We plan to expand a completed pilot study that evaluated the prevalence of thyroid abnormalities in relation to childhood exposure to atmospheric emissions of radioactive iodines from the Mayak Nuclear Weapons Plant in Ozyorsk, Russia. The pilot study population was composed of a defined cohort of approximately 900 Ozyorsk residents who were born between January 1, 1952 and December 31, 1953. The exposed population was comprised of persons who lived in Ozyorsk during the years of heavy atmospheric releases (1952-1953). Members of the nonexposed group moved to Ozyorsk between 1967 and 1991, i.e. when there were almost no radioactive releases. Results from the pilot study suggest an elevated prevalence of thyroid nodules in the exposed population. Given the positive results from the pilot study and the US Department of Energy's (DOE) decision to fund a dose reconstruction project for the Ozyorsk population, we intend to expand the study to include an additional 350 people born and living in Ozyorsk between 1954 and 1955, i.e. exposed to moderate levels of radiation .
Methods similar to those used in the pilot study will be used in the expanded study. Members of the study population will be invited to participate in a special thyroid screening protocol when they come for their annual routine medical examination at the Ozyorsk automated dispensary system (ASDOC). The thyroid gland will be clinically examined by two ASDOC physicians specifically trained in thyroid palpation. Thyroid abnormalities will be detected based on physical examinations, assessment of TSH levels, and ultrasound imaging. Biochemical laboratory tests, including Free T(4), and anti-thyroperoxidase antibodies will be assayed as necessary. Patients will be sent to a consulting endocrinologist if the palpation, ultrasound or laboratory findings suggest a thyroid disorder. Fine needle aspiration (FNA) biopsy will be performed when a tumor is suspected. Although the FNA will not be done as part of the study research, but rather as part of the regular Ozyorsk medical system, the results will be given to the study staff to help make diagnostic decisions. Patients with complicated thyroid disease will be referred to an experienced consulting thyroid specialist. Patients with diagnosed thyroid disease will be treated within the regular medical system in Ozyorsk.