1) The Chernobyl catastrophe and health care
By Michel Fernex
This manuscript represents a chapter in a book to be published in France on Belarus.
The original is in French and it is also available in Russian in Internet at:
www.chernobyl.da.ru. The origin and consequences of the Agreement concluded
between the World Health Organisation (WHO) and the IAEA are discussed. This
Agreement may explain why the WHO remained absent during the first five after the
Chernobyl accident on health studies and in particular studies on the genome The
WHO-IAEA Agreement has led to risks for scientists intending to study and publish on
the real consequences of such accidents or even the show damages due to chronic, lowdose radiation in the organism due to incorporation of radionuclides with food.
2) Western responsibility regarding the health
consequences of the Chernobyl catastrophe in Belarus, the
Ukraine and Russia.
Bella Belbéoch
Introduction
The accident at Chernobyl nuclear plant has to be considered as an unprecedented catastrophe
in the industrial world given the scale of radioactive polluted land, the levels of contamination
and the huge number of people affected.
Since the beginning of the nuclear crisis after Unit-4 had exploded, Western pressure has been
exerted to minimize the health impact evaluation of the accident regarding the long term effects
of low levels of radiation (cancer and genetic effects) which will affect the inhabitants of the ex-
USSR* exposed to radiation. In fact, quite unexpected health problems emerged shortly after
the accident giving rise to an obvious increase of morbidity especially amongst children. They
pushed into the background the delayed effects of radiation but, like these effects, they have not
only been minimized but even denied by the Soviet authorities and by Western experts as well.
To dismiss the field-observations made by local medical doctors it is often said that they did not
correspond to the effects observed on A-Bomb Japanese survivors. But the point is that the
two situations are not identical at all. In Hiroshima and Nagasaki the exposure to radiation was
essentially external and the flash lasted a very short time (the follow-up began only five years
after the bombings). After Chernobyl the "emergency phase" lasted a long time (huge amounts
of radioactive releases continued all through the month of May) and exposed people to external
radiation from the plume and from ground radioactive deposits, but also to internal radiation by
inhalation of radioactive air and ingestion of heavily contaminated food. Then followed a phase
of chronic exposure, internal exposure essentially through ingestion of food contaminated by a
cocktail of radionuclides. No reliable data exist for such a situation : Chernobyl is the first
large-scale "experiment" of this kind in the world.
Radiation-controlled zones** have been decreed in the Ukraine, Byelorussia and Russia, where
caesium-137 ground deposition densities were higher than 5 curies per km2 (Cs137>5 Ci/km2)
[1]. More than 800 000 inhabitants were living on these areas [2] and more than 7 million on
2
territories with radioactive caesium pollution above 1 Ci/km (see annex).
As time elapsed, worsening of people's health, especially children's, caused great anxiety and
complaint among the population. Later on, street demonstrations took place : people wanted to
be evacuated from contaminated areas. The definite position taken in favour of people's
demands by eminent members of the Academy of Sciences both in the Ukraine and in
Byelorussia, quite a very unusual situation in the USSR (and in other countries), have obliged
Republican and Moscow authorities to consider the necessity of new evacuations. In July and
October 1989, the Byelorussian authorities released "relocation" plans concerning about
120 000 of the most exposed inhabitants of the so-called zones of strict radiation control
2
(Cs137>15 Ci/km ), with some villages far away from Chernobyl, more than 200 km.
With the help of Western experts, Moscow authorities have been very efficient in opposing the
complete realization of these plans and their extension to the whole of the zones under radiation
control. Quite obviously the essential concern of these experts was related to the management
of a possible nuclear crisis in their own country.
We will chronologically summarize some significant facts from the point of view of postChernobyl health problems.
Vienna, 25-29 August 1986. IAEA International Experts' Meeting. First evaluation of
the health consequences in the aftermath of Chernobyl
Attended by worldwide experts and organized by the International Atomic Energy Agency
(IAEA), this conference aimed to analyse the accident at the Chernobyl nuclear plant and its
consequences. The different study groups' sessions took place behind closed doors and
information was released to journalists in daily press-conferences (seemingly with no protest
against this kind of "information").The Soviet delegation, headed by V. Legasov, presented a
voluminous report (370 pages), a general main part and 7 annexes dealing with more
specialized questions [3]. Annex 7 was completely devoted to "Medical-Biological problems"
and was at the origin of an intense dispute.
Besides detailed data related to acute radiation injuries which have affected the people sent into
very "hot" places close to the destroyed reactor and exposed then to very high doses (on-site
personnel, firemen who struggled with the burning reactor etc.) and on whom were tried
unsuccessful bone marrow transplantation, the report not only made an estimation of the
external doses received by the 135 000 evacuees from the 30 km area around the nuclear plant
which became the "prohibited zone", but also dealt with the long-term health consequences of
the accident for 75 million inhabitants of the European part of the Soviet Union. Their external
collective dose was estimated and also their internal collective dose for a period of 70 years due
to chronic contamination by radioactive caesium.
With the hypothesis recommended in 1977 by the International Commission on Radiological
Protection* (ICRP) of a linear relationship between the number of fatal radiation-induced
cancers and the exposure dose [without a threshold], it was possible, taking into account the
ICRP risk factor of the fatal cancer excess per unit dose of radiation and knowing the collective
doses, to calculate roughly the number of long term radiation-induced cancer deaths [4]. Annex
7 gave also the approximate number of thyroid cancer deaths due to radioactive iodine intake.
(The Soviet report did not consider strontium-90 but indicated that it might become important
afterwards).
