Background: Environmental problems can significantly influence population health. Cardiovascular diseases (CVDs) are the most common cause of death in developed countries including in Kazakhstan. The aim of our study was to assess the relationship between exposure to ionizing radiation and mortality risks from major CVDs for the population of Kazakhstan living in areas adjacent to the Semipalatinsk nuclear test site (SNTS). Materials and Methods: The study of the structure and dynamics of cardiovascular mortality was based on the State Scientific Automated Medical Registry (SSAMR) database. Among members of the exposed group, the median equivalent radiation dose was 864.0 mSv, compared to 64.4 mSv in the control group. It should be noted that almost the entire population of the Semipalatinsk region was exposed to some degree of radiation; however, the Kokpekti district received the lowest radiation doses. Results: Mortality rates from CVD were statistically significantly higher in the radiation-exposed population from 1960 to 1994, with RR fluctuating from 1.118 to 8.7. The predominant mortality events were chronic coronary heart disease, chronic cerebrovascular disease, and hemorrhagic stroke throughout the study period, and acute myocardial infarction within 20 years of the start of nuclear testing. In the exposed group, RR = 10.35 for chronic cerebrovascular disease, RR = 3.56 for hemorrhagic stroke, and RR = 5.77 for peripheral arterial atherosclerosis. A dose of 100–500 mSv increased the risk of mortality from CVD by 3.14 times, and a dose of >600 mSv increased it by 7.05 times. Conclusions: A link has been established between long-term exposure to ionizing radiation and increased risks of mortality from CVD in the population of areas contaminated with radiation as a result of nuclear testing.

Studies on health effects of radiation exposure to residents around the Semipalatinsk nuclear test site (SNTS), Kazakhstan, are necessary for epidemiological assessment of radiation-related health risks after low-dose irradiation. Radiation dose estimates are the principal point for radiation epidemiological studies. These estimates should be based on the most reliable initial data, used for dose estimations. The comparative critical analysis of various available archival and published initial data, namely values of historical exposure dose rates and values of soil contamination by 137Cs in considered settlements, including information about dates, times and locations of measurements, was performed with the aim to select most reliable and realistic initial data necessary for estimation of settlement-average accumulated external doses for some settlements located in the vicinity of radioactive clouds’ trajectories related to the most significant tests at the SNTS. Results of estimation of accumulated external radiation dose to air, based on these selected initial data, are presented for 18 settlements. Calculated accumulated external doses were compared with retrospective instrumental dose estimates for settlements, where data on TL/OSL luminescence retrospective dosimetry with quartz-containing samples or electron spin resonance (ESR) dosimetry with tooth enamel were available. Estimation of settlement-average external radiation dose to air is the first important step necessary for the next step—individualized radiation dose estimations among different age, professional and ethnic-specific groups of population lived in the study settlements considering behavior, shielding, location and relocation factors in each population group. This is a subject of future work.

Background. Over two decades of medical observation have been conducted among residents living near the Semipalatinsk Nuclear Test Site, an area affected by chronic exposure to ionizing radiation. This study focuses on thyroid diseases, which are known to be among the most radiosensitive conditions following nuclear fallout. Materials and Methods. A cohort of 3,240 individuals who underwent thyroid ultrasound examinations between 1998 and 2002 was selected for long-term follow-up. Vital status, clinical diagnoses, and registry data were regularly updated. In 2023–2024, a detailed questionnaire was administered to 1,099 surviving participants to evaluate lifestyle, behavioral, and reproductive risk factors. Individual thyroid radiation doses were retrospectively estimated based on age at exposure, place of residence, and dietary patterns. Results. The overall