<P> Despite spurious studies from Germany and Turkey, the only robust evidence of negative pregnancy outcomes that transpired after the accident was the increase in elective abortions, these "indirect effects", in Greece, Denmark, Italy etc., have been attributed to "anxieties created" by the media . </P> <P> In very high doses, it was known at the time that radiation can cause a physiological increase in the rate of pregnancy anomalies, but unlike the dominant linear - no threshold model of radiation and cancer rate increases, it was known, by select researchers who were familiar with both the prior human exposure data and animal testing, that the "Malformation of organs appears to be a deterministic effect with a threshold dose" below which, no rate increase is observed . This teratology (birth defects) issue was discussed by Frank Castronovo of the Harvard Medical School in 1999, publishing a detailed review of dose reconstructions and the available pregnancy data following the Chernobyl accident, inclusive of data from Kiev's two largest obstetrics hospitals . Castronovo concludes that "the lay press with newspaper reporters playing up anecdotal stories of children with birth defects" is, together with dubious studies that show "selection bias", the two primary factors causing the persistent belief that Chernobyl increased the background rate of birth defects . When the vast amount of pregnancy data simply does not support this perception as no pregnant individuals took part in the most radioactive liquidator operations, no pregnant individuals were exposed to the threshold dose . </P> <Ul> <Li> Down syndrome (trisomy 21). In West Berlin, Germany, prevalence of Down syndrome (trisomy 21) peaked 9 months following the main fallout. (11, 12) Between 1980 and 1986, the birth prevalence of Down syndrome was quite stable (i.e., 1.35--1.59 per 1,000 live births (27--31 cases)). In 1987, 46 cases were diagnosed (prevalence = 2.11 per 1,000 live births). Most of the excess resulted from a cluster of 12 cases among children born in January 1987 . The prevalence of Down Syndrome in 1988 was 1.77, and in 1989, it reached pre-Chernobyl values . The authors noted that the isolated geographical position of West Berlin prior to reunification, the free genetic counseling, and complete coverage of the population through one central cytogenetic laboratory support completeness of case ascertainment; in addition, constant culture preparation and analysis protocols ensure a high quality of data . </Li> </Ul> <Li> Down syndrome (trisomy 21). In West Berlin, Germany, prevalence of Down syndrome (trisomy 21) peaked 9 months following the main fallout. (11, 12) Between 1980 and 1986, the birth prevalence of Down syndrome was quite stable (i.e., 1.35--1.59 per 1,000 live births (27--31 cases)). In 1987, 46 cases were diagnosed (prevalence = 2.11 per 1,000 live births). Most of the excess resulted from a cluster of 12 cases among children born in January 1987 . The prevalence of Down Syndrome in 1988 was 1.77, and in 1989, it reached pre-Chernobyl values . The authors noted that the isolated geographical position of West Berlin prior to reunification, the free genetic counseling, and complete coverage of the population through one central cytogenetic laboratory support completeness of case ascertainment; in addition, constant culture preparation and analysis protocols ensure a high quality of data . </Li>

How many countries were subject to fallout from chernobyl