Chronic exposure to ionizing radiation from uranium legacy sites remains a significant public health concern in Northern Kazakhstan. This review evaluates epidemiological, clinical, and environmental evidence published between 2000 and 2025, with particular emphasis on studies conducted during 2014–2023 in the Stepnogorsk region among populations residing near former uranium mining sites. Residents were exposed to annual external gamma doses of approximately 1.0–3.5 mSv and radon-related doses of up to 1.2 mSv. Cancer registry analyses revealed 1913 malignancy cases in the exposed group (vs. 358 controls), with digestive (29%) and respiratory (17%) cancers predominating. Early signs of chronic radiation syndrome (CRS) were consistently observed, including olfactory dysfunction, immunosuppression, vestibular disturbances, hematologic anomalies, and elevated chromosomal aberrations (1.3–1.5× baseline). Non-cancer morbidity was also elevated, including hypertension (32% vs. 24%), chronic bronchitis (14% vs. 8%), and reduced forced expiratory volume in one second (FEV₁; −9.7%), indicating broader systemic effects. These results underscore the need for targeted public health strategies incorporating CRS biomarker screening, cancer surveillance, personal dosimetry, and environmental remediation in uranium-impacted communities.

Background/Objectives: Radon is a naturally occurring radioactive gas and the leading source of natural radiation exposure worldwide; however, its systemic biological effects in children remain poorly understood. This study examined the association between cumulative indoor radon exposure and inflammatory biomarkers among children residing in rural communities of the Aqmola region in Kazakhstan. Methods: The study included 87 children and adolescents (42 exposed and 45 controls). Radon exposure was measured in residential and school environments, and a composite Radon Exposure Index (REI) was constructed to estimate cumulative exposure over time. Serum concentrations of inflammatory biomarkers, including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-8 (IL-8), were measured using validated immunoassay methods. Multivariable linear regression models adjusted for age, sex, body mass index, pubertal development stage, and heating type were used to evaluate associations between REI and biomarker levels. Results: Children and adolescents living in the radon-exposed community had significantly higher REI values than controls (7.75 ± 0.85 vs.4.83 ± 0.41, respectively). Among the biomarkers examined, CRP, TNF-α, IL-1β, IL-8 and IL-6 were not significantly associated with radon exposure. Conclusions: These findings do not support the use of the evaluated inflammatory biomarkers as indicators of early biological effects of environmental radon exposure in this population. However, the clear exposure contrast observed between study settings underscores the ongoing public health relevance of radon as an environmental hazard. Continued efforts to monitor and mitigate radon exposure in high-risk regions remain essential, particularly in environments where children spend substantial amounts of time.

Background/Objectives: Cancer incidence and mortality are key epidemiological indicators for evaluating the long-term biological effects of chronic low-dose radiation exposure. The aim of this study was to assess the incidence, structure, and relative risk of digestive tract cancers (ICD-10 C15–C26) among populations exposed and not exposed from uranium waste storage site in North Kazakhstan over a 10-year period (2014–2023). Methods: A retrospective population-based analysis was conducted using national cancer registry data, including data for residents of Stepnogorsk and nearby settlements (exposed group) and Akkol (control group). Results: A total of 588 cases were identified, including 465 in the exposed group and 123 in the control group. The mean age at diagnosis was similar (~65 years), and most cases were diagnosed at advanced stages (III–IV: ~58–60%). The leading cancer types were colorectal (38–40%) and stomach (29–31%) in both groups. The incidence rates were comparable (85.27 vs. 87.40 per 100,000), with an overall relative risk (RR) of 0.98 (95% confidence interval [CI]: 0.80–1.19), indicating no significant difference. Site-specific analysis showed no significant variation for esophageal, stomach, or colorectal cancers. A higher, but not statistically significant, risk was observed for pancreatic cancer (RR = 1.61; 95% CI: 0.90–2.89). Temporal analysis demonstrated similar trends in both populations, with incidence rates decreasing from 91.37 to 79.08 per 100,000 in the exposed group and from 97.40 to 78.13 per 100,000 in the control group between 2014–2018 and 2019–2023. Conclusions: Overall, digestive tract cancer incidence and structure were comparable between groups, with no statistically significant increase in the exposed population.