Community Research and Development Information Service - CORDIS

FP7

CO-CHER Report Summary

Project ID: 605302
Funded under: FP7-EURATOM-FISSION
Country: France

Final Report Summary - CO-CHER (Cooperation on Chernobyl health research – CO-CHER)

Executive Summary:
In the period 2008 to 2010, an international group of experts and advisors under leadership of the International Agency for Research on Cancer (IARC) carried out the European Union funded project “ARCH: Agenda for Research on Chernobyl Health”. ARCH brought together a multidisciplinary group of experts with considerable experience in the follow-up of the health consequences of the accident. After conducting a comprehensive review of the current status of research on the health effects from the Chernobyl accident, the ARCH group proposed a Strategic Research Agenda (SRA) - http://arch.iarc.fr/documents/ARCH_SRA.pdf. The SRA underlined the need for well-designed and coordinated long-term studies. This view was shared by MELODI in its Advice of November 2011 (http://melodi-online.eu/doc/NoteARCH_SRA.pdf). Following the ARCH SRA recommendations and the MELODI advice, the CO-CHER project (Cooperation on Chernobyl Health Research) funded by the European Union further prioritised research needs in epidemiology, clinical medicine, mental health, dosimetry, molecular biology, pathology and risk communication. The group also carried out an assessment of the existing research infrastructures to form a basis for future research on long-term health effects of the Chernobyl.

The long-term Chernobyl Research Programme (CRP) was finalized after further discussion and input from the partners and experts who participated in the international symposium held at IARC, Lyon on 11 June 2016 to mark the 30th anniversary of the Chernobyl accident. Chernobyl provides direct evidence of the consequences of a major nuclear accident; there is a need to turn this experience into an opportunity to fully understand radiation effects on human health in order to provide a solid basis for radiation protection recommendations and to inform health planning for prevention and care for those exposed after future accidents. To capitalize fully from the Chernobyl experience there must be an appropriate research infrastructure. In accordance with the ARCH SRA and the advice of the MELODI expert group, the highest priority defined by CO-CHER is the establishment of a Chernobyl Lifespan cohort, similar to the action taken after the atomic bomb exposures in Japan, together with a series of individual studies covering the main health consequences. The most suitable populations to form the Chernobyl Lifespan cohort as identified by the ARCH Expert group and further discussed within CO-CHER, are Chernobyl liquidators (clean-up workers), people who were exposed in childhood and had direct measurements of thyroid radioactivity performed shortly after the accident, including exposed in utero, and also evacuees.

CO-CHER recommends a continuation of the project by convening a multinational body (Chernobyl Research Committee) to facilitate international collaborations and research. The group could be supported by a Secretariat to facilitate information exchange and provide guidance in obtaining and maintaining agreements between researchers and data custodians and to identify funding opportunities. This would serve to support the scientific aspects of the CRP and its sustainable funding process and would supplement research that is already underway. The proposed CRP covers a time period of up to 6 years and recommends prioritized studies in the areas of epidemiology, biology, and dosimetry, it defines their interrelationship and also deals with management aspects. While specific topics of the CRP can be funded through various funding schemes, including open calls or research agreements between various institutions, the establishment and maintenance of the Chernobyl Lifespan cohort, together with the Chernobyl Research Committee, shall be considered independently from these and supported through the agreements between the European Commission and relevant organisations in Belarus, the Russian Federation, Ukraine, the United States of America, and Japan. Within CO-CHER, collaborative agreements were concluded with the relevant research institutions and organisations from Belarus, the Russian Federation, and Ukraine, and represent a commitment to international cooperation in the long-term studies of health effects of this major nuclear disaster.

Project Context and Objectives:
Although 30 years have passed, the Chernobyl nuclear power plant accident on 26 April 1986 has an iconic status in the public consciousness. The accident resulted in the most severe exposure of humanity to ionizing radiation apart from the 1945 atomic bombings in Japan. Currently there remains disagreement over both the Chernobyl consequences to date and those that could be expected in the future, largely due to lack of comprehensive, coordinated effort to delineate the overall physical and mental health consequences.

