In this special issue: 15th International Conference on ...worldinfo.org/wp-content/uploads/library/wer/english/2006_fall_Vol... · dioactive release and subsequent 10 day fire at

Communicating accurate scientific information on environmental health is the overarching goal of World Information Transfer (WIT). We firmly believe that scientists have a responsibility for maintaining an objective perspective towards the information upon which public health policy is based and that the public has a reciprocal obligation to protect scientific research from ideological bias. From this perspective, WIT organized its 15th International Conference on the theme of “Living with Radiation in the Modern World: Commemorating Chornobyl, Remembering Hiroshima and Nagasaki.” The scientific findings from the Conference are presented in this issue of our World Ecology Report.

To commemorate the 20th anniversary of the Chornobyl nuclear disaster, WIT’s 15th Conference was co-sponsored by the Government of Croatia, Govern-ment of Ukraine, the Permanent Mission of Japan to the UN, and was organized with the collaboration of the United Nations Environment Programme (UNEP), the United Nations Development Program, (UNDP), the UN Division for Eco-nomic and Social Affairs (DESA), and the International Atomic Energy Agency (IAEA). The following Missions to the United Nations lent their names in support of the Conference: Azerbaijan, Bangladesh, Bulgaria, Dominican Republic, Geor-gia, Hungary, Kazakhstan, Mexico, Oman, Poland, Slovenia, Thailand and Unit-ed Kingdom. The New York Eye and Ear Infirmary and Dr. Daniel Igor Branovan co-chaired our Conference and organized the full day segment on thyroid cancer. The complete scientific findings from this segment will be available separately. Dr. Bernard D. Goldstein, Professor and former Dean of the School of Public Health, University of Pittsburg co-chaired the segment on Health Consequences of Radia-tion. Stakeholder Forum lent its support to the Conference.

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15th International Conference on Health and Environment: Global Partners for Global SolutionsLiving with Radiation in the Modern World: Commemorating Chornobyl, Remembering Hiroshima and Nagasaki

Special Issue Summer/Fall 2006Vol. XVIII No. 2 & 3

United Nations Headquarters, New York, April 19 and 20, 2006

Dr. Christine K. Durbak

H.E. Valeriy P. Kuchinsky

H.E. Mirjana Mladineo

H.E. Kenzo Oshima

Dr. Toshiteru Okubo

Prof. Zvonko Kusic

Dr. Daniel Igor Branovan

Dr. Michael Balonov

Mr. Werner Obermeyer

Ms. Marta Ruedas

Dr. Cham Dallas

Dr. Paul Lioy

Dr. Maida Galvez

Dr. Patricia Myskowski

Dr. Vladyslav V. Bezrukov

Prof. Mykola D. Tronko

Mr. Carter F. Bales

First session: H.E. Kenzo Oshima; H.E. Valeriy P. Kuchinsky; Dr. Christine K. Durbak; H.E. Mirjana Mladineo.

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In this special issue:

World Ecology ReportWorld Information Transfer

Summer/Fall 2006 2 3World Ecology Report

World Information Transfer

Summer/Fall 2006

Statement by Dr.Christine K. Durbak Chair, World Information Transfer

We are most pleased to welcome you today to our 15th International Conference on the theme of “Living with Radiation in the Modern World: Commemorating Chornobyl, Remembering Hiroshima and Nagasaki”, co-sponsored by the Government of Croatia, Govern-ment of Ukraine the Permanent Mission of Japan to the UN, and with the collaboration of UNEP, UNDP DESA and IAEA, and with the support of the Perma-nent UN Missions of Azerbaijan, Bangladesh, Bulgaria, Dominican Republic, Georgia, Hungary, Kazakhstan, Mexico, Oman, Poland, Slovenia, Thailand and United Kingdom. We are particularly grateful to H.E. Valeriy Kuchinsky, Permanent Representative of Ukraine, H.E. Mirjana Mladineo, Permanent Representative of Croatia and H.E.Kenzo Oshima, Permanent Representative of Japan for their assistance and support in the preparation of this Conference.

“We have not inherited the world from our forefathers…

we have borrowed it from our children”

My topic today will focus on “Exploiting the Percep-tion of Risk.”

Nineteen years ago, when we founded World Informa-tion Transfer in the aftermath of the Chornobyl nuclear tragedy, we made a pledge to communicate scientifically validated information on the interrelationship between human health and the environment. We based our initial commitment on available scientific knowledge of the tragedy. On the 20th anniversary of the world’s worst nuclear accident, we renew our commitment to provide valid, reliable, scientific information not only about this nuclear tragedy but also on the full range of health is-sues related to environmental contamination.

Errors committed during the unprecedented ra-dioactive release and subsequent 10 day fire at the Chornobyl Power Plant 20 years ago, provided WIT with its raison d’être. Since we held our first conference at the United Nations 15 years ago, just before the Earth Summit, we have expanded our audience to include the

next generation, as you will see throughout the day. We understand the critical necessity for teaching our future leaders HOW to seek scientific truth and HOW to cope with the uncertainty of not knowing.

Some of the students with us today were born just after the nuclear accident. Within the first year after Chornobyl, the NY Public Research Interest Group (NYPIRG) sent out a call for baby teeth of New York-ers born within 6 months of the Chornobyl explosion. They were doing an experiment to see if the baby teeth contained elevated levels of Strontium 90, a radioactive isotope causing bone cancer. If high enough levels were found, parents would know their child had an elevated risk for developing bone cancer at some point in life. Bone cancer is currently incurable. The significance of this early attempt to identify potential health conse-quences from the Chornobyl accident is that the study missed the mark.

A great deal of research has been done, over the past 20 years, to accurately identify the health and environ-mental impact from Chornobyl in the most affected region - in Europe where the nuclear fallout landed in all directions - as well as in other parts of the world as reflected by this early NY study. We now know that the two major human health effects from the Chornobyl ex-plosion are: thyroid cancer, a curable disease that could have been prevented in many cases, and mental health problems, particularly post traumatic stress disorder (PTSD), that also could have been prevented or at least minimized.

We need to understand that environmental condi-tions contribute significantly to stress factors that affect a considerable number of individuals worldwide. Some people died as a result of the immense psychological stress experienced by those living in contaminated regions. The presence of significant post traumatic stress disorder is one of the key findings of the recent publications of IAEA and UNSCEAR. Post traumatic stress disorder and the delayed and long-term effects of psychic trauma have been documented in many dis-aster settings. Since early responses to traumatic stress often may be highly predictive of future adjustment, many studies have been undertaken to determine the incidence and composition of acute stress reactions fol-lowing a traumatic event such as Chornobyl. The level of exposure to the stressor is the factor most implicated in acute stress response. Dislocation of thousands of people from their homes is a major factor responsible for the PTSD present among the Chornobyl victim population.

Most people following a traumatic occurrence will respond initially with considerable distress that they manifest in a fairly predictable pattern of symptoms,




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which subsides with time. However, the readjustment period for some people is sometimes long and compli-cated by long term distress that is often unaddressed. This issue needs particular attention for the victims of Chornobyl.

What could have been done, immediately, to have prevented or limited human illness and suffering? • 1-told the people to remain indoors until the fire was

extinguished; • 2-told the people not to drink fresh cow’s milk because

fresh milk was the main source for 131Iodine to enter the body causing cancer of the thyroid;

• 3-widely distributed KI (potassium iodide) pills; • 4- given truthful data to the public.

In the countries where none of these four actions were taken, the result has been the public’s misconcep-tion that mental retardation and birth malformation were related to radiation, which is contrary to current scientific findings. We know that exposure to radioactive iodine (Iodine 131), the major component of the Chor-nobyl release, causes thyroid cancer, but does not cause mental retardation or fetal malformations. In rare cases, during the first 2-4 weeks of human gestation, if the fetus is directly exposed, can radiation cause birth defects.

Chornobyl was the 4th event that influenced public perception of risk from nuclear accidents. Because of its scale, this event evoked the possibility of a vast public health threat from radiation. To the general public, the differences in reactor configurations between the Chor-nobyl style RBMK reactor (used for production of pluto-nium for weapons) and the newer, safer plants in other parts of the world became irrelevant.

The significant nuclear accidents that preceded and followed Chornobyl are as follows:• 1957 - Windscale, UK – where a combination of human

error and erroneous indication led to a fire at a weap-ons plant that produced weapons-grade plutonium. The fire caused a release of radio-nuclides into the en-vironment through ventilation shafts. The public were immediately informed to stop drinking milk for two months by the government.

• 1961 –The US Army’s SL-1 reactor outside of Idaho Falls, Idaho, was critically damaged. The bodies of three men involved were buried in lead coffins due to the amount of radioactive contamination. The build-ing that the reactor was housed in contained most of the contamination, although high levels of Iodine-131 were detected downwind on vegetation for several days. The cleanup cost millions of dollars and the ex-posure of crews to high levels of radiation.

• 1979 - Following a reactor scram at Three Mile Island, near Harrisburg, Pennsylvania in the USA, a power-op-

erated relief valve (PORV) failed to open. This caused indications that the operators were not expecting and thus they overrode safety system initiations and a par-tial core melt occurred due to overheating. The popu-lation was evaluated immediately.

• 1986 - Chornobyl:– During special testing at the Chornobyl nuclear facility, a rapid power rise caused a steam explosion and fire that destroyed the con-tainment structure and released a large amount of radioactivity into the environment. As of 2004, IAEA and UNSCEAR report approximately 56 deaths are attributed to this accident, with the long-term effects of the radiation exposure being unknown. The evacu-ation of the local area was conducted by the Soviet military after many days of silence. Much criticism has been expressed as to the inadequacy of timeliness of the procedures used. The effects of this accident have been seen worldwide with the monitoring of vegeta-tion and livestock for contamination.

• 1999 - Thirteen years after Chornobyl, in Tokaimura, Japan, as workers were setting up to process uranium for making nuclear fuel, too much uranium was added to the container and a nuclear reaction occurred. The workers saw a blue flash and vacated the area imme-diately. The resultant reaction continued for up to 20 hours and was halted by severing the cooling water lines to the container. Neutron radiation was detected at remote sites, but the increase in readings was ini-tially assumed to be ‘background noise’.

In each case, the public took actions based on the ‘perceived danger’ rather than on the actual danger pre-sented. The response of the public is not based on the specifics of the actual release of radioactivity, but on the perception of danger. Whether or not the population will follow the directives of the local and state authori-ties or act on their own depends on the established lev-els of trust in the authority, as well as the intrinsic logic of the information offered.

The Chornobyl catastrophe also reinforced the pub-lic’s mistrust at authorities of that time, because of their denial of the extent of the danger of the accident. The accident also reinforced economic and social problems which were present at that time and which eventually contributed to the end of the cold war and disbanding of the former Soviet Union.

Most people following a traumatic occurrence will respond initially with considerable

distress that they manifest in a fairly predictable pattern of symptoms




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Three Mile Island accident halted construction of new nuclear plants, and currently, the perceived risk of nuclear terrorism has put nuclear energy in the center of the public attention with often uninformed discus-sions. This is also one of the reasons why we need to raise awareness of the possible consequences of a nuclear ca-tastrophe based on scientific data.

Since 1992, we have convened our annual confer-ence here at the United Nations to provide updated research on radiation contamination and the follow up to the human health consequences of Chornobyl. Enormous resources are still required to address the social, economic, health, environmental and psycho-logical effects of the Chornobyl accident if the human cost of the tragedy is to be mitigated. Most significantly, if the people of the region and of Europe are to be pro-tected, the rebuilding of the Sarcophagus should begin in the very near future. The rebuilding was supposed to be completed in 2005, it is 2006 and it has not yet begun. To this end, I welcome a resolution passed at the US House of Representatives on April 4 of this year, which recognizes the 20th anniversary of the Chornobyl nuclear disaster and supports continued U.S. assistance to the Chornobyl Shelter Fund.

Today, one week before the United Nations General Assembly Special Session commemorating the 20th an-niversary of the Chornobyl tragedy, we will hear experts present scientifically validated data on issues of radia-tion from Japan, the victims of Hiroshima and Nagasaki to Chornobyl, the largest radiation explosion in the his-tory of the world. We will also hear from other experts studying radiation from a variety of sources.

In this room are international thought leaders from the worlds of medicine, environmental science, diplo-macy, economics and business, who have gathered here for the next two days to share information about the in-timate relationship between our health and the health of our environment. It has been our experience, and it remains our hope, that this annual forum will continue to provide information exchange, contacts and, ulti-mately, solutions, for what is one of humanity’s great-est and least publicized challenges: keeping people healthy by maintaining a safe and clean environment. It is also our hope that the young people you will see at our conference as well as others in their generation will not repeat the errors of their elders. In conclusion, I would like to repeat the ancient proverb: “We have not inherited the world from our forefathers…we have borrowed it from our children.” We need to keep that proverb in our minds and hearts for the sake of our future generations. Thank you.

Statement byH.E. Valeriy Kuchinsky Permanent Representative of Ukraine to the United Nations

First of all, let me thank the World Information Transfer and its President Christine Durbak for organ-izing this important international forum for fifteenth consecutive year, and for giving me the opportunity to address the distinguished audience today.

I would also like to extend my appreciation to other co-sponsors of today’s Conference: the Permanent Mis-sions of Japan, Croatia, Poland, the Department of Eco-nomic and Social Affairs of the United Nations, United Nations Environment Programme, and the Internation-al Atomic Energy Agency.

I wish to pay special tribute to the distinguished Permanent Representative of Japan, Ambassador H.E. Kenzo Oshima, whose dedication and perseverance in combating the after effects of the Chornobyl disaster are broadly known. I must admit that Ambassador Oshima received wide recognition in my country during his ten-ure as the UN Coordinator for International Coopera-tion on Chornobyl.

My heartfelt thanks also go to the Permanent Mis-sions of Azerbaijan, Bangladesh, Bulgaria, Dominican Republic, Georgia, Hungary, Kazakhstan, Mexico, Oman, Slovenia, Thailand and the United Kingdom for their kind support in holding the Conference.

Today’s conference takes place at a special point in time. Next week we will solemnly observe the twentieth anniversary of the Chornobyl catastrophe, the most hor-rible and the worst nuclear disaster that humanity ever witnessed. Almost twenty years ago – on April 26, 1986 – unit 4 of the Chornobyl nuclear plant exploded and set on fire, releasing vast amount of radiation into the atmosphere.

This was a disaster of global proportions. The United Nations General Assembly – the world’s most authorita-tive body –unequivocally concluded last year that Chorno-byl has been the major technological catastrophe in terms of scope and complexity that raised fundamental humani-tarian, environmental, and health questions affecting all humankind. What does that mean in practical terms?

In 1986 the failed reactor disgorged almost the en-tire periodic table. The winds that carried the pollution over the world led to a catastrophic level of radioactive contamination over immense territories. Suffice it to




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say, that almost 10 per cent of the territory of Ukraine was exposed to direct radiation. Although my country has been hardest hit, the pollution also penetrated into Belarus, Russia, Sweden, Finland, Poland, Bulgaria, Germany, Italy, Turkey and the United Kingdom. In-credibly, a rise in radiation was recorded even in Japan. According to the IAEA, radioactive material from the plant was detectable at various levels over practically the entire Northern Hemisphere.

The focus of our Conference today on health and environment is particularly pertinent in the context of Chornobyl. The twentieth anniversary of the tragedy should serve as a unique opportunity for the interna-tional community to look afresh at its impact on health and environment.

The tragedy has taken a the toll on Ukrainian nation. For us, the word ‘Chornobyl’ means nearly 3 million af-fected people, including 1.2 million children. It has also left deep scars on 200,000 people from 170 localities that had been evacuated in its aftermath. These high figures bear witness to the enormity of the catastrophe. But the global nature of the disaster can obviously not be meas-ured solely by external signs such as the breadth of the area polluted and the number of people imprisoned by the invisible radioactive veil. It is still more important to find out the genetic damage it has caused and, unfortu-nately, will continue to cause for generations to come. Up to now, we do not know yet the real extent of its impact.

Many hard lessons have been learned from Chornobyl, including the need for transparent, timely,

and credible information.

Robert Louis Stevenson once said, “The cruelest lies are often told in silence”. Perhaps, the catastrophe represents one of the most salient examples of what we in the United Nations call “hidden or neglected” emer-gency. Reliable information about the accident and the resulting contamination was not available to affected people for about two years following the accident. Con-sequently, this has led to distrust and confusion about health effects. This confusion continues up till now.

Admittedly, it was only in 1989, three years after the accident, that the Government of the USSR requested the International Atomic Energy Agency to assess the ef-fects of the tragedy and to evaluate the effectiveness of the relief operation. Until then, the catastrophe slipped off the radar screen of the humanitarian community. Too many people were doomed to suffer because their emergency had not been recognized. Lots of lives might have been saved if the political will had been there – which was not the case.

