Chernobyl weapons test Global Sweden Global Sweden 2,600,000 5,300. Malignancies 225, , ICRP 60 Malignancies

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3 Atmospheric nuclear Chernobyl weapons test Global Sweden Global Sweden All nuclides (PBq) 2,600,000 5,300 Cs-137 (PBq) Collective dose, excl 14 C 4,500,000 10, ,000 6,000 (mansv) Malignancies , , ICRP 60 Malignancies ,278 Tondel 2006 Moberg, ed. The Chernobyl fallout in Sweden, UNSCEAR

4 Increased incidence of malignancies in Sweden after the Chernobyl accident a promoting effect? Am J Ind Med 2006 Mar;49(3): Authors affiliations Martin Tondel, Peter Lindgren, Bodil Persson Division of Occupational and Environmental Medicine, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden Peter Hjalmarsson Department t of Health and Society, Division i i of Social Medicine i and Public Health Science, Linköping University, Linköping, Sweden Lennart Hardell Department of Oncology, University Hospital, Örebro, Sweden 4

5 Inhabitants in 8 out of 21 counties in Sweden 0-60 years old 1986 Same address, Dec 31, 1985 and Dec 31, 1987 Dwelling coordinate (100 m) National Land Survey of Sweden Digital maps (200 x 200 m) Geological Survey of Sweden (TGR) and Swedish Radiation Protection Authority (Cs-137) GIS-technique to match dwelling coordinate with TGR and Cs-137 Categories for TGR and Cs-137 with the same proportions of population ( ) 5

6 Number of people and cases of malignancies Cs-137 Population 1988 Malignancies ngy/h () , (30.8) 10, ,518 (24.4) 8, ,588 (19.1) 6, ,875 (15.7) 5, ,014 (5.0) 1,735 > 85 56,724 (5.0) 1,718 Total 1,137,106 (100.0) 33,851 6

7 From airborne measurements to digital map 200 m 200 m 200 m 200 m 200 m 200 m 200 m 200 m 7

8 GIS - example of layers roads longitude hydrology longitude topography p longitude

9 GIS - map grid caesium-137 V V coordinate points dwellings roads V lakes V forest 9

10 GIS dwellings at a coordinate grid V V caesium-137 coordinate points dwellings D1 D2 D3 roads S lakes 100 m forest 10

11 GIS individuals at a coordinate Id Born Sex Dwelling Coordinate id M D D1 D2 D M D F D M D S 100 m F D M D M D

12 GIS Cs-137 map grid V V V caesium-137 coordinate points dwellings roads lakes forest 12

13 GIS coordinates grid caesium-137 V coordinate points dwellings roads lakes forest 13

14 GIS overlay Cs-137 and coordinates grid V caesium-137 V coordinate points dwellings roads lakes forest 14

15 GIS geometric join V V V grid caesium-137 coordinate points dwellings roads lakes forest S S S S S S S S 64 S 58 6 S S S S 31 S S S S S

16 GIS individuals and exposure S S Id Born Sex Dwelling Coordinate S id Cs-137 S M D M D S 49 S S F D S 64 S M D S S S F D S 31 S M D S S M D S S

17 MH-IRR, EAR and ERR adjusted d for: A. Population density by parish B. Population density by municipality (H-regions) C. Lungcancer by municipality (proxy for smoking) D. Total cancer incidence (geographic difference) E. Terrestrial Gamma Radiation (TGR) 17

18 Total malignancies MH-IRR MH-IRR ,6 1,3 1,4 1,15 1, , ngy/h 0,85 0,7 ngy/h MH-IRR MH-IRR ,3 1,3 1,2 12 1,2 1,1 1,1 1 0, ngy/ h ngy/h 0,9 18

19 EAR per 10 5 py Total malignancies ngy/h EAR per 10 5 py ngy/h EAR per 10 5 py y ngy/h EAR pe er 10 5 py ngy/h 19

20 Conclusion Increase in the incidence of total malignancies related to increasing caesium radiation in the time period which contributes to the increase in the follow-up period After control for confounding factors this increase can be seen in MH-IRR, EAR and ERR. 20

21 Environmental Average (min-max) Radon 0.8 (0.2-10) Indoor γ 0.54 ( ) Cosmic 0.34 ( ) Food/water 0.17 ( 0-10) K ( ) Man-made Average (min-max) Medical 0.9 ( ) ) Flight (0-3.4) Chernobyl - External ( ) - Internal (0-2) Sum ( ) Outdoor γ (0-1) Sum ( ) Annual effective dose (msv) in Sweden 2005 SSI-rapport 2007:2 2 Total ( ) 21

22 Transfer of 137Cs from Chernobyl debris and nuclear weapons fallout to different Swedish population groups Rääf, Hubbard, Falk, Ågren, Vesanen. Sci Total Environ 2006;367: Effective dose over a 70 y period: 1. general Swedish population µsv/kbq m 2 2. reindeer herders 700 µsv/kbq m 2 3. hunters 100 µsv/kbq m 2 4. rural non-farming populations µsv/kbq m 2 5. farmers 50 µsv/kbq m 22 Transfer from ground deposition determined by: 1. dietary habits 2. inclination to follow the recommended food restriction by the authorities Transfer to the general population is a factor 3 lower for the Chernobyl fallout than nuclear weapons fallout due to: 1. higher awareness of the public and authorities nuclear weapons fallout during the growth season

23 80000 Radiation ngy/h mean median Cs TGR Indivi iduals p Population Cs-137 TGR ngy/h ngy/h ngy/h 23

24 Radiation 1500 Individ duals caesium-137 TGR ngy/h

25 MH-IRR Total malignancies (95 CL) TGR (adj age, category 1) 1,25 1, ,15 1,1 1,05 1 0,95 0, ngy/h 25

26 MH-IRR Total malignancies (95 CL) TGR (adj age, category 1) Cs-137 (adj A-E) 1,25 1, ,15 1,1 1,05 1 0,95 0, ngy/h 26

27 Cohorts Follow-up period Malignancies (n) Personyears Dose (msv) ERR per Sv (95 CL) Chernobyl ,851 13,391, (0;23) Atom bombs , ,184, , (0.33;0.51) Semipalatinsk , , (1.35;2.27) incident cases of total malignancies deaths in all solid cancer 27

28 The Excess Relative Risk (ERR): RR-1 in the fully adjusted model using the Poisson regression Dose rate as a continuous variable The ERR per 100 ngy/h (95 CL 0.001;0.084) 001;0 084) 28

29 Excess Absolute Risk (EAR per 10 5 person-years) SIRD ij = (SIR ij -SIR jk ) EAR ij = (SIRD ij SIRD 0i ) ij ij 0i i = time period or follow-up, j = exposure category, k = , 0 = reference category (0-8 ngy/h). By definition SIRD 0i is not influenced by the exposure i.e. is 0i an underlying time trend or secular trend. 29

30 Hiroshima-Nagasaki, Japan Chernobyl accident, USSR Source Atomic bombs Nuclear power plant explosion Exposure Instant high 1945 Protracted low since 1986 Radiation Neutron, gamma Gamma Route of External External and internal exposure Dose assessment Final dosimetry 2002? Ongoing Follow-up Population Two cities, 560,000 in 1945 Europe, 572,000,000 in 1986 Malignancies Mortality Incidence, mortality Strength Already long time follow-up High doses Individual dose assessment Long time follow-up in future Low doses Dose assessment from 1986 Weakness No data Short follow-up period Few persons with low dose Extrapolation to low dose Few persons with high dose No individual dose assessment 30