Western responsibility regarding the health consequences of the Chernobyl
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Western responsibility regarding
the health consequences of the Chernobyl catastrophe in Belarus,
the Ukraine and Russia
The accident at Chernobyl nuclear plant has to be considered
as an unprecedented catastrophe in the industrial world given
the scale of radioactive polluted land, the levels of contamination
and the huge number of people affected.
Since the beginning of the nuclear crisis after Unit-4 had
exploded, Western pressure has been exerted to minimize the health
impact evaluation of the accident regarding the long term effects
of low levels of radiation (cancer and genetic effects) which
will affect the inhabitants of the ex-USSR* exposed to radiation.
In fact, quite unexpected health problems emerged shortly after
the accident giving rise to an obvious increase of morbidity especially
amongst children. They pushed into the background the delayed
effects of radiation but, like these effects, they have not only
been minimized but even denied by the Soviet authorities and by
Western experts as well.
To dismiss the field-observations made by local medical doctors
it is often said that they did not correspond to the effects observed
on A-Bomb Japanese survivors. But the point is that the two situations
are not identical at all. In Hiroshima and Nagasaki the exposure
to radiation was essentially external and the flash lasted a very
short time (the follow-up began only five years after the bombings).
After Chernobyl the "emergency phase" lasted a long
time (huge amounts of radioactive releases continued all through
the month of May) and exposed people to external radiation from
the plume and from ground radioactive deposits, but also to internal
radiation by inhalation of radioactive air and ingestion of heavily
contaminated food. Then followed a phase of chronic exposure,
internal exposure essentially through ingestion of food contaminated
by a cocktail of radionuclides. No reliable data exist for such
a situation : Chernobyl is the first large-scale "experiment"
of this kind in the world.
Radiation-controlled zones** have been decreed in the Ukraine,
Byelorussia and Russia, where caesium-137 ground deposition densities
were higher than 5 curies per km2 (Cs137>5 Ci/km2)
. More than 800 000 inhabitants were living on these areas
 and more than 7 million on territories with radioactive caesium
pollution above 1 Ci/km2 (see annex).
As time elapsed, worsening of people's health, especially children's,
caused great anxiety and complaint among the population. Later
on, street demonstrations took place : people wanted to be evacuated
from contaminated areas. The definite position taken in favour
of people's demands by eminent members of the Academy of Sciences
both in the Ukraine and in Byelorussia, quite a very unusual situation
in the USSR (and in other countries), have obliged Republican
and Moscow authorities to consider the necessity of new evacuations.
In July and October 1989, the Byelorussian authorities released
"relocation" plans concerning about 120 000 of
the most exposed inhabitants of the so-called zones of strict
radiation control (Cs137>15 Ci/km2), with some
villages far away from Chernobyl, more than 200 km.
With the help of Western experts, Moscow authorities have been
very efficient in opposing the complete realization of these plans
and their extension to the whole of the zones under radiation
control. Quite obviously the essential concern of these experts
was related to the management of a possible nuclear crisis in
their own country.
We will chronologically summarize some significant facts from
the point of view of post-Chernobyl health problems.
Vienna, 25-29 August 1986. IAEA International Experts' Meeting.
First evaluation of the health consequences in the aftermath of
Attended by worldwide experts and organized by the International
Atomic Energy Agency (IAEA), this conference aimed to analyse
the accident at the Chernobyl nuclear plant and its consequences.
The different study groups' sessions took place behind closed
doors and information was released to journalists in daily press-conferences
(seemingly with no protest against this kind of "information").The
Soviet delegation, headed by V. Legasov, presented a voluminous
report (370 pages), a general main part and 7 annexes dealing
with more specialized questions . Annex 7 was completely devoted
to "Medical-Biological problems" and was at the
origin of an intense dispute.
Besides detailed data related to acute radiation injuries which
have affected the people sent into very "hot" places
close to the destroyed reactor and exposed then to very high doses
(on-site personnel, firemen who struggled with the burning reactor
etc.) and on whom were tried unsuccessful bone marrow transplantation,
the report not only made an estimation of the external doses received
by the 135 000 evacuees from the 30 km area around the nuclear
plant which became the "prohibited zone", but also dealt
with the long-term health consequences of the accident for 75
million inhabitants of the European part of the Soviet Union.
Their external collective dose was estimated and also their internal
collective dose for a period of 70 years due to chronic contamination
by radioactive caesium.
With the hypothesis recommended in 1977 by the International
Commission on Radiological Protection* (ICRP) of a linear relationship
between the number of fatal radiation-induced cancers and the
exposure dose [without a threshold], it was possible, taking into
account the ICRP risk factor of the fatal cancer excess per unit
dose of radiation and knowing the collective doses, to calculate
roughly the number of long term radiation-induced cancer deaths
. Annex 7 gave also the approximate number of thyroid cancer
deaths due to radioactive iodine intake. (The Soviet report did
not consider strontium-90 but indicated that it might become important
There was a general outcry : the estimate of the long-term
impact of the Chernobyl catastrophe on cancer mortality was a
possible range of 30 000-40 000 extra deaths
(more than 80% due to caesium) in 70 years representing up to
0.4% of the normal number of cancer deaths. These numbers were
considered too high by Western experts.