Several organizations reported the impacts of the Chornobyl accident at the time, but all had problems assessing the significance of their observations because of the lack of reliable public health information. The fig-ures of Chornobyl-related fatalities, in the ‘Chornobyl’ report by Greenpeace, which was launched only yester-day, are much higher than all other previous estimates. Renowned international experts calculated that more than 100,000 people would die from the effects of the catastrophe. A recent study by German scientists, which was commissioned on the request by the European Par-liament members and released this month, revealed that death toll includes 60,000 people who died from cancer as a result of radiation exposure. It also says that a predicted 25,000 cases of cancer in the future will be attributed to radiation exposure.

Anyway, what we can tell now for sure is that it was an extremely serious accident with major health con-sequences, especially for thousands of workers, the so-called liquidators, exposed in the early days after the accident who received very high radiation doses, and for the thousands more stricken with various forms of radiation-induced cancer and other diseases.

My country recognizes the updated findings of the Chornobyl Forum that finally found consensus on the health and environmental consequences of the explo-sion. The latest conclusions of the Forum are in line with earlier expert studies, which said that tens or even hundreds of thousands of lives have been at risk after the disaster. Impressively, the report finds more than 600,000 people received high levels of exposure, includ-ing reactor staff, emergency and recovery personnel and residents of the nearby areas.

The report rightfully warns about the mental health effect of the accident on the local population, which was affected by high anxiety levels. People in the con-taminated territories have suffered a paralyzing fatalism; many of them “took on the role of invalids.” Psychoso-cial effects among those affected by the accident are similar to those arising from other major disasters such as earthquakes, floods and fires.

On a final note, let me emphasize that the assess-ments and prediction of health disorders related to radiation exposure from Chornobyl must be vigorously followed-up up for many decades ahead. This is abso-lutely essential to get insight into the real magnitude and health effect of the accident among the nearly 5 million affected individuals.

Our Conference today is uniquely placed to bridge divides and overcome prejudices, misconceptions and polarizations around the health effects of the Chornobyl catastrophe. We consider the outcome of the Confer-ence as complementary to that of the Chornobyl Forum.




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Meetings like this one are essential for sending a mes-sage of remorse for the past, and a message of resolve for the future. In that hopeful spirit, please accept my best wishes for our successful conference. I thank you.

Statement byH.E. Mirjana MladineoPermanent Representative of Croatia to the United Nations

It’s my honor to be here as a layman in the field of nuclear issues. Let me begin first of all by saying that the Croatian mission to the United Nations is very happy to co-sponsor this conference now for the 3rd year in a line. I’m honored to be here today repre-senting Croatian government at the moment when we commemorate twenty years since the Chornobyl dis-aster. As my dear colleague has said very often we go into our own personal thoughts in dealing with such situations, and I’m also going to start on the personal note.

Of course I remember the day of April 26th in 1986 when the accident of Chornobyl happened. I was in my hometown of Zagreb, and I remember the hourly reports of Croatian experts in measurements of radioactivity. I think that this was a very important situation where we have had the proper response from the authorities that have really warned us about what is going on. We were warned to stay inside. I had to use all my powers of persuasion to keep my then nine-year-old daughter inside during such a beautiful day. It was very difficult to explain radiation to her. It does not immediately hurt. You cannot see it. It has no smell. And still it is so terrifying. And I remember a map of Europe, which showed the waves of radiation spreading first to the northern and then also to the central and southern parts of Europe. We believed then that in Croatia only the coast and its islands were spared because of the large dividing mountain range, which somehow we believed stopped the radiation to cross. All of us who were old enough, we remember it vividly. We share all our compassion and sympathy with the victims and their families who have to deal with the consequences even now, twenty years after this accident.

The Croatian government believes that we need to keep global attention on the consequences of radia-tion. This is why we are sponsoring this conference for the third year. We need to recognize that the Chornobyl nuclear power plant continues to be a potential source of danger in the center of Europe. Minimizing this threat in the near future and on the basis of new technology is in everyone’s interest. The comprehensive radiation clean-up and economic and social rehabilitation of the affected areas are issues of great importance in addressing the consequences of this terrible disaster. This is the reason why my delegation was very active in negotiating and co-sponsoring the resolution A/60/14 on strengthening international cooperation and coordination of efforts to study, mitigate, and minimize the consequences of the Chornobyl disaster. We believe that this resolu-tion is a step forward. Apart from recognizing the difficulties faced by the most affected countries in minimizing the consequences of the Chornobyl dis-aster, it also stresses the need for the socioeconomic development of the region.

It is our hope that this conference will also be a step forward in this direction, and will enhance the focus on the Chornobyl accident by the international com-munity. We are very pleased that Professor Zvonko Kusic, who is a member of The Croatian Academy of Arts and Science and academic and practitioner in the fields of nuclear medicine and radiology, will be speaking this afternoon on the changing trends in the incidence and mortality of thyroid cancer in Croatia from 1968 to 2002.

Statement by H.E. Kenzo OshimaPermanent Representative of Japan to the United Nations

My distinguished colleagues, Ambassador Kuchinsky of Ukraine and Ambassador Mladineo of Croatia, have already established a good base for our discussions to-day by covering most of the important topics concern-ing the Chornobyl disaster. I would like to add a few comments from the perspective of Japan and that of a former UN Coordinator for International Cooperation on Chornobyl that I had the pleasure of serving until a few years ago.

The Croatian government believes that we need to keep global attention on the

consequences of radiation.




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Twenty years ago, the world witnessed one of the most terrible accidents in history. The Chornobyl acci-dent was a horrendous tragedy because of the direct hu-man cost, the large tracts of land poisoned, the scale of displacement of the populations, the loss of livelihood, and the trauma suffered by the people. The victims of the tragedy were confronted by a situation which they could scarcely understand and against which they had no means of defense.

Today, as we mark the anniversary, our hearts go to the people of these blighted lands who, in the face of continuing danger and risks, have persevered in their efforts to rebuild communities and fight their way back to normalcy.

The international community has also responded in a spirit of humanity and fellowship. Non-governmental organizations have played a crucial role in this humani-tarian endeavor – both those NGOs that have brought tangible, material assistance to the affected popula-tions, as well as those that helped to mobilize and raise awareness of the need for this assistance. And today, it is gratifying that these efforts continue in various parts of the world.

We must not forget the Chornobyl disaster; we must not lose the important lessons learned from that terri-ble disaster with the passage of time. And we must keep learning yet unlearned lessons from the disaster to keep the posterity from repeating the mistakes and from the same suffering.

Although much of the news coverage has disap-peared from the international media and the public interest may have waned, the truth is that still many of the affected people, their families and their communi-ties continue to suffer in various forms. Health hazards are still deadly, but now they are more insidious. There is woefully inadequate knowledge among the victims about the perils that they and their offspring face. There are concerns about the environmental impacts of the radiation, there are continuing difficulties faced by the afflicted communities arising from economic and social dislocation caused by the disaster. Thus the long-lasting, even permanent, scars linger, some visibly while others invisibly, but equally terribly.

I had an opportunity myself to observe some of the unspeakable damage and painful reality on the ground when I visited the Chornobyl region of Ukraine and Belarus four years ago in my capacity as Coordinator of

International Cooperation on Chornobyl. In the places I visited, the physical, psychological, environmental and socio-economic consequences were still painfully evident. It was clear that for the affected communities and population to resume their normal lives, they would have to make determined efforts to overcome them, and, in so doing, they needed appropriate moral sup-port and material and scientific assistance from the out-side world as well as from their own government.

I know much effort has been made by national gov-ernments, and the international community, including the UN and UN agencies, and NGOs came to help pro-vide those assistance and support. But clearly there is much more that can and should be done to assist those in need, to undertake more research into radiation-re-lated diseases and environmental and other impacts.

The twentieth commemoration of the Chornobyl disaster this year is a unique opportunity to renew our individual and collective resolve to keep alive the legacy of this most terrifying man-made disaster and keep it on the international agenda. To this end, it is encouraging to see so many initiatives that have been undertaken to commemorate this anniversary, and I commend you, Dr. Durbak, for your tireless efforts to focus international attention on the long-lasting effects of the catastrophe. I also commend World Information Transfer for its spon-sorship of this important event.

I myself come from a city in Japan, Hiroshima, which had known the horrors of a nuclear catastrophe only too well. The effects of nuclear exposure on a population, a subject Dr. Okubo will probably discuss in his keynote address, can still be observed and researched in Hiro-shima and Nagasaki 60 years after the blast.

At the Chornobyl Forum, health and environmental experts under the able leadership of IAEA and WHO have found the rate of thyroid cancer among the af-fected populations is not as high as expected. This is an encouraging finding, and I commend the partici-pating experts for their work. Nevertheless, I believe we still need to keep our eyes on the long-term effects of radiation. Together with the need for community re-habilitation and development, we have ample reason to continue our efforts in this area and make appeals to the international community for its support.

To this end, it is encouraging that the United Nations system is now better equipped to respond to the issues posed by long-term effects of the Chornobyl disaster.

Clearly there is much more that can and should be done to assist those in need.

Disseminating accurate information is an indispensable part ofthe work of mitigating fear




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The Chornobyl Forum successfully concluded its work and is moving towards disseminating its findings. UNDP has taken up the role of focal point, reflecting the shift from emergency relief to longer-term recovery. The In-ter-Agency Task Force is holding regular meetings con-necting headquarters and field offices. The General As-sembly will hold a special commemorative meeting next week. Together, we have generated a strong momentum in our efforts to mobilize international support to meet the long-term needs of the affected populations.

For its part, Japan has made, and will continue to make, contributions to the efforts of affected countries and populations to achieve a recovery from the Chor-nobyl disaster. In Ukraine, the UNDP country team is implementing a project rooted in community-level ef-forts, with the aim of effecting a sustainable, long-term economic recovery. Japan has offered financial contribu-tion to this project through the United Nations Human Security Trust Fund, which the Japanese government has funded.

Another important project to empower people is the International Chornobyl Research and Informa-tion Network (ICRIN). ICRIN was launched three years ago to provide affected populations, communi-ties and interested institutions with readily available access to scientific information and data that would as-sist them in reaching informed decisions on long-term recovery and help ameliorate the complex and diverse humanitarian, ecological, economic, social and medi-cal problems of the affected territories. Disseminating accurate information is an indispensable part of the work of mitigating their fear and helping them make progress for sustainable development. Japan stands ready to discuss how it can best support this important ICRIN project.

It is not only government that has shown an interest in following the situation of the populations affected by the Chornobyl disaster. Last Sunday, a group of interested citizens organized a seminar in Tokyo com-memorating the twentieth anniversary of Chornobyl. With the experience of Hiroshima and Nagasaki, many people in Japan have demonstrated solidarity with the affected people by the Chornobyl disaster. Today and tomorrow, the long-term effects of radiation exposure and the lessons of how to live with or even cope with them will be discussed in depth. World Information Transfer is making a significant contribution to our ef-forts to address these difficult and complex questions. It is certainly helping maintain international attention on this subject and move the agenda forward. Once again, I commend you for your efforts and sincerely hope that you will have a very productive meeting. Thank you very much.

Acute Radiation Symptoms

Epilation (loss of hair)Vomiting FatigueFeverDiarrheaPetechiae of skinGastro-intestinal bleeding Sore throat and other oropharyngeal symptoms

Late Health Effects of Exposure to the Bombings of Hiroshima & Nagasaki, with special Reference to Age/Sex

Dr. Toshiteru OkuboChairman, Radiation Effects Research Foundation of Japan

Thank you ladies and gentlemen. I will talk today about the latest results from the long-term, follow-up study of the Atomic bomb survivors in both Hiroshima and Nagasaki. The uranium A-bomb dropped on Hiroshima on August 6th, 1945, had an estimated energy content equivalent to that of sixteen kilotons of TNT.

A plutonium bomb with an estimated energy content equivalent to that of twenty-one kilotons of TNT was dropped on Nagasaki three days later.

The power of the explosions were so great that almost everything within a one kilometer radius from the hypocenter was destroyed. Very few people could

Number of Deaths by Cause, 1950-2002Cause of Death Number %

Total 67,817 100%,

Cancer and other neoplasms

Solid cancer 15,041 22.2%

Leukemia, Lymphoma, Multiple Myeloma 900 1.3%

(Leukemia) (399) (0.6%)

Neoplasms of benign or unspecified nature 696 1.0%

Non-neoplastlc diseases

Blood diseases 296 0.4%

Other diseases 47,378 69.9%

External causes 3,346 4.9%

Ill-defined or unknown causes 160 0.2%




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have survived in this area. However, several concrete buildings remained.

I would like now to touch briefly on the acute effects of the bombings. In Hiroshima, approximately three hundred and sixty thousand people including troops and other temporary visitors were present at the time of the bombing. It was estimated that thirty nine percent of the population, approximately one hundred and forty thousand people, died immediately or within the year that the A-bomb was dropped. Roughly two hundred and twenty thousand people survived the Hiroshima bombing.

In Nagasaki, twenty eight percent of the population was killed. This means that out of two hundred and fifty thousand people, seventy thousand died.

Acute radiation symptoms in general are listed above, however, in Hiroshima and Nagasaki, they were complicated by exposure to intense thermal rays and by the various injuries that resulted from strong wind blasts. Approximately fifty percent of the bomb’s output energy was emitted as wind. Thirty five percent of the bomb’s energy was released as heat. Ionizing radiation comprised only fifteen percent of the energy. While heat rays caused superficial burns characterized by persistent keloids, the most frequent injuries were acquired as a result of the plethora of flying glass shards.

Epilation, loss of hair, was one of the most apparent acute effects of radiation exposure. There is a correlation between the frequency of epilation and distance from the hypocenter. Observations of epilation made by various study groups concur that approximately fifty percent of the people within a one kilometer radius of the hypocenter suffered from hair-loss.

The chronic or late health effects of radiation, my main focus, is now going to be addressed.

The Radiation Effects Research Foundation (RERF) was established in 1975. It acquired twenty-eight years

This Prefectural Industrial Exhibition Hall was located one hundred and fifty meters west of the hypocenter. The build-ing was almost completely destroyed. Thirty people working in the building were killed. Since then, the building has been kept as a monument. It was registered as a UNESCO world heritage site in 1996. Nagasaki Urakami Cathedral was located five hundred meters west of the hypocenter. It was completely destroyed.

worth of information amassed by its predecessor organization, the Atomic Bomb Casualty Commission (ABCC). RERF is a unique institution dedicated exclusively to researching the late effects of radiation exposure from the A-bombings of Hiroshima and Nagasaki.

A survey on A-bomb exposure was part of Japan’s 1950 national census. This survey revealed that approximately two hundred and forty eight thousand people had been exposed to the bombs. All of the long-term, follow-up studies being conducted by ABCC/RERF were based on this survey. Some of the mortality studies retrospectively examined past death certificates to 1950 but all other systematic studies were launched in 1958, thirteen years after the bombings.

In 1958, a basic cohort called the Life Span Study (LSS) was organized. This study examined approximately one hundred and twenty thousand of the two hundred and eighty four thousand A-bomb survivors from both Hiroshima and Nagasaki. (This total number of survivors could be calculated due to information collected from the 1950 census.) The LSS has been followed by research that uses information from death certificates in order to examine mortality rates.

The Life Span Study examined:1) All of A-bomb survivors who were heavily exposed

to radiation2) A select population of people who were less exposed.

Individuals from this population were matched, by age and sex, with individuals from the first group

3) Non-exposed individuals who migrated to both Nagasaki and Hiroshima within five years of the A-bomb explosions. Individuals from his third group were also matched, by age and sex with individuals from the first group of heavily exposed individuals.

The Adult Health Study (AHS) is a sub-cohort of the LSS. The size of this cohort is approximately twenty thousand sub-




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jects. Since AHS’s inception in 1958, subjects from the study have undergone biennial health examinations.

In addition, other research has addressed preva-lence of cancer. There are record linkages between the cancer registries of Nagasaki and Hiroshima. These linkages have allowed us to conduct research on cancer incidence.

The research has not been limited to only original survivors. Individuals from two subsequent “generations” have been studied. The individuals from the “first generation” were exposed to radiation in utero. In both 1945 and 1946 a total of thirty six hundred newborns were identified. Some of these newborns have been included in the AHS study since 1976. When speaking of the late effects of radiation, there is no distinction between these newborns and subjects from the LSS and AHS. The individuals from this “second-generation” were the direct offspring (F1) of people who were exposed to the radiation. This F1 group includes offspring born with either one parent or both parents exposed.

This table classifies the major causes of death. Cancer and other neoplasms comprise between twenty-three and twenty-four percent. Non-neoplastic, including blood disease and other diseases, comprises seventy percent. The cause of few mortalities are unknown. Therefore, the follow-up status of this cohort is good.

Approximately twenty six thousand of the one hundred and twenty thousand LSS members were not in either city at the time of the bombings. These individuals are used as a control group. Based on the death rate of the control group, the expected number of deaths for the exposed is calculated. Then, the observed number of deaths is deducted from the expected number in order to obtain the excess number of deaths. Attributable fraction is defined as the proportion of excess death number to the total number of deaths.

