Radiation epidemiological studies in Russian National Medical and Dosimetric Registry with respect to Chernobyl accident: I. Cancer and non-cancer registration system among Chernobyl liquidators and the population living in the areas contaminated with radionuclides in Russia (history and the present status)

The RNMDR is a multi-level information system. Primarily it is integrated in the existing health care system. In principle primary health care is provided at the levels of uchastoks (local), rayon’s (district) and oblasts (province). Regional centers have been established for compiling and processing data from the oblast level. Thereby, four hierarchical levels exist federal, regional, oblast and rayon. Regional centers have been set up for each of the 11 administrative, so-called economical regions of Russia. They have to be regarded as decentralized units of the central registry as their main task is to channel the information flow from the local to the federal level. According to the normal Russian administration these regions are further subdivided into republics, oblasts and krays. At present there are altogether 89 units at this level. These units are further subdivided into rayon’s, altogether more than 2,000 in the Russian Federation. Four of the oblast units (Bryansk, Kaluga, Orel and Tula oblasts) have at the same time the logistical status of a regional center. These oblasts represent the most contaminated geographical areas in Russia. The software for all levels of surveillance is used for computerization of primary information collection, uniform data base support and statistical and radio-epidemiological analysis. Thus the software employs advanced computer techniques to collect, store, process, transfer and analyze demographic, medical, dosimetric and epidemiological data and ensures the reliability of software products at all levels of surveillance, as well as their lack of complexity and ease of use for medical personnel. The software falls into two functional parts - database support and analysis of information collected. Databases of large-scale and local registries store information in different ways, i.e. these bases are of different physical structure. In order to make the analytical part of the software flexible and multipurpose, i.e. independent of the specific features of particular bases, access to them should be uniform. The system of statistical and radio-epidemiological data analysis (SDA) enables the basic epidemiological indexes to be calculated in the interactive mode. It also provides thorough statistical and radio-epidemiological analysis of data from the RNMDR primary documents. Standard and specialized software in use are integrated into a unified information system of storage and epidemiological, medical and statistical analysis of data.