At the press conference on August 26th, Dan Beninson, chairman
of the study group on the health consequences of Chernobyl said
that these Soviet figures were " extremely overestimated
". For Morris Rosen, Director of the Safety Division
at the IAEA, the upper limit for the number of deaths was 25 000
and it fell down to 10 000 two days later and Beninson's
to 5 100 . At that time Beninson was chairman of the ICRP
and people set great value on his opinion (he was also top official
of nuclear energy in Argentina). For Beninson and Rosen the Soviet
figures were too high because caesium internal contamination had
been overestimated. Let us point out that such an affirmation
could not have had any scientific basis at that time.
This annex 7, very troublesome for promotors of nuclear energy,
has in fact been almost completely censored. Only a few people
were made acquainted with its existence. In France, the main report
was translated and widely distributed but not the annexes. Afterwards,
Soviet and Western experts never referred to this annex 7 as if
it had never existed.
Revision of the initial estimation
As early as october 1986 the internal dose was 10 times too
high according to some European experts . In January 1987 "
After a five days visit in USSR top IAEA officials called
the first post-accident assessments of damage health effects "apparently
too pessimistic" and should be decreased by a factor five
to seven " .
To gain credibility the re-assessment had to be worked out
by Soviet experts themselves. It was started during the first
Vienna IAEA meeting and specified afterwards.
May 1987 : at the WHO conference in Copenhagen ,
resulting from " evidence of a positive trend of
the radiation hygiene situation as a result of the implementation
of large-scale protective and preventive measures " A.
Moiseev reduced the previous external dose estimate by a factor
1.45 and the internal dose by a factor between 7 and 10.5. Nevertheless
he admitted that one year after the catastrophe an important proportion
of local milk in Byelorussia was still contaminated above the
Cs137 permissible levels and " had to be withdrawn from
direct consumption and sent for reprocessing " but
he did not give any information about this process. One might
question if this milk was not sent to remote regions of the USSR
(Armenian powdered milk was analysed by CRII-RAD, an independant
French association, and high levels of radioactive caesium were
found ). Let us recall that "democratisation" of
radiation doses by increasing the number of exposed people, each
person receiving a smaller dose, does not change the final balance
: the same collective dose leads to the same number of fatal radiation-induced
cancers with the linear relationship (without a threshold) recommended
by the ICRP between the number of cancers and the total dose .
By adding that the values given in his communication must be "
considered as "upper" estimates of the radiological
consequences of Chernobyl " Moiseev, in fact, went back
to a model with a threshold.
September 1987 : L. A. Ilyin and O. A. Pavlovskij presented
a new report on the Radiological consequences of the Chernobyl
accident in Vienna at the IAEA's international conference .
The subtitle of their report was " Analysis of data
confirms the effectiveness of large-scale actions to limit the
accident's effects ".
According to the authors, right after the accident the decision
was taken to evacuate 115 000 people, including the inhabitants
of Pripyat, to prevent them from receiving whole body and thyroid
doses up to the emergency dose limits prevailing at that time
in the USSR. (The 18 700 inhabitants of Byelorussia evacuated
between June and August 1986 are not mentioned). The report indicated
that " a total of 5.4 million people including 1.7 million
children received iodine prophylactically " [against
radioactive iodine]. Introduction of large-scale measures to protect
the public, such as standards for foodstuffs, have been efficient
especially the interdiction of milk exceeding the permissible
iodine-131 level of 3 700 becquerels per liter (3 700
Bq/l). Average infant thyroid doses were given for the northern
most contaminated regions of the Ukraine while for Byelorussia
the average is reported for all the country* .
No increase of morbidity was observed in children and no difference
between "dirty" (contaminated) and "clean"
areas. For the first time radiation phobia syndrome was
The estimate of the collective effective dose equivalent p4commitment
for the whole Soviet population (278 million inhabitants) through
ingestion of radioactive caesium was 18 times lower than the first
1986 estimate for only 75 million inhabitants. In April 1988
L. A. Ilyin re-increased this dose  and finally the United
Nations Scientific Committe on the Effects of Atomic Radiation
in its UNSCEAR 1988 Report averaged Ilyin's two estimates and
therefore reduced the 1986 estimate of annex 7 by 9 . M. Beninson
should have been pleased with this new value.
Both Ilyin and Pavlovskij were in the list of authors of the
1986 Soviet report. Therefore their 1987 and 1988 articles quoted
above should be considered as a true self-criticism.
The collective dose reduction was supposed to be the result
of countermeasures efficiency. This official optimism was in complete
disagreement with V. Legasov's testament published in Pravda
(May 20th, 1988) in which he gave evidence of the incredible
lack of care which followed the Chernobyl catastrophe [V. Legasov
killed himself on the second anniversary of Chernobyl]. The
supposed effectiveness of countermeasures is rather doubtful,
given the well known ineffectiveness of Soviet bureaucracy and
the shortage of "clean" food which should have been
imported into zones of strict control, given also the number of
the rural population accounting for almost half of the 75 million
people of annex 7, with a self-sufficient way of life, consuming
local "dirty" foodstuff (just after the accident iodine-131
levels in cow's milk reached 1 million Bq/l in some districts
of Byelorussia ). Heavily contaminated meat was partly destroyed
in Byelorussia but was also exported to be mixed up with "clean"
meat . Meat above permissible levels of Cs137 was sold even
in Moscow . Standards for tea were introduced in quite a "democratic"
way, depending on the regions and the kind of consumers. For example
cleaner tea was sold in Moscow and heavily contaminated regions
than in factory cafeterias and in less contaminated areas .
