Radioactivity in the environment chapter 14 the legacies of soviet nuclear testing in kazakhstan fallout, public health and societal issues

Radioactivity in the environment chapter 14 the legacies of soviet nuclear testing in kazakhstan fallout, public health and societal issues Radioactivity in the environment chapter 14 the legacies of soviet nuclear testing in kazakhstan fallout, public health and societal issues Radioactivity in the environment chapter 14 the legacies of soviet nuclear testing in kazakhstan fallout, public health and societal issues Radioactivity in the environment chapter 14 the legacies of soviet nuclear testing in kazakhstan fallout, public health and societal issues

Radioactivity in the Environment, Volume 19

ISSN 1569-4860, http://dx.doi.org/10.1016/B978-0-08-045015-5.00014-9

The Legacies of Soviet Nuclear Testing in Kazakhstan

Fallout, Public Health and Societal Issues

Susanne Bauer * , a , Boris Gusev b , Tatyana Belikhina b , Timur Moldagaliev b , c , and Kazbek Apsalikov b

Chapter Outline

14.1 The Semipalatinsk

Nuclear Test Site 244

14.2 Research into Radiation

Effects of Nuclear

Testing Near

Semipalatinsk during

Soviet Time 245

14.3 Radiation Risk Research

in Kazakhstan during the Early Post-Soviet Years 248 14.4 Addressing Nuclear

Legacies in the New Economy of Kazakhstan 253 14.5 Conclusions 255

This chapter reports on the legacies of nuclear testing at the Semipalatinsk nuclear test site, Kazakhstan Drawing on selected on-going local studies, we discuss current frameworks and conditions for the documentation of fallout effects in Kazakhstan Research into the local health impact of nuclear fall-out in the populations living in adjacent areas has remained scarce for most nuclear test sites worldwide After 1991 the new independent states of the former Soviet Union implemented programs to address and document the impact of radiation exposures resulting from Soviet nuclear activities In the Chelyabinsk area, Southern Urals, there was considerable contamination

as a result of the Kyshtym accident in 1957 and due to the Mayak plutonium production (Burkart & Kellerer, 1994; Polikarpov & Aarkrog, 1993) The nuclear industries in Southern Urals have led not only to exposures among workers, but also to unprecedented internal exposures due to radioactive

a Goethe University Frankfurt, Department of Social Sciences, Frankfurt/Main, Germany

b Research Institute for Radiation Medicine and Ecology, Semei, Kazakhstan

c Semei Medical University, Kazakhstan

*Corresponding author: E-mail: bauer@soz.uni-frankfurt.de

discharges of the plant into the Techa river, which served as the water supply

to downstream villages

The development of the Soviet nuclear program after World War II involved uranium mining through the Wismut AG in East Germany From there, the uranium ores were transported to the Soviet Union and, in part, pro-cessed at the Mayak plutonium facilities in Southern Urals Nuclear warheads were developed in Arzamas-16 and prepared for nuclear testing at the two major test sites Semipalatinsk and Novaia Zemlia One end of this Cold War nuclear production chain was the Semipalatinsk polygon (test site) located

in the steppe areas of the Soviet Republic of Kazakhstan Even though the Central Asian steppe was sparsely populated, numerous settlements and a few smaller towns with 10,000s of inhabitants were within a few hundreds

of kilometers distance to the epicenters The population of Semipalatinsk

Sekerbaev, Rozenson, Tchaijunusova, & Apsalikov, 1998) Moreover, numer-ous summer and winter pastures of collective farms that had replaced the formerly nomadic livestock economies were located in the areas that were heavily exposed due to atmospheric nuclear testing between 1949 and 1962

In the early years after the dissolution of the Soviet Union, formerly classified information on nuclear issues became available for the first time In addition to

a veritable information boom in the public sphere, governments of the new inde-pendent states began to retrospectively estimate cumulative fallout doses of the populations in the exposed areas With the end of the Cold War division that had shaped nuclear science west and east of the iron curtain, much of this research was practiced in novel constellations of international cooperation and shifted to issues of management and mitigation of nuclear legacies Since there were differ-ent practices and assumptions of what counted as proof of exposure in post-Cold War radiation science, epidemiological risk assessments in particular were done

in different ways in Soviet and western traditions Epidemiology was not the only discipline involved in risk assessment, as a host of physical and biological meth-ods of dose reconstruction and biomarker measurement had evolved

The study of health effects of radiation takes place through large-scale epidemiological studies, including studies of medical and occupational expo-sures Largely however, this line of research has built on studies of the atomic bomb survivors in Hiroshima and Nagasaki The follow-up of the atomic bomb survivors was the largest epidemiological study at the time Its core aim was to derive quantitative radiation risk estimates and study the dose– response relationship of effects in this exposed population Since the late 1940s until the mid-1970s, these studies were conducted first by the Atomic Bomb Casualty Commission (ABCC) and then by the successor organiza-tion, the Radiation Effects Research Foundation (RERF) in Hiroshima In the 1950s and 1960s medical studies on the bomb survivors in Japan focused on genetic effects of radiation (Lindee, 1994) and later on increases in cancer

Vaeth, and Mabuchi (1996) These studies have become standard references for any investigation of radiation risk including those conducted on Soviet nuclear legacies after 1991 Moreover, current regulations and dose limits for occupational exposures are based largely on the results from the studies of atomic bomb survivors

When information on the nuclear facilities became accessible to inter-national research, western researchers hoped to complement and validate current risk estimates through epidemiological studies of the exposures in the Soviet Union Especially with regard to nonuniform exposures in the intermediate and low dose range, scientists emphasized the uncertainties of extrapolations from the high acute external exposures of the atomic bomb survivors to the lower doses Thus, the importance of “learning” from expo-sures in the Soviet Union was stressed, framing these projects as “unique opportunities” for radiation biology (Burkart, 1996) Of particular interest

to radiation research were the exposures involving chronic internal expo-sures and thus different from Hiroshima and Nagasaki Largely with the rationale of improving current risk estimates and regulation, funding for collaborative research was made available by the European Union as well

as by the US National Institutes of Health, Japanese agencies, and as part of many bilateral agreements during the 1990s At first, international studies

of nuclear exposures in the Soviet Union concentrated on the health impact

of Chernobyl, before scientists also trained their attention to exposures due

to the Southern Urals nuclear facilities and the fallout from nuclear testing near Semipalatinsk

This chapter seeks to describe the current documentation efforts of the public health impact in contemporary Kazakhstan as well as post-Soviet miti-gation projects following the closing of the Semipalatinsk test site in 1991 While little information on radiation and health was openly available on the radiation exposures in the Soviet Union until the late 1980s, research into health effects took place since the 1950s in closed, military institutions, the Institute of Biophysics and related institutions in Southern Urals and in Semi-palatinsk Today’s Institute of Radiation Medicine and Ecology in Semei (formerly Semipalatinsk) is based on one of these institutes, the Dispanser

No 4, as the institute was called when founded in 1957, in charge of eco-logical and health monitoring in the areas surrounding the nuclear test site Focusing on research of the Institute of Radiation Medicine and Ecology,

we review studies on local health effects and describe the implementation of epidemiological research in Soviet and the early post-Soviet era as well as

in today’s Kazakhstan Rather than conducting a review of risk assessments,

we attend to the changing conditions of knowledge production in the Soviet and post-Soviet context Thus, this chapter provides an insight into current assessments of the long-term impacts, including societal issues and psycho-social effects and the local public health consequences of radiation exposure

in the past

14.1 THE SEMIPALATINSK NUCLEAR TEST SITE

Construction works for the first nuclear test site began after a Decree of the Council of Ministers of 19 June 1947 On the northeastern end of the future test site in the central Asian steppe areas west of Semipalatinsk, a closed nuclear weapons research city was built It was named Kurchatov, after the Soviet atomic physicist and engineer; in command of Stalins’s atomic bomb project was the chief of the secret police Lavrentii Beria (Gordin, 2009) The town of Kurchatov did not appear on maps except for a train station named “konechnaia”

west of the city of Semipalatinsk (now: Semei), situated in the northeastern part of Kazakhstan, bordering the Altai region, the Mongolian Republic, and China More than 110 atmospheric and 340 underground tests were conducted near Semipalatinsk between 1949 and 1989 (Iakubovskaia, Nagibin, & Suslin,

1998; Mikhailov et al., 1996; Grosche 2002) A total of 715 Soviet nuclear tests were carried out between 1949 and 1990, with 456 and 130 near Semipalatinsk and on Novaia Zemlia, respectively1 In addition to the nuclear tests at the two test sites, 129 nuclear detonations took place outside these test sites—in the Russian Federation (91), in Kazakhstan (33), in Ukraine (2), in Uzbekistan (2), and in Turkmenistan (1) (Mikhailov et al., 1996) Some of these nuclear explosions were conducted for nonmilitary purposes, for instance for construction and the planned large-scale irrigation projects

The first nuclear device, an above ground fission bomb that was exploded on August 28, 1949, resulted in fallout northeast of the Semipalatinsk test site Due

to weather conditions prevailing at the time of the explosions, among the admin-istrative regions adjacent to test site, the Semipalatinsk and Ust-Kamenogorsk regions of the Kazakh Soviet Republic were affected most Fallout also extended to the southwestern parts of the Altai region, an administrative unit, now part of the Russian Federation, located north-east at approximately 200 km from the borders of the test site.2 Atmospheric nuclear tests conducted from

1949 until 1963 caused considerable radiation exposures in the proximity of the test site In particular, the explosions in 1949, 1951, 1953, 1956, and 1962 contributed major fractions of the cumulative radiation dose in villages adja-cent to the test site (Bauer, Gusev, Pivina, Apsalikov, & Grosche, 2005; Gusev,

1 At the second nuclear test site on Novaia Zemlia atmospheric nuclear tests were conducted between 1955 and 1962, with the most contaminating nuclear detonation on September 7, 1957 resulting in exposure of reindeer herds and consumers of reindeer meat (Burkart et al., 1999; UNSCEAR, 2000).

2 In the early 1990s the Russian Ministry of Emergency Situations set up a Federal Program

“Semipalatinsk Test Site/Altai” The program included the compilation of health data and dose reconstruction as well as a registry of the rural population of Altai region settlements (Shoikhet, Kiselev, Algazin, et al., 2002; Shoikhet, Kiselev, Loborev, et al., 2002; Shapiro, Kiselev, & Zaitsev, 1998; Shoikhet et al., 1999) These exposures northeast of the Kazakhstan territory were largely due

to fallout from the first Soviet nuclear test in 1949.

Rozenson, & Abylkassimova, 1998; Gusev, Sekerbaev, et al., 1998) The first Soviet thermonuclear bomb (yield: 400 kt TNT equivalent) of August 12, 1953 was the only time when a part of the downwind settlements were evacuated to other nearby areas, a measure that did not prevent exposure After a preliminary moratorium on atmospheric nuclear tests of 1963, underground testing contin-ued through 1989, with the last explosion carried out on October 17th, 1989 (Mikhailov et al., 1996) Several underground explosions resulted in craters, e.g those on January 15 and October 14, 1965, and also produced a radioactive cloud and near-surface contamination (Izrael et al., 2000)

The nuclear test site was officially closed by Decree of president Nursultan Nazarbaev on August 29, 1991, 42 years after the first Soviet atomic bomb test The scientific institutes in Kurchatov on the former test site, with several research reactors, were integrated into a reorganized National Nuclear Center that has continued operations now focusing on nuclear energy, nuclear tech-nologies, radiological monitoring, and risk assessment

14.2 RESEARCH INTO RADIATION EFFECTS OF NUCLEAR TESTING NEAR SEMIPALATINSK DURING SOVIET TIME

While there was secrecy around the nuclear program and radiation risks, epidemiological research in the Soviet Republic of Kazakhstan was con-ducted mostly by the “Dispanser No 4”, a medical research unit in Semi-palatinsk that reported to the Institute of Biophysics Yet, the first biomedical investigation of health effects was carried out by the Institute for Regional Pathology through what was later referred to as “Balmukhanov-Atchabarov

carried out between 1956 and 1960 after an “unknown intoxication” had been reported in cattle of the “Thelmann Kolkhoz” located close to the epicenter of

beta-activity in soil, plants, and food products, veterinary examination of livestock animals as well as a comparative medical survey of the health status of the populations in rural areas in the Almaty, Karaganda, and Semipalatinsk regions While in the Alma-Ata region, levels of radiation were found within the range of background values, the situation was different in the Abaiski dis-trict of the Semipalatinsk region Here, radiation levels in soil samples were reported to substantially exceed the Soviet dose limits of 10−7 Ci/kg Further, this early expedition found pathological organ alterations in sheep and goats

in areas close to the test site (Academy of Sciences of the Soviet Republic of Kazakhstan, 1958)

The medical part of the study was aimed at a description of the charac-teristics of regional pathology in terms of disease prevalence The physicians examined 1635 people aged 4–90 years in five districts of the Semipalatinsk and Almaty regions The report for the population of the Semipalatinsk region

showed high prevalence of hematological alterations and a range of vegeta-tive disorders, disorders of the gastrointestinal tract and respiratory system (Academy of Sciences of the Soviet Republic of Kazakhstan, 1958) These conditions were described as mass phenomena, found in healthy individu-als, and also among young people The report’s authors came to the con-clusion, after ruling out brucellosis, helminthosis, or vitamin C deficiency

as causes for the observed differences between the areas, that the observed

of the Soviet Republic of Kazakhstan, 1958) The report remained classified and Soviet authorities did not support the report’s conclusions (Balmukhanov

et al., 2002)

In 1957 the Dispanser No 4—a specialized center for the study of radiation effects—was opened in Semipalatinsk (Nugent, Zhumadilov, Gusev, & Hoshi,

specialized in oncology and radiation medicine Its main tasks included radiation monitoring, assessment of the health impact due to fallout, and medical

follow-up of the population living in areas affected by fallout From 1962, staff at the Dispanser No 4 comprised 120 employees, including 42 medical doctors and nurses In addition to the clinical sections of a ward with 20 beds, physicians car-ried out regular examinations in eight districts of the Semipalatinsk region At the time, this work was classified “top secret” and any contact with the military insti-tutions and research on the test site were strictly prohibited Thus, these activi-ties of health monitoring were completely separated from the military activiactivi-ties

of measuring radiation doses throughout the 1960s and 1970s Focusing on the study of medical effects, the institute broadened its research activities in radiation biology, cytogenetics, and medical follow-up during the 1970s A first internal report compiled in 1981 compared the highly exposed population (determined

by age at exposure) of six heavily exposed settlements (Sarzhal, Kainar, Karaul, Dolon, Kanonerka, Mostik) (5600 persons) with the remaining residents of these settlements (12,000), reporting increased solid cancer rates in the highly exposed group

It was only with the late 1980s that more information became available An interdepartmental commission was set up by the Soviet Ministry of Health in 1989

to address public concerns regarding the impact of radiation exposures This study provided epidemiological documentation for exposed settlements and measured radioactive strontium and cesium in soil samples collected in areas downwind of the test site It also reported cytogenetic studies of chromosome aberrations among three groups—people living in settlements close to the test site, students at the Medical Academy who had recently moved to the area, and students and faculty born in Semipalatinsk These cytogenetic examinations carried out at the Institute

of Medical Radiology, Obninsk confirmed increased frequencies of aberrations in villages near the test site (Sevan’kaev et al., 1995) These results, together with other early reports of increased rates of cancer and congenital malformations, played an important role in negotiations about further research and compensation

programs.3 Radiation measurements in soil confirmed the presence of alpha-emitters The commission’s report was finalized during Soviet time and recognized that in particular the 1949 and 1953 nuclear tests resulted in considerable contamination due to fallout in areas of Kazakhstan and in the Altai region and that external doses

to the adjacent population exceeded Soviet radiation safety limits (Balmukhanov

et al., 2002) All these findings would lend support to calls by the government of Kazakhstan for international assistance in the management of nuclear legacies Researchers from the Soviet Centre for Oncology of the Medical Academy and the Soviet Health Ministry published a descriptive study of the incidence of malignant tumors in the Semipalatinsk region in 1991 (Bul’bulian & Tokareva,

1991) They compared age-standardized incidence rates by administrative units, according to official records to general rates of the Soviet Union and the Soviet Republic of Kazakhstan between 1959 and 1988 Age-specific incidence rates

of malignant tumors were found higher in the Semipalatinsk region than in the Soviet Union or Kazakhstan as a whole, mainly due to oesophageal cancer Incidence rates of malignant tumors in the lymphatic and hematopoietic system were lower in the Semipalatinsk region in the 1960s and 70s, but reached the level of the Soviet Union and exceeded Kazakhstan levels in the mid-1980s The observed general increase of malignant neoplasms in the general popula-tion was considered to be partly due to improvement of cancer diagnostics and registration standards (Bul’bulian/Tokareva, 1991)

A study of childhood cancer incidence in the administrative regions border-ing the test site was conducted by Zaridze, Li, Men, and Duffy (1994) Scientists collected documentation of cancer cases of children aged up to 14 years between

1981 and 1990 from all hospitals in the three regions (Semipalatinsk, Pavlodar, and Karaganda), using census data of 1979 and 1989 as a reference Statistical tests were conducted for association between incidence and distance to the epicenter of nuclear tests (air and underground test sites, atomic lake) A significant inverse trend with distance to test epicenter was shown for acute leukemia and for all cancers com-bined Using distance to the test site as exposure proxy, rates of childhood cancer were found increased closer to the test sites in the Semipalatinsk and (former) East Kazakhstan regions Yet, some regional variations in the Pavlodar and Karaganda regions, especially for leukemia incidence could not be explained by distance to the test site Here, Zaridze et al (1994) discussed an influence of urban/rural status, exposure to chemical carcinogens from Karaganda industrial plants and other factors Public debates over radiation risk due to fallout in the late 1980s were fol-lowed by a veritable information boom after the closure of the nuclear test site

in 1991 and numerous calls to assess the public health impact Despite the amount of health research conducted over the decades and first attempts to link exposure and disease data, securing epidemiological proof for radiation effects

3 Increased cancer mortality rates (by 40%) were reported in Sarzhal and Kainar when compared

to Kokpekty, an area with minimal exposure (Balmukhanov et al., 2002).

remained a challenging task for researchers in Kazakhstan, in particular given the lack of infrastructure and resources for research during the immediate post-Soviet years as well as the inconsistency of information and the difficulties in obtaining to primary documents for dosimetry

14.3 RADIATION RISK RESEARCH IN KAZAKHSTAN DURING THE EARLY POST-SOVIET YEARS

According to the 1949 census, 1.5 millions of inhabitants were living in the administrative regions adjacent to the territory of the test site at the time of atmo-spheric nuclear testing Delineating the areas of exposure after decades of nuclear exposure and reconstructing doses posed challenges: The exposure depended on weather conditions, wind directions that formed the trajectories of the radioactive cloud as well as on radionuclide deposition, shielding, season, and accumula-tion in the food chain During Soviet time, estimates of effective doses to the population had been reported in classified internal reports of the Institutes of Biophysics (Stepanenko et al., 2011) In the open literature, the first publication that gave dose estimates (Tsyb et al., 1990) estimated maximal effective doses at 1.6 Sv in Dolon, the settlement with highest exposure in 1949 Most of the early dose reconstructions were based on measurements of gamma–radiation that the military conducted during and after each nuclear test, or on measurements of soil samples conducted that now could be used as additional data for dose estimation For decades, these data had also been kept separate from the health studies done by the physicians and their reports to the authorities in Moscow Apart from descriptive comparisons by exposure status or area, epidemiological link-age of dose estimates and disease rates had not been possible until the 1990s When the test site was closed, however, much of the primary information includ-ing military data were transferred to the Central Physical Technical Institute in Sergiev-Posad near Moscow and access to primary data for dose reconstruction was limited for scientists in Kazakhstan (Balmukhanov et al., 2002)

The staff of the Dispanser No 4 (now Institute of Radiation Medicine and Ecology) conducted a first exposure mapping in 1991, using soil samples col-lected in the 1960s and measured for residual radionuclides As identified by the interdepartmental commission’s study, administrative districts were assigned to radiation risk zones based on information on two major dose-contributing

et al., 1998) Aimed at a first estimation of the exposed population numbers— relevant for social and public health programs in the Semipalatinsk region—three district-based exposure zones4 were defined (Gusev, Sekerbaev, et al., 1998)

4 After administrative reforms in 1997, the Semipalatinsk region became part of the East Kazakhstan

oblast’ with the center Ust-Kamenogorsk Here, we refer to exposed territories and demographic

data of the former Semipalatinskaia oblast’ divided into 15 administrative districts (raiony).

This assessment ranked the population of the Abaiskii, Abralinskii, Zhana-Semeiskii, and Beskaragaiskii districts (situated closest (40–100 km) to the test site) at highest risk, followed by the districts situated at 150–250 km to the test site as “zones of intermediate exposure” and districts situated at distances of 250–800 km from the testing area as exposed to low or negligible doses The first definitions of three zones of radiation risk were carried out in order to plan further research and develop a compensation policy

The radiation risk zoning was also used to estimate the number of exposed people: According to the first mapping of “radiation risk zones” of the Semipal-atinsk region, among a total population of 294,000 in 1949, 46,000 people lived

in high exposure districts 159,000 people lived in areas with intermediate expo-sure levels and 89,000 people in districts with low radiation expoexpo-sure (Gusev, Rozenson, et al., 1998; Gusev, Sekerbaev, et al., 1998; Rakhypbekov et al., 1999;

Nugent et al., 2000) In the late 1950s and early 1960s, the population of the Semipalatinsk region increased due to immigration from bordering territories of China and relocations from other regions of the former USSR to Kazakhstan, in particular with Khruchchev’s agricultural reform that set out to cultivate large steppe areas of central Asia through irrigation By the end of 1962, the total population of the Semipalatinsk regions had increased to 471,500, with radia-tion exposures depending on age at exposure and, for migrants to these areas, on the time of their relocation While most high exposure areas were located in the Semipalatinsk region, areas in the Ust-Kamenogorsk region (now merged into the East Kazakhstan region) needed to be considered as well

It was this first risk zoning that also entered the “Law on the Social Protection

of the Citizens and Victims of the Semipalatinsk Nuclear Test Site” issued in 1992 (Iakubovskaia et al., 1998; Nugent et al., 2000) The law introduced four expo-sure groups (with estimated dose ranges of >1 Sv, 350 mSv–1 Sv, 70–350 mSv, 1–70 mSv), each of which were assigned different levels of compensation and benefits The latter allotted small direct payments (depending on exposure category and calculated by a coefficient related to the minimum social welfare), additional paid holidays and retirement at younger age as well as free medical treatment and rehabilitation if indicated The implementation of the program was postponed throughout the 1990s and amended by additional regulations As a later result however, people living in exposed areas could demand information on their exposure status as well as claim respective medical care and rehabilitation in case

of a radiation-induced disease (such as cancer, thyroid disease, diseases of the hematological system, cardiovascular disease, and congenital malformations).5

A retrospective cancer-incidence study compared an exposed area consisting

of eight exposed villages and five nonexposed villages of a comparison area in

5 Decree No 34 “On the approval of the list of diseases associated with exposure to ionizing radiation and rules to establish causal relations between disease and exposure to ionizing radiation” Government of the Republic of Kazakhstan (13 Jan 2004).

the Kokpektinskii district using five year cumulative incidence information of the period from 1949 to 1990 (Gusev, Rozenson, et al., 1998; Gusev, Sekerbaev,

et al., 1998) These cross-sectional comparisons describe the temporal devel-opment of solid cancer incidence and found a marked increase in cancer rates

in the exposed areas at 20 and 40 years after exposure The study described the shifts in proportions of the different cancer localizations, using a multiple cross-sectional design with inclusion of young age groups at each 5-year inter-val The differences between groups were significant for esophagus cancers and for stomach and liver cancers combined Until 1970, esophagus was the most frequent cancer site with declining rates from the 1970s onward, whereas the incidence of stomach and liver cancers increased over time The second peak of excess cancer rates was mainly related to high rates of lung, breast and thyroid carcinoma (Gusev, Rozenson, et al., 1998; Gusev, Sekerbaev, et al., 1998) While such local studies both in Kazakhstan as well as in the Altai region focused on cancer patterns in the population at a descriptive level, standard approaches of western cancer epidemiology aim at analytical studies, using individual-level instead of area data to avoid aggregation bias that epidemiologists termed “eco-logical fallacy” One of the challenges for western epidemiologists working with these data was that they did not fit their standard formats of cohort designs with a person-years approach or of case–control studies

After the independence of the Kazakhstan Republic and the official clo-sure of the test site, the Kazakhstan government asked for assistance in the assessment and management of its nuclear legacies The UN General Assembly adopted a resolution on Semipalatinsk at its 52nd session in December 1997, asking for the support the international community in the assessment of the economic, ecological, and humanitarian consequences of nuclear testing in this region In 1998, a UN needs-assessment mission developed an integrated program of priority projects on health, humanitarian aid, ecology, economic development, and information dissemination The report to the 53rd session of the General Assembly led to a second resolution on Semipalatinsk, stating the need for international attention, cooperation and coordination of responses to the legacies of the Semipalatinsk test site (United Nations General Assembly,

1998) Since then, international efforts have been intensified that assess the radiological situation on the test site, also involving IAEA and WHO Many of these international efforts defined as their first step to narrow down and confirm actual doses, which shifted priorities away from health effects to validation of the dosimetric data Also a range of analytical epidemiological studies were begun in the mid-1990s, striving to enroll and incorporate into the western epi-demiological formats the data collected or available from the Soviet records of the public health system and the Dispanser No 4 (Grosche et al., 2002; Bauer

et al., 2005; Bauer, Gusev, Pivina, Apsalikov, & Grosche, 2006; Land et al.,

2008; Mudie et al., 2007, 2010; Grosche et al., 2011)

These research projects conducted in international collaboration analyzed the data that had been collected since the 1960s—two historical cohorts set up