prevalence of thyroid disorders reached 63%, with 33% of respondents reporting the use of hormone replacement therapy. The highest rates were observed among individuals with reconstructed thyroid doses in the range of 100–300 mGy. The integration of survey findings with clinical and dosimetric data allowed for a more comprehensive understanding of dose-dependent health effects. Conclusion. The results confirm the long-term impact of low-to-moderate radiation exposure on thyroid health and support the importance of integrated health monitoring approaches. This experience offers practical lessons for developing regional health surveillance systems in other chronically exposed populations. Введение. На протяжении более 20 лет проводился мониторинг состояния здоровья населения, проживающего в районах, прилегающих к Семипалатинскому испытательному полигону. Основное внимание уделено заболеваниям щитовидной железы как органа, особенно чувствительного к радиационному воздействию. Материалы и методы. В исследование включена когорта из 3240 человек, прошедших ультразвуковое обследование щитовидной железы в 1998–2002 годах. Сбор клинических данных, информации о vital-статусе и результатах диспансерного наблюдения продолжался в течение всего периода. В 2023–2024 гг. было проведено анкетирование 1099 живых участников для оценки поведенческих и репродуктивных факторов. Индивидуальные дозы облучения щитовидной железы были реконструированы с учетом возраста на момент воздействия, места проживания и особенностей питания. Результаты. У 63% опрошенных ранее диагностированы заболевания щитовидной железы, 33% получали гормональную терапию. Наибольшая распространенность патологии отмечена среди лиц с реконструированной дозой облучения 100–300 мГр. Объединение анкетных, клинических и дозиметрических данных позволило выявить дозозависимые эффекты и поведенческие модификаторы риска. Заключение. Результаты подтверждают отдаленное влияние хронического радиационного воздействия на эндокринное здоровье и подчеркивают необходимость комплексных региональных программ наблюдения за пострадавшими популяциями. Кіріспе. Семей ядролық сынақ полигонына жақын орналасқан елді мекендерде тұратын халықтың денсаулық жағдайы 20 жылдан астам уақыт бойы жүйелі түрде бақыланып келеді. Бұл зерттеуде радиациялық әсерге аса сезімтал ағзалардың бірі – қалқанша безі ауруларына ерекше назар аударылды. Материалдар мен әдістер. Зерттеуге 1998–2002 жылдар аралығында қалқанша безінің ультрадыбыстық тексеруінен өткен 3240 адам енгізілді. Мониторинг барысында өмірлік мәртебе, клиникалық диагноздар және медициналық деректер тұрақты түрде жаңартылып отырды. 2023–2024 жылдары 1099 тірі қатысушы арасында сауалнама жүргізіліп, мінез-құлықтық және репродуктивті факторлар бағаланды. Жеке дозалар жас, тұрғылықты жер және тамақтану үлгілерін ескере отырып қайта есептелді. Нәтижелер. Сауалнамаға қатысқандардың 63%-ында қалқанша безі ауруы анықталған, ал 33%-ы гормоналды терапия алған. Ең жоғары көрсеткіштер 100–300 мГр дозасын алғандар арасында тіркелді. Анкеталық, клиникалық және дозиметриялық деректерді біріктіру...

The study is aimed to analyze the death causes of the population exposed to prolonged ionized radiation due to living near the Semipalatinsk nuclear test site. Materials and methods of the study. The initial information for creating the cohort was the data of the study implemented in 1998-2002 with 3539 randomly selected individuals affected by the Semipalatinsk Nuclear Test Site. For each cohort member having the vital status “Dead” the date and cause of the death are verified. Results. The studied cohort included 50.6% men and 49.4% women. The main causes of death of residents of villages exposed to prolonged exposure to ionizing radiation were diseases of the circulatory system - 54.7%; neoplasms - 20.7%; respiratory diseases - 7.1%. Life expectancy was higher in women than in men, however, did not differ depending on nationality, and differed statistically significantly depending on the area of residence. The frequency of circulatory system diseases as a cause of death was higher in residents of areas with extreme, maximum and increased radiation risk compared to residents of areas of minimum radiation risk. Our research demonstrates the need of further study of the correlation of mortality and diseases of circulation system and cancer and prolonged exposure to radiation as a result of living near Semipalatinsk Nuclear Test Site. Цель. Настоящее исследование направлено