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Chernobyl: Consequences of the catastrophe 25 years later
by Janette D. Sherman, M.D., and Alexey V. Yablokov, Ph.D
San Francisco Bay View
April 27, 2011
Editor's note: The Bulletin of Atomic Scientists asked Dr. Sherman, recognized worldwide for her expertise on Chernobyl, to write this article last year, then rejected it just before deadline, probably considering it too alarming. In it, she reports the widespread expectation of another nuclear power plant failure and the catastrophic consequences. Now, a few months later, the world commemorates the 25th anniversary of Chernobyl while watching the Fukushima meltdown.
For more than 50 years, the World Health Organization (WHO) and the International Atomic Energy Agency (IAEA) have abided by an agreement that in essence allows them to cover each other's back – sometimes at the expense of public health. It's a delicate balance between cooperation and collusion.
Signed on May 28, 1959, at the 12th World Health Assembly, the agreement states:
“Whenever either organization proposes to initiate a programme or activity on a subject in which the other organization has or may have a substantial interest, the first party shall consult the other with a view to adjusting the matter by mutual agreement,” and continues: The IAEA and the WHO “recognize that they may find it necessary to apply certain limitations for the safeguarding of confidential information furnished to them. They therefore agree that nothing in this agreement shall be construed as requiring either of them to furnish such information as would, in the judgment of the other party possessing the information, interfere with the orderly conduct of its operation.”
The WHO mandate is to look after the health on our planet, while the IAEA is to promote nuclear energy. In light of recent industrial failures involving nuclear power plants, many prominent scientists and public health officials have criticized WHO's non-competing relationship with IEAE that has stymied efforts to address effects and disseminate information about the 1986 Chernobyl accident, so that current harm may be documented and future harm prevented.
For years, concerned individuals have held vigils outside WHO's Geneva headquarters urging it to function as an independent agency of the United Nations, free of influence from the IAEA because they want to prevent another tragedy. Chernobyl has shown that societies everywhere – especially Japan, France, India, China, the United States and Germany – must distribute stable potassium iodide (KI) before an accident and must provide independent, publicly available radiation monitoring of both food and individual in-body irradiation levels with the aim of documenting the danger and preventing additional harm.
On the 20th anniversary of Chernobyl, WHO and the IAEA published the “Chernobyl Forum Report,” mentioning only 350 sources, mainly from the English literature, while in reality there are more than 30,000 publications and up to 170,000 sources that address the consequences of Chernobyl. By 2006, there had been 10 major publications concerning Chernobyl published in England, Germany, Russia, Ukraine, Belarus and the United States, with scientists currently publishing new data.
After waiting two decades for the findings of Chernobyl to be recognized by the United Nations, three scientists, Alexey Yablokov, Vasily Nesterenko and Alexey Nesterenko undertook the task to collect, abstract and translate some 5,000 articles reported by multiple scientists, who observed first-hand the effects from the fallout. These had been published largely in Slavic languages and not previously available in translation. The result was Chernobyl: Consequences of the Catastrophe for People and the Environment, published by the New York Academy of Sciences in 2009.
According to the official records, the destruction of the Chernobyl reactor was the result of both design factors and human error. Many technocrats hope that engineering feats will provide benefits for society, but from the sinking of the Titanic to the recent British Petroleum oil blowout in the Gulf of Mexico, it is apparent that neither technology nor humans are error-proof. To mitigate this and any future nuclear disasters, it is critical to learn about the extent of the Chernobyl disaster and continue research into the effects upon the biosphere and all that live in it.
The greatest amount of radioactivity fell outside of Belarus, Ukraine and European Russia, extending across the Northern Hemisphere as far away as Asia, North Africa and North America, while the greatest concentrations continue to affect the 13 million living in Belarus, Ukraine and European Russia.
Immediately after the catastrophe, release of information was limited, and there was a delay in collecting data. WHO, supported by governments worldwide, should have been pro-active and led the way to provide readily accessible information. These omissions resulted in several effects: limited monitoring of fallout levels, delays in getting stable potassium iodide to people, lack of care for many and delay in prevention of contamination of the food supply.
Key to understanding the effects is the difference between external and internal radiation. While external radiation, as from x-rays, neutron, gamma and cosmic rays, can harm and kill, internal radiation – alpha and beta particles – when absorbed by ingestion and inhalation releases damaging energy in direct contact with tissues and cells.