There was a general outcry : the estimate of the long-term impact of the Chernobyl catastrophe
on cancer mortality was a possible range of 30 000-40 000 extra deaths (more than 80% due
to caesium) in 70 years representing up to 0.4% of the normal number of cancer deaths. These
numbers were considered too high by Western experts.
At the press conference on August 26th, Dan Beninson, chairman of the study group on the
health consequences of Chernobyl said that these Soviet figures were " extremely
overestimated ". For Morris Rosen, Director of the Safety Division at the IAEA, the upper
limit for the number of deaths was 25 000 and it fell down to 10 000 two days later and
Beninson's to 5 100 [5]. At that time Beninson was chairman of the ICRP and people set great
value on his opinion (he was also top official of nuclear energy in Argentina). For Beninson
and Rosen the Soviet figures were too high because caesium internal contamination had been
overestimated. Let us point out that such an affirmation could not have had any scientific basis
at that time.
This annex 7, very troublesome for promotors of nuclear energy, has in fact been almost
completely censored. Only a few people were made acquainted with its existence. In France,
the main report was translated and widely distributed but not the annexes. Afterwards, Soviet
and Western experts never referred to this annex 7 as if it had never existed.
Revision of the initial estimation
As early as october 1986 the internal dose was 10 times too high according to some European
experts [6]. In January 1987 " After a five days visit in USSR top IAEA officials called the first
post-accident assessments of damage health effects "apparently too pessimistic" and should be
decreased by a factor five to seven " [7].
To gain credibility the re-assessment had to be worked out by Soviet experts themselves. It was
started during the first Vienna IAEA meeting and specified afterwards.
May 1987 : at the WHO conference in Copenhagen [8], resulting from " evidence of a positive
trend of the radiation hygiene situation as a result of the implementation of large-scale
protective and preventive measures " A. Moiseev reduced the previous external dose estimate
by a factor 1.45 and the internal dose by a factor between 7 and 10.5. Nevertheless he admitted
that one year after the catastrophe an important proportion of local milk in Byelorussia was still
contaminated above the Cs137 permissible levels and " had to be withdrawn from direct
consumption and sent for reprocessing " but he did not give any information about this
process. One might question if this milk was not sent to remote regions of the USSR
(Armenian powdered milk was analysed by CRII-RAD, an independant French association,
and high levels of radioactive caesium were found [9]). Let us recall that "democratisation" of
radiation doses by increasing the number of exposed people, each person receiving a smaller
dose, does not change the final balance : the same collective dose leads to the same number of
fatal radiation-induced cancers with the linear relationship (without a threshold) recommended
by the ICRP between the number of cancers and the total dose [4]. By adding that the values
given in his communication must be " considered as "upper" estimates of the radiological
consequences of Chernobyl " Moiseev, in fact, went back to a model with a threshold.
September 1987 : L. A. Ilyin and O. A. Pavlovskij presented a new report on the Radiological
consequences of the Chernobyl accident in Vienna at the IAEA's international conference [10].
The subtitle of their report was " Analysis of data confirms the effectiveness of large-scale
actions to limit the accident's effects ".
According to the authors, right after the accident the decision was taken to evacuate 115 000
people, including the inhabitants of Pripyat, to prevent them from receiving whole body and
thyroid doses up to the emergency dose limits prevailing at that time in the USSR. (The 18 700
inhabitants of Byelorussia evacuated between June and August 1986 are not mentioned). The
report indicated that " a total of 5.4 million people including 1.7 million children received
iodine prophylactically " [against radioactive iodine]. Introduction of large-scale measures to
protect the public, such as standards for foodstuffs, have been efficient especially the
interdiction of milk exceeding the permissible iodine-131 level of 3 700 becquerels per liter
(3 700 Bq/l). Average infant thyroid doses were given for the northern most contaminated
regions of the Ukraine while for Byelorussia the average is reported for all the country* .
No increase of morbidity was observed in children and no difference between
"dirty" (contaminated) and "clean" areas. For the first time radiation phobia syndrome was
mentioned.
The estimate of the collective effective dose equivalent p4commitment for the whole Soviet
population (278 million inhabitants) through ingestion of radioactive caesium was 18 times
lower than the first 1986 estimate for only 75 million inhabitants. In April 1988 L. A. Ilyin reincreased this dose [11] and finally the United Nations Scientific Committe on the Effects of
Atomic Radiation in its UNSCEAR 1988 Report averaged Ilyin's two estimates and therefore
reduced the 1986 estimate of annex 7 by 9 [12]. M. Beninson should have been pleased with
this new value.
Both Ilyin and Pavlovskij were in the list of authors of the 1986 Soviet report. Therefore their
1987 and 1988 articles quoted above should be considered as a true self-criticism.
The collective dose reduction was supposed to be the result of countermeasures efficiency. This
official optimism was in complete disagreement with V. Legasov's testament published in
Pravda (May 20th, 1988) in which he gave evidence of the incredible lack of care which
followed the Chernobyl catastrophe [V. Legasov killed himself on the second anniversary of
Chernobyl][13]. The supposed effectiveness of countermeasures is rather doubtful, given the
well known ineffectiveness of Soviet bureaucracy and the shortage of "clean" food which
should have been imported into zones of strict control, given also the number of the rural
population accounting for almost half of the 75 million people of annex 7, with a self-sufficient
way of life, consuming local "dirty" foodstuff (just after the accident iodine-131 levels in cow's
milk reached 1 million Bq/l in some districts of Byelorussia [3]). Heavily contaminated meat
was partly destroyed in Byelorussia but was also exported to be mixed up with "clean" meat
[14]. Meat above permissible levels of Cs137 was sold even in Moscow [15]. Standards for
tea were introduced in quite a "democratic" way, depending on the regions and the kind of
consumers. For example cleaner tea was sold in Moscow and heavily contaminated regions
than in factory cafeterias and in less contaminated areas [1]. In the Ukraine people were advised
only in July 1989 of restrictions against the picking of mushrooms, wild berries and medicinal
plants [16].
