Estimation of radiation-induced health hazards from a \u201cdirty bomb\u201d attack with radiocesium under different assault and rescue conditions

Alexis Rump,Andreas Lamkowski,Patrick Ostheim,Matthias Port,Michael Abend,Stefan Eder,Cornelius Hermann

doi:10.1186/s40779-021-00349-w

Abstract

In the case of a terrorist attack by a “dirty bomb”, blast injuries, external irradiation and the incorporation of radioactivity are to be expected. Departing from information about the radiological attack scenario with cesium-137 in the U.S. National Scenario Planning Guide, we estimated the radiological doses absorbed. Similar calculations were performed for a smaller plume size and a detonation in a subway. For conditions as described in the U.S. scenario, the committed effective dose amounted to a maximum of 848 mSv, even for very unfavorable conditions. Red bone marrow equivalent doses are insufficient to induce acute radiation sickness (ARS). In the case of a smaller plume size, the ARS threshold may be exceeded in some cases. In a subway bombing, doses are much higher and the occurrence of ARS should be expected. The health hazards from a dirty bomb attack will depend on the location and the explosive device. The derived Haddon matrix indicates that preparing for such an event includes education of all the medical staff about radiation effects, the time lines of radiation damages and the treatment priorities. Further determinants of the outcome include rapid evacuation even from difficult locations, the availability of a specific triage tool to rapidly identify victims at risk for ARS, the availability of an antidote stockpile and dedicated hospital beds to treat seriously irradiated victims.

Highlights

In the case of a terrorist attack by a “dirty bomb”, blast injuries, external irradiation and the incorporation of radioactivity are to be expected
We focused on the medical countermeasures that should be put in place to be prepared in case of a dirty bomb attack and their optimal mix to maximize the benefits for the victims [20, 21]
Open space detonation (National Planning Guide scenario 11) Assuming that 2300 Ci cesium-137 is contained in the explosive device and 90% are aerosolized and the victims are evacuated from the inner zone within 30 min of the detonation, the committed effective dose will amount to

Summary

Introduction

In the case of a terrorist attack by a “dirty bomb”, blast injuries, external irradiation and the incorporation of radioactivity are to be expected. Terroristic threat by dirty bombs Risk is often defined as a product of damage size and the probability of occurrence [1]. Transportation systems must be viewed as one of the vulnerable targets as they are difficult to protect [6, 7] It seems untenable with present technology means to screen each commuter boarding a subway in a large city, and the emergency countermeasures in the case of a bombing incident underground are challenging. The threat of terrorists using chemical, biological or radiological materials alone or in combination with explosive devices is of great concern (CBRN terrorism). Radiological terrorism by using a radiological dispersal device (RDD, “dirty bomb”, explosive device with added radioactive material) is a significant threat, as the construction is not much more complicated than building a conventional bomb. Besides the radioactive contamination of surfaces and infrastructures with a marked economic impact, the short- and long-term health effects on victims located in the proximity of the detonation point must be considered

Results

Discussion

Conclusion