Radiobiological science is not new, and Chernobyl's adverse outcomes were to be expected, but new adverse effects in humans, animals and plants were documented for the first time by those who directly observed the human and biologic populations exposed to the fallout.
As a result of the accumulation of Cesium-137 (Cs-137), Strontium-90 (Sr-90), Plutonium (Pu) and Americium (Am) in the root soil layer, radionuclides have continued to build in plants over recent years. Moving with water to the above-ground parts of plants, the radionuclides – which earlier had disappeared from the surface – concentrate in the edible components, resulting in increased levels of internal irradiation and dose rates in people, despite natural disintegration and decreasing total amounts of radionuclides over time.
Bioaccumulation results in concentration in plants, mushrooms and animals and can increase a thousand-fold as compared with concentrations in soil and water. The factors of accumulation and transition vary considerably by season even for the same species, making it difficult to discern dangerous levels of radionuclides in plants and animals that appear to be safe to eat. Unfortunately one cannot see, smell or taste radioactive isotopes and, in general, they cannot be cleaned up.
While there have been some reports of wildlife thriving in the 30-km exclusion zone around Chernobyl, the appearance is deceptive, with most being immigrants. According to morphogenetic, cytogenetic and immunological tests, all of the populations of plants, fishes, amphibians and mammals that were studied there are in poor condition. This zone is analogous to a “black hole,” essentially a micro evolutionary “boiler,” where gene pools of living creatures are actively transforming, with unpredictable consequences.
The accumulation of Sr-90 into plants is greater than that of Cs-137, but it varies by species, population and area. Thus, grazing animals concentrate Sr-90 in their milk, and then into the food supply.
People who rely upon wild plants and game animals found their food supplies diminished, as mushrooms, wild game and berries were contaminated and could not be used as food.
Plants developed deformities of their roots, fruits, leaves, pollen and spores, and land and aquatic plants show chromosomal changes and mutations that were rare or unheard of before the catastrophe.
It may be that disappearance of one or more species in an ecosystem may bring about the collapse of an entire system.
Radioactive contamination re-circulates through the biosphere via rain, snow, fire and water. Seasonal growth and decay of plants contributes to spread contamination to other plants and animals. Fires spread plant and soil contamination via air currents, and the spectacular wildfires in Russia that occurred in 2010 have not been fully documented.
Adverse human health findings
Those profoundly – and expectedly – affected are the liquidators, the young and healthy men and women who worked to stop the fires and to contain the release of radioactivity. Miners were recruited and many worked to tunnel under the reactor.
Of the estimated 830,000 people conscripted to do the work, by 2005, some 125,000 – 15 percent – were dead, mostly from circulatory and blood diseases and malignancies. Of those from Belarus who worked May to June of 1986, versus those who worked July to December 1986, more developed stomach or thyroid disease and had a greater incidence of cancer. Malignancies were expected, given the liquidators' close proximity to intense radioactivity.
Heart disease accounted for 55 percent of deaths in the earlier workers. The increase in non-malignant diseases was new to the world of radiation medicine, and documented only because there were so many victims and so many scientists and physicians who observed the victims.
Children born to liquidator families were seriously affected with birth defects, thyroid cancer, an increase in central nervous system tumors – in Kiev – and generally poor health. There was also an overall increase in juvenile morbidity, cataracts in children and diseases characteristic of accelerated aging.
In Belarus and the area of Ukraine around the Chernobyl site, children in general have poor health, including loss of intellect. Based upon the research of multiple researchers, it is estimated that in the heavily contaminated areas of Belarus, only 20 percent of children are considered healthy, placing an enormous burden upon governmental resources to provide medical care and education for those affected.
Significant adverse human health findings
General morbidity increased all of the contaminated territories and is correlated with the density of radioactive contamination as documented in Chernobyl: Consequences of the Catastrophe for People and the Environment.
Blood and circulatory systems:
Radioactive contamination resulted in diseases of the blood, blood-forming organs and the circulatory system and is a major factor in overall morbidity for inhabitants of contaminated territories, including evacuees, migrants, liquidators and their children. It is becoming clear that one of the common reasons for these functional impairments is radioactive destruction of the endothelium, the covering of the inner surface of vessels. Leukemia incidence, largely involving the bone marrow damage, increased not only in children and liquidators, but also in the general adult population.