Follow-up studies of the cohort by now have revealed various late health effects of the radiation exposure. The annual trends for the calculated number of excess deaths per year for leukemia, all other cancers (solid cancers), and non-cancer diseases were examined. Only leukemia increased during the first several years. Increases of all other deaths associated with radiation became apparent twenty years after the A-bombings. One must consider that this year is the twenty-year anniversary of the Chornobyl nuclear disaster. Peaks of the deaths resulting from this accident are expected to be observed from 2010 to 2020.

Attributable fraction by radiation has been contrasted with non-attributable number of cancer mortalities by the major site. The cases to contrast these attributable fractions were observed between 1950 and 1990.

More than half of leukemia cases were attributable to radiation, but only seven and one fifth percent of all other cancers on average were attributable to radiation. This proportion varies by site.

Dose information is indispensable because it gives us insight when studying the health effects of radiation on other populations. Within several years after the A-bombings, an increase in leukemia was recognized and the necessity of dose information realized. Distance from the hypocenter is the primary information on dose in our case. In addition, shielding status is another essential factor for individual dose estimation.

Soon after the LSS cohort was established, an individual interview survey was launched. This interview

survey was established in order to record exact exposure, location, and shielding status. In addition, an extensive research project called the Ichiban Project was started in the US. Its purpose was to clarify the explosion process. It provided the exact nature of the radiation reached to each individual and allowed exact individual organ dose estimates using distance and shielding data. The first

version of the individual dose estimate system was called T65D. This abbreviation represents “temporal dosimetry system of 1965.” This dosimetry system was completely




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revised and improved in1986. Once revised, the dosimetry system was called DS86. We recently revised DS86, creating DS02, which was completed in 2002.

Excess Relative Risk (ERR) per one Gray has been proposed and used in RERF reports in order to make application of the study results easier for risk evaluation and to establish protection standards for other populations. ERR can be calculated from the risk ratio minus one. Risk ratio is the observed rate divided by the reference rate, or control rate.

As radiation dose increases and solid cancer also increases, there is no threshold in the occurrence of solid cancers. Solid cancer is observed forty seven percent more often among those exposed to one Gray than among controls. This calculation is based on an observation of ten thousand seven hundred and fifty five deaths.

When the ERR/Gr for various solid cancers was examined, it became clear all cancers except for cancers of the rectum, pancreas, uterus, and prostate, showed a significantly increased risk. When the magnitude of the increment and the number involved are taken into consideration, esophagus, colon, lung and breast are the major corporeal sites of increased risk.

As shown in the above figure, the risk for cancer correlates with an individual’s age at the time of bombing. One’s age at the time of the bombing is inversely proportional to the risk of acquiring cancer. The younger an individual was at the time of the bombing, the higher risk of solid cancer he/she has. This relationship is maintained throughout the follow-up period. ERRs for all age groups show a decreasing tendency to acquire solid cancer with increasing attained age.

Excess Absolute Rate (EAR) of solid cancer is another indicator used to describe the magnitude of increase of excess cases. ERR (the previous rate) represents magnitude of risk and EAR gives an idea of the absolute increased number. Even though radiation risk of solid cancer decreases with attained age, EAR increases steeply with attained age. This increase is due to the fact that background cancer frequency increases exponentially with age.

Leukemia is a specific health effect of radiation exposure. Only leukemia increased in the early stages of the follow-up period after the bombings. One can find the number of deaths from leukemia by examining the bone marrow dose and attributable fraction. Attributable fraction increased with dose. As the radiation dose increases the excess cases of leukemia per ten thousand person-years also increases (see figure).

However, their relationship is not linear, rather it is quadratic. When examining a dose-response curve, one will notice that the curve begins from zero. When

examining the attributable proportion of radiation-related leukemia deaths by radiation dose for bone marrow, it becomes clear that the fraction is increased with the dose increment.

For any age, background solid cancer mortality for men is higher than for women. However, excess risk of radiation is higher in females than in males. As a result, the life-time risk of cancer becomes comparable between the sexes when combining both background and excess risk. The background frequency is higher in men than in women but the attributable fraction by radiation exposure, is more in women. As a result, both attributable and background proportion becomes almost comparable in both sexes. These sex-related excesses are apparent in cancers of the lung, bladder, stomach and thyroid. But liver cancer and calculus of the kidney and ureter display the opposite gender difference.

The longer the follow-up research continues, the more apparent increases in radiation-exposure related diseases other than cancer become. Diseases that have been proven to be significant include cardio-vascular, respiratory, and digestive diseases.

RERF research results have been used for establishing radiological protection standards by various international and national organizations such as ICRP, UNSCEAR of the United Nations, and BEIR in the United States. RERF’s international role has been rated highly by Dr. Sinclair, former president of US National Council on Radiation Protection and Measurement. Dr. Sinclair stated, “Among investigations providing the basis for radiation protection standards worldwide, the atomic-bomb survivor study is the most long-standing and extensive ever taken.” Scientific society also gave us the highest praise by calling LSS the “epidemiological gold standard.”

LSS has many strengths especially when is compared with other epidemiological studies. In short, big cohort size, long follow-up period, good linkage system with death certificates and cancer registries, and reliable dose estimates are the primary factors leading to the




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study’s acclaim. However, there is decreasing trend in number of LSS members. Within the next thirty years, most members will have died.

However, the expected mortality number will increase in the next ten years and continue to be high throughout the period. This large mortality number allows us to confirm observations disclosed to this point. It also allows us to analyze further details including age or sex differences. It will become clear whether observed marginal results are fact or simply observations that occurred by chance.

The RERF Life Span Study is more important than any other radiation-related study because it has more power to produce risk estimates for fifteen individual organs, it has the power to demonstrate the shape of the dose response, it has the power to find the lowest doses for which there are statistically significant risks, it has the power to examine the effect of variables such as age and sex, it has the power to follow the fate of the youngest cohorts that were between the ages of zero and nineteen when the bombings occurred, and lastly, it has the power to demonstrate latency and whether the risks of solid tumors increase in time. Further issues that concern original survivors and their offspring still need to be investigated. For survivors, the following issues must be addressed in future studies:

cancer, non-cancer diseases, confounding factors and risk modifying factors, acceleration of aging, psychological effects, low-dose exposure, and medical exposure. For the offspring of survivors, further studies must be carried out in order to examine DNA abnormalities, cancer, and non-cancer diseases.

Changing Trends in Incidence and Mor-tality of Thyroid Cancer in Croatia, 1968-2002

Prof. Zvonko Kusic` and prepared with the assistance of Nina Dabeli, Tomislav Juki, Marin Prpi, Arijana Znaor, Marko Turi University Hospital �Sestre Miloserdnice�Zagreb, Croatia

Dr. Durbak, Dr. Strauss, dear colleagues, ladies and gentlemen: It is a great honor and pleasure for me to par-ticipate in this important conference, and I would like to thank the organization for inviting me to the meeting.

Croatia is a central European and Mediterranean country situated south from Austria and east from Italy, across from the Adriatic Sea. The surface of Croatia is about fifty-seven thousand square kilometers, which is slightly larger than Switzerland and smaller than Aus-tria. The population of Croatia is around four and a half million.

There is a wide range of thyroid cancer incidence in females worldwide, from very low rates to very high rates. Croatia is among the countries with high inci-dence rates of thyroid cancer in females. There is a similar situation for males, as Croatia is also among the countries with high incidence rate. On the contrary, mortality rates from thyroid cancer in Croatia in fe-males are among the lowest group.

Here we can see incidence rates of thyroid cancer, which range in males from one half in Ireland to four and one-fifth in Iceland, and in females from one and nine-tenths in India to eleven and three-fifths in Israel.

In 2002, in Croatia the annual incidence of thyroid cancer was two and three-hundredths in males and




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eight and ninety three-hundredths in females. Overall incidence was five and fifty seven-hundredths. In that year, thyroid cancer was diagnosed in fifty-eight males and two hundred and seventy-two females, an overall three hundred and thirty cases. Mortality rates were thirty two-hundredths for males and forty three-hundredths for females per year. With twelve deaths in males and twenty-five deaths in females, an overall thirty-seven deaths were recorded.

During the past six decades, up to a five-fold in-crease in incidence rates of thyroid cancer was re-corded worldwide. This has largely resulted from the rise in the incidence of differentiated thyroid cancer, particularly papillary cancer. Genetic and environmen-tal factors play key roles in modulating thyroid cancer pathogenesis. Possible explanations for the rise in inci-dence of thyroid cancer worldwide are exposure to ion-izing radiation, changing levels of iodine nutrition, and evolution in clinical practice, with improvements in di-agnostic practice, especially introduction of ultrasound guided fine-needle biopsies in the mid-1980s. Many studies reported high prevalence of papillary micro-car-cinoma at autopsy findings from five percent even up to thirty-five percent. It is presumed that if the entire pool of occult papillary thyroid cancer rate was identified ante mortem, the result could be an enormous increase in the apparent incidence of papillary thyroid cancer.

Over the past thirty-five years, there has been an eight-fold increase in incidence rates of thyroid cancer in Croatia in females. In the same period, there was a two and five fold increace in incidence rates in males. During this period, many factors could have influenced the inci-dence rates in proportion of different pathological types of thyroid cancer in Croatia. In 1974 and 1988, there were changes in pathohistological diagnostic criteria by

WHO. It can be assumed that about one third of follicu-lar cancer diagnosed before 1974 would now be classi-fied as papillary cancer. In 1986, the Chornobyl accident occurred and influenced the incidence of thyroid cancer in some areas, but probably not in Croatia. The war in Croatia in 1981 could also have possible influence, at least in collecting data and the level of medical care. And finally, in 1996, a new regulation of higher iodine content in salt was introduced, which caused further increase of the papillary to follicular thyroid cancer ratio. However, mortality from thyroid cancer in Croatia has not changed significantly over the last thirty-five years.

Severe radioactive fallout that originated from the damaged Chornobyl nuclear reactor was spread and transported all over Europe in 1986. Fortunately, due to prevailing meteorological conditions at the time af-ter the accident, Croatia was only partially affected in the Northwest region. The distance from Chornobyl to Zagreb, the capital of Croatia, is approximately one thousand and two hundred kilometers. After the Chor-nobyl accident, the activity of radioactive fallout that contaminated the Croatian territory in 1986 was esti-mated to be approximately 5.2 x 10 to the 15th power Bq, which is about 0.28% of the total activity released. The contamination was unevenly distributed in the country, ranging from zero to over two hundred thousand Bq/m³ in some areas.

The total rainfall activity was calculated as the sum of the gamma-activity of the following radionuclides: 103Ru, 131I, 132Te - 132I, 134Cs, and 140 Ba - 140La. Radioiodine in the atmosphere was the greatest risk for the thyroid gland.

This table shows the proportions of different nuclides to the total contamination measured on May 4, 1986 in Croatia. Short-lived nuclides, 131I and combined 132Te - 132I contributed to 72% of the con-tamination. Activity measured in the air in Zagreb, the




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Croatian capital, on May 6, 1986 at 15:00 hours, was one and eighteen-hundredths Bq/m3, corresponding to less than fifty percent of the average annual allowed concentration. The average annual dose in 1986 in Croatia was fifteen percent larger than the average dose calculated in the period from 1982 to 1985. It means the Chornobyl accident caused just a borderline sig-nificant increase of the total radiation dose in Croatia in 1986. After the Chornobyl accident, the temporary increase in activity of 131I was recorded in Zagreb, just in the period from April 3rd to May 5th, 1986.

Despite the increase in overall incidence of thyroid cancer in Croatia, the incidence of thyroid cancer in children and adolescents in Croatia remained stable at low levels. The first period was before the Chornobyl accident, with eight cases of childhood thyroid cancer. In the second period, the presumed latency period be-tween exposure to iodine’s radiation and developing thy-roid cancer which is thought to be approximately eight to ten years, from 1987 to 1994, there were seven cases of thyroid cancer. And the third period was from 1995 to 2002, when the possible radiation effect of Chornobyl would be manifested, and there were nine cases of thy-roid cancer. Despite significant and constant increase of overall thyroid cancer, vis-à-vis these three periods, there was no increase of childhood thyroid cancer in Croatia.

Also, satisfactory iodine prophylaxis in Croatia was probably a protection factor against radioiodine for the Croatian population. Over the last fifty years iodine nutrition status in Croatia has changed from severe io-dine deficiency to iodine sufficiency. In 1953, the first regulation obligatory iodination with ten milligrams of potassium iodine per kilogram salt for human iodine consumption was introduced, and at the time, this was one of the most progressive regulations in Europe. Ten years later, a three-fold decrease of goiter prevalence, together with the disappearance of cretinism was recorded. At the beginning of 1990, mild to moderate iodine deficiency still persisted in Croatia with the over-all median of urinary iodine excretion between four and nine micrograms per decilitre. In 1996, the new ob-ligatory regulation requiring twenty-five milligrams po-tassium iodine per kilogram salt was introduced, and in 2002, a national survey in schoolchildren demonstrated that Croatia is an iodine-sufficient country.

Over the last thirty years, there has been a constant rise in the papillary to follicular thyroid cancer ratio in thyroid cancer patients in Croatia, probably as a result of multiple factors, especially improvements in diagnostic procedures and better iodine prophylaxis. There is also a constant decrease of anaplastic thyroid cancer incidence.

In the last two decades, there has been a constant de-crease of thyroid cancer size. For instance, median of thy-

roid cancer from the period of 1988 to 1992 was twenty millimetres, whereas in the period from 2000 to 2004, it was twelve millimetres. Possible reasons are better iodine prophylaxis, and detection at earlier stages because of more frequent use of ultrasound and ultrasound-guided fine needle biopsy. And despite the significant decrease in the incidence of thyroid cancer in Croatia observed in five-year periods, from 1988 to 1992 versus 2000 to 2004, there was no change in mortality rates.

In conclusion, we can say the incidence of thyroid can-cer in Croatia, similar to other countries, has increased in both sexes during the past decades, mostly due to im-proved diagnostics. The mortality from thyroid cancer has remained constant or even declined, reflecting the growing proportion of less aggressive cancers, detection at earlier stages, and probably more efficient therapy. No significant difference in trends of thyroid cancer inci-dence before and after the Chornobyl accident has been observed in children and adolescents in Croatia. Levels of ionizing radiation in Croatia caused by the Chornobyl accident were too low and its impact on thyroid cancer incidence in Croatia is negligible. And finally, besides having a healthy and safe environment, Croatia has also recently been recognized as one of the most attractive countries in the world. Thank you very much.

Living with Radiation: Diagnosis and Treatment of Thyroid Cancer after the Chornobyl Nuclear Accident.

Dr.Daniel Igor Branovan, M.D., New York Eye and Ear Infirmary

On behalf of the New York Eye and Ear Infirmary, and with deep appreciation to our partners in this ef-fort, the World Information Transfer and Dr. Christine Durbak, I would like to welcome you to the second day of the conference, entitled Living with Radiation: Diagnosis and Treatment of Thyroid Cancer after the Chornobyl Nuclear Accident.

Almost 20 years exactly have elapsed since the worst peace time nuclear accident in the entire human his-tory, which took place in Chornobyl, then Ukrainian Republic of the Soviet Union on April 26, 1986. Previ-ously unimagined amount of radioactive contaminants was ejected from the doomed reactor, and within a few weeks spread around to cover almost the entire




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Northern hemisphere. The regions closest and down-wind from the reactor sites, regions of Ukraine, Russia and Belarus received the greatest amount of radiation fallout. Within the highly volatile elements was radio-active iodine, the element that is essential for the de-velopment of thyroid hormone, and which therefore is concentrated in the victims’ thyroid glands.

It is of no surprise then, that rates of thyroid cancer escalated dramatically, first in young children, then ado-lescents, and now, after the expected 20 year latency pe-riod, in adults. The dynamic nature of the world’s popu-lation being that it is, the at-risk population has spread far beyond the confines of Ukraine, Russia and Belarus, hundreds of thousands now residing in the heart of the New York metropolitan area. Their increased thyroid cancer rates have augmented yet another concerning trend, the general increase of thyroid cancer among the American population in the past two decades.

Thus, American physicians and surgeons now find themselves facing an imminently curable, yet dramati-cally escalating disease of thyroid cancer among our patient population. We, however, know that we are not alone in confronting this important illness. We are fully prepared to learn from the vast experience of our Ukrainian, Russian and Belarus colleagues, who, unfortunately, have struggled with, and for the most part, succeeded in managing thyroid cancer among their populations, even in spite of limited financial and technological resources.

Today, for the very first time at this level in the United States, and in the very appropriate surroundings of the United Nations, a group of talented and experienced international experts in the field of radiation-induced thyroid cancer will share with you their findings and ex-pertise. We hope to implement their recommendations in developing a comprehensive system of early diagnosis and management of thyroid cancer in the United States.

Once again, I would like to thank our distinguished partners, World Information Transfer, respected con-ference lecturers, and all guests, and participants. Our deep appreciation to our sponsors: Tekneco Solutions and Genzyme Therapeutics.

