Abstract
Possible effects of Chernobyl fallout on outcome of pregnancy in Finland were evaluated in a nationwide follow-up study. The outcomes were the rate of live births and stillbirths, pregnancy loss, and induced abortions by municipality. Exposure was assessed based on nationwide surveys of radiation dose rate from the Chernobyl fallout, from both external and internal exposures. Using these measurements, we estimated the monthly dose rate for each of the 455 Finnish municipalities. On average, the dose rate from Chernobyl fallout reached 50 microSv per month in May 1986--a doubling of the natural background radiation. In the most heavily affected area, 4 times the normal background dose rates were recorded. Given the underlying regional differences in live birth, stillbirth, and abortion rates, we used longitudinal analysis comparing changes over time within municipalities. A temporary decline in the live birth rate had already begun before 1986, with no clear relationship to the level of fallout. A statistically significant increase in spontaneous abortions with dose of radiation was observed. No marked changes in induced abortions or stillbirths were observed. The decrease in the live birth rate is probably not a biological effect of radiation, but more likely related to public concerns of the fallout. The effect on spontaneous abortions should be interpreted with caution, because of potential bias or confounding. Further, there is little support in the epidemiologic literature on effects of very low doses of radiation on pregnancy outcome.
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- Angleton G. M., Benjamin S. A., Lee A. C. Health effects of low-level irradiation during development: experimental design and prenatal and early neonatal mortality in beagles exposed to 60Co gamma rays. Radiat Res. 1988 Jul;115(1):70–83. [PubMed] [Google Scholar]
- Auvinen A., Hakama M., Arvela H., Hakulinen T., Rahola T., Suomela M., Söderman B., Rytömaa T. Fallout from Chernobyl and incidence of childhood leukaemia in Finland, 1976-92. BMJ. 1994 Jul 16;309(6948):151–154. doi: 10.1136/bmj.309.6948.151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bertollini R., Di Lallo D., Mastroiacovo P., Perucci C. A. Reduction of births in Italy after the Chernobyl accident. Scand J Work Environ Health. 1990 Apr;16(2):96–101. doi: 10.5271/sjweh.1803. [DOI] [PubMed] [Google Scholar]
- Buzhievskaya T. I., Tchaikovskaya T. L., Demidova G. G., Koblyanskaya G. N. Selective monitoring for a Chernobyl effect on pregnancy outcome in Kiev, 1969-1989. Hum Biol. 1995 Aug;67(4):657–672. [PubMed] [Google Scholar]
- Cordero J. F. The epidemiology of disasters and adverse reproductive outcomes: lessons learned. Environ Health Perspect. 1993 Jul;101 (Suppl 2):131–136. doi: 10.1289/ehp.93101s2131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Czeizel A. E. Incidence of legal abortions and congenital abnormalities in Hungary. Biomed Pharmacother. 1991;45(6):249–254. doi: 10.1016/0753-3322(91)90025-o. [DOI] [PubMed] [Google Scholar]
- Ericson A., Källén B. Pregnancy outcome in Sweden after the Chernobyl accident. Environ Res. 1994 Nov;67(2):149–159. doi: 10.1006/enrs.1994.1070. [DOI] [PubMed] [Google Scholar]
- Ford J. H., MacCormac L., Hiller J. PALS (pregnancy and lifestyle study): association between occupational and environmental exposure to chemicals and reproductive outcome. Mutat Res. 1994 Oct-Dec;313(2-3):153–164. doi: 10.1016/0165-1161(94)90045-0. [DOI] [PubMed] [Google Scholar]
- Ginzburg H. M. The psychological consequences of the Chernobyl accident--findings from the International Atomic Energy Agency Study. Public Health Rep. 1993 Mar-Apr;108(2):184–192. [PMC free article] [PubMed] [Google Scholar]
- Grosche B., Irl C., Schoetzau A., van Santen E. Perinatal mortality in Bavaria, Germany, after the Chernobyl reactor accident. Radiat Environ Biophys. 1997 Jun;36(2):129–136. doi: 10.1007/s004110050064. [DOI] [PubMed] [Google Scholar]
- Haeusler M. C., Berghold A., Schoell W., Hofer P., Schaffer M. The influence of the post-Chernobyl fallout on birth defects and abortion rates in Austria. Am J Obstet Gynecol. 1992 Oct;167(4 Pt 1):1025–1031. doi: 10.1016/s0002-9378(12)80032-9. [DOI] [PubMed] [Google Scholar]
- Harjulehto T., Aro T., Rita H., Rytömaa T., Saxén L. The accident at Chernobyl and outcome of pregnancy in Finland. BMJ. 1989 Apr 15;298(6679):995–997. doi: 10.1136/bmj.298.6679.995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harjulehto T., Rahola T., Suomela M., Arvela H., Saxén L. Pregnancy outcome in Finland after the Chernobyl accident. Biomed Pharmacother. 1991;45(6):263–266. doi: 10.1016/0753-3322(91)90027-q. [DOI] [PubMed] [Google Scholar]
