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Studies of Health Effects from 

Nuclear Testing near the 

Semipalatinsk Nuclear Test Site, 

Kazakhstan 

 

Bernd Grosche1, Tamara 

Zhunussova2, Kazbek Apsalikov3, 

Ausrele Kesminiene4  

 
1Federal Office for Radiation Protection, 
Department of Radiation Protection and 
Health, Oberschleissheim, Germany; 
2Norwegian Radiation Protection 
Authority, Department of Monitoring and 
Research, Osteras, Norway; 3Scientific 
Research Institute for Radiation Medicine 
and Ecology, Semey, Kazakhstan; 
4International Agency for Research on 
Cancer, Lyon, France 

 

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Abstract 

The nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today’s radiation 

protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of 

research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb 

testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and 

evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, 

new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to 

linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further 

developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview 

of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing 

out directions for future epidemiologic studies. 

Keywords: Semipalantinsk nuclear test site, Kazakhstan, radiation health, environmental health 

 

Studies of Health Effects from 

Nuclear Testing near the 

Semipalatinsk Nuclear Test Site, 

Kazakhstan 

Bernd Grosche1, Tamara 

Zhunussova2, Kazbek Apsalikov3, 

Ausrele Kesminiene4  

 
1Federal Office for Radiation Protection, 
Department of Radiation Protection and 
Health, Oberschleissheim, Germany; 
2Norwegian Radiation Protection Authority, 
Department of Monitoring and Research, 
Osteras, Norway; 3Scientific Research 
Institute for Radiation Medicine and Ecology, 
Semey, Kazakhstan; 4International Agency 
for Research on Cancer, Lyon, France  

Review 

The Semipalatinsk nuclear test site (STS) is 

located in the present East-Kazakhstan Oblast (or 

administrative division) of Kazakhstan, a country that 

was previously a part of the Soviet Union. The test site is 

named after the city of Semipalatinsk (in Kazakh: 

Semey) and is located approximately 150 km west of the 

city. The test site covers an area of 18,500 km², or 7,143 

square-miles. The STS was a major site for nuclear 

weapons testing by the former Soviet Union, and it was 

where the former Soviet Union conducted their first 

nuclear test on August 29, 1949. Afterwards, 456 nuclear 

explosions were carried out between 1949 and 1989, 

including 111 atmospheric events (86 air events and 25 

surface events) between 1949 and 1962.1,2 After the 

Limited Test Ban Treaty was signed in 1963, the tests at 

STS were restricted to underground shafts and tunnels so 

that little or no offsite environmental contamination was 

caused; except for four events that occured between 1965 

and 1968, within the framework of peaceful uses of 

nuclear energy program, which was designed for earth-

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moving purposes (e.g. the construction of artificial lakes, 

canals, and harbors). The last event conducted at the STS 

was on October 19, 1989. The total yield of atmospheric 

events conducted at the STS is reported to be 6.58 

megatons of TNT equivalent, which corresponds to 

approximately 66% of the total estimated Soviet bomb 

yield.3  

The test site had three major testing areas. 

Atmospheric bomb tests were performed at Ground Zero. 

Over 200 underground nuclear tests were performed in 

the Degelen Mountains. 123 underground nuclear tests 

were conducted in the Balapan area, one of which led to 

the formation of  Lake Chagan (or Lake Balapan), which 

is sometimes called ‘Atomic Lake’ due to the current 

radioactive environment.2 During the tests, access to the 

site was strictly controlled by the Soviet armed forces, 

and no civilian use of the area was permitted.  

Previous analyses made by several institutes 

from different countries might provide insight into the 

health effects from low dose radiation exposure, as 

defined by the European low-dose initiative MELODI.4,5 

There have also been numerous biological studies 

published on radiation effects.6-11 The European 

Commission has funded a new project to assess whether 

it is possible to create a unified cohort of individuals 

affected by the atomic bomb testing,12 which, if 

successful, could provide numerous insights into the 

health effects of radiation exposure. Beyond giving an 

overview on already published evidence, this paper 

provides recommendations about future research 

directions on radiation health effects. In particular, the 

authors would like to argue that it is necessary to better 

link future epidemiological cohort studies with biological 

research either based on already collected, existing 

biomaterial or on biomaterial that will be sampled in the 

frame of the future investigations. This manuscript aims 

to provide an overview on previous studies focused on 

the health effects of the nuclear testing by evaluating 

information on dosimetry efforts and insights on the 

direction of future epidemiological studies. 

