Q & A about ICARR and Chernobyl

Fountain at Maydan Nezalezhnosti (Independence Square)

Yesterday, I spent the day reading RTI International’s proposal to the Department of Energy regarding the ICARR study. The hefty document was published about a year ago, on June 13, 2006. It answered many of my lingering questions about ICARR, which I have summarized in Q and A format below.

However, before I begin, I would like to introduce some new terms.

• In Ukraine, what I have been calling “the Ark building project” is more commonly known as “the Chernobyl Shelter Implementation Plan,” or “SIP.” I will be using both terms interchangeably from now on.
• Ukrainian scientists have a special name for the old, deteriorating sarcophagus: “Object Shelter” or “Shelter Object.” It sounds a little strange in English, but I will be using the term from this point on when it is convenient for me to do so.
• NSC = New Safe Confinement = “The Ark” (see below)
• The acronym “ICARR” technically refers to the group of institutions who form the International Consortium for Applied Radiation Research (Duke, RTI, RCRM, etc.). The real name for project itself is the “Chernobyl Research and Service Project (CRSP).” However, according to my mentor, people are now just calling CRSP “ICARR,” as I have been.
  
• Up to this point I have been using the Russian transliteration of “Chernobyl” instead of the Ukrainian “Chornobyl.” I generally prefer to use the Ukrainian version (which is why I write Kyiv instead of Kiev), but since I have used “Chernobyl” for over two months (and since it’s the most familiar version for Americans) I’m not going to change it now. But just know that Chernobyl and Chornobyl are one in the same thing!

Q & A

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Q: What organization funded the Ark building project (a.k.a. Chernobyl Shelter Implementation Plan [SIP])?

A: The European Bank of Reconstruction and Development, which is comprised of 28 countries, including the US.

Q: Which engineering firms were hired to design the Ark?

A: Bechtel International Systems (they designed the Trans-Alaska Pipeline, the Athens Metro, and the new Tacoma Narrows Bridge in Washington State), Battelle Memorial Institute, and Electricite de France.

Q: What are researchers so interested in SIP?

A: There is currently a lack of baseline and longitudinal time series measurements on the health effects of low-level radiation in humans. The ICARR project would solve this problem. By studying workers conducting renewed clean-up efforts at the Chernobyl Nuclear Power Plant (ChNPP), researchers may be able to characterize how the human body reacts to low-level radiation before, during, and after exposure.

Q: When did SIP begin, and how many workers are expected to work on it?

A: Hiring of workers began in 2004; 10,000 to 15,000 people will have worked on it by 2010.

Q: What are the roles of the various institutions involved in ICARR?

A: RCRM conducts entry and follow-up medical surveillance and worker safety programs.
RTI International creates and maintains the project’s data coordinating center. It also serves as the main contractor.
Duke University organizes the service and research projects.
UNC-Asheville (and also RCRM) conducts biological and public health oriented research.
Together, these four institutions comprise the International Consortium for Applied Radiation Research, or ICARR.

ChNPP by satellite

Q: What are ICARR’s major activities?

A: 1) Conducting hypothesis driven genomic, biological, and prospective epidemiologic research approved by an external committee, and 2) providing medical care and public health services to improve the quality of life for workers. Bio-specimens are being collected and stored; information is being shared between the four ICARR institutions via a health information exchange system on the Internet; and a time series of measurements on workers is being collected.

Q: So ICARR is not a specific research project in itself, but rather the name of the plan to create a scientific infrastructure in Chernobyl?

A: Correct. ICARR is laying the foundation for researchers to design prospective studies – observational or experimental – as well as for them to provide public health and medical services in Chernobyl.

Q: How does the ICARR project (a.k.a. CRSP) compare to other studies on low-level radiation in humans?

A: ICARR is the largest project ever undertaken to collect and analyze a combination of clinical and genomic information related to low-level human radiation exposure as exposure occurs.