- Havenaar J., Rumyantzeva G., Kasyanenko A., Kaasjager K., Westermann A., van den Brink W., van den Bout J., Savelkoul J. Health effects of the Chernobyl disaster: illness or illness behavior? A comparative general health survey in two former Soviet regions. Environ Health Perspect. 1997 Dec;105 (Suppl 6):1533–1537. doi: 10.1289/ehp.97105s61533. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Irgens L. M., Lie R. T., Ulstein M., Skeie Jensen T., Skjaerven R., Sivertsen F., Reitan J. B., Strand F., Strand T., Egil Skjeldestad F. Pregnancy outcome in Norway after Chernobyl. Biomed Pharmacother. 1991;45(6):233–241. doi: 10.1016/0753-3322(91)90023-m. [DOI] [PubMed] [Google Scholar]
- Knudsen L. B. Legally induced abortions in Denmark after Chernobyl. Biomed Pharmacother. 1991;45(6):229–231. doi: 10.1016/0753-3322(91)90022-l. [DOI] [PubMed] [Google Scholar]
- Kulakov V. I., Sokur T. N., Volobuev A. I., Tzibulskaya I. S., Malisheva V. A., Zikin B. I., Ezova L. C., Belyaeva L. A., Bonartzev P. D., Speranskaya N. V. Female reproductive function in areas affected by radiation after the Chernobyl power station accident. Environ Health Perspect. 1993 Jul;101 (Suppl 2):117–123. doi: 10.1289/ehp.93101s2117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Körblein A., Küchenhoff H. Perinatal mortality in Germany following the Chernobyl accident. Radiat Environ Biophys. 1997 Feb;36(1):3–7. doi: 10.1007/s004110050048. [DOI] [PubMed] [Google Scholar]
- Lam D. A., Miron J. A. Global patterns of seasonal variation in human fertility. Ann N Y Acad Sci. 1994 Feb 18;709:9–28. doi: 10.1111/j.1749-6632.1994.tb30385.x. [DOI] [PubMed] [Google Scholar]
- Mays C. W. Stochastic and nonstochastic concepts: is revision needed? Health Phys. 1988 Aug;55(2):437–441. doi: 10.1097/00004032-198808000-00044. [DOI] [PubMed] [Google Scholar]
- Neutra R. R., Swan S. H., Hertz-Picciotto I., Windham G. C., Wrensch M., Shaw G. M., Fenster L., Deane M. Potential sources of bias and confounding in environmental epidemiologic studies of pregnancy outcomes. Epidemiology. 1992 Mar;3(2):134–142. doi: 10.1097/00001648-199203000-00012. [DOI] [PubMed] [Google Scholar]
- Odlind V., Ericson A. Incidence of legal abortion in Sweden after the Chernobyl accident. Biomed Pharmacother. 1991;45(6):225–228. doi: 10.1016/0753-3322(91)90021-k. [DOI] [PubMed] [Google Scholar]
- Pampfer S., Streffer C. Prenatal death and malformations after irradiation of mouse zygotes with neutrons or X-rays. Teratology. 1988 Jun;37(6):599–607. doi: 10.1002/tera.1420370609. [DOI] [PubMed] [Google Scholar]
- Parazzini F., Repetto F., Formigaro M., Fasoli M., La Vecchia C. Induced abortions after the Chernobyl accident. Br Med J (Clin Res Ed) 1988 Jan 9;296(6615):136–136. doi: 10.1136/bmj.296.6615.136-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perucchi M., Domenighetti G. The Chernobyl accident and induced abortions: only one-way information. Scand J Work Environ Health. 1990 Dec;16(6):443–444. doi: 10.5271/sjweh.1761. [DOI] [PubMed] [Google Scholar]
- Rojansky N., Brzezinski A., Schenker J. G. Seasonality in human reproduction: an update. Hum Reprod. 1992 Jul;7(6):735–745. doi: 10.1093/oxfordjournals.humrep.a137729. [DOI] [PubMed] [Google Scholar]
- Savitz D. A., Whelan E. A., Kleckner R. C. Self-reported exposure to pesticides and radiation related to pregnancy outcome--results from National Natality and Fetal Mortality Surveys. Public Health Rep. 1989 Sep-Oct;104(5):473–477. [PMC free article] [PubMed] [Google Scholar]
- Spinelli A., Osborn J. F. The effects of the Chernobyl explosion on induced abortion in Italy. Biomed Pharmacother. 1991;45(6):243–247. doi: 10.1016/0753-3322(91)90024-n. [DOI] [PubMed] [Google Scholar]
- Trichopoulos D., Zavitsanos X., Koutis C., Drogari P., Proukakis C., Petridou E. The victims of chernobyl in Greece: induced abortions after the accident. Br Med J (Clin Res Ed) 1987 Oct 31;295(6606):1100–1100. doi: 10.1136/bmj.295.6606.1100. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ulstein M., Jensen T. S., Irgens L. M., Lie R. T., Sivertsen E. Outcome of pregnancy in one Norwegian county 3 years prior to and 3 years subsequent to the Chernobyl accident. Acta Obstet Gynecol Scand. 1990;69(4):277–280. doi: 10.3109/00016349009036146. [DOI] [PubMed] [Google Scholar]
- Viinamäki H., Kumpusalo E., Myllykangas M., Salomaa S., Kumpusalo L., Kolmakov S., Ilchenko I., Zhukowsky G., Nissinen A. The Chernobyl accident and mental wellbeing--a population study. Acta Psychiatr Scand. 1995 Jun;91(6):396–401. doi: 10.1111/j.1600-0447.1995.tb09799.x. [DOI] [PubMed] [Google Scholar]
- Vyner H. M. The psychological dimensions of health care for patients exposed to radiation and the other invisible environmental contaminants. Soc Sci Med. 1988;27(10):1097–1103. doi: 10.1016/0277-9536(88)90304-8. [DOI] [PubMed] [Google Scholar]
- Wilcox A. J., Weinberg C. R., O'Connor J. F., Baird D. D., Schlatterer J. P., Canfield R. E., Armstrong E. G., Nisula B. C. Incidence of early loss of pregnancy. N Engl J Med. 1988 Jul 28;319(4):189–194. doi: 10.1056/NEJM198807283190401. [DOI] [PubMed] [Google Scholar]
- Zhang J., Cai W. W., Lee D. J. Occupational hazards and pregnancy outcomes. Am J Ind Med. 1992;21(3):397–408. doi: 10.1002/ajim.4700210312. [DOI] [PubMed] [Google Scholar]