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CHERNOBYL5. Nonmalignant Diseases after theChernobyl CatastropheAlexey V. YablokovThis section describes the spectrum and the scale of the nonmalignant diseases thathave been found among exposed populations. Adverse effects as a result of Chernobylirradiation have been found in every group that has been studied. Brain damage hasbeen found in individuals directly exposed—liquidators and those living in the contaminatedterritories, as well as in their offspring. Premature cataracts; tooth and mouthabnormalities; and blood, lymphatic, heart, lung, gastrointestinal, urologic, bone, andskin diseases afflict and impair people, young and old alike. Endocrine dysfunction,particularly thyroid disease, is far more common than might be expected, with some1,000 cases of thyroid dysfunction for every case of thyroid cancer, a marked increaseafter the catastrophe. There are genetic damage and birth defects especially in childrenof liquidators and in children born in areas with high levels of radioisotope contamination.Immunological abnormalities and increases in viral, bacterial, and parasiticdiseases are rife among individuals in the heavily contaminated areas. For morethan 20 years, overall morbidity has remained high in those exposed to the irradiationreleased by Chernobyl. One cannot give credence to the explanation that thesenumbers are due solely to socioeconomic factors. The negative health consequencesof the catastrophe are amply documented in this chapter and concern millions ofpeople.5.1. Blood and Lymphatic SystemDiseasesFor both children and adults, diseases ofthe blood and the circulatory and lymphaticsystems are among the most widespread consequencesof the Chernobyl radioactive contaminationand are a leading cause of morbidityand death for individuals who worked asliquidators.5.1.1. Diseases of the Blood andBlood-Forming Organs5.1.1.1. Belarus1. The incidence of diseases of the bloodand blood-forming organs was 3.8-fold higherAddress for correspondence: Alexey V. Yablokov, RussianAcademy of Sciences, Leninsky Prospect 33, Office 319, 119071Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.Yablokov@ecopolicy.ruamong evacuees 9 years after the catastrophe.It was 2.4-fold higher for inhabitants of the contaminatedterritories than for all of the populationof Belarus; these rates were, respectively,279, 175, and 74 per 10,000 (Matsko, 1999).2. In 1995, for the Belarus liquidators, incidenceof diseases of the blood and bloodformingorgans was 4.4-fold higher than forcorresponding groups in the general population(304 and 69 per 10,000; Matsko, 1999;Kudryashov, 2001).3. The incidence of hematological abnormalitieswas significantly higher among1,220,424 newborns in the territories contaminatedby Cs-137 at levels above 1 Ci/km 2(Busuet et al., 2002).4. Incidence of diseases of the blood andthe lymphatic system was three- to five-foldhigher in the most contaminated Stolinsk andLuninetsk districts in Brest Province in 1996than in less contaminated districts (Gordeiko,1998).58