Prospective cohort study of residents near the Semipalatinsk nuclear test site - feasibility

Mechanisms and sources for case ascertainment (cancer and non-cancer mortality/incidence) were identified. Quality of mortality and incidence data and diagnosis criteria were evaluated and outcomes to be studied were identified. The study outcomes identification was based on detailed description of all information sources available for different types of health outcomes, followed by the assessment of data quality and completeness including review of case ascertaiment procedures, diagnostic criteria, morphological verification and cross-checking the information coming from various sources. Activities undertaken: March 30-April 2, site visit to Semey, Kazakhstan. During our site visit we realized that some cancer information has never been used for Semipalatinsk studies and could be very useful for a future study on cancer incidence. Careful evaluation of the availability of other medical documents such as patient's case history, and medical chart, is required to collect information on morbidity. Opportunity to use existing specialized computer registries on cardiovascular and other non-cancer diseases is currently studied. External Advisory Board meeting, 11-12 May 2015, IARC, Lyon, France. A report, summarizing the results of the feasibility assessment for an integrated cohort study in the future, was prepared and submitted for evaluation to the External Advisory Board (EAB). Further work on profiling the population mortality with stroke and ischemic heart disease with the cancer causes of death is needed. It was recommended include environmental exposures to the population in addition to the radiation exposure. Continuous examination of the thyroid disease should be considered. November 9 2015, Helmholtz Centre, Munich, Germany - Dissemination workshop The results from the project were presented to the low dose radiation risk research community in conjunction with the annual MELODI (Multidisciplinary European Low Dose Initiative) workshop. March 14-15 2016, Norwegian Radiation Protection Authority - Final meeting A final meeting of all project participants, as well as the EAB was conducted at the NRPA. Project results were summarized, the draft final report for the European Commission was discussed with the EAB, and plans for revising the report according to their input was made. Potential follow up studies based on the results of the project were also discussed.

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The health effects of exposures to fallout from Soviet nuclear weapons testing for the residents living near by the Semipalatinsk nuclear test site in Kazakhstan are not well investigated. There are reports with contradicting results coming from the studies conducted on two independent cohorts: "historical" and "new". Both use different control groups and dosimetric methods. The two cohorts have a high probability of including the same individuals. There is a need to investigate possibilities to merge them in order to avoid duplication of efforts and resources for future studies of the health effects in these populations. The main objectives of our feasibility study include: developing and testing mechanisms for identifying members in the two cohorts; identification and testing of data linkage mechanisms; characterization and validation of dose assessment methods; determination of the outcomes to be studied; identification of case ascertainment mechanisms and sources, depending on the outcome; investigate the feasibility to collect data on confounding factors; setting up and testing procedures for follow-up; development of a proposal for a full epidemiological study; setting up mechanisms for collaboration and coordination of future activities. The project will bring together scientists from Europe, Kazakhstan, Russia, and Japan with the aim of conducting a feasibility to set up a unique cohort to address the dose-effect relationship for both cancer and non-cancer effects from low to moderate chronic doses (external and internal). Other populations exposed to low to moderate dose radiation like in Fukushima or elsewhere can benefit from the outcomes of studying the unique Semipalatinsk cohort and the results will contribute to a better understanding and quantification of radiation risks for low to moderate chronic doses. The proposed project is in line with the Strategic Research Agenda of MELODI.