Re: Chernobyl Death Toll?

[John Goldsmith <gjohn@bgumail.bgu.ac.il>]

Dear Radsafers:
     As an epidemiologist closely following the approximately 
100,000 immigrants to Israel who were exposed to Chernobyl, and through 
meetings organized by the World Health Organization, in contact with 
much of the research in Russia, the former Soviet Union, and other countries,
I believe that the death toll from Chernobyl is indeterminate.  The
immediate deaths are countable and officially accepted.  There are at
least three possible sources for additional deaths, as well as the 
predictions based on exposure estimates.  
    First, the clean-up workers, called "liquidators" certainly had 
high exposures during the early post-explosion period, and presumably 
some of these exposures could have been lethal.  However  all such personnel
are or were required to have annual examinations, and most of the organiza-
tions doing such exams were not prepared or equipped to distinguish 
deaths due to exposure from deaths due to other factors.  So the reports
we have available talk of large numbers of "excess" deaths from conditions 
not usually related to radiation exposure.
	Secondly, a number of studies of possible increase in cancer have 
been done and these may be divided also into three groups,(1) the excess of 
acute leukemia in children, generally considered to be related to acute 
radiation exposure, and expected between 5 and 10 years post-exposure. 
So far, this increase has not been found. (2) an 
increase has been found in thyroid cancer, especially in children, and 
while what has been reported appears to be more invasive than other 
childhood thyroid cancer, the death rate is not very high.  (3) Based on
experience of the Hiroshima-Nagasaki population, a late (15-30 year) in-
crease in solid tumors would be expected, and it is both too early and the 
data systems in Russia and the CIS are not so very experienced with how to 
detect an increase over expected, since most of the cancer registries 
involved are of recent origin.
	Up to now, the Israel Cancer Registry has not observed any significant 
increase in cancer among the affected immigrants, but we are looking and
concerned.
	If Russian and CIS health statistics and cancer registries can 
be given sufficient training, support and collaboration they may be brought 
up to the point that authoritative estimates can be obtained.  At present,
Chernobyl mortality is better described as indeterminate, rather than 
be based only on the acute deaths  or on projections based on experience 
elsewhere.
       John R. Goldsmith, Ben Gurion University, Gjohn@bgumail.bgu.ac.il