title: Elevated congenital anomaly rates and incorporated cesium-137 in the Polissia region of Ukraine.
abstract: BACKGROUND
  Investigations soon after the 1986 Chornobyl (Chernobyl in Russian) accident of exposed populations residing elsewhere in Europe led government and international agencies to conclude that exposures to cesium-137 (Cs-137) were not teratogenic. Our observations of elevated population rates of neural tube defects (NTDs) and microcephaly and microphthalmia (M/M) in the Rivne Province in Ukraine, which were among the highest in Europe, prompted this follow-up investigation inclusive of whole-body counts (WBCs) of Cs-137 among ambulatory patients and pregnant women residing in Polissia, the most polluted region in Rivne.
  
  
  METHODS
  Yearly (2000-2012) population rates of NTDs and M/M and WBC patterns of ambulatory patients (2001-2010) and pregnant women (2011-2013) in Polissia and non-Polissia regions of Rivne were analyzed.
  
  
  RESULTS
  The NTD and M/M population rates in Rivne remain elevated and are statistically significantly higher in Polissia than in non-Polissia. The WBCs among residents in Polissia are statistically significantly higher than among those from non-Polissia.
  
  
  CONCLUSIONS
  NTD and M/M rates are highest in the Polissia region of Rivne and are among the highest in Europe. In Polissia, the WBCs of Cs-137 are above officially set permissible upper limits. The results are based on aggregate data of NTDs and M/Ms and average WBC values. Further investigations of causality of the high rates of NTDs and M/Ms are needed and urgent strengthening policies and implementations to reduce exposures to teratogens, in particular radioactive nuclides and alcohol, and consumption of folic acid supplements are indicated.
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.
authors.forename: Wladimir
authors.initials: W
authors.lastname: Wertelecki
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.
authors.forename: Alfred
authors.initials: A
authors.lastname: Koerblein
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.|Rivne Province Regional Medical Diagnostic Center, Rivne, Ukraine.
authors.forename: Bogdana
authors.initials: B
authors.lastname: Ievtushok
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.|Khmelnytsky City Perinatal Center, Khmelnytsky, Ukraine.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Zymak-Zakutnia
authors.affiliation: Rivne Province State Sanitary-and-Epidemiologic Service, Rivne, Ukraine.
authors.forename: Oleksandr
authors.initials: O
authors.lastname: Komov
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.|Human and Animal Physiology Department, Eastern-European University, Lutsk, Volyn, Ukraine.
authors.forename: Illia
authors.initials: I
authors.lastname: Kuznietsov
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.
authors.forename: Serhiy
authors.initials: S
authors.lastname: Lapchenko
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne, Ukraine.|Rivne Province Regional Medical Diagnostic Center, Rivne, Ukraine.
authors.forename: Zoriana
authors.initials: Z
authors.lastname: Sosyniuk
mesh_terms: D000328:Adult; D002588:Cesium Radioisotopes; D047852:Chernobyl Nuclear Accident; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D008831:Microcephaly / Q000453:epidemiology*; D008850:Microphthalmos / Q000453:epidemiology*; D009436:Neural Tube Defects / Q000453:epidemiology*; D011247:Pregnancy; D000069079:Radiation Exposure; D016008:Statistical Distributions; D014455:Ukraine / Q000453:epidemiology
chemical_list: D002588:Cesium Radioisotopes
keywords: Chornobyl; Polissia; Ukraine; cesium-137; malformations; microphthalmia; neural tube defects; pregnancy; radiation