E. D. Williams
EDITOR,-Neither the editorial’ nor the three articles relating to the Chernobyl reactor accident make more than a passing mention to the
one major increase in malignancy that has so far been identified-namely, the greatly increased incidence of childhood thyroid cancer in the
exposed population of southern Belarus, which was first reported in 1992.’ The pathology was documented in 1993, the relation to the disaster has been reviewed, and the paradox that isotopes of iodine may be carcinogenic to the thyroid in normal children despite their safety in adults with Graves’ disease has been discussed. As was reported at a recent World Health Organisation meeting in Rome, the increase has now also been recorded in the northern Ukraine and is continuing in Belarus.
Thurstan B Brewin gives the impression that the Chernobyl accident was fairly trivial and that we know all about the dangers of radiation. He is concerned that the dangers of radiation are being exaggerated, but he goes too far in the direction of complacency. We most certainly do not know all about the dangers of radiation-for example, we need to know more about the tissue specific effects of different radioactive isotopes. Complacency, and a belief that we knew all about the dangers, led to huge releases of various isotopes from the Hanford nuclear facility in the United States, partly as a deliberate but covert experiment.’
Despite the accident at Chernobyl there is clearly a case to be made for nuclear power, but it must be made against a background of openness and a realistic assessment of risk. The accident at Chernobyl was unprecedented, with about 1018 Bq of radioactive isotopes released. While studies of low level exposure are valuable, studies of the effects of the fallout in the exposed population in the vicinity of Chernobyl are more likely to be helpful. Currently several international organisations are cooperating with local scientists in studies of the population exposed to much higher levels of fallout around Chernobyl than were seen in Western countries. The proper response to
future incidents must be informed by information gained from studies of the consequences of Chernobyl.
E D WILLIAMS
Professor of histopathology
Department of Histopathology,
Addenbrooke’s Hospital,
Cambridge CB2 2QQ
1 Boice J, Linet M. Chemobyl, childhood cancer, and chromosome
21. BMJ 1994;309:139-40. (16July.)
2 Auvinen A, Hakama M, Arvela H, Hakulinen T, Rahola T,
Suomela M, et al. Fallout from Chemobyl and incidence of
childhood leukaemia in Finland, 1976-92. BMJ 1994;309:
151-4. (16July.)
3 Hjalmars U, Kulldorff M, Gustafsson G on behalf of the
Swedish Child Leukaemia Group. Risk of acute childhood
leukaemia in Sweden after the Chemobyl reactor accident.
BMJ1994;309:154-7. (16 July.)
4 Sperling K, Pelz J, Wegner R-D, Dorries A, Gruters A,
Mikkelsen M. Significant increase in trisomy 21 in Berlin nine
months after the Chemobyl reactor accident: temporal correlation
or causal relation? BMJ 1994;309:158-62. (16 July.)
5 Kazakov VS, Demidchik EP, Astakhova LN. Thyroid cancer
after Chemobyl. Nature 1992;359:21.
6 Baverstock K, Egloff B, Pinchera A, Ruchti C, Williams ED.
Thyroid cancer after Chemobyl. Nature 1992;359:21-2.
7 Furmanchuk AW, Averkin JI, Egloff B, Ruchti C, Abelin T,
Schappi W, et al. Pathomorphological findings in thyroid
cancers of children from the Republic of Belarus: a study of 86.
cases occurring between 1986 (‘post Chernobyl’) and 1991.
Histopathology 1992;21:401-8.
8 Commission of the European Communities. Thyroid cancer in
children living near Chernobyl. Expert panel report on the
consequences of the Chernobyl accident. Brussels: CEC, 1993.
EUR 15248 EN.)
9 Williams ED. Radiation-induced thyroid cancer. Histopathology
1993;23:387-9.
10 Brewin TB. Chemobyl and the media. BMJ 1994;309:208-9.
(16 July.)
11 Napier BA. Hanford environmental dose reconstruction
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2541819/pdf/bmj00465-0060a.pdf
