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128TABLE 5.73. Comparison of the Incidence (per1, 000) of Strictly Registered Congenital Malformations,Medical Abortuses, and Fetuses in MinskCompared with Gomel and Mogilev ProvincesContaminated at Levels above 15 Ci/km 2 (Lazjuket al., 1999)MinskTerritories/periodContaminated districtsCongenital 1980–1985, 1986 ∗ –1996, 1986 ∗ –1995,malformations n = 10,168 n = 20,507 n = 2,701All CMs 5.60 4.90 7.21 ∗∗CNS anomalies 0.32 0.53 0.54Polydactyly 0.63 0.53 0.79Multiple limb 0.07 0.10 0.28defects∗ Second half 1986; ∗∗ p < 0.05.in a 5-year period; afterward there were severalcases a year (Horishna, 2005).2. After 1986 the number of children withCMs increased in the contaminated territories(TASS, 1998; Golubchykov et al., 2002).3. Disability owing to congenital defects inchildren newborn to 15 years of age increasedmore than threefold in the Ukraine from 1992–1993 to 2000–2001: from 10 to 31 per 10,000(UNISEF, 2005: table 1.5).4. The peak incidence of CMs in the periodfrom 1987 to 1994 occurred in 1990 (Orlov,1995).5. For children irradiated in utero, the occurrenceof CMs increased significantly (5.52 ±0.22 vs. 2.95 ± 0.18 in controls, p < 0.001)and the spectrum of CMs changed (Stepanova,1999).6. The number of the small congenital malformations(anomalies of development) correlatedwith the level of in utero irradiation(Stepanova et al., 2002a).7. Developmental anomalies in childrenfrom heavily contaminated districts occur upto 2.8-fold more frequently than in less contaminatedareas (Horishna, 2005).8. Previously rare multiple CMs and severeCMs such as polydactyly, deformed internal organs,absent or deformed limbs, and retardedgrowth increased significantly in the contaminateddistricts (Horishna, 2005).9. Occurrence of officially registered CMsincreased 5.7-fold during the first 12 years afterthe catastrophe (Grodzinsky, 1999).10. The incidence of CMs is twice as high incontaminated districts (Horishna, 2005).11. Ten years after the catastrophe, thelevel of congenital malformations in RivneProvince increased from 15.3 to 37.3 (per 1,000neonates), most noticeably in the heavily contaminatednorthern districts (Evtushok, 1999).12. Among the 13,136 children bornto 1986–1987 liquidators, 9.6% had officiallyregistered CMs. Common developmentalanomalies include scoliosis; throat and toothdeformities; early tooth decay; dry, rough, andleathery skin; abnormally thin, tightly clusteredhair; and alopecia (Stepanova., 1999, 2004;Horishna, 2005).13. The highest incidence of CMs amongchildren born to liquidator families was observedin 1987–1988, when there were up to117 per 1,000. Thereafter the ratio began todecrease: 83–102 children in 1989–1991; 67 in1992; and 24–60 in 1993–1997 (Figure 5.13).14. According to the Neurosurgery Institute,National Ukrainian Medical Academy in Kiev,after the catastrophe 98% of central nervoussystem anomalies were due to hydrocephalus.The average annual increase in central nervoussystem defects was about 39% among 2,209registered cases in the period from 1981 to 1985compared with 4,925 cases from 1987 to 1994.From 1987 to 2004 the incidence of brain tumorsin children up to 3 years of age doubled(Figure 5.14) and in infants it increased 7.5-fold(Orlov et al., 2001, 2006).15. The highest incidence of maxillofacialCMs (mostly cleft upper lip and palate) occurredin children born within 9 months afterApril 26, 1986, and was six- to tenfold morecommon in the more contaminated areas ofKiev City and Kiev and Zhytomir provincescompared with the less contaminated provincesof Vinnitsa and Khmelnitsk (Nyagu et al.,1998).