It is generally recognized that there is an elevated risk of thyroid cancer after childhood exposure to radioiodines from Chernobyl fallout. Little evidence of other post-Chernobyl health effects does not mean that no effect has occurred or will not occur in the future. Radiation-related diseases continue to occur decades after exposure, therefore continued studies are needed to fully evaluate the radiological impact of the accident. Long-term studies of the Japanese atomic bomb survivors have demonstrated the importance of life-span follow up of exposed populations that can fully evaluate the consequences of radiation exposure, including a significant increase in solid cancers more than 25 years, and cardiovascular effects more than 40 years after the bombing.

In 2008–2010, an international group of experts and advisors, led by the International Agency for Research on Cancer (IARC), carried out the European Union (EU)-funded “Agenda for Research on Chernobyl Health” (ARCH) project. The ARCH project focused on reviewing the current knowledge about the health effects of the Chernobyl accident, identifying further research needs, and creating the strategic research agenda (SRA) later annotated by the Multidisciplinary European Low Dose Initiative (MELODI). One of the project′s conclusions was that well-designed and coordinated long-term studies of the health effects of the accident are of great importance to comprehensively evaluate and to adequately inform the exposed population by providing objective (rather than speculative) estimates of the consequences.

Building on this foundation, the overall objective of the EU-funded “Cooperation on Chernobyl Health Research” (CO-CHER) project was to establish an international collaboration to facilitate long-term research on the health effects of the accident. The CO-CHER focused on:
1) identifying key institutions (authorities and research bodies) worldwide that are willing to commit to future collaboration on Chernobyl research;
2) conducting a thorough assessment of existing research infrastructures in terms of their suitability and needs for further improvement if establishing future Chernobyl lifespan cohorts;
3) developing a long-term Chernobyl Research Programme (CRP) with agreed-upon research priorities;
4) reaching collaborative agreements with the relevant authorities in the three European countries most affected by the accident (Belarus, the Russian Federation, and Ukraine), as well as with research bodies and authorities in Europe, Japan, and the USA.

Project Results:
• Creation of an international network of Chernobyl research institutions

At the start of the project, key institutions (authorities and research bodies) with relevant capacity and a proven interest in conducting research into the effects of the Chernobyl accident, were contacted worldwide and invited to participate in the project. An international network was thus established that is committed to long-term future collaboration on Chernobyl research. The network includes institutions in Belarus, the Russian Federation, Ukraine, Japan and the United States of America.

During the course of the project, four groups of recognized experts in epidemiology, dosimetry, mental health and risk communication, and molecular mechanisms were invited to join the project. Each group met in person and discussed remaining gaps in knowledge of Chernobyl consequences, defined scientific priorities and made recommendations for future research in their respective field. The resulting list of recommendations was then discussed at a meeting of all the partners and experts. The recommendations were prioritized taking into account the availability and suitability of the resources that would be required and the value of the results that could be obtained.

CO-CHER recommends a continuation of the project by convening a multinational body to facilitate collaborations and research activities on the international level. The group should be supported by a Secretariat to facilitate information exchange and provide guidance in obtaining and maintaining agreements between researchers and data custodians and to identify funding opportunities. This would serve to support both the scientific aspects of the Chernobyl Research Program (Deliverable 2.1) and its sustainable funding process and would not interfere with research that is already underway.

• Assessment of existing infrastructures

In order to know what research areas could be explored in the future, it was essential to have a clear picture of the existing resources and their availability.

To achieve this, a thorough inventory of the existing infrastructures including rosters and cohorts of affected populations, dosimetry databases, and biobanks, was carried out using a specially developed questionnaire and all the relevant published reports and papers were reviewed. These infrastructures were then analysed and assessed in terms of their suitability and areas where improvement is needed, in preparation for establishing future Chernobyl lifespan cohorts. The results of the inventory and recommendations on suitability and potential for improvement of existing research infrastructures were summarized in technical reports and submitted as Deliverable 3.1 “Evaluation of the cohorts of exposed populations suitable to form Chernobyl life-span cohort”, Deliverable 3.2 “Overview of dose reconstruction methods used in analytical studies related to the Chernobyl accident”, and Deliverable 3.3 “Report on inventory of stored biological samples”.

