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.

Abstract

To investigate childhood cardiac arrhythmia and chronic exposure to caesium-137 (¹³⁷Cs) resulting from the Chernobyl accident. 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). Russian territories affected by the Chernobyl fallout (Bryansk region). This cross-sectional study included 18 152 children aged 2-18 years and living in the Bryansk region (Russia). 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. 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). 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.