All forecasts concerning thyroid cancer have been wrong. Chernobyl related thyroid cancers have rapid onset and aggressive development, mostly in the papillary form, affecting both children and adults.
The marked increase in thyroid disease and thyroid cancer in children is linked to the release of radioactive iodine. Of concern is damage to the thyroid of the unborn, with concomitant loss of intellectual function. To date, an important finding is that for every case of thyroid cancer there are about 1,000 cases of other forms of thyroid gland pathology. In Belarus alone, experts estimate that up to 1.5 million people are at risk of thyroid disease.
The quantity and activity of various groups of lymphocytes and thus the production of antibodies, including various immunoglobulins, stem cells and thrombocytes, are altered. The ultimate consequences are immunodeficiency and an increase in the frequency and seriousness of infections and of acute and chronic diseases. The suppression of immunity as a result of this radioactive contamination is known as “Chernobyl AIDS.”
There was a marked increase in respiratory morbidity everywhere in the contaminated territories. In the first days after the catastrophe, respiratory problems of the mouth, throat and trachea in adults were basically linked to the gaseous aerosol forms of Iodine-131 (I-131), Ruthenium-106 (Ru-106), and Cerium-144 (Ce-144). Further damage to the respiratory system was caused by “hot particles” – the firm particles of uranium fuel melted together with other radionuclides. “Chernobyl dust” has been found in liquidators' bronchial tubes, bronchioles and alveoli for many years.
A wide spectrum of reproductive function disorders and urogenital morbidity exists in those living in contaminated territories. These include abnormal development of the genitalia, sperm pathologies, including dead sperm, low sperm mobility, disorders of secondary sexual characteristics, degenerate changes of the placenta, delay in sexual maturation, primary infertility, complications during pregnancy and birth, and perinatal and neonatal deaths.
Significantly high levels of alpha radionuclides were found in bone tissue of aborted fetuses from mothers living in the contaminated territories in Ukraine. Changes in sex ratios at birth were documented in Denmark, Finland, Germany, Hungary, Norway, Poland and Sweden.
Chromosome aberrations in peripheral blood cells were among the first ominous signs of the Chernobyl catastrophe and revealed a correlation between the level of aberrations and a number of pathological conditions. Somatic chromosomal mutations were linked to congenital malformations and protein polymorphism. Mutations in mini-satellite DNA are only some of the genetic changes resulting from radionuclide exposure, but the overwhelming majority of Chernobyl-induced genetic changes will not become apparent for several generations.
Liquidators and residents of the contaminated territories often complain of bone and joint pain. Bone function is a balance between the formation of bone and the natural re-absorption process. Because a number of isotopes become deposited in bone these diseases may be due to either hormonal disorders or direct damage by irradiation to the cellular predecessors of osteoclasts and osteoblasts. Sr-90, produced in the splitting of uranium is deposited in children's bones and teeth and linked to diseases later in life. (Sherman, 2000; Mangano and Sherman, 2011)
In contaminated Ukrainian territories, children have been born without bones (“jellyfish children”), a condition seen previously only in the Marshall Islands after the nuclear tests of the 1950s.
Throughout the more contaminated territories, visual abnormalities occur with greater frequency than in less contaminated areas and include premature cataracts, vitreous degeneration, refraction errors, uvitis and conjunctivitis. It is disturbing that only after 2000 did medical authorities begin to recognize the radiogenic origin of the large increase in cataracts among liquidators and evacuees from the Chernobyl territories. Official recognition occurred 10 years (!) after doctors began to sound the alarm and 13 years after the problem was first registered.
Congenital malformations and anomalies:
Wherever there was Chernobyl radioactive contamination, there was an increase in children born with anomalies and congenital malformations (CMs), including previously rare multiple structural impairments of the limbs, head and body. (Wertelecki, 2010). Analysis of more than 31,000 Belarussian abortuses revealed that the incidence of officially registered CMs increased in all of the contaminated territories and was especially significant in areas with Cs-137 levels of contamination higher than 15 Curies per square kilometer (15 Ci/km2).
In Belarus, some 24 percent of the children in the territories with Cs-137 levels less than 1 Ci/km2 were born with CMs; 30 percent had CMs in territories with levels of 1-5 Ci/km2, and 83 percent had CMs in districts with contamination levels above 15 Ci/km2. The Russian State Registry, which included more than 30,000 children born to liquidators, revealed 46.7 percent had congenital anomalies and “genetic syndromes,” with the prevalence of bone and muscular abnormalities being 3.6-fold higher than corresponding normal Russian parameters.