на анализ причин смерти населения, подвергшегося пролонгированному воздействию ионизирующего излучения вследствие проживания вблизи Семипалатинского испытательного ядерного полигона. Материалы и методы исследования. Исходной информацией для формирования когорты послужили данные исследования, проведенного в 1998-2002 гг., где приняло участие 3539 лиц, выбранных методом «случайного отбора», из числа случайно отобранных лиц, пострадавших в результате деятельности СИЯП. Для каждого члена когорты, имеющего жизненный статус «Умер», верифицирована дата и причина смерти. Результаты. Исследуемая когорта на 50,6% состоит из мужчин и 49,4% из женщин. Основными причинами смерти жителей сел, подвергшихся пролонгированному воздействию ионизирующего излучения можно отнести болезни системы кровообращения – 54,7%; новообразования – 20,7%; болезни органов дыхания – 7,1%.; Исследуемая когорта на 50,6% состоит из мужчин и 49,4% из женщин. Продолжительность жизни была выше у женщин, чем у мужчин, не отличалась в зависимости от национальной принадлежности, и статистически значимо различалась у лиц, в зависимости от зоны проживания. Частота болезней системы кровообращения, как причина смерти, значительно выше у лиц, проживавших в районах с чрезвычайным, максимальным и повышенным радиационным риском (р = 0,02) в сравнении с лицами, проживавшими в зоне минимального радиационного риска. Вывод. Наше исследование показывает необходимость дальнейшего изучения связи между смертностью от болезней системы кровообращения и злокачественных новообразований с длительным воздействием радиации в результате проживания вблизи Семипалатинского ядерного полигона. Бұл зерттеу халықтың өлімінің себептерін талдауға бағытталған, Семей ядролық сынақ полигонының жанында тұрып иондаушы сәулеленудің ұзақ әсер етуіне ұшырағандар. Зерттеу материалдары мен әдістері. Когортты қалыптастыру үшін бастапқы ақпарат 1998-2002 жылдары жүргізілген зерттеу деректері болды, онда "кездейсоқ іріктеу" әдісімен таңдалған 3539 адам СИЯП қызметінің нәтижесінде зардап шеккен кездейсоқ таңдалған адамдар арасынан қатысты. "Қайтыс болған" өмірлік мәртебесі бар когорттың әрбір мүшесі үшін өлімнің күні мен себебі тексеріледі. Нәтижелер. Зерттелетін когорт 50,6% ер адамдар мен 49,4% әйел адамдар болды. Иондаушы сәулеленудің ұзақ әсеріне ұшыраған ауыл тұрғындарының өлімінің негізгі себептеріне қан айналымы жүйесінің аурулары – 54,7%; ісіктер– 20,7%; тыныс алу органдарының аурулары – 7,1%; Зерттелетін когорт 50,6% еркектерден және 49,4%...

Introduction: The effects of chronic low-dose ionizing radiation on human health have been the subject of scientific research for several decades. However, the long-term effects of chronic low-dose irradiation on the human body, including those of the third and subsequent generations, remain unresolved. The aim of this study was to conduct a preliminary assessment of the health screening results of the Beskaragay district population, including second- and third-generation residents exposed to radiation from nuclear weapons testing. Materials and Methods: A screening study of the Beskaragay district population was conducted, including questionnaires on health status, risks of developing non-communicable and socially significant diseases, and lifestyle. A preliminary analysis included 222 patients. All participants underwent a somatic assessment, as well as general clinical and biochemical analysis. Statistical analysis was performed using SPSS 20.0 (SPSS Inc., New York) and Jamovi (version 2.5.5; https://www.jamovi.org). Results: The mean age and age distribution differed statistically between men and women (p = 0.0071), with men being more likely to be aged 40–49 years (34.5%). 63.5% of participants had lived in the area since birth (65.3%). The median systolic blood pressure in men was 130 (IQR 10) mmHg, which was significantly higher than in women (p < 0.001). 