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самооц1нка здоров'я населения укра1ни
внасл1док чорнобильсько! катастрофи
у п1зн1й фаз1 авар11
Власюк Н.В., Тарасюк O.G., Антомонов М.Ю.
HEALTH SELF-ASSESSMENT OF UKRAINIAN POPULATION AS A RESULT OF CHORNOBYL ACCIDENT ON THE LATE PHASE
n its scale and impact on the environment and society the Chornobyl disaster had become a phenomenon of global importance, in the number of dead and injured people from the consequences and economic losses. On the territories which was not directly affected by explosion factors radioactive contamination is painfully perceived by the population and gives rise to anxiety for own health and health of their relatives [1]. At the late period after the Chornobyl accident, determination of population radioanxiety (for the first time the expression "radiation anxiety or radioanxiety" was introduced in 1988 due to the Chornobyl accident), which living on the contaminated and relatively "clean" areas, is one of the topical problems of accidental impact on people health in Ukraine.
VLASIUK N.V., TARASIUKO.Y., ANTOMONOV M.Y.
SI «O.M. Marzeyev Institute for Public Health of the NAMS of Ukraine», Kyiv
УДК
613.648.4:614.876:621.039.58
Keywords: Chornobyl accident, health self-assessment, radioanxiety, questionnaire survey, late phase of the accident, significant relationship.
Radioanxiety - is the emotional and psychological condition, when person overestimates subjectively dangers for health of objectively existing minor radiation exposure [2]. Radioanxiety status is normal and adequate human response to radioecologi-cal situation after the accident. However, high radioanxiety level among population reduces the quality of life and worsens his health.
The accident affected millions of people, and has become a factor in the occurrence of stress among adults and children. There is 30 years of the experience of outreach programs for population on areas of radioactive contamination. According to scientific research carried out in 20022006 [3-5] it was found that from 40 to 69% of the population in contaminated areas feel fear, haunting memories, compulsive thoughts and feelings because of the Chornobyl accident. Meanwhile, 51.5-55.6% of healthy people feel fear, anxiety, irritation, insomnia.
Public opinion poll conducted by the Institute of Sociology in 1997 (ten years after the accident) showed that 20% of suffered after Chornobyl accident were still in a state of social and psychological maladjustment, "Chornobyl destroyed my life".
САМООЦ1НКА ЗДОРОВ'Я НАСЕЛЕННЯ УКРА1НИ ВНАСЛ1ДОК ЧОРНОБИЛЬСЬКОI КАТАСТРОФИ У П1ЗН1Й ФАЗ1АВАР11
Власюк Н.В., Тарасюк O.G., Антомонов М.Ю.
ДУ «1нститут громадського здоров'я iM. О.М. Марзеева НАМН Укра/ни», м. Ки/в Мета: виконати науковий анал'\з отриманих даних ндивдуального опитування населення Укра/ни та провести оцнку залежност самоощн-ки здоров'я респондент'1в вд оiзних фактооiв у пiзнiй фазi аварп на Чорнобильськй АЕС. Методи: аудиторне анкетування дтей та заочне анкетування /хшх батькв у Рiвненськiй, Житомирськй, Ки/вськй, Одеськй областях та м'ютах Ки/в i Славутич. Обробка результата виконувалася за допомогою стандартних про-грам Microsoft Office 2010. З використанням таб-лиць спряженост та коефiцiентiв кореляцп Пiосона i Спiомена проведено оцнку залежност самооцнки здоров'я опитаного населення Укра/ни вд оiзних фактооiв у пiзнiй фазi авари на Чорнобильськй АЕС.
Результати. За результатами анкетування сформовано базу даних, яка мстила 2918 коректно заповнених анкет; серед респонденш 64% стано-вили учн та студенти i, вдповдно, 36% - íхнi батьки. Виявлено достоврний зв'язокмжоiвнем здоров'я та статтю (%2 = 163,31; р<0,001) - б'льш'ють респондент'¡в чоловiчоí стат оцнюе свй стан здоров'я набагато краще на вдмну вд жночо/; м'ж
рiвнем здоров'я / рiвнем освти (г5 = 0,99; р<0,001), де значна частина респонденш з середньою освтою оцнюе свое здоров'я прше, нжопитан з вищою освтою; мiжрiвнем здоров'я та ощнкою рад'ацйного забруднення територп, на якй проживають опитан (г5 = 0,24; р<0,001); а також мж самооцнкою здоров'я респондент'1в залежно вд оцнки рад'ац/йного вм'юту у продуктах харчування, що вони споживають (%2 = 118,03; р<0,001). Таким чином, опитане населення Укра/ни, незалежно вд самооцнки здоров'я, переконане, що вони проживають на рад'1ацйно забрудненй територп, а продукти харчування, як вони споживають, мстять рад 'юнукл 'щи. Третина респонденш з «хорошою» та майже третина з «вдмнною» самооцнкою стану здоров'я переконана, що Чорнобильська авар '\я досить сильно впливае на Iхне здоров'я та здоров'я /хн'кблизь-ких, зв'язокдостов'рний (г5 = 0,33; р<0,001). Виявлено достов'рний зв'язок(%2 =25,31; р<0,001) мжсамоощнкою здоров'я населення Укра/ни / стурбован'ютю населення Укра/ни щодо актуаль-ност '¡снування Зони Вдчуження. Так вважають 91,52% респонденш, як оцнили свй стан здоров'я «погано», та 81,75% - «вдмнно».
Ключов! слова: Чорнобильська катастрофа, самооцнка здоров'я, рад!отривожн!сть, анкетування, пiзня фаза аварп, достов'рний зв'язок.
© ВласюкН.В., Тарасюк О.€., Антомонов М.Ю. СТАТТЯ, 2016.
41 Environment & Health №4 2016
Especially women and rural residents consider that they are "the victims of the accident". Youth is characterized by their optimism, self-reliance, and economic initiative [6].
The objective was to perform scientific analysis of received data from questionnaire survey of Ukrainian population and to estimate dependence of self-assessment of respondents' health on different factors at the late phase after the Chornobyl accident.
Subject of inquiry: secondary school pupils (16-18 years), students and their parents in different regions of Ukraine.
Research methods. Data collection was carried out using specially designed questionnaire which was offered for young people and their parents. Questioning
was conducted among respondents in Rivne, Zhytomyr, Kyiv, Odesa regions, also in Kyiv city and Slavutych town. Forming of the database and results preprocessing was performed using standard programs in Microsoft Office 2010. According to the survey results obtained database contains 2918 correctly completed questionnaires; 36% of respondents were parents, 64% — schoolchildren and students.
Individual questionnaire contained six sections: general information, health status, nutrition, effects of the Chornobyl accident and safe operation of nuclear power plants, radiation and risk.
Using contingency tables, Pearson and Spearman correlation coefficients (to test the association between two variables), we assessed depending of health
Table 1
Health self-assessment differed by the sex of the respondent
Sex Health status
excellent good satisfactory bad very bad Totals
male 170 500 308 33 5 1016
Column, % 62.04% 40.00% 25.60% 20.00% 31.25%
Row, % 16.73% 49.21% 30.31% 3.25% 0.49%
Total, % 5.85% 17.19% 10.59% 1.13% 0.17% 34.94%
female 104 750 895 132 11 1892
Column, % 37.96% 60.00% 74.40% 80.00% 68.75%
Row, % 5.50% 39.64% 47.30% 6.98% 0.58%
Total, % 3.58% 25.79% 30.78% 4.54% 0.38% 65.06%
Totals 274 1250 1203 165 16 2908
Total, % 9.42% 42.98% 41.37% 5.67% 0.55% 100.00%
Health self-assessment differed by the education of respondents
Education level Health status
excellent good satisfactory bad very bad Totals
secondary 145 506 300 38 6 995
Column, % 52.92% 40.48% 24.94% 23.17% 37.50%
Row, % 14.57% 50.85% 30.15% 3.82% 0.60%
Total, % 4.99% 17.41% 10.32% 1.31% 0.21% 34.23%
secondary specialized 6 81 242 49 5 383
Column, % 2.19% 6.48% 20.12% 29.88% 31.25%
Row, % 1.57% 21.15% 63.19% 12.79% 1.31%
Total, % 0.21% 2.79% 8.32% 1.69% 0.17% 13.18%
higher, incomplete higher 123 663 661 77 5 1529
Column, % 44.89% 53.04% 54.95% 46.95% 31.25%
Row, % 8.04% 43.36% 43.23% 5.04% 0.33%
Total, % 4.23% 22.81% 22.74% 2.65% 0.17% 52.60%
Totals 274 1250 1203 164 16 2907
Total, % 9.43% 43.00% 41.38% 5.64% 0.55% 100.00%
self-assessment in Ukrainian surveyed population from different factors in the late phase of the Chornobyl accident.
Main results of the study. Responses concerning health self-assessment differed by the sex of the respondent. Study results are shown in table 1.
This shows that most of the males (62.04%) rated their health status as "excellent", when 68.75% of women respondents rated it as "very bad". The relationship between the health level and sex in our study was significant (x2= 163.31, p<0.001).
It is known that education level can influence on health self-assessment [7], so we analyzed the results of our survey to test the hypothesis. The results of this analysis are presented in table 2.
Table 2 shows that 44.89%, 53.04% and 54.95% of respondents with higher education assessed their health respectively as excellent, good and satisfactory. Among those who have secondary education the most respondents assessed their health as bad or very bad (60.67%).
In general, according to the results of our survey the relationship between the level of health and education level was significant (rS = 0.99; p<0.001).
According to the results presented in table 3, we analyzed the dependence of health self-assessment and evaluation of radiation contamination in which respondents live.
Data from table 3 show that respondents who rated their health as "bad" (43.03%) and "very bad" (37.50%) believe that they live in the contaminated area. However, 16.36% and 12.50% of respondents who similarly rated their health convinced that the area where they live is "very contaminated". And besides, attention is drawn to the fact that significant proportion of respondents who assessed their health as "excellent" (11.31%) and "good" (25.12%) are concerned about this issue too and also consider the territory of their residence as "radioactive contaminated".
The relationship between the health level and assessment of radiation contamination where respondents reside is statistically significant (rS = 0.24; p<0.001).
Table 4 presents the results of subjective assessment of radia-
№ 4 2016 Environment & Health 42
Table 2 level
САМООЦЕНКА ЗДОРОВЬЯ НАСЕЛЕНИЯ УКРАИНЫ ВСЛЕДСТВИЕ ЧЕРНОБЫЛЬСКОЙ КАТАСТРОФЫ В ПОЗДНЕЙ ФАЗЕ АВАРИИ Власюк Н.В., Тарасюк О.Е., Антомонов М.Ю.
ГУ «Институт общественного здоровья им. А.Н. Марзеева НАМН Украины», г. Киев
Цель: выполнить научный анализ полученных данных индивидуального опроса населения Украины и провести оценку зависимости самооценки здоровья респондентов от различных факторов в поздней фазе аварии на Чернобыльской АЭС. Методы: аудиторное анкетирование детей и заочное анкетирование их родителей в Ровенской, Житомирской, Киевской, Одесской областях и городах Киев и Славутич. Обработка результатов выполнялась с помощью стандартных программ Microsoft Office 2010. С использованием таблиц сопряженности и коэффициентов корреляции Пирсона и Спирмена проведена оценка зависимости самооценки здоровья опрошенного населения Украины от различных факторов в поздней фазе аварии на Чернобыльской АЭС. Результаты. По результатам анкетирования сформирована база данных, которая содержала 2918 корректно заполненных анкет; среди респондентов 64% составляли учащиеся и студенты и, соответственно, 36% — их родители. Выявлена достоверная связь между уровнем здоровья и полом (х2 = 163,31; р<0,001) - большинство респондентов мужского пола оценивает свое состояние здоровья гораздо лучше в отличие от женского; между уров-
нем здоровья и уровнем образования (г3 = 0,99; р<0,001), где значительная часть респондентов со средним образованием оценивает свое здоровье хуже, чем опрошенные с высшим образованием; между уровнем здоровья и оценкой радиационного загрязнения территории, на которой проживают опрошенные (г3 = 0,24; р<0,001); а также между самооценкой здоровья респондентов в зависимости от оценки содержания радионуклидов в продуктах питания, которые они потребляют (х2 = 118,03; р<0,001). Таким образом, опрошенное население Украины, независимо от самооценки здоровья, убеждено, что они проживают на радиа-ционно загрязненной территории, а продукты питания, которые они потребляют, содержат радионуклиды. Треть респондентов с «хорошей» и почти треть с «отличной» самооценкой состояния здоровья убеждены, что Чернобыльская авария достаточно сильно влияет на их здоровье и здоровье их близких, связь достоверная (г3 = 0,33; р<0,001). Обнаружена достоверная связь (х2 = 25,31; р<0,001) между самооценкой здоровья населения Украины и обеспокоенностью населения Украины относительно актуальности существования Зоны отчуждения. Так считают 91,52% респондентов, оценивших свое здоровье «плохо», и 81,75% — «отлично». Ключевые слова: Чернобыльская катастрофа, самооценка здоровья, радиотревожность, анкетирование, поздняя фаза аварии, достоверная связь.
tion content in consumed food products and health self-assessment of respondents.
From presented in table 4 resulting data it is clear that without regard to respondents' health self-assessment, all of them believe that consumed food products contain radionuclides. It is the common opinion of the majority of respondents with "bad" (70.91%) and "very bad" (50.00%) feeling; respondents with "good" and "excellent" feeling think in a similar way (46.64% and 36.76% respectively). The result of our study was significant (X2= 118.03, p<0.001).
Study results show respondents' subjective assessment of the Chjrnobyl accident on their health and the health of their family members'. These results are presented in table 5.
Table data show that 31.71% of respondents with "good" and 24.74% with "excellent" health self-assessment are convinced that Chornobyl accident is quite affects on their health and the health of their family members. It should be noted that among respondents with "bad" and "very bad" health self-assessment there are very small percentage (1.66% and 0.55%) of people who believe that Chornobyl accident does not affect on health (their and their family members') at all.
The relationship between level of health self-assessment and respondents' subjective evaluation of impact of Chornobyl acci-
dent on their health and the health of their family members' is significant (rS = 0.33; p<0.001). Also, according to survey
Table 3
Estimation of radioactive contamination of the territory where respondents live differed by health self-assessment
Contamination of the territory Health status
excellent good satisfactory bad very bad Totals
very clean 25 22 13 1 3 64
Column, % 9.12% 1.76% 1.08% 0.61% 18.75%
Row, % 39.06% 34.38% 20.31% 1.56% 4.69%
Total, % 0.86% 0.76% 0.45% 0.03% 0.10% 2.20%
almost clean 80 242 101 11 1 435
Column, % 29.20% 19.36% 8.41% 6.67% 6.25%
Row, % 18.39% 55.63% 23.22% 2.53% 0.23%
Total, % 2.75% 8.33% 3.48% 0.38% 0.03% 14.97%
satisfactory 123 635 647 55 4 1464
Column, % 44.89% 50.80% 53.87% 33.33% 25.00%
Row, % 8.40% 43.37% 44.19% 3.76% 0.27%
Total, % 4.23% 21.85% 22.26% 1.89% 0.14% 50.38%
quite dirty 31 314 374 71 6 796
Column, % 11.31% 25.12% 31.14% 43.03% 37.50%
Row, % 3.89% 39.45% 46.98% 8.92% 0.75%
Total, % 1.07% 10.81% 12.87% 2.44% 0.21% 27.39%
very dirty 15 37 66 27 2 147
Column, % 5.47% 2.96% 5.50% 16.36% 12.50%
Row, % 10.20% 25.17% 44.90% 18.37% 1.36%
Total, % 0.52% 1.27% 2.27% 0.93% 0.07% 5.06%
Totals 274 1250 1201 165 16 2906
Total, % 9.43% 43.01% 41.33% 5.68% 0.55% 100%
43 Environment & Health №4 2016
results Ukrainian population regardless of health self-assessment consider that the most important result of the accident is the existence of the Exclusion Zone for today. Relevant results are shown in table 6.
Results in table 6 show that respondents who rated the state of health as "bad" (91.52%) consider the existence of the Exclusion as an important consequence of the Chornobyl accident; high percentage of respon-
Table 4
Health self-assessment differed by assessment of radiation content in consumed food products
Food Health status
contamination excellent good satisfactory bad very bad Totals
yes 100 583 680 117 8 1488
Column, % 36.76% 46.64% 56.62% 70.91% 50.00%
Row, % 6.72% 39.18% 45.70% 7.86% 0.54%
Total, % 3.44% 20.08% 23.42% 4.03% 0.28% 51.24%
no 81 225 123 7 3 439
Column, % 29.78% 18.00% 10.24% 4.24% 18.75%
Row, % 18.45% 51.25% 28.02% 1.59% 0.68%
Total, % 2.79% 7.75% 4.24% 0.24% 0.10% 15.12%
don't know 91 442 398 41 5 977
Column % 33.46% 35.36% 33.14% 24.85% 31.25%
Row, % 9.31% 45.24% 40.74% 4.20% 0.51%
Total, % 3.13% 15.22% 13.71% 1.41% 0.17% 33.64%
Totals 272 1250 1201 165 16 2904
Total, % 9.37% 43.04% 41.36% 5.68% 0.55% 100%
Table 5 The relationship between respondents' subjective assessment of Chornobyl accident influence on health (their and their family members') and health self-assessment
Influence of Chornobyl accident on health Health status
excellent good satisfactory bad very bad Totals
not at all 94 184 76 6 2 362
Column, % 34.56% 14.78% 6.35% 3.64% 12.50%
Row, % 25.97% 50.83% 20.99% 1.66% 0.55%
Total, % 3.25% 6.36% 2.63% 0.21% 0.07% 12.51%
very little 78 353 166 14 1 612
Column, % 28.68% 28.35% 13.88% 8.48% 6.25%
Row, % 12.75% 57.68% 27.12% 2.29% 0.16%
Total, % 2.70% 12.20% 5.74% 0.48% 0.03% 21.15%
some extent 83 567 732 66 6 1454
Column, % 30.51% 45.54% 61.20% 40.00% 37.50%
Row, % 5.71% 39.00% 50.34% 4.54% 0.41%
Total, % 2.87% 19.59% 25.29% 2.28% 0.21% 50.24%
strong enough 14 117 181 55 2 369
Column, % 5.15% 9.40% 15.13% 33.33% 12.50%
Row, % 3.79% 31.71% 49.05% 14.91% 0.54%
Total, % 0.48% 4.04% 6.25% 1.90% 0.07% 12.75%
very much 3 24 41 24 5 97
Column, % 1.10% 1.93% 3.43% 14.55% 31.25%
Row, % 3.09% 24.74% 42.27% 24.74% 5.15%
Total, % 0.10% 0.83% 1.42% 0.83% 0.17% 3.35%
Totals 272 1245 1196 165 16 2894
Total, % 9.40% 43.02% 41.33% 5.70% 0.55% 100%
dents with self-assessment "excellent" (81.75%) has the same point of view.
According to our survey it was confirmed a statistically significant relationship between health self-assessment and anxiety due to existence of the Exclusion Zone as legacy of accident on Chornobyl NPP (x2 = 25.31, p<0.001). This is one more evidence which proves that the education concerning radiation factor is failed in our country. In fact, at present according Likhtarov I.A. "...as of 2015, approximately 60% of the 30-kilometer zone have no radiological contraindication even to people re-evacuation. Moreover, there are no contraindications in making meat and dairy production in the area. This is based on titanic databases of environmental data from professionals working in the Administration of the Exclusion Zone" [8].
Conclusions
It was found statistically significant relationship (x2= 163.31; p<0.001) between health level and sex; the most male respondents assess their health status more positively, unlike women.
Health self-assessment and educational level are strongly associated (rS = 0.99; p<0.001). Much of the respondents with secondary education estimate their health worse than respondents with higher education.
Statistically significant relationship was identified between health self-assessment and evaluation of radiation contamination of territory where respondents live (rS= 0.24; p<0.001); and also between health self-assessment and assessment of radiation content in consumed food products (x2 = 118.03; p<0.001). So regardless of health self-assessment surveyed Ukrainian population believe that they live on radiation contamination territories and consume food with radionu-clides.
Analysis of health self-assessment and respondents' subjective assessment of Chornobyl accident influence on health (their and their family members') found that one third of respondents with "good" and almost one third with "excellent" health self-assessment are confident of strong affects on their health and the health of their family members from Chornobyl, significant relationship (rS = 0.33; p<0.001). It was identified significant rela-
№ 4 2016 Environment & Health 44
tionship (x2 = 25.31; р<0.001) between health self-assessment of Ukrainian people and existence of the Exclusion Zone as legacy of accident on Chornobyl NPP; 91.52% of respondents with assessment "bad" and 81.75% with assessment "excellent" consider in such way.
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Table 6
The relationship between health self-assessment and existence of the Exclusion Zone as legacy of accident on Chornobyl NPP
Existence of the Exclusion Zone Health status
excellent good satisfactory bad very bad Totals
yes 224 1088 1091 151 16 2570
Column, % 81.75% 86.83% 90.69% 91.52% 100%
Row, % 8.72% 42.33% 42.45% 5.88% 0.62%
Total, % 7.69% 37.38% 37.48% 5.19% 0.55% 88.29%
no 50 165 112 14 0.00% 341
Column, % 18.25% 13.17% 9.31% 8.48% 0.00%
Row, % 14.66% 48.39% 32.84% 4.11% 0.00%
Total, % 1.72% 5.67% 3.85% 0.48% 0.00% 11.71%
Totals 274 1253 1203 165 16 2911
Total, % 9.41% 43.04% 41.33% 5.67% 0.55% 100%
kontseptsiia, model, tekhnologii : diss. ... doktora psikhologich-eskikh nauk [Information-and-Psychological Safety of the Population under Conditions of Radiation Effect Risk: Conception, Model, Technology : Doctor of Sciences (Psychology) Thesis]. Sankt Petersburg ; 2009 : 429 p. (in Russian).
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Hagitiwno go pegaK^'i 16.08.2016
45 Environment & Health №4 2016