With the passage of more than a decade, we do not know the full extent of the health of children and grandchildren born to those who were contaminated by the Chernobyl fallout, but research must continue to find out. (Holt, E., 2010)
Central nervous system:
The most serious effect of the Chernobyl radiation is to the brain and is a major medical, social and economic problem for the affected individual, the persons' family and society at large.
Studies of liquidators and those irradiated in utero reveal that even small amounts of nuclear radiation, considered harmless by official measures of radiation exposure, resulted in marked organic damage of the frontal, temporal and occipitoparietal lobes of the brain. These organic changes are reflected in nervous system dysfunction, including perception, short-term memory, attention span and operative thinking and result in behavioral and mental disorders and diminished intelligence.
Recent studies show that schoolchildren from the most exposed areas in Sweden who were in the sensitive gestational period during the Chernobyl release were significantly less likely to qualify for high school. (Almond et al., 2007) A recent study of Norwegian adolescents revealed the adverse effect of low dose Chernobyl radiation exposure in utero on cognitive function (verbal IQ). (Heiervang et al., 2010)
Inexplicably, WHO had a special project on brain damage in the Chernobyl territories, which was abruptly stopped after the first definitive results. It is becoming clear that low-dose and low-dose rates of radiation have a profound effect upon fine structures of the nervous system, upon higher nervous system function and upon neuropsychiatry function.
Many pro-nuclear critics have attributed the latter to “radio-phobia,” but documentation of disease is not limited to the human population. With few exceptions, animal and plant systems that were studied demonstrated structural abnormalities in offspring, loss of tolerance and viability, and genetic changes. (Møller and Mousseau, 2010) Wild animals and plants did not drink alcohol, smoke or worry about compensation.
Total number of victims
The number of victims is one of the most contentious issues between scientists who collected data first-hand and WHO/IAEA that estimated only 9,000 deaths.
The most detailed estimate of additional deaths has been done in Russia by comparing rates in six highly contaminated territories with overall Russian averages and with those of six lesser-contaminated areas, maintaining similar geographical and socioeconomic parameters. There were over 7 million people in each area. Documentation is as follows:
The region under study exceeded the Russian average in both over-all mortality and increased rate of mortality. The total number of additional deaths, calculated on the basis of the standardized mortality rates, is estimated at 60,400 (95 percent CI: 54,880 to 65,920) – or 34 persons per 1,000. From 1990 to 2004, the number of additional deaths represents 3.75 percent of the entire population of the contaminated territories and agrees well with the figure of 4.2 percent for Ukraine. (National Ukrainian Report, 2006)
For the populations in all the contaminated territories together – European Russia 1,789,000 (1999), Belarus 1,571,000 (2001) and Ukraine 2,290,000 (2002) – and based on the additional rate in Russia, the total number of extra deaths from Chernobyl in Belarus, Ukraine and the European part of Russia is estimated to be 212,000 for the first 15 years after the catastrophe.
While this calculation seems straightforward, it might underestimate the real figures for three reasons according to Khudoley et al. (2006):
When we apply the additional mortality of 34 extra deaths per 1,000 population for the 15 years 1990-2004, which was derived above, to the cohort of liquidators not living in contaminated zones (400,000), to the evacuees and to people who moved away from contaminated areas (350,000), then we expect another 25,500 deaths in this period. The overall number of Chernobyl-related deaths up until 2004 in the former USSR is estimated to be 237,500.
Assuming that 10 million people in Europe, outside the former Soviet Union, live in territories with a Cs-137 ground contamination higher than 40 kilobecquerels per square meter, or 40 kBq/m2 (>1.08 Ci/km2), and that the mortality risk is only half that determined in the Chernobyl region, that is, 17 deaths per 1,000 inhabitants – and with better food and better medical and socioeconomic status – up until 2004, we can expect an additional 170,000 deaths in Europe.
Assuming further that the other 150 million Europeans living in territories with a Cs-137 ground contamination below 40 kBq/m2, the additional mortality will be 10-fold less – i.e., 1.7 deaths per 1,000 in 1990-2004 – then we can expect 150,000 x 1.7 or 255,000 more deaths in the rest of Europe.