Statement by Dr. Michael Balonov International Atomic Energy Agency (IAEA),Vienna, Austria

I would like to speak today about completion of basic Chor-nobyl Forum operations and the

Forum’s findings and recommendations. The Chorno-byl Forum initiated by the International Atomic Energy Agency (IAEA) early in 2003 included eight relevant UN organizations and the three countries most affected by the Chornobyl accident, Belarus, Russia and Ukraine, represented by their high level governmental represent-atives and experts. In a series of managerial and expert meetings, the Forum considered the environmental and health consequences of the Chornobyl accident.

The major products of the Forum are the two tech-nical reports: “Environmental Consequences of the Chornobyl Accident and Their Remediation: Twenty Years of Experience” coordinated by the IAEA; and the “Health Effects of the Chornobyl Accident and Special Health Care Programmes” coordinated by the World health Organization (WHO). Both reports have been recently printed; they are also available on the web.

The digest Forum report, “Chornobyl’s Legacy: Health, Environmental and Socio-Economic Impacts and Recommendations to the Governments of Belarus,

the Russian Federation and Ukraine”, that is intended for wide distribution, is also available on the web, both in English and Russian. As indicated bythe report’s ti-tle, it considers both the scientific issues and practical recommendations to the governments of the affected states and relevant international organizations. Along with the summaries of two technical reports, it also contains analysis of the socio-economic impact of the Chornobyl accident, which was prepared by the UNDP and based largely on the 2002 UN study “Human Con-sequences of the Chornobyl Nuclear Accident – A Strat-egy for Recovery”.

All of the Forum reports were presented and dis-cussed during the International conference entitled “Chornobyl: Looking Back to Go Forwards” held in Vi-enna in September 2005. The conference was accompa-nied by an intensive press campaign in the mass media. In his concluding statement, the Forum and Conference Chairman, Dr. B. Bennett, inter alia, “stress(ed) that our conclusions are more than just valid, objective, scientific statements. They are a consensus of all of the scientists, international organization staff and representative of governments who participated in the Chornobyl Forum and this conference. All of us agree … with the evalua-tions of the health and environmental effects.” Let me

Apart from the dramatic increase in thyroidcancer incidence among those exposed at a young

age, there is no clearly demonstrated increase in the incidence of solid cancers or Leukemia

due to radiation.




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present you briefly the major findings and recommenda-tions of the Chornobyl Forum:

The accident at the Chornobyl nuclear power plant in 1986 was the most severe in the history of the nuclear power industry, causing a huge release of radionuclides over large areas of Europe and especially over Belarus, Russia and Ukraine.

The highest radiation doses were received by emer-gency workers and on-site personnel, in total about 1000 people, during the first days of the accident, and doses were fatal for 28 workers. In time more than 600,000 peo-ple were registered as emergency and recovery workers (‘liquidators’). Although some received high doses of ra-diation during their work, many of them and the major-ity of the residents of areas designated as ‘contaminated’ in Belarus, Russia and Ukraine (over 5 million people) received relatively low whole-body doses of radiation, not much higher than doses due to natural background radi-ation. The mitigation measures taken by the authorities, including evacuation of people from the most contami-nated areas, substantially reduced radiation exposures

and the radiation-related health impacts of the accident. Nevertheless, the accident was a human tragedy and had significant environmental, public health and socio-eco-nomic impacts.Childhood thyroid cancer caused by ra-dioactive iodine fallout is one of the main health impacts of the accident. Doses to the thyroid received in the first few months after the accident were particularly high in those who were children at the time and drank milk with high levels of radioactive iodine. By 2002, more than 4000 thyroid cancer cases had been diagnosed in this group, and a large fraction of these thyroid cancers is at-tributable to radioiodine intake.

Apart from the dramatic increase in thyroid cancer incidence among those exposed at a young age, there is no clearly demonstrated increase in the incidence of solid cancers or leukemia due to radiation in the most affected populations.

There was, however, an increase in psychologi-cal problems among the affected population, com-pounded by insufficient communication about radiation effects and by the social disruption and economic depression that followed the break-up of the Soviet Union.

It is impossible to assess reliably, with any precision, numbers of fatal cancers caused by radiation exposure due to the Chornobyl accident, or indeed the impact of the stress and anxiety induced by the accident and the response to it. An international expert group has

made projections to provide a rough estimate of the possible health impacts of the accident and to help plan the future allocation of public health resources. The projections indicate that, among the most exposed populations (liquidators, evacuees and residents of the so-called ‘strict control zones’), total cancer mortality might increase by up to a few percent owing to Chor-nobyl related radiation exposure. An increase of this magnitude would be very difficult to detect, even with very careful long-term epidemiological studies.

Since 1986, radiation levels in the affected environ-ments have declined several hundred fold because of natural processes and countermeasures. Therefore, the majority of the ‘contaminated’ territories are now safe for settlement and economic activity. However, in the Chornobyl Exclusion Zone and in certain limited areas some restrictions on land-use will need to be retained for decades to come.

The Governments took many successful countermeas-ures to address the accident’s consequences. However, recent research shows that the direction of current efforts should be changed. Social and economic restoration of the affected Belarusian, Russian and Ukrainian regions, as well as the elimination of the psychological burden on the general public and emergency workers, must be a priority. Additional priorities for Ukraine are to decommission the destroyed Chornobyl Unit 4 and gradually remediate the Chornobyl Exclusion Zone, including safely managing radioactive waste. Preservation of the tacit knowledge developed in the mitigation of the consequences is es-sential, and targeted research on some aspects of the environmental, health and social consequences of the accident should be continued in the longer term.

The Forum consensus was recognized and commend-ed by the 60th General Assembly of the United Nations and positively reflected in its resolution on Chornobyl. The General Assembly recommended to widely dissemi-nate Forum’s findings and recommendations through UN organizations and the mass media. Currently, the Forum members are working on the issue of informa-tion dissemination. Thank you for your attention.

Health and Environmen-tal Linkages to Radia-tion Waste Disposal and Sustainable Resource Management

Mr. Werner ObermeyerDeputy Director, United Nations Environment Programme (UNEP)

At the heart of this predicament lie theunsustainable consumption patterns.




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It is a privilege for UNEP to again be involved in this annual event by the World Information Transfer. One week from today, on April 26, the world will com-memorate the 20th anniversary of the Chornobyl disas-ter, but many people seem to have already forgotten the humanitarian and environmental consequences of this tragic event.

Over the last few weeks the European press has re-ported that hundreds of farms in the United Kingdom still suffer from the fallout that occurred. In mainland Europe, hundreds of people continue to suffer from inexplicable diseases, many of them children born from adults that were contaminated.

Last year the world remembered the end of the Sec-ond World War, 60 years ago. While in Europe the war came to an end in a more conventional manner, the eastern theater saw the first use of nuclear arms by hu-man against human – with the destruction of the cities of Nagasaki and Hiroshima in Japan. For many years thereafter, the survivors and their children suffered the terrible consequences of these acts.

The year 2005 witnessed unprecedented signals of environmental change. Hurricanes and other coastal storm cycles caused billions of dollars of damage, in ad-dition to loss of lives and the displacement of thousands of people. The Indian Ocean Tsunami and Hurricane Katrina focused the world’s attention on the destruc-tive effects of natural events. There is now, beyond any reasonable doubt, a realization that the globe’s climate is changing. The Arctic is melting at an unprecedented rate and three of the last four years have been the warm-est in the history of the earth. While the upsurge in Avian flu cases reminds of the early indications of the HIV/AIDS pandemic, few people realize that every day almost as many children die from water borne diseases as those that die from AIDS. Changing weather patterns also exacerbate the spread of diseases across geographi-cal areas not affected in recent history.

Water resources, an issue we discussed in this forum just a few years ago, are rapidly being depleted and 50% of wetlands – which has such an important function in water conservation - have been lost. Similarly, species loss - from fish to birds to plants - continues at a rate that cannot be replenished by nature.

At the heart of this predicament lie the unsustain-able consumption patterns that foster the ever-increas-ing search for cheaper and faster production patterns. Emerging economies such as India and China have an insatiable need for paper, steel and oil, as well as supplies of energy. Imagine that if the ratio of motor vehicle own-ership in China would be the same as in the USA (3 for every 4 people), there would be more cars on the road in China than in the rest of the world. The resultant air pol-

lution would be difficult to imagine, and will affect the whole region.

Although many countries are coming to realize the high environmental costs associated with economic development that does not internalize natural capital, and the world is aware of the finite nature of fossil fuels, there remains a wide difference of opinions on which energy path to follow.

The markets for wind and solar, as well as bio-fuels, have steadily grown in recent years, but remain small in percentage terms. In many industrialized countries nu-clear energy is again viewed as a reliable and economic alternative. The nuclear debate is also being linked to se-curity concerns, as the situation in Iran illustrates. But at what cost will we turn to nuclear energy again. Despite tre-mendous gains in technology advances and safety mecha-nisms, the financial investment to construct dozens of nu-clear power plants in the USA alone will be astronomical. Little is being said on disposal of radioactive waste.

In general, it is assumed that low level radioactive waste is broken down after storage - that could last from 10 to 50 years. High level waste normally would require stor-age periods 10 times longer. Consider the vast number

of new nuclear plants that have to be constructed if the world does not change energy consumption patterns, and where these enormous amounts of waste would have to be stored. In addition, any kind of radiation fallout af-fects not only the air that we breathe, but also soil, crops and plants, as well as animals. Bearing all this in mind, is it not worth considering to rather invest these billions of dollars in renewable energy technologies?

In UNEP we have had a long standing relationship on nuclear matters with the international community through the UN Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), which the General Assembly established in 1955. UNSCEAR is based in Vienna and consists of 21 member states who work on behalf of all 191 UN Member States and the internation-al scientific community. The work of the Committee re-ceives considerable leverage from contributions in kind provided by 58 national scientific organizations and by the four international organizations that participate in its deliberations.

UNSCEAR’s original role of collecting and evaluat-ing information on the levels and effects of ionizing ra-diation has slowly changed over the past decades. Today, we focus on learning lessons such as Chornobyl, on pro-viding a sound scientific basis for evaluating radiation

Little is being said on disposal of radioactive waste.




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Chornobyl adopted by the UN in 2002. The creation of the Chornobyl Forum, the distinguished body that concluded its work with the impressive findings and recommendations in September 2005, was another. UNDP has now fully assumed all coordination func-tions, including the drafting of the 2005 biennial re-port by the Secretary General to the General Assembly on Chornobyl.

It won’t surprise you when I say that everyone re-members where they were in 1986 when they first heard about the nuclear accident at the Chornobyl Nuclear Power Plant. This was truly a global shock, when every-one shared fear of an invisible menace that threatened millions of people.

Here we’d like to recognize with gratitude the en-gagement and financial support of the governments of Japan, Switzerland, Canada, the US and the EU, as well as the tireless efforts of countless Chornobyl charities. Most people outside the region assume the problem has long been solved. For insiders, howev-er, Chornobyl remains frozen in time. As one of the Belarus scientists put it during a Chornobyl Forum, people in her country divide time into life before the accident, and life after it. Chornobyl changed things life completely.

Entire communities in affected areas have long felt themselves marked by Chornobyl; they have felt they faced a death sentence cast by radiation. The message of the Chornobyl Forum was thus a profound break-through, a real milestone. This message is a reassuring and hopeful one: the damage, both to human health and natural environment, has been much smaller than is commonly assumed. People in the affected communi-ties can, with very few exceptions, pursue normal lives. It is important to stress, however, that this message of reassurance does not in any way diminish the suffering that the affected communities have experienced. Their suffering is real, it continues to this day, and it would be a mistake to dismiss it as somehow “irrational,” “imag-ined,” or “self-induced”.

We view the upcoming 20th anniversary of the Chor-nobyl nuclear accident as a very important occasion to showcase forward-looking solutions to problems faced by Chornobyl-affected communities. This need was stressed in the Secretary General Kofi Annan’s 2005 report to the General Assembly, which noted, “As impor-tant as it is to honor the sacrifice and losses of the past, the best way to attract and keep fresh international atten-

risks and protective measures, emergency preparedness, waste disposal and environmental rehabilitation.

While the health risks associated with radiation are evident, tragic events such as Chornobyl have taught us much about the environmental effects of contamination on groundwater supply, livestock and fish, agricultural produce and safe and hygienic sanitation. We know that a third of the planet’s population still lack adequate sanitation and that the biggest cause of water pollution in developing countries is sewage. Responsible envi-ronmental management of water resources is therefore intricately linked not only to health, but also to food production and especially the well being of those most vulnerable in our society, the children.

In UNEP we have ongoing programmes on Gen-der, Health and the Environment, as well as alliances on linking Children with Healthy Environments. Our work on Persistent Organic Pollutants, which are finding their way across the oceans to remote areas, as well as on Chemicals Management, have shown that the challenge of securing a planet safe for tomorrow’s generation remains as daunting as it was when UNEP was created in 1972. Although we have made gains over the past decades, we should not live in the illusion that our increase in knowl-edge can prevent another nuclear accident – one that may be far worse than those we have witnessed so far. It is my hope that meetings such as these, and the important work being done by World Informa-tion Transfer, will help us all to remain vigilant and, above all, involved. Thank you.

Statement by Ms. Marta Ruedas, Deputy Regional Director for Europe and CIS, United Nations Development Programme (UNDP)

It is a real honor for me to represent UNDP at this important gathering. As many of you know, transfer of coordination responsibilities on Chornobyl from the Office of the Coordinator for Humanitarian Affairs to UNDP took place in 2004. This shift in responsibility was a recognition that, after 18 years, the challenges facing the communities of Chornobyl were best served by a focus on economic development and the crea-tion of new livelihoods rather than on the provision of emergency humanitarian aid. This transfer was one of the many consequences of the “new strategy” on

Lack of opportunity and fear of radiation prompted an exodus of young and skilled people from the region.




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tion will be by identifying a way forward on Chornobyl”. We are co-organizing two high-level international com-memorative conferences - in Belarus between April 19-21 and in Ukraine between April 24-26. A special session of the General Assembly on Chornobyl will take place on April 28 here at UN Headquarters in New York.

UNDP�s contribution to Chornobyl ForumUNDP’s contribution to Chornobyl Forum has been

to assess the socio-economic impact of the accident, and to make policy recommendations in this area to the three Governments. In summary, the accident had an enormous socio-economic impact. Some effects are a direct result of the accident and the policies adopted in its aftermath: the shutdown of the reactor; the cost of alternate energy supplies; the cost of relocating 350,000 people; the cost of constructing new homes and infra-structure for those relocated; the cost of developing and applying “clean” cultivation and farming techniques; the cost of a vast system of radiation monitoring; and the overwhelming burden of benefits and privileges for those classified as victims of Chornobyl—a group that now numbers an estimated seven million people.

However, it is crucial to remember that the Chor-nobyl accident was followed in a few short years by the disintegration of the Soviet Union, the creation of three new independent states with significant Chornobyl-af-fected territories, the breakdown of the old command economy and Soviet-era trade ties, and their replace-ment with a range of market-oriented reforms and “transition” economic policies. These factors were eve-rywhere disruptive, but in the “contaminated” regions the disruption they caused tended to be blamed entirely on Chornobyl.

Economic transition hit rural communities hard everywhere, particularly where collectivized agriculture had functioned with very large subsidies from the state. Since in Chornobyl affected regions most communities relied upon farming, this posed a double burden: first radiation made much agricultural production off-limits, then market forces made cheap inputs and preferential pricing vanish. Even after radiation receded to safe lim-its, Chornobyl-area “branding” hampered sales. Inves-tors stayed away. High unemployment and, particularly, underemployment were the result. For many, depend-ence on state benefits became a way of life.

Lack of opportunity and fear of radiation prompted an exodus of young and skilled people from the region. The demographic profile of the region became badly skewed. An aging population meant that deaths exceeded births, further fuelling fears that the region was somehow a poisonous death trap. As was the case across much of the former Soviet Union, life expectancy fell precipitously—

though in Chornobyl, radiation rather than cardiovascu-lar ailments or lifestyle causes such as alcohol and tobacco abuse and accidents wrongly took the blame.

As a result of all these factors, a “culture of depend-ency” developed in many communities affected by Chor-nobyl. People tended to wait for the state to come to the rescue, and when it did not, to sink into apathy and fatal-ism. A sense of abandonment took root, and the self-reli-ance needed to compensate was lacking.

The bottom-line message, then, that UNDP brings is that poverty, not radiation, is the real danger. This prob-lem is not unique to the Chornobyl-affected communi-ties, but they face it in a particularly acute form.

What is UNDP doing? What solutions do we have to offer?

Radiation fears have been laid to rest, but the plight of communities remains dire. So UNDP’s contribution comes in the form of proposed solutions to some of the problems faced by affected countries, communities and individuals. These solutions, which build on both field work in Chornobyl-affected communities and UNDP’s development experience worldwide, fall into three areas.