Environmental health exposures 

The 111 atmospheric events conducted between 

1949 and 1962 caused the primary source of radioactive 

contamination of the environment and the majority of the 

radiation exposure of the public. The most damaging 

tests, in terms of exposure, were those conducted on 

August 29, 1949 (with a yield of 22 kilotons (kt) TNT 

equivalent), September 24, 1951 (38 kt), August 12, 1953 

(400 kt), and August 24, 1956 (27 kt). Most of the other 

explosions led to exposures that affected only the test 

ground, not the vicinity of the test site. 

The population living closest to the test site was 

exposed to relatively high levels of radiation. Settlements 

affected by the 1949 test were located north-east of the 

test site (e.g. Dolon and Cheremushka), but traces from 

this test have also been documented in residents living 

further away in the Altai region in Russia.13 The tests of 

1951, 1953, and 1956 affected settlements south and 

south-east of the test site (e.g. Kainar, Karaul, 

Kaskabulak, Sarzhal, and Znamenka).   

Both, external and internal exposures need to be 

considered when estimating the individual doses to 

which residents have been exposed. External exposure 

was caused by the radioactive clouds and submersion, 

whereas internal exposure is caused by the consumption 

of contaminated foods. Food consumption varied 

between the different ethnic groups living in the 

contaminated areas, such as Kazakhs, Russians, and 

Germans. The first effort to evaluate both external and 

internal exposure was attempted in Kazakhstan and 

published in 2000.14 The extensive work of different 

international groups has found that the calculated doses 

tended to overestimate the actual exposures,15-18 where 

the village of Dolon was used as the primary location for 

comparing different methods for dose estimates. During 

a research meeting held at the University of Hiroshima in 

2005, researchers with different approaches to 

retrospective dosimetry compared and discussed their 

results, paying close attention to reasons for large 

variation among estimates. The results from this 

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workshop were published in a special issue of the 

Japanese Journal for Radiation Research in 2006, with 

agreement achieved about exposure doses for Dolon.19 

Today, the previously published U.S./Russian joint 

methodology is considered as being the most 

appropriate.18  

 

Previous studies on health effects  

The first studies on health effects associated 

with nuclear bomb testing were of a descriptive nature. 

One of the first published reports focused on the 

increased age-specific incidence rates of malignant 

tumors in the Semipalatinsk Oblast compared to the 

general population of the Soviet Union and Kazakhstan 

populations.20 Based on the survey data that was 

collected in five year intervals from 1949 onwards, 

increased cancer incidence rates were reported in highly 

exposed villages compared to the villages of the 

Kokpektinskii district (control area).21 In an ecological 

study of childhood cancer incidence in four 

administrative divisions adjacent to the STS spanning 

from 1981 to 1990, an increase in relative risks for all 

cancers, including leukemia and brain tumors, were 

reported in children living less than 200 km from the test 

epicenter compared to children residing more than 400 

km from the test site.22 In 2000, a comprehensive book 

was published, which included information on the 

incidence and mortality of a few selected diseases such 

as cancer, cardiovascular disease, and mental retardation, 

as well as the prevalence of congenital malformations.2 

Overall, there was clear evidence of unfavorable health 

outcomes in the population living around the test site. 

Based on data that were collected from 1960 to 

1991 by the National Research Institute of Radiation 

Medicine and Ecology of Kazakhstan, a cohort was 

established which became known as the “historical” 

cohort. This cohort was comprised of approximately 

20,000 individuals. Half of these individuals came from 

exposed villages and the other half came from a 

comparison (unexposed) area. The first analyses were 

based on the dosimetry system developed by Kurakina et 

al.14 and focused on cancer mortality with follow-ups 

until 1999.23,24 A more recent analysis employed a 

dosimetry system, which was developed by the U.S. 