Given that 20 percent of the radionuclides released from the Chernobyl reactor were deposited outside Europe, with an exposed population of 190 million and with a risk factor of 1.7 per 1,000 as before, we can expect 323,000 additional deaths outside Europe by 2004.
Data from multiple scientists estimate the overall mortality from the Chernobyl catastrophe, for the period from April 1986 to the end of 2004, to be 985,000, similar to those of Gofman (1994a) and Bertell (2006) and a hundred times more than the WHO/IAEA estimate.
Overall effects of radioactive fallout
While fallout was measured in many countries, multiple short half-life isotopes were largely un-measured. Decades of research have confirmed that radioisotopes become deposited in various parts of living systems. In humans, I-131 and I-129 concentrate in the thyroid, Cs-137 in soft tissue, and Sr-90 in teeth and bones.
Combined effects from exposure to multiple isotopes that concentrate in various portions of a human or animal have not been fully examined, however, by comparing disease rates in communities with increased levels of radiation to others with low levels, or pre-Chernobyl levels, while maintaining similar socio-economic factors, distinct patterns of effect emerged in those who received the Chernobyl fallout.
Fallout deposition was uneven and remains uneven. Aerial measurements were largely of Cs-137 fallout, which has a gamma component detectable from a plane or helicopter, but even with monitoring, hot spots remained ill defined. The effects of “hot particles” was first documented when upper respiratory, skin and eye problems became manifest soon after the Chernobyl explosions. The particles consist of radioactive metal, largely alpha emitters that cause significant damage when in contact with living cells.
The effects from the Chernobyl catastrophe change over time, many ongoing and some increasing in adverse effect as, for example, Plutonium-241 (Pu-241) that decays to Americium-241 (Am-241), with a half-life of 432 years. Am-241 is water-soluble, moves through the food chain, and emits both gamma and alpha radiation. The ultimate effect upon migratory birds and sea life is not yet determined, but such contamination could result in the collapse of significant numbers of species and food sources.
A 2008 publication of the Ministry of Ukraine of Emergencies and Affairs of Public Protection from the Consequences of Chernobyl (“Atlas of Ukraine Radioactive Contamination”) shows dire predictions for the spread of increasing amounts of Am-241 around the Chernobyl site, westward into the Pinsk Marshes that form the border between Ukraine and Belarus, and south into the Dnepr River where it flows into the Black Sea near Odessa, empties through the Bosporus to the Aegean, and ultimately reaches the Mediterranean Sea.
The westward spread is augmented by commercial canal traffic that connects the Priyapat River to the Bug, Vistula and Oder Rivers and finally into the Baltic Sea. Thus in addition to the atmospheric spread immediately after the disaster, contamination continues to spread via water routes.
To date, not every living system has been studied, but of those that have – animals, birds, fish, amphibians, invertebrates, insects, trees, plants, bacteria, viruses and humans – many with genetic instability across generations all sustained changes, some permanent and some fatal. Wild and domestic animals develop diseases similar to those found in humans
It takes 10 decades for an isotope to completely decay, thus the approximately 30-year half-lives for Sr-90 and Cs-137 mean it will take nearly three centuries before they have decayed, a mere blink of the eye when compared to Plutonium-239 (Pu-239) with a half-life of 24,100 years.
The human and economic costs are enormous: In the first 25 years, the direct economic damage to Belarus, Ukraine and Russia has exceeded $500 billion. To mitigate some of the consequences, Belarus spends about 20 percent of its national annual budget, Ukraine up to 6 percent and Russia up to 1 percent. Funding from other countries and from the U.N. is essential to continue scientific studies and to provide help to those who continue to live with significant radioactive contamination.
The tragedy of Chernobyl shows that societies everywhere – especially Japan, France, India, China, the United States and Germany – must consider the importance of independent, publicly available radiation monitoring of both food and individual in-body irradiation levels with the aim of documenting the danger and preventing additional harm and to have stable potassium iodide (KI) readily available to prevent thyroid damage.