First, information. This has been a central challenge from the start. For outsiders, the Soviet failure to inform the rest of the world about the Chornobyl nuclear acci-dent was a sign of the lurking menace of communism. For insiders, for citizens of the Soviet Union, who learned of the peril only over time, the lack of prompt and proper information created a sense of betrayal and mistrust that persists to this day. • Recent research has shown that people in the Chorno-

byl region still lack the information they need to lead healthy, productive lives. Information itself is not in short supply; what is missing are creative ways of dis-seminating information in a form that induces people to change their behavior. Propagation of healthy life-styles is as important as providing information on how to live safely with low-dose radiation. To improve the mental health of the population and ease fears, credible sources need to dispel the misconceptions surrounding Chornobyl. The International Chornobyl Research and Information Network (ICRIN) is the vehicle we envis-age for disseminating this information in a way that is both credible and accessible to local residents.

• Second, reorientation of government policies. Let me cite a few examples:

1. The mild impact of radiation should prompt an overhaul of zoning definitions and regulations, as many areas now classified as too dangerous for human habita-tion or commercial activity are in fact quite safe.

2. The reassuring prognosis for radiation-related diseases should provide yet another argument for chan-




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neling investment away from specialized hospital facilities and towards better primary and preventive health care.

3. The low, virtually risk-less levels of radiation risk faced by most Chornobyl-area residents should prompt a radical overhaul of Chornobyl benefits and privileges, so that the truly needy are covered by an efficient, targeted mainstream social welfare program that covers the entire population and the ailing are similarly assisted by main-stream health care provision—and so that scarce budgetary resources can be channeled to more productive spending that promotes growth, employment, and investment.

The point is not just to change policies specific to Chornobyl, but also to adjust broader economic and social policies in ways that will spur economic develop-ment nationwide, including, inevitably, in the Chorno-byl regions. The development of sturdy local businesses depends heavily on sensible regulations at the national level, including straightforward rules on founding and registering companies, simplification of licensing and inspection rules, provision of affordable finance, and market-oriented training and education policies.• Third, community development. Here we draw heavily

on our recent experience in Ukraine, where a holistic approach we call “area-based development” aims es-sentially to restore a sense of community self-reliance by showing local residents that they themselves hold the key to their own recovery, whether in the field of health, employment, or communal services such as heating and water. We find this an especially exciting prospect because the methodology is simple; the costs are modest; and the impact can be stunning, as towns and villages once reduced to paralysis and resignation rediscover the true meaning of “community”.

Going forward, these are three areas—information, policy, and community development—around which UNDP intends to organize its efforts in supporting the three Governments on Chornobyl recovery. Co-operation among the three countries, assisted by our three Country Offices and our coordination efforts at United Nations headquarters, is crucial to this ef-fort. Since funding is in short supply, successes in one area should be shared and replicated in others.

Concluding thoughts• Chornobyl has long inspired nothing but despair. Yet

the Chornobyl Forum findings have shown conclusively that fear of radiation is a far greater threat to the affect-ed individuals and communities than is radiation itself. We at UNDP are both honored and proud to be able in helping to transform a generation of defeated “victims” into a generation of proud “survivors”. We intend to de-vote every effort to transform what has haunted the re-gion as a symbol of fear and destruction into a triumph of human perseverance. Thank you for your attention.

Mass casualty response to nuclear weapons: updated lessons from Chornobyl and Hiroshima/Nagasaki.

Dr. Cham E. DallasCDC Center for Mass Destruction Defense, University of Georgia, Athens, GA.

In the 60 years since the use of atomic weapons on

Hiroshima and Nagasaki, and particularly in the 20 years since the Chornobyl disaster, the proliferation of nuclear weapon materials has made it increasingly important to prepare for the health consequences of nu-clear war on earth. The demise of the “cold war” led to a decrease in the significance of the doctrine of mutual as-sured destruction, or the use of hundreds or thousands of nuclear warheads, and a long awaited decrease in the immediate stockpile of ready-to-use weapons. However, the emergence of numerous smaller sources of nuclear materials has led to the greatly increased potential for the use of one or a few nuclear weapons.

The “lessons learned” from Hiroshima, Nagasaki, and Chornobyl are presented, in reference to their significance in formulating the appropriate medical response for large numbers of casualties resulting from atomic detonations and the airborne dissemination of large amounts of radioactivity. As nuclear weapons have dramatically increased in their destructive capacity since these initial events, the chilling implications for medical response for these unprecedented consequenc-es will be discussed. Included will be the unexpected outcomes for radiation-induced birth defects, the stag-gering medical impact of the sheer numbers of thermal injuries with thermonuclear weapons (such as mass fire-




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storms), and low technology approaches to dealing with large scale injuries from nuclear weapon detonations. Preparing for the enormous impact of nuclear weapon use is obviously critically important, and attainable goals in medical preparation by the international community are needed as never before.




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The most important direct exposure to radiation from a forest fire is inhalation of nuclides that are attached

to particles or to free products in the atmosphere

Sources of Radiation Exposure in Community Environments: An Example - Wildfires

Dr. Paul Lioy, ProfessorEnvironmental and Occupational Health Sciences Institute, Robert Wood Johnson Medical School of N.J. UMDNJ

It is a pleasure to share some thoughts with you about one issue with respect to exposures to radiation that re-ally does not get a lot of attention. I was asked to give a talk on this topic and to do some work we have been do-ing for the last few years, and I hope to give you a little bit of insight as to how exposure science does try to deal with critical issues associated with the potential for hu-man health effects.

Human exposure science is defined as “Studies human contact with chemical, physical or biological agents occurring in their environments, and advances knowledge of the mechanisms and dynamics of events either causing or preventing adverse health outcomes,” and is the link between environmental science, toxicol-ogy, and epidemiology. Nuclear radiation has probably been the best studied in terms of human exposure or the various agents, which we have around. Radiation

has been examined in terms of nuclear accidents and also in terms of the events of Hiroshima and Nagasaki. In this particular context we are going to look at the actual association of human exposures to radiation through wildfires.

This can occur because of a number of different processes. Let us say you have a nuclear power plant. That power plant emits a small load of radiation over time, and that load of radiation just accumulates in the fires. You can also have nuclear accidents just like you had in Chornobyl where there is a large quantity of material that’s deposited in the forest or in any other serviceable area like an agricultural region over time. Usually the highest concentrations are relatively close to the source. When you think about a large accumula-

tion of material that may in fact cause one to not come back to an area for a long period of time, you look into areas like exclusion zones as being the highest con-centrations. So if you view an accident as the ultimate source of radiation, the fire after the accident could be a secondary source of radiation, and it goes on and on from there.

The most important direct exposure to radiation from a forest fire is inhalation of nuclides that are attached to particles or to free products in the atmos-phere. Ingestion is a little bit more difficult. That occurs after the fire is over. The material, which was generated in the fire, the combustion products, deposits to the ground. Obviously in an uncontrolled burn the deposi-tion is very close to the source. So therefore you would have not only what was originally in the forest, but also an accumulation of material that was associated with the burn. Vegetation also takes this up. When the in-halation is farther away, human beings are more likely to eat vegetation, but the closer to the area where the impacted region is, the more likely that material will be ingested by animals. When talking about Chornobyl this morning, the issue of higher incidence of thyroid cancer was related to the fact that apparently people were drinking the milk of contaminated cows that were grazing in the fields in and around the area damaged by Chornobyl. This is not a process that is unique to that; after a wildfire you would have the same thing—mate-rial would be deposited. The issue is how much, how far away, and whether or not the fires are going to be concerned about a significant burden of that material in those vegetative products. External exposure is obvi-ously very common. That is basically radiation that is deposited on the ground and will be absorbed into the body because of one or more different radio nuclei.

We really do care about this because it actually does change the balance of radiation in an area. It is a sto-chastic process. If you think about any place in the United States, or any other part of the world that uses nuclear power or still has tests of nuclear material, it is most clear that the forest biota will bioaccumulate this material. The fact of the matter is that for the most part, it is very low and you will not see major impacts. How-ever, in areas that are very close to an exclusion zone, or the point of release of a large amount of radiation, this in fact could be a problem. For the past few years we have been trying to model this, to see what in fact this is and how one would deal with the impact of such a radia-tion release in the environment.

We develop an intense modeling capability to do this. It is a modeling capability that takes into account things like the forest propagation heat models, envi-ronmental data, thermo-gradients in the atmosphere,




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meteorology, dispersion, aerosol release. These are the scientific principles that go into developing these plume models so that we can actually understand what the level of exposure will be after an event. We do this prospectively because we want to be able to help peo-ple plan and help people learn a strategy to mitigate problems as quickly as possible, while still knowing that complex events often occur.

For the Department of Energy for the United States, we looked at the Savannah River Site. There were a number of plants generating fissionable material for weapons and, as time went on and this operated for over fifty years, there was a certain amount of accu-mulation of radiation in the forest around the plant. During that time there were controlled burns, which are needed in certain types of forests to minimize the amount of overgrowth in the forest. The Department of Energy wanted us to see what happens when we get be-yond the controlled burn, what we would have to think

Deposition from Fire and Plume in Chornobyl Accident Zones

about in terms of radiation that might be released in the forest into the community. This is not high-level radiation and an entity of the federal government was interested to learn the amount of this material that could be released. We wanted to look at forests in the boundary around the plant to see the impact of the forests on humans in a sur-rounding area. There are several small cities in and around the area, including one of the largest golf courses in the United States, Augusta National, near the Savannah River Plant in South Carolina.

Most people are probably aware that we developed a meteorological plume model. There have been plume model generations on boards of various conferences, which I am sure most of you have seen. In fact, we released a nuclear weapon in New York City this morning. When building these models, we to take into account temperature, humid-ity, and other factors of fires, and therefore, this is a very sophisticated model. This plume has buoyancy; it is filled with energy because of the fire. As a result, a tremendous amount of energy is added into the system.

We are trying to develop a model that actually examines the mobile material in an alternate site than that of the burn. When observed at the site of the burn, little black boxes are visible and we believe that the boxes are combustion particles. Because of their large size and relationship to what the source would be, they cannot be true com-

We do this prospectively because we want to be able to help people plan and learn a strategy to mitigate

problems as quickly as possible

Radiation hotspots resulting from the Chornobyl nuclear power plant accident

bustion particles. This information clearly indicates what we are trying to understand.

We visualized an event occurring on a typical day in 1995 so that we could use realistic data, true time infor-mation, and try to bring into the model something that

seems to be reality. This method successfully replaces the previous strategy of making a hypothetical case that may in fact never actually occur because we were using hypothetical meteorological variables, hypothetical variables about how much forest would burn, and hypo-thetical variables about the entire process. We tried to make this seem as authentic as possible without creat-ing a real fire.




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One situation involves a forest at the center of the burn. We provide the heat profile, the smoke pollution that moves upward. There is a lot of air movement in and around the plume, which takes the material up into the atmosphere. At the peak of the cloud where the height of the temperature and the background begin to shift closer to one another so that it does not rise anymore, much of the material travels up into the atmosphere.

If you look at this from a three-dimensional point of view, you are able to learn what happens as a result of a forest fire. The fire travels from one direction to the other, and then, in this case, the fire breaks. This issue is important for areas that are located near oceans. This is actually about a hundred miles inland, but sea breezes affect the motion of plumes. You may expect the wind along with all of the material to move a certain way. With a sea breeze, however, wind can push it in the opposite direction as well, causing everybody in the area to be af-fected. That is partly due to the sea breeze and the high temperature, which emits its material up very quickly into the atmosphere. We deliberately did not put red, green, and blue in here to indicate the concentrations

because that was not the purpose of this study. The clear message is that after a burn moves, the material spreads in every direction while the radiation travels from place to place. The fact of the matter is that in this particular situation, the radiation levels would be relatively low be-cause the concentrations of the radiation would be very low in the forest. If you have a place that has a lot of bio-accumulation of radiation though, this blue could turn into orange and then red, in such a way that indicates a large spread of material as a second source of radiation and a secondary source of exposure. It is impossible to ignore wildfires in high-level radiation situations, even years after the event, as being a potential secondary source of radiation. One must remember that when thinking about re-habitation.

Forest fire models must account for long range and short range transport effects to determine which peo-ple should remain inside and which should leave. When considering the long term effect of the fire and where the deposition is, one has to think about the long range and short range issues also, in terms of how much of the material will be deposited from the atmosphere.

If you take a look from the standpoint of the Chor-nobyl accident, this is clearly an example of the Cesium-

Forest fire models must account for long range and short range transport effects to determine which

people should remain inside and which should leave.

137 distribution in the areas downwind of Chornobyl. Obviously, if a fire took place in one of these areas, one would have to consider the red zones, especially in the exclusion zones, areas that may lead to material being moved from one place to another. I think it is impor-tant to recognize that fact because in these confiscated zones for closure, how fast do you want to move back? Clearly, one of the most important issues is the decay time, the decay rate of the radionuclides. Cesium-137 has a half-life of thirty years, so this material will be around for a while. Within that period of time, I would not be surprised if a forest wildfire occurs. Reasons for concern are large forest areas, abandoned buildings, and many forests around the areas in which the build-ings were abandoned.

Radiation Exposure in ChildrenDr. Maida GalvezMt. Sinai Medical CenterNew York, NY

I am going to be sharing the pediatric perspec-tive, specifically speaking about radiation exposure in childhood. One of the key lessons learned from these historical events is that children were dispro-portionately affected by their exposure to radiation.

Much of what we know now about radiation exposure in children we learned from the late Dr. Robert Miller. He was formerly of the U.S. Public Health Service. In 1954 Dr. Miller traveled to Japan as head of the Atomic Bomb Casualty Commission. This led to the formation of the Committee on Radiation Hazards and Congenital Malformations that then led to the development of the American Academy of Pediatrics Committee on Envi-ronmental Health, a scholarly body whose mission is




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to promote the environmental health of children. They have now offered a number of policy statements specifi-cally on environmental health concerns in childhood. Dr. Robert Miller is considered the father of children’s environmental health.

There are unique windows of vulnerability to en-vironmental exposures in childhood that span all age ranges. Specific to each of these phases of life are unique behaviors that may predispose children to environmen-tal exposures.

There are several key principles in children’s envi-ronmental health. That is, children are uniquely vul-nerable and they may potentially have greater exposure than adults. There are several reasons for this. The first reason is that they have a higher respiratory rate, or minute ventilation, so they may have higher exposures to potential environmental exposures that are inhaled. Secondly, they play closer to the ground. This is a devel-opmentally age-appropriate behavior, but for exposures that lie closer to the ground, for instance, vapors from mercury, a heavy metal, they could be disproportion-ately exposed to that. Third, frequent hand to mouth behaviors, which again are age appropriate for certain developmental stages, may expose children to a greater portion of say lead dust that may be on the ground. Lead dust is coated on the ground; where the children are crawling, and then they have frequent hand to mouth behavior which allows for direct ingestion of the potential exposure. Fourth, children eat more pound for pound per body weight. They also have unique diets, which may include frequent consumption of apples, apple juice, grapes, so they may be exposed to a higher level of pesticides.

Children also have immature metabolic pathways making them potentially more susceptible to environ-mental exposures. Alterations or damage to develop-ing cells is thought to be the cause for a higher risk of certain medical conditions later on in life. Children also have a greater shelf life, meaning that exposures early

on in life have a greater potential for developing long-term consequences as opposed to adults.

So how does this relate to radiation exposure? Let us take a developmental stage like in-utero exposure. In pregnant women that are exposed to radiation, their babies have a smaller head size and may potentially be at risk for mental retardation. There are studies that looked at exposures in four to seventeen weeks of ges-tational age and eight to twenty-five weeks of gestational age. Mental retardation is thought to be due to altera-tion in neuronal migration.

What we know about the thyroid cancer that was seen in the Ukraine during this period was that the latency period was short, four years as opposed to ten years, which was the norm, and it was aggressive.

The Kemeny Commission, which was convened to in-vestigate the incident at Three Mile Island concluded that mental stress would be the main effect of a nuclear reac-tor disaster. We have seen this again and again with many natural and man-made disasters throughout the world.

Traveling across the Atlantic from New York to Lon-don is the equivalent of receiving a chest x-ray. A CT scan of the brain has six hundred times as much radia-tion as does an x-ray of the brain. It is thought that about 30% of CAT scans that are performed in children are not necessary. There is a great movement towards care-ful consideration of the risks and benefits of performing a CT scan. While it is an important diagnostic tool, we do have to remember that in a study by Brenner et al., who is a Columbia radiation oncologist, that these expo-sures from CT scans are thought to account for fifteen hundred excess cases of cancer later on in life.

The American Academy of Pediatrics put out a policy statement in 2003 on radiation disasters in children. I think a student had asked earlier this morning, are there plans set in place. These are basically the guidelines set in place by the American Academy of Pediatrics Com-mittee on Environmental Health. In disasters involving radioiodines they recommend that potassium iodide (“KI”) can prevent damage to the thyroid, but that it must be administered before or immediately after the




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exposure, within twelve hours. They only recommend use of potassium iodide in consultation with public health authorities, and for further information, families can turn to the Food and Drug Administration. The FDA website has information, not only on the adminis-tration of potassium iodide, but also on the formulation and places where you can actually purchase potassium iodide formulations that are FDA approved.