In the Ukraine people were advised only in July 1989 of restrictions
against the picking of mushrooms, wild berries and medicinal plants
Private information began to arrive in France : in contaminated
regions of the Ukraine and Byelorussia the health of inhabitants
was worsening, complaints against the authorities were growing
(as shown in Microphone, a film by G. Shkliarevski and
V. Kolinko). Detailed maps of radiation-controlled zones with
Cs137 levels above 5 Ci/km2, were published in Sovetskaya
Byelorussia (February 9th, 1989) showing their extent. From
the article one could get an idea of the large number of people
affected in their daily life : food monitoring, supply of "clean"
food if local food was too "dirty", medical care, advice
to use special tractors with airtight cabs, small bonus of monthly
"danger money" etc. . The chairman of the Byelorussian
Council of Ministers has summarized the situation by saying "
we have been unable to put back the radioactive djinn in the bottle
" (Pravda, February 11th, 1989,).
Finally, Moscow authorities disclosed maps in Pravda
(March 20th, 1989), showing the general gamma-field pattern measured
on 10th May 1986 with gamma dose readings for the Ukraine,
Byelorussia and Russia. The dose rates used as basis for deciding
on the early evacuation of people in 1986 were also given : prohibited
zone for dose rates above 20 milliroentgen per hour (20 mR/h),
evacuation above 5 mR/h, temporary evacuation of pregnant women
and children between 3 and 5 mR/h. From these maps it is not clear
why areas far away from Chernobyl (districts of Gomel, Mogilev
and Bryansk) where gamma dose rates above 5 mR/h were recorded
on 10th May 1986 were not included in the early evacuation plans.
At the end of 1988 it was known that some villages in the Ukraine
of Narodichi district close to the prohibited zone were about
to be evacuated.
Concept of "Safe" living. Life time exposure :
"35 rem per 70 years"
The legal definition of contaminated areas decreed by
Soviet authorities consisted of areas with Cs137 deposition density
above 1 curie per km2. In 1989 more than 7 million
people lived in these areas. (At the same time, in the UK, sheep
were still forbidden for consumption, yet, their grazing pastures
in highlands -Scotland, Cumbria etc.- were 2 or 3 times less contaminated
than 1 Ci/km2). People were to be resettled from heavily
contaminated areas with Cs137 levels higher than 40 Ci/km2,
some places are far away from Chernobyl.
Criteria for "relocation" : the "safe"
living concept was worked out in September 1988 by the USSR authorities
. It was summarized in newspapers by the words " 35
rem per 70 years ". It is considered safe to live in
a place where the dose accumulated during a 70 year-lifetime will
not exceed 35 rem. If this dose exceeds 35 rem people had to be
moved away and resettled in a new place. This life-long dose is
calculated by radiological protection institutes, all of them
depending on the Health Ministry of the USSR and therefore completely
under control of Moscow authorities. Besides the dose received
during the emergency phase (irradiation by the radioactive plume
and ground deposits, inhalation of radioactive particules and
aerosols, ingestion of contaminated food) the lifetime dose has
to include the dose to be received in the future by living
in a given place of residence. Therefore, besides external dose
due to radioactive deposits, the lifetime dose must include the
effective committed dose in 70 years due to ingestion of Cs137-contaminated
food. Hot particles (containing transuranic elements ) were not
considered. All these calculations depend on models : life-style
and diet, metabolism, etc.
If this calculated dose exceeded 35 rem, relocation had to
be decided. (L. Ilyin, head of the Soviet radiological protection
said " it is not an evacuation but a planned displacement
of people ". In places where the life-long dose was supposed
not to exceed 35 rem, a normal lifestyle could be resumed with
consumption of local food and no further import of clean food.
This concept "35 rem per 70 years" (0,5 rem/year,
or 5 millisievert/year) had to become law on January 1st, 1990.
Its authors assured that it was in line with ICRP recommendations.
Byelorussian scientists, at the top level of the Academy of Sciences
have fought against this law and brought forward another concept,
7 rem in 70 years (0,1 rem/ year) while Ukrainian scientists proposed
10 rem. Among the pertinent arguments of Byelorussian scientists
 let us just recall that, since its Statement from the 1985
Paris meeting, ICRP recommended a lifetime average annual dose
of 1 millisievert (1 mSv =0,1 rem).
The World Health Organization Experts.
The dispute between Byelorussian and Moscow scientists was
open to the public in March 1989, during long debates of the session
of the Soviet of Byelorussia and needed afterwards a special session
devoted to 35 rem per 70 years which took place at the
Byelorussian Academy of Sciences in Minsk with the participation
of three WHO experts. Besides M. Waight, (WHO secretary), appeared
as WHO experts Dan Beninson, mentioned before, and Pr. P. Pellerin,
the head of French Services of Radiological Protection (SCPRI).
Let us recall that at the Copenhagen WHO meeting held on 6th May
1986, only a few days after the reactor had exploded, delegates
of all European countries presented the dose-rates values recorded
in their country when it was reached by the plume. France, represented
by a delegate of Pr. Pellerin's Services did not give any precise
value and indicated only : "low" . One might
question if it is for this reason that, some years later, WHO
qualified Pr. Pellerin to intervene in the radiological protection
of the Soviet population.