Given profound weather effects – earthquakes, floods, tsunamis etc. – human fallibility and military conflicts, many believe that it is only a matter of time before there is another nuclear catastrophe. Nuclear fallout knows no state or national boundaries and will contribute to increase in illnesses, decrease in intelligence and in instability throughout the world. The economic costs of radioactive pollution and care of contaminated citizens are staggering. No country can maintain itself if its citizens are economically, intellectually, politically and socially impoverished.*
When a radiation release occurs, we do not know in advance the part of the biosphere it will contaminate, the animals, plants and people that will be affected, nor the amount or duration of harm. In many cases, damage is random, depending upon the health, age and status of development and the amount, kind and variety of radioactive contamination that reaches humans, animals and plants. For this reason, international support of research on the consequences of Chernobyl must continue in order to mitigate the ongoing and increasing damage. Access to information must be transparent and open to all, across all borders. The WHO must assume independent responsibility in support of international health.
Given the continuing and known problems caused by the Chernobyl catastrophe, we must ask ourselves: Before we commit ourselves to economic and technological support of nuclear energy, who, what and where are we willing to sacrifice and for how long?
Bertell, R. “The death toll of the Chernobyl accident.” In: Busby, C.C. and Yablokov, A.V., (Eds.), ECRR Chernobyl 20 Years On: Health Effects of the Chernobyl Accident. ECRR Doc. 1, Green Audit Books, Aberystwyth, pp. 245, 248, 2006; Second Edition; PDF copy of First Edition (4 MB).
Gofman, J.W., Chernobyl Accident: Radioactive Consequences for the Existing and Future Generations. Vysheihsaya Shcola, Minsk. 576 pp., 1994 (in Russian)
Heiervang, K.S., et al. “Effect of low dose ionizing radiation exposure in utero in cognitive function in adolescence.” Scandinavian Journal of Psychology, 2010, doi: 10.1111/j.1467-9450.2010.00814.x
Holt, E., “Debate over health effects of Chernobyl re-ignited.” Lancet. 375(9724): 1424-1425, 2010 (PDF copy)
Khudoley, V.V., Blokov, I.P., Sadovnichik, T., and Bysaro, S., “Attempt to estimate the consequences of Chernobyl catastrophe for population living in the radiation-contaminated territories of Russia.” In: Blokov, I.P. (Ed.), “Consequences of Chernobyl Accident: Estimation and Prognosis of Additional Mortality and Cancer Diseases.” Center for Independent Environmental Assessment, Greenpeace-Russia, pp. 3-19, 2006 (in Russian)
Mangano, J.J. and Sherman, J.D., “Elevated in vivo strontium-90 from nuclear weapons test fallout among cancer decedents: A case-control study of deciduous teeth,” International Journal of Health Services, 41(1):137–58, 2011
Ministry of Ukraine, “Emergencies and Affairs of Public Protection from the Consequences of Chernobyl,” “Atlas of Ukraine Radioactive Contamination,” Intelligence Systems GEO, Ltd., 2002, 2008
National Ukrainian Report. “Twenty Years of Chernobyl Catastrophe. Future Outlook.” (Kiev) www.mns.gov.ua/news_show.php? 2006 (in Russian)
Sherman, J.D. Life's Delicate Balance: Causes and Prevention of Breast Cancer. Taylor and Francis. New York. 273 pp. 2000
Yablokov, A.V., Nesterenko, V.B., Nesterenko, A.V., “Chernobyl Consequences for People and Nature.” “Nauka” Publ., Sankt-Petersburg, 367 pp., 2007
Yablokov, A.V., Nesterenko, V.B., and Nesterenko, A.V., Sherman-Nevinger, J.D., Consulting Editor, Chernobyl: Consequences of the Catastrophe for People and the Environment, New York Academy of Sciences, 1181:1-327, 2009.
Janette D. Sherman, M.D., is a physician and toxicologist, specializing in chemicals and nuclear radiation that cause cancer and birth defects. The author of Chemical Exposure and Disease and Life's Delicate Balance: Causes and Prevention of Breast Cancer and Consulting Editor of Chernobyl: Consequences of the Catastrophe for People and the Environment; she has worked in radiation and biologic research at the University of California nuclear facility and at the U.S. Naval Radiological Defense Laboratory at the Hunters Point Shipyard in San Francisco. From 1976-1982, she served on the advisory board for the EPA Toxic Substances Control Act. Throughout her career, she has served as a medical-legal expert witness for thousands of individuals harmed by exposure to toxic agents. Dr. Sherman's primary interest is the prevention of illness through public education and patient awareness. She can be reached at email@example.com and www.janettesherman.com. Co-author Alexey V. Yablokov, Ph.D., can be reached at firstname.lastname@example.org.
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