Private information began to arrive in France : in contaminated regions of the Ukraine and
Byelorussia the health of inhabitants was worsening, complaints against the authorities were
growing (as shown in Microphone, a film by G. Shkliarevski and V. Kolinko). Detailed maps
of radiation-controlled zones with Cs137 levels above 5 Ci/km2, were published in Sovetskaya
Byelorussia (February 9th, 1989) showing their extent. From the article one could get an idea
of the large number of people affected in their daily life : food monitoring, supply of "clean"
food if local food was too "dirty", medical care, advice to use special tractors with airtight cabs,
small bonus of monthly "danger money" etc. [1]. The chairman of the Byelorussian Council of
Ministers has summarized the situation by saying " we have been unable to put back the
radioactive djinn in the bottle " (Pravda, February 11th, 1989,).
Finally, Moscow authorities disclosed maps in Pravda (March 20th, 1989), showing the
general gamma-field pattern measured on 10th May 1986 with gamma dose readings for the
Ukraine, Byelorussia and Russia. The dose rates used as basis for deciding on the early
evacuation of people in 1986 were also given : prohibited zone for dose rates above 20
milliroentgen per hour (20 mR/h), evacuation above 5 mR/h, temporary evacuation of pregnant
women and children between 3 and 5 mR/h. From these maps it is not clear why areas far away
from Chernobyl (districts of Gomel, Mogilev and Bryansk) where gamma dose rates above 5
mR/h were recorded on 10th May 1986 were not included in the early evacuation plans. At the
end of 1988 it was known that some villages in the Ukraine of Narodichi district close to the
prohibited zone were about to be evacuated.
Concept of "Safe" living. Life time exposure : "35 rem per 70 years"
The legal definition of contaminated areas decreed by Soviet authorities consisted of areas with
2
Cs137 deposition density above 1 curie per km . In 1989 more than 7 million people lived in
these areas. (At the same time, in the UK, sheep were still forbidden for consumption, yet, their
grazing pastures in highlands -Scotland, Cumbria etc.- were 2 or 3 times less contaminated than
2
1 Ci/km ). People were to be resettled from heavily contaminated areas with Cs137 levels
higher than 40 Ci/km2, some places are far away from Chernobyl.
Criteria for "relocation" : the "safe" living concept was worked out in September 1988 by
the USSR authorities [17]. It was summarized in newspapers by the words " 35 rem per 70
years ". It is considered safe to live in a place where the dose accumulated during a 70 yearlifetime will not exceed 35 rem. If this dose exceeds 35 rem people had to be moved away and
resettled in a new place. This life-long dose is calculated by radiological protection institutes, all
of them depending on the Health Ministry of the USSR and therefore completely under control
of Moscow authorities. Besides the dose received during the emergency phase (irradiation by
the radioactive plume and ground deposits, inhalation of radioactive particules and aerosols,
ingestion of contaminated food) the lifetime dose has to include the dose to be received in the
future by living in a given place of residence. Therefore, besides external dose due to
radioactive deposits, the lifetime dose must include the effective committed dose in 70 years
due to ingestion of Cs137-contaminated food. Hot particles (containing transuranic elements )
were not considered. All these calculations depend on models : life-style and diet, metabolism,
etc.
If this calculated dose exceeded 35 rem, relocation had to be decided. (L. Ilyin, head of the
Soviet radiological protection said " it is not an evacuation but a planned displacement of
people ". In places where the life-long dose was supposed not to exceed 35 rem, a normal
lifestyle could be resumed with consumption of local food and no further import of clean food.
This concept "35 rem per 70 years" (0,5 rem/year, or 5 millisievert/year) had to become law on
January 1st, 1990. Its authors assured that it was in line with ICRP recommendations.
Byelorussian scientists, at the top level of the Academy of Sciences have fought against this
law and brought forward another concept, 7 rem in 70 years (0,1 rem/ year) while Ukrainian
scientists proposed 10 rem. Among the pertinent arguments of Byelorussian scientists [17] let
us just recall that, since its Statement from the 1985 Paris meeting, ICRP recommended a
lifetime average annual dose of 1 millisievert (1 mSv =0,1 rem).
The World Health Organization Experts.
The dispute between Byelorussian and Moscow scientists was open to the public in March
1989, during long debates of the session of the Soviet of Byelorussia and needed afterwards a
special session devoted to 35 rem per 70 years which took place at the Byelorussian Academy
of Sciences in Minsk with the participation of three WHO experts. Besides M. Waight, (WHO
secretary), appeared as WHO experts Dan Beninson, mentioned before, and Pr. P. Pellerin, the
head of French Services of Radiological Protection (SCPRI). Let us recall that at the
Copenhagen WHO meeting held on 6th May 1986, only a few days after the reactor had
exploded, delegates of all European countries presented the dose-rates values recorded in their
country when it was reached by the plume. France, represented by a delegate of Pr. Pellerin's
Services did not give any precise value and indicated only : "low" [18]. One might question if it
is for this reason that, some years later, WHO qualified Pr. Pellerin to intervene in the
radiological protection of the Soviet population.
