Among the 134 workers who suffered acute radiation sickness (ARS) after being exposed to very high doses of radiation, 28 died due to ARS. 19 others died by 2004 of other causes. For the wider population of 72,000 emergency workers with estimated doses, an estimated 216 had died of effects of radiation by 1998 (Bennett, 2006). This is the source of the low number of approximately 200.

The actual number of deaths due to radiation from the accident is impossible to measure accurately. It isn't possible to attribute the cause of any individual cancer case to as accident or non-accident. Given measurements of an exposed population compared to an equivalent control non-exposed population, the accident-caused deaths can be estimated; this is the method used to estimate the 216 deaths above. However, for most of the affected people, the expected increase in cancer rates is quite low compared to the normal cancer rates, and it is very difficult to accurate estimate the increase. This is made worse by changes in health care, alcohol consumption, and smoking rates, which have been affected by economic and other changes over time which included very dramatic changes such as the fall of the Soviet Union and economic collapse.

Estimates of the expected future accident-caused deaths were about 4,000 for the most-affected 600,000 people (evacuees, emergency workers, etc.), and about 5,000 among the 6,000,000 people living in the other contaminated areas. In addition, there would be some accident-caused deaths in the rest of minimally-exposed Europe. The projection of 4,000 additional deaths for the most-affected 600,000 people is in line with the estimate of 216 deaths among 72,000 emergency workers by 1998. There are high estimates of the number of deaths, including a very high estimate of 300,000 and also a high estimate of 200,000 by Greenpeace. These appear to be gross overestimates - extrapolating the death rate among the 72,000 emergency workers to the wider population of 6 million people in contaminated areas, and then tripling it, only brings the total to about 50,000 deaths, and the wider population with lower exposure than the 72,000 emergency workers should have a lower rate of additional deaths.

Brown's book is not science, and it isn't (good) history either. It presents many anecdotes, and is very selective with the science that is presented as "correct". One of the scientists interviewed for the book, Jim Smith, reviewed the book, and discussed the science and mis-science in detail (Smith, ). Smith had other complaints about the book. For example, Brown dismissed his work on wildlife populations in the area by presenting him as a scientist who didn't feel it necessary to go to the Chernobyl area to draw his pre-formed conclusions about the effect of the accident, ignoring (a) the first three authors from Belarus with plenty of local experience, and (b) Smith's approximately 40 visits to the Chernobyl area. From Brown's book, the reader easily gets the impression that Smith's work can and should be ignored, e.g., as noted in this review of Brown's book:

• https://forbetterscience.com/2019/10/23/kate-browns-manual-for-survival-a-chernobyl-book-review/

Smith also points out some good points about the book, things that Brown quite rightly and justifiably criticises. The conclusion to Smith's review summarised both good and bad about Brown's book:

Kate Brown has a journalist's skill in capturing the individual tragedies of many people's lives in the Chernobyl contaminated lands and she puts this to good use in describing her many visits to these areas. The problem is real, but I think the diagnosis offered in Manual for Survival is very wrong and damaging. People in the Chernobyl affected areas need more jobs, more economic development, better healthcare and better nutrition. Current radiation should be the least of their concerns, though I understand why many (not all) still worry.

Smith's review is available online as an open access publication, and I recommend reading it: https://iopscience.iop.org/article/10.1088/1361-6498/ab17f2

References

Bennett, Burton; Repacholi, Michael; Carr, Zhanat, eds. (2006). Health Effects of the Chernobyl Accident and Special Health Care Programmes: Report of the UN Chernobyl Forum, Expert Group "Health". Geneva: World Health Organization (WHO). https://apps.who.int/iris/bitstream/handle/10665/43447/9241594179_eng.pdf

Jim Smith, "Review of Manual for Survival by Kate Brown", Journal of Radiological Protection 40(1) 337-348. https://iopscience.iop.org/article/10.1088/1361-6498/ab17f2