90.1% of patients had grade 1–2 thyroid enlargement. Cortisol levels were higher in men — 319.0 (122.0) nmol/L versus 249.3 (145.2) nmol/L in women (p = 0.020), while the opposite trend was observed for insulin. The median individual doses of external gamma radiation among participants were 1.8 cSv (IQR: 0.4–4.2) and did not differ statistically between men and women (p = 0.433). Conclusions: The results of this phase of the study highlight the need for an expanded sample, in-depth clinical, laboratory, and instrumental examinations, and further registry development to study the relationship between radiation exposure and the development of somatic diseases in the offspring of exposed individuals. Введение: Эффекты хронического низкодозового ионизирующего излучения на состояние здоровья человека являются предметом научных исследований в течение нескольких десятилетий. Однако остается нерешенным вопрос о долгосрочных эффектах хронического низкодозового облучения на организм человека, включая лиц третьего и последующих поколений. Целью настоящего исследования являлось предварительная оценка результатов скринингового состояния здоровья населения Бескарагайского района, второго и третьего поколения лиц, подвергшихся воздействию радиации вследствие испытаний ядерного оружия. Материалы и методы: Проведено скрининговое исследование населения Бескарагайского района, анкетирование участников о состоянии здоровья, рисков развития неинфекционных и социально-значимых заболеваний, образа жизни пациентов. В предварительный анализ включено 222 пациента. Всем участникам проводили оценку соматического состояния, а также общеклинический и биохимический анализ. Статистический анализ проводился с применением программ SPSS 20.0 (SPSS Inc., New York) b Jamovi (версия 2.5.5; https://www.jamovi.org). Результаты: Средний возраст и распределение по возрастным категориям статистически различались между мужчинами и женщинами (p = 0,0071), среди мужчин преобладали лица в возрасте 40–49 лет (34,5%). 63,5% участников проживали на данной территории с рождения (65,3%). Медиана САД у мужчин составила 130 (IQR 10) мм рт. ст., что было достоверно выше, чем у женщин (p <0,001). 90,1% пациентов имели увеличение щитовидной железы до 1–2 степени. Уровень кортизола был выше у мужчин - 319,0 (122,0) нмоль/л против 249,3 (145,2) нмоль/л у женщин (p = 0,020), в то время как для инсулина установлена обратная тенденция. Медианные индивидуальные дозы внешнего гамма-облучения участников составляли 1.8 сЗв(IQR: 0.4–4.2) и статистически не различались между мужчинами и женщинами (p = 0.433). Выводы: Результаты данного этапа работы подчёркивают необходимость расширения выборки, углублённого клинико-лабораторного и инструментального обследования, а также дальнейшее накопление регистра для изучения связи радиационного воздействия с развитием соматических заболеваний у потомков...

Background: The Semipalatinsk Nuclear Test Site (SNTS) represents a unique example of long-term population exposure to ionizing radiation. This study aimed to assess the health status of individuals from three generations permanently residing in territories affected by radioactive contamination resulting from nuclear weapons testing at the SNTS, based on the findings of a population screening examination. Materials and Methods: A cross-sectional screening study was conducted among 2802 adults aged 18 years and older. The exposed group consisted of residents of the Abay and Beskaragai districts of the Abay Region and their descendants (n = 1358). The control group included residents of Arshaly village in the Akmola Region with no history of radiation exposure (n = 1444). All participants underwent a structured questionnaire survey, clinical examination, biochemical and hematological testing, and assessment of thyroid function. Individual radiation doses were obtained from the State Scientific Automated Medical Registry of Persons Exposed to Radiation (SSAMR). Results: Arterial hypertension (p < 0.001), chronic ischemic heart disease (p < 0.001), thyroid disorders (p < 0.001), malignant neoplasms (p = 0.003), renal diseases, and respiratory diseases were significantly more prevalent in the exposed population than in the control group. Exposed individuals also demonstrated significantly higher levels of total cholesterol, triglycerides, and the triglyceride-glucose (TyG) index, indicating increased insulin resistance. After adjustments, the only outcome that retained a statistically significant association with radiation dose was thyroid disorders (adjusted OR per 10 mSv increase = 1.017; 95% CI: 1.009–1.025; p < 0.001). ROC analysis demonstrated a moderate discriminative ability of radiation dose with respect to arterial hypertension (AUC = 0.715), chronic ischemic heart disease (AUC = 0.735), and ischemic stroke (AUC = 0.711). Conclusions: The findings suggest long-term adverse health effects associated with radiation exposure among populations residing near the SNTS. Continued epidemiological surveillance and medical monitoring of exposed individuals and their descendants are warranted.