Editorial Chernobyl, Fukushima, and beyond: A health safety perspective It is truly unfortunate that the Fukushima tragedy refuting a causal relationship between radiological Rajiv Sarin was to happen in the 25th year of the Chernobyl accidents and some common multifactorial health disaster. Just as the dust was settling and the conditions give rise to exaggerated fears even ACTREC, Tata Memorial Centre, Navi scientific world was in the process of bringing out among medical professionals. Discussing the Mumbai- 410210, a mature narrative of the long-term health effects fears, rumors, and truths about the health effect of India. of Chernobyl, the fury of nature resulted in another Chernobyl, Mati Rahu, an Estonian epidemiologist, nuclear accident at Fukushima. If Hiroshima and has invoked the Allport and Postman’s basic law of For correspondence: [1] Dr. Rajiv Sarin, Nagasaki are unthinkable and buried in the deepest rumor. This law postulates that the circulation of Prof. of Radiation recess of human shame, Chernobyl and Fukushima a rumor is roughly equivalent to the importance Oncology and I/C have kept the fear alive. In light of the Fukushima of the rumor to the person who hears or reads Cancer Genetics Unit, accident, the International Atomic Energy Agency it multiplied by the uncertainty or ambiguity Director, ACTREC, (IAEA) and its member states are re-examining the surrounding the rumor. Unfortunately, the Tata Memorial Centre, Navi Mumbai-410210, safety of the existing and future nuclear technology. inherent fear of radiation has been compounded India. by the paucity of a scientifically valid yet simple E-mail: rsarin@actrec. What truly is the risk of nuclear accidents and the uncluttered narrative of the adverse effects of gov.in associated health hazards? Is the reality closer to radiation, finding its way to the common man. the calculation of safety experts and governmental agencies or to the speculation of the common man The United Nations Scientific Committee on the and nongovernmental agencies? In the backdrop Effects of Atomic Radiation (UNSCEAR) through a of nuclear accidents and the way Chernobyl was series of reports on Chernobyl, the first of which initially handled, opponents of nuclear technology appeared in 1988, gives a detailed account of are always reading between the lines and fearful of the health effects of radiation exposure after a shroud of secrecy. The proponents on the other this accident.[2] The WHO media center has also hand try to circumvent obstacles from what they presented a comprehensive, unbiased, and lucid consider as ill-informed laity, led by an amorphous account of the health effects of Chernobyl, well group of intellectuals, politicians, social scientists, suited for members of the public as well as for and academicians. As medical specialist users the professionals who are not familiar with the of ionizing radiation, it is important for us to language of radiobiology or epidemiology.[3] The understand public concerns with radiation safety WHO report is based on the series of WHO expert which is bound to be heightened after nuclear group meetings that reviewed all scientific evidence accidents. Our inputs could also bring a greater of health effects of the Chernobyl accident in the understanding of health hazards from radiation first 20 years. To mark the 25-year period after within the scientific community and we are Chernobyl, the IAEA website has a series of 25 stories best placed to engage members of the public for presented through photographs and videos which genuine concerns or misconceptions they may have capture the essence of environmental, societal, regarding radiation, especially low-dose radiation and health impact of Chernobyl.[4] Narratives of AAccessccess tthishis articlearticle onlineonline and medical uses of radiation. human experiences from organizations which WWebsite:ebsite: www.cancerjournal.net many of us perceive as multinational super DDOI:OI: 10.4103/0973-1482.82908 The health risks due to radiation exposure and the bureaucracies and technocracies reassure our faith PPMID:MID: 2217686931768693 causality can be ascertained only through long-term on global mechanisms reaching out to the global QQuickuick ResponseResponse Code:Code: and detailed radiobiological and epidemiological community. The Royal College of Radiologists studies. There are some well-defined time- and has brought out a special issue of its official dose-dependent health hazards of radiation such as journal – “Clinical Oncology” – in May 2011 with acute radiation sickness, cataracts, thyroid cancer, Gerald Thomas as its Guest editor. This special and leukemia. The challenges in establishing or issue titled “The radiobiological consequences of Journal of Cancer Research and Therapeutics - April-June 2011 - Volume 7 - Issue 2 109 Sarin: Chernobyl, Fukushima, and beyond the Chernobyl accident 25 years on – April 2011” makes a is extremely low at 1%. This would result in 50 deaths from significant contribution by bringing out a detailed account of pediatric thyroid cancers over 30 years. In order to understand the physical and psychological health impact during 25 years how radiation causes thyroid cancers and to understand the of the Chernobyl disaster. behavior of this cancer, through multinational collaboration a unique resource has been created in the form of the Chernobyl The explosion on April 26, 1986, at the Chernobyl nuclear Tissue Bank.