The WHO experts' report was published in Sovetskaya Byelorussia (11 July 1989) under the
title : "Experts' point of view". WHO experts concluded that, " in post-accident situations, an
exposure of 35 rem during a lifetime of 70 years was quite a conservative value, (...) This
value was in agreement with international recommendations based on assessments of ionizing
radiation health risks. (...) If asked to fix a limit on the lifetime cumulative dose they should
have chosen dose-limits of 2 to 3 times 35 rem " [the underlining is mine].
The report disparaged those scientists opposed to the life-dose limit supported by Soviet
authorities " (...) Scientists who are not well versed in radiation effects have attributed various
biological and health effects to radiation exposure (...) These changes (...) are more likely due
to psychological factors and stress ".
In short, everything is known about radiation health effects, first-hand observations made by
local medical doctors had to be in line with widespread consensus. It is worrying to see how
these experts are denying an obvious fact : the Chernobyl catastrophe has the very sad privilege
of inaugurating a new "experiment" in the medical field. They are trying to close the only way
to approach it, first and foremost, all biological and medical information has to be registered
and taken into consideration.
At the end of July 1989, during the Byelorussian Parliament's session which adopted the
evacuation plans, the Health minister of Byelorussia referred to the WHO report and declared
that Byelorussian scientists who opposed the 35 rem lifetime dose were ignorant of radiation
questions. (Reported by I. I. Lichtvane, Vice-president of Academy of sciences, Sovetskaya
Byelorussia, 1st August 1989).
In Paris some people became upset. What was Pr. Pellerin doing in the Ukraine and in
Byelorussia making a false statement that a lifetime dose of 35 rem was in conformity with
international recommendations and suggesting even higher limits 2 to 3 times 35 rem which are
outside the prescribed French regulation ? Was Pr. Pellerin, a civil servant of the health minister
in charge of French radiological protection, no longer obliged to respect French law when he
was representing WHO ? Five associations asked many questions to the French health minister
but never received an answer [19].
Meanwhile, through information available in France and first-hand news from medical doctors
and journalists coming back from the Ukraine and Byelorussia it became obvious that the
population's health was worsening (thyroid gland disorders, immunodeficiencies etc.). The
answer of Soviet authorities was : radiophobia. Later on demonstrations took place in Minsk.
September 1989 : letter from 92 Soviet experts to M. Gorbachev to enforce the "35 rem
lifetime concept"
The French Group of Scientists for Information on Nuclear Energy (GSIEN) got a copy of this
letter dated 14 th September, 1989 and sent to the President of the Supreme Soviet of the
USSR with 92 signatures of top scientists " working in the medical and radiological fields and
concerned by the situation created by the Chernobyl accident " [20].
They wrote : " At each step of its elaboration this concept has been accompanied by a
systematic consultation and a careful appraisal of various international organizations such as
IAEA, WHO, UNSCEAR, which looked at it from all its angles and have approved it ".
Some arguments developed in this letter which oppose Byelorussian and Ukrainian proposals
of lifetime doses of 7 or 10 rem instead of 35 rem, seem to us very important " In the choice of
the lifetime limit of 35 rem the National Radiological Protection Commission of the USSR has
paid attention to the fact that the limit has to include the dose received in the past three years,
and in some agglomerations this cumulative dose is already about half the recommended
lifetime dose ". In addition, in some villages where the dose of 35 rem has already been reached
or soon will be, the decision of resettlement was taken a long time ago but " for some
incomprehensible reasons has not yet been carried out in practice ". Furthermore " (...) it must
be kept in mind that, since the accident, in most agglomerations of the permanent control zone,
this dose (7-10 rem) has already been reached or will be reached in the near future ". The
authors invoked the deep psychological and health detriment that could be caused by the
" [displacement] resettlement of hundreds of thousands of people (up to one million) (...). If
this 7-10 limit is adopted as a criterion for resettlement the problem will appear for the
inhabitants of many big towns and district centers ". They further added that it cannot be taken
for granted that good medical care could be assured in case of " a plan of resettlement of one
million people ". [The underlinings are mine].
Thus, at that time, hundreds of thousands of people, up to one million, would have needed to
be resettled if the 7-10 rem lifetime dose had become law. The comparison of these figures with
the number of people living in all areas submitted to radiation control brings out clearly that the
one million people figure is consistent with the number of all inhabitants of radiation control
zones where Cs137 ground deposition is above 5 Ci/km2 (see annex).
One might wonder why, as years passed, official estimates of people's cumulative doses were
shrinking away in contaminated areas, and ask if this could not be the result of tampering with
data, and readjusting measurements and models ...[20].
"The international Chernobyl Project". ICP Report.
In October 1989 the USSR government requested the IAEA to carry out an international
experts' assessment of the health impact of Chernobyl and to evaluate the effectiveness of the
protective measures taken by the Soviet Authorities. One goal of ICP was also to assist them
and provide guidance on radiological protection subjects including their lifetime dose concept
of 350 millisievert (35 rem) for "safe" living in areas affected by radioactive contamination.
Besides Soviet experts, 200 specialists from 25 countries and 7 multinational organizations
(IAEA, UNSCEAR, WHO, EEC etc.) participated in the Project.