The WHO experts' report was published in Sovetskaya Byelorussia
(11 July 1989) under the title : "Experts' point of view".
WHO experts concluded that, " in post-accident situations,
an exposure of 35 rem during a lifetime of 70 years was quite
a conservative value, (...) This value was in agreement with international
recommendations based on assessments of ionizing radiation health
risks. (...) If asked to fix a limit on the lifetime cumulative
dose they should have chosen dose-limits of 2 to 3 times 35
rem " [the underlining is mine].
The report disparaged those scientists opposed to the life-dose
limit supported by Soviet authorities " (...) Scientists
who are not well versed in radiation effects have attributed various
biological and health effects to radiation exposure (...) These
changes (...) are more likely due to psychological factors and
In short, everything is known about radiation health effects,
first-hand observations made by local medical doctors had to be
in line with widespread consensus. It is worrying to see how these
experts are denying an obvious fact : the Chernobyl catastrophe
has the very sad privilege of inaugurating a new "experiment"
in the medical field. They are trying to close the only way to
approach it, first and foremost, all biological and medical
information has to be registered and taken into consideration.
At the end of July 1989, during the Byelorussian Parliament's
session which adopted the evacuation plans, the Health minister
of Byelorussia referred to the WHO report and declared that Byelorussian
scientists who opposed the 35 rem lifetime dose were ignorant
of radiation questions. (Reported by I. I. Lichtvane, Vice-president
of Academy of sciences, Sovetskaya Byelorussia, 1st August
In Paris some people became upset. What was Pr. Pellerin doing
in the Ukraine and in Byelorussia making a false statement that
a lifetime dose of 35 rem was in conformity with international
recommendations and suggesting even higher limits 2 to 3 times
35 rem which are outside the prescribed French regulation ? Was
Pr. Pellerin, a civil servant of the health minister in charge
of French radiological protection, no longer obliged to respect
French law when he was representing WHO ? Five associations asked
many questions to the French health minister but never received
an answer .
Meanwhile, through information available in France and first-hand
news from medical doctors and journalists coming back from the
Ukraine and Byelorussia it became obvious that the population's
health was worsening (thyroid gland disorders, immunodeficiencies
etc.). The answer of Soviet authorities was : radiophobia. Later
on demonstrations took place in Minsk.
September 1989 : letter from 92 Soviet experts to M. Gorbachev
to enforce the "35 rem lifetime concept"
The French Group of Scientists for Information on Nuclear Energy
(GSIEN) got a copy of this letter dated 14 th September, 1989
and sent to the President of the Supreme Soviet of the USSR with
92 signatures of top scientists " working in the medical
and radiological fields and concerned by the situation created
by the Chernobyl accident " .
They wrote : " At each step of its elaboration this
concept has been accompanied by a systematic consultation and
a careful appraisal of various international organizations such
as IAEA, WHO, UNSCEAR, which looked at it from all its angles
and have approved it ".
Some arguments developed in this letter which oppose Byelorussian
and Ukrainian proposals of lifetime doses of 7 or 10 rem instead
of 35 rem, seem to us very important " In
the choice of the lifetime limit of 35 rem the National Radiological
Protection Commission of the USSR has paid attention to the fact
that the limit has to include the dose received in the past three
years, and in some agglomerations this cumulative dose is already
about half the recommended lifetime dose ". In addition,
in some villages where the dose of 35 rem has already been reached
or soon will be, the decision of resettlement was taken a long
time ago but " for some incomprehensible reasons has not
yet been carried out in practice ". Furthermore "
(...) it must be kept in mind that, since the accident, in most
agglomerations of the permanent control zone, this dose (7-10
rem) has already been reached or will be reached in the near future
". The authors invoked the deep psychological and health
detriment that could be caused by the " [displacement]
resettlement of hundreds of thousands of people (up to one
million) (...). If this 7-10 limit is adopted as a criterion
for resettlement the problem will appear for the inhabitants of
many big towns and district centers ". They further
added that it cannot be taken for granted that good medical care
could be assured in case of " a plan of resettlement
of one million people ". [The underlinings are mine].
Thus, at that time, hundreds of thousands of people, up to
one million, would have needed to be resettled if the 7-10 rem
lifetime dose had become law. The comparison of these figures
with the number of people living in all areas submitted to radiation
control brings out clearly that the one million people figure
is consistent with the number of all inhabitants of radiation
control zones where Cs137 ground deposition is above 5 Ci/km2
One might wonder why, as years passed, official estimates of
people's cumulative doses were shrinking away in contaminated
areas, and ask if this could not be the result of tampering with
data, and readjusting measurements and models ....
"The international Chernobyl Project". ICP Report.
In October 1989 the USSR government requested the IAEA to carry
out an international experts' assessment of the health impact
of Chernobyl and to evaluate the effectiveness of the protective
measures taken by the Soviet Authorities. One goal of ICP was
also to assist them and provide guidance on radiological protection
subjects including their lifetime dose concept of 350 millisievert
(35 rem) for "safe" living in areas affected by radioactive
contamination. Besides Soviet experts, 200 specialists from 25
countries and 7 multinational organizations (IAEA, UNSCEAR, WHO,
EEC etc.) participated in the Project.
