Registry of population living around

Semipalatinsk nuclear test site: an important infrastructure for studies of low-

dose effects A. Lipikhina Research Institute for Radiation Medicine and Ecology Semey, Kazakhstan

Semipalatinsk nuclear test site

From 29.08.1949 through 19.10.1989, 465 nuclear tests were conducted on the Semipalatinsk nuclear test site, including 88 atmospheric, 30 ground , 347 underground nuclear tests

Creation date: 21.08.1947 The first test: 29.08.1949

The last test: 19.10.1989 Closing date: 29.08.1991

The area of test site :: ~18 500 sq.km

In March, 1957, a specialized classified medical

institution "Antibrucellar Dispensary" No. 4 of the USSR Ministry of Health was opened

in the city of Semipalatinsk.

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Main dispensary’s activities included:

- studying effects of radiation factors on environment, people and animals;

- reconstruction of radiation situations and effective exposure doses based on empirical models and on measurements of residual radiation in environmental objects;

- radiation and hygienic monitoring of the territory of the Semipalatinsk region adjacent to the nuclear test site;

- development of mid-term and long-term health programs for minimization of consequences of the nuclear weapon tests.

"Top secret"

On August 8, 1991, the Research Institute for Radiation Medicine and Ecology was established on the basis of the Dispensary No. 4 of the USSR Ministry of Health.

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Institute’s Mission: - Realization of a state policy in the field of radiation medicine and ecology; - Implementation of the inter-industry cooperation; - Carrying out scientific and medical research and providing medical services to the population of the Republic of Kazakhstan affected by ionizing radiation.

Nuclear weapon tests on the Semipalatinsk nuclear test site

Main tasks

Reconstruction of radiation doses

Estimation of size of groups at radiation risk

Assessment of medico-demographic

consequences

Medico-social minimization of radiation exposure consequences

The State Scientific Automated Medical Register (SSAMR)

Purposes of the SSAMR creation:

- To provide a long-term individual follow-up of the people exposed directly to radioactive fallouts and of their offspring (1st and 2nd generations);

- To estimate radiation doses;

- To monitor and evaluate health status of exposed people;

- To study radiation-related effects using incidence and mortality data on exposed people;

- To develop an optimal strategy for minimization of exposure consequences for people’s health.

Milestones of the Register construction

- Detailed review of register construction methods in the countries that experienced similar radiation and hygienic situations;

- Cooperation with specialists from Radiation Effect Research Foundation (RERF, Hiroshima, Japan) who provided methodical, scientific and practical help to our institute. The software for the register was developed by the RERF Department of information technologies;

- In 2003, Ministry of Health of the Republic of Kazakhstan approved the scientific program for creation of the state scientific automated medical register (SSAMR) of Kazakhstan population exposed to ionizing radiation;

- In 2013, specialists of the institute carried out a considerable modernization of the register’s software that resulted in increase of register’s functionality, and of amount of stored information.

Algorithm to collect information for the Register’s database

– Registration of persons eligible for inclusion into the register;

– Completion of registration card on each person;

– transfer of information in health management,

–annual recruitment archive paper of primary documents.

Health Department in regions and in cities of

Astana and Almaty

– Collection of registration cards;

– Quality control of collected information;

– Transfer of the registration cards and summary tables to the Research Institute of Radiation Medicine and Ecology, Semey

Research Institute of Radiation

Medicine and Ecology

– Data quality checks;

– Sending requests to verify questionable or incomplete information;

- Maintenance of the registry;

– Preparation of reports for the Ministry of Health on progress in registration of exposed people.

Medical establishments providing primary health care: district

hospitals, rural ambulatories, medical cabinets, feldsher posts

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Responsibilities of the authorized organizations

SSAMR Ministry of Health

For completion of the register database various sources of information are used: - Legal documents:

-household books, - archives materials of the Semey city and regional centers, -acts certificates of death causes from archives of the REGISTRY OFFICE,

- Medical documentation:

-stories of diseases, -results of screening, polyclinic and stationary examinations of the

population, - Survey of inhabitants by house to house rounds with verification of the documents confirming the accommodation fact in this territory.

passport data nationality radiation route

education, profession

received radiation dose

existence and numbers of official documents

results of medical complex examination conducted by the NIIRME physicians

cause and data of death for a deceased person

information on offspring of a person who were directly exposed to radiation (children, grandchildren, great-grandchildren)

results of whole-body counter measurements

information on availability of biosample (blood, DNA, tissue)

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The State Scientific Automated Medical Register as of 01.11.2015

209 030 alive

107 610 deceased

S S A M R

316 640 people

Sub-register of people known to be alive

Sub-register of death cases and causes

An example of automated selection

Selection criteria: women resided in the Beskaragay area during the period from 1949 to 1963. Selection results: 1721 persons. Performance time: 7,52 seconds.

Examples of automatic requests outputs

Frequency tables

on nationality

and occupation

and sex

Nowadays the work on adaptation and assimilation of information by 8400 people from a register database with the European database of the scientific MELODI platform on research of influence of radiation low doses on a human body is being carried out. The following data are integrated from the register database into the European platform: - Registration data: individual’s ID, sex, nationality, date and place of birth, - Medical information: diagnoses names and dates, presence of congenital defects, in case of death – a cause of death, - Dosimetry data: radiation route, radiation dose. - Information on lifestyle factors: smoking, alcohol, - Availability of biological samples: blood, DNA, tumor and normal tissues.

The report was carried with the support from the Grant agreement № 323310 (SEMI-NUC) with the EU under EURATOM FP7 Programme

Sank for your attention.