The final ICP report was delivered at the international IAEA meeting in Vienna (21-24 May
1991) [21]. It was concluded that no health disorders could be attributed directly to
radiation exposure. The ICP experts' estimates of both internal and external doses for the
surveyed contaminated settlements were lower by a factor of 2 to 3 than the values officially
reported by Moscow health authorities.The representatives of Byelorussia and the Ukraine
have publicly demonstrated their disagreement.
The introduction emphazised the fact that the USSR government had already benefited from
international assistance. Mentioned above, the team of WHO experts was first sent there in
June 1989. Then the League of Red Cross and Red Crescent Societies which both came to the
same conclusion as WHO : psychological stress and anxiety were causing physical symptoms.
The International Chernobyl Project reached the same conclusion.
Concerning the safe lifetime dose of 35 rem for relocation, " the protective measures taken or
planned for the longer term, albeit well intentioned, generally exceed what would have been
strictly necessary from a radiological point of view. The relocation and foodstuff restrictions
should have been less extensive ". As regards the social cost of relocation policy " (...) due
account has not been taken by the authorities of the many negative aspects of relocation (...) ".
And also, " In applying a lifetime dose criterion for relocation it is not appropriate to take into
account of past doses ".
Some special points : all examined chidren were found in good health. Concerning thyroid
gland disorders, no abnormalities in thyroid hormones. No statistically significant difference
was found for any age group between surveyed contaminated settlements and surveyed
settlements used as controls. Thyroid nodules were extremely rare.
Concerning neoplasms " The data did not reveal a marked increase in leukaemia or thyroid
tumours since the accident ; however (...) the possibility of an increase in the incidence of these
tumours cannot be excluded. Only hearsay information relating to such tumours was available
". Hearsay information ? The 1990 incidence of thyroid cancer in children was already 20 times
the pre-Chernobyl incidence [22] and that year Pr. Demidchik had operated upon 29 children
for thyroid cancer (59 in 1991 and more and more after).
No information was given about immunological deficiencies observed in children. No mention
of the increase of chromosome aberrations. " No statistically significant evidence of an increase
in incidence of foetal anomalies as a result of radiation exposure ". Quite a strong assertion
when compared with the results which will be published by G. J. Lazjuk [23][24].
Some issues were not investigated at all : nothing about the health of the liquidators*, of the
early evacuees, no estimate of people's early doses received during the emergency phase.
A peculiar point : Pr. Pellerin provided 8 000 film badge dosimeters which were distributed to
residents of selected settlements in contaminated areas : " For a two-month exposure period
90% of the results were under the detection limit (of 0.2 mSv) ". Let us point out that this
detection limit corresponds roughly to a normal background dose (without extra-radiation)
accumulated during the same two-month period. Therefore, no radiation above natural
background was detectable in these selected villages ? Pr. Pellerin performed also whole body
countings : the amount of incorporated caesium was found very low, as if "clean" food had
been exclusively consumed in these selected contaminated villages. All information we got
from contaminated radiation-controlled zones contradicts such an assessment. How can we
trust it ? Let us recall a communiqué released by Pr. Pellerin's Services some days after the
outset of the Chernobyl catastrophe : " [In France] the situation has come back to normal ",
but without having been abnormal before ...
The "new" concept. Paris, April 1991 [25].
This concept, worked out by a team of Soviet scientists headed by academician S. Belaeyev,
was presented in Paris and became law in May 1991. We will summarize it below.
- Since 1st January 1990, countermeasures have been implemented to ensure that the lifetime
dose will not exceed 35 rem (350 mSv). It is supposed that they were crowned with success
and therefore this limit of 35 rem has become useless.
- From now on past doses will not be taken into account. Only future averted doses should
be considered for relocation (this point gives entire satisfaction to ICP experts). Doses received
from 1986 to 1991 have to be considered only to improve living conditions but not for
relocation. [Previously, according to the State Union republican programme of emergency
measures for 1990-1992 on liquidation of the Chernobyl accident consequences (April 1990)
relocation was compulsory for inhabitants of areas with Cs137 levels above 40 Ci/km2,
whereas the annual dose is likely to exceed 0.5 rem (5 mSv) and also for pregnant women and
2
children from areas with Cs137 levels 15-40 Ci/km ]. From now on, no massive compulsory
relocation is justified. Any additional resettlement should only be done on a voluntary basis.
- For 1991 and thereafter, the effective dose should not exceed 1 mSv/year (0.1 rem) which is
the lower level of intervention. If annual doses exceed 1 mSv, radiological monitoring of
environment and food, medical control, agrotechnical decontamination work [which proved
unsuccessful in the past] etc. still go on. These measures must be optimised to limit average
annual doses to 5 mSv in 1991 and to lower values afterwards.
The introduction of an annual dose limit of 1 mSv seemed to give satisfaction to Byelorussian
and Ukrainian scientists. In fact, after having gained time and by ignoring past doses, the
Soviet authorities have eliminated the possibility of new massive compulsory relocations.
Relocation of all inhabitants of Cs137 contaminated zones above 15 Ci/km2 (enacted by
Republican parliaments) is no longer ascertained unless on a voluntary basis.
The implosion of the USSR and the emergence of independent Republics will aggravate the
post-Chernobyl situation through food shortage and financial problems. By giving support to
Moscow authorities, the intervention of WHO and international agencies in the management of
the post-Chernobyl crisis has ruined the efforts of those scientists who tried to give better
protection to the population living in contaminated areas. And for that we are responsible.