The final ICP report was delivered at the international IAEA
meeting in Vienna (21-24 May 1991) . It was concluded that
no health disorders could be attributed directly to radiation
exposure. The ICP experts' estimates of both internal and
external doses for the surveyed contaminated settlements were
lower by a factor of 2 to 3 than the values officially reported
by Moscow health authorities.The representatives of Byelorussia
and the Ukraine have publicly demonstrated their disagreement.
The introduction emphazised the fact that the USSR government
had already benefited from international assistance. Mentioned
above, the team of WHO experts was first sent there in June 1989.
Then the League of Red Cross and Red Crescent Societies which
both came to the same conclusion as WHO : psychological stress
and anxiety were causing physical symptoms. The International
Chernobyl Project reached the same conclusion.
Concerning the safe lifetime dose of 35 rem for relocation,
" the protective measures taken or planned for the longer
term, albeit well intentioned, generally exceed what would
have been strictly necessary from a radiological point of view.
The relocation and foodstuff restrictions should have been less
extensive ". As regards the social cost of relocation
policy " (...) due account has not been taken by
the authorities of the many negative aspects of relocation (...)
". And also, " In applying a lifetime dose criterion
for relocation it is not appropriate to take into account of past
Some special points : all examined chidren were found in good
health. Concerning thyroid gland disorders, no abnormalities in
thyroid hormones. No statistically significant difference was
found for any age group between surveyed contaminated settlements
and surveyed settlements used as controls. Thyroid nodules were
Concerning neoplasms " The data did not reveal a marked
increase in leukaemia or thyroid tumours since the accident ;
however (...) the possibility of an increase in the incidence
of these tumours cannot be excluded. Only hearsay information
relating to such tumours was available ". Hearsay information
? The 1990 incidence of thyroid cancer in children was already
20 times the pre-Chernobyl incidence  and that year Pr. Demidchik
had operated upon 29 children for thyroid cancer (59 in 1991 and
more and more after).
No information was given about immunological deficiencies observed
in children. No mention of the increase of chromosome aberrations.
" No statistically significant evidence of an increase
in incidence of foetal anomalies as a result of radiation exposure
". Quite a strong assertion when compared with the results
which will be published by G. J. Lazjuk .
Some issues were not investigated at all : nothing about the
health of the liquidators*, of the early evacuees, no estimate
of people's early doses received during the emergency phase.
A peculiar point : Pr. Pellerin provided 8 000 film badge
dosimeters which were distributed to residents of selected
settlements in contaminated areas : " For a two-month
exposure period 90% of the results were under the detection limit
(of 0.2 mSv) ". Let us point out that this detection
limit corresponds roughly to a normal background dose (without
extra-radiation) accumulated during the same two-month period.
Therefore, no radiation above natural background was detectable
in these selected villages ? Pr. Pellerin performed also
whole body countings : the amount of incorporated caesium was
found very low, as if "clean" food had been exclusively
consumed in these selected contaminated villages. All
information we got from contaminated radiation-controlled zones
contradicts such an assessment. How can we trust it ? Let us recall
a communiqué released by Pr. Pellerin's Services
some days after the outset of the Chernobyl catastrophe : "
[In France] the situation has come back to normal ",
but without having been abnormal before ...
The "new" concept. Paris, April 1991 .
This concept, worked out by a team of Soviet scientists headed
by academician S. Belaeyev, was presented in Paris and became
law in May 1991. We will summarize it below.
- Since 1st January 1990, countermeasures have been implemented
to ensure that the lifetime dose will not exceed 35 rem (350 mSv).
It is supposed that they were crowned with success and therefore
this limit of 35 rem has become useless.
- From now on past doses will not be taken into account.
Only future averted doses should be considered for relocation
(this point gives entire satisfaction to ICP experts). Doses received
from 1986 to 1991 have to be considered only to improve living
conditions but not for relocation. [Previously, according to the
State Union republican programme of emergency measures for 1990-1992
on liquidation of the Chernobyl accident consequences (April 1990)
relocation was compulsory for inhabitants of areas with
Cs137 levels above 40 Ci/km2, whereas the annual dose
is likely to exceed 0.5 rem (5 mSv) and also for pregnant women
and children from areas with Cs137 levels 15-40 Ci/km2].
From now on, no massive compulsory relocation is justified. Any
additional resettlement should only be done on a voluntary
- For 1991 and thereafter, the effective dose should not exceed
1 mSv/year (0.1 rem) which is the lower level of intervention.
If annual doses exceed 1 mSv, radiological monitoring of environment
and food, medical control, agrotechnical decontamination work
[which proved unsuccessful in the past] etc. still go on. These
measures must be optimised to limit average annual doses to 5
mSv in 1991 and to lower values afterwards.
The introduction of an annual dose limit of 1 mSv seemed to
give satisfaction to Byelorussian and Ukrainian scientists. In
fact, after having gained time and by ignoring past doses, the
Soviet authorities have eliminated the possibility of new massive
compulsory relocations. Relocation of all inhabitants of Cs137
contaminated zones above 15 Ci/km2 (enacted by Republican
parliaments) is no longer ascertained unless on a voluntary basis.