National Cancer Institute for the purpose of studying 

thyroid diseases, amongst the population living near the 

Semipalatinsk nuclear test site (see Figure 1). 

 

Figure 1: The 18,000 km2 area of the Semipalantinsk Test 

Site (indicated in red attached to Kurchatov (along the 

Irtysh river), and near Semey, as well as Karaganda and 

Astana 

 

 The dosimetry system was based on a joint 

U.S./Russian dose reconstruction methodology that 

combined the experience of dose-reconstruction 

scientists in Russia and the U.S.16,18 Another study 

looked at mortality associated with cardiovascular 

disease.25 While given doses, around 90 milliGray (mGy) 

on average, with a maximum of 630 mGy, had no effect 

on cardiovascular disease, the analyses of mortality due 

to solid tumors had to be revised to incorporate the 

updated dosimetry system. The dosimetry system 

developed by Kurakina et al.14 generally gave higher dose 

estimates in comparison to more recent systems,16,18 

including the University of Hiroshima consensus 

meeting. 

A cross-sectional study of the prevalence of 

thyroid diseases was conducted using 2,994 residents 

from eight villages. The study involved ultrasound 

screening, and malignancy status was confirmed by 

cytopathology evaluation. In terms of excess relative risk 

per unit dose, the dose-response findings for nodule 

prevalence were compatible with those from populations 

exposed to medical X-rays and atomic bomb survivors.26 

Another study looking at the differences between birth 

cohorts of those in East Kazakhstan found that those born 

closest to the dates during the nuclear tests had an 

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increased risk of numerous health problems, including 

cardiocascular disease and cancer.27  

Two studies looked into possible radiation 

effects in the offspring of exposed individuals. The first 

study focused on investigating whether the exposures led 

to a significant change in the sex ratio of newborns. 

Based on 11,464 single births from 3,992 mothers 

exposed to radiation during 1949–1956, the overall sex 

ratio was 1.07 (e.g. 107 boys per 100 girls), which was 

comparable to the sex ratio in Kazakhstan in the mid-

2000s (1.06).28 Using a subset of 141 twin deliveries from 

3,992 mothers, further analyses were conducted on the 

effects of radiation exposure on same sex and different 

sex twin delivery. There was an increase in the odds of 

having different sex twins for births occurring within 5 

years after exposure compared with more than 20 years 

after exposure [OR = 4.08 (95% CI: 1.11, 15.07)] in all 

villages, regardless of exposure level.29 Another study 

focused on the frequency of mini-satellite mutations in 

exposed offspring and unexposed (control) offspring, and 

found a negative correlation between mutation rate and 

the parental year of birth in the exposed F1 generation, 

with the highest mutation rate in the most exposed cohort 

of parents born before 1960.8 

To our knowledge, no additional studies have 

been conducted on mental disability or congenital 

malformation. 

 

Data bases 

Several databases and registries have been 

developed over the past few decades, which need to be 

further explored for risk analyses. One of these resources 

is the previously mentioned historical cohort.23 Another 

database is the registry of the population of the former 

Semipalatinsk Oblast. Initiated in 1949, this registry is a 

valuable source of health data, including information on 

residential histories, vital statistics, and causes of death 

for over 100,000 individuals.30 This database includes the 

participants of the historical cohort. More recently, a joint 

Japanese-Kazakh effort was initiated by a group headed 

by the late Dr. Ogiu from Japan, focusing on creating a 

database of exposed residents and those from a 

comparison area – which is different from the one used 

for the historical cohort. This database was designed to 

include residential history and causes of death.31 As 

mentioned earlier, one of the tasks of the SEMI-NUC 

project12 is to test how the two databases may be linked. 

A respective report is under development, which will 

define how to best use available data from both databases 

for future epidemiological research. 