Careful analysis of existing cohorts and potential groups of exposed populations, as well as sources and procedures of cancer and non-cancer incident and mortality case ascertainment demonstrate the feasibility of the construction of high-quality life-span cohorts of clean-up workers, and individuals exposed in childhood and adolescence with direct thyroid activity measurements carried at the time of the accident. Long-term studies of already existing groups with known radiation doses, both those exposed to fallout as children and those exposed as young adults, would provide invaluable information on the lifetime risks of both external and internal exposures. Hence, much of the work required for establishing the study cohorts has already been carried out. The necessary scientific skills, know-how and infrastructure have been developed in each of the countries for epidemiological studies in general, as well as exposure assessment and assessing various health outcomes pertinent for radiation exposure. Comprehensive, high-quality cancer registration systems exist in Ukraine, Belarus and the Baltic countries.

Exposure assessment provides a solid basis for dose estimation for various populations from several sources of radiation, including direct measurements of radioactivity in the environment, individuals’ direct thyroid radioactivity measurements and collection of information on lifestyle factors relevant for radiation exposure. Individual doses for Chernobyl-related analytical epidemiological studies are favourably compared with many other non-Chernobyl studies because Chernobyl doses have been calculated with a relatively high degree of reliability and are based on a large number of measurements, either performed on humans or made in the environment, and include well-characterized dose uncertainties. Although many measurements have been used to prepare dose estimates, there are others that need to be given further proper consideration and utilization, for example, the measurements of the total radioactivity in milk to confirm the validity of the individuals’ thyroid dose estimates; or the available official dose records in a large fraction of clean-up workers to determine if at least some of them could be used in large epidemiologic studies as an alternative to the implementation of the RADRUE dose reconstruction method that is very costly and time-consuming. Despite the most advanced assessment of uncertainties in individual dose estimates conducted in some of the post-Chernobyl studies, the question on how to properly account for the questionnaire-related uncertainties (for example, those associated with the poor recall of the whereabouts of the clean-up workers during their mission at the Chernobyl site) remains to be answered.

One of the main tasks of the assessment of the Chernobyl research infrastructures was to construct an inventory of existing biobanks and collections of biological samples and to evaluate their potential for integration in future studies on health outcomes of the Chernobyl accident. Collection and preservation of tumour tissues and paired samples of normal tissues or blood is essential to study somatic and germline changes involved in radiation carcinogenesis. This is particular important for major radiation events where large numbers of radiation-related tumours occur with known long latency and possible molecular evolution of the tumours over time. Storage of such samples allows the future application of novel modern molecular techniques that may provide answers to some of the basic questions in carcinogenesis and, specifically, in radiation-induced carcinogenesis. The review and discussions within the molecular biology and pathology expert group revealed that: 1) There has been an ad hoc rather than systemic and integrated approach for collecting tumour and blood samples in most of the studies, except the Chernobyl Tissue Bank (CTB), and National Cancer Institute (NCI)-supported collections of UkrAm and BelAm cohorts; and 2) molecular studies are seldom linked to epidemiological studies.

Before making any further more specific recommendations on the suitability of the reviewed collections, the following technical aspects need to be addressed: a) the different approaches used in different laboratories must be compared and standardized and; b) the quality of frozen samples needs to be tested before making any proposals for future molecular studies and for supporting the maintenance of the tissue bank in Belarus.

The most comprehensive information on thyroid cancer patients exposed under the age of 19 years in Ukraine and Russia are included and available in the CTB. It includes paraffin embedded blocks (PEB), fresh frozen tissues (FFT) and blood samples that allow studying radiation-associated thyroid cancers’: a) genomic signature; b) phenotype and genotype correlation with latency, iodine deficiency, and radiation dose; and c) genetic predisposition. The CTB project provides an invaluable experience of how data from various sources could be collated together and become a central resource for various types of molecular and pathology studies, and how the data access should be governed.

The scope of CTB can be extended by including other cancer sites, e.g. brain tumours in clean-up workers and breast cancers in women exposed in childhood and adolescence, if funding could be agreed.

The existing collection of thyroid tumour tissue and blood samples in Belarus, after quality assessment, has the potential to be used for future studies of Chernobyl associated thyroid cancer aiming to better understand molecular mechanisms of thyroid carcinogenesis and its relationship to radiation exposure. Moreover, is may be used to better understand sporadic thyroid cancer epidemics worldwide.
When planning the creation of a life-span cohort of liquidators, it is essential to envisage an opportunity for establishing a tissue bank on liquidators collating existing research data and collecting new biological samples which can be integrated in the CTB.

Discussions with the sample custodians from the three most affected countries and relevant authorities have revealed that existing national regulations do not forbid the use of biological material in international projects.