Health consequences in the aftermath of Chernobyl
Thyroid cancer and radioactive iodine
An abnormal increase of thyroid cancer in children was reported in Belarus in two scientific
letters published in September 1992 in Nature [26] and met, at first, great scepticism among
scientists working in the field of medical and radiological protection who denied that this
increase could be the result of Chernobyl [27]. It was only after the data had been endorsed by
well-known European scientists that the "hearsay" information (as written in ICP Report) was
accepted as being true. It was the first time that some Western scientists (belonging to WHO !)
gave support to medical doctors from the ex-USSR and they have to be thanked for their
obstinacy. Thyroid cancer in children was also observed in the Ukraine and in Russia but with
lower incidences than in Belarus. The number of thyroid cancer in adults increased enormously
during the first 7 years after the accident but has since stabilized.
Experts' reconstructed thyroid doses are now on the rise. Who really got the millions of tablets
of stable iodine as reported by Ilyin in 1987 ? The ICP Report concluded that the general
response of the authorities had been broadly reasonable in the emergency phase [21]. But S. L.
Belyayev conceded in 1991 that the countermeasures " have not always been taken in due time,
not when they were really necessary and sometimes not completed " [25].
What about radionuclides other than iodine ?
Experts ensure us, at least in France, that apart from some 200 cancer deaths which will affect
the "liquidators" in next decades, the only cancers due to Chernobyl will be thyroid cancers in
children having been exposed to radioactive iodine. After surgery, everything is fine. Thus the
Chernobyl health consequences will be limited essentially to psychological disorders.
In other words, does it mean that, aside from radioactive iodine, the cocktail of radionuclides
(found in children's blood in the Ukraine and Byelorussia), caesium-137 and 134,
ruthenium-106, strontium-90 etc. without forgetting transuranic elements like plutonium
included in "hot particles", when ingested and inhaled will have no effect at all on the body ?
Thyroid cancer in children is a rare disease and its dramatic increase shortly after the accident
gave clear evidence of its relation to radioactive iodine. But other radiation-induced cancers due
to other radionuclides and to external exposure will only appear after latency periods of 10-50
years. If the follow-up of Chernobyl exposed populations in the next fifty years fails to show
any statistically significant excess of cancer deaths it will not mean that this excess does not
exist (especially if health statistics are under control of the management authorities). Even if the
future Chernobyl radiation-induced cancer deaths are only a small fraction of the normal
number of cancer deaths they might represent a total number of tens of thousands of deaths
when applied to a huge population [13].
Furthermore, Chernobyl was followed by a morbidity increase implying some worsening of all
functional systems which, in future, might be responsible for an increase of mortality for
causes other than cancer. Please take note : In case of a severe nuclear accident, stable iodine
will not protect people from radionuclides other than iodine and will not suppress the long
term health consequences for the people exposed to the radioactive fallout.
Relocations after 1989
It is quite impossible to know exactly how many people have been moved away from the
radiation-controlled zones and resettled compulsorily since 1989 and after the independence of
Republics in 1991 because the number of voluntary relocations is never given. In 1993 the
Ukrainian Minister of Chernobyl Affairs indicated 98 000 relocations since 1989 [13]. The
Belarussian 1996 report of Ministry for Emergencies and Population Protection from the
Chernobyl NPP Catastrophe Consequences indicated that the resettlement of the population is
basically completed. 131 200 persons have been resettled [it seems that the 24 700 persons
evacuated in 1986 are included]. No indication about the number of voluntary relocations.
An upper estimate of the number of resettled inhabitants for the three Republics of the exUSSR might be around 300 000. This is far below the million people who should have been
compulsorily resettled from all radiation-controlled zones and who scared Ilyin and his
colleagues so much when they referred the matter to President Gorbachev in September 1989.
In Paris, Belyayev [25] asserted that it had been concluded from cost-efficiency or cost-benefit
analysis in matters of countermeasures implementation, that relocation is uneffective in most
cases. [But only managers and decision-makers evaluate costs, not the simple citizens.
Belyayev did not give any precision about the price of a radiation-induced cancer or of other
diseases]. Nevertheless he had admitted previously that " relocation could practically avert any
further exposure dose " which is quite obvious.
These doses that could have been averted for the million inhabitants of areas with
radiation control represent diseases, suffering and deaths for them and their progeny.
And our experts have helped the central Soviet authorities to reduce the number of
people to be relocated.
New ICRP recommendations in the event of a major nuclear accident
The ICRP made recommendations to protect the public in case of a severe nuclear accident in
publication 40 (May 1984). In the early phase, the countermeasures are sheltering, stable iodine
distribution, evacuation. Two levels of dose, the lower and upper levels, determine the dose
range in which each countermeasure has to be implemented [28] : below the lower level of
dose, countermeasure is not warranted, above the upper level its implementation should almost
certainly have been attempted.
- Sheltering : whole body projected dose between 5 mSv (0.5 rem) and 50 mSv (5 rem).
- Administration of stable iodine : projected thyroid dose between 5 and 50 mSv.
- Evacuation : projected whole body dose between 50 mSv (5 rem) and 500 mSv (50 rem) and/
or projected equivalent organ dose (thyroid, skin), between 500 and 5000 mSv.
Each step of decision-making requires cost-benefit optimisation. A countermeasure should be
introduced " only when its social cost and risk is less than those resulting from further
exposure ". Of course ordinary citizens are kept in ignorance of the subtle calculations of
experts (with cost as a major parameter) who are discussing the price of their life. At that time
ICRP did not consider long-lasting situations like Chernobyl's, where three years after the
accident, lots of people still had to be moved away from contaminated areas and resettled.
After Chernobyl : obviously ICRP has drawn many lessons from Chernobyl disaster
regarding dose limits for introducing countermeasures as shown by the new intervention levels
recommended in 1992 (publication 63).
In the event of an accident the projected dose is calculated for each exposure pathway but the
key concept for an intervention is the averted dose which is the dose saved by implementing a
protective action. The " (...) implementation of a given protective action will be justified if its
benefits, which include radiation detriment averted, are greater than its associated detriments ,
in terms of non-radiological risks associated with it, its financial cost and other, less
quantifiable consequences such as social disruption ".
For the early phase, the worrying aspect of these recommendations is that precise values are
given only for the almost always justified intervention levels.These justified upper limits
correspond to the previous 1984 upper limits. They are in contrast to vague lower values of the
range of optimised intervention levels, in which the optimised value has to be " not more than a
factor of 10 lower than the justified value ". Averted dose estimates will depend on the moment
at which a given countermeasure is introduced. Experts will "optimise" the costs to decide if
this measure is worth implementing at that time. In case of a severe nuclear accident, authorities
might be tempted to use the simple upper justified values as intervention levels. In fact, for
ICRP, the only imperative requirement is to avoid serious deterministic effects.
As regards relocation which refers to the long-term removal of people from an affected area
(like post-Chernobyl relocations after 1989) the justified level is 1 sievert (100 rem). But ICRP
publication adds that " the justified level of averted dose for relocation might even be higher
than this reference level ".
In line with its previous 1984 report which advocated optimised cost-benefit analysis, the new
report specifies some monetary costs of implementation of a countermeasure strategy. For
example relocation analysis requires to know the cost of one man-sievert, the collective dose
unit related to the price of one person's life in case of a fatal radiation-induced cancer. In the
table below are given the values for 3 parameters, for three types of countries : c is the cost of
relocation per unit time (one month), alpha is the cost of unit collective dose (man-sievert), c/
alpha is the derived value for the dose-rate (per month) at which relocation is optimised.
Type of country
c
(US$ per man-month)
alpha
c/alpha
(US$ per mansievert)
(mSv per month)
Rich developed
Developed
500
100 000
5
200
20 000
10
Developing
(US$ per man-month)
(US$ per mansievert)
(mSv per month)
Rich developed
Developed
500
100 000
5
200
20 000
10
40
3 000
15
Developing
From the table it is possible to derive the price of life.The life of a developing country's
inhabitant is worth 33 times less than of a rich developed country.The estimated price of a rich
American's life is 2 million US$, the life of a poor Chinese only 60 000 US$ ! [4].
The dose-rate c/a value at which relocation is optimised is 15 mSv/month (1,5 rem/month) in a
developing country, 3 times more than in a rich developed country. It is concluded that " the
derived value for the dose rate at which relocation is optimised is about 10 mSv per month and
is fairly robust around this figure ". The duration of such a relocation is not indicated. With 10
mSv/month, that is 1 rem/month, the Soviet 35 rem criterion would be attained in 3 years...
Over 10 years, a cumulative dose of 120 rem would be of the same order of magnitude than the
highest value recommended by Pellerin and Beninson " 3 times 35 rem". There's nothing
surprising about that. Pellerin was a member of ICRP's Committee 4 which prepared the new
recommendations while Beninson was the chairman of ICRP.
Finally, in the management of the Chernobyl nuclear crisis by the authoritarian Soviet power,
135 000 people were evacuated in 1986 and some 300 000 people were relocated after 1989.
(Not enough, unfortunately, as shown previously). But who knows, a Western democratic
government (like ours) might have imposed quite higher dose limits to avoid relocation of
people and therefore left them to live in heavily contaminated areas...
The analysis of the intervention of Western experts in post-Chernobyl management
demonstrates clearly that they gave unreserved support to the Central Soviet authorities
and their relevant experts to the detriment of the population's health. The activity of
Western experts has almost never been criticized either by the scientific community or
by the intermediary bodies (medical profession, trade-unions, associations etc.) and
medias.
Therefore we have to assume full and entire responsibility for the health consequences
of the Chernobyl catastrophe. Furthermore, our experts have gained experience
through Chernobyl. Since then, they have brought in strictly economic criteria for the
management of future nuclear crisis. One has to remember that the possibility of a
severe nuclear accident with its trail of dramatic consequences cannot be ruled out on
our own nuclear reactors.
November 1997
Bella Belbéoch is Secretary of the Groupement de Scientifiques pour l'Information sur
l'Energie Nucléaire (group of scientists for information on nuclear energy) which edits a
quarterly review La Gazette Nucléaire, 2 rue François Villon, 91400, France. Fax :
33160143496
(To be published in the Acts of the 2nd International Scientific Conference on Consequences of
Chernobyl Catastrophe Health and Information : From Uncertainties to Interventions in the
Chernobyl Contaminated Regions, Geneva, 13th and 14th November 1997, Centre
Universitaire d'Écologie Humaine et des Sciences de l'Environnement, Geneva, Switzerland).
References
•
[1] Gazette Nucléaire n96/97, Juillet 1989. Dossier Tchernobyl trois ans après.
[2] AIEA. INFCIRC/380 Vienne, 25 Juillet 1990.
[3] USSR State Committee on the utilization of nuclear Energy : The accident at the
Chernobyl nuclear plant and its consequences. Information compiled for the IAEA
Expertí Meeting, 25-29 August 1986, Vienna.
