Is exposure to ionising radiation associated with childhood cardiac arrhythmia in the Russian territories contaminated by the Chernobyl fallout? A cross-sectional population-based study

Objective

To investigate childhood cardiac arrhythmia and chronic exposure to caesium-137 (¹³⁷Cs) resulting from the Chernobyl accident.

Design

Prospective cross-sectional study using exposed/unexposed design conducted in the Bryansk region from May 2009 to May 2013 on children selected on the basis of ¹³⁷Cs soil deposition: control territories ([¹³⁷Cs]<37 kBq per square metre, where children were considered as unexposed) and contaminated territories ([¹³⁷Cs]>555 kBq per square metre, where children were considered as exposed).

Setting

Russian territories affected by the Chernobyl fallout (Bryansk region).

Participants

This cross-sectional study included 18 152 children aged 2–18 years and living in the Bryansk region (Russia).

Main outcome measures

All children received three medical examinations (ECG, echocardiography and ¹³⁷Cs whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests.

Results

Cardiac arrhythmia was diagnosed in 1172 children living in contaminated territories and 1354 children living in control territories. The crude prevalence estimated to 13.3% in contaminated territories was significantly lower than in control territories with 15.2% over the period 2009–2013 (P<0.001). Considering ¹³⁷Cs whole-body burden as exposure, cardiac arrhythmia was found in 449 contaminated children and 2077 uncontaminated children, corresponding to an estimated crude prevalence of 14.5% and 14.2%, respectively, which does not differ significantly (P=0.74). Also, we investigated the association between territory, exposure to ¹³⁷Cs and cardiac arrhythmia: the adjusted OR was not significant (0.90 with 95% CI 0.81 to 1.00; P=0.06) for the territory. For ¹³⁷Cs whole-body burden, the ORs close to 1 did not reach statistical significance (P for trend=0.97).

Conclusion

This study does not observe an association between cardiac arrhythmia and ¹³⁷Cs deposition levels in the Bryansk region exposed to Chernobyl fallout. The suspected increase of cardiac arrhythmia in children exposed to Chernobyl fallout is not confirmed.

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