Key scientists from the affected countries are committed to joint efforts and data sharing in order to accomplish a comprehensive assessment of the full long-term impact of the Chernobyl accident.

• Development of Chernobyl Research Programme and timetable

To make the best use of this unique opportunity to increase our understanding of the effects of radiation and nuclear accidents, the CO-CHER project developed the Chernobyl Research Programme (CRP) based on the recommendations agreed by the partners and experts. The CRP is a sustainable plan for research into the health effects of the Chernobyl accident that makes optimal use of the available resources (Deliverable 2.1). The success of the proposed future programme depends strongly on collaboration between the researchers, data custodians, stakeholders and funding agencies that play a major role in assuring the sustainability of Chernobyl research. The CRP is based upon existing knowledge, ongoing and planned studies (for example, in exposed children) and identified gaps in research. Recommendations are made for future studies, in particular amongst liquidators and possibly other affected populations. The CRP also proposes a timetable for these future studies (Annex of Deliverable 2.1). The CRP was finalized after further discussion and input from the partners and experts who participated in the international symposium held at IARC, Lyon on 11 June 2016 to mark the 30th anniversary of the Chernobyl accident.

The aim of the CRP is to create an environment that ensures sustainable research and facilitates implementation of the most informative studies by the responsible research institutes, including possible new collaborations and initiatives, and to outline a coordination mechanism and timetable for implementation of these activities.

It recommends convening a multinational body (Chernobyl Research Committee) to facilitate international collaborations and research. This group would be supported by a Secretariat to facilitate information exchange and provide guidance in obtaining and maintaining agreements between researchers and data custodians and to identify funding opportunities. Inherent to such recommendation, is the need to take into account interests of the key institutions involved in Chernobyl research and to secure seed funding for convening the Chernobyl Research Committee and helping to launch new studies proposed in the Chernobyl Research Programme.

The Chernobyl Research Committee should comprise representatives of the main research and funding institutions that are committed to sustainable research into the health effects of the Chernobyl accident that have been identified through consultations with the institutes involved in the CO-CHER network. The Committee is also open to other institutions that are extensively involved in research on Chernobyl health effects.

Setting up the mechanism for convening the Chernobyl Research Committee and supporting Secretariat will require immediate funding. Finalizing the sustainable funding agreement could take considerable time and investment, and it is important to identify seed funding (for the first 1–2 years) through consultations and agreements with potential funding bodies that already have been initiated in CO-CHER.

Based on the list of priorities discussed and agreed by the partners and experts, the CRP recommends studies in the areas of epidemiology, biology, and dosimetry, it defines their interrelationship and also covers management aspects.

It is recommended to follow-up the CO-CHER project with a two-year pilot study setting up a Life Span cohort of Chernobyl liquidators. The pilot study would test the CO-CHER developed mechanism of coordination through developing and harmonizing criteria and procedures for data combining, demonstrating the feasibility of collecting biological samples, and performing descriptive analyses of combined data. If proved to be successful, further analytical epidemiological and molecular biological studies can be conducted, and following-up the Life Span cohort of Chernobyl liquidators is recommended. The research timetable also includes specific actions on studies in children with direct thyroid measurements, people exposed in utero, and possibly, offspring and evacuees. A number of cross-cutting issues are included in the recommended studies, specifically, improvement of dosimetric aspects, and integration of biological, mental health and risk perception facets.

The full Chernobyl Research Programme is presented in Annex 1.

• Concluding agreements with appropriate governing structures

It is important to carry out research that will ultimately provide a comprehensive picture of the health consequences of the largest nuclear accident in the world to date. As some political issues may be associated with collaboration with and between the three countries most affected by the Chernobyl accident, it is essential that sustainable agreements with the relevant authorities from Belarus, the Russian Federation and Ukraine, as well as with other research institutions, are obtained and maintained.

To ensure cooperation and collaboration on future research, and to help assess the long-term health consequences of the Chernobyl accident, as well as to promote and conduct high-quality research to strengthen the evidence base that underpins cancer prevention and control, agreements have been negotiated and signed with the leading research institutions, specifically with N.N.Aleksandrov National Cancer Centre of the Republic of Belarus, Minsk, and with Republican Research Centre for Radiation Medicine and Human Ecology, Gomel, Belarus; with A.Tsyb Medical Radiological Research Centre branch of the National Medical Radiological Research Centre of the Ministry of Health of the Russian Federation; and with National Academy of Medical Sciences of Ukraine (Deliverable 5.2).

