Assessment of and therapy following contamination through the lungs or gastrointestinal tract

Abstract

Incorporated radionuclides are excreted from the body by naturally-occurring processes. Some radionuclides, however, are retained for very long periods by tissues such as bone and liver. The objective of successful therapy is to block the uptake of radionuclides from the respiratory and gastrointestinal tracts, or to prevent circulating radionuclides from reaching critical tissues. It is essential, therefore, for the clinician to have a rapid means of identifying the contaminating material and to have some knowledge of its solubility before planning treatment. Many techniques and therapeutic agents have been claimed to be totally or partially successful when tried out in experimental animals, but few of these procedures have been used effectively in man. Some success has been achieved by the use of Prussian Blue in blocking the gastrointestinal uptake of radiocaesium; in blocking the uptake of radioiodines by the thyroid gland with stable iodide; and in the complexation of circulating transuranium and lanthanide elements with chelating agents, thereby enhancing their renal excretion. The author discusses some of the problems in assessing the magnitude of an accidental intake and summarises the treatments used.