Pregnant Women with High Levels of Caesium and High Rates of Congenital Anomalies near Chornobyl

We report population-based rates of congenital anomalies in the Rivne province of Ukraine. The rates are significantly higher in the northern half of Rivne, a region called Polissia which is polluted by Chornobyl ionizing radiation. In this region of forested wet-lands, also called Prypiat Marshlands, the soils are distinct from those in non-Polissia. The soils in Polissia transfer caesium more readily to plants than those in non-Polissia. The rates of some specific female prevalent congenital anomalies and incorporated ionizing radiation levels are higher than in nonPolissia. The elevated rates of congenital anomalies belong to the category of blastopathies, which arise before the uterine implantation of the fertilized egg (blastula) or during the initial stages of embryogenesis. The blastopathies noted are conjoined twins, sacral teratomas (embryonal tumors of the lower spine), neural tube defects (anencephaly and spina bifida among others), and microcephaly-microphthalmia (reduced head size and/or reduced ocular globes). These elevated rates of blastopathies are persistent and are among the highest reported in Europe. Our measurements of IR are limited to incorporated levels of caesium. However, we have detected the presence of strontium in potato plants grown in P. Other investigations detected high levels of tritium in the Prypiat river which apparently stem from releases by either or both nuclear power plants in the Rivne region. The average caesium incorporated by 3,865 pregnant women from Polissia was 40.4 and among those from non-Polissia was 11.3 becquerels per kilogram of body weight respectively. The levels of incorporation of caesium have risen significantly over time. A comprehensive analysis of prenatal exposures to alcohol, another potent cause of congenital anomalies, did not reveal contrasts between Polissia and non-Polissia. The observations in Rivne stem from descriptive epidemiological investigations seeking to detect associations to guide prospective cause-effect investigations. The concurrence of elevated population-based rates of blastopathies and higher incorporated levels of caesium in pregnant women reflect an association, although such is not a proof of causation. The observations in Rivne are sufficiently compelling to justify prospective investigations of specific cause-specific