Implementation of Federal Target Programs Aimed at Mitigation of Consequences of Nuclear Weapon Tests at the Semipalatinsk Test Site.

Conditions, Results and Perspectives

(The Altai Region, Russia)

Ya.N. Shoikhet, V.I. Kiselev, S.N. Dikarev, I.B. Kolyado

Radiation exposure to the Altai region population is conditioned by the atmospheric nuclear weapon tests during 1949-1962 at the Semipalatinsk test site.

Radioactive fallouts in the Altai region were due to 48 explosions and especially due to the tests on August 29, 1949 and August 7, 1962. Over 270,000 individuals acquired total cumulative effective dose over 50 mSv during the test on August 29, 1949, among them 40,000 people received the dose over 250 mSv.

The population of certain rural areas of the Altai region and of town Rubtsovsk were exposed to radioactive fallout with the dose over 50 mSv.

In 169 settlements the dose exceeded 50 mSv, in 49 settlements - 250 mSv, and in 6 of them the dose was estimated to be over 1000 mSv.

The problem of mitigation of radiation accidents consequences in the Russian Federation is being solved since 1991 on the governmental level in the scope of target federal programs:

• Rehabilitation of population and social-economic development of the Altai region areas exposed to radioactive fallout from the nuclear tests at the  Semipalatinsk test site, for the period of 1994- 2000;

• Medical, social assistance to the population and normalization of sanitary and hygienic conditions of the Alati Republic settlements exposed to radioactive fallout from the nuclear tests at the Semipalatinsk test site, for the period of 1996- 2000.

The term of realization of these programs was extended to 2001 by the resolution of the Russian Federation Government, issued on December 30, 2000.

Despite the negative consequences of the economic crisis that continue influencing on all the spheres of life in Russia nowadays, a significant scope of work was fulfilled during the past decade.

The health effects of radiation exposure in the population residing along the explosions traces was scientifically confirmed.

Additional reconstruction procedures of doses, acquired due to the tests of 1949-1962, stated that additional number of settlements had been exposed to radiation in health-significant doses.

Practical medical assistance manifested itself in:

-         annual medical examinations of the Alai region population in order to estimate health effects of the population and to improve efficiency of early disease diagnostics and treatment;

-         medicare in cases of complicated forms of diseases due to exposure:

-         other medical and health-improving measures for the exposed population.

Taking into account the fact that all rehabilitation measures have been taken long after the tests, it caused the long-period treatment of diseases complicated in their pathogenesis. The Health Care organizations have taken on-site additional measures for medical assistance to the exposed population. Technical abilities of medical institutions and personnel qualification are of importance in such situations. Alongside with ensuring of medicare availability in the exposed settlements, a specialized network of medical centers has been developed. These centers embrace the main scientific and practical medical potential. The Program allowed to additionally built a number of medical institutions of stationary profile for 637 patient-sites, of ambulatory profile - for 1944 patient-visits a day. This allowed to enhance an existing medical network in the region.

Besides, 15 social objects had been built and launched into exploitation. Among them there are a number of boarding houses for 120 people; 24 schools for 6018 pupils, two children gardens for 230 children, two internats for parentless children for 160 children, dwelling houses with the common area of 35,9 thousand square meters, water-supply systems - 54,7 km, electricity networks - 95,6 km, heating system networks - 6,5 km, telephone networks - 62 km.

The measures taken allowed to solve problems of medical character and life conditions in the exposed settlements.

However, medico-demographical and social situation in the Altai region remains tense. Mortality rate form malignant neoplasms among the exposed with the dose interval 500 - 1000 mSv 1,7 times exceeds the one among the non-exposed. Mortality rate among the exposed with the dose 1000 mSv and higher exceeds the one among the non-exposed 2,5 times. The highest level of additional mortality from malignant neoplasms is observed among individuals exposed in early ages (0 - 15 yaers at exposure). Mortality rate form malignant neoplasms of digestive organs among them is 2,4 times higher than mortality rate among the non-exposed, and mortality rate form malignant neoplasms of respiratory organs is 2,8 times higher. Increased mortality and incidence rates of non-tumor diseases are observed in the exposed residents of the Altai region as compared to the non-exposed.

An integrative health index in the population (that includes data on 34 types of most frequent mass diseases) indicates a certain dependency on radiation exposure level. Nowadays the medical register includes over 40000 exposed individuals.