Schools and other childcare settings that are within ten miles are also recommended to have KI readily avail-able to them, not necessarily to stockpile it but to have readily available access. This ten mile distance however is very controversial, and some have recommended that they expand this even further. As we have seen in histori-cal events, the fallout areas can be far greater than ten miles in radius.

Keeping in mind the principle that children are uniquely vulnerable, if you are zero to eighteen years old, or you are a pregnant lactating woman, your thresh-old for exposure is lower because of the unique vulner-ability of childhood, and the KI dose is adjusted accord-ing to your age as well.

Evacuation is critical if possible; it is not always pos-sible. If evacuation is not possible, then shelter in base-ments or masonry buildings is recommended. This formula here is a shielding factor looking at the dose received inside the structure versus the dose received if

the structure were not in place. So if you are in a wooden frame building that is basically like being outdoors. But if you are in a home basement, a masonry home, or a large office or industrial building you are far more protected than you would be if you were in a wooden structure.

The AAP may recommend the temporary discontinu-ation of breastfeeding when pregnant women or lactat-ing women are exposed to radiation. There are several sources for environmental health information, and this is the AAP’s Pediatric Environmental Health Hand-book, which is a very useful guide for physicians and other health care providers to better understand some of the exposures and the long-term risk to children. Also another textbook on environmental health entitled, En-vironmental Health, From Global to Local, which was edited by Dr. Howard Frumkin.

There is also here, at Mount Sinai School of Medi-cine in New York, a Pediatric Environmental Health Specialty Unit (PEHSU). We have a toll free line. We re-ceive clinical consultations from families, communities, and schools on any number of suspected environmental exposures or diseases considered to be of environmen-tal toxin origin. We are also involved in education, out-reach and advocacy efforts.

There are PEHSUs in each EPA federal region of the U.S. Our PEHSU covers New York, New Jersey, Puerto Rico, and the Virgin Islands. There are now PEHSUs located internationally, so there is one in Edmonton, Canada, there is another in Cuernavaca, Mexico there are plans for one in Argentina, and also in Spain. So they are rapidly becoming a national and international resource.

I will end with a quote from Dr. Landrigan, “children are not merely a special vulnerable group within our population but rather the current inhabitants of a de-velopmental stage through which all future generations must pass. Protection of the health of fetuses, infants, and children is essential for sustainability of the human spe-cies.” This is particularly important for any future events to ensure that we keep these basic principles in mind.




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Radiation and the Skin: A Spectrum of EffectsDr. Patricia Myskowski Memorial Sloan Kettering Cancer Center New York, NY

This morning I will go over some of the effects of ra-diation on the skin. Obviously I have a bias since I am a dermatologist but I will try to give a complete overview of the different types of radiation that can affect the skin. You have already heard about some them this morning, and I will give you a perspective about some of the things we might need to know for the future.

Now, when I talk about radiation there are a number of types, and I will go over them. I will be covering UV radiation, which, of course, is natural or sunlight, and the different subtypes of that, specifically ultraviolet B, C, and A. I could give a number of different examples about the sun and all of the things it does. Of course, it has a lot of wonderful effects from just being responsible for life on earth, photosynthesis, warmth, and metabo-lism of some vitamins, like vitamin D. It also kills differ-ent pathogens, and it actually may have some effects in mood elevation, which may be why some people are ad-dicted to tanning salons because it can cause endorphin release. But too much ultraviolet radiation from the sun, such as what we are experiencing in this century and in the last century, can have some very deleterious effects on the skin. And by these we think of skin cancer primarily, as well as aging of the skin. Virtually all aging of the skin is not just due to getting old; it is from ultra-violet radiation. And also another issue is cataracts. So I will touch on a number of these today.

In the middle of the electromagnetic spectrum are the types of UV radiation that are most relevant to the skin. UV includes UV C, the shortest wavelength, UV

B, which everyone always hears about, responsible for immediate suntans, and UV A, the longer wavelengths, which have come into the forefront more recently, with the understanding of some of the long term effects that these can have as well. Visible light has longer wave-lengths, as you can see, and then there are infrared and radio waves after that. And on the other end of the spec-trum we have x-rays and gamma rays.

Much of the UV radiation does not reach us here on earth and is absorbed. UV C naturally does not reach our lives here on earth. It can be made artificially, and occasionally was used in the germicidal sense in some operating rooms years ago, but we do not have to worry about UV C in our daily life. UV B is partially filtered out in the stratosphere and the troposphere, and this is where the depletion of the ozone layer comes into play because it really helps us have less of the UV B coming through. UV A tends to make it to the earth’s surface most of the time.

This is kind of a conventional wisdom and a conven-tional overview of UV radiation and the skin. UV B, are

those short wavelengths from 280-310 nm that are the burning rays you think about when you go to the beach. They are more common in the summer. And UV A are the longer wavelengths that can give you what we call a delayed tan and they are present year-round. They do not have the same seasonal fluctuation that UV B does. And as I mentioned, we are becoming increasingly aware of the importance of UV A on carcinogenesis, and a lot of late effects on the skin.

There are a number of factors that enter into this. First of all is your basic underlying color. If you are very fair-skinned, you have no innate sun protection. If you have very dark skin and are very darkly pigmented, then you actually have an innate sun protection factor of 6. In other words, just having pigment in your skin if you are more darkly pigmented, allows you to stay out longer and not get a sunburn and prevent suffer-ing from many of the deleterious effects of excessive UV exposure. That also applies to the chronic effects, which are photo aging and skin cancer, again, occur-ring more often in fair-skinned people because they do not have the protection. And these are the acute cosmetic effects, if you will, of UV radiation. Now, you have to remember: there is no such thing as a “healthy tan”—that is truly an oxymoron. Your epidermal cells are so upset because they are having this DNA damage caused by UV B that they are trying to make a shield,

You have to remember: there is no such thing as a “healthy tan” that is truly an oxymoron.




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and so they start to make melanin, which is what you get as a tan. It is just an effort to protect you from more of this terrible DNA destruction that is going on. So that is what a healthy tan is, if you will.

But, in a more concrete way, these are the long-term effects of excessive UV radiation, and there is really an epidemic of skin cancer in the US. This occurs more often in fair-skinned people, includes all types of skin cancer. We feel that all of these are related, either di-rectly, or epidemiologically, to UV radiation exposure. These are some statistics from 2004 showing the inci-dence of skin cancer in the US. You have to remem-ber that skin cancers tend to be underreported, even melanoma. It does not appear in all cancer registries and in many other countries it is not reported. Basal cell carcinoma and squamous cell carcinoma of the skin, as a rule, are not reported to the cancer registries such as the SEER data banks and a number of other cancer registries. So the incidence is probably much higher than we know. And it has been estimated that in 2005 there were almost 106,000 melanomas, about 60,000 of them being invasive melanomas, and about 46,000 being melanomas in situ which are in the very early, very curable stages, probably related more to awareness and early detection.

Now, what are some of the reasons for this epidemic of skin cancer? Well, it is quite complex. One of them, of course, is ultraviolet exposure. Fashion is an important element. For example, people have commented on the fact that melanomas are most common on the lower legs of women. In the past, women did not wear short skirts and did not have much sun exposure. Therefore, we did not see melanomas in the early part of the century. But now with the different fashions, and recreational sun exposure, including outdoor activities and tanning, we certainly do.

One thing we know for sure is that the incidence of skin cancer, again primarily in fair-skinned people, increases with age. Melanoma does tend to occur at all ages. About a quarter of them are in patients under 40, so it can affect people in very, very vital parts of their lives. But basal cell carcinomas and squamous cell carci-nomas do tend to increase with age and with sun expo-sure. We think that basal and squamous cell carcinomas are more associated with chronic sun exposure, but the short, intermittent exposure, which can be highly im-muno-suppressant as I mentioned, has been associated

with melanomas. For example, people who live in Eng-land or non-sunny climates and then go for that Carib-bean vacation and get that acute sunburn experience a kind of sun exposure that is immuno-suppressant and may lead to melanoma.

It is estimated that one in five Americans will have skin cancer in their lifetime, probably basal cell carci-noma if fair-skinned. In contrast to squamous cell car-cinoma, this is slightly more intermittent. For example, farmers would have squamous cell carcinoma more often. But people who take a lot of long vacations with recreational sun exposure, would be those with basal cell carcinomas, and the vast majority of them, not sur-prisingly, are located on sun-exposed areas, specifically the head and neck.

Squamous cell carcinomas are less common and are also associated with sun exposure. It’s not uncommon for patients to have both. Patients who have had organ transplants and then have sun exposure, especially if they are fair-skinned, have a tremendously increased chance of squamous cell carcinoma. Even viral infec-tions with the wart virus, human papiloma virus, can in combination with UV radiation, lead to squamous cell carcinomas.

This graph shows how the incidence of melanoma has increased in the last century. It is estimated that the risk in fair-skinned people is now about 1 in 60. There is a lot of early detection going on. I do not know how much patient education has had an effect on melanoma as far as sun exposure, but I think cer-tain people know to do self-exams. They know that if you have a family history of melanoma you’re at higher risk, and if you have lots and lots of moles, or unusual moles, you are at higher risk. And people tend to either come to dermatologists or make their family members come to dermatologists so that we can screen them. And even though the risk of melanoma is increasing, the mortality rate is not. I think a lot of

Skin cancers tend to be under-reported, even melanoma.




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that is related to early detection and patient awareness of the risk factors.

UV light causes cancer in a number of ways. When you lay on the beach, and the sun feels good, you need to think of everything else that is going on. Your langerhan cells are getting damaged. Your langerhan cells are like these little watchdogs in your epidermis. If they see anything, a foreign antigen that should not be there, like a tumor cell, they just grab it up and sen-sitize your T-cells to attack it. But these poor guys get really damaged by UV and if you get badly sunburned, they are basically wiped out for a week, leaving you pretty defenseless. Believe it or not, getting a nice, healthy suntan or sunburn can cause changes in your T-cells so that your suppressor T-cells increase and your helper T-cells kind of take a backseat. And if you wonder about your helper T-cells, those are the same cells that are targeted by the HIV virus. So, everybody wants to have a lot of helper T-cells, but UV light changes that balance.

Now, of course, dermatologists tell you to stay out of the sun and, if possible, to use a sunscreen so that if you are going to go out, you will not burn as much. It is esti-mated that 30 million people do not listen to us and use indoor tanning salons, especially adolescents and young women.

I should also mention that to dermatologists, UV is used therapeutically for a wide variety of diseases, but these can have the same long-term side effects used therapeutically. Next I would like to talk about ionizing radiation. Of course, ionizing radiation is used thera-peutically. In the mid 20th century, it was used to treat acne and different infections.

There are a number of reports of the acute and chronic effects of Chornobyl. Many of the acute effects were related to the contamination of the skin either from the floor, when there were severe burns on the feet, or the face, shoulders and hands. The longer-term ef-fects in patients at Chornobyl have been published, and a number of patients have had skin involvements some-times over an extensive area of the skin, usually on the exposed areas corresponding with contact to contami-nated water. The most common changes have been in the radiation dermatitis: telangiectasia, hyperpigmenta-tion and radiation keratoses, although, skin cancer has started to be seen.

So, in conclusion, there are various types of radiation that may have specific effects on the skin, and in the case of ultraviolet radiation, these effects are increasing in frequency. Physicians have to be aware of all the differ-ent types of radiation and all the different effects for the prevention of skin disease in the future.

Effect of Ionizing Radiation on Human Aging: a Longitudinal Study of the Chornobyl Disaster Liquidators

Dr.Vladyslav V. Bezrukov, Director, Institute Of Gerontology Kyiv, Ukraine

Twenty years have passed since the time of Chornobyl Nuclear Power Station accident. However the opinions regarding influences of this grave ecological disaster on the viability, health and aging of human individuals are still contradictory. It is important, first of all, to note that evaluations of ionizing radiation influences on human aging and life expectancy are far short of ambiguity.

First investigations on the biological age assessment in the Hiroshima victims did not register any radiation influences on the aging process. In 1994, W. Hollings-worth finished writing his reminiscences about those large-scale investigations with the following words: “The question about interrelationships between radiation and aging was and has remained open so far”.

N. Shock [1984] presented data on the absence of ac-celeration of aging processes in subjects who had been exposed to atomic bombing in Hiroshima and Nagasaki even 15-20 years afterwards.

Moreover, low-to-intermediate doses have been ob-served to enhance growth and survival, augment the immune response, and increase resistance to the mu-tagenic and clastogenic effects of further irradiation in plants, bacteria, insects, and mammals - L. Sagan [1987], C. Congdon [1988], A.Upton [2001] .

At the same time, D. Grahm [1969] in his cross-sec-tional studies, J.Maisin (1992) and many present-day investigators used to think that any kind of chronic ra-diation curtails the population life cycle.

PurposeThe aim of the present investigation was to study the

influences of ionizing radiation on the Chornobyl acci-dent liquidators.

Study subjectsOne hundred seventy-six individuals, the Chorno-

It is estimated that one in five Americans will have skin cancer in their lifetime.




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byl accident liquidators, between the ages of 25 and 65 years, took part in the study.

In this paper I will present the results of studies car-ried out by two research groups from the Kiev Institute of Gerontology.

The first research group (A) investigated the integral, psychological and cardiopulmonary ages in 1989 (three years after the explosion), involving 124 liquidators (85 men and 39 women) who participated in the recovery work immediately or 5 months after the explosion.

The second research group (B) undertook a study in two stages, one, in 1989 and, second, follow-up, in 1994. Fifty-two male-liquidators were divided in two subgroups: 1st – the individuals with the absorbed 0.25-1 Gy radiation dose, and 2nd – those whose absorbed dose made 1-2 Gy. The latter subgroup consisted of individuals who had suffered the first degree radiation disease in 1986.

MethodsThe biological age presents an objective tool for eval-

uating influences of various external factors, including the radiation factor.

The determination of age- and radiation-related changes at the level of an entire organism was done via assessing the integral biological age [IBA].

Considering the fact of a heterochronic aging of various body organs and systems and in view of the vari-ety of adaptive mechanisms responsible for homeostasis maintenance, it was decided to make a partial evalua-tion of age changes in the separate organism functional systems. Following from available literature data about predominant injury of cardio-vascular and nervous sys-tems and the disturbance of psychological adaptability in subjects exposed to ionizing radiation, it was decided to use the partial models for cardiopulmonary and psy-chological BA measurement.

The cardiopulmonary, psychological and integral biological ages were assessed according to a method,

which had been developed at the Kiev Institute of Ger-ontology.

Test batteries included parameters, correlating high-ly with the chronological age:- Arterial systolic blood (SP), diastolic (DP) and pulse

(PP) pressure, in mm Hg;- Breath holding during inhalation (BHin) and exhala-

tion (BHex), in sec;- Lung vital capacity (LVC), measured by the apparatus

“Spirotron” (Drager Firm), in ml;- Body weight, in kg;- Lens accommodation (A), in dioptries;- Hearing acuity (HA), measured by an audiometer “MA-

21”, in dB- Static balancing (SB) on the left leg, in sec; - Pulse wave velocity along arterial vessels of elastic (Ve)

andmuscle types (Vm1);- Rates of pulse wave velocities: radial artery \aorta,

femoral artery\aorta;- ECG RR and QT intervals, SI – systolic index;- Health self-appraisal (SA) – the questionnaire of 29

questions;- Wexler symbol-digit test (subtest) (WT);- Level of depression (D); - Level of hypochondria (H); - Level of neurotism (N); - Level of social integration (SocI); - Correction index (C).

R-R and Q-T intervals, systolic index (SI), pulse wave velocity rate along elastic and muscle type vessels (Ve – along the aorta, Vm1 – along the radial artery, and Vm2 – along the femoral artery) were measured on a poly-graph “Mingograf-34.




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Results

The first series of investigationsIn all age groups of liquidators, the integral biologi-

cal age was higher than the corresponding population standard. Less pronounced increase was seen in cardiop-ulmonary BA. Most pronounced changes were noticed in the psychological BA values.

The older was the age group, the lesser was the radia-tion effect on study parameters (younger people were more sensitive to the effect of radiation). This was true for PBA as well.

In the given series of investigations, dose-dependent effect of radiation on the IBA was shown. Changes in BA were more pronounced in those liquidators who partici-pated in clean-out work immediately after explosion at Chornobyl nuclear power station. This difference was more pronounced in older age groups, although absolute values of changes were higher in younger liquidators.

The second series of investigationsAccording to the initial study data of 1989, radiation

influences on IBA increase were more marked in the un-der 40-year old liquidators. At the same time, the CPA indices were even lower than the population standard.

The comparison of the IBA indexes in the persons exposed to varying degree of radiation (0.25-1 Gy or 1-2 Gy) has revealed dose-dependent effect: the greater was the absorbed dose, the more marked was the tendency towards increase in the IBA and CPA values (especially seen during IBA dynamic assessment in separate indi-viduals).

It is known that people whose profession is linked with hazards and strenuous work have a good health sta-tus, and we had such observation in studying accident liquidators. Among the latter, we distinguished regular workers of the Chornobyl NP Station and volunteer workers.

