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Thyroid examination in highly radiation-exposed workers after the Chernobyl accident

¹ Division of Endocrinology, Department of Internal Medicine² Radiation Medicine Research Group and WHO-Collaborating Centre for Radiation Accident Management, University of Ulm, D-89081 Ulm, Germany³ Department of Dermatology, Federal Armed Forces Hospital, D-89081 Ulm, Germany⁴ Scientific Centre of Radiation Medicine, UKA-252050 Kiev, Ukraine⁵ Institute of Hematology, Erasmus University of Rotterdam, NL-3015 Rotterdam, The Netherlands

(Correspondence should be addressed to B O Boehm who is now at Division of Endocrinology and Diabetes, Albert-Einstein-Allee 23, University Medical Centre Ulm, D-89081 Ulm, Germany; Email: bernhard.boehm{at}uniklinik-ulm.de)

^* (B O Boehm and M Steinert contributed equally to this work)

Context: Radioactive contamination from the Chernobyl nuclear accident that happened on the morning of 26th April 1986 had a major impact on thyroid health in the Belarus region.

Objective: Observational study of a cohort of 99 adults, most strongly exposed to ionizing radioactivity.

Design, setting and patients: Observational study performed between 1998 and 2000. The cohort comprised 99 workers (92 male) of the Chernobyl nuclear power plant. Examination including physical examination, ultrasonography of the thyroid gland and measurement of serum free thyroxin (fT₄), free triiodothyronine (fT₃) and TSH. Anti-thyroperoxidase (anti-TPO), antithyroglobulin (anti-Tg) antibodies and thyroid stimulating immunoglobulin were also determined.

Main outcome measures: The impact of exposure to high-dose radiation, including radioactive iodine, on the thyroid gland was examined.

Results: Levels of fT₄ in all probands were within the normal World Health Organization-defined range. Elevated levels of fT₃ were found in two workers (2%), high titres of anti-TPO and anti-Tg antibodies were present in four subjects (4%). Mild hypothyroidism was present in one patient. Enlargement of the thyroid gland was observed in 17 workers (17%). There was no evidence of clinically overt thyroid cancer.

Conclusions: The Chernobyl accident showed surprisingly little impact on the thyroid in a cohort of workers strongly exposed to radiation. Our data suggest an age-dependent heterogeneity in response to the short-lived radioiodine isotopes and favours long-term follow-up analysis.