Due to significant reduction of funding from the Federal budget, erection of number of socially important buildings that had been planned in the scope of the Program was stopped.

Attempts to correct chemical and technical soil composition in order to produce ecologically healthy food products and cattle forage failed. Measures on reproduction of forests in order to improve the ecological situation in the region partly succeeded.

Hence the economy situation in Russia hadnft allowed to fulfill all the objectives of the Program during the planned period on improvement of medical aid service for the exposed population, supplying the medical basis with up-to-date diagnostic and medical equipment, providing effective medicaments and necessary food additives for the patients.

A prolonged and resource-bulky character of mitigation of medical and social consequences of radiation exposure on population demanded further governmental support to the Altai region necessary to take measures on rehabilitation of population and social-economic development of the Altai region territories, exposed to radioactive fallout from nuclear tests at the Semipalatinsk test site.

A new target Federal Program has been approved by the Resolution ‡‚ 637 of the Government of the Russian Federation issued on August 29, 2001: «Mitigation of consequences of radiation accidents for the period till 2010». The state client of the Program is the Ministry of Defense Emergency and Liquidation of Disasters. The Program includes the following sub-programs:

• Mitigation of consequences of Chenobyl accident;

• Mitigation of consequences of an accident on the nuclear facility plant gMayakh;

• Mitigation of consequences of nuclear tests at the Semipalatinsk test site.

The mentioned programs presuppose realization of measures aimed at radiation, medical, social and psychological protection of individuals exposed to radiation and rehabilitation of radioactively contaminated areas as well.

The aim of Federal Program «Mitigation of consequences of radiation accidents for the period till 2010» is to complete by year 2011 measures associated with providing social-economic rehabilitation of areas and radiation protection of population of the Russian Federation, exposed to radioactive fallout from the nuclear weapon tests at the Semipalatinsk test site.

The main objectives of the Program are:

• to complete building and input into exploitation health care institutions, educational institutions and dwelling houses, that has been initiated during the former programs, and to provide houses for immigrants from contaminated areas;

• to provide necessary medical and psychological aid to the exposed individuals and their offsprings of I and II generation;

• to provide scientific basis for decision-taking concerning basic program measures.

A specific feature of this Program is a complex character of funding – form Federal Budget, Local Budgets and non-budget sources.

The measures of the Program embrace tree major topic divisions:

• social-economic rehabilitation of the exposed population and territories;

• health protection of the exposed individuals and their offsprings of I and II generations;

• decrease of exposure levels in population and rehabilitation of radioactively contaminated areas;

• radiation and sanitary-hygienic monitoring of environmental objects and food products, monitoring of population doses;

• social-psychological rehabilitation of the exposed individuals.

A scientific maintenance of the Program, international collaboration and information-analytical maintenance of the Program are presupposed to increase efficiency of the planned measures.

In the scope of practical realization of the Program, measures of health protection, medical and psychological rehabilitation of the exposed individuals are considered to be of prime importance as well as radiation control and decrease in dose levels in population.

A probability of medical consequences of exposure in decades after the tests in the exposed population including gliquidatorsh of accidents and in further generations states a necessity of continuous medical observation over the health of this category of people. 

The strategy basis in the sphere of health care of the exposed individuals includes evaluation (current and prognostic) of health effects and practical measures aimed at decrease of medical consequences of radiation exposure.

The Program presupposes the following practical measures:

• to provide activity of National Radiation-Epidemiological Register;

• to provide medical assistance to the exposed individuals and their offsprings of I and II generations;

• to provide activity of interdepartmental expert councils for ascertaining cause-consequence  association of diseases, invalidity and mortality with radiation exposure.

In the result of the presupposed measures the following will be conducted:

• personal registration of the exposed individuals and their offsprings of I and II generations with indication of necessary dosimetric and medical information;

• special medical assistance to the exposed individuals in the institutions of federal and local levels;

• organization of medical and prophylactic institutions with diagnostic equipment, medicaments, that provide ambulatory, stationary and consultative assistance to the exposed individuals, including liquidators of radiation accidents;

• creating mobile medical teams for medical aid in the remote settlements of the Altai Republic;

• annual training of medical personnel for institutions providing assistance to the exposed;

• expertises of medical documents in the interdepartmental expert councils in order to state association of diseases, invalidity and mortality with radiation exposure from nuclear tests at the Semipalatinsk test site.