Q: How did the researchers manage to convince the Department of Energy to fund such an expensive project?

A: In their proposal, they repeatedly emphasized that a major health threat to the US and world community is the purposeful misuse of ionizing radiation as a weapon of terrorism. They made it clear that ICARR would help to counteract this threat by generating research.

Q: What hypotheses are ICARR project developers putting forth?

A: That ionizing radiation, even at low doses, can be manifest in changes of molecular profiles obtained from whole blood, and that these profiles can be used to develop predictive models for exposure. Also, that this information can be mechanistically linked to diseases and outcomes of interest, and that specific exposure-response biomarkers can be determined.

Q: How much fuel remains in the Shelter Object?

A: Since the disaster on April 26, 1986, over 95% (or 180 tons) of irradiated nuclear fuel is still inside the Shelter Object.

Q: What were the health effects of the Chernobyl disaster on the community?

A: There has been an increase in leukemia and cardiovascular disease in liquidators, evacuees, and residents. Also, there was an increase in thyroid cancer in children. Interestingly, according to the DoE proposal, there has been no increase in birth defects. (The film Chernobyl Heart begs to differ – see my previous post here.)

Q: What exactly are the risks for workers in Chernobyl?

A: Due to the “unique origination of the Shelter Object,” radiation hygienic conditions cannot be made in compliance with world safety standards. Workers will be exposed to fission and activation products (90Sr and 137Cs) as well as TUE radionucleotides (238Pu, 239Pu, 240Pu, 241Pu, and 241Am). Employment at SIP is particularly dangerous because these radiological risks are combined with the general industrial risks associated with building a giant steel-and-concrete structure. The job places extreme requirements on workers’ somatic health and psycho-physiological capabilities.

Q: Are the workers reimbursed for participating in ICARR?

A: Not exactly. Participants are informed of the research objectives of the study, and their participation is sought in the spirit of altruism and community health promotion. However, when their blood is first taken, participants are reimbursed 100 UAH (= 20 USD) for their time. 100 UAH is about one-tenth of the average Ukrainian monthly salary.

Q: Can you describe the different medical examinations that workers must undergo?

A: 1. Individual Inspection Control Exam – a periodic medical exam, the timing of which is determined by the medical classification of the worker (i.e. how likely he is to get sick).
2. Special Control Exam – an extensive medical and psychological exam conducted on workers who are found to exceed existing standards for radiation control. It is used to reclassify and reconfirm worker eligibility.
3. Current (Pre-Shift) Exam – a daily exam conducted at the ChNPP.
4. Periodic Control Exam – a general medical exam conducted once yearly.
5. Output Control Exam – an extensive series of medical and psychological exams conducted on all workers leaving employment at SIP.

Q: Can you describe the process for gathering specimen from Ark workers?

A: At each worker’s baseline and follow-up medical exams, a researcher collects blood for DNA genotyping and epigenetic analysis; RNA for gene expression analysis; and serum for protein and metabolite profiling. The process takes about 5 minutes. After collection, the specimens are split into duplicate sets, bar-coded, and then sent one to a Ukrainian facility, and one to the US.

Q: How detailed is the information that ICARR researchers have collected on workers?

A: The combination of longitudinal clinical information and biological data gives researchers an exquisitely detailed molecular phenotype of each worker related to his ionizing radiation dosage.

Q: What’s an example of the types of research that will be conducted within the ICARR infrastructure?

A: One of the start-up projects was designed by a scientist at Duke. He plans to do gene expression analysis of the peripheral blood from Ark workers to develop a molecular signature of human radiation exposure. His goal is to be able to quantify or predict an individual’s susceptibility to disease based on radiation dose.

Q: What’s an example of the types of services that will be provided to workers within the ICARR infrastructure?

A: Stem cell therapy services will be provided to the 200-400 workers at highest risk of exposure who are involved in early structural stabilization. Researchers in Ukraine have stored their hematopoietic progenitors for this specific purpose.