1995. In 2002 or 2003. This publication would hold some historical interest, but would no more bring scientific revelations as over 70% of the papers were published elsewhere. Controversies expressed in the discussions would be interesting.
The full presentation of Prof. Okeanov in 1995, may still be important. The presentation of the Minister of Health of Ukraine has not been published, where he indicated that already 10% of the liquidators were invalid (now one third of them are invalid, which is a problem for all former republics of the Soviet Union), and that diabetes mellitus was sharply increasing in his country (not due to excessive food intake, the population becoming rapidly poorer). The speech of Claude Haegy, from the Government of Geneva was also very stimulating.
Other papers would be worthwhile being published, but the number of readers would be 100 time smaller than for the full proceedings published in in March 1996. In the meantime, the knowledge increasedDiscussions would have been interesting. Remarks such as that of Prof. Yarmonenko, saying: “Should in a congress any paper mention effects of low-level radiation, the organizers should immediately exclude the author !” We know now that the genome can be altered by very low-level radiation, and that these changes may persist over generations. This cannot however justify the efforts and cost of publishing the full proceedings of the 1995 WHO Conference, after a delay of seven years.
Dr. Nabarro stated very clearly that he wishes that scientists remain independent in all WHO projects. He demands objectivity and transparency and refuses interference from outside, even from the IAEA. The offer to further allowing us to communicate by telephone or e-mail, was also a very constructive conclusion expressed by Dr. Nabarro.
We are very thankful for the commitment and the concern expressed for the affected population, especially for the children of the Chernobyl area. A message of the Secretary General of the UN, Kofi Annan, states that 9 millions of adults, i.e. two millions of children, suffer from the consequences of Chernobyl, and the tragedy is only beginning. “The legacy of Chernobyl will be with us and our descendants for generations to come”.
Michel Fernex—Professeur emerite, Faculte de Medecine de Bale, ex-membre de Comites Directeurs de TDR
(Programme special de Recherche pour les Maladies Tropicales), OMS.
The Chernobyl Catastrophe and Health
By Michel Fernex
Michel Fernex, MD, Professor emeritus, Medical Faculty of Basel, former member of Steering Committees of Scientific working groups on malaria and filariasis, WHO Geneva.
Introduction
After the explosion and the fire in the atomic reactor N. 4 in Chernobyl, radioactive fallout were registered in large parts of the Northern Hemisphere of the planet. The northern part of Ukraine, the South-East of Russia and the territory of Belarus have been contaminated to the greatest extent. The level of the radioactive fallout on the territory of Belarus, a non-nuclear state, was two times as high as that of Ukraine and Russia together.
It would have been essential to thoroughly investigate the consequences of the Chernobyl accident. The Belarusian population, which suffers most, should have been extensively studied from the medical and genetic point of view. Unfortunately, the pronuclear lobby, including the International Agency of Atomic Energy (IAEA) made use of all their influence to reduce the significance or to deny the data coming from the most affected countries. Their goal may have been to avoid paying compensations to the states and to the victims: in Belarus two million people, of 500.000 children, still live in heavily contaminated areas. Moreover, the evacuated population and 800,000 workers in charge of the decontamination of the area close to the exploded reactor, the so-called liquidators, are now scattered in different republics of the former USSR.
It is necessary to understand by which methods the pronuclear lobby and the IAEA achieve their goals and to assess the price of this attitude for Belarus: economic, medical, demographic and social problems of the republic appear to be the consequence of this policy. Twenty five per cent of the national budget is spent for the alleviation of the consequences of Chernobyl. In order to ensure a real protection for the victims, it would be necessary to provide much more help to the population, and in a different way, compared to the actual strategy. Rich countries possessing nuclear technology would have been in a position to take over these expenses. Contrary to other industries, the nuclear industry does not need to contract insurance capable to compensate the consequences of a catastrophe such as Chernobyl. This would cost such an amount, that nuclear electricity would become too expensive. Therefore, it would be fair to assign to the states the payment of the debt of civil responsibility.
It is difficul
t to understand why the Belarusian authorities seem to follow the demands of the pronuclear lobby. It is much easier to explain why the World Health Organization (WHO) became so inefficient in this field: it is still blocked by an “Agreement” signed in 1959 with the International Agencyfor Atomic Energy (IAEA).
The agreement between the WHO and the IAEA
and the Chernobyl disaster.
After the explosion of the reactor, the authorities concealed the information, released it finally much too late and did not consider it necessary to tell the truth [1, 2, 3, 4]. This reaction of the authorities was responsible for “ignorance and uncertainty” concerning the radioactive contamination, which followed the explosion of the reactor. Up to the year 2000, the flow of misinformation has not stopped. Thereby it is useful to remember a technical report published by the WHO in 1958 [5]. The report contains a chapter devoted to a “policy in case of an accident” and ends with a wish: ”Nevertheless, from the point of view of mental health, the most favorable solution for future uses of peaceful atomic energy would be the appearance of a new generation, which would learn to adapt to ignorance and uncertainty”
This apology of ignorance reflects an absence of respect for populations which contradicts the spirit and the letter of the Constitution of the WHO (8). This paragraph was read by Mr. Claude Haegi, representing the government of Geneva at the Conference organized by the WHO on the consequences of the Chernobyl accident, in November 1995 in Geneva. Mr. Haegi also quoted a statement of the Director-General of the IAEA, who, according to the newspaper “Le Monde” of August 28, 1986, four months after the accident, declared that “in view of importance of nuclear energy, the world could bear with one accident of the Chernobyl dimension per year”. And Mr. Haegi concluded his speech declaring: ”One Chernobyl is enough. It is necessary to aspire to absolute security”.
The Crime of Chernobyl- The Nuclear Gulag Page 77
