%0 Report %D 2011 %T The psychological and welfare consequences of the Chernobyl disaster: a systematic literature review, focus group findings, and future directions %A Sonny S. Patel %A Jonathan M. Samet %X

On April 26, 1986, a nuclear disaster occurred at the Chernobyl Nuclear Power Plant, contaminating areas of what are now modern-day Belarus, Moldova, Russia, and Ukraine. Beyond radiation exposure and cancer risks, the disaster led to the imposition of diverse acute and chronic stressors on the people living around the site. Principal among these health effects are psychological consequences, including ongoing psychological stress, post- traumatic stress disorder, and diminished well-being.

Substantial time has now passed since the disaster occurred and the possibility of health effects other than cancer has not been sufficiently addressed. This report assesses the research conducted on these health effects, particularly quality of life, functioning, and neuropsychological status among the victims of the disaster. Through a systematic review approach, this report documents the range of studies that have been carried out—largely cross-sectional surveys with several cohort (follow-up) studies. This report includes 50 publications; their results have been considered within the outcomes of anxiety, depression, post-traumatic stress disorder, well-being, and cognition.

Based on this systematic review, we find that there is evidence for adverse psychological and welfare consequences of the Chernobyl disaster. The extent of the available research, however, was limited and the various Chernobyl-affected groups have not been systematically investigated. In research subsequent to the disaster, emphasis has been given to cancer risk, as a result of the widespread radiation exposure to workers and the population. Nonetheless, the studies conducted show consistent indication that exposure to the Chernobyl disaster, broadly construed, has led to adverse psychological consequences. They point to a range of adverse effects that might be mitigated through evidence-based interventions. However, the available data are again limited in their coverage of affected populations and they fail to provide a picture of ongoing challenges to well-being faced by the populations in the area affected by the accident.

As one step in exploring future research directions on the neuropsychological consequences of the Chernobyl disaster, we arranged for focus groups to learn the most critical concerns of residents in Kiev (Kyiv), Ukraine today. In general, the focus group discussions gave useful insights regarding people’s perceptions, concerns, and attitudes towards their health and the current state of health care in Kiev. For most respondents, health was considered one of the most important values in their lives; however, few reported about the medical services used in cases of illness. Among the main concerns on the future health consequences of the Chernobyl disaster, many respondents said that children need to have more detailed investigation of their health, including physical and mental health. The following emerged with consensus as key issues: dissatisfaction with the quality of the medical care, the use of non evidence-based diagnostics and treatments, lack of knowledge in the population about the signs of both physical and mental disorders, concerns about children’s health, and the potential impact of environmental factors including the Chernobyl disaster.

In this report, we have considered two sources of evidence on the long- term neuropsychological consequences of the Chernobyl disaster: the published research evidence available in the accessible literature and the findings of focus groups conducted in Kiev in March, 2011. The broad findings from these two sources are convergent and clear: twenty-five years after the Chernobyl disaster, the populations affected at the time, whether by being displaced or exposed to radiation, have sustained neuropsychological consequences and these consequences remain of public health and medical significance.

At the 25th anniversary year of the disaster, it would be timely to give greater discussion to the topic of long-term neuropsychological consequences. Our recommendations address this need. They broadly cover future research, potential interventions, and networking in Ukraine, Belarus, Russia, and Moldova. In addition, we recommend the need for further understanding on how evidence on the neuropsychological consequences of the disaster and related support could make a difference to motivate action by policymakers. We also recommend
a comprehensive cataloguing of ongoing research and an evaluation of opportunities for expanding studies to cover neuropsychological outcomes.

 

%I USC Institute for Global Health %P 1-125 %G eng %U https://uscglobalhealth.files.wordpress.com/2016/01/chernobyl_report_april2011.pdf