PREVALENCE AND SEVERITY OF SOMATIC DISTRESS AND FATIGUE AMONG RESIDENTS OF EAST KAZAKHSTAN REGION EXPOSED TO RADIATION DUE TO THE ACTIVITY OF THE SEMIPALATINSK NUCLEAR TEST SITE
Background: since Kazakhstan belongs to the range of industrialized world nations, most of its territory is affected by anthropogenic and man-induced risk factors, which contribute to the development of unfavorable ecological situation that has negative impact on the population health. Nuclear weapons tests at the Semipalatinsk nuclear test site have caused significant adverse changes in the habitat of hundreds of thousands of people who are now forced to live and conduct economic activities in territories contaminated with radionuclides. Studying the long-term effects of small radiation doses on the state of mental functions of local residents appears to be interesting. The stressful situation among the population of contaminated territories was gradually fueled by the dissemination of information on significant and irreversible consequences of nuclear weapons tests on human health.
The aim of this study was to investigate the prevalence and severity of somatoform disorders and increased fatigue among residents of Abai and Borodulikha districts affected by long-term tests at the Semipalatinsk Nuclear Test Site, compared with residents of the ecologically safe Kurchum district.
Materials and methods. This study had cross-sectional design. To achieve the study aim, a survey was conducted, which covered the population of three districts of East Kazakhstan region: Borodulikha, Abai and Kurchum. The sample size for the Abai district composed 222 people, the sample size for Borodulikha district was equal to 233 people, while the one for Kurchum district (control group) was 245 people. To assess the presence and severity of somatic distress the PHQ-15 scale was utilized, while the Multidimensional Fatigue Inventory (MFI) was used to test the presence of fatigue. The statistical processing of the study results was carried out using the SPSS statistical package (Statistical Package for the Social Sciences) version 20.0 for Windows (GMU Semey). Pearson’s chi-square and Mann-Whitney criterion were used to compare two groups of nominal variables. Differences between groups were considered to be significant if they had a 5% significance level (p <0.05).
Results: the prevalence of somatic distress based on the PHQ-15 scale showed the minimal level (0-4 points) among residents of the Abai region in 72.1% of cases as compared to the inhabitants of Borodulikha district and Kurchum village (54.5% and 48.2%, respectively). The differences in the frequency of minimal degree of somatic distress were statistically significant when comparing Abai and Kurchum districts (p <0.001), as well as Abai and Borodulikha districts (p <0.001), but were not significant when comparing Kurchum and Borodulikha districts (p = 0.171475). A mild degree of somatic distress (5-9 points on the PHQ-15 scale) was found in the control group (Kurchum village) more frequently than in Abai and Borodulikha districts (50.2%, 23.6% and 41.9%, respectively). The index of activity decrease in the residents of Abai region was equal to 10.098, which indicates a high degree of fatigue, while in the Borodulikha and Kurchum districts this index appeared to be similar and amounted to 8.184 and 8.158 respectively, which signaled the presence of moderate fatigue.
Conclusions: the psychophysiological status of the surveyed population was characterized by the prevalence of general asthenia, decreased activity, manifestation of somatic symptoms of moderate severity, which had a direct dose-effect relationship, i.e. were most pronounced among residents of Abai district, which had the highest doses of radiation.
Yuliya M. Semenova1,
Lyudmila M. Pivina1,
Yersin T. Zhunussov1,
Tolkyn A. Bulegenov1, Almira M. Manatova1, Tatyana I. Belikhina1,
Nurlan E. Aukenov1, Tamara Zhunussova2
1 Semey State Medical University, Kazakhstan, Semey, Republic of Kazakhstan;
2 Norwegian Radiation Protection Authority, Oslo, Norway
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13. Hoffmann F.O., Apostonaei A.I., Thomas B.A. (2002). A perspective on public concerns about exposure to fallout from the production and testing of nuclear weapons // Health Physics. 2002; 82:736–748.
14. Ibrayeva Zh., Aldyngurov D., Myssayev A., Meirmanov S., Zhanaspayev M., Khismetova Z., Muzdubayeva Zh., Smail E., Yurkovskaya O., Pivina L., Semenova Y. Depression, Anxiety and Somatic Distress in Domestic and International Undergraduate Medical Students in Kazakhstan // Iran J Public Health. 2018. 47 (6), 919-921.
15. Kawano N., Hirabayashi K., Motsuo M., Taooka Y., Hiraoka T., Apsalikov K. Human Suffering Effects of Nuclear Tests at Semipalatinsk, Kazakhstan: Established On the Basis of Questionnaire Surveys. Journal of Radiation Research. 2006;47:Suppl, A209–A217.
16. Markabayeva A., Bauer S., Pivina L., Bjørklund G., Chirumbolo S., Kerimkulova A., Semenova Y., Belikhina T. Increased prevalence of essential hypertension in areas previously exposed to fallout due to nuclear weapons testing at the Semipalatinsk Test Site, Kazakhstan // Environ Res. 2018 Jul 9;167:129-135.
