liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Malignancies in Sweden after the Chernobyl accident in 1986
Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

On 26 April 1986 an accident occurred in the Chernobyl nuclear power plant resulting in the release of large amount of radionuclides. Almost five percent of the total released caesium-137 was deposited in Sweden. The incidence of malignancies in the most affected counties in Sweden was investigated in three epidemiological studies.

In the first study the incidence of malignancies in children and adolescents was studied for the period 1978-1992. The parishes and their inhabitants were classified according to the ground deposition of caesium-137 on an analogue map provided be the Swedish Radiological Protection Authority. A continuous increase of brain tumour incidence observed during the time of the study had no clear relationship to the Chernobyl fallout. A somewhat decreased relative risk of ALL was observed in areas with increased deposition. Other malignancies showed no changes in incidence over time or with regard to the exposure of caesium-137. In study II and III we enlarged the study base by including adults. We improved the methodology by defining a cohort of subjects who lived in the same parish from 31 December 1985 to 31 December 1987. The inhabitants from seven counties were included. Parishes were classified the same way as in study I. Due to the large number of individuals six exposure categories could be created; <3, 3–29, 30–39, 40–59, 60–79, and 80–120 kBq caesium-137/m2. The inhabitants of the 117 non-affected parishes (<3 kBq/m2) served as reference. During the 1988-1996 followup, 22,409 malignancies were recorded. The MH-IRR in the fully adjusted model was 1.00 (reference), 1.05, 1.03, 1.08, 1.10 and 1.21, respectively. ERR was 0.11 per 100 kBq/m2 (95% CL 0.03;0.20). A more advanced method was used in Study III by ignoring the exposure classification for parishes, and instead matching the dwelling coordinate to a digital map of deposition of casesium-137. In spite of a more valid exposure classification the risk estimates were similar in study II and III. Also, the ERR during the longer follow-up of 1988-1999 was almost identical, 0.10 per 100 kBq/m2 (95% CL 0.00;0.23). The strongest dose-response relationship was seen in the first four years (1988-1991). No obvious excess for leukaemia or thyroid cancer was recognised in either study II or III. The estimated number of exposure related cases was calculated to 849 in study II and 1,278 in study III. Our interpretation is that we have shown an increased incidence of total malignancies with dose-response relationship for caesium-137, only a few years after the Chernobyl accident. In study IV we compared the two different ways of classifying the exposure in study II and III. Out of the 450 parishes 111 got a different classification. The similar risk estimates in study II and III could probably be explained by relatively homogenous exposure in the parishes making the intra-parish difference less influential, especially when included in categories. In study V we examined the urinary excretion of 8-OHdG in Belarussian children from areas with high and low fallout of caesium-137, respectively. We found significantly lower urinary 8-OHdG levels in children from rural contaminated areas compared to urban uncontaminated areas, suggesting an urban, rather than a radiation related, risk factor.

Using the Hill criteria for causality there is support for a causal inference between the fallout of caesium-137 from the Chernobyl accident and the increased incidence in total malignancies in Northern Sweden.

Place, publisher, year, edition, pages
Institutionen för molekylär och klinisk medicin , 2007. , 57 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1001
Keyword [en]
Epidemiology, Environmental, Chernobyl, ionising radiation, geographical information systems GIS, 8-OHdG, Malignancies, Low dose, Dose-response, Latency, Causalty
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-8886ISBN: 978-91-85715-17-6 (print)OAI: oai:DiVA.org:liu-8886DiVA: diva2:23612
Public defence
2007-06-04, Aulan, Hälsans Hus, Campus US, Linköpings Universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2007-05-15 Created: 2007-05-15 Last updated: 2009-08-22
List of papers
1. Incidence of neoplasms in ages 0-19 y in parts of Sweden with high 137Cs fallout after the Chernobyl accident
Open this publication in new window or tab >>Incidence of neoplasms in ages 0-19 y in parts of Sweden with high 137Cs fallout after the Chernobyl accident
Show others...
1996 (English)In: Health Physics, ISSN 0017-9078 (print) 1538-5159 (online), Vol. 71, no 6, 947-950 p.Article in journal (Refereed) Published
Abstract [en]