[4] The collective dose, in man-sievert units, is the product of the total number of
persons by one person's average dose in Sv. The number of the fatal radiation-induced
cancers is derived from the product of the collective dose by the risk factor. In 1977
(ICRP 26) the fatal cancer risk factor was 1.25% per sievert. (125 fatal cancers will
result from a dose of 10 000man-Sv. In 1990 (ICRP 60) it increased to 5%/Sv (500
fatal cancer will result from 10 000 man-Sv). If a collective dose of 1 man-Sv costs
100 000 US$, the price of 1 life is 2 million US$ (100 000 US$ : 0.05) but it seems
that this price represents the social cost of one death and not the price of one's life
which, evidently, has no price.
[5] Science, Sept. 12, 1986, vol. 233.
[6] Commission des Communautés Européennes. Líaccident nucléaire de Tchernobyl
et ses conséquences dans le cadre de la communauté européenne, COM (86) 607, Oct.
1986.
[7] Nucleonics Week, May 10, 1990, p. 3.
[8] A. Moiseev, Analysis of the radiological consequences of the Chernobyl accident
for the population in the European part of the USSR. WHO Consultation on
Epidemiology related to the Chernobyl Accident, 13-14 May 1987, Copenhagen.
[9] Libération 4 nov. 1987.
[10] L. A. Ilyin, O. A. Pavlovskij Radiological consequences of the Chernobyl accident
in the Soviet Union and mesures taken to mitigate their impact, IAEA Bulletin 4/1987.
[11] L. A. ILíIN The Chernobyl experience in the context of current radiation
protection problems Proceedings of an international conference, Sydney 18-22 April
1988, Radiation Protection in nuclear energy, vol. 2 p. 363.
[12] UNSCEAR Report to the general Assembly 1988 Sources, effects and risks of
ionizing radiation. The USSR collective committed effective dose equivalent is 226 000
man-Sv.
[13] Bella et Roger Belbéoch Tchernobyl une catastrophe Editions ALLIA, Paris 1993.
[14] Sobecednik, n17, Avril 1989, in Gazette Nucléaire n96/97 (1989)
[15] Gazette Nucléaire n84/85, Janvier 1988, p. 26
[16] Pravda Ukrayini, 5 and 15 July 1989. Maps in [17] and [13].
[17] Gazette Nucléaire n100, Mars 1990. Dossier Gestion post-Tchernobyl p. 16.
[18] Chernobyl reactor accident. Report of a consultation, 6 May 1986, WHO,
Copenhagen.
[19] Gazette Nucléaire n101/102 Mai 1990 p. 32
[20] Gazette Nucléaire n109/110 Juin 1991. Dossier Tchernobyl 5 ans après (22
pages).
[21]The International Chernobyl Project. An Overview. Assessment of radiological
consequences and evaluation of protective peasures. Report by an international
Advisory Commitee, May 1991.
[22] Dr. Marie-Hélène Montaigne, Association Avicenne, Ronchain, France.
[23] G.I. Lazjuk et al. Radiation Protection Dosimetry vol. 62, n1/2 (1995) p. 71-74
Frequency of changes of inherited anomalies in the Republic of Belarus after the
Chernobyl accident
[24] Gazette Nucléaire n157/158, Mai 1997. Dossier Tchernobyl 11 ans après (12
pages).
[25] S. T. Belyayev, V. F. Demin Les conséquences à long terme de Tchernobyl, les
contre-mesures et leur efficacité. Actes de la conférence internationale les accidents
nucléaires et le futur de líénergie. Leçons tirées de Tchernobyl. 15-16-17 Avril 1991,
Paris.
[26] Scientific Correspondence Thyroid cancer after Chernobyl, Nature, 3 Sept. 1992,
vol. 359 V. S. Kazakov, E. P. Demidchik, L. N. Astakhova, p. 21
K. Baverstock, B. Egloff, C. Ruchti, D. Williams, A. Pinchera, p. 21-22
[27] B. Belbéoch, En Biélorussie : cancers de la thyroïde chez les enfants
Gazette Nucléaire n 119/120, Août 1992.
[28] M. Genesco, private communication, 28/2/1989. At that time this authorized
officer from the state-financed civilians rescue organization said that, in the emergency
phase, if the projected dose could exceed the lower level of a countermeasure, this
countermeasure should be implemented.
Books recommended :
Zhores Medvedev, The legacy of Chernobyl, Basil Blackwell, Oxford, 1990.
•
Permanent People's Tribunal, IMCC, Chernobyl, Vienna, 12-15 April 1996.
(International Peace Bureau 41 rue de Zurich, 1201, Geneva, Switzerland).
•
Annex
Population living in legally contaminated areas in the Ukraine, Byelorussia and
Russia (Cs137 > 1Ci/km2)
Cs137
ground deposition
level
Population
(in thousands of inhabitants)
2
(Ci/km )
Byelorussia
The
Ukraine
Russia
Total
~ 2 300
1-5
1 840
~ 2 250
~ 6 400
113
5-15
(zones of periodic
radiation control
267.2
584.4
15-40
(zones of permanent
strict radiation
control)
204.2
80.9
95.7
29.7
206.3
>40
compulsory
relocation
1990-1992 ?
4.6
11.6
19.2
35.4
Byelorussia
The
Ukraine
Russia
Total
~ 2 300
1-5
1 840
~ 2 250
~ 6 400
113
5-15
(zones of periodic
radiation control
267.2
584.4
15-40
(zones of permanent
strict radiation
control)
204.2
80.9
95.7
29.7
206.3
>40
compulsory
relocation
1990-1992 ?
4.6
11.6
19.2
From references [2] [13] [20].
35.4