title: Childhood leukaemia in Belarus, Russia, and Ukraine following the Chernobyl power station accident: results from an international collaborative population-based case-control study.
abstract: BACKGROUND
  There is little evidence regarding the risk of leukaemia in children following exposure to radionuclides from the Chernobyl Nuclear Power Plant explosion on April 26, 1986.
  
  
  METHODS
  This population-based case-control study investigated whether acute leukaemia is increased among children who were in utero or <6 years of age at the time of the Chernobyl accident. Confirmed cases of leukaemia diagnosed from April 26, 1986 through December 31, 2000 in contaminated regions of Belarus, Russia, and Ukraine were included. Two controls were matched to each case on sex, birth year, and residence. Accumulated absorbed radiation dose to the bone marrow was estimated for each subject.
  
  
  RESULTS
  Median estimated radiation doses of participants were <10 mGy. A significant increase in leukaemia risk with increasing radiation dose to the bone marrow was found. This association was most evident in Ukraine, apparent (but not statistically significant) in Belarus, and not found in Russia.
  
  
  CONCLUSIONS
  Taken at face value, these findings suggest that prolonged exposure to very low radiation doses may increase leukaemia risk as much as or even more than acute exposure. However the large and statistically significant dose-response might be accounted for, at least in part, by an overestimate of risk in Ukraine. Therefore, we conclude this study provides no convincing evidence of an increased risk of childhood leukaemia as a result of exposure to Chernobyl radiation, since it is unclear whether the results are due to a true radiation-related excess, a sampling-derived bias in Ukraine, or some combination thereof. However, the lack of significant dose-responses in Belarus and Russia also cannot convincingly rule out the possibility of an increase in leukaemia risk at low dose levels.
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. sdavis@fhcrc.org
authors.forename: S
authors.initials: S
authors.lastname: Davis
authors.forename: R W
authors.initials: RW
authors.lastname: Day
authors.forename: K J
authors.initials: KJ
authors.lastname: Kopecky
authors.forename: M C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: P L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: A M
authors.initials: AM
authors.lastname: Michalek
authors.forename: K B
authors.initials: KB
authors.lastname: Moysich
authors.forename: L E
authors.initials: LE
authors.lastname: Onstad
authors.forename: V F
authors.initials: VF
authors.lastname: Stepanenko
authors.forename: P G
authors.initials: PG
authors.lastname: Voillequé
authors.forename: T
authors.initials: T
authors.lastname: Chegerova
authors.forename: K
authors.initials: K
authors.lastname: Falkner
authors.forename: S
authors.initials: S
authors.lastname: Kulikov
authors.forename: E
authors.initials: E
authors.lastname: Maslova
authors.forename: V
authors.initials: V
authors.lastname: Ostapenko
authors.forename: N
authors.initials: N
authors.lastname: Rivkind
authors.forename: V
authors.initials: V
authors.lastname: Shevchuk
authors.forename: A F
authors.initials: AF
authors.lastname: Tsyb
mesh_terms: D017677:Age Distribution; D016022:Case-Control Studies; D047852:Chernobyl Nuclear Accident; D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D007953:Leukemia, Radiation-Induced / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011829:Radiation Dosage; D018788:Radioactive Hazard Release; D011874:Radiometry / Q000379:methods; D002094:Republic of Belarus / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology; D014455:Ukraine / Q000453:epidemiology