title: Dietary supplementation with radionuclide free food improves children's health following community exposure to (137)Cesium: a prospective study.
abstract: BACKGROUND
  Following the Chernobyl nuclear disaster of 1986, vast areas of Ukraine became contaminated with radionuclides. We examined health effects of school-based food intervention for children in a rural region Narodichi, Ukraine, exposed to low-level radiation through diet of locally produced foods. Until 1995, children received three daily meals with low content of artificial radionuclides which were subsequently reduced to two.
  
  
  METHODS
  Annual health screening data (1993-1998) were examined using a quasi-experimental regression discontinuity analysis (n = 947 children; 3,573 repeated measurements). Generalized Estimating Equation models evaluated effect of the food supplementation reduction on hematologic measures and prevalence of anemia, acute respiratory illnesses and diseases of immune system.
  
  
  RESULTS
  Prior improvement of several hematologic parameters diminished after food supplementation was reduced. From 1995 to 1996, levels of hemoglobin and erythrocytes decreased from 12.63 (95% CI: 12.56-12.71) to 12.46 g/dL (% CI: 12.39-12.52) and from 4.10 (95% CI: 4.07-4.12) to 4.02 (95% CI: 4.00-4.04) × 10(12)/L, respectively. In agreement, the prevalence ratio (PR) of previously declining anemia increased from 0.57 to 1.31 per year (p(interaction )< .0001). The relation between food supplementation and hemoglobin levels was modified by residential (137)Cs soil levels. After food supply reduction, PR of common cold and bronchitis increased from 1.27 to 2.32 per year (p(interaction) = 0.01) and from 1.09 to 1.24 per year (p(interaction) = 0.43), respectively.
  
  
  CONCLUSIONS
  Food supplementation provided by the Ukrainian government likely prevented development of anemia in many of the children residing in the contaminated district. Food supplementation after the community exposure to radioactivity through a diet of locally grown foods should be considered as an effective approach to reduce adverse health effects of radiation.
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA. mcmahond220@gmail.com.
authors.forename: Daria M
authors.initials: DM
authors.lastname: McMahon
authors.affiliation: Research Center for Radiation Medicine, Academy of Medical Sciences of Ukraine, 53 Melnikova St., Kiev, 04050, Ukraine. xrisk@ua.fm.
authors.forename: Vitaliy Y
authors.initials: VY
authors.lastname: Vdovenko
authors.affiliation: Research Center for Radiation Medicine, Academy of Medical Sciences of Ukraine, 53 Melnikova St., Kiev, 04050, Ukraine. profstepanova@i.ua.
authors.forename: Yevgenia I
authors.initials: YI
authors.lastname: Stepanova
authors.affiliation: Division of Epidemiology, Biostatistics, and Environmental Health Science, School of Public Health University of Memphis, 301 Robison Hall, Memphis, TN, 38152, USA. karmaus1@memphis.edu.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Karmaus
authors.affiliation: Division of Epidemiology, Biostatistics, and Environmental Health Science, School of Public Health University of Memphis, 301 Robison Hall, Memphis, TN, 38152, USA. hzhang6@memphis.edu.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA. eirving@tulane.edu.
authors.forename: Euridice
authors.initials: E
authors.lastname: Irving
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA. svendsee@musc.edu.|Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, South Carolina, 29425, USA. svendsee@musc.edu.
authors.forename: Erik R
authors.initials: ER
authors.lastname: Svendsen
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D002588:Cesium Radioisotopes / Q000009:adverse effects*; D047852:Chernobyl Nuclear Accident; D002648:Child; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D005507:Food Contamination, Radioactive; D006305:Health Status Indicators; D006801:Humans; D007154:Immune System Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011446:Prospective Studies; D000069079:Radiation Exposure / Q000009:adverse effects; D011832:Radiation Injuries / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D012140:Respiratory Tract Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014455:Ukraine
chemical_list: D015415:Biomarkers; D002588:Cesium Radioisotopes