STRUCTURE AND CHARACTERISTICS OF THE CHORNOBYL NPP ACCIDENT SURVIVORS REASONS OF DEATH ACCORDING TO THE MATERIALS OF MEDICAL EXPERTISE FOR THE CAUSAL RELATIONSHIP OF DISEASES WITH THE EFFECT OF IONIZING RADIATION IN THE REMOTE POSTACCIDENTAL PERIOD (2024 year).
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UNLABELLED: Problem of the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe during performance of professional, military or official duties and / or living on radiation-contaminated areas, additional exposure not through their own fault but due to a radiation accident, caused the development of a special form of medical expertise as part of the of medical social protection system for suffered contingents in the remote postaccidental period. OBJECTIVE: To study and characterize the structure of the survivor categories (clean-up workers and victims) of the Chernobyl Catastrophe in the remote post-accident period (2013-2024) regarding the causal relationship of disease that became the reason of death with the effect of ionizing radiation and due to harmful influence of the Chornobyl Catastrophe based on the materials of expert cases of the Central Interdepartmental Expert Commission of the Ministry of Health of Ukraine (CIEC). MATERIAL AND METHODS: The work was performed in the design of a retrospective study that based on analysis of the structure of all categories of Chornobyl NPP accident (ChNPP) survivors during 2008-2024 years and studying of 58,137 medical expert cases, including 19,524 postmortem cases, which were considered by CIEC during 2013-2023 to establish a causal relationship between the disease and influence of radiation exposure and other harmful factors and conditions during ChNPP accident. RESULTS: The total number of adult survivors as on 01.01.2024, compared to 2008, decreased by 581,170 persons, or by 31.68 %. The number of clean-up workers of the accident decreased by 124,382 people (45.01 %), that means - during the last 15 years, almost every third-second participant in the liquidation of the consequences of the accident at the ChNPP died. The number of adult victims decreased 29.41 % (458,233 persons). In the structure of medical expert cases, the leading place as a disease that became the reason of death is occupied by oncological diseases - 52.10 %, chronic circulatory diseases and their complications make up 42.00 % (cardiovascular system - 19.60 %, cerebrovascular system - 22.40 %), chronic diseases of the respiratory system - 3.00 %, other diseases in general - 2.90 %. In the structure of oncological postmortem expert cases (n=10,172) during2013-2024 the main reason of death belongs to oncohematological diseases (18.00 %), colon cancer (15.00 %), breast cancer for woman (13.00 %), prostate cancer for man (11.99 %), lung and upper respiratory tract cancer (8.01 %). CONCLUSION: In the remote post-accidental period (2013-2024) has increased the necessity of expertise of the causal relationship of disease that became the reason of death with the effect of ionizing radiation and the ChNPP accident consequences. During 2013-2024 period quick reducing for all survivors' categories of the Chornobyl NPP accident taken place. In the structure of medical expert cases during 2013-2023 the leading place of the disease that became the reason of death is occupied by oncological, cardiovascular and cerebrovascular diseases.