Fallout and health: Chernobyl’s legacy, early-life exposure, and protective behavior

We study the long-term effects of early-life exposure to low-dose radiation from the 1986 Chernobyl disaster on adult health and fertility outcomes. Exploiting exogenous variation in radioactive fallout across Italian municipalities, we construct a radiation exposure index and link it to administrative data on hospitalizations (2004–2016) and delivery certificates (2002–2019) for 18 birth cohorts (1976–1993). Women exposed in utero or during early childhood exhibit elevated rates of thyroid disorders, cancer, spontaneous abortions, and stillbirths in adulthood. These effects are not observed among those exposed later in childhood, pointing to heightened biological vulnerability during critical developmental windows. Comparable effects for men are found only for cancer, consistent with women’s greater susceptibility to thyroid dysfunction and higher diagnosis rates. We also uncover behavioral heterogeneity in realized exposure: municipalities with higher private avoidance costs and lower socioeconomic status suffered more severe health impacts. In contrast, political alignment with the national government did not predict compliance with safety advisories. Overall, our findings highlight the enduring health consequences of early-life environmental shocks and the role of behavioral frictions in amplifying biological risks.