Military medicine during the aftermath of the disaster.
The reactor not only a source of electricity, but also its consumer. Yet from the active zone of the reactor is discharged nuclear fuel, it is necessary to continuously circulate the water in order to avoid overheating of the Fuel rods. Usually part of the electric power turbines are selected for the own needs of the reactor. If the reactor is stopped (fuel switching, preventive maintenance, emergency stop), the power of the reactor comes from adjacent blocks.
Medical services personnel and units in the 30 km zone was centralized. So, as a part of the OG MO in Chernobyl was created by the medical service. She obeyed the medical stations of military units, medical battalions, radiometric laboratory, SER. On the deployment of medical units and establishments of their work head CWMU MO the General-the Colonel of med. services F. I. Komarov reported regularly to the Minister of defense Marshal of the Soviet Union S. L. Sokolov.
In addition, medical aid to the population and liquidators provided medical services of military districts (the Kiev, Belorussian, Carpathian). Their composition consisted of 39 medical institutions and units of the total number of medical .
In sectors 30 km zone of Chernobyl, was formed by the medical service with their subordinate medical battalions and sea.
During the liquidation the aftermath of the Chernobyl disaster and military medical service solved two main tasks.
provide health authorities with practical and methodological assistance in the examination and treatment of the population exposed to ionizing radiation.
conduct activities to prevent overexposure of the military personnel involved in liquidation of consequences of the accident with the sanitary – epidemiological treatment, such as in the areas of operations and areas of population.
Further increased and other directions in the work of military physicians, such as clinical dynamic observation of the health status of personnel involved in the execution of radiation-hazardous works, as well as military personnel and members of their families of workers and employees of the Soviet Army serving on radioactive contaminated territory.
Given the dispersion of evacuees and the need to perform large volume of work in a short time, from the deployed medical institutions was formed more than 30 medical teams to conduct medical examinations of the population of hematologic and radiographic studies.
To 11 may 1986, work on the mass survey of the evacuated population was almost complete. Outpatient total sample was 78 thousand people of local population. Completed more than 36 thousand hematological and radiographic investigations. Stationary surveyed 454 people (98 people per clinic, military medical Academy im. S. M. Kirov and 356 people in the medical battalions.
In addition, after a full medical examination had been evacuated from the disaster zone and accommodated in pioneer camps, in sanatoriums of the Ministry of defense is located on the southern coast of Crimea and in the suburbs more than 6. 5 thousand servicemen of the workers and employees of the S. A. Navy.
As an example, the examination of the population can bring the activities of the medical service of the Kiev military district in Borodyansky district of Kyiv oblast : “Here the work involved a separate medical battalion radiometric laboratory four regimental aid station and ten mobile medical teams – therapeutic laboratory and radiological. The structure of mobile medical teams were fickle, and their equipment was determined from the population subject to the survey in each locality and the date. Within each group generally consisted of head physicians therapists medical laboratory scientist laboratory technicians nurse.
Group staffed dosimetry devices microscopes lab property health car and worked mostly as a rule, on the basis of local health services.
To conduct radiological examinations of one person on average spent 2.3 minutes. Blood tests were carried out simultaneously with the dosimetric control.
At the initial stage of the liquidation the aftermath of the disaster medical service of the armed forces faced a number of difficulties associated primarily with the uniqueness of the situation lack of experience of work in such conditions.
One of the first and the key problems was the establishment of maximum permissible doses of radiation contamination levels by radioactive substances of leather, clothing, food, water, environmental objects. The representatives of various ministries and departments, scientists there was no consensus about the degree of danger of those or other radiation factors and how to protect themselves from their influence. With the active and purposeful activities of representatives of military medical services mainly of specialists of the Central military medical Directorate was justified and enacted by order of the Minister of defence of the USSR limit exposure for military personnel involved in liquidation of the aftermath of the disaster equal to the level of emergency exposure of individuals is constantly working with RV – 25 REM.
It wasn’t all smooth, as desired. As one of such examples, we present “fight” for the establishment of the dose limit for military personnel involved in forestry in the 30 km zone of the ChNPP (in time of war, the public dose limit for military personnel is 50 REM) [123.
“In the first days of the Chernobyl disaster, the chief hygienist of the Ministry of defense reported to the chief CWMU about the need for military personnel to enter public dose limit of 25 REM. The proposal was based on the requirements of the order of the Minister of defence of the USSR 1983 № 285 and recommendations of the NRB-76.
This question was required to coordinate with the Chairman of the national Commission on radiation protection, academician of RAMS L. A. Ilyin. At the first meeting L. A. Ilyin asked not to hurry and to delay approval for a few days. At the second meeting the matter was agreed upon and the dose limit of 25 REM has been approved by the chief CWMU USSR Ministry of defense.
In early may, the chief of CWMU main hygienist MO this decision by telephone was reported to the chief of chemical troops of the Ministry of defense Colonel General V. K. Pikalov, who in response said the following “You give me no lecture read. Here is the Deputy Minister of health of the USSR E. I. Vorobyov and other luminaries in medicine and we decided to set the dose limit of 50 REM military personnel, as stipulated in wartime.
The decision to establish the dose limit of 25 REM in first part of may was given for the performance is also the chief of the medical service of the Kiev military district General-major of medical service V. N. Fadeev, who soon reported that the command of the requirements of the medical service is not going to fulfill, and to address the issue required the Directive of the General staff of the USSR armed forces.
Upon arrival to Chernobyl, the team of specialists CWMU on the night of 13 to 14 may 1986 amounted to the draft orders of the head of operative group on radiation safety. – Order number 1 and for the prevention of epidemics – Order # 2. 14 may head of the operational group of the army General I. Gerasimov these orders signed, but from the order of safety ruled out the first sentence on the dose limit of 25 REM.
In connection with the current situation, CWMU e a proposal to impose a dose limit of 25 REM may 21, 1986 order of the Minister of defense of the USSR № 110 of the dose limit of 25 REM was determined for all military personnel involved in liquidation of consequences of accident. With the introduction of this order, sanitary supervision over radiation safety has taken on a legal basis.
Over the 1986-1990 monitoring was subjected to 239281 soldier. The dose of 25 REM has received 237151 people (99%), more than 25 REM (max Baer 72) – 2130 (less than 1.
In the process of sanitary surveillance over compliance with radiation safety standards of the military unit went to certain areas only after a preliminary assessment of the radiation situation. Was performed control of correctness of equipment and maintenance of military camps, food facilities, common areas, quality equipment, timely replacement of contaminated RV bed and underwear, with the organization of its decontamination, prevention of drift of radionuclides from the places of work in residential towns, the water supply etc. In particular, on the recommendation of a health service for water used water only from artesian wells with depth of the aquifer 60-70 m. the Physico-chemical and bacteriological tests of water were carried out 1 time per month, radiometric – 1 time a week.
Great importance was attached to systematic monitoring of the health of the personnel. Directly in the military units the doctors conducted a survey of complaints of state of health, performed the necessary hematological and other investigations.
Smooth the main health event during the period the work was carried out thanks to the clear organization of medical supplies, created from the first days of the provision of medicines, laboratory instruments and reagents, disinfectants and other property. For medical support of the troops who took part in liquidation of consequences only in 1986 was delivered 160 tons of medical property and 66 units of medical and sanitary equipment.