Nuclear issues and the Russian invasion of Ukraine—an update

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This article is part of The Cancer Letter's Saving Ukraine's cancer patients series.

In last week’s issue of The Cancer Letter, I discussed potential nuclear dangers resulting from Russia’s invasion of Ukraine (The Cancer Letter, Feb. 25, 2022). Unfortunately, several events I predicted might happen have occurred.

First, some background on how we got to this point. 

Ukraine became an independent nation in 1991. At that time, it was the world’s third largest nuclear power, after Russia and the U.S. Soon thereafter, Ukraine decided to denuclearize. 

There were several reasons for this, which included the high cost of maintaining nuclear weapons capabilities. Plus, the operational codes to launch were in Moscow, not Kyiv, and it was unclear whether Ukrainian engineers could unravel these codes. There was also worldwide fear of these weapons falling into the hands of rogue states or terrorists.

In return for denuclearization, Ukraine received imprecisely defined security assurances (not guarantees) from the U.S., U.K., and Russia encoded in the Budapest Memorandum. Disputes were to be adjudicated by the UN Security Council, where Russia has veto authority, which they exercised last week.  

So much for assurances. This was no doubt duly noted by nuclear states, such as Israel, North Korea, and countries with nuclear aspirations, such as Iran.  

It’s interesting to consider whether Russia would have invaded a nuclear-armed Ukraine. Impossible to know—but it is likely this would have given the Kremlin pause. Even one deliverable nuclear weapon is a potent disincentive. 

Back to Ukraine. Last Thursday, Feb. 24, Russian troops captured the decommissioned Chernobyl power facility complex in Pripyat. It is uncertain why they took control. The most likely explanation is that it’s on the path from Belarus to Kyiv. 

Let’s hope none of the scenarios I discuss happen—but it’s always best to be prepared.  The public and politicians know little about nuclear issues or radiation and often turn to physicians for explanations and advice.

Some sources report increased background radiation levels in the 30-kilometer Chernobyl exclusion zone. If this is true, the greatest danger is to Russian troops and not Ukrainian civilians. This danger seems small, but it refreshed Ukrainians’ memory of the accident, which is associated in many people’s minds with the collapse of the Soviet Union.

As I discussed last week, Ukraine has 15 other nuclear power reactors from which it gets about 50% of its electricity. Also, it has many nuclear fuel waste storage facilities. These facilities are tempting targets for Russian military strategists. 

It is possible or even likely that these persons may not fully realize the implications of such targeting. Six water-water energetic reactors (VVER 1000) are sited at the Zaporizhzhya nuclear power facility, which Russian troops took control of Monday. Two reactors are temporarily shut down, but the remaining four are online.  

There are reports of normal operations, but it is obviously tempting from a military perspective to shut these reactors down and deprive the civilian population of electricity hoping to expedite a surrender. However, an unplanned shutdown of a nuclear reactor is not simple or without risks, certainly not in the fog of war. Another concern is whether a large number of nuclear operators might flee Ukraine with their families, leaving the reactor complexes understaffed.

Last week, I also discussed several ways a nuclear power facility can be damaged in a conventional war. Although nuclear power facilities generate electricity, they need to be connected to the electrical grid as a safety precaution. Disconnection from the Japan electricity grid was partially responsible for the Fukushima Daichi accident. Nuclear power facilities also need a constant water supply to cool the nuclear fuel. 

One can easily imagine disruption of a major water pipeline causing a meltdown.  We need to add to these unpleasant scenarios a cyberattack, which could, intentionally or not, knock out operations of a nuclear power facility, resulting in dispersion of radioactive materials over a wide area—perhaps a substantial part of the land mass of Ukraine. Think of the Stuxnet attack on Iran nuclear centrifuges, presumably by Israel and the U.S.

That’s not all. There were reports Monday, Feb. 28 of a missile attacks on a nuclear waste storage facility near Kyiv, and an attack on an electrical generating facility supplying power to a nuclear waste storage facility near Kharkiv. So far, the International Atomic Energy Agency, a body of the UN, reports no widespread radiation leak—but this may be just good luck.

On Thursday night, a building at the Zaporizhzhya nuclear power facility was set alight by a missile attack, and subsequently, Russian forces took control of the facility. The fire was quickly extinguished and Ukraine authorities and the International Atomic Energy Agency report no radiation leak. 

However, as I discussed last week, this event at Europe’s largest nuclear power facility shows the dangers of a conventional war in a nuclear age. Whether Russia will allow the facility to continue operating or shut it down to deprive the civilian population of electricity is unclear. 

The process of taking Zaporizhzhya offline requires technical expertise and is not without challenges and risks. The world is standing by. There is a emergency meeting at the UN Security Council Saturday on this issue.

Even if there is no plan to attack Ukraine’s nuclear power or nuclear waste storage facilities, artillery and missiles are flying everywhere, sometimes with seemingly unintended consequences, such as hitting a civilian residential tower in Kyiv Sunday, Feb. 27.  As we unfortunately learned in Iraq and Afghanistan, “precision targeting” is a relative term.

What might one or more of these events mean to Ukraine? 

At one extreme, consider several Chernobyl-like accidents with large numbers of soldiers and civilians with acute radiation syndrome on both sides of the conflict. Large populations might have to be evacuated, with potential long-term consequences such as increased leukaemias and other cancers. And then there are profound economic, social, and psychological consequences. There are no real winners of a war in the nuclear age.

The latest and most alarming development is Mr. Putin’s order to upgrade Russia’s nuclear weapons to a special mode of combat duty. This does not correspond to any known nuclear alert level, and seems more a warning to the U.S. and NATO. However, as we know from the Cuban missile crisis, things can quickly spiral out of control.

Putin and his associates are being strongly sanctioned by the U.S., EU, and a wide range of other countries including Japan, Australia, and Singapore, and even previously neutral Switzerland. The result is likely to be a fortress Russia mentality with its attendant risks of escalation. 

Antonio Gutierres, UN secretary general, noted Monday, Feb. 28:  “Nothing can justify the use of nuclear weapons. We face what could easily become Europe’s worst humanitarian and refugee crisis in decades, with the numbers of refugees and internally displaced multiplying by the minute.”

Let’s hope none of the scenarios I discuss happen—but it’s always best to be prepared.  The public and politicians know little about nuclear issues or radiation and often turn to physicians for explanations and advice. Readers of The Cancer Letter should take an active role in educating the public and policymakers to the dangers of attacking a country with nuclear facilities. 

Benjamin Franklin famously advised fire-threatened Philadelphians in 1736: “An ounce of prevention is worth a pound of cure.”


Gale’s editorials about Chernobyl are available here. His retrospective on Fukushima is available here.

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Robert Peter Gale, MD, PhD, DSC(hc), FACP, FRCP, FRCPI(hon), FRSM, LHD, DPS
Visiting professor of haematology, Centre for Haematology Research, Department of Immunology and Inflammation, Imperial College London

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