17. Schwerin M., Schonfeld S., Drozdovitch V., Akimzhanov K., Aldyngurov D., Bouville A., Land C., Luckyanov N., Mabuchi K., Semenova Y., Simon S., Tokaeva A., Zhumadilov Z., Potischman N. The utility of focus group interviews to capture dietary consumption data in the distant past: dairy consumption in Kazakhstan villages 50 years ago // J Dev Orig Health Dis. 2010 Jun;1(3):192-202.
18. Skvortsov V., Ivannikov A., Tikunov D., Stepanenko V., Borysheva N., Orlenko S. Considerations regarding the implementation of EPR dosimetry for the population in the vicinity of Semipalatinsk nuclear test site based on experience from other radiation accidents // J Radiat Res. 2006 Feb;47 Suppl A:A61-9.
19. Smets E.M.A., Garssen B., Bonke B., De Haes J. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue // Journal of psychosomatic research. Volume 39, Issue 3, April 1995, P. 315-325
20. Stawkowski M.E. “I am a radioactive mutant”: Emergent biological subjectivities at Kazakhstan’s Semipalatinsk Nuclear Test. American Ethnologist. 2016;43(1):144-157.
21. Takamura N., Yamashita S., Namba H., Alipov G., Ito M., Sekine I., Espenbetova M., Raisov T., Gusev B. Need for investigation of thyroid disease around Semipalatinsk nuclear testing site, Kazakhstan // Thyroid. 1998 Jul;8(7):635-6.
22. Whitehead L. The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures // J Pain Symptom Manage. 2009 Jan; 37(1):107-28.
23. Witthöft M., Fischer S., Jasper F., Rist F., Nater U.M. Clarifying the latent structure and correlates of somatic symptom distress: A bifactor model approach // Psychol Assess. 2016 Jan;28(1):109-15.
24. Yabe H., Suzuki Y., Mashiko H., Nakayama Y., Hisata M., Niwa S. Psychological distress after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident: results of a mental health and lifestyle survey through the Fukushima Health Management Survey in FY2011 and FY2012 // Fukushima J Med Sci. 2014;60:57-67.
25. Zaroff C.M., Davis J.M., Chio P.H., Madhavan D. Somatic presentations of distress in China. Aust N.Z. // J Psychiatry. 2012 Nov;46(11):1053-7.
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6. Bauer S., Gusev B.I., Pivina L.M., Apsalikov K.N., Grosche B. Radiation exposure due to local fallout from Soviet atmospheric nuclear weapons testing in Kazakhstan: solid cancer mortality in the Semipalatinsk historical cohort, 1960-1999. Radiat Res. 2005 Oct;164(4 Pt 1):409-19.
7. Creed F.H., Tomenson B., Chew-Graham C, Macfariane G.j, Davies I., Jackson J., Littlewood A., Mc Beth J. Multiple somatic symptoms predict impaired health status in functional somatic syndromes. Int J Behav Med; 2013. 20:194–205.
8. Drozdovitch V., Schonfeld S., Akimzhanov K., Aldyngurov D., Land C.E., Luckyanov N., Mabuchi K., Potischman N., Schwerin M.J., Semenova Y., Tokaeva A., Zhumadilov Z., Bouville A., Simon S.L. Behavior and food consumption pattern of the population exposed in 1949-1962 to fallout from Semipalatinsk nuclear test site in Kazakhstan. Radiat Environ Biophys. 2011 Mar;50(1):91-103.
9 Faessler L., Perrig-Chiello P., Mueller B., Schuetz P. Psychological distress in medical patients seeking ED care for somatic reasons: results of a systematic literature review. Emerg Med J. 2016 Aug;33(8):581-7.
10. Gordeev K., Shinkarev S., Ilyin L., Bouville A., Hoshi M., Luckyanov N., Simon S.L. Retrospective dose assessment for the population living in areas of local fallout from the Semipalatinsk nuclear test site Part I: External exposure. J Radiat Res. 2006. № 47 (Suppl.A), A129-136.
11. Grosche B., Lackland D.T., Land C.E., Simon S.L., Apsalikov K.N., Pivina L.M., et al. Mortality from cardiovascular diseases in the Semipalatinsk historical cohort, 1960-1999, and its relationship to radiation exposure. Radiat Res. 2011; 176(5): 660-9.
12. Hirabayashi K., Kawano N., Muldagaliyev T., Apsalikov K. The psychological effects and their factors among inhabitants around the Semipalatinsk Nuclear. Japanese Review of Political Society. 2014, Vol.2. P. 7-19.
13. Hoffmann F.O., Apostonaei A.I., & Thomas B.A. A perspective on public concerns about exposure to fallout from the production and testing of nuclear weapons. Health Physics. 2002; 82:736–748.