The implosion of the USSR and the emergence of independent
Republics will aggravate the post-Chernobyl situation through
food shortage and financial problems. By giving support to Moscow
authorities, the intervention of WHO and international agencies
in the management of the post-Chernobyl crisis has ruined the
efforts of those scientists who tried to give better protection
to the population living in contaminated areas. And for that we
Health consequences in the aftermath of Chernobyl
Thyroid cancer and radioactive iodine
An abnormal increase of thyroid cancer in children was reported
in Belarus in two scientific letters published in September 1992
in Nature  and met, at first, great scepticism among
scientists working in the field of medical and radiological protection
who denied that this increase could be the result of Chernobyl
. It was only after the data had been endorsed by well-known
European scientists that the "hearsay" information
(as written in ICP Report) was accepted as being true. It was
the first time that some Western scientists (belonging to WHO
!) gave support to medical doctors from the ex-USSR and they have
to be thanked for their obstinacy. Thyroid cancer in children
was also observed in the Ukraine and in Russia but with lower
incidences than in Belarus. The number of thyroid cancer in adults
increased enormously during the first 7 years after the accident
but has since stabilized.
Experts' reconstructed thyroid doses are now on the rise. Who
really got the millions of tablets of stable iodine as reported
by Ilyin in 1987 ? The ICP Report concluded that the general response
of the authorities had been broadly reasonable in the emergency
phase . But S. L. Belyayev conceded in 1991 that the countermeasures
" have not always been taken in due time, not when they
were really necessary and sometimes not completed " .
What about radionuclides other than iodine ?
Experts ensure us, at least in France, that apart from some
200 cancer deaths which will affect the "liquidators"
in next decades, the only cancers due to Chernobyl will be thyroid
cancers in children having been exposed to radioactive iodine.
After surgery, everything is fine. Thus the Chernobyl health consequences
will be limited essentially to psychological disorders.
In other words, does it mean that, aside from radioactive iodine,
the cocktail of radionuclides (found in children's blood in the
Ukraine and Byelorussia), caesium-137 and 134, ruthenium-106,
strontium-90 etc. without forgetting transuranic elements like
plutonium included in "hot particles", when ingested
and inhaled will have no effect at all on the body ?
Thyroid cancer in children is a rare disease and its dramatic
increase shortly after the accident gave clear evidence of its
relation to radioactive iodine. But other radiation-induced cancers
due to other radionuclides and to external exposure will only
appear after latency periods of 10-50 years. If the follow-up
of Chernobyl exposed populations in the next fifty years fails
to show any statistically significant excess of cancer
deaths it will not mean that this excess does not exist (especially
if health statistics are under control of the management authorities).
Even if the future Chernobyl radiation-induced cancer deaths are
only a small fraction of the normal number of cancer deaths they
might represent a total number of tens of thousands of deaths
when applied to a huge population .
Furthermore, Chernobyl was followed by a morbidity increase
implying some worsening of all functional systems which, in future,
might be responsible for an increase of mortality for causes other
than cancer. Please take note : In case of a severe nuclear
accident, stable iodine will not protect people from radionuclides
other than iodine and will not suppress the long term health consequences
for the people exposed to the radioactive fallout.
Relocations after 1989
It is quite impossible to know exactly how many people have
been moved away from the radiation-controlled zones and resettled
compulsorily since 1989 and after the independence of Republics
in 1991 because the number of voluntary relocations is never given.
In 1993 the Ukrainian Minister of Chernobyl Affairs indicated
98 000 relocations since 1989 . The Belarussian 1996
report of Ministry for Emergencies and Population Protection
from the Chernobyl NPP Catastrophe Consequences indicated
that the resettlement of the population is basically completed.
131 200 persons have been resettled [it seems that the 24 700
persons evacuated in 1986 are included]. No indication about the
number of voluntary relocations.
An upper estimate of the number of resettled inhabitants for
the three Republics of the ex-USSR might be around 300 000.
This is far below the million people who should have been compulsorily
resettled from all radiation-controlled zones and who scared Ilyin
and his colleagues so much when they referred the matter to President
Gorbachev in September 1989.
In Paris, Belyayev  asserted that it had been concluded
from cost-efficiency or cost-benefit analysis in matters of countermeasures
implementation, that relocation is uneffective in most cases.
[But only managers and decision-makers evaluate costs, not the
simple citizens. Belyayev did not give any precision about the
price of a radiation-induced cancer or of other diseases]. Nevertheless
he had admitted previously that " relocation could practically
avert any further exposure dose " which is quite obvious.
These doses that could have been averted for the million
inhabitants of areas with radiation control represent diseases,
suffering and deaths for them and their progeny. And our experts
have helped the central Soviet authorities to reduce the number
of people to be relocated.
New ICRP recommendations in the event of a major nuclear
The ICRP made recommendations to protect the public in case
of a severe nuclear accident in publication 40 (May 1984). In
the early phase, the countermeasures are sheltering, stable iodine
distribution, evacuation. Two levels of dose, the lower and upper
levels, determine the dose range in which each countermeasure
has to be implemented  : below the lower level of dose,
countermeasure is not warranted, above the upper level its implementation
should almost certainly have been attempted.
- Sheltering : whole body projected dose between 5 mSv
(0.5 rem) and 50 mSv (5 rem).
- Administration of stable iodine : projected thyroid
dose between 5 and 50 mSv.