Comprehensive studies of the Chernobyl accident are of great importance to the study of long-term low dose rate effects, for the improvement of the bases for radiation protection, and importantly, to adequately inform the exposed population by providing properly researched studies that give reliable rather than speculative estimates of the consequences.

Potential Impact:
Epidemiological studies of populations affected by the Chernobyl accident have already provided important findings concerning the link between radiation and cancer (and non-cancer) outcomes. This has proved to be important for improving our scientific understanding of radiation effects and for the development of radiation protection measures in the case of future nuclear accidents.

To date, most Chernobyl studies have focussed on cancer and major non-cancer specific diseases, leaving the mental health consequences of the accident poorly understood. Some studies have administered in-depth measures of mental health along with brief self-reports about physical health, or in-depth examinations of physical health with little or no information on mental health, but never both. Given the close relationships between physical health and mental health, it is critical that future studies of liquidators and exposed residents include state-of-the-art measures of both aspects of health.

As discussed with the CO-CHER partners and experts, another unique challenge for studies of populations affected by massive disasters is the lack of confidence of these populations in the information they receive from scientists. To a large extent, this is a consequence of the political issues surrounding responsibility for the cause and remediation of the disaster, media reports on health effects that conflict with scientific findings, and a lack of experience among scientists in communicating science to the general public. Studies on risk perception, despite the fact that 30 years after the accident they can be affected by recall bias, can help to inform risk communication strategies in case of future accidents.

The long-term mental health effects and major concerns of the affected populations (evacuees, liquidators, exposed early in life, thyroidectomy patients, residents of contaminated areas, and resettlers and offspring of these) have not been adequately evaluated. Integration of mental health specialists into multidisciplinary teams of ongoing or planned studies on physical health effects, and integration of elements of mental health assessment in the ongoing or planned epidemiological studies of liquidators and exposed residents to identify consistent patterns of long-term health effects can be used for developing and tailoring intervention programmes in the aftermath of nuclear disasters.

Chernobyl provides rare and direct evidence of the consequences of a major nuclear accident; there is a need to turn this experience into an opportunity to fully understand radiation effects on human health in order to provide a solid basis for radiation protection recommendations and to inform health planning for prevention and care for those exposed after future accidents.

Continuing follow-up of Chernobyl-exposed populations would be instrumental in filling important gaps in current knowledge. Studies of the extensive thyroid gland exposure to radioactive iodine isotopes sustained as a result of the accident, particularly in childhood, can lead to a better understanding of the molecular mechanisms involved in thyroid carcinogenesis and thyroid cancer epidemics worldwide. Study populations with reliable dosimetry estimates and high-quality biological samples could provide information about the genomic signature of radiation-associated thyroid cancer, the correlation of phenotype/genotype and latency, iodine deficiency or radiation dose as well as about the existence of a genetic predisposition.

For cancers other than thyroid, where monitoring of cancer incidence rates indicate an increase, further assessment of phenotype and genotype characteristics, the magnitude of risk, as well as dose-response-relationships could also be informative. In addition, CO-CHER recommends assessment of the feasibility of integrating research on mental health and risk communication into well-established cohorts to assess the attributable health effects and assist in defining public health strategies and risk communication policies in the areas affected by the Chernobyl and Fukushima accidents, or any other potential future nuclear accidents.
To mark the 30th anniversary of the Chernobyl accident and bring attention of potential funding bodies and stakeholders, a one-day satellite symposium entitled “Chernobyl – 30 years after” was organized in the context of the CO-CHER project. The meeting took place on 11 June 2016 at the offices of the International Agency for Research on Cancer in Lyon, France in conjunction with the IARC 50th Anniversary Conference on Global Cancer that was held at the Lyon Convention Centre from 8–10 June 2016.

The aim of the Chernobyl symposium was to present an overview of the current knowledge on the long-term health consequences of the accident and to discuss future research directions that can improve our understanding about the effects of low-dose radiation exposure on human health. The keynote lectures were delivered by recognized experts in the field of epidemiology, dosimetry, mental health and molecular mechanisms. Over 70 participants attended the meeting from 23 different countries (see Annex 2).

