Igor Gusev

Health effects in those with acute radiation sickness from the Chernobyl accident.

The Chernobyl accident resulted in almost one-third of the reported cases of acute radiation sickness (ARS) reported worldwide. Cases occurred among the plant employees and first responders but not among the evacuated populations or general population. The diagnosis of ARS was initially considered for 237 persons based on symptoms of nausea, vomiting, and diarrhea. Ultimately, the diagnosis of ARS was confirmed in 134 persons. There were 28 short term deaths of which 95% occurred at whole body doses in excess of 6.5 Gy. Underlying bone marrow failure was the main contributor to all deaths during the first 2 mo. Allogenic bone marrow transplantation was performed on 13 patients and an additional six received human fetal liver cells. All of these patients died except one individual who later was discovered to have recovered his own marrow and rejected the transplant. Two or three patients were felt to have died as a result of transplant complications. Skin doses exceeded bone marrow doses by a factor of 10-30, and at least 19 of the deaths were felt to be primarily due to infection from large area beta burns. Internal contamination was of relatively minor importance in treatment. By the end of 2001, an additional 14 ARS survivors died from various causes. Long term treatment has included therapy for beta burn fibrosis and skin atrophy as well as for cataracts.

Medical Management of Radiation Accidents, Second Edition

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Acute Effects of Radiation Exposure Following the Chernobyl Accident

Information on the conditions of irradiation and clinical records of the acute radiation sickness (ARS) in victims of the accident at the Chernobyl nuclear power plant were reported in August 1986.1,2 Prognostic evaluations of the outcomes of the hematopoietic injuries were presented in April 1987.3 Data on the early effects of the radiation were also included in an appendix to the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Report.4 Further in-depth analysis of the clinical phase of ARS has been ongoing. Some results of this analysis are presented in this chapter.