Chernobyl Liquidators' Health
as a Psycho-Social Trauma

4.5. Summary of possible effects of non-radiation harmful factors upon health

       Despite until now it is considered (McFarlane and Yehuda 1996: 164, emphasis added) that

       the impact of (psychological) trauma on physical health is a neglected topic

the data already available do outline the scope of both mental and physical health effects. In this subchapter, in order to create a certain general picture of possible effects of non-radiation harmful factors, I will briefly sum up what effects upon health have been already mentioned within the four frameworks dealt with in this chapter, laying the main emphasis upon the data on traumatic stress framework (McFarlane and Yehuda 1996: 164—166).
       Selye's (1992) concept of distress gives a general idea, that, under excessive load, in the organism, like in a chain, the weakest link breaks. This means that impact of “the Chernobyl distress” may consist in increased rate of “ordinary” diseases, to which the person-liquidator is presupposed. Increase of adrenal glands, atrophy of thymus, gastrointestinal ulceration which serve as objective indicators of (and, thus, accompany) distress (Selye 1992: 26), are another expected outcomes, stemming from this concept.
       Occupational stress of high-demand, low-control occupations is associated with higher rates of coronary heart diseases (Baker and Karasek 1995).
       Effects of extreme and unusual environments on health include destructive/self-destructive behaviours, psychosomatic problems, post-traumatic stress disorder (PTSD), hallucinations, and community mental health problems. The individuals who had extremely harsh experience may develop PTSD, which, according to (Suefeld 1987) includes hyper-reactivity to stimuli associated with the experience, nightmares, guilt feelings, apathy, and psychosomatic illness. The most common psychosomatic symptoms are sleep disturbances, headache, fatigue, sore muscles, and gastrointestinal dysfunction. Cardiovascular system is mentioned as the most salient locus of change.
       Traumatic stress (essential part of it is embraced but not limited to PTSD) framework (Van der Kolk, McFarlane and Weisaeth 1996: x; emphasis added) sees dissociation of traumatic memories from other life experiences, their “storage” outside of ordinary awareness as a core injury, which “may be expressed in such seemingly incomprehensible symptoms as physical ailments, behavioural re-enactments, and vivid sensory reliving experiences”.
       There is a hypothesis that chronic hyperarousal, inherent to PTSD, depletes biological and psychological resources necessary for experiencing a wide variety of emotions; it results in the failure to fully process emotional events, which, in turn, leads to both further physiological hyperarousal and psychosomatic problems. This hypothesis is supported by studies showing that emotional numbing and psychosomatic problems are intimately related, and that “low level of emotional expression lead to impairment of immune function and to an increase in physical illness” (Van der Kolk and McFarlane 1996: 12—13; emphasis added). The data of case studies father expand idea about expected aftermath of disasters and atrocities on health.
       The studies of war veterans as subjects (these studies constitute the majority of research on the relationship between physical symptoms and trauma) has shown that the veterans with the PTSD, as compared to those without it, reported a higher rate of cardiovascular, neurological, gastrointestinal, audiological, and pain symptoms64. Victims of natural disaster in Puerto Rico had a higher incidence of new gastrointestinal or pseudoneurological symptoms than those non-affected.
       Both concentration camp victims and the merchant seamen of North-Atlantic convoys of WW2 had much higher mortality than the control group. In the first period after the imprisonment, the deaths were caused by infectious diseases; later coronary arterial disease, lung cancer and violent death were most common. A different study of the concentration camp victim survivors showed that not only PTSD symptoms, but also various vegetative symptoms, psychosomatic and conversion complaints accounted for problems with occupational functioning and absences from the work (McFarlane and Yehuda 1996: 167). “Devastating effect of extreme and long-lasting stress on subsequent health” was considered arguably the most consistent finding of the series of studies of the concentration camp survivors (Van der Kolk, Weisaeth and van der Hart 1996: 60). Extreme trauma was once again shown to have severe biological (along with psychological, social and existential) impacts, and to impair capacity to cope with both biological and psychological stressors later in life.
       Survivors of Alexander Kielland oil rig disaster (in which 123 men were killed) had increased rates of both physical and psychiatric disorders, the effect remain valid for the 8-year follow-up. The difference in the rate of psychiatric disorders was especially striking: 12.3% in the survivors vs. 1.5% in the control group65 (McFarlane and Yehuda 1996: 162).
       Thus, it is possible to conclude that impacts of various harmful factors, severe experiences, harsh circumstances, disasters or atrocities upon individuals may result in a set of psychic and physical disorders and diseases66; non-specific to the traumatic event. This conclusion, and the set of the diseases and disorders outlined, seems to be in a qualitative agreement with the Chernobyl-liquidators' health data.

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Studio ARWIS  Kharkov, 2001