At the meeting, the project coordinator presented the draft Chernobyl Research Programme (CRP) that was one of the major deliverables of the CO-CHER project (Deliverable 2.1) to the symposium participants. The CRP identifies future research priorities and proposes a timetable for future studies.

A number of stakeholders were present and during the lunchbreak, an open round-table discussion took place with the participation of the IARC director, Dr Christopher Wild to identify possible sources of funding for the proposed future research programme.

Concluding the Symposium open round-table and scientific discussions, the following recommendations were drafted with input from the symposium participants following the presentation of the Chernobyl Research Programme by the project coordinator, namely
• To endorse the Chernobyl Research Programme to create an environment that ensures sustainable research on Chernobyl health effects.
• To convene a multinational body – “Chernobyl Research Committee” to facilitate international collaborations and research. The group should be supported by a Secretariat to facilitate information exchange and provide guidance in obtaining and maintaining agreements between researchers and data custodians and to identify funding opportunities.
• To support the development and coordination including harmonization of Chernobyl Lifespan cohorts, similar to the actions taken after the atomic bomb exposures in Japan, together with a series of individual studies covering the main health consequences.
• To look for sustainable funding for convening the Chernobyl Research Committee and helping to urgently launch the next phase of the Chernobyl Research Programme.
In the framework of the CO-CHER project, project’s objectives, main achievements, established research priorities and recommendations were extensively disseminated through publications, presentations at scientific meetings and conferences.

• Publications

Papers, book chapters, monographs:

Ivanov V, Kochergina E, Zelenskaya N, Maksioutov M, Tumanov K, Shchukina N, Chekin S. Methods for analysis and quality control of medical information on diagnosed cerebrovascular diseases in the Russian cohort of Chernobyl emergency workers (liquidators). Radiation and Risk. 2015, 24(2): 77-84. [in Russian]

Weiland N, Steiner M, Grosche B. Gesundheitliche Folgen des Unfalls von Tschernobyl – 30 Jahre danach [Health effects of the Chernobyl accident – 30 years on]; Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Sep;59(9):1171-7. [in German]

Drozdovitch V, Chumak V, Kesminiene A, Ostroumova E, Bouville A. Doses for post-Chernobyl epidemiological studies: are they reliable? J Radiol Prot. 2016 Jun 29;36(3):R36-R73.
Havenaar JM, Bromet EJ, Gluzman S. The 30-year mental health legacy of the Chernobyl disaster. World Psychiatry. 2016 Jun;15(2):181-2. doi:0.1002/wps.20335.

Rozhko A, Nadyrov E, Veyalkin I. Medical Effects of Chernobyl Disaster in the Republic of Belarus: 30 Years after. Medical Radiology and Radiation Safety. 2016; 61(3): 81–88. [in Russian]

Rozhko A, Nadyrov E, Veyalkin I, Stozharov A, Bogdan E, Nikinovich S, Semenenko O, Zaharova O, Chaikova Y, Cheshyk A. Medical effects of Chernobyl disaster in the Republic of Belarus: 30 years after. Medical and biological problems of life activity. 2016; 15(1): 31–42. [in Russian]
Thirty Years of Chornobyl Catastrophe: Radiological and Health Effects. National Report of Ukraine. Editor-in-chief: Bazyka D.A. 2016, NRCRM, Kyiv. www.nrcrm.gov.ua/en

Health effects of Chernobyl: prediction and actual data 30 years after the accident. Edited by V.K.Ivanov, A.D.Kaprin, Moscow, GEOS. 2015. 450 p. ISBN 978-5-89118-688-0 [in Russian]
Abstract in Conference Proceedings:

Rozhko A, Nadyrov E, Veyalkin I. Medical effects of Chornobyl disaster in the Republic of Belarus: 30 years after. International Conference “Health effects of the Chornobyl accident – 30 years aftermath”. Book of abstracts, Kyiv, Ukraine, 18-19 April 2016; p.126. http://nrcrm.gov.ua/downloads/abstracts_18_04_16.pdf

Kesminiene A and Ostroumova E. Lessons from Chernobyl: do we need sustainable environment for informative research? Radiation Protection Week, Oxford, UK, 19 – 23 September 2016; p.121. https://drive.google.com/file/d/0BzMSB7bRDjakS29NWXNkQnN2Z2s/view .

