Chronic radiation syndrome (CRS), or chronic radiation enteritis,[1][2] is a constellation of health effects of radiation that occur after months or years of chronic exposure to high amounts of radiation. Chronic radiation syndrome develops with a speed and severity proportional to the radiation dose received (i.e., it is a deterministic effect of exposure to ionizing radiation), unlike radiation-induced cancer. It is distinct from acute radiation syndrome, in that it occurs at dose rates low enough to permit natural repair mechanisms to compete with the radiation damage during the exposure period. Dose rates high enough to cause the acute form (> ~0.1 Gy/h) are fatal long before onset of the chronic form. The lower threshold for chronic radiation syndrome is between 0.7 and 1.5 Gy, at dose rates above 0.1 Gy/yr.[3] This condition is primarily known from the Kyshtym disaster, where 66 cases were diagnosed. It has received little mention in Western literature;[3] but see the ICRP’s 2012 Statement.[4]

In 2013, Alexander V. Akleyev described the chronology of the clinical course of CRS while presenting at ConRad in Munich, Germany. In his presentation, he defined the latent period as being 1–5 years, and the formation coinciding with the period of maximum radiation dose. The recovery period was described as being 3–12 months after exposure ceased. He concluded that "CRS represents a systemic response of the body as a whole to the chronic total body exposure in man."[5] In 2014, Akleyev's book "Comprehensive analysis of chronic radiation syndrome, covering epidemiology, pathogenesis, pathoanatomy, diagnosis and treatment" was published by Springer.[6]

Symptoms of chronic radiation syndrome would include, at an early stage, impaired sense of touch and smell and disturbances of the vegetative functions. At a later stage, muscle and skin atrophy and eye cataract follow, with possible fibrous formations on the skin, in case of previous radiation burns. Solid cancer or leukemia due to genetic damage may appear at any time.[7]

Case studies

Semipalatinsk Nuclear Test Site surrounding areas

Kazakh people living in towns and villages located around the Semipalatinsk Nuclear Test Site have experienced a variety of adverse health effects which, due to the proximity of their living and working environments to known radioactive hotspots, may be considered under the umbrella of chronic radiation syndrome. Though assessed in a “minimal risk category” for state reimbursement for possible harms done by the nuclear testing at their border, residents of Koyan village along with others in Oktyabr village and nearby Kurchatov experience continuing exposure to radioactive isotopes found in the same areas used for grazing their animals and growing food.[8] Threats in the form of wildfire to the hay stockpile used to feed their livestock over the winter oblige them to set forth in groups into the largely unmarked and unobstructed areas located containing known craters leftover from underground nuclear tests, as there is no state assistance in the form of a fire brigade nearby.

While not facing more media stereotypical forms of mutation from exposure to the radiation, residents of Koyan are generally prone to a variety of illnesses, including but not limited to hair loss, frequent nosebleeds, unexplainable burns to the skin, cataracts, cancer, hypertension, headaches, anemia, skin rashes, and bone pain.[8] Some other possible physical mutations did exist among the 50 people living in Koyan at the time of Magdalena Stawkowski’s study of the area, but not serious enough to be considered by locals or some scientists as a “failure to adapt” to the radiation in their surroundings, who instead view themselves in contrast to other living things which have greater visible physical changes as a combination of “normal” and “mutants”.[8]

References

  1. ↑ Theis, V.S.; Sripadam, R.; Ramani, V.; Lal, S. (2010). "Chronic Radiation Enteritis". Clinical Oncology. Elsevier BV. 22 (1): 70–83. doi:10.1016/j.clon.2009.10.003. ISSN 0936-6555. PMID 19897345.
  2. ↑ "Radiation Enteritis and Proctitis: Practice Essentials, Pathophysiology, Etiology". Medscape Reference. 2019-11-18. Retrieved 2019-12-27.
  3. 1 2 Gusev, Igor A.; Gusʹkova, Angelina Konstantinovna; Mettler, Fred Albert (2001-03-28). Medical Management of Radiation Accidents. CRC Press. pp. 15–29. ISBN 978-0-8493-7004-5. Retrieved 2012-06-11.
  4. ↑ ICRP (2012). ICRP Statement on Tissue Reactions / Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context. Vol. ICRP Publication 118. Ann. ICRP 41(1/2). Compare the published draft (ICRP. "Early and late effects of radiation in normal tissues and organs: threshold doses for tissue reactions and other non-cancer effects of radiation in a radiation protection context" (PDF). Archived from the original (PDF) on 3 November 2014. Retrieved 11 June 2012.) and note dose thresholds.
  5. ↑ Akleyev, Alexander (2013-05-13). "Chronic Radiation Syndrome (CRS) in residents of the Techa riverside villages" (PDF). Archived from the original (PDF) on 2016-05-31.
  6. ↑ "Chronic Radiation Syndrome | Alexander V. Akleyev | Springer". www.springer.com. Retrieved 2016-04-30.
  7. ↑ Grammaticos, Philip; Giannoula, Evantia; Fountos, George P. (2013-02-27). "Acute radiation syndrome and chronic radiation syndrome" (PDF). Hellenic Journal of Nuclear Medicine. 16 (1): 56–9. PMID 23570025. Retrieved 2019-09-09.
  8. 1 2 3 STAWKOWSKI, MAGDALENA E. (February 2016). ""I am a radioactive mutant": Emergent biological subjectivities at Kazakhstan's Semipalatinsk Nuclear Test Site". American Ethnologist. 43 (1): 144–157. doi:10.1111/amet.12269. ISSN 0094-0496.
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