The topic started by the rapid response [1] was further developed in the letter [2]. The following comment might be of importance for the public health. I am sincerely grateful to Prof. Andreas Nidecker for his response [3] to my letter [2], and agree to his remarks, in particular, to the following:
"Several critiques expressed in the letter to the editor make no sense, especially the one indicating that elimination of Cs-137 is only effective when the food continues to be contaminated with Cs-137. This is clearly wrong; the principal reason for the efficacy in this case is due to the important biliary excretion of Cs-137, where it would be immediately reabsorbed: in the absence of pectin in the bowel, the elimination of Cs-137 is only 13.9% within three weeks, which would allow the calculation of the biological half-life of radiocaesium in these children; (The biological half-life of radiocaesium varies from 60 to 150 days, depending on the publications, and could be calculated from the findings of the group receiving placebo)." [3]
This comment is correct, and it was caused by an omission on my part. It was also written additionally in the letter [2]: "The sorbents, if they are indeed efficient, would absorb all caesium isotopes equally, because the isotopes have identical chemical properties and only slight differences in atomic weight. Considering the above, the biological half-life of the stable and radioactive caesium must be practically equal. In conclusion, as it was stated in the letter [2], if pectin indeed absorbs Cs+ ions so efficiently that their concentration in body fluids declines, it can induce compensatory retention of the whole caesium, including Cs-137 accumulated previously, when its contents in the environment and foodstuffs was higher: all children in the studies [4,5] came from the areas contaminated after the Chernobyl accident. Moreover, excessive loss of caesium may cause its increased assimilation (including Cs-137) after the return of the children to the contaminated areas. Paradoxically, if the sorbent treatment [4,5] is indeed efficient, its final effect can be opposite to the desired one.
References
1. Jargin SV. Publications exaggerating Chernobyl consequences: some examples. BMJ Rapid Response of 22 August 2009.
2. Jargin SV. Reduction of radiocaesium load: supplementation of Cs versus it's depletion by enterosorbents. Swiss Med Wkly 2011;141:w13166.
3. Nidecker A. Reply to the letter to the Editor "Reduction of radiocaesium load" by Sergei V. Jargin. Swiss Med Wkly 2011;141:w13164.
4. Nesterenko VB, Nesterenko AV, Babenko VI, Yerkovich TV, Babenko IV. Reducing the 137Cs-load in the organism of "Chernobyl" children with apple-pectin. Swiss Med Wkly 2004;134:24-7.
5. Bandazhevskaya GS, Nesterenko VB, Babenko VI, Yerkovich TV, Bandazhevsky YI. Relationship between caesium (137Cs) load, cardiovascular symptoms, and source of food in 'Chernobyl' children - preliminary observations after intake of oral apple pectin. Swiss Med Wkly 2004;134:725-9.
Rapid Response:
Re: Rekindled passion: fire and fallout
The topic started by the rapid response [1] was further developed in the letter [2]. The following comment might be of importance for the public health. I am sincerely grateful to Prof. Andreas Nidecker for his response [3] to my letter [2], and agree to his remarks, in particular, to the following:
"Several critiques expressed in the letter to the editor make no sense, especially the one indicating that elimination of Cs-137 is only effective when the food continues to be contaminated with Cs-137. This is clearly wrong; the principal reason for the efficacy in this case is due to the important biliary excretion of Cs-137, where it would be immediately reabsorbed: in the absence of pectin in the bowel, the elimination of Cs-137 is only 13.9% within three weeks, which would allow the calculation of the biological half-life of radiocaesium in these children; (The biological half-life of radiocaesium varies from 60 to 150 days, depending on the publications, and could be calculated from the findings of the group receiving placebo)." [3]
This comment is correct, and it was caused by an omission on my part. It was also written additionally in the letter [2]: "The sorbents, if they are indeed efficient, would absorb all caesium isotopes equally, because the isotopes have identical chemical properties and only slight differences in atomic weight. Considering the above, the biological half-life of the stable and radioactive caesium must be practically equal. In conclusion, as it was stated in the letter [2], if pectin indeed absorbs Cs+ ions so efficiently that their concentration in body fluids declines, it can induce compensatory retention of the whole caesium, including Cs-137 accumulated previously, when its contents in the environment and foodstuffs was higher: all children in the studies [4,5] came from the areas contaminated after the Chernobyl accident. Moreover, excessive loss of caesium may cause its increased assimilation (including Cs-137) after the return of the children to the contaminated areas. Paradoxically, if the sorbent treatment [4,5] is indeed efficient, its final effect can be opposite to the desired one.
References
1. Jargin SV. Publications exaggerating Chernobyl consequences: some examples. BMJ Rapid Response of 22 August 2009.
2. Jargin SV. Reduction of radiocaesium load: supplementation of Cs versus it's depletion by enterosorbents. Swiss Med Wkly 2011;141:w13166.
3. Nidecker A. Reply to the letter to the Editor "Reduction of radiocaesium load" by Sergei V. Jargin. Swiss Med Wkly 2011;141:w13164.
4. Nesterenko VB, Nesterenko AV, Babenko VI, Yerkovich TV, Babenko IV. Reducing the 137Cs-load in the organism of "Chernobyl" children with apple-pectin. Swiss Med Wkly 2004;134:24-7.
5. Bandazhevskaya GS, Nesterenko VB, Babenko VI, Yerkovich TV, Bandazhevsky YI. Relationship between caesium (137Cs) load, cardiovascular symptoms, and source of food in 'Chernobyl' children - preliminary observations after intake of oral apple pectin. Swiss Med Wkly 2004;134:725-9.
Competing interests: No competing interests