The incidence of neoplasms in childhood and adolescence in northern and central Sweden before and after the radioactive fallout from the Chernobyl accident was investigated in an ecologic study, 1978 to 1992. The study included all parishes in the six most contaminated counties classified after aerial mapping of ground radiation from 137Cs and investigated 746 cases of neoplasms in ages 0-19 y, diagnosed in the six counties. Incidence and relative risks of neoplasms were compared in areas with high, intermediate, and low contamination after versus before the Chernobyl accident in 1986. A continuous increase of brain tumor incidence in the ages 0-19 y during the period 1978-92 without clear relationship to the Chernobyl fallout was discovered. No clear relationship between the incidence of brain tumor and the exposure to varying levels of radiation from 137Cs was apparent. A somewhat decreased relative risk of acute lymphatic leukemia appeared in areas with increased exposure. Other neoplasms showed no changes in incidence over time or with regard to exposure. Until now, there is no indication that the Chernobyl accident has affected the incidence of childhood and adolescence neoplasms in Sweden, but it is still too early for any final conclusion about the effect of this event.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14505 (URN)
Available from: 2007-05-15 Created: 2007-05-15 Last updated: 2009-08-21
2. Increase of regional total cancer incidence in North Sweden due to the Chernobyl accident?
Open this publication in new window or tab >>Increase of regional total cancer incidence in North Sweden due to the Chernobyl accident?
Show others...
2004 (English)In: Journal of epidemiology and community health, ISSN 0143-005X, Vol. 58, no 12, 1011-1016 p.Article in journal (Refereed) Published
Abstract [en]

Study objective: Is there any epidemiologically visible influence on the cancer incidence after the Chernobyl fallout in Sweden?

Design: A cohort study was focused on the fallout of caesium-137 in relation to cancer incidence 1988–1996.

Setting: In northern Sweden, affected by the Chernobyl accident in 1986, 450 parishes were categorised by caesium-137 deposition: <3 (reference), 3–29, 30–39, 40–59, 60–79, and 80–120 kiloBecquerel/m2.

Participants: All people 0–60 years living in these parishes in 1986 to 1987 were identified and enrolled in a cohort of 1 143 182 persons. In the follow up 22 409 incident cancer cases were retrieved in 1988–1996. A further analysis focused on the secular trend.

Main results: Taking age and population density as confounding factors, and lung cancer incidence in 1988–1996 and total cancer incidence in 1986–1987 by municipality as proxy confounders for smoking and time trends, respectively, the adjusted relative risks for the deposition categories were 1.00 (reference <3 kiloBecquerel/m2), 1.05, 1.03, 1.08, 1.10, and 1.21. The excess relative risk was 0.11 per 100 kiloBecquerel/m2 (95% CI 0.03 to 0.20). Considering the secular trend, directly age standardised cancer incidence rate differences per 100 000 person years between 1988 to 1996 and the reference period 1986–1987, were 30.3 (indicating a time trend in the reference category), 36.8, 42.0, 45.8, 50.1, and 56.4. No clear excess occurred for leukaemia or thyroid cancer.

Conclusions: Unless attributable to chance or remaining uncontrolled confounding, a slight exposure related increase in total cancer incidence has occurred in northern Sweden after the Chernobyl accident.

Keyword
ionising radiation, epidemiology, environment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14506 (URN)10.1136/jech.2003.017988 (DOI)
Available from: 2007-05-15 Created: 2007-05-15 Last updated: 2009-08-21
3. Increased incidence of malignancies in Sweden after the Chernobyl accident: a promoting effect?
Open this publication in new window or tab >>Increased incidence of malignancies in Sweden after the Chernobyl accident: a promoting effect?
Show others...
2006 (English)In: American Journal of Industrial Medicine, ISSN 0271-3586 (print), 1097-0274 (online), Vol. 49, no 3, 159-168 p.Article in journal (Refereed) Published
Abstract [en]

Background After the Chernobyl accident in 1986, as much as 5% of the released caesium-137 was deposited in Sweden due to a heavy rainfall 2 days after the event. A study of increased incidence of malignancies was initiated after the accident.

Methods The cohort included 1,137,106 inhabitants who were 0-60 years old in 1986 and lived in 8 counties of Sweden with the highest fallout of caesium-137. With the dwelling coordinate, GIS-technique and a digital map on caesium-137, each individual was matched for the exposure. Adjustments were made for several potential confounding factors. During the follow-up 33,851 malignancies was recorded 1988-1999.

Results Exposure categories were: 0-8 (reference), 9-23, 24-43, 44-66, 67-84, and 85 nGy/hr. The corresponding adjusted Mantel-Haenszel incidence rate ratios for total malignancies during follow-up amounted to 1.000, 0.997, 1.072, 1.114, 1.068, 1.125, respectively. The excess relative risk per 100 nGy/hr with the same adjustments and time period was 0.042 95% confidence limit 0.001;0.084. An excess for thyroid cancer or leukemia could not be ruled out.

Conclusion Increased incidence of total malignancies possibly related to the fallout from the Chernobyl accident is seen.

Keyword
caesium-137, ionising radiation, nuclear power, low dose, epidemiology, environment, background radiation, cancer, GIS, cohort
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14507 (URN)10.1002/ajim.20271 (DOI)
Available from: 2007-05-15 Created: 2007-05-15 Last updated: 2009-06-05
4. Parish classification or dwelling coordinate for exposure assessment in environmental epidemiology: A comparative study using Geographical information System
Open this publication in new window or tab >>Parish classification or dwelling coordinate for exposure assessment in environmental epidemiology: A comparative study using Geographical information System
2008 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 405, no 1-3, 324-329 p.Article in journal (Refereed) Published
Abstract [en]

Background: Two previous epidemiological studies on the incidence of total malignancies in Sweden after the Chernobyl accident have shown consistently increased risks. The first study used an analogue map on (CS)-C-137 from 1986 to classify individuals in terms of the parish they lived in. In the second study, dwelling coordinates were matched to a digital map from the year 2000 to assess the individual exposure. To establish the accuracy of the exposure assessment using the larger unit of parish, instead of coordinates, we decided to compare the methods.

Methods: On the analogue map eleven isolines on the deposition of Cs-137 (kBq/m(2)) were used to classify all individuals in each of the 450 parishes. Using the digital map, by contrast, each dwelling with its inhabitants could be matched to Cs-137 deposition at a coordinate level. A population-weighted average of Cs-137 deposition was calculated for each parish. In total, 1,126,960 individuals and 450 parishes were included and analysed into six different exposure categories.

Results: Using the new parish exposure index, 111 out of the 450 parishes were reclassified as a result of the increased resolution of the digital map (86 parishes) or unequal distribution of the population compared with the deposition (25 parishes). Seventy-five per cent of the parishes remained in the same exposure category as on the analogue map.

Conclusion: Using dwelling coordinates for exposure assessment may not always be superior to parish classification. Nor is it always a cost-effective way of estimating the exposure, especially if the exposure in a parish is relatively homogenous or if parishes can be merged into broader categories with little intra-parish difference.

Keyword
Analysis, Caesium-137, Chernobyl, Disease, GIS, Health, Malignancies, Method, Spatial
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16141 (URN)10.1016/j.scitotenv.2008.07.019 (DOI)
Available from: 2009-01-08 Created: 2009-01-07 Last updated: 2017-12-14
5. Urinary 8-hydroxydeoxyguanosine in Belarussian children relates to urban living rather than radiation dose after the Chernobyl accident: A pilot study
Open this publication in new window or tab >>Urinary 8-hydroxydeoxyguanosine in Belarussian children relates to urban living rather than radiation dose after the Chernobyl accident: A pilot study
Show others...
2005 (English)In: Archives of Environmental Contamination and Toxicology, ISSN 0090-4341, Vol. 48, no 4, 515-519 p.Article in journal (Refereed) Published
Abstract [en]

As a result of the Chernobyl accident in 1986, exposure to radioactive cesium is still a concern in the contaminated regions of Belarus. We tested the hypothesis that long-term radiation exposure from the Chernobyl accident might increase the urinary excretion of the oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG), in Belarussian children. Urinary 8-OHdG was determined in two groups of children (—n = 31 and n = 46) —living in contaminated and uncontaminated areas of Belarus, respectively (the majority of the unexposed children lived in the capital Minsk). The children from the contaminated areas had a significantly higher annual summary effective dose but significantly lower urinary 8-OHdG levels than the children from the uncontaminated areas. Unexpectedly, children living in uncontaminated urban areas had significantly higher urinary 8-OHdG levels than children living in uncontaminated rural areas. There was no statistically significant effect of sex or body mass index on urinary 8-OHdG, but there was a weak significant inverse correlation to age as well as to the annual summary effective dose. These findings suggest that radiation from the Chernobyl accident is now a less important contributor to oxidative stress in Belarussian children than urban living.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14509 (URN)10.1007/s00244-004-0079-z (DOI)
Available from: 2007-05-15 Created: 2007-05-15 Last updated: 2009-06-05

Open Access in DiVA

fulltext(241 kB)2463 downloads
File information
File name FULLTEXT01.pdfFile size 241 kBChecksum MD5
639d004bcb8d6b56ab47302a06ab34a84483aa2ed7ca8a68cf63135cc444e9991a3ab320
Type fulltextMimetype application/pdf

Authority records BETA

Tondel, Martin

Search in DiVA

By author/editor
Tondel, Martin
By organisation
Occupational and Environmental Medicine Faculty of Health SciencesOccupational and Environmental Medicine Centre
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 2463 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 5114 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf