In the article, problems of nuclear pollution with products of the nuclear fuel division are analyzed. The chronology of the development of negative consequences of the damage is described. Features of the «hot particles» exploded into the air during the period of damage liquidation are analyzed. The particles are divided to following types: the first type includes the particles appearing after nuclear fuel dispersion; the second one is presented by volatilable particles condensed from explosion, gas clouds. The most unstudied domain is the interaction of the human being with the latter type of particles.

It was discovered that in general the particles of the first type are presented by unsoluble compounds of ¹³⁷Cs coupled with the uranium fuel matrix.

Moreover, in the article, the question about the estimation of the internal radiation is pointed. That problem is solved with mathematical models describing the particles behavior in the human organism. That behavior depends on two chief factors: the dispersity of the particles and their transportability through the alveo-capillar barrier. The chemical destruction is the basic process inducting radionuclide entrance into blood through the pulmonary interstition. The further behavior of the particles depends on their dispersion. In case of the fust factor, the particles smaller than 1 mkm are spoken about, because the larger ones precipitates on the nasal mucus lamina and then follows into digestive tractus. The level of the second factor influence is' ranged into three inhalational classes: D , Y and W (day, year and week). For true estimation of internal radiation doses it is necessary to evaluate the belonging of each radionuclide to specific class. That models were confirmed by results of the damage witnesses investigation.

The authors emphasized the necessity of the building of theory of the tumor development under influence of the «hot particles» to obtain vital risk estimations of inhalation radionuclides entrance.

The aerosol radiation damage of airways was registered among Chernobyl catastrophe liquidators. There are few scientific data of aerosol radiation damage of airways. 9 liquidators — males at the age of 33—43 — were examined in our institute. They worked in highly dusted atmosphere that caused the inhalation of radioactive dust. The chronic obstructive bronchitis was diagnosed in 4 cases and chronic bronchitis with purulent sputum- in 4 cases and bronchial asthma — in 1 case. All patients were healthy before 1986. The first symptoms of the disease were found in 3 cases when the patients worked on atomic station in 1986 and in 6 cases — 3—6 years later. The specific feature of the disease was torpide inflammatory process with progressive respiratory failure. The pulmonary function testing demonstrated the obstructive abnormalities and the reduction of diffusing lung capacity. The examination of BAL discovered- the macrophages with polygonal optically dense particles in their cytoplasm. X-ray spectral analysis showed the existence of Np, FR, Pm, Pa, Pu in these particles. Thus, we suppose that inhaled radionuclides may play a significant role in the genesis of respiratory abnormalities for this patients category.

Lungs of 27 persons who participated in liquidation of Chernobyl accident and died from acute radiation sickness were studied histologically. Pulmonary infectious complications were found, including invasion of viral, bacterial and fungal agents. The data concerning 2 patients with cytomegalovirus pneumonitis, 3 ones with focal bronchopneumonia and 3 cases of pulmonary candidosis are shown. Being depended on hematopoietic function the inflammatory reactions were areactive during postirradiation aplasia and became typical within the recovery beginning.

It is well known that the inhaled dust particles are present in the cytoplasm of alveolar macrophages of the patients with pneumoconiosis during many years. Similar mechanism of long-term deposition of the radioactive dust particles in alveolar macrophages is very important especially in connection with Chernobyl events and nuclear weapon tests in the atmosphere. A man of 66 years old who took an active part in the liquidation of Chernobyl catastrophe consequences, whose irradiation dose was 24 roentgens was examined. In march 1993 during the prophylactic examination the peripheral lung tumor of the lower left lobe with the penetration into the lung root was discovered by the method of computer tomography. The certain histological features very typical for adenocarcinoma were found in the samples of the tumor. Moreover, with the help of the electron microscopy method it was found that the cytoplasm of 40% of alveolar macrophages contained large (0,5—1,0 mkm in diameter) high density particles. By X- and gamma-ray spectrometry methods a significantly high level (0,1—0,18 Bq) of ¹³⁷Cs was detected in all investigated samples of tumor tissue in March 1993. The increased level of ¹³⁷Cs in the liquidator's lung is good evidence of the long-term accumulation of radionuclide in the lung tissue.

Electron spin resonance (ESR) technique was used to study the whole blood, blood components and bronchoalvcolar lavage (BAL) fluid of patients with lung pathology and liquidators of Chernobyl catastrophe consequences. The main clinical group consisted of 8 liquidators; the control group included 3 patients with chronic obstructive bronchitis, one with lung adenocarcinoma and one donor, who were not Chernobyl liquidators. It was shown that the samples of BAL, blood plasma and leucocyte concentrates of Chernobyl liquidators have free radical products registered by ESR technique, the concentrations of these products being dependent on the length of work of the liquidators at the 4-th Energy Unit of Chernobyl atomic power station.

It was shown that these parametric centers are radiation-induced and have melanin-containing nature. The main place of these compound localization were lungs. The melanin containing free radical products were not discovered in the patients with pulmonary diseases who did not take part in the liquidation of Chernobyl catastrophe consequences. The changes of content of the plasma proteins ( transferrin and ceruloplasmin) and blood components in the tests of the patients with pulmonary diseases and Chernobyl liquidators had the opposite directed dynamics.

Bronchoalveolar lavage (BAL) of 9 young man who took an active part in the liquidation of the Thernobyl wreck’s consequences during may—July 1986 was analyzed in order to investigate: absolute and different cell count; b) possible presence of the radioactive particles in the cytoplasm of alveolar macrophages; c) chemical structure of these particles. Control group — 8 man without lung diseases. Whole absolute cell count in the liquidators BAL was greatly increased in comparison with control group (0,9+0,01-10 /ml and 0,2+0,03-10 / ml in control group) but different cell number was not different from healthy subjects. Cytoplasm of 30—60% of alveolar macrophages contained large (0,5—1,0 mkm in diameter) high density particles. Chemical analysis of these particles was performed by the method of X-ray spectrometry with accerating tension 80 kV, sensitivity of the channel — 40V and number of channels — 1024. Only cytoplasm and part of the high density particles in alveolar macrophages from liquidators contained U, Np, Pu, Fr, Pm, Pa. Cytoplasm of lymphocytes and erytrocytes of these patients, nets, buffers and epon for electron microscopy did’t contained such kind of the elements. Thus, it was determined that alveolar macrophages can take part in the deposition of actually unsoluble radioactive dust particles and parts of nuclear fuel.

The up-to-date approaches to «hot particles» studying were applied in this investigation. A complex of morphological and phisical-chemical methods make it possible to detect and identify the «hot particles» in the autopsy material of the lungs from 2 males at the age 27 and 25, who participated in the liquidation of Chernobyl katastrophe consequences in 1986. The patients died after having worked in the zone of katastrophe 1 and 2,5 years from cerebral hemorrage and acute leukemia respectively. For analyzing the autopsy material the gamma-spectrometry, hystoautoradiography, scanning electron microscopy and x-ray microanalysis methods were applied. The elemental and isotope content of these particles was the same as that of the «hot particles» detected in the zone of the katastrophe. The results obtained make it possible to suppose that the «hot particles» have been inhaled and existed for a long time in the human bodies. On the basis of these data we suppose that the «hot particles» are the cause of respiratory and other systems disorders.

The method of triboluminescence for an integral estimation of the functional condition of the children's respiratory system affected by a complex of ecological factors after Chernobyl katastrophe was applied. The non-respiratory function of the lungs was investigated by analysing the air condensates exhaled by 36 children at the age of 7—15 years. It was found that the kinetic parameters of triboluminescence of the condensates exhaled by the children, living in ecologically unequal areas may be different. The changes of these parameters may be caused by the activisation of the free oxygen radicals of the condensate components due to the radiation factors discovered in the zones exposed to the irradiation after Chernobyl katastrophe.

Respiratory function of 9 males at the age of 33—43 who participated in Chernobyl katastrophe consequences liquidation was studied. 4 at them suffered from chronic obstructive bronchitis, 4 — from chronic obstructive bronchitis with purulent sputum and 1 — from asthma.

Different ventilatory alterations were found in 4 cases: mild obstruction (1), moderate obstruction (1), mild hyperinflation (1), mild restriction (1). Three variants of mixed ventilatory defects were also observed in other cases: moderate obstructive defect combined with mild hyperinflation — in 2 cases, combination of moderate obstruction and hyperinflation — in 1 case and mild obstruction with moderate hyperinflation in 1 case. Diffusing lung capacity investigation showed that the most frequent type of alterations (6 cases) was an isolated decrease of DLCO/Va ratio without decrease in DLCO.

Gas exchange studies during the exercise test demonstrated a marked decrease of exercise tolerance. In 3 cases the maximal oxygen uptake was less than 50% pred., and in 5 cases this index was 50—70% pred. An increased dead space volume to the tidal volume ratio and the ventilatory equivalent for O₂ demonstrated the gas exchange inefficiency and confirmed the results of DLCO measurement.

The results obtained suggest that these patients have a wide spectrum of respiratory function impairment. Atipical pattern of lung diffusing capacity disorders among the majority of patients can be explained by the nature of radionuclide lung damage.

Free radical status of 9 liquidators of Chernobyl katastrophe consequences was investigated. The level of lipid peroxidation, extra- and intracellular ratio of oxygen active form (OAF) and concentration of calcium ions in the phagocytes in the bronchoalveolar lavage (BAL) and blood were studied. It was found that the above parameters in the blood cells are the same as in those of the healthy people. But the greater formation rate of active radicals in the BAL cells and increased content of lipid peroxidation products and calcium ions was witnessed. According to the data obtained, the activization of free radical processes in the examined patients lungs may be interpreted as the distant results of aerosol radiation damage. Different possible approaches to the treatment of Chernobyl catastrophe liquidators are discussed.

The results of epidemiological analysis of mortality from pulmonary diseases and lung cancer among the population, exposed to radiation in the region of South Ural, are presented. These groups of patients include the persons exposed to radiation due to in 1957 accident and after the radiation products contamination of the Techa river. The dose of radiation equal to 0,2—127 cZv hasn’t changed the mortality from pulmonary diseases and lung cancer in this group of patients. But there is a tendency in the morbidity of bronchial asthma among population living on the territory, concomitated by radiation to increase. The investigation must be followed by the analysis of morbidity and pulmonary function tests.

The comparative analysis of morbidity, mortality and in validation of the population of Altay region and other regions of West Siberia (Kemerovsky, Novosibirsky, Omsky, Tomsky, Tyumensky) is presented in this paper. It was found that in recent years in spite of a more favorable ecologic situation in this area the level of morbidity (hematological disorders, cardiovascular disorders, urinary diseases), mortality from infectious, parasitic, pulmonary diseases and malignant tumors and invalidisation of the population increased. The main cause of this is supposed to be the consequences of nuclear weapon tests in the atmosphere in 1949-1962 on the testing ground near Semipalatinsk at the border of Altay region. The data on repeated pollutions by the products of nuclear disintegration in Altay region are reported.

The comparison of the prevalence rate of pulmonary diseases among the population of several districts of Altay region, exposed to different levels of irradiation during the nuclear weapon tests in 1949 was carried out. 3521 children and 12293 adults were examined. The prevalence rate of pulmonary diseases for them due to the radiation dose to which the adult population was exposed in 1949 was investigated.

It was found that the morbidity of their children was not immediately caused by the degree of irradiation to which their parents were exposed in 1949. But among the adults the maximal prevalence of pulmonary diseases was discovered in the zones of maximum level of irradiation (above 100 cZv) and the minimum — in the zone of effective dose below 35 cZv. Disorders of respiratory system were found among the persons bom during intensive tests in the atmosphere (1949—1963) and exposed to the irradiation in 1949 during their puberty period. It is confirmed, by these people often having acute abscesses.

The investigations of morbidity of lung cancer among the population of Altay region were carried out. The higher level of morbidity of village population as compared with the urban population, the high rate of lung cancer among women and the prevalence of small-cell and large-cell carcinomas were discovered. Alpha-radionuclides with high level of activity in lung tissue and lymphglands metastasis were registered. The high titer of antibodies to Epstain-Barr vims and the high degree of chromosome «brittleness» in the oncogen areas in T-lymphocytes as well as the low value index of DNA-reparation with a high factor number which characterizes the antitumor resistance were found among the population of this region. It may connected with the nuclear weapon tests in the atmosphere on the testing ground near Semipalatinsk in 1942—1962.

In the article, numerous facts are presented concerning the sharp increase of the radiational load to citizens of Russia, especially to children which are most sensitive to radiation. The reason of the increase arc baseless and sometimes useless roentgenologic studies that have sometimes a systemic character and are named as dispanserization, prophylactic fluorography, or fluoromammography. In total, that moment leads to the morbidity increase dealing with the radiational load and, therefore, to the mortality increase.

The article contains the call addressed to medical and pediatric society to pay much attention to the harm of baseless use of radiation methods in medical practice with diagnostic aims.