What strategy of secondary prevention after a nuclear beyond design-basis accident?
Martin Walter, MD, Michel Fernex, Professor and MD., Claudio Knüsli, MD
31th march 2012
There is no doubt, that ionizing radiation causes solid cancers and other malignancies such as lymphomas and various forms of leukaemias. Malformations (due to teratogenesis or mutations), other genetic abnormalities or even more severe genetic abnormalities in the following generations as well as disturbed brain development are also scientifically accepted consequences of ionizing radiation.
Confronted with these facts we must decide within the society which risks we will and can accept from radiation produced by normal and abnormal operation of nuclear power plants.
In the case of a nuclear accident like the beyond design-basis accident (an in german so called «SuperGau») of Chernobyl or the Fukushima - we must protect the population as far as possible and as much as technically achievable from the possible consequences of ionizing radiation.
We have learned lessons from the Chernobyl disaster and we can implement this lessons for reducing radiation damage in people affected by the Fukushima Dai-ichi accident.
We must take into consideration that ionizing radiation causes not only malignancies, teratogenesis and genetic disorders but also diseases of the endocrine system, the heart and the circulatory system, in addition to psychological problems and psychoses, stillbirths , increased perinatal mortality and disturbances of the sex odds ratio of lifebirths.
Proposals for a secondary prevention strategy after a nuclear power plant disaster
In the eventual case of a nuclear disaster in Switzerland we would propose to our government:
· Distribution of stable iodine already when a release of radioactivity could just be anticipated or when a meltdown is possible., After the Chernobyl accident a significant increase of thyroid cancer incidence in children and young adults was observed. Iodine prophylaxis has been shown to be a safe and effective procedure among 10 millions of children in Poland, preventing 131iodine induced thyroid cancers. 131iodine has a short half live of 8 days. Eighty days after incorporation an individual dosimetry is no longer useful, because almost all incorporated 131iodine has decayed.
· If prophylactic intake of iodine tablets was not done, routine sonographic screening for thyroid cancer in children is mandatory.
· Food must be systematically measured for radioactive isotopes and limits must be set in a differentiated manner to protect with first priority children and, especially, pregnant women.
· Children and adults as well, must be controlled by whole body counter measurements with best technical instruments to detect anticipated and unanticipated burdens of 137cesium and 134cesium.
· Sampling deciduous teeth of children to measure 90strontium contamination of children.,
· Measures must be taken to reduce the burden of Isotopes such as providing immediately clean food. Intake of pectines aiming at depletion of the body burden of isotopes is strongly recommended,. Protection against extern radiation resulting from the contamination of the soils with radioisotopes is also important. Maybe the only realistic measure will be evacuation of contaminated regions.
· In Switzerland we as an NGO would never accept a dose limit of 20 mSv/year for children as a long-term dose limitation.
· As an indicator of detriments one have to build up cancer registries long before the accident, as well as malformation registries and other morbidity registries. What happens with the incidence of malignant tumors, general morbidity of children and adults after a nuclear accident? We have to get facts - not epidemiological estimates as until now - about these consequences.
· For prevention of cardiac diseases children must undergo cardiac examination to find and define cardiac arrhythmias if they have a detectable 137cesium- and 134cesium burden.
· Statistical research must be done to observe the sex odds ratio before and after the Fukushima accident.2 The human embryo is very sensitive to radiation, female embryos more than males.
· Scientific research must take into consideration the genomic instability produced by radiation, which will be transmitted to the next generations. Perhaps we will have a paradigm change in radiation biology from target theorem to a more complicated model of radiation damages. An already accepted concept?
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