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MAIN RESULTS OF THE MEDICAL CARE PROGRAM:

Diagnostic results.

• Out of 18 910 children from Russia, Belarus and Ukraine, 59% have endocrine system problems, being thyroid hyperplasia the most significant and followed in order of frequency by digestive tract disorders (57,6%), adenopathies (30,4%), otorhinolaryngological system problems (29,3%) and skin diseases such as vitiligo, alopecia and psoriasis.
• Regarding eye diseases (13.4%), refraction disorders prevail; and
• 7.7% of patients present with cardiovascular disturbances mainly functional heart murmurs, and to a lesser extent functional cardiopathy.

Patients carrying tyroid hyperplasia.
 
Regarding thyroid hyperplasia, 53.7% was classified as IA, followed by thyroid hyperplasia IB (25.6%), II (10,4%) and III (0,8%).
We must remark that although Ukraine is a goiter-endemic country where most of patients improve their condition if they get in contact with iodine-rich environment, recent studies show a significant increase of thyroid cancer. The follow-up of these patients plays an important role in early diagnosis of the disease.
 
Digestive tract disorders.

Several digestive disorders are significant elements in this group of patients. The endoscopic studies performed in patients who suffer from recurrent abdominal pain reveal chronic gastritis (23.4%), parasitism caused by Giardia Lamblia (19.7%), chronic duodenitis (17.0%), gastric lymphoid hyperplasia (12.4%), hiatal hernia (7.7%) and patients with recurrent abdominal pain of unknown etiology (6%).
 
Otorhinolaryngological diseases.

Chronic tonsillitis was the main disease (64.2%) followed in order of frequency by chronic pharyngitis (6.2%), hypoacoustics (6.1%), septal deviations (4.6%) and epistaxis (4.3%).
 
Hematological diseases:

out of the total number of Ukraine patients received in this centre, 289 had haematological and immune diseases, most of them with different types of leukaemia and 6 have required bone marrow transplantation. The rest of patients have been treated with chemotherapy and radiotherapy according to their individual characteristics.
 
Oncological diseases.

One hundred and seventeen patients with tumor processes have been treated; 90.5% were malignant and just 9.5% benign.
 
Psychological disturbances.

Psychological disturbances are expressed as posttraumatic stress centred on anxiety, depression, and over-assessment of objective and subjective losses from the disaster, leading to inadequate tendencies in the formation of individual personality.
 
Result of dosimetric evaluations.

Since the beginning of the Cuban assistance program for children affected by Chernobil accident in 1990, the Center for the Protection and Hygiene of Radiations (CPHR) has developed a series of dosimetric and biomedical studies to evaluate the impact of the accident.

These studies have made it possible:

• Collect original data on the internal pollution by CS-137
• Estimations of total, external, and internal irradiation dose including that in thyroid.
• Find out the behaviour of morbidity, the development and changes of hematological, thyroid, cytogenetic and biochemical indicators depending on the pollution suffered by children and on the location surface pollution.
• Create, with these pieces of information, an important database which is considered by some international experts as unique in this field and which makes the Cuban study one of the most acknowledged sources of information for the evaluation of the Chernobil accident radiological impact. See IAEO Technical Documents (TEC-DOC) , page 10 paragraph 4.

The results achieved in roughly 8000 children prove that:

• Outdoor irradiation was the most important contributor to the total dose that is estimated at <1-170 mSv for 70 years.
• Twenty seven percent of children come from clear areas, 25% from areas with various levels of pollution, 23% from the evacuated areas and 25% from zones whose field pollution by Cs-137 is still unknown.
• Some internal pollution is still detected in over 60% of children
• The levels of internal pollution caused by Cs-137 range from 1.5 to 565 Bq/kg
• The internal dose generating this pollution ranges <1 – 9 mSv for 70 years.
• Thyroid hyperplasia frequency tends to augment with the increase of internal pollution and surface pollution caused by Cs-137.
• The other medical and biological indicators do not show any alteration if they are analyzed on the basis of internal pollution and surface pollution by CS-137.

The perspectives of the studies that are carried out in CPHR are aimed at the implementation of techniques that allow:

• Assessing the direct effects on DNA and the peculiarities of the repair process from damages caused by low radiation doses.
• Detecting the expression of molecular indicators associated to carcinogenesis.
• Evaluating the cellular cycle changes and the apoptosis (cell death).
• Determining mutations and markers in the hematopoietic system as possible early indicators of long-term irradiation effects.