A comparison of these two groups showed that chang-es in the integral BA value (13.9 ±4.4 years) of volunteer workers were higher than those for the Station regular (cadre) workers (1.4 ±2.5 years). The similar ratio was established when evaluating the CPA indexes.

Noteworthy is the fact that chronological age of vol-unteer workers was almost 10 years lower than the chron-ological age in the Station regular workers. It should be mentioned that the dose “load” of volunteer workers did not exceed the radiation dose in station cadre workers. One may assume that the above-said differences in the aging rate (changes in IBA and CPA) are conditioned, firstly, by the age and, secondly, by the more thorough medical selection of cadre workers and by the more serious professional training of cadre workers for the Chornobyl NP Station.

Paired correlation analysis of the IBA, CPA with their components has revealed most significant correlations between them.

As is seen, the systolic arterial blood pressure (SP) in both, integral and partial IBA models, presents the most significant core factor related to the IBA determination. This finding has been also confirmed by factor analysis results where “arterial pressure” is the key factor in IBA formation in the case of accident liquidators. Consider-ing the high frequency of hypertonic type vegetovas-cular dystonia (68%) and blood pressure increase with accelerated aging, it may be assumed that these changes can be enhanced in the future.

Follow-up studies on the liquidators, which were car-ried out 5 years after the first study (altogether 8 years af-ter the Chornobyl accident), allowed us to trace changes in the IBA and CPA and in their separate indices.

As can be seen from, the IBA (compared to popula-tion standard) increased by 8.4±4.4 years. As in the cross-sectional studies, increase of IBA indexes took place mainly in the younger age group: in the group under 40 years the IBA excess over population standard made




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19.0±3.2 years and in the group above 40 years it was only 3.1±1.1 years.

The CPA changes were much less pronounced. The unchangeability of CPA indexes was also conditioned by the age factor: the older age group was much “younger” (by 2, 3 years) than their population counterparts, compared to younger group in which the CPA index exceeded the population standard by 6.9 years.

At the same time, such IBA and CPA indices as the BHin and SB worsened (almost two-fold), the Ve, Vm1 and Vm2 became higher, and the number of diagnosed CPA diseases increased.

As seen, the processes of accelerated aging, which are conditioned by negative ionizing radiation influences, lead to changes which can be nominally subdivided into two categories:

(1) changes of predominantly organic character (as evidenced from the worsening of elasticity of the arter-ies – Ve, Vm1 and Vm2 indices), and

(2) changes of predominantly functional (worsening of BHin and SB indices), the quantitative characteristics of which has a definite element of subjective influence of study individuals themselves.

In the longitudinal versus cross-sectional investiga-tions, the age- and dose-dependent effects of radiation were more noticeable. In the patients whose absorbed dose was 1-2 Gy, the IBA indexes increased two-fold after 5 years (11.5±2.3 years against 5.4±1.4 years in the liqui-dators who had received 0.25-1 Gy radiation dose).

As known, the aging is a universal process; still it is characterized by heterochronicity and heterotopicity. The ionizing radiation enhances these specificities of aging, as evidenced from the dissociation of integral and partial (cardiopulmonary) BA. Of note, compared to the integral index, separate estimation criteria for the IBA may carry much greater information about the character of age-associated processes.

For instance, the results of factor analysis indicate that during five years there took place a transformation of the factors, which form the biological age of the liq-uidators. If the main factor (factor 1) in Study 1 was the arterial blood pressure (in addition to the chronological age), with the time passing a peculiar “pathologisation” of the aging process has occurred, that expressed itself in the great number of diagnosed diseases and the more marked influence of health self-appraisal factor.

Conclusions(1) Ionizing radiation influence on human organism

is to be considered as the factor accelerating aging proc-esses.

(2) Ionizing radiation accelerates the rate of hu-man aging depending on received dose. At least, this

concerns comparing thos individuals who had been exposed to 0,25 – 1 Gy and 1 – 2 Gy doses.

(3) Studies have confirmed age-dependent sensitivity of human being to ionizing radiation: the younger age people are more subject to its negative influences.

(4) Ionizing radiation not only accelerates the rate of aging, but also changes considerably the quality of this process, by enhancing its heterochronic and hetero-topic expression.

(5) Negative ionizing radiation influences result in the phenomenon of “pathologisation” of the aging, in the development of polymorbidity, so peculiar for aging. Indicative of this is an increased number of diseases in the subjects who had been exposed to radiation.

(6) The IBA assessment method has been found as a suitable tool for detecting adverse ionizing radiation ef-fects on human health and aging.

Note: This research was done with the collaboration of Dr. Volodymyr P. Voitenko and Dr. Mykola G. Akhaladze.

Developing the Best Practices Model for Diagnosis and Treatment of Thyroid Cancer among Exposed Populations

Prof. Mykola D. Tronko V.P. Komisarenko Institute of Endocrinology and Metabolism Academy of Medical Sciences of Ukraine Kyiv, Ukraine

20-year observations confirm that one of the major medical problems resulting from the accident at the Chornobyl Nuclear Power Station is thyroid pathology, in particular, thyroid cancer.

The data included in this presentation have been obtained as a result of implementation of national and international scientific programs. The presentation will be focused on an analysis of epidemiological studies of thyroid cancer incidence depending on gender, age, and place of residence of subjects at the time of the ac-cident. In addition, data will be presented on thyroid cancer treatment, main morphologic types of carcino-mas, and data on thyroid cancer incidence depending on exposure dose.

In 1992 a clinico-morphological Register has been established at the Institute of Endocrinology and Me-tabolism of the Academy of Medical Sciences of Ukraine,




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based on statistical reports on the number of thyroid can-cer cases in subjects aged 0 to 18 years at the time of the Chornobyl accident for all 27 regions of Ukraine, and on a review of medical records of patients having received surgical or postoperative treatment at the Clinic of the In-stitute of Endocrinology. Also, thyroid cancer incidence per 100 thousand representatives of population groups of different age has been calculated, and a comparison made of the incidence rates for six regions of Ukraine with the highest levels of contamination by iodine radionuclides (Kyiv, Chernihiv, Zhytomyr, Rivne, Cherkassy regions, and City of Kyiv), and for the other 21 regions of Ukraine for the period 1986-2004. Register data are updated on a regular basis with additional information.

An estimation of Register’s data by age at the time of the accident shows that for the post-Chornobyl period (1986-2004) 3394 cases of thyroid cancer in patients born in 1968-1986 (0 to 18 years at the time of the accident) have been registered. Of these, 2410 were children aged up to 15 years during the accident (0 to 14 years), and 984 were adolescents aged 15 to 18 years (Fig. 1).

The rise in thyroid cancer incidence among chil-dren at the time of the accident occurred mainly at the expense of the six regions of Ukraine with the highest levels of contamination by iodine radioisotopes follow-ing the accident (Kyiv, Chernihiv, Zhytomyr, Rivne, Cherkassy regions, and City of Kyiv). In these six regions the incidence rate for the period 1986-1989 was 0.16 per 100 thousand children at the time of the accident, which practically did not differ from the rate for the other 21 regions of Ukraine.

In subsequent years - 1990-1995; 1996-2001; 2002-2004, the incidence exceeded on average by 4 - 4.5 times the rates for the other regions. The data obtained sug-gest that this rise is due to radiation factor.

A similar tendency was also noted among the adoles-cents of the six northern regions: the incidence rate was also higher than for the other regions of Ukraine, but

this increase was much less significant as compared with children.

I would like to focus on the analysis of distribution of thyroid cancer patients born in 1968-1986 by their age at the time of the accident (Fig. 1):

So, the percentage of children aged up to 5 years was less than 1%; from 5 to 9 years: 16.5%; from 10 to 14 years: 35%; adolescents: 47.6% (1986-1989).

The most significant changes were noted in the group of children aged from 0 to 4 years at the time of the ac-cident: up to 21.8% (1990-1995); 23.6% (1996-2001); 19.8% (2002-2004).

Some increase (though insignificant) in the percent-age of children aged 5 to 9 years was also noted. Con-trary to this, the percentage of children aged 10 to 14 years and adolescents is decreasing. These data suggest a substantial increase in the part of children who were aged up to 4 years in 1986 and whose thyroid gland was more highly sensitive to radioactive iodine exposure.

This was also confirmed by joint investigations car-ried out with the Ukrainian Center for Radiation Medi-cine, that have clearly demonstrated, beginning from 1990 - in children aged from 0 to 4 years at the time of the accident - a steady increase in additional incidence practically for all dose zones. Additional incidence is incidence minus spontaneous level. The most pro-nounced increase was noted for a thyroid exposure dose of 1 Gray and more.

A comparison of thyroid cancer incidence (at the time of surgery) in children born before 1987 with those born after the accident shows a notable difference: an increase in thyroid cancer incidence among exposed children by 10 to 15 times. At the same time, among chil-dren born after the accident, that is, those non-exposed following the accident, the rate was practically within the range for the period before the accident.

A significant rise in thyroid cancer incidence was noted in children who were operated at the age up to 15 years, at the expense of the regions of Ukraine with the highest levels of contamination by radioactive iodine.




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A similar situation was reported as regards thy-roid cancer incidence for the six northern regions of Ukraine among adolescents born before the accident, in which this rate was 3-5 times higher than for the other regions of Ukraine.

An analysis of thyroid cancer incidence for the six more highly contaminated regions and other regions among young adults (aged 19 to 36 years) has shown the lowest rates compared to children and adolescents at the time of surgery, and these rates became significant only in 1998.

Thus, it should be noted that for the post-Chornobyl period, beginning from 1990, a significant rise in the number of thyroid cancer cases and incidence has been reported for the cohort of subjects aged 0 to 18 years at the moment of the accident, especially among children aged 0 to 14 years at the time of the accident.

An analysis of the main types of carcinomas has shown that in all age groups and for all periods of fol-low-up more than 90% of cases represented papillary carcinoma, both among children, adolescents, and young adults. Follicular carcinoma was within the range 3% to 6%; medullary carcinoma was reported in 3.7% of cases among children, 1.4% of cases among young adults. Anaplastic carcinoma was reported only in two cases of adolescents.

Histologically, the papillary carcinomas under study were distributed into the following subtypes or variants:

Typical papillary cancer, characterized by: a) presence of numerous papillae that formed

arborescent ramifications, in central part of which a fibrovascular stem is located; presence of specific calcifi-cates called psammoma bodies;

b) presence of sharply cleared nuclei, looking as a “watch glass”.

Here I would like to stress that tumors of such struc-ture have a steady age dependence, that is, percentage of these tumors is increasing with patients’ age: on aver-age from 12.3% in children to 23.4% in adolescents, and 38.3% in young adults.

In case of follicular variant of papillary carcinoma, there were isolated typical papillae, or no papillae at all, but nuclei were obviously cleared and had cytoplasmic inclusions.

The third variant is represented by the solid variant of papillary carcinoma. Tumors of alveolar-solid struc-ture were predominant, with presence of psammoma bodies in cell nuclei.

Tumors of such structure had signs of most pro-nounced aggressive biological behavior as regards extrathyroid spreading, vascular invasion, presence of regional metastases, as compared with other variants of histological structure of papillary carcinoma

It should be noted for all age groups, with time, a significant increase in the percentage of mixed variant of papillary carcinoma. Papillary carcinomas of solid-follicular structure were most specific to post-Chorno-byl cancers in children at the time of surgery. At the same time, with increasing latent period, there was an increase in the percentage of carcinomas with typical papillary structure

It should be stressed an increase, with time elapsed after the Chornobyl accident, in the percentage of tu-mors measuring up to 1 cm: up to 4.1%, 11.8%, and 18.8%, respectively, which is undoubtedly due to an int-ensification of screening examinations.

According to the data of the Department of Surgery of the Institute, thyroid malignant tumors reported in patients of child’s and adolescent’s age have particular features and a high biological potential of malignancy. Clinically, this manifested by a short latent period of de-velopment without signs of changes in general somatic status, and by a high organ and lymphatic invasiveness. In 52.4% of patients extrathyroid tumor spreading was noted. 55.1% of patients had regional metastases to lymph nodes of the neck. 8.2% had distant metastases to lungs.

The principles of early diagnosis of thyroid carcino-mas lie in an objective assessment of oncological danger from all focal thyroid neoplasias, detected by ultrasound investigation. Biopsy of these tumors with cytology study of cell material allows to improve the accuracy of preop-erative diagnosis of thyroid cancer.

For years, the choice of therapy and volume of thyroid surgery in case of highly differentiated thyroid cancer have been a matter for debate. In the presence of cases of radioinduced thyroid cancer and taking into consid-eration a high aggressiveness of its clinical course, we have revised our surgical approach by excluding organ-preserving operations, and we consider that the method of choice in the treatment of differentiated forms of thyroid cancer is extrafascial thyroidectomy followed by therapy with radioactive iodine and suppressive




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hormone therapy. An analysis of the results of thyroid cancer treatment has shown that primary thyroidectomy decreases the risk of relapses of the disease as compared with organ-preserving operations.

Thyroidectomy is always associated with an increased risk of such specific postoperative complications as la-ryngeal paresis and hypoparathyroidism. These compli-cations are the main cause of disability, and, with quite high survival rates, this reduces the efficacy of patients’ rehabilitation. The surgeons of our Institute have devel-oped a priority method of thyroid surgery, allowing to reduce the number of postoperative complications (de-crease in persistent laryngeal paresis from 6.8% to 3.2%, persistent hypoparathyroidism from 4.3% to 1.1%.

Favorable results of thyroid carcinoma treatment served as an objective criterion of assessment of treatment efficacy. Survival rate for a period of 5 years is 97.3%.

In most of patients (871 persons, 56.0%) only residu-al thyroid tissue was found. This group of patients made a quick recovery (747 patients, 85.5%) (1-2 courses of iodine therapy). This emphasizes once again the neces-sity of early diagnosis. In case of metastases, especially distant ones, recovery is slower and requires a larger number of radioiodine therapy courses. Our position on this question is that we are treating all patients with differentiated thyroid cancer until complete recovery.

Thus, out of 1544 patients operated on for a differen-tiated thyroid cancer 1310 are recovered, and the rest of patients continue receiving treatment.

What main conclusions may we draw based on the data presented ? I would like to dwell only on key issues. • After the Chornobyl accident in Ukraine, begin-

ning from 1990, a significant rise in the number of thyroid cancer cases and incidence was noted in the cohort of subjects aged 0 to 18 years at the time of the accident, especially among chil-dren aged 0 to 14 years during the accident.

• Patients’ distribution by age at the time of the ac-cident points out that the most significant increase in the number of thyroid cancer patients occurred at the expense of children who were aged up to 4 years in 1986. This group has increased last years as compared to 1986-1989 by more than 5 times, which allows to highlight the exposed contingent aged up to 5 years as a group at maximal risk.

• This is confirmed by the data concerning a steady in-crease just among children aged 0 to 4 years at the time of the accident, of additional thyroid cancer incidence with increasing thyroid exposure dose. The most pro-nounced increase has been reported for the highest average thyroid exposure dose of 1 Gray and more.

• Most of thyroid carcinomas (more than 90% of cases) in patients who were children or adolescents at the

time of the Chornobyl accident, represented papil-lary carcinomas. A certain increase has also been noted in the percentage of follicular carcinomas with increasing time elapsed after the Chornobyl accident.

• Papillary carcinomas were characterized by significant changes in morphologic structure with time elapsed after the Chornobyl accident, that is, with increasing latent period of tumor development. The most aggre-ssive papillary carcinomas as to their biological behav-ior were reported in children operated at the age of 4 to 14 years in 1990-1995, i.e. in the presence of a short latent period of development. Such carcinomas had mostly solid and solid-follicular structure and displa-yed high invasive properties, were characterized by a high incidence of development of regional metastases.

• With time elapsed after the accident, the age of those exposed in childhood and adolescence was increasing, and there were significant changes in morphologic fea-tures of papillary carcinomas towards a gradual decrease in the percentage of carcinomas with solid structure, decrease in invasive properties of tumors, increase in the percentage of encapsulated forms and “small” car-cinomas measuring up to 1 cm, which suggested overall an improvement of the character of biological behavior of tumors, and was confirmed by a significant decrease in the percentage of cases with signs of extrathyroid spreading and presence of regional metastases.

• The principles of early diagnosis of thyroid carcinoma lie in an objective assessment of oncological danger from all focal neoplasias of the thyroid, that are de-tected by ultrasound investigation. Biopsy of these tumors with cytology study of cell material allows to improve the accuracy of preoperative diagnosis of thyroid cancer.

• The method of choice in the treatment of differenti-ated forms of thyroid cancer is extrafascial thyroidec-tomy followed by therapy with radioactive iodine and suppressive hormone therapy. An analysis of the results of thyroid cancer treatment has shown that primary thyroidectomy decreases the risk of relapses of the dis-ease as compared with organ-preserving operations.

And, finally, allow me to express my most sincere th-anks to the leading scientific Centers for their close and fruitful co-operation:

Great-Britain: Cambridge University, Wales University Japan: Nagasaki University U.S.A.: National Cancer Institute, Columbia Univer-

sity, University of Illinois, University of Pennsylvania 1 International Atomic Energy Agency (IAEA), World Health

Organization (WHO), United Nations Development Programme (UNDP), Food and Agriculture Organization (FAO), United Nations Environment Programme (UNEP), United Nations Office for the Coordination of Humanitarian Affairs (UN-OCHA), United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR).




Summer/Fall 2006

Climate Chaos and Biodiversity Destruction: Our Changing World and What We Can Do About It

Mr. Carter F. BalesManaging Partner of The Wicks Group of Companies L.L.C.

I’d like to touch on four topics today. What is it about humanity and human nature that seems to be itself so hostile to nature and is getting us into a peck of trouble? Secondly, how is the world changing both in terms of world economy and the physical world? Because the two are inextricably linked. Third, what does this mean for the survival of the world, as we know it? And, finally, if I have time, what we can do about. Although, again, there are far more expert people than I who can address the subject of what to do about it.

Human nature is obviously the root cause of the fact of why we are using up the world and pumping it full of heat, which is about to come back and really bite us. And, I think, it really does come out of a strong and understand-able kind of environmental development of humanity, which causes people and therefore causes organizations to take the reward, or the comfort, now and seriously, and deeply, discount the future. So, I think probably in the past, particularly in primitive times, it made good sense to take it now and not worry so much about tomorrow. So, I do think that this is fundamentally in human mi-crocode, and it does create a terrific short-term bias. So there’s a field now called behavioral economics, which is the hybrid offspring of economics and psychology. It’s a study in why the so-called rational actor theory of human behavior usually doesn’t work. Doesn’t really explain what’s going on. So, I’ve looked into behavioral eco-nomics and some of the leading behavioral economists observe that future events are experienced as having only half the value of present events and that would sug-gest that a future threat as compared to a present reward would not be seen as very threatening, if you will. So it’s a consequence and if we end up with a world of, I’ll be a little harsh, let’s call them short-term optimizers, and perhaps procrastinators, when it comes to confronting an important issue such as global climate change.

Human behavior seems to be driven by the near-term and not by the long-term. And up until recently, that’s been fine because the globe we live on has had a lot of

slack in it and we’ve been using the resources, but its had an adequate regenerative capacity and in fact, the compounding effect of resource use and the growth in humanity’s numbers and in the growth of humanity’s economic needs, we’ve kind of run out of slack and the world is being overtaken by runaway resource use.

I would indeed assert that the number one problem facing humanity in the twenty-first century is the use of natural resources, the exhaustion of natural resources, what it’s doing to the globe, and what it’s doing to our future capacity as a civilization. Also, if you look at how world economies work, and nation-state economies, there is an enormous short-term bias built into the eco-nomic processes, the implicit pricing systems that are used to value resources and to price any by-products of physical production. There are a lot of goods that are used in the US, and around the world, that are still effec-tively free, or fundamentally under priced.

Obviously when you dump sewage into a fresh water lake or a river, or into the sky, you’re getting a free good, a free use of those environments for the waste of society. I think it’s pretty clear if you talk to the economists that we’ve kind of hit the limits of the old market systems that failed to price and internalize environmental externali-ties. We need to reinvent the way we price some of this. Its not beyond our capacity, it seems to be beyond our will. This idea of sort of short-term bias and “take it now” which we find in economies we also find regrettably in private enterprise, probably more strongly in private en-terprise. Private enterprise, corporations, have a practice of applying very high discount rates concerning future investments which cause corporations to be oriented very much towards efficiency in their investments, kind of short term gains and not to consider the anti-societal byproducts of industrial activity.

So the short-term bias is seen very much in corporate behavior. And that all says to me that concepts like sus-tainable development or sustainable use, are really more of a prayer than a program. They’re very, very hard to put into practice unless we have some more fundamental re-forms. Now, perhaps fortunately the crisis in our climate will bring us to the realization that we have to make these changes because I don’t think anything else is going to bring us to the realization that we have to cost the earth more appropriately. Let’s take over-fishing as an exam-ple. World fisheries are very near permanent collapse. They’re suffering irreversible damage. More than 75%, more than ?, of world fish stocks are in jeopardy includ-ing many fish of high commercial value, tuna, haddock, cod…. And remember that the primary protein source for 1 billion people on this planet is fish. So, if we fish out the waters we’re causing a protein crisis in this world and we are rapidly fishing out the waters.




Summer/Fall 2006

Of a hundred fishing zones that were surveyed re-cently in the North Atlantic, more than half were judged as should be closed because of stock depletion. Only 10 of the 100 had enough fish to sustain current levels of fishing. So, what’s going on with the global fishing in-dustry? It seems hell bent on destroying the raw material on which it’s built. And again the answer is short-term bias and mis-pricing. We have global fishing subsidies amounting to at least fifteen billion dollars annually, which is about 20% of the world’s commercial catch. So, you can see the distortions that are caused by the subsidy program. The subsidies are luring more and larger ships into the water to chase fewer and smaller fish. The big fish are being fished out. It’s an unsustainable result; it’s a rig market. It’s rigged against the fish, it’s rigged against our population, and it’s rigged agains our chil-dren. And it’s particularly rigged against developing countries; because they can’t compete against these big subsidized fishing organizations.

To get their own fishing fleets going, their own fish-ing industries going, developing countries have a great difficulty because it is not a level playing field. So if your time horizon is short, then the fish in the seas or the trees in the ground are always worth more harvested in the fall than managed for long-term productivity. Now, when you talk with skeptics about this, some of them say, well you know it’s happening slowly and science will save us. Science and technology will bail us out. Science has dem-onstrated clearly the reality and the urgency of global climate change and established the causes, the driving factors. But technology, which is kind of the sister of sci-ence, really hasn’t done the job.

Technology itself is doubling about every eighteen months in mass. But, our condition is not improving, and what’s happening is that the output of science is re-ally seen in technology development where we haven’t in fact, what I’ll call, a short-term harvesting of science by commercially sponsored technology developers, kind of the “take it now” philosophy once again.

So, technology is being used principally for short-term efficiency gains or for products that are developed with-out close attention to their environmental cost. Technol-ogy is being used to improve practices at the margin not to address fundamental problems. It’s an emphasis more on, what I would call exploitive technology as opposed to sustainable technology. And technology is helping mankind empty the oceans of that protein and fish we

must have. We’ve got fish finders you know the run-on sonar. We are drag-fishing that destroys the bottom and destroys the capacity of fish to regenerate. We’ve brought industrialization to fishing with a drive towards scale; the boats are larger, and a drive towards efficiency. The fish have no chance and replenishment rates in world oceans are taking a dive. They are going way down. So, what’s wrong? It would seem to me that human institutions, lets call them governments or some would call them the pub-lic order, would be able to keep up with the implications of rapid growth and science and technology, and guide it, towards not only longer-term benefit, but towards the avoidance of undesirable second order consequence. And it’s not happening. It just is not happening. It may be happening in some economies. But what’s happened is that the debate is kind of substantially distorted by energy-producing companies, the auto industry, and the general lack of interest of the public. So, the government doesn’t feel the pressure to get smart on what the risks and likely outcomes are. With limited understanding of the risks, it’s really not surprising that there is little urgency for action. So, science and technology are not going to save the situation.

I would say that science and technology, on balance, have hastened the destruction of the natural world by their emphasis on exploitive activities and waiting for sci-ence and technology to bail us out is a fool’s error. Now, how is the world changing? What does this all mean? Let me make just a couple of other points. One is that economics and economic forces in the natural world are completely linked, and what’s happening is that eco-nomic forces are driving the destruction of the natural world. We are at the beginning, and I would argue, of a major, major global economic boom. The world econo-my is about to shoot through the roof. Vastly accelerated global warming and natural habitant destruction will happen because development is very carbon-intensive and, again we have this short-term bias. The emerging economies are growing much more rapidly than the so-called developed economies, roughly double the rate of the advanced economies. And, in 2005, the emerging economies produced more than half the world output in constant dollars. So, many of the emerging economies have very carbon-intense production and there are also many economies where the world’s forests exist, and where the world’s forests are being cut down. In the BRICs alone, which is Brazil, Russia, India, and China, the number of households with annual incomes over 3,000 will literally double within the coming three years. So, economics are definitely driving major change.

You are getting the increase in heat-trapping gases from industrial activity, and then you are getting the re-duction of the capacity to process those gases back into

We end up with a world of short-term optimizers when it comes to confronting an important issue

such as climate change.




Summer/Fall 2006

oxygen by the destruction of the natural world. So, Artic ice is melting at an accelerated pace. Fifty cubic miles of Greenland, ice, fresh water, went into the ocean in the last year. Fifty cubic miles; it’s an enormous amount. Sea levels are rising, ocean temperatures are rising, and storms are becoming more frequent and intense. And what is generally not known is that there are feedback loops in here, where with the thaw of world ice for exam-ple, mechanisms keep kicking in that keep the process going and accelerates it. Ice reflects 90% of the sunlight back that strikes it, whereas ocean water absorbs 90% of energy. So, ice melts, of course, faster than the warming ocean and the warming ocean is a larger ocean since wa-ter expands with heat.

I think I have to acknowledge that we have three na-tions that are going to determine the outcome of global climate change. One is the United States, home to less than 5% of the world population but generating fully a quarter of all green house gases. Second is China, which has doubled its economy in the last decade and is very car-bon-intensive. China’s bringing on light about a thousand megawatts of coal based dirty energy every week and will soon be the largest emitter and India is following behind. It’s not industrializing quite as rapidly but it is industri-alizing. The average American produces twenty times the amount of carbon dioxide as the average Asian; but remember that in China and India you have 2.4 billion people, all working to improve their economic futures.

And what is happening to fresh water, which is our most precious resource and is in strong decline? Seventy percent of fresh water is used for irrigation. I think the outcome of no matter what we do, and we damn well got to get started doing something, is that fresh water is go-ing to decline in supply rapidly. That means productive farmland will decline rapidly. There will be creeping desertification as areas convert to desert. Food produc-tion will become more costly and erratic, raising costs and hurting food-producing nations. Ocean levels will flood coastal cities and low-lying lands, even if it’s only a three-foot rise by the end of the century. Storms are going to become a lot tougher. You know, there are six and a half billion people living near coastlines??. With a three-foot sea rise and tougher storms, these people are in trouble. And then, of course, world fisheries are going to collapse. More erratic and violent weather patterns, a lot more rain, which has some positive and some nega-

tive. Temperature volatility and rapid species extinction and loss of world biodiversity. I think the most important point is that the bulk of the pain is going to fall on the world’s poorest people. These are the people who live off of nature and they are going to be hurt much more than others are. So, can we sustain the modern economy with 7 to 8 billion people living on our fragile planet, I guess is the question. Or is Mother Nature turning into the world’s most formidable terrorist? I think I’ll stop here. The imperatives of what to do deal with turning back deforestation, improving markedly transportation efficiency, moving to more efficient power generation, developing broad improvement in energy use in homes and buildings and industrial processes, getting people to reduce their personal carbon footprint.

And, finally and importantly, just in closing, we do have to, and you can help here, we do have to reform glo-bal trade agreements and implement new mechanisms to promote cooperation on climate change and biodi-versity protection. The Kyoto Agreement was admirable, but carbon credits are limited projects that promote reforestation. The biggest problem is deforestation. We need to stop it, not just replant. The World Trade Or-ganization needs major reforms. Its non-discrimination requirements do not allow countries to impose import taxes that factor in environmental costs of production. If you want to tax higher, products that absorb more energy, and therefore create more carbon byproduct, you can’t actually do it under the World Trade Organization. It’s also totally failed to address the issue of subsidies and ob-viously for over-exploitation of world fisheries, this is key. It is not agreed that multilateral environmental agree-ments among the governments will take precedence in international trade, and that’s an essential reform. So, what the scientists would say is that if we get on this stuff, there’s maybe a 20% chance of a major catastrophe like the Greenland ice sheet breaking off and melting, which would lead to a twenty foot rise in ocean, or an agricul-tural crunch, because the average temperature of raising agricultural products would rise two degrees centigrade. That itself would probably cut total production by twenty to thirty percent. So, I think we’re at the proverbial icy edge of win or lose or inflexion point here. Human na-ture is not helping us because of the short-term bias. The corporate structure, by not pricing all the poison it puts out into the world, is not helping us. We have to reform the way we account, but my question is will climate change go down as the greatest act of mass denial in the history of humanity. And, I will say, on our current path that is quite likely. We’ve got maybe five to ten years to get the arrows pointed in the right direction and if we don’t act now, it’s likely to be too late to save the world from some very, very serious, climate-driven outcomes. Thank you.

Human nature is not helping us because of the short-term bias.




Summer/Fall 2006

World Information Transfer, Inc., (WIT) is a not-for-profit, non-gov-ernmental organization in General Consultative Status with the United Nations, promoting environmental health and literacy. In 1987, inspired by the Chornobyl nuclear tragedy, WIT was formed in recognition of the pressing need to provide accurate actionable information about our dete-riorating global environment and its effect on human health to opinion leaders and concerned citizens around the world. WIT exercises its man-date through:• World Ecology Report (WER). Published since 1989, the World Ecology

Report is a quarterly digest of critical issues in health and environment, produced in four languages and distributed to thousands of citizens throughout the developing and developed world.

• Health and Environment: Global Partners for Global Solutions Conference. Since l992, WIT has convened what we believe to be one of the world’s premier forums for the presentation of scientific papers by international experts on the growing clinical evidence supporting the link between degrading environments and diminished human health. The conference has been convened as a parallel event to the annual meeting of the UN Commis-sion on Sustainable Development. The scientific papers presented at the conference are available on WIT’s web site.

• Human Information CD ROM library. This project consists of a library of CDs each of which focuses on a subject within the overall topic of De-velopment and Health information. Our Human Information CD ROM Library offers one bridge across the “digital divide” for both developed and developing countries. The project is continuous with future topics being developed.

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• www.worldinfo.org WIT provides through its web site up to date science based information on the relationship between human health and the natural environment, including the papers from the WIT’s annual con-ference and the World Ecology Reports.

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• Centers for Health & Environment. Centers for Health & Environment. The aim of the Centers is to promote research, education, and solutions. The first center was opened in Ukraine in 1992; the second center opened in Beirut, Lebanon in 1997 at Bir Hasan, United Nations Street, Al-Salaam Building.

WIT operates from headquarters in New York City with regional representa-tives in Australia, Belgium, Canada, Costa Rica, Egypt, France, Germany, Netherlands, Israel, Japan, Korea, Lebanon, Morocco, Pakistan, Romania, Sweden, Switzerland, Ukraine and USA.

World Information Transfer is a Non-Profit, Non-Governmental Organization in General Consultative Status with the United Nations, Promoting Health andEnvironmental Literacy.


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Dr. Christine K. Durbak, CHAIR & CEO

Roland A. DeSilva,EXECUTIVE VICE CHAIR

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Dr. Sophie BalkDr. Nicki BeredjickDr. Ruth EtzelDr. Bernard D.GoldsteinAmb. Nina K. KovalskaDr. Philip J. LandriganDr. Patricia MyscowskiDr. Scott RatzanDr. William N. RomDr. Mark RobsonJay Walker


World Ecology ReportWorld Information Transfer, Inc.(ISSN #1080-3092)475 Park Avenue South, 22nd FloorNew York, NY 10016TELEPHONE: (212) 686-1996FAX (212)686-2172E-MAIL: [email protected] EDITION AVAILABLE ON:

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AFRICA:Dr. Mohamed El-Banna74 Sawra St. Heliopolis, 11341 Cairo, EgyptTel: (202) 368-2887; Fax: (202) 365-0492 E-mail: [email protected]

CANADA:Taras V. Boychuk350 The East Mall, Toronto, ON M9 B3Z Tel: (416) 836-4512 E-mail: [email protected]

CHINA:Judy Kayee Sin3 Hop Yat Road 4th Floor,Kowloon, Hong Kong, ChinaE-mail: [email protected]

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Summer/Fall 2006 40

Second session: Dr. Maida Galvez; Dr. Claudia Strauss; Dr. Christine Durbak; Dr. Paul Lioy; Dr. Zvonko Kusic; Dr. Vladyslav Berukov

Third session: Dr. Michael Tuttle; Dr. Matthew Ringel; Dr. Daniel Igor Branovan; Dr.Christine Durbak; Prof. Alexander Rumyantsev; Dr. Mykola Tronko; Dr. Gregory Randolph

First session: Dr. Cham Dallas; H.E. Ambassador Kenzo Oshima; H.E. Ambassador Valeriy Kuchinsky; Dr. Christine Durbak; H.E. Ambassador Mirjana Mladineo; Mrs. Irena Zubcevic; Dr. Toshiteru Okubo.

This issue was made possible through the generous contribution of Merrill Corporation.

Documents

In this special issue: 15th International Conference on ...worldinfo.org/wp-content/uploads/library/wer/english/2006_fall_Vol... · dioactive release and subsequent 10 day fire at