[7] The Chernobyl data also provide clear evidence power plant resulted in the largest ever environmental for early stage cataracts, specifically, the posterior subcapsular release of radionuclides from a civilian operation and this was cataracts with threshold radiation doses that otherwise are deposited over large areas of Belarus, the Russian Federation, considered safe in current radiation protection guidelines.[5] and Ukraine. The main radionuclides responsible for a health impact were Iodine-131 (half-life 8 days), Cesium-134 (half-life The impact of Chernobyl cannot be measured only by cancers 2 years), and Cesium-137 (half-life 30 years). Several hundred and cataracts. It left a deep psychosocial impact on the affected thousand “liquidators” from the nuclear establishment, army, population. The sense of loss and broken social networks was and local agencies were marshaled by the USSR regime to clean accompanied with the social stigma of being an “exposed up or contain the radioactive mess in and around Chernobyl. person.” Lack of reliable information among people in the The UNSCEAR report shows that of the 600 workers present first few years resulted in widespread mistrust and false on the site during the early morning of April 26, 1986, 134 attribution of many health problems to radiation exposure. received high doses of radiation ranging from 0.8 to 16 Gy and Diminished facilities for health care, excessive smoking, suffered acute radiation syndrome. Within the first 3 months and drinking that accompanied the dissolution of the Soviet of the accident, 28 of these brave men died from radiation Union all contributed to the reduced average life span in exposure. Another 19 died during the period 1987–2004 due the Chernobyl-affected countries. While we always focus on to different causes, not necessarily associated with radiation human health and mind, I could not find any authentic account exposure. of what happened to the thousands of pets that would have been left behind in haste, with their furs full of radioactive Within months of the accident, 116,000 citizens were contamination. evacuated to noncontaminated areas and another 230,000 were relocated in subsequent years. Five million people Gluzman from the Ukranian Psychiatric Association[8] provides continue to live in contaminated areas with low radioactivity another insight in the role of medical academia in interpreting levels of Cesium (37 kBq/m2) and a quarter of million people and exploiting such tragedies. He describes how the pendulum continue to live in areas classified by Soviet authorities as swung from the initial secrecy during the Soviet regime to the strictly controlled zones where the radioactive contamination hyperbole in the newly independent Ukraine. The Ukrainian exceeds 555 kBq/m2.[3] The WHO expert group has estimated Chief Psychiatrist of the Ministry for Health Protection the average effective dose accumulated over a 20-year period declared that 30% of the Ukrainian population ran the danger for different groups, and compared it with the average natural of dementia from low-dose radiation. Gluzman appreciates background radiation of 48 mSv over 20 years and that from that unlike some medical professionals, the sociologists medical exposure such as a whole-body CT scan which gives in Ukraine demonstrated common sense and scientific a dose of 12 mSv. The average total dose over 20 years was impartiality. However, they published in specialized journals estimated to be >100mSv for the 240,000 liquidators, >50 which never reached the public and could not influence public mSv for the 270,000 residents of the high-contamination zone, opinion. Ukrainian sociologist Natalia Panina denounced >33 mSv for the 116,000 evacuees, and 10–20 mSv for the the phenomenon of “radiophobia” which she defined as a 5 million residents of the low-contamination zone. Children deliberate attempt to interpret the normal and natural fear of various ages including those who were in utero received experienced by many humans under conditions of lack of significant radiation exposure, primarily to the thyroid gland, information as being the result of a pathological process. from consuming milk contaminated with radioactive iodine. Gluzman finishes his personal perspective by expressing anguish that none of the Ukrainian pseudoresearchers who After the unfortunate initial fatalities from acute radiation speculated on various parascientific myths were divested of sickness, the most significant health impact of Chernobyl scientific titles and high managerial positions which came to was the huge surge of thyroid cancer in over 5000 children them based on their astounding declarations and findings in exposed to the radiation after the Chernobyl accident.[5] the Chernobyl aftermath.