Ivanov V, Galkin V, Kaprin A. National Radiation Epidemiological Registry: results of operation and perspectives of development. E-Book. Health effects of Chernobyl: prediction and actual data 30 years after the accident. Obninsk, A.Tsyb MRRC, May 17-19, 2016. p. 57. Available at: http://www.radiation-and-risk.com/abstracts.pdf . (Accessed on September 26, 2016). [In Russian]

Maksioutov M, Korelo A, Tumanov K, Ivanov V. A radiological data bank of Joint Chernobyl Register of Russia and Belarus. E-Book. Health effects of Chernobyl: prediction and actual data 30 years after the accident. Obninsk, A.Tsyb MRRC, May 17-19, 2016, p.90 (Available at: http://www.radiation-and-risk.com/abstracts.pdf . (Accessed on September 26, 2016). [In Russian]

Presentations:

A. Kesminiene: CHERNOBYL: Opportunities and challenges for cancer research, DCEG, NCI, Bethesda, USA, 10 February 2015

A. Kesminiene: Cancer following the Chernobyl nuclear plant accident: current picture and future research perspectives. ICRR, Kyoto, Japan, 25-29 May 2015

A. Kesminiene: Cancer following the Chernobyl nuclear plant accident: opportunities and challenges for research. Atomic Bomb Disease Institute, University of Nagasaki, 2 June 2015

A. Kesminiene: CO-CHER: Cooperation on Chernobyl health research, Overview. NERIS GA meeting, Bratislava, Slovak Republic, 19 January 2016

A. Kesminiene: CO-CHER: Cooperation on Chernobyl Health Research. International Chernobyl Cooperation Strategy Development 3rd expert meeting, Minsk, Belarus, 29 February 2016

A. Kesminiene: CO-CHER: International effort into sustainable Chernobyl Health Research. Health effects of the Chornobyl accident - 30 years aftermath. Kyiv, Ukraine, 18-19 April 2016

D. Bazyka: Thirty years of national and international cancer research after the Chornobyl accident in Ukraine. Health effects of the Chornobyl accident - 30 years aftermath. Kyiv, Ukraine, 18-19 April 2016

B. Grosche: Die gesundheitlichen Effekte durch den Reaktorunfall von Tschernobyl [Health Effects of the Chernobyl Accident]. Federal Office for Radiation Protection, Munich, Germany; 21 April 2016

B. Grosche: Chernobyl – Health effects. Module “Radiation and Environmental Epidemiology”, MSc course Epidemiology, University of Mainz, Germany; 6 June 2016

E. Ostroumova: CO-CHER: Setting the scene for future research on Chernobyl. Health effects of Chernobyl: prediction and actual data 30 years after the accident. Obninsk, Russia, 17-19 May 2016

V. Ivanov: National Radiation Epidemiological Registry: results of its work and perspectives on the registry development. Health effects of Chernobyl: prediction and actual data 30 years after the accident. Obninsk, Russia, 17-19 May 2016

A. Kesminiene: CO-CHER: Setting the scene for future research on Chernobyl. Symposium “Chernobyl – 30 years after”. Lyon, France, 11 June 2016

E. Cardis: Long-term health effects after Chernobyl. Symposium “Chernobyl – 30 years after”. Lyon, France, 11 June 2016

J. Havenaar: Physiological consequences of the Chernobyl disaster. Symposium “Chernobyl – 30 years after”. Lyon, France, 11 June 2016

D. Bazyka: Thirty years of national and international cancer research after the Chornobyl accident in Ukraine. Symposium “Chernobyl – 30 years after”. Lyon, France, 11 June 2016

V. Drozdovitch: Doses for post-Chernobyl epidemiological studies: are they reliable? Symposium “Chernobyl – 30 years after”. Lyon, France, 11 June 2016

A. Kesminiene: Lessons from Chernobyl: do we need sustainable environment for informative research? Radiation Protection Week, Oxford, UK, 22 September 2016

A. Kesminiene: Research on Thyroid Cancer - from Chernobyl to Fukushima. The 5th International Expert Symposium in Fukushima on Radiation and Health: Chernobyl +30, Fukushima +5: Lessons and Solutions for Fukushima’s Thyroid Question. Fukushima, Japan, 26-27 September 2016

List of Websites:
http://co-cher.iarc.fr

Related information

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CENTRE INTERNATIONAL DE RECHERCHE SUR LE CANCER
France

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Nuclear Fission
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