 

Biological material 

Biological samples from individuals living in 

the affected areas have been collected in numerous 

studies;6-11 however, to our knowledge, not all were 

stored. In recent years, the National Research Institute of 

Radiation Medicine and Ecology in Semey started 

collecting blood samples and teeth from the persons still 

residing in the villages close to the former STS and stored 

them in a biobank.32   

 

Discussion 

This review demonstrates that different datasets 

are available for investigating health effects of radiation 

among the population living in proximity to the 

Semipalatinsk nuclear testing site. The EU-funded 

project SEMI-NUC aims to evaluate to what extent the 

different data sets can be linked and whether there is a 

possibility to use this data for a future prospective cohort 

study. To that end, possible follow-up mechanisms are 

going to be tested, including monitoring of incidence and 

mortality data, where the outcomes of interest are cancer 

and non-cancerous diseases. Avenues of ascertainment of 

vital statistics and cause of death have yet to be identified 

and validated. Thus, available sources of information 

must be defined (e.g. death certificates, hospital records, 

etc.). Methodologies that were used to calculate doses for 

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existing cohorts have to be reviewed and compared, 

including identifying potential discrepancies and reasons 

for the discrepancies. Furthermore, it will be important to 

evaluate the quality and the content of existing 

biomaterials. Such evaluations will need to look at how 

samples were processed and stored, which types of 

equipment was used for DNA extraction, methods of 

evaluation of previous cytogentic analyses, and the 

condition of stored tissue samples. In addition, there will 

be evaluations of the possible use for modern technology 

analysis. For the latter, validated SOPs have already been 

developed and are available on the internet.33 Newly 

collected biomaterial will mainly come from elderly 

participants since the last bomb testing that led to 

significant exposures to the public was conducted in 

1954.  

However, there are other interesting options for 

future research on the effects of low to intermediate 

doses. The large data sets independently developed by 

Katayama et al.30 and researchers from the Radiation 

Effects Association31 give rise to the possibility of 

investigating transgenerational effects. Further, there is a 

three-generation data set available at NIIRME, which 

includes limited results from previously conducted 

chromosomal aberration analyses. The collection of the 

relevant information for this dataset is currently 

underway. 

Although research on the health effects of low 

to medium exposures from the nuclear testing is of high 

public health relevance, a major limitation is that studies 

mentioned in this paper are not well connected with each 

other. This makes an overall joint evaluation difficult. 

Additionally, epidemiological research in the area close 

to the test site faces a number of difficulties. One of the 

problems is that exposures are dominated by the 

radioactive plumes (external), but for some health 

endpoints, internal exposures are of a higher relevance. 

Since exposure estimates have been carried out many 

years after actual events, this introduces another source 

of bias. Another limitation is that biological materials 

from the affected population were not always properly 

stored and labeled. It is difficult to link available 

biological material to individuals included in the 

epidemiological studies and their demographic data.  

Despite the fact that difficulties exist, studies of 

individuals affected by atomic bomb testing have the 

potential to contribute to a better understanding of 

radiation exposure risk, particularly because the 

population is not a randomly selected one (e.g. nuclear 

workers have much fewer and lower exposures in 

comparison to atomic bomb survivors).34,35 However, 

calculating internal exposures is still a challenge. For a 

complete coverage of the area affected by the nuclear 

bomb testing at the Semipalatinsk test site, dose estimates 

have to be developed for settlements that have not yet 

been included in the existing dosimetry systems. 

Accordingly, one of the tasks of the SEMI-NUC project 

is to test the feasibility of dose reconstruction.  

In summary, data are available for more than 

100,000 persons forming a large cohort which needs to 

be further investigated.30 Furthermore, the range of 

external doses as described in the study of cardiovascular 

diseases (i.e. 0-630 mGy) is wide enough to conduct 

meaningful health studies.25 Lastly, the data from the 3-

generation studies are of high interest to study 

transgenerational effects. Overall, this line of research 

has great relevance not only for the region of Central Asia 

but also to countries around the world affected by nuclear 

testing. 

 

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GROSCHE 

 

 

This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 

This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 

Central Asian Journal of Global Health 

Volume 4, No. 1 (2015)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2015.127  |  http://cajgh.pitt.edu 

 

 

Figure 1: The 18,000 km2 area of the Semipalantinsk Test Site (indicated in red attached to 

Kurchatov (along the Irtysh river), and near Semey, as well as Karaganda and Astana 

 

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