14. Ibrayeva Zh., Aldyngurov D., Myssayev A., Meirmanov S., Zhanaspayev M., Khismetova Z., Muzdubayeva Zh., Smail E., Yurkovskaya O., Pivina L., Semenova Y. Depression, Anxiety and Somatic Distress in Domestic and International Undergraduate Medical Students in Kazakhstan. Iran J Public Health. 2018. 47 (6), 919-921.
15. Kawano N., Hirabayashi K., Motsuo M., Taooka Y., Hiraoka T., Apsalikov K. Human Suffering Effects of Nuclear Tests at Semipalatinsk, Kazakhstan: Established On the Basis of Questionnaire Surveys. Journal of Radiation Research. 2006;47:Suppl, A209–A217.
16. Markabayeva A., Bauer S., Pivina L., Bjørklund G., Chirumbolo S., Kerimkulova A., Semenova Y., Belikhina T. Increased prevalence of essential hypertension in areas previously exposed to fallout due to nuclear weapons testing at the Semipalatinsk Test Site, Kazakhstan. Environ Res. 2018 Jul 9;167:129-135.
17. Schwerin M., Schonfeld S., Drozdovitch V., Akimzhanov K., Aldyngurov D., Bouville A., Land C., Luckyanov N., Mabuchi K., Semenova Y., Simon S., Tokaeva A., Zhumadilov Z., Potischman N. The utility of focus group interviews to capture dietary consumption data in the distant past: dairy consumption in Kazakhstan villages 50 years ago. J Dev Orig Health Dis. 2010 Jun;1(3):192-202.
18. Skvortsov V., Ivannikov A., Tikunov D., Stepanenko V., Borysheva N., Orlenko S. Considerations regarding the implementation of EPR dosimetry for the population in the vicinity of Semipalatinsk nuclear test site based on experience from other radiation accidents. J Radiat Res. 2006 Feb;47 Suppl A:A61-9.
19. Smets E.M.A., Garssen B., Bonke B., De Haes J. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of psychosomatic research. Volume 39, Issue 3, April 1995, Pages 315-325
20. Stawkowski M.E. “I am a radioactive mutant”: Emergent biological subjectivities at Kazakhstan’s Semipalatinsk Nuclear Test. American Ethnologist. 2016;43(1):144-157.
21. Takamura N., Yamashita S., Namba H., Alipov G., Ito M., Sekine I., Espenbetova M., Raisov T., Gusev B. Need for investigation of thyroid disease around Semipalatinsk nuclear testing site, Kazakhstan. Thyroid. 1998 Jul;8(7):635-6.
22. Whitehead L. The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures. J Pain Symptom Manage. 2009 Jan; 37(1):107-28.
23. Witthöft M, Fischer S, Jasper F, Rist F, Nater UM. Clarifying the latent structure and correlates of somatic symptom distress: A bifactor model approach. Psychol Assess. 2016 Jan;28(1):109-15.
24. Yabe H., Suzuki Y., Mashiko H., Nakayama Y., Hisata M., Niwa S. Psychological distress after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident: results of a mental health and lifestyle survey through the Fukushima Health Management Survey in FY2011 and FY2012. Fukushima J Med Sci. 2014;60:57-67.
25. Zaroff C.M., Davis J.M., Chio P.H., Madhavan D. Somatic presentations of distress in China. Aust N.Z. J Psychiatry. 2012 Nov;46(11):1053-7.
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Семенова Ю.М., Пивина Л.М., Жунусов Е.Т., Булегенов Т.А., Манатова А.М., Белихина Т.И., Аукенов Н.Е., Жунусова T. Частота и тяжесть соматоформных расстройств и повышенной утомляемости у жителей восточно-казахстанской области, подвергшихся облучению вследствие деятельности Семипалатинского ядерного полигона // Наука и Здравоохранение. 2018. 5 (Т.20). С. 125-134. Semenova Yu.M., Pivina L.M., Zhunussov Ye.T., Bulegenov T.A., Manatova A.M., Belikhina T.I., Aukenov N., Zhunussova T. Prevalence and severity of somatic distress and fatigue among residents of East Kazakhstan region exposed to radiation due to the activity of the Semipalatinsk nuclear test site. Nauka i Zdravookhranenie [Science & Healthcare]. 2018, (Vol.20) 5, pp. 125-134. Семенова Ю.М., Пивина Л.М., Жунусов Е.Т., Булегенов Т.А., Манатова А.М., Белихина Т.И., Аукенов Н.Е., Жунусова T. Семей ядорлық полигон қызметі салдарынан Шығыс Қазақстан облысының сәулеге шалдыққан тұрғындары арасында соматоформды бұзылыстар мен жоғары қажудың жиілігі мен ауырлығы / / Ғылым және Денсаулық сақтау. 2018. 5 (Т.20). Б. 125-134.Related publications:
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PREVALENCE AND SEVERITY OF SOMATIC DISTRESS AND FATIGUE AMONG RESIDENTS OF EAST KAZAKHSTAN REGION EXPOSED TO RADIATION DUE TO THE ACTIVITY OF THE SEMIPALATINSK NUCLEAR TEST SITE