- Evacuation : projected whole body dose between 50 mSv
(5 rem) and 500 mSv (50 rem) and/or projected equivalent
organ dose (thyroid, skin), between 500 and 5000 mSv.
Each step of decision-making requires cost-benefit optimisation.
A countermeasure should be introduced " only when its
social cost and risk is less than those resulting from further
exposure ". Of course ordinary citizens are kept in ignorance
of the subtle calculations of experts (with cost as a major parameter)
who are discussing the price of their life. At that time ICRP
did not consider long-lasting situations like Chernobyl's, where
three years after the accident, lots of people still had to be
moved away from contaminated areas and resettled.
After Chernobyl : obviously ICRP has drawn many lessons
from Chernobyl disaster regarding dose limits for introducing
countermeasures as shown by the new intervention levels recommended
in 1992 (publication 63).
In the event of an accident the projected dose is calculated
for each exposure pathway but the key concept for an intervention
is the averted dose which is the dose saved by implementing
a protective action. The " (...) implementation of a given
protective action will be justified if its benefits, which
include radiation detriment averted, are greater than its associated
detriments , in terms of non-radiological risks associated with
it, its financial cost and other, less quantifiable consequences
such as social disruption ".
For the early phase, the worrying aspect of these recommendations
is that precise values are given only for the almost always
justified intervention levels.These justified upper limits
correspond to the previous 1984 upper limits. They are in contrast
to vague lower values of the range of optimised intervention levels,
in which the optimised value has to be " not more
than a factor of 10 lower than the justified value ".
Averted dose estimates will depend on the moment at which a given
countermeasure is introduced. Experts will "optimise"
the costs to decide if this measure is worth implementing at that
time. In case of a severe nuclear accident, authorities might
be tempted to use the simple upper justified values as
intervention levels. In fact, for ICRP, the only imperative requirement
is to avoid serious deterministic effects.
As regards relocation which refers to the long-term removal
of people from an affected area (like post-Chernobyl relocations
after 1989) the justified level is 1 sievert (100 rem). But ICRP
publication adds that " the justified level of averted
dose for relocation might even be higher than this reference
In line with its previous 1984 report which advocated optimised
cost-benefit analysis, the new report specifies some monetary
costs of implementation of a countermeasure strategy. For example
relocation analysis requires to know the cost of one man-sievert,
the collective dose unit related to the price of one person's
life in case of a fatal radiation-induced cancer. In the table
below are given the values for 3 parameters, for three types of
countries : c is the cost of relocation per unit time (one
month), alpha is the cost of unit collective dose (man-sievert),
c/alpha is the derived value for the dose-rate (per month)
at which relocation is optimised.
Type of country
(US$ per man-month)
(US$ per man-sievert)
(mSv per month)
From the table it is possible to derive the price of life.The
life of a developing country's inhabitant is worth 33 times less
than of a rich developed country.The estimated price of a rich
American's life is 2 million US$, the life of a poor Chinese only
60 000 US$ ! .
The dose-rate c/a value at which relocation is optimised is
15 mSv/month (1,5 rem/month) in a developing country, 3 times
more than in a rich developed country. It is concluded that
" the derived value for the dose rate at which relocation
is optimised is about 10 mSv per month and is fairly robust around
this figure ". The duration of such a relocation is not
indicated. With 10 mSv/month, that is 1 rem/month, the Soviet
35 rem criterion would be attained in 3 years... Over 10 years,
a cumulative dose of 120 rem would be of the same order of magnitude
than the highest value recommended by Pellerin and Beninson "
3 times 35 rem". There's nothing surprising about that. Pellerin
was a member of ICRP's Committee 4 which prepared the new recommendations
while Beninson was the chairman of ICRP.
Finally, in the management of the Chernobyl nuclear crisis
by the authoritarian Soviet power, 135 000 people were evacuated
in 1986 and some 300 000 people were relocated after 1989.
(Not enough, unfortunately, as shown previously). But who knows,
a Western democratic government (like ours) might have imposed
quite higher dose limits to avoid relocation of people and therefore
left them to live in heavily contaminated areas...
The analysis of the intervention of Western experts in post-Chernobyl
management demonstrates clearly that they gave unreserved support
to the Central Soviet authorities and their relevant experts to
the detriment of the population's health. The activity of Western
experts has almost never been criticized either by the scientific
community or by the intermediary bodies (medical profession, trade-unions,
associations etc.) and medias.
Therefore we have to assume full and entire responsibility
for the health consequences of the Chernobyl catastrophe. Furthermore,
our experts have gained experience through Chernobyl. Since then,
they have brought in strictly economic criteria for the management
of future nuclear crisis. One has to remember that the possibility
of a severe nuclear accident with its trail of dramatic consequences
cannot be ruled out on our own nuclear reactors.
Bella Belbéoch is Secretary of the Groupement
de Scientifiques pour l'Information sur l'Energie Nucléaire
(group of scientists for information on nuclear energy) which
edits a quarterly review La Gazette Nucléaire, 2
rue François Villon, 91400, France. Fax : 33160143496
(To be published in the Acts of the 2nd International Scientific
Conference on Consequences of Chernobyl Catastrophe Health
and Information : From Uncertainties to Interventions in the Chernobyl
Contaminated Regions, Geneva, 13th and 14th November 1997,
Centre Universitaire d'Écologie Humaine et des Sciences
de l'Environnement, Geneva, Switzerland).
 Gazette Nucléaire n96/97, Juillet 1989.
Dossier Tchernobyl trois ans après.
 AIEA. INFCIRC/380 Vienne, 25 Juillet 1990.
 USSR State Committee on the utilization of nuclear Energy
: The accident at the Chernobyl nuclear plant and its consequences.
Information compiled for the IAEA Expertí Meeting,
25-29 August 1986, Vienna.
 The collective dose, in man-sievert units, is the product
of the total number of persons by one person's average dose in
Sv. The number of the fatal radiation-induced cancers is derived
from the product of the collective dose by the risk factor. In
1977 (ICRP 26) the fatal cancer risk factor was 1.25% per sievert.
(125 fatal cancers will result from a dose of 10 000man-Sv.
In 1990 (ICRP 60) it increased to 5%/Sv (500 fatal cancer will
result from 10 000 man-Sv). If a collective dose of 1 man-Sv
costs 100 000 US$, the price of 1 life is 2 million US$
(100 000 US$ : 0.05) but it seems that this price
represents the social cost of one death and not the price of
one's life which, evidently, has no price.
 Science, Sept. 12, 1986, vol. 233.
 Commission des Communautés Européennes.
Líaccident nucléaire de Tchernobyl et ses conséquences
dans le cadre de la communauté européenne,
COM (86) 607, Oct. 1986.
 Nucleonics Week, May 10, 1990, p. 3.
 A. Moiseev, Analysis of the radiological consequences
of the Chernobyl accident for the population in the European
part of the USSR. WHO Consultation on Epidemiology related
to the Chernobyl Accident, 13-14 May 1987, Copenhagen.
 Libération 4 nov. 1987.
 L. A. Ilyin, O. A. Pavlovskij Radiological consequences
of the Chernobyl accident in the Soviet Union and mesures taken
to mitigate their impact, IAEA Bulletin 4/1987.
 L. A. ILíIN The Chernobyl experience in the
context of current radiation protection problems Proceedings
of an international conference, Sydney 18-22 April 1988, Radiation
Protection in nuclear energy, vol. 2 p. 363.
 UNSCEAR Report to the general Assembly 1988 Sources,
effects and risks of ionizing radiation. The USSR collective
committed effective dose equivalent is 226 000 man-Sv.
 Bella et Roger Belbéoch Tchernobyl une catastrophe
Editions ALLIA, Paris 1993.
 Sobecednik, n17, Avril 1989, in Gazette Nucléaire
 Gazette Nucléaire n84/85, Janvier 1988,
 Pravda Ukrayini, 5 and 15 July 1989. Maps in
 and .
 Gazette Nucléaire n100, Mars 1990. Dossier
Gestion post-Tchernobyl p. 16.
 Chernobyl reactor accident. Report of a consultation,
6 May 1986, WHO, Copenhagen.
 Gazette Nucléaire n101/102 Mai 1990 p.
 Gazette Nucléaire n109/110 Juin 1991. Dossier
Tchernobyl 5 ans après (22 pages).
The International Chernobyl Project. An Overview.
Assessment of radiological consequences and evaluation of protective
peasures. Report by an international Advisory Commitee, May
 Dr. Marie-Hélène Montaigne, Association
Avicenne, Ronchain, France.
 G.I. Lazjuk et al. Radiation Protection Dosimetry
vol. 62, n1/2 (1995) p. 71-74 Frequency of changes of inherited
anomalies in the Republic of Belarus after the Chernobyl accident
 Gazette Nucléaire n157/158, Mai 1997. Dossier
Tchernobyl 11 ans après (12 pages).
 S. T. Belyayev, V. F. Demin Les conséquences
à long terme de Tchernobyl, les contre-mesures et leur
efficacité. Actes de la conférence internationale
les accidents nucléaires et le futur de líénergie.
Leçons tirées de Tchernobyl. 15-16-17 Avril
 Scientific Correspondence Thyroid cancer after Chernobyl,
Nature, 3 Sept. 1992, vol. 359 V. S. Kazakov, E. P. Demidchik,
L. N. Astakhova, p. 21
K. Baverstock, B. Egloff, C. Ruchti, D. Williams, A. Pinchera,
 B. Belbéoch, En Biélorussie : cancers
de la thyroïde chez les enfants
Gazette Nucléaire n 119/120, Août 1992.
 M. Genesco, private communication, 28/2/1989. At that
time this authorized officer from the state-financed civilians
rescue organization said that, in the emergency phase, if the
projected dose could exceed the lower level of a countermeasure,
this countermeasure should be implemented.
Books recommended :
Zhores Medvedev, The legacy of Chernobyl, Basil Blackwell,
Permanent People's Tribunal, IMCC, Chernobyl, Vienna,
12-15 April 1996. (International Peace Bureau 41 rue de Zurich,
1201, Geneva, Switzerland).
Population living in legally contaminated
areas in the Ukraine, Byelorussia and Russia (Cs137 > 1Ci/km2)
ground deposition level
(in thousands of inhabitants)
(zones of periodic radiation control
(zones of permanent strict radiation control)
compulsory relocation 1990-1992 ?
~ 2 250
~ 2 300
~ 6 400
From references   .