Fallout from Chernobyl. Thyroid cancer in children increased dramatically in Belarus.

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.

Professor of histopathology
Department of Histopathology,
Addenbrooke’s